Fresh Start

I have spent the last decade preparing to go to medical school and become a physician.  Four years ago, after finishing graduate school, I was rejected across the board from the 12 medical schools I applied to.  I was told (actual quotes): “you have too much public health experience and not enough clinical medicine experience” (the 6 years and >1000 hours spent volunteering in a nursing home didn’t count because it happened before I graduated from high school), “maybe you should take more undergraduate courses to increase your GPA” (my 3.92 graduate GPA doesn’t offset my 3.33 undergraduate GPA because only the undergraduate GPA is counted in US News and World Reports rankings), and “you need to include physician shadowing in your application” (I had shadowed physicians before, but used my limited space to discuss leadership positions I held and accomplishments made in student government, city and state government, and non-profit organizations).

So, I’ve spent the last few years working as an analyst for hospital organizations.  This is great, except hospitals are slow to try new things.  My experience has been that innovation is confined to a department within the organization, and not encouraged of all its employees.  New ideas are met with a deafening “meh” from middle management, followed by stern encouragement to focus on getting back to writing reports or whatever exactly it is that you do.  There are departments for innovation and process improvement.  Let them do their job so you can continue doing yours.

This puts me in an awkward position.  My goal, as is the case for most med school hopefuls, is to help improve the lives and health of people.  I think this can be accomplished by using policy, technology, public health, and medicine.  It’s clear from pretty much every health-related news story I’ve read in the last 5 years that the status quo isn’t working.  US health care is expensive.  People are getting sicker.  That’s not exactly a formula for success.

And I’m part of the problem.  My salary isn’t used to provide direct patient care, and I’m not given the resources to really be able to create solutions to the problems I’m presented with.  So, I’m forced to do just enough to keep the machine moving without actually fixing any part of it.  It’s job security at the expense of patients.

So, out of all of this, I am thrust into yet another quarter-life crisis.  Perhaps the most epic of my quarter-life crises: how do I help improve the lives of the greatest number of people, see my contributions recognized and adopted, and still continue to pay my mortgage?

I wish I had an answer.

Being a physician could be a move in the right direction.  I was accepted in a subsequent application cycle to TouroCOM, an osteopathic medical school in Harlem focusing on underserved populations, but I have deferred for a year.  Medical school is expensive, both in dollars and time.  And I do not want to be forced to practice medicine instead of innovation just to pay back student loans.

In the meantime, I locked myself in my bedroom for a weekend, turned off my cell phone and gchat, and started coding.  The result was Epicenter, a tool (currently being re-written) to help analyze patient data, combine patient data with other data streams, share findings, and take action.  This app ended up winning Practice Fusion‘s Analyze This! Health 2.0 Developer’s contest.  Who knew I could code?

Since then, conversations started on Twitter led to new jobs, friendships, and opportunities.  It quickly became clear that the path I was headed was not going to accomplish my goals, so it was time to try something new.  I quit my job and found a place in San Francisco.

I have mixed feelings.  In a way, my story (and others) epitomize the problems with health care and medical education.  The systems talk about the need for change, fresh ideas, and leadership among incoming medical school classes, but then continue to admit people based heavily on very traditional measures of aptitude and pre-medical experiences.  How can you expect change to occur when you’re continuing to admit all the same people?

However, in rejection comes opportunity.  I would not be doing what I’m doing today had I been admitted to medical school when I first applied.  In fact, I wouldn’t be doing much of anything for the next 7 years other than study and work.  So, if my goal is to improve the lives of people, then what I’m doing today is closer to immediately achieving my goal than my original plan.

Regardless, I’ve learned to acknowledge that I have no idea what I’m doing or where I want to go.  I just know what isn’t working for me and the greater health care system, and that I want to be part of the solution.  Medical school, graduate school, or health tech start-ups are all potential answers to my question.  I’ve tried two of those before, so I think it’s time to try the third.

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