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2. Osteopathic Medicine and Surviving Your Second Year of Medical School with Dr. Bryce Brohol ๐ŸŽ™๏ธ

Updated: 3 days ago

๐ŸŽ™๏ธ Podcasts are a great way to learn about a variety of topics, and The Physician Pharmacist Podcast is no exception. Hosted by licensed pharmacist and now 4th-year medical student Nathan Gartland, this podcast explores the unique pathway of combining pharmacy and medicine. In episode 2, Dr. Bryce Brohol joins Nathan to discuss his experience as a second-year medical student at Liberty University College of Osteopathic Medicine.


๐Ÿ“• The podcast is structured around several goals, including an overview of the medical school application process, a discussion of osteopathic vs. allopathic medical education, and insights into medical research and specialty choices. Nathan and Dr. Brohol cover a lot of ground in this episode, sharing their personal experiences and offering advice for listeners who are considering a career in medicine.


๐Ÿ“˜ One of the most interesting parts of the podcast is when Dr. Brohol discusses his journey from pharmacy to medicine. He explains that he always had an interest in medicine, but didn't want to dedicate that much time to studying. However, after observing physicians and residents on rounds during his introductory rotations in pharmacy school, he had an epiphany and realized that medicine was what he wanted to do. This is a great example of how exposure to different fields can help clarify your career goals.


๐Ÿ“— The podcast also covers the application process for medical school, including advice on how many programs to apply to and the importance of letters of recommendation. Dr. Brohol shares his experience of applying to 15 osteopathic programs and 40 allopathic programs, as well as the challenges he faced with his GPA and academic integrity issues. He also discusses the importance of preparing for the MCAT, and how he had to navigate taking the exam while balancing a rigorous pharmacy curriculum.


๐Ÿ“’ One of the most informative parts of the podcast is when Dr. Brohol explains the difference between osteopathic and allopathic medicine. He notes that there is no clinical difference between the two, but that osteopathic physicians are required to complete several hundred hours of osteopathic manipulative medicine practice in school. This hands-on approach to medical care combines aspects of physical therapy and chiropractic, and is unique to osteopathic medicine.


๐Ÿ“• Throughout the podcast, Nathan and Dr. Brohol offer valuable insights and advice for aspiring medical students. They stress the importance of understanding your personal strengths and weaknesses, and tailoring your application accordingly. They also encourage listeners to take advantage of opportunities to explore different fields through volunteering and shadowing, as these experiences can help clarify your career goals.


๐Ÿ“˜ Overall, episode 2 of The Physician Pharmacist Podcast is an engaging and informative discussion of the unique pathway of combining pharmacy and medicine. Nathan and Dr. Brohol offer valuable advice and insights for aspiring medical students, and their personal experiences provide a relatable perspective on the challenges and rewards of pursuing a career in medicine. Whether you are considering a career in medicine or simply interested in learning more about the field, this podcast is definitely worth a listen.

For more resources to get started, check out some of our other blog post content!

Enjoying the podcast and want to listen to more? Visit The Physician Pharmacist Podcast for a list of episodes. Here's a featured episode below!

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Osteopathic Medicine and Surviving Your Second Year of Medical School

Podcast Transcript:


nathan gartland

Welcome to the physician pharmacist podcast, a show designed to shed some light on a very unusual pathway into medicine. I'm your host, Nathan Gartland. I'm a licensed pharmacist and second year medical student. I'm also the author of farm D to MD and the owner of the physician pharmacist company. Most pharmacy students and professional graduates are aware of the possibility of going to medical school, but very few actually take the leap. We're here to unpack some of these details and open your eyes to the possibility of a career in both pharmacy and medicine. In today's show we will be we will cover topics related to applying to medical school and in depth look at osteopathic medicine, the importance of research not only for pharmacists, but for medical students alike introduce national medical boards and finish up with expectations for clinical rotations. I'm very excited for our second episode of the physician pharmacist podcast mini series where we will be interviewing Dr. Bryce grow Hall, a second year medical student and good friend of mine from pharmacy school. Dr. Gro Hall first began his journey by attending Duquesne University where he completed his pharmacy doctorate in 2020. Upon graduation, he elected to continue his health care training by receiving his for his medical education at Liberty University College of Osteopathic Medicine in Virginia. He is also almost done with his second year of medical school and has begun preparation for our first set of national medical boards, formerly known as USMLE. Step one and the complex. Welcome Dr. Gro Hall.


Speaker 2

Hey, Dr. Gartland. Good to be on. So I said my name is Bryce roll hall. I'm a pharmacist graduating from Duquesne University in 2020. Originally from Hershey, Pennsylvania, now located in Lynchburg, Virginia.


nathan gartland

All right. Wonderful. Well, thank you for joining the show today. We're just going to start out with a few general questions. And then we'll kind of work through the episode and you know, address some of the points that we covered in the beginning. So now that we've heard a little bit about you, let's start unpacking some of the details of you know, and your origin story. What got you started with pharmacy in the first place.


