AUA Pulse Issue 11

Phi-DE & AMWA Coordinate AUA’s First HIV/AIDS Seminar

Phi Delta Epsilon and the Ameri-can Medical Women’s Association held the first HIV/AIDS Seminar at AUA on July 31st in Classroom A on North Cam-

pus. As students of AUA, we have made Antigua our home for the sixteen months of our curriculum, and we feel that it is

imperative for us, as future physicians, to be as involved as possible with the

community. The rise in numbers of people with HIV in Antigua, as documented by the AIDS Secretariat, has

us concerned, especially seeing the decline in other countries due to extensive public health programs. Of-tentimes, it is a matter of simply getting the informa-tion out there, as you are well aware. The objective of

the seminar was to raise money for the non-government funded HIV clinic in Antigua to help them in their fight

AMERICAN UNIVERSITY OF ANTIGUA COLLEGE OF MEDICINE

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What’s Inside?

HIV/AIDS Seminar..............................1-2Water Water Everywhere....................3To Borrow or To Quit?.....................4-5Students Voice Loan Issues..............6-85th Semester Site Reviews............9-13 Farewell from Khrystal......................14Rumor MIll...........................................15The Prostates of Nevis................16-17DFC News...........................................18The Counseling Corner..............19-20Opinion...........................................21-22Restaurant Review........................23-24

against this awful disease. We hope that this will help

bridge the gap between lo-cals and students. We wanted to show the people

of Antigua that the students of AUA take their responsi-bility to the community that has embraced them seri-

ously. Our list of speakers for the night included Dr. Prince Ramsey, a family

physician and expert on HIV/AIDS and Dr. Lester Si-mon, Chief Pathologist. There was also live testimony from an HIV positive patient. Overall the event was a resounding success, and $1860 EC was raised for the

community. We hope to continue hosting many simi-

lar functions in the future.


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Dr. Prince Ramsey (left) and Dr. Lester Simon at

the event

An HIV-positive patient shares his experiences

By: Gurdeep Singh Nagi

Phi-DE VP and Med 3

Water water ever y where. . . but no t a d rop to f lush

As a baby, I had a tendency to stay up past midnight. In middle school, I frequently read under the cov-ers with a flashlight until 2 a.m. In college, I waited tables in an all-night diner and went to sleep with the sun. Now in medical school, I often find myself up all night studying. This routine has not posed a problem for me until lately. ... Because lately there has been no water on West campus at night.

I understand that Antigua is literally a ‘desert’ island and there is a water shortage everywhere. How-ever, I also know there is a large black water-storage tank back by the parking lot, and that I have never been without water at home this semester. Thus, I wonder why we must suffer through the night unable to use the bathrooms or water fountain on campus. Sometimes the security guards even lock the bath-room doors and tell us the only option is to go home and come back. ... But what about those students who have no transportation, or who live far from West campus? Even for those of us lucky enough to live close by, is it reasonable that we should have to budget in 20 minutes or so for each bathroom break? Factor in the coffee and energy drinks and we are looking at a lot of wasted time.

I also wonder about the lack of communication regarding the issue. I don’t remember receiving any AUA emails this semester regarding the shortage, or what the plan of action is on how to solve it.

I have been communicating with Dr. Bell via email as I write this editorial, and my hope is that he can come up with at least a temporary solution for these final weeks of classes. We have enough stress with Shelf exams, loan applications and everything else. ... We shouldn’t have to worry about going to the bathroom too.


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Katie Schmitz - Med 3AUA Pulse Editor-in-Chief

To Borrow or To Quit?I must admit that this article has been the most difficult to write. From the continually changing news to the ac-tual facts, I have been torn trying to decipher between the truth and what the student body needs to hear. So as many may have already heard the AUA once again has given us a situation that is hard to chew. So to clear up any confusion and clarify all the rumors here is the ultimate reality check.

1. The only loan company for Fall 2009 is Bank of Lake Mills, the school no longer has Ed Invest.

2. For students who have a second distribution from Bank of Lake Mills, the new loan policy will NOT pertain to you for the Fall 2009 semester. Allocation of your funds will be in full.

3. The new loan covers tuition/ fees and gives an allowance of $3000US for semesters Pre-Med to Med 4. All clinical semesters will have an allowance of $4000US.

a. Tuition: $ 10,632 (for Basic Sciences), If a block course is taken then this will be added to this portion of the loan ONLY.

b. Fees are no longer inclusive of health insurance, but this still will remain mandatory for all stu-dents to have.

c. $3000: This amount is not based on average cost of living, but is an allowance given to students to handle miscellaneous expenses. They include but are not limited to transportation, housing, food, repayment of interest on your new loan and required health insurance policy.

