What if I don't get into any Med School...then what?

Pre-Med & Medical School Pre-Med Topics
41

<p>The safe practice of nurse anesthesia requires physician, i.e., anesthesiologist supervision. A nurse anesthetist does not enjoy the same independence and responsiblity that a physician does, although the compensation is very good and the hours are likely better than a physician.</p>

<p>See <a href="http://www.asahq.org/Washington/nurseanesscope.pdf%5B/url%5D"&gt;http://www.asahq.org/Washington/nurseanesscope.pdf&lt;/a>

[quote]
Anesthesiology 2000;93:152-163
Anesthesiologist Direction and Patient Outcomes. Conclusions: Both 30-day mortality rate and mortality rate after complications (failureto-rescue) were lower when anesthesiologists directed anesthesia care. These results suggest that surgical outcomes in Medicare patients are associated with anesthesiologist direction and may provide insight regarding potential approaches for improvingsurgical outcomes.

[/quote]
</p>

42

<p>CRNA's are at the same level as a Nurse Practictioner, so the autonomy they are likely to have is going to vary from place to place, hospital to hospital. Some institutions will allow a lot more leeway for their CRNA's (rural settings in particular), while other surgery centers are going to require a lot of supervision from the MD's.</p>

<p>The whole idea of earning an MD though is to have that autonomy. You go to school the longest, have the most on-the-job training, the most intense admissions, most intense licensing all for the ability to be independent. While there is an emphasis on the health care team, I think most doctors and medical students feel that they should be the leader - not go unquestioned, but be in charge of moving the discussion towards a final plan.</p>

43

<p>The high complexity nursing jobs are much more challenging than most people realize. </p>

<p>CRNA's, like other nurse practitioners and some other nursing specialists have a great deal of automony and responsibility. The nurse anesthetists are often the only anesthesia person in the OR with the patient for long periods of time, perhaps the entire case. The "supervision" provided by the anesthesiologist can be nothing more than "call me if you have a problem and you need another set of hands". In ICU care, the nurses are the experts in the minute-to-minute management of the patients. If something goes badly fast, they are almost always the first people to intervene, and often the patient's only hope is that the nurse gets it right the first time.</p>

<p>Add to that endless demand for their services, regular hours, very good pay, and far lower educational debt and you get a pretty appealing health care field. Even once you substract rotating shifts, it looks good.</p>

<p>These sorts of nurses have to learn a lot of medicine, and they need academic skills only slightly below those for medical students. It would be great for someone who just missed getting into medical school. Those undergrads who really could not learn the pre med science at all and bombed their premed courses might well become nurses, but probably not CRNA, CCRN, or NP.</p>

44

<p>I keep hearing about these DO schools? What are they all about? As a college student, I am still interesting in being a doctor but like most of us out there, what happens if I don't make it? I have thought about going to grad school or get experience but I don't know if that is the right choice. I also wanted to know if what you major in really plays a part in this too. I just want to be successful and help people no matter what I do in life. I already had my experiences in the hospital and have done numerous things such as work, volunteer etc and I have been doing this since the beginning of high school and right now I am doing a college student summer internship program again in the hospital. I just wanted someone's opinion about what really happens through the rigous program. I mean, there are lots of smart college kids out there and we all are fighting for the same thing. So things get soo limited and the competition gets fierce....
Thanks for listening... :-)</p>

45

<p>Your major doesn't matter.</p>

<p>DO schools I would advocate, certainly relative to international medical schooling. Admission standards are lower, and the authority/independence is pretty much the same, although of course in academic circles there is a prestige element to an MD degree. DO candidates can apply for MD residencies but not vice versa.</p>

46

<p>DO's are generally better received than american FMG's; especially well respected are DO's who come from a family DO tradition.</p>

<p>Graduating from any american medical school will likely serve you better than becoming an american FMG.</p>

<p>Advanced practice nursing, CCRN, PA school, chiropractic, and certified OR tech first assistant are all options that allow meaningful patient contact.</p>

47

<p>Sorry, my last post left some elements unclear.</p>

<p>1.) Admissions to DO schools is easier than to American MD schools as a general rule, although it's considered less prestigious and there are some exceptional situations where that matters.</p>

<p>2.) I would advocate DO school over international medical school for American citizens.</p>

<p>I just realized my last post might have implied that any MD (US or otherwise) would be more prestigious than a DO, and that's certainly not what I meant.</p>

48

<p>Oh ok...Thank you! Also...what do you think about Post-baccalaureate programs? Do you think they are very helpful?</p>

