Category: Blog

4 Secrets for a Successful Career after Medical School

4 Secrets for a Successful Career after Medical School

Dear students:


Please go to medical school, finish medical school and become a doctor. This is a personal request from a 47-year-old future patient of yours. By the time I reach my elder years I’m going to need access to some medical professionals with at least a couple of decades’ worth of experience under their belts. Mathematically speaking, that means you. I confess that my advice to you may be self-serving, but at least you know I’m honest…

I’m not going to pretend to understand the intellectual, physical, and emotional challenges that you will have to manage in medical school. Others can comment more informatively about that than I. I’m not a clinician. I’m a career health care consultant. I have been practicing in, observing and writing about our health care system since the mid-1990s. The best doctors I know are more than great practitioners. They have thoughtful perspectives on a variety of issues that impact your profession. You might want to develop some of these opinions too.
With this in mind, I wish to pass on some insights on a few topics that will impact you as your career unfolds. If you start thinking about these issues now, you will begin to develop your own ideas which will help you to proactively manage your professional life.

Who needs sleep when you can think about things like…

1. REIMBURSEMENT: Advocate for direct consumer-to-provider pay models of reimbursement.
In this time of policy flux, lots of ideas about how to transform the health insurance system are being proposed. To many, a European-style, single payer system sounds attractive because of its simplicity and egalitarianism. Unfortunately, it will likely never work in America. I believe our country is too large, too diverse and too unhealthy to be managed centrally by the federal government. We’re also a capitalistic nation. We simply will not tolerate socialized medicine. Instead, we might consider an American-style single payer system where the single payer is the patient. Rather than routing money through the government and/or insurance companies for a service delivered by you, the doctor, the patient would just pay you directly. This is true consumer-driven health care. This model has already gained traction in low-acuity service environments (“minute-clinics”) and has started to gain a foothold in more acute care settings like ambulatory surgery centers. If you need any convincing that this direct pay model is a good idea, I encourage you to visit the business office of your hospital or clinic. Then go have a beer.
This model will not replace the way that all health care is reimbursed for every single patient. But it can start to simplify the payment system and move pricing towards figures that are set by the market – not by the government or an insurance company. Please re-read this section after you get your license and start thinking about employment options. When you’re a partner in a medical practice, you’ll appreciate the phrase “cash is king.”

2. CLINICAL STUDIES: Engage in useful studies that can offer low cost, high quality results.
A few years ago I spoke with an individual who was conducting a study on cancer rates in women in Sub-Saharan Africa. If a study existed that had a flawed data set, this was it. The notion that any woman in Sub-Saharan Africa would live long enough to develop cancer meant that she had already cheated death from a whole host of mortality factors including but not limited to complications during childbirth, dysentery, HIV, and violence. I am not saying that the study was “bad”, just that there are bigger fish to fry. Think long and hard about the usefulness of what you’re studying. In contrast, consider a recent report that recommended a protocol that dramatically improves outcomes for patients that present in the ER with a hip fracture. Expediting surgery within hours rather than waiting several days reduced patient discomfort, rehabilitation time and mortality rates. Costs associated with these issues were reduced or eliminated. Most importantly, lives were saved. Win-win!

3. TECHNOLOGY: Embrace technologies that transform care rather than solutions that automate processes.
A September 2005 Health Affairs article cautiously stated that “The adoption of interoperable EMR systems could produce efficiency and safety savings of $142–$371 billion.” In case any of you were wondering, that didn’t happen. Analysts under-estimated the costs of implementation as well as the challenges of collecting and connecting a comprehensive data set. Many EMRs include scanned PDF files. The data on those files cannot be analyzed through the EMR, although it is considered “electronic.” Here are some departments that love scanned PDFs: legal and compliance. There have also been high hopes that wearables will transform health care. The problem is that most wearables simply capture data. It’s up to the user to do something with the information. The individuals that will be influenced to take action based on wearable data are the people who buy these products in the first place. It’s the individual’s motivation, not the device, which drives change. In other words, just giving people Fit-Bits isn’t going to help them with their obesity problems.
Telemedicine is a different story. Here’s a great low-cost way to broaden access to care, engage with patients on a more regular basis, and reduce costs. To be sure, telemedicine has yet to be fully regulated. As doctors, I encourage you to view telemedicine as an effective care delivery tool rather than a job-killing threat.

