First week complete!

Thanks for kicking me in the pants, NP Oddysey!

Orientation started last Wed, which we had two days of.  I think the best part of orientation was seeing OMM demonstrated. 

The format for classes is four hours of one subject at a time.  We have had three physio lectures so far.  All seem to be review with a few clinical anecdotes thrown in there.  However, the review now is what I may have learned in one 'test' unit in one day rather than over several days.

I was pretty broken up at the beginning of last week over having to be away from my husband and kids.  In some ways it is good because I get more alone time than I would normally.  Most of the other married students have their spouses move with them, but it is not possible for us. 

We have our first test next monday.  I am almost done reading all the chapters, and have an outline typed up to which I plan to add class notes, and then input key facts into a flash card software to study with.

Also I think I have found myself a study group, and should be meeting with them tomorow eve.

I also really like the LECOM Fitness Center.  I think it is the best fitness place I have been in.  I have no idea what they charge the general public to use it, and don't want to know.  It has an awesome locker room, with all the ammenities.  You don't have to pay extra for classes, and they are always doing some sort of 'fun' fitness activiites.

This is of course in accordance with the DO philosophy of staying healthy being the best medicine. Mind-Body-Spirit
....
I don't have any great deep personal revelations yet, I will update you when I get one!

Will I Become a Different Person?

This post is mostly related to family interactions.  For sure, I am not the same person I was 10 years ago, 5, 3 or 1 year ago.  I feel that as a person I am continually evolving based on my previous life experiences.  At the same time at the age of 32 most people would agree that my personality is fairly formed.  Is it?  I also have no doubt that medical training and the stresses and victories involved with it will also cause me to become a 'different person'.  My fear is that this new person I become may not be compatible with my current family relationships.  The mere title of "doctor" may change people's opinions of me for better or worse.  If I am perceived as being 'rich' will family members come to me for money?  How will they react if I say YES or NO?  (If I were to say YES I would imagine that they would feel that further financial support would be predicated on a continued positive relationship and if I were to say NO I would imagine that they would feel that I am simply being an asshole.)

Also, it is very common for romantic relationships to break apart during med school.  Most stories I have heard have been of a serious dating relationship breaking up.  My husband and I have been a couple for over 10 years.  I am willing to say that we are a fairly stable couple.  But I feel that Med School can make any relationship challenging esp. when you add the stress of making a cohabitation relationship into a long distance one  (whether that distance is 362 miles away or 2258.811 miles away in a foreign country).  Even in the most ideal situation I would imagine that it is going to be difficult. I recently found this forum on SDN; however, I cannot seem to find official stats on this Med School Divorce Stats.  Clearly I don't want a divorce but it seems that the stats are out there.

What if I become more assertive, more augmentative, more used to getting my own way, more judgmental, or cynical when listening to a purported natural cure someone relays to me that they read in 'hippie weekly'?  What if I fail in this attempt and become despondent?  Will this personality change make it impossible for me to carry on my relationships with my friends and family?  What if the cost of pursuing my dream is loosing everyone I now have close to me?

I think this is procrastination

So, with three weeks remaining, well two and a half now, before I would leave for MERP (If I go to MERP) I have been feeling the crunch.  Before I left I wanted to do a lot of projects

1. Scan old photos of family and friends to have them on my computer for when I am gone
2. List things on eBay to finance my medical education
3. Get the back yard in a state so it is not too difficult for my husband to care for
4. Box up some of my belongings that will not be used for the duration of MERP/ROSS so they are out of my husband's way
5. Backup my laptop on the external hard drive in case it dies while I'm gone.

I want to get done with these projects soon and would rather just work on them now and hopefully get done with them early and have the remaining weeks to play around.  However, I can't tell if I am using these to actively procrastinate instead of doing worthwhile activities such as pre-study for MERP.

The fact that I "might" not go to MERP has given me a bit of leeway to think that I can sort of waste time on these projects, although I think that they do have some value. 

What do you think?  Time wasting procrastination, or Making my final preparations and getting my affairs in order before a long absence?

Finding an endorser for student loans

Due to circumstances which I do not want to specify here, I am unable to obtain Grad Plus loans myself without an endorser.  Endorsing a loan is similar to co-signing, if the loan holder skips town and fails to pay then you have to pay.  With the loans for med school being an estimated 250-350k that can be a lot of money for someone without a medical degree to pay back.  At the same time, these are government student loans and so you can get deferments if you are unemployed, in school, don't make enough money, etc...  The government has been very kind in working with me on repayment of my current student loans.  They are not loan sharks and will work with the student for repayment.  As I understand it currently, the worst that could happen is they would garnish wages and tax returns if you get behind.  I don't ***think*** but I could be wrong that they don't put liens on your property or reposes your vehicles, business properties, or home. (but I could be wrong or the rules may change in the future; and in fact I can't get a straight answer from them as far as what they do do when you totally skip out on student loans)

So, in order to obtain an endorser for my grad plus loans, I thought it most appropriate to ask my mother (closest family member) to endorse for me.  This ended up in producing several phone calls where she explained her own dire financial circumstances and explained to me how she could not repay the loan, and they would take away my step father's farm equipment, and how they would take away her retirement and kick her out of the nursing home.  Also, that she did not make enough money to pay back the loan.  I told her nevermind and then asked my aunt (her sister).

