Quadriplegic acceptance into medical school: please help!

[biogirl215]

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Could you PM me his name/contact info as well?

Thanks!

 

[beanbean]

I wouldn't say Law2Doc is slamming any doors shut. It is much more politically correct to encourage people on pre-allo, but these responses often do not help prepare an applicant for obstacles he/she may face. Knowing what the doors are is important to keep them from shutting on you.There are two types of obstacles present in this situation; objective and subjective.

Subjective obstacles are those such as the preconceived notions and bias of others towards applicants with disablities. Regardless of a school's official guidelines, the OP has asked for input on schools which have previously embraced disabled applicants such as those with spinal cord injuries. Right or wrong, there are certainly some schools would give a more positive reception to the OP than others based on a climate of acceptance or prejudice.


Objective obstacles are the standards that must be met to graduate from med school and the standards that must be met to graduate from residency. These are more cut and dry, but also may have alternative solutions. What are the clinical competancies required and how are they evaluated? What alternatives are acceptable? Will a med school or residency accept a clinical competancy based on knowledge or must the skill actually be performed. Is it acceptable to perform skill on a sim manequin or must it be demonstrated in practice? What skills and physical duties are required when on clinical rotations? What are the options (such having an assistant with you) that are acceptable to a program or school?

I admire your drive and passion for PM&R. Your research and effort to talk with others who have successfully completed the same path is excellent. Along each step of the journey, make sure your motivations remain true to your passions and that you have never crossed to a motivation of proving you can "do this." I mention this not because of your disability, but because it is a trap many premeds, med students and residents fall into without realizing it. When being a doctor stops being something you want to do and becomes something need to do; reevaluate and make sure your passion is still clear. You contacts and support system from other mds with injuries will help you combat the negativeness that others may exhibit

I do encourage you to read the thread in the residency forum regarding "calling in sick". It demonstrates some of the intolerance of "weakness" some residents have in other residents. In the arena of overworked and stressed out residents, significant resentments of others can occur when people feel they are being worked harder to balance another residents needs. Unfortunately, for some residents compassion for others does not extend to their fellow residents at times and some institutions do not have a cushion to provide backup in the face of sick time or the personal needs of residents.

Sorry for the long post! Best of luck to you on your journey.

 

[walderness]

Thank you for the very thoughtful post.

I wouldn't say Law2Doc is slamming any doors shut. It is much more politically correct to encourage people on pre-allo, but these responses often do not help prepare an applicant for obstacles he/she may face.

The point here is not that he is discouraging. Its that hes not constructive.

Telling me that I NEED to suture and stay over night, etc. does not help the situation when this has been proven false in the past.

Objective obstacles are the standards that must be met to graduate from med school and the standards that must be met to graduate from residency. These are more cut and dry, but also may have alternative solutions. What are the clinical competancies required and how are they evaluated? What alternatives are acceptable? Will a med school or residency accept a clinical competancy based on knowledge or must the skill actually be performed. Is it acceptable to perform skill on a sim manequin or must it be demonstrated in practice? What skills and physical duties are required when on clinical rotations? What are the options (such having an assistant with you) that are acceptable to a program or school?

yes, this requires significant exploration. unfortunately, its difficult to do until you are in the situation. nobody is going to run thru a hypothetical with me before i get in. But I am going to bring them up to my contacts...

in this case, i greatly appreciate this list! i've also sifted thru the rest of the thread for concerns like this.

I do encourage you to read the thread in the residency forum regarding "calling in sick". It demonstrates some of the intolerance of "weakness" some residents have in other residents. In the arena of overworked and stressed out residents, significant resentments of others can occur when people feel they are being worked harder to balance another residents needs. Unfortunately, for some residents compassion for others does not extend to their fellow residents at times and some institutions do not have a cushion to provide backup in the face of sick time or the personal needs of residents.

that sounds like their problem...if someone wants to crap on me because i cant move my patient, thats fine. my life is still way more difficult and my situation will always require that i work harder...i can see their ignorance a

Sorry for the long post! Best of luck to you on your journey.

i appreciate the long post! and you, too.

 

[walderness]

i met a lady named jody who's a md/phd quad at uconn but lost her contact info. i also had not regained my personality or sense of self after injury when i met her, so we didnt talk much...do you know her, bean?

by and you, too, i meant good luck to you too. while i appreciate you, it sounded personal and kind of creepy when i read it and realized the insinuation.

 

[funklab]

Good luck, walderness!

I am going through some of the same issues as you (but obviously not all of them, I am T6 complete premed still). We just have to prove ourselves a little more than others.

 

[ACSurgeon]

Very interesting thread. Few comments questions:

1- Did you attain the GPA and MCAT scores as a quadriplegic? From your posts it seems like this is recent is it? The reason I ask is because you might have a better chance if you were disabled a while ago and were able to pull off this success despite that.

2- U of Wisconsin did graduate a blind man. However, I read an article in which he was described as an outstanding clinician (his touch, smell and hearing senses more than made up for the lack of sight).

3- Medical school is taxing on the body, are you sure you want to put yourself through this? If your disability slows you down enough, it might be virtually impossible to get through med school in a reasonable amount of years (again, see #1).

4- As many have said, there are limited med spots and a HUGE shortage of doctors, and I know you won't try to convince us that you will be able to do what any other doctor can in a given day (at least not alone). The reason I suspect this is that you are already convinced that med school, residency etc should bend their rules for you. They can only do this so much before it is a losing batttle.

Best of luck.

 

[ACSurgeon]

Why is it that people lose touch with reality when it comes to medicine? If someone with physical disabilities wanted to be a home contracter or plumer, people wouldn't encourage said person but would point out how unrealistic it is. I don't mean to be insensitive, but there must be logic along with emotions when approaching such a topic. Medicine is a very demanding field, and at this point, needs all the help it can get (shortage etc). If someone who is not in medical school aknowledges that they do not have the abilities to get through the standard requirements of medical school and residency, why do we get all emotional and support this idea? Just a thought.​

 

[beanbean]

i met a lady named jody who's a md/phd quad at uconn but lost her contact info. i also had not regained my personality or sense of self after injury when i met her, so we didnt talk much...do you know her, bean?

by and you, too, i meant good luck to you too. while i appreciate you, it sounded personal and kind of creepy when i read it and realized the insinuation.