4. Ethics: Read philosophy.
Your generation of doctors will face an unprecedented number of ethical situations where the cost for treatment and the need for care will come into intense conflict. A current concern is how costly hepatitis c drugs, which can run $1,000 per pill, are covered. Depending on patients’ insurance and financial situations, they may or may not be able to afford treatment. And when it comes to certain public health outlets, such as prisons, care is rationed; some inmates don’t get treatment at all. Wrap your brain around that. Advances in genetic studies and precision medicine will generate wonderful treatment options in the coming years. As with any new technology, be it an iPhone or a custom-tailored pharmaceutical, the early adapters of these cutting-edge products will be the wealthy. This inequity in care access is not strictly an American problem. Folks from all around the world come to America to get the treatments they want because they can afford to pay for them. (Some of you doctors are pretty amazing too!)
The American health care system has its issues. But know that many people are working to close the gap in care access and quality so that together, we can improve the health and wellness of all Americans.

Thank you for your commitment to such an important profession. Best of luck!

Guest post by Janis Powers
@janis_powers

Janis Powers is a health care consultant, adviser and writer. Her articles have appeared in The Huffington Post, Hospitals & Health Networks, Healthcare Financial Management and Becker’s Healthcare. Her work-in-progress book Health Care: Meet the American Dream outlines a redesign of the American health care payment system. You can learn more about Janis on her site http://janispowers.com

7 Key Factors for Choosing the RIGHT Location for Your Medical Practice

7 Key Factors for Choosing the RIGHT Location for Your Medical Practice

 

Becoming a physician is a long, arduous journey. After many years of hard work, you finally reach the point of completion and begin your career as a physician. As you embark on the next steps of your vocation, one important factor must be determined… Where to locate your practice?

Choosing your location is an important decision and one that should not be made solely based on the clinical nature of the job. Due to my years of experience, both working directly for hospitals and as a third-party physician recruiter, I would suggest the following factors to consider:

1) Geographic Location

When choosing to relocate, there are many geographical factors that can sway your decision such as optimal climate and desirable neighbourhoods. It’s important to keep in mind that although these factors can be very tempting, there are future life changes that may also be important to consider such as career opportunities for your spouse, proximity to desirable schools and the growing needs of a family that may come your way.

2) Clinical

When considering the clinical aspect of the role, you need to take into account the following:
Are there enough patients to ensure both clinical competency as well as financial goals?

Is the patient population a group that would consistently need the clinical services you provide? Has the hospital invested in the needed equipment and budget for continued investments over time?

Have they completed a resources plan for the department in order to forecast future hiring and investment?

3) Relationship with Administration

What is the relationship like with the hospital or clinic administration? Given the interdependency with other healthcare providers and administration, these relationships will have a great impact on the environment you work in. The better the relationship the better the environment.

4) Market Share

The hospital or clinics reputation in the region and their market share is important and can potentially impact the clinical volumes and access to resources in the area.

5) Academic

Depending on personal preference, you will want to explore what opportunities exist for continued training as well as leadership development. Look into what affiliations they have with external academic organizations and teaching prospects.

6) Compensation

Compensation can be a key factor, however if you don’t have favourable responses to items 1 to 5, no amount of money will make it a great place to work. Keep in mind that a relocation allowance is not an incentive or bonus, but rather a resource that will make the process of relocation less daunting to tackle.

7) Recruiting Process

Lastly, I believe that the relationship you build during the recruitment process will be a good indication of the brand and culture of the organization and how helpful they will be as you go through the licensing and credentialing process.

Thankfully the process usually transpires over several months and thus allows the time to ask these questions and examine the fit. Physicians don’t move frequently so ensuring a thorough decision process at the start gives the best chance of a long-standing mutually beneficial environment.

Guest Post by:  Kevin Kirkpatrick, Managing Director of TMA Executive Search has worked recruiting physicians and planning for physician staffing for the last 12 years in Canada and the United States. He has worked with academic, urban and rural communities to recruit physicians.
Debunking the ‘Doctor Type’

Debunking the ‘Doctor Type’

 

Sometimes, your greatest obstacles can be in your own head.

Take resident physician Kyle Evers, MD. Throughout high school, he had a strong interest in the sciences and a natural desire to help people. Yet when thinking about his future career, medicine barely crossed his mind as a possibility.

Why? He didn’t fit his own notion of “the doctor type.”

“In my mind, doctors were people who never had to study—those kids who got straight A’s without even trying,” Dr. Evers explains. “That wasn’t me. So I didn’t really consider myself a future doctor.”

Today, Dr. Evers is a third-year resident in internal medicine at Memorial University Medical Center in Savannah, Georgia. It’s safe to say his views on who can be a doctor have expanded—along with his confidence in himself.

Discovering His Passion

When I ask Dr. Evers why he chose internal medicine, he says he loves the diversity of it—and begins ticking off all the different specialties he enjoys. Rheumatology. Nephrology. Gastroenterology. Cardiology. Endocrinology.

“My intern friends would joke that I wanted to specialize in everything, because when starting each new rotation, I would change my mind and decide that one was my favorite,” Dr. Evers says with a laugh. “I just wanted to do everything.”

