PMY 234 : ICU Nurse Turned Medical Student Discusses Her Journey

Session 234

Sarah is a current 3rd-year medical student and former CTICU nurse who now wants to be a Cardiothoracic Surgeon! Listen to her journey and how others reacted.

The paperback version of The Premed Playbook: Guide to the Medical School Interview will finally be released on June 06, 2017. (Pre-order the book and get almost $100 in giveaways including one-month access to my mock interview platform and lifetime access to my 13-part video series on medical school interview. Simply test PREORDER to 44222 to get instructions on how you can enter to also win one of the 50 copies to be given away. Promo runs until June 04, 2017)

Back to our episode today, Sarah is the second guest on the show that came from a nursing background. She shares with us her transition from being a nurse into a medical student along with her share of challenges. If you're a nurse thinking about making this same transition and worried about how your colleagues are going to react to this, take a listen to learn from Sarah's experience.

[05:15] Her Interest in Being a Physician

Sarah had to deal with a lot of self-doubt in terms of becoming a doctor being 34 years old yet traditionally raised. So she thought being a girl, nursing was her automatic path into medicine. But as she worked and got into critical care, she realized she really wanted to do what surgeons are doing and it was something she knew she could do so she went back to take some classes.

To begin with, her initial interest in health care was mainly influenced by her dad who is an engineer and would always call “Nurse Sarah” to treat his wounds he got from woodworking. Then the show ER came out and seeing that inspired her even more to help people.

Not the best student in high school, Sarah would consider herself as a late bloomer, nor medical school was on her horizon back then. But she wanted to help people and thought being a nursing associate could be her quickest route. Pharmacy was not an option since she loves talking to people and being around them.

[08:30] Nursing and Self-Doubt

Sarah's path to nursing was not smooth and easy as she she had to teach herself math for someone who didn't do well in high school. She had to go through an academic advisor to help guide her along her path as to what classes she needed to take and in what order.

While in nursing school, she found her first open heart surgery which she thought was so cool. Already a year in nursing school, she talked one day with her academic advisor and expressed her interest in going to medical school and was told she had to take things one step at a time.

Then she got a job as a nurse after graduation and did not continue to apply to medical school for a couple of reasons. She got married shortly after and established her personal life more. She also wanted to work a bit to be able to save some money so she could pay up her student loans and then go back to school to get her Biology degree. Additionally, she was not 100% certain that she could still be a doctor. Still, self-doubt kept on creeping in and this basically kept her in nursing for about a year and half before she finally started to move forward.

Sarah thinks her self-doubt must mainly come from her academic performance being a nontraditional student and not having the highest scores in school. She had this picture in her heard that in order for someone to be a doctor, you have to be a 4.0 student and have everything aligned so she thought her background would not be appreciated. Her biggest hindrance was thinking that they only want the best so she wasn't good enough.

[11:36] Working with Mentors and Getting Discouraged by Physicians

Sarah got into critical care, which is a very hard area of nursing to get into. Her manager was just feeding her whatever she wanted in terms of patients she wanted to manage, which was not always the case in nursing. Sarah was lucky enough to have a strong person and a good mentor for her. She also told her about going to medical school and her mentor totally encouraged her and supported her.

Sarah actually found that a lot of physicians she worked with discouraged people from going to medical school which made her a little apprehensive but her mentor really pushed her forward, instilled that faith, and saw things in her that she did't see in herself. So she knew she had to go for it.

Shortly after she spoke with her nurse supervisor about her interest in going to medical school, a new trauma surgeon started and Sarah found out she was a former critical care nurse herself. So she met with her one-on-one and helped her draft her personal statement. She basically saw that her mentor could do it so it became more tangible for her considering that nurses-turned-doctors are hard to find.

[15:40] Why Not Nurse Practitioner?

Sarah had a similar story with her mentor. As they discussed why doctor and why not nurse practitioner or nurse anesthetist, they simply both agreed that it wasn't the leap they were looking for. They wanted to be the ones to make the full decision and be the shapers of the plan and care for the patients.

She definitely hates the term “mid-level providers” most hospitals use but the reason those were not the avenue for her is having worked at several different locations from a community hospital to academic centers throughout different states and Sarah saw how varied their roles were from hospital to hospital, practice to practice, state to state. In one place, for instance, their nurses couldn't even interpret if an NG tube was placed properly on an x-ray.  In short, the autonomy varied based on practice, based upon hospital and state, which was something Sarah did not like.

Another reason she wanted to take the medical school path is that as a nurse, you take orders from doctors and nurse practitioners and while you can question them but in the end if you don't agree with something, it's going to be hard to stomach that. Sarah says they have a bit more of a sixth sense sitting at the bedside all day that can't be conveyed to any other way to certain people. Not having that authority and the ability to do those things and to be told you can't do it since it's not within your scope of practice was not something she was looking for.

[18:10] Articulating Your Reasons During Interview

At every single interview she was on, this question of why she didn't just become an NP or PA always came up. Sarah recommends to nurses going into medicine that they need to prep on this question for the interview. You need to know why you didn't and it needs to be a good reason. Sarah adds there needs to be self-discovery, introspection, and maturity that comes with your decision to be able to articulate that clearly to those interviewing you for them to understand and look inside of your rationale fro choosing it. They want to know you're doing it for the right reasons and that you've looked into other avenues.

Fifty percent of Sarah's reason for going into medical school is not being able to get enough of learning the pathophysiology of things because she feels she has only scratched the surface in medicine and now entering her third year, it has taught her to levels she would have imagined. That knowledge and passion to learn more and the why of things, although they have always been a big component for her, they were not enough. She wants to used that knowledge to formulate more holistic plans for her patients and be able to provide plans of care that she's fully behind and that she believes. She basically wants that autonomy to do so and use that knowledge she got. Knowledge is therefore a huge component of why she entered medical school but now the entire protion of the pie.

I definitely agree with Sarah 100% because what's missing from just the knowledge part of it which is all focused on you, is that patient care. How are you going to turn that knowledge into something that benefits the patient?

That said, Sarah adds you can always go into other areas if you simply want to learn something. There are now online courses that are being taught at these Ivy league schools that you can access for free. But the reason that separates doctors and nurses from other people is the drive to apply it directly into hands-on patient care. Having this answer in your heart when you're answering this question is definitely the right way to approach it.

