# Becoming MD



## Rico911 (Jan 24, 2010)

Hey guys! I'm from NY I took the EMT b exam Thursday pretty sure I passed just waiting for results to start my new journey... I'm 24 years old I been around the block for my young age. I studied marketing at university I worked in wall st, as a cars salesmen, loan officer, custodian, life guard, basically I try to stay busy. My main thing is I'm very ambitious and just like any young kid my age I wasn't exactly sure what I wanted to do in life but what ever I do I want room for advancement. Emt is my stepping stone I want to become a firefighter but I know how difficult that is in NYC so I'm looking for a plan b and c in case my plans fail, my question is what are the steps to becoming a medical director. I wonder if I'm too old to start that path now. I want to know what it takes what's the benefits(salary,etc)how much schooling and any general advice you guys have.


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## vquintessence (Jan 24, 2010)

Step one:  Improving sentence structure.


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## mycrofft (Jan 24, 2010)

*Maybe move your post to the EMS lounge area?*

EMT isn't a stepping-stone, there is not a real career ladder (as I found out when I was 27 and entered nursing school as an EMT and former firefigher) like that.


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## Veneficus (Jan 24, 2010)

The steps to becoming a medical director are quite simple. (implementation can be a bit of a challenge though)

You graduate undergrad with the prerequisites and GPA to apply to medical school, take an entrance exam (In the US it is the MCAT) score well and get accepted to medical school.

You complete 4 years of medical school(in the US) and score well enough on your USMLE Step I and step II (both parts) at which point you get accepted into a residency. If your state requires a medical director to be an emergency physician you have only to be accepted into one of the most competitive specialties in US medicine. 

After 3 years of residency and probably another year or two with an EMS fellowship to round out your resume, you get a job as a doctor. You might have to search around for a place looking for a medical director, but I have noticed most start out as an assistant to an established one. After his interest in EMS is over he may hand you the reins.

Pay for an Emergency Physician is pretty good. There are several websites that point out the starting and average salaries. Lowest I saw was $120,000 a year starting.

You are not too old to start, but it is a rather tough plan B or C. I Don't suggest you tell the admissions board at the med school you are applying to that you wanted to be a firefighter and medicine was plan B or C.

If you want to be a firefighter, it would probably be easier to move to someplace that was hiring them. (not easy in today's economy) but probably much easier than becoming a medical director.


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## Rico911 (Jan 24, 2010)

Y go from being a firefighter to EMT???


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## medichopeful (Jan 24, 2010)

Rico911 said:


> Y go from being a firefighter to EMT???



Why not write out the word "why?"


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## JPINFV (Jan 24, 2010)

Too old to start? Nope. There are a lot of my class mates who are in their 30's. If you start now, you'll be starting medical school at 28. 

However, medicine as a "plan B or plan C" to being an EMT-B is laughable. Lots of people start out in college as a premed. Of the faction that actually makes it to applying, still only about half of all applicants makes it into an MD school and DO (I honestly don't know the exact numbers. The AACOM, from what I've seen, posts numbers for each school individually, but not for the entire applicantion season) school is getting tougher and tougher to get into every year. If you want to be a medical director, then shoot for medical school first, not EMT-B first until you figure things out. Starting from scratch, the process is at least 11-12 years long.


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## VentMedic (Jan 24, 2010)

Rico911 said:


> Emt is my stepping stone I want to become a firefighter but I know how difficult that is in NYC so I'm looking for a plan b and c in case my plans fail, my question is what are the steps to becoming a medical director.


 
Do you want to do medicine or fight fires in NYC?

Your plans of A, B and C are miles apart. 

You can easily become an EMT and then a Paramedic in NYC in a relatively short period of time while waiting for an opening in the FD. 

For the FD, age will be a factor depending on your overall physical health and conditioning.

If you want to be a phyisican then follow the advice of JPINFV and Veneficus.


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## Rico911 (Jan 24, 2010)

Well I didn't reaaly know what the steps were to go the MD way that's y I asked... If that's what I wanted to do it would have to be plan A cuz sound like a lot... Bascially I'm going to get my paramedic cert in the fall but I'm tryna get down with FD I'll take medic but fire is what I wanted to do a long time... The salary is competetive and you got more than enough free days out the week to make some good extra cash with a light gig or two... But I don't think Im up for another 12 years of school...


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## Rico911 (Jan 24, 2010)

Yea I agree but if I get down with the fdny doing emt or medic it's easier to go fire. You  take the promotional exam and I think it's about every 2 years not every 4 like the general public... I'm thinking this will help my chances that can't be bad


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## JPINFV (Jan 24, 2010)

The reason it doesn't make sense is because it's like saying, "I'm going to play college baseball, but if that doesn't work out I'm going to play in the MLB." If it's your plan B, please please please have a plan C. 