It might seem hard to believe that someone with such an obvious affinity for medicine could have ever doubted his potential in the field. But Dr. Evers had discounted medicine since his teenage years, and it wouldn’t resurface until he was majoring in biology at LaGrange College. Recognizing his talent, a few of his professors encouraged him to reconsider the career he had long since dismissed.

“I kind of laughed it off at first, but then it became this recurring idea,” says Dr. Evers.

So he did an internship with a general surgeon in his college town. Then, he got a job as an orderly in the operating room, where he worked during his last year and a half at college. “That sealed it,” says Dr. Evers. “I knew I wanted to be a doctor.”

A Diverse Perspective

Dr. Evers decided to attend Ross University School of Medicine in the West Indies for a few reasons, including residency placement rates and overall reputation. In addition, he was intrigued by the option to choose either a single location for his clinical clerkships or experience multiple hospitals throughout the country.

“I love to travel and being able to experience new cultures, so being able to do that while getting a medical degree was a no-brainer,” says Dr. Evers.

Sure enough, during his clinical year, Dr. Evers took advantage of the option—getting a taste for medicine in Miami, New York, Cape Cod, Connecticut and Michigan.

His favorite? Miami. (“I love the culture and the bilingual nature of everything—and there’s amazing food.”)

“You can learn medicine anywhere if you’re willing to study. The real difference is the environment and the experiences,” says Dr. Evers. “That was the key benefit for me. If you work at only one place, you may think every hospital operates like that, but if you move around, you quickly realize how different hospital systems are. And each system has its strengths.”

Making a Home

His rich background across many hospitals helps him appreciate his residency hospital, Memorial Health, that much more.

In particular, Dr. Evers was struck by the “family atmosphere” he sensed at Memorial. During his interview, he was impressed by the interaction between residents and attending physicians. Not only did they stay after meetings to chat, they clearly made an effort to get together outside of work as well.

“It was very comfortable, very warm,” he says. “It’s a very personal environment.”

That environment is good not only for having friends outside of work—it’s also a key factor in helping the hospital run smoothly. Dr. Evers credits the friendly atmosphere with fostering open communication that’s led to great relationships across residency lines.

“Here, the staff is dedicated to patient care and diligent in their jobs,” says Dr. Evers. “It takes a lot of pressure off residents.”

And it’s clear that the feeling goes both ways.

“Dr. Evers is one of our most exceptional residents,” says Dr. Timothy Connelly, associate residency program director at Memorial Health. “I’m grateful for his awesome contributions to our program.”

The Real Doctor Type

Today, that high school student who thought he wasn’t the “doctor type” seems a world away from this dedicated physician who’s enamored with his work and singularly focused on patients.

Dr. Evers says he can’t imagine himself doing anything else.

“Even if I had a billion dollars and didn’t have to work, I’d still want to do this job. I can’t think of anything more perfect for me,” he says.

In fact, while some of his medical school classmates are earning their MBAs or have an eye towards management in the future, Dr. Evers couldn’t be happier exactly where he is.

“I don’t have administrative aspirations,” he says. “I just like taking care of people.”

Guest Post By Kristin Baresich – [email protected]

 

 

​9 Gift Ideas for Medical Students

​9 Gift Ideas for Medical Students

Happy Christmas-hannuka-kwanza-ramadan everyone! And if you’re just glad to be able to air your grievances and achieve some feats of strength, happy Festivus! (go watch Seinfeld my dear millennial classmates if this one goes over your head) Whatever holiday you celebrate this season, you can bet that your beloved medical student is probably exhausted from a well fought semester. Well friends, family, significant others, and other loved ones, I am writing today to you, yes you, to encourage you this season to think out of the box when it comes to gifts for your favorite future physician. That’s why I’ve attempted to come up with some atypical gift ideas that I believe would brighten any medical student’s holiday….

Note-I’m not going to be suggesting a gym membership-every medical student in my honest opinion should already be exercising regularly. If not, make a Gym Membership unofficial number 10 on this list.

1. Subscription Food Services 

At this point, you’ve probably been inundated with those aggressively innocuous commercials for services like Blue Apron, Plated, and HelloFresh. Despite that, these services are excellent, with quality, healthy ingredients. And most importantly, they taste incredible and are actually cheaper than going out to eat (which admittedly, every medical student does way too much). Your medical student will appreciate eating something other than the pasta bakes and gas station burritos more than you could know. If you’d rather send them away with some delicious snacks rather than meals, Naturebox and Graze (both stamped with the Matthew Wright Seal of Awesome) have got you covered. Prices range and vary greatly based on how often you want services to come.

2. This Adorable Guy

Your smarty pants medical student deserves a plushy brain. End of story. Or if they don’t like that, you can always buy them a giant microbe to remind them who’s really in charge. These guys make excellent stocking stuffers.

