- 268: This Nurse Practitioner is on His Way to Medical School
Matt has been accepted to multiple medical schools after realizing that he wanted to do more with and for patients. After working as an NP, he's starting med school.
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Back to today's episode, Matt is on his way to medical school. He is an NP and he talks about his journey, why he chose to be an NP and why now he's choosing to go to medical school. If you're in a similar situation, maybe you're a nurse, a PA, a NP, whatever you're doing, and you're contemplating a career switch, be sure to listen to this episode to get some insights.
[02:40] Coming from a Nontraditional Background: Deciding to Become a Nurse
At 17, Matt had no idea what he wanted to do while one of his best friends was finishing nursing school and going to nurse practitioner school. So he got sold on the idea of job security if he chose the NP route. He'd be able to write prescriptions and make money.
His uncle owned an ambulance company and his brother was a firefighter and a paramedic. So basically, he was around the field of healthcare and would hear people talking about it. But it wasn't anything he too seriously.
Initially, he wanted to take International Business but he felt there was a lot of uncertainty in the field considering job security is important. On the other hand, if he became a nurse, he would be able to pay the bills while figuring out his real passion, which eventually came to be medicine.
As a nursing student, he found the courses to be generally easier but he admits not being too focused, not setting himself up for success. He ended up finishing with a GPA of 3.01. He was doing just enough to pass the classes and to get into NP school. So got into nursing with the intention of becoming a nurse practitioner.
"I got into nursing with the intention of becoming a nurse practitioner and I actually didn't do much research to figure out what would have been expected of me."
Not having done research as to what was least expected of him to be able to get into NP school, he found out in Junior year that he wasn't actually making the cut. So he realized he had to focus and he ended up going above the 3.0 threshold most schools were looking for.
[06:22] The Desire to Become a Physician
It was during his second year that he thought of becoming a physician. He felt he can really do it. At that time, he was enjoying what he was learning, although he wasn't necessarily doing well. So he reached out to a couple of his professors. Within the nursing community itself, there are teams of physicians and nurses. And the nurses in their faculty responded that he could actually do what most physicians do as an NP unless he wanted to do surgery. They have CRNAs so they could do anesthesia too. But this is not true because there are limitations to what NPs can do. In short, they were questioning why he would want to commit himself to being a physician. At that time, he thought of giving it a shot to see if he'd enjoy it. And so he did.
There are plenty of nurses there that could become great physicians but it doesn't mean they want to or should go on to medical school. Ultimately, what really triggered him to want to apply to medical school was back when he worked (and still is) as an NP at a cardiac surgery ICU. He describes the attending physicians as very inspirational where you get to see patients and so he got to be intimate with patients.
"I felt like if I'm trained, I can offer even more to people."
Matt started as an NP when he was 23 and made the decision to pursue medical school when he was 25. His thought process behind this was what he'd be doing over the next ten years. And he saw himself still doing the same thing day in and day out with the same skills. At some point, he'd be working with younger physicians and figured he'd get frustrated later on in his career. And he doesn't see himself doing administrative stuff either. Additionally, he's a family trained nurse practitioner so he does critical care. That said, he had to do a lot of self-learning.
Students need to understand that when you go to a hospital, you get credentialed by an office that does it. They'd list everything based on your training what you can or can't do. And based on one's training as an NP and the PA's training or the physician's training, everybody is credentialed and privileged at a different levels. This alone, limits you, based on your training. On one hand, you can self-direct knowledge and learn it yourself. You can just go online and buy all these books. But from the activity standpoint, there's still a lot that you're going to be able to do.
Matt adds that they have a great setup for the PAs and NPs. They have a lot of autonomy but the degree of autonomy at their facility was more than most facilities. So if he wanted to switch, he'd be taking some steps back as far as his privilege is.
[12:40] Letting People Know You're on This Journey
Matt actually kept it a big secret that he was going to apply to medical school. But he had to set up his schedule in a certain way just so he could take classes. And eventually, he told people and they were happy for you
He started asking his attending physicians for letters of recommendations and they were all happy for him. He thought he was going to get grilled but they were just very excited for him. Matt stresses that in choosing your career, you have to consider lifestyle balance. And for him, as an NP, it wasn't enough. And although physicians are very busy, they're still happy and making money. They're able to travel and do all those things. That being said, you'd have to go through the rigorous process of being a resident and all that stuff.
"A lot of the people I work with, the PAs and NPs, they couldn't understand why I wanted to do it."
Now that Matt has gotten three acceptances to medical school, he believes the letters of recommendation played a big role in getting accepted. He adds that candidates have to have a level of maturity But it's hard to gauge. And nontrads have the opportunity to showcase what sets them apart from the more traditional student. And Matt feels lucky enough to have people who understand the process and writer letters for him. They've watched him and observed him at the bedside, interacting with patients. "Nontraditional students have the opportunity to showcase what sets them apart from the more traditional students."
[16:20] Course Correction
Matt did a do-it-yourself postbac and finished nursing school. And although he got a 3.01 GPA , he crushed his postbac. And this was because he already had an end goal in mind. He knew what he needed to do to get there. And he would have had himself to blame if he didn't. He says having that sense accountability really helped him.
