Confused and Torn Pre-Health Student

Nontraditional Premed Discussion
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I am going to try to keep this short because it is most likely similar to the other posts I’ve read on here. TL:DR at the bottom.

To start things off, I am a 24 year old combat medic in the National Guard (I like to call myself a hobbyist). I have one deployment under my belt where I treated over 300 trauma patients in an ATLS and OR setting. I was an integral part of a Forward Surgical Team, FST, and overall have loved my experience deployed. I have been fortunate enough to have the opportunity to do some really high level procedures compared to my civilian certification, which is a NREMT-B.

My plan out of high school was to go to some business school somewhere in NC. I was in Future Business Leaders of America and was thinking of pursuing something in the finance/entrepreneurship. I didn’t want to drain my parents financially so I decided to join the National Guard to pay for school. My choices at the time were mechanic or medic and I wasn’t the most mechanically inclined. I had a neighbor who was a pharmacist and I consider her my mentor she informed me about the field of pharmacy and I was hooked. Since talking with her after my combat medic training I have been working towards going to pharmacy school.

COVID-19 strikes and I lose my job as a pharmacy technician and my classes (as well as everyone elses) move online. I do get good news during this time as I find out I get into my pharmacy school of choice. I get covid-19 State Active Duty orders for the National Guard and was working full time for the guard during the summer semester. This is where my academics go poorly, I absolutely struggle through the second semester of college physics and have to ultimately drop the class and defer pharmacy school for a year.

During this year I am working towards completing the last two pre-reqs online and work as an anesthesia technician at UNC main hospital and I have been loving it. Working with the CRNAs, Anesthesiologists, and patients have been extremely rewarding, much more so than working as a pharmacy technician. I understand that working as a pharmacy technician and working as a pharmacist are vastly different in roles and responsibilities, but I am starting to have my doubts about the field of pharmacy. This is in part due to things I’ve heard from pharmacists in retail and things I’ve noticed from pharmacy forums on reddit. Watching the doctor of comedy on YouTube (a pharmacist that was fired due to being a comedian) I have also noticed that pharmacist salaries are starting to diminish (not that it was my biggest deciding factor but for the responsibilities and work that a pharmacist is charged with it doesn’t seem worth it).

Overall, speaking with the med students, residents, and attendings, I am starting to have doubts about my passions in pharmacy and am wondering if I would feel more fulfilled doing something that had significantly more direct patient care involved. My road blocks are the fact my grades suffered during the COVID pandemic and the move to online classes which are my weakness. I do not have an undergraduate degree and most of my 100 credits are from a community college. I am just looking for advice to see what my options are before I jump into the deep end.

Apologies for the short book and thanks for reading.

TL:DR
Soon to be pharmacy student had to defer for a year due to COVID and personal circumstances (poor excuse, I know). Starting to feel uncertain about the pharmacy field and wondering if other avenues in medicine would be a better fit. Drop in grades and lack of undergrad degree & no MCAT are barriers I have to overcome. Looking for advice on how I should approach possibly switching to medschool.

Thanks for reading my condensed version.

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Like many others will advise you, if you want to be an MD/DO badly enough, it will happen. Many schools are being more lenient than ever for grades that were obtained during the online transition, but unfortunately that does not mean that they are completely forgiven - bad grades are still bad grades. Thankfully, grades are only one aspect of an application, and are primarily used to, “get you in the door”. Everything else: ECs, references, research, clinical hours, shadowing, volunteer work, personal statement, secondary’s, interviews, etc., are what actually get you into med school. A GPA will get you invited to the table.

As I’m sure you know, nearly all medical schools have a cutoff GPA of 3.0, meaning anything less is automatically filtered out before any human deems it worthy/unworthy, regardless of how powerful the application is beyond GPA. Many school also look for an upward trend, because it means you are slowly understanding how to grasp and succeed at difficult course loads. While 100 credits from a community college is not ideal, it is probably not as bad as you think. As long as you take the majority of the upper-level prereqs at a university (biochem, Ochem1/2, etc.), you’ll be just fine.

For reference, I am graduating with my bachelor’s in nursing this April, and plan on taking the MCAT and applying this upcoming cycle. I go to a medical campus (nursing/med/pharm/pt/dental/PA/etc.), and have talked to a few pharm and PA students who were less than thrilled, and plan to apply to med school after they graduate. That being said, I have talked to far more pharmacy students who were absolutely in the right place, and couldn’t see themselves doing anything but pharmacy.

So, my questions would be…
Have you extensively shadowed physicians in multiple specialties (not just from your working military EMT background, like actually shadowed - including family care)? Have you done, or how do you feel about research? What is your overall GPA currently (higher than 3.0, upward trend minus this last COVID semester)? How do you feel about working 80 hour weeks for the next 1+ decades? What about physics was difficult (this is a weed-out course, and you really have to put in the effort to learn it - it can usually be algebra, not calc)? And, why medicine beyond “I want more direct patient care”?

