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Cosby High School Pre-Med


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  • --Happier when taking non-science classes --NIH research and Honors project --Late pre-med contact prevented more guidance and assistance and limited my medical and volunteer experiences.
  • --Happier when taking non-science classes --NIH research and Honors project --Late pre-med contact prevented more guidance and assistance and limited my medical and volunteer experiences.
  • Transcript

    • 1. What was I thinking? A medical career in-progress Cosby High School March 22, 2011
    • 2. Why am I here?
      • I am here to discuss what life as a doctor is like based on my perspective. I am going to talk about my thoughts and my experiences and I hope to provide some insight along the way.
      • PLEASE ask questions.
    • 3. What is a doctor?
      • What does a doctor actually do?
      • What skills and qualities should a doctor have?
      • What kinds of doctors are there?
    • 4. What is a doctor?
      • What does a doctor actually do?
    • 5. What is a doctor?
      • What does a doctor actually do?
        • Care for patients.
        • Teach.
        • Research.
    • 6. What is a doctor?
      • What skills and qualities should a doctor have?
    • 7. What is a doctor?
      • What skills and qualities should a doctor have?
        • Intelligence
        • Patience
        • Thoughtfulness
        • People skills
        • Empathy
    • 8. What is a doctor?
      • What kinds of doctors are there?
    • 9. What is a doctor?
      • What kinds of doctors are there?
        • Surgeon vs. medical
        • Specialist vs. primary care
        • Adult vs. children vs. women ’s health
    • 10. A typical month of health care in the United States
    • 11. How did I decide to apply to medical school?
      • High school:
        • Did not really have a strong desire to enter medical school.
        • A lot of people advised me that “You should be a doctor” but I really didn’t think too much about it.
        • I took AP Biology as a senior and realized that I really understood and enjoyed it.
        • Received a summer research internship at the National Institutes of Health. The exposure that I had in this program gave me a better understanding about medicine.
    • 12. How did I decide to apply to medical school?
      • Undergrad: medical vs. grad school
        • Actually, I needed to decide between a science and non-science major.
        • Declared a Biology major, with a lot of lab classes, but I enjoyed classes more when I was taking more non-science electives
        • Lots of basic research experience--mostly at the NIH, but also undergraduate research.
        • Limited medical and volunteer experience
    • 13. How did I decide to apply to medical school?
      • As my junior year began in college, I decided that I wanted to pursue a medical career.
      • Late contact with my pre-med advisor limited my options somewhat, but I had ensured that was completing required classes.
      • Took a practice MCAT and did well enough to keep going.
    • 14. What is the best pre-medical path?
      • Early contact with pre-medical advisors
      • Academics: Biology, Chemistry, Physics and English requirements
        • High-level Bio and Chem classes are helpful
        • Challenging and wide-ranging coursework
        • You can major in anything you like (including arts and humanities)
    • 15. What is the best pre-medical path?
      • AMCAS Application
        • Tests: MCAT (biological sciences, physical sciences, verbal and written sections)
        • Recommendations: good letters from people who know you well
        • Activities: medical and community service, leadership roles are important
        • Essays: be creative (but not too much) and address issues not well addressed elsewhere
    • 16. How long does it take?
      • I submitted my application in August, but did not get any scheduled interviews until January
      • I did get rejection letters pretty quickly
      • First acceptance in April (EVMS)
      • Accepted off the wait list to VCU SOM in May--the week of graduation
      • Accepted off the UVA wait list in late June but declined
    • 17. Mistakes I made
      • Should have had earlier contact with my pre-med advisor.
      • More medical and volunteer experience would have helped.
      • I really did not have a back-up plan had I not been accepted into medical school; I was fortunate that things worked out.
    • 18. Career path decisions?
      • MD vs. PhD vs. clinical research
        • Actually, applied to most medical schools in MD/PhD programs, but was not accepted to any
        • As time passed, clinical focus was more appealing and research less so
        • I decided in my 2nd year of medical school to pursue a clinical career
        • Since returning to Richmond in 2007, clinical research is more interesting and more available.
    • 19. What is medical school like?
      • VCU SOM curriculum (for now--probably changing in the next couple of years):
        • M1: basic sciences--anatomy, biochemistry, physiology, immunology, etc
        • M2: some basic science with clinical relevance--microbiology, pharmacology--followed by systems-based teaching on illnesses, treatment, etc.
        • Foundations of Clinical Medicine--longitudinal program in M1 and M2 to teach history, physical exam and clinical decision-making skills
    • 20. What is medical school like?
      • VCU SOM curriculum:
        • M3: clinical rotations: Ob/Gyn, Psychiatry, Internal Medicine, Family Medicine, Neurology, Pediatrics, Surgery
        • M4: currently require 2 clinical rotations: an Acting Internship and a Critical Care elective. The rest of the year is completely elective
    • 21. What is medical school like?
