Dr. Andrea Tooley shares her journey from premed to current Ophtho resident. She didn't know a lot about the premed journey, but fought to inform herself. Andrea has a YouTube channel called A Doctor in the House. She shares her journey to medicine including chasing down anybody in scrubs and the mistakes she made, the successes she had, and everything in between.
[01:20] A Love for Ophthalmology and Her Flying Gig
Having always loved science since late middle school, Dr. Toole already thought medicine would be a good career for her by mid high school and considering she never had any exposure to health care growing up and not having any physicians in her family. But she always wanted to have that secure career that offers certainty and being able to interact with people so medicine was what she thought fit her personality. As to why she wanted security, Andrea has always been a planner who has always mapped out her future which she thinks is an innate character.
To test the waters whether medicine was right for her, she has done shadowing with a few people early in high school including a general surgeon and a nephrologist that was set up through her school that had kind of a career day but they could actually go to work with some of these people. Still it was little exposure but it wasn't until eleventh grade when she got her pilot license and she flew airplanes in high school that she met this pilot who told her about the ophthalmology-related nonprofit organization he was involved with. Upon reading about the organization, Andrea finally found her aha moment and thought it was what she wanted to do with her life. From then on, she started reading more about ophthalmology and shadowing more surgeons. But it was when she fell in love with the organization's concept of helping people see and eradicating blindness that she made her big declaration that it was what she wanted to do with her life.
Andrea initially didn't know about ophthalmology but when she started reading about what the organization was doing, she couldn't imagine anything better than giving someone back their vision. And that to her was the essence of what an amazing career would be. International work was also another component Andrea was interested in and so she thought a doctor would be the best job ever.
Andrea's stepfather who flew airplanes encouraged her to try it and she loved it. So she got her license in high school and flew a little in college. Once she got to medical school, she simply found it impractical to fly an airplane. Considering how expensive it is and knowing it wasn't her first priority at that moment, she had to let it go. She hasn't flown in years but she would love to get back to it one day.
[07:25] Choosing a College
Her decision to be a doctor didn't actually play any part into choosing where she wanted to go to college. In hindsight, she wished she had been more strategic about it. With lack of guidance, her dad being an architect and a musician mom, neither of them had any great graduate school-type advice for her. She also went to a tiny school in Indiana so they didn't have any big school-type counseling for choosing a college. She basically didn't think about it, more so, not even knowing how to think about it. As a result, Andrea applied to a bunch of random schools in Florida, New York, and Indiana where she ended up going to Butler University in Indianapolis. She actually got a scholarship that was a full ride to any Indiana school but she got wait listed at Notre Dame and felt devastated leaving her with Butler as her only option thinking she wasn't going to turn down a full ride. But what seemed to be the worst point of her life turned out to be the greatest thing since she enjoyed every minute of it. She found that a smaller liberal arts school fit her personality so much better than a bigger school. Not having any prior introspection into all this, Andrea was thankful everything ended up well for her. But if she had to do it all over again knowing she wanted ophthalmology, she would have chosen a school connected with a medical school with a strong ophthalmology program which would have been the smartest thing to do. What she recommends to students out there interested in a certain specialty is to find a medical school, if you can, in-state. It's always the way to go in terms of financial cause. But be a little strategic about it if you're very interested in one certain specialty.
With Butler not having a connection with any medical school, Andrea recognizes the difficulty of getting involved with research in a medical school or to shadow or get to know the department as an undergrad. What Andrea did instead is to remain involved with the nonprofit organization she was involved with in high school which was out of her own effort and outside of Butler. Nevertheless, Andrea still finds Butler to have a great premed community with wonderful professors who were great mentors to her in terms of academics and leadership but nothing specifically geared towards ophthalmology nor towards a certain medical school.
[11:40] Premed Struggles and a Positive Mentality
Andrea describes college as a fun time where you can try out so many new things and push yourself so she was heavily involved on campus at Butler. She overloaded her plate with too many clubs and groups plus her sorority and friends. However, she explains that when you're a premed, you have to say no to this certain event or be able to go on a night out and it wasn't easy for her. So she learned time management and organizational-type skills because she had to or she would have otherwise fallen apart which she in fact did at times.
Moreover, there were a couple of classes they had to take that were really hard which they all struggled through and this is true of any premed. Generally, she found her school to be very supportive, she learned so much, and grew as a person. Luckily, she didn't find herself in a cutthroat community at Butler. One of her best friends was pre-dental. They took the same classes and studied for everything together even when her friend was in dental school while Andrea was in medical school. Her best girl friend was premed so she didn't see any competition within her group even within her bigger study group although Andrea thinks she could have been just oblivious. She believes you find what you're looking for and for her part, she focused on seeing positive things so she may have overlooked, nevertheless, she didn't find the negativity, even in medical school.
