Medical Specialty Aptitude Test

As every medical student knows, first year of medical school everyone is talking about all the funny new words you get to learn; Tenesmus is my favorite.

Second year is all about studying and USMILE step I. And third year is about deciding what type of doctor you will become. The classic surgery vs medicine approach is a good place to start, but beyond that most things begin to fall apart for a lot of people.

Advice on the subject is almost endless and I have found that the more people you ask the more answers you will get. Never-the-less, it’s good to ask lots of questions and find out as much as possible about your areas of interest. The Univeristy of Virgina has this snazzy Medical Specialty Aptitude Test that may steer you in a good direction. If you are still not sure however, here are son alternative ways you can choose a specialty.

The British Medical Journal published an article in 2005 by Boris Veysman called Physician, Know Thyself, it includes the algorithm, posted above, to use as a guide when choosing a residency. I’m not sure of the sensitivity and specificity but I think most physicans say it's pretty accurate. If that algorithm didn’t solve all your problems this video may help. ZDoggMD and Dr.Harry gives a nuanced break down of a few different types of doctors and what to expect if you decide to join their ranks. Don't let the beatboxing and Justin Bieber impressions distract you from the pearls.

There Must Be A Better Way

10 Steps To Avoid Becoming "That Doctor"

“What man actually needs is not a tensionless state but rather the striving and struggling for some goal worthy of him. What he needs is not the discharge of tension at any cost, but the call of a potential meaning waiting to be fulfilled by him.” - Dr. Viktor Frankl

Recently, I was examining a 4 year old boy who came to the clinic with a cough. As I bent my six foot five inch frame down to his level and pressed my stethoscope to his small chest, he watched me intensely. I flashed him a quick smile; he returned the favor and continue to observe every move I made. When I finished listening to his lungs, his curiosity could no longer be contained. He looked at me and said, “Can I listen to your heart now?” So for a moment we traded places; he became the doctor and me the patient. He was actually quite good at imitating me by quietly tuning in to hear my heart beat and prompting me for a deep breath by inhaling and nodding for me to follow suit. As he was finishing with my exam, his mother, beaming with pride, said, “He wants to be a doctor, and that’s what I want him to do too.” I chuckled thinking at once of my many sleepless nights, stress over exams, and the events with family and friends I had already missed in pursuit of this noble goal, and I’m just getting started.

As the little boy and his mom left the clinic, I began to think about the many overworked physicians I see or speak to, who started out like my young patient then slowly had the wonder and excitement sucked out of their physician experience. Some doctors have even responded to my questions for advice with, “I have no idea why anyone would want to go into medicine any more!” If I’m honest, sometimes I feel they may have a point. Then again, I have met physicians who still love the work they do. Over the weekend, I spent some time with a family friend who is an ER doctor. I asked if he got frustrated by all the “waste of time” consults he sees in the emergency department. Looking at me genuinely he said, “Every patient visit is an honor for me, I see them as a life I can touch.” I guess I shouldn’t have been taken back, but I didn’t expect that response from an ER doc with 30 years under his belt.

The question that begs to be asked is simple, "What’s the difference?" We have all met different versions of both doctors and one has to wonder what makes a doctor bitter, miserable, and look 10 years older than they should and the other still happy to examine or even reexamine a child with a cold because his pushy paranoid mom insists her son needs a prescription right now! Does it all come down to specialty, work hours, who gets paid more, or just personality?

This question is one that I am not qualified to answer, and is one that I will likely continue to answer throughout my career. However, I did find a great start in a comment Dr. Arlen Meyers posted in response to my post on Practicing Medicine In The Year 2050. You can read it there, but it’s worth a reprint.

For those who don’t know, Dr. Meyers is and ENT Surgeon, entrepreneur, author, educator, and CEO and President of the Society of Physician Entrepreneurs.

Here's what I would say to students interested in medicine:

1. Like anything else, follow your heart, not your parents.
2. There are lots of ways to make a difference with an MD degree other than seeing patients.
3. You will need to get your ticket punched (MD degree, residency) to do most of them.
4. Don't tell the admissions officer at the medical school that you have no interest in practicing medicine.
5. Hear all the people who are bitching. Just don't listen to them.
6. Don't be a slave to debt if possible. Sacrifice and pay it off as soon as possible.
7. Taking care of business is a part of taking care of patients. Start learning it as soon as possible on your own because you won't learn it in medical school.
8. Innovate
9. Innovate
10. Innovate

These ten steps are not a prescription for an easy, turn-key career, but they will allow you to have a career on your own terms. I believe that these 10 things will make the difference between physicians who continue to stay engaged and passionate and those who become jaded and defeated.

I'm Traveling During My Med School Breaks... What About You?