49

<p>ANESTHETIST POSITION - TALLAHASSEE, FLORIDA
$40,000 sign on bonus with 4 year commitment;
$30,000 for 3 years (all up front)
$5,000 Vacation in San Destin, FL or Disney World for just for interviewing
$121,000 Base salary - OT after 42 hours/week
$5,000 - Participant on the call schedule (1st through 5th call)*
$5,000 - Participant on the 11 to 7 shift*
$300-$50 Weekday call pay incrementally decreases as call level decreases
$400-$300 Weekend** call pay - plus hours worked
$3000 Educational stipend every 2 years
$5000 Relocation allowance
-Full family medical coverage in EPO (HMO) and a high deductible PPO, both
with BCBS
-40lK with a 5% contribution, based on gross pay and is straight deposit
-Short term and long term disability (long-2/3 salary, begins 6 months after leave)
-5 weeks of vacation/education and 6 at 10 yrs., 7 at 15 yrs
-5 days of sick leave per year. There is no carry over for vacation. Sick days
carry over and max at 4 weeks.
-Free meals are provided at the hospital.
* 5 calls are required per month
**Weekend call is not required
CONTACT: SHANE ANGUS at 850-443-8068 or
<a href="mailto:shaneangus@yahoo.com">shaneangus@yahoo.com</a></p>

50

<p>My understanding was that post-bacc programs are for students who hadn't completed their premedical requirements during their undergraduate careers. Is this not right? Can students who were premed in college enroll in a post-bacc?</p>

51

<p>In Southeast Florida with no call.
<a href="http://www.gaswork.com/cgi-bin/ipbltview.exe?PostIDNum=50442%5B/url%5D"&gt;http://www.gaswork.com/cgi-bin/ipbltview.exe?PostIDNum=50442&lt;/a>

[quote]

Estimated Minimum Annual Income $300,001 - $310,000
Estimated Maximum Annual Income $330,001 - $340,000
Is the compensation paid as an Employee or Independent Contractor? Employee (IRS form W-2)
Malpractice Paid? Yes
Does this job provide Income from fee-for-service individual practice? Negotiable
Weeks Paid Educational Leave $1500
Weeks Paid Vacation 4
Medical Insurance Paid? yes
Disability Insurance Paid? yes
Retirement Plan Paid? yes
Will Interview Expenses be Paid? negotiable

[/quote]
</p>

<p>In Orlando doing office based anesthesia with no call (supervising CRNA's 90% of the time)
<a href="http://www.gaswork.com/cgi-bin/ipbltview.exe?PostIDNum=50327%5B/url%5D"&gt;http://www.gaswork.com/cgi-bin/ipbltview.exe?PostIDNum=50327&lt;/a>

[quote]

Estimated Minimum Annual Income $370,001 - $380,000
Estimated Maximum Annual Income $370,001 - $380,000
Is the compensation paid as an Employee or Independent Contractor? Independent Contractor (IRS form 1099)
Malpractice Paid? No
Weeks Paid Vacation 6 weeks
Will Interview Expenses be Paid? Negotiable

[/quote]
</p>

52

<p>So given different admissions standards (anesthesia is one of the ROAD specialties, and that's already once you're in medical school), the time value of the years lost, and the fewer hours (42 a week!), I'm sure that anesthesia pays better - somewhat - but anesthetist positions actually come out looking pretty good.</p>

<p>Don't forget your tax brackets, too - anesthetists take home $112,000 (including bonus), and anesthesiologists take home $240,000. And that's only because Florida has no state income tax. In CA they'd both be paying another 6%. I'm also not including disability, medicare, etc. (although I am including SS).</p>

53

<p>From the very good Syracuse Health professions advisory site
<a href="http://hpap.syr.edu/pblist.htm%5B/url%5D"&gt;http://hpap.syr.edu/pblist.htm&lt;/a>

[quote]
Post-baccalaureate work consists of academic study undertaken after earning a bachelor's degree; it can be toward a degree (D.D.S., D.M.D., D.P.M., D.V.M., D.O., M.A., M.D., M.P.H., M.S., O.D. Ph.D., another bachelor's degree, or a number of others), toward certification in some specialty, or course work that does not result in a certificate or a degree. Many college graduates find that they need to improve their academic credentials before making successful application to medical schools.</p>

<p>Others who wish to change careers to become physicians, dentists, veterinarians or other health professionals discover the science requirements of most health professions schools (general biology, general chemistry, organic chemistry and general physics, as well as mathematics) and the need to demonstrate recent academic achievement. Each individual should assess very carefully (preferably with help from a pre-professional adviser or an admissions officer at a professional school of choice) her/his past record, need for improvement, and the type of post-baccalaureate program which will satisfy that need.</p>