Andrea found great benefits of a smaller liberal arts school in as much as there are some aspects that fell short of and a bigger school might have been better. She felt the person designated as their premed advisor was not that well informed but she had great professors and mentors whom she found as her great premed advisors having had a lot of one-on-onetime with them and receiving premed advice from them. She also remembers having a strong premed community of students in spite of a less established faculty-run premed community compared to bigger schools that have stronger, pre-existing premed framework to help students along the way. Andrea had to do a lot of researching on her own and remembers running after people scrubs who are medical students from another school and asking them about everything they know. She would be asking for advice and basically took a lot of things into her own hands.
It's this mentality that Andrea has of going out there and finding information. She adds you have to make it happen for yourself. There are so many people out there who want to help you. You can Google things and find stuff online. Find people in coffee shops or ask friends of friends, basically just try using every resource available to you.
[18:01] Strategies for Choosing a Medical School
Andrea went straight from undergrad to medical school applying to the Early Decision application at Indiana University. It's a binding acceptance so you're only allowed to apply to one medical school and apply early in the cycle then you find out early in October which is way early for the medical school acceptances. If you're in, good but if you don't get it, technically, you still have time to apply to other schools but it's going to be late in the cycle. She had heard that if you've met all those requirements, as long as you didn't have a felony on your record, then you would probably get in. She thought going to a state school that has a great medical school would be a great financial decision. Knowing she was a decent applicant having met all the requirements for early decision to IU, she felt confident that she would get in.
Again, knowing fairly well that she was interested in ophthalmology, she still didn't consider this in choosing her medical school. She didn't think about the ophthalmology aspect at all. Now she's thinking maybe she should have tried to go to a medical school that was connected with a stronger ophthalmology residency. Although IU has a strong ophthalmology residency program, there are also other state schools that have it. If she had to do it all over again, Andrea says would have been more strategic about choosing her medical school.
Andrea explains that as when she was applying to medical school as an undergrad, you are so far from residency that she didn't even know what internship is. She would have just looked at residency rankings but she's not sure whether she would have looked at specific qualities in a program. She was heavily invested in this nonprofit organization so maybe she would have chosen a program that had a faculty associated with that nonprofit. For example, one of her co-residents wanted to do ocular oncology which she had known she wanted to do since high school. She was very strategic about where she applied to medical school and residency fully knowing she wanted a program that had ocular oncology which not every ophthalmology program has. So Andrea recommends that if you have a niche you're interested in or you've done research in a certain area, look at residency programs that are strong in that one area and then find a medical school associated with that. Ultimately, she recommends going to a school where you think you're going to be happy because your biggest thing is to succeed in medical school. You can pick medical schools with the best associated residency but you don't like the medical school, but maybe you won't even make it to the residency because you hated school and you didn't do well. So much of it is going where you think you're going to succeed. Andrea adds making a financially smart decision is important.
In addition to Andrea's advice, I always say to students, don't go to a great medical school. Go to a medical school that will make you great. Too many students look at the name and the prestige and don't think about what's going to make them happy. Andrea further paints this picture that you can be a superstar anywhere or a crummy resident or medical student at Harvard. It's all up to you.
[24:35] Mentorship and Student Interest Groups
Andrea was so excited to finally be starting medical school and she was just really intense during medical school. She knew she was getting into ophthalmology and grades were really important to her so she simply was so into it. Although she didn't mean to be, Andrea admits she was a total gunner. And looking back, she just shakes her head in shame.
Andrea has always been pragmatic about everything. Getting into medical school and residency, her thought process was that if she got good grades and worked hard then she will get into medical school and get into residency. She knew ophthalmology was very competitive so she knew she had to get the best grades possible along with research. She wanted to get involved with ophthalmology research really early which she did and she also got involved with the ophthalmology student interest group at her medical school early where she got a lot mentorship from other medical students who had just matched or those applying and she moved up every year. On the other hand, Andrea's research mentor was just out of fellowship and was very helpful.
Additionally, Andrea also remembers some premeds attending the student interest group meetings which is a great thing for any premed to do so you can meet people. She recommends that if they let you go, then definitely go. Their group at IU also started a free eye clinic so they would have premeds come to the clinic to help see patients and get them involved. So if you're near a medical school, contact the school and contact whoever is in charge of the student interest group for whatever specialty you're interested in. It's a great way to get involved.
