It’s been more than ten years since starting medical school. I can hardly recall what I felt was on the horizon at that time but I remember the overwhelming pride and optimism. Ben Gurion University’s Medical School for International Health (MSIH) offered an education that was rich in global health combined with a small program that was in its infancy relative to the century-old institutions in Canada. My class was a grab bag of students of different ages and stages in their lives with diverse backgrounds and experiences. It was a group of people who may not have otherwise found one another in friendship had it not been for the common interest in global health and studying medicine.
Adapting to a foreign environment
Medical school was thrilling at almost every turn, but the obstacles were different to those I’d anticipated. For me, the greatest challenges were social and psychological. I found myself in a foreign country paying bills, grocery shopping, weathering road rage and trying to live my day-to-day. Life in Israel was complex. The political climate was too convoluted to even generate a steady opinion, let alone express it. The work week was off-cycle from North America and the time change made it hard to manage the disconnect. The people were loud and opinionated, often making me feel claustrophobic. In order to anchor myself to reality, I immersed myself in studying medicine and seeing patients. It took time to adapt and when I was able to reflect on it, I realized that the process of adaptation was itself a skill. It was much more of an active process than a passive one. Learning to adjust as a stranger to a well-established and culturally foreign environment was perhaps the greatest part of my education at the time.
The type of doctor I always wanted to be
Residency was almost the complete reverse. I had read the same texts and written the same exams as the Canadian students and I was well prepared. Culturally I was fluent, but I had been trained in a system that was vastly different in its personality. I was constantly surprised by the little nuances of language and culture around medical care. It wasn’t just me. There were students who trained in Ireland, Australia, the UK and the Middle East who all felt the same way. It took me a few months before I felt indistinguishable from my Canadian-trained colleagues. It wasn’t until the field had leveled that I was able to draw from my medical training in Israel. I began to realize that those day-to-day experiences that were so trying for me were quite integral to the development of my medical persona. I was able to relate to patients and their families during their time of vulnerability. I was familiar with the insecurity that comes with poor command of a language and the dependence on others to be truthful and honest. It was by far my biggest asset as a trainee and it allowed me to excel. Most of all, it helped me to be become the type of doctor that I had always wanted to be.
In medicine, passions can be a moving target and we tend to oscillate according to an abundance of advice, often based on other people’s experiences. As residents, we were used to being told what to do and what to avoid. In many ways it made our lives easier but it could also be limiting. My medical school experience, however, taught me that most limits are artificial. I had jumped through innumerable hoops along the way and where there weren’t hoops, I created them. Living abroad had taught me a resilience that could never be learned in a classroom.
Today, I work as a staff at an overcapacity academic teaching hospital in Toronto. I enjoy my clinical and academic work but it would not be enough on its own to ignite my passion as a doctor. What fuels me is the drive to constantly improve in order to provide better care and create a better experience for patients. Many of my colleagues feel the same way but change can be slow, obstacles can be large and people tend to fatigue. My tests of resilience and adaptability in Israel taught me that limits are dynamic and with some creativity the solutions can be found if there is enough determination to find them. My passion for medicine has continued to grow and I welcome each new obstacle as an opportunity to draw from experiences in Israel and the skills that I developed over a decade ago.
William Caryl, M.D., is a General Internist at Credit Valley Hospital in Mississauga, Ontario at the University of Toronto in Canada. William completed his Internal Medicine residency at the University of Toronto. Following residency, he sought opportunities to work with under-served populations in his native Canada. As he administers care to patients, William applies the many lessons he has learned from his time at MSIH.