[22:20] Dealing with Unpleasant Interactions

Sarah has quite a remarkable approach in how she deals with even her negative interactions saying she always had something to take away from it, even when in the heat of the moment. It's about taking that negative energy and turning it into a positive light which is also what you should go for in life in general. Sarah explains you're always bound to come across conflicts and that's something that's going to always happen in your career so you need to be able to convey that to the people interviewing you because they need to know you can work with people and that you're willing to also listen when there are conflicts and try to figure out a resolution together. Things like this make interesting stories and the interviewers will push for those so you have to be able to take your positive spin on it and think about how you appropriately solved the problem.

[24:06] Premed Advising, Flexible Schedules, and Financial Avenues

About a year and a half into nursing, Sarah met with an academic advisor at a four-year institution and he laid it out for her the timeline for applying to medical school. Sarah proudly says it was the right first step.

As a nurse, there are different avenues and the one Sarah used was what they call registry. They had a more flexible scheduling and didn't have to schedule 36 hours a week. She didn't have to do certain times and worked every single weekend for at least 24 hours and would sometimes pick up an eight-hour shift. It can be hard being in four-year institutions since they have traditional school hours and not everything is available online so Sarah had to get creative, nursing being the perfect avenue for that because of the different hours you can pick up.

Nursing is super flexible but you also have to focus on keeping those grades up because ultimately, if you only care about the money aspect, you might have to give up some of those great scores and that might hinder you in getting into school.

As to why she didn't choose to go to a community college that may give a more flexible schedule, Sarah explains that what medical schools won't tell you is that they may take different weights for an A from a top 10 school versus an A from a very small community college. So she saw it as a way for her to prove to them that she went to a good school and did very well there.

There are other ways to go about this like taking part-time classes. For full-time nurses, it's only three days a week. You can also get student loans to help offset your living expenses, this is something she took advantage of. There are financial avenues to help support you during getting your advanced degrees.

[27:22] Four-Year Universities versus Community Colleges

As to the idea that medical schools looked four-year institutions and community colleges differently, she obtained this information from meeting with different admissions advisors as well as from doctors that served on admission committees. Sarah is a big proponent of networking and meeting as many people as possible in getting information. It basically took her three years to get to her bachelor's degree so over those years she gained different alliances with people and was able to get those information from conversations with them off-the-cuff. So it wasn't something they advertised but it's being thrown around on the internet and on different websites.

I agree with it to some extent. A lot of students will look at two different four-year institutions and will look at one that they're maybe not excited to go to thinking it's going to be a bigger hit on their medical school application or it's going to be looked at more favorably. A lot of the discussions I've had with students are around those types of scenarios. Once you're up to a four-year school, unless you're talking Harvard versus some four-year Podunk university in Alabama, but across the board, there's so little variability for most students to worry about it.

Sarah adds that as long as you perform well on the MCAT or have a great background that augments that, medical schools look at you as a holistic candidate. And she agrees that most four-year institutions are going to be okay.

[30:20] Starting Medical School and Leveraging Her Nursing Background

Thinking she was just going to be fine considering she's used to handling stress being an ICU nurse and having went to school, Sarah still found medical school to be stressful and she acknowledges the need for a good, strong support group around you. Indeed, she describes the analogy of drinking through a fire hose couldn't be more perfect and she didn't totally had a grasp of what it meant until she started medical school.

The hardest thing for her was not only the sheer, vast amount of information she had to face, but also, the anti-social portion of it which she had to adjust to having to stay for longer hours in the library.

Her nursing background has helped her in starting medical school such as the life lessons she learned, ways she talked to people, and how to handle stress inn general considering the stressful nature of job nurses have. She also has taken on mentorships towards her fellow classmates and was able to help tutor some of them especially in Pharmacology. Because of nursing, she knows the names of the drugs and the dosages and their indications which are no longer new to her.

Within a couple of weeks within her university, they already started seeing patients in clinics and their attending surgeon commented she was light-years ahead of the other students and is already acting like she's an attending as far as her comfort level. She basically already knows how to handle difficult situations such as if a patient yells at you and be able to roll with the punches instead of being freaked out. However, there were times when she wanted to handle certain portions of patient care which were not within her scope as a medical student (that nurses do) and this was quite difficult for her being used to the all-over patient management.

Moreover, Sarah is fairly aware that working with residents and attendings, she should not come off as overly confident and know-it-all so she had to balance it out since they are the ones grading your and they're the ones teaching you so you have to be humble. At the same time, you have to learn how to speak up and recommend different things in a way that's coming off as abrasive.

[35:55] Negative Feedback from Other Nurses

Sarah actually had to deal with this problem having a lot of negative feedback from other nurses. She had to insist that she still is a nurse and she continues to advocate for the nurses because she is still part of the team. She is not leaving not because nursing is not good enough, but it's not just the road for her. Sarah explains this is something you will experience as a nurse working and trying to go to medical school so you have to be very careful with who you tell this to and who you surround yourself with otherwise it's going to be an issue.

As an actual practicing physician, nurses speak highly of physicians that were nurses before. Apparently, the harder part is when you're actually making the transition because they don't fully understand why you're making that change.

[37:37] The Application Process and Personal Statement

Sarah found the application process to be a lot longer than she anticipated. She took the MCAT twice and she wanted to make sure she performed at a level she wanted to because she did not want to be hindered with the kind of schools that would pick her. She describes it as a very arduous process and it took more time than she thought.

Sarah advises that if you're thinking of family planning or dating somebody and you're giving them the realistic expectations as far as how long this process would take, always consider that it could take another year or two before you can actually land in medical school. Sarah didn't have previous knowledge of rolling admissions and that you only get accepted during these times and the whole application process itself takes an x amount of time. So you have to do your homework on that before you apply.

Sarah iterates that you have to write your personal statement 10+ times over before you get it right and you have to get so many eyes on it. The personal statement being a critical portion of the application, you have to get yourself across. You have to talk about what sets you apart and Sarah believes being a nurse is very favorable and so you need to draw upon that in your application process.

