Photos by Peggy Peterson
There is a shared background among every person who bears the letters “MD” after their name: They’ve gone through four years of medical school, learning similar basic sciences knowledge and clinical skills necessary to pursue medical licensing after they graduate.
But, along the way, each student’s journey to that medical degree is highly unique.
Last year, we checked in with three students who were halfway through medical school about their path through the Perelman School of Medicine—selected from a larger group who were first profiled in a Penn Medicine magazine story called The Path to Penn Medicine when they were entering first-year students in 2015. This spring, we caught up with more members of the group to hear, in their own words, how their journey has progressed.
Halfway through the third year of medical school is when students’ journeys truly begin to differentiate in the Penn curriculum. The students have begun charting their individual educational courses for the rest of their medical education. After progressing together in small teams through three semesters of preclinical learning in the classroom and laboratory, students spent two semesters in a rigorous rotation of core clinical clerkships where they learned to work with patients in real-life care settings. Now, they are pursuing elective classes of their choice, scholarly pursuits such as research, additional specialized clinical training experiences, and more. Those who are enrolled in dual degree programs will transition this fall from their medical studies to a year (for master’s programs) or more (for doctoral programs) of other graduate study. By the fall before they graduate, all of the medical students will have made plans for their post-med school life, typically choosing a specialty and applying for residency programs.
A Brief Re-Introduction
Gina Chang:
Attended Washington University in St. Louis, where she majored in biology and in ancient studies, focusing on Greek and Roman history. She came to Penn Medicine as an accomplished cellist, playing as the principal cellist in the Washington University orchestra, and giving private lessons on the instrument to underserved students. Prior to starting medical school, she also volunteered abroad in Argentina and Peru, shadowing pediatric surgeons and translating for a physical therapist to help children learn to brush their teeth.
Michael Stephens :
Was also a biology major with experience in international volunteering, in Guatemala in his case. As an undergrad, he was president of the Thomas More College Student Government Association and played NCAA Division III tennis. He chose to pursue medicine because it is service-oriented and a way to help others that utilized his scientific and analytical interests.
The First-Year Medical School Experience
Gina Chang:
The first year was a time of adjustment, to a new city, new friends, and an overwhelming amount of information. The moments I remember most clearly, though, were the ones spent with my friends and classmates: the Sunday afternoon that my learning team spent making dinosaur costumes instead of studying for our anatomy exam (priorities!), apple-picking with classmates, and camping on the roof of JMEC after we had to cut our weekend backpacking trip short due to a thunderstorm.
Overall, in the preclinical time, I was surprised by the amount of time I had to do the things I wanted to do. I went into medical school with the expectation that it would be all-consuming and that the majority of my time would be spent studying. While I definitely felt challenged and did spend a fair bit of time studying, I felt like I was able to work on other, non-school related projects and have time to spend with old and new friends. Part of the reason I chose to go to Penn was that the students I met seemed well-balanced, able to study hard but also maintain other interests and relax, and I was happy to find that that was the case.
One of the highlights of my first year was getting to know my learning team. I was surprised by how well we got along and how close we became given that we were put together fairly randomly. I looked forward to the days that we had small groups because I could always count on something funny happening or being said, and also knew that I would come away from it knowing more than I had going in.
The Second Year: Clinical Clerkship Rotations Begin
Michael Stephens:
Beginning the clerkships—the clinical half—in January 2017 was a substantial transition; the comfort of a classroom in which almost all of my education up to that point had occurred was exchanged for the clinic or operating room.
My first rotation was surgery at Penn Presbyterian Medical Center and I was quickly acquainted with how remarkable the experience of being able to perform these procedures could be. What impressed me about the field of surgery was is the power of being in an interventional specialty. Many surgeons were able to directly impact the lives of their patients who would come in with some problem necessitating a procedure and would leave that a short time later with resolution of that malady.
The next block for me was split between pediatrics at Children’s Hospital of Philadelphia (CHOP) and OB/GYN at the Hospital of the University of Pennsylvania (HUP). My pediatrics rotation represented my first experience with clinical medicine after my surgical rotation, and I surprised myself with how quickly I came to appreciate the complexities of inpatient management. In particular, what I really loved was thinking about a patient presentation, applying what I had learned in my preclinical education to formulate a differential diagnosis, and developing a plan to treat the problem.
Gina Chang:
Something I hadn’t expected to come out of that year is that you get grouped with different people for every rotation, and as a result I got closer with a lot of people in my class I hadn’t expected to, who I didn’t know before. That was a nice aspect of the year. It was sad to leave my learning team—we were really close—but it was nice to realize there were also other really cool people in the class.