My aunt, at first said that she would endorse the loan and that is the time that I got the money out of my retirement to pay for MERP.  I wasn't going to get the money out without assurance that I could get loans upon arriving on Dominica.  A few weeks later, she calls me to say that the loan situation is keeping her up at night, and she wanted to talk.  I said sure, understanding that this is a big leap for her.  She first asked, what if I died, or was injured so that I could not work.  I then called direct loans to ask this because I wasn't sure myself.  They said that if I died the family would have to show them a death certificate and they would forgive the loans.  Similarly, if I were permanently disabled I would get a doctor's letter stating this and that I would not be able to work and they would forgive the loans.  I conveyed this to her and she seemed ok with it then.  Several weeks later I get another call that we must talk about the loan situation again.  She explained that she is past middle age and is just now being able to buy her own house and does not want to loose her house and is afraid that she would loose her house.  Also, she said what if I do not get into some of these primary care government programs that repay loans, what would I do then.  To this I said that even if I don't get into those programs then as a doctor I would still make more than enough to repay the loans.  She was then worried about what if I got into med school and decided that this was not for me, and then ended up with the loans what would I do then?  I assured her that I was not going into this lightly.  And indeed it has been my dream since at least high school.  Then I said that even if I can't stand to look at a patient there are lots of other doctor jobs such as working for pharma, writing, reporting, teaching, etc...  All of these pay the equivalent of a regular doctor salary (minus perhaps malpractice insurance).  She also asked if I would make enough money with mal-practice insurance.  I said it just depends on where I practice and my specialty and I wasn't sure yet about that.  Then she said she would feel better about endorsing the loan if someone else endorsed it with her.  I called the direct loan people to verify, but it is not possible to have two endorsers.  They really only need one and indeed having two just increases the risk to the family.

At this point, I felt like she was telling me without telling me directly that she did not want to endorse this grad plus loan.  I did not want to ask my married family because I felt that this is something I should ask my family of origin, but my mother in law agreed to endorse the loan without a second thought.

I think that this really speaks to my family of origin versus my married family.  My grandmother always had a rule to never have money dealings between family members.  She felt that it was too risky and could cause a rift.  It seems that this has carried on to the next generation.  Additionally, they have always said that getting a loan for ANYTHING (cars, houses, education) is a waste of money due to the interest.  Their philosophy has been if you cannot pay cash for it you just don't get it.  My married family is not that way and they often swap property, and help each other out financially.  I think that this is just a difference in family dynamics, and am not sure the term for it but I'm sure there is.  I do not feel that my mother in law will hold it over me that she is endorsing this loan or make me feel bad or shamed for it.  I do feel that my family of origin would.

I also feel somewhat let down by my family of origin, in that I have always felt this pressure to succeed, and yet when I have this opportunity they do not stand up to support me.  This really takes the wind out of my sails and wants me to just quit all together.  Why should I give them the bragging rights to say "my daughter is a doctor" or "my daughter is going to med school" when they won't even help me to pay for it?

I also feel that this is another way that my family holds itself back.  I think that no matter how well someone behaves there may be a time when one must rely on their family for financial support.  This is how families get ahead in the world.  I am thinking of a guy starting out and asking for a business loan to start a shop or something.  Yes, the American Dream is to climb up out of poverty and into wealth and success but I can't imagine Thomas Edison, Richard Murdoch, or Bill Gates doing this without even a little support from family members.  By not supporting me they would be essentially blocking my climb to the top.  Not sure what else to write about this.

Also inherent in this reluctance is the idea that I would get these loans and then run away to Canada and not pay for them.  My mother and aunt must think that this is something that I am capable of doing and would do otherwise they wouldn't bring it up.  What kind of person do they think that I am if they think that I would do this?  Are they just pretending to believe in me?  Do they really think I am just a slime bucket and are not telling me?  What do they really think of me?  They must think pretty low of me if they think that I would do this.

Conversely, my mother-in-law must believe in me greatly to cosign for this loan with-ought much thought to it.  She is past retirement age and has not had a great deal of financial wealth in her lifetime.  Yet, she believes in me enough to take on this great risk, and I am thankful to have her.

