What’s your image of a medical student? The privileged child of parents rich enough to invest heavily in their child’s future career? The son or niece of a prominent doctor? A person nagged by parents to become “a doctor or lawyer”? Meet three new young medical graduates who shatter these stereotypes. Furthermore, the three have each topped the Mount Hope Medical School graduating class of 2003, winning special awards.
TRICIA GONZALES
Tricia Gonzales won the Medal for Best Overall Clinical Student on all four (4) UWI campuses in final exams. By this she got top marks overall in the final exams for the two-year Clinical period, when exam results were compiled in the areas of Medicine, Surgery, and Obsetrics and Gynaecology. She got honours in surgery and a distinction in obstetrics and gynaecology Tricia Gonzales has a cool reserve and a “proper” deportment, and its no surprise to learn she’s a former convent girl. But what magnifies her achievement of topping “Clinical” studies across all four UWI campuses is her humble roots. She neither hides nor emphasises this but is matter-of-fact about it. While it is said that any graduate owes much of their success to the family that supported them, Gonzales reveals that hers had little to give her materially but gave much spiritually.
She is the third child of a single mother, Albertina Gonzales, a domestic, all living in a humble area. She has strong views about the role of parents. Gonzales recalled the ordeal of medical studies, saying: “It was really difficult, The workload is extremely heavy, especially at exams. Most exams counted towards your final mark, so you couldn’t lapse. You weren’t allowed to fail anything or you’d have to repeat it. In the last six months there is a tremendous amount of work. In the end you can’t know everything and are thinking there’s always more to be done.” Life as a medical student, she said, was extremely fascinating, adding: “You meet a wide variety of people; Everybody has their own little story.” Gonzales then paid tribute to her mother for supporting her through her five years of medical study. She said: “I’m from a single-parent family. My mother is now very much on a high, more excited than I am about things. My mother has really been there for me, a lot, in a really significant way. Despite how difficult it was she really supported me throughout. She would go beyond the call of duty to make sure I was happy. Despite having a single parent, I was perhaps more loved than children of a nuclear family. Parents are responsible for a lot of ills in the society and if they pay more attention to their children we would have a lot less problems. My mother has prayed a lot for me ever since she realised I had the potential for medicine. Never underestimate the power of prayer and positive thinking.” Herself wearing a crucifix around her neck, symbolising her Roman Catholic faith, Gonzales said: “My mother is from quite a religious background. She is very quiet in her spiritual life, a lot more prayerful than people would imagine. For me the church started off at a very young age, not just you wake up one day…It gives you a great deal of focus, especially on the more positive things, and it makes it easier to go through a lot of difficult problems in your life.”
Asked what aspects of health she’d like to champion, she replied: “Adolescents. I’d like to work with them, whether in a medical environment or not. There’s so much that can be done to make a difference in their lives. Take the time to show them that somebody does care about them. The moment somebody steps into their lives to show they care, their attitude changes. A lot of time fathers are absent from the home and that plays a major part. Two parents are always better than one. Some single parents get overwhelmed.” Gonzales explained her fascination with medicine: “Now simple things can be done for things which people would have died from before — a lot of things. For example the invention of antibiotics has changed the trend of diseases. Now we have lifestyle diseases. Now that everybody is immunised, the things people die from have shifted. In healthcare there is now a great trend to preventative medicine or primary health care. So many diseases are due to lifestyle — like cardio vascular disease — that if you can modify your risk factors you can decrease the amount of money the health system has to spend on treatment.” She disclosed her pet subject in medicine was surgery. She explained: “It gives you something definite to do for your patients. You operate and the problem is usually resolved, for good, so you don’t have to keep treating the patient. I would like to do surgery in the future, after I finish my internship of 18 months.”