<p>Listed below are four categories of post-baccalaureate programs:</p>

<pre><code> o Those for minorities or individuals under-represented among health professionals.
o Those for people who have completed few, if any, of the science courses required; some of these programs are very selective.
o Other, non-degree granting programs that are listed by schools/counselors having support staff able and willing to provide the proper advice and support.
o Degree-granting programs that differ in some respects from the standard graduate programs in university science departments.
</code></pre>

<p>For graduating students who need to improve their credentials (whether or not you applied to medical school and were rejected), it probably is better to go to a new school to do post- baccalaureate work. Although it might be more comfortable, for a number of reasons, to stay at your Alma Mater, the fact that you need to improve very likely is related to what makes you comfortable.</p>

<p>For students graduating with a major in biology, bioengineering, or even chemistry, it is unlikely that taking a few more courses in the same field will enhance the academic record. Such students probably should enroll in a standard M.S. program in science. To do so means that one applies to graduate school, meeting the basic requirements for entry, and also for acceptance by the department as a suitable degree candidate. For such acceptance by (or matriculation in) most university science departments, it will be necessary to demonstrate commitment to finish the degree; they do not welcome students who hope to drop out after acceptance by a medical school; some of the programs listed below differ in this respect.</p>

<p>It is possible to enroll at many schools as a non-matriculated graduate student; you pay your money and take the courses (if space is available). Anyone doing this should seek guidance. In fact, it is possible to undertake post-baccalaureate work in a number of different ways. For example, at Harvard University, Dr. William Fixsen advises students in the Harvard Extension School (the continuing education unit of that University); there is also in the graduate school a Special Student Program which enrolls students who are not working toward a degree, and undoubtedly some students are enhancing their credentials in other programs.

[/quote]
</p>

54

<p>My obsession with always having a B plan became overwhelming sometime after sophomore year, despite the fact that I was 1 course shy of completing my prereqs with a 4.0.
Besides trying to doublemajor (which might not happen for financial reasons), I am trying to be pre-med, pre-pharm, pre-law, and maybe pre-dent at the same time.
I will probably graduate in 4.5 years altogether (2.5 to go). Upon graduation I will have a semester to devote to applying to ~15 med schools and to ~10 grad schools (some of which are far more selective than med schools) for one of my majors and maybe 1 (UCSF!!!) or 2 pharm schools.
If it doesn't work out I will explore other options the next year.</p>

<p>Bottom_line 1: I don't fathom that I can pull anything good with a BS and I don't believe in MS. I don't believe in DO and overseas med schools either (unless it's England; canada is ok but it's too cold)</p>

<p>Bottom_line 2: I am a guy with a plan.</p>

55

<p>Some of the things you've mentioned simply don't add up: You're obssesed with having a plan, but yet don't 'believe' in certain viable options; You are trying to be pre-everything instead of really focusing your energies in one area; You can't double major, but are taking a course load that will take you 4.5 years (even though you completed the pre-med requirements in two years). These arent' meant as criticisms, just seemed odd to me. However I do have issues with what you've described.</p>

<p>And despite all that, your current plan is flawed. As you've described it, you're waiting until after graduation to apply to your graduate schools (whether they be med, pharm or other). For med school admissions you cannot do that if you are hoping to start in the August immediately following you graduation. For example if you are going to graduate in 4.5 years, you'll be done in December of 2008. If you want to start med school in August 2009, you have to submit your application in the summer/early fall of 2008. Waiting until the spring semester of 2009 to prepare means you'd be waiting to start in August 2010.</p>

<p>Another consideration is that you say you can't double major because of finances, and yet are planning on applying to nearly 30 programs in different areas. Just your AMCAS alone is going to be $580. If we assume $75 per secondary (private schools will be higher, many state schools will be lower), and you secondaries from all of them, that's another $1125. Pharmacy school applications are $135 for one, and $40 each additional school applied to. I'm assuming that grad schools have somewhat similar costs associated with them. This doesn't even include the costs and preparations needed to take the MCAT, the PCAT and the GRE (MCAT is $210, GRE is $130, PCAT is $105, DAT is $170 plus $15 for each additional score report to dental schools over 5, and the LSAT is $118).</p>

<p>As for the pre-pharm/pre-dent thing. As I've said many times before, these professional schools do not take kindly to failed med students who view them as "easier" schools to get into, or some sort of backup plan. They want to know that you are actually dedicated to the profession and that this is something you are really wanting to do, so you must have experiences that are in line with demonstarting that. You have to work in a pharmacy or have shadowed a dentist multiple times, worked in a denture lab or been president of the pre-pharm club. There are 1000's of people out there whose life's dream it is to become a professional in one of these areas, and have spent years preparing themselves for admissions. Why would an admissions committee select you over them when that school is merely a back up plan for you?</p>

