In AICM, you will be required to sign up for a QBank, USMLE World particularly; and you are required to complete at least 50% of the Qbank before finishing the semester. They require you to start the Qbank after the USMLE Step 1 prep review and at the beginning of the rotations of AICM. There are around 2100 questions from USMLE World QBank and completing 50% of it in 2 months is possible but with full concentration. However, in AICM you are required to complete around 1050 questions, which is 50% of the Qbank, with clinical rotations. In clinical rotations you will have to do presentations for each rotations, you will be at the hospital majority of the day, plus you are required to do overnight on calls for Internal Medicine rotation, and USMLE World is a very difficult Qbank. USMLE World requires a person full concentration and commitment to successfully get the most out of the Qbank. One of my friends, who was on dean’s list in Bonaire, took an entire day to do one block of the QBank because of the extreme difficulty of the questions.

AICM Schedule includes the first 2 months of USMLE Step 1 review in a classroom, then the next 2 months the students do orientation and clinical rotations in the clinical floor. With rotations one cannot complete 1050 questions and fully get through the explanations. The only way to get through the questions is to blindly and randomly click answers so the AICM instructor sees that you are doing the questions. By blindly clicking on the questions you are just satisfying the teacher and you’re wasting your money because you are required to pay for USMLE World questions which goes from $99 for 30 days to $400 for one year.

My advice to the upcoming MD4 students is to do USMLE World questions starting from MD4. You will have a lot of time in MD4 semester because MD4 classes not as difficult as MD3 classes. Most MD4 students in SJSM make the mistake of relaxing in the last semester because the hardest semester is over. However, MD4 semester is a perfect opportunity to get started in being better prepared than the previous students. If you are consistent with USMLE World questions then you can finish all of it before MD4 semester is over. If you just do 20 questions a day from USMLE World, and thoroughly go over the answers and explanations then you will have time to study for MD4 classes plus enjoy having fun in the last four months in Bonaire/Anguilla.

For upcoming AICM students, if you have at least 2 months before AICM semester begins, then finish on round of USMLE World questions for Step 1, and trust me you won’t regret it. By doing so you will be able to go over the questions faster in AICM and you will satisfy the requirement for a grade and you will get the most out of it.

If you finish USMLE World questions in Bonaire or Anguilla, then the USMLE Step 1 review in AICM will be very effective in helping you because it will be a very good review. However, if you don’t do the questions then the USMLE review will be a waste of your time, and you have no choice about it because you have to attend it for a grade.

If I knew then what I know now I would not have wasted so much time on the island twiddling my thumbs; therefore, take my advice and start early. I write these blog posts to help my fellow students in SJSM because no one else does; that’s why I take the time to write them because valuable information can make or break a student. The information is presented to you so, it’s up to you to use it, good luck.

I know this post should have been published before I posted the AICM posts but better late than never. Anyways, the Saint James School of Medicine class of Fall 2010 is the school’s largest class. We started with 70 students initially and graduated with less than 60 unfortunately. For the new comers this class will be remembered by all those who interacted with us. For new students, ask around and your fellow students and they will tell you our class is one of the most friendliest classes out there. We did our best and took time out of our schedules to help out the newcomers. Unfortunately, someone told me that other classes on the island are not like that. The following is a picture of the class, which was taken in MD4 semester.

Health Fair
The SGA of Saint James School of Medicine held a health fair a while back to provide free medical treatment to the community. We spoke with the local church and arranged the event on October 31st to give back to the community. We set up different stations for the patients to check up with their blood pressure. BMI, height, weight, vision, dental, and other medical measurements were taken and counseling were given based on their health status. Yes, luckily we have an experienced dentist as a SJSM student in the MD4 class, and he offered his services free to the community. We also had a BBQ arranged by the MD3 students. It was a success, and several pictures were shown in the Bonaire Reporter, a local newspaper.  On of them I posted below.

