K.C. Interview

K.C. is in the second year of medical school at Rosalind Franklin University and answered these questions about being a med student in January 2011. I’m Dan Copulsky, and K.C. is my partner. We are both bored of the question (and all its variations) “what kind of medicine do you want to practice?”

How long does medical school take? When do you become a doctor?

Medical school is traditionally four years long. The first two years are mostly spent in the classroom taking graduate-level science courses that are relevant to medicine. There are also some labs, and different schools offer different amounts of exposure to real patients and/or “standardized patients” (paid actors who we practice physical exam skills with). The third and fourth years are spent in hospitals and clinics learning more about different medical specialties.

After passing those four years and the standardized U.S. Medical Licensing Examinations, we get M.D. degrees, but we can’t practice independently until we’ve gone through a Residency program in the specialty we’ve chosen. Residency is intensive, supervised, on-the-job training, which is three to seven years long depending on the specialty.

How often do you have class and how often do you go?

My school usually has three to four hours of classes per day five days a week, often with a few hours of lab every week.

If there’s a lecturer I think is really good, I’ll go to most of his or her lectures. I think most of our lecturers are pretty terrible, so I only go to class for a few hours every week. If I don’t understand something in the notes, most of our lectures are recorded, but the notes are usually more thorough than the spoken lectures, so that’s unusual. My labs are all required.

Do you get grades? Have tests? What about homework, projects, or other assignments?

This varies a lot from school to school. Lots of med schools are Pass/Fail and some of those will also give honors. My school gives A, B, C, and F. No plusses or minuses or D’s. Grades for most classes are determined by block exams which happen every 3 weeks (this also varies a lot from school to school).

We don’t really have homework. Most people need to study for a number of hours every day to pass the exams. We have a handful of classes that require posting to an online discussion board or doing a write-up of a patient interview, but assignments like that are pretty infrequent.

What’s your impression of medical school’s ability to prepare students to be good doctors?

I can’t really answer that yet. The first two years provide a good knowledge base, but a lot of the students spend most of their time holed up in the library, and I think a few too many of them forget how to interact with other people. Since most of us are going to spend a whole lot of time interacting with people as doctors, it doesn’t seem like very good preparation to me. I guess, if nothing else, we’re learning stamina.

I’m assuming that third and fourth year will be better for learning how to interact with patients, and we’ll definitely learn more clinical skills.

I’ve heard that despite all this, we’re going to start residency and have no idea what we’re doing for a while. But I’d imagine it would be much worse without the basic introduction that medical school provides.

What’s the discussion of health care reform like inside medical school? How much do people talk about it? Do opinions tend to go in certain directions more than in the general public?

It’s a fairly common topic of discussion. Professors make comments alluding to their opinions on the issue and student groups invite speakers who talk about reform from the point of view of the medical community. It seems to come up in casual conversation fairly regularly, depending on who you hang out with. We’ve had lectures in our clinical reasoning class and our preventative medicine/patient safety class.

I think the focus of the discussions tends to be a little different from in the general public. People talk about how reform will affect our ability to pay off our student loans, how it will affect residency program openings in different specialties, how it might affect malpractice insurance, how Obama’s plan is expected to change the model of patient care, etc. But most of the out-of-class discussion isn’t that different from the discussion going on everywhere. Students disagree about whether healthcare should be considered a right or a privilege. We talk about what we like and don’t like about the imminent changes, we talk about what we think will work and what we don’t think will work.

Most medical schools, mine included, have taken a general pro-reform stance and supported more radical reform than what’s now been approved. We have a few professors who have made it clear that they oppose reform, but most of our professors seem to support what’s happening.

What changes do you think we need to make to be a healthier country?

Plain and simple, everyone needs affordable access to preventative care. Catching and treating common problems like hypertension and diabetes early helps stop them from causing devastating complications later. Patients are more likely to follow through with lifestyle modifications and take their medications if they’re regularly checking in with a health care professional.

Going along with that, we need to learn to eat smaller portions of healthier food and to exercise. I know it’s easier said than done, but it’s really important—obesity and sedentary lifestyle have caused rates of diabetes to soar, along with death from heart disease, stroke, and many cancers. A few quick tips we’re told to give patients: prepare food from scratch at home whenever you can, eat slowly and wait twenty minutes before getting seconds if you’re still hungry, park at the edge of the parking lot so you have to walk farther to get to the store, shop mainly around the edges of the grocery store (fresh fruits and veggies, raw seafood and meat, low-fat dairy, fresh bread), and start exercising gently by walking thirty minutes three times a week instead of making unreasonable goals that you can’t live up to.

Do you have any suggestions for what people can ask to start conversations with medical school students other than what kind of medicine they want to practice?

I like being asked about interesting topics I’ve recently learned about. And about my professors—there are always good stories about professors.

Also, we shouldn’t give advice about your medical problems, but we learn a lot about normal processes and diseases, so if you want a thorough explanation about why something happens the way it does (e.g. How does ibuprofen work? Why do bruises turn green? How do vaccines work?), a medical student is a good person to ask.

What’s it like to be a medical student and visit doctors for your own health?

I feel like my doctors have more respect for me and give more thorough explanations about what they’re concerned about or why they’re giving me a particular medication. I think they’re also more upfront about it when they don’t know what’s wrong.

I always kind of feel like a hypochondriac when I go to the doctor now though—I worry about weird rare things that could explain all my symptoms and the doctor needs to remind me how much more likely it is that I have something common.

What do you tell people who ask for your medical advice or say something about their health that suggests they’d benefit from it?

I try to keep medical advice at a minimum, since I’m really not in a good position to be giving it. I can list off a bunch of things that might be wrong and ask some questions to make sure it’s not an emergency, but after that I usually tell people that they should see a doctor if it continues.

If a person with no medical training gives other people medical advice that’s blatantly wrong or controversial, I’ll say so and give an explanation. If someone gives other people advice that’s just a little off, I usually leave it alone or throw in a comment that nudges them in the right direction. I don’t like correcting people or pulling the medical student card, but so many people like to give medical advice and have no idea what they’re talking about. I draw the line when someone gives advice that could be dangerous or discourage someone from seeking treatment.

Are colds and flus sexually transmittable?

Not in the strict sense of “sexually transmittable.”

Once you’re sick with a cold or flu, other people catch it through your respiratory secretions. Every time you sneeze or cough or wipe your nose on your hand and touch something, you’re giving your virus a chance to find a new host. You won’t catch a cold or flu from sexual fluid, but being in bed with someone who has one of these very contagious viruses is a good way to catch it. If your partner coughs or sneezes, the virus is in the air, ready to be breathed in. If your partner hasn’t washed his or her hands since blowing his or her nose and touches your face, you’ve been exposed. If you’re really determined to avoid a respiratory virus, your best bet is to not spend time around someone who’s got one.

Send K.C. a message through Dan – dan@questionriot.com