[39:40] Selection of Medical Schools

In choosing which schools to apply to, Sarah looked up MSAR in terms of demographics. She was looking for schools that favored diversity and those that looked at nontraditional students more. She didn't want anything that felt toxic or she didn't feel at ease when you're interviewing there. She wanted to feel like they were looking for the right candidate and they were invested in her already that's why they gave her the interview. Sarah can happily say that the school she is in now is the perfect fit.

Sarah recommends that if you're in academics as a nurse and they have a medical school, network away with that because that is what really helped her out. She actually met their Chief of Surgery who worked with her as a heart transplant surgeon and got into the whole process and she was able to bring her concerns to the table. She adds that in order to get a feel for the school, you have to actually go there and reach out to the admissions advisor while starting to take courses to reach out for guidance especially the school you're interested in attending.

I want to add that one of the biggest mistakes students make when looking at schools is they look at those stats but those are averages. Half of the students that are admitted are below that average while the other half are above. So it's only one small piece of how you should be looking at a school.

[42:40] The Most Rewarding Part as a Medical Student

For Sarah, interactions are the most rewarding part for her. She recalls during a rotation at a surgery clinic and met an older couple. The surgeon introduced her as the future heart surgeon and the woman looked at her and talked about she was so proud of her considering not too women actually enter this field and it was something she would have wanted to do when she was younger. Sarah didn't realize how special this is sometimes and when someone says something like this, it touches her because it means she has an impact on them and makes her realize how far she had come on this journey.

[44:42] Final Words of Wisdom

Sarah leaves us with an inspiring advice to not ever let yourself doubt yourself. You're going to be old one day anyway so don't worry about the time and the things that you have to sacrifice to go into it because in the end, everything you do is going to mean so much more than any of those momentary stresses. Sarah actually sat down with a 60-year-old taking a calculus class who told her she's going to be old one day but she wants to be old doing what she loves and having no regrets. Don't let time or any of those other stressors get in between you and your goal. You can do it. It's never impossible. Just put your blinders on and go forward.

[45:50] Enter to Win a Copy of My Book!

Text PREORDER to 44222 and get instructions on how to win a copy of The Premed Playbook: Guide to the Medical School Interview as well as remind you on how to preorder the book at Barnes and Noble and the free giveaways you can get with that.

Next week on The Premed Years Podcast, I will be talking with someone who is very well-informed with healthcare, the policies and bills being pushed through. She has a podcast all about reading the bills going through Congress. I'm bringing her on the show to help you get a better understanding of what's going on in this world in the healthcare world here in the U.S. to help you prepare better in your interviews.

Links:

The Premed Playbook: Guide to the Medical School Interview (Pre-order the book and get almost $100 in giveaways. Simply test PREORDER to 44222 to get instructions on how to go about it.)

MSAR (for MD schools)

College Information Book (for DO schools)

Transcript

Introduction

Dr. Ryan Gray: Hey before we dive into today's episode, I want to let you know that my book, ‘The Premed Playbook: Guide to the Medical School Interview' is hitting bookshelves on June 6, 2017. You can preorder the book and get almost $100 in giveaways by texting ‘PREORDER' to 44222. Again text ‘PREORDER' to 44222 and I'll show you how you can preorder the book from Barnes and Noble, and get close to $100 in giveaways.

This is The Premed Years, session number 234.

Hello and welcome to The Premed Years, where we believe that collaboration, not competition, is key to your success. I am your host Dr. Ryan Gray, and in this podcast we share with you stories, encouragement, and information that you need to know to help guide you on your path to becoming a physician.

Now as I said in the opening, I am super excited to get ready to finally re-launch my book, ‘The Premed Playbook: Guide to the Medical School Interview.' For those of you who may not have heard this journey before with this book, I launched this on Kindle only back in August of 2016 and sold I think over 1,000 copies, and was picked up by a publisher, and they had me stop selling the Kindle version several months ago- many months ago actually now at this point, and the Kindle version is out now. Kindle, and iBooks, and Nook, and kind of anywhere eBooks are. But the paperback copy, the paperback release is coming June 6, 2017.

And I was super recently. I walked into the local Barnes and Noble, and I went up to the counter, and I said, “Hey there's this book being released next month. I was wondering if you guys were going to carry it.” Because I hadn't heard anything from the publisher whether or not Barnes and Noble was going to carry the book. The way that the book industry works, I'm learning all of this, is that when you have a publisher that doesn't guarantee that you get into the bookstores. They go, they have a sales team, and they go to these book buying events, and they pitch the book to the bookstores, and then the bookstores have to want to carry that book.

And so I hadn't heard anything, and I didn't have super high hopes because it's a very, very small audience, and so I walked up to the customer service and I said, “Hey there's this book, it's being released next month, I was just wondering if you were going to have a copy.” And he said, “Yeah we're expecting a copy.” I was like, “Yes!” I didn't say that out loud, I just kind of smiled. And Allison was standing there next to me, and the guy was like, “Hey do you want me to reserve you the copy?” And I said, “No that's okay, thanks.” And Allison goes, “He's the author!” And it was fun. It was fun.

But I would love for your support, and for that, in recognition of you supporting me by preordering the book from Barnes and Noble, the paperback copy from Barnes and Noble, I am giving away one month access to my brand new mock interview platform, and lifetime access to my thirteen part video series on the medical school interview.

So if you would like to check into that, you can text ‘PREORDER' to 44222 and I'll also give you instructions in that email that comes on how you can enter to win one of fifty copies that I'm giving away. The contest for that ends on June 4, 2017.

So with that said, I am super excited about today's guest. Somebody who started in this world, it seems we've had a couple guests recently, or Sarah will be the second guest recently that came from a nursing background, and why now she is transitioning into wanting to be a medical student. So very interesting journey, and some interesting questions. I know it's been coming up- it came up once recently, somebody asking about a nurse transitioning to medical school, and how other nurses will treat that nurse turned physician. And so I actually talked to Sarah about that in this episode. So if you're interested, if you're a nurse thinking about making that transition and you're worried about how your colleagues are going to react, take a listen and see what Sarah says.

Sarah, welcome to The Premed Years. Thanks for joining me.

Sarah: Hey, thanks for having me.

Dr. Ryan Gray: Thank you for taking some time out of your busy schedule preparing for Step 1. Crazy time, so excited.

