AHH...I almost made the interviewer cry. HELP!!

[Corvus Riley]

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*shrug* I had a Dr. Pepper and reviewed all of this mess. While I agree that there is an element of growing up involved in the desire to be a doctor, what with the Messiah Complex that pops up sometimes, rather than the Rubik's Complex which is much better in my opinion *snicker* But still, if this is what the OP wants to do then there isn't a problem with it inherently, though there is an element of realism that should be added, which I do not deny. Ruralfamilydoc, if after all of this nonsense you still feel that you want to go into rural medicine then go for it. There are many schools in this country, the first that comes to mind is FSU, that specifically cater to people such as yourself. You will, though, need to remember that it will be difficult. You have lots of time between now and then. Whatever you choose, you should maintain your motivation and passion for it and don't be discouraged, least of all by an internet forum.

 

[kiyomander]

One of the reaons why I believe the OP received answers that are perceived as harsh is that one of these threads crops up every week, so it seems. Honestly, I am sick of it. Most of the posters have no experience in the medical field, and very little life experience. I would not "rip him/her a new one" so to speak, I just want a specific answer. Unfortunately, there is not one.

I respect you for working overseas in areas where healthcare is practically nonexistent and for wanting to pursue a specialty where you can do that. If you were an MS3-4, or perhaps a resident, I might be more inclined to believe you when you say you want to work in parts of the world with no access to healthcare. However, the odds that most people pursue this route is extremely low.

Thanks... I'm new to these msg boards and blame my crankiness on old age. I'm 34. I left a career behind, completed a post-bacc, sacrificed a LOT, and am interviewing right now with the rest of you. One thing I've noticed in many of my physician friends who took the traditional route and never really experienced a career or life outside of medicine is how jaded they are. It makes sense given how hard they had to work to become doctors and the stress of residency. I'm not crazy. I know that we have a very broken health care system and that what lies ahead of me will not be easy, but I do have perspective. I've routinely worked 50-60 hour weeks, been abused by supervisors, made good money at times, struggled financially at other times, but at the end of the day, it was all rather empty and depressing. When I discovered medicine, it was like a dark cloud lifted. Even my worst, most stressful day in O-chem or studying for the MCAT, or cleaning up a patient's BM while volunteering were all better than anything I'd experienced in my previous career. While I appreciate that you feel it's necessary to prepare each other for the difficulties ahead, it's also vital to preserve some sense of idealism as it is so rare to find in the working world. 😛

I know this thread is not about me, it's about the OP. If he/she crashes and burns, I'm sure there will be a ton of schadenfreude. However, I just want to offer him/her my encouragement. If he gets spanked by reality and pursues another path, that's ok, at least he tried. What's important is that someone is willing to try.

 

[cbrons]

troll?

 

[psy]

troll?

Trolls usually don't answer questions and try to be polite. I think this post should be Stickied so that future premeds with similar idealism/goals will take a closer look at themselves and to keep similar posts from reappearing every application cycle.

 

[cleothecat]

I have been a physician for 27 years+.

I still remember my father who started out as a rural doc, and often received payment in kind (ie a chicken) for his services.
I know physicians from North America working in refugee camps for next to nothing.

Why bash a future colleague who is committed enough to work for next to nothing to treat patients. Perhaps it are the cynical premeds in North America who are the greatest challenge to medicine today, not the 48 million uninsured we all hear about.

I hope the SDN'ers chill out and give kudos when they are truly deserved.

 

[sealsk22]

a

 

[Corvus Riley]

I have been a physician for 27 years+.

I still remember my father who started out as a rural doc, and often received payment in kind (ie a chicken) for his services.
I know physicians from North America working in refugee camps for next to nothing.

Why bash a future colleague who is committed enough to work for next to nothing to treat patients. Perhaps it are the cynical premeds in North America who are the greatest challenge to medicine today, not the 48 million uninsured we all hear about.

I hope the SDN'ers chill out and give kudos when they are truly deserved.

We need more doctors on here. Perspective gets lost quite easily on SDN....

 

[Thrombomodulin]

.

 

[liquid8r]

I have been a physician for 27 years+.

I still remember my father who started out as a rural doc, and often received payment in kind (ie a chicken) for his services.
I know physicians from North America working in refugee camps for next to nothing.

Why bash a future colleague who is committed enough to work for next to nothing to treat patients. Perhaps it are the cynical premeds in North America who are the greatest challenge to medicine today, not the 48 million uninsured we all hear about.

I hope the SDN'ers chill out and give kudos when they are truly deserved.

