Is it better to practice in underserved areas?

[hlchess]

Some secondary apps ask you whether I want to practice medicine in medically underserved areas. I personally don't really care about it, but does medical schools like it better if we say we want to practice in the underserved areas?

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[AggieJohn]

Some secondary apps ask you whether I want to practice medicine in medically underserved areas. I personally don't really care about it, but does medical schools like it better if we say we want to practice in the underserved areas?

They probably prefer honesty... but yes, I believe they generally look favorably upon the desire to serve in an underserved area.

 

[AmoryBlaine]

Especially state schools!

 

[DropkickMurphy]

Just say yes. A lot of schools prefer students (or at least claim to) that want to practice in "underserved" areas. If I can find an underserved area that isn't a slum or the backwater in the middle of nowhere, I'll gladly practice in the local emergency department.

 

[newbie1kenobi]

They probably prefer honesty... but yes, I believe they generally look favorably upon the desire to serve in an underserved area.

Better yet, also explain how practicing in an underserved area will benefit you as a professional (e.g., you thrive on intellectual stimulation and challenges, or the experience will provide you with opportunities to hone your clinical skills due to the independent nature of the underserved practice setting, etc.). I did not include this in my PS or secondary essays, but rather was asked about it during an interview. Including it in your secondaries may catch their attention, but I would only include it if it is something that you honestly believe in. As the poster above has mentioned, you'll need to be honest about it because it will show when they ask you about it during the interview.

 

[72531]

I think maybe you should be honest and not just do what you think they want to hear..

 

[tacrum43]

If you put it down, but don't have any real interest in actually practicing in an underserved area, the admissions committee will see right through it.

 

[Duchess742]

i honestly do want to go into academic medicine b/c i really like teaching and research. is that an ok reason for why i don't want to practice in an underserved area?

 

[Duchess742]

plus, my father practices in an underserved area, and he sometimes gets paid in canned beans and stuff like that.

i'm not too big a fan of the canned veggies, so maybe that's a valid excuse

 

[riceman04]

Just say yes. A lot of schools prefer students (or at least claim to) that want to practice in "underserved" areas. If I can find an underserved area that isn't a slum or the backwater in the middle of nowhere, I'll gladly practice in the local emergency department.

I like your honesty even though it, in some ways, shows your shallow view of society....but then again...who am I to talk.

When you find an underserved community that is neither the "hood" nor the boondocks you should make a statement on the evening news announcing your findings.

Then maybe you and all the docs who share similar views will venture out of the box you call society.

Yikes I vented...but for some reason I am not going to erase...oh well! I guess since I just spat fire I should expect some in return...so I'll be waiting in the wing for my time to once again hit the ice.

cya

 

[DropkickMurphy]

I like your honesty even though it, in some ways, shows your shallow view of society....but then again...who am I to talk.

When you find an underserved community that is neither the "hood" nor the boondocks you should make a statement on the evening news announcing your findings.

Then maybe you and all the docs who share similar views will venture out of the box you call society.

Yikes I vented...but for some reason I am not going to erase...oh well! I guess since I just spat fire I should expect some in return...so I'll be waiting in the wing for my time to once again hit the ice.

cya

No fire back....Just a simple question (actually two): Is it too much to ask that I don't want to live an hour from anywhere that acknowledges the existence of news other than crop prices or in an area where I need to get a concealed carry permit to keep myself safe on my way to work? Why is it so bad that if I want go spend four years of my life and something on the order of $150K becoming a doc, that I chose to not live and practice somewhere less than desirable? That doesn't make me shallow....it makes me realistic.

 

[Dr. V]

If you put it down, but don't have any real interest in actually practicing in an underserved area, the admissions committee will see right through it.

This is not the adcoms first rodeo. They are pretty good at what they do and most of the time very good at weeding out untruths.

 

[riceman04]

No fire back....Just a simple question (actually two): Is it too much to ask that I don't want to live an hour from anywhere that acknowledges the existence of news other than crop prices or in an area where I need to get a concealed carry permit to keep myself safe on my way to work? Why is it so bad that if I want go spend four years of my life and something on the order of $150K becoming a doc, that I chose to not live and practice somewhere less than desirable? That doesn't make me shallow....it makes me realistic.

