FWIW: My History

[nontrad314]

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Hey Ya'll,

I've been out of pocket for awhile, but I'm back now. I plan to be active here in the near future.

I want to say that it's good to see everyone again. I have to admit that these forums in general are just such outstanding resources! There's only 1 reason for that: There are so many excellent contributors: exlawgrl, moose, efex101.... actually just about everyone!

Ya'll are doing a great job. I want to make sure I've said that.

Time to get to the point. I was going to reply to the 'Why did you switch?' but chose to do so here. Further explanation will be given below.

 

[nontrad314]

I'm going to write my version of my history or at least how I currently understand it. To do so requires that I first give several qualifications.

Here they are:

No. 1. This is basically the no holds barred version. Elsewhere, I posted some broad strokes but avoided naming the names. Simply put, there are numerous reasons why it's a bad idea to generially name names. In this version I will be naming some names, but not all. That's part of the no holds aspect here. [Names and other details are available via PM; according to context]

No. 2. This version is not one that I believe has ever been presented to anyone in its entirety. What I mean by that is I cannot think of any reason why anyone who knows me in a professional or personal context ever had a reason to see all of this information in the same place. There are no big secrets here. Instead, there are what I believe to be contributing factors; the point is that I don't know of anyone who has ever had a reason to know all of these factors. That includes adcomms.

No. 3. My primary motivation for this history is that I believe that someone somewhere might gain something from what I have to say. I believe there is a good chance of a contribution since there are several different factors involved in my history; those factors overlap with factors covered elsewhere in various threads.

No. 4. My secondary motivation for this history is as a reference. I want to get involved in several dialogues around here and there is significant overlap between my history and these dialogues. Hence, this material is gathered to serve as a reference.

 

[nontrad314]

As I mentioned elsewhere, there is a tradition of the medical professions in my family. That includes physicians, dentists, veterinary medicine etc. It's important to say this because I believe it is a factor. But the way this factor is expressed in my case is indirect.

In particular, my father's father was a GP in rural areas of the Dakotas, Minnesota and Oregon. As I understand it, the man essentially worked himself to death. The stories that are told are of the variety that include blizzards and babies and surgeries with tooth picks. I would not be surprised to hear anecdotes about his work that include various national parks, farms, indian reservations, etc. The point being, as far as I understand it, his work was as rural as rural gets.

My grandfather relocated his family to Oregon sometime during WWII. At that time, as I understand it, there were shortages in medical equipment at the med school and my grandfather donated time and resources to the surgery department. Around the same time my other grandfather was attending the med school, but dropped out to work on the war effort. In particular my mother's father was a Greek american immigrant; consequently being fluent in Greek had a contribution to make to the production of ships in the iron works.

Sometime around 1949 my father's father (the GP) went out to buy a horse in McMinnville and never returned. As the story goes he had a massive MI, sat down under a tree and never got up again at the age of 44 with three kids at home waiting for him.

Simply put, the effect to my father's family was a sort of 'Fall from Grace'. As I understand it, his death was attributed to his choice of a career in medicine and all things medically related were consequenlty considered 'bad'. My father in particular was encouraged by his mother to pursue engineering, which he did (very happily). My uncle and aunt however (as I understand it) resisted the temptation to call all things medically related 'bad' and she became a neurologist and he became involved in vet med.

For reasons that I do not understand, my father's family has a penchance for travel. My Aunt, the neurologist, originally attended XYZ liberal arts college but then transfered elsewhere to study (I believe) Anthropology. She married a young professor of Urdu and Sanskrit and established a family. She started her medical studies at the age of 36 (as a single mother I believe) and specialized in Neurology. She practiced in Detroit for many years with (as I understand it) subspecialization in GSW head trauma. At the age of 50 she signed with the Army and worked overseas on a variety of posts. My uncle joined the Army at 18, was stationed in Germany where he started a family with a German national. Later he became involved in vet med and agricultural work and worked in Egypt, Sudan and elsewhere.

For some reason, my father shares this bug with his siblings and when I was 5 I moved with my family to Britain where I lived for the next 8 years attending British public schools. [A British public school is equivalent to an american private school in the sense that the education is funded privately.]
At 13 my family relocated to Houston, Texas, where I graduated from high school. Since my parents relocated to Houston, they've relocated to Norway, Britain (again) and now they live in France (which I don't visit since I'm not overly fond of the place).