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Firstly, I would like to thank you for your great reply.

Secondly, I will try to answer all of your questions in the order that you asked them for organizational purposes.

  1. Unfortunately, I did not need any shadowing hours for pharmacy school so I am sitting at a workable 0 hours. Also unfortunate is it seems like options to shadow are rare to find right now. I could ask some of the physicians at the hospital I work at to see if any of their colleagues are allowing people to shadow them.
  2. I did not need research for pharmacy school however, I am sure I could find something worth researching in NC. Thankfully I live in the Research Triangle Park area so there is not a shortage of labs around where I live.
  3. My current GPA is 3.2 which is greatly less than ideal. Before COVID wrecked havoc I was on an upward trend of 3.5-3.75/semester.
  4. I am fine with putting in the work for however long. I am a true believer of nothing ever worth doing was easy. This was something my drill sergeant said every so often during basic training and it has stuck with me ever since.
  5. Like a big fat dummy I decided I could take it online during the summer semester (with another class) knowing math is not my strongest subject. (no excuses) I was also doing active duty orders for the National Guard that ate up most of time (again no excuses). It was calculus based because the admissions office at the pharmacy school said that they preferred calculus based.
  6. I will share a story from my deployment that I feel like was a real memorable experience.

During my deployment, the Forward Surgical Team (FST) I was working with was seeing around 7-8 trauma patients a day (there were certainly times that we didn’t see any patients) and often times the patients showed up at the same time. This day was no different. The FST consisted of 2 MDs, a trauma surgeon and a general surgeon, a CRNA, a RN, and around 4-5 medics. I was going through the mass casualty procedures set in place, and it wasnt my first or last one, and my patient was pretty simple. He was an older male patient who had multiple penetrations/fragmentations in his upper back and his thighs due to a blast. After following the medics bread and butter, MARCH, I ensured that he had occlusive dressings, pain medication and was just overall comfortable. During this time he began to repetitively thank me, in Kurdish (which I dont speak. The interpreter told me what he was saying). Seeing the hope in his eyes and having him shake my hand as we loaded him into the ambulance/ minivan+ it was honestly something that touched me on such a deep level that I have been unable to experience working in retail pharmacy. A lot of the patients I saw working with the FST would not have made it to the main hospital, around 4 hours away, and I am truly grateful that I was given the opportunity to make a difference in those peoples lives.

One question I do have for you is: do you think it would be beneficial to retake OCHEM 1/2 at the university level if I have already completed them?

I look forwarded with conversing with you in the future.

Thanks,

Andrew

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Andrew,

As long as you did well enough in them (ochem 1/2), and can advocate in an interview for why you took them at a community college level, you honestly should be fine. Only the most nitpicky schools will care, so don’t apply to those.

As for your story, wonderful experience understanding the direct patient-provider union. So, why not nursing? You can make a difference, directly, just like in your story, you get thanked profusely, and you use science every day (I’m sure you see where I’m going with this). Be specific, so specific that there can only be one path for you: Medicine, MD/DO.

My story is similar, and after caring for hundreds of patients during my clinical rotations, I’ve decided that I want to do exactly what I’m doing now, but at a higher level, and with the fundamental understanding behind it all. I want to be the leader - the ship’s captain, and believe that I need to push to be the very best at my craft; this means medicine, not NP/PA. Nursing treats symptoms, phenomenally I may say, but lacks the substratal information for why. Which specific receptors (nAChr a4b3), what ED50 and dose, which muscle group, what pathway, etc.

Shadowing can happen, you have all the time in the world. You want at least 50-100 hours. Schools like seeing everything done over a timeline of years, not months, because otherwise it looks like you’re just checking “boxes” (which you would be if you finish everything in 4 months, then move on never to do it again). Research isn’t required, but definitely looks good at research schools, which many are. a 3.2 GPA is low for MD, but never say never - DO might be something you should look into if you haven’t. Many of the smartest docs I know are DO. Volunteer work is huge, both clinical and nonclinical (200+ hours each). A good personal statement takes months to perfect, with hundreds of working drafts. And be just a good human, do fun things like skiing or playing an instrument - don’t be a mindless robot, and talk to the committee about that in interviews. Nobody cares that you want to help people, everyone wants to help people.

Medicine uses brains, but exponentially dips after you reach the intelligence floor. Once you meet the minimum, all that matters is 3+ standard deviation industriousness/work ethic. You have to be able to grind for 60-80 hours per week for decades, sometimes doing things you vehemently find distasteful. Most of the time, however, you can’t see yourself doing anything else.

Worry about your grades, but don’t get a sertraline prescription over them. The average GPA/MCAT for MD is 3.5-3.7/515, DO is 3.2-3.5/511. Do well, and become the best damn candidate there is.

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Thanks for another reply, I have been really enjoying the conversation. I greatly appreciate all the advice you have given me.