I knew of her and had heard of her injury, but I don't have anymore info for you. I hope she is doing well.

I know it is easy to say it is "their problem" when referring to resentful residents, but some can be very petty and vindictive. Your friends who have been through residency with disabilities will give sound advice as to how to handle these fools in a politically correct manner. Although I think once you get to the actual PM&R portion of training this would not be an issue.

I also think most people on some level have hesitation about where exactly do we draw lines and when do we make acceptions and grant alternatives. How much assistance should one person get? Is undergrad assistance ok, but your on your own for grad school or med school? Is it OK to give one person more resources so they may pursue medical school, with the potential to give much back to the community, even if it means having less resources to give to others in need? These are complex questions and some of the answers can be tough to swallow. Your advocacy for your strengths and abilities can be a tough fight when everyone seems to have a different idea of how this all should work.

Good luck to you and the others who have responded from similar situations.
Deirdre

 

[walderness]

Why is it that people lose touch with reality when it comes to medicine? If someone with physical disabilities wanted to be a home contracter or plumer, people wouldn't encourage said person but would point out how unrealistic it is. I don't mean to be insensitive, but there must be logic along with emotions when approaching such a topic. Medicine is a very demanding field, and at this point, needs all the help it can get (shortage etc). If someone who is not in medical school aknowledges that they do not have the abilities to get through the standard requirements of medical school and residency, why do we get all emotional and support this idea? Just a thought.​

I wanted to do emergency medicine but gave it up for these reasons. My goals as a physician have changed but are no less valuable.

The analogy does not hold and is based in ignorance. I'm not going to spend any more time defending my choices to some anonymous group of naysayers. This was never the intent of the thread. Start your own thread and call it "keep quads from entering med school" and have your fun.

I'm very grateful for the contacts and encouragement from this thread.

 

[braintrust]

I know of a graduate student freind of mine from high school who is also a quad with similar mobility and statistics. From what I can remember he has been rejected twice from JABSOM in hawaii (and is IS). So I am fairly certain that U-hawaii is not willing (or possibly able) to make the accomadations necessary for a person with your disability. Hopefully this helps narrow your search

 

[AmoryBlaine]

Its helpful to hear the nuances like this to bring them up to the disabled drs. who have done it. and also, for instance, the usmle requirements from the other poster. these are things you wouldnt necessarily think of unless youve been thru it. so anything else you can think of would be great and i'll list them out and ask...i'm gonna start putting together a list "causes of concern"...would be a good analysis tool i think.

i talked to a c7 doc 2 days ago, he started the site disaboom.com. amazing guy. he said he conducts a better physical exam than most other docs in his med group. but his words were "you can do it and love it."

he did not seem to be too concerned for me asa far as tribulations. his only warning was that the 6-week surgical rotation allowed little sleep because it takes a quad like 3 hours to empty bowels and shower and get dressed so that allowed only 2 hrs sleep. he said to do the rotation in plastics to minimize this problem.

everyone realizes that i'm a para but have minimal hand function, right? i can pick things up with tenodesis, etc so my hands are good for most everyday things. still is a big deficit for medicine, however...

Impossible. Wait until you learn the actual steps of the physical exam and then tell me if someone with only one arm could be a master of it.

I'm not saying your mentor/friend isn't competant, but that's a pretty bold and entirely subjective statement to make about his colleagues.

 

[AmoryBlaine]

Why is it that people lose touch with reality when it comes to medicine? If someone with physical disabilities wanted to be a home contracter or plumer, people wouldn't encourage said person but would point out how unrealistic it is. I don't mean to be insensitive, but there must be logic along with emotions when approaching such a topic. Medicine is a very demanding field, and at this point, needs all the help it can get (shortage etc). If someone who is not in medical school aknowledges that they do not have the abilities to get through the standard requirements of medical school and residency, why do we get all emotional and support this idea? Just a thought.​

Speaking as a recently graduated physician and an incoming resident, the OP is making unreasonable demands of the system.

1. Unreasonable demands of his fellow students. What happens for your anatomy group? Do they just do all the work while you get to observe? Part of getting through anatomy is dealing with physical exhaustion, from which you would presumably be exempt. What about students on your surgery team? Are they going to have to do spend extra hours in cases since you can't go?

2. Unreasonable demands of clinical faculty. Part of the completion of our neuro clerkship included demonstrating competance doing LPs on a simulator. Are you exempt from this? Do they instead try to determine if you understand the theory of lumbar puncture? It just makes no sense and would not be fair to your classmates against whom they would be forced to try to compare you for a grade. Also the faculty would presumably be essentially unwilling to give you a poor clinical eval (even if it were deserved) for fear of reprisal.

3. Hugely unreasonable demands of his future resident colleagues. Let's say that you do match into PM&R. Are you going to be a 100% member of your housestaff team? No way. So where does that extra work that you are not doing go? It doesn't just dissapear into the mist -- it goes to your felllow residents. They will be people who likely did not know you and may feel (justly) slighted for being placed into a class that is essentially -1. Someone else brought up the issue of call -- will you be exempt? Can you run a code? Can you admit patients quickly and thoroughly or are the incoming residents going to get slammed with the carry over from your "shift." The accomadations that will have to be made for you will be made on the backs of your fellow residents - none of whom will be asked for their permission.


Medicine is not a birthright. Lazymed's comparison to manual labor jobs is spot on. If you want to become a quad/tetra plumber you would be laughed out of town. I could go through the litany of physical/technical skills that I have picked up in med school - IV access, suturing, central lines, LPs, thoracentesis, hell - I bet I could even get through a post-morterm C-section if you held a gun to my head. If you think I'm bragging you are missing the point. I don't just know how to think, I know how to do. I'm not a grad student of human medicine, I'm a doctor.

 

[dr1day]

Speaking as a recently graduated physician and an incoming resident, the OP is making unreasonable demands of the system.

1. Unreasonable demands of his fellow students. What happens for your anatomy group? Do they just do all the work while you get to observe? Part of getting through anatomy is dealing with physical exhaustion, from which you would presumably be exempt. What about students on your surgery team? Are they going to have to do spend extra hours in cases since you can't go?

