TeacherTreks17

"Doctor, doctor, give me the news...."

This is my son-in-law, Colin. It is one of my favorite pictures of him because I took this picture, so I know who he is looking for (Emily in the Philadelphia Marathon) and what he has in his coat pocket (an engagement ring).

This again is Colin, M.D. He has, for some reason, taken a liking to this neon-green bandana.

Colin, once again, and Emily on their wedding day. Thank goodness she didn't let the hat deter her.

How well do you know your doctor?

We see them in an office or a hospital, or we know they are examining our lab reports or EKG results, and we have an ultimate trust and respect for what they do.

They "give us the news" and we return to our family and friends.

And so do they!

I've learned more about doctors over the past 4 years or so, and I've learned a lot (Finally I can understand Med School vs. Residency vs. Fellowship...) I've learned how much they work, even when they're not there. I've learned that they have families and friends and they enjoy life, and I've learned that they are thinking about us more then we realize.

As part of my CAREER exploration for my freshmen, I asked Colin some questions to give those who are considering the medical field some advice and insight. His answers made me love him more, not just for what they say, but because he took the time to help out his blog-obsessed mother-in-law!

So whether you are interested in becoming a doctor or if you just want to have an appreciation for one, read on!

1. Colin, M.D.

2. What was your high school and year of graduation?

Archmere Academy, 2005 (Go Auks!)

3. At what point in your life did you know you wanted to become a doctor?

I actually didn't know until the end of my sophomore year in college, which is actually quite late when compared to other prospective medical students. Throughout high school and into college, I always had an interest in science, specifically biochemistry. I started to do research in a biochemistry laboratory (test tubes, cell cultures, Western blotting, the whole nine yards) and found that it was actually very lonely and there was no human contact. As such, I decided to take my interest in science to a field where there would be more interaction-- which was medicine.

4. Did you go to your pediatrician and think"I'm going to do that someday?"

I actually didn't! Many of my colleagues will say something to this effect though. Whether it is a family member or a doctor who treated them growing up, many of my peers will say that this inspired them. Personally, my pediatrician was just the bringer of vaccinations and the gatekeeper of lollipops.

5. Your college and Year of Graduation?

University of Delaware (Go Blue Hens!), 2009

6. What was your most challenging class in college?

There are two or three classes that really stand out. Organic chemistry is very challenging, and I know a number of people who ended up changing their career path because they could not get through the course. I think what makes it so difficult is that it requires you to think about chemistry in three dimensions and involved building models of various molecules and interpreting the various chemical reactions they may undergo. It was very challenging.

Additionally, because I was a biochemistry major, I needed to take a graduate level course on the biochemistry of nucleic acids. The level of complexity that was discussed was very hard to grasp at times. There was also a physical chemistry course and its associated required laboratory component which led to some very, very late nights.

7. Did you take any class (completely different from all the science-type classes) that you really enjoyed?

I took ballroom dance in the spring semester of my senior year which was amazing! It was right in the middle of my core science classes, and it was a great break to the monotony of basic science.

8. Can you provide a basic "path" of education that a doctor follows? It's tough sometimes for people to understand undergrad/medical school/residency, etc. Please also add the "additional" step that you have taken. What do some people do if they choose not to start a Fellowship?

This is going to be a long answer.

First, in high school, just worry about doing your best, keeping your grades up, and going to the best college that's the right fit for you and where you feel you will be able to excel. In college, MOST future physicians typically choose to be a biology or biochemistry major, or at least focus on a science-oriented major (engineering, psychology, etc.). During your junior year of college, you start gathering your letters of recommendation, researching medical schools, studying and taking your Medical College Admissions Testing (MCAT), and preparing to apply to medical school in your senior year. During senior year, you interview for admission to medical school, and if all goes well, hear about your acceptance. The national acceptance rate to medical school is around 40%. GPA, MCAT scores, letters of recommendations, and extra-curricular activities are all extremely important.

In medical school, the four years are fairly standardized. The goal of the first year is to put everyone on the same page. As such, the make-up of the year is primarily a core science curriculum involving biochemistry, physiology, and everyone's favorite, ANATOMY with CADAVER LAB. There are also courses built in to begin exposing medical students to interacting with patients, including how to take a patient history, how to break bad news to a patient and their family, how to perform the basic physical exam, etc.

The second year of medical school centers around the foundations of clinical medicine, specifically learning the functionality of the organ systems in the body, the various disease states that affect them, and the standard of care when it comes to diagnosing and treating these various ailments. You learn the normal, the abnormal, and how to make it normal again.

The summer between your 2nd and 3rd year of medical school, you take Step 1 of your United States Medical Licensing Exam (USMLE), which is an EXTREMELY important score, as higher scores open doors to more prestigious residencies in the years to come.

The third year of medical school is spent "on the wards." You are in the hospital and in clinics caring for patients (Finally!) under the guidance of medical residents and attending physicians. You are exposed to the major specialties in for large blocks of time (internal medicine, pediatrics, OB/GYN, psychiatry, surgery, family medicine) to help you gain insight into what field you may be interested in pursuing. Usually, there is also some time to explore other alternative career paths that you may be interested in as well which are not well represented in the large blocks of time (ophthalmology, radiology, dermatology, pathology, various surgical specialties, etc).

After third year, you make the decision regarding what field you wish to practice as a specialty and begin to apply to residency. With this comes another application process, in addition to taking Step 2 of the USMLE.

During your fourth year of medical school, you work on refining your interest in a specialty. For interest, if you are interested in surgery, you will spend more time rotating with the surgical groups, and also though different surgical sub-specialties (vascular surgery, colorectal surgery, minimally invasive surgery, cardiac surgery). If you are interested in internal medicine, you may spend time doing rotations in cardiology, oncology, pulmonology, or rotating in the intensive care units. As this is occurring, you will be interviewing at various residencies programs.

In the middle of March, Match Day arrives! Match Day is a day where after all your interviews, you submit a list of programs that you found to be the best fit. Additionally, all the residency programs additionally generate a list of candidates in whom they are the most interested. A computer algorithm then determines where you end up doing your residency based on where you ranked the program and where the program ranked you. The day can be filled with drama, as often times, people end up moving across the country for residencies, which is often intentional, but sometimes not. This is not your typical job interview where you apply and are or are not offered the job-- you apply to lots of different "jobs" and open an envelope on that day in March and find out what job you will be taking. This makes it especially important to only apply and interview to programs where you would like to attend-- you may end up there! In May or June, medical school concludes, and you graduated with your medical degree! (Woo-hoo!)

Your first year of residency is referred to as your "intern year" regardless of specialty. This is a rough adjustment period, as you were not a doctor mere months before, but you are now suddenly responsible for major medical decisions in the care of real patients. It is important to know that during this process, you have great teachers and guidance along the way should the environment become overwhelming. Additionally, you take the final step of your USMLE (Step 3), and that's the end of that specific board examination.

After your first year, you then become a resident, and your role changes. The Johns Hopkins internal medicine residency has an expression to describe the three years of residency as "You bleed, you read, then you lead" to represent years 1-3, respectively. The 1st year can be a difficult transition and it takes time to get used to the work load, the 2nd year you spend catching up and learning the critical information you may have missed or not had time to learn during year 1, and the 3rd year puts you in more of a supervisory and teaching role on the team.

Residency programs vary in length, but all are a minimum of 3 years. Pediatrics is 3 years, internal medicine is 3 years, OBGYN is 4 years, surgery is 5 years. The longest is neurosurgery, which is NINE years. After each residency program, you are a certified for independent practice... but only after you finish you corresponding board examination. If you are specifically interested in a particular field, you can choose to specialize further with a fellowship.