3. Subscriptions to Music and Audio Services 

The sad fact of the matter is, as much as we medical students love learning, and as good as reading is for your brain, most days, we’re all too exhausted to do it as much as we should, and far too often we sit in front of the computer screen and burn our eyeballs out, failing to get enough sleep. To fight this, I listen to a lot (try at least 30) different podcasts as well as audiobooks. I cannot recommend services like audible, pandora, and spotify (for music as well as podcasts) enough for the medical student-audiophiles out there. A personal favorite book to get started is “Quite: The Power of Introverts in a World that Can’t Stop Talking”

4. Office Supplies

Hear me out on this one. I’m not talking about low quality notebooks and pens. What I mean is that medical students spend so much time at a desk writing and taking notes, that creating the proper work environment is key. So,  that means finding quality lighting (especially if your med-student gets the winter blues), a quality chair, or even a standing desk. Maybe it means buying them a little bonsai tree, or some high-quality pens and notebooks to write or journal with. Your medical student might look at you with some eye rolls, but they’ll thank you for it in the long run.

5. Indulge Their Hobbies

Look, even med students need non-school hobbies. Maybe they like craft brewing, or excellent coffee. Maybe they’re a musician, or a botanist, or into building their own computer, or they love to ski. Whatever it is, nudge the student in your life to continue to enjoy their passions in whatever way you can. Heck, for me, it’s as simple as asking for a new board game for Christmas. So, whatever your student’s “thing” is, indulge them this Christmas season.

6. Peace of Mind

Maybe this is the introvert in me talking, but you know what sounds really great after an endless semester of studying and exams? Turning my brain off and starting at a wall for a few hours. Whatever the case is, one of the greatest gifts you can give your medical student is the gift of quietness. So please don’t ask too many questions about why we aren’t seeing anyone at the moment, or plan for us to visit relatives all break. Those things are good, make no mistake, but it will be important to learn to respect your student’s need for quietness and recovery this season. I especially encourage those looking for a “gift” in this area for their student to consider a pair of active noise cancelling headphones (I love mine), or even a bout in a sensory-deprivation chamber.

7. Self-Care Items

Be it comfy clothes, massages, bath bombs (still not really sure what that is), tea, coffee, suduko or crossword puzzles, coloring books (yes, coloring is for adults, and it’s awesome), favorite homemade foods, or a fancy haircut/mani/pedi, self-care items cannot be undervalued.

8. Experiences

Look, I’m not saying we can all afford a trip to Cabo for the holidays or anything (heaven knows I can’t), but some of the best gifts I have ever received have been those that allowed me to try something new. For example, Receiving concert tickets (tickets to Trans Siberian Orchestra is still my favorite Christmas surprise while I was growing up), gift cards to restaurants they love, lessons for a new hobby or skill, sky diving lessons, or if you can afford it, a vacation. Any opportunity to experience this beautiful world we live in is one of the most incredible gifts a medical student can receive.

9. Pay a Bill

Do I need to explain how poor we are right now? Please just pay our phone bill or make a car payment, or if you’re feeling especially generous-pay rent for a month. This is honestly one of the easiest, kindest things you can do for your student this season.

Most importantly, remember to love your medical student and meet them where they are at in this season of life. Hug them, listen to them, and care for them this holiday season. Happy Holidays from MotivateMD to all of you! Best of Luck!

By Matthew Wright
Medical College of Wisconsin

We Will Keep on Fighting

We Will Keep on Fighting

During my second year of medical school, a doctor asked a group of us to write down a few qualities that we thought a good physician should have. Rolling my eyes, I wrote down “empathy, honesty, and perseverance.” It was a question that I had heard too many times during my medical school interviews, and had stopped giving much thought to my answer. The doctor then asked us to share our response with the rest of the group, with examples of how these qualities were applied to a medical setting. My other classmates began reading their answers, which were all typical responses to such a question. Some said intelligence, others said compassion, and a bunch shared my idea of empathy, honesty, and perseverance. However, when it was one student’s turn to share his response, he only read one word: “fight.”…

My stomach immediately clenched when I heard that answer. I associated it with competitiveness, and I wondered why in the world he would think that it was the most important quality in a physician. But as he kept going, the idea behind his response was made clear. “Physicians need to have fight,” he said. “Medical students need to have fight. When times are tough, and you’ve been working hard, you just have to keep fighting.”

Although I continue to believe that empathy, honesty, perseverance, intelligence, and compassion are all incredibly important characteristics as a physician, that day I decided that the one quality I would work on is having fight.  In fact, medical students already have a good sense of fight. We fought through all of the pre-med pre-requisites, combatted the daunting MCAT exam, and slayed the medical school admission process. When we finally make it to medical school, we fight through the core sciences, demolish anatomy, tackle all of the systems, and absolutely destroy Step 1. No medical student lacks this type of fight. It has always been in us, and always will be.