<p>I don't mean to tear you apart here, its just that when you look at everything you are talking about, it becomes obvious to the outside observer that you would be better off focusing your energies in one direction, hopefully in the direction of something you are passionate about. It's fine to have a plan B, but if preparations for the backup plan alter you ability to do well in the first place, then it's not worth it.</p>

56

<p>Thanks for the post-bac. advice.</p>

57

<p>Bigredmed:

[quote]
Some of the things you've mentioned simply don't add up: You're obssesed with having a plan, but yet don't 'believe' in certain viable options

[/quote]

Of course one has to eliminate some options. I would hardly call overseas med schools a viable option. [edited out - Mod JEM]

[quote]
You are trying to be pre-everything instead of really focusing your energies in one area;

[/quote]

As I said already I am one course short of completing all premed requirements with a 4.0. I think that's being focused enough.

[quote]
You can't double major, but are taking a course load that will take you 4.5 years (even though you completed the pre-med requirements in two years).

[/quote]

I did say "probably" and it is due to the fact that I transferred. I could always have a major and minor, can't I now?</p>

<p>
[quote]
If we assume $75 per secondary (private schools will be higher, many state schools will be lower), and you secondaries from all of them, that's another $1125.

[/quote]

First: $1125 or even 5,000 is not really comprable to 21,500+ per semester or 16,000+ per quarter (from your point of view, sicnce you don't know if I am going to Yale or Stanford)
Second: [edited out - Mod JEM]</p>

<p>"How much does it cost to use AMCAS?</p>

<p>AMCAS charges an application processing fee of $160 for one (1) medical school designation, and $30 for each designation thereafter."
<a href="http://www.aamc.org/students/amcas/faq/processing.htm%5B/url%5D"&gt;http://www.aamc.org/students/amcas/faq/processing.htm&lt;/a&gt;&lt;/p>

<p>"FAP eligibility decisions are tied directly to the U. S. Department of Health and Human Services' poverty level guidelines. For the 2006 calendar year, applicants whose total family income is 200% or less of the poverty level for their family size are eligible for fee assistance.
<a href="http://www.aamc.org/students/applying/fap/start.htm%5B/url%5D"&gt;http://www.aamc.org/students/applying/fap/start.htm&lt;/a&gt;&lt;/p>

<p>[final comments edited out - Mod JEM]</p>

58

<p>1.) BRM is right at least about the timing. Interviews start coming in January? I didn't have a single interview after December.</p>

<p>EDIT: Given that you have now removed this concern from your post, I suppose my point was well-taken.</p>

<p>2.) I do want to warn you that if you're at a UC, you should take very seriously the concern that people will show if you take longer than 4 years to graduate. The reason my warning is UC-specific is that if you're at (say) Yale, then I am assuming you know this and have already considered it.</p>

<p>3.) You're ignoring BRM's most important point, which is that to be pre-something is more than just a courseload; it involves extracurriculars and devotion to the field. Taking the predental coursework does not qualify one for dental school; speaking in a de facto rather than de jure manner, then, you aren't really pre-dental or pre-law at all unless you have the extracurriculars and commitment (to say nothing of standardized tests) to match.</p>

<p>4.) I find BRM's estimates of the secondary process to be quite close to the mark, although of course your comparison to tuition is true as well.</p>

<p>5.) I must say that the tone of your posts here on this thread - and I can't fathom why, since you've never struck me like this before - are quite rude. Were I in BRM's shoes - and I have been with another poster - I would simply stop answering your questions, for the simple reason that it's not fun to be quoted intentionally out of context and referred to as a "fool".</p>

59

<p>I apologise for my tone.</p>

<p>Would you please elaborate on #2; I am not really sure what you are referring to.</p>

60

<p>I simply mean that while it's apparently reasonably common to spend more than four years as an undergraduate at a UC, I think UC students tend to underestimate the fact that it's moderately (I'd say) looked down upon - fairly or not, people may infer some kind of difficulty in planning or academic continuation on your part.</p>

<p>In other words, just as you "don't believe" in DO school or international school (a position I am sympathetic to), I think you will probably find some folks on adcoms who "don't believe" in taking longer than four years to graduate - that is, they will be inclined against your resume for that reason. Of course it will not be a decisive factor on an otherwise strong record, but it may end up mattering.</p>