4. The new minimum GPA requirement is a 2.5 for all continuing students and a 2.75 for all new. The GPA will not be cumulative, but based on Summer 2009 semester only. The only exception will be in the case of a student’s summer GPA not meeting the minimal requirement, at this time their overall cumulative will be considered.


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5. The new FICO score is a 675 without a cosigner and 650 with. All international students will need a US cosigner.

6. There will now not be the option of loan deferment. There will be an immediate payment on the interest of the loan. The new interest will be calculated based on LIBOR + (6.25% - 9.75%)

7. The origination fee will now be on a sliding scale from 6-8%.

8. AUA Loan/Override will still be available to students who qualify. A minimum GPA of 3.0 is required for eligibility. This will only be available to continuing students and will not apply to new/transfer stu-dents.

I know this may seem like a lot to take in but there are alternative ways to make up for needed money. First, I strongly urge students to use their family and friends to cover the monthly interest rates. I do understand that this is not option for many, so I encourage those to use the next two options. Outgoing SGA president Chris Rhyne suggested that students place the allowance money in a CD account for 3 months at a time. This will help combat some of the interest from your loan with the interest gained on the CD. This will also help you establish a safety reserve for future monthly payments.

The second option is taking on a Master’s program at an online college. The school is currently assisting stu-dents with a program in Health Care Administration MBA from Plymouth State University. This additional pro-gram will allow you to tap into loan programs that currently are not available to AUA students. But this option should be weighed heavily in comparison to your already rigorous med school education.

Remember that “The ultimate measure of a man is not where he stands in moments of comfort and convenience, but at times of challenge and controversy.” (Martin Luther King, Jr.)


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What is life really like after WE leave AUA? We asked all 5th semester students to fill out an evaluation of their site. The star ratings are analyzed based on the last question of the evaluation that stated: On a scale of 1-5, with 1 being the worst and 5 the best, rate the overall quality and educational value of this site. The information provided is based on the students’ personal opinions and in no way reflects the AUApulse or AUA THINC sites. We thank all the 5th semester students who participated and ask those who have been selected for these sites to use this as a guide. Thank You, Khrystal Boone Asst. editor in chief


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Staten Island, NY… Dusan Bosotov

I love NY! It is seriously the best location if you have the drive to learn! We are in the hospital 2 wks in the same dept Monday-Thursday 9am -1pm on average with some exceptions, depending on the department. On Fri we have lecture 1-3:30 or 4 and a very short quiz that doesn’t matter for your grade, it’s just for attendance. In the depts. it’s very laid back, no questions asked, just shadowing and you can learn a lot if you want to. You have all the time in the world to study and to do questions on a daily basis. I am home over the weekends, which means I am not touching the books. If you can organize and follow the schedule, this is the place to be. The dorm over there we couldn't even see because doctors have priority and I got here when residency for the year starts so it was very difficult to get it. I live in SeaView Estates (201 Hamilton Ave, Staten Island, NY 10301), which is 10 min by car. There are about 4 or 5 students living in this apartment complex and some of them are taking the bus, which is like 20 min. The apartments here are very nice and they are a good deal. You can get 4 months where you pay 150 more, 6 months where you pay 100 more and 1 year contracts. I got here when they had a deal that if you sign a year contract, you get the 1st month free, so I did that; I want to do all my rotations here. The prices are 1150 for 1BR and 650 for studio, I think. If you want you can call at 718-815-3334. Ask for Linda and mention my name when you talk to her. Hope this helps, if you need some more info let me know! P.S. The best part is that we are done with clinical rotations on July 31st and we have the ICM Shelf on August 14th and the Comp on August 21st. You do the math!!!


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Miami, FL…

Sim

Q . Please describe your average day and week? A . Mon-Thurs 9-1 Clinicals (Placed in Family/IM private Clinic for entire semester): Consists of

interviewing patients, taking patient histories and the reason for visit. Afterwards I then have to present the chief compliant and other issues to physician when he arrives and learn more about the diagnosis and other physical examination techniques along with treatment for the patient from the physician. Fri Class 4 hours. ( 1hr Case Presentation, 1hr Didactic (Clinical Vinette Review), 2hr Lecture on Organ System.) Sat 1 hr mornings H/P Practical Physical Examination Review. Very Similar to DPS/ICM lab but in small groups of 5 or less.

Q . Do you feel that this site provides adequate time and educational preparation for the USL M E Step 1? Please explain.

A . Yes because you usually get over 8 hours a day to allocate to step1 studying which I have been trying to do. So by the end the month I will have been able to complete about 150hours+ in about 20-25 days or so of solid step1 studying. Educational preparation from the actual classes isn’t as great as it should be if you are not studying throughout the semester. You must have learned something in basic science or at least know the first aid to able to get something out of class or else it will be a bore and totally over your head. It’s fine if one has reviewed the subject the lecture will be one. Also some of the Docs who teach like to provide hints and clues about what might be tested and other high yield information.