Speaker 2

So I feel like a lot of people who get into the medical field in high school, I was always good at science and math. I feel like the natural progression is their first thought is obviously something in the medical field, not necessarily a pharmacy or medicine necessarily, but something in that area. Pharmacy offered a little bit of an expedited route. Only six years at most schools. It came with a fairly prestigious title, a doctorate and a pretty good starting salary.


nathan gartland

That's fantastic. Yeah, I mean, that's part of the reason you know how I started with pharmacy in the first places as well. So, you know, was going to medical school, then always like your plan, it seems like you were focused more on pharmacy for that, you know, initial period of time.


Speaker 2

So to be honest, I always had an interest in medicine. I remember being a freshman and a sophomore at Duquesne University. We were I was doing some volunteering at a hospital. They were it was a requirement for Duquesne University undergrads. And I remember seeing the physicians, the residents on rounds doing their thing in their offices. And I always Honestly, I was always really in awe about that. I thought it was so cool. But once again, I didn't want to dedicate that much of my life to studying I always thought, you know, I don't want to be in school until I'm in my mid 30s. So I kind of push it to the back of my mind. Fast forward a couple years when I'm on my introductory rotations, it was my AP to actually I was in the ICU at one of the nearby University of Pittsburgh hospitals. And when we were rounding in the ICU on the team, I kind of watched the residents, the fellows and the attendings interact. It was kind of sort of an epiphany where it was like, wow, like, that's what I want to do like this is it. It wasn't something I was looking for something I expected. It kind of really just came out of nowhere. Was there from there on out? You know, that was that was a?


nathan gartland

Yeah, absolutely. Was there anything in particular that like really solidified it? Or was it just the cohesiveness and like the hands on part of medicine that, you know, really invigorated you to, like pursue this particular career.


Speaker 2

So it was kind of going back and forth between the attending and I believe he was the acute care Fellow at the time. It was kind of just their open discussion they had with each other where they were guiding how the rounds were going. The pharmacist was important, the nursing staff was important. But you know, these were the guys they were in charge, they were making the medical decisions. And they were the one kind of using their expertise to really guide the treatment of the patient. And that's something that really appealed to me. And something that I didn't realize that was important to me until I kind of saw it in action for the first time.


nathan gartland

Yeah, absolutely. And then kind of using that your pharmacy knowledge and background to kind of take that level of care to the next step is, you know, super important as well. So additionally, you know, let's kind of look into your medical school application period because we you know, both of us went through this at the same time. And we did it during our pharmacy tenure. And you know, that was had a whole bunch of, you know, pitfalls and issues with that. But so let's talk a little bit about applying to medical school. We already addressed some of the application logistics in our first episode of the series with Dr. Timothy do. But I'd like to further this discussion, you know, with your own reflection and expertise. So when did you apply? What roadblocks did you overcome? And how did you tackle the MCAT.

Speaker 2

So I applied, I submitted my application, and it was around June or July in the summer, between my my fifth year and my sixth year. So I would say, I started working on my application just before clinical rotations in our app, you started your sixth year, I would say honestly, the largest roadblock, I would say wasn't even the MCAT. I'll touch on that here in a second. But I would say the biggest issue is realizing that I all of a sudden had to build a CV. I was not extremely involved in pharmacy school, because I'm sure as a lot of you watching this know, or listening to this knows that in pharmacy, unless you're interested in an extremely competitive residency program, it's it's kind of a little bit more Completion ask, you don't really need a really high GPA to get into a lot of different pharmacy fields. Specifically, retail. Being involved in organizations is kind of fulfilling and can be fun, but it's not as important. Unless you're looking for that high level residency. It is more of a completionist thing, where you know, you're applying to medical school, it is very important based on your research, your your volunteering, your grades, things like that. So kind of overcoming those first few years where I really wasn't terribly involved, that was a challenge. Moving on to the MCAT. The MCAT was a challenge. But I would say it was more so for a challenge because we had to navigate it. While we were involved in the rigorous pharmacy curriculum, I can honestly say that pharmacy was just as hard if not more difficult than I found medical school to be. So finding time to tackle an exam as enormous and just intimidating as the MCAT. while also trying to keep up my grades in pharmacy school, that was a very large challenge, I found myself doing 1415 hours of studying a day, seven days a week for probably five to six months straight. And that that became exhausting after time.


nathan gartland

Yeah, I definitely can reminisce of those fun, fun, late night, library sessions, and you just had a lot of good stuff in there. And that I want to unpack real quick. And just to clarify for the audience, you know, when it comes to medical school applications, most most of you might not be aware that it's actually a year long process. So it needs you basically have to have your whole application set up and prepared ahead of time, in comparison to maybe something like a residency, like a pharmacy residency that can be done, you know, obviously, through the tenure of your school, as you get research projects, and so and so on, and you know, work on your grades, but the actual application period is relatively short compared to the medical school process. Yeah, I love that. And then especially with the MCAT, you know, that's a very important medical school metric, that a lot of you know, pharmacists, and, you know, regular medical, you know, applicants overlook in the sense that they think this test is something that can be shooed away from and it really isn't, you know, that we have ended up having to take the exam twice? And do you want to tell us a little bit more about, you know, our first and second attempts at the MCAT?


