Alumni Association UAG

Roger F. Villalba, M.D. Guest Speaker at the 2004-01 entering class

I would like to start by welcoming you all to the Universidad Autónoma de Guadalajara (otherwise known as the UAG). Congratulations. This is the start of a new chapter, a new circle in your lives. You have, each one of you, made it to where few have gone. Just reaching medical school is an achievement unto itself. Using this as a springboard to becoming a physician is your next great challenge.

As I was thinking what to say, I thought of what I needed to hear at that point in my life. After all, 11 years ago I was in the same situation that you find yourselves in now. A foreign country, a foreign language, and a foreign medical school.

I must tell you something very important at this point. Each one of you has what it takes. To pass your classes, to pass the first step of the United States Medical Licensing Exam and to be accepted to the Fifth Pathway program. Each one of you, also, has it in you to become an excellent resident and an excellent physician.

This, however, will not be easy. At this point I remember what I was going through when I was in one of those seats: fear, nerves, and anxiety. Before you know it, after four impossibly long, yet incredibly quick years it will be replaced by excitement and relief.

You will go through times when you will want to scream, rant, shout, and quit. You will swear that there really is a conspiracy. You will want to trash your room, throw your books, start listening to the voices in your head, and get drunk. Do not do that. Some of you may even throw a friend through a window. When I did it to a friend he passed Step I over the next two days so it must have been a good thing, right? Do not do that either.

Again, this can be conquered. You can and will succeed.

Why do I know this? Because, believe me. If I made it through medical school so can you.

Just before I came to Guadalajara my situation was not unlike yours, and it may even sound familiar. I had been wait-listed in Allopathic and Osteopathic medical schools in the United States. I was told by my college pre-medical guidance counselor that he did not think it was wise to leave the United States. I was told by another college professor that she had grave concerns that I was leaving.

“You may not make it back into the United States system,” “wait it out,” and “it’ll happen next year” are just a few of the things I was told.

Thank God I did not listen.

As it happened, in my second year I went to a medical school convention as a student representative with the North American Student Association representing the UAG. It was there that I ran into my pre-med counselor from college.

By then he had completely changed his tune. Not only did he congratulate me, but he asked me to speak to college pre-meds about my experiences of going to a foreign medical school. Obviously, he did not recall our conversation from a couple of years prior. Also, he did not know it at the time, but he had made my hit-list.

Well, I called it a hit-list anyway. It was a list of people who either thought that I could not or would not make it through medical school. Anyone who doubted me would go on the list. At one point I put my mother on that list. I even put some classmates on that list.

Why would I do this? Motivation. Every time I became tired or wanted to quit or shut my eyes for “just another five minutes” I would look at this list, which I taped to my desk, and want to succeed with them, without them or in spite of them. Thank you, Pablo Neruda.

Believe me, I tell you this not to be self-serving, but because you can do it. After all, anywhere you go for a medical education it is hard work. I guess that means that the secret is … that there is no secret. It requires persistence and an iron-butt.

As some friends and I joked, “A medical career is not kind to the human form.”

Right now, I would like to point something else out to you. Just because you are here does not mean that you are inferior or a second fiddle to anyone anywhere.

In fact, here is a partial list of places where recent graduates have gone:

New York Medical College
University of California, Los Angeles
University of Southern California
State University of New York, University Hospital Stonybrook
St. Vincent’s Hospital, New York
University of Texas, Southwest
University of Puerto Rico
University of Wisconsin

You may know others who have graduated from here who have gone to other places.

What about specialties?

How about Internal Medicine, Family Practice, Nuclear Medicine, Neurology, Obstetrics and Gynecology, Pediatrics, Surgery, Radiology, and Psychiatry.

This list is not compiled from the past thirty years.
It is from the last three.

Obviously, what I’m trying to get across to you is that not only is it possible for you to succeed, but it is expected. Too many people have gone through UAG successfully to say that it can not be done or that it is too hard.

Now you have to ask yourself why a residency program would choose you over someone else? Who cares as long as they choose you!

Seriously, there are advantages being in this system. On the floors, no one cares where you graduated medical school from. They just want to know if you can get the arterial line, drop the NG tube, or assist on a code-blue, write a good History and Physical as well as a good note.

Here you will be included in clinical training almost immediately. When I would tell friends back home about this they were surprised, because we started into clinical training so early in our medical careers.

Almost immediately we were “hands on.” No professional patients for us, thank you. You will get the real thing. I remember that a friend was working at a Cruz Roja station (a Red Cross station) in the middle of nowhere and he had to help the attending physician with a grandmother who was burnt and blistered when her pot of frijoles exploded. What about listening to an asthmatic patient’s wheeze or a congestive heart failure patient’s crackle? As a first year?

You also have the advantage of having learned a second language. There are some who have rarely uttered a word of Spanish since high school. If it has not changed it soon will. How else are you going to go shopping for food? Ask for a taxi? Ride a bus? Get a date?

It sets you apart from the American, Indian, Russian, African, or Phillipine students, because you will be called upon many times to translate. During my 5th Pathway I did my elective in Emergency Medicine. One day a Spanish-speaking gentleman came in who fell onto a branch while in a tree. Don’t ask me how, but the branch perforated his rectum. The poor fellow needed surgery, but no one in the ER spoke Spanish. “That’s okay,” said the surgical resident, “no one from his family speaks English so I guess that makes us even.”

To make a long story short, they asked me to explain the surgery to the patient, get consent, re-explain everything to the family, and translate the answers to any questions. As a reward, they allowed me to scrub and assist in the surgery when I was done with all that. Actually, they allowed me to retract. As you will see, the reason for medical students in surgery is retraction.

In residency on Long Island, there were days when I hardly spoke any English. A fellow resident went to school in Israel so we made a deal. He could see the patients who spoke Yiddish and I would see the ones who spoke Spanish.

Right now, I am working in Phoenix, Arizona. Believe me, the Spanish is an advantage.

With such an increase in the Spanish-speaking population in the United States it will be an important asset for your residency and in your professional career.

Finally, you get to work, breathe, study, and play in a foreign culture. This is incredibly important to you as it will hone one of the most important aspects of your medical practice. It will make you a well-rounded human being. Why is this so important?
Because it will help you develop communication skills.

To understand where someone is coming from and to convey what a blood test, an imaging test, or an upcoming surgery means and how it will impact their lives is probably the most important aspect of medicine.

If there is an art to medicine that is it.

To sum up then, work hard and pick your spots to play carefully. Also, don’t throw your friends through windows, don’t be the guy with the loudest stereo or the coolest car, eat some street corn, go to the beach, get the runs, play softball, and be careful with the agua trucks. Always be grateful, appreciative, and never forget where you came from.

Thank you and good luck to you all.