However, while we are constantly focusing on this type of fight, another one tends to be forgotten. The fight we constantly have with ourselves. It is the fight that not a lot of us talk about, although it is the most important battle of all. It is the fight to wake up early on a rainy Sunday morning, when the last thing we want to do is study. It is the fight to stop comparing yourself to your classmates when they are bragging about how much studying they did the night before. It is the fight against the study guilt you have after you decide to take a much needed break. It is the fight to not feel lonely when you see pictures of your college friends going out on a Saturday night, while you were studying for an exam. It is the fight to tell yourself that it is okay to not always know the answer to a pimp question during rounds. It is the fight to admit that being tired doesn’t make you lazy. And finally, it is the fight to think that maybe it is okay to have a few weaknesses, and even more okay to ask for help. Because chances are, a lot of your classmates are fighting these fights too.

Studying and working in the medical field is not an easy thing to do. While it is simple to get lost in the world of patient care, you have to always remember that the most important patient to care for is yourself. And if you ever have a hard time fighting to do that, it okay to ask someone to help fight with you. We are all united in this battle, despite how hard things seem to be. We are smart enough, focused enough, and good enough. And most importantly, we will keep on fighting.

By Breanna Goldner, Lake Erie College of Osteopathic Medicine Class of 2018 
What Next? Finding Power in Powerlessness

What Next? Finding Power in Powerlessness

​Wednesday, November 9th was a strange day. As I passed a tree on my way to class that morning, I paused. It was a tree I’d seen every day for over a year, yet that morning it seemed different. The result of the night before had shaken my core and forced me to question even the smallest truths I knew to be true. I am an immigrant, a person of color, and have lived in America for 22 of the 24 years I’ve been alive. I’ve been a citizen for almost a decade now. But Wednesday morning, as I stared at that familiar tree, I felt suddenly unwelcome in the place I call home.

 

​Election night was a roller coaster of emotions. I flashed back to every moment in my life where I felt judged by the color of my skin. I thought about being teased over my lunches in elementary school, snide remarks overheard on the streets, and being pulled aside for further screening in security lines as my mind raced to make sense of the night’s proceedings. But in that moment, there was no sense to be made. With every fiber of my being, I felt as though my very existence had been judged and then rejected outright. I found myself at my friends’ doorstep in a complete meltdown. I felt the tears streaming down my cheeks, the knot tying ever tighter in my stomach, my legs that threatened to give way every moment I stood and my chest pounding as I trapped every scream I wanted to let out.

Words hurt. And the words that have been spoken this year have left me scared. They have left me feeling vulnerable. But more than anything, they have left me feeling devalued and dehumanized.

So here I was, Wednesday morning, unable to focus, unable to concentrate, and unable to grip reality. I sat with a friend in the library as he told me that his parents were afraid to go to their Mosque on Friday. I had no words of reassurance for him. All I could do was be with him and let him know that he wasn’t alone.

In the midst of this chaos, I turned to the place where I didn’t feel alone. I turned to the incredible privilege of being in medical school and sharing that experience with over 100 truly special classmates.

The diversity in our class is inspiring. Almost two-thirds of my classmates are female and three-quarters of us identity as members of a minority. Our diverse student body promotes culturally competent care, partakes in a variety of holidays and religious events and shares the flavors of their unique cuisines with all. I am now more thankful than ever for being a part of this bastion of inclusion. This is what has kept me together these past few weeks. As a class we have grieved. We have been disappointed. We have faced a bitter irony that couldn’t be more apparent. Here we were, giving so much passion and energy to someday heal a country that had just hurt us all.

Wednesday morning was cathartic. No one had to say a word. We cried, we hugged, and we lifted each other up. We were used to commiserating together over the typical struggles of medical school, but this time it was different. This time we were truly healing each other’s souls. We told each other we belonged, that we were wanted, and that we would keep each other safe.

Medical students are creatures of action. We are hardwired to find tasks that need to be done and to finish them with ruthless dedication and excellence. For better or for worse, it is likely the reason we ended up where we are today. Thus, to see a group so rooted in action be moved to a state of powerlessness therefore was especially sobering. As we slowly recovered from the gut punch, however, everyone’s minds turned to what actions we could take. As tough as it was to think about school and exams, we recognized that we had a responsibility because of our positions as medical students.

One of my classmates asked a faculty member what can we do to change things. How can we have an impact? Her response was “get your degree.”  She is completely right. We have been handed an enormous opportunity. We have the option to let this event break us and send us down a spiral from which we may not recover. Or we can stand up and recognize that we have the chance to be leaders and to serve our communities. To speak for those too scared and vulnerable to speak to themselves. And to work to heal them. Most importantly, we can use this occasion to remind ourselves just why we entered medicine in the first place.