Q . How much is your average cost of living? A . Rent: 750 Utilities/TV/Cable Internet: 80 Food: 200-300 Transportation: bus 50-70

Q . Please describe your best and worst exper ience at this clinical site? A . I don't feel there was a "best" or "worst" experience here, at least clinically related anyway. The best thing

about Miami is you get time to study as well as some exposure to the clinical setting. Some people may feel otherwise, but I feel that I have learned quite a bit about how patients behave in front of a white coat and how to find out when they are lying. The coolest thing about being in the clinical setting is you get see the disease or the pathology right in front of your eyes versus reading about it in a textbook. Another great feeling is when a person presents with certain signs and symptoms and you can have a diagnosis in mind that is confirmed by the preceptor or physician. Other than that, I would say Miami has also being operating its 5th semester site the longest so that experience it has does add to its value. I wouldn’t say it is the best nor the worst site AUA has to offer as I have no firsthand knowledge of other sites, so it would be wrong of me to say that. But I will say my goal was to maximize my prep time for USMLE Step1 and I feel I have been given that chance here in Miami to spend my free time after clinicals and class, studying for the USMLE step 1. Southbeach is also an added bonus for well timed study breaks:)

Q . If there is any advice that you could give to students who are considering this site, what would it be? A . Don't buy into hype or rumors and make an informed choice. Please speak to a few people directly at the

sites you are interested in as they can share their own experience at that particular AUA 5th semester site. I am in Miami, and in a nutshell I will say it gives students a lot time to study for my step1 which was what I wanted, well at least for me anyway. I also was able to find a place that is walking distance from the lecture center and near a bus stop that takes right me to the hospital. The city is also really nice and the 5th semester staff also tries their best to keep everyone updated via email of any changes to class schedules or updates. I would recommend Miami to anyone who wants time to study, as there will be a lot of time after clinicals and class to do so. And don't be disappointed if you don’t get the site you want, as Miami was not my first choice as I didn’t have enough information about it, but things happen for a reason and Miami was the best site for me considering my circumstance.


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Atlanta, GA… Reprinted from April 2009

Michael Dixon

Q . Please describe your average day and week? A. Average week: We have two….as we alternate weeks with one week didactic and one week

clinical Q . Do you feel that this site provides adequate time and educational preparation for the USL M E Step

1? Please explain. A. The Didactic week is sitting in a classroom (in AMC) from 9-4 (M-Th) and 9-2(F). The Clinical

week will vary depending on location (there are many ) usually Mon-Thur 8:30-4:30 and Fr 8:30-1:30… I feel Atlanta is heads above the other sites because the didactic sessions are over 95% dedicated time for Step. This is the first site (for AUA) that has incorporated a prep class into 5th and in my opinion is a tremendous asset and success.

Q . How much is your average cost of living? A. My wife and I are paying $850 /month for a two bedroom 2 bath, W/D apt…elec is about $85,

Water is about 55, cable/internet is about 40. Located in Metro Atlanta on the north side next to a river. We love the location and it seems to be fairly centrally located, but not downtown. AMC is 13 miles away but with traffic can be 20 to 40 minutes. You would definitely need a car, to make life easier and to get to clinical, carpooling happens all the time. Chantel tries to match carpoolers with a closer location, if possible to minimize travel.

Q . Please describe your best and worst experience at this clinical site? A. My best experience has been: Tough choice between Dr Sullemon who teaches the didactic

sessions and Dr Bennett who is the director, both have many years experience organizing and teaching international students and Dr B. was one of my clinical attendees. Then there is the rest of the staff who help run the Atlanta program. Chantel is very organized, timely with responses, very friendly and personable individual. {Dr Sullemon has also taught Prep classes on his own and is well versed and has practiced in UK, USA, Canada and knows many of the professors at AUA. He is an excellent instructor and teaches more than 75% of the material from his notes and not ppt. We don’t know what his weak subject is, because we have not seen him weak in any area yet. I think he is an excellent instructor}. My worst experience has been with the NY office and not being allowed to sit for the Comp in February or anywhere else, because they could not find a spot for me.

Q . If there is any advice that you could give to students who are considering this site, what would it be?

A. The only piece of advice I would give is, be prepared to work hard and study long. If you want to slide by in 5th and relax, take weekends off, see every site that there is to see in Atlanta, then don’t come. The Director Dr B and Dr S…love students that want to learn. They don’t like, in fact neither do I, anyone who is looking for shortcuts to medicine. If you want to be prepared to take Step one in 4-8 weeks (instead of the 4-8 months the average AUA student seems to take) after completion of 5th by following their formula for success, then Atlanta is the place to be. The core book they suggest is First Aid and the didactic sessions are built around but also expanded.