That makes you realistic in terms of living within a society and thriving according to how you desire to....but, to me, it is not realistic as a physician to automatically refuse to provide basic services to areas that are in dire need of those services b/c it does not fit within a cookie-cutter lifestyle. But then I guess, that just shows how different we all are.

I always forget that we all have differing reasons for why we pursue something (I am not trying to suggest anything).

So you are saying that if there is a hospital, located on the fringes of a not so nice area, primarily servicing the underserved, you would work there?

 

[Duchess742]

That makes you realistic in terms of living within a society and thriving according to how you desire to....but, to me, it is not realistic as a physician to automatically refuse to provide basic services to areas that are in dire need of those services b/c it does not fit within a cookie-cutter lifestyle. But then I guess, that just shows how different we all are.

I always forget that we all have differing reasons for why we pursue something (I am not trying to suggest anything).

So you are saying that if there is a hospital, located on the fringes of a not so nice area, primarily servicing the underserved, you would work there?

yo, although it might be a bit hard for you to conceptualize, people living in decent areas are sometimes in need of healthcare too...so it's good we have both people like you who want to run off and save the underserved and people like dropkickmurphy who want to help the "served" folks too.

seriously, if you follow the logic of your argument, then everyone with the "proper" motivation for wanting to be a doctor should want to practice international medicine in underserved areas too. apparently wanting to live in a certain place isn't a good enough reason for being able to choose your own lifestyle. don't want to live in africa? too bad! riceman thinks you shouldn't be a doctor.

 

[riceman04]

yo, although it might be a bit hard for you to conceptualize, people living in decent areas are sometimes in need of healthcare too...so it's good we have both people like you who want to run off and save the underserved and people like dropkickmurphy who want to help the "served" folks too.

seriously, if you follow the logic of your argument, then everyone with the "proper" motivation for wanting to be a doctor should want to practice international medicine in underserved areas too. apparently wanting to live in a certain place isn't a good enough reason for being able to choose your own lifestyle. don't want to live in africa? too bad! riceman thinks you shouldn't be a doctor.

What I said should in no way make you assume people should practice in another country.

And it is not hard to conceptualize that EVERYONE needs healthcare...that is not the issue...The issue is that people are staying away from underserved areas when it is evident that services are truly needed is these areas.

It's just funny how people are willing to put anything down on their application if it will get them into medical school...and in the end wont give a rat's ass about the health disparities that exist in our own country.

 

[aliziry]

yo, although it might be a bit hard for you to conceptualize, people living in decent areas are sometimes in need of healthcare too...so it's good we have both people like you who want to run off and save the underserved and people like dropkickmurphy who want to help the "served" folks too.

seriously, if you follow the logic of your argument, then everyone with the "proper" motivation for wanting to be a doctor should want to practice international medicine in underserved areas too. apparently wanting to live in a certain place isn't a good enough reason for being able to choose your own lifestyle. don't want to live in africa? too bad! riceman thinks you shouldn't be a doctor.

That make no bloody sense at all. People living in not so decent areas are almost always in need of healthcare. So we should just ignore them. And about international medicine lets fix one problem at a time shall we love. Fix Americas healthcare problem and then worry about others.

 

[DropkickMurphy]

It's just funny how people are willing to do put anything down on their application if it will get them into medical school...and in the end wont give a rat's ass about the health disparities that exist in our own country.

Actually Riceman is one of the few people I don't take as a condescending little bastard when he says something like that because I know he actually means it. He has my respect (despite differences in philosophy) and that is something not a lot of people can claim.

 

[Duchess742]

That make no bloody sense at all. People living in not so decent areas are almost always in need of healthcare. So we should just ignore them. And about international medicine lets fix one problem at a time shall we love. Fix Americas healthcare problem and then worry about others.

yo, your ECs on mdapplicants are really cool. are u planning on practicing in egypt at all, or is this post an indication that you're not?

 

[riceman04]

Actually Riceman is one of the few people I don't take as a condescending little bastard when he says something like that because I know he actually means it. He has my respect (despite differences in philosophy) and that is something not a lot of people can claim.

I have to admit that my frustration was misdirected at you instead of at people who put up a front...and that you dont do (which is why I sincerely respect your honesty).