2. Unreasonable demands of clinical faculty. Part of the completion of our neuro clerkship included demonstrating competance doing LPs on a simulator. Are you exempt from this? Do they instead try to determine if you understand the theory of lumbar puncture? It just makes no sense and would not be fair to your classmates against whom they would be forced to try to compare you for a grade. Also the faculty would presumably be essentially unwilling to give you a poor clinical eval (even if it were deserved) for fear of reprisal.

3. Hugely unreasonable demands of his future resident colleagues. Let's say that you do match into PM&R. Are you going to be a 100% member of your housestaff team? No way. So where does that extra work that you are not doing go? It doesn't just dissapear into the mist -- it goes to your felllow residents. They will be people who likely did not know you and may feel (justly) slighted for being placed into a class that is essentially -1. Someone else brought up the issue of call -- will you be exempt? Can you run a code? Can you admit patients quickly and thoroughly or are the incoming residents going to get slammed with the carry over from your "shift." The accomadations that will have to be made for you will be made on the backs of your fellow residents - none of whom will be asked for their permission.


Medicine is not a birthright. Lazymed's comparison to manual labor jobs is spot on. If you want to become a quad/tetra plumber you would be laughed out of town. I could go through the litany of physical/technical skills that I have picked up in med school - IV access, suturing, central lines, LPs, thoracentesis, hell - I bet I could even get through a post-morterm C-section if you held a gun to my head. If you think I'm bragging you are missing the point. I don't just know how to think, I know how to do. I'm not a grad student of human medicine, I'm a doctor.

While I agree there may come a time when the OP will have to modify his dream, I don't think he's quite there yet. Like I mentioned before there is a quadraplegic PM&R resident in Charlotte who's doing fine. He does have an assistant who's with him to grab charts etc. and I don't know if there's any resentment on the part of his colleagues. Also, he was already in school when his accident occured so his classmates had already bonded with him and were probably more willing to help than the classmates of someone who comes in on day one needing a lot of accomodations.

I think it would be unfair to the OP for people to blindly tell him "You can do it" even when all evidence says the opposite, but I just don't think he's at the give up point yet. After he talks to all 126? MD schools and however many DO schools without success, then perhaps he should reconsider his options, but not yet.

 

[Law2Doc]

Thank you for the very thoughtful post.



The point here is not that he is discouraging. Its that hes not constructive.

Telling me that I NEED to suture and stay over night, etc. does not help the situation when this has been proven false in the past.

It's not an issue of my being constructive. Constructive implies that there is something you can do on your own to accomplish what you need to to be a doctor. But in fact, IMHO, you are going to have to rely on some school's willingness to modify their clinical year curriculum to make it possible for you to complete it. And then a residency to do the same. So no, I cannot be constructive because I don't see anything you can do on your own, beyond find schools that have made accommodations. If they want to do that, that's up to them -- I don't have the ability to close any doors on you. I actually hope you get what you want, but I see lots of good reasons why you might not, and I think you oversimplify things when you want schools to revise what constitutes clinical medical training so that you can get to an end target that you believe you can actually do.

And no, the reference to "walking rounds" was not a dig at you -- that is what they are called (as opposed to "table rounds" where you go over patients at a conference table -- which is less common) when you actually go from room to room throughout the hospital seeing patients. And these rounds tend to involve lots of stairs and multiple floors, and chasing of attendings who rapidly race around the wards and stop for no one (certainly not a lowly med student), so again you'd need adjustments to be made to even participate in this daily event.

I certainly know of a lot of schools that send out questionnaires to applicants requiring them to verify that they have the physical ability, dexterity and visual and auditory acuity necessary to make it through their clinical years. They do this because in their opinion, you need these abilities to get through the clinical years, ie to become a doctor through their school. A HUGE part of the clinical years of med school is procedural. You learn to put in lines and tubes, suture, intubate, put in foleys, do LPs, deliver babies, perform physical exams, chest compressions and CPR and running codes. There is a ton of chasing around the residents, fetching charts and other scut, standing/scrubbing in on surgeries, doing overnight calls. And this all culminates with residency, where you are going to at times be alone on the wards trying to keep your charges alive, which often means having to do a lot of these procedural things on your own. If you are up to the task then great. If you expect these tasks to be eliminated so you can become a doctor on your own terms, then I just don't agree, largely for the reasons mentioned by Amory Blaine above. You don't get to define what constitutes medical training. You need to become a doctor first and a specialist second. Not jump to specialist just because that is a pace you can manage.

The folks who are not being constructive are those who are saying "you can do it" without having ever done a clinical clerkship year of medicine and having no notion of what it involves.

 

[45408]

The analogy does not hold and is based in ignorance. I'm not going to spend any more time defending my choices to some anonymous group of naysayers. This was never the intent of the thread. Start your own thread and call it "keep quads from entering med school" and have your fun.

Why doesn't the analogy compare?

Medicine is not a birthright.

Agreed. A lot of SDNers tend to think otherwise.

 

[GreenShirt]

Wow OP, I just can't imagine having worked so hard towards a goal and then having something so tragic happen. It's inspiring that you're forging ahead despite the setback. I wish you the best of luck.

I think a lot of the procedures learned in medical skill aren't ever used by doctors depending on the specialty they go into (ie. delivering babies, suturing) or just aren't preformed by physicians period (ie. foleys, IV's, CPR). Having exposure to them is educational, but if you aren't going to use them it's not the end of the world IMHO that you don't physically perform them during your training. On the other hand, the physical exam is the bread and butter of every physician's practice, so it would be a big setback not to be able to perform them.

Medicine is largely cerebral, so I think it's an asset to any medical school to have a highly intelligent candidate matriculate even if accomodations have to be made.

 

[Tin Man]

I think a lot of the procedures learned in medical skill aren't ever used by doctors depending on the specialty they go into (ie. delivering babies, suturing) or just aren't preformed by physicians period (ie. foleys, IV's, CPR). Having exposure to them is educational, but if you aren't going to use them it's not the end of the world IMHO that you don't physically perform them during your training. On the other hand, the physical exam is the bread and butter of every physician's practice, so it would be a big setback not to be able to perform them.

Medicine is largely cerebral, so I think it's an asset to any medical school to have a highly intelligent candidate matriculate even if accomodations have to be made.

That's a horrible argument. If that case held true in every situation, then the entire pre-med curriculum would be PART of medical school, not just a requirement.

