Medic School to Med School

[EpiEMS]

All other things being equal, research is going to win out against being an EMT when it comes to the application game.

I completely agree, and I think that's part of the problem.

 

[CrackerBDingus]

I completely agree, and I think that's part of the problem.

It really is. But it also isn't. Real world experience should be a huge factor in decisions but the logic behind research is more or less the idea that as a medical doctor you are going to be doing patient care AND research and experiments of procedures. I realize not every MD does this but a large portion do. Personally, I can't stand research and agree it is a problem.

My only hope to get research at all between my work schedule and class schedules is if I can make a connection with my neighbor who is a neurosurgeon or with my friend's mother who is a ENT and developed a hearing-aid (this screams good for resume to me).

 

[JPINFV]

I completely agree, and I think that's part of the problem.

Why? EMS experience isn't going to mean much when a physician has 2 years of full time clinical work, in contrast to, what, 4-5 months of part time clinicals for paramedic, significantly less for everything else? In contrast, unlike EMS, physicians are expected to be able to read, interpret, and appropriately implement new research. That makes understanding how research is conducted rather important.

 

[JPINFV]

My only hope to get research at all between my work schedule and class schedules is if I can make a connection with my neighbor who is a neurosurgeon or with my friend's mother who is a ENT and developed a hearing-aid (this screams good for resume to me).

I did my undergrad at UCI and research was considered a class (Bio 199).

 

[silver]

It really is. But it also isn't. Real world experience should be a huge factor in decisions but the logic behind research is more or less the idea that as a medical doctor you are going to be doing patient care AND research and experiments of procedures. I realize not every MD does this but a large portion do. Personally, I can't stand research and agree it is a problem.

My only hope to get research at all between my work schedule and class schedules is if I can make a connection with my neighbor who is a neurosurgeon or with my friend's mother who is a ENT and developed a hearing-aid (this screams good for resume to me).

Why not make your work into research?




I don't see any problem with research as the scientific method is crucial and a good understanding of what is good research is needed for medicine. Personally all my research experience is clinically, so I also didn't have to just toy around with rats or mice. Instead I spent a summer observing nurse and physician processes in in-patient units.

 

[CrackerBDingus]

I'm going to CSUF due to cost. I'm supporting myself currently, really stuck in a hard place. No classes to get research done, even though 3 the required classes for a psych major are all research oriented. I wish I could do something like that from UCI. Lol

 

[Akulahawk]

All I was going to add is that while I know a couple people that did go from Medic to Med School, my bit of advice is sooo simple. If you want to be a Paramedic, fine. Just don't let it slow you down from getting into Medical School, if that is your goal. Whatever happens, don't let being a Paramedic slow you down. Remember, if you start early, you have that much longer after you pay off your student loans to enjoy the financial rewards of being a physician. If I started now, I'd be darned close to retirement by the time I'm all done paying off those loans...

 

[EpiEMS]

Why? EMS experience isn't going to mean much when a physician has 2 years of full time clinical work, in contrast to, what, 4-5 months of part time clinicals for paramedic, significantly less for everything else? In contrast, unlike EMS, physicians are expected to be able to read, interpret, and appropriately implement new research. That makes understanding how research is conducted rather important.

Granted, I'm neither a pre-medical student nor a physician. However, I'm a student of economics, and I can say this much: medical training (the pre-graduate, graduate, and post graduate components) is costly, both in terms of cash and time. Better that the budding physician have some experience with the sick and injured,:censored:the dead and the dying than somewhere half way thru studying for the MCATs or part-way through third year clerkships realize he/she can't stomach illness, injury and death.

Beyond the consideration of waste, experience in EMS or similar clinical work shows you what the realities of medicine are on the "boots on the ground" level. Plus, learning how to develop a rapport with a patient is essential – how many pre-med kids have you met who couldn't make friends with a cute puppy, let alone a scared little old lady?

Look, research is great. I wouldn't knock it. But a physician is a provider of medical care (emphasis on care) first and foremost. Learning to care for people is first. Treating them is next.

 

[JPINFV]

Granted, I'm neither a pre-medical student nor a physician. However, I'm a student of economics, and I can say this much: medical training (the pre-graduate, graduate, and post graduate components) is costly, both in terms of cash and time. Better that the budding physician have some experience with the sick and injured,:censored:the dead and the dying than somewhere half way thru studying for the MCATs or part-way through third year clerkships realize he/she can't stomach illness, injury and death.