I work in a free clinic that serves a number of immigrants from Asia, the Indian Subcontinent and the Middle East. I have seen firsthand the impact this year’s events has had on my ability to provide quality care. I’ve had patients ask me if our clinic would close down depending on the outcome of the election. My classmates have seen patients whose depression and anxiety is rooted in the Islamaphobic hate speech they have encountered. I have met clinic volunteers who are afraid of speaking their native language in public. Recently, our clinic encountered a different message. People have called our clinic to say that our patients don’t deserve the care we provide. But this just means we work harder. That we continue to provide support and care to those who come to us. We must stop feeling powerless and understand the role we can play in the future and beyond.

I am not completely there just yet. I am still processing. But I know this moment will be a call to action. With Step 1 looming and the burden of academic burnout weighing me down, this shall be a moment of clarity and rejuvenation. I know my work is now more important than ever before and the stakes are too high. I do not shirk this responsibility, rather I embrace it, taking solace in the strength my classmates offer. I am excited for what the future holds and I will be ready for the work that lies ahead.

-2nd Year Medical Student at UC Davis School of Medicine (Guest Post)
Prophylaxis for Burnout: Learning to Enjoy the Present

Prophylaxis for Burnout: Learning to Enjoy the Present

As I stepped out from my friend’s house, I allowed myself to be enveloped by a once familiar sea of people in maize.

It’s been a while. “Alex, did you miss this?”

My friend asked as we made our way to the stadium.
                   Did I miss this?

I inhaled the crisp autumn air until my lungs were completely full and slowly exhaled.  It was my first time back in Ann Arbor since I started my second year of medical school at Wayne State. My instinct was to shout YES! Yes, I missed college dearly. I missed the naïve excitement of college, the students not in medicine, the naps between classes, the late Sunday brunches, the sports, the food, the city, and even the professors.

As I reminisced on my undergraduate career that went by with a blink of an eye, I became solemn. Life sure seemed a lot simpler back then. Now my life consisted of endless exams coupled with sleepless nights, course-packs that created mountain ranges in my room, competition that turned friendliness into jealousy, and dread from the looming threat of Step exams. All of it had taken a toll on me. No, I didn’t miss college. I longed for it. The times were simpler. The stakes were lower. The life was easier.
In that moment, I wanted to lift my younger college-self up and shout at him. Enjoy the moment! Bask in it. You will crave it when it’s over. Then it dawned on me. The poison of reminiscing is that we forget the pain and only remember the good. We yearn for the past and forget to enjoy the present. College was definitely a great four years of my life, but I had forgotten the toll of being pre-med and the uncertainty of applying to medical school had taken on me. Juggling my classes, research, and volunteering while trying to maintain my science GPA was a grueling process. The truth is that each step of the way in this journey to becoming a doctor is challenging. I can’t let reminiscing about the past supersede enjoying the present. I felt the future resident version of me grabbing me and telling me to enjoy the moment just as I was about to do the same with my previous college self. The staircase only gets steeper from here. I must learn to enjoy each step.
As I finished reflecting, I took my seat among 120,000 other football fans in the Big House and let out a big sigh of relief. My racing mind came to an ease. Enjoy the present. Life is sometimes hard. But not now. Now is the time to soak in the sun. And the game.
It doesn’t matter where you are in the journey of becoming a doctor, learning to enjoy the process and present is essential for living a happy burnout-free life. Like my high school calculus teacher always said about limits, “It’s not about the destination, it’s about the journey.” Let’s enjoy this journey together.

-Alex Yang (Guest Post)

3rd year MD/PhD Student at Wayne State University – School of Medicine

What is understood does not have to be explained…

What is understood does not have to be explained…

“You are living the American dream, why would you put yourself through years of distress for a career that is filled with anxiety and politics?” I know she was only concerned for my well-being and her words were well intended, but they still cut deep; striking a nerve I have yet to perceive. The sting from the conversation lingered for weeks, and weighed heavy on my consciousness.

After much thought, I knew why the question hurt so much. I have been defending my decision, both internally and externally, for quite a while. The hardest thing, despite my education to this point, is being unable to eloquently articulate my desire to continue this crazy, sometimes uncertain, journey. I cannot describe why I would funnel my years of education and job experience into a job as an inpatient scribe, making slightly above minimum wage, while my peers chase executive salaries. Why would I devote 7-10 years of my life to work my way up the ranks in a world that seems to be more and more entrenched in a political framework?

I have yet to find the words to explain it, but whenever I am in a hospital, I simply know this is where I am meant to be. I continue to be humbled by the unparalleled nature of the doctor/patient relationship. Moreover, watching physicians tenderly heal patients so they can return home to their loved ones is amazing.

