Focus?

[Zhang Ji]

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Hi,

Can anyone comment on the benefit or detriment of being very focused on one's goals from the adcom's perspective?

I am an acupuncturist now, and know that I want to pursue a psychiatric residency and career. Why? Because my mentor is a psychiatrist who later incorporated Chinese medicine into his treatments. I treat many psychiatric conditions now😛TSD, schizoaffective disorder, bipolar, depression, GAD, and even dissociative identity disorder. And I see just how much further training would benefit me, even though I am successful with my present methods. And I've also realized that anti-psychotics and in-patient care have their uses when employed judiciously.

At 35 y.o., and with my experiences, I have a clear sense of my direction, and the theoretical, even philosophical, foundations of my integrative approach. And I feel a pressing sense of urgency as well. Though I could sit down with psychiatrists and discuss their work, and my own, I am just starting pre-reqs. I feel a little upside-down in that respect.

I wonder where my present work places me in terms of shadowing, volunteering, and research. I've been working for a neurologist who supports my applications to med school. But I wouldn't call it shadowing exactly. Even though I've had better results than meds with his migraine patients.

So with that, do you think it would be perceived favorably, negatively, as naivete, or hubris?

 

[DrMidlife]

Being dead-set on psych at this point isn't necessarily a good sell. I think the stereotype that you're up against may be the 20 year old med school applicant who is convinced he wants to be a vascular surgeon specializing in trauma and dearly hopes to do his residency at Duke. You know, and the kid hasn't ever had a girlfriend or been out of his home state yet, so the adcoms roll their eyes. In general, I think that in the med school app stage, we're not supposed to know what kind of medicine we want to practice yet. We're supposed to be open to possibilities, and figure it out during clinical rotations.

If your desire to go to med school is based on the need to be able to prescribe, there are easier ways to gain that authority. Nurse practitioners and physician assistants can prescribe, with increasingly loose oversight by an MD or DO. You can be a PA with as little as 2 years of schooling, depending on your background. There are NPs who specialize in psychopharmacology and do nothing but prescribe antidepressants.

Within medicine, I could see you in rehabilitation or pain care, as well as in psych. If you're able to get exposed to these specialties, you might get a better perspective on whether western med is what you need, vs. the simple need to write scrip.

I think most people in western med ed will expect you to leave your acupuncture background behind, and not doing so will take some effort. If you have the backbone to carve out your own specialty, I think you can have a huge impact.

 

[zeff]

I think talking about what led you to pursue medicine a little later can only help, and is even expected; in your case, you have a really interesting story to tell, and in your shoes I would absolutely discuss the career arc you are describing, as long as you acknowledge that you haven't had enough exposure to different specialties to know with certainty what you will do, etc, etc, and/or can do so without coming off as if you know more than the interviewer (a little humility goes a long way in this process!).

I can't vouch for this, you should find someone knowledgable to ask, but my general sense is that alternative medicine has gained some currency in this country, and is even taught as an elective at some med schools nowadays.

 

[Zhang Ji]

Thanks for the insight. The common denominator here is: be flexible about future specialties. I have been hearing alot about PM & R, and I'll seek out further exposure to other disciplines as you suggest.

I don't see how I could be equated with a 20-year-old as described however, since for example I worked in a hospital in China over 6 years ago, and have been teaching Chinese medicine for 4 years. I've been told that I will probably have to shelve my acupuncture during school, and learn to keep my mouth shut especially. But regardless of what specialty I end up doing, I have experienced the efficacy of Chinese medicine far too greatly to leave it behind forever. I would not really have that degree of agency as a PA or NP. It's not the prescribing rights I'm after, rather it is the unparalleled scope of education that I am determined to achieve. Thanks again for the responses.

 

[DrMidlife]

I don't see how I could be equated with a 20-year-old as described...

I'm not saying the comparison is reasonable, just that adcoms don't see many older applicants, and when we do show up, adcoms don't necessarily know what to do with us. I wouldn't assume, in the early stages, that app reviewers will stop to think about you as a mature and seasoned professional among the multitudes of youngsters. A lot of schools get 5000 applications - some get 10,000. There's no numerical data on how many applicants are over 35, but from one graph in the MSAR I can interpolate that it's well under 500 (out of 39,900 in 2006).

I do a lot of worrying about all these numbers, but I don't think you need to do the same. I'm 41 and not that interesting. You're fundamentally interesting, having trained in China, and being willing to play the game here as well. As I've said before, you're going to be a compelling candidate.

 

[QofQuimica]

I actually have the opposite opinion; I don't think it's very cool to be 35 years old and tell an interviewer that you don't know what you want to be when you grow up. It wouldn't impress me much at all to hear that coming from you, whereas I'd expect it from a 22-year-old. You are talking about going back to school for 7+ years of training and changing your career; that is not something you would decide to do without a lot of thought about the purpose and goal of the change. So, if you do know what you want to do with a medical degree, and it sounds like you do, then you should say so. I would suggest, however, to explain that you plan to use your alternative medicine background as a complement to standard Western medicine techniques. Definitely avoid badmouthing Western medicine and/or physicians; it's not smart to insult your interviewers. Instead, emphasize that there are limits to what you can do for your patients with your current training, and that you believe that you can provide the best care to your patients by integrating both types of training (assuming you really believe this). to you. 🙂

 

[Zhang Ji]

Dr. Midlife: Again that gives me a little more clarity. I really haven't considered the numbers per se. That's an interesting perspective. And thanks for the encouraging words.

 

[Zhang Ji]

Q: You hit the nail on the head. I've seen many cases where a continuity of care across an alternative/conventional spectrum would have relieved suffering more quickly and completely. And in psychiatric conditions continuity of care often literally means inpatient treatment.

 

[Non-TradTulsa]

Agree with QofQ. At 35, you want to present a very clear vision of what you want to do. They're perfectly aware that you might change your mind as far as specialties go - but what you do not want to do is look like medical school is some kind of a "lark" for you. You've got to show them that you've thoroughly thought things through, and you know what you want to do. Such a clear vision might be questionable in a 21-year-old, but it's admirable in a 35-year-old.

Besides, the absolute #1 cardinal rule of interviewing is: no B.S. If that's your clear vision, tell the truth. Interviewers can smell fake from a mile away. Show 'em your passion - they love that.