So, I’m a 4th year medical student. For the longest time in medical school, I thought I was going into Family Medicine. Third year changed that. You’re just exposed to so much. I realized I liked becoming the specialist, working with my hands, having both longitudinal and case-based relationships, and working in an outpatient setting. After exploring several fields, I realized that Ophthalmology was a perfect fit. I love so much about the field, and am working to get involved in a variety of projects at Kellogg Eye Center leading up to applying this fall.
The project that I’d like to share with you brings my premedical experience into my new career. In my former life, I would build websites, do public relations, and practice brand marketing for a number of nonprofits and businesses. In my present experience, I realized that it was difficult to discover which ophthalmology resources in terms of books, videos, podcasts, and match information are most recommended. At first, I surveyed recently-matched medical students and residents just to answer my own curiosity. Then, I decided to publish the results.
The final product — although by its very nature, a work in progress — is Pre-Ophtho.com. It is an ophthalmology resource for medical students that contains “near-peer” recommendations. Near-peer is a concept that I’ve really appreciated here at Michigan. It means learning from people who have recently experienced what you are about to experience, so preclinical medical students ask clinical medical students how to study for sequences, boards, exams and get access to study guides, for example. Clinical trunk students can ask branch students about which electives are interesting, and so forth. My website continues that tradition, presenting the resources that recently-matched students and residents suggest to clinical medical students interested in Ophthalmology.
I’m happy that I’ve been able to combine medicine, marketing and web development together for this project. Going forward, the plan is for Michigan’s Ophthalmology Student Interest Group to update the site each year with new podcasts, videos and other recommendations.
Good luck to you in your medical adventures — and don’t forget to ask near-peers for advice.
If you’re not familiar with the phrase “high yield,” you must be an applicant. Every medical student is familiar with the phrase. Some embrace it. Other shudder with repugnance. But the reality is, as you move along through your pre-clinical years, you become a bit more than merely aware of the notion that there are aspects of your education that will be tested on Step 1 of the USMLE, and facts that simply are not. High yield — the facts that matter for Step 1. High yield — optimizing your sow for the maximum reap.
Nutrition — other than knowing your testable vitamin and cofactor associations (which you bloody well better) — is not a high yield topic for Step 1 of the USMLE. Nobody is going around freaking out about the ins and outs of the Mediterranean diet, or the merits of low carb vs. plant based vs. any of the other topics that our patients are grappling with for their everyday lives. But it matters. And I’m not going to spend this blog trying to lay out the case for why diet and lifestyle matters to our patients. Just open your eyes to the people we are caring for in our hospitals and clinics. What could be more impactful?
Angie Sullivan giving a tour of amazing eating in the student lounge
Nonetheless, I’m sure you’ve gathered that this is a passion of mine. And I should say that while it’s a passion — it’s one I haven’t even been able to live up to myself during medical school, which has confounded me. While many of my classmates seem to have gotten more buff and in shape over the last two years, I have not. But let’s set that aside. I came into medical school thinking that I wanted to focus on diet and lifestyle, and even in grappling with the issue in my personal life, I think I’ve done it.
But going to this school has given me a chance to serve on committees and on student council where I can lend a voice to the legitimacy of wellness, diet, lifestyle, etc. in the context of medical education and culture. I’d really love to help evolve the culture of medicine to where we’re taking care of ourselves and our associates. I’d love to see hospitals be a paradigm of awesome health. To serve healthy food that is also affordable and actually inspire people when they come to the hospital with the possibilities around good eating and living. So, at Michigan I try to do the little things to see and be these changes myself.
So, the meditation group I’ve got going with a few friends has been a part of that. We meet once a week at a time that supports our own lives, and it’s been a great little group. Starting last year, a friend and I started another group — a regular nutrition lunch series aimed around topics in our curriculum. She really took the lead, and organized some great talks on sports nutrition, diabetes management, and heart-healthy diets, to name a few. But as medical students, we truly are strapped for time. We are going from one thing to the next, constantly studying, and I’d rather an issue as important to our lives and those of our patients such as nutrition not fall to students to organize.
So, we’ve found a local organization, Plant-Based Nutrition Support Group that is willing and interested in taking a leadership role in planning and executing talks. It’s been an excellent partnership so far. One of Michigan’s staff members has really been the point person for getting this series going, and I’m so grateful that she’s able to do this. Nutrition really needs a stakeholder at the institutional level to sustain itself as a topic worthy of continued importance in our lives as medical students. I would love to see a higher-level collaboration go on between the medical school and a newly-formed graduate program run through Michigan’s School of Public Health called — you guessed it — the Department of Nutrition Sciences.
I honestly hope that my part in organizing these activities is a small contribution to my ultimate goal — evolving the culture of medicine.
