Andrew Taylor Still MD, DO, the founder of osteopathic medicine, started a new model for treating patients after years as a practicing MD physician. He was driven to start a new model for medicine in the United States due to the rampant over-use of drugs like heroin and cocaine for the treatment of so many common ailments in the 1800’s. He was seeing so many people harmed (often permanently) by these chemical interventions that he strived to develop a more conservative model of healthcare delivery based on promoting homeostasis, supporting the body’s natural disease fighting abilities (immune system), and optimizing the structure-function relationship (anatomy) that underlies all of life. He had such positive results that he continued to develop his methods and started his own medical school where he taught these principles as an effective way to approach the treatment of disease. This conservative medical treatment method caught on and quickly grew into the second largest form of medicine in the US. However, it wasn’t until the US military started accepting DOs as military physicians did osteopathy become so integrated into US healthcare that MDs and DOs are nearly indistinguishable today.
Things are beginning to come together.
Before I started medical school, I had a pretty strong interest in a specialty called physical medicine and rehabilitation (PM&R). However, as any physician can tell you, everything can change when you’re in your third and fourth year working in the hospitals and experiencing all of the great medical specialties. One of them may just jump out and grab you, and who knows what specialty you’ll end up going into? At this stage of the game, however, I am really excited about PM&R and it seems like maybe the universe wants me to be a PM&R doctor too because, as I said, things are coming together.
One month ago I was just plodding along as a first year medical student, nothing of note to report. Now, I am sitting here as the new president of the PM&R club at LMU-DCOM, the co-chair for the national student council executive committee for the national osteopathic PM&R organization (AOCPMR), and fresh off a week-long shadow experience with a PM&R doctor at Vanderbilt’s new PM&R department. Some things are just meant to be!
Originally published in TheDO magazine Aug.2, 2013
The day I was accepted to medical school, I was trying to go about my life as usual and quell the internal freak-out building up inside of me. I laced up my running shoes and jumped in the car. Cell phone: check. Wallet: check. Gym ID card: check. As I drove toward the gym I noticed my fuel light glowing on my dash. At the gas station, I started pumping, then compulsively checked my phone for the 50th time that day.
It was Saturday afternoon, and I’d been able to think of little more than medical school since my Monday interview at Lincoln Memorial University-DeBusk College of Osteopathic Medicine in Harrogate, Tenn. Accepted students would receive a call on Friday, I was told. As Friday came and went sans said call, I was trying to come to terms with the fact that I likely wasn’t accepted, while still holding out a shred of hope and remaining glued to the phone.
“I could finally stop anxiously checking my mailbox every day and my phone every 30 seconds.”
Pop! The gas pump handle released; my tank was full. I got back in my car and checked my phone again. Still nothing. I reassured myself that this was the perfect time for a long, intense workout to help relieve my stress. I was at the gas station’s exit when my phone finally buzzed. Omg! It was an unknown number. Could this be it?! My hands started shaking from nervousness and excitement.
“Hi Ryan, this is Dean Wieting from LMU-DCOM …”
My heart leapt in my chest, and I thought I might faint. I pulled over and parked. J. Michael Wieting, DO, a dean of clinical medicine at LMU-DCOM, told me that I was in! I was officially on my way to fulfilling my dream of becoming a doctor. And the nervous waiting was over!
For many students, the moment of acceptance sparks the process of transitioning from premed to bona fide medical student. The process is a metamorphosis of sorts. It brings new challenges, experiences and goals as you slowly alter the way you view yourself and the world. In one moment the culmination of years of hard work are realized, and you officially become part of the medical community. A door opens to new opportunities and experiences and a lifetime of learning, healing and helping.
Post-acceptance, one must navigate this transformation. Although it may seem like a smooth and easy shift you’ve been waiting to make for years, numerous things change, some of which are unexpected. My transition has been slightly different than I imagined but nonetheless great. I write about it with the hopes that my insights may help other transitioning premeds.
When I was accepted, the first feeling I had—other than incredible euphoria—was relief. I could stop worrying about my application, my secondary essays and my interviews. I could finally stop anxiously checking my mailbox every day and my phone every 30 seconds. It was time to pump back up the old worn-out self-esteem and get ready for a new challenge. But at first, I just enjoyed the freedom from worried waiting.
After a few days of reading and relaxing with friends, I started on my matriculation paperwork. It was fun because these were the first official documents I filled out as a medical student. On the flip side, this process also includes filling out the Free Application for Federal Student Aid (FAFSA), which can be quite depressing if you are taking out loans. Finding housing is also really important, as the longer you wait the harder it is to find a good place. LMU-DCOM has student housing options on campus, but I checked other school websites and Craigslist for off-campus options, which can be significantly cheaper. I used the classifieds section of LMU-DCOM’s student government website. Your school may have a similar website. I also suggest joining your class Facebook group—many upperclassmen will join the group to answer questions and post housing options. The Facebook group seems to be the easiest way to find a roommate.
Once the essentials are taken care of, everyone has his or her own ‘plan’ about what to do before medical school. Fortunately or unfortunately, a substantial amount of time usually sits between your acceptance and the start of medical school. This is the one thing I wish I had been more prepared to confront. I was accepted to LMU-DCOM in early February, but do not start classes until August. There may be six months dividing the day you find out you are in medical school and the day you can finally begin classes. However long it feels, the time off is immensely beneficial for decompressing and preparing before you ship out.