Also, I have gotten a lot of comments from my Aunt and Mother abut, "we are not rich".  Yes, I come from a lower middle class background.  But I think that richness is a state of mind.  This may be the fundamental difference between my philosophy and theirs.  I think that even if you start out "not rich" you can change that.  Just because you come from a family of factory workers and farmers doesn't mean that you are destined to be a factory worker or farmer.  That IS the American Dream after all.  I choose not to settle.


Am I acting entitled to think that they must support me in this?  I feel that I am being respectful of my mother's and aunt's world views and financial principles by not asking for their help any further, and not pushing this issue.   I hope I am not acting like a spoiled child.  I just see massive debt as a requirement to become a doctor.  That is how the system is set up and I can't change it.  That is just the way it is.

I will no longer be pursuing my family of origin to help me in financial matters, and will follow my grandmothers' advice to just not have money dealings with family and leave it at that.  It seems that she is right there is too much of a danger of creating a family rift.

You're Going Wheeerrreee???

People have been very congratulatory when I tell them that I have gotten into MedSchool.  The inevitable follow up question is -- where are you going?  I usually say that I am going to Ross University which is a Carribean med school; and that I will be on the island of Dominica for approximately 16 months before returning to the states for clinical rotations.  At this point people usually confuse Dominica (dom-i-NEE-ka) for the Dominican Republic.  I understand this confusion, because I probably couldn't have pointed Dominica out on the map prior to applying to Ross.  People may then ask, why Dominica?  Which is a fair question.  I haven't found a nice way to say that it was the only school that accepted me yet; so that is what I say.  Some people have been worried that I won't be able to practice in the States or that there may be some discrimination because of where I went to school.  It is true that Ross is considered to be a foreign Med School.  There is a different certification process for foreign med students.  The fact that I am already a US citizen and speak English as my native language will make things easier for sure.  I spoke with another physician who had done his training in the Phillipines. He said that you can get a Medical Education there for about $6,000 us.  I am sure that there are many fine doctors trained in the Phillipines, I don't think that route is for me. 

I think that Ross has a good reputation as a med school which accepts students who may not be the perfect candidate on paper.  As a result, they do have a higher failure rate than more selective schools.  And yes, they do charge an arm and a leg.  To go to Ross you have to be really serious about going to med school.  You have to put your money where your mouth is, and take a big leap of faith.  I think you would find it hard to get someone to say that going to Ross is easier than any US med school. Moving to an island outside of your native country, thousands of miles away from any familiar faces, adapting to a new culture and climate, living without a CAR! These are all obstacles that a Ross student faces.  However, the reward for me is knowing that at the end of it I will be able to help people with their healthcare decisions will be worth it for me.

What being a teacher has taught me about being a student...

I use the term "teacher" here loosely.  I don't get caught up in terminology. To me, teacher=faculty=instructor.  Here are a few things I learned from my teaching experiences. 


First, your faculty are probably not nearly as prepared as they seem to be.  When I started teaching I took on 5 separate subjects for which I had no preparation.  No slides made up, hadn't even read the text.  Granted I had these classes as an undergrad and so remembered some stuff, but I felt like I was "faking it" through most of my lectures. 

Second, many students don't stand out.  There is a much talked about 'middle of the class' for which the teacher may not have any recollection of.  If you miss class, or get failing grades and I have to put you on a 'watch list' to the administration you will stand out.  If you sit in front of class and answer questions or if I read your paper and I feel that you have done a good job you will also stand out.  However, if you do you work at a minimum and attend class but do not raise questions or responses I may not remember you at the end of things.  I feel somewhat bad about this but it is a reality of having a lot of blank faces stare at you day after day. 

Third, some students are just meant to stand out.  In line with rule two, a student that emails for clarification on the finer points of respiratory alkalosis, every day, may stand out.  A student who sends a succession of 9 panicked emails because they got a B+ on an assignment and their average has been drug down to 98% tends to stand out.  It seems invariably in each class there are one or two of these type A students.  I completely understand where they are coming from.  These people are sacrificing time and money to earn a degree and so want the best return on their investment.  To be sure there are often misprints in test questions and sometimes the 'correct' answer has been incorrectly identified by the IT personnel who translate paper tests into electronic format.  Each quarter a test is administered it gets 'better' just because more people have taken it.  Also it is true that the squeaky wheel gets the grease.  If a student can logically argue why they put an answer on an assessment and I agree with them I will often award points even if it is not inline with the answer I was looking for.  I usually identify these students early on and only answer their emails after my various other weekly tasks are done. 

