EMT Pre-Med Struggling

[Febrifuge]

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Hey, I need a little feedback, and there's a good range of folks here.

I'm an EMT-B, and spent about a year and a half working in the ED as a tech; I gradually came to the realization that even though I'd spent years saying "jeez, I would never put myself through that torture," I do in fact want to work in healthcare, so I decided on the MD or DO route. I looked at a lot of angles and decided I had to take a crack at the doctor thing, or I'd always wonder if I should have.

Now, I'm a semester in to my post-bac (33% done!), and I'm hurting bad, from an academic point of view. Everyone agrees, I'm smart, I'm hardworking, I'm dedicated... but my grades suck. My test-taking abilities suck. It's time to think about what I'm doing here, and what I want to do about it. There's nothing about me that would make me a bad doctor... except that if things continue the way they've been going, I'll never set foot in a med school as a student.

One option is to go away quietly, work on the math skills and the study skills, and come back in a year or so. The downside here is I'm already 35, I have a life to lead, and if I drop out now, I might never drop back in. It took a lot of decisionmaking and preparation to get me to the point where I was comfortable even trying this. I had hoped it would not be as bad as I'd feared, but it turns out it's exactly that bad.

Another option is to tough it out and fight with Fall courses. (orgo II, calc, animal physiology and physics -- even though I never took trigonometry in high school.) To learn as I go. The upside here is it satisfies my "never give up! never surrender!" impulse, and I could do unexpectedly well. But the downside could be another semester with a sub-3.0 GPA.

A third way, which came to me immediately upon learning my grades, is to stop making myself crazy. To think about what I'm really trying to accomplish, and find a better way to do that than the pre-med route that is making me hate life. There are programs out there for health professionals that concentrate on health sciences and don't screw around with physics and calculus: they're called nursing programs.

I could earn an MSN and work as an emergency nurse anywhere. I'd be damn good at it. I'd have better geographic mobility, a wide array of options, and if I decide I want to be an NP I can be a working nurse while I put that together.

But is that a brilliant idea that plays to my strengths, or is it the desperate ravings of a depressed, angry student? I'd like to hear any reactions, from all corners. Thanks for reading. :/

 

[ockhamsRzr]

Feb man, I wish you had mailed me earlier because I know it can suck and I know where you are right now (I pass through there myself more than I want!).

It's hard and for fogeys like us when the pressure to succeed and never make any mistakes is far more intense than for some of the younger folks. But you have more options than you might be able to see from your present depths.

One option, and we had both considered this last fall, is PA. I know you did the ED tech thing back home and I'll assume that the clinical part of medicine was a good vibe for you. From my experience at Children's these days I'm so much closer to going PA than ever before. I have witnessed so many docs spending so much time on non-medical/non-clinical activities that I became dismayed at a future where I invest the next 10 years of my life for a gig that's not what I thought it was.

I've had the opportunity to ask about 30 docs (between 30 and 55years old) if they're happy with their choice and whether or not they'd do it again. The short answer is virtually none of them (other than my kid's Ped) said yes (and this is at THE best kids hospital arguably in the world). The younger ones said it sucks, it's long, it's not worth it; and the older ones said that it's not what it used to be and that medicine isn't fun anymore. At the same time, as a clinical researcher, I've come to realize that I love the clinical side of medicine and have been able to see the role of the PA as being tailor-made to that part of healthcare.

Now, take physics and shove it, flush calc down the toilet, and orgo II can lick my a$$. I'll belly up to A&P, think about the GRE and apply to Northeastern, Yale and Univ of New England for a masters in PA and after one didactic year I'll be side by side with med students and residents for a year, and then I'm working. Starting salary for a PA, about $70k. After 5 years close to $100 depending on how much you're working while carrying about $75k in debt. Compare that with an FP or ped doc who is making $150 carrying about $200k in debt.

