The Making of a Western Medical Doctor

The Making of a Western Medical Doctor - A blogpost by Dr. Carolle

All my life I had attended all-girl schools in Haiti. It was comforting to see that about one-fourth of the students here–and half the Haitians—were women.

It wasn’t easy studying in Spanish while in medical school. Some of my books were in that language but I purchased others in French and English. My goal, while studying in Spanish, was to be able upon graduation to take the ECFMG, the Educational Council for Foreign Medical Graduates exam. Passing that allows international medical graduates who wish to be licensed as a physician in the United States to complete a U.S. residency hospital program.

During our last year of medical school, we were lucky to have the help of some Jewish-American students. We made special arrangements for clerkships during the last semester of medical school at the Kingsbrook Jewish Medical Center, located in Brooklyn and associated with Down State University Medical School.

To be accepted into a postgraduate program in the US as we had planned, we needed to spend a year interning in an accredited hospital, and another year of Servicio Social (social services) with the Department of Public Health in Mexico. At the end of that year, I took the final exam and obtained my Physician and Surgeons diploma, the Titulo de Medico Cirujano. Meanwhile, I still had to pass the exam given by the Educational Council for Foreign Medical Graduates.

We heard that internships were available through the Ministry of Health at the University of the West Indies, in Jamaica. This hospital was known for handling rare diseases, most of which we had only read about in books. We were told that the training was good, and that medical students from England and Canada chose clerkships in Jamaica during the winter months. Several of us opted to do this, as we believed that we could acquire sufficient experience to pass the foreign medical graduate exam. The pay was good, and the food, people, and reggae music were icing on the cake.

I was lucky to be trained by nurse midwives in Jamaica, who taught me that birthing was a natural event. I learned that given sufficient time, any woman could deliver without need for an episiotomy. The rate of Cesarean section was only 4%, compared to at least 20% in the US.

I was pleased to find that almost a quarter of the physician residents were women. Up until then, most doctors in Jamaica had been male, so being a woman equated to being a nurse even if you wore a white jacket and stethoscope. Because old habits die hard, any man walking the hospital floor—whether an orderly, lab tech, or the cleaning person—was greeted as “doctor” by the uneducated patients. In the beginning this was exasperating. But eventually when I said, “Good morning, I’m your doctor today,” and the reply to me was, “Yes, nurse,” I would just smile and proceed to do my job as if this exchange never happened.

Change comes slowly sometimes, but it comes.

I returned to rural Mexico and spent a year in community medicine, delivering babies, often without running water or electricity. I was accepted for postgraduate training in obstetrics and gynecology at Mount Sinai Medical Center, in Milwaukee, Wisconsin, where I nearly froze to death! I finally visited San Diego during the winter months. When I realized that I could stick my hand outside the car window and let the breeze flow through my fingers without freezing, I knew that San Diego would be my home.

The last two months of my training were spent at UCLA. By then, I was licensed to practice medicine in Wisconsin, and had earned reciprocity to practice in California. I had also passed the written board for my specialty. I did not care that San Diego had few black doctors, and no other black female obgyn. I’ve never minded breaking the ice. For four years, I remained the only female obgyn in the hospital where I practiced and the only black female ob-gyn in private practice for 12 years.

Two years later, after passing my oral board examination, I became a board certified obstetrician and gynecologist, and eventually a “Fellow of the American College of Obstetricians and Gynecologists.”

Next week: The Making of an Intuitive Obstetrician and Gynecologist…

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