The military.

Interestingly my blog has evolved over time. I originally started it to help myself sort out and record the major decisions that are associated with becoming a medical doctor. Slowly it has turned into a very sporadic journal of my experiences and thoughts. I suppose that isn't a bad thing, but it does explain the decreased frequency of my posts. I keep a journal anyway so it seems redundant to post one online. Though it is probably almost as private because I really doubt very many people stumble across this blog anyway.
So from now on: I'm only going to post when I am faced with a major decision or milestone on my way to becoming a doctor.

To follow my own advice: for about the last 8 months I have pondered the possibility of joining the military to help with medical school. As of right now I have decided against it:
1. I'm not worried about trying to pay off medical school before I become a practicing physician anyway.
2. I do not want to be locked into a commitment, particularly with the ever-present possibility of being forced to practice as a General Medical Officer while awaiting a slot to open in a military residency.
3. Though the likelihood of being deployed is low if I were to go through the National Guard (the course that I think is by far the best option of the armed forces), the possibility of being delayed by such a deployment is not worth the risk.
That being said, there are some real merits to taking the military route. Many people do and don't regret it one bit. I just don't think it is for me. In any case it wouldn't be beneficial for me to enlist until I am accepted to a medical school anyway.

Health care reform!

I've decided not to worry about what is going to happen with all of this health care reform. I tried to look into it and untangle how it would actually affect me as an MD but I was unable to do so. Cudos to everyone who is making their voice heard and helping to make the reform better for all of us, but I have chosen to just let things go forward and deal with whatever comes. I know what path I want to walk and I am going to continue down that path.
My experience in the Orthopedic Center as a volunteer has convinced me even more that I want to be a Family Practice doctor. The concept of picking just one specialty and focusing on it does not appeal to me as much as it used to. I am the kind of person that likes to know a little about a lot of different things, not necessarily everything about just one or two areas of specialty. My friends know me for my incessant spouting of random facts on various weird topics. The appeal of being a doctor that deals with all areas of medicine continues to excite me.

Empathy

I just wanted to mention something I observed today about some of the staff in the ER. I overheard several staff members talking about a couple of patients that had died recently. Frankly, I was a little disturbed at how callous some of them seemed to be. I suppose that might be a defense mechanism or something. If you let every death give you trouble then you would be miserable working in the ER. Whatever the cause or reason, I never want to be like that. I don't want to become desensitized to someone else's pain. I hope I never do.

A fulfilling day

I had a great time in the ER today. I really feel like I'm getting to know how everything works and today I feel like I really made a difference. It was very busy with all kinds of patients. I felt like I was able to make their visit a little less traumatic. I really enjoy getting to know people and helping them one on one. I definitely don't want to work anywhere were I can't get to know the people I work with. I also am finding that even things like Orthopedics are too repetitive to keep my interest. It seems I am just built to become a Family Practice Doc. We'll see.

Bump on a log

So I didn't learn or get anything done this week. I was sick last weekend so I didn't go to the ER on monday. Then on thursday nobody was there to train me in the orthopedic center so I basically did nothing for an hour and a half before leaving. Sad! I really want to help people but at this rate I'm not making much of a difference. I am looking forward to school again so I can kick my but in gear and stop moping around.

Missed the ER this week

I was sick over the weekend so I couldn't go into the ER today to help out. I did want to share something I watched last time I went and what I learned from it. I was walking back from the waiting room on my way to check on some patients when I suddenly heard a most terrible wail followed by intense sobbing. I looked over to see a woman (maybe in her twenties) sitting down and a hospital employee sitting across from her. The woman was trying hard to control herself but couldn't help but choke out intense tears. I didn't immediately know what was going on, and there wasn't much I could do to help. I soon found out that she had been awaiting her fathers transfer to the ER when she recieved news that he had unexpectadly passed away while in transit. I always kinda wondered what it would be like to have to tell someone terrible news. I thought that I might shy away from such a thing. But as I watched this poor woman struggle I couldn't help but want to reach out to her. Telling someone bad news might be hard, but doing it right could make a world of difference to someone. I now know that I'm not afraid of doing something like that because I know that I could make a difference and help someone get through something very difficult. It reminds me of a friend back east who had a miscarriage and said that a patient doctor who was willing to just sit with them for a time while he could have been off doing other things made a HUGE difference to her and her husband. That is the kind of doctor I want to be.

So what's the E.R. REALLY like?

