IMG Spotlight: Dr. Christopher Morris

My Experience as a USIMG
By Christopher Morris, MD

In the 1970s the US medical hierarchy was concerned that there was an excess of medical trainees; as a result, a limit on the number of medical students, as well as the number of federally funded residency and fellowship positions was put in place.  The numbers did not change over the next decades; as a result the number of physicians needed in the US has not kept up with the demand of the rise in population.

Unlike many of my peers in college I was lukewarm about going to medical school; during summers spent working in immunology labs I developed a love of the subject and considered a career in research.  While in graduate school I realized that I was too much of a “people person” for bench research and developed a desire to go to medical school.  Unfortunately, I was applying at a time when there were 9 applicants for every medical school position; while I had my interviews, the numbers were against me.

My father and I had a heart-to-heart discussion about my options; as a result of his experiences working with graduates who had trained in Guadalajara, Mexico, I applied and was accepted at the Autonomous University of Guadalajara (UAG).

I was not a stranger to the Mexican culture; as a child my family visited an aunt and uncle who lived in Mexico City, and my family also spent a month in Cuernavaca twice.  Still, living and studying medicine in Guadalajara provided me numerous experiences not available to US med students.  Performing a good history and physical examination at UAG was reinforced upon us from our first semester, and this has proven to be valuable to me as a rheumatologist. When I visited a former mentor at a US medical school I described my physical diagnosis class experiences during my first semester; a colleague of hers who turned out to be the Pediatrics chair bemoaned that when asked about whether a patient’s liver was enlarged the chief resident replied, “the ultrasound report was not back.”

My training in Mexico provided me experiences that were not available to most US trainees. During my dermatology rotation we saw patients with tuberculoid leprosy skin lesions.  As medical students we were expected to work in outreach clinics from day one.  One of my stints was spent at a clinic located in a village on the floor of a canyon in northern Jalisco; access to the town 60 miles away as the crow flies from Guad was either via a nine-hour bus ride or a bush plane flight that landed on a dirt airstrip, and apart from the clinic generator the village had no electricity.  We flew into Huichol Indian villages on the sides of mountains to provide “house calls,” and provided the only allopathic care readily available to them.

Not all of my experiences were positive; while in Guadalajara we Americans had our lives turned upside down when a US Consulate official there was abducted, tortured, and murdered by a drug cartel.  This had us all looking over our shoulders wherever we went.

I have realized that my experiences in Mexico has actually helped me feel more at home in the southern Appalachian region of the US.  The “low tech” life in the Southern Appalachians can be closer to the Mexican lifestyle than those living in the “canyons” of Manhattan.  As a rheumatologist, the importance of a good history and physical examination cannot be overestimated.  I regularly explain to residents rotating in my office that the best diagnostic tools we have are our eyes, ears, and hands. Overreliance on advanced lab and imaging studies can lead to delays in diagnoses that might be readily picked up by a good diagnostician.

The latest innovation we are facing is artificial intelligence, or “AI.” I recognize the potential that AI has to help our patients; however, I feel that this also has the potential of becoming a situation of “GIGO,” garbage in, garbage out. We need to make sure that assessment of a patient’s health problems includes a thorough problem-directed history, followed by a physical exam focusing on the patient’s signs and symptoms.  The diagnosis of rheumatologic diseases is based on a combination of medical history, physical findings, lab and radiographic results, not just a positive autoantibody study.

I recognize that there are differences between the US and Mexican cultures, and each has its advantages and disadvantages.  Often things are not always better or worse, just “different.”  These differences have made me a better physician, and I will always cherish my time I spent “South of the Border.”

 

Dr. Morris served as SMA's 2020-2021 President.