You are right...it is totally realistic as a human being to want to stay safe. And I really cannot fault you for saying what you said...b/c the fact of the matter is that a doc who is alive to provide care where it is needed (and that is everywhere) is better than a dead doc who tried to provide his/her services in an area where not even some of the locals can appreciate what is being provided.

So, I say that not to backpeddle, but rather to say that I know where you are coming from.

cya around....getting super tired

 

[aliziry]

yo, your ECs on mdapplicants are really cool. are u planning on practicing in egypt at all, or is this post an indication that you're not?

Thanks but I dont think Ill return to Egypt practice medicine. Your ECs are bloody great and that MCAT doesnt hurt either.

 

[Duchess742]

I have to admit that my frustration was misdirected at you instead of at people who put up a front...and that you dont do (which is why I sincerely respect your honesty).

You are right...it is totally realistic as a human being to want to stay safe. And I really cannot fault you for saying what you said...b/c the fact of the matter is that a doc who is alive to provide care where it is needed (and that is everywhere) is better than a dead doc who tried to provide his/her services in an area where not even some of the locals can appreciate what is being provided.

So, I say that not to backpeddle, but rather to say that I know where you are coming from.

cya around....getting super tired

hmm...yeah, this guy is pretty cool. esp. the "rice" part

 

[Duchess742]

Thanks but I dont think Ill return to Egypt practice medicine. Your ECs are bloody great and that MCAT doesnt hurt either.

aww thanks. and the fact that you use "bloody" in normal conversation is pretty awesome!

 

[asunshine]

i honestly do want to go into academic medicine b/c i really like teaching and research. is that an ok reason for why i don't want to practice in an underserved area?

no, unless you will not be doing any clinical medicine. you can definitely teach and practice clinical medicine in underserved areas (even our free clinic is a teaching clinic), so i don't know if adcoms would take that as a valid reason. underserved does not necessarily mean rural.

to everyone else,
where i live, there are hardly any clinics or hospitals in "bad" areas, as in you need to feel the need to arm yourself. hospital administrations realize scary (or sparsely populated) places do not attract business, so they stay far away from them. maybe your definition of "bad" is more loose than mine....

maybe a better question would be, would you be willing to take on some medicare/medicaid patients or non-insured patients as a part of your practice, even if it means for free? would you spend a day a week practicing somewhere underserved if you spent the other 4 (or 6) at your "nice" office? lots of MDs i know do this. you can say you don't want to relocate, etc, but you might want to give back in other ways.

*personally*, i think the point of medicine is to help those that are sick become well again (or better able to deal with their disease), and anyone who won't take certain patients for reimbursement reasons (not saying anyone here!) is letting self-interest rule their practice instead of genuine concern. obviously, you don't have to be Mother Theresa, but there is no reason you can't be a little gracious....

 

[asunshine]

you can always commute to an underserved area, too....

 

[Hopeful_Doc]

how is underserved defined? no physicians within x miles?

 

[Duchess742]

no, unless you will not be doing any clinical medicine. you can definitely teach and practice clinical medicine in underserved areas (even our free clinic is a teaching clinic), so i don't know if adcoms would take that as a valid reason.

to everyone else,
where i live, there are hardly any clinics or hospitals in "bad" areas, as in you need to feel the need to arm yourself. hospital administrations realize scary places do not attract business, so they stay far away from them. maybe your definition of "bad" is more loose than mine....

maybe a better question would be, would you be willing to take on some medicare/medicaid patients or non-insured patients as a part of your practice, even if it means for free? would you spend a day a week practicing somewhere underserved if you spent the other 4 (or 6) at your "nice" office? lots of MDs i know do this.

*personally*, i think the point of medicine is to help those that are sick become well again (or better able to deal with their disease), and anyone who won't take certain patients for reimbursement reasons (not saying anyone here!) is letting self-interest rule their practice instead of genuine concern. obviously, you don't have to be Mother Theresa, but there is no reason you can't be a little gracious....

well fine then. i guess my answer will now be "as long as the underserved area has sufficient facilities for me to engage in rigorous neuroscience/neurological research (with fmri) and as long as i don't get paid in canned vegetables (canned fruits might be ok)"

 

[MossPoh]

Is there a magic number that states whether an area is considered "underserved". I know some are rather obvious that they need help and they need it fast, but some really aren't. Dropkick..you're from Indiana so you can probably answer it best for me. Would Knox county be considered "underserved" ..I mean Vincennes isn't exactly a village, but it isn't like an area of high wealth or jobs. I was always the rich kid there and I have met people now that make me look like one of those kids in the dollar a day commercials. Good Sam in vincennes I consider a fairly nice hospital...and responds to a fairly large area since the Princeton hospital is somewhat dismal. They also get new technology quite a bit..but by no means is it a research mecca where people surge to in hordes or anything. So what is a deal with an area like that? (This is the type of community I'd like to return to..while maybe not vincennes a town in the 15 to 35k range with maybe a small uni of some sort)...