Sarah: Oh yes, thank you. No problem. No problem.

Dr. Ryan Gray: So you're in medical school now.

Sarah: Uh huh.

Meeting Sarah

Dr. Ryan Gray: But was medicine always- being a physician always something on your mind? Because you were a former nurse.

Sarah: Right.

Dr. Ryan Gray: I guess once a nurse, always a nurse.

Sarah: Absolutely. Yeah so I never thought medicine- I always thought, ‘Oh I'd love to be a doctor someday. That would be great.' But then there was a lot of self-doubt. They say that you're your own worst enemy, and that's so true for me. And I believe like I'm a little bit older, so I'm 34. I know I'm not that old, but I was a little bit more traditionally raised, so I thought being a girl, nursing is my automatic path into the world of medicine. But as I worked, and got into nursing, and into critical care, I realized, ‘I really want to do what these surgeons are doing, and I think I could do it.' So I went back and took some classes, and here I am.

Dr. Ryan Gray: Wow. So let's rewind a bunch.

Sarah: Sure.

Dr. Ryan Gray: So you were interested in healthcare. What initially drew you into healthcare to begin with?

Sarah: My dad probably was a big person that propelled me into that direction. He's an engineer and always had his hands busy doing stuff, which meant woodworking, and he'd hurt himself, and he'd come up to me and be like, “Nurse Sarah, come fix this wound,” and put me to work. And then so that started my piqued interest, and then of course ER came out with like the original Dr. McDreamy of like George Clooney and all them.

Dr. Ryan Gray: Oh yeah.

Sarah: So I remember seeing that and I was like, “Oh my gosh, when people are at their worst, we can be there to help them.” I've always been kind of a helper and a caregiver.

Dr. Ryan Gray: Yeah. So your dad, Nurse Sarah, do you remember any specific conversations where you were kind of pushed into nursing?

Sarah: Not in particular. I was not the best student in high school. I'd say I'd call myself like more a delayed bloomer in a nicer way of putting it. But I think that it wasn't even on my horizon going into medical school, and nursing had- when I was going to school, Associate's degree in Nursing was the way to go. And I'm like, ‘Well a couple years of school, I'll be able to like help people which I want to do, and have a great job.' So I was like, ‘Alright let's give this one a whirl.' So that's how it kind of started. I didn't want to go into like pharmacy, or physical therapy, because I wanted to like be the one- nurses I think are the Jack or Jill of all trades. We do a little bit of everything, and that part excited me.

Dr. Ryan Gray: Yeah and it's hands on patient care versus being a pharmacist or something where you're touching drugs all day long.

Sarah: Right, exactly. I love talking to people, and being around them, and the whole holistic picture of patients.

Second Guessing Nursing

Dr. Ryan Gray: Yeah so you go into nursing. Anytime during your nursing career, were you second guessing what you were doing at that point?

Sarah: Yes actually. So my ride into nursing was not easy. I had to like teach myself math, but like I said I wasn't doing very well in high school, and so it's a rough ride into nursing and I had to go through an academic advisor to kind of help guide me along my path, and like what classes I should take, and in what order, and things like that. So in nursing I saw my first open heart surgery in nursing school, and that was the coolest thing to me. The surgeon goes, “Look at this. This will probably be the last time you ever see a human heart get stopped on purpose.” And I'm like, ‘I don't know if that's the last time because I'm really interested in cardiothoracic surgery.' So I talked to my academic advisor one day, I'm just like, “Hey I think I want to go to medical school.” And I was about a year into nursing school, she goes, “Sarah slow it down. Just finish. First things first, we got you to this point, just finish this first, and then we can talk about the rest.” So yeah I started with that. I actually left the college after I graduated, had a job, and my nursing manager-

Dr. Ryan Gray: Well let's stop there.

Sarah: Sure.

Dr. Ryan Gray: Why did you not re-engage as soon as you like graduated nursing school? Why didn't you just immediately apply for medical school, or go back and get whatever pre-req's you were missing and then apply to medical school?

Sarah: I think there's a couple reasons for that. I got married shortly after, and kind of established my personal life a little bit more. And then I wanted to like work a little bit, save some money, pay off some of my student loans, and then go back into school again because I would have to go back and get my biology degree. But also I wasn't 100% certain that I could still be a doctor. I was still kind of self-doubting, so that kind of held me- kept me in nursing for about a year and a half before I started moving forward.

Dr. Ryan Gray: What were you telling yourself? What were the words you were using for the self-doubt? Was it more being a female physician? Was it more being able to handle the rigors of medical school academically?

Sarah: I would say academics. And my thing is, like I said I'm a very nontraditional student. I didn't do the highest scores in school, and I didn't get the highest scores on most everything, and to me I was like, ‘Well in order to be a doctor you have to be a 4.0 student, and you have to have like everything aligned, and the stars align, and all that.' So I thought that my background wouldn't be appreciated, so that was my biggest hindrance, is I was like, ‘Well I came from- I didn't do the best, so they only want the best, so I'm not good enough.' You know?

Dr. Ryan Gray: Yeah. Alright so you take a little detour in life. At what point in your career did you finally say, ‘Okay now is my time'?

Pushback from Physicians

Sarah: So shortly after starting nursing- so I went into critical care, which is a very hard area of nursing to get into, and sort of master, and I don't think anybody ever masters it. But my manager was there and she was just feeding me, like whatever I wanted. I'm like, “Oh my goodness, I want to take care of a really sick septic shock patient today. I want to learn how to manage that, or I want to do this.” She's like, “Let's go, let's do it,” which is not always the case in nursing. There's like a term that nurses eat their young, so I got very lucky that I had such a strong person and a good mentor for me. And I said to her, I go, “You know I was always thinking about going to medical school, I want to be a surgeon.” I'm like, “Don't laugh.” She's like, “Why would I laugh?” She goes, “You should do that.” She goes, “Sarah, I fully believe in you.” So it was having a mentor that completely supported me and wasn't self-doubting because I actually found that a lot of physicians I worked with were the ones that were saying don't do it, so it made me a little apprehensive, but she really pushed me forward, and she really instilled the faith and saw things in me that I didn't see in myself.

