From Ilorin to the U.S.A with Dr Ifedolapo Arinola

Michael Akande

600-level Medicine & Surgery

University of Ibadan

Can you please introduce yourself?
My name is Dr Ifedolapo Arinola. I am an Internal Medicine Physician in Atlanta, GA.

Thank you very much! We are glad to be doing this with you.
Same here

What’s it like living in the US?
It’s been great with lots of opportunities and room for professional and personal growth. Professionally, it’s an amazing experience working where things actually get done and are not just read about.

That’s something we all hope for. How was Nigeria for you before you left though?
Personally, Nigeria was not as bad as it is now. I left before things in the health system deteriorated to this level. I will always appreciate the opportunity Nigeria gave me and the great minds that taught me. Nigeria was and is still a fun place for me to be, but there are lots of things to be done.

When did you leave Nigeria and in which Nigerian school did you have your medical education?
I left Nigeria in 2014, just after I finished house job and NYSC camp. I attended the College of Health Sciences, University of Ilorin, Kwara State. Working abroad as a doctor

The years have truly passed. How was your medical training in Nigeria?
My medical training was great and pretty intense. Looking back, a lot could have been done differently. My training serves as the foundation of the great physician I aspire to be.

Aspire to acquire your desires, I guess.
Hahaha.

During your training, was there anything that prompted your desire to leave Nigeria? Or was the decision made after school?
Sincerely, I didn’t want to leave Nigeria. The decision was made by my parents and an uncle in the US.  I resisted at first because I was actually supposed to leave immediately after medical school. I fought to wait for house job and my best friend’s wedding. I was even holding a grudge against them sef, for pushing me out (imagine!). Then, two months to the end of my house job, there was a two-month NMA/ARD strike. At that point, I knew I needed to leave and I was glad some people thought of that option for me. Working abroad as a doctor

 If I have this ginger around me, I’ll japa as soon as I can. Did having all these people “pushing” you help with the process of leaving Nigeria?
It most definitely did. Thinking about it, I was slightly stupid then.

Nigeria could do that to a person, honestly. How did you go about the process of leaving Nigeria? And did you encounter any stumbling blocks on the way?
I’ll say the process of leaving Nigeria—the initial part—was already made for me. I was already registered for a Kaplan course in the US. So majorly, what I did was come in, go to the Kaplan to study, take some of their live lectures, prepare for the exams and take the USMLE. I’ll say the major stumbling block was lack of information because no one really knew the process from start to finish, so I was learning about the process as I went on. At Kaplan, an educator talks to you and gives you a timeline for you to take the exams. But I transferred from New York to Houston, where I met more Nigerians. I got more information and realised I didn’t even need as much time to study as I was given at Kaplan—one could actually take all the exams in a year and apply for residency. Then, I didn’t know the process to apply for residency. It was that bad. This is why I take it upon myself now to let anyone that calls me know what it takes from start to finish before they make the decision. Do you want to come to the US or not? Because coming to the US is very capital intensive. A lot of money will be spent and it takes a longer time to get through with USMLE. Sometimes, it’s not a sure thing—you can get into residency here or you might not get into it. There are a lot of technicalities to it. Working abroad as a doctor

I’ll give one major example of a lack of information. When I came in and spoke to the educator I was given at Kaplan, he wrote out this plan for me to take Steps 1 and 2 in a year and a half—probably roughly 2 years—but after a while, it just seemed like a long process to me. With the information I got in Houston, I realised I could do this in a shorter time. I ended up doing all my exams within 7 months and tried to even apply for residency the same year. That just gives you an idea of how you can get different or wrong information some times.

So as always, it’s definitely better to be fully informed on various opportunities so that one would know the best way to go. Was it easier for you while doing it yourself than with the Kaplan group?
I would say that at the end of the day, you have to study yourself. You have to know yourself and know what works for you. How Kaplan majorly helps is that you get the student visa through them and that way, you are legal to stay in the US. I got into the US in late December and started the course early January. I only took their courses in Step 1 but this put me in the mood for studying and kept me on my toes. All in all, you have to study yourself.

Oh, definitely. We still haven’t found a way to just stuff all the knowledge into our brains automatically (sad face over here). Can you give an estimate of the cost of following this process to get to the US? Also, if you can, let us know how you raised/got the money to cover the cost.
Well, I sincerely can’t give the exact amount. Kaplan depends on the course you register for, but if you need them for your student visa while you sort out getting into residency—an average of 2 years—that is $20k and above. You’ll need to sort out accommodation, feeding and transportation throughout this period. I’m not exactly sure how much USMLE exams are. Step one costs around $900; Step 2 CK, around $900; and Step 2 CS, about $1500. Application for residency is an entirely different ball game. Application to programs will cost about $2000 and above. You should also get ready for accommodation, flight and transportation costs for the interviews you get. So, like I said, it varies. And I’m sure they are more expensive now because I went through the process over 5 years ago.

