Dr. Richard Beddingfield is a cardiothoracic anesthesiologist and author of Med School Uncensored: The Insider’s Guide to Surviving Admissions, Exams, Residency, and Sleepless Nights in the Call Room. We talk about his journey and what he learned along the way.
Richard was a nontraditional premed student. He only found out later in the game that he wanted to be a physician. Right now, he’s a practicing cardiothoracic anesthesiologist in Wisconsin.
I have five copies of Richard’s book to give out. To get a chance to win, leave a comment in the comment box below, specifically about what you’re most worried about surviving when it comes to medicine. Also check out our other podcasts on Meded Media Network.
[02:38] His Desire to Become a Physician
Richard was studying business back in college, majoring in Computer Information Systems. And he just happened to notice an advertisement for an event called Mini Med School in Michigan. It was six or seven sessions where the event would have some speakers from the University of Michigan. They would speak about a variety of topics related to medicine, specifically about a systems-based approach.
Initially, he never really considered medicine and he wasn’t sure if he was ready for that. So he was a senior when he went to the Mini Med School. He remembers being fascinated by learning about the human body and how it works, etc.
Meanwhile, he was enjoying his work in information technology. He was almost graduating at that time. He worked for another year or two. So the thought about medicine just got stuck in the back of his mind. To him, it was too hard for him to redo everything. And then he finally got the degree.
Then he started volunteering at a nearby hospital a couple times a week, few hours each time. He did outpatient surgery, pharmacy, and medicine wards. He was basically the same stuff volunteers do. But he took advantage of that opportunity by asking everyone he keeps in contact with – physicians, nurses, PAs, etc. He asked about their careers, what they’re doing, likes and regrets, what they’d do differently.
Then he started shadowing out of his volunteering experience where he met a couple of other physicians. He asked them if he could follow them around for a day.
And when he decided to so some prereq classes in the University of Minnesota he met someone who was in a similar boat. So they bonded well and his new friend helped him with his research project on health literacy. He’d go to the county hospital a couple times a week to collect data from patients.
So the idea of medicine was born during his senior year of college year in 2001. By 2003, he decided it was something he wanted to do; so he went back in the summer of 2003. And he started doing his prereqs.
Instead of doing a formal postbac program, he designed the courses to fit his needs. He was able to do some part-time work at nights too so he was able to help pay the bills. Then he took the MCAT in Spring of 2004.
[11:15] Transitioning Into Medical School: Struggles and Studying Techniques
Richard recalls it as a very intense studying period. He had been out only a year and he was glad it was not that long. He still remembered how to do it. So it was not as hard as when you’ve been out for ten years. When he was done with premed work and he took the MCAT. It was that point that he thought he was done for the time being. So was only able to focus on writing his essays and secondary applications and interviewing.
He was working in an office at that point and found the job so he could continue to pay the bills while going through the medical school application process. And it took almost a year to do it. For him, this was nice respite from all the studying.
Richard considers himself a good student, having come out of college with a good GPA. Though there were times he also had to work hard. But he believes almost everybody who gets into medical student is a good student. They frequently didn’t have to work extraordinarily hard to do that. You had to study and put in your time. But most people coming in never really had a point where they were just struggling to get by.
With his premed classes, he describes them to be very difficult, because he was taking all the sciences classes at the same time. And he was in classes with mostly freshmen and sophomores who are also still figuring it out.
Starting medical school, Richard says it was a different story. They started with an intense six-week straight anatomy course. And it was a different league. It almost consumes all your time. For him, that was the bigger transition point for him. But he was able to adapt to it by honing his study skills and managing his time well.
There’s no point in sitting there with an anatomy book or a book in your lap if you’ve reached that point where you know you’re just not acquiring anything more. It’s easy in high school or college but it’s different in medical school. Either you’re focused and studying. But if you think you can’t continue anymore, enjoy your life a few minutes and go back to studying.
[17:50] Second Guessing His Decision and Finding Motivation
Richards admits having second guessed his decision at many points. And he things most physicians, if they’re honest with themselves, will think about whether it’s the best decision nor not.
