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A thought on, "What should I do in my gap year?"

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Alejandro

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Hi everyone!

So the end of the academic year is here for some of you, and some have a couple months before graduating-and everything in between. So I wanted to share a thought about what to do for the gap year. Assuming you've made the decision (I'm sure many of us have spoken about WHY to take a gap year, but moving forward from that...what does one do in the gap year?)

If you're a philosopher and enjoy deeper thinking and questioning everything you do, this might be a good exercise. For the straight-shooter, box-checker, hoop jumper, this might drive you nuts.

From my own experience as an interviewer and when I have to talk about people, I've learned that there is no "ideal" gap year activity. Common ones I've heard of include:

-Lab researcher (local lab, research fellowship, NIH program, etc)
-Clinical volunteer (ER, ICU, Floors, clinics)
-ER Scribe
-Crisis center
-International (travel vs global health clinics)
-Tutor (MCAT, subject specific, etc)
-Patient care technician/ER tech
-EMT
-Peace corps/Americorps
-Teach for America
-Health navigators

Truth is, there are a ton of activities out there. In fact, there is no perfect activity. The biggest question is what you are able to get out of said activity. Again, for people who are straight-shooters who are good hoop jumpers who can't think critically/deeply, this is difficult.

It is difficult because you're having to reflect on your experiences. All of these roles have nothing to do with being a physician, but in many cases, what society is at large. You will often interact with society at large in a different context than what you're used to. Why? Because for many of you, you will have spent your past 4 years sheltered on a university campus/ivory tower surrounded by people who are like-minded, eager to pursue a higher education, and likely have the socioeconomic means to be in that position. Then, you get a REAL JOB (Yes, taxes, retirement, etc), and stuff starts to get real. And you realize that not everyone has the same educational background. Confession: I once used to judge a lot of people who went to a community college, or a trade school. After I took time off and got a real job, I realized that I should judge (if I have to) on how hard they work and who they are as people, not what initials they have next to their name. Academia can easily rope you into a world of elitism. And that's BAD. Especially as a physician.

In case you haven't realized, I have inadvertently just given you an answer to what I would've appreciated had I been interviewing myself (as I'm looking back on what I wrote). Again, these types of reflections are the deeper things that people say, "oh wow, this person learned something." "Or, dang they're super mature and have real insight." Again, just checking boxes will never let you understand this, because you're too busy just trying to check in or check a box, and doing the minimum necessary to put it on your resume.

So, my advice: Do something that you're passionate about. Be the best you can be at that activity. If you're gonna do research, be proud of the research that you do. "Publishing" is a STUPID goal, because any researcher who has had some experience knows that the amount of work you place into a project does not always correlate to the #'s of publications you get. I once worked in a lab where I got a pub in Science, only because of a summer side project that I did where the results were critical in publishing a study. I had a friend who worked every day and night in the lab, could run circles around me with different molecular biology techniques and couldn't publish it because her experiments failed (for whatever reason). So, its about what you take away from it. And for you to continue to work hard, push the envelope, to ask more questions, to explore a new hypothesis, and OWN your research. And, usually that will result in a publication, and if it doesn't I'm sure your PI would write in your letter that you're a rockstar. For many, working that hard will result in a pub anyways.

It's the same with being, say an EMT. I really care less about those who check those boxes, saying they have some silly EMT certification. What I care about, is what you've seen/experienced. What's it like to work 24hr days? When you're getting up in the middle of the night to an emergency? When you're responding to a critical patient? When you have to talk to families? When you walk into someone's house that looks NOTHING like yours (drugs, guns, sex, alcohol, etc). Logging x hours help you get there, but really it is what you take away from that experience.

Maybe I'll dabble with TFA, or peace corps-what are you learning about society as a whole? What types of socioeconomic barriers are there for education/literacy, versus health as a whole? What anecdotal evidence can you share? How did you have to grow from said experiences?