 

[plainolerichie]

I think most of the time when people serve in underserved areas, they go into something like family practice or internal medicine (you know, primary care). Personally, I am not interested in primary care.

I do think if you sincerely want to serve in an underserved area, that will help you getting into many medical schools. I was honest about not wanting to go into primary care or specifically serving underserved areas (it's still up in the air, just not set on it and probably won't) and didn't get into one of my state schools that specializes in primary care and serving the underserved (ETSU).

The only thing is, I think many people who apply, even specifically to ETSU, just say that because they know it would help them get in. Many people who graduate ETSU; however, do not go into primary care of the underserved and it's only slightly different than most schools, despite that being an important factor in determining acceptance.

In other words, I think many people will lie about it because they know it can help. You shouldn't though.

 

[MossPoh]

Yea. I don't think I'll be lying when/if that day comes along. Of course that is because I firmly beleive in the not being able to judge before I actually experience the stuff. I have some interests...but they are just interests as of now. I know I'd get my mind set on something and find out I hate it then feel really guilty for hating it or something..so I just avoid that.lol

 

[DropkickMurphy]

Yeah, the Good Sam is a great hospital regardless of it's size while Gibson County in Princeton......well, you'd be better off being treated by an alcoholic vet who graduated at the bottom of the class at Ross.

 

[noonday]

so, how about this. how about people just be themselves, apply in an honest and straightforward fashion, do their best, and stop trying to manipulate the system through little white potential half lies? i swear everyone loses if you do that...

i mean, i was a strange, unorthodox applicant, and i didn't tweak myself into what other people told me that the adcoms might want, and sure, i got a lot of rejections, but i also got a few acceptances, and those schools were...shockingly...decent fits for me. one was nearly perfect (and i wouldn't have guessed it ahead of time). i could have tweaked and strategized and *maybe* have gotten into more places that way, but, you know what? the real me wouldn't have fit at those as well. because i wouldn't have shown them *me*, i would have shown them the verson i thought they wanted, and that's not real.

just be you. and let them be them. and we'll all end up where we're supposed to be. and happier for it.

 

[72531]

What I said should in no way make you assume people should practice in another country.

And it is not hard to conceptualize that EVERYONE needs healthcare...that is not the issue...The issue is that people are staying away from underserved areas when it is evident that services are truly needed is these areas.

It's just funny how people are willing to put anything down on their application if it will get them into medical school...and in the end wont give a rat's ass about the health disparities that exist in our own country.

I am right there with you. It pisses me off what people will say just to improve their chances of getting in. If you are not willing to help the people that need to be helped the most, how can you be a physician? Maybe it's just me. Maybe I'm too idealistic but I would think a physician should be compassionate and a humanitarian...

 

[Dr. V]

I think most of the time when people serve in underserved areas, they go into something like family practice or internal medicine (you know, primary care). Personally, I am not interested in primary care.

I do think if you sincerely want to serve in an underserved area, that will help you getting into many medical schools. I was honest about not wanting to go into primary care or specifically serving underserved areas (it's still up in the air, just not set on it and probably won't) and didn't get into one of my state schools that specializes in primary care and serving the underserved (ETSU).

The only thing is, I think many people who apply, even specifically to ETSU, just say that because they know it would help them get in. Many people who graduate ETSU; however, do not go into primary care of the underserved and it's only slightly different than most schools, despite that being an important factor in determining acceptance.

In other words, I think many people will lie about it because they know it can help. You shouldn't though.

While I agree with you about not lying, I just graduated ETSU and there were a great many that never claimed to want to do primary care. ETSU knows everyone doesn't want to do that and accepts people that have no interest in primary care every year.