Doing what you love during a Medical School break can be a lot more productive than you realize. 

So if your medical school is anything like mine, there will be a constant buzz in the air about what to do during the summers and breaks. Who's researching what? and when? and where?! What paper have you gotten published?!!! HAVE YOU SHADOWED DR. AWESOME?! LETTERS OF RECOMMENDATION! AHHH! It's like the big, hairy, scary behemoth in the room. Everyone is trying to figure out what everyone else is doing so they can properly gauge just how much overacheivment is necessary during their time off. Well, I've got an idea that I probably shouldn't share because then my secret will be out. DO SOMETHING DIFFERENT.

The concept is pretty straightforward. If everyone in the room is wearing a red sweater because they think that's what you have to do to get into the party, how much do you think you will stand out if you don the red sweater as well? Now let's say that your favorite color is blue and you decide that you don't care that everyone says you're supposed to wear the red sweater, you're jolly well gonna wear the blue one and show up to the party anyway. Do you think you'll stand out?

Sometimes it seems like medical students want so badly to stand out, but at the same time they have this crazy (and somewhat legitimate) fear they won't check all the right boxes.

Cut to my life. Travel is my passion. I never feel more focused, fulfilled, or alive than when I am boarding a train or listening to the pilot welcome me aboard. Travel feels like home to me. Because of this passion I have, I travel every chance I get.

When it came to the end of college I had received my acceptance to medical school, but I was planning on deferring for a year. All the options for deferment I had considered weren't quite what I was looking for, and then a friend casually mentioned a trip he was planning... and what a trip it was. Take a world map and make the center of it the pacific ocean. Then draw a point at the southernmost tip of South America and another at the southwesternmost point in Africa. Then connect them using the longest overland route possible. This gives you some idea of the scope of this trip.

This idea lit me on fire and I could think of little else. I finally knew what it was like to be passionate about what I was doing and it was glorious. I was researching, building a website, looking at the possible routes and where the difficulties would lie. Hours would fly by researching this or that detail of travel and I would barely notice. This was far from my mindset throughout most of my college experience. I was fully engaged in what I was doing and loving every minute of it.

Then came the day to shove off into the grey mist of the unknown and board that plane bound for Patagonia. My friend and I had a rudimentary route worked out and enough money saved to last for a year of ultra-bootstrapped travel (we hoped). Then we started traveling and I realized that I wish I was doing research... just kidding. The year was, I can say without hesitation or reservation, the most interesting and mind expanding year of my life.

I visited 42 countries on 5 continents. I had the opportunity to meet some of the most intensly interesting people on this planet and make friendships with people the world over. I was honored to be able to take in the sites, sounds, smells, and cultures of a great many places, if even for only a few fleeting days. I rode on trains, buses, cars, motorcycles, planes, goat trucks, subways, scooters, bicycles, and just about every other mode of transportation you could envision, in pretty much every condition imaginable. I even had the good fortune to volunteer my time and work with some amazing Doctors at some amazing mission hospitals. It was not always easy or comfortable, but it was an education like no classroom, laboratory, or online course could have given me. And we made it. We traveled from Cape Horn to the Cape of Good hope the long way around. If you care to read about the trip our blog is www.thewholeworldround.com.

I say all that not to brag or gloat, but mearly to point out that you CAN leverage your passion to your benefit and to the amazement of others... DURING MED SCHOOL. I'm trying to be real here. How many conversations do you think I've had about my trip since I got back? Do you think many medical students did a trip like that last year? Do you think this sets me apart and allows me to have conversations with people I would not normally be able to engage? Innovative people, passionate people and leaders are drawn to other people who have those same qualities.

Okay that's great, so what's the point?

When you are thinking about what to do with your upcoming break, don't just think about which box you can check off on the list of things to do in medical school. Draw your own box, man! Find a way to leverage your passion into a life experience that you can grow from. If that's travel, GO TRAVEL. If you're a passionate knitter of hats, DO THAT (then give them away to kids who are bald from chemo). If it's research, by all means research till your blue in the face! Volunteer in a hospital or research WHILE you travel (abroad programs). Be innovative with it, be creative, but most importantly... do it. If you are in love with what you are doing, it will show through to the people that matter. Cliche yes, but no less true. Remember... the blue sweater. Wear it! Love it! Stand out.

Practicing Medicine In The Year 2050

Our future patients may need vaccines and antivirus software.