She said her internship would include three month stints in each of surgery, medicine, paediatrics, obstetrics and gynaecology, and community health. “So you can see what you like and what you can do over an extended period of time,” she explained. Just ten days into her internship, she said: “So far it’s interesting. It’s a lot of hard work — a basic 40 hour work week plus two days per week being on call at the hospital. Some days are so hectic you don’t breathe. You just go from ward to ward, from patient to patient. Sometimes the general public doesn’t appreciate how much we give. After working 18 hours any human being would be tired.” Sunday Newsday asked her whether the high fees of medical school were now creating a generation of businessmen-doctors. Gonzales said she would like to see scholarships and sponsorships more closely targetted at more needy students, who might miss them by one or two examination marks. She said students without scholarships or sponsorship had trouble paying the $192,000 fees for the five year course. Were private doctors too money hungry? She replied: “You have to go back to the reason you went into medicine in the first place. I think we should be well compensated, but that shouldn’t take away your basic humanity. You shouldn’t slight people who cannot afford you. People can’t go to a private doctor for free but if somebody walks in off the street and says “I can’t afford this, your reason for being a doctor kicks in and goes beyond financial gratification. If a person has just $40 and your price is $80, $40 isn’t going to make or break you.” She then disclosed: “Some of the best doctors in TT work in the general hospitals.” She thanked her former teachers of Nelson Street Girls School and Holy Name Convent, Port-of-Spain, her Mount Hope lecturers and all her friends. Gonzales concluded: “I wouldn’t say it was easy but difficult to get where I am. But whatever situation you are in, socially and financially, that shouldn’t stop you from dreaming big dreams. Whatever your circumstances in life, once you put your mind to what you want you can make your dreams come true. I’d like to thank all the people who contributed in one way or another to helping me.”
KYLA THOMAS
Kyla Thomas in the final Clinical exams won the Medal for Best Student in Obstetrics and Gynaecology and the Fiona Phelps Prize in this subject, and the RBTT Prize for Community Medicine Outspoken Kyla Thomas is about to take up a Rhodes Scholarship to do a PhD at Oxford University, having suspended her internship.
She explained: “I’m off to do three years of medical research at Oxford into cervical cancer screening. I chose this because I like obstetrics and gynaecology and it is combined with public health. Also, because cervical cancer is such a big problem in TT. There is an easy screening test and no woman should die from cervical cancer. I have a passion for doing something about that.” Thomas estimated TT had five times the rate of occurrences of cervical cancer than the UK, which she said had more successful screening programmes. Both her parents are teachers, and her five siblings are also doing well, one brother even following her into medical school and her twin sister is studying law at Hugh Wooding Law School. Her mother, Lyn Thomas, is acting principal of Enterprise Government Primary School and her father, Glenford Thomas, is acting vice-principal of Presentation College, Chaguanas, being a biology teacher and a sports coach. She said there were no predessecor doctors in her family, but that her parents had always encouraged their children to do what they enjoyed. “So we all did different subjects,” she explained. She described her parents as being an appropriate mix of strict and liberal. “Dad’s a bit more liberal. When we were younger if we wanted to go somewhere we would get permission first from Daddy and then just tell Mummy. They weren’t really “strict” but just taught us to be disciplined. I could talk to my mother about anything and I still do. And she’s an excellent judge of people.”
But she revealed that it was not her parents but her school teachers who had first told her to pursue medicine. “My teachers at SAGHS told me to do medicine because I was good at science and I like people. Daddy said ‘Are you sure you want to do medicine’?” Laughing, she added: “You can’t say he was “pushing” me. Our parents simply encouraged us to do what we liked to do.” She praised her family for nurturing the characters of her and her siblings. “We are close, but have a lot of independence of thought. Because we are all strong-willed we argue and debate a lot. Our parents always taught us that once you know you are right, be vocal and speak your mind. Stand up for what you believe in. They encouraged us.” Her parents had also decried time wasting, she explained: “Everyone had to get into some activity. I played the piano and pan, and then in medical school was on the students council. We always had to get involved, so we would not be just boring personalities.” She confirmed that her parents had a social conscience and activism, saying: “Daddy is not paid to be coach and he gives up a lot of his time. Mummy always plans the calypso and Carnival competitions at Daddy’s school. I myself write calypsos which I use to perform at SAGHS.”