I just got home from my first shift in the emergency department at the University of Utah. What's my first impression? I like it! But I don't think I'd actually want to work there. Here are a few of my observations:
First of all, it is boring MOST of the time. Sure you have people coming in for minor things all day, but really exciting cases only happen maybe once a shift. I don't mind the lack of excitement, (after all I am someone who wouldn't mind just working in a doctors office) but there is an important thing missing from the ER. I noticed that the doctors go from person to person without spending time actually getting to know the patient. They pop in and give an oral or rectal exam or something like that and then POOF! they're on to the next patient. A family practice Doc may not get to deal with really exciting cases but at least they get to know their patients.
The thing I like about being a volunteer is that I get to talk to people without any fear of wasting time. Today I chatted with a gentleman for almost an hour about all kinds of stuff. I was just keeping him company while he waited for a CT scan. I love that! I've always loved getting to know and talking to interesting people. I like to hear about where they've been and what they've learned. So I love being a volunteer in the ER. But so far I definitely don't want to work there.
No, I don't get to watch emergency surgeries or anything either. As soon as airmed lands I'm supposed to stay out of the way until things calm down. I get to watch from a distance though. It's all good.
I hope I like the Orthopedic Center as much! I'll find out on wednesday.

The ER is pretty cool

So I had my volunteer orientation in the emergency department today. I'm excited to work there! It was so cool to see how that part of the hospital works. Even though I only scratched the surface today I was already able to make some observations about jobs I thought were cool, and some others I don't want to touch with a thirty foot pole. Radiology is out. Respiratory therapy is in. I can't wait to keep learning and observing! As a volunteer I do a lot of scut work, but hey I need to start at the bottom and work my way up. YEE-HAW!!

I'm in

Well I have been accepted as a volunteer up at the University hospital. I will be working one day a week in the emergency department and one day a week in the orthopedic center. Cool! I'm excited to get my feet back on the ground working in a hospital. I'm hoping I will learn even more about what exactly I want to do...and what I definately want to avoid. Hopefull I'll make some good connections with people at the hospital too. I'm excited! I should start in the next 2 weeks.

Grinding my teeth

Well final grades are in and I relatively bombed the semester. No As. Mostly Bs. This makes it impossible for me to retain my scholarship with the U through next semester. So I have a big decision coming up: Do I want to transfer to Weber State University as I qualify for a scholarship there? If so would I continue a major in Biology or switch to something else. Big decisions. A Summer to decide.
Good news: I will be volunteering at the U's med center this summer. Woot!

Swine Flu Scare

Now there's something I never considered. How will a pandemic affect the healthcare industry. Well, in Mexico many workers are simply retiring early to avoid the increased risk of infection that is inherent with working with sick patients. Interesting. If the same thing begins to happen in the US, those of us not scared away by the risk of infection may find more job opportunities and less competition. I'll take that! I guess there might be at least one good side to this terrible disaster.

T'aint so bad

I still need to find out about malpractice suits...
But in the meantime I thought I'd address another concern that pre-med students face: Family Life. The medical field, particularly the training and schooling, is notorious for being hard on families. At least to those who don't know much about it. This is a concern that has caused me considerable worry in the past. After all, the main reason I want to become a doctor is to bless my future family. If getting there tears my family apart what is the point???
Well, a couple of factors have led me to lay this concern to rest. Probably the most tangible is that I have met, and know, several families in various stages of medical training. Not only did these families seem happy, they actually seemed to excel in their closeness and love. I asked several medical students what they thought about raising a family in med school and they said it actually brought them closer together. How on earth is that possible? Well, with less free time on your hands they said that you usually value that time a lot more and make sure to spend it with your family. Also, facing big decisions like where to go to residency or where to ultimately practice brought them together even more. Several months ago I e-mailed the wife of one of these medical students and asked her how she felt as the wife of a future doctor. Here is part of what she said: "So to try to answer your question...Jaron's choice to be a doctor was definitely one that he/we made with LOTS of prayer and thoughtful consideration. It has been hard on our family, sure. We go a week at a time with little interaction with him but we made the choice together and whenever he does have time he gives it to us 100%. His career has also been an immense blessing in our lives. We never would have had all the wonderful adventures that we have had without the whole medical school experience. We have lived in wonderful places, met amazing people and experienced so much. I think the greatest comfort for me as Jaron's wife is I know that he was meant to be a doctor. He is so gifted at helping people in through his career and I whole-heartedly believe that Jaron's career has meant to be part of our path in life."...."IT WILL BE HARD! Getting to know different people all over I have come to understand that challenges come in all shapes and sizes so no matter your career, as long as you and your wife remember to pray together... and put God and each other first, you'll make it through on top (at least that's what I'm banking on!)"
Encouraging words.
So what exactly is your schedule like in med school? Early morning till mid afternoon. Sounds pretty average, right? Well, the difference is that you also need to spend a couple of hours studying each day. That still leaves at least an hour or two (maybe more for someone who studies pretty well like me) to spend time witht the family. Also, a med student gets several weeks of vacation each summer. Residency is reasonably similair from what I could gather, though you will have to rotate through late night shifts occassionally. A resident now works around 60+ hours a week, and that number declines each year. The site I learned most of this from was "www.medschoolready.com" but right now the site is down. I hope it comes back, as it proved to be very useful.
So there you go! An exceedingly long post that should at least put to rest one of your concerns.

A good question...

I was talking to a friend the other day who is debating what he choose as his career. He is split between lawyer, Doctor, or Dentist. As we talked, he asked a really good question. How does malpractice affect Doctors these days and what does the future look like concerning it? I really have no idea. I know doctors face lawsuits all the time and for that reason they are forced to pay big time in insurance. But I really don't know much more than that. I also don't know how "universal healthcare" would influence the way malpractice suits are handled. I'll have to look into it.....

1st little snag

Well, I've already noticed my first problem with my new major. It makes me feel like a number. This is something I saw coming. I switched from a relatively small department to the biggest department on campus. There are literally hundreds of other students here at the U that are both Premed and have my same major. Kind of hard to stand out in a crowd like that.
On the other hand, I rejoice in the day when I will be DONE WITH MATH. I would have a long struggle in more math classes ahead if I hadn't switched. So in the end, I don't second guess my decision.

My style

Watching Trauma: Life in the E.R. today helped me realize that I pretty much really want to be a family practice doctor. The lure of having regular hours, a specific demographic of patients that I have control over, and time to make important decisions seems too good to be true in one career. I have decided that is what I will tell people when I get asked "so what kind of doctor do you want to be" (a question I get a couple of times a week). I am aware that I am making this decision with limited experience, and that a million years lie between me and when I'll actually have to decide what to practice, but it is nice and comforting to have that extra little bit of vision about the future. Another reason for family practice: I am the kind of person that likes to know a little about everything, not someone who likes to know everything about one thing. A brain surgeon KNOWS brains. A family doctor knows how brians work, but he also knows how every system works in the body too. Plus I've always liked to get to know people and I think a Family Practice doc has much better odds of getting to know people for a long time. As a mentor once told me "a surgeon meets a lot of different people, but a family practice doctor gets invited to weddings and baby showers".

Summer Plans

Well, I'm now in the middle of making another decision. What should I do this summer to prepare me for med school? I still have quite a few things on my list of stuff that I need to do. No rest for the weary. I need to do several physician shadowing days, I need to volunteer or work part time in some place where I can get patient contact hours, and I need to do a summer research program. I think I might try to get one or two physician shadowing days in this summer, but I am mostly going to focus on getting patient care experience. I can worry about research next year, when I am more familiar with the staff and programs at the University. I'm hoping I can actually get paid patient care experience. Like an actual job. Rather than just volunteer. But either way I will be happy to get back to helping actual patients. I haven't done that since High School. Busy summer here we come! (of course I'll still make time for vacations and stuff though).

Dentistry....

Another tempting alternate to becoming an MD is the highly enticing proposition to go into Dentistry. Just today I was having a conversation with one of my friends and I was led to wonder why I have chosen Medicine over Dentistry.
1st of all, I am comforted by the increased flexibility in the medical field. From eye doctors to trauma surgeons to family practice doctors and everything in between there are a lot of different options for a lot of different personalities. I always saw dentistry as having a little less variety. My friend did point out that there are a lot of different kinds of dentists (oral surgeons, etc.). I still don't see that the differences between different kinds of dentists come close to the huge differences between various kinds of doctors. I have always been a little indecisive and that little extra cushion of decision flexibility is comforting.
2nd, I have heard from others' experience that practicing dentistry in Utah is highly competitive. Furthermore, there are no dental schools in Utah so one must fork over the extra cash to go to school elsewhere. There are even more hurdles to overcome when it comes to moving from state to state as a dentist as well.
That being said, who can argue that the standard of living that dentists have is not AMAZING. Very kind hours, great work environment, a satisfying occupation, and good pay are all very enticing.
I'm still planning on medicine, and by this summer making a switch to dentistry will become time consuming and costly. Until then I'm still open to persuasion. We shall see.