For those who have not seen or heard of the documentary, Transcendent Man, it is a film that chronicles the life and work of author, inventor, and futurist Ray Kurzweil. The film is at once fascinating and uncomfortable. It makes The Matrix look like a prophecy the will soon become reality. In another 40 years, according to Kurzweil, you may be presented with the same desicion as Neo, swallow the red pill and end up downloading kung fu. He firmly believes that in the next 40-50 years humans will merge with machines, and artificial intelligence will become self aware. So if you are sick of trying to remember intimate details of purine metabolism, forget it, just download the software update. The reason we will need to enhance our brains is simple. Technology will eventually hit a point referred to as “the singularity”  where improvements will be made so fast that the normal human brain will not be able to keep up without plugging into the matrix, so to speak.

This movie also explores the future of medicine. Doctors will have machines the size of red blood cells armed with one thousand times the computing power of my mac. These little cyborgs will go cruising through our vasculature diagnosing and treating disease as they float along. Really, it's unfortunate we have to wait for them because if I have to get pimped on nephrotic membranoproliferative glomerulonephritis one more time, I think I might loose it.

I guess no can say for sure what the field of medicine will look like in even 20 years; but one thing is for certain, it will have many changes. In fact, medicine is likely to change more in the next 20 years than it has in the last 100, which is both a frightening and exciting thought. For the physicians of the next generation, memorizing and mastering the current treatments and practices will not be enough. The next wave of great doctors will be creative thinkers, innovators, and those who are most able to embrace and navigate change. All that said, I might still wait a few years before I start downing pills offered to me by some random large black man in a leather coat.

Rethinking What's Possible As A New Doctor

Thoughts after Medical Fusion Conference

Next time you find yourself in The Maldive Islands with no plans and some spare cash, book a room at The Conrad Maldive Rangali Island Resort. In addition to the group of overwater bungalows, with a coral reef for a front porch, they will turn the underwater dinning room into a hotel suite, for the right price. The idea for a hotel room positioned 20 feet underwater amidst a vibrant coral reef teeming with fish is a concept anyone could dream up. However, taking that dream and turning it into a reality is a whole different story. When you learn about someone who made a big dream come to fruition, it forces a rethink. You begin to question all the assumptions held about “what’s possible” and this also leaves you open to new and bigger possibilities.

The 2011 Medical Fusion Conference in Las Vegas, Nevada has just finished and the weekend was packed with speakers who have spent their careers rethinking and redefining “possible” in medicine. I was fortunate to have the weekend open and was able to attend, because my current rotation is outpatient pediatrics. But this silver lining had a grey cloud. Though the first lecture was scheduled to begin at 8:00 am on friday morning, for me, the day began at four hunched over the toilet revisiting the previous night’s dinner. I guess I had one too many kids sneezing in my face that week and my normally stellar immune system was no match for those walking petri dishes. After two more episodes of reverse peristalsis I was less than enthusiastic about spending all day listening to lectures.

My apathy melted away almost instantly as the first speaker, Dr. Barry Silbaugh got up and shared his experiences working as the CEO of The American College of Physician Executives, his international medical work, and his thoughts on how to pursue a non-traditional career in medicine. As the morning went on I found my excitement building as one after another the speakers continued to shatter the assumptions I held about what is possible as a medical professional. By the time Dr. Greg Bledsoe finished his presentation on living and working abroad I was glowing with enthusiasm, though it could have just been my fever, but either way I had just been presented with a new paradigm and was ready for more.

As the conference continued, my immune system finally resumed control of my gastrointestinal system, and I was repeatedly amazed at the innovative and creative individuals sharing the trials and successes of practicing medicine on their own terms. My favorite part of the conference was the accelerator sessions at the end of each day. These sessions provided a chance to connect with the speakers on a more personal level. As a medical student this provided me with a rare opportunity to sit down with great doctors and pick their brain for advice. I was honored by the way they engaged my questions, offered sound advice, and challenged me to continue to think outside the box in my own career.

The experience I had at Medical Fusion was one I believe will become a defining point in my professional career. It is for that reason I have decided share what I learned and work to build a community where medical students can rethink what’s possible in medicine. Now that I have met so many talented physicians who are engaging medicine in a way that excites them, I know I want to do the same. The weekend helped me to rethink the kind of doctor I aspire to become. I hope this site will do the same for you and who knows may be some day we’ll be seeing patients at a hospital clinic 20 feet under the sea.

Options: The Light At The End Of The Medical School Tunnel

Knowing what's possible after medschool makes all the difference.

Thoughts are swirling around my head at a centrifugal pace that would dizzy even Oksana Baiul. So many new ideas and options to consider. Options, that’s what I’m excited by the most. I now feel I have the ability to plot my own course through this perilous and stormy sea of arduous and often aggravating academic acrobatics known to the lay person as “medical school.” That ability is priceless to me.

I am someone that will happily wade through any amount of crap, provided : 1) I have some degree of control over what particular flavor of crap it is and 2) That I see some higher purpose to the wading… the proverbial “light at the end of the crap”. Med School isn’t crap per se, but if we’re being honest with one another… it seems suspiciously similar to it at times. This is especially true when the light at the end of the tunnel seems to be flickering and desirable options seem scarce.

