Things to Come

December 27, 2006

A few things are going to start popping up here. First, I’m going to begin studying for the USMLE come Jan 4th and I plan on keeping everyone who cares up to date on how I select review books, choose a plan of attack, and generally fare over the next two months with a “How to I Prepared for the USMLE” series.

Second, the medico-economics of health care continues to fascinate/infuriate me. I’m a Pessimistic Kantian, so if I’m going to walk around wishing that someone had already written a personal guide to explain this to me then my ethic dictates that I have to make one myself (since I wish some future-self had saved me the trouble). I’ll be gathering what I can online and bringing it here for your easy consumption as “My Health Care Education.”

Third (and a sensitive topic for those in the Caribbean), I am applying for transfer to a US medical school in March with the possibility of interviewing in June/July of 2007. This will be interesting for me because 1) I have no idea how to go about it as information for prospective transfers isn’t exactly advertised or accessible at SGU, 2) I may end up producing a helpful guide while publicly failing myself, and 3) I’ll get to address some of the reasons why I think transferring is an important step for me and whether that contradicts what I’ve written (a guide about how great SGU is) and said (with MedScape) previously. “Transferring from a Caribbean Medical School” should be interesting.

But that all starts in a week. In the meantime, I’d like to draw your attention to the updated “SGU Guides.” Whereas before it was simply a link to the Welcome to Grenada site, it now has a menu of things I’ve written that don’t fit easily into the longer version but still deserve a home. I hope it helps.

Cheers for now, topher.

The Mathematics of Packing

December 18, 2006

**This post’s content and format was inspired by The Simple Dollar.**

You can bring 100lbs+ to school but can only return home with 50lb and now you have to decide what stays and what goes. Ready to pull out your hair?

When coming to the islands (either Grenada or St. Vincent), a typical flight takes you to San Juan on American Airlines followed by a prop plane taking you the rest of the way (American Eagle, Caribbean Star/Sun, Liat, etc.). To benefit from the business of the larger companies, these smaller island carriers agree to handle the promised luggage allowance. So coming to the islands, I was allowed 2 x 50lb checked luggage, 1 x 40lb carry on and a 1 x personal bag not to exceed 15lb. For those keeping track at home, that’s 155lbs.

These smaller airlines have smaller airplanes and so cannot possibly take all of this promised luggage, so instead they take what they can with each flight and come back for the rest later. This means that most students coming to the islands wait a few days to receive everything.

Going back is a different story. The larger airline may have changed its guidlines and will now allow two checked bags not to exceed 70lbs in total (that’s a loss of 30lbs) or the smaller airline may decide (at their discretion) not to honor your previous luggage allowance when leaving the islands and restrict you to a single 50lb bag.

So what are you to do? Read the rest of this entry »

Welcome to Grenada, A Student’s Guide for Students

December 4, 2006

I have been silent in this space for a little while now but I have not been lazy. The end of my first two years is 10 days away and I will soon leave the Caribbean for a permanent place back home in the US. I have taken a comprehensive diagnostic test of my skills clinically and academically (both in-house) and I just returned from a trip to Grenada to finish work on a two-year project of mine. These are exciting times.

I’m incredibly proud of the work that’s now over. Coming in at 11,000 words, it’s about as long as an Atul Gawande article with about 1/11,000 of the readership.

Welcome to Grenada, A Student’s Guide for Students” began in April of 2005 as a seven-page introduction to your new life on the island. It has since swelled to include information and advice for the first two years of island living. With our fingers crossed, we hope it eventually has information for the clinical years, interviewing for residency, and a guide to the match (with specifics for FMGs).

The editors believe in the power of honesty. If I told you that everything was perfect, would you believe anything I said? With that in mind, we hope you find our honest take on attending Saint George’s University to be helpful and that by showing you the rust you will appreciate the shine. For more on why we wrote this and our general mission statement, please read the Letter From the Editors.

And with that, I am exhausted. A lot has happened and the telling will all have to wait until I’m sipping egg nog, wearing a ridiculous sweater, and enjoying being the tannest man in the room.

Happy Holidays, topher.

Books for St. Vincent

October 22, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.


4th term was the exception in that you could pitch your tent with one book and live in it. That’s pretty much over now. You have three classes to worry about this term. Pathophys, Pharm, and Hospital (clinical skills).