This thread certainly does not represent SDN or pre-meds at large, just so you are aware. I have attempted to defend the OP for his ambitions but it has been difficult because he has said some rather outrageous things. My father was a rural hospital administrator for 25 years and our family went through many hardships. I want nothing more than to see ambitious pre-meds continuing to address rural health issues.

 

[MilkmanAl]

I agree. There was alot of good information from posters in varying levels of training, from non-trad premed to attendings. Mods, what do you think?

My trolldar is quiet. This thread has been surprisingly sane.

 

[Thrombomodulin]

.

 

[MDHopeful08]

To the OP, how do you know that it was your response that made the interviewer get emotional? I can think of like 4 other things that could've made him teary eyed just off the top of my head:

-had a cold (about to sneeze, i get teary eyed when im about to sneeze)
-allergies
-onions?
-maybe you reminded him of a sick/passed relative
-maybe he realized it was his night to do the dishes

....so don't assume it had anything to do with your response.

 

[liquid8r]

"We see more students who start out wanting to really make a difference by pursuing an incredible goal. However, somewhere along the way these goals are usually left behind when students realize this is no longer a priority, loans pile up and we just want to get through, get out, get into a good specialty where the hours are somewhat normal (as normal as can be in medicine), the stress is low, and the pay is solid."

Thrombo, you are dead on with the sacrifices that rural physicians must make in their career choices.

First and foremost, I want it to be known that rural areas are only a subset of locations suffering from primary care shortages. The shortage is widespread and can be found virtually everywhere.

As a graduate of a rural high school from a rural state, there were options available to receive pre-conditional acceptances to medical school. Only 10 are accepted each year. In my state, you had to attend a state college and then attend the state medical school. You received full tuition all the way from undergraduate school through medical school. After fulfilling a primary care residency, you would then return to a designated rural area and practice for a minimum of five years. These programs are effective to a certain extent but the physician turnover is obviously a problem. The advantage, however, is that it allows physicians to hold to their promise as pre-meds and they are in zero debt for doing so.

The over-arching problem for rural physician recruitment is that there are so few rural applicants to medical school. Urban and suburban area applicants are not likely to practice in a rural area if they have never lived there. There needs to be more active recruitment in rural areas and more programs in place to reward physicians to practice in rural areas. Debt-forgiveness is a major issue. How can we financially reimburse rural physicians better without raising costs for everyone else?

Perhaps the rural physician is an entirely different breed of doctor than the rest and should be treated so in the admissions process. My family physicians in my rural area were DOs and provided us excellent care. They did not have high MCAT scores (my family doctor actually told me her score was a 21). I am not advocating to lessen the standard set by many schools but to merely increase recruitment efforts in rural areas. For a start, every public, state school should consider a rural physician program such as I stated above with tuition reimbursement.

 

[tncekm]

Wow, I've seen a lot of cynicism in my life, but to find so much of it here on a site dedicated to aspiring doctors makes me sick.

I'm sorry, but the old cliche "money doesn't grow on trees" does apply here. And, unless you can convince the rest of the world (6.5 Bn ppl) to donate their time to one another, and that each one of their work-hours is equivalent to the next persons, you're going to have to deal with that reality.

I had to take a step back and remind myself that most of you haters are probably just finishing up college, and haven't yet acquired some much needed perspective. Believe it or not, there are people out there who genuinely want to make a difference, who aren't motivated by money, and who believe that they have a moral obligation to be of service to the poor. Just because you have a vision for your own future medical career that doesn't involve this type of service, you don't need to scoff at others' idealism.

Most of us do enjoy helping people. Its not fair, or even well considered, to label people making realistic statements as selfish and arrogant. Unfortunately, "free care", as the OP puts it, isn't "free care". The money always comes from somewhere. Come back at us with your argument when you've convinced all 6.5 billion people that their work-hours are equivalent to the next guy and that we should just donate our time to one another--wonderful utopian idea, but very unrealistic.

BTW- I'm walking away from successful career and about to take on a massive amount of debt in order to pay for medical school, and I fully intend to dedicate my career to practicing global medicine. Money isn't everything.

That's very noble of you. Good luck. And, you're right... money isn't everything. But, it is required for everything you want to do.

 

[Thrombomodulin]

.

 

[tncekm]

I have been a physician for 27 years+.

I still remember my father who started out as a rural doc, and often received payment in kind (ie a chicken) for his services.
I know physicians from North America working in refugee camps for next to nothing.

Why bash a future colleague who is committed enough to work for next to nothing to treat patients. Perhaps it are the cynical premeds in North America who are the greatest challenge to medicine today, not the 48 million uninsured we all hear about.