[28:35] Fellowship in Oculoplastic Surgery
Having matched into a fellowship now, Andrea felt she was so laser-focused on ophthalmology since she was sixteen until getting into residency and realizing you don't learn a lot about ophthalmology in medical school. She had done a ton of shadowing and clinical experience as well as surgery and thought she had seen a lot as far as medical school went but when she actually started finally doing it in residency, she couldn't find something she thought she would have really fallen in love with or she thought was something she could do everyday for the rest of her life. She didn't feel like she could do cataract surgery everyday for the rest of my life. She also discovered that she doesn't love looking through lenses as much as you should to be an ophthalmologist. So she chose a fellowship in oculoplastic surgery, which is a plastic and reconstructive surgery around the eye that does orbital surgery. You can do combo surgery with neurosurgeons or ENT-type surgeons. She loves the patient population so to her, it felt different than intraocular surgery (cataract surgery). She just fell in love with this and she didn't feel this way about any other subspecialty within ophthalmology.
In terms of choosing her specialty, it's not really that she second-guessed ophthalmology but she also liked little pieces of a lot of specialties. She loves surgery and she loved her general surgery rotation but she didn't like the macroscopic nature of general surgery as she preferred the smaller, microscopic nature of ophthalmology. She also loved neurology and liked the patient and clinic aspects of it but for her there wasn't enough procedural aspect to neurology. She likes talking to people and loves the patient and clinic aspects but she she didn't love being in a hospital and doing an in-patient service. So she liked so many things but nothing really made it difficult for her to choose ophthalmology.
[32:00] Her Rise to Social Media Fame
When Andrea was studying for Step 1, she started reading blogs as an escape from what was seemingly a miserable life studying for Step 1. She's also into healthy eating, nutrition, and fitness so she started reading blogs about them. So it started as a fun little escape for her and thinking it was also something she could do, she wanted to share her recipes and her experiences as a medical student. The day after she took Step 1, Andrea started her blog without any goal or intention for it at all except for using it as her little place to document and chronicle her third and fourth years of medical school as well as some kind of a repository of her recipes. This way her family can read them so they can always keep in touch with her. But Andrea ended up getting small readership and found people were more interested in the medical school side of things and cared less about healthy living stuff. Since this was a bit off the genre of her blog, she thought of making a YouTube video instead talking about medical school. So she started making little videos talking about things like what to study or what she wished she had known about medical school or her third year experiences and people liked them.
Andrea describes making these videos is so fun being able to interact with people and connect with premeds. It's fun helping people with whom you were also in their shoes just a few years ago. From there, she started doing more interview-type videos. Although not a priority since residency is number one and learning how to be an amazing ophthalmologist, Andrea doesn't put her 100% into it but she does this when she can which is okay. This brings her joy so she keeps doing it. Check out her videos on her YouTube channel, A Doctor in the House, and her blog at www.AndreaTooley.com.
[35:40] The Biggest Challenge of Premeds and Medical Students
Andrea explains this is not an easy path for anybody and what she hears most from people is how do they stay motivated and she gets that question all the time. People lose motivation considering this is a long and arduous journey as well as people dealing with self-doubt. Both of those combined, it's hard to stay in a mental state and have that mental fortitude to continue especially these days where everything is getting more competitive and cutthroat. There is so much on the internet and test scores and averages just keep on getting higher and higher and the standards are getting impossibly high. Just to have the strength to keep going and to get through it is such a challenge so Andrea encourages people to surround yourself with a family that helps you and supports you as well as friends that support you and study with you. Lastly, just put one foot in front of the other. Nobody really likes working this hard but just keep doing it and you will get there. You need to enjoy the process along the way but you're not going to enjoy every minute of it. So just find that balance where you're not miserable abut you're still working hard and this for her is what she finds as the biggest challenge.
Looking back, the most memorable part of it for Andrea was matching into ophthalmology residency which to her was a culmination of so many years of having a school and finally getting that phone call from her program director welcoming her into the residency. She also felt the same way getting into medical school and getting that envelope in the mail. She says it's those moments you've worked so hard for that you'll never ever forget that feeling that it was worth it and you did it. Lastly, she just remembers the bits and pieces of the whole thing studying and it's all great. At the end of the day, we all want to be good physicians and help our patients and that makes it so worthwhile.
[40:05] Final Thoughts
You don't have to be perfect to get into medical school and know everything to get into medical school. You just need to work hard. Work hard for your dreams and get as much information as you can along the way. You don't need to know it all right now. Just start working towards that path of getting into medical school and one day, you will get there.
Andrea's blog www.andreatooley.com
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