Or let's look at volunteering in a clinical setting, because this often makes me snore a lot during interviews. Did you ever try to talk to a patient? Tell me an interesting patient encounter. What made this person interesting as a person, not as a "carrier of disease"? So they are sick, how did they get there in the first place? What non-medical factors put them in that position? How as a physician, am I going to address these problems? Will that silly white pill fix all of the problems that each of these people face on a daily basis?

These are the types of things that I want to see from applicants with their activities, especially a gap year. Funny part, is that many applicants just say, oh yes it was cool. I learned a lot about, doing xyz. But to be honest, you're not applying to be a teacher, ER restocker, a PCT, a scribe, or paramedic. You're applying to be a physician, who takes care of people with medical problems that are often the manifestation of social problems as well. The goal is to learn lessons that you cannot learn in medical school, or to learn lessons on how the rest of society or healthcare functions. And, how you as a physician can take these lessons to incorporate them into your practice.

So, in essence, how should you think? It's a philsophical issue: Doing activities as an end in itself, rather than a means to an end.

So what does that mean? Nothing that you do MUST ABSOLUTELY BE CLINICAL. A clinical activity such as volunteering on the side should suffice. It ultimately has to demonstrate that you learned something from that activity. Last anecdote I want to share, my most powerful activity was being a clinic secretary. Yep, nothing clinical. No blood, no touching of people. But, what I was able to reflect on, was that I learned how much work goes behind the scenes in a medical practice. All of the paperwork, all of the privacy laws (and how they often OBSTRUCT care rather than facilitate it), how hard it is for our patients to pay for their bills and face them in person as they ask for help, have to deal with all of the customer service and diffuse belligerent patients. And most importantly, to respect all of the work that all of the non-doctors do. Because they haul @$$ too. And to be honest, these lessons were clutch as a med student, and now as a resident. And I don't expect these lessons to be useless as an attending. But nope, I didn't touch anyone, I didn't run some fancy test, no I didn't do CPR, and I didn't save a life from some wild intervention.

And, for the record, working in the ER as a technician, the first activity I did was I brought someone back from the dead (coding) with CPR. But it didn't take those M.D. letters for me to do that. So sorry, "saving a life" can't be a reason to be a physician. Think deeper.

So, hopefully this gave you some insight as to what I and maybe some others think about the gap year activity. You have to do something that you can learn something from, and to be able to tell the admissions committee about.

Adcoms, administrators, fellow residents and med students-your thoughts? Anything else you'd like to add?

Lastly, sorry for the long post-wasn't sure how this post was going to evolve but I like how it turned out.
 
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maplecookie

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Thank you so much for this post

I am at this point looking at taking a gap year and originally thought to continue my research. But after much consideration, I decided that as much as I have done and love my research, my gap year will also be a good time to leave the ivory tower of academics and really have more time to pursue clinical and volunteering in the community. At first, I was kind of nervous at the thought of leaving my familiar university grounds but now I am more optimistic and look forward to expanding my horizons.

This post has really hammered home a lot of the points I was thinking about my possible gap year and given me inspiration
 

Goro

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I have a high regard for people who volunteer in hospice, with the developmentally disabled or mentally ill. Very few people are comfortable with confronting mortality.
 
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RNtoMD87

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When asked "Why do you want to be a doctor"? by an adcom as a nurse

How does "I feel unsatisfied with my level of knowledge, and though I enjoy caring for patients, I want a much deeper level of understanding and a greater responsibility of care" sound?

If not good, what do adcoms like to hear from nurses? What do they see as an admirable reason to do medical from nursing?
 

dr.waffles

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To piggyback off of T-Swift, another really great Americorps option that is specific to health is National Health Corps. I decided to join it this year because I was really interested in working with undeserved populations AND health, and it has been an amazing experience! One thing I really appreciate is that we have monthly training meetings where we learn about different topics related to health. I have walked away from a good handful of those meetings knowing that I will be a better, more informed, more compassionate doctor in the future because of what I have learned. It's also nice because unlike becoming an EMT or CNA, you don't have to do any prior training, but you are still able to get a really good look into medicine. I could talk about it forever! I wish more people knew about this program because it has been such a great experience! I would love to talk to anyone more about it if you are interested!
 
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