For instance, am I going to use every part of Gen Chem? Or Physics? Or Biochem? These courses are fundamental in medicine, and it is likely that they are required because they are utilized on a case-by-case basis in actual, practicing medicine by select doctors, but does anyone ever use ALL of it (or, with some doctors, ANY of it)?

CPR isn't just something you learn just to prove you can do it. CPR is taught because there very well may be a situation where a doctor may need to perform CPR for any reason. No one really "expects" anyone to have a heart-attack in time to have a CPR-able person in the room. That's why it's a good skill for everyone to have.

I would imagine that, strangely enough, some skills are taught in medical school not just as brainwork, but because they MAY need to be utilized at some point in your career, and if you can't perform said skills, it could have serious consequences for the patient. Saying, "Well, as long as you KNOW how to do CPR, you'll be fine" is completely ridiculous. What's the point of knowing CPR if you can't do it?

 

[Law2Doc]

I think a lot of the procedures learned in medical skill aren't ever used by doctors depending on the specialty they go into (ie. delivering babies, suturing) or just aren't preformed by physicians period (ie. foleys, IV's, CPR).

Wait until your internship year when you (a physician) are alone on the wards at night and someone's IV comes out and the nurses cannot get a line in and so they call you (and they will). And then the patient starts to code and you need to start doing chest compressions or facemask bagging to keep him alive, maybe put in a central line or a chest tube (which have to be anchored in with a suture BTW). This IS what a doctor is supposed to be able to do. Having this background and skillset is a huge part of what it means to be a doctor. Doctors aren't just specialists. You get to be a doctor first and a specialist second. That's the whole point of many specialties requiring prelim years in medicine or surgery (as the specialty OP wants to go into does). And why they teach this kind of stuff in the latter half of med school. You aren't qualified to be a doctor after the first two years of med school. You hopefully are more prepared after the latter two. You definitely will be after the ordeal known as the prelim or internship year. And once you are a doctor, you can become a specialist. But you always retain the doctoring part in your back pocket.

Medicine is partly cerebral, but a very big part is not. Which is why the latter, more heavily weighted years of med school are the clinical (procedurally oriented) ones.

 

[walderness]

Wait until your internship year when you (a physician) are alone on the wards at night and someone's IV comes out and the nurses cannot get a line in and so they call you (and they will). And then the patient starts to code and you need to start doing chest compressions or facemask bagging to keep him alive, maybe put in a central line or a chest tube (which have to be anchored in with a suture BTW). This IS what a doctor is supposed to be able to do. Having this background and skillset is a huge part of what it means to be a doctor. Doctors aren't just specialists. You get to be a doctor first and a specialist second. That's the whole point of many specialties requiring prelim years in medicine or surgery (as the specialty OP wants to go into does). And why they teach this kind of stuff in the latter half of med school. You aren't qualified to be a doctor after the first two years of med school. You hopefully are more prepared after the latter two. You definitely will be after the ordeal known as the prelim or internship year. And once you are a doctor, you can become a specialist. But you always retain the doctoring part in your back pocket.

Medicine is partly cerebral, but a very big part is not. Which is why the latter, more heavily weighted years of med school are the clinical (procedurally oriented) ones.

Wait until youre in practice and you get a catastrophic injury. If you are in pm&r, ip sci/abi, little need for hands on work, do you give up your entire practice because you can't suture? The same rationality follows...

Theres a large grp of physicians and faculty who are pushing for quads in medicine. I'm not going to let some group of med students/first-year residents, who have not practiced and have such an incomplete perspective of physicianship, try to change my mind. Esp since you also have no perspective on disability.

Per the above situation, I would plan to not let that happen.

This was back in 1990:

http://query.nytimes.com/gst/fullpage.html?res=9E0CE7DA173CF934A15752C1A964958260

 

[walderness]

Impossible. Wait until you learn the actual steps of the physical exam and then tell me if someone with only one arm could be a master of it.

learn what sci is and then you can comment. i'm worried that they allowed you to graduate.

 

[biogirl215]

1- Did you attain the GPA and MCAT scores as a quadriplegic? From your posts it seems like this is recent is it? The reason I ask is because you might have a better chance if you were disabled a while ago and were able to pull off this success despite that.

Sorry, but I have to take issue with this statement.. What's the implication here--that people with physical disabilities are somehow less capable of intellectual ability and academic success? As someone who has always been noticably disabled, I've often dealt with the annoying, hurtful assumption that physical disability=cognitive disability/mental ******ation... I don't think that's what you're implying here, but... actually, what ARE you implying?

I think posters are doing well to ask the hard questions here, as I think they have a place. Personally, I've often wondered if I have what it takes to complete the physical requirements of med school/residency and if I would truly be able to be a good attending. Honestly, I don't know. I'd like to think I can, but I won't want to go to med school if I didn't feel I could be a good, competent physician, and it's hard to get a straight answer on that. Like the OP said, they're tough questions because no one will really give you trial run, and while you do want to be realistic, you don't want to needlessly shut perfectly viable doors, either. People tend to be two-faced on this issue, which makes it harder... The only one-faced people seem to be Drs. who have physical disabilities themselves, in my experience.

 

[futuredo32]

I just wanted to wish walderness and all of the other differently abled people who have posted in this thread the very best of luck in medicine or any other field you pursue. Your determination is really inspiring. 🙂

 

[walderness]

Sorry, but I have to take issue with this statement.. What's the implication here--that people with physical disabilities are somehow less capable of intellectual ability and academic success?

Agree here. My favorite is when waiters look towards other ppl at the table for my order. I am interested in what the implication is as well...

I think posters are doing well to ask the hard questions here, as I think they have a place. Personally, I've often wondered if I have what it takes to complete the physical requirements of med school/residency and if I would truly be able to be a good attending. Honestly, I don't know. I'd like to think I can, but I won't want to go to med school if I didn't feel I could be a good, competent physician, and it's hard to get a straight answer on that.

I think our perspectives here may be different since I made it all the way up to the primary and some secondary applications as an able-body. Then, the accident threw a wrench in the spokes. So you may have a clearer perspective. And I realize that nagging desire to not give up all my dreams is noise. I think the accident just focused my goals and desires.

I think it's so very wrong for people to try to make me feel guilty to give this a shot. Honestly, for monetary reasons, I really don't have to work again. But I truly want to give this a shot. I just hope I don't run across people like this on my way.

