Questioning the medical path?

One of my students recently emailed me with questions about medical school. It was a pretty lengthy reply, but my roommate thought it was something I should post (in case there is anyone out there with questions of there own). So, here is my reply.

May it help someone, please know, however, that I believe it takes a special person to get to/into med school. If you think you can do it, you are that special person. There is a lot of intrinsic motivation needed, as well as a good work ethic. Anyone who gets in shows a huge achievement of getting in should be very proud of their efforts. ...

• What exactly is an MD?

MD stand for Medical Doctor. It is just one type of degree that you can get to become a physician. The other one is called a DO, which stands for doctor of osteopathy. Both degrees will allow you to practice medicine in the states if you are licensed here. I'm not sure if DO schools are found outside the states, but MD schools are.

• Should one take pre-med as an undergraduate course or take another major?

There is actually no such thing as being a pre-med major. It is just the class work that you are going through with the hope of going to medical school. I did my undergraduate work in biology, but a lot of people do other things. My best advice is to do whatever you want to do (as far as major). The only stipulation is that you get the required classes for med school in (2 years of chemistry, physics, english, and some bio classes). The reason that I went biology is, firstly, because I love biology and secondly because I thought I would be better prepared for the MCAT (Medical College Admissions Test) that you need to take before applying to medical school (think SAT for medical school, only way more specific).

• How much does it cost to get into medical school?

Well, that's a good question. If you want to start from the beginning, there's the cost of undergrad to get you to med school (which depending on where you go can get pricey). I went to a private school for college, so that cost me about $100,000 (plus application fees, etc). Then there is the price of the MCAT, which I think is about $500, but I could be wrong (a lot of people also take test prep classes though, and those get expensive, Kaplan runs about $1400). Then there is the cost of applying through AMCAS. With AMCAS you pay an initial fee of $50 for sending your application to 1 school. Any additional school is another $30. On average, most people apply to about 9-12 schools, so you're looking at around $300-500 depending on how many schools. This is your primary application.

After your primary application there is the secondary applications that you get from schools wanting more information. Each school's secondary costs you about $50-100 (multiple that by how many schools send you secondaries, which most will).

Now, you're almost done with the application process and its time for interviews. Interviews must be done on campus and you must look professional, meaning most kids go out and buy a new suit and then pay for travel expenses to the school (gas, lodging, and many a meal).

That's a lot of money as you can tell, but a lot of times it can be paid with your financial aid (if you budget wisely) or through parental help (if your parent's are nice enough to help you out). I think that last year I spent about $1000 on my applications/interviews, not including the plane ticket back to the states.

• Are you always busy with schoolwork/college work? How many hours of work does medical school give out?

College is a lot of fun, and you will have time to have fun and be social. However, when you're looking at medical school there are sacrifices that need to be made. Unlike a lot of other kids going to school, you have more school to go through. That means that your grades really count, as does learning the material to do well on the MCAT. This means that pre-meds usually work harder than some of the other people in college.

Medical school is a lot of work. I have class from about 9-5 on most days. But I am also studying for about 6-8 hours a day. The thing is, by the time you get here you should be used to working (not as much, but at least you should have a good work ethic) and even though you feel like a nerd, if you look around everyone is doing the same thing. So it at least makes it more bearable. Also, there is time to have fun. My friends and I try to go out at least once on the weekends, and we joke around during study breaks. But, I can't lie and say that it isn't a lot of work.

• Do you plan on getting married and starting a family? When? (sorry this is kinda random, but if i was gonna be a doctor would i have time to do that?)

Yes, I do plan on getting married, as do many of my classmates (I'm still waiting for that person to walk into my life though). Some of my friends here are already married and some are engaged. One of my friends from college got married after her 1st year of medical school, and generally, if it works out, this is a good time to get married as it is the longest summer you have during medical school. I had one friend who got married after undergrad before going to med school as well. It can be done, but it is also a hard thing to balance at times. However, if your significant other understands the demands of medical school, and medicine in general, it should be better.

However, it is true that a lot of relationship (usually the non-engaged, non-married ones) don't make it through. A lot of times the other person can't handle the decrease if communication or time spent together.

As for starting a family. Some people are able to do that during school. In fact, one of the guys in my class just had a baby last week. Also, my school has a program that allows you to become a modulated student, this means that you take half the first year courses at a time (1st year is 2 years long) if you have some other priorities, such a family, in your life. A lot of people learn how to balance it though and some people have kids during residency. I personally don't see that happening any time soon with me, so I'm thinking that I'm not going to be looking at that until after residency.

• What kind of training must one go through before they become a doctor?

Well, of course there is medical school. Med school is 4 years, 2 of which are class room work (at my school we also have some clinical work... learning how to take a history and physical). After your second year you take the 1st step of the boards based on the bookwork.

The second 2 years are spent in rotations in the hospitals, actually learning about the different fields of medicine and preparing you for knowing what to do when you get out. After your 3rd year you take the 2nd step of the boards that is both a written and giving physical exam.

Once you finish those 4 years you are technically a doctor, however, you're training is not done. You must go through residency. Residencies last for different times depending on what they are. Primary care residencies (family practice, pediatrics, internal medicine) usually are 3 years. However, some of other ones, such as specific surgery specialities, can take up to 7. You can then do something called a fellowship, this is if you want to subspecialized into a field. For example, I'm planning on doing peds hematology/oncology. I need to do a pediatric residency and a fellowship in peds heme/onc.

• How intense is Medical school? is it as scary as some people say?

Med school is pretty intense (I'll attach a doc of my calendar so you can get a feel for scheduling), but your undergraduate work should prepare you for taking the next step up to med schoo. It is not scary, although, there can be scary moments (your first day in cadaver lab, taking exams, etc). To be honest, I'm having a lot of fun admist all the work. You also don't necessarily need to go to class (at least at some schools). My school streams all the lectures online, which means that if you don't want to go to one you can watch it later, and even watch it at twice the speed if you so desire. I learn a lot from going to lecture though (or at least it reinforces concepts), so I tend to go to classes.

• What kinds of classes are you taking in medical school and what classes would be good to take in college?

First year is typically "Normal", by that I mean normal anatomy and physiology: anatomy, histology (microscopic anatomy), embryology (form fertilization to birth), biochemistry, physiology (how things work), genetics, nutrition, and neuroanatomy

Second year is typically "Abnormal", which means pathologies and what happens when things go wrong (bugs and drugs): immunology/microbiology (bugs, diseases), pharmacology (drugs), pathophysiology (when your normal functions go wrong), pathobiology, psychiatry, and then abnormal biology of all the different systems.

Through out both of these years we have a class called Clinical Medicine which basically teaches us how to be doctors

• How many years of education have you gone through after high school?? how much more do you have before you become a doctor?

So far I've done 4 years of undergraduate work. Counting this year I have 4 more before I'm a doctor. I then will have about 7 years of residency and fellowship, during which I'm a doctor, but still in training.

• what will you plan to do after medical school?

I'm planning on going into a pediatrics residency. But I'm not really sure yet. I just know that residency is the next step and I'm waiting for God to direct exactly where that step will be. Hopefully I be getting married sometime along the way and starting a family. But one thing I learned is that God directs your steps. You might have a general idea of what the next step is, but you can't make it unless God tells you to place your foot down (ie. I know God wants me to be a doctor, but He also brought me to Thailand last year).