Dr. Ryan Gray: So the physicians were saying don't do it. Were these cardiothoracic surgeons that were saying this?

Sarah: No, it was a general array of doctors, and I think some of them were- you know how in any profession you have some people that are burnt out, or a lot of lions would be like, “Oh it's not the same as it used to be.” And I'm like, “Well I don't know how it used to be and how it changed.” And then I realized, I go, “I don't ever want to be 60-something years old and sitting there and just regretting that I never did something that I wanted to do.” I wouldn't want to sit there with that thought on my mind. So I said, “You know what? I've got to go for it.”

Dr. Ryan Gray: What was the harshest thing a physician ever said to you as you revealed your secrets?

Sarah: Oh boy. Oh the worst part is, because you know I'm woman was, “How are you going to have kids? And you're not going to be able to have a happy life. Something's going to have to give.” And I'm like, “Oh.” I'm like, “Okay, how are you doing it?” You know? So the harshest thing was more like the older- the generational differences with the physicians that were older still seeing my role as being more a stay-at-home type person, which they're like, “Nursing is great because they have the great hours, but how are you going to have a life? You're never going to have a life. Your life is over.” I'm like, “Oh my goodness.”

Dr. Ryan Gray: I'm assuming these are male physicians that are saying this?

Sarah: Yes, yes.

Dr. Ryan Gray: Of course. Giving men a bad name.

Sarah: They're not all bad, we need our advocates.

Seeking Out Mentors

Dr. Ryan Gray: So you found a mentor with this nurse supervisor that you had who finally was a voice for you that believed in you. Did you have anybody else in your life that believed in you and was able to support you through this?

Sarah: Yes, so shortly after I was speaking with my nurse supervisor about that, a new trauma surgeon started at our job, and found out that she was a former nurse herself in critical care. So she was amazing. She met with me one-on-one, helped me like draft my personal statement. I saw that she could do it so it was more tangible for me.

Dr. Ryan Gray: Yeah she was somebody that obviously looked like you being another female, but also coming from basically the same exact background as you.

Sarah: Right which is very rare to find. It's hard to find the nurse turned doctor.

Dr. Ryan Gray: Yeah. Did you find that she had a lot of the same reasons for going into becoming a physician?

Sarah: Yes, yes it was a very similar story. Because we had discussed- she said, “Why not nurse practitioner? Why not nurse anesthetist?” And we just both agreed that it wasn't the leap we were looking for, and that we wanted to be the ones to make the full discussion and carry all that- you know what I mean. We wanted to be the ones that are the shapers of the plan of care for the patients, and that role.

Deciding to Pursue Medical School

Dr. Ryan Gray: So talk about that a little bit more in depth. So a nurse that's listening to this right now who's looking at all of these avenues from PA to NP, what was it about those roles, these so called ‘mid-level' providers that wasn't enough for you?

Sarah: Yeah and I hate that term, ‘mid-level' providers, but that's what a lot of hospitals use. But the reason that those were not the avenue for me, is I've worked at several different locations. I've worked at several different locations, I've worked from a community hospital to academic centers in different states and things. And their role varied from hospital to hospital, practice to practice, state to state. And in one place our nurses couldn't even interpret if an NG tube was placed properly on an X-ray, in another state this and that. So the autonomy varied based upon practice, based upon hospital and state, and I didn't like that. The thing is, is another reason kind of why I went into this, is as a nurse you take these orders from doctors, nurse practitioners, and other things, and you can question them, but in the end if you don't agree with something it's really hard to stomach that. You know what I mean?

Dr. Ryan Gray: Unless there's like some patient harm that's going to happen, right?

Sarah: Right then we're the protectors, we're like, ‘Absolutely not.' But you know sometimes we have a little bit more of a sixth sense sitting at the bedside all day that can't be conveyed any other way to certain people. So not having that like authority and the ability to do those things, and to be told, “No you can't do that, that's not within your scope of practice” is not something that I was looking for.

Dr. Ryan Gray: Okay, that makes sense. Was that something- let's kind of fast-forward to interviews and discussing your background during interviews. Was that something that came up, of questioning this leap into becoming a physician and why not NP, PA?

Sarah: Every single interview I was on, that was one of my questions. So if there's something that nurses going into medicine, they need to prep on, would definitely be that question. Is you need to know why you didn't, and it needs to be a good reason, not just ‘I want the fame and glory.'

Dr. Ryan Gray: What fame and glory?

Sarah: I know, right? I'm recording from my private yacht right now. I'm just kidding. No but you know, you need to know why, and to have that self-discovery, and have that introspection and maturity that comes with a decision like that, and to be able to articulate that clearly to those interviewing you makes them understand and look inside of your rationale and why you chose that. They want to know that you're doing it for the right reasons, and that you've looked into other avenues.

Dr. Ryan Gray: Yeah. So let's talk about your reasons. I don't think we really dug into a lot of specifics. So a lot of the reasons that I hear from students that are making this leap, even coming from an NP or PA to medicine, is discussing- like I, the person that's making this career transition, I need more information. I want to know more of the pathophysiology, more of the anatomy, and everything else that's going on. Is that a good reason in your mind? And what were your reasons?

Sarah: I think that's part of a good reason. I think that that is definitely about 50% of what mine is, is I can't get enough. I loved, as a critical care nurse, learning the pathophysiology of things, but I still feel like I only brushed the surface. And medicine, now entering my third year, has taught me to levels that I wouldn't even imagined or sometimes wanted to go. No but has really- that knowledge and always that passion to learn more and the ‘why' of things has always been a big component, but not enough. I want to actually use that knowledge to formulate more holistic plans for my patients, and provide plans of care that I'm fully behind and I believe in, and I want that autonomy to do so and use that amazing knowledge that we get. So the knowledge is definitely a huge component of why I entered it, but not the entire portion of the pie I guess you'd say.

Dr. Ryan Gray: Yeah. Perfect, perfect answer because what is missing from just the knowledge part, which is all focused on you, is that patient care. How are you going to turn that knowledge into something that benefits the patient? And so the way that you formulated that is great.

Sarah: Right and that- if all you want to do is learn something, then you could go into other areas. But the reason that separates doctors and nurses from other people is this drive to apply it directly in hands-on patient care. So having that in your answer and your heart when you're answering these questions is definitely the right way to approach it.