Merck ManualPathophysiology is not Pathology or Physiology. In Path, everything that was going to go wrong pretty much did and you were left to memorize buzz words. In Physiology, you were an idiot trying to understand the magic of breathing. PathoPhys is much more clinical and could have been named “What do you do with a patient’s chart?” In other words, if you learned Path and Phys, we can assume you know a lot already and can skip the easy stuff. You’ll be given stacks of notes for Renal, Cardio, etc. There is no need to buy a surgery textbook for the surgery lectures, or the Atlas of Diagnostic Imaging for the radiology lectures, and so on. I recommend… Read the rest of this entry »

Island Culture

August 29, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.


English is the language spoken in Grenada. In the school guide, they describe it as a “slightly lilting Caribbean accent”. I disagree. Those Grenadians that work with the university, or in another position that requires constant exposure to tourists and students, are easy to understand. Those that have very little exposure to foreigners can be near unintelligible, but once you have an idea for what someone is trying to say, everything seems much clearer. It is not unlike listening to lyrics from a difficult song after you have already read them in the CD jacket.

If you have a healthy sense of humor, the stressful things about Grenada can be hilarious. First off, if you go to a restaurant and read the menu, do not kid yourself and think that what is on the menu is available. The menu is instead a list of things that were once available and may be available in the future. This is due either to a lack of ingredients, the staff is too busy to make your order, or the staff does not care to make your order. So order something else with a smile.

Second, if you order a drink at a US bar and it takes more than a few moments, it is often because the place is very busy and the bar is understaffed. If you order a drink in a Grenadian bar on a dead night when you are the only customer, it will take even longer. This is not because the bartender is trying to piss you off or ruin your whole day as some dramatics will say, it is instead because the island is a slow place and you need to get used to it. That Grenadian bartender could turn to you and ask, “What’s your hurry anyway?” Try to remember that there is no hurry and life will be a lot easier on you.

Grenadian Weather

August 29, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.


The wet season is very wet and runs from August to December. It can rain for days on end. If you bring an umbrella, make sure it is the type that opens to form a complete sphere around you, because the rain falls sideways. Honestly, go to a camping store and get a waterproof cover for your backpack, a light waterproof jacket and a shamie. You will be the envy of everyone. Another thing to consider is the mosquitoes. The breeding ground for mosquitoes is standing water, and there will be a lot of it. Invest in a mesh tent for your bed and screens for your windows (only applicable if living off campus). Want to know a fun trick? Instead of a mesh net, get a standing oscillating fan. If you go to sleep with it by your head, the mosquitos get sucked into the back of it and murdered. You get to wake up the next morning with a pile of them on the ground. Good times.

There is little rain in the dry season which runs from January till June. It is the best time to be on the island and enjoy everything that it has to offer. Go to the beach, learn to kite surf, bring your surf board, or rent a jet ski. Head to the capital and learn how to haggle in the market. Most of all, remember to get a tan so that people believe you when you say that you go to school on a tropical island.

School Culture

August 29, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.


During your first two weeks here you have carte blanche to introduce yourself to as many people as you wish. Your class will probably go out each night that first week and I recommend you go each time. The first week does not contain difficult material and you will not have another chance like it. After this grace period the classes pick up a bit, people fall into routines and your opportunities to meet every member of your class will start to drop off.

SGU operates by four-month-long terms. This tricks you into thinking that each term is a year long and that people in second, third and fourth term are somehow separated from you. This is of course nonsense. The uppertermers will have advice for you on every class and most of it should be ignored. Instead, find a good DES tutor, give yourself a few weeks, and then start making judgments on how to handle your course load. Everyone should go to the Department of Educational Services (DES) office and take a look at all of their handouts on studying, test-taking strategies, and review sessions. It is a goldmine of helpful information.

SGU students study like they party: hard. Go to the Crab Races at The Owl every Monday night at Grand Anse beach. On Wednesday, everyone heads over to Stewart’s Dock for drinks and a live band. If you like to keep going until 4am, Banana’s is the place for you. There are so many organizations on school that every weekend has at least one sponsored party at the Aquarium, Thai Beach, Kudos, etc. Take advantage while you can. Before too long you will start looking forward to the weekend because it means no more classes and you have time to study. Yes, you will be ‘that guy.’

