How I did Semester at Sea while at Medical School

I have alluded to this before, but medical students rarely do Semester at Sea, and when they do, they are usually there for a short while. For example, the few medical students from the University of Virginia who spend a few weeks on the tropical leg of a Spring voyage; or inter-port students, like the Indian medical student who sailed with us from Myanmar to India.

The reason for this is three-fold: for one, SAS students are mostly undergraduate, and mostly from the USA, where medicine is a postgraduate degree. Secondly, the nature of medicine is such that it is very hard to leave temporarily to another institution – not to mention the difficulty in arranging to “miss” practical rotations. Lastly, I’ve not yet seen any SAS courses that are accepted for medical accreditation.

sas libary

But I was insistent that I wanted to do SAS – so this is how I did it. (This is kind of my approach to any unorthodox endeavour that I really want to do.)

Figure out the realm of possibility

At first glance, people familiar with my school would say it is impossible to disappear for four months without delaying graduation. In fact, they still think it is, because our school is known for being strict. For many of our years of study, it certainly is, but after some thinking I figured this out:

IMPOSSIBLE: My year would have three theory courses in the four months of absence. I needed them all to continue to Student Internship – we don’t have any optionals.

POSSIBLE: I could do them via the internet as a kind of distance learning if my proposal was convincing enough.

IMPOSSIBLE: One of those classes (Bioethics) had compulsory class-attendance, as mandated by the HPCSA. I could not graduate without perfect attendance.

POSSIBLE: There was also a bioethics class on my voyage, so perhaps that could make up for it. I would still have to do my own school’s assessment and projects, but I could prove that I had attended Bioethics classes.

IMPOSSIBLE: I would have eight weeks of practical rotations while away, which I would miss. If not completed by August I would forfeit my on-time graduation.

POSSIBLE: Because fifth year is a year with an elective period, I could do SAS as an elective, then use those four weeks when I returned for my rotations-catch-up. Additionally we had two weeks of holiday and two weeks study-time. I would also use those to do rotation catch-up.

Talk to the right people

A lot of getting things organized in any bureaucracy is knowing which chains of command to follow – and knowing who is friendly. I learned this in student government.

I first spoke to our assistant registrar, to confirm that my plans were possible albeit difficult, and to find out if I could have her support. She was excited with me right from the start, and helped me to plan a course of action.

I then organised individual meetings with every professor and supervisor for my rotations, both theoretical and practical. Some were so excited about what I could learn from the start, while others needed a little more convincing. Eventually, I had everyone’s support.

An incredible effort was put into these meetings – I compiled a portfolio and proposal letter for every individual, along with examples of other times I went of the beaten track of medicine and still performed well. I wanted them to see that I had thought about every possible snag. I wanted it to be really difficult for them to say no.

Finally I spoke to the people who had the final say: our course convener, who then spoke to the deans, who then discussed the idea at their faculty council meetings. And finally I had the all-clear.

From SAS-side

I made contact with the ship’s assistant academic dean, who would receive my tests from my university, proctor them when I was writing, and then send them back to the university.

As per SAS regulations, I had to take four classes through U.Va on the ship. At the beginning of the voyage, I made sure to talk to every professor that taught me – explaining that I was taking a double course load, and that there may be times that I could not attend class due to tests for my school. Fortunately that never happened, by it was good for them to know, and they always gave me advice for my side-projects.

The elective

Doing SAS as an elective meant I needed outcomes. I decided to combine my U.Va classes, and my explorations of the countries, in such a way to make it a Public Health/Research Elective, where I observed alternative healers and public health in each country.

It was not easy – I received confirmation of funding for SAS-proper less than a month from departure, so I did not have sufficient time to get ethical clearance for a decent research project. Thus the research ended up being more “visiting sites and soaking up as much information as possible” than true publishable research.

Yangon General Hospital, from outside
Yangon General Hospital, from outside


Internet on the ship was super-slow, so I could only download podcasts in the various countries. I was self-teaching pharmacology, which has never been my strong suit. I was also doing some group projects on my own.