And yes, you can go BSN, onto MSN, onto NP, heck onto DNP if you want. But it would seem a longer road to get to the same clinical status and less money. But Feb, the decision has to be yours. I was just telling my wife yesterday (after this grueling back and forth about med school versus PA school), that the bottom line is that today I would like to be a doctor, or a resident, in med school, or even applying. But sadly, at 35 with two kiddos, it's an incredibly difficult decision (and sacrifice) to make knowing that I still have more than a year and a half BEFORE I apply. For me, slowly, and only after working with a lot of docs in a great hospital asking a lot of questions, have I realized that being a PA is OK--in fact it's more than OK, it's really the right thing for me at this place and time. I don't miss the next ten years of my boys lives and I am doing the part of medicine that I have come to realize is the most important to me.

I don't have to wonder when studying for the MCAT whether or not my grades and boards in med school will ALLOW me to practice in the field I want (and I'm actually a good test taker). As a PA, pick where you want to live, pick the specialty you want and find a Doc who will hire and train you. Want to be a hospitalist, be one. Want to work outpatient, do it. Sick of FP, find a derm job; sick of Derm, do a 1 year Gen Surg residency and be first assist in all the appys you want--sick of that, work in the ED.. The point is that you can contribute in the ways that most people think about medicine, you can enjoy career flexibility and you can earn a good living feeling good about what you do.

The thing about the test-taking abilities is that it never stops as a doc. MCAT-USMLE1,2,3-Shelf exams-written board cert-oral board cert (PS. 40% of all comers fail the board written board cert, and 60% fail the oral on the first try...and these are DOCTORS!). The tests never stop and it's a blessing that you found it out now.

Please pm me (or email) and we can talk more about this stuff. Don't despair up there, or feel alone! We've all been there man, all of us.

Been there, your comrade in arms,

ockham

 

[ockhamsRzr]

Hey Feb

You can look at it this way. You can be an NP @ age 41, a PA @ age 37 or a MD/DO @ age (after residency) 42. No matter how you slice it your going to get to age 42.

Mike,

I think ALL non-trads have heard those words more than once, but there's a flip side to it that the simplicity of the statement belies. I DO NOT think it's the case with Feb, but with me (the same age and same place along the path as Feb) it is very much the case. That is, yes you will be 42 (or 45 much more realistically: 37 at med school matric, 41 at grad, 4 year res= Doc free and clear at 45), BUT what was the quality of your life and the sacrifices along the way in order to be a Doc when you're "45 anyway".

In a sense it's a cost-benefit-analysis looking at the delta between your life given two separate trajectories but the same end point. The problem is that life is NEVER a simple analytical equation. It's ALWAYS emotional, always sensual, and never quanitifable. The choice continues to be the hardest I'll ever have to make as it requires either blind motivation (that is, eliminating all doubt and simply pushing forward) or a soothsayer to inform you 20 years hence that you are happy with your decision.

However, Mike's advice is sage when it comes to calc, physics, and the zoology crap. Perhaps Bennington is unwilling to let you "tailor" your post-bacc, Feb, but get the hell out of calc, take algebra-based physics, take only the classes you NEED to smoke to get into med school.

And of course for a broadly interested, untethered sot like yourself, have you considered med school in Ireland through the Atlantic Bridge program. Hell 5 years at Trinity (a world-class university) is pretty damn attractive (anyone want my wife and kids for 5 years...I'll be at the pub)!

All the best Feb, an good advice, Mike,

Ock

 

[Annette]

I struggled with the MD/PA question, and I picked the wrong side. I had the PA school acceptance in hand, but decided that I wanted the MD. I wish I knew then what I know now. (Always nice to include a cliche. 🙄 ).

Examine what you want. Do you want patient contact, developing a good one-on-one relationship? How much time do you want to spend with the patient? Will you be happy giving a patient only 10 minutes of your time, or do you want to give more? Nurses are able to give alot more time than the PA's, and the PA's more than the docs.

How much documentation and paperwork do you want to do? Everyone has paperwork, but as an MD, I'm stuck filling out alot of crap! For my clinic patients who have home health help (even just a maid) I have to double check meds, PT orders, allergies, etc, every 120 days! I can't farm it out. PA's are likely to have less of this crap, and nurses even less so.