I hope the SDN'ers chill out and give kudos when they are truly deserved.

Its all very noble, but I just can't imagine how it will all work out financially. There is some bartering that can be done of course, but when it comes down to it there has to be significant amounts of money coming in because you can't pay suppliers with chickens.

If you can tell me how to give uninsured and poor people medical treatment without having to worry about going broke and out of business, I'd love to know. I think I've probably had health insurance a total of 3 of my 25 years of life, so I'm sympathetic to the needy. It just seems so impractical and impossible...

 

[sirius08]

A troll isn't necessarily hostile - just looking for attention.

 

[liquid8r]

The specialist issue you bring up is another bear in itself. I do not have a clue how to solve that issue other than creating rocket-propelled specialty service shuttles to and from rural areas (helicopters work well enough in a pinch I guess). Rural America is just too spread out.

I guess I believe that if more spots were made available for rural FP, they should be filled with adequate recruitment efforts. Is there a shortage of instate applicants in Arkansas to med school? Our rural FP program (Nebraska) is rather competitive.

 

[engineeredout]

A prudent interviewer's next question would've been "Ok Starry-Eyed Premed, how do you expect to actually accomplish this?"

Its okay, we can all just advocate the need for change without actually having a plan to back it up. If you need a little help getting started, turn on Fox News or CNN and watch the election coverage.

 

[Thrombomodulin]

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[MilkmanAl]

there are no shortage of instate medical school applicants to UAMS.

While I suppose that's technically true, I've heard the state mandate that UAMS must admit an equal number of applicants from each of the 4 congressional districts screws things up pretty royally. In short, the 2 most rural districts end up with absurd acceptance rates around 40% and 70% while the districts with the University of Arkansas and Little Rock get a bit shafted. I don't know any of the specifics or if those numbers are even accurate, though. That's just the word on the street.

There's no question that things here are set up for a hard sell of primary care, particularly primary care in rural areas. There are scholarships out the butt for people interested in rural practice, and we have informational sessions about family practice constantly. Last week, there was a hospital fair soliciting people for primary care residencies.

I do not know about the competitiveness of our rural program.

It's not competitive at all. I'm not even sure they reject anyone who applies, but you have to get at least waitlisted before you're eligible. Even at the cost of giving someone a free ride to med school (~$70k for all 4 years), admitting an applicant who is contractually obligated to practice primary care in a rural county is far too good to pass up.

 

[Hurricane95]

Returning back to the point of the thread...Sounds like your interviewer was a royal wuss-bag. This is the first time I hear of the one GIVING the interview being the one who cries.

 

[RURALFAMILYDOC]

I tried coming up with some smartass sarcastic comment but I'm just laughing too hard. I could only imagine pulling the doctors aside that I shadowed during one of their examanations to say "Hey I think you're ripping the patient off"

Actually, after I told him about the free clinic, he said "I hadn't thought of that. I want you to bring me information in tomorrow about it so that I can use when I encounter uninsured patients. In the mean time, go in and talk with that patient about it."

Then, at lunch he called me out and told all the residents what I had done and said that he admired me for already being an advocate for the patients even though I'm just pre-med.

 

[Thrombomodulin]

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[sirius08]

Actually, after I told him about the free clinic, he said "I hadn't thought of that. I want you to bring me information in tomorrow about it so that I can use when I encounter uninsured patients. In the mean time, go in and talk with that patient about it."

Then, at lunch he called me out and told all the residents what I had done and said that he admired me for already being an advocate for the patients even though I'm just pre-med.

OP, you go by several names, don't you?

 

[RURALFAMILYDOC]

I do?

 

[Livingapparatus]

the story gets even better!

 

[gujuDoc]

cleothecat and liquid8r, this is mainly addressed to you guys because you made some excellent points that I would like to discuss.

I realize that we are experiencing a crisis in rural health care, as fewer med students go into primary care every year. I also agree that many premeds are cynical before they even get to the application/interview process for medical school, with me being one of them. Unfortunately, I believe a part of this is the dismal health care system. We see more students who start out wanting to really make a difference by pursuing an incredible goal. However, somewhere along the way these goals are usually left behind when students realize this is no longer a priority, loans pile up and we just want to get through, get out, get into a good specialty where the hours are somewhat normal (as normal as can be in medicine), the stress is low, and the pay is solid. It is unfortunate that this happens, but I don't see a reversal anytime soon. I guess my opinion is that I would rather tell a premed that he is too ambitious than to encourage him and years later he regrets the decision. We truly believe that we can make a difference, yet stories about frivolous lawsuits, increasing malpractice insurance, rising tuition costs, and decreasing reimbursements seem to kill what indealism we have left by the time we finish with training.