...but ok, path to medical school:

Get admitted to a university. If you completed a 4 year degree in marketing, you can also look into a post-baccalaureate premedical program. Regardless of which route you take, you're going to end up taking, at a minimum, general chemistry, organic chemistry, calculus, physics, and a year of biology. Labs included with those as appropriate. Some schools will also require or highly recommend a course in biochemistry, writing, or humanities, but these last requirements vary by college. Additionally you're going to want to try to find some time to volunteer, possible do some research, and get some clinical experience. While working as an EMT-B (certified is not the same as work) is a clinical experience, it is kinda of weak overall. 

After you complete your prereqs, you're going to want to take the Medical College Admissions Test (MCAT). The MCAT is a 4 part exam involving 3 multiple choice sections covering general chemistry/physics, organic chemistry/biology, and verbal reasoning. These parts are normalized and testers are given a score between 1-15 per section with an average score of 7. The final section is an essay portion which is given a letter grade. The exam itself is now computer based (however, unlike the NREMT exam, the MCAT is not adaptive), but expect it to take at least 4 hours (which is better than the 10 hours it took when it was written). The average MCAT score is a 21 (7 per section). The average applicant to medical school is 27. The average score for matriculates is around 30. 

Now you enter the application cycle. Most schools will receive around 6000-7000 completed applications, interview around 700, and accept 400-500 for a class of 200 students. Making it to the interview stage at any specific school is a combination of scores and luck. Even if a student has a 4.0 gpa and 45 MCAT (in which case, someone just full filled Washington University in St. Louis's wet dream), it would still pay to apply broadly. 

Application for MD schools is done through the American Medical College Application Service (AMCAS), DO schools through the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS), and Texas schools through Texas Medical and Dental School Application Service (TMDSAS). Regardless, the application process is essentially the same for all schools. The primary application (through the above services) includes your academic information, extracurricular (including work, volunteer, clinical, etc), exam information, and a personal statement. Then most (most don't screen, but a few do) of the schools that you apply to will send you a secondary application that will vary from school to school, but can include additional short answer essays, listing of extracurricular, a picture, and a check for normally around $100. 

Now, if you're lucky, you get invited for an interview. Depending on the interview, you will either get accepted, wait listed, or rejected. Some schools will form a second wait list once they fill their class where the people on it are offered a deferred spot in the next year's class. Otherwise, if you aren't pulled off the wait list or are rejected you get to repeat the entire process next year. Almost all schools will accept applications from reapplicants, however some schools will limit the number of times that people can apply. To be fair, this is probably more for the applicant than for the school. It's very easy to sink thousands of dollars (I probably spent $3000-4000 dollars last cycle between primary application costs, secondary application costs, and traveling for interviews) into applying with nothing to show for it but rejection letters. 

Veneficus and I aren't being harsh because we're elitist turds who thinks that only a select few geniuses makes it to medical school (to paraphrase a physician on a JEMS Connect thread, 'cream floats to the top, but so do gaseous turds'). The stark reality is that medical school isn't really a "plan B" and the application game to get in is long, hard, and expensive. If you're serious, it is something to work for, and I'll encourage anyone who is serious about medical school.  However it's not really a fall back position.


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## medicdan (Jan 24, 2010)

JP, as usual, excellent post. Thank you.

OP, is it possible you are confusing MEDICAL school with MEDIC school? MEDICAL school is, as JP and Vene have just described a 12+ year journey, involving all above.

MEDIC, short for PARAmedic school is a 1-2-3 year program training you to become a paramedic, or provide Advanced prehospital life support.

Oh, and please, for all of us, re-read your posts for grammar, spelling and full words ("4", "y" and "u" don't count).


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## Lifeguards For Life (Jan 24, 2010)

JPINFV said:


> The reason it doesn't make sense is because it's like saying, "I'm going to play college baseball, but if that doesn't work out I'm going to play in the MLB." If it's your plan B, please please please have a plan C.
> 
> ...but ok, path to medical school:
> 
> ...



I've looked into this several times and have found varying answers with little to no credibility. When applying to med school, does beginning your education at a community college, and then transferring to a 4 year university ""hurt" your application? Assuming MCAT, GPA, and background are competitive, would most committees opt for a student who has attended a four year university, over a transfer student?


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## JPINFV (Jan 24, 2010)

I honestly don't know. I know that the 'conventional wisdom' on SDN (caveat emptor) is to try to do all of the prereqs at a 4 year if possible. Your best bet would probably be to email an admissions department and ask.


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## Lifeguards For Life (Jan 24, 2010)

JPINFV said:


> I honestly don't know. I know that the 'conventional wisdom' on SDN (caveat emptor) is to try to do all of the prereqs at a 4 year if possible. Your best bet would probably be to email an admissions department and ask.



