I gazed out of the window of the Cessna aircraft carrying a total of 3 passengers, thinking about how far I had come, and how far I had yet to go, while I struggled to keep my mind off of the intense headache caused by the pressure changes midflight. Out in the horizon, the sun glared with a brilliant orange hue, and I closed my eyes as I let its rays bathe me in its warmth.

We hadn’t been in flight for more than 30 minutes when the pilot turned around to proclaim that one of the engines was malfunctioning and that we had to make an emergency landing. Needless to say, I did not know what to make of this statement. I initially thought about how this could be my last couple of moments on this Earth. Maybe this was it? I quickly snapped out of it when I saw my mother, who was visibly shaken at that revelation. I tried to remain calm and reassured her that we were going to be okay. At the very least I had to pretend for her sake in order to keep her calm. As I looked to my right, the young man (also entering into the same school as I) was praying. What the heck was I thinking coming down here to study?

Believe it or not, that was my first real experience coming down to study Medicine at the Medical University of the Americas in Nevis. We eventually landed safely back in Puerto Rico, and some time later we took a proper aircraft to Nevis. I vowed to never step foot on a tiny aircraft like that again!

It is hard to explain what my initial expectations were, arriving at this unfamiliar place called Nevis to study medicine. I had read up on countless forums about the school; some posts were light and inspiring, while others were bleak and unforgiving. My friends and family would cast doubt at my decision to pursue my studies in a relatively underdeveloped country. They would comment about how tough it would be to live on my own.

I remained positive for the most part and believed I could handle everything. Moving away from home for the first time was exciting, but I didn’t really know what I was getting myself into. Being thrust into this completely new environment with people who I did not know took me out of my comfort zone. The first few weeks were a tough adjustment. Not knowing where the grocery store was, not knowing how to get around the island, not knowing how to prepare and study for courses… There was so much to learn and so many adjustments to make.

All of the courses I was enrolled in started off with a bang from day 1 and did not let up. The material we were learning was not inherently difficult, especially considering the vast majority of the students had already taken pre-requisite courses. As is the classic proverb of Medical School, the real tough part is the volume of information that must be learned and mastered in a relatively short amount of time. I had to become comfortable with understanding big concepts and not sweat over the small details. In addition, I had to be able to pick out the most important and clinically relevant information from thousands of lecture slides and purely commit them to memory. These were tough skills to learn, but over time, with persistence and perseverance, it became easier.

I believe the toughest part of my first semester was pushing myself to stay consistent and work hard every day. Most people think they can handle this and that it would be easy to study on a tropical island. My friends seem to think all I do is go to the beach everyday and study under the palm trees while sipping on coconut milk. This is far from the truth, as I probably have only stepped onto a beach 10 times over the past 16 months. The whole ordeal is quite stressful. There is very little free time. At best, you may go out once or twice over the span of 3 weeks (the length of each “Block” of material tested) and maybe work out a couple of times per week. The rest of the time is spent either in class or studying.

As the weeks passed by, the unrelenting daily grind took its toll. Finding motivation during tough times was difficult. I felt compelled to constantly remind myself why I was there. This was a golden opportunity at a life I always envisioned for myself. I could not just sit idly by and not work hard. My family was depending on me. My financial future was at stake. This loan would not pay for itself. I had to push through, do my best, and succeed. There was much at stake.

It was important that I formed a social support system with close friends on the island. Just speaking to someone about my fears or apprehensions took some of the weight off of my shoulders. Perhaps even joking around and having a good laugh for five minutes helped dissipate some of the tension that built up while constantly studying.

It might seem like I am painting a bleak picture of my experience, but the truth is, my time on the island has been a deeply humbling and gratifying experience. I am a firm believer in facing challenges head on and not giving up. Even if the challenge seems insurmountable, putting your heart and soul into something you truly believe in is the quintessential principle of life. Success and happiness do not come to fruition out of thin air; it is the by-product of blood, sweat and tears. Countless hours spent scouring through books, learning in classes and labs, as well as riding the emotional rollercoaster of successes and set-backs — these all take an emotional, physical and psychological toll on ones’ psyche. Developing proper coping mechanisms is essential for dealing with the stress. This might include working out, watching an episode of your favorite TV show, going out to a nice dinner, or skyping loved ones from back home. In order to prevent the burnout faced by many, it is important to be able to turn your mind off from time to time and just relax.

Learning from mistakes is imperative. Becoming complacent or rigid in the face of adversity is a recipe for disaster. While personal, social, or career failures are a deep blow to one’s self-esteem and sense of self-worth, it is an opportunity for self-reflection and personal change. Rome wasn’t built in a day, and neither are success and happiness. Keeping your sight on long-term goals and striving to achieve them little by little lays the foundation for a fulfilling life.

So you want to be a doctor? No problem! All you need is some hard work and dedication. The rest will take care of itself.