      • USMLE National Board Exams:
        • Step 1: basic science knowledge; taken between M2 and M3
        • Step 2: clinical practice and clinical decision-making; taken beginning of M4
        • (Step 3: necessary to get license, taken after internship)
    • 22. Not exactly what I expected…
      • A lot of work, studying, stress, long nights: there were some tough days, and more long nights than I had expected.
      • And the friendships, support, teamwork: these made the days and nights better, and made for long-standing relationships.
    • 23. Financial issues
      • Took loans the first year, was able to participate in a Commonwealth of Virginia Primary Care Scholarship program all 4 years, SOM scholarships
      • Janet worked all 4 years
      • Lived cheap.
      • Graduated with minimal debt ($16k)
    • 24. Life/school balance
      • My wife and I got married 2 months after graduating William and Mary.
      • This added a challenge: I had to focus on studies and academics while also spending time at home.
      • I budgeted time every day and every weekend when Janet and I could spend time together without school getting in the way.
    • 25. What ’ s the point?
      • It can be easy to become disillusioned. Certainly, this sounds like a lot of work.
      • Remember your individual motivations:
        • PATIENTS need care
        • Desire for a SERVICE career
        • Calling to a VOCATION
    • 26. After medical school…
      • After completing medical school, almost everyone enters a residency program to learn a specialty
      • (the first year of residency is your internship)
      • A chance to learn increasingly complicated diagnostic and treatment skills, patient management, decision-making, etc
    • 27. After medical school…
      • I chose to specialize in Family Medicine because:
        • I wanted to work in a rural / underserved area, and the scope of practice would be very valuable
        • I liked the opportunity to care for patients at all stages of their lives
        • Opportunities for procedures
        • Community and preventive care oriented specialty
    • 28. How do you choose your residency?
      • There is a national residency match program: you choose your favorite programs, they choose their favorite applicants, and then a computer program matches things as best it can.
      • VCU SOM typically has a better than 95% rate of matching students to one of their top 3 programs.
    • 29. After medical school…
      • Matched to the Blackstone Family Practice residency program: a rural-based program in Southside Virginia.
      • Full-scope of training, including emergencies, preventive care, etc.
    • 30. Finally: a real doctor
      • After graduating residency, I entered a private practice in Keysville Virginia and worked there for 4 years.
      • In Keysville, we had a wide-ranging practice with a high proportion of chronic illnesses and geriatric care.
      • We did deal with numerous minor emergencies and the occasional life-threatening emergency.
    • 31. Finally: a real doctor
      • As the 4 years came to an end, I realized that I was more interested than I thought in teaching and working with medical students.
      • I am fluent in Spanish, and was realizing that this was much less common among physicians in Central Virginia than I thought.
      • Came to work at Hayes E. Willis Health Center in South Richmond in August 2007 to have more teaching opportunities, work in a community health center, and work with Spanish-speaking communities.
    • 32. Life in practice
      • Once completing residency, things have been a lot more fun.
      • I can focus my practice on things I like to do, or that I do well.
      • In group practice, sharing call allows a lot of personal flexibility.
      • I am trying to stay active in the practice, the medical school and the community.
    • 34. What ’ s a typical week in primary care?
    • 35. What do family physicians do?
      • Family physicians provide comprehensive and continuous primary care health care to:
      • individuals and families
      • women and men regardless of age or disease
      • infants, children and adolescents regardless of disease
    • 36. Family physicians provide
      • Prevention & management of acute injuries and illnesses
      • Health promotion
      • Hospital care for acute medical illnesses
      • Chronic disease management
      • Maternity care
      • Well-child care and child development
      • Primary mental health care
      • Rehabilitation
      • Supportive and end-of-life care
    • 37. Procedures performed by family physicians
      • Arterial lines
      • Audiometry
      • Casting
      • Central lines
      • Colonoscopy
      • Colposcopy/LEEP
      • EKG
      • Excisions of moles, nevi, cysts, warts, skin tags
      • Endoscopy
      • Intubation
      • Joint Injections
      • Paracentesis
      • Pap Smears
      • Pulmonary function testing
      • Punch biopsies
      • Skin biopsies
      • Spirometry
      • Suturing lacerations
      • Thoracentesis
      • Ultrasound imaging
      • Tympanometry
      • Vasectomy
    • 38. What FP attributes are valued?
