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Navigating medical school
What does it take to become a doctor in the 21st century?

By CATHY BREITENBUCHER
Photos by Dan Bishop

January 2015

Ashley Quinn works with a patient.

Becoming a doctor is about understanding relationships.

How do organs work together to function properly? How do medications interact with one another? How do underlying conditions affect overall health?

Being a doctor is about relationships, too.

Connecting with patients. Using technology. Navigating the changing health care system.

Successful doctors have to balance it all, as Ashley Quinn already knows.

Quinn is a second-year student at the Medical College of Wisconsin ó busy with classroom work, up to 12 hours a day of studying, volunteer work, friends, a long-distance boyfriend and even intramural softball.

"That was a big life lesson for me the first month I was here, to know my limits ó ĎOK, thatís too much studyingí or ĎI should probably be studying more,í" she says. "Finding that balance is definitely very tricky."

Quinn, who turns 24 in March, grew up in Verona, the younger of two daughters of a kindergarten teacher and a printing business owner. She played soccer and volleyball as a kid and landed a job at a movie theater when she was 15.

"I did pretty well for myself in high school, but I didnít know what I wanted to do," says Quinn. "I knew I liked science, and I thought math was really cool.

"Everyone has their own story of how they got to medical school. I came to the realization on my own. Maybe thatís why I enjoy reaching out (to high school girls) so much. I want to make it easier for other people to know what they want to do."

Those people skills set Quinn apart and will contribute to her success as a physician, according to Todd Hoagland, associate professor of cell biology, neurobiology and anatomy at the Medical College of Wisconsin.

"Itís what separates the best doctors from the really good ones ó not only having the technical savvy and expertise to solve the patientís problem, but also the bedside manner," he explains.

Quinn arrived on the MCW campus in 2013 just months after earning a bachelorís degree in biomedical engineering from UW-Madison. Not all med school students come directly from undergrad ó many donít get accepted right away and re-apply the following year, some come after getting a masterís degree, others start med school after working for a while.

Even in a difficult economy, would-be doctors line up for the privilege of paying about $260,000 to attend four years of medical school. For its 200 slots per year, MCW receives more than 7,000 applications.

Knowing those steep odds, Quinn was too scared to pick up when she saw a 414 area code on her phone, just days after her admissions interview in the fall of 2012. "I was getting off the bus one night in Madison, walking back to my apartment, and I thought, ĎI donít think I can answer this,í and I let it go to voice mail," she relates. "They left an acceptance voice mail and it was really exciting ó I still have it."

UW-Madison offers a career counseling center devoted to pre-med students, and Quinn is glad she took advantage of it. Another factor that helped her decide to pursue medical school was her two-plus years of work experience in a research lab in Madison. "I loved the science and being able to do things with my hands," she explains, "but I felt it kind of fell short in the aspect of being able to help people. I wanted to do things that more directly affected people."

Some students are opting for MCWís accelerated medical school program in Green Bay, scheduled to welcome its first students this July. (A similar program in central Wisconsin will launch in 2016.) Completing a medical degree in three years rather than four saves a student about $65,000 in tuition and fees and gets him or her into practice and earning a salary that much earlier.

Itís not for everyone, though. "If youíre a mediocre student, youíre going to get crushed," cautions Hoagland.

At the satellite campuses, instead of filing into an auditorium for classes, students sometimes will listen to lectures by MCW professors in Milwaukee via live video or podcast. Instructors will be adding Skype office hours so students can get questions answered.

"We expect to have live meetings with groups of students who are maybe 50 or 100 miles apart," says Hoagland, explaining yet another planned use of technology. "Theyíll be Skyping or in Google chat rooms where everybody can see everybody in Milwaukee, with a preceptor talking to them about patient experiences."

Also coming soon: a video system allowing out-of-state students to transmit images from their cadaver dissections to professors in Milwaukee, and a video library of studentsí clinical work to help confirm diagnoses and teach other students.

"The students are running faster than the faculty when it comes to the adoption of technology," says Hoagland. "The 50-year-old physician who is teaching in medical school didnít even grow up with computers. Itís a radical change." MCW is on the forefront of that technology. Quinn calls it "the coolest thing Iíve ever seen." Itís an oversized computer tablet called an Anatomage Virtual Dissection Table. MCW got one in 2013; worldwide, only about 110 medical schools, simulation centers and physician assistant programs have them, according to the California company that invented and sells them.

Data from actual CT scans and two-dimensional images render a life-size interactive 3-D model of the human body. With the touch of the screen, students can isolate the bones, circulatory system and organs to identify problems. The model can be rotated, sliced or segmented.

Itís like first-year gross anatomy class, minus the cadaver and smell of formaldehyde.

"There are similar apps on our iPads that I use frequently to study," Quinn says excitedly. "You can add or subtract layers of muscle, and it really helps you to understand the 3-D relationships that you need to know for anatomy."

And study she does. Four mornings a week, Quinn is in class for four hours. She usually walks back to the apartment she shares with another medical student, four blocks away, for a 40-minute lunch break. Then, itís time to hit the books until about midnight, though she does take breaks to avoid losing her motivation. She enjoys cooking and usually watches one episode of a TV show while making dinner.

On weekends, she also studies, but fits in shopping and workouts and goes to the movies. She ran the Brewers Mini last fall, her first half-marathon.

"In undergrad, I was doing engineering and math, and it was conceptually difficult but not real time-consuming," she says. "In medical school, I feel that the concepts are more straightforward, but there is just so much of it and itís very time-consuming. There is some memorization, just understanding all of the words. The drug names ó just being able to say them ó is a feat in and of itself."

First-year students at MCW take exams about every five weeks. The pace picks up in second year ó there are quizzes or midterms about every two weeks.

Still, Quinn makes time for volunteering. Sheís helped out school nurses at nearby elementary schools and worked at a clinic for the uninsured. She helped organize a daylong program with the American Medical Womenís Association for high school girls to promote careers in science, technology, engineering and medicine.

"Being able to interact with the community, to give back to them, helps motivate you and reminds you what you are here for," says Quinn.

Hoagland says thereís an old joke among medical school faculty, that they can already see at orientation which specialties a student might be interested in. Quinn is a long way off from needing to decide, but is thinking about cardiology.

With the Affordable Care Actís impact still revealing itself, Hoagland says some specialties might not pay as well as they have in the past. But, he adds quickly, money isnít the reason people are in medical school.

"Over the last decade, students have been choosing fields that have better lifestyles, like emergency medicine where you donít have a patient workload. You work 9-to-5, or a 12-hour shift, and you leave," he says.

Quinn says the ACA comes up sometimes at family gatherings, so she is trying to understand it better. Then again, her family also watches "Greyís Anatomy," leaving her to explain that to them, too. "When I watch it, I see things they should have diagnosed in five minutes instead of an hour, and Iím thinking, ĎIím pretty sure it doesnít work that way,í" she says with an easy laugh.

"I get a little numb to all the perfectionism when it comes to academic transcripts, because almost all the medical students you see are darn smart," says Hoagland. "What really shines and sets students apart are those who do all that and are pillars of the community.

"We have a lot of great students who try to motivate young kids. We keep going, and we try to inspire the next generation to be better than we are."







 


This story ran in the January 2015 issue of: