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Tuesday, April 20, 2010

Me and My Shadow, Part 4

Periodically I have a medical student do a clinical rotation with me and at the end, I ask them to write an essay about their experience working with me in my micropractice. I am ashamed to say that I have been sitting on a couple of essays since 2007-2008. I kept meaning to post them but time just sort of slips away and before you know it, it's the next decade. So with apologies to Andrew for the late posting, here are his thoughts on his 5 week clerkship with me from October 2007 (all the more impressive because he wrote this during his surgery rotation!):

I am just starting the fifth week of my surgery rotation at the Keck School of Medicine at USC. These past four weeks have been a very exciting time for me, as surgery has been my career of choice since I applied to medical school. At the same time, when I left Dr. S’s office four weeks ago, I was sad to leave what was an extremely educational experience and what became a very comfortable environment for me. From a medical student standpoint, I must be honest about my initial expectations of family medicine. Not knowing much about the specialty, I unfairly assumed that the patient cases would get repetitive and uninteresting. I figured that the rotation would be simply another roadblock between me and my career as a surgeon.

Now, after completing the rotation, I am thankful of two things. First, that my assumptions were, for the most part, wrong. (Actually, I will say that some of the patient cases got repetitive such as common colds, strep throat, annual physicals, flu shots/immunizations, etc. Such cases may not be as interesting or complicated as the heart valve replacements I have seen most recently, but I suppose even those cases may at some point become repetitive as well.) Second, that my experience with Dr. S changed a roadblock into a gateway. I was introduced to the “art of medicine,” where being a good doctor was not about the ability to diagnose a patient with diabetes but more about the ability to perform a comprehensive examination of each patient while taking the time to connect with patients on a more personal level.

From a medical student’s perspective, I found Dr. S’s practice to be unique and in a way… idealistic. In our first and second years of medical school, we are taught to perform the idealistic patient interview and physical exam that, when done thoroughly, take anywhere from 30 minutes to 1 hour to complete. We are also trained in the skills of bedside manner. When our actual clinical years of training begin during third year, we throw away two years of instruction, and instead fumble through 10-15 minute interviews/physicals. Sad as it may be, that is exactly what happens to most medical students. Fortunately, I was given the opportunity during my family medicine rotation to experience the ideal patient encounter. I can see how this model of family practice provides doctors with greater satisfaction and enjoyment over the style that forces physicians to see a larger volume of patients.

From a personal perspective, learning about micro practices has opened up new career possibilities. More and more I am discovering how much I enjoy life outside of my career. While I am almost certain surgery will continue to interest me, I am equally certain that my family and social life outside of medicine will become (if it is not already) more important to me. Weeks into my surgery rotation, I am realizing that surgery will most likely require my attention full-time or for even longer hours, while family medicine, especially micro and concierge type practices afford much more flexibility in time.

Though I am even more conflicted now about choosing a medical specialty, I am glad to have had such a unique opportunity with Dr. S. So I will close this entry by saying thank you, and I hope in the future to have the opportunity to write of my own experiences with private practice if that is where my career takes me.

Andrew Wong, MS3

A belated thank you, Andrew, for your thoughts and honest opinions.

One positive consequence of posting this 2 years late is that I can look up what has happened to Andrew since then. He was selected as one of the participants in USC Keck School of Medicine Dean's "Year for Research" Program for Medical Students for 2008-2009, doing research in orthopedic surgery in Pittsburgh.

I suspect he is now finishing his 4th year, preparing to graduate from medical school, and getting ready to pursue his dreams. Good luck, Andrew, and I hope you find that ideal balance between career and personal life. This is the wish I have for all physicians. And, of course, especially for solo docs.

Tomorrow: Me and My Shadow, Part 5: Erin's Clerkship