 

[Law2Doc]

Wait until youre in practice and you get a catastrophic injury. If you are in pm&r, ip sci/abi, little need for hands on work, do you give up your entire practice because you can't suture? The same rationality follows...

I don't get your logic. If you can do the job, you can do the job, but if you cannot do the job, you cannot do the job. The clinical years of med school and the prelim year are part of the path to this career, regardless of how much you'd like to deemphasize them. If you can do them (or can find places to make accomodations), fantastic. If you cannot do them, then you'll find something else. I'm not telling you to give up. Just telling you that you can't redefine medical training because it might make your dream unattainable at many places.

 

[SoCalGirl]

I don't get your logic. If you can do the job, you can do the job, but if you cannot do the job, you cannot do the job. The clinical years of med school and the prelim year are part of the path to this career, regardless of how much you'd like to deemphasize them. If you can do them (or can find places to make accomodations), fantastic. If you cannot do them, then you'll find something else. I'm not telling you to give up. Just telling you that you can't redefine medical training because it might make your dream unattainable at many places.

I think you've made your point and we know where you stand. What's the idea in beating it in over and over? We get it, already. 🙄

Bottom line, it's not your decision, and he's doing the research in order to find out what needs to be done. It really doesn't matter whether you agree or don't agree.

 

[abbaroodle]

Great discussion! I am sorry the OP is having to have it, and I hope he finds a rewarding career for himself in whatever field he so desires!

I actually had a discussion with my Ob-gyn and surgery course directors when I ended up on crutches and couldnt scrub on cases. (Only 1 week of gyn and a couple weeks of surgery but I wasnt sure for how much of my gen surgery rotation I would be on crutches....) While my situation obviously doesnt compare at all to what the OP has to face, we did talk about what they wanted every student to get out of the rotation.

The surgery clerkship director really didnt care if I could retract or throw sutures. She really wanted every student to know how to approach an accute abdomen, a trauma pt, etc. She wanted a student to know the indications for surgery, post-op management, potential complications and how to deal with them, etc. (Yes, she wanted us to see cases up-close which you cant do from a stool in the corner of the room, but that was far less important. She also wanted me to have a chance to experience surgery and the field. But thats a different story.)

Also, remember the hospital runs just fine when there are no students around. They may help out in the OR and run errands, but when they go on vacations, things still happen.

I think the OP clearly knows he is going to face many challenges and ultimately limitations. But I think we need to think about what it means to be a physician and go to medical school, not just "can he take overnight call."

 

[Law2Doc]

Also, remember the hospital runs just fine when there are no students around. They may help out in the OR and run errands, but when they go on vacations, things still happen.

The point of being a student isn't to make the hospital run. But the point of your internship year will be. Hospitals rely on this cheap labor and will milk it for all they are legally allowed. And you learn the stuff you need to survive this year by being a student. I think you are missing some of the point of clerkship here. Sure, part of it is getting the kind of exposure you describe in surgery and OBGYN. But a much bigger part of it is to have skills you will need for the next level.

 

[45408]

learn what sci is and then you can comment. i'm worried that they allowed you to graduate.

Your air of condescension is not going to help you. No one here has told you not to apply, so go ahead and do so. We're not holding you back.

 

[GreenShirt]

Wait until your internship year when you (a physician) are alone on the wards at night and someone's IV comes out and the nurses cannot get a line in and so they call you (and they will). And then the patient starts to code and you need to start doing chest compressions or facemask bagging to keep him alive, maybe put in a central line or a chest tube (which have to be anchored in with a suture BTW). This IS what a doctor is supposed to be able to do. Having this background and skillset is a huge part of what it means to be a doctor. Doctors aren't just specialists. You get to be a doctor first and a specialist second. That's the whole point of many specialties requiring prelim years in medicine or surgery (as the specialty OP wants to go into does). And why they teach this kind of stuff in the latter half of med school. You aren't qualified to be a doctor after the first two years of med school. You hopefully are more prepared after the latter two. You definitely will be after the ordeal known as the prelim or internship year. And once you are a doctor, you can become a specialist. But you always retain the doctoring part in your back pocket.

Medicine is partly cerebral, but a very big part is not. Which is why the latter, more heavily weighted years of med school are the clinical (procedurally oriented) ones.

I guess it's helpful when you're an intern and the hospital dumps the scut work on you, but my point is that when you're an attending you won't be doing most of these hands-on things pre-meds dream about but are done by nurses in real life. Who would have an easier time starting an IV? The nurse whose been doing it daily for 5 yrs of the physician who hasn't started one since they were a resident 5 yrs ago? My PCP barely knows how to give a shot because his nurses always do it for him. In the two years I spent working in the ED, I never saw a physician do compressions or start lines on a coding patient because that was the nurses/paramedics job.

My point is that from the point of being a source of slave labor for the hospital, they're essential skills, but from the point of view of a physicians they're activities not essential because they are rarely encountered.

 

[elwademd]

Wait until youre in practice and you get a catastrophic injury. If you are in pm&r, ip sci/abi, little need for hands on work, do you give up your entire practice because you can't suture? The same rationality follows...

Theres a large grp of physicians and faculty who are pushing for quads in medicine. I'm not going to let some group of med students/first-year residents, who have not practiced and have such an incomplete perspective of physicianship, try to change my mind. Esp since you also have no perspective on disability.

Per the above situation, I would plan to not let that happen.

This was back in 1990:

http://query.nytimes.com/gst/fullpage.html?res=9E0CE7DA173CF934A15752C1A964958260

Great discussion! I am sorry the OP is having to have it, and I hope he finds a rewarding career for himself in whatever field he so desires!

I actually had a discussion with my Ob-gyn and surgery course directors when I ended up on crutches and couldnt scrub on cases. (Only 1 week of gyn and a couple weeks of surgery but I wasnt sure for how much of my gen surgery rotation I would be on crutches....) While my situation obviously doesnt compare at all to what the OP has to face, we did talk about what they wanted every student to get out of the rotation.

The surgery clerkship director really didnt care if I could retract or throw sutures. She really wanted every student to know how to approach an accute abdomen, a trauma pt, etc. She wanted a student to know the indications for surgery, post-op management, potential complications and how to deal with them, etc. (Yes, she wanted us to see cases up-close which you cant do from a stool in the corner of the room, but that was far less important. She also wanted me to have a chance to experience surgery and the field. But thats a different story.)