Speaker 2

Yeah, so me and Dr. Gartland, kind of had a had a time on the first MCAT go around. We both I think largely underestimated. I wish I had never taken an exam like that before, I didn't realize the level of importance weighed upon not only, you know, the facts and the details of all the different body systems, but really just taking the exam. Getting used to an eight hour exam is not something that that should be overlooked, because I would argue that is far more important than the information itself. I believe, I don't think I think I might have taken a single full length practice exam prior to taking it the first time. And obviously, as as we discussed, I took it twice. So the first exams were did not go too well. The second time around, I believe I took somewhere in the neighborhood of nine or 10 full length exams. And obviously seeing that I'm in medical school now it kind of went a little bit better than the first time. So definitely would recommend taking more time to practice questions and practice full length exams.


nathan gartland

Yeah, 100% agree with that, you know, folk for any one interested in you know, pursuing medicine focus on the MCAT. That's going to be your primary, you know, barrier to entry for a lot of medical schools considering you have the pharmacy background and life experience that a lot of other applicants might not have. So moving moving on, how many programs did you end up applying to? And what would you recommend students apply to more or less of the the number that you picked?


Speaker 2

So I'm in a fairly, I was in a fairly unique situation, my GPA coming out of pharmacy school was not great. You will be evaluated with your GPA side by side as someone who did philosophy as an undergraduate or psychiatry. So where they were getting a 4.0, you know, taking general science courses or four years, we were taking pharmaceutics and all these, these clinical body system pharmaceutical courses with high level biology, chemistry, so in they don't really give you a lot too much slack. So my GPA was on the lower end. At the same time, I also had an academic integrity from my freshman year. So that's something that weighed negatively on application a lot. So that being said, getting back to the question, I applied to a lot of programs, I believe it was something around 15 osteopathic programs and 40, allopathic programs, that is far more than the average student, I believe the average is somewhere between 18 and 20 for the normal applicant, but like I said, that's something that you would need to tweak to your application, your strengths, weaknesses, as far as if you're willing to move across the country, do you want to stay where you are? It's, it's a very personalized decision, I would say.


nathan gartland

I think it's funny too. But there was a point in time where we would add another program pretty much every other week, and then you would text me Oh, I just added this program. And I would be you know, very pressured to to also add that program. So we were probably building off of each other a little bit there. So definitely, like you're definitely right, the amount of most applicants apply around 18 to it's raising so around 25 wishes while but there's no perfect number, I think it depends a lot on like the statistics of the individual. So additionally, you know, applying to medical school has a lot of moving parts. But one feature that is commonly overlooked are letters of recommendation. How many letters of recommendation should applicants get? And do students need a do letter of you know from a physician, like a letter of recommendation from an osteopathic physician for like admittance to an osteopathic program? Because this is something that I came across and it helped me up in some areas.


Speaker 2

So once again, that's it's it's not really clear cut answer, you know, you're gonna have to do a lot of research about individual programs because every medical school has their own requirements. Some are very easy and vague. Well, they'll say, hey, just give us three letters from faculty or school. Nothing more specific. Some will say, hey, you need five letters. One is science. One is non science, one needs to be a principal investigator for a research project, one needs to be an administrator, and one needs to be a physician. So it really depends on the school. Overall, I believe I have six or seven total because you can pick and choose which letters you send to which programs. So overall, I'd recommend you get to science faculty, I would say one non science faculty, I would get a letter from a research faculty member, a letter from an administrator or your school if you're close with any of them. I would also recommend getting to physician letters if you are applying to osteopathic programs, and I will touch on the osteopathic one in a moment here. But definitely if you can want allopathic and osteopathic would be best, as far as needing an osteopathic letter for their programs, specifically, that's also going to depend on which schools you apply to a large number of schools do require a letter from an osteopathic physician. But I would say it's not an overwhelming majority, I would say probably about 60%, the other 40% however, they strongly recommended. So is it a requirement for those programs? Absolutely not. However, if you're looking to get into medical school, you don't really want to lower your chances any more than you have to. So if possible, it's definitely better, you're better off to try to get one.


nathan gartland

Yeah, that 100% I think the general recommendation is to get approximately five. And then obviously, the more letters you get, the better because you can pick and choose, like you mentioned of which programs they go to, or if you know that you have a very strong research letter that might be something that you utilize for a heavier Research Program, heavier, you know, emphasis on research on their application. So you also mentioned a little bit too with ABI rotations, you know, I guess with hippies that was influential and you know, kind of in figuring or helping you direct yourself towards, you know, a pathway in medicine. Was there anything that you experienced on copy rotation specifically that furthered your interest in medical school?


