Trinity School of Medicine has always prided itself on the strength and ambition of its students. So many future physicians come our way looking for something new; whether that's a unique learning environment built on support and a strong relationship with the faculty, a curriculum with an emphasis on clinical skills and service to patients, or just a true opportunity to live up to their potential.
In this latest edition of our alumni spotlight, meet Dr. Jennifer Young. Read about attending Trinity, the opportunities and perspectives she gained from her time there, and what brought her from Hamilton, Ontario to Ohio's Cleveland Clinic as an interventional radiologist fellow.
What brought you into medicine?
I had considered becoming a doctor, but I had no idea how to do so. I come from a family of construction workers, but I really loved studying science in undergrad (Dr. Young has an MS in biochemistry and biomedical sciences from McMaster University in Hamilton, Ontario). At one point, I was studying at Osaka University on exchange. While I was there doing research, I met a few doctors and honestly, they were amazing people. They were dedicated, compassionate, truly cared about their patients. At that moment, I realized I wanted to study medicine. I was able to find an English copy of the MCAT book in Osaka, and ended up writing the exam there in Japan.
What brought you to Trinity?
Actually, part of the reason I was looking at Caribbean schools in the first place was because in Japan, the term of study (semester, quarter, etc.) is off kilter from the traditional North American timeline. Because I didn’t have my final transcripts from Osaka, I would have had to wait a year to apply for the next year. It would have been two years lost. I thought, "No, I can’t do that. It's a huge waste of time." And Canada is so competitive, I wasn’t even guaranteed a spot in medical school there even if I did wait.
While I was researching schools, Trinity held an info session in Ontario. I attended and got a really good vibe from everyone I met. The administration was really friendly and very genuine. They weren’t trying to hide anything and were very on point about what Trinity was offering. At the time (in 2009), Trinity was a new school, they had no reputation. They admitted that it might be challenging for us. I appreciated the honesty. So, I applied, and they accepted me and that was it, off I went! I wouldn't have to wait those two years. I could start almost right away. I actually skipped my undergraduate commencement ceremony because I was already on St. Vincent starting medical school.
My family is actually a "legacy" at the school, too. My brother is attending Trinity right now and about to take Step-1 and head to Baltimore for his clinical clerkships.
There's honestly so much, I need to break it up a bit into different areas. First, there was the clinical side of things.
As students from more wealthy countries going into Milton Cato [ed. Trinity's affiliated teaching hospital on St. Vincent], to us, the hospital felt under-funded and under-staffed. We watched the doctors basically perform miracles every day. Their physical exam is on point. It really is exceptional and something that's lacking in some North American hospitals.
Even speaking as a radiologist: we rely heavily on CAT scans, MRIs, imaging, etc. They didn't have that at Milton Cato when I was there. As a result, we got a really, really strong foundation in physical exams. I once watched an attending smell the air and notify the staff that a patient had c.diff. They knew immediately and found the patient, it was incredible. My residency is at a community hospital and trauma center next to Cleveland Clinic. We sometimes feel under-funded compared to the main facility, but in St. Vincent I watched doctors without access to IV antibiotics work out how to administer crushed and diluted pills through an NG tube to treat infections.
Another thing I'll carry with me is St. Vincent English [ed. note: St. Vincent is an English speaking country, there can be heavy dialect features from a unique St. Vincent Creole]. When you first get to the island, you don't yet have an ear for it. Taking a medical history is challenging enough as a first term student, but going to the hospital an speaking to Vincy patients added an unexpected challenge. We had a very smart Vincentian classmate who we were always happy to be paired with at the hospital because she could "translate" during those early interactions with patients.
That early interaction in the hospital within the Vincentian community that welcomed us makes students pragmatically aware that not everyone has the same language, education, or culture. Communication can be a bigger problem then the medical treatment itself as a barrier to diagnose and give that treatment. For example, when I was in a family medicine elective in Chicago, our patients were primarily Spanish speaking, so it was necessary to learn at least a handful of Spanish words. Or in Detroit, different socioeconomic classes would use slang words that were completely foreign to me. So, starting early on, whether in St. Vincent or in the USA, I learned a lot of useful ways of to communicate that I still use in my everyday practice.