Doom update...

Ok, so I did a bunch more research about how the future of healthcare will affect me. Here are my conclusions:
The thing that is scaring everyone is the concept of "universal healthcare". This type of system is employed in all modernized western economies except the US. The basic concept (from what I could gather) is that the government will cover the costs of healthcare for all individuals in the nation. There are so many opinions flying around out there that I'm not even going to touch on whether this is a good idea or not. I'll just mention what things I learned that might affect me as a future Med Student.
1st: there is a general consensus that MD salaries will drop in a universal healthcare system. In western Europe salaries are less than half of what they are in the U.S. That would put salaries at around 80 to 100k a year. Everybody shouts that you shouldn't care about money at all if you want to be a doctor. But the way I see it is that anyone who truly didn't care about money and just want to help people could work as a CNA, EMT, or Medical Assistant and be very happy for the rest of their lives. Salary does make a difference. It is not my motivation for going into medicine, but it is part of the motivation for me going all the way to getting an MD.
2nd: Doctors might have less flexibility due to the fact that they would probably all be getting paid the same as each other. No added benefit for being really good or for going into a really hard specialty. Bad doctors would get the same amount of money as good doctors.
3rd: It will be really hard for Obama to pull this off. Most democratic presidents have tried to do this. All of them failed. And they also didn't happen to have an economic mess on their hands. Odds are there will be changes, but not to full blown universal healthcare.

If you want to learn more go on google and type in "universal healthcare affects doctors". You'll see plenty of different pages with interesting information. My conclusion:

A lot of fear is thinning the amount of competition heading towards medical school. Chances are there will be no sweeping changes anyway. I know I want to go into medicine so I might as well go for MD since I believe I can make it and I know I would like it. My love of caring for other people shouldn't hinge too much on government policy and income. Still going for it!

Internet: "what rumors?"

So, the first conclusion I have come to in my search for basis in the rumors of healthcare doom is this: they didn't come from the internet. Searching google has not brought very many negative indications about the future of healthcare. So I have no idea where people are digging this stuff up. I did find the followig link:
http://www.medicalnewstoday.com/articles/67662.php
and:
http://medheadlines.com/2008/11/19/us-doctors-disillusioned-60-wouldnt-recommend-medical-profession/
both of which talk about how most doctors would not recommend their career to others. Odd because this article:
http://www.gallup.com/poll/16048/Be-Doctor-Most-Common-Career-Advice.aspx
says that most parents and adults would recommend that kids become doctors.

So I'm even more confused than when I started. As evidence that I'm not crazy here's an actual anectdote of a warning from a friend I recently received:

He too wants to become a doctor. He's a little older than me and has the benefit of already having a job in the medical field as a rep for an orthopedic device manufacturer. His dad is an orthopedic surgeon. When I talked to him about all of this fear floating around he said that his dad told him it would probably be wise to switch to another field if Obama gets elected.

So the fear is out there. I just don't know where it is coming from. My next goal is to find out what exactly the democrats plan to do with the healthcare industry. Maybe that will help me root out the source of the paranoia.

Troubled waters...

The world is coming to an end! Healthcare will soon cease to exhist as democrats take control and totally destroy the medical field.... Or so I've heard.
I can't tell you how many times I've been warned that going into medicine is "risky" right now because, in the opinion of many, all that lies ahead is doom and gloom. I'm going to try to spend the next few weeks investigating these claims the best I can. Of course the future can't be predicted, but I have my suspisions that things aren't nearly as bad as many say. I sure hope not.
I do see a benefit from all of this paranoia. Less competition! If more of my classmates drop out of the running for medical school because of their fear, I guess I have better odds. The way I see it, people will always get sick. They will always want to get better. And they will need someone to help them with that. I see the healthcare industry growing as the population grows and ages, not falling to pieces under an "oppressive democratic regime."
We'll see what I dig up.

A dose of my own medicine....

Incidentally, since my last post I have decided to follow my own advice and switch majors. I have been careful so far to take classes that allowed me to switch to other science majors without having to backtrack; and today I made the decision to switch my major to Biology. It can stand on its own and it will be quicker and easier than a physics major. Since beginning my first biology class this semester I discovered that I loved it and am better at it than physics. So, biology here I come!