Dr. Ryan Gray: Yeah. And let's be honest, in our information age, if you want more information you can go and find it. You don't need to go to medical school to do that.

Sarah: Exactly. I mean now there's like courses online that are taught at these Ivy League schools that you can access for free. So it's not a matter of not getting it easily, you can get that.

Dr. Ryan Gray: Yeah but what are you going to do with it? So that's great.

Sarah: Exactly.

Turning Negative Interactions into Positive Experiences

Dr. Ryan Gray: So it's interesting, I've heard a couple things from you from the discussion about disagreeing possibly with some physicians’ orders, and then when you were talking about using that new information that you're learning now to create plans that you agree with. It sounds like there's some encounters that you've had in the past of some negative experience with physicians. How did you go about talking about those in your interviews, or did you try to avoid those types of interactions?

Sarah: I didn't try to avoid those interactions, but the way you have to address them is you learn from every interaction you have. So whether it be positive or negative, even during my negative interactions, there's something I took away from it. Even in the heat of the moment when you're angry and all that. But to take it and turn it into a positive light is always the way you should go in life in general. And I've had differences, many differences in opinion. I'm a Chicago girl with a big mouth, so I do not hold back, and I advocate very strongly for my patients. So you're always bound to come across conflicts, and that's something that's always happen in your career, and you need to convey that to the people interviewing you because they need to know that you can work with people, and that you're willing to also listen when there are conflicts, and try to figure out a resolution together. Sometimes that doesn't always happen though, you know? So those make interesting stories, and they will push for those. So when they do push for those, make sure you take your positive spin on it, and think about it, and how you grew from it, and how you appropriately problem solved.

Dr. Ryan Gray: Yeah don't just blame the other person and say, “It was all his fault. Nothing good came from it.”

Sarah: “I don't think he slept the night before. Yeah he was cranky. I didn't do anything wrong, I never do anything wrong.” And they'd be like, “Okay red flag.”

Dr. Ryan Gray: Perfect, I love it. So what is the timeframe that you were looking at when you finally made this decision and be like, “Okay I'm ready to go back and do this.” When was this?

Sarah: So I was about a year and a half into nursing, and I met with an academic advisor at a four year institution, and we laid it out. He told me when I would graduate from that, when I would take my MCAT. So it was really cool in that first meeting to have my plan laid out like, “Okay so you'll take your MCAT this summer, this summer here, and you'll do this and that.” So that was the right first step.

Combining Medical School with Working Full-Time

Dr. Ryan Gray: Definitely meeting with an advisor is great. Were you able to continue working as a nurse and go back to school? Were they flexible in building a schedule around you?

Sarah: Yeah so there are different avenues as a nurse, and the one I used was what we call Registry. So I had more flexible scheduling, I didn't have to schedule 36 hours a week, I didn't have to do certain times. So I worked probably- I worked every single weekend in school, so 24 hours at least, and then I would sometimes pick up an eight hour shift from like 3:00 to 11:00 because it's hard with four year institutions because they have traditional hours of school and not everything's available online. So I had to get creative, but nursing is the perfect avenue for that because there's always different hours you can pick up. So nursing is super flexible, but always focused on keeping those grades up because in the end, all you care about is the money aspect, then you might have to give up some of those great scores and that might hinder you in getting into school.

Dr. Ryan Gray: Yeah. So what if a student listening to this is transitioning from one career to another, not nursing, and doesn't have that flexibility of just piling on some weekend hours? Why did you look at a four year institution and not a community college that was maybe a little bit more flexible schedule-wise for you?

Four Year Institutions Versus Community College

Sarah: So I think what some med schools won't tell you is an A from let's say a top ten school versus an A from a very small community college, they might take different weights with those. So I saw it as a way to prove to them that, ‘Look here, I went to a good school and I did very well there.' There are ways with nursing that you can- I took part-time classes, you could do that. Because nurses for full-time, it's only three days a week. So I mean they're long days, don't get me wrong, but there are different ways you can go about it part-time. You can get student loans to help offset your living expenses, and that is something I took advantage of a little bit. So there are different financial avenues to help support you during getting your advanced degrees and things.

Dr. Ryan Gray: Yeah, okay so I want to challenge you a little bit.

Sarah: Okay.

Dr. Ryan Gray: Have some fun. The comment about what schools won't tell you, and looking at some higher institutions, four year institutions versus community colleges. Where did you obtain information like that?

Sarah: I obtained information from meeting with different admissions advisors, and also from doctors that served on admissions committees. So this had been- I'm a big proponent of networking and meeting as many people as possible and getting information. So most of it came from like off-the-cuff conversations from individuals I got to meet over the years. Because my path, getting my Bachelor's degree took me about three years part-time, so over those years I'd gained a lot of different alliances with people and was able to get some off-the-cuff information like that. So yeah, it was not something they advertised.

Dr. Ryan Gray: Yeah and it's always thrown around on the Internet and different websites and stuff, and I agree to some extent with it. I think a lot of students- the reason I wanted some clarification, I think a lot of students will look at two different four year institutions and look at one that maybe they're not excited to go to because they think it's going to be a bigger hit on their medical school application, it's going to be looked at more favorably. And so a lot of the discussions I have with students are around those types of scenarios of like- look the name, once you're up to a four year school, unless you're talking Harvard versus some four year podunk university in Alabama. But across the board there's so little variability for most students to worry about it.

Sarah: Right and if you go to a smaller four year school, it's okay. As long as you performed decently on the MCAT, or have a great background that augments that, they look into you as a holistic candidate- or should. But definitely I think that taking more courses at a two year school versus the four year, I agree with you that most four years are going to be okay. So don't go pay $80,000 a year in tuition when you can pay a lot cheaper and get a decent education.

Dr. Ryan Gray: Don't cancel your acceptance right now after hearing this.

Sarah: Yes, exactly.

Dr. Ryan Gray: So it's awesome, it sounds like from the get-go once you made this decision, you surrounded yourself with people that could support you, and advise you, and guide you. Nothing though prepares you for starting medical school, and what that is like. Talk about that transition from going from working as a nurse, and doing your premed classes, so being kind of full-time times two, although you were part-time classes, and then starting medical school. What was that process like for you?