 

[nontrad314]

As I mentioned, I have a British public shool education that spans the ages of 5-13. During that period my Aunt was studying Neurology and my uncle on my mother's side was studying Radiology. Consequently, in the house in which I lived there simply was never a doubt about medicine for me. There were constant stories about what was going on with the Neurologist and Radiologist mixed in with the stories of my grandfather the GP.
In short, for whatever reason, there was absolutely no doubt whatsoever and I actually focused my 10, 11, 12, year old efforts along such lines.

As utterly absurd as this probably sounds, I believe this point is actually significant since, when I was in Britain, at the age of 13 students do make a choice of their career paths; including whether or not to prep for A and O levels or whether or not to pursue a trade. The transition year is somewhere around 13 with (what was then called) the 13+ exam. Thus, at the age of 10, I was given career advice by a head master sitting down with me and reviewing my grades and asking 'What I want to be when I grow up'.

In any event, all that came to nothing when I moved to Houston. At first I was still gung ho about medical school and medicine. But, in Houston things simply got weird and integrating into the American system proved to be a big mess. I did fine without ever opening a book (did even better on the SAT), but I despised the school I attended and instead I decided to focus my attention on sports. One thing led to another and before I knew it I had state and national rankings and started teaching the sport (as an assistant instructor to my coach) to age ranges between 5 and 45. That experience really set the seed for me in terms of the educational process.

Senior year came along and I decided to go to XYZ liberal arts college following my Aunt's example. I had no idea what I was going to major in but I chose physics since it seemed generic enough to establish a foundation on which to build one of a variety of careers. I continued teaching my sport in the local community as time permitted and also got involved in tutoring. It was pretty awesome and I really enjoyed the teaching process.

Medicine however, was still on the horizon, and so it seemed sensible for me to work in Biophysics. So I did, including a summer internship in biophysics which was (simply put) an excellent experience. The internship was extended into the subsequent semester and the PI and I were set up to publish a paper and present it at a big conference.

Unfortunately, due to what I currently believe (in my 20-20 hindsight professional opinion) was a consequence of an entrenched turf battle one of the mucky mucks in the department had a big problem with the work I was doing and whether or not I needed to be concentrating my efforts elsewhere; while the PI was the one really responsible for the work related to the paper and the presentation...and so should be the one doing the work.

This turn of events ticked me off to no end; so I decided to go fishing for a semester, which I did: In the Bering Sea as a deck hand on one of the first American boats to work in the Russian Fishery. Simply put, it was an experience of a lifetime working in the fishery and I learned alot about teamwork and good humor out there. I traveled that summer before returning to school; where I finished my BA in mathematical physics with an original thesis and a commendation for academic excellence.

The physics undergraduate experience challenged me along the lines of a u-grad education essentially teaches you that 'you know that you don't know'. So, I decided to pursue physics; the idea always being that a physics education is a good foundation for one of several careers (including academia or industry). I wrote an original MA dissertation (with associated papers that are now extensively cited in the literature) in nuclear physics at a small research university. From there it was natural to do a PhD. I got in to a top tier program and in 2002 I wrote, defended and published (with multiple papers) a PhD in computational physics with astrophysical applications. The dissertation led to post doc offers at NASA and similarly competitive programs. Invited talks associated to the work are all respectible.

 

[nontrad314]

My career has been two fold; including what is considered a traditional academic career and a career in industry.

[I consider my work as a physics PhD graduate student as part of my career. I understand that others feel differently about what constitutes a career in relation to degrees, but that is where I side with the issue. Simply put, I paid all of my graduate tuition myself with money I earned as a researcher, as an instructor, and as a professional in business. My results in research contributed to grants, publications, and invited talks and are results that are used by my research collaborators, the larger research community and have been built on (through citations etc). Finally, my research methods and results were regularly a source of conversation in industry in terms of relevant skills applicable to job duties.]

In terms of my graduate career, there are two components: Teaching and Research. Between 1997 and 2002 I taught approximately 500 students in upper level engineering courses, physics for science majors, and physics for poets. In 1999 as an independent consultant I wrote an integrated curriculum of mathematics and physics courses for a high school in Texas. The courses have continued to run between 1999 and today. In 2000 I was promoted to the level of faculty at the university where I was finishing my dissertation. Each of these teaching experiences were different, with different types of budgets, students, materials and objectives. If I were to pursue a career in education than these experiences would serve toward that end.

