Dealing With Chronic Illnesses as a Premed and Med Student

Session 402

Following a fibromyalgia diagnosis as a premed, Vikki almost gave up on her premed journey. Now, she’s an M3!

Vikki is here today to share some words of encouragement for those of you out there suffering with your illnesses and with your issues that there’s hope for you on this journey.

During medical school, Vikki discovered she has another chronic health issue, which is diabetes. She also talks about how it’s like being a Canadian medical student and some things to know about Canadian healthcare if you’re looking to apply to Canadian medical schools.

For more podcast resources to help you along your journey to medical school and beyond, check out Meded Media.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[01:40] Interest in Becoming a Physician

Vikki had always wanted to become a physician. She was plagued by insecurity and didn’t think she could do it knowing how competitive it is in Canada. But what solidified the idea that she was going to go to medicine was when she was diagnosed with an autoimmune chronic pain condition called fibromyalgia.

She was 25 at the time she was diagnosed and the doctor who diagnosed her was quite rude. She was already studying for the MCAT at that time. The doctor told Vikki that she should marry a rich man if she wanted to improve chronic pain. It was not the right time to be funny.

He also said a whole bunch of awful things. He said he didn’t know any doctors or any lawyers who had fibromyalgia, which is just not true. There are lots of them out there. Vikki just found this to be so devastating because she was already suffering through pain. So she decided to put her MCAT books away for a while. At that point, she wanted to quit and not pursue medicine. So Vikki looked into law school, into pharmacy, and into everything else that someone hadn’t told her she couldn’t do.

And one thing that her sister told her that stuck with her was that no one also told her that she could be a doctor. So Vikki rallied and she managed to make it through. What solidified her decision to get into medicine is to become better than the doctor she saw.

There are a lot of students who have very similar stories of doctors treating them poorly or their families poorly and this has motivated them to get into medicine. But I don’t recommend students who go down this path just for that reason.

Conversely, Vikki was already on the path even before that unfortunate encounter with the doctor. So it only gave her more motivation to get in gear and finish up what she needed to finish up.

Vikki’s desire to become a doctor stems from how she likes seeing the team atmosphere of medicine. The doctors are never making decisions alone. And Vikki has always wanted to work with people in a capacity to be able to advocate for them as well as support them.

[06:12] Choosing Medical Schools in Canada

In the U.S., public schools want students in their states and this is very similar to the schools in Canada where they want students from their province.

Knowing that statistics are rough in Canada, Vikki tried not to get too bogged down in the details as to how she would be choosing schools. Saskatchewan is a relatively easy or easier province to get accepted in compared to Ontario or BC. She applied to four medical schools, but she messed up her application for one.

Vikki decided that she was going to try, anyway, the worst that could happen was they were going to say no. Then she’d consider applying to the states because there are way more options there. Or she could try again in Canada and just continue to work on her application. Time wasn’t something she was super worried about, especially given all of her health concerns.

“I always looked at time as just being more time to get my life together before starting medicine.”Click To Tweet

[08:19] The Hardest Thing About Being a Premed

For Vikki, the hardest thing about being premed was the self-doubt and putting herself out there. She was convinced she would never actually get an application submitted, or the fear of someone saying no. The fear of judgment and the fear of failure are very common among premed students.

Overcoming self-doubt is a work in progress. Vikki is in her third year and they’re now moving into clerkship so she’s close to being in a stressful place. Part of dealing with that is being prepared, especially when moving into patient care situations. But a lot of it is just reminding herself that it’s anxiety and it is imposter syndrome. It’s all of these things that your brain plays on you. But just learn how to work through it to a certain extent so you could get through it.

[12:40] Advice to Students Looking to Get Into Canadian Schools

First off, know the province that you’re living in terms of what good medical school expects.

“As Canadians, we get a ton of advice from American students and things are just so different here.”Click To Tweet

For instance, the University of Saskatchewan is way more numbers-based. You need GPA and MCAT scores and things like that. So you have to know the requirements for where you’re going. Also, if you don’t have a competitive enough GPA or MCAT score, if you can’t improve on those or you want to get in faster, then you have to open up your options of applying to the states.

[14:48] Being in Med School While Dealing with a Chronic Illness

Dealing with her chronic illness, Vikki recognizes the need to balance her studies and health Because she can’t study if she doesn’t look at her physical health. So she has to take breaks whenever she needs them. She also has to constantly recognize her drive to be successful.

Vikki also learned the importance of reaching out for help and not being afraid of managing things with other people. Because other people can help both keep things on track like when she misses a class or things like that. So it’s easier for her to have that kind of support.

“It’s really about being proactive.”Click To Tweet

There is no procrastination in chronic illness because you can’t rely on yourself to feel well enough to cram or do that kind of thing. So time management has been huge for her.