She spoke of the rigours of medical school. Thomas said: “So many people fell out of the course after second year. Even though I enjoyed myself, the course boiled down to survival of the fittest, with people just cutting down each other. Most students would not have had the same experience of a good time that I had. “As a student rep, they’d come to me with their complaints, and most really don’t have a good experience at med school. UWI claimed to have become more student friendly but in my valedictorian speech, I said that was a “bold statement.” There have been some improvements — like we now have staff-student liaison meetings — but a lot more needs to be done. But for me I got an all-round experience. The students I met really made my experience worthwhile. If I had to do it all over again, I would.” But it was hard to be a student representative. She said: “A lot of the time going to meetings with administrative staff was wasting your time. There were advantages and disadvantages to being class rep. Some faculty staff would not appreciate your being outspoken…and then you had to do an oral exam (viba voce) to qualify for a distinction or honours, maybe facing the same lecturer(s). The orals are so subjective. They are not marked or tape-recorded, so you have no recourse. You are only told you passed or failed the exam. Many students have had their results from written exams downgraded after their orals.”
What would she like to contribute to medicine? “I have a vision to try to change the health-care system. I feel I need to give back. If you see what’s offered at the nation’s hospitals, you would wonder how patients and stafff can tolerate this every day — the standard of the hospitals. Most people who can’t get medicine free in hospital just have to do without. The level of care is sub-standard. The EHS workers, the patients, everybody is frustrated. If you were to take a well person and put them in hospital, they’d get ill. Staff are trying to give what they can, given the low resources. Pregnant women have to sit on hard benches. There’s no equipment or machinery. If you have to test a foetal heart beat with a non stress test, there is no paper in the machine. For diabetics there are no testing strips. The nurses try to work magic with what is given to them. More improvements to the health system are needed and I think we have the money to do so. The WHO says five percent of GDP should be spent on health but we probably spend just two percent.” Asked to identify a pressing health issue, Thomas said lifestyle diseases. She said: “Your decision on diet will affect your quality of health, as to how healthy you’ll be in the future. It’s now more about prevention than anything else. That’s the way it’s going.”
What message did she have for the general public? “People need to demand more from their represenatives with respect to the level and quality of health-care they receive.” Asked where she hoped to be in 10 or 20 years time, she said: “I want everything — a successful career and family life. I want to be content with myself and try to make a difference, in whatever small way.”
SHERRY SANDY
Sherry Sandy in the final Clinical exams won the Medal for Best Student in the subject of Medicine. She also topped four campuses for the Best Question 5 in Surgery, and won prizes in Community Medicine and the Observed Structured Clinical Exam.
Sherry Sandy is from a close-knit Hindu family, but her inspiration to become a doctor came from an unexpected source, at a very young age. She, like her two colleagues, paid tribute to her family and fellow students for their support over the five-year course. Sandy said: “My colleagues helped me through the vast amount of work. I wonder how anyone can get through on their own. We all did past papers together, examined patients together and discussed them, and they would constructively criticise me. They really helped me through medical school. It’s nice to have people going through what you are going through. The campus doesn’t do didactic teaching, but you take a history from your patient and learn from your patient. It’s a lot easier when you have a lot of people pitching in. “There were moments when you wondered why you had chosen medicine. You were graduating after your friends and for a long time earning less than them. But now I’m on the job and have reached one goal in my life, I’m enjoying it — the personal satisfaction. At the end of the day you help a lot of people.” Sandy’s father is principal of Williamsville Junior Secondary School and her mother is also a teacher, at Couva Government Secondary School. Both are mathematics teachers. Her two brothers both won national scholarships and are graduates of MIT.