In terms of research, I worked in computational physics with astrophysical applications. As exotic as that might sound it simply amounts to a form of engineering work. I have worked closely with mechanical, electrical and biomedical engineers in industry and the bottom line is that the difference between our backgrounds occurs almost exclusively in the data sets. The day to day work horse techniques are universal; the only real difference is in experience with interpretation of the inputs and outputs [at this stage there is ample opportunity for debate since many forward that intuition concerning the data sets is what constitutes a 'professional'; be that as it may, the every day techniques are universal and the intuition for this kind of nuts and bolts work really occurs (at best) once a month or so].

In any event, the domain of application in my research was astrophysical. The work was done in a highly competitive enviroment characterized by multi-million dollar grants, super computers, world leaders in respective fields, PBS shows, and New York Times articles. In 1998 I was working in a research group that I greatly enjoyed. The work we were doing was very challenging and interesting and my colleagues and the atmosphere was anything anyone could ask for. In the spring of 1998 I was working in a group of two other researchers and we were regularly putting in all nighters 3 or 4 nights a week every week, month after month.

In the middle of that situation I was informed that my best friend of 30+ years was diagnosed with Multiple Sclerosis. As favorable as the prognosis is for MS the fact remains that MS is a disease of unkown etiology and course that adversely affects 1000's daily. Further, the treatments, literature and general understanding now for MS are not what they were in 1998. I read everything I could get my hands on; and everything I could get my hands on basically said the same thing: 'MS is not understood'.

Simply put, MS was a dramatic eye opener for me that put my life in perspective. My attitude about scientific research simply has not been the same since. What struck me was the profound disparity of the irrelevance of my work and the disparity of the energy I was investing in my efforts.

I finished my projects and continued in the general direction that I had started but it simply was not the same. I knew I had to find another line of work than a career in physics research. That actually wasn't good news for me, becuase I was 1 year in to my PhD with 4 more to go.

So, I started looking around for opportunities for alternate careers with focus on industries having more direct impact. I found a firm working in financical engineering that used a technology identical to the technology I was using in my research. I did look in to biomedical research but I could not find a fit between my research group in physics and a biomedical group. That left Financial Engineering alone.

So I settled for Financial Engineering. The thinking was: 1. A solid understanding of economics, business and finance is important and of direct impact, 2. The work will expand the 'marketability' of my skills / resume / CV, 3. There is a strong international component, 4. The work will pay the bills.

I established a relationship with the firm having dual purpose technology; where I could continue with my physics research 30 hours a week through the conclusion of my PhD while working for the firm 30 hours a week.

This arrangement worked well and I worked in Financial Engineering between 2000 and 2005 as an applied mathematician. My customers were leading Wall Street firms in America, Europe and Asia. The work led to recognition in the form of invited talks, invited work shops, numerous international consulting projects, contributions to patents, publications and revenue.

Something to note is that this period included the economic period 2001 - 2003. I don't know how or why we made it through that period, but we did. [Everyday that I left work I wondered if tomorrow was going to be the day we'd have to close the doors]. Somehow, someway, we made it. I believe part of the explanation for our ability to make it through that time was the nature of our products and their utility (economic justificaiton) for our customers (who were universally cutting back during this period).

I finished my PhD in August 2002 and received offers from NASA and elsewhere. I approached my firm and told them it was time for me to leave and they asked me to stay to help them out of the period they were in. It was simply impossible for me to leave them in a worse position then when I had joined them so I stayed until the begining of 2005.

 

[nontrad314]

In 08.02 I was committed to continue working with my firm to turn the situation around. For me, it was a worthy cause to do that. In the interim I decided to use my time to determine my career intentions; based on my work experiences to date.

As I said, in 08.02 I had offers for post docs and offers in industry. Both sets of offers were attractive, but for almost opposite reasons. For example, the p-docs had less stress with less financial return. The industry offers had more stress with more return. Other factors included more team vs less team oriented work, more vs less 'face time', etc. Finally, there was the factor of the immediacy and relavancy of the work itself; the contribution being made by the work.