Rural healthcare and primary care are 2 different things. You use the terms interchangeably. But the reality is rural areas need more then just PCs. they need specialists as well. they need surgeons as well. They need other fields too, not just primary care physicians. It is all types of physicians that are lacking in these areas.

 

[RURALFAMILYDOC]

There's not a great enough need in rural areas to justify paying a hand surgeon or a neurosurgeon though. Where I live, people are sent to the city for that kind of treatment. Yes, specialists are important, but the need for PCPs needs to be met first.

PS. I have no other alias. But, if you think I have a twin, tell me so I can PM them. It's near Halloween so maybe I do have a long-lost twin😱

 

[LostLost]

did u eat onion for lunch?

 

[KittycooMD]

Gosh, everyone is up in arms about all this! RURALFAMILYDOC, I completely believe that you genuinely want to go into rural medicine. As a non-traditional (read: older!) applicant, I understand people wanting to do different things with their medical career rather than just living in Beverly Hills and serving the rich (don't get me wrong, that is also needed and indeed honorable!). It's my pipe dream to open my own free clinic someday, so I am 100% behind your endeavors! I wish you the best of luck and hope you do achieve your dreams 🙂

 

[bozz]

Congrats RURALFAMILYDOC,

Maybe most people missed it, but RURALFAMILYDOC has gotten into several schools where he has presented his goals. He's obviously doing something right. He has the right to be idealistic.👍 His interviewers are obviously more knowledgeable about medicine than all of us. They found something compelling about his drive, and he got in.

That's what matters. So I think we all need to chill before we get ahead of ourselves. The OP wasn't looking for an analysis of his goals. I think that's been taken care of by his interviewers.

 

[goldenwest]

Actually, after I told him about the free clinic, he said "I hadn't thought of that. I want you to bring me information in tomorrow about it so that I can use when I encounter uninsured patients. In the mean time, go in and talk with that patient about it."

Then, at lunch he called me out and told all the residents what I had done and said that he admired me for already being an advocate for the patients even though I'm just pre-med.

An interviewer crying about a heart-felt story and a doctor that wants information on a free-clinic. I give you kudos if you're for real but I've never seen an elephant fly.

 

[MilkmanAl]

Congrats RURALFAMILYDOC,

Maybe most people missed it, but RURALFAMILYDOC has gotten into several schools where he has presented his goals. He's obviously doing something right. He has the right to be idealistic.👍 His interviewers are obviously more knowledgeable about medicine than all of us. They found something compelling about his drive, and he got in.

That's what matters. So I think we all need to chill before we get ahead of ourselves. The OP wasn't looking for an analysis of his goals. I think that's been taken care of by his interviewers.

I don't think that's true at all. They probably see a student motivated by the "right reasons" who can at least sort of back up what he's planning to do. You're not expected to be a health care expert before starting med school. His ideals look decent enough on paper that he's regarded as someone who sincerely wants to help people by practicing medicine. Whether or not his goals are realistic is probably irrelevant where the interviewers are concerned.

 

[tncekm]

I don't think that's true at all. They probably see a student motivated by the "right reasons" who can at least sort of back up what he's planning to do. You're not expected to be a health care expert before starting med school. His ideals look decent enough on paper that he's regarded as someone who sincerely wants to help people by practicing medicine. Whether or not his goals are realistic is probably irrelevant where the interviewers are concerned.

I agree with this. I'm sure most people really love his enthusiasm and how he has the "patient first" mentality, but I doubt any inyerviwer or ADCOM member see something in his ideas they haven't themselves wished for, only to find out it's not so easy to make it happen. Again, I think the OP's motives are nobile and I can sympathize with him, it just seems very impractical.

 

[MsKrispyKreme]

Actually, after I told him about the free clinic, he said "I hadn't thought of that. I want you to bring me information in tomorrow about it so that I can use when I encounter uninsured patients. In the mean time, go in and talk with that patient about it."

Then, at lunch he called me out and told all the residents what I had done and said that he admired me for already being an advocate for the patients even though I'm just pre-med.

Best
Troll
EVER!

 

[bozz]

I don't think that's true at all. They probably see a student motivated by the "right reasons" who can at least sort of back up what he's planning to do. You're not expected to be a health care expert before starting med school. His ideals look decent enough on paper that he's regarded as someone who sincerely wants to help people by practicing medicine. Whether or not his goals are realistic is probably irrelevant where the interviewers are concerned.