Like most people in medical school find, through college you’re usually doing quite well. In med school, there were classes he was good at and in some, he wasn’t or just average. It was those times that he had a little bit of self-doubt. This is not uncommon, considering you’re surrounded by so many talented and good students.
That said, it was just more of self-doubt rather than regretting doing it. Moreover, he describes pre-clinical years to be pretty challenging. You’re just sitting there, attending lectures, and taking exams.
To keep his motivation during those times, he stayed involved. He encourages students that in some point during the medical training process, to do some research. He actually put his name on a list of students interested in doing research. He realized he enjoyed being in the operating room and doing more procedural work. At that point, he was already considering doing Emergency Medicine, Anesthesia, and Surgery.
So he put his name on the list of students and he got paired up with a urologist who was doing research on kidney stone patients. He started doing it in the first summer between his first and second year. He spent a lot of time going to the operating room, collecting data and talking to patients. It means juggling research with your medical school responsibilities, but with proper planning, being with patients helped keep him motivated.
[22:19] His Thought Process in Choosing His Specialty
Richard was a nontraditional student and didn’t decide to get into medical school until years after graduating college. But it was more organic in medical school, as he would describe it. He enjoyed internal medicine as well as all the rotations. He took some more than others.
He recommends premeds that every time you start with a new rotation, approach it with much of a blank slate as you can. Try to not come in with any sort of prejudice. Say you don’t know much about it and see what this is. Who knows, maybe you’ll love it.
So Richard tried to be more open-minded and as result, he enjoyed different aspects of different specialties. But at the end of the day, he personally found that he was more willing to stay late in situations where he was dealing with more hands-on specialty or rotation. Emergency medicine was one of the early ones he dealt with and surgery.
Depending on how you medical school set up is arranged, some students didn’t have a lot of rotations until later in their second year. Unfortunately, you have to get involved in terms of choosing your specialty by starting at that point. As with University of Minnesota where Richard attended, they had a fairly flexible way of arranging their classes. He also knew from his volunteering and shadowing experiences as a premed that he enjoyed his time working with outpatient surgery and the like.
So from there, it was just more of deciding on the individual details. Number one, whether he enjoyed the work of surgery enough to do a surgical residency. He believes this is a big decision considering how consuming the specialty can be.
Alternatively, if you don’t feel surgery is something you want to do, then you have those other options like ER, anesthesia, and the like. So he just decided what practice setting he enjoyed the most which was working in the operating room. He enjoyed the medical side of it and just being in the operating room outside of the curtain for him, doing surgical work wasn’t as exciting for him. So he chose anesthesia.
[27:35] Dealing with Turf Wars
Richard has always been practical in analyzing things and having gone through private practice, he realized that the baits and questions about the turf wars are all over the place. They’re broader than anesthesia and CRNAs, which is typical example. Other departments go through the similar issues as well. For example, ER departments don’t have ER-trained people and they just have internal medicine or physician assistants manning ERs. Or you could have orthopedic foot and ankle specialists versus pediatrists. But at the end of the day, Richard was fascinated by anesthesia and the environment. So he started talking to more and more people.
Working with CRNA’s and physician assistants, he has seen a lot of options. And all he knows that at their hospital, the acuity of patients has increased at most big hospitals. The same is true in remote hospitals in rural areas.
Richard explains that they’re now routinely in the operating room working on people in their 70’s, 80’s and even 90’s. They’re doing heart surgeries on them or liver resections or lots of orthopedic care. These are sick patients. They require a lot of understanding of all the physiology going on with medicine. He adds that in general, there’s a place for all the different providers of care. At their hospital, he feels like their hospital has a demand for anesthesiologists. And the same with other fields. Most specialties have “mid-level providers” but that’s not reducing the demand for physicians. Because patients appreciate the education and experience physicians bring regardless of the specialty.
That said, we don’t really know what the future holds. But to bring this to full circle, Richard mentions this turf war has been talked about back in the 60’s and 70’s. In fact, one of the physicians during his mini med school experience who sort of became his mentor, he was a premed right when the Medicare Act was passed. And he was told not go into medicine since Medicare was going to ruin it.