The Day-to-Day

August 29, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.


As a First-termer, I got up every morning around 7am and checked the class schedule. Typically only two courses are taught a day with each getting two hours of lecture time. On some days you will have Anatomy lab that can begin at 8 or 9am and lasts for three hours, or you have Histology lab at 8 or 10am that lasts for two hours. Lectures begin at 1pm each day and last until 5pm. You do not need to bring much to campus. I usually put my laptop, water bottle, two three ring binders and two textbooks into my backpack and grab the bus.

Eating on campus is not hard though students do complain about the selection. At the top of the hill (you will know it well) there are vendors selling fresh fruits and the Patels selling homemade Indian food. Halfway down campus is the Student’s Center which has two restaurants (Glover’s and Pearl’s) along with a convenience store. At the base of campus is the Sugar Shack. You will not go hungry.

Time before and after lecture is often spent in the library. The library has wireless internet and so should your computer (the “Computing at SGU” section of the SGU website does a good job of preparing you). During peak hours it can be difficult to get a strong connection (bringing an Ethernet cable is a bad move, as many of the plugs on campus work sporadically). The wireless network extends throughout campus into the lecture halls (you can follow lectures online or check email during breaks), across to the bus stop and down to the Student Area (where the gym and restaurants are located). Some students are able to get a connection in their rooms as well. If you live off campus in Grand Anse dorms there is a study room with a wireless connection. High-speed internet is available in off-campus apartments through a contract with Cable & Wireless.

The Last Phone You’ll Every Buy

August 29, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.


Motorolla Phone

No one gets a landline and you should not bring a cordless phone with you. So that means you are buying a cell phone. Since you are now going to travel from the mainland to Grenada and St. Vincent’s (and possibly Prague) you probably want a phone that can work in all areas. For this, you need to buy a Quad-Band GSM phone. There are two main companies that offer GSM service in the USA. AT&T and Cingular are now merged into one company, and the second company is T-Mobile. So here’s what you do:

1) buy a Quad-Band GSM phone from one of these companies
2) make sure that it is a pay-as-you-go phone with a SIM card
3) Google “unlock SIM” and pay for your phone to be unlocked

I’ll explain all of that:

There are four major broadcasting systems used throughout the world. So a Quad-Band phone means that you’ll never have to buy a new phone for travel. The SIM card is a chip that contains your phone number and your contacts. Put another way, it does not matter from what phone you call: if you put your SIM card in any phone the person you are calling will see that it is you. So if you buy a SIM Quad-Band phone at home, you will have a SIM card with your home’s area code. When you come to Grenada, you will buy another SIM card with a Grenadian number. At this point, you can simply switch the SIM cards while you’re one the islands and then switch them back when you return home. Taping them into your passport is a nice way to keep track of them when not in use.

The reason you have to “unlock” your phone is so that your T-Mobile phone (for example) will operate with a Digicel SIM card from Grenada (for example). Pay-as-you-go means that if you want to talk for ten minutes, you buy ten minutes. If you talk over that, the phone simply cuts off (after a warning of course). This means that you cannot possibly suffer overage charges and you don’t get roped into a contract. And why do you have to pay to unlock your phone? Because T-mobile doesn’t want you to buy there phone and then use it with an AT&T SIM card. T-mobile wants your money. Typically, these companies will unlock your phone for free if you’ve owned it for three months, but if you’re reading this now that’s a bit of late notice. So pay to have it unlocked from a separate code vendor and you should be set.
Some students make use of internet phones as well.

All in All, I paid $95 (phone $50, SIM $20, Unlock $25)

There are several programs that allow you to make phone calls over the internet for pennies a minute to anywhere in the world. Skype, Netphone, and PCPhone are popular programs and only require a headset with microphone.

A Picture is Worth…

August 29, 2006

For current, updated information about attending SGU, review of SGU textbooks, and access to more SGU resources, please visit the Welcome to Grenada site.


1000 Words

It’s amazing how a few photographs taken by students can add some perspective to the place. Go to and search for ‘SGU.’ It says something that the students love the school enough to put all of this together themselves.

My favortite albums are shot by