By Maria Jose Salinas, VIDA Interpreter in Nicaragua

Hello everybody my name is Maria Jose Salinas, I am a medical student in Nicaragua, and I have been an interpreter for VIDA Volunteer Travel for a year now.

Working for VIDA has been a wonderful experience for me because I get to know the med student volunteers and get to share experiences with them. I also get to enjoy the humane part of the career I chose, as VIDA assists in very poor communities where sadly health is not really a priority for everyone. I also get to learn from the experience of the Nicaraguan Doctors who also give their time and their love by volunteering for VIDA.

Being a medical student in Nicaragua has been a great opportunity for me to help people with their health care, not really for the money I would make when I become a Doctor, as many of you may think. Here in Nicaragua, as in many developing countries, this is a career of love, due to the fact it is not well paid.

Last year, I spent my 5^th year of Med School at the Maternal and Children’s Hospital “Fernando Velez Paiz”, which is a public hospital in Managua. There, the medical assistance and medications are free for the people. Being there was an awesome adventure for me, because I felt that I helped so many people, like never before in my life. I assisted as a pre-internal doctor under the supervision of many specialists, and helped many pregnant women and many children in need. I felt blessed to have the chance to help so many people. I had patients with leporine lips, infantile cerebral palsy, assisted deliveries for many pregnant women, and much more.

Now, let me explain how medical schools work here in Nicaragua:

1. There are Public schools like UNAN (Nicaraguan Autonomous National University of Managua, in Managua and Leon) where the admission process is a little difficult because you have to pass admission tests that include math exams, Spanish exams and a psychometric exam. If you pass these three exams with excellent grades, as well as senior grades, then it means you are qualified to study medicine in this school and you will be admitted. If the grades on your admission tests are not in the range to qualify for medicine then you have the opportunity to select a second career option and you could be admitted for that one. However, if your grades are not good enough for any one of those two you selected, then you are not accepted. You must go to another university or come back next year for another tryout.

If you are admitted at UNAN, the education is free; you just have to pay for enrollment each semester. The medical career lasts eight years in public schools (5 years of medical studies, 1 as an intern, and 2 of social service in the communities).

In the social service the Health Ministry in Nicaragua (MINSA) distributes the students according to their places of origin or according to their preferences, in case they want to serve away from their homes. At this point students start to work as doctors in hospitals and health centers.

2. On the other hand there are also Private schools (like American University, Catholic University, Military School, etc.) where the admission process is less complicated than in public schools, but you have to pay the fees they each set for the career, including the enrollment and monthly payments.

The difference between public and private is that the private schools don’t do the two years of social service; they just do the internal year for a total of six years of study to become doctors. The internal year is also in many cities of Nicaragua, wherever the school sends them to provide services. The faculty’s curriculum is almost the same in Private and Public School.

I would like to explain a little about my experience during the five years I have spent studying at the Catholic University:

—In the first year we start by taking general classes like math, statistics, biology, chemistry, anatomy.

—In the second year we learn how wonderful this science is, and we start to learn how the body works in physiology class. We also learn about the tissue’s composition of our body in histology class, how we grow up in our mother’s belly in embryology class, and also epidemiology, where we learn the impact of the most common diseases all over the country and America in general. This allows us to compare what disease is most common or learn if we are expecting a disease that may cause a large impact in Nicaragua.

—In the third year we continue learning about the beauty medicine in classes like parasitology, microbiology, pathology, immunology, semiology (science in which we learn how to do physical exams on patients so we can determine the patient’s diagnosis based on their signs and symptoms). This is the year we start to go to hospitals and practice.

—In the fourth and fifth years we do clinic rotations in hospitals in departments such as Internal Medicine, Surgery, Gynecology, and Pediatrics.

—And in the sixth and last year we do the internal year, which is when we are able to treat patients repeating the four medical rotations I mentioned previously. Then we become doctors!

Once we become doctors, we can apply to any residencies in the country, but in this case there are not private schools, just public ones. We have to go to UNAN University and apply for the residency of our choice. It is always important to have good grades from the first years of the degree and we must take general exams where they evaluate topics from the four rotations (Internal Medicine, Surgery, Gynecology and Pediatrics). If you pass that exam, you get accepted into the residency! In Nicaragua there are many spaces for Internal Medicine, Surgery, Gynecology and Pediatrics, on the other hand spaces for Dermatology, Ophthalmology, Pediatrics Surgery, Plastics Surgery, are more restricted.

I think Medicine in Nicaragua differs from the United States and Canada in many ways. First, the fact that in Nicaragua people have the opportunity to study medicine and not pay anything other than the enrollment. There are also opportunities to get scholarships and the University helps the students by giving them places to live, food and some cash, as long as the student receives excellent grades throughout their studies. On the other hand, I have heard and researched that in United States and Canada med students take four years of premed studies and then start medical school, which is great because student know more about biology and chemistry. (Correct me if I’m wrong!)

This is as much as I can share for now, I’ll begin my 6^th year in March 2013, I’ll keep you posted. Hope you enjoyed my article, and if you are a medical student always remember:

“Let food be your food and food be your medicine”. Hippocrates

“Wherever the art of medicine is loved, there is also a love of humanity”. Hippocrates