Beyond the consideration of waste, experience in EMS or similar clinical work shows you what the realities of medicine are on the "boots on the ground" level. Plus, learning how to develop a rapport with a patient is essential – how many pre-med kids have you met who couldn't make friends with a cute puppy, let alone a scared little old lady?

The "boots on the ground" experience, in terms of medicine, is best going to be provided through shadowing. Similarly, for the human component, the various non-EMT clinical activities (such as volunteering) provides a better proximation of disease and injury from a physician standpoint than EMS. The vast majority of physicians neither deal with prehospital emergency medicine, or even any emergency medicine. When the primary care physician is dealing with an emergency, often the best choice for them is to call 911.

Look, research is great. I wouldn't knock it. But a physician is a provider of medical care (emphasis on care) first and foremost. Learning to care for people is first. Treating them is next.

Without research we'd still be placing leeches on patients to 'remove bad blood.'

 

[medicsb]

I'd probably be more into the idea of research being a pre-req if it was more clinically oriented. Any decent bio course should orient one to the scientific method, you don't need to play around on bench doing "research" you don't care about for someone else to learn that method.

I'm willing to bet that most physicians have only minimal participation in research - the only number I could find was 30,000 (Health policy and ethics : a critical examination of values from a global perspective. Ed. Roger Worthington and Robert Rohrbaugh), and according to a NYT article (http://www.nytimes.com/2009/10/27/health/research/27patt.html), there are ~ 788,000 practicing physicians, which means that less than 4% are participating in research. So, of the ones participating in research, how many are doing anything beyond enrollment and initiating experimental treatments, etc.? I'm willing to bet that is where the majority participate, so why are undergrads providing slave labor to labs to fulfill an unwritten pre-requisite when they have no intention of doing bench research and probably have little intention of doing any clinical research? Why are they in a lab doing the work that a PhD would do, when the actual work an MD/DO would do - when it comes to research - is far different?

The whole process is completely disingenuous and I think is ridiculous that so many encourage it (I'm not necessarily referring to anyone here, more so ad-coms and academic advisors). I don't see any real reason for a pre-med to do research unless it is something they actually want to do.

Anyhow, I'm spending too much time thinking about this. I gotta get back to work.

 

[Melmd]

Do it as soon as you can!

The vast majority of physicians neither deal with prehospital emergency medicine, or even any emergency medicine. When the primary care physician is dealing with an emergency, often the best choice for them is to call 911.

I totally agree!

 

[systemet]

I'd probably be more into the idea of research being a pre-req if it was more clinically oriented.

Not looking for an argument, but interested as to what you would consider to be "clinically-oriented research?".

Any decent bio course should orient one to the scientific method, you don't need to play around on bench doing "research" you don't care about for someone else to learn that method.

I think you can teach epistemology, and produce students who are knowledgeable about epistemology. What you probably can't teach is an appreciation for how slow the actual research process is, how difficult it can be to choose how to analyse data, or which data points to discard, how you react to results that don't fit your previous model, and how you redesign an experiment and move forwards when something fails / forces you to alter your original hypothesis.

I also think that you have to spend more than a few credit hours, if you want to be able to look at research in a specific area and try to intelligently argue the merits of different publications reporting conflicting results.

I'm willing to bet that most physicians have only minimal participation in research - (....)

Agreed.

why are undergrads providing slave labor to labs to fulfill an unwritten pre-requisite when they have no intention of doing bench research and probably have little intention of doing any clinical research?

This is two separate issues. The "slave labour" issue could be applied equally to the PhD student making $18,000 / year, or the postdoctoral fellow making $35,000 after 10 years of education. Both are probably working 80 hour + weeks, with no overtime, little or no benefits, and with nothing near the future earning potential of a physician. Academia is oversaturated with trained individuals willing to work long hours for poor pay. It's not unionised, and staff tend to be on temporary contracts, with few employment rights.

In many groups an undergraduate student is a net drain on resources, and most undergraduate projects don't produce publishable data. In my opinion, the people really getting exploited are the grad students, with the postdocs coming a very close second.

The research for med school seems to be a symptom of a different, but related problem. A lot of people would like to become physicians. There are few spots for medical students, so the competition is fierce.

Why are they in a lab doing the work that a PhD would do, when the actual work an MD/DO would do - when it comes to research - is far different?

