Delivering Babies in Honolulu and Taking the Test in Chicago

Northwestern Medical School prided itself in all its clinical departments, the strength of their faculty and teaching abilities, as well they should. A right for a Top 20 medical school in the rankings, for what they are worth. In particular, they were particularly proud of their Obstetrics and Gynecology and Pediatrics programs. Oddly, they were also the only two rotations available to students in the Army Health Professions Scholarship Program (HPSP) for “outside” rotations. HPSP came about when I mentioned to my father my third year of college that I wanted to go to medical school. He asked me “So? What do you want from me?” I replied, “Well, it takes time and money”, to which my father replied “You have more time than money so join the Army.” And that is how that happened. Ironically, when I wanted to join the Marines after high school, my parents did not support me joining the armed forces – until they paid for medical school…

Anyways, I did my pediatrics rotation in Chicago when Children’s Memorial Hospital was in Lincoln Park and rode my bike in December and January from downtown to get to the hospital. You haven’t lived until you ride a bike along Lake Michigan in January.

So when it came time for my Ob/Gyn rotation in February and March I opted to do my rotation at Tripler Army Medical Center (AMC) in Honolulu and get a break from the winter. Tripler AMC is a large coral pink building overlooking Oahu with Pearl Harbor in the distance. There were some Dole banana plantations a few miles away.

As the only medical student on the service, I would work in the labor and delivery ward from 7 PM to 7 AM, than assist in the gynecology clinic doing routine well women visits, pre-natal check ups and sick call for a few hours and the rest of the time was mine until 7 PM again. For nearly 7 weeks I played golf nearly everyday after finishing up in the clinic before my night started again. The Army, Navy, Air Force and Marine bases on Oahu all had excellent golf courses available anytime as long as there weren’t any generals scheduled to play for around $7 a round as I recall. Working nights and playing days resulted in my skin turning the color of the outside of a coconut. Weekends were spent taking low-cost commercial or military hops to Kauai, Maui or Lanai or the “Big Island” for more golf or snorkeling.

I learned a ton and did a ton, delivering babies nearly every night on a busy labor and delivery ward that performed over 3,000 deliveries a year. I also presented a lecture to the Ob/Gyn staff physicians and residents on cervical cancer, taking pictures from the pathology department of low-grade and high-grade dysplasia and invasive carcinomas.

In the end, I received high marks and praise for my service and while I enjoyed the experience, learned that it was probably not going to be my career choice. Nonetheless, I returned with a grade of “Honors” on my clinical rotation back to Northwestern.

Back in Chicago, there was a written and oral examination required to complete the Ob/Gyn rotation. The oral examination did not start very well. I walked in with my coconut tan and was immediately asked by one of three attendings in long gray coats “Where the hell have I been?” I told them Hawaii. They were not pleased. The first question was “What famous comedian died of ovarian cancer?” I responded with “Gilda Radner”. I don’t think I learned this on the rotation but I recalled her premature death to cancer. The attendings were not pleased. This was followed by one of them sliding a speculum across the table and asking me to demonstrate its use. In thin air. I did that. The next 18 questions were a blur but I got through them. Then I completed the written exam. Apparently I scored very high on these as well, including receiving the highest score on the oral examination for the group that completed the rotation during that time.

When final grades came out, I received a “P” for “Pass” rather than an “H” for “Honors” as I thought I should have given my clinical performance and test scores. When I questioned the dean about this and the matter was investigated, apparently the department thought I should only receive a “P” since I completed the rotation elsewhere rather than on the Chicago campus. I argued this made no sense if I completed the exams with higher scores than my peers, I must have acquired the necessary fund of knowledge, if not exceeded it, regardless of where I completed the rotation, tan skin or not. I went back and forth with the department arguing I should receive a higher grade than was given originally.

Ultimately, the grade was changed, shortly before graduation, after having matched for internship months prior. As a matter of principal, it worked out but I think the department reluctantly did so, perhaps thinking that students who completed their rotations elsewhere could not be as successful without being trained by their own attendings. But the training I received in the coral pink hospital proved differently.