Incredible. Does that influence how you practice now?
I think that the fact that I know it’s possible to make diagnoses without the high tech imaging is still applicable for me as a radiologist. If no imaging is available for interpretation but the clinicians are still pushing for radiologic procedure, I have a cultivated ability to read the notes, see the patient, look at the labs, and still help the team come together to direct management. It's a complex and serious process, but I don’t feel intimidated.
What about the community?
When I was in school, I was the SGA president [ed. Student Government Association] after the first president, Chris DeNapoles. In addition to the workload, we were always having events and making plans. There are just so many different personalities that come to Trinity, it makes the place unique.
Practicing in the States, either rotations or now near the end of my residency, intermingling with students from US schools, I've experienced a more standard personality type among them. Driven, very type-A. They fit into the stereotype of medical students that I think most of us picture. At Trinity, a lot of people there came from a different walk of life, a different job, or a different academic background. It was a non-traditional mix of people and perspectives. The one thing we all had in common was we wanted to be doctors. My colleagues at Trinity had such a dedication to what they’re doing, it really went against the reputation of Caribbean schools, people that "couldn't make it" in US schools. It was people that weren't given a chance to "make it" in US schools and Trinity gave them that opportunity and support.
When it comes to becoming a doctor, Trinity students really want it, and they're dedicated to making it happen. To this day, it's the most well-rounded, interesting life experienced I've had. It's an environment that brings so much to medicine that I just don't see now as a resident in other populations. Piggy-backing off of that, it makes for fun interesting interactions at every facet of life, so much personality walking around on campus.
One of our almost daily traditions was a super aggressive volleyball match played around 5:00 PM almost every day. It was how we would release all our tension. Throwing sand, kicking, any rule was totally out the door, you just had to get the ball over the net. We would have a blast. People would also play Ultimate on the steep hill on campus, they called it the "Aggro Crag" and would switch who was playing uphill between points.
Beyond that, a colleague of mine named Amie was the glue of our term, and she made it a point that we would have "Uni Breakfast," [ed. referencing the unified exams] the day before we took each of our exams.
We’d have a buffet breakfast, we would just make pancakes, and waffles, and everything. All morning, students would stop by and eat. It was such an important gathering for everyone, a way to wind down and enjoy each other’s company for a moment. There was no obligation; hit the buffet and go to the library or stay around for a chat, whatever you needed to do to succeed. Our apartment was like that; there was a lot of seating we’d collected over our time there, it had a cafe vibe.
You're actually finishing up your residency. Would you like to talk about it?
Sure! I'm a radiologist with one year left before my fellowship in interventional radiology starts. Radiology is one of those rare specialties that you actually have to match into twice. Once in another related specialty for an intern year, and in the radiology core residency itself. It's double the interviews, double everything. Two programs pick you in the same year, one you go right away, the other has a delay because of that first internship.
I did my surgical internship at at Wayne State-Detroit Receiving Hospital, and it was a wild ride. It was trauma surgery, so it was very exciting. Thirty hour shifts, trauma call, and I saw a lot. Gun shots, stabbings, car accidents, drug overdoses, those were the norm because we were the trauma center. Those were some of my best memories in medicine, running to trauma bay, running triage, learning the independence I still value.
Radiologists can be a bit more timid about procedural medicine sometimes, but if we are doing a lung biopsy that results in a pneumothorax, I can quickly treat it by putting in a chest tube and save a life. These are the sorts of skills that make you feel good about being a doctor. I got to cultivate a lot of those emergent skills in that intern year, which have proven useful as I aimed my career towards interventional radiology.
Any stand-out memories from that surgical year?