"I knew what I needed to do to get there. And if I didn't perform I had no one to blame but myself. So holding myself accountable really helped."
Additionally, he thinks being older has helped him understand what worked for him as a student. And balancing this while working, he says working has actually helped him develop time management skills. As your patient list is piling up and you still have a hundred other things you need to do, you figure out how to get things done. So he simply made sure to take care of things that need to be taken care of and when it needed to be done. This wasn't something he had during his undergrad.
Matt admits having questioned why he was doing this at some points. Whenever he'd be asked why he's doing this, he would have to reflect on why he was actually doing it. He had to convince himself that it wasn't an egotistical thing. And that he really wanted to do this for a living. Then he realized he was investing everything into this but there's a light at the end of the tunnel.
[18:35] Public Service Loan Forgiveness
There are different pathways you can take to pay your debts off. And so Matt thought of taking advantage of one of them. For instance, if you work for nonprofit for ten years, you make income-based repayments. After ten years, whatever left is forgiven. Matt says this is actually offered in a lot more places than people realize. Matt worked in Washington, D.C. and they're not missing doctors. But there are programs that just because it's not underserved, their nonprofit status makes it eligible for these forgiveness programs.
*Our current administration is trying to get rid of public service loan forgiveness. So for a lot of students going through this process who may be hoping to work for ten years and getting the rest of it get wiped out, it's very likely that it will be gone.
This being said, Matt points out that you shouldn't let the cause of this influence your decision to do it. The regret is a worth a lot more than whatever you're paying in student loans. You'll pay it off. It's not going to happen quickly. But once you're there, it just becomes part of your monthly bills and you're done."
"The regret is a worth a lot more than whatever you're paying in student loans."
And it can happen pretty quickly if you continue living like a student on your attending salary. So it can happen. To add to what Matt said, I want students to understand that if this is what you want, then do it. Don't regret it in ten years that you didn't pursue this.
[21:35] The Interview Experience
Matt recalls his first couple of interviews to be close to his application. They only found out their pathway once they started asking questions. He describes the conversation as being so fluid and very comfortable for him. They would ask more clinical questions from medical students which he was surprised about. Being comfortable with his first interview just kind of added to the momentum he had on his other interviews.
Having had multiple interviews and acceptances at this point, Matt says what has been the biggest key to his success was by doing well in his postbac and on the MCAT. HE also tried to tell his story as compelling as he could. Everybody has a story when they're approaching this but he thinks having had the background that he has, his story is interesting. So it's all about telling a good story and letting them understand that he's into this and that it resonates with the,.
"They're interviewing people who are academically capable of doing it. They've already weeded that out. They want to know who's actually going to embody their philosophies."
In framing his story, he saw being a physician as an evolution of his career. And having learned from every experience, he critically reflected upon the good and bad decisions and was able to grow from that. So he made this very clear to the people he was interviewing.
One of the biggest mistakes students make is they talk from the standpoint of knowing what being a physician is like and they're prepared for it. But you don't really know. And even as an NP, there are probably things they wouldn't know at the back end of things.
[26:07] Working as an NP While in Medical School
Matt is considering working on the weekends once a month or so just to have a little extra spending money. He has always worked days and nights so his body is used to being awake at random hours. Also, whatever he learns in medical school, he could probably apply into the clinical setting early on. Nevertheless, he intends to make a little bit amount of money while in medical school.
[27:15] Matt's Hopes in the Future
Matt foresees himself going into surgery, not knowing what exactly. But he loves doing procedures, like he's doing his procedures now. And he gets a lot of gratification from seeing things that work and that don't and then find a resolve. For now though, he is loving cardiac surgery, where he is working for four years now. And he finds the specialty to fascinating. But he feels it's still too soon to tell.
[28:40] Dealing with Negative Feedback from Other People
Matt did receive some discouragement from getting into medical school. But he thinks these attendings are reaping the rewards. One suggested he was doing it for the money. But he didn't want to argue since you're not making any money until much later anyway and you've already invested so much. He has never been motivated by profit.
Money shouldn't be a concern for Matt considering that he has already been working as an NP. He adds that you can't do this for the money.
"You definitely can't do this for the money. And if you try to do it for the money, you'll become exhausted and frustrated about the whole process at some point."
Finally, Matt says that if you're more interested in what you're going to do day to day, physician is the way to go especially for the more intricate subspecialties, particularly surgical subspecialties.
[31:10] Matt's Finals Words of Wisdom
For those thinking about becoming an NP or PA or looking at medical school and questioning the path they're on, Matt's advice is to do a lot of shadowing experience to see what the different professions do day to day. Just see what's out there and what's available. Then be honest with yourself. Are you willing to commit the time it takes and sacrifice the time, money, including your weekends with friends and the vacations. It's going to be a lot of sacrifices for a very long term investment.
The most rewarding thing for Matt so far is when he got accepted, having waited so long for it. And eventually, you grow as a human along the way as you're helping patients and their families.
- 2018-01-10 10:00:00 UTC