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Pontiac, MI… Reprinted from April 2009

Christopher Day

Q . Please describe your average day and week? A . During the week MWF are spent in clinical rotations and Tuesday and Thursday are reserved for

class. Our class is taught by Dr. Yanez and it focuses on clinical medicine with some basic science correlations. Classes go from 8-11 am, the hours for clinical rotations really vary on what specialty you are doing. I have been assigned to Internal medicine (7am-1pm), the clinic (8am-1pm) and surgery (6am-10am). The hours are very conducive to studying on your own.

Q . Do you feel that this site provides adequate time and educational preparation for the USL M E Step 1? Please explain.

A . Michigan definitely provides the students with ample time to study for the step 1 exam. We don't have an exam prep course built into our curriculum like they do in Atlanta, but if you are focused on your own this isn't a major detriment. I am planning on taking the Kaplan retreat after the semester is over and I have had enough time on my own to begin my studying. The lectures incorporated in the curriculum, while emphasizing clinical medicine, do revise many of the topics from the basic sciences.

Q . How much is your average cost of living? A . I live in a single apartment in a suburb of Pontiac. My rent is $560, which includes a carport,

heating, and gas. Electricity and water are extra, but significantly cheaper than Antigua astronomical rates. On average I pay $50 combined for electric and water. Cable and internet from Comcast runs $70 a month

Q . Please describe your best and worst experience at this clinical site? A . Best experience has been in the clinic rotations. Here you and one other student work in the

clinic with up to 5 residents and two attendees. It gives the students a great opportunity to meet doctors in all of the stages of medical education. Additionally you are able to really ask questions and learn a lot from the residents and attendee physicians. The worst experience has just been in the lack of good management by AUA. I get the feeling that if the hospital were able to run the program without AUA's interference we would be better off. For example, our interim exam is composed of 100 questions from exam master. It was mandated by AUA that all students have to bring their own laptops to take this online exam from a q bank that does not reflect what we have been lectured on this semester.

Q . If there is any advice that you could give to students who are considering this site, what would it be?

A . Pick Michigan if you want a good balance between learning clinical skills and study time for the step. From what I have heard other sites either give the students too many hours working in the hospital or don't require them to do anything.


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FAREWELL...The time of year has come again to say farewell to our current Med 4s as they continue their journey to their 5th

semester sites in the U.S. As the current Med 4 class representative, it is my honor to write this message to my class. Yes guys, it’s true - we are now in our final home stretch! I encourage you to not use this time in vain, but rather spend it in reflection. Realize that your memories will consist of good and bad moments, and because of this combination you are now a stronger individual. Know that your period here was for divine right. I hope you will value your education and will not use the fact that you were educated in the Caribbean as a crutch, but as a

unique stepping stone. From the many strange and at times culturally different things that we have all been ex-posed to, the most important keys have been to remain patient and humble throughout it all. I pray that those who are lacking the proper mindset of professionalism will grow up and realize that you will now reflect not only yourself, but the school. To some this may seem minute, but to those coming after you this means the world.

This is also my last article for the Pulse, so to my wonderful head editor Katie Schmitz, you are an incredible person with an exceptional mind. I must admit that at first I was wary about how we would work together, but with many ups and very few downs, I can say that we were an excellent team. I thank you for the opportunity to be your assistant editor and wish you luck in all your life’s endeavors. With that being said, I now have the great honor once again, and for my final time, to say goodbye and good luck!

Always remember, a true doctor’s integrity is not measured based on fame or wealth, but on service and selflessness. With this in mind, please also take the time before you leave to say farewell and thanks to your professors, security guards, cleaning staff, ad-ministration, and SGA representatives, because these jobs are done

with little reward.


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Khrystal Boone - Med 4AUA Pulse Assistant Editor-in-Chief

THE RUMOR MILL:“I heard that one of the organizers of the Harry Potter premiere pocketed half of the ticket sale profits.”

Fact: An organizer of this event did indeed take home 50% of the profits ($5 EC per ticket) while the White Coat Committee received the other 50%.

“I heard that the Pathology II Professor, Dr. Suneet, will not be returning next semester.”

Fact: Dr. Suneet will not be returning next semester to teach Pathology II but may be returning in future semesters.

“I heard that AUA is opening a School of Veterinary Medicine.”

Fact: According to Dr. Bell, I learned that “AUA is on the verge of signing an affiliation agree-ment with Virginia Tech regarding a vet program. The contract is scheduled to be signed next week in New York and AUA will start a vet program in January 2010 at the new campus.”

“Is it true you can take 3 block courses?”

Fact: In an email from Dr. Bell, he stated that "in general the policy is defined in the student handbook but the Dean of Academic Matters can override with my permission of the Deans council in exceptional circumstances.”