Where do you want to work? All three have pretty wide choices, and all can subspecialize. But the demands of the job will be a lot different. Do you want some flexibility to go see your kids soccer game? Don't pick being an MD. I've been told that an MD has to see a minimum of 22 patients a day to keep a practice afloat. That doesn't leave a lot of time to see the kids' games.

How much responsibility do you want? This really is the big question. Once you are an MD (or DO), you can't go back to a lesser degree of responsibility. For example, even if you work as a PA, once you have the MD, you will be held to the level of an MD even if you haven't kept (or even had) your licesence. Docs are quiting medicine because they can't afford the malpractice insurance. Have you heard of PA's or NP's, etc doing that? If you want the patient care and contact, but don't want the full liability, don't go the MD route. Do you have to be the one with the final word?

How much debt are you willing to have? I'm in for a quarter of a million. Before interest.

How much pain and suffering are you willing to put yourself and family through? School is the easy part. Residency is extremely painful, even with the 80 hour rule. Is missing your little ones grow up worth it? Is the distance that develops between you and your spouse because you are post-call, just want to sleep, but you two need to talk, worth it? PA's and NP's get to be human during training.

What do you consider to be the plus side of being a physician? Is it enough to put yourself through many painful expensive years? Seeing what the PA's do in the hospital, and their relative independence makes me want to rewind my life. Getting to be called "Doctor" just isn't worth it.

 

[Febrifuge]

This is awesome, you guys. Thanks. "Is the juice worth the squeeze?": perfect.

I thought all the PA schools were requiring two semesters of Physics now, too? And I've come to understand they're certainly not easier to get into, or get through, than med school.

Physics I is not Calc-based, but Physics II is. Also on the Calc subject, I realize there are 120-some med schools in the USA, and about 20 to 25 that still require Calc. My home state has three med schools, and they're ALL on that list. But then again, PA would be a better deal for me, all around. It's more like the job I actually want to do. So, forget Calc.

I took Human Bio last Fall (with no lab; it was a distance course) and got an A. So I need a Bio lab of some kind. The Animal Phys course is what my school has to offer; it's meant to satisfy one of the two Biology slots (part one was Cell Bio). I think I can use it, inasmuch as it satisfies the prereq there.

But you're right, all of youse. As "helpful" as it is to get a taste of how things will be evaluated from here to forever, there's no percentage in being miserable. I agree that I'd always wonder "what if" unless I give it a good shot -- and it could be that this *IS* my shot.

Ock, I'll send you a note for sure. I have some shadowing lined up for Sunday and I move out of this place tomorrow so it might be later on. 😀

 

[jendc08]

Maybe you could try taking less difficult classes at a time. Like spreadin gout orgo and physics or whatever. I know you may be in a rush to finish up...but you will probably do better and be lessed stressed out.

 

[Jambi]

Everything has been said (here and the EM forum). So I'll just offer my support in whatever decision you decide to make.

 

[hospPA]

I thought all the PA schools were requiring two semesters of Physics now, too? And I've come to understand they're certainly not easier to get into, or get through, than med school.

If you are considering PA school, you have to get your grades up. A sub 3.0 will likely not get you into any PA program especially if they are in required hard science courses.
NP school also likely requires decent grades, but as there are a zillion programs vs. 130 PA programs, so your odd's may be better. You would have to do the RN then too.

I am sorry to hear about your plight. Good luck.

Pat

 

[Jessicakarate]

Febrifuge, summer classes are more fast paced than regular semester classes, and your school's sounded even more fast paced than normal summer classes. You might find the more moderately paced fall classes easier to handle; you'll be just as busy but you'll have more time to wrap your brain around the concepts. What about taking all the classes you were planning on taking in the fall, but substitute pre-calc for calc. Then, take all your spring semester classes except your calc based physics II class. Take Calc I and physics II the following fall, and spend the rest of the year studying for the April MCAT.

