For many students interested in the field of medicine, the decision between clinical or research work can be difficult. What if I don’t want to deal with patients? What if research is too repetitive? To give more insight into some of these questions, I interviewed Dr. Andrew Wood, Friends Select’s Advanced Biology teacher, who used to work as a pediatrician, and Sean Kelch, the school’s interim biology teacher, who worked in a research lab at the University of Pennsylvania.
Andrew Wood’s Path to Becoming a Doctor and a Teacher
Andrew didn’t know he wanted to go into medicine until the end of his undergraduate studies. At Howard University, he was undecided until his sophomore year. He considered studying philosophy because he was interested in different ancient cultures, but he realized that they all had a strong connection to nature. Therefore, he ventured into biology and picked a zoology major with a minor in chemistry.
During internships, Andrew had the chance to do a lot of bench research, which he found intellectually stimulating, but “isolating.” He wanted more “immediate human interaction,” so he considered either teaching or medicine. Ultimately, he took the MCAT, a 7.5-hour exam required for medical school, and went to the University of Pennsylvania Perelman School of Medicine. Andrew was attracted to the upfront, social aspect of the medical profession, rather than research.
Medical school is split into two phases: two years of preclinical training, where students learn science training and doctoring, and two years of clinical training, which is hands-on experience in a hospital. During the second phase, students participate in rotations, where they work with patients in various specialties under the direct supervision of a physician. Normally, there are seven core rotations: general surgery, internal medicine, family medicine, obstetrics and gynecology, neurology, psychiatry, and pediatrics.
By the end of the third year of medical school, most students have chosen a specialty area or patient population to pursue and begin preparing to apply to residency training. After graduation, people will get matched to a residency program that lasts about two to six years, depending on the specialty. During that time, they will study and take the United States Medical Licensing Examination (USMLE), a two-day test to grant independent practice.
Regarding the first two years of medical school, Andrew said, “It actually wasn’t any more difficult than undergraduate, in terms of the material you were learning.” The thing that made it harder was the volume of material: “In the first year, you covered the same amount of material you would have read in four years of undergraduate.”
For Andrew, he was in the classroom from 9 a.m. to 5 p.m., then he’d study on his own for five or six hours daily. He found it overwhelming and difficult to memorize everything, but he enjoyed the clinical part. During the second half of medical school, Andrew got to apply everything he’d learned to real-world situations, such as handling a heart attack. He got to work with actual patients in a hospital, even though it was a bit dangerous, given that all the students were sleep-deprived from the long hours.
In addition, he realized he disliked surgery because he felt the culture was authoritarian. Andrew said, “It’s very hierarchical in terms of the people above you treat the people below them really horribly. It’s not true everywhere, but I think it’s true to some degree.” In addition, it takes longer to become a surgeon compared to other disciplines, and Andrew didn’t want to be in that environment, since he was already married and had a child. Ultimately, he decided on pediatrics. He observed how most pediatricians liked their patients, “which is not true of all types of doctors,” and seemed more like “well-adjusted people.” Andrew has a skill in working with younger people, which is especially useful for properly examining and treating illnesses in kids. In addition, he was interested in the complicated topic of human brain development.
During the last two years of medical school, Andrew worked “close to 100 hours a week. If it dropped down to 80 hours a week, then it’s [considered] a slow week.” This is the same for residency, which is a crucial, full-time training phase for physicians after medical school, varying from 3-7 years depending on the specialty. One major problem during these long shifts is sleep deprivation. Andrew said, “The sleep deprivation and stress build up… just feeling like you have to be vigilant and pay attention all the time.” This hindered his ability to make good judgment and complete his workload: “I’ve fallen asleep while I was writing orders on a patient several times.” However, residency is a good way to gain experience and apply everything that was learned in medical school. Residents learn to trust their diagnoses and the right judgment calls; they will understand that they can’t know everything, so being familiar with the common cases is crucial.
After completing residency and acquiring the necessary license, residents can become doctors in a specialized field. Andrew went into pediatric primary care because it was a broader field, as he was less interested in specific specialties. He liked being the first person to handle medical problems and being able to follow a child’s process as they recovered. A doctor’s job is to “narrow down [problems] to try and get an actual diagnosis of what’s happening. It’s a process of knowing how to arrive at the right diagnosis eventually, not necessarily knowing everything.”
One of the downsides, however, is not spending enough time with patients because of the large volume. Andrew was seeing “five patients an hour, which is like 12 minutes a patient…You could be going over a year’s worth of health history in about five minutes, and if they’re not perfectly healthy, that’s not enough time to do that.” Since he was part of a group practice, the other doctors were sometimes annoyed with him because he “took more time with the patients, which [he] was happy to do.” He eventually left the group after seven years and opened his own practice for 3.5 years. Later, he closed his office and turned towards teaching, which had been in the back of his mind since his undergraduate years.
Sean Kelch’s Research Career Trajectory
On the opposite end of the spectrum, researchers don’t have to attend medical school. Instead, after their bachelor’s degree, many people obtain an M.D. and/or a Ph.D. in a specific field. During their university years, many choose to do lab work and gain research experience.
Sean Kelch graduated from Rensselaer Polytechnic Institute with a bachelor’s degree in biology. He then worked as a research specialist in the Penn Perelman School of Medicine’s Institute for Translational Medicine and Therapeutics, which he said: “gave me a really cool glimpse into the world of science and put me in the same room with some of the smartest people I have ever met.” Like Andrew, Sean was able to apply the knowledge he gained from college to plan and perform lab experiments. Specifically, he did research on the connection between circadian rhythms and metabolism. He even co-wrote a paper detailing his findings, which you can read here.
Many medical researchers conduct experiments to test new medicines or treatments and publish their findings to share with others. The topics are numerous, and many cover various fields. Researchers often work with colleagues from different disciplines and healthcare professionals to gain a more well-rounded perspective on their study. Many also complete a postdoctoral fellowship, a mentored position to conduct research, lasting between two and five years, after getting their doctoral degree.
Sean’s favorite part of being a researcher was “learning so much about the world around [him] every single day.” He had a lot of opportunities to meet scientists who shared their deep knowledge in their respective fields. The most difficult part was “dealing with the experiments that didn’t work out without taking it personally.” It’s definitely part of the process to make mistakes, but it can be frustrating sometimes.
Advice for Students Interested in the Medical Field
Lastly, I asked Andrew and Sean for their advice for students interested in entering the medical field. Andrew said, “Well, first of all, don’t do it if your parents want you to be a doctor. That’s the most important thing… I think the real struggle is to find out how to maintain your sanity in our system, where it’s really set up to benefit the insurance companies more than the people who actually do the health care.” Unfortunately, this is common in clinical care: insurance companies sometimes deny payment for a treatment or test. “A lot of people going into medicine don’t realize how much of it is just arguing with administrators and insurance companies,” said Andrew. “So long as you have the right attitude, it can be a wonderful profession.
Sean advised, “Don’t be afraid of not knowing what you want to do, approach things with an open mind, and chase what makes you curious. The best researchers I met during my time in the lab were driven by a personal desire to answer questions they had about the world around them.”
Whether you want to go into research or clinical care, it’s always important to have the right mindset and set aside time to take care of yourself.
Sources:
- Association of American Medical Colleges: What to Expect in Medical School
- St. Matthew’s University: What Happens After Medical School Graduation
- American Medical Association: How to get started in research