Also, remember the hospital runs just fine when there are no students around. They may help out in the OR and run errands, but when they go on vacations, things still happen.

I think the OP clearly knows he is going to face many challenges and ultimately limitations. But I think we need to think about what it means to be a physician and go to medical school, not just "can he take overnight call."

i think going to medical school and becoming a physician, may be, in many ways, different from practicing as a physician.

can you get into medical school? your stats would seem to say so.
will you do fine in the first 2 years? probably so, as its mostly/entirely lectures... though i'd be interested in what the schools would ask/what accomodations there would be for a class like gross anatomy or histology.

how would 3rd and 4th year go? probably ok, as students aren't a necessity... though again, there would have to be accomodations for the physical limitations. abbaroodle mentioned being on crutches for a rotation... where you'd still have the use of your hands to evaluate an "acute abdomen". not being able to use your hands/arms quickly and efficiently is a part of this. but again, i think accomodations could be made.

so, i think with the proper accomodations, you could matriculate and graduate medical school.

but after that, what would happen?
pm&r is going to require a preliminary year, which is essentially internal medicine. there are going to be expectations of interns, such as helping to run codes which may requires central line placement, intubation. there are some aspects of the physical exam that require the use of hands/arms (using a stethoschope, digital rectal exam, testing for dysmetria).

provided you feel confident you can do these, that's great. but if you need a lot of accomodations for basic intern work... i'm not sure what happens. do you get to slide ("i couldn't do the d.r.e.", "i couldn't test for a fluid wave"), do other interns have to make up your work... is there some other alternative?

i think that's its commendable that you have the desire to pursue medical school. what i think you really need to ask physicians is what will be the expectations of internship, residency, and post-residency life? applying for state medical licensure, as many states ask if you have any physical limitations, and if so, what they are. applying for hospital privileges, as again, they will ask about physical limitations. will your malpractice rates be significantly different for a given specialty, given your disability?

not trying to discourage you, but these are real issues that you'll eventually face within medicine, regardless of the specialty you enter into.

 

[AmoryBlaine]

learn what sci is and then you can comment. i'm worried that they allowed you to graduate.

I'm going to proceed with an unseemly pulling-of-rank here. The fact that you as a pre-med student think that you have a better grasp than I do of what exactly a complete physical exam entails is just laughable. You are a college student who has seen focused parts of it done by mentors. I have learned it head to toe and performed it hundred of times.

You also suggest (again laughably) that despite graduating from a well-respected medical school I have no idea about the nature of spinal cord injury. This does not even deserve further comment.

You shouldn't be worried that they allowed me to graduate, because despite disagreeing with you on an anonymous internet forum I am not a terrible person or clinician.

 

[BoredMD]

I am not a terrible person or clinician.

Yay for you!! Want a cookie?

 

[AmoryBlaine]

It's not an issue of my being constructive. Constructive implies that there is something you can do on your own to accomplish what you need to to be a doctor. But in fact, IMHO, you are going to have to rely on some school's willingness to modify their clinical year curriculum to make it possible for you to complete it. And then a residency to do the same. So no, I cannot be constructive because I don't see anything you can do on your own, beyond find schools that have made accommodations. If they want to do that, that's up to them -- I don't have the ability to close any doors on you. I actually hope you get what you want, but I see lots of good reasons why you might not, and I think you oversimplify things when you want schools to revise what constitutes clinical medical training so that you can get to an end target that you believe you can actually do.

And no, the reference to "walking rounds" was not a dig at you -- that is what they are called (as opposed to "table rounds" where you go over patients at a conference table -- which is less common) when you actually go from room to room throughout the hospital seeing patients. And these rounds tend to involve lots of stairs and multiple floors, and chasing of attendings who rapidly race around the wards and stop for no one (certainly not a lowly med student), so again you'd need adjustments to be made to even participate in this daily event.

I certainly know of a lot of schools that send out questionnaires to applicants requiring them to verify that they have the physical ability, dexterity and visual and auditory acuity necessary to make it through their clinical years. They do this because in their opinion, you need these abilities to get through the clinical years, ie to become a doctor through their school. A HUGE part of the clinical years of med school is procedural. You learn to put in lines and tubes, suture, intubate, put in foleys, do LPs, deliver babies, perform physical exams, chest compressions and CPR and running codes. There is a ton of chasing around the residents, fetching charts and other scut, standing/scrubbing in on surgeries, doing overnight calls. And this all culminates with residency, where you are going to at times be alone on the wards trying to keep your charges alive, which often means having to do a lot of these procedural things on your own. If you are up to the task then great. If you expect these tasks to be eliminated so you can become a doctor on your own terms, then I just don't agree, largely for the reasons mentioned by Amory Blaine above. You don't get to define what constitutes medical training. You need to become a doctor first and a specialist second. Not jump to specialist just because that is a pace you can manage.

The folks who are not being constructive are those who are saying "you can do it" without having ever done a clinical clerkship year of medicine and having no notion of what it involves.

I love reading L2D's posts ...

This one encapsulates better than any that I have (or could) the issue. Someone with such a large disability who wants to become a physician is not just looking for appropriate accomadation -- they are asking a medical school to redefine its training program to suit one person. Someone with such a large disability who wishes to enter a particular speciality is not just asking for accomadation -- they are asking a residency program to create a custom spot just for them.

 

[AmoryBlaine]

I guess it's helpful when you're an intern and the hospital dumps the scut work on you, but my point is that when you're an attending you won't be doing most of these hands-on things pre-meds dream about but are done by nurses in real life. Who would have an easier time starting an IV? The nurse whose been doing it daily for 5 yrs of the physician who hasn't started one since they were a resident 5 yrs ago? My PCP barely knows how to give a shot because his nurses always do it for him. In the two years I spent working in the ED, I never saw a physician do compressions or start lines on a coding patient because that was the nurses/paramedics job.

My point is that from the point of being a source of slave labor for the hospital, they're essential skills, but from the point of view of a physicians they're activities not essential because they are rarely encountered.

a) At what institution do nurses or paramedics place central lines during codes?

b) Having something be rarely encountered does not make in inessential. In my future practice I will (hopefully) rarely do emergent thoractomies but that does not mean they are not an essential skill for me to have.