“I heard that if a student places him or herself into the extended basic sciences program, their 5th semester tuition will be waived.”

Fiction: Mr. Greenberg informed me that “those students who choose to opt for extended pro-grams will no longer pay more for their education than those on the regular track. With the in-creased pressure to achieve a 2.5 G.P.A. to qualify for the loan program, some students may elect to take a lighter course load. This was the request from second semester students. We felt that if the students felt this would enable them to achieve a higher level of success, they should not have to pay a higher cost for their education. This adjusted cost will go into effect for the September semester.” Perhaps if a student completes Basic Sciences in 5 se-mesters, the tuition they save over each semester may add up to the cost of the 5th semester.

Heard any rumors lately? Wanna know the facts? Email me: [email protected] and I’ll do my best to get to the bottom of it. Tune in next time for more rumors, and more truths!*Note: Issues above have been thoroughly researched and cited. Any questions or concerns should be directed to Vaseem Ahmed at [email protected]


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By: Vaseem Ahmed Med 3

mailto:[email protected]




The Prostates of NevisPart of every medical student’s evolution to becoming a physician involves learning a series of diverse

and challenging physical examinations. Somewhere between fear and fascination lies one of the more

intimidating ones included in this transitional sequence: The prostate exam.

Dr. Thwaites, a urologist holding practices in both Antigua and North Carolina, generously afforded the

opportunity to four AUA students earlier this summer to accompany him during a free prostate examination

clinic on Antigua’s neighbor; Nevis. A team led by Med 4 Amber Milward that included Med 3s Donish Siddiqi,

Raj Shah and Richard Dwyer, began a long productive day at the small Caribbean island nations’ lone hospital.

Liat airline’s alarming predictability to loose their luggage containing medical supplies and professional attire

somewhere during the 15 minute flight assisted the teams’ seem less transition of blending into the friendly laid

back nature of the close to 200 local men, who were waiting patiently in the chairs of Alexandra Hospital’s

waiting room upon their arrival.

Included in irrefutable medical infancy is learning how to appropriately document a clinical history.

Starting with this crucial step, the AUA group enjoyed the privilege of learning the life stories of all the

participating men, whose friendly attitudes and congenial disposition set up the stage nicely for the inevitable

awkwardness all anticipated of the looming “first time.” Only when Dr. Thwaites was comfortable enough with

their professionalism and confidence did he finally grant each student the opportunity with the simply put and

abundantly clear instructions that accompanied the tube of lubricating jelly he offered for assistance; “examine

the prostate.”

Asking him for last-minute advice and the most important thing to keep in mind after cutting our

fingernails, AUA Chair of Pathology Dr. Krishnanand offered the following uncompromising guidance: “Wear

gloves.” Taking that recommendation helped while investigating the unfamiliar environment of a man’s prostate

felt from inside the rectal lumen. In addition, the team also attempted to recall page 674 from Mosby’s 6th

Edition.

Dr. Subhash Shah, a Chicago-based physician and father of Raj, also provided pre-exam direction from

his own experience of more than 30 years of clinical practice. He started by stressing that the examination

involves a combination medical knowledge and social awareness. The exam itself puts the patient in a very

vulnerable position. As a physician, you must have the ability to relax the patient, not only to make the him


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more comfortable, but to actually complete the exam itself. All of the exams performed were in the prone

position with the patient’s upper body leaning forward over the examination table. Before you insert your finger

into the anus ask the patient to take deep breath to have him both relax and to relax the anal sphincter. With your

lubricated index finger insert it into the anal canal at 3 O’clock or 9 O’clock position of the anal sphincter. Both

these positions are the least innervated and will provide the least amount of discomfort for the patient. Once

inside the anal canal you will be able to feel the prostate with the pad of your finger. The goal of the exam is to

get a generalized idea of the size of the prostate and to detect any nodules or irregularities. A normal prostate

should be smooth with a good amount of rebound from the tissue. The combination of the physical exam with

prostate-specific antigen (PSA) testing provides a complete screening for prostate cancer.

By applying these techniques, the event was not only a success, but also a valuable learning experience

for the students. When the future opportunity presents itself during clinical rotations after the Chief Resident

asks who wants to perform the first prostate exam, not only will the AUA Nevis group raise their (gloved)

hands, but they will undertake the examination with utmost confidence.


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By: Richard Dwyer (left)and Raj Shah

Med 3

DFC Raises Money for CharitiesOn July 1st, Doctors for Christ hosted a campus-wide bake sale that required cooperation from the entire student body and all three campus locations. Without incident, the bake sale resulted in a well-organized and highly supported event. Funds were raised for future DFC projects in Antigua, and the organization’s ongoing support of humanitarian aid min-istries in Haiti.