Speaker 2

I would say yeah, as I went through my rotations, I would say my overall interest in medicine definitely increased. They kind of I felt like it would verified what I had learned in my in my second introductory rotation. I felt like I had made the correct decision, not only because I didn't really enjoy the pharmacy aspect as much, there's no doubt that pharmacists have an immense importance in the medical field and patient care. I think a lot of physicians would be lost without their pharmacist on call in a lot of hospitals. That being said, it wasn't specifically for me as you know, I as I because I am where I am obviously now. That being said, as far as specific specialties I would say that there's no I think of my my earpiece that steered me towards a specialty, but it definitely steered me away from a few. Just for example, I loved oncology class. When I took it in pharmacy school, I thought that that was going to be a really a really high a really strong interest for me going into medicine. I in that I did a Clinical Oncology rotation at the Johns Hopkins Hospital in Baltimore, and hated it. It was depressing, it was just absolutely not something I could see myself doing. And I think I realized that I liked the course professor, the professor who taught us more than I like the information. So that was a little bit of a difference there. So it's something that I've definitely realized is not in my future. So there was that benefit of my rotations. Yeah,


nathan gartland

and that's exactly what rotations are forced to kind of check off a few things you might not find the perfect match, you know, when you you know, advance through those particular rotations, but you will definitely cross some some things off the list. It's funny because I remember, you know, my Hopkins rotation and I absolutely loved my oncology, you know, rotation, but you're the opposite of that. But I also hated cardiology. So it's just kind of goes both ways. And that's something you know, I know you're interested in. Alright, so let's take a few minutes and talk about osteopathic medical schools, and unpack some of the ambiguities of Osteopathic Medical Education. I'm sure some of the listeners are curious to explore the differences between this field and traditional allopathic medicine such as MD credentials to some the credentials do our mystery despite their abundance and equal ability to practice under law. Could you give us a short overview about the profession?


Speaker 2

So honestly, the simplest way to put it is the osteopathic physician and the allopathic position, there's there's no difference clinically, the real difference comes in is that osteopathic physicians are required to complete it and it's going to change depending on the school somewhere between three to 400 hours of osteopathic manipulative medicine practice when you're in school. So if the if that has its benefits, however, it does make things a little bit more time consuming, less time to study for boards, less time to study for courses. So it can be a bit of a negative depending on who you talk to. But that that really I would say is the is the only true difference in practice. I don't know if any of the listeners have a lot of experience in the hospitals. However, a lot of the time the physicians name tags will just say physician you won't even know if they're an MD or do there's actually been a few times I remember from happiness where the physicians and techs at MD and I looked them up to see where they went to school and they went to an osteopathic medical school. So there's really just after medical school after rotation, the ambiguity between them really is almost non existent in most institutions.


nathan gartland

And you mentioned this additional training, I believe it's called like osteopathic manipulative medicine or something along those lines. Oh, mm. Can you tell us a little bit more about what that is? Exactly? I know that it's a hands on approach to to medical care. But you know, could you unpack that a little bit more for us?


Speaker 2

Yeah, so osteopathic manipulative medicine is basically the hands on portion of what you will learn as an osteopathic physician, I would describe it best as a hybrid between physical therapy and chiropractic. It's a little bit a little bit more of the milder aspects of chiropractic. It's a lot of range of motion. It's a lot of telling, looking at tissue tissue texture changes, looking at displacement of muscles, bones, things of that nature. And really what it is, is you're basically looking for a simple way to treat a patient's condition without prescribing medications without ordering expensive tests, something you can do right there in the office, that if it solves their problem, phenomenal. And if it doesn't, you still have all the tools that an allopathic does to continue on with their treatment. So that's really the best way I can describe it. It's kind of just a first step therapy that in the right situation, it can maybe be advantageous. And other times, like I said, you can kind of just move on and treat them as any physician would. And if not used in every situation. Obviously if the patient comes in with difficulty breathing and heart palpitations, you're not going to be looking to treat them with omm.


nathan gartland

Absolutely. And you know, as a fellow pharmacist, I can understand you know, avoiding medications as much as possible because we know all the side effects that are associated with them. And polypharmacy is a major problem. So looking for alternatives that might be more effective. Before we non pharmacologic, you know, alternatives is definitely an important facet of medical care. So I've also heard some arguments that osteopathic medical students have a harder time matching into competitive competitive specialties. How true is this statement and is there truly a disadvantage or is this more of an antiquated viewpoint?


Speaker 2

So it's it's kind of a little bit of a given take. Overall, the answer would be yes it is it is harder to match into a competitive specialty as an osteopathic student. I think the word, I think the words more difficult, the phrase more difficult has morphed into impossible in some circles. I have spent my fair share of time on student dr.net and read it and you will see a lot of misinformation on there. And like I said, in general, yes, it is more competitive. But that is far from impossible. Just recently, in our last class, we had this this past match of weeks ago, we had two students mentioned a dermatology two into orthopedic surgery, and somebody read matching it to radiation oncology. So there really isn't any specialties that are off limits, it's just going to require a little bit of harder work, it's going to require a little bit more perseverance. And to be honest, if you're motivated, and it's something you want to do, it really shouldn't be a problem. I personally am interested in orthopedic surgery. And really, I'm doing everything I can to make that possible extracurriculars research grades, and I truly believe that it's not going to be an issue for me. On the flip side of it being more competitive it also in some residence and some specific residency programs, it's almost easier because you do have the traditionally osteopathic only residency is prior to the merger with the nrmp. Or I forget the actual name of the organization, but the merger with MD and DO residencies technically MDS can apply to those residencies. But historically, and even after the merger, they they do traditionally take DEOs only so you do have a fair number of spots that are almost reserved for back roulette for lack of a better word. So there is opportunity.