That flickering light strengthened a little when I ran across the freelance MD website. I had been scouring the internet looking for ideas on innovative and interesting outlets for someone with an MD degree. In short I was looking for options. It’s not that I absolutely abhor the thought of a traditional clinical practice, but I wasn’t all too excited by it either. What gets ME pumped is the the world of ideas, possibilities, and innovations. How can I improve the process? Are there better ways of being an MD?

These are the questions for which I was seeking answers. There were scattered accounts of doctors working on their own terms; perhaps on as an expedition doc to the jungles of Africa, or making a career of disaster relief consultancy, or gallivanting off to Alaska for 6 months as a locum tienens doctor. These ideas excited me, but I had no mentors to council me on how to steer myself toward this type of career or whether it was possible at all. If I told someone about these ideas, I often got a “Yeah, go for it man (eye roll)” or “Don’t mind Jeremy, he’s a little crazy” response.

Then one friday afternoon after slogging through some scintillating biochem, I stumbled in through the front door of freelanceMD.com. Five hours of reading later, I realized that this was the group of people I had been looking for. People that are innovating and LEADING in their non-traditional medical fields. Wilderness medicine, International Medicine, Concierge Medicine, Disaster relief and humanitarian medicine, Medical Entrepreneurship, Internet Medicine, Medical Writing, and on and on. The possibilities astound. It didn’t take me long to realize that medical students need access to minds like these.

My internet search had taken me to a thousand different sites with a juicy tidbit here or there, but I was always left wanting more. I hadn’t found the consolidated source of information on non-traditional medical routes I was looking for until I ran across Freelance MD. And so… we’ve decided that medical students need exposure to these ideas, they need options. They need mentoring from inquisitive and innovative minds in medicine. They need to network and dialogue with like-minded students DURING medical school and they need to see the light at the end of the crap and put themselves in a position to effect change in the medical status quo. Hopefully this site can do that for you. Here, we’re about doing things a little differently. If any of this resonates, then you’ve come to the right place. Welcome.

How To Become An Author On Uncommon Student Doctors

Uncommon’s single goal is to deliver quality information to student physicians who want access to information to control their medical careers and lifestyle.

Of course, this information comes form our contributing authors who are willing to share their time and effort to provide access to the best information and experitise around lifestye, income and career for physicians.

Writing takes time. Closely examining the latest developments takes its time as well. If you're a thought leader with information to share and want to make it available to our readers as one of our writers, we welcome your participation and help!

Of course, you don't need to become a "Contributing Writer" for Freelance MD. You can interact with the community—Including our writers—by leaving comments or using our community forums. You can also write and submit a guest post and have it appear in the main blog and all of our RSS feeds.

But this post is for those who may consider becoming part of the team. Here's a pretty simple FAQ that walks throught some of the common questions about our contributing team. Let's get on with it.

Who can become an writer?

You, if you have expertise that's of interest to our physician readers and you're willing to share it. However, you need to know what you are talking about and be certain that you can write well; possessing solid writing skills is a must. If you're funny, charasmatic and prolific... well, that's just frosting on the cake.

Why should I write for Freelance MD? I've got my own site.

Ah... you'll notice that all of our writers have their own sites, run their own businesses, and are generally pretty damn busy... So why are they writing for Freelance MD?

First, they believe in what we're doing. If you've been around medicine in any capacity for more than a day, you'll already know that physicians are hungry for real information that they can use to gain more freedom and control of their careers and lifestyles.

Second, we bring eyeballs. It's true that everyone has their own site. It's also true that you need readers to make the effort an time involved in running your own site and business work. If no one is reading your site, what's that effort worth?

Freelance MD aggregates all of this expertise in a way that everyone benefits from it. If you're a physician that wants more freedom and control, Freelance MD is the place, and if you're interested in getting in front of physicians who are action oriented thought leaders, they're here too. So, instead of writing for a few hundred readers, you can write content that will be read by tens of thousands.

Third, we build reputations. Read through our author bios and ask yourself if these aren't people that you want to be associated with.

Lastly, we help you build your business, organization, and products. In fact, that's part of our business.

Sounds great! How do I start?

To start, we'll usually ask you to write a few “guest posts". If it goes well, we escalate the discussions to see if you'd fit in our writing team. We have no tight deadlines—the quality is very important to us. However, we ask our writers to keep us informed about the progress—we usually can guide the writers in the “right” direction, assist them and support them with some ideas or some resources. We don't have any hard and fast rules but we usually ask authors to post at least two new articles in a month.

Just contact us and let us know you're interested.