|
 Applying
to graduate school(s):
I knew
from high school chemistry, physics and math that I wanted to go into a
science discipline. My first lab rotation in college solidified my
desire to work in molecular biology. After working in a lab for a couple
of weeks, I knew I wanted to attend graduate school and obtain a PhD in
molecular/cellular biology. Basically, in the lab I quickly picked up on
the techniques and direction of the project and this made me excited
about advancing the project. I also met many encouraging graduate
students that prompted me to follow in their foot steps and become a
graduate student. As an undergraduate, I envied the graduate students
day to day experiences and their future careers. This furthered my
desire to attend graduate school and pursue a career in research. The
idea of pursing a masters degree never appealed to me. I was interested
in the study of medicine and research which resulted in enrolling in a
combined MD and PhD program.
At
first glance UTMB was not an attractive choice for me based on my area
of research interest (cancer cell biology). I interviewed at UTMB not
expecting to really come to Galveston but when I left my interviews, I
was impressed with the people and the slower pace of life on the island.
I knew if I chose to come to UTMB my lab selections would be limited but
I knew Galveston and UTMB would offer a good quality of life.
I also was drawn to UTMB by the strong student body interaction provided
by the on campus fraternity system. In addition to life style and
student interactions, I also was strongly pulled in by the innovative
medical school curriculum. UTMB appeared to put great thought and
planning into their medical school curriculum (block system and organ
based learning) and this was very appealing to me because I like to
study a single subject in great depth at one time. The medical
schools block system allowed for this type of studying and was much more
appealing compared to the other institutions traditional 5 lectures on
different subjects from 8am to 5pm.
My
interviews at UTMB were fairly standard in comparison to other
universities. I participated in 3 medical interviews and 3 graduate
interviews. Each interview was approximately 30 minutes long and mostly
focused on my undergraduate research experiences. The interviews did not
prepare me for my first year of medical or graduate school, although all
interviewers asked if I had questions for them and I suppose at this
point in the interview I could have learned more about what to expect
from graduate school. The pre-interview orientations gave the basic plan
and layout of the graduate education requirements and this information
was sufficient to give me a realistic expectation of the activities of
graduate school.
When I first received my acceptance into the MD/PhD program at UTMB I
was very excited. After interviewing at all the universities UTMB was
ranked at the top of my list.
Since my first acceptance letter was from UTMB and UTMB was my first
choice, I was very excited. It was also comforting to know months in
advance where I would be relocating. This gave me plenty of time to
research housing opportunities. Subsequent to receiving my UTMB
acceptance, I also received acceptance into several other universities.
Since Galveston was my first choice and I had received the acceptance so
early the other acceptance letters were meaningless.
Precandidacy experiences:
Did
not participate in BBSC (substituted by 2 years of medical school).
I
chose my department, not based on my mentor, but on the requirements of
the department. Luckily my mentor is a faculty member in 3 departments,
and one of them happened to be Cell Biology. Initially, I had selected
BMB as my primary department affiliation. After discovering the Cell
Biology program (later than I would have liked to) I compared the
curriculum, degree requirements and department heads. Following this
review of the two programs, the Cell Biology program looked more
supportive and better tailored to an MD/PhD student. The curriculum of
Cell Biology honored my undergraduate and medical training for some
course work and therefore shortened the total time I needed to spend in
graduate classes. This facilitated speeding up my graduate thesis work
due to the added time I had to spend in the laboratory.
Choosing rotations was relatively easy based on my interest in cancer
cell biology and the limited number of faculty members in the Sealy
Center for Cancer Cell Biology. I basically rotated with each faculty
member in the Sealy Center for Cancer Cell Biology and after completing
my rotations, I had a good idea of the lab I wanted to join. As I
participated in lab rotations, I looked for a mentor that was
understanding and willing to educate. I was not interested in a mentor
that was authoritative and overbearing. I wanted time to explore my own
directions on projects and have some freedom in my projects direction. I
also looked for a well funded mentor, although lack of funding would not
have dissuaded me from joining a lab that met all my other criteria.
Ultimately, I chose a mentor outside of the Sealy Center for Cancer Cell
Biology, which meant I had to slightly compromise my research interests
to find a suitable mentor. My choice to go outside the Sealy Center for
Cancer Cell Biology was based partly on the limited number of mentors in
this center and because most of the faculty in this center were moving
to a different institution within a year after I started graduate
school. I had no interest in moving after one year to graduate school,
therefore I ultimately chose a mentor in a different specialty.
My
relationship with the mentors of labs I did not join was positive. I put
one mentor on my dissertation committee. The other mentors moved to
another institution, so I no longer have correspondence with these
mentors.
Applying for candidacy was mostly a pleasurable experience. As hard as
it is to believe, the process of applying for candidacy was smooth and
enjoyable. The time allotted for taking the qualifying exam was well
within reason (two weeks for part 1 and two weeks for part 2). The
difficulty was average, and did not distract me from my main focus of
generating preliminary results to generate my proposal. The proposal
itself was also only mildly stressful, but altogether a useful learning
experience. I wrote my proposal in NIH (NINDS) format for a pre-doctoral
candidate and submitted it to the NINDS following my proposal defense.