nathan gartland

Yeah, and I think a lot of that information, that misinformation that you were discussing, is an antiquated viewpoint in the sense that it's been many, many years since that data has been, you know, pushed out there. And I think programs are becoming a lot more accepting of having deals on on staff and they're becoming equal basically professions, not to say that they weren't equal before. But um, you know, when it comes to matching it to some of the more prestigious hot like, traditional medicine, residency positions, so I think within the next 10 years, you know, there will be no distinction between them, which is, you know, a wonderful thing. So let's take a minute and transition over to research. So similar to pharmacy school, medical students are expected to get involved in academic research to help bolster their future residency applications. I have been a major proponent for working as a pharmacist while in medical school to stay up on my license and generate some additional income. Because of this, I'll admit that I've been much less involved in research during my tenure. While I still feel there's ample time to get involved, I wish I had gotten involved a little bit sooner, to have some more projects under my belt. I know you personally have chosen to work a little less to forward your research aspirations. So my question for you is how was your pharmacy background helped you conduct research, and why is research so important during medical school?


Speaker 2

So I would like to preface and say that I have not worked. During my time in medical school, I am licensed in the state of Virginia, I could go work in a retail pharmacy if I wish to. And I would also like to say that I could, what the time constraints, there'd be no reason that I couldn't pick up one or two shifts a week and make that entirely possible while still being successful in medical school. I have chosen not to just because with my interest in orthopedic surgery, I felt like I kind of needed to dedicate all of my time to schoolwork, research, extracurriculars, grades, things of that nature. With research specifically, I feel that my pharmacy background in completing the research, I would say it hasn't really had much of a benefit either way or a negative. I think where it's helped is kind of seeking out research projects. Coming from a pharmacy school and coming from a similar doctorate program, you realize, you know, how to find projects, what's the best way to go about doing things, how to network and work your way into different avenues of research. And that's something that I didn't really have to learn it was something I already came in with that knowledge base. And I'm sure there were students who didn't go to barber school who had that knowledge as well. However, that's just how I personally felt it helped me the most it wasn't kind of walking into. It wasn't it wasn't walking in blindly. I felt like I had a good background to build on and how to find projects, how to network and how to really make the most of my situations. As far as research being important in medical school, I would say it really it's that my answer is going to change based on what specialty you're interested in. I would recommend everyone does some sort of research because of the end. You don't want to get to your third years realize that you love surgery or dermatology and then realize hey, I didn't do anything yet. So I better kick get it in gear so I'd recommend finding something. However, that's not saying that everyone needs to go out and have seven posters for publication. And and, you know, five more being written in his manuscript currently. Yeah, it's gonna be very person dependent.


nathan gartland

Absolutely. And yeah, like you said, it's very dependent on the particular of interests that you have and what kind of specialty you want to pursue later on. I know, for orthopedics, I believe that the most recent data suggested that applicants who match needed about five research projects, it doesn't really define if it's a publication or, you know, presentations or just being involved in a project. So, you know, that's pretty big number to, to kind of meet and match. And obviously, you want to be above the average when it comes to competitive specialties, like vascular surgery or radiation oncology, like you mentioned, or even dermatology. So definitely being on top of that, and using your your pharmacy background is very helpful when it comes to finding projects. I think a lot of it too comes from, like you said, the professionalism component, you know, how to approach a lot of the research coordinators, as well as just having that farm deep behind your name. It's essentially like some credentialing and that you're basically a shoo in for any kind of medication based projects, you know, they want you on this project. Oh, you're a medical student and your pharmacist. Wow, you know, this is perfect. There's meant to be. So I think that's also a very helpful feature. So, transitioning on. So essentially, it's difficult to work on projects, obviously, during the semester, is there anything you would recommend to pharmacy students or medical students? You know, how do they balance, doing research while doing good in school?


Speaker 2

Yeah, so I would honestly, my first recommendation is, don't do research your first semester. I know some people do. And there's a lot of people who are good students who can manage both. However, everyone in undergrad thinks that they are going to get into medical school and knock it socks off, they think they're going to be the top of their class. And in reality, I think, as a pharmacy student, you're a little bit more prepared in this avenue, because you've already dealt with a rigorous course load. However, a lot of people don't realize how difficult it is, you can hear other people's perspectives. But in the end, you have to really experience it to know that, hey, you're going to be studying 80 hours a week, like, at least some people will some people can get away without doing that, however, so I would get your footing first academically, find out what works for you how to study the best, with the least amount of time being the most productive with the time that you're putting in. Once you go from there, you can find time to work in your research projects. A lot of projects are not going to take up 2030 hours a week. I know a lot of my projects require me to do maybe two, three hours a week. And then obviously that can give or take depending on what's going on. But really, like I said, just find out what works best for you academically and studying. And then you can kind of figure out, how much time can I divulge to research? When can I do it, maybe if you have an exam coming up, maybe make it a little bit less effort. But like I said it really, the first thing you got to do is find out you know how to go about your academics the best way you can.