Deposit
Yes, the Bonairians will give your money back if you put a deposit down to get your residency permit. I got my money back and it was a stressful process. For the new upcoming students, you don’t have to put down any deposit for immigration. The policy was by the Bonairan government, but now since the island is taken over by the Dutch, no deposit is required to get a residency permit.  Also, in order for you to leave the island, make sure you get your passport stamped with the exit stamps.  If you don't do so then there could be problems at the airport.

Final Block Tests
The MD4 students are getting rowdier day by day as the time is drawing closer to the end of the semester. MD4 students are running around getting things prepared for the white coat ceremony and getting things sold and packing things up. All the tickets out of Bonaire have been sold for half of the weekends of December. There are only weekend flights that fly to USA. Only in rare times will a plane go to USA any other time. We have 2 blocks of tests left and I have to be focused. The excitement of finishing Basic science and getting out of Bonaire is among all of us.

Clinical Preparation
It feels good to know that we’re on our way to clinical clerkship. Even though AICM is an introduction, we will be in a hospital setting so, it feels good to know that we are closer to our goal of becoming MDs. The only obstacle we have to overcome is the dreadful USMLE. My parents said the clinical package came to our house in the States. We all have to get CPR certified before the class starts in AICM.

White Coat
The white coat committee seems to be walking around taking pictures and video recording and discussion out loud what to do for the ceremony. Every semester the MD4 class makes a white coat presentation of fun times and they present it to everyone in the ceremony; for our class, the talented white coat committee is making one and I hope it turns out good.

The last 30 days seems to be the most hectic; in 30 days I am leaving Bonaire. I got myself in a position where I have to complete so many tasks in less than 30. All MD4 students are to complete a big research project and present the project. The research project requires using principles of epidemiology. We can work in a group of 4 to 5 people. Epidemiology is not my favorite subject nor is it interesting. The topics covered are very boring and to me yet I have to learn the material; the subject is basically biostatistics.

Other tasks I have to keep up are studying for PDI and Systemic Pathology. Honestly, I am so sick of coming to class every day. I study better while I’m in the comfort of my home. I am far more focused on the subject when I am in my room with no one around me to distract me. However, by Saint James School of Medicine’s attendance policy, all students are required to have 80% attendance per block in order to take the block exams.

Tuition Increased

The SJSM newsletter came out and 52 students have applied to the national match program so, it looks as if SJSM is improved a lot in terms of helping students pass Step 1. Tuition went up $500 from $4,500 to $5,000, if this keeps on going up then SJSM will no longer be the cheapest medical school to go to. Clinical tuition increased also; it’s now $7,500. Before, when I was an MD1, the tuition for clinical clerkship was $6,900; so it went up by$600. I hope they don’t increase it anymore until the school gets federal loans otherwise students will have to take long breaks from months to years in order to pay for school.

As for AICM, many classmates have talked to Chicago office and found a very strict policy for the first clinical semester.

Before anyone can take the USMLE Step 1 exam the following conditions must be met by the student:

- Take AICM Semster

- Pass NMBE Exam

- Pass ExamMaster Exam made by the school

Once the conditions are met, the school will give the green light to take the USMLE Step 1. Don’t think you can take it without the permission of SJSM. No medical student can take the USMLE Step 1 without the permission of a medical institution.

PDI is a challenging class in MD4; it requires you to take whatever you learned in the previous semesters and use it altogether; PDI stands for Physical Diagnosis Introduction & Clinical Medicine so you can see why it's hard, now we're entering the clinical arena.  There are no notes to copy from. Dr. P speaks, and it's your job to take notes or record his lectures on an audio device.  I have found it kind of challenging to get the attention I need with our big class of 60 people. The class is divided in to 2 groups; each group takes turn surrounding the gurney while the instructor teaches the concepts of examination.  Thank GOD for the internet; I've found videos online to help me in PDI.  I have gathered them to a playlist and it's displayed below; the concepts the videos show are taught in class and if you watch them over and over again then you'll get very familiar with the examinations. If we have to learn any new concept in class for block 2, then I will update the playlist below with new videos.

The videos include shifting dullness, fluid wave, Murphy's sign, Rovsing's sign, and rebound tenderness.

