Living and studying in India as a born and raised mid-western citizen of the U.S. is not the usual trajectory. For many people who wish to dip their toes into the oncoming waves of medical school. I chose to go this route because of the future prospects of a profession and a way to live with my extended family. I hadn’t been to India since I was around the age of 10 years old. Even then, it was only for a maximum of 3 weeks on a family vacation.
My parents were born in Pune, which was small city in the state of Maharastra. I say was a small city because it now has boomed in both population and real estate. There are roads and highways recently constructed that had not existed when my parents grew up. My dad had often told me that he would bike from home to school every day.
Western presence
The western presence in this eastern country expanded immensely since I was there 12 years ago. As a kid I remember having one option when it came to American food being sold in India. It was a Pizza Hut across from where my paternal cousins lived with my aunt and uncle. Now that same street has a Pizza Hut, a Subway, a McDonald’s, and a Papa John’s. The average teenager had their favorite “Friend” from “Friends.” They were just as excited to see the next Marvel superhero flick. Hindi-English and Marathi-English were predominantly spoken.
When I went to Dr Dy Patil Medical College for the first time, I was easily able to talk to people. I didn’t understand Hindi that well. However, I knew Marathi because my parents had spoken to me in their native tongue as a child. One of the first encounters I remember having was at the anatomy lab where the cadavers were kept. I was split into a group of 5 people. It turned out that they were all international students as well. There were a couple Americans from New Jersey and California. A few from Dubai and the Emirates, and one from Nigeria who was born in India.
From the start a lot of people knew me and the other international students. The reason was we had different accents and were speaking mainly in English. The biggest change for me was the age difference. Most of the kids in my first year of medical school were all only 18 because in India there is no undergraduate studies prior to medical school. After high school you are tasked with pursuing your profession right after graduation. I was often told that calling it medical school was the wrong term, since school in India is used to label grades 1-12. I would usually chime back with a well you’ve seen House, Scrubs, and Grey’s Anatomy. Then I would go on to say that the characters would also refer to it as “medical school”.
Already I could tell that these kids were at the age and maturity level of my younger siblings. This was crazy for me to grasp! All my life I had always been the youngest in my grade growing up from high school through college. It was interesting and a vastly different experience than what I was used to. Now that I was the oldest kid in the class of around 300. I was often teased for this being called a “dinosaur.” It didn’t help that I wore a T-shirt with a Brontosaurus.
It had a humorous caption saying “All my friends are dead”. For once I felt like I had a wiser and mature viewpoint on life at least compared to my classmates. If there was any silly arguments I would just let it pass me by. I could recall similar instances for getting upset or being frustrated as to why people were acting a certain way. I would chalk it up to them being young. There were many instances where I remember having similar experiences when I was four years younger. It’s crazy but definitely true that your brain doesn’t stop maturing until roughly around the age of 25.
Having a younger peer group helped in a lot of unexpected ways. Humor is the best medicine and the childish jokes that was inspired from curiosity rather than hatred was always welcoming. However, the curriculum and exams of “medical school” in India was a completely different story…
The Unusual Exams
For the most part if you grew up in America you would know that exams tended to be of the multiple choice variety. This would go on and continue into the college entry exams such as the SAT and ACT. I had gone to a private high school and from there a college.
At the college things got even more standardized in terms of the format of exams. I believe this was done out of the convenience of grading for the teachers. Stepping up to medical school in America things for the most part become standardized exams with multiple choice options.
Of course they are way harder than any exam before that stage in life. In India the exams are set in a very different way. There were small internal exams which eventually led to the bigger preliminary exams. If you had gotten around 50 percent grade then you were eligible to take the final exam.
Just regarding the written portion of the exam each subject would be divided into two days: Paper I and Paper II. I describe it as written because it was written. Strictly essays written by hand in pen. On average you had to answer 8 out of 10 “one liners”, 5 out of 7 “short answer questions”, and 2 out of 3 “long answer questions”. Each paper was around 3 hours each and the second paper was the next day. This meant that each subject of first year had a written portion of 6 hours each. This was extremely hard to get used to for me, as I had only ever written long essays for English papers back in high school.
Most of the students in India had had these kind of essay exams for their entire lives so I believe they didn’t have to adjust as much as I had to. Of course if you are reading this and you’ve graduated medical school in America then you probably are in as much shock as I was when I heard about the exam format.
There’s already so much information they can test you on and from that impossible to learn everything amount of content they usually only tested at most 15 percent of what you studied. The pros of a multiple choice exam is no matter what the answer is always in front of you with the con being there’s no partial credit if you pick the wrong answer.
On the other hand written exams you had to dig into your knowledge about the particular topic and just write until your hand started hurting and then keep writing. An example would be “Describe and identify the nerve and blood supply of the muscles supplied radial nerve.
Give examples and describe the clinical applications of a radial nerve injury. Include drawings whenever possible. Already you can see how vague this question is and even then you had to work fast and learn how to manage time. If you basically got all the points on one question (which also never happened) for writing 3 pages on that question it wouldn’t matter if you didn’t spend enough time on the other questions.
Time Management
This time management skill was probably the most overwhelming tactic I had to learn and master during my 5.5 years in India’s medical school. Luckily, there were old papers and they would often times re-use some questions from the past 1-5 years. However, even if they re-used the questions they only would take the super important or difficult questions. You were either lucky or not lucky depending on if you studied the right old exam. Memorizing a 3-4 written page answer front to back with diagrams is no easy feat and could take at least an hour to learn it while studying before hand.
Countless nights of back to back tests with hardly any sleep was some of the most stressful. However, it was satisfying accomplishment I’ve undertaken in my life. I would get super mad and frustrated in the beginning because I often get overwhelmed. It was very hard but I never gave up because I knew I could do it if I put the time and effort into it. I have never spent so much time studying for an exam before medical school but I knew I could push through and learn a lot of material and information that would be applicable later down the line in my professional career.
Medical school no matter where in the world you do are requires dedication. Back in high school and college I and many other students at most had to study 1-2 hours for an exam. When it comes to the vast majority of material in medicine it helps to have a higher IQ than the average joe (in order to pick up and internalize information) but even that didn’t help if you did not spend the proper amount of time reading and understanding the material.
I think some of the people in history who have changed the world in the scientific field were the people who weren’t necessarily the smartest but the ones that persevered no matter what life threw at them. You can be the smartest person in the world but if you don’t put effort into your craft then that’s a waste of the gift you were given. This principle directly applies to the attitude you need to have in order to excel in medical examinations.
The Practicals
The practical portion also known as a “viva” was around 2-3 hours for each subject. It consisted of identification of anatomy gross specimens and histology slides. Biochemistry consisted of doing an experiment and interpreting the values. Physiology was more of clinical applications such as demonstrating cranial reflexes. The practical portion did increase my anxiety levels and sometimes it was the luck of the draw as to what the examiner wanted to ask you. I was lucky to be an international student because I stood out with my unusual accent, which lead to pleasant introductions before my practical exam started with the examiner starting out asking where in the States I was from and I would then proceed to tell them that my distant family all lived in Pune.