Gunner Training's founder (who is also currently a Resident in the Harvard Combined Plastic Surgery Residency Program and a clinical research fellow at the Massachusetts General Hospital) was recently interviewed by Omar Baig (founder of PreMedNetwork.com, a leading network and resource for pre-med and medical students). In the interview, Frank talks about challenges future students will face, what he loves about his work, etc. The original interview can be read here as well as below.
We look forward to your thoughts and comments!
Q: What do challenges do you see for physicians in the future?
"As a profession we face a number of complex and daunting challenges, all of which are redefining medicine. We have to address new limitations/regulations on our training, the continued expansion of healthcare as a percentage of our national economy, and the accelerating pace of scientific/medical discovery.
A fair amount has been written regarding the limitations on both medical student and resident education. One article that stands out in my mind talks about the “4 horsemen of the medical education apocalypse.” In short, teaching patient shortages, teacher shortages, conflicting systems, and financial problems work in concert to undermine medical student education. In residency, similar factors exist that undermine resident education, including the transition to mandated limits on work hours, and increased patient volume at the same time as increased demands for top-quality care.
As for healthcare as a percentage of GDP, in my mind the massive amount of money at stake means that more and more non-physicians will enter the healthcare marketplace. We simply aren’t training enough physicians to handle the volume, so physician extenders, pharmaceutical companies, and others will expand to fill that void. As physician share of the healthcare market shrinks, our influence will also diminish. Ultimately, I think patient care will suffer. So as a profession, this is something we need to address but it’s obviously a tricky problem.
Lastly, the pace of scientific and medical discovery is accelerating far too quickly for our current educational system. In 2009, more than 80,000 clinical trials were conducted. How are we, as physicians, going to parse these findings for the most significant ones and incorporate them into our practices? That’s why I think systems like Gunner Training will be increasingly important."
Q: What do you like best about what you do?
"The most rewarding experiences are ones where I’m the one curing a problem. While it can be life saving (e.g. relieving a tension pneumothorax), it doesn’t have to be – I’ve enjoyed debriding and treating decubitus ulcers because I’m the one doing it."
Q: What are the things that really matter in being a great physician?
"I think this is a difficult question. I think the primary driver in being a “great physician” is a desire to provide excellent patient care, regardless of the cost. You have to be willing to go the extra mile to do a thorough physical exam, to push for the CT or MRI that rads doesn’t want to approve, etc. On the other hand, that same drive can get in the way of providing great care. For example, if taking care of a patient forces you into conflict with other medical staff and physicians, well that’s great if you can get it done but it can hurt your efforts to care for other patients later on because you’ve angered some colleagues."
Q: What are some important skills to develop as a student?
"Two skills come to mind here: 1) learning to think in a very organized, rigorous fashion and 2) not forgetting the things you’ve learned. For a physician, rigorous, clear thinking is the difference between doing all the right things for your patients vs. doing an “ok” job. It’s also the most important tool for excelling academically. If you can master the second skill, not forgetting the things you’ve learned, then classes become a lot easier."
Q: How much physician shadowing experience do you recommend for premeds?
"I think it’s important to get just enough shadowing to get a realistic picture of what medicine is like. Real medicine isn’t about saving lives all the time or making great discoveries all the time. It’s not even about having great relationships with all of your patients. I think pop culture and our tendency to place medicine on a pedestal tend to give us the wrong impression about medicine.
Beyond that 'just enough,' shadowing doesn’t teach you any skills, it doesn’t teach you any medicine or science. It would be better to spend that time learning real-world things, like how to execute a plan or how to navigate complex systems to accomplish actual goals."
Q: What role have mentors played in your life?
"Mentors have been critical in my professional life. Great mentors set the bar, so when work gets difficult and you’re tempted to cut corners, you can always think of your mentor and have a true gauge of the right thing to do. Mentors don’t have to be attending or professors; two of my best mentors in med school were residents."