Are you sure? Not all medical research is epidemiology. There's plenty of MD / PhDs out there, and plenty of clinicians spending a percentage of their time doing basic research. I've met a lot of MD / PhDs who do 100% research, lots of MDs who are spending 20% of their time doing research. I've met CV surgeons doing graft experiments in rats. Anesthetists doing basic science experiments on vascular reactivity following LPS or TNF, etc.

The whole process is completely disingenuous and I think is ridiculous that so many encourage it (I'm not necessarily referring to anyone here, more so ad-coms and academic advisors). I don't see any real reason for a pre-med to do research unless it is something they actually want to do.

I can agree that the selection process for medical school seems extremely difficult, and that for the large percentage of physicians who aren't going to conduct their own research, having experience in this area seems unnecessary.

I'm not sure what the answer to this problem is, though, when there's so many well-qualified applicants and so few spots. At some point, the selection committees have to be able to distinguish people, and if they feel research is important, they're going to use that as a metric.

I feel sorry for anyone who is doing lab work against their will. And I have a lot of respect for anyone who's juggling a heavy course load with extracurriculars, with research, and paid work. But I also think that the contribution of undergraduate project students to academic research is very small, and the lack of pay / slave labour issue is a little farther-reaching.

 

[Veneficus]

lurking, but need to add some perspective.

The idea that PhDs (especially in medicine) sit all day in a lab with rats is a bit inaccurate.

I will concede there probably some who do.

But in my opinion the reason a lot of basic science undergrads attempt to move on to an MD/DO (from now on I will just type MD, but in my mind are in all respets equal sort of like he/she) is because the mean earning power of an MD is considerably higher than a basic scientist.

Also, because of the way schools select for MDs.(90% schools all over the world) basic science grades are the major determining factor. People who do well in science are apt to do well on medical school entrance exams. Even in Europe. When determining a future, who does not play to their strengths?

There is a lot of complaints based on a subjective "what makes a doctor" and nobod takes up that banner more often or with greater intensity than I do, but the fact remains, as more objective criteria is used, nonclinically minded science people are always going to be the best on paper.

As for medical research, permit me to tell you I spend no time at all in a lab. Doing anything with anything other than people.

But, good and medically applicale clinical research explains why. It elucidates mechanism, because that changes practice. Correlation studies alone are nothing but a big con that uses scientific method to give credibility to a want. (a good example is for billing. "Studies show....so we are going to do it and you are going to pay for it." but I could type a book on it.) Most medical scientists will tell you even the best research is often not absolute. It is also based on what we know today. Tomorrow, everything could change with one discovery.(and frequently does)

I have only one use for medical science. To apply it to patients. The department I work in has the same stated goal. We are now in the process of submitting the second publication of original research on a new AKI marker.

It has only one purpose, to assess for and guide clinical decisions in a timely manner. (since most treatment is time dependant)

I have personally been a lead author on a paper published about it. My major conclusion was that it requires serial measurements, it is not "troponin like." which is good in ICU, but not in an ED.

I am also looking a new approaches to reducing the mortality of ruptured aortic aneurysms. (no rats or pigs involved)

One of the things the dept does that I am most fond of is the department is a resource to physicians. They actually call and ask for knowledge when standard treatments are not working on their patients. It is sort of like being "the doctor's doctor."

Academic medicine is easily 20-40 years ahead of standard treatments. If I or my family is sick, I want the MD/PhD treating them. Especially over "standard" approaches.

Many clinicians do not realize, they are all clinical researchers. They observe 10s if not 100s of thousands over time. They change their decisions (I hope) based on these experiences. They keep detailed records of what happens and doesn't. What works and doesn't. When collected and compounded, this data is used to advance medical practice.

These same physicans pass on their opinions to the next generation of doctors. Perhaps not in the form of a published paper, but just because something doesn't appear in print doesn't mean it is not useful.

As for undergrads scrubbing beakers and feeding mice... Waste of time. I agree it is far more useful for aspiring doctors to learn how to relate and interact with people.

Nobody goes to see a medical scientist when they are hurt or sick. They go to see the doctor. (Who as I said, by default is a medical scientist.)

Medicine is the art of applying science to real people. Neither can function or survive without the other.

 

[medicsb]

Not looking for an argument, but interested as to what you would consider to be "clinically-oriented research?".

Anything that has to do directly with patients, from epidemiological research to RCTs.