Yes! I coiled three splenic lacerations in the same night! It's still a record at the hospital. I was on trauma call that night and had to go in around 11:00 PM. I got called back in after that, and as I was leaving after coiling the second one, a third came in. All three were unrelated car accidents.
What made you consider radiology in the first place?
Dr. Ambrose [ed. attending radiologist at Milton Cato Memorial Hospital in St. Vincent] brought me into radiology, actually. I didn’t know anything about radiology beyond the basics before I met her. On the island, we did a learning-rotation through the radiology department. Dr. Ambrose has a very gruff demeanor, but she's incredibly dedicated to what she's doing. I liked her immediately. Without much explanation, she put an x-ray up, shows us the costophrenic angles, the cardiac silhouette, and throws up another beside it. She stares at us and says, “What's wrong with this one?”
One was normal, the other abnormal, and as I was going back and forth it reminded me of playing Where’s Waldo? as a child. When I found the abnormality, it was love at first sight. I knew I wanted to be a radiologist. I read up more on the specialty, and got to know the anatomy, and came to love diagnostic imaging. While doing extra electives with Dr. Ambrose [ed. this is still during basic sciences on St. Vincent] and then rotating in the states, I kept learning more and more. At one point, the attending back in the US was walking me through the hall and we went by an interventional room. I was instantly captivated: the technology, the patients, the work, it had me.
I suppose I had a step-wise progression to it as my education continued. I didn’t know from the beginning what I wanted to do, but it all fell into place. I feel very lucky to have discovered something I was so passionate about within medicine.
Any advice for current or future Trinity students?
Do it. If you want to be a doctor, just do it. It’s 100% worth it.
Caribbean students have to hustle a little harder, but honestly we're already used to it, so just get out there and shine. That said, there's a lot in our advantage, too. One thing way in our advantage, especially at Trinity, is the breadth of elective opportunities available. Trinity's clerkships coordinator works very hard to help students find away-rotations nearly anywhere, if they're interested in pursuing them. I actually took five radiology electives in my last year and went to all different hospitals. Radiology departments all over knew who I was, so when it came time for residency match, they knew me and ranked me well. That was a huge, huge advantage over US students who often just stay put at their school's hospital, maybe doing one away rotation nearby, and that's it.
Another thing: Take advantage of any visiting clinical professors when you're on the island! Your teachers know and work with people and are network connections for Trinity students. One faculty member, Dr. Welsh, our hem-onc professor [ed. hematology and oncology], helped jump start my research at Rush in Chicago. He didn’t owe me anything, but he was my teacher and there to help us, so he helped. Speaking frankly, the Trinity faculty is so nice, so helpful; I’m far from the only one with that story. They really do have a lot to offer "back home" and are always happy to help the students.
I have to say, one disadvantage to training abroad (and this already might be different for newer students), is nomenclature. A lot of what's shorthand for US medical students by nature of studying in the US for those first two years, we had to be pick up when got to our clinical rotations. For example, I actually showed up knowing how to place an NG tube, but I hadn't heard it referred to as a "Dobhoff" until I got to the US. The hesitation of needing that clarification sometimes gave people the wrong impression that I didn't know a basic concept. I knew it, just by a different name. Similarly, I wasn't trained on EMRs prior to starting rotations and didn't know how to quickly access the numbers I was asked for from the labs.
Really though, the people, the faculty, the opportunities? You can't beat it. My starting term was six people. If I didn’t show up to class, the professor would send students to my door to check on me. We were held so accountable at Trinity, there was no escaping it (in a good way). It’s such a family environment, and it's an unusual family made up of people you wouldn’t really reached out to or have otherwise gotten to know. At Trinity, you come together as a unit in a deeply connected way, and the people that were my classmates, I still talk to every day in a group chat. The bonds I made there are life long.
Thank you so much for your time, Dr. Young, and congratulations on your upcoming interventionist radiology fellowship at The Cleveland Clinic!