DFC also hosted yet another successful banquet on Saturday June 18th. Thanks to God Almighty, the event not only met but surpassed all expectations. The banquet featured the DFC choir, praise team, dance team, and the Chain Breakers dance troupe from Bible Believers Fellowship in St. John’s, Anti-gua. Individual DFC members also took the stage in hopes of inspiring the audience with their God-given talents and dy-namic personalities.

“Stepping Out in Faith” was the theme for this semester’s show-case. It focuses on how to reach God, and professes how important of a role faith plays in strengthen-ing our relationship with Him. When faced with situations where there seems to be no way out, and all options are exhausted, the best thing to do is to invite God back into your life and to hold on to his Word. Hebrews 11:1 says “faith is the substance of things hoped for, the evidence of things not seen.” When we don’t know the outcome of a situation but we believe that things will play out in our fa-

vor…that is faith.

A portion of the proceeds from the banquet was donated to Hope House, a home for homeless teenagers here in Antigua. Doctors For Christ (DFC) is devoted to enrich-

ing the lives of its members both spiritually and academi-cally. The organization con-tinues to raise funds, and draw support, for a number of outreach organizations in An-tigua and elsewhere around the world. We would like to take this opportunity to thank our sponsors, friends, faculty

members, and colleagues for making this semester a huge success! Thank you and God bless!


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By: Stephen Dada Med 3

James M. Rice, RhD

The AUA Pulse is scheduled to have one more issue to be published soon. I want to write about “survival strategies”, but I am not sure if I need to write about end-of-the semester strategies or beginning-of-the-new-semester strategies. Ironically, when I started to think about it, the various suggestions and guidelines were quite similar. So, I opted to write about both.

As a psychologist, I am often asked to give advice and I rarely do so. I do not presume to know everyone’s situation, their academic status, or their emotional issues. These strategies are therefore general guidelines and recommendations, not specific clinical recommendations. The goal here is to “survive” the end of this semes-ter…or the beginning of the next one. Here we go:

1. Get organized. Develop a study plan and follow it. How much time do you need to study to prepare for an exam, a shelf test, or a quiz? I have no idea—that is up to you to figure out. Some undergraduate programs recommend 3-5 hours of study and preparation for every hour spent in class or lab. And this is medical school. When counseling students, I often suggest the following “benchmark”: How many hours would it take for you to prepare sufficiently so that you can walk into the exam and say to yourself, “I have read the assigned chapters, attended the lectures, reviewed the Powerpoint slides and lectures notes, and I am ready to take this exam.” When students are able to do this, their test anxiety is minimal and they just do better.

2. Stay focused. There are countless distractions here in Antigua—beautiful beaches, cheap alcohol, parties, student organizations, and a diverse culture. Of course it is


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The Counseling Corner “Survival Strategies: How to survivethe end of this semester (or maybe the

beginning of the next one)”

easy to get distracted. In fact, I want to encourage you to be distracted—but not before the big exam, the lab final, or that important shelf exam. Distraction should be a part of your study plan, but it is important to balance those distrac-tions with the study time needed to master the material needed to complete your basic sciences here at AUA.

3. Get enough sleep. One of the biggest problems students exhibit here at AUA is poor sleep habits. I recently spoke with a student who was complaining about poor concentration and focus. I asked this student how many hours he slept at night and he replied, “3-4 hours”. Back home in the USA he reported needing 8-9 hours per night. This student was getting less than 50% of his required sleep, and he wonders why he is not concentrating and focusing in class? We know adequate sleep is associated with improved cognitive functioning, including attention and memory.

4. Address your nutrition. I am not an expert in this area, but I do know that medi-cal students frequently skip meals—sometimes because of other obligations, sometimes to save money. Regardless of the reason, your brain will function bet-ter if it is well-nourished.

5. Exercise. Earlier in this article I mentioned the importance of distraction. Exercise may be the optimal distraction. While reading, studying, and preparing for exams require extensive time sitting (I won’t call it passive), exercise requires you to be active. It gets you up and it gets you moving. You should be aware of the secon-dary benefits of exercise (e.g., endorphin release) and even more important—having fun!

So, whether you are preparing for the end of this semester or beginning to prepare for the next one, all you need to do is get organized, stay focused, get enough sleep, and address your nutrition and exercise.

Of course, while doing all this, you still need to pass your classes.

I know it’s tough. Keep at it.


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By: James M. Rice, RhD

Associate Professor & University Counselor

Opinion Page:The Public ‘Option’: A Prescription for Failure Americans voted for Barack Obama because they wanted “change”. One ‘change’ Obama and many of his Democratic col-leagues up on the Hill want des-perately to implement is a change in the way healthcare is provided and paid for. In short, Obama is hell bent on becoming a major player—if not the only player—in America’s healthcare industry. Before that happens, it might be a good idea to look at our govern-ment’s track record in running economic enterprises. It is abso-lutely horrendous.

