USA medical elective experience

It was in summer of 2007 that I went for my final year medical student electives to USA. It was pretty much all too unexpected and pretty poorly planned that I was also surprised the day I reached US that am finally here.
It all began in December of year 2006 when this idea was first floated to me of going for US medical electives in final year. At that time, I was in my 4th year of medical school in Rawalpindi Medical College and was giving my 3rd professional exam. Being a very mediocre student and especially super mediocre in Medical School, my interest was always governed more by being career-oriented at that time then bookish studies for my exams.

When this idea was first given to me, I outrightly rejected it that my parents won't agree being from a normal middle class, working class pakistani family. And also, half of my close relatives being doctors and none of them having gone for any electives whatsoever put my idea in a weak position even before it began. Me and my love discussed the various elective ideas and she being very optimistic and interested in the whole matter also pushed me in looking into it. So slowly, after gathering some guts I asked my father and mother one day in early January of 2007 that I wish to do US medical electives and that how important they would be for me and my career and my studies. I further made it clear that I won't be going there just for USA electives experience but also will be appearing in United States Medical Licensing Exam - clinical skills part. And within a few days, quite contrary to my thinking, my parents granted me the approval. This 'go-ahead' signal was perhaps as surprising to me as it was surprising for them. The real thing was not their decision in deciding what I should do or not do, but in fact I needed their financial support if I did go for such an endeavour.
So, then began the long process of sorting out electives' universities in USA which offer medical electives to foreign students, especially from Pakistan. In the process, I sat for TOEFL iBT, payed different fees to different programs and went through various processes of making my transcripts and sending them to different US medical schools from my medical school. The important thing to mention here is that I was never helped in this matter by anyone except the internet and anyone or everyone who really wishes to go for USA elective experience can be frothing from all the required information if he/she spends sometime online searching for all the available info. Doing it by my own self totally, I had to go through a lot of trial and error. Lost money, received rejections from alot of the programs and since I was also applying for USMLE and doing the whole paperwork for my love also, it was kind of difficult and marred with troubles. By April, nothing seemed to be going fine. My final hope rested in Rosalind Franklin University and the University of Wisconsin. Email being a slow and unreliable method for me in this regard, I decided to start calling all of them. A positive response on phone from Rosalind Franklin for an available seat in august of 2007 made me look for other universities with openly listed faculty phone numbers. So, I started calling all of them and it was sheerly good luck that I called Ms. Pam in University of Texas Southwestern Medical Center at Dallas just asking about any avaliable US medical electives for foreign students that summer. The reply was astoundingly wonderful and made me extremely ecstatic. She told me that they have seat avaliable in even May and June of 2007. Since it was early April, I took no time and sent my application materials through DHL the VERY SAME evening at 5 pm.
Some days later, it was on my close uncle's wedding reception day that I called again to know of my application when I was given the good news that I have been accepted. I at-once followed with seri's application but their seats were filled so it got approved in another department and also in another university of the University of Texas system. Then began the hectic paperwork for visa and it went quite smoothly. In fact it went much more easily then I expected and the only thing that got bogged down a little bit was the security clearance, also called the administrative processing. Things did look a bit difficult as administrative processing took some time but finally all was set for me to head for my USA electives experience. Getting a leave from my own medical school was not a problem in Pakistan ;) ...
I received my passport back after a wait of a month while I was supposed to begin my elective earlier. So, the same day I received my passport, I went to look for a plane ticket to US. That day proved to be useless as we couldnt really find a good ticket with a good deal. As it was my first time going to USA, my end destination was Dallas in Texas, and I had to reach the DFW Airport within 2 days. So, my demand from all travel agents was to make my itinerary all the way from islamabad in pakistan to Dallas in Texas. Being a difficult task to find such a flight deal on a day's notice, my first day looking for it was a disappointment. The next morning, we finally were able to find a deal for that same day's night. It was a good deal with its own problems though. The biggest being that I will have to have a stayover of 14 hours at Dubai.

I ran home and began packing. Sometime after midnight my parents came to drop me at the airport. And then began my first US adventure. The emirates flight to Dubai was smooth. Stay was prolonged at Dubai but I was able to enjoy all of the time in exploring every inch of the place. My next flight was long and really exciting as I was flying to United States for the first time. Got to see a lot of countries from sky including Jordan, Italy and France as well as arabian sea, mediterranean sea, persian gulf and Atlantic Ocean. I landed at JFK Airport in new york city at around 7 am the day before my first US elective day. It took awhile to get through immigration and to get to Terminal 2 where I was supposed to get on Delta Airlines flight to Dallas. Another surprise awaited me there as I was told that my seat is not confirmed. After raising some hue and cry and finally getting a new bording pass, the flight was cancelled. All the passengers were put on next flight which was going 3 hours later. Finally, when I sat in that plane, I was so sleepy that I slept straight through 3 and half hours of flight. It was really great to see the Dallas skyline and finally to get on the ground. But I was about to find that my US adventure is just beginning as Delta had left my main suitcase back at JFK airport. I was told that they would deliver my bag at my given address but I was too worried to leave my bag at the mercy of Delta, so I waited for 4 hours at airport till the next flight arrived with my bag and I had a sigh of relief. A novice as I was in world travels, I had arranged my stay here totally through craigslist. And didn't really know where I was heading except that I had that guy's address, cell number and a printout of our email correspondence. But when I reached his place after paying heftily to the cab driver, I was finally relieved to find a nice guy with a nice home, and a room ready for me. It was well enough for me since I really wasn't looking for any more adventure for the time being. After ironing my clothes quickly, I went to bed to wake up early next morning.
My stay in south side of Dallas provided me a good opportunity to look at the lower strata of society in US and get to see life up and close in a different world. It took me 50 minutes daily to commute to the UT Southwestern campus from my place. Both of my internal medicine electives were based at the Parkland Hospital. The same Parkland Hospital where President John F Kennedy died :(

