On taking a year away from medical school
Last summer, after finishing the arduous task of taking our first round of board exams (USMLE Step 1), most of my classmates began their third year of med school and entered the world of clinical medicine. A small group within my class—as with most medical school classes—postponed their third year to pursue other interests. I was among this group.
Medical students can spend time away for many reasons. The most common reason is to pursue an additional degree—PhD, MPH, MBA, MSc, JD, etc. For those in combined degree programs, they usually sandwich the majority of this degree work right in the middle of their four years of medical school. Students may also take time away from med school to pursue a research year. Many fellowships exist for this explicit purpose. Students can go to places such as the NIH or CDC to work with some of the top scientists and researchers in the US for a year.
I had been interested in these opportunities from the beginning of med school. I ruled out the degree programs simply because I already have an MPH. While there are subjects I touched on during my graduate work that I would like to pursue further, I didn’t think they were worth a year away from medical school. I also looked into the NIH, CDC, and privately funded fellowships such as the Doris Duke Clinical Research Fellowship and Howard Hughes Medical Research Fellowship. These are fantastic opportunities to work at world-class research institutions. But, again, I didn’t think they were worth a year away from medical school. I already had quite a bit of research under my belt and (based on my research experiences) I knew the difficulties of trying to conduct meaningful research within a single year timeframe.
I am not trying to denigrate these opportunities; they are all excellent and potentially career-changing for most. However, for anyone considering taking time away from medical school to pursue such an opportunity, a cost-benefit analysis must be undertaken. Such analyses are difficult because they are based on many unknown factors, specifically (1) how will this experience enrich my current education and open doors for me and (2) how will adding another year or more to my medical education impact pursuits outside of medicine (i.e.—family, entrepreneurial opportunities, private career, other interests, etc). This second point is very difficult to analyze because it exists in the uncertain, abstract future.
I initially decided a year away from medical school would not be beneficial for me. I already had quite a bit of research experience. While going to work at some place like the NIH or CDC might be very cool, I felt those were experiences I would likely get a chance to have (if I wanted) later in my career. However, I am currently in the middle of a year away from medical school. So what glorious opportunity changed my mind?
Early in 2011, I released a simple iPhone app that provided mobile access to an evidence based clinical practice guideline for treating children with pneumonia. This app was based on a guideline orignially developed at Children’s Mercy Hospitals and Clinics. I worked with Dr Jason Newland on this project. While our app has enjoyed some measure of success, we envisioned something more. I was fortunate enough to find some people at Children’s Mercy who agreed with this vision and materially supported the vision.
I actually debated whether or not I should take the opportunity. It was a large risk. Unlike established research fellowships, no model for project success really existed. What if the entire project failed? I would have taken a year away from school and come up with a big, fat goose egg. What if support for the project disappeared? I could be left in the middle of an academic year not in school and with no money. However, I would also have the opportunity to be a small participant in the mHealth movement, utilizing cutting-edge technology to improve patient care.
Ultimately, I couldn’t say “no” to this opportunity. I felt it was a unique time to participate in something new that will likely change the face of health care. I may never have another opportunity like this. Things may still not work out. But, I’ve already learned a ton and had the chance to work with some incredible people—essentially, this is what any opportunity should be about.
The main project I am working on is progressing nicely through its development phases. I hope to share more about this project—the process and final result—when we are closer to releasing the end product.
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