Trust Me. I'm a Med Student

Learning the science. Developing the art. At LMU-DCOM


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Be Real

Why did you apply to medical school? While I’m 100% certain that not everyone did it for humanistic reasons, my experience with my fellow classmates suggests that the majority of people did. Most people enter into medicine with lofty ideals about wanting to help people, giving back to the world, doing their part, caring for others at their time of greatest need, etc. And that is the way it should be!  Considering medicine is about treating PEOPLE, it would make sense that you would want to recruit future doctors who are humanistic. Except that saying it out loud or on paper sounds trite – in fact so much so that I was advised repeatedly NOT to write about humanism in my application to medical school. Looking back I regret NOT writing about humanism.

I think what it boils down to is being real. How can you be “passionate” about medicine before you ever work in medicine? Saying that you are is silly (and trite) and just speculation. You are a pre-med and have never been a doctor, never felt the pressures, known the stresses, or understood the challenges of being a doctor. Admissions people can only read about how passionate some naïve pre-med is about something they know nothing about so many times before they start hating everything, especially your application. So you need to be creative and express your interest in a way that isn’t painful to read or you should try saying something else.

I ended up writing about purpose, realism and the irrefutable value of medicine in society for my personal statement. Looking back I think I missed the mark just a little bit. What I was feeling was true but I couldn’t express it. I was trying to convey that my inspiration to pursue medicine was humanistic in nature, but without sounding too…..humanistic. Over the last year and a half the thing that I wanted to say in my personal statement has started to become clearer – partly due to my introduction to the medical specialty Physical Medicine and Rehabilitation (which I wrote about here).

Physical Medicine and Rehabilitation (PM&R) is a medical specialty that is extremely unique. It is the second smallest specialty in terms of number of physicians who are practicing PM&R, its scope of practice is broad, and quite frankly it is not extremely well understood, which is laughable because I think PM&R is the epitome of medicine embodying all the things that medicine stands for. And this is the heart of the matter. Medicine is about human beings, it is humanistic and it is emotional, dramatic, challenging, scary, exciting, happy, sad, and all the other things that humans experience. It is ridiculous to think that medicine is purely tissue, cellular, microscopic abnormalities completely detached from people and their brains/minds/emotions.

PM&R knows this deeply and focuses on the person – body mind and soul – as a principle of healing and rehabilitation. It is well known that a person’s emotional state can help them or hurt them when recovering from a major injury or trauma. It follows then that a person’s emotional state is a part of their health and their disease and needs to be incorporated into their medical picture and treatment plan. PM&R is the only specialty I know where you get to practice medicine, real medicine (prescribing drugs, doing procedures, taking a history and physical, examining patients, ordering scans and biopsies, etc.) but all the while focusing on the patient – their lifestyle, attitude, emotions, family, physical limitations, wants and desires. It is a field of medicine that nurtures the soul and makes you realize everyday that you practice medicine for people and that it is a humanistic endeavor. Maybe the most humanistic endeavor there is.

So, yes, I wish I had written in my personal statement that I want to pursue medicine for people, for relationships, for happiness and for sadness, and for the chance to feel like a human being every day.

Here’s to humanity.

Keep it real


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Picking Up the Pace

Year two is getting heavy. This past week consisted of lectures, labs, a simulation, a wedding in Nashville, and finally an exam yesterday. This next week holds even more: three meetings, many lectures, two labs, another exam, Osteoblast (event to introduce all of the first years to the various clubs on campus), our first PM&R club meeting, and a practical exam. The following week looks about the same. And I assume all the rest after that – until Christmas.

Some of the pictures I took for Instagram last week:

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In the Books

My first year of medical school is officially in the books and I must say that I’m glad to move on. First year was definitely challenging in many ways, but it also made me stronger – very much a ‘trial by fire’ sort of affair. At times (many times) it seemed like I made a terrible decision to go to medical school, but after a refreshing summer break and beginning second year (which is MUCH better, so far) I can say it’s worth it in the end. Although I have repressed much of my first year experiences, I am going to summarize the good times and the other times from the first year of med school:

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Summer Time Fun Time

Sorry, everyone for the blogging blackout – I suffered from post first-year fatigue syndrome and had to let the swelling in my brain go down… And of course I had to soak up my LAST SUMMER EVER. But my new (lofty) goal is to post something every single week, so you all get a sense of what med school life is all about – plus some of my personal rants, of course. So watch out for my posts EVERY Monday! – AND CHECK MY TWITTER/INSTAGRAM! —–>>>

Q: Ryan, I heard you wanted to soak up your last summer ever. What did you do for your last summer break ever?

A: Well, I suppose I could have gone on a cruise, or hiked the Appalachian Trail, or visited Iceland? I really should have gone on a road trip, or backpacked Europe, or at least gone to Dollywood :) …. but instead I stayed at school and researched lipid metabolism. But it was actually pretty cool! And sometimes is was even fun!

Here are some pictures of the lab I was working in this summer at DCOM:

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DO vs MD

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.

AT still

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Things are Coming Together

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!

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Accepted

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!

Metamorphosis

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 NeglectedGod’s HotelTo 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.

 

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