I think you can teach epistemology, and produce students who are knowledgeable about epistemology. What you probably can't teach is an appreciation for how slow the actual research process is, how difficult it can be to choose how to analyse data, or which data points to discard, how you react to results that don't fit your previous model, and how you redesign an experiment and move forwards when something fails / forces you to alter your original hypothesis.

Most of what you mention would be great for the individual who plans to be an principal investigator or co-investigator. The average physician doesn't need to know how to run a trial or perform prospective cohort studies, etc. But, they certainly need to know how to interpret studies and be aware of the biases and methods, which is part of the medical curriculum in the US.

I also think that you have to spend more than a few credit hours, if you want to be able to look at research in a specific area and try to intelligently argue the merits of different publications reporting conflicting results.

Maybe, maybe not. I took 10 credit hours of classes specifically dedicated to clinical research and that isn't including the courses on healthcare statistics. Clinical research courses were great, I thought, and I'm sure it was better than what was provided in medical school. But i think what was provided in med school was adequate, which was approximately equivalent to a 3 credit hour course.

This is two separate issues. The "slave labour" issue could be applied equally to the PhD student making $18,000 / year, or the postdoctoral fellow making $35,000 after 10 years of education. Both are probably working 80 hour + weeks, with no overtime, little or no benefits, and with nothing near the future earning potential of a physician. Academia is oversaturated with trained individuals willing to work long hours for poor pay. It's not unionised, and staff tend to be on temporary contracts, with few employment rights.

In many groups an undergraduate student is a net drain on resources, and most undergraduate projects don't produce publishable data. In my opinion, the people really getting exploited are the grad students, with the postdocs coming a very close second.

You're probably right, but I'm not against pre-meds doing lab research because of poor compensation.

The research for med school seems to be a symptom of a different, but related problem. A lot of people would like to become physicians. There are few spots for medical students, so the competition is fierce.

Oh, i know.

Are you sure? Not all medical research is epidemiology. There's plenty of MD / PhDs out there, and plenty of clinicians spending a percentage of their time doing basic research. I've met a lot of MD / PhDs who do 100% research, lots of MDs who are spending 20% of their time doing research. I've met CV surgeons doing graft experiments in rats. Anesthetists doing basic science experiments on vascular reactivity following LPS or TNF, etc.

I know it's not all epidemiology. In my previous post, I did not mention epidemiology. I've met MD/PhDs, too. And I've met a lot who do research and don't have PhDs. I imagine most physician researchers do not have PhDs. But, when it comes down to it, the average physician does not conduct research of any kind. This is why the de facto pre-req of research is so obnoxious to me.

 

[medicsb]

The idea that PhDs (especially in medicine) sit all day in a lab with rats is a bit inaccurate.

Yeah, I was over generalizing.

But in my opinion the reason a lot of basic science undergrads attempt to move on to an MD/DO (from now on I will just type MD, but in my mind are in all respets equal sort of like he/she) is because the mean earning power of an MD is considerably higher than a basic scientist.

It has been my experience that the bio major would be about 1/4 to 1/2 as big, enrollment wise, if pre-meds didn't think it would help them get into medical school or help them once they got in. In many ways it probably is helpful in the first year to have been a bio major. But I don't know how many go into sciences wanting to be scientists, but chose medicine for the better pay.

But, good and medically applicale clinical research explains why. It elucidates mechanism, because that changes practice. Correlation studies alone are nothing but a big con that uses scientific method to give credibility to a want. (a good example is for billing. "Studies show....so we are going to do it and you are going to pay for it." but I could type a book on it.) Most medical scientists will tell you even the best research is often not absolute. It is also based on what we know today. Tomorrow, everything could change with one discovery.(and frequently does)

I have only one use for medical science. To apply it to patients. The department I work in has the same stated goal. We are now in the process of submitting the second publication of original research on a new AKI marker.

It has only one purpose, to assess for and guide clinical decisions in a timely manner. (since most treatment is time dependant)

I have personally been a lead author on a paper published about it. My major conclusion was that it requires serial measurements, it is not "troponin like." which is good in ICU, but not in an ED.

I am also looking a new approaches to reducing the mortality of ruptured aortic aneurysms. (no rats or pigs involved)

One of the things the dept does that I am most fond of is the department is a resource to physicians. They actually call and ask for knowledge when standard treatments are not working on their patients. It is sort of like being "the doctor's doctor."