If you come to Michigan — I’d like to invite you to join me and my passionate classmates who have issues that are dear to them. It’s an active time at our medical school, with a lot of opportunity to find niches where you’d like to see change, and to work hard to be useful. Just off the top of my head, I can list a myriad of issues that are being addressed by student organizations in collaboration with interested faculty: healthcare inequality, transgender rights issues, global health, ethics, technological innovation, curriculum change, black lives matter, Medical Student Grand Rounds.
Find the chunk that matters most to you and dive in.
May the Yield be High.
Living life, learning and loving it.
This picture is from August 2009. It’s from a KSL TV story about one of my favorite clients — a brand new farmer’s market at the time on the diverse west-side of Salt Lake City. I’m the guy with the trumpet. The guy looking on became the chair of Salt Lake City Council. I’d been working for myself in public relations at that point for a year. It was glorious and challenging. Every day meant waking up and participating in the flow of life. It meant serving on city- and state-wide committees and advisory councils. It meant knowing your neighbors and their needs. Finding and fitting into niches. People would pay me (and my company) to do work for them! The clients I had – farmer’s markets, a coalition of mothers campaigning for clean air, a bird zoo, a statewide senate race, yoga studios, a chain of indie record stores, a professional cycling race, to name a few – represent a diverse coalition of interests that represent as well as anything else who I am and what I stand for. I was on TV, wrote editorials, was featured in a magazine spread and generally felt like I was making an impact in my community. With friends, we started a community radio station. It was a blast. The Community Foundation of Utah even gave me an award for it — one that I neither expected nor paid attention to. I wasn’t trying to get into medical school. It was just the life I happened to be living! I was fortunate enough to be in a position to work for the causes that I was attracted to — and were attracted to me. Ah, the entrepreneurial spirit.
I’d like to fast-forward 3 years. I’m sitting in the well-decorated waiting of an elite east-coast medical school on the first possible day of interview season at this particular school. The other applicants and I are nervously awaiting our judgments-er-interviews. In walks the admissions director, a stately and feisty woman who in summative assessment declares “you’re all the same to me. Every one of you. Elite grades, the highest MCAT scores, impeccable records, glowing letters of recommendations. But you’re the same as one another and every other applicant.” It’s a rough thing to hear. And immediately – as intended – cuts you down to size. What size? Whose size? For what purpose? So that we are malleable into physicians. Fine. But after leading a life – an actual life – and then going to two years of pre-med courses, waiting a year through the admissions process – and then embarking on medical school – it is difficult to hear “your past is nothing, your slate is clean, you are ready to be impressed upon.” Perhaps this is true to some extent – we are needing to be rewired to think like physicians. But, oh, what you may be missing out upon by wiping fresh medical students clean of their life’s experience.
And this, I believe, is an area in which Michigan is establishing itself to really excel in medical education.
Flashing forward again now to a month ago. I had the chance to watch a baseball game with the dean of medical student education at Michigan. It was a great experience. I’d like to relay a conversation we had about what it’s like to actually “delay life” to go to medical school. And we’re not just talking about my “special flower” of an experience. We’re talking about the fact that across the country some of the top test-takers and accolades-earners are sequestered into medical schools, essentially shuttered from society for 4, 8 (residency), 12 (fellowship) years in addition to their undergraduate coursework and experiences which in many ways are often geared toward getting into medical school in the first place. We spoke of the vast potential energy trapped in this national resource. Think about it – some of the biggest nerds with the biggest hearts memorizing the Krebs cycle. Again.
I don’t want to speak for the dean. I just wish to relay my point of view from our conversation; why I think that Michigan’s evolving curriculum contains the spirit of unleashing some of this pent-up potential. None of us coming into medical school are – or wish to be – tabula rasa. We come with our expressed and hidden desires. Our passions. The excitement we bring into the medical field. For many of us, we look upon the current state of healthcare and see massive inequality; disparity that ought to be fixed. Others see political opportunity; ways to use their skills within the legislative system to create change. Others are hardcore biomechanical engineers who want to create gadgets. We’ve got master-pipetters (God bless them) that just want to (bless their hearts) sequence DNA all day long and invent cures for obscure diseases. We’ve got folks that singlemindedly and not secretively whatsoever want, wish and need to become the highest powered surgeon on the planet. And society needs folks like that.
What I think we’re trying to do at Michigan is create a place – through trunks, branches and paths of excellence – where students can find, create and flourish within niches. Can carve their space. Can be entrepreneurial in their educational endeavors. And can make an impact on healthcare while they are in medical school. This is the spirit of our conversation, from my perspective. Right now the curriculum is an evolving structure. M2s are voluntarily demoing components of the curriculum that are being rolled out for M1s. It’s an exciting process. There are growing pains, and like any moment of change, great opportunity. Many of my classmates are actively involved in committees that are shaping the curriculum. A few friends and I are organizing co-curricular nutrition seminars. Another group of students is hosting weekly meditation groups. Students are running free health clinics, putting on lunch talks about any interest imaginable, inventing paths of excellence, creating peer-reviewed journals, and hosting Medical Student Grand Rounds. I could extend the list all night. The point is: you carve your niche. You grab a piece of the school and help grow it. In many ways, as a second year medical student, I feel like the intrepid guy in the photograph at the top of this blog – a guy with a passion on a mission, wielding a trumpet for who-knows-what-reason and raising a fuss about a cause I care about.