 

[LizzyM]

1- Did you attain the GPA and MCAT scores as a quadriplegic? From your posts it seems like this is recent is it? The reason I ask is because you might have a better chance if you were disabled a while ago and were able to pull off this success despite that.

The reason why this question may come up has to do with time management skills. The time required for activities of daily living, including toileting, are higher now than when you were an undergrad. How will you handle keeping up with academics given that you have fewer available hours in a day?

In addition, is your general health good or are you functioning sub-optimally due to chronic or recurrent infections?

These might be questions that will come up at interview.

 

[smq123]

I guess it's helpful when you're an intern and the hospital dumps the scut work on you, but my point is that when you're an attending you won't be doing most of these hands-on things pre-meds dream about but are done by nurses in real life.

Yeah, and the point is YOU HAVE TO SURVIVE INTERNSHIP BEFORE YOU CAN EVEN DREAM OF BECOMING AN ATTENDING. Heck you have to survive your OB/gyn and surgery clerkships (which are all VERY hands-on) before you can even dream of becoming an intern!!

Why is this basic point escaping everyone?!

i think that's its commendable that you have the desire to pursue medical school. what i think you really need to ask physicians is what will be the expectations of internship, residency, and post-residency life? applying for state medical licensure, as many states ask if you have any physical limitations, and if so, what they are. applying for hospital privileges, as again, they will ask about physical limitations. will your malpractice rates be significantly different for a given specialty, given your disability?

not trying to discourage you, but these are real issues that you'll eventually face within medicine, regardless of the specialty you enter into.

Thank you, elwademd for being one of the few voices of reason (along with Law2Doc and AmoryBlaine) on this thread.

Look, accrediting standards require that you be able to perform certain skills before becoming a licensed physician. Now, maybe you can avoid doing some of them, or get accomodations. But...avoiding ALL of these skill requirements?

The physical diagnosis skills that all physicians can perform is one of the things that differentiates MDs/DOs from the PhDs that study pharmacology or physiology. These PhDs also know a lot about diseases and drugs...but they lack the full physical diagnosis skills that would enable them to make a diagnosis.

Now, maybe the OP DOES deserve a spot in medical school and residency. I don't know, and that's not my call to make. But insisting that these physical diagnosis maneuvers are not "important" or that not being able to do them is a "trivial problem" is unrealistic.

 

[Tin Man]

I agree with the L2D crowd here...

As much as we would love to believe that America really is a land of equality, things don't happen just because we want them to.

The OP may be perfectly suited to some specialties, but that doesn't mean that he can enter into that specialty without going through the EXACT same training every other physician in the country has to go through. There is a point to medical school, and it's not just to test the brain power of the students. That's what pre-med is for.

Medical school is to teach you essential skills for the field of medicine, regardless of the chances of you actually using said skills. If you can't physically perform these skills, then no one has the obligation to change what is considered medical training just so the OP can wear a white coat.

The chance to get to medical school is NOT a right, as thousands of pre-meds find out every year. It is not even a gift given to those who work hard, as many thousands of pre-meds who worked hard find out every year. It is a gift given to those who QUALIFY and who are CAPABLE of practicing medicine the way that is currently authorized in the United States.

If you can't meet the criteria, then not only should it not happen, but it likely won't happen.

It's tough news, and it's news I personally had to accept with my dream job before I started even considering medicine. But there are a lot less broken hearts for those who look at reality as is.

As I said earlier in my posts, if you feel you can handle medical school, then convince the medical schools of it. Your grades need to be as good (if not better) than all other applicants, and you have to be able to prove you can handle what they can. If not, then don't get your hopes up.

 

[GreenShirt]

Now, maybe the OP DOES deserve a spot in medical school and residency. I don't know, and that's not my call to make. But insisting that these physical diagnosis maneuvers are not "important" or that not being able to do them is a "trivial problem" is unrealistic.

It's up to medical educators and schools to determine what defines a physician and whether a quadriplegic doctor is beneficial or harmful to society not us SDNers (although it is fun to debate). It's the OPs decision whether he/she wants to invest their time and money in something that may be difficult for them to obtain.

I'd say being able to do H&Ps is vital to every doctors existence but the value of procedures is highly variable. Is a pathologist harmful to their patients because they're not the best at delivering babies? Is an immunologist with poor suture skills a detriment to society? Is a psychologist worse off if they can't preform a proper cricothyrotomy? You're saying that these skills define the essence of a physician and I'd say they are secondary to a physicians ability to properly diagnosis and create treatment plans for their patients. The big question, I think is how is the OP going to be able to preform a physical without help? Since there are doctors out there who practice with similar disabilities...it's apparently a surmountable obstacle.

 

[SoCalGirl]

It's up to medical educators and schools to determine what defines a physician and whether a quadriplegic doctor is beneficial or harmful to society not us SDNers (although it is fun to debate). It's the OPs decision whether he/she wants to invest their time and money in something that may be difficult for them to obtain.

The big question, I think is how is the OP going to be able to preform a physical without help? Since there are doctors out there who practice with similar disabilities...it's apparently a surmountable obstacle.

Good points. 👍

 

[smq123]

I'd say being able to do H&Ps is vital to every doctors existence but the value of procedures is highly variable.

😕 Do you know what H&P stands for? History and PHYSICAL. I'd argue (having done numerous physicals over the past year or so) that it's very, very, very hard to do a halfway decent physical exam if you don't have the use of your hands.

Is a pathologist harmful to their patients because they're not the best at delivering babies? Is an immunologist with poor suture skills a detriment to society? Is a psychologist worse off if they can't preform a proper cricothyrotomy?

a) Psychologists don't go to medical school.

b) The point is not whether you will need every skill that you learn in residency or medical school. The point is that you need to demonstrate some proficiency in these skills (yes, even delivering babies) before you are even allowed to consider becoming a pathologist or immunologist.

And the immunologist needs to get through an internal medicine residency (where he will need to know how to do central lines, ABGs, and LPs) before becoming an immunologist.

You're saying that these skills define the essence of a physician and I'd say they are secondary to a physicians ability to properly diagnosis and create treatment plans for their patients.

No - these skills DO define the essence of a physician.