The grant scored well (just out of the funding range) and I took this as
an indication that the process of becoming a candidate was useful. In
other departments/programs I know that students must write up a grant in
a specialty outside of their own, and while this could be useful, it
would have distracted and taken up time that I am sure was better spent
in the lab thinking about thesis experiments.
Plans after graduation:
My
experiences here at UTMB have definitely shaped my outlook on medicine
and research. Having time to experience a research project for 3 to 4
years allows great time for exploration and growth. This time in the lab
has allowed me to grow as a researcher and make the next step to
understanding what it would take to be successful at the next level.
Currently, my experiences have reaffirmed my desire to practice academic
medicine. I feel it is this setting that will allow the best balance of
research and clinical experience. Therefore, my current career
objectives have been strengthened in the time I have attended UTMB.
Miscellaneous:
Relationships with students, faculty, secretaries, ect.; have for the
most part been positive. I have had great discourse with other students
regarding our projects and have enjoyed their company in non-academic
settings. Faculty has for the most part been kind, helpful and
accessible. With secretaries, interactions are highly dependent on the
individual’s personality, but overall my experiences have been positive.
Secretaries are instrumental in helping send grants and get orders
placed so working well with them is extremely beneficial. As for the
program director, Cell Biology’s program director, Dr. Golda Leonard’s
personality constitutes one of the major drawing forces for the Cell
Biology graduate program. It is her enthusiasm and student centered
approach to running the program that makes it a joy to be in graduate
school. As for department chairs, after half of my PhD we have recently
obtained a new department chair. The previous department chair Dr.
Willis was a pleasure to talk to and a great mentor/teacher. Our new
department chair Dr. Epstein has only recently joined the program so
time will tell how his leadership shapes the department.
My
non-educational activities at UTMB have consisted of participating in
the medical fraternity system and working out. The fitness facilities at
UTMB are amazing for the size of the institution and have been a great
feature of being a student. Also the uniqueness of being the only
medical school in Texas with an active fraternity system offers
unprecedented opportunities for social interactions outside of class and
builds strong relationships with future physicians and scientists.
The
satisfying aspect of coming to school/work daily is the chance to
advance the field and to become a better researcher/physician. This
place is a training ground and therefore everyday I look forward to
becoming more astute and better at practicing research/medicine. What
makes for a bad day at UTMB is a research set back day. These research
set back days (experiments fail) are inevitable but depression can be
overcome by having multiple lines of experiments on-going at the same
time, an event that limits the number of experiment set back days. Also
in the face of failed experiments, having friends near that will listen
and share their experiences with failed experiments helps ease the
disappointment and depression.
Funding… Initially my funding was supplied via the MD/PhD program. Upon
entering a lab my funding was assured for only two years of research. At
the two year junction no additional funds have been attained and
therefore I have had to TA medical school classes to support myself in
graduate school. When this route of funding is no longer available, I am
uncertain as to where my funding will be obtained. The department and
the MD/PhD program have shown little interest in funding a student for 1
to 2 years of my remaining graduate research project. I have also
actively applied for national and local funding for my project, but have
not yet secured my own support. Efforts will continue.
Undergraduate Institution: Texas A&M University
Age: 28
Gender: Male
Nationality: American
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 I
have been interested in science for as long as I can remember. Some of
my earliest memories involve life science exercises in elementary
school. I had my first inklings that I was interested in research
science while I was in junior high. I decided to attend a magnet high
school with a science enrichment program, where I could spend my
afternoons working on a Science Fair project. It wasn’t until my junior
year of college when I started interning during the summer with Dr. Glen
Evans, an MD/PhD at UT Southwestern, that I became aware of the
existence of combined degree programs.
A combined degree seemed a perfect fit for my love of applied research
and human pathophysiology.
I chose UTMB ultimately, honestly, because they chose me for their
MD/PhD program. However, I was impressed in my interviews with the
collegial attitude of the professors I met. It seemed to be a very
friendly, cooperative atmosphere compared to some of the hostility and
extreme politics which I had witnessed
at UT Southwestern. It seemed to be a laid back campus, and real estate
in Galveston was very affordable. A low cost of living made Galveston an
attractive destination for a graduate student.
I had
to apply for two consecutive years before I was accepted off the waiting
list for admissions. The program director called me at home and left me
a vague answering machine message, after my mother had directed him to
call me there. I was frustrated that she hadn’t instructed him to call
me at work. I was so excited I tried to locate his home phone number
with directory assistance so I could find out if I had been accepted. I
could think of no other reason why he would call, so I went out for a
beer with my roommate at the time. It was the next morning when he
called me at work. He meandered getting to the point of telling me I’d
been accepted, and I wanted to just ask him point blank. Once he finally
asked me if I was still interested in attending, I very quickly told him
that I was. It seemed like a ridiculous question. When I told one of the
faculty in the Center where I worked, Skip Garner, I remember him
telling me something to the effect of “Welcome to the rest of your
life…” which sort of summed up the life changing nature of my acceptance
into the program to me.
In the
combined degree program, I was exempted from the BBSC. I arrived early
to complete my first graduate lab rotation, and then entered medical
school in the Fall. I came to UTMB with relatively broad interests. I
had met Norbert Herzog and found him to be a very personable, down to
earth person. I had some interest in infectious disease, so I thought
his lab would be interesting for a first rotation. Primarily, it was