I'll look into it further, as med school has become an interest to me as of late.

I have seen some top contributors over at SDN voicing concerns at attempting to take all of the prerequisites (whenever possible) at community colleges. Though they did acknowledge due to economic reasons, that it may be more feasible to take the one and two hundred block classes at a community college and transfer to a four year university



Though, just to be clear, becoming a physician is not a logical back-up plan, just in case being an EMT doesn't work out?:unsure:


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## JPINFV (Jan 24, 2010)

The problem with SDN is that even out of the top posters, most of them don't know anything past the mechnics of applying and what their application had. If anyone to talk to over at SDN, it's Lizzym since she's an ad com member.


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## Rico911 (Jan 25, 2010)

I think I wrote it wrong or u misread it but u right MD ain't no plan b. I didn't have a clue what it required that's y I asked... But if u gotta go to med school take tha mcats that's too much... I guess my real question was what exactly is a MD I was under the impression it mightve been superior emt personal..


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## MrBrown (Jan 25, 2010)

Medical director is a physician because EMTs and Paramedics do not legally practice under thier own license and cannot dispense prescription medication to patients.

Therefore, each has a standing order which is an instrument of delegation allowing that prescription medication to be supplied for administration at that particular time under the conditions set forth and by the medical director.

In some parts of the world, Paramedics do not have a medical director and are not required to have a standing order.  The UK is one such case.

Many countries including New Zealand are working on such a system where we will not require a standing order to administer medications because we will have ambos that have thier own license to supply prescription medications without the say so of a doctor.

Note that in many jurisdictions there is also no "online" direction and ambos are not required to call for orders; such as here.


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## JPINFV (Jan 25, 2010)

A medical director is the physician in charge of medical oversight. At the most basic, the medical director writes the medical protocols that a service or region operates under. In better services, the medical director has direct involvement in quality assurance by insuring the the EMS providers operating under his/her medical license are providing appropriate medical care to their patients. Since in the US EMS providers are not an independent medical provider, they operate under the physician's unrestricted license to practice medicine.


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## medichopeful (Jan 25, 2010)

Rico911 said:


> I think I wrote it wrong or *u* misread it but *u* right MD ain't no plan b. I didn't have a clue what it required that's *y* I asked... But if *u* gotta go to med school take tha mcats that's too much... I guess my real question was what exactly is a MD I was under the impression it mightve been superior emt personal..



No matter what you decide to do in EMS (or elsewhere), proper use of the English language is key.  I would suggest you start practicing it now


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## Veneficus (Jan 25, 2010)

Lifeguards For Life said:


> I've looked into this several times and have found varying answers with little to no credibility. When applying to med school, does beginning your education at a community college, and then transferring to a 4 year university ""hurt" your application? Assuming MCAT, GPA, and background are competitive, would most committees opt for a student who has attended a four year university, over a transfer student?



I don't think anyone will give you a straight answer. But I will offer this advice having taken basic science classes at a community college and having to repeat them at a university.

They are equal only on Paper. The depth and volume of the university classes made the CC classes look like high school. 

The other question I had that nobody would answer is "how much does prior work experience count?"

I heard all kinds of answers from a lot to nothing. (depending on the school I asked) I even asked a few docs that were former medics and a former nurse. When I sat for my interview with the deans of my school, my prior experience was the last question, and guaging the look on their faces and the fact the prior question was "Where is your family from?" I am guessing a decision was made before they asked about my employment history.

The CC college courses may not serve you very well on the MCAT or an Admission examination. (depending on where you go)


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## Jon (Jan 25, 2010)

JPINFV said:


> A medical director is the physician in charge of medical oversight. At the most basic, the medical director writes the medical protocols that a service or region operates under. In better services, the medical director has direct involvement in quality assurance by insuring the the EMS providers operating under his/her medical license are providing appropriate medical care to their patients. Since in the US EMS providers are not an independent medical provider, they operate under the physician's unrestricted license to practice medicine.


And in worse services, the medical director is the guy that signs off on the license renewal, and fills out the DEA paperwork to replace narcs. And the field providers may not know who it is, let alone ever have met him or sat with him to get signed off.

Jon


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## Tincanfireman (Jan 25, 2010)

Rico911 said:


> I guess my real question was what exactly is a MD I was under the impression it mightve been superior emt personal..


 
You can get comprehensive answers to your questions and followup information on the information from Vene and JP here.


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## Jon (Jan 25, 2010)

And with that, I think we've discussed this to the extent needed.

I'm gonna go ahead and close this thread based on invocation of the Google corollary to Godwin's Law.

Jon


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