In 1913, while the Balkans were fighting against the Ottoman Em-pire in the First Balkan War, the U.S. government was busy strengthening its naval forces. The federal government figured it was being overcharged by private steel companies for armor plate needed for battle-ships and estimated a government-run plant could produce armor for only 70% of what the steel companies charged.

When the government-run steel plant was finally finished—three years after WWI ended—it was millions over budget and capable of producing armor plate at twice what the private steel companies charged. The government’s plant produced one batch of steel and then boarded up its windows, never to reopen.

In 1965, the federal government enacted Medicare, which is no different economically, other than the source of its premiums, than a regular health-insurance company. Unlike Blue-Cross or UnitedHealthcare, however, Medicare is a bureaucratic nightmare, riven with waste and fraud. The U.S. government spends $800 billion a year on Medicare and Medicaid, $60 billion of which is estimated to be lost to fraud. Last year the GAO (Government Accountability Of-fice) estimated that at the very least, one-third of all Medicare disbursements for durable medical equipment—such as wheelchairs and hospital beds—were improper or fraudulent. Medicare was so lax in its oversight that it was approv-ing orthopedic shoes for amputees. That’s not a joke.

These examples are not aberrations; they are typical of how governments run enterprises—into the ground. The rea-sons why government is incapable of running a lemonade stand, much less a multi-trillion dollar industry, are numer-ous:

1. Governments are run by politicians, not businessmen. Politicians are only capable of making political decisions, not economic (or logical) ones. They are, after all, first and foremost in the re-election business. And because they


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need to be re-elected, politicians always have a short-term bias. What looks good right now is far more important to politicians than long-term consequences, even when they are easily foreseen. The snowballing disaster of Social Se-curity, Medicare, and Medicaid has been obvious for years, but politics has prevented needed reforms.

And politicians always favor parochial interests over sound economic sense. Consider the following scenario: There is a national water shortage and Senator Pellegrino is chairman of the Senate Water Committee. There are two technologies that are possible solutions to the problem, with Technology A widely thought to be the more promising of the two. But a company that has been developing Technology B is headquartered in Senator Pellegrino’s state and employs 15,000 workers there. Which technology is Sen. Pellegrino going to use his vast legislative influence to push?

2. Politicians need headlines like alcoholics need Johnnie Walker. Executives need profits. This means politicians always have a need to do something (“Sen. Pellegrino acts on the Water Crisis!”), even when doing nothing would be the better option. Markets will always deal efficiently with gluts and shortages, but letting the market work does not produce favorable headlines and, indeed, often produces the opposite (“Sen. Pellegrino is Nowhere to be Found on Water Crisis”).

3. Governments use other peoples’ money, whereas corporations play with their own money. Private enterprises are wealth-creating machines in which various people (labor, managers, and investors) come together under a defined set of rules with the goal of creating more wealth collectively than they could separately.

A labor negotiation in a private enterprise is a negotiation over how to divide wealth that is created between stock-holders and workers. Both parties realize if they drive too hard a bargain they risk biting the hand that feeds them. Just ask General Motors and the United Auto Workers.

But when, say, a public school board sits down in the conference room to negotiate with a teachers union or de-cide how many administrators are needed, taxpayers are taken to the cleaners. Before Mayor Michael Bloomberg (a career businessman worth more than $20 billion) was elected in 2001, the NYC public school system had an administrator-to-student ratio 10 times as high as the city’s Catholic school system. Why would the public schools need 10 times more paper-pushers? There is no logical reason. But the government does not need a logical reason to do anything because it has no higher power to answer to. If I didn’t have to answer to American Express or the IRS, I’d have 10 Ferraris, 5 mansions, a trans-oceanic yacht, and a Gulfstream G550.

Obama says the healthcare market “has not worked perfectly.” Indeed. Only God, supposedly, and Wrigley Field, ac-tually, are perfect. Anyway, given the heavy presence of government regulations, the market, such as it is, is hardly free to work.

Regarding reform, fiscal conservatives like me are often accused of belonging to a party of “no.” Fine. That is an in-dispensible word in politics because most new ideas are quixotic and mischievous. The proposed healthcare “reform” bills are no exception. Furthermore, the First Amendment’s lovely first five words (“Congress shall make no law”) set the negative tone of the Bill of Rights, which is a list of government behaviors, from establishing religion to conduct-ing unreasonable searches, to which the Constitution says: No!

Nowhere in the Constitution does it mention a “right” to healthcare. Absent a change in that sacred document, Obama and Congress have no business intro-ducing one.