Physicians perform these skills to help TREAT their patients. And that's the essence of being a physician - diagnosis AND treatment. Not just creating treatment plans, but, in many cases, actually performing that treatment themselves.

 

[SoCalGirl]

This thread is veering way off the original question, which was asking about schools that would be willing to make accommodations for the OP. You guys aren't the be all end all on this topic despite what you may think. Medical schools will be the ones making that decision, not you and arguing about it is pointless.

 

[Sean2tall]

I am surprised by how important and critical everyone makes medical school to be. If you don't put in a chest tube or even an IV during medical school, the world will keep turning. Sure, there is some element of "work" during clinical rotations, but completing school is not some grand achievement like the commencement speeches make it out to be.

Maybe some places are hugely understaffed by students and residents and they actually "need" you to put in that chest tube, but I doubt it. In my experience the "workload" is just an illusion. I have never seen a code where the transitional resident going into PM&R is the only person there and has to "save the patient's life." There are plenty of residents around (surgery, ER, Anes, etc.) who actually need to learn vital procedures for their career.

I believe 100% that a person with disabilities like this could do an excellent physical exam, but I'm sorry for even commenting. As has been said numerous times, the OP is not interested in critique of his plan just advice on where to apply.

 

[SoCalGirl]

I am surprised by how important and critical everyone makes medical school to be. If you don't put in a chest tube or even an IV during medical school, the world will keep turning. Sure, there is some element of "work" during clinical rotations, but completing school is not some grand achievement like the commencement speeches make it out to be.

Maybe some places are hugely understaffed by students and residents and they actually "need" you to put in that chest tube, but I doubt it. In my experience the "workload" is just an illusion. I have never seen a code where the transitional resident going into PM&R is the only person there and has to "save the patient's life." There are plenty of residents around (surgery, ER, Anes, etc.) who actually need to learn vital procedures for their career.

I believe 100% that a person with disabilities like this could do an excellent physical exam, but I'm sorry for even commenting. As has been said numerous times, the OP is not interested in critique of his plan just advice on where to apply.

The OP stated that he's been doing research on this matter so I'm sure he's already getting a critique of his plan. My comment was geared towards those who are acting like they are the ultimate authority on this subject when they clearly are not.

 

[Dazedinvt]

So there are essentially two different debates going on here. I know it's pointless to try to clarify... do you or do you not need to do a physical examination in order to complete medical school?

Do you or do you not have to master and demonstrate proficiency in clinical skills in order to graduate from medical school?

Can a quadraplegic perform a physical examination?

Can a quadraplegic perform clinical skills?

I'm seriously asking, I have no idea.

Is the student providing an assistant to help with tasks that he cannot perform?

Can one bypass the physically demanding elements of medical school to specialize in a specific field?

It just seems like L2 and the resident are bringing up arguments about medical school and residency and the other posters are countering with arguments about practicing physicians in specific specialties.
I don't see those as comparable.

sh**, JACO in the ED all day and I'm too tired to really contribute.

 

[45408]

This thread is veering way off the original question, which was asking about schools that would be willing to make accommodations for the OP. You guys aren't the be all end all on this topic despite what you may think. Medical schools will be the ones making that decision, not you and arguing about it is pointless.

That's all well and good if it were just pre-meds chatting in here, but there have been doctors and school faculty posting in here, in addition to the fact that many/most medical schools use medical students as interviewers. So, just because you aren't one of them doesn't change the fact that actually there are a number of people in this thread who will be involved in making that decision.

 

[Depakote]

Just a reminder to keep the discussion civil and refrain from any personal attacks.

 

[SoCalGirl]

That's all well and good if it were just pre-meds chatting in here, but there have been doctors and school faculty posting in here, in addition to the fact that many/most medical schools use medical students as interviewers. So, just because you aren't one of them doesn't change the fact that actually there are a number of people in this thread who will be involved in making that decision.

Obviously, the OP is going to be discussing his situation with the medical schools in order to find out whether or not accommodations can be made before he applies to those schools so I really don't see the point of debating this at all. He's already stated that he's been in touch with schools/others in similar situations. If schools aren't willing to make those accommodations, they will let him know that it can't be done. Sitting on the internet arguing about what skills make a great doctor just seems irrelevant to me when that wasn't the original intent of the thread.

 

[45408]

I really don't see the point of debating this at all.

Hi, welcome to the Internet. That's what we do here.

 

[SoCalGirl]

Your air of condescension is not going to help you.

Speaking of condescension...

Hi, welcome to the Internet. That's what we do here.

🙄 So clever...

Now might be time for me to check out that new ignore feature.

 

[biogirl215]

I think our perspectives here may be different since I made it all the way up to the primary and some secondary applications as an able-body. Then, the accident threw a wrench in the spokes. So you may have a clearer perspective. And I realize that nagging desire to not give up all my dreams is noise. I think the accident just focused my goals and desires.

Perhaps I'm misreading you or wasn't clear (both highly possible)... The issue with the physical requirements is my main stumbling block when thinking about med school... I believe (perhaps naively or incorrectly) that I could fulfill the academic side of a medical education welll (and you have already proven that you can 🙂 ), so the question for me lies in "can I do this, physically?" and if so, I would pursue the academics.

I just hope I don't run across people like this on my way.

Oh, you will, sadly. You'll run across people who will support you to your face and knock you behind your back and people who will just flat insult you to your face. You'll face this and things like this a billion times, especially if you decide to pursue medicine.

For example, last semester I applied for a fairly non-physical job, a TA for an intro class. I had a great app (per my interviewer's comment), great interview (again, per his comment), previous TA experience, and a "glowing" (again, according to my interviewer) rec from the prrof who I TA'ed for. After my interview with him, I got an email from the professor doing the hiring/interviewing, saying that I was an outstanding candidate but that he really didn't want to hire a TA with a disability because he doubted my ability to collect papers, lecture, etc, and worried I would be a "burden" on my professor despite my previous sucessful experience. He said that had it not been for my disability, he would have hired me in a second. I wrote him back and addressed his concerns point by point and held my breath. In the end, I got the position, but it took a lot of extra fight, and medicine will take even more so. Being physically disabled isn't all bad, but it makes everything harder--it takes a lot of fight, and especially something like medicine--I wonder if I have that degree of fight in me, myself.