nathan gartland

Yeah, and always having research projects not only helps your application to medical school, but it also will help your application for pharmacy residencies. If you're not particularly interested in medicine, or you might be interested in medicine to three years, you know, outside of school. So it's important, you know, when you have those resources to to take advantage of them reach out to research coordinators, reach out, reach out to your faculty and seek out those opportunities, because they're there, they might just be tucked away. Awesome. So I think we're ready to transition to our next big topic, which is discussing step one. And step one to clarify as the USMLE step one exam, which is are basically the first of three national licensure examinations required to practice medicine. This is essentially like an eight Plex, but during the middle of medical school, so traditionally speaking, your score would serve as a major qualifier to make you competitive for a specialty of interest. Just this year, there was a massive decision to make the exam pass fail. So what is on this exam? And how how much do medical students typically need to study for it? How would you compare it to the nape Plex to put it in perspective for our listeners?


Speaker 2

So in comparing it to an exam, I would say it's far closer. Well, for people who haven't taken the MCAT I would compare it way closer to the MCAT than I would to nape Lex. But to kind of describe what is on the exam, I would say it's basically just a culmination of everything you've learned in your first two years of didactic curriculum. It's very nitpicky, it's very detailed and it's very disease or it's very does disease oriented, I'll say for lack of a better term. Basically, it's questions that will give you a list of symptoms, maybe some imaging, maybe some labs and you will basically have to come to the conclusion of You know what, what is this patient dealing with, they'll throw in biochem, they'll throw in histology, things that aren't as clinical in nature, but are extremely important for physicians to understand and have a background for when they're making clinical decisions. As far as how much you need to study, this is kind of a new, we're kind of shifting in a new direction here with what we just discussed as being pass fail, because prior to this, a lot of people studied for five, six months kind of full time, because you want to get the best score possible. Now this is shifting to pass fail, getting that top two, your score isn't nearly as important. And it quite frankly, isn't worth sacrificing your grades at your school. Me personally, I try to allocate around 15 hours a week to studying, that's going to basically depend on exams as well. So I just had a large exam the other day, the week prior, I didn't study at all just because it was too time consuming to watching lecture and getting everything organized. However, this coming week is or this week I'm currently in is a little bit more laid back. So I will probably allocate, I would probably say maybe 25 to 30 hours to kind of catch up and make up for that previously.


nathan gartland

Yeah, I think it's been a monumental decision to switch it to pass fail. Just you know, from our perspective, it's much easier because we don't have to put in as much effort at the time. And I agree with the decision just because like you mentioned the material itself. It is more clinically minded, but a lot of it is very superficial clinical medicine. There's not as strong of an emphasis on medications. It's very nitpicky, like you mentioned, as well as there's a lot of histology. If our listeners histology is essentially cells, it's not something you you get exposed to quite a bit in pharmacy school. So when that when I had my first histology class, I was pretty confused of what was happening. We were looking at, like microscope slides. So it's pretty useful for a pathologist perspective, because that's how we make a lot of diagnoses, based off of like cellular pathology, but that's also something that we're tested on, which I don't think is completely relevant, especially when you know, 90% of people graduating, I'd say 99% of medical students who are graduating are not going to be pathologist. So I don't know why we have to look at, you know, cells in a petri dish. But that's my two cents. So as an osteopathic medical student, do you take different boards in the USMLE? Step one.


Speaker 2

So yes and no. So to be licensed in the United States, as an osteopathic physician, you are required to take complex AI what the acronym stands for it is slipping my mind at this exact moment. But basically, it's the osteopathic equivalent of USMLE. Instead of step one, you take level one. Now, for the yes and no component you are like I said, you are required to take all three levels of complex level 123. However, if you are interested in a specialty that is predominantly MD driven, which if we're being honest, or most of the more competitive ones, it's not mandatory, but it's almost in full, it's almost an informal rule that you should take USMLE as well. I will personally be taking both exams, and I recommend that any osteopathic medical students or pharmacy students applying to osteopathic medical school, I recommend you take USMLE in the future as well. I hope that that will switch someday and that you want to take a look at some boards. But as of now, that's kind of a hand you're dealt if you want to remain competitive for a lot of these specialties.


nathan gartland

Yeah, absolutely. And, you know, I think it's interesting, too, that this decision to make it pass fail, it forces students to focus not so much on you know, one single exam that defines their entire career and allows them to bolster their application, like we've mentioned already, through research through a community involvement through shadowing experiences, and obviously, you know, academic grades. So I think that's, I think it's a good direction that we're headed in, although we're the guinea pigs for this experiment. So I might be, I might have a very different opinion in a couple years. All right, so gearing up for clinical rotations, we're gonna switch over to our last topic of the day, which would be our medical school clinical rotations. So unlike pharmacy, medical students start their clinical rotations during their third and fourth years. Some programs even are even starting rotations after just 18 months of education, so about a year and a half. Like most things, students tend to learn the best through hands on experiences, similar to appy rotations in pharmacy, medical students are expected to complete several mandatory experiences. Would you be able to briefly talk about the different rotations medical students take and how that would compare to Abby rotations? Because for Abby rotations, for example, we would do an acute care rotation versus you know, how does that translate to medical school rotations?