Moreover, one of the interesting things is that it is changing so rapidly in terms of technology and treatment modalities. They are making some things possible now that weren’t possible at all even ten or fifteen years ago.
As a cardiothoracic anesthesia, he spends about third of his time at the hospital focused on cardiac surgery patients. And now, they’re having an increasing number of trans capillary and valve replacements. They are cardiologists at their hospital in conjunction with cardiac surgeons. They’re doing what used to be an open chest, open heart procedure, and aortic valve replacement. They can do it now in an hour and a half or a couple of hours under deep sedation. They apply local numbing medication in the groin and use catheters to go up and deploy new aortic valves. He can’t imagine that a cardiac surgeon 20 years ago.
This is completely changing and disrupting huge areas of cardiology and cardiac surgery just the way that stents did back in the 80s and 90s. That said, it’s difficult to predict since medicine is changing so rapidly.
At the end of the day, you just have to decide what do you really enjoy? Talk to some of the people in the field. Go ahead and hang your hat on it. As with Richard, he thinks he can get a good career of it. Patients are getting sicker. Procedures are getting more complicated.
[35:40] About Med School Uncensored
Richard realized he wanted to do a book during his senior year in medical school. He volunteered to mentor some premeds at the University of Minnesota. Particularly, he met a young premed for coffee, where he answered some questions the person had who was interested in getting into medical school. Then he asked him some questions about what they were expecting once they’re in medical school. So he thought writing the book was a great way to help premeds with the details and the logistics of how to get in. He wanted to reassure them about the different steps along the way. He thought there was something missing that tells premeds and early medical students what medical school is like.
So in the book, he talks about the premed process and some of the basics. But he leaves a lot of the details to other folks. What he really wants to get at is the big picture. What he imagined is if someone had an older brother or sister six or seven years older. They’re a premed and their older sibling just finished the process. And then you’re sitting down over some coffee or beer. So, he wanted an unvarnished reality of what’s it’s like in medical school and residency. Then he goes all the way through getting into fellowship and the pros and cons of it. And finally, the actual process of getting your first job – what you need to watch out for and what you can do through the process.
So, it was that interview with that student back when he was a high school senior. He didn’t have time in medical school to write a book but he found a little more time during fellowship. He started jotting down the Table of Contents or simply what to talk about. Then in between fellowship and getting his first job, he just set the ground running and wrote all his thoughts down. He wanted to get it while it’s still fresh in his mind where he still had that trainee mindset. He then began reading books on how to publish a book and the rest is history.
[42:50] A Message to Premed Students
Richards finds that premeds have the motivation and the drive. And the thing to remember is to try not to get bogged down on things like the turf wars and the like. Since the details are going to change. The training process to become a physician is so long. If you’re premed right now, you’re probably not going to be practicing until around 2027, which is about a decade minimum, assuming you’re doing a three-year residency.
When Richard started as a premed, nobody talked about the Affordable Care Act and so on. And people are going to talk about different things. Just remember why you want to do it and it’s what’s going to get you through. Of course, the desire to help people in the very intimate fashion. Those types of goals are what’s going to get you through the day. You can’t be distracted with what’s happening now because it’s changing.
He also remembers some students wanting to do medicine to find a cure to a certain disease. And he tells them it may be a little too specific. Because the time you’re out there, that might not even be an issue anymore. So just focus on your broad goals and what drew you in. For him, it was simply the fascination with learning more about the human body, how it works, the disease process, physiology, etc. And he always enjoyed working with people and having a job where he gets to interact with different people.
So whatever is drawing you to medicine, just hold on to that. Don’t get distracted with the political and economic stuff. You’ll figure it out some way. There will always be an opportunity for you. It may not look exactly like what you’re expecting right now but it will be there.
[47:11] Win a Copy of Richard’s Book!
Get a chance to win Richard’s book by leaving a comment below about what you’re most worried about “surviving” – whether that means the premed world, getting to medicine, getting to medical school, residency, etc. I have five (5) copies of his book to give out.
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