Academic medicine is easily 20-40 years ahead of standard treatments. If I or my family is sick, I want the MD/PhD treating them. Especially over "standard" approaches.

Many clinicians do not realize, they are all clinical researchers. They observe 10s if not 100s of thousands over time. They change their decisions (I hope) based on these experiences. They keep detailed records of what happens and doesn't. What works and doesn't. When collected and compounded, this data is used to advance medical practice.

These same physicans pass on their opinions to the next generation of doctors. Perhaps not in the form of a published paper, but just because something doesn't appear in print doesn't mean it is not useful.

As for undergrads scrubbing beakers and feeding mice... Waste of time. I agree it is far more useful for aspiring doctors to learn how to relate and interact with people.

Nobody goes to see a medical scientist when they are hurt or sick. They go to see the doctor. (Who as I said, by default is a medical scientist.)

Medicine is the art of applying science to real people. Neither can function or survive without the other.

I pretty much would agree with everything you said and it sounds like you have a great job at a great place and will likely make a great doctor and scientist.

 

[Tigger]

It has been my experience that the bio major would be about 1/4 to 1/2 as big, enrollment wise, if pre-meds didn't think it would help them get into medical school or help them once they got in. In many ways it probably is helpful in the first year to have been a bio major. But I don't know how many go into sciences wanting to be scientists, but chose medicine for the better pay.

Many of the pre-med bio and chem majors I know chose to major in these subjects just because they were going to have to take a bunch of courses in these subjects anyway. If you show up at a liberal arts college knowing you want to go to med school but have no idea what you want your bachelor's to be in, it just makes sense to get a science degree since you can you use your pre-med courses towards your major courses. Science majors at undergrad only institutions also have a much easier time getting research opportunities within the department since the faculty does not have grad students to use as research assistants.

And then there's people like me who decide to be a political science major before realizing they want a career in healthcare. I was too deep into my major (half done) when I realized I wanted a career in healthcare, so I have to resort to taking the hard sciences as electives, which is not what I would term the "preferred method." It's tough switching between polisci (which I love) and sciences all the time, two different sorts of studying.

 

[JPINFV]

Another thing is how many pre-meds enjoy biology, regardless of if they're looking at going into research?

And then there's people like me who decide to be a political science major before realizing they want a career in healthcare. I was too deep into my major (half done) when I realized I wanted a career in healthcare, so I have to resort to taking the hard sciences as electives, which is not what I would term the "preferred method." It's tough switching between polisci (which I love) and sciences all the time, two different sorts of studying.

That's why my minor is in Poli Sci. Plus the fact that the minor only required a handful more courses outside of the breadth requirements at my undergrad.

 

[Tigger]

Another thing is how many pre-meds enjoy biology, regardless of if they're looking at going into research?



That's why my minor is in Poli Sci. Plus the fact that the minor only required a handful more courses outside of the breadth requirements at my undergrad.

If we had a PoliSci major I might have considered a switch to biology. In the end I'm still happy as I think I've improved my writing and oral communication skills much more than my science major friends and these skills' importance cannot be understated regardless of where I end up.

 

[CrackerBDingus]

If we had a PoliSci major I might have considered a switch to biology. In the end I'm still happy as I think I've improved my writing and oral communication skills much more than my science major friends and these skills' importance cannot be understated regardless of where I end up.

There have been many studies conducted showing that liberal art or social science majors usually have higher verbal and writing MCAT scores than their hard science peers. Conversely, obviously those people also tend to not score as highly on the bio, chem, and physics portions of the test. Choose your poison. I love psychology, and I'm going to study it because I love it and I will have fall backs in med school does not follow through.

 

[FLdoc2011]

A lot of good comments here.

I do agree with the feeling that if the end goal is medical school then do that and not try to fit in medic school as something "pad" a resume or for experience. Now if you're still undecided and truly want to go to medic school until you've made up your mind then that's fine.

I had several classmates who were medics/EMTs prior to med school and i think all did it as an actual job during college or as a prior career and then ended up changing plans and applied to med school. More of them went into emergency medicine than probably the average student, but it didn't provide any real advantage during med school. And really nothing does, we had folks from all sorts of backgrounds (business owners, RNs, medics, chemistry PhD, etc...) and med school was pretty good about throwing everyone on a level playing field. It was humbling to a lot of those people.