The Third Year: Differentiation
Michael Stephens:
I was still trying to figure out my way in medicine by the end of second year. To that end, things have kind of crystallized around a career path and pursuing dermatology. It wasn't like an ‘aha’ moment where one day I woke up and was like, ‘this is for me.’ It was on my radar for a while. It’s kind of comforting and nice to know that there’s a trajectory and I am starting to think about where I see myself, and starting to differentiate if you will.
I’m going to apply into dermatology in September. What I’ve been doing towards that end is crafting the courses and clinics that I'll be in to build towards that. I finished Step 1 [of the national medical licensing exam] in February, and then I did my medicine sub-internship at the VA. That’s an experience where, especially at the VA, you're given a lot of autonomy. You start to take on more responsibilities that are expected of graduates—interns specifically. You more or less function as the front-line provider for your patients, which is an incredible experience.
I’m currently on the dermatology elective, so that will take me to the end of third year. It’s a little bit nebulous where third year ends and fourth year begins. Then I have some [Department of] Medicine [subspecialty] electives, a pediatric dermatology rotation, then I apply.
Gina Chang:
I did my pediatrics core clerkship in the fall, and I really liked that. That is what I had been thinking I was going to like the most, so it was good to have that validation and to confirm that I do want to do pediatrics. I’ve been doing electives in peds, trying to choose between that and peds/neuro; that’s its own residency track, so I have to make that decision before I apply to residency programs.
[But first I will be] doing an MPH program here. That starts in the fall.
It was something I’d thought about when I got to Penn, but only applied in December. I had been going back and forth as to whether to do it now as a dual degree [and graduate with an MD and MPH in 2020], or to do it later as a fellow or at some other point in my training when I might have a better idea of what specifically I wanted to study. Pursuing it now, it’s a good opportunity to get basic skills like statistics and learn more about health care as a system. And it will be nice to be on a regular grad student schedule, with a few classes over the week and a lot of flexibility in scheduling.
Extracurricular Ventures
Gina Chang:
Photo by Dan Burke
The major highlight of the second year of med school was starting the Penn Med Symphony Orchestra. After spending the first year of med school missing being able to play cello regularly, it was so exciting to not only have music be a part of my life again but to find a whole community with similar feelings. When we started the orchestra, I honestly didn’t expect there to be so many people – physicians, nurses, grad students, other professionals – who were willing to give up the little free time they have to come to rehearsal, and it was truly heartwarming to receive such a positive response.
We’re still having our two yearly concerts and next trying to expand to three concerts a year; it may or may not happen this year. [Last September, we joined with the Philadelphia Orchestra for a special rehearsal.] We have a soloist this year for the spring concert [held April 29], and we have ideas for other things to do in the future with the orchestra. The other thing that’s in the process of happening now is making a classroom curriculum related to music and medicine, working with Dr. Horace DeLisser.
In addition to the orchestra, I’ve been volunteering with United Community Clinic (UCC) since I was an MS1 and served as one of the community outreach coordinators to plan the Bike Rodeo, UCC’s annual health fair in August 2016. Volunteering at UCC gave me an opportunity to see patients and motivated me throughout the preclinical months that often seemed far removed from patient care. It was also rewarding to be able to provide services to people who are uninsured or underinsured, although it left me wishing I could do more to ensure that these patients get regular, affordable care from primary care physicians of their own, instead of having to go to student clinics (there are definite limitations to the care we can provide, especially in terms of the lack of continuity with rotating med students). [Now in my third year,] I have been helping to run the upperclassmen volunteer side of things. First and second year students volunteer there every week. Third and fourth year students serve as their mentors and help to coordinate volunteers.
Michael Stephens:
[During my preclinical semesters] I joined the Medical Student Government as a class representative, the Wood House council, and the Course Representatives committee. I also led the Dermatology Interest Group as a co-chair and have been volunteering at the University City Hospitality Coalition (UCHC).
These experiences have been incredible complements to my educational experiences and allowed me to maintain many of the interests I had when I first started medical school. In particular, having the opportunity to volunteer at UCHC in West Philadelphia during my preclinical years was especially meaningful, as this really represented my first foray into clinical medicine. To be able to provide health care for our clients, many of whom were homeless and would not have had access to care otherwise, functioned as an early affirmation of why I decided to pursue a career in the medicine in the first place.
One neat thing about UCHC is that, as a first and second-year student, you kind of learn the ropes of patient care, how to do a history and physical, almost in preparation for the clerkships. But then once you're on the other side of the clerkships and you've developed all of these skills, you have the opportunity to go back as an upperclassman and more or less pay it forward and help endow those skills in the first-year students who are now learning them for the first time. That’s a neat experience to be able to have a different perspective on things, and still be able to be involved in patient care and help patients, but also have that added component of mentoring.