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For all you not-senior students of SJSM you will love MD4. The schedule is a bit relaxed and we have time to sleep and study for the tests. We have 4 tests but 2 of them are from one class. We have PDI tests with one that is multiple-choice where we take it like any other tests and the other one is practical one where we perform physical exams on a patient. The patient is actually another classmate we choose to be our partner. The other tests are Epidemiology and Systemic Pathology (Pathology II).

The schedule is great as well, on the week of the test, on that Thursday we have the multiple-choice test for PDI, and on the following day, a Friday, we have the practical for PDI. On Friday everyone is assigned a certain time of the day to show up to be tested; we have 20 minutes to get tested per pair. The weekend is the time to study and on the following Monday we have Systemic Pathology and Epidemiology tests. Therefore, on Thursday we have the PDI theory exam at 8 AM, on Friday we have the PDI practical exam on our given schedule, on Monday we have System Pathology II at 10 AM and then we have Epidemiology at 2 PM. So yeah that’s the schedule for MD test.

As in terms of difficulty, I would say it’s a bit better than MD3 because now we have only 3 subjects instead of 5 subjects to study for.  The subjects are not easy though, they are still difficult but studying for them is more relaxed now.  Therefore, we have more time in our hands to learn the material well. Some people are actually taking the extra time to start studying for Step 1.

It’s been a week of MD4 and things are very different than MD3, thank GOD. The classes seem to be far more relaxing and I’m not that stressed out about it. We have a hospital bed in the classroom now because the instructor uses it to teach us PDI. He’s teaching us the introduction to clinical medicine; he’s teaching us the skills we need for the AICM semester. Overall my mind is very relaxed after MD3 ended.

We still are in the same classroom and at random moments you can see this short Indian guy get up and go outside during class. After 5 seconds or so he would come back. I never knew what he was doing till someone told me that he goes out to release gas. Indians eat a lot of rice and other curry food and I guess it makes that guy fart often.

I still haven’t met all of the MD1s. Apparently there was a welcome party last Friday in City Café and I didn’t go. I haven’t gone out much this semester yet but I do plan to. If you are an MD1 and a regular reader of this blog and you still haven’t figured out who I am then don’t bother trying. There are about sixty MD4 students and you have to get to know all of us to figure it out. I got word that on a Muslim holiday, on Eid last week, the Muslims asked about who the writer of this blog was at their breakfast table.

AICM Update
I got word from some students who are already in AICM that the rotation is very tiring. I thought they would be in the hospital for 4-5 hours but I was wrong. You’re in the hospital around the same time as you are in class in Bonaire. You will be basically following a doctor and you will be on the front lines of diagnosing patients. You’re not going to be alone though, you will be in a group. The hospital is a teaching hospital so you may be with medical students from other schools.

It’s been a killer semester and MD3 is finally over. I can’t believe it went by so fast. Overall this semester is what medical school is all about: sleepless nights, drowsiness, constant studying, 4+ cups of coffee, etc. Did it pay off, well I am and MD4 so yeah. The struggles I went through got me through. Honestly, I didn’t get much time to study, rest, and eat. The volume of information that I have to read, comprehend, and memorize is just overwhelming. MD3 is known to be the toughest semester and the Pharmacology course to be the toughest course. For the upcoming MD3s I am telling you get your gear locked and buy yourself a big long coffee mug because you’re going to use it.

The dean assured me that MD4 is a lot easier except for Pathology II (Systemic Pathology) but it’s only one class and we won’t have sleepless nights studying for it. MD4 is known as the semester of resolution of difficulty. For those who are in my MD4 class, they have plans to throw BBQs, parties, fundraising events, etc. So let’s see how it goes. Everyone says that MD4 is like college all over again. You can actually not study everyday and still get an “A” because you only have one hard class to concentrate on. The other classes we have to take is Epidemiology and the practical and lecture of PDI (Physical Diagnosis Introduction/Introduction to Clinical Medicine). For MD4 we basically have three classes therefore, we’ll have a lot of time on our hands

In a future post I will write about my review of MD3 along with tips and mistakes I have made.