Picking a Major

As I have learned more and more about medical school expectations I am beginning to realize that they really don't care what kind of major you have. They are MUCH more concerned with GPA, MCAT score, leadership experience, volunteer experience, etc.
So what major should a future doctor pick? That is really up to the individual.
I picked this reference off the University of Utah's Medical School site: "The University of Utah School of Medicine does not recommend or require any specific undergraduate academic major. We recommend that students choose a major field for which they have enthusiasm and interest."
Now this doesn't mean that you should be careless about selecting your major. There are a couple of really important things to consider:
1. Some majors take longer than others. In my opinion the quicker you can get to medical school the better so I have chosen to avoid any majors that take longer than 4 years to complete. The quicker I can get into medical school the quicker I can become a doctor. Adding minors also costs time and doesn't seem to be worth it to me.
2. Picking a major also influences what kind of faculty and fellow students you will be associating with and getting to know. Faculty that are well-connected in the science and medical fields will be more likely to help you get into research opportunities that will help you get a feel for what your specific interests are when it comes to medicine.
3. I have also been advised that it is wise to get a major that can stand on its own. One that can get you a job if you end up deciding not to go to medical school when you are in the latter part of your college career. True, you can always change your major if you change your mind about medicine; but switching majors usually costs you time becuase you will inevitably have taken courses in one major that you won't need in another.

PA vs. MD

Any pre-med student will eventually get tempted to go another path: Physician Assistant. For several months last year I seriously entertained this possibility and studied it thoroughly. It can be a very tempting proposition. Why might it be so great? As a PA you would still get to do much of what a medical doctor would do, however you only have to go to 3 years of school. On top of that there is a lot of flexibility in the profession and it is much easier to switch your line of specialty later in life. Plus you still get paid in the neighborhood of 80,000 dollars a year (varies depending on specialty). Sounds great! Not so fast though. Becoming a PA is highly competative. Just to give you an idea: about 1 in 5 in-state applicants to the University of Utah's Medical School will be admitted, while only 1 in 20 in state applicants to their PA school are admitted. That's a big difference! In addition to it being highly competative, the fact that you only need to spend 3 additional years after graduation to become a PA is also decieving. Most PA schools require their applicants to have thousands of hours of patient contact work. As a matter of fact the average accepted student into the University of Utah programs has 8,000 hours. For me that means that after I graduate I would need to spend 2 to 4 years working full time as a medical assistant, CNA, Phlebotomist, etc. in order to acrue the needed hours of experience. So in the end I might be looking at 7 years or more of post graduate work to become a PA. Suddenly the 4 years of med school plus 3 to 5 years of residency doesn't look so bad.
Here are some useful links if you are thinking about making the switch to PA:
http://physician-assistant.advanceweb.com/ Salary info.
http://consusrankings.com/2008/05/05/us-news-best-graduate-physician-assistant-programs-2007/ Ranks PA programs as of 2007
http://www.usnews.com/articles/business/best-careers/2008/12/11/best-careers-2009-physician-assistant.html Article on why PA is ranked one of the most promising careers
http://www.usnews.com/articles/business/best-careers/2008/12/11/overrated-career-physician-2009.html Article on why being a Doctor is rated one of the most overrated careers
http://web.utah.edu/upap/docs/upap-demographics-2008.pdf Demographics of PA students at the University of Utah. Notice especially the work-experience section.

This continues to be a decision that causes many people stress. When I originally posted this, healthcare reform wasn't in the picture. I am in MD school now (I feel this was ultimately the best route for me), but I hear rumblings from several MD specialists that things are moving towards better job security for PAs, PTs, OTs, etc. Others say just the opposite. It will be interesting to see where things end up. 

Where I'm at.

I'm off and running. 1 year of college under my belt with 3 to go before...more school. After that...more learning. Thus are the expectations of your average joe Pre Med student. I don't know if I stand out yet but hopefully by the time I apply to med schools I will. I'd say that is something that worries me now. It seems that the course to med school is crowded with a lot of talented people...and a lot of them know it and aren't too shy about showing it. I'd say I'm pretty average. I'm 21. I currently am cramming my brain at the University of Utah. I have a Pre-Medical Physics major (you should see people's faces when I spit that out). 3.8 GPA. It looks like I'll be applying for med schools in 2011 and graduating in 2012. Between now and then I'm going to try to fill my resume with community service, volunteer service, patient contact, physician shadowing, and leadership experiences. Hopefully I can do all that while still maintaining my sanity, having good old fashioned fun, and maybe even find a wife.