As a mother of four beautiful children, the wife of an Army soldier, a college graduate, and proud homeowner, I am living the American dream. Despite all of this, I feel alive when I study the human body.  In addition, the excitement of new ground-breaking medical advances is unreal. One day, I will have the honor of utilizing these medical advances to save lives. Lives that would have been lost before such progression.

As a mother and a military police officer, effective communication is my life and was once my source of income.  Yet, I have simply stopped trying to explain my new-found passion that fuels my desire to take on tremendous debt and intense studying and training.

Ultimately, I know that my pursuit of medicine is the best decision I have made. Some days the pressure to explain this is too great, yet the tears are a reminder of the underlying passion. No words need to be exchanged with my children. They know what I am pursing. My hope is that nontraditional premeds reading this, those who similarly cannot eloquently articulate their desire to pursue medicine, will be equally encouraged. Save your energy for the long days and nights ahead. In short, true passion cannot and should not be explained.

-Jessica D, North Carolina A&T (Guest Post)

Contact: [email protected] 
Twitter: msknowitall1922

Medical School Survival Tools

Medical School Survival Tools

“How’s medical school?”

This simple question is often one of the first asked in conversations with family and friends. Some days I can honestly answer, “It’s going well. Thanks for asking.” Other days, it’s all I can to do suppress the urge to grunt and say, “Please don’t make me go back.”

As I near the end of my first semester, I’ve come to realize that my perception of medical school changes quickly and often. Factors including the amount I’ve slept, whether or not I’m caught up on lectures, and the presence or absence of external issues (family, relational, etc.) have a profound impact on how I perceive the daily stressors of medical school. At times, medical school seems to be the most fascinating and fulfilling endeavor in the world. Other times, I lose sight of the forest for the trees, seeing only my list of assignments and tests that lie ahead. After wrestling with these ups and downs for the past four months, I’ve found three means useful in working through the rough patches of medical school.

1. Be thankful
During times of high stress, I tend to let thankfulness go by the wayside. However, taking a moment to stop and reflect on one’s blessings can reframe a difficult situation. By being accepted into medical school, I’ve been given an opportunity that is available to only a fraction of a percent of the world’s population. Daily, I learn about the intricacies of the human body: its design, its failings, and what we can do to treat it. Simultaneously I am equipped with the various skills I will need to one day assume the intimate role of a caregiver and physician. Though classes challenge (and at occasionally frustrate) me, I am undeniably blessed to be a medical student and a future doctor. To attend medical school is a gift that I am deeply grateful to have received.

2. Look past the temporal
Taking a step back to look at problems in a larger context has been an invaluable exercise this fall. As a Christian, part of living my faith in medical school means examining situations in the context of eternity. Doing so helps me remember why I am in medical school and what I am to focus on during my time there. Looking at my problems, failures, and successes in the context of eternity brings relief and humility; each appears infinitesimal compared to God and His sovereignty. I am reminded that my hope and identity are rooted in someone far greater than myself and my achievements: Jesus. Finally, looking past the temporal cultivates thankfulness as I recognized God’s innumerable provisions in my life.

3. Admit weaknesses
This is arguably the most difficult, as it requires the laying aside of one’s pride and the willingness to be honest with self and others. Going into medical school, I felt like I had my life together. I was a young man with a college degree who cooked, cleaned, and was beginning to exercise regularly. I had a pretty good handle on “adulting,” if I do say so myself. Then classes began. After the first two weeks, I felt as though I had been run over by a small freight train. Suddenly I was expected not only to “adult,” but to do so while drinking out of a fire hydrant of information that I had to learn and apply on regularly scheduled tests. As I’ve gradually improved at balancing life and school, I’ve become acutely aware of how weak I am. I could not survive medical school on my own. Admitting my weaknesses and need for help to God, family, and friends, has resulted in the formation of a strong support system, with individuals who are aware of my struggles and willing to talk, pray, and assist in any way they can.

I have by no measure fully mastered the intellectual and emotional roller coaster that is medical school. I still get stressed and am prone to fall into cycles of frustration, often ignoring my own advice to be thankful, to look past the temporal, and to admit my weaknesses. However, I am growing and progressing. My hope is that others will find encouragement in my writing, and that together, we can work toward creating a culture of healthier medical students and physicians.

Guest Post – by Wayne Grey

MD/PhD student – Class of 2020

Better to Burnout than Fade Away?

Better to Burnout than Fade Away?

Physician burnout is a hot topic lately.  The trade magazines, e-mails, and even popular media have been featuring stories on physician burnout.
In case you haven’t been paying attention, here are 10 links from a quick google search:

§  New York Times
§  Physicians Weekly
§  Medscape
§  Consumer Affairs
§  Americain Medical Association
§  Huffington Post
§  Washington Post
§  Chicago Tribune
§  Hospitals & Health Networks

What is burnout?