Why not have a better healthcare system? Why not make a medical education system that makes more sense? I think we’re taking a step forward – albeit one somewhat into the unknown – with the evolving curriculum at Michigan. Look, you still have to buckle down and muscle your way through OCHEM 1&2, PCHEM 1&2, BIOCHEM, CALC 1&2, PHYSICS 1&2, etc. You’ve still got to study sometimes when you could be dreaming, exploring, playing, and actively contributing. You’ve still got to take that financial, time and opportunity cost to get into and get through medical school. And your Physics MCAT score is still the best predictor of your future USMLE Step scores (good for me) and still has no correlation to how you’ll do as a physician (work on your skills). But “carving your niche at Michigan.” I just like the sound of it. It’s a step in the right direction.
Hah – it’s late and time to be pushing off. To the spirit of desire that fuels your mad quest to become an amazing physician – you eminently weird soul who is reading this. You could be making money, riding a bicycle and doing yoga. All day long. But you want to become a physician. We need folks like you.
Summer’s almost over. I’m driving back from Atlanta this weekend. Orientation starts 7am Monday morning, followed by a full day of lectures and… an ice cream social. Going back and forth has become somewhat normal for me over the course of my first year in medical school. Fortunately, the med school administration, counsellors and curriculum are supportive of such a life outside of school. Still difficult, but you learn to adapt.
One lesson that I’ll try to take into this year is about boundaries and simplifying life when possible. I discovered (surprise surprise) that I have the habit (a big surprise is coming) of saying yes to every possible volunteer activity and overcommitting myself. Now, it’s always meant a lot to me to finish projects that I start, and to do what I say I’m going to do. These are good virtues. But the quality of “less is more” and “give yourself time” are harder hats for this guy to wear.
I’m a person who likes many things — just look at my (over-abundance of) experience before medical school. There is always one more interesting project. Another cause to be championed. And never, ever, ever ever ever, a shortage of worthy pro bono work to be done. Years ago, I learned to stop doing these projects (good projects!) for the goal of receiving a “thanks.” But the sheer force of habit continues to pursue a myriad of projects.
My mentor (as did my fiancé) told me a few times over the course of last year, that the first year of medical school is as good a time as any to practice saying “yes” and “no.” Yes to the things I must do. That fill me up and give me more energy. And to the things that simply must be done. And “no” to a lot of other stuff. There is so much good stuff out there. SO MUCH. But it’s OK to set limits with yourself. And it’s important to communicate these to others.
So, as I get ready for the second year of medical school (evil mantra: it’s hard and it only gets harder), I’ve looked at a list of suggestions from past students. Every bit of coexisting and contradictory and worthwhile advice. And I know this for sure: there will be an abundance of room for practice.
What a tremendously inspiring week I’m emerging from….. LEAPS into IM. This is a retreat/workshop organized by AMSA and the Academic Consortium for Integrative Medicine, of which Michigan is a member. Let me tell you what we did, and of my experience.
First of all, I came there after my first year of medical school. I’m not going to lie: it was a challenging year for me, as the culture of medicine and the rigor of constant studying took a year-long toll on my serenity and peace of mind. At this conference, this was a common experience. There were 30 medical students at the LEAPS conference and 10 faculty facilitators from various U.S. medical schools. We shared an unspeakable bond and connection. I told the people of my experience, and they said “yes, we have known this, too.”
In small groups, we shared our experience and aspirations. Our desires to heal ourselves and our patients, in body and mind and soul. Our love for life and concern for the wellbeing of our fellows. We bathed in the sunshine of Oceanside, CA at the Old Mission San Luis Rey. We practiced yoga, mindfulness meditation, Tai Chi, massage, OMM, experienced acupuncture, and participated (rather fully) in a shamanic drumming circle. I cannot tell you of the power of this week. I felt so utterly renewed in my desire to be a physician and a deep, deep fellowship with the people I met at this beautiful conference. So many tears were shed as the layers of stress and anxiety accumulated over the course of M1 year peeled off of me. I found myself leading circles of fellow students in breathing exercises and Sun Salutations. When we presented to one another, we congratulated and encouraged one another. It was just such a nourishing experience.
One of our final projects was to write one another notes. I will cherish these messages throughout the summer, will hope to draw upon them during the upcoming school year, and will keep my fellow students in my heart as I keep moving forward on the very strange path of becoming a physician.