Speaker 2

So to touch base a little bit on the structure of rotations, I would say the overall structure is similar to pharmacy school where you have a set number of mandatory rotations that every student takes These are generally for a medical students. These are generally done during your third year. And they'll include things such as internal medicine, OBGYN, pediatrics, surgery, Family Medicine. And then depending on your school, you may get some elective rotations during your third year, I personally don't, my entire three year schedule is picked for me. And then your fourth years, you will get your chance to do your elective rotations. As opposed to pharmacy where only some people do residency, obviously medical students, everyone is required to do a residency to practice medicine. So some of these elective rotations will be turned auditions or sub internships sub i, these are going to be rotations that you do at hospitals that are residency programs you're interested in. So it's basically just a two to four week job interview. These are things you have to apply to. And a lot of them will be the programs that you end up doing a residency at it. So it's extremely important to take them as seriously as you can.


nathan gartland

100%. And I actually appreciate that we start rotations a little bit earlier in the education process compared to pharmacy, which is in the final year. I enjoyed that we started in our third year because it gives me more time to experience a lot of different fields, and really hone in hone in on what kind of medicine you know, field of medicine I'm interested in. So for instance, I'm starting surgery first this summer, and I've never even been in an operating room before. So I think that's a great opportunity to really, I'm just gonna get tossed to the wolves. But it's I mean, that's how you learn the best. So it's going to be a fun experience. And I think it's a lot of different things I might not have ever seen before, you know, versus I guess like ABI rotations, I was I had seen a lot of like the community based pharmacy. But with medicine, there's a lot of different avenues that you can take like anesthesiology, or explore some other more niche topics, which I think is pretty cool. So I guess for yourself, you know, what are you looking forward to most for upcoming rotations. I know, my priority right now is like yourself is studying for step one and getting that out of the way. But once we start rotations, what are you looking forward to the most?


Speaker 2

Oh boy. So I'm being honest, the first thing I'm looking forward to is not having class anymore. The second thing I'm looking forward to really is getting out there and back into the hospital. If you're listening to this, now you might be just you might be doing IVs. Or you might be in the middle of your appy rotations and don't take it for granted, being out there in the clinics, actually being able to practice medicine, going from that environment back into a classroom is not fun. And the burnout will hit you way quicker than it will most traditional students because you're on your eighth at this point of higher education where most of them are on year four or five. So really just looking forward to getting back out there, seeing patients just being in the environment of a clinic or hospital, I would say


nathan gartland

I would agree with that 100% as well. Just getting out of the library, like you said, we're on your eighth, we're hardened veterans at this point. And, you know, I leave to the pharmacy, and then I you know, come back the next morning and I have like three hours of lecture like in person mandatory sessions. So that can definitely, you know, hurt the morale just a little bit. Because I'm out here practicing. And then I'm out here we have rotations previously. And we were basically operating, you know, as a pharmacist in these particular settings, obviously with supervision, but it's a very, you know, a very different field to be in when you're actually on the wards. So it's it's exciting. So I am looking forward to that aspect as well. So do you think your skills and training from pharmacy will help you excel on rotations?


Speaker 2

Oh, absolutely. However, not in the ways in my opinion, as much as you'd think having that background knowledge of that medication is inherently important, and it'll be something that will help you succeed. However, more importantly that I would say that a the comfortability of being in a hospital, just knowing how to act and how to attend rounds and kind of stay out of the way but also stay involved. That's something that takes a while and I'm sure Dr. Garland can can attest, it's not something that you pick up on and really get good up until the end of your APA year where you kind of really start to get into a groove and figure out what you're doing. aside for just how to, you know, behave on a rotation, I would say clinical decision making nothing specific but just the thought process of clinical decision making is something that also takes a very long time to hone your skills. And not that we are going to be our experts by any means as pharmacists coming right out of school. However, you're still have a leg up on all your other peers. Being able to take in multiple different pieces of clinical information and arrive at one final decision is not something that you can just learn overnight. So having that experience in clinically in making clinical decisions is really kind of an invaluable piece of information that I think not a lot of people applying to med school from pharmacy school really take into consideration. Yeah,


nathan gartland

I love that. Because what they teach you in pharmacy school is not necessarily the diagnostic component of medicine. But they teach you first, second, third, fourth line, you know, treatment regimens and treatment algorithms. That is something I feel like at least in my medical education that's been overlooked to some extent, because we focus so heavily on diagnose diagnostics. So combining those two perspectives on the medical boards, I think is going to be just super, super helpful for us. You know, what do you do when this first line product doesn't work, or the patient can't take it due to some contraindication. So in a lot of medical students might sit there and think I've no idea I've never heard of these second line drugs versus the pharmacist is like, oh, we have five different products we could recommend. And here's the list of them in order of price. So I think that's going to be something super, super important. I love that point. All right. So we're coming to the final few minutes of our show today. And I want to ask a few closing questions. So do you think this is kind of, you know, adding on to what we just mentioned before, but do you think having a pharmacy degree will help with your ability to practice medicine, or communicate with patients in the future?