      • Deep understanding of the whole person
      • Act as a partner to patients over many years
      • Talent for humanizing health care
      • A command of complexity
    • 39. Family physicians ’ whole-person orientation and training ensures that FPs…
      • Consider all of the influences on a person ’s health
      • Know and understand peoples ’ limitations, problems and personal beliefs when deciding on a treatment
      • Are appropriate and efficient in proposing therapies and interventions
      • Develop rewarding relationships with patients
    • 40. Family physicians have a unique influence on patients ’ lives
      • Serving as partner with patients to maintain well-being over time
      • Empowering with information and guidance that are needed to maintain health over time
      • Providing care that includes long-term behavioral change interventions that lead to better health
      • Developing ongoing communication between patient and physician
    • 41. Family physicians are relationship-oriented, which ensures…
      • Good relationships with other physicians and health care providers.
      • Better patient understanding of complex medical issues and improved participation in the care process.
      • Less expensive and better healthcare experience for patient.
    • 42. Family physicians have a natural command of complexity and
      • Thrive on managing complex medical problems
      • Integrate all of the medical and personal issues facing an individual
      • Break down medical terms and complex medical issues to make it easier for patients to understand
    • 43. Lifestyle of Family Physicians?
      • 39.7 hours per week in direct patient care
      • 50 hours per week in patient related activities
      • Avg. wks worked – 46.9 weeks
        • 5 weeks for vacation/CME
      • Avg. Income for 2006: $161,000
    • 44. Where do family physicians practice?
    • 45. Life in practice
      • Currently, working 8 to 5, 5 days a week and I take call every 4th week (telephone call only)
      • 2 1/2 days Pediatrics (mostly in Spanish) and 2 days general Family Medicine
      • Hayes E. Willis is a community health center; patients who do not have medical insurance are able to apply for assistance through the VCC program
    • 46. Life in practice
      • Currently, I have been teaching VCU SOM students in their required M3 Family Medicine rotation.
      • Teaching an Foundations of Clinical Medicine students in a new evening clinic at the CrossOver Ministry medical center.
      • Helped set up an M4 elective with a focus on medical Spanish (there is an increasing need, locally and nationally, for Spanish-speaking physicians).
    • 47. Life in practice
      • Involved over time in various service activities:
        • Organizations: Rural Area Medicine clinic in Wise County, Piedmont HIV/AIDS Services and Education, Richmond Medical Reserve Corps, Dominican Aid Society of Virginia
        • Individual: immigration detainee medical review and evaluations
        • International: ongoing community development and medical relief project in the Dominican Republic; medical director of a relief trip to Nicaragua; participant in 2 separate trips to Honduras
    • 48. International medicine and global health
      • I have been involved in 10 medical service trips in 3 countries (2 Honduras, 1 Nicaragua, 7 Dominican Republic)
      • Project leader in Nicaragua and the DR
      • Ongoing trips to the DR with W&M undergrads and with VCU SOM and SOP students (via HOMBRE)--last in the DR in January , planning for June
    • 49. International medicine and global health
    • 50. International medicine and global health
    • 51. International medicine and global health
    • 52. International medicine and global health
    • 53. International medicine and global health
    • 54. International medicine and global health
    • 55. International medicine and global health
    • 56. Where I am now
      • My wife and I are still happily married 14 years into this
      • Medical school debt is fully paid off, and my service requirement for my scholarship has been satisfied
      • I am on the clinical faculty at VCU SOM, working in a community health center where I can provide medical care to patients regardless of insurance status
    • 57. Would you do it over again?
      • YES
      • There have been challenges along the way, and there are challenges still, but at the end of the day I feel like I am making a difference
      • Look for opportunities to increase your knowledge and skills, and to provide service to patients and the community--this keeps you renewed and up-to-date
    • 58. Thanks
      • Some slides were copied from the American Academy of Family Physicians Your Future is Family Medicine presentation.
    • 59. What thing has Dr. Ryan been least involved with during his career?
      • Teaching Medical Students
      • International Medical Service
      • Seeing patients at a community health center
      • Conducting research
    • 60. Dr. Ryan was chosen to attend VCU and UVA medical school
      • Immediately after he applied
      • Through a guaranteed admissions program he applied to out of high school
      • Off waitlists
      • By the AMCAS system
    • 61. The M1 and M2 years are mostly focused on
      • Basic Sciences
      • Clinical Rotations
      • Residency Training
      • Building surgical skills
    • 62. The M3 and M4 year consist of
      • Shadowing physicians
      • Clinical Rotations / Applying to Residency Programs
      • Taking more science courses
    • 63. Which of these personality traits are not needed to be a doctor:
      • Thoughtfulness
      • Impatience
      • Empathy
      • Intelligence
    • 64. When should you meet your college's pre-medical advisor:
      • Soon after you start college
      • Just before taking the MCAT test
      • As you finish your medical school application
      • At graduation
    • 65. What kinds of patients can a Family Physician care for:
      • Children
      • Adults
      • Pregnant Women
      • All of the above