Had her parents pushed her to do medicine? Sandy replied: “No. It was something I decided at ten years old. My brothers and friends who knew people studying medicine tried to discourage me because of the hard time in medical school. But once I was in medical school my brothers told me ‘You’ll be a great doctor.’ They made me out to be tough. If you make a decision, stand by it, finish it. “My brothers were always first in their class in secondary school. There was pressure on me to follow, but inspiration also.” But no pressure had come from her parents, she being self-disciplined after standard three. “They would have to tell me to take a break from studying. Medicine I call a vocation. For me it wasn’t about prestige or money, I just thought ‘How can I help people?’ and that was one of the best reasons.” Was she close to her parents and brothers? “We are all very close, including my Dad’s brothers and sisters and Mum’s brothers and sisters. I knew all my grandparents and they were all inspirations to me. One grandmother is still alive. When I became a doctor she cried. My parents are Hindus and they taught us to say our prayers every night, although I’m very open to all religions. They made us go to the temple every Sunday, even if they weren’t going. Our neighbourhood is pretty close-knit, and a lot of people around here won scholarships. There were a lot of activities in the village, Baucarro (near Freeport). That’s where this humanity, wanting to help people, came from.” She then related how a tragedy had inspired her. At the time when she was about ten years old, two young brothers from the village, aged about 18 and 15 years, had gone to Las Cuevas Beach. One had got into difficulty and the other had tried to save him. Neither boy made it.
Sandy recounted: “There was this woman (Rita Persad) whose two children had died, drowned. She devoted her life after that to social work. She reinforced my family life. It’s nice to be re-inspired. Her strength itself was awesome. To see that was inspiring. They were really nice children. Their funeral was so big, the police had to close off the road.” Sandy said Mrs Persad started a school in impoverished Korea Village. “She started it from scratch and now it is a thriving school. She had been just an ordinary housewife, but went to learn to teach. “She was one of the first people I called when I became a doctor. She had this prayer she used to say, ‘Thy Will Be Done’, saying that instead of asking God for what you want, instead ask Him to make you an instrument of His will. After her classes you’d be in goosebumps. You really felt spiritually renewed.” She recalled her experiences on the wards: “In TT patients are very tolerant. Although you make mistakes when you are learning to do procedures for the first time and cause the patients discomfort, they are still very empathising and they encourage you and say they know you are still learning.” Sandy revealed her pet interests in medicine lay in the high-tech interventional areas like cardiology and gastroenterology. “You intervene via surgery. Unlike conventional medicine, these allow you to treat the patient in a way that affects them quickly.” But she added: “I’m pretty young (23), so although you have plans they can change pretty quickly. That’s why I’d like to go to the USA to see first hand the new cures and treatments which are helping people. A lot of my lecturers did that and came back to TT.” She was particularly taken by the new technique of radio nucleotide scanning to detect damage in the heart’s cardiac tissue. “Before, you had to observe the functioning of the heart to detect any damage, but now this is like an X-ray of the heart. It’s so accurate. Before you had to be “testing,” but now you know for sure. This treatment sets the tone for other treatments. Medicine has advanced so far. It makes you wonder what we’ll come up with in the next 20 years. “Abroad gene therapy is also a cure for a lot of ailments. In cancer treatment they have now started to direct the drugs to the tumour only, reducing the side effets of chemo-therapy. All this will keep you interested in the job. Apart from the satisfaction, it’s a fascinating field.”
What did she think was the main issue for an ordinary person seeking access to healthcare in TT? Sandy said: “I think they have to wait too long to access treatment. The health system depends on the two main hospitals, but should be diversified. The health centres should play a greater role. What we should emphasise is preventative care which we are not doing enough. We have so many chronic diseases and these same patients are over indulging in alcohol and are overeating. So the public itself needs to accept responsibility for its health. Health centres have started to play a bigger role and are encouraging healthy diets and exercise.” She added: “When I was doing optmology (eyes) our lecturers pointed out the prevalent rate of glaucoma in TT was very high like diabetes. But if caught early it can be treated. There should be screening programmes to detect diseases at a treatable stage.” What would she like to contribute to medicine? “To see what this population needs, what changes need to be done. “That’s why I decided to do my internship in TT. Then to see what’s abroad and what I can feasibly bring back here, what efficient forms of treatment. “I’m hoping that pretty soon there’ll be a cure for HIV. When I see paediatrics and the children with HIV…That’s the downfall in medicine the toll it takes on you.” So, with the aspirations of young medics like Tricia Gonzales, Kyla Thomas and Sherry Sandy, our health system faces a bright future.