 

[deleted6669]

feb-many pa programs do not require physics or calc. pm me here or at www.physicianassociate.com and I can recommend a # of good pa programs that would accept an applicant like yourself.
also at this point don't get caught up in the whole degree thing. if I am remembering correctly you already have a bs degree so you could do an associate or certificate level pa program now and get the ms later while working at your 1st full time job. there are a # of accredited postgrad ms programs that can be completed online in 1-2 years after you pass your boards and are working full time.they only require that you be a pa with a bs level degree(does not have to be bs in pa). I did the nebraska distance learning option postgrad masters in em in 1 year while working full time.
do yourself a favor and go to pa school as opposed to np. you seem to be much more interested in the medical model and being taught by md/do staff instead of nurses and learning real medicine in clinicals for 2200 hrs instead of 500 makes a big difference.also as a pa you can change specialty as often as you want. as an np you are limited in your options.
option 2....there are always D.O. programs and the carribean if you really need to be a physician.......I don't know if you have worked with d.o.'s but they are just as good as their md counterparts and tend to be nicer folks overall. the chief of em at my last job was a d.o.
22 docs in the group with 1 d.o.(the chief) so your options are in no way limited in em as a do. they tend to look more at life experience than just raw #s when looking at your app for medschool. there are lots of folks with 22- 24 mcats who became great d.o.'s

 

[CrazyPremed]

I don't want to spend any time repeating what has already been said, but it's good advice.

The truth is - although I think a great majority of doctors work crazy hours and don't spend much time with patients - there are many that do. Many doctors, including my own - work in group practice, make great money (more than enough to cover college debt), and don't work five days a week. This isn't common, but it's not unheard of. If you are trying to convince yourself that you don't want to go a certain route, you may be seeking out only those who are unhappy pursuing that path.

Secondly, do what you want to do, not what is the easiest or most cost effective. It's very easy to get caught up in the money issue, but a job is more than that. I'm sure that you can find a job that would pay you twice what you make as an ER tech, but who gets your 40 hours a week?

Finally, regardless of the program you chose, you'll have to revamp your study skills. I've spent this summer taking many nursing entrance exams, only to see the majority of the class (who have been out of school for a while) fail them on a regular basis. As premeds, I think that we have the idea that nursing programs will be a walk in the park. While some of them may not academically be equals to premed studies, they can be extremely aggressive. Also - depending on where you live - the waiting lists can hold you back almost as long as it takes to get into medical school! Just something to think about.

I'd take some time off to figure out what you really want, take some easier classes to get back into the swing of things, and realize that it will really work itself out for you. Good luck in whatever you do.

CrazyPremed

 

[Febrifuge]

Yo ho ho, all.

Just by way of update, I will indeed be taking it a little easier this Fall, and for now anyway, I'm going to proceed with the PA plan. The more I think and the more I learn about the processes we go through, in order to get to our various destinations, the more I come back to that idea I had about 6 or 8 months ago: balancing the pros and cons, the responsibility and the independence, PA really does seem like the future of health care. It's also possible that med school education might drive me insane.

So, thank you to one and all. Annette, your note struck a chord with me, as I can definitely imagine feeling the same way. Ockham, I sent you a note. Emed, I'm already doing research on programs (Midwest and Northeast, mostly, but who knows) and I'd welcome any suggestions. And Fall will be a human-level semester, so I will hopefully be able to think straight and make a firm decision sometime soon.

 

[deleted6669]

FEB-CAN'T OFFER MUCH INSIGHT FOR MIDWEST BUT FOR NORTHEAST TRY:
YALE, STONY BROOK, NORTHEASTERN, UNE, DREXEL, PCOM, GW, CORNELL(IF SURGERY IS AN INTEREST)
AND REMEMBER TO CHECK OUT
WWW.PHYSICIANASSOCIATE.COM FOR INFO ON THE WHOLE PA PROCESS
WWW.AAPA.ORG FOR GENERAL PA INFO
WWW.APPAP.ORG FOR INFO ON PA RESIDENCIES(OPTIONAL BUT ENCOURAGED)