The first day of electives went really fine as I was able to round with my attending who was a really nice lady. Her name was Dr. Wada and she was my attending for only 1 week. Later on, Dr. Wada would also be the attending of Seri along with the same fellow that

was mine too during the rotation in Infectious Diseases. For most part in my rotation, my attending was Prof. Dr. Paul Southern who was a very nice person. A very friendly and caring teacher who helped me and is still helping me in my further studies. Other than him, my fellow Dr. DeMarco was equally superb and extremely nice to me. It was his first rotation as a fellow too so we had good 3 weeks of fun and patient care. With me, there was a PA student doing her rotation too. Her name was Kristin and she is now a qualified Physician Assistant working in Houston. There were also a lot of other students and teachers who I interacted with but couldnt keep contact with all of them. During those electives, I found out the prevalence of Pseudomonas Aeruginosa in hospitalised patients in US. Saw a lot of MRSA cases and the worse lower extremity infections in Diabetics. I found a big percentage of patients in US hospitals to be the classic text book cases of HTN and DM co-morbids. The overall experience for me was quite new and exciting. Totally different workup as compared to the ones we do in pakistan and different modes of teaching provided me ample opportunity to see and learn. Also, I was able to see the healthcare at its almost best as compared to the one provided in pakistan.

Unfortunately for being in Pakistan, health and education have always been the last priority for the government ever since Pakistan was created. Compared to all that, I think that USA has one of the best healthcare even though many people will not agree with me. Back to my USA elective experience , my 2nd elective was in rheumatology and on my first day I received a 5 lb book called 'A PRIMER OF RHEUMATOLOGY' which definitely for me was not a primer but a bulldozer because it was so heavy that on leaving USA, I had to leave it at the airport (along with other stuff as my bags were above the allowed weight limit).

My time through my second elective was equally good as the first one, except that it was a bit more boring. And since I had to prepare for my step-2 USMLE, my time was kind of preoccupied. I finished my US medical electives on 30th august and had a 1st september flight to houston which was nothing less then an adventure as I was really short of money so I took the 408 bus at 5 30 am in morning. And I had to ask the lady at fastonia's home to give me a free ride up to 408 for which she was really generous to come and drive me to bus stop at 4 am in morning. At the DFW airport, I had to dump close to 20 lbs of stuff to bring my luggage weight in range so that I do not have to pay extra 25 $ per bag. Flight was quick for about 45 minutes and I shot a video of whole flight....yes! whole flight. At Houston, the Days Inn shuttle arrived on time and I reached the hotel in late afternoon. My time spent there was really good as I was able to hook up with some Indian, Syrian and Pakistani docs who were all there for Step-2 CS. Not only that we all hung around together for 3 days but we also practiced together our FA and uworld cases. Arbaz, Garima, Mansi, Puneet bhai, Ibrahim and Manzoor. Suddenly, I had more friends in USA and most of them are still good friends of mine. Not just that but about half of them are residents and they have been a great source of information for me in my USMLEs.
On 4th of september I gave my USMLE step-2 CS with some of them and then went for a fish burger at McDonalds. Early next morning, I was on a flight to NYC to see Talha. Those were some great 5 days I spent in NYC. Not just with my school days friend Talha but another of my old buddy Junaid came from Toronto, Canada. We were together after a lapse of around 9-10 years and it was just amazing. We spent a wonderful time there. Walked all over Manhattan, went to Long Island beaches, watched movies together and hung out with Talha's friends. But all good times come to an end and so was it there. Soon after, I left for Pakistan and after spending sometime at Dubai, I was back in Islamabad. It wasn't just that. I went to my Medical School the same morning I touched down at Islamabad Airport with a new vigor for medicine and some good stories to tell.

My overall experience was awesome and my level of trust greatly increased on people, which reached its epoch on my second trip to US in 2008. I was able to spend some quality time in Dallas, went to Houston, saw New York and also went to Fortworth which became an important city to me next year for another reason. Looking back now, I just say that everything that happens has a part to play in the bigger picture. Not exactly talking of divine intervention but just that my USA elective experience was as best as it could be. And lastly, its not that difficult as people think it to be anyways.

I again went next year for other reasons but did two more months of US medical electives. With time, I have been able to build a good USA elective experience that may help me a long way I guess.