The variance in the types of work covered by these offers made me literally sit down and prioritize the factors that are important to me in a career. So, one day I sat down and made my list of prioritized factors. Here they are (with my rankings):

1. I prefer work with a direct and immediate impact (industry > teaching > research)

2. I prefer work with a scientific basis (research > teaching > industry)

3. I prefer work with a physical (including manual aspect) and social component in the day to day actual minutes of the work (teaching > industry > research)

The conclusion of this exercise was no conclusion: My prioritized list didn't 'spit out a bottom line'. That day sitting at my chair with my list, I asked myself if there was any career I could imagine that had all of these factors. For whatever reason, I found that medicine fit:

1. (medicine > industry > teaching > research)

2. (medicine > research > teaching > industry)

3. (medicine > teaching > industry > research)

That conclusion was good news (I had found an answer) and really bad news: Go back to school? Have I lost my mind? A PhD going to med school? That's crazy. But, I actually knew some individuals who had done exactly that: Came out of situations identical to mine and gone on to careers practicing medicine.

More importantly,the more I thought about medicine the more it seemed 'natural'.

This is hard to say well, but I'll do my best. In my work in physics at some level it always seemed to me that I was doing something unnatural and forced. It felt like I was somehow 'living someone else's life'; as if my career 'didn't really belong to me'. An odd and uncomfortable feeling I have to admit. However, when I started thinking about medicine it was as if 'it fit'. My general feeling was 'Medicine? Yes! Exactly! That's me!'.

The contrast between my 'intuitions' about medicine vs other careers is very sharp.

I believe this relates in part to factors concerning MS, my family background, and my educational experiences; e.g., early factors, etc. But, I would be surprised if that was the only explanation for the disparity of my intuition: An analytical component related to my professional experiences and prioritized list must contribute to this intution at some level.

My general attitude was: 'Ok. Let's see where this goes'. So, I started investigating the how's and why's of pursuing medicine; including consulting with practicing physicians (family, former colleagues, and friends), volunteering, wrote the MCAT and attended pre reqs. The more I learned about the possibilities and obstacles the more I felt compelled to pursue medicine.

 

[cfdavid]

Wow. That's one hell of a background. It's obvious that you've given this a great deal of thought. Go for it, and don't look back.

I think your history is a huge asset to you, and the adcoms should think the same.

What I love most about medicine is the number of diverse opportunities. It's just such a broad field. It's interesting, challenging, and can be rewarding.

Also, the journey itself will be a riot. Tough, but it will definately be an adventure. Good luck!

 

[nontrad314]

cfdavid,

many thanks for the feedback.

yes i agree with you. in several respects. my situation is nontraditional in a few ways. but, as you point out, after starting the journey toward medicine i have found many people sharing some significant over lap with aspects of my background.

here's an example, on my weekends i worked as a volunteer in a trauma center for 18 months. it was a really fantastic experience. alot happened. but i was very very impressed by the staff. that is one thing that stood out to me in a big way.

anyway, one of the first things that happened when i started volunteering in the ED was that i found that many of the nurses, techs and physicians had something common in their background to mine. one tech had worked in the fishery. many nurses had a lot of international experiences (which actually came up when a patient from switzerland sort of appeared out of nowhere). one physician had a ranch and was interested in cattle. another physician had a curiosity about physics. one physician was a DO with a nontrad background.

anyway, they were all really cool people. all of them. the experience really turned me on to emergency medicine in general.

but, thanks again for your feedback.

i want to add more in general and to other threads and will be doing so in the near future.

just a bit busy at the moment.

more to follow...

 

[cfdavid]

Yeah, my experiences in the ED have been great as well. I've intereacted with mostly DO's, but also some MD's. They've been really cool people, and I had a chance to see a variety of different procedures such as an emergency pace maker.

What I like about EM is that it can be technical, and highly procedural. What I don't like is the lack of follow through/up from a patient perspective.

I like FP for the relationship aspect, and I think that an entreprenurial physician (and somewhat aggressive) could incorporate enough minor procedures into the practice to keep it interesting. Also, I think that innovative FP's can also do things like varicose vein treatments and other procedures like cellulite treatments. These are not that difficult to learn, can be profitable, and would also be rewarding.

In fact, the AAFP encourages FP's to think outside the box and to look for income generating procedures that can be incorporated into the scope of their practice. In the long run, this will be good for the specialty given that a healthy income and a stimulating practice will attract more people to what many consider a vital role in healthcare (FP).