[17:43] The Biggest Surprise of Medical School

Vikki was already halfway through er second year of medical school when she got diagnosed with diabetes. At that time, they did a full-day diabetic workshop in Endocrinology. And they discussed insulin dosing among other stuff.

Part of that was they got to check their blood sugar using a glucometer, which should be super fun as a group of healthy medical students.

But her sugars came up at over 300 American numbers, which is not good. The nurse who was doing it was excited thinking it was an opportunity to talk about how if you have sugar on your fingers, your sugars will be high. So she had Vikki go wash her hands and she came back and her sugars were higher. So that didn’t help. Vikki’s life was consumed with this new thing that wasn’t even diagnosed yet.

“If you think med school is hard, try studying for diabetes when you're being diagnosed with diabetes.”Click To Tweet

At that moment, she decided that her health had to come before medical school. She made her doctor’s appointment and she spoke with the Office of Student Affairs to start getting things rolling for the support that she might need and if she needed a med withdrawal, which she didn’t.

Another common misconception is that people don’t take time off once they start. The biggest thing to understand for a lot of students just from a medical school perspective is once you’re in, they want to keep you there. So it’s okay to take some time off during medical school, whether you fail a test and you have to work through that or you need to take a break because you’re having a baby or you have a health issue, or whatever. Vikki also emphasizes the importance of asking for help whenever you need it.

“Where students run into trouble is when they aren't communicating as much as they need to be to be getting the support that they need.”Click To Tweet

[23:00] Vikki’s Goals and Aspirations

Especially being a female and being diagnosed with chronic pain, and then being diagnosed with diabetes a little later on, Vikki experienced stigma from other health care providers, as well as from the general community.

But even when she was diagnosed with diabetes this year, it’s amazing to hear the different stereotypes within the medical community.

Vikki’s goal is ly provide excellent patient care. But she also wants to work with people and work with educational systems to help it make it easier for students with diverse perspectives to be successful in medicine. It is possible, but it is harder. And these are things that people need to figure out.

If there was one piece of advice she wished she had gotten earlier, it would be that of having more confidence. That despite all of the things that go wrong along the way, they’ll make you a better doctor. So she would have advised herself to just take them in stride as much as possible.

[24:41] What You Need to Know About Canadian Healthcare

Canadian healthcare has its flaws. People think highly of Canadian healthcare, and it is great. She can go to the hospital whenever she needs to. But it doesn’t cover everything. And so some things actually end up being more expensive up in Canada.

So it’s a different system to work in. However, she would prefer to work in the Canadian system than the American system, just because of the single-payer billing system which is awesome.

For example, her diabetes supplies. In the States, a lot of times things are covered through your private insurance plans that don’t end up covered through Canadian insurance plans. So things like insulin pumps aren’t covered for adults except for two provinces. Her continuous glucose monitor isn’t covered at all. She gets 10 test strips a day covered for fingerpicking which is not very many.

“It's a very common stereotype in universal health care systems that they'll pay for the care. But they won't pay for the convenience or technology.”Click To Tweet

And that’s one of the biggest problems is just you don’t get the more current or things that are shown to reduce cost long-term for emergency costs. It’s hard to convince the government that the initial cost is worth it.

Another example is that there’s a new gene therapy that was just approved a few months ago here in the states that costs $2.1 million. It’s a one-time gene therapy that’s approved here in the States, but Canada isn’t approving it because there’s another medication for the same disease. But it’s a spinal tap injection that happens every four months here in the States. So it’s $375,000 a year for that medication. So as Vikki has said earlier, Canadian healthcare also has its pros and cons.

Vikki adds that the drug coverage in Canada is something they’re fighting for as medical students through the Canadian Federation of Medical Student

To get a more expensive drug covered, physicians have to go through the worse options first. This can be very problematic especially with the type two diabetes treatment in Canada. It’s crazy that they’re giving people a drug first that essentially wears out the pancreas faster before they’re willing to go to the better drugs. That’s because of how the funding structure is.

That being said, insulin prices are insane in the States. When people are buying things out of pocket, it’s not that expensive. It’s when insurance companies are involved that you’re looking at thousands of dollars.

But I live in Colorado where we have an amazing governor and he kept insulin at $100 a month out of pocket last year. So we’ll see lots of changes on the forefront of the US healthcare system, which is something to be hopeful for.

[29:46] Final Thoughts

Vikki’s wish is for more patients to become doctors because it’s so needed. At the end of the day, what we need is empathy.

And for physicians who aren’t patients and who have never been patients and who don’t have family members who are patients, it’s much harder for them to empathize with what their patients are going through.