I will try to retake Ochem 1/2 because my grades are C/B respectively. As far as nursing goes I hold similar views to you. I want to lead and make decisions knowing the full picture rather than getting told to do something and just holding a little puzzle piece in comparison. Another reason why the MD/DO route is my goal is because I teach/train junior combat medics in the process of what we do in a trauma or sickcall (think urgent care) situation but I want to know the why of what we do in those situations. I really enjoy teaching and I think as a MD/DO I would be able to teach to the fullest potential beyond a PA/NP/Nurse level (not saying they can’t be fantastic teachers). A lot of combat medics that I have met have aspirations to be midlevel or advanced practitioners (CRNA, MD, etc.). This, at least for me, is highly motivating because I want to keep up with all that they are learning so I fight not be left behind. I have started to look into shadowing at the hospital I currently work at and Ill look into shadowing at the hospital in the next city over (Duke :nauseated_face: Carolina fans represent). I will also reach out to the physicians in the area to see if they’ll allow me to shadow.

The only concerning thing about DO in NC is that the only school with a DO program is Campbell which is an expensive private university. After watching Dr. Grays video about strong connections to out of state schools I may be able to apply to some schools in Michigan. I’m wondering if out-of-state DO programs will consider me if I apply. I am expecting, after the spring semester, to take the next year or so to obtain a bachelors degree and do some GPA repair.

A question:

  1. Do you think my time in the National Guard, where I responded to natural disasters, would count as volunteer time? I can most definitely find somewhere to volunteer around where I live.
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To answer your question, if you were required to do it or you got paid to do it, it does not count as volunteer work. It would count instead as non-clinical experience, and potentially a most meaningful (3 total) experience on applications.

Don’t do something to, “not be left behind”, because that means you are a follower not a leader. At least, don’t list that as a reason behind your wanting to become a physician. I know it all sounds so counterintuitive, but things like: Continual learning, science, helping people, “I love ochem/medicine”, etc., are all cliche and overused reasons. It has to be something from inside you, and only you, and you have to figure out how to put it into words (because it’s there, sometimes it’s just hard to find).

Shadowing will be brutally difficult right now because of COVID. You can by all means try, but don’t get discouraged when 50/50 people say no. Even in the #1 state school I’m in right now, we are still having troubles getting students placed for mandatory clinical hours - it’s getting better, but it’s been seriously rough. It will get better by late spring or summer of next year.

Be honest to yourself about the strength of your application, when the time comes. Apply for a mix of schools based on that, and make sure you are applying to the right schools (I know…). There are tons of lists out there about this, some you have to pay for, and you can always talk to a premed advisor. I would say most shoot for 15-20ish schools, always apply to your state schools which will value you more, and mix in MD/DO (so, like 12DO and 8MD), 5 or so should be reach schools, and the rest are safety schools. It is okay to apply out of state, it would be literally impossible otherwise to apply to 20 schools. Just make sure you apply to the right schools based on what those individual schools value compared to your individual application.

3.0+ GPA is a minimum cutoff, higher is better, with yearly improvements. Only really retake prereq C’s (if you’re going to at all), unless you have to retake a B for some reason. Just push to get a 3.7-4.0 in your last classes for an undergrad to show improvement, and start working on filling out your application over the next few years (I’m not entirely sure when you plan on applying). Spend at least 2-3 months (or more) studying for the MCAT, that way you can offset a lower than average GPA (510+). Remember, GPA/MCAT gets you an interview, everything else gets you in.

Be a GOD of a candidate: feeding the homeless for 400 hours, shadowing three heart transplants, an ER physician, two rheumatologists, an NP, a pediatrician and a family practitioner, volunteering at a STICU for 300 hours as a patient advocate and communicator, working as a CNA/EMT/Scribe for 1000 hours, teaching 2nd graders how to read, tutoring/SI/TA biology and math, publishing a paper on the perfect pH for brewing beer or genetic manipulation in knockout mice, start a club at your university in underwater basket weaving, play the violin and shoot paintball on the weekends, and so, so much more. If you’re anything like me three years ago, this sounds daunting and impossible, but that’s medicine in a nutshell. Just one step at a time, every day, and eventually you’ll get there.

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Thank you for your reply.

My timeline right now is probably going to put me applying during the 2023 cycle so that I have ample time to complete my undergrad and work on becoming a god of a candidate.

Its funny that you mentioned a heart transplant because my first day of training as an anesthesia technician I had the honor to see portions of one.

I really appreciate the advice. I will do some introspection and see why exactly I want to become a physician. (100% for sure do not love OCHEM, so thats out, lol)

I hope this reply hasnt been too choppy. Our conversation has definitely given me some food for thought and it looks like I have some serious revamping and scheduling of my life that I need to do.

Thank you for your help,

Andrew

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I agree with the comment about ‘why not nursing?’ It sounds like it could be a career field you would enjoy. Since I’m a bit late to the game, what did you decide?