That's what I meant as well

 

[tachycore]

Ruralfamilydoc, no, it's not impossible to do what you've stated. I'm an internal medicine resident, and I have been solicited by several rural areas with great starting salaries. I've also listened to several speakers in medical school who were also well-off rural doctors (PCP's). They spoke of devoting a half-day clinic once a week for free consultations. This was one of the ways they provide care to those who otherwise won't get it. Several classmates worked in underserved communities (urban and rural) and appreciated the experience enough, it influenced their choice of residency.

That being said, I do agree with the others about student loans and other obligations. Don't let your idealism die, but do temper it with the experiences and lessons you gain in your training. It does sound like you struck a positive chord with your interviewer, so I wouldn't worry.

To the others, the burden of premed, medical school, and residency can get to you. I still remember being a starting MS3 and being treated as a scut monkey only little higher than an intern. Over the last 2 years, I've treated drunkards, crack addicts, uninsured, and most likely illegal immigrants in the VA and county hospitals. And I know full well that it is my and everyone else's tax money that pay for their care. In contrast, I've also served in several major private hospital settings.

Now, I've entered my research period where I can reflect on it all. Am I resentful? Honestly, a little. Did I gain anything besides a grueling education? A greater appreciation for normal people and amazement such systems exist. I also remember several attendings telling me they rediscovered their humanity/empathy post-residency. I admire those who retain theirs despite the hazing.

P.S. Don't lump us internists with family practice folk. Most of us (~80%) end up in true subspecialties (cardiology, critical care, all/immun, etc). And you really think all rural doctors will have the luxury of social workers?

 

[GreenShirt]

Actually my medical school exclusively does their rotations with an organization that offers healthcare regardless of a patient's ability to pay. We rotate through one of the thousands of Federally Funded Community Health Centers in the country. Most of the patients are Medicare/Medicaid but there's also a good chunk that are private insurance or uninsured. The CHCs operate of Federal Grants and donations more or less. The doctors I spoke with say they make the same or even double what they did in private practice mostly because the government pays their malpractice and the organization teaches them how to properly bill so they get maximum reimbursment. So being a PCP for the underserved doesn't mean you will starve or sleep in a hovel.

As for the OPs question, I don't think it's bad you almost made the interviewer cry as long as it was because he was moved. Since he was a rural doc himself he probably identified with what you were saying and it's likely that you speak very well and from the heart.

 

[Thrombomodulin]

.

 

[liquid8r]

Wow. This thread is probably one of the most interesting/relevant threads I have seen on SDN. There are so many different perspectives weighing in.

"I've also listened to several speakers in medical school who were also well-off rural doctors (PCP's). They spoke of devoting a half-day clinic once a week for free consultations."

I have heard of these free consultation clinics and think this sounds like a very realistic option for the OP to pursue. Tachycore, do you have any more information about these consultations? I would think there would be some major logisitics involved such as setting a cap for amount of patients that could visit in a given period, how long each patient could be seen, and how to prioritize patients based on economic status and state of health.

 

[Calf]

I think it's great if you can really connect with an interviewer. One interviewer and I both got a little teary eyed talking about dealing with the death of a particular breast cancer patient. It was very moving and the best interview I've ever had.

 

[tachycore]

Sorry to respond so late. Unfortunately, I never did ask those MD's about logistics re: free clinics. If you attend talks given by those who go on mission trips, several of those practice these once a week clinics.

If I had to guess, it would depend on the location (rural vs. urban vs. inner city), insurance (medicaid, medicare, pro bono), urgency, and available resources (free samples, vouchers, laboratories/diagnostic services, etc.). Someone in a rural area can worry less about setting limits on number of patients seen (less dense, less frequent) and can probably set aside a fund to use. Whereas inner city would depend more on community health drives and volunteer clinics and more on donations.

Regardless, there are possibilities already in practice.

 

[husky10501]

He asked me why I wanted to do family medicine in a rural area. He is a rural family doc.

As I was talking, I got chills and he got all teary eyed and didn't write anything down. After I was done speaking, he just went directly into the next question after he stared at me a minute.

Is it bad to elicit an emotional response from your interviewer?

Dude, what if he was just testing your sensitivity? Maybe you unfortunately faced one of those interview urban legends when your interviewers just set you up in some certain situation to see how you'd react to it. For all we know he could have faked those tears and wanted to you be like "are you okay" or "would you like some tissues" or something like that. hahaha.

 

[chewsnuffles]

the OP's trolling

 

[WannaBePreMed]

the OP's trolling

This was my first thought when I was reading this a few months ago but I didn't want to call him out on it....

If only adcoms had a troll detector.....