Speaker 2

Well, I'll kind of break that down into the practicing medicine and like endemic communication as well. So practicing medicine, I would say definitely, um, you'll realize soon enough, when you're in medical school, that the pharmacology we're taught is extremely baseline. I mean, they're teaching you about ACE inhibitors. And they only tell you about what Senator Pro and don't tell you about the 14 other ACE inhibitors that are out there. And they're unique pharmacokinetics, and all the other things that are just important to know. And at least from my experience, on an app ease, you'll meet physicians who don't even really have a firm understanding of a lot of that stuff. So having that that breadth, and that depth in your pharmacy knowledge will become extremely important, as you're, you know, going on your rotations, and then at the residency and then even practicing as an attending. As far as communicating with patients, I would say that definitely, you have a benefit in coming from a pharmacy program. I know personally, I think that if you have any experience in retail pharmacy, I think that will benefit you even more so. Because you know, if you've been in retail, some of the patients can be difficult is a kind way of putting it. So knowing how to manage that and how to handle people like that. That is, you know, that's something that's going to be immensely important, because you're not always going to have your patients who love to see you and are happy to be there and just happy go lucky. You're going to know how to deal with the bad the bad patients, for lack of a better word as well.


nathan gartland

Yeah, just having that that temperament is super important, as well as that confidence to approach a patient do a, you know, an interview or a history. And then I love when you have to ask about oh, their chronic medications that they're taking? Well, that that's super, super easy, you know, from having a pharmacy background versus all my peers are writing down and scribbling down everything that like a tour of us that and what you know. So it's just a very helpful and useful thing. I think so I think having the pharmacy background has been influential. So for individuals considering medical school after pharmacy school, do you have any other recommendations you'd like to share with them based on your experiences so far?


Speaker 2

So honestly, my biggest thing is, is if you're on the fence, if you're kind of deciding whether or not you want to go to medical school, medical school is right for you. I would make sure that it's something you absolutely want to do. And I'm sure Dr. Gartland can attest to this. And really anyone who's applying to medical school, if you want to go to medical school, you want to be a physician, you know it, it's not something that you're, maybe we'll see how I got how things go. Like, like I described in my sort of Epiphany esque situation. I knew it immediately once I was in that ICU, and I saw those physicians interacting with the residents and the patients like that was dead, like I was done, like my pharmacy career was effectively over for the long term. So just make sure that, that it's something that you really want. This is a long and quite frankly a miserable road. But the end goal is definitely worth it. If it's what you truly want.


nathan gartland

Dr gro Hall is not going to sugarcoat it, but now I'd agree you have to 100% be passionate about this this career path do you have to forego you know, a pretty high six figure income you have to forego you know, the relaxation that you could be having all your friends are finishing up residency or finishing up. You know, they're they get off the clock out of work and they're done for the day. And we're sitting here still, you know, in the library after you know 20 hours of studying non stop so it is a calling I think but um you know, having the background really helps quite a bit.


Speaker 2

Yeah. And just just to add in I do want to preface and say that, you know, this I wouldn't be I wouldn't rather be anywhere else like I'm here because I want to be a position more than pretty much anything else in the world. So, honestly, like I said, it's just it's just it's just something a desire that you need to have and a lot of people do. It's definitely it's definitely Look calling for lack of a better word.


nathan gartland

And building off that final point. I don't think I asked you yet but what kind of specialty Are you interested in? And why?


Speaker 2

So I wouldn't say I have kind of a tear. Here's my list, I would say number one is definitely orthopedic surgery. Like I mentioned before. I honestly I haven't I have an interest in surgery, like you. I've never actually been in an order before. So I'm looking forward to my first surgery rotation. And I really just hope that I don't dislike it. I am big into sports, I think it would be awesome to kind of have that hybrid between sports medicine and the surgical specialty. Outside of orthopedic surgery, I always loved cardiology, I know you kind of touched on this before, but they really was one of my favorite topics. I did an app irritation at the Cleveland Clinic main campus, which is one of the top cardiac hospitals in the world. And I absolutely loved it. So kind of in between im and ortho right now.


nathan gartland

Yeah, exactly. For those of you don't know if anyone's interested in like cardiology, there is a basically transition period where you have to do internal medicine first, before you can apply to that particular fellowship versus orthopedic surgery is direct. You just apply into that particular program. Well, great. So Alrighty. So we've come to the end of our interview, and I'd like to thank all of our listeners for their attention and interest in medicine. If you have any additional questions about medical school journey, check out my personal website, www dot physician pharmacist.com. Before we let you go, Bryce, how can our listeners get in touch with you?


Speaker 2

Yeah, so you can send me an email. That's going to be B as in boy, and then my last name, so G R O. H. O l@liberty.edu. Feel free to send me an email anytime. Also on LinkedIn. I think my profile is on the physician pharmacist website as well.


nathan gartland

All right, well, thank you so much for being on the podcast, Dr. Gerhart, I look forward to seeing what medicine and pharmacy take you have a great week and best of luck with your step studies.


Unknown Speaker

Yeah, thank you. You do doo



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