Fellowships are sub-specialty training programs-- they are most common in internal medicine, where fellowships include cardiology (heart), oncology (cancer) , nephrology (kidneys), pulmonary/critical care (lungs and ICU), infectious diseases, etc. However, certain surgical specialities have fellowships too-- vascular surgery, transplant surgery, subsets of orthopedic surgery (ankle, spine, shoulder, hand, etc.) People really choose to do fellowships if there is an area of interest they developed during residency that they'd like to expand further upon and spend the rest of their career treating.

9. Where did you go to Medical School?

Sidney Kimmel Medical College (of Thomas Jefferson University)

10 . Was it as grueling as everyone perceives it to be?

Medical school is very difficult-- there is no question about that. You will be pushed to the limit when it comes to studying, mostly because of the volume of information that you need to know. There will be lots of late nights in the library, lots of coffee consumption (or tea or soda or water if you're good), a lot of late night runs to Sheetz or WaWa to refresh, and many, many naps. However, I think that people don't realize there are aspects of medical school that are fun! You meet some great people from all over the country with a variety of other interests who also want to kick back just as much as you when the tests are over. Plus, most programs are major cities, so there is always a lot to do and explore when you have some free time.

11. What was the best part of Medical School and the worst?

The best part of medical school was easily the people that you meet and the relationships that you develop with your classmates. The worst part is the frequent examinations and the uncertainty-- will I pass this board exam, will I match where I want to, will I EVER get to leave the library tonight?

12. Please explain your Fellowship Program.

So currently, I'm a cardiology fellow at the University of Maryland. This means I finished 4 years of medical school and 3 years of internal medicine residency. Because of my interest in the heart, I wanted to pursue a cardiology fellowship. Fellowship is a way that you can be immersed in the field and get exposure to all aspects of a given field. For cardiology, you are exposed to caring for people who are having heart attacks and require stents in the heart, you are exposed to putting in pacemakers for people with abnormal heart rhythms, you are exposed to interpreting ultrasounds and CT scans of the heart, and you are exposed to caring for patients in an out of the hospital who have any problem related to the function of their heart. I personally find the way the heart functions and population of patients who develop heart disease to be the most fascinating, which is why I chose to pursue this specialty.

13. I sometimes see you in scrubs and other times I don't---can you explain that? (It's all about the clothes!)

This is a great question! It really depends on two things: time of day and which rotation I happen to be on at the time.

In regards to timing, if I am working an overnight shift, I wear scrubs mostly for the sake of comfort. There is also a possibility during the night that I may need to do a procedure on a patient which may lead by scrubs bloody. If that happens, I will need to exchange them, which is easy to do with scrubs, but not as easy to do in a button-down shirt. Plus, Emily would be VERY mad if I got blood on my clothes.

When it comes to rotation, certain rotations, like ones where I would be doing procedures, require you to wear scrubs. If I am performing cardiac catheterizations (imaging of the arteries [blood supply] of the heart to determine if there are blockages) or assisting in putting in pacemakers (minor surgery), I would need scrubs because 1) They are sterile when obtained from the hospital and 2) if they get bloody, you can exchange them out. If I am only seeing patients in the outpatient offices, I typically dress up with a shirt and tie.

14. If you weren't a doctor, what profession would you have entered?

I've thought about this, and I'm not sure. I initially wanted to say I would want to work in a research lab, but there isn't much human-human interaction there, and that would drive me crazy.

So, I honestly think I would have wanted to be a communications major and tried to be a news anchor.

15. It's time for that all-important advice for students considering this field. What would you say they should know before beginning

Before starting, just know that it is a long road, but there is definitely light at the end of the tunnel. Keep your head up and stay positive during the process, even when it gets grueling. If you are interested in medicine, you need to keep your grades up and develop study skills that you will be able to utilize when you are feeling overwhelmed by the amount of material. Finally, be confident in your decision to pursue medicine! The path can be rough sometimes, but if you are passionate about your ultimate goal, you can use this as motivation to achieve success! (Sorry, that's a bit corny)

It's OK, Colin, because I'm about to get corny.....