As an undergrad I was a BAD student.  I would often skip class or not turn in assignments.  I could rectify this by doing well on tests and usually got good grades.  As an instructor I feel that if I take the time to make up an assignment it is often not just for my own enjoyment but because I feel that it will help the students to master a certain subject; and as such it is sometimes a personal affront if they do not take the time to complete certain things.  Lesson learned, attend class, and do assignments even if they seem stupid or a waste of time. 

Don't act a fool in class.  I never did this as a student, but if people are talking in class.  (I went to school in a pre-texting age, but cell phones are annoying as hell).  If you attend class, be attentive.  If you cannot wait until after class to have a conversation / (text or other wise) please leave.

I do enjoy my students and like to feel that I am helping people leave a factory/waitress/stay at home mom occupation to make more money for their families.  As many complaints as I have about a few bad apple students by biggest complaints about teaching are administration.  At the schools I teach at, I am expected to take attendance, monitor dress code, police food/drink in classrooms.  I feel that at the post secondary level students should be treated as adults.  I feel my job as faculty is to teach.  Many of the career colleges have to guarantee to their accrediting bodies that the students attend a certain percentage of classes.  I am even expected to note if a student comes in 5-10 minutes late.  I feel that I have better things to do than monitor this type of thing however. 

In summary, I think that after being in the driver's seat I would be a much better passenger.

I'm 32

I've mentioned in previous posts that I am a non-traditional med student.  I'm 32 years old, which by med school standards is quite ancient.  Traditional students graduate from college at 20 or 21 and then go right into med school the following fall.  I am a good 10 years older than the traditional student.  There are several things that this later start time will affect.

The first thing that starting med school at this age brings up is lifetime earnings potential.  Each year I waited I have sacrificed a year of my top income potential.  In other words, if I will be making $200,000 per year when I retire at the age of (65?) I could have made that top income for another ten years thus I am missing out on $2 million in income.  Granted, as a physician I will be making enough money to live comfortably and by that time I should have my $250,000 in student indebtedness paid off by then, so it shouldn't be a matter of necessity.  Alternatively, if I want I could work until I am (75?) (assuming I am healthy until then).

The second thing, and this is more important to me, is reproductive potential.  Being female, my huevos are reaching their expiration date.  At the age of 36 my batch of potential zygotes will decrease precipitously.  If I start school in September I will be hitting the age of 33.  My eggs will be expired before I leave medical school.  If I want to have biological children I should consider making alternative plans.  I could harvest some eggs, freeze them, and hope that in 10 years or so when I am out of residency, that will be successful.  From what I read, lots of women have pregnancies throughout medical school, internship, or residency.  However, it does add another level of difficulty to an already difficult endeavor.  In addition to this, assuming a successful pregnancy, there is the matter of daycare, and how much time will a resident be able to devote to a developing youth? Indeed, there are other alternatives such as adoption or not having children at all.  Both are valid options.  This is something that I still haven't decided about.  A physician I once knew would often say, "Lack of decision is in fact a decision made." 

Reflections on loosing 40 lbs

As of today, I have lost approximately 40 pounds since last October, and am at the halfway point of my weight loss journey.  I recently looked at photos that were taken last June, and was amazed at the transformation.  I have gotten rid of all of my 'before' clothes and am selectively getting new clothes but not going crazy because I anticipate not being able to wear them for a very long time either. 

There has been a lot of change in the way society has perceived me.  One of the first things I noticed was I was shopping in a local grocery store and had bought some generic brand of pizza sauce.  Someone just asked me out of the blue, "Hey is that any good?"  I was surprised that someone would just start talking to me.  I quickly came up with a response and chatted with the lady while we were waiting in line at the checkout.  This never happened when I was bigger.  This also happened to me when I was waiting in line at the Wall-Mart photo center waiting on photos.   

While thinking about this situation later a few possibilities came into mind.  First, I thought that perhaps after loosing weight I might have better self esteem and probably dress better and might even exude more friendly vibe to strangers.  The other option was that people are just more friendly to thinner people than they are to bigger people. 

I had the opportunity to discuss it with a friend, and she thinks that if you fit into the cultural perception stereotype of what people want to see then you are more visible than those that do not.  In other words, I was somewhat invisible to the rest of the world when I was bigger, and as I got smaller I once again fit people's expectations and became more visible. 

I think that same thing happens to other groups of people.  For example, those who do not fit into typical gender stereotypes may be invisible, as do those in different racial/ age/ disability/ homelessness, etc... stereotypes.  I'm not really saying that this is necessarily a good or bad thing but more of an observation on one thing that I noticed.  Some people may or may not want to be visible at times. 

The lesson I learned from this experience is to be more aware myself of the cultural blinders I may have on at times.  I can't change all of society, but I can change the way that I comport myself in the society I currently live in.