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By: Jeffrey Wilson Med 1

A Rave Review for Trappas Bar in English Harbor

Word of mouth recommendation has been my primary means of trying out new eateries in Antigua. But this of-ten leaves more to be desired, as students tend to only try out so many places. After being a regular at Subway, KFC and occasionally Papi’s (if one’s stomach is up to it), the list runs thinner and thinner as we entertain other, wilder options.

In nearly three semesters of searching for a good place to eat, my roommate and I finally found one, and quite appropriately, it involved the spirit of exploration. Two days after the Behavioral Block started in April, we had our first mini, and being satisfied with the grade for hours worth of studying (enter sympathetic comment for those souls braving regular semester Behavioral Sciences), we needed a good break. At the same time, our minds were elsewhere. So perhaps with the goal of making up for lost time during spring break, when it came time to turn right at All Saints Road to head to Casanova and have a celebrated chicken platter, we opted for the left turn that pointed to English Harbor. Twenty minutes later, we were even more famished, but found our-selves in the most scenic part of the island. The majestic sights only quelled our hunger for so long, until we drove down to the Dockyard where a lively port and its denizens went about their business.

We approached two of the maritime folk and asked what the best place to eat was. They replied that after dusk they were headed to Trappas, which is one of the best eateries in English Harbor. We decided we would do as the natives and walked in. The place required reservations but after explaining it was our first time and we had driven all the way from Coolidge, the hostess graciously let us in and asked kindly if we could be done by 8:30 when the larger crowds with reservations arrived. We were hungry enough to eat in the first hour so we had ab-solutely no complaints.

From the get-go Trappas had our hearts, and I doubt that will change anytime soon. Upon being seated, we were presented with an easel that had the menu in chalk writing! The place was set on an appropriately lit but cozy


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enough setting that screamed Antigua; at the same time, the atmosphere was like an exotic restaurant in New York City. The menu, our waiter explained, had a set of items for each group, the starters and entrees, and des-serts. But each item name has below it a list of ways to customize the dish, essentially allowing for it to be pre-pared anyway the patrons desired. The starters were $24EC each and ranged from beer battered scallops and shrimp to prosciutto.

The main dishes were the highlights of all of Antiguan cuisine with the various fusions that the culture has to offer. Take the Thai Red Curry cooked with an option of chicken, beef or shrimp. This luscious dish was simply to die for, had hints of Thai food and hosted an intimate mix of West Indian curry and traditional Indian spices. The item we tried from the main courses was the 8 oz. steak. It was clear from how little we spoke during the meal that every item was on point. “This 8 (oz) feels more like a 10,” was all my roommate could utter. Each item on the entrée menu is priced at a flat $48EC.

On successive trips to Trappas, almost biweekly, we have had the pleasure of trying out other mains such as the Blackened Mahi Mahi, the Big Angus Burger, the Tomato Basil or Creamy Pasta, each with their unique blend of culinary perfection that has yet to be replicated in places such as the Sticky Wicket, a place most of us are familiar with.

The dessert is on an entirely different level. Only when one could be no more satisfied from a meal, the dessert menu is introduced; it, again, trumps all other eateries. My mother used to say presentation is key, and Trappas has presentation at its peak by serving each dessert item in a glass boat accompanied by ice cream. Desserts range from the Rum Cake to the Chocolate layer cake to the superb Key lime Pie.

We have tried the atmosphere of Trappas for small group trips and for birthday dinners, and each time the serv-ice is perfect. The hostess, Carline Tranter, who owns the restaurant with her husband and chef Simon, comes over frequently to check on the patrons and makes sure they are well taken care of. But the amazing food and the successive devouring makes her queries seem almost like interruptions.

The trip to English Harbor just to dine is worth it for Trappas, but for those of you concerned about the distance, fear not. Trappas is located within 12 miles of our Jasmine Court Campus. The drive through the various hills and the parishes outside of St. John’s provide ample scenery through quiet towns like Liberta. (AUA Trivia: For which town does ICM/DPS professor Dr. Simon coach the children’s cricket team? Answer is in the previous sentence). There are old churches and ruins that are evident as you drive through approaching Nelson’s Dockyard at the apex of English Harbor. On approach down the last hill, you will pass through a portion of the Nelson’s Dockyard National Park, which should quell those of us nostalgic about summer family road trips to state parks at home. Please bring your camera. The pictures to be taken are enough to make any friend back home jealous of our island schooling.

When asked about this upcoming review and requesting a discount, Mrs. Tranter has graciously agreed to take care of AUA students when we arrive. So go plentifully and enjoy. It is also recommended that you make a reservation as early as possible by calling the restaurant at 268 562 3534 or via email at [email protected]. Bon appétit!


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By: Mamunur Rahman Med 2



AUA Pulse Issue 11

Documents

Transcript of AUA Pulse Issue 11