I don't know what other schools numbers are but until this year ETSU was at either 62 or 68% primary care. I don't remember for sure what the exact number was, but hey were very proud of that.

Then our class killed it because only 45 or 48% are technically doing primary care. I have no idea what the average is now but I think we killed it LOL. There were 13 of us that went into Surgery alone.

That stat for this particular year is misleading though because I know for a fact that three of us that went into surgery are going to underserved areas for practice and will go on mission trips as well. Two of us completed the Rural Track for that reason but none of us will get counted into their stats because of our chosen field but what we are going to do basically fills that same goal and the school doesn't get credit for it.

 

[SeminoleFan3]

I want to practice in an underserved area overseas. Should I not put that in my secondaries (seeing as I won't be practicing in the states)?

 

[Dr. V]

I want to practice in an underserved area overseas. Should I not put that in my secondaries (seeing as I won't be practicing in the states)?

By all means if you honestly want to do that then put that down in the appropriate place. The same way that adcoms are really good at teasing out untruths they are also really good at knowing when you are honest. If you want to do it you will be able to answer their questions easily and good enough that they will believe you. A genuine desire to help the underserved is always an admirable trait to the adcoms I know and the ones of other schools that state their mission is to serve the underserved.

 

[asunshine]

well fine then. i guess my answer will now be "as long as the underserved area has sufficient facilities for me to engage in rigorous neuroscience/neurological research (with fmri) and as long as i don't get paid in canned vegetables (canned fruits might be ok)"

sounds good!

i guess i was just trying to say, while someone may not want to work in underserved areas, they can (and should) still serve underserved people.

 

[DropkickMurphy]

they can (and should) still serve underserved people.

That's right....I won't turn away anyone who needs my help. However I refuse to limit myself to practicing in an area where I do not want to be.

 

[sponge]

how is underserved defined? no physicians within x miles?

Well, I don't think there's one set way. One thing you can do is check what certain organizations do. The AMCAS application will mark a "(U)" next to areas that it considers underserved. (This is done by county, and so New York County (Manhattan) with its millions of people, is considered underserved, even though there are definitely some areas that are not).
The National Health Service Corps (whose members get their med school paid for, and in return must work in underserved areas for the number of years they got their tuition paid for in med school, with a two year minimum, and they must go to primary care) also defines a list of underserved areas. You can see how they do that here in their job listings http://nhsc.bhpr.hrsa.gov/jobs/ and at the bottom of the page, search areas you are interested in.

I think most of the time when people serve in underserved areas, they go into something like family practice or internal medicine (you know, primary care). Personally, I am not interested in primary care.

National Health Corps as well as other loan repayment plans unfortunately only help primary care physicians. However, this does not mean you can't assist underserved populations as a cardiologist or neurosurgeon. After all, many people in these areas need this specialized physicians even more because of their lack of access to regular healthcare. As was said before, you can always just commit a day or so a week to help those communities.

 

[8744]

Heck. I'll serve the underserved. I just want to get paid for it. That's why I'm going into Emergency Medicine. We see everybody. Poor, downtrodden, ******, crack addicts, dopers, bikers, Episcopalians....everybody.

P. Bear
PGY-1 Emergency Medicine in 30 days.

 

[DropkickMurphy]

Episcopalians

HEY!

Heck. I'll serve the underserved. I just want to get paid for it. That's why I'm going into Emergency Medicine.

Exactly....nothing like making almost double what a FP or IM doc makes for dealing with the same patients while having a better lifestyle too.

 

[MacGyver]

If you put it down, but don't have any real interest in actually practicing in an underserved area, the admissions committee will see right through it.

Uhhh no they wont.

Get real guys, its easy to fool the adcom into believing you want to do rural medicine. As long as you dont f#ck up and admit that it was a charade, the adcom wont know whether you are lying or telling the truth.

 

[aliziry]

Heck. I'll serve the underserved. I just want to get paid for it. That's why I'm going into Emergency Medicine. We see everybody. Poor, downtrodden, ******, crack addicts, dopers, bikers, Episcopalians....everybody.

P. Bear
PGY-1 Emergency Medicine in 30 days.

Hes got a point...before the other stuff. Anyway if someone works in an underserved community they should be paid just as much as anyone else. Paying them less just tells everyone that they are not worth as much as other doctors.

