Medical School in the Caribbean…is it right for your family? by Sylvia Siegel

There I was, sitting on a cramped plane holding my son, then two and a half months old. My husband and I were talking excitedly. We couldn’t wait to get there. What would it be like? How hot is it going to be? Will the locals embrace us? Are we going to survive the journey?

We had been up for 38 hours or more the day before. I lost track eventually. My mom picked all of us up, dog included at the hotel in Vermont. We drove for a few hours packed to the gills in our car. As soon as we got there I started crying. We were leaving all of our family behind to embark on a journey to a country we hardly knew anything about.

We were to leave the airport in Boston at 7am. The plane had mechanical problems, so
we left a few hours late. We arrived in Puerto Rico as our connecting flight left – without
us. We were exhausted…and dressed in our winter clothes with a new baby, an 80- lb
Golden Retriever and ridiculous amounts of luggage.
Stranded.
The airline put us up at the Marriot Hotel, but they didn’t accept pets. After much
arguing, a car was sent and we were taken to the most beautiful, expensive hotel I have
ever seen. I couldn’t imagine that they took pets. I think someone must have bribed them.
I have never slept so well. For the first time, our son slept through the night. It was
wonderful!
The next morning, we finally boarded our flight. All three of us, the dog in the cargo, 6
large suitcases, 3 carry-on’s and a laptop. The flight was short to the island. We were
flying so low; the other islands and an occasional volcano were visible.
The airplane swooped through the trees, weaving in and out. We could almost touch the
tree tops because they were so close. Before I knew it, we were ready to land. There
were houses made of plywood cinderblocks and sheet metal, banana trees everywhere,
mountains, and the most beautiful lush rainforest I have ever seen. We had arrived on the
island of Dominica, the West Indies. Our closest mainland was now Venezuela. “Wow!”
was my only thought. “We’re finally here.” Finally, we are living my husband’s dream
of going to medical school.
As we got off the plane, my thoughts changed from “Wow!” to ”Wow! It is so hot
here!” How am I going to survive this heat?” “When we left Vermont, it was 28 degrees
Fahrenheit. Now, here I stood in a pair of brand new shorts, a tank top, and flip-flops
(with the whitest legs ever) and I was ready to pass out from the heat.
We went through customs at the airport. This proved a little difficult. It was difficult to
understand the local dialect, but we managed to do okay with lots of “What? I’m sorry, I
didn’t understand the question”. The airport was not your average airport. It was very,
very small and lacking in so much that we consider normal. It was hot, all luggage was
moved by hand and the only business was one little stand that sold things to eat and
bottled water. Later, when we left the island, I found out they don’t even scan your
checked luggage. They just ask you what is in it. It took about two minutes to get from
customs to the exit. In that short walk, many of the locals tried to hustle us. Thankfully,
my husband has no problem telling people to back off. If it had been only me, I would
have had nothing left at the door. We picked up our luggage and were asked some
standard questions about what we were bringing in to the country. Since we were
students and had a child, they were quick to let us pass.
Outside, we found a driver that we came to know as Alexis. He was a nice guy – one of
the most reliable, honest people we met while we lived there. He had a fleet of transport
vehicles. He had many drivers that would pick up locals and students. Because he was a
hard worker -and trustworthy -he also had a contract with the university. Driving through
the winding roads and mountains almost made me sick. Thankfully, we sat with parents
from India coming to visit their daughter. They were veterans of visiting the island.
Talking with them kept me from getting car sick. After an hour-long, horn-beeping,
brake-slamming insanely fast weaving ride, we made it to our new home.
Because of our dog, we had to pre-rent a house. We had never even seen pictures. We
just knew it had two bedrooms and a yard. We pulled up to a small white house with
shutters, a small porch and a fenced-in yard. We found out that it did have hot water…in
the shower…when you flipped a switch. My first thought was laundry, believe it or not. I
ended up doing it by hand for months…. king sized sheets and bath towels included.
You can imagine my complete joy when an American woman walked out of the
neighboring house to greet us. We shared a yard and she had a German shepherd. We
were so excited! Our dog was happy to have a friend, too. Our landlord came to greet us
and give us the keys. She was a very kind woman and every now and then she would
bring us the most delicious pineapple.
The woman next door was in her 50’s, a lay mid-wife, mom of 6 and a mother figure to
me. Me, with a new baby, thousands of miles from home and any one I could count on.
She was going back to school to get her MD.
Many people refer to Dominica as a third world country. They don’t have a lot there, but
it is far from third world. They have phones, cable, internet, banks, and even a pizza
place! The university seems to be what keeps the island running. The country is very
poor. They used to be ruled by England, but gained their independence. We heard that
once that happened, combined with a catastrophic hurricane, the island was never the
same.
Dominica has the most delicious bananas, pineapple and mango I have ever tasted. The
fruits and vegetables will never compare anywhere else. They are rated in the top five in
the world for scuba diving. They have the most beautiful rain forest, waterfalls, boiling
lake, Emerald pool, and colorful birds and parrots. There are iguanas hanging around the
campus, coconuts, mangos and guava always falling to the ground. With a baby, I really
did not get to do too much on the island. But, if you don’t have children (or if they are
older) there are many things to do. You can island hop, snorkel, scuba dive, hike, day
trips to the capitol of Roseau, and – of course – hang out at the beach.
Although life on the island may have looked like a tropical fantasy, it often felt more like
a nightmare! We were there for 16 months. It was a long 16 months. There were
constant power outages. And then there was the heat, the lack of reliability from the local
community, goats, cows and bulls tied up on the side walks, stray dogs, starving children,
roosters crowing in your windows at all hours of the day and night, dirty drinking water
after the rains, mosquitoes that could carry you away, centipedes that can leave a nasty
welt, my favorite….”advice” from the locals on how to raise my son (and in the end, my
daughter too) and the constant wonder if we were going to make it out of there.
Looking back, I’m not sure if we would have done it all over again. The cost of travel,
the extra certification to do residency in the states, the stigma of being a foreign grad, and
being away from family, friends, and what I consider a comfortable lifestyle was hard. It
was an adventure, but going this route is not for the faint of heart. In the end, it did give
my husband the chance to become a doctor.
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Sylvia Siegel is currently the very busy parent of three toddlers. She is married to a PGY-
1 resident in obstetric and gynecology.