Author: Daniel Moses

​Daniel L. Moses is member of the Campbell University’s Jerry M. Wallace School of Osteopathic Medicine class of 2017. He graduated from Lyon College in Batesville, Arkansas with a B.A. in history and from the George Washington University with an M.A. in International Affairs. Daniel worked for more than 8 years in international policy and development in both the U.S. and abroad. He is the Founding Director of the Campbell University Community Care Clinic, the National Conference Coordinator of the Society of Student-Run Free Clinics, and a member of the American Osteopathic Association’s Bureau of State Government Affairs. He also has two cats.

Categories
General Lifestyle

Goals between 1st and 2nd Year

When we were young, summer days were our most free. Our neighborhoods suddenly became hives of activity; kids playing baseball in the streets, video game sessions lasting all day, trips to the pool, family vacations, and most importantly, no school. Those days of summer seemed too short, and during the long winter months when school seemed to stretch on forever, I often sat and daydreamed of the days when I could wear shorts and a t-shirt. For many, summer vacations can last through college, with time spent abroad or back home enjoying the comforts of their childhood. Medical school, however, changes the game.

For those who come straight to medical school from their undergraduate institutions, the last true summer might be the one between the first and second year of medical school. In fact, most schools give students several weeks off to decompress after the long struggle of first year. Therefore, it’s worth asking: what do we do with this time? With that question in mind, I went out and queried fellow students from all years, as well as several physicians in practice and in academia, in order to collect ideas. Not surprisingly, there were a huge variety of answers, but they divided into two basic camps. About half said to do something, anything, to prepare ourselves for our future careers, and the other half said to enjoy the last vestiges of our youth.

The arguments are valid on both sides of this debate. Amongst those who said to do something “productive,” about 75% said to, more specifically, gather experience in an area of interest. Whether through shadowing or more formal experiences such as research opportunities, the idea is to gain whatever knowledge and experience you can to make choosing a specialty easier. Additionally, these measured voices said, you will gain a little extra something on your CV that might impress residency programs. For instance, a friend who had an interest in mental health and addiction medicine spent the summer doing research in a major university setting. He applied months in advance and said the experience changed his life. On the other hand, the remaining 25% said to spend time studying for the Boards. “They’ll creep up on you quickly, so best to start early,” one professor told me. He suggested creating a plan of action for the summer, including high yield topics to review each week.

The “do nothing” crowd, or those on the other side of the argument, also had their say. Many advocated that this last summer is the perfect chance to do a few things that simply won’t be possible in the years ahead. “For those who enjoy traveling, take the chance to get away,” they repeated again and again.  A student who recently matched into PM&R told me that he went to Europe for 4 weeks, rode the train, met lots of great people, and “stayed as far away from studying as [he] could.” He added that this gave him the chance to recharge his batteries before tackling the challenges of second year and beyond. While traveling Europe might not be possible for all of us, finding ways to decompress should be. A family medicine physician who has spent 20 years in practice told me that he went home, saw family, and spent lots of time fishing.

In the end, there is no clear path. Just like with everything else, how to spend that last summer is a very individual choice. My own experience involved taking time off to rest and reflect, and also spending a month locked in a room with some fellow students crafting a business plan for a student-run free clinic, which, after a lot of work and fundraising, opened the next year. I also completed a 2 week internship in rural medicine. I wouldn’t change anything about the summer; both of those work experiences motivated me in different ways regarding the type of physician I want to become, while taking time to rest rejuvenated me for the trials ahead. No matter what you choose, remember to do what makes the most sense for you. If you need the rest, take the chance to get it. If you want to work on something you feel passionate about, do that. While it may seem like another multiple-choice question, in the end, there is no wrong answer.

Featured image:
travelling by Elvira S. Uzábal – elbeewa

Categories
General Reflection

Standing Outside the Match

My favorite online resource, Wikipedia, calls gambling, “wagering of money or something of value (referred to as “the stakes”) on an event with an uncertain outcome with the primary intent of winning additional money and/or material goods. Gambling thus requires three elements be present: consideration, chance and prize.”[1] It’s a funny quirk of medical student life that we all involve ourselves in gambling during our final year. The National Residency Matching Program (NRMP) can certainly fit the definition above. The med student wagers their future (“something of value”) on the Match (“an event with an uncertain outcome”) with the goal of finding the program that best suits them (“with the primary intent of winning”). The risk involved is certainly a calculated risk, as the give-and-take of applying, interviewing, and ranking allows us the opportunity to influence the outcome, but it is a risk nonetheless. In fact, it’s worth noting that much of the NRMP data was analyzed by Anna-Maria Barry Jester on the FiveThirtyEight blog last year. The major takeaway of her work was that while the system may very slightly favor the student, at the end of the day, it is the Match’s algorithm that decides.[2]