 

[DropkickMurphy]

It isn't so much where you practice, but how you practice. EM docs make a lot more in most places than FP docs and for good reason.

 

[LizzyM]

Federal designations of underserved factor in the number of primary care docs per 1,000 population as well as the proportion of the population that is living in poverty, the infant mortality rate for the area, and the proportion of the population that is 65 or older. See http://bhpr.hrsa.gov/shortage/muaguide.htm

You could search out the info for a county that interests you and calculate its score.

Certainly, applicants whose home towns are underserved and who are interested in returning there after graduation can honestly report that they want to serve their underserved community. The rest, I think, need to make a case why they want to go somewhere -- because they have experience with rural or inner-city communities (Teach for America, Ameri-corps etc) and they have other strong rationales for seeking to establish a primary care practice in an underserved area (people who can't get treatment for hypertension might need a neurosurgeon eventually but it is far more desirable to provide primary and secondary prevention than to use high tech medicine after the horse is out of the barn.

 

[plainolerichie]

While I agree with you about not lying, I just graduated ETSU and there were a great many that never claimed to want to do primary care. ETSU knows everyone doesn't want to do that and accepts people that have no interest in primary care every year.

I don't know what other schools numbers are but until this year ETSU was at either 62 or 68% primary care. I don't remember for sure what the exact number was, but hey were very proud of that.

Then our class killed it because only 45 or 48% are technically doing primary care. I have no idea what the average is now but I think we killed it LOL. There were 13 of us that went into Surgery alone.

That stat for this particular year is misleading though because I know for a fact that three of us that went into surgery are going to underserved areas for practice and will go on mission trips as well. Two of us completed the Rural Track for that reason but none of us will get counted into their stats because of our chosen field but what we are going to do basically fills that same goal and the school doesn't get credit for it.

I guess you'd know more about ETSU than I would, maybe I was just making excuses as to why I got rejected . Many of my friends who seem like they'd be shoe-in's got rejected from them or didn't even get an interviews. I always thought it was because they are not interested in primary care.

 

[MossPoh]

Yeah, the Good Sam is a great hospital regardless of it's size while Gibson County in Princeton......well, you'd be better off being treated by an alcoholic vet who graduated at the bottom of the class at Ross.

Heh. Well Vincennes Radiology does send one of their radiologists over to Gibson County for a few week stent every now and then. It is kind of the seen as a punishment. I think they just started transitioning over to PACS not too long ago. Also one of their ER docs at Gibson County is a pretty good guy...although sometimes he doesn't like to listen to directions. (Personal story there) Plus they give away lots of free stuff. Every other pen in our house is from gibson general, not to mention pads of paper, golf towels, jackets...why modernize your hospital when you can pimp out people with a saweet hat and jacket eh?

 

[jojocola]

Does anyone know what a doctor has to go through when working in an underserved area as opposed to a served one? Name some difficulties that a doctor in a underserved area encounter that a served one would not.

I'm still in a neutral position about this. I love patient contact. This is why "general" doctor seems to stand out for me. Serving in an underserved area would take away from that because most of my patients would not speak english.

 

[MossPoh]

Does anyone know what a doctor has to go through when working in an underserved area as opposed to a served one? Name some difficulties that a doctor in a underserved area encounter that a served one would not.

I'm still in a neutral position about this. I love patient contact. This is why "general" doctor seems to stand out for me. Serving in an underserved area would take away from that because most of my patients would not speak english.

That depends...........not every area is predominantly spanish speaking. In fact there are tons of areas that just are really rural and nobody cares to work there since they have to drive an hour to go to a mall or something...which with traffic in the busy cities can be about the same amount of time anyway. There are also plenty of specialities that involve patient contact without being in family practice....bs'ing and talking with patients can happen in a lot of areas.

 

[newbie1kenobi]

I want to practice in an underserved area overseas. Should I not put that in my secondaries (seeing as I won't be practicing in the states)?

Just a suggestion, you can state that you are interested in practicing international medicine (e.g., Doctors without Borders).

 

[72531]

Just a suggestion, you can state that you are interested in practicing international medicine (e.g., Doctors without Borders).

I was wondering how they would feel if you mentioned Doctors without Borders. It seems like a good thing but won't they not like the fact they are losing a doctor?