Sarah: So I came into it- you know you hear people complaining about how hard the first two years of med school year are and they are awful. But I was like, “I've got this. I've worked two jobs, I've went to school, I've been an ICU nurse, I can handle stress, and I'm perfect, right? I'm going to be just fine.” Oh boy it's still stressful and you still need a very good strong support group around you because it is not like anything you've experienced before. And the analogy drinking through a firehose couldn't be more perfect, and I didn't truly grasp what that meant until I started medical school.

Biggest Challenges of Starting Medical School

Dr. Ryan Gray: What was the hardest thing for you?

Sarah: The sheer vast amount of information was one thing, but I think also like I said I'm a very social person, and switching from being able to study with friends and get together more often turned into more ‘I'm living in the library alone with my noise canceling headphones on.' So the anti-social portion of it with having to be in the library for long hours, longer than I'd been used to in the past, that was quite the adjustment.

Dr. Ryan Gray: Yeah.

Sarah: I'll spend the entire weekend in the library no problem, versus before where you'd just spend four or five hours a day.

Dr. Ryan Gray: Well you asked for that knowledge and they gave it to you.

Sarah: I did. Oh they did.

How a Nursing Background is Helping in Medical School

Dr. Ryan Gray: Do you think- or what aspect of being a former nurse has so far helped you in these first couple years of medical school, if any?

Sarah: It has helped quite a bit. There are life lessons that you learn, ways to talk to people, how to handle stress in general because we have some of the- nurses have a very stressful job. That has helped prepare me. Not only that, I've taken on some more mentorships towards my fellow classmates and was able to help tutor some of them through different portions. Especially pharmacology, nursing has really helped me because I know the names of the drugs, the dosages, and what we use it for. This wasn't all new to me.

Dr. Ryan Gray: Just being able to pronounce them is a win in medical school.

Sarah: Exactly, yeah. So yeah that part definitely helped, and also just like I said, when I went out- at my university within a couple weeks were already in a clinic starting and seeing patients, versus my other peers. The surgeon I worked with said, “You are lightyears ahead of these other students that I work with. You already act like you're an attending as far as your comfort level,” not my self-confidence. But you know, so that will definitely be in your favor. You know how to handle difficult situations, if a patient yells at you or whatever, you can roll with the punches instead of being freaked out like, “Oh my gosh, the patient doesn't like me.”

Dr. Ryan Gray: Has there been any awkward situations where you're interacting with an attending or residents or whoever, and you like slip back into Nurse Sarah and be like, “Oh wait a minute, I'm a medical student. I can speak up or do something differently here.”

Sarah: Yeah so I was in a room once and the patient's NG tube, which is- well I guess if you're listening to this you might know a thing or two about what an NG tube is. But it was dangling by a thread and I wanted to like go and tape it back on the nose, and I should have spoke up about it, but before I could it already had fallen out and it was just me and the doctor in the room. And the nurse got mad blaming us that we did it, and I was like, ‘Oh man.' So there's times where like I want to perfect something or change something, but it's not the scope I'm in. So I shadowed infectious disease, and there was a patient there that was in shock and I was looking at the vitals, and the management, and I was like, “Well we should probably do this and that,” and he's like, “Well that's great but we don't do that portion of this care. We can recommend this,” and I was like, “Oh my gosh this is hard for me.” Because I'm used to the all over patient management, you know?

Dr. Ryan Gray: It sounds like that would be helpful though, maybe in the future when you're a little bit more autonomous, and interacting with the nurses and the rest of the staff because of your experience.

Sarah: Yes it definitely will be. It's going to be hard navigating when working with other residents and fellows to not come off as over-confident and a know-it-all, trying to balance it out a little bit because they're the ones grading you, and they're the ones that are teaching you, and you have to be humble but also learn how to speak up and recommend different things in a way that's not coming off as abrasive or a know-it-all. You know what I mean?

Negative Treatment after Transitioning from Nursing to Medical Student

Dr. Ryan Gray: Do you think- there's a lot of fear that I've heard from some nurses that are interested in making this next step, the fear of once you are a physician, being treated negatively by other nurses because you're now not one of them, and you wanted to be a physician, and nursing wasn't good enough. Do you think that's going to be an issue?

Sarah: So it's funny you mention that. That was actually one of the hardest things I dealt with, and actually as a nurse still working, even mentioning that was a problem for some people, and I had a lot of negative feedback from certain individuals. And that was really hard to deal with because I was like, “Well no I'm still a nurse, I'm always going to advocate for my nurses, I'm still part of this team, I'm not leaving because I don't think nursing is good enough, it's just not the road for me.” So I think that's something you'll experience as a nurse working trying to go to medical school, so you have to be very careful with who you tell and who you surround yourself with, because that is definitely going to be an issue. I think as an actual physician practicing, the nurses always spoke highly of the physicians that were nurses before. They'd say, “Oh yeah, Dr. This and Dr. That, they used to be nurses, that's why they're amazing.” So you get a little bit of street cred from that. I think the harder part is when you're actually making the transition, I don't know if some of the staff will be challenged by that and not full understand why you're making that change.

Application Process as a Former Nurse

Dr. Ryan Gray: Okay. Your path, we skipped over a big part of your path, and that's the application process. What was it like for you having applied to nursing school, got to nursing school, out working, and now laying what seems to be your life on the line, and just spilling your guts in your essays and everything else. What was the application process like for you?

Sarah: It was a lot longer than I anticipated. You know you think it's like, ‘Okay I'm going to write a personal statement, and then I'm going to submit this stuff online, and this and that, and the MCAT.' Well I took the MCAT twice, and I won't be shy about that because it's a big test and I wanted to make sure I performed at the level I wanted to because I didn't want to be hindered going forward with what kind of schools picked me. But it was a very arduous process, and a lot more than I thought of, and it took more time than I thought. So if you're thinking of family planning, or you're dating somebody and you're giving them realistic expectations as far as how long these processes take, always consider that it could take another year or two before you actually land in med school. Because I didn't know about rolling admissions, and that you only get accepted during these times, and that the whole application process itself takes X amount of time. So do your homework on that before you apply. And then also the personal statement, you'll write that thing- I can't even tell you, maybe ten plus times over before you get it right and get so many eyes on it.