My school wanted me to write my tests at the same time as my class back home, so once, when in Japan, I had to write a test at 21h00.

I returned to South Africa less than a week to my exams, which caused quite a bit of exam stress.


I don’t regret it. My grades turned out just fine, and I learned so much. I got to travel the world because my school was willing to try something completely new with and for me.

When I first heard about Semester at Sea, I thought there was no way that I would be allowed to have this experience. But just as Medicine can take you places, it need not keep you from going places. Sometimes, all it takes is some incredibly fine planning.

On a rooftop in Marrakesh
On a rooftop in Marrakesh


  1. Sachi says:

    Sounds like it was a wonderful experience 🙂 I visited the website of SAS and was dismayed to see that they only accept postgraduate applications after 1 year of graduating from undergraduate course. 😦 i would’ve loved to try this out, too! 🙂

    1. It was wonderful! I’m sorry to hear that though 😦 I didn’t realise they had a limit like that for postgrads. Maybe one day soon you can sail with them as a shipboard doctor though 😀

  2. BookerTalk says:

    A good illustration of that expression “where there is a will there is a way”. Those experiences will last you a lifetime.

    1. Quite true. It was definitely a stubborn will! And you are right, I will never lose the value of those experiences.

  3. Scott Ramsey says:

    Great write-up! It was great being in class with you and you have impressed me with your drive and confidence. Best wishes for 2014!

    1. Thank you, Scott! I really appreciate your kind words. I hope that 2014 will be an incredible year for you!

  4. Good for you! Obviously most people don’t attempt it, but you truly made it happen!

    1. Thank you 🙂 It probably isn’t for everyone – I have some friends who don’t think it sounds like a fun experience at all. But I loved it, of course.

  5. Kristin says:

    I really enjoyed this post! It takes a lot of courage to propose and follow your own course of study. It sounds like you learned a lot and created some great opportunities though. I found your blog via Asti @ A Bookish Heart. I look forward to reading more of your unique perspective on medicine, travel, and books!

    1. Hi Kristin, it’s great to see you here! Thanks so much for stopping by and commenting, I appreciate it. A wonderful 2014 to you, and keep well!

  6. Nancy Ackelson says:

    I am so glad you found ways to make this work, you are awesome Mariechen!!!
    Happy New Year!!!

    1. Thank you, Nancy. I am super happy it worked out too. Wouldn’t change it for a thing. Happiest of new years to you, too!

  7. Ellen Ramsey says:

    Thank you for including a photo of the shipboard library, Mariechen! Glad to been a tiny part of helping you accomplish SAS. Persuasion and list making are highly useful skills for all kinds of life experiences! -Your Favorite SP13 Librarian

    1. I loved the SAS library! So many awesome books I found there (and I found refuge among those shelves sometimes). You were a great librarian for SAS! Thanks for stopping by, Ellen, it’s nice to see you 🙂 Happy New Year, I hope it will be a great one!

  8. serend1p1ty says:

    This is amazing! Kudos to you – I’m sure your efforts just paved the way for many more medical students in the future! Also, I love your blog and can’t wait for future posts! [:

    1. Thank you so much. I surely hope that more med students can attend if they want to. Glad to have you here!

  9. Study China says:

    Wow, you really made things happen on your own. I guess if anybody’s willing to put in the effort to make things happen – then it will happen!


    1. It’s true – sometimes it just takes a lot of pushing forward and not taking “no” for an answer.

  10. Tentacles says:

    But just as Medicine can take you places, it need not keep you from going places.

    This cannot be better stated. I agree that traveling is an essential part of development, especially when you’re young. So happy to see that you were able to accomplish this trip – what an adventure! I hope you continue to forge new adventures, no matter how busy life becomes.

    1. Thanks so much, that’s so sweet! I’ve decided that traveling has to somehow form part of my future. Whether I take extended breaks to feed the travel bug, or make it part of my career, remains to be seen.

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