Some students will take a few months off and enjoy doing nothing because it may be the last time they ever have the opportunity. Others will continue to work up until they start classes in order to stay busy and fill the coffers. And some will study anatomy six hours a day in order to be (or feel) more prepared for the intensive first-year anatomy course. I personally did some of everything. I continued working for a few months, got married, traveled, brushed up on some anatomy (anatomy coloring book!), and have had plenty of “do-nothing” days. I’ve filled them by hanging out with friends and family, eating one last meal at all my favorite restaurants, exercising (to counteract all my eating out), getting tan at the pool, and reading (Left Neglected, God’s Hotel, To Kill a Mockingbird).
Taking at least some time off before school starts is a fantastic idea. Enjoy the peace and focus on things you love to do; it will help you to prepare emotionally for the long and demanding road ahead. Like me, you may find that not having work to get done, a project to complete, or a schedule to follow takes getting used to—but your reduced stress level will thank you.
‘The humanity within medicine’
With my free time, I also researched the various clubs and volunteer opportunities that are now available to me as an official medical student. A great place to start is by signing up early for the Student Osteopathic Medical Association (SOMA)—they have plenty of resources for new medical students.
You can also identify the groups you want to get involved with at school by researching the various clubs available on campus. And if you have a specialty in mind, you can usually join its organization for free or for a small fee. I joined the American Osteopathic College of Physical Medicine and Rehabilitation and the American Academy of Physical Medicine and Rehabilitation, and I also spent some time researching osteopathic manipulative medicine more in depth and getting psyched about it.
The more I read about OMM, the more fascinated I become. I’m so grateful that I will be able to perform these techniques and use my hands to heal. In my research on rehab medicine, I’ve discovered an array of useful OMM techniques used often in this specialty, and I can’t wait to learn more.
Beginning a career in medicine is thrilling—and daunting. It takes an enormous amount of dedication to get into medical school and will surely take even more perseverance to finally become a physician. Despite this truth, I hope all the newly minted osteopathic medical students preparing for their first year are as excited and proud as I am to be training to be osteopathic physicians.
As new medical students, we are stepping into a world of incredible rewards and responsibilities. We are taking on a long, arduous education in order to help people, challenge ourselves and understand humanity. We are ambitious, caring and idealistic. I hope that as we learn medicine, we don’t lose our ideals. I hope that the system of health care doesn’t dilute our excitement to learn and practice medicine every day. I’m confident that each one of us will work hard to build strong relationships with our patients and colleagues. This is the core of the osteopathic identity—we focus on the humanity within medicine. And personally, I hope to maintain the joy, excitement, and gratitude I felt on the day I got the call that changed my life.
During my first semester of medical school I transformed from eager, excited, enthusiastic, medical student into – by the start of my second semester – a cynical, removed, studying machine. My desires, dreams, and ideals were extracted from me and replaced by darker, more practical concerns like grades, grades…. and grades. I study so that I can make good grades and have a future that includes the next semester of medical school. More and more I find that I no longer study because I am fascinated by human physiology: the wonderful, self-sustaining system that is the body, and am hardly inspired by the notion of one day being able treat disease, remove pain, or fend off death. Continue reading
I want to start by saying that I am thrilled to be training for a career as an osteopathic physician. I think there are characteristics of a DO’s training that are so valuable that I wouldn’t trade this experience for another. I think those characteristics are primarily due to the inherent humility, selflessness, passion for the art of medicine, and care for the community that has been a part of osteopathic medicine since its inception, likely as a result of it being viewed as an alternative or non-mainstream field of medicine. Essentially, no one did it for the prestige and that attitude is still alive and well in osteopathic education. But these characteristics are a part of the intangible aspects of osteopathic medical education, the feel of the school and the people in the profession. This is not due to the curriculum, the training hospitals, or even necessarily the professors; it’s the culture that grew from the principles of osteopathic medicine. Essentially, osteopathic medicine is typical medicine. Simply calling the medicine DO’s learn in medical school “osteopathic medicine” suggests that it is more different from “mainstream” medicine than it truly is. However, I appreciate the subtle differences and the humble culture that resulted.
I’m currently in my second semester of medical school. That means that I hate my life. I studied for 32 of the last 48 hours. If you are thinking about going to medical school, make sure you think especially hard. I have to make a concerted effort every day to do something that isn’t studying just to try and prevent medical school from owning my soul. That being said, (I had to get it off my chest!) there are a handful of experiences in your first year of medical school that are really awesome and they serve as reminders of why I tolerate the torture of the first two years of medical school. These are the “Object Structure Clinical Experiences” or OSCEs.
What is a Physiatrist? Not a Psychologist or a Psychiatrist, or a Physiologist. A Physiatrist (Fizz-Eye-Uh-Trist) is a physician (MD or DO) who is trained to care for individuals as they recover or rehabilitate from diseases or injuries. It is the type of physician you become after training in a ‘physical medicine and rehabilitation’ (PM&R) residency program for 4 years after medical school. The breadth of the specialty is vast but unified by the underlying focus on treating the musculoskeletal system. In fact over 80% of disability in the world is musculoskeletal in nature. Physiatrist are trained to treat all that can go wrong either in traumatic injuries like car accidents or in chronic diseases like muscular dystrophy, multiple sclerosis (MS) or even diabetes. PM&R doctors treat the whole patient, not just the injury/disease. This means that they place a heavy emphasis on improving quality of life and restoring function and ability through non-surgical means.