Decisions...decisions...

Backgroud: There was an exchange of emails before this one.  They're not necessary to understand what's going on here.

Edwin,

Thank you for what you've shared. I was caught off guard at first when you challenged me to think about why I want a more competitive residency program. To clarify things, I am uncertain of what I should choose to practice for the rest of my life. It is a weighty and difficult decision to make. Every specialty in medicine is fascinating. Simply put, I want to be able to do it all. I want to be able to replace hips when necessary and at the same time, I want to be able to perform an emergency cricothyrotomy, repair a cleft lip, etc. Obviously, this is extremely naive and indecisive of me - I feel like a child brought to the toy store and I'm only allowed to choose one toy to stick with for the entirety of my childhood. Getting back to 'competitive' residency programs, I don't want to be a resident at the most pretigious residency program. I want to be a resident at the residency program that will train me to be the most effective doctor I can be.

I have no intention of feigning interest in research when what I mainly want is to make positive impacts on the lives of patients that I am in direct contact with. To be honest, I don't know enough about clinical research to desire it; perhaps it would allow me to do exactly what I said I wanted to do in the sentence before this one. In any case, regardless of what type of role I intend to take on as a physician, residency programs for certain specialties, both clinically- and research-oriented, expect research publication from students.

Medical students speak of the R.O.A.D. to success. It stands for Radiology, Ophthalmology, Anesthesiology, and Dermatology respectively. These are some of the specialties that require research publication regardless of future intent of applicants to pursue research or clinical medicine. In fact, even non-research oriented hospitals will want to see research experience from applicants for these specialties. There are several other specialties that students tend to place in a similar category as ROAD that hasn't been associated with a clever acronym yet. To name a few: orthopedics, plastics, neurosurgery, urology, otolaryngology, and radiation oncology.

Students who have gone before me have spent the 3 months between their first and second year of medical school to commit to an already ongoing research project relevant to their desired specialty. If lucky, the research is published and the student gets his or her name on the publication as the last author. I really liked what you suggested about analyzing where my intentions lie - strong clinical contribution or commitment to research. Right now, I am leaning towards heavy clinical involvement and am peeved at the fact that I am expected to do research to remain a competitive applicant. In fact, I'll go as far as to say that a three-month commitment to a research project probably only allows superficial exposure and probably doesn't add very much to the study. Perhaps research experience and publication is a litmus test for residencies to gauge how dedicated students are to their specialties?

I will continue to reflect on what you've sent me in your email. I feel as though 4 years of medical school is barely enough time to just superficially experience all the different types of specialties. It's just been a bit overwhelming that students are expected to have made up their minds barely into first year of medical school. The Chair of Orthopedics at Henry Ford Hospital Systems in Detroit gave a talk at school a few weeks back and indicated that future orthopedic surgeons would have had an unwavering desire to pursue the specialty even before starting medical school! 

-Alex




The response

Dear Alex,

i didn't mean to throw you. my main message is that you should first know where your heart is and then you can pursue all of the steps to get what you want. importantly, everything you do from that point on should be singularly focused on that ultimate goal.

it sounds like you want to be a general surgeon and then practice in a 3rd world nation where you can perform a large variety of procedures to help people dramatically. i wonder if there are opportunities to travel to Africa or India as a medical student and assist with operations or even perform them. this experience will provide you with much more real world experience and demonstrate commitment to surgery than you can ever show by spending a few months in a lab. being a 4th author on a low level journal will not impress anyone. showing that you spent a year in nairobi and operating on children with appendicitis -- now that's something that will get you into the best clinical training program possible.

yours,

Edwin

He has a point.  General surgery will allow me to do many different things and I would become a very effective/high-impact doctor, provided that I'm a good surgeon.  Still, I can't say that my path is clear.  I thankfully still have some time to figure it out.  A life of philanthropy and service sounds extremely rewarding and something that is right up my alley of interests, but a life of leisure and comfort continues to whisper from a place not too far.

First month of medical school

I suppose it's been a "transitional" month as I was told it would be. Having been out of school for some time, I felt out of my element the first week, but it didn't take much longer for me to feel at home again. Academia is a place I would like to dwell in forever, and just thinking about this reminds me of a Ghandi quote:

"Live as if you were to die tomorrow, learn as if you were to live forever."

Ghandi was apparently a pretty wise man.

My first exams were more than bearable. I have a feeling that the school intentionally scared us as much as they could in order to trick us into over-preparing. I actually realized that this was the case, and didn't study as much as other people did. Instead, I went running, lifting, reading, golfing, drinking, and TV watching. After all, medical school is supposed to be all about balance, isn't it?

Don't get me wrong. I worked. I put in the amount of hours I deemed necessary and then some more to make sure that I had everything down. But the main thing was that I was ready. I had been exposed to tough academics before. Granted, engineering was vastly different - crunching numbers for hours just to get one homework problem correct - it still prepared me for the rigors or medical school. I remember during my senior year at Michigan, my design project in Chemical engineering by itself required 40 hours a week out of me; add on my other commitments and I had an 80 hour/week schedule. In fact, after that year, the post-bacc program that I entered at a Ivy league school seemed as though it could have been much more difficult.

I made quite a bit of new friends at school. This is actually one of the biggest things that attracted me to Wayne State. The class of 300 ensures that there are people who you are bound to get along with, and of course those who make you tick. Fortunately, I get along with most people, and I love spending time with people whose backgrounds are vastly different from mine. People fascinate me, and that's one of the main reasons that I'm going to medical school in the first place. It's about people, not about me, not about me, not about me. I catch myself forgetting this at times because I study, study, and then study some more just so I...ME...MYSELF can get the best grade I can get. Passing is great. P(assing)=M.D. but why not desire more? After all, Wayne State, your motto is "Aim Higher".