Fourth year med students are now receiving their “prizes” after going through the “consideration” and “chance” phases of the Match. As a 3rd year med student, I’m firmly rooted in the consideration phase. I’ve already decided my future specialty (family medicine), which is more than some can comfortably say, but now I have 500 programs to sort through, and how can anyone possibly decide where to apply? The consideration phase of my gamble on the Match is just as much of a lottery as anything. Sure, I get to make the final choices, but if there is a perfect program, how do I know it’s not the one I left off my list? It’s a familiar process at least, since it is similar to applying to medical school in the first place. I sent my applications out nationwide, to both osteopathic and allopathic schools. While the system didn’t rely upon an algorithm to decide, the stakes were nearly as high, with just as much uncertainty.

The process of sifting through residencies, though, is better left for another day. Currently, I just stand back and watch as my older brothers and sisters plan their futures. I’m both envious and wary. Certainly it would be nice to know, to have a clear objective. There is a lot of security in certainty. Then again, there is a reason the casinos are always so full in Las Vegas. People love the allure of any game of chance. When the dice are rolled, in that brief moment before the outcome is known, everyone has the potential to be a winner. No one puts a program as number one on their rank list hoping they aren’t selected to go there, just as no one places a bet on number 17 in roulette hoping the ball lands elsewhere.

I’m looking forward to the Match next year. I like to play the odds, always hoping that my number comes up. Luckily, while I may have no say in what cards are dealt in poker, I do have a say in how the Match ends. I get to meet with programs and all the people who populate them. I get to talk about my passions and plans and hope they get a feel for who I am on those interview days. And when I place my rank list, whatever choices I make, I hope I’ve done enough to pick a place that wants me just as much. When the Match algorithm runs, churning out the yes’s and no’s, I hope my number comes up.

Featured image:
Gambling by Alan Cleaver

Categories
General Lifestyle Reflection

New Job

Every 4 weeks I start a new job. New boss, new co-workers, new hours. This is both the curse and blessing of a medical student in the clinical years. There are some rotations I just can’t wait to end, while others I wish could go on all year. (If there are any of my preceptors reading this blog wondering which category they fit into, don’t worry, yours was definitely the one I wanted to continue forever!) Since I’m a non-traditional student, I had a few jobs over the years. For instance, I worked for a couple years as a civilian contractor for the military. I was doing stuff that sounded really important on paper but was perhaps a bit more mundane in real life. In those days, I knew career civil servants who had been doing the same thing for 30 years or more, sometimes scarcely moving from their desk. I cringed at the thought, but for them, 4 weeks was like a day, and even my entire 4 years of medical school would be seen as no time at all. In fact, one old curmudgeonly co-worker once consoled me after my project was shot down by a Colonel who was also our boss: “Don’t worry, we can get that done when the next guy comes along. These military guys move on after 3 years anyway.” I remember thinking, “In 3 years?! I’m not waiting that long!” It’s no wonder I don’t do that job anymore.

There have been other jobs along the way that have been equally confounding. My first job after grad school was at a non-profit science and tech operation. I was so excited about what I was doing; I thought I really was playing a big part in the volumes of analysis that they put out. Then, a couple months after I started, my boss took me out to lunch for Secretary’s Day, which I promise is a real thing. I sat there eating my meal in utter confusion. I was apparently an assistant, and I always thought I was an analyst.

I recently started a new rotation, my ninth “new job” since beginning my third year. Nowadays it takes me just a couple hours to figure out if it’s going in the good or not-so-good category. Luckily, this one seems to fit squarely in the former. It’s a clinic position, so I have to learn where everything is, and of course most importantly, who to talk to about lunch, as in if there will be any free meals and on which days. This office is used to medical students. I can tell because they made very little initial effort to welcome me. That’s not to say they weren’t nice, indeed they very much were. But there is a different mentality for those who see faces like mine come and go every month. They already know me to a degree, since I’m just the interchangeable body inside the same white coat, with the same 3 or 4 books stuffed into my pockets, and the same questions. They won’t waste their time unless I turn out to be “one of the good ones,” whatever that means.

Sometimes as I wander through all these positions as such a neophyte, I think, does a med student even matter? Are we contributing? The short answer is probably no, until you get that one patient who starts talking maybe just a bit more because the med student seems to have a little more time. Or that patient who feels better just from having been heard, or perhaps reveals some small detail that they didn’t tell anyone else.  Then, in those few moments, I don’t mind being new on the job. I remember that being new is not always a bad thing. In fact, occasionally it can come in handy.

Featured Image:
Lost? by Susanne Nilsson