Dr. Ryan Gray: Yeah some of the students I'm working with are on like draft fourteen or fifteen right now. So it takes awhile.

Sarah: It does, and that's a critical portion of the application, is get yourself across so they don't just toss your application side and you're just not sounding like the rest of everybody, “Oh I just want to help people.” Okay that's great but what sets you apart is what you have to talk about, and being a nurse is very favorable, and you should definitely draw upon that in your application process.

Dr. Ryan Gray: How did you choose what schools to apply to and ultimately where to go?

Sarah: So schools to apply to, I looked on- I think it's called- I can't remember the name.

Dr. Ryan Gray: MSAR.

Sarah: Yeah, MSAR. So many acronyms. But I used that to look at like demographics. I wanted a school that appreciated diversity and I'm at our school right now which is amazing for that. I wanted someone that looked at nontraditional students more. I didn't want a program that was- I didn't want anything that felt toxic or you didn't feel at ease when you were interviewing there. I wanted them to feel like- or I wanted to feel like they were looking for the right candidate, and that they were invested in me already, and that's why they gave me the interview. So schools where I didn't feel that, I wasn't as excited about attending, but I've got to say that the school that I'm in now is like the perfect fit.

Dr. Ryan Gray: Yeah that's awesome. It's good to find that. Was that something that you found prior to applying just from looking online? Did you take a visit to the campus before you applied? How do you get that feel before you actually interview there?

Sarah: So I actually worked there, which I highly recommend if you're in academics as a nurse and they have a medical school. Network away with that because that is really what helped me out, and I met our Chief of Surgery who worked with me as a heart transplant surgeon, and got into the whole process with him, and I brought my concerns to the table like, “This school is very good, I don't know if I fit all the-” what's that acronym again?

Dr. Ryan Gray: MSAR, yeah.

Sarah: Yeah MSAR. I'm like, “I don't fit all the perfect numbers with MSAR,” and this and that, and he goes, “You know what Sarah?” He goes, “We are a school that prides ourselves in diversity and having different candidates, and your application is very unique, and we can see the value in you besides these numbers.” And that to me was perfect. So I think you have to get a feel for the school by actually going there, and definitely reach out to an admissions advisor while you're starting to take courses, to reach out for guidance especially the school you're interested in attending.

Dr. Ryan Gray: Yeah, one of the biggest mistakes I think students make when looking at schools, is they look at those stats. They look at the average MCAT, average GPA for the schools in the MSAR, and the College Information Book for DO schools, and the one thing that isn't really taken into account even though it's completely obvious, is that those are averages. And half of the students that are admitted are below that average, and half are above.

Sarah: Exactly.

Dr. Ryan Gray: It's only one small piece of how you should be looking at a school. So I loved your discussion there about that.

Sarah: Right, right.

Most Rewarding Part of Medical School

Dr. Ryan Gray: What has been the most rewarding part, now that you're on this side in medical school, the most rewarding part that maybe you didn't see coming?

Sarah: Oh there are so many interactions, it's hard to even say. You know I think like one of the times I was sitting in there, I did my rotations for my first two years of med school in a surgery clinic, and I had an older couple there, and the surgeon introduced me as, “Hey this is Sarah, she's going to actually be a future heart surgeon. Isn't that pretty cool?” And the woman looked at me and she goes, “You know,” she goes, “I am so proud of you.” She goes, “There are not many women entering this field and I am just so proud to see that a woman's entering this, and something I would have loved to do myself when I was younger.” So that part was really neat that someone was like- I don't realize how special this is sometimes. You don't take it for granted but you're like, ‘Yeah I'm going to be a doctor.' That's great and all, but I don't have a God complex. So when someone says something like that it really touches me because it means that I had an impact on them, and that they were proud of me. It makes you realize how far you've come in this journey and it's just- it's full circle. I mean I ran into that Chief of Surgery that was my mentor at a national conference I got a scholarship for, and he saw me as a now entering third year of medical student. So those moments are like profound to me because you come full circle and you can see yourself sitting at their desk as a nurse, scared about what school you're going to get into, and now you're at a national conference with them enjoying a glass of wine together.

Dr. Ryan Gray: That's awesome.

Sarah: Yeah.

Words of Wisdom to Healthcare Professionals Looking to Make a Change

Dr. Ryan Gray: So Sarah, what final words of wisdom do you have for the nurse out there, or other healthcare worker looking to make the leap but is scared about the process, and the time commitment, and the financial commitment. What do you say to them to let them know that it's completely worth it?

Sarah: Don't ever let yourself doubt yourself. But the other thing is, is you're going to be old one day anyways. You're going to grow older. Don't worry about the time and the things that you have to sacrifice to go into it because in the end everything you do is going to just mean so much more than any of those momentary stresses. And I say that was my most important thing was sitting next to a 60-year old taking a calculus class with me. She goes, “I'm going to be old one day, but I want to be old doing what I love and have no regrets.” Don't let time, don't let any of those other stressors get in between you and your goal. You can do it, I've done it. I changed and turned my life around, it's never impossible, just know that- just put your blinders on and go forward.

Final Thoughts

Dr. Ryan Gray: Alright there you have it, Sarah, nurse turned medical student and on her way to wanting to be a cardiothoracic surgeon which is pretty awesome. So thank you Sarah for taking some time out of your day, I wish you the best moving forward.

I want to remind you if you would like to enter to win a copy of ‘The Premed Playbook: Guide to the Medical School Interview,' you need to text ‘PREORDER' to 44222 and I will give you instructions on how to preorder, and I'll also remind you about preordering the Barnes and Noble book, and what you can get with that. So again, ‘PREORDER' 44222.

I hope you have a great week, we'll catch you next time here at The Premed Years where I talk to somebody who is very, very well-informed with healthcare, and the policies and bills that are being pushed through. She has a podcast all about reading the bills that are going through Congress. And so I brought Jen on to talk about that so that as you prepare for your interviews, you'll have a little bit of a better understanding of what is going on in this world, in the healthcare world here in the US, to give you a better idea of how to talk about it in your interviews. So hopefully that will be helpful. Again that's next week here at The Premed Years. Have a great week, we'll see you next time.

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