How is burnout defined?  In this context, it is described as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment.  In another context, it might be the guy who started smoking weed in 7th grade and now hands you the stub from your movie ticket, keeping the other half for his employer.
Of course, in this post, we’re talking about physician burnout brought on by increasing bureaucracy, increasing hours and expectations, decreasing time with patients, pay for performance, unfair ratings systems, etc…  It wouldn’t be tough to come up with a list of 101 ways a physician’s life can be made more stressful.

Why Does Burnout Matter?

Why should we care?  On a personal level, burnout is not a good feeling.  A burned out physician may not be able to give every patient the level of care they’re expecting.  A burned out physician may be more likely to make a mistake.  A burned out physician may not be at his or her best at home, leading to marital conflict, decreased life satisfaction, making work even more difficult to stomach every day.  It’s easy to envision a cycle that repeats itself, becoming a downward spiral that can’t possibly end well.
The repercussions are not good for patients.  Would you want to be seen by a physician who dreads coming to work each day?  A physician who is more likely to abuse alcohol or other substances?  One who is more likely to contemplate suicide?  The stakes are that high.

The Prevalence of Burnout

How common is burnout?  Quite common and increasing.  A recent article published in the Mayo Clinic Proceedings showed at least 1 symptom of burnout in 54.4% of physicians in 2014, up from 45.5% 3 years earlier.  Satisfaction with work-life balance decreased from 48.5% to 40.9% over that time.  A 2012 articlepublished in JAMA showed 45.8% of physicians exhibiting at least 1 sign of burnout, and physicians having an overall burnout rate about 10% higher than the non-physician worker.  Dissatisfaction with work-life balance was about double when compared to the non-physician.
What can be done?  There are big, system-wide answers and there are tiny, change-your-routine answers.  I won’t pretend to have them all, but I can at least tell you what others have done or suggested.  Stanford is rewarding emergency physicians with its time banking program, offering “meals, housecleaning and a host of other services — babysitting, elder care, movie tickets, grant writing help, handyman services, dry cleaning pickup, speech training, Web support and more.”
A recent newspaper editorial suggests the public needs to rally around its doctors like it has its teachers, who have been subject to the myriad of metrics in the recent past.  The AMA has released its STEPS Forwardprogram to help physicians gain control of their professional lives.
Common recommendations to relieve burnout are the usual suggestions to relieve stress:  eat better, take time for yourself, exercise… I’m just not sure how many of us can yoga our way out of professional misery.

My answer to physician burnout

What do you suppose I would suggest to help prevent or alleviate symptoms of burnout? Can you read the words at the top of the page, you know, that whole FIRE acronym?  I believe working toward a goal of Financial Independence, and seeing real progress toward that goal, can do wonders for the psyche.  If you are experiencing burnout, but can see a sliver of light at the end of that career tunnel, and you can watch that sliver expand and shine brighter, your outlook on your career and life might start to glow brighter as well.
When you are saving like Dr. Anderson, you know that you won’t be stuck in this position forever.  Starting from scratch, you could achieve Financial Independence within about 10 years.  That may seem like a long time depending on the stage of your career, but it’s less than the combined years you put in to college, medical school, and residency.
Once you have achieved FI, you’ll have options to lighten the load you’re carrying.  You can work fewer days or hours if your position allows.  You may be able to drop the worst part of your job, while maintaining the part you enjoy.  For example, The White Coat Investor is dropping his overnight E.D. shifts now that he’s got a sizeable nest egg.
You will be empowered to enact the changes you need.  If the only appealing option is to be done entirely and stop working, you can do that too.  And let every day be a Saturday.
Personally, I would rather remain gainfully employed than walk away at the age of 40.  I haven’t taken a formal survey or questionnaire, but I would guess my burnout score would be pretty low.  Some workdays are tougher than others, but I don’t dread them or end them feeling overwhelmed and exhausted.

Burnout varies by specialty

I may be in a specialty that is somewhat shielded from the bureacratic nightmares that plague primary care. The term “prior authorization” does not factor into my workday; I don’t have to worry about dotting enough i’s and crossing enough t’s to magically transform a clinic visit into a Level 3.
The 2015 Medscape Lifestyle Report show anesthesiology having a burnout rate of 43%.  That’s not as low as the dermatologists, reporting a survey-low 37% burnout rate, but quite a bit better than the 50% to 53% seen in emergency, internal, and family medicine, general surgery, and infectious disease.
In My My, Hey Hey, Neil Young tells us that it’s better to burnout than fade away (a worldview repeated by Def Leppard in Rock Of Ages).  I think I’ll ignore their collective wisdom, and do my best to fade away when I’m ready for my career to wind down.  From what I’ve read, burnout can be downright ugly.
What do you think?  Feeling burned out?  Why or why not?  Would progress towards or achievement of Financial Independence change anything for you?  Sound off in the comments below.

By Physician on Fire