Thank you very much for this.  Those that want to leave would just have to plan for this and more. How does medical education there differ from that of Nigeria’s?
Well, there are a lot of differences between medical education here and in Nigeria. I wouldn’t undermine what we went through because based on our circumstances, we got the best we could in Nigeria at that time. They only offered what they had. One major thing here is the number of medical students per class. At Morehouse school of medicine, where I trained, they just increased theirs to 100 per class and you still can’t compare that with Nigeria that has hundreds per class. Also, here, it’s set up so that you are approved to have the number of students you can handle. The clinical aspect is also different. I know as a resident you have just 2 students—maximum of 3—attached to you per time. So you can imagine how much attention is given to those students, how much exposure they’d have, and that makes a lot of difference. There’s no room for anyone to hide, so you know that everyone is getting the best they can. I also don’t think exams are set up for you to fail. I’m not saying that was what was done in Nigeria but they have a different system entirely in Nigeria. There’s always room for improvement.

One major thing I think can be done is for people that have seen what is being done in other places to help incorporate it into what we have now. The clinical exposure here is pretty intense. It’s not like they have it easy down here. I have medical students here from morning till evening/night but it’s the quality of what they are being taught and the quality of what they are being exposed to. I think they have way more experience than we do but that doesn’t take away from our clerking skills. I’d say our patient interviews in Nigeria are way more intense and we can gather much information; that’s one major thing that still works for me here. We are good at asking questions that are relevant to our patient’s diagnosis. In Nigeria, we don’t do a lot of imaging—patients might not have money to do tests—whereas the practice here is tests and imaging intensive. In Nigeria, with limited options, you pretty much only carry out tests that matter. Working abroad as a doctor

I see. These are important things to note and it’s good to know that we can still carry a major strength to another country if we choose to. If you had the option to move to another country, where would you go to and why?
Lol… That’ll be hard o. I will love to visit other countries (on my bucket list). But the only 2 countries I’ve seen myself live in are Nigeria and the US.

Understandable. With the things that have been going on recently in the US, have you personally faced any difficulties while staying there?
Personally, NO.

Well, that’s definitely a good thing. When you have time off, what do you like to do? What are your favourite spots?
I mostly stay home, binge-watch some series and movies and spend time with my husband. I started residency with six other Nigerians and we have been family since. So we have frequent hangouts on our days off.

Oh, nice. What are your top 3 series if I may ask?
Lol… I don’t have top ones; I enjoy a wide array of them—all American and some ongoing—Scandal, Fifty the series, The Resident, Prodigal Son, 911, The Good Doctor. I just record them and binge-watch.

I’ve only watched Scandal and The Good Doctor here; I should note the others down. What do you miss the most about Nigeria and would you ever consider coming back?
I miss my suya and asun. Just the atmosphere and the people (we know how to jaiye). Ain’t no party like a Naija party.  I will definitely be back to do something to help the health sector in my own little way. That has always been my passion. Moving back… it’s an ongoing discussion to be reviewed with time. Working abroad as a doctor

Suya with the darkness ingredient. Definitely a fave 😂. Have you returned to Nigeria since you left though? And how often?
 Yes, I have. Once per year since 2017.

That’s good. Have a taste of home once in a whole.
Yes o.

On a scale of 1-10, how would you rate your experience in the US and if you got to have this whole journey all over again, would you choose the US again?
9. Most definitely; I would choose the US over and over again.

Awesome stuff. What do you love the most and what do you dislike about medical practice there?
Likes:
Great access to health care.
Having the opportunity to do what is best for your patient, not being limited by tests and imaging (availability of resources).
Professional growth.
Equal opportunity (mostly).
Good structure of the healthcare system and the training of medical personnel.

Dislikes:
Cost of health care (very expensive).
Wastage in healthcare (a lot of unnecessary tests and imaging studies are done because they are available).

Availability of resources is now a two-sided coin. Nigerian Doctors will say a lot of “God when” at the thought of experiencing that.
Haha.

This has been an interesting interview!!! But I just want to know how the food there is compared to our local delicacies 😌? Are they easily accessible there?
It was great chatting with you. Well, I have been lucky to live in cities where they are easily accessible (Houston and Atlanta). I cook great if I can say that about myself; I am a picky eater. The food here is good too but eating out is not healthy, so it’s not a frequent occurrence for me. I am a local girl fa 😂.

Ha. You added “fa”. Where in Nigeria are you from/where did you grow up?
“Fa” is from Ilorin. I am from Ekiti state, grew up in Ilesha, Osun state 😁

Was wondering o. Because I’m from Kwara state (Offa though) and my people say that a lot. We are all one last last.
Abi o. Working abroad as a doctor

Thank you for your time. We really appreciate it and I enjoyed this interview.
You are welcome.

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