So I'm aiming high. I don't know exactly what I want to do with my medical career yet. The possibilities are many and I have little time to figure out what type of medicine I should practice. But I promise to not practice a type of medicine because it is my only choice. I refuse. I will keep as many doors open as I can, and I won't just get a foot in each door. I'll be aiming to have as many doors as wide open as I can. Does this make me a gunner? Maybe. Is "gunner" a made up term that's more of a joke than anything else? Yup.

Motivation

In the past, there have been times where I lacked it. But in medical school, I am seldom without it. This is because everyone around me is always studying, or they're pretending to. This in turn causes me to study, or to pretend to. Thus, motivation is never lacking.

More specifically, I tend to play some catch-up on the material that we learn at school. That said, there are students who are always well-prepared and have no trouble in showing other students up. You can call them whatever you'd like - good student, douche bag, gunner, whatever. And often, I get shown up by students like these or those who went home the previous night and had HAM (hard as a mofo) study sessions. This is like a bucket of gasoline to the little ember that is my motivation.

So thanks for studying so hard my peers.

Follow-up to: Nerd Alert

Studying is not too bad. I know it only gets worse, but the amount of information that my class has been handed is definitely handle-able. With a class of 300, there are students who are stressing out to degrees I can hardly tolerate, and then there are students who are totally stress/care-free about what we've been force fed straight into our brains the past three weeks.

I myself am in the middle of the continuum. Probably more towards the relaxed/carefree side. I mean care-FREE, not care-LESS. Big difference.

And into week 3, I still enjoy studying. I obviously don't do it all the time, and it could potentially be true that I don't do it enough (I went to bed last night at 9pm and woke up at 6am...it was awesome, but also not so awesome because I didn't get stuff done).

All in all, medical school is enjoyable so far. The main thing is to continue in being thankful for what I have. This thankful mindset helps me to be humble and to appreciate even the not-so-appreciable aspects of medical school.

Age in medical school

There is a wide range of ages in medical school at WSUSOM. I already knew this, but a classmate of mine who entered medical school without having taken any time off after undergrad mentioned how she felt as though she were behind other people who had built up impressive resumes with experiences that are diverse as well as respectable. She also mentioned that she felt young and said so in a way that made her sound as though she were inferior for it.

Different people will always present different experiences. Some will have more to share, and some less, but as I thought over this "issue", I realized that, just as it is in love, age in medicine is just a number.

At the end of the day, people in medical school are trying to earn their M.D. degrees in order to become a doctor. Regardless of whether a classmate sitting next to you at lecture has a masters or doctorate degree, the fact is that that person is your peer, and at that point in time, you are equals. You are both students pursuing after the goal of becoming a doctor, and having the extra degree/letters after your name doesn't change the length of time to be committed, the number of tests to be taken, or the amount of information that has to be absorbed for medical school.

As a non-traditional applicant who has taken time off after undergrad, I feel that it is actually advantageous to be a younger medical student. Sure, you may not be as mature as others who are entering medical school later and you may not have experienced as much, but when you've been accepted into medical school just as others who have masters and Ph.D.'s have been accepted into medical school, you should remember that you were able to surmount the very same obstacle (getting into medical school) as the older/more experienced applicants without having to do as much as they did. You should be proud of yourself for this.

I will agree that there are different things to be considered for people who are entering medical school at different ages (e.g. marriage), but in the end, age, young or old, makes little to no difference in education (maybe except for the higher malleability/absorbing power of brains during younger ages).

Is medical school a competitive environment?

I've read in more than one place that I shouldn't think of my classmates in medical school as enemies or competitors, but as friends and partners who go through times of hardships together.

BULL SHIT...kind of.

I'm sure I'll make friends in medical school. I have no doubt that some of them will be friends that I keep in contact with for the rest of my life. I wouldn't put myself beyond finding my future wife in medical school. Still, these things don't change the fact that when time comes to apply for the next step - residency - I'll be competing against all of my classmates and everyone else who went to medical school and graduated the year that I did. This means that I need to score better, participate in more extra-curriculars, and obtain more research experience than my compatriots.

Moreover, I feel that many people are driven by competition. I myself have the desire to be better than others and this drives me to go the extra mile compared to my peers. I could be wrong about this and I could be the only one who feels this way, but past experiences tell me that it's not. I don't mean to say that I think or know I am better than others, but I aspire to be.

Technically, medical school itself is not a competition, but there will be a competition - for the best residencies - that considers medical school performance as one of the main criteria to be considered.

If people have given this more thought than I have, and know better or more than I do, I welcome their insights. I know that as an individual, my views can be quite limited.

Day 15 — The person you miss the most

Sorry. This is another entry that's not going to get addressed. I don't really miss anyone unless I am in a romantic relationship with her (which at the moment, I don't have). My immediate family is near, and although I wouldn't mind seeing my relatives living in SK, I can't really say I miss one more than any other...lol. I'm actually quite blessed. I have my family close to me and good friends not too far. Sorry if you read this and you expect to be missed. I'm not as sentimental/emotional as people think I am. I mellowed out a lot post-undergrad. A lot less anger; a lot more chill, go-with-the-flow, don't-give-a-shit type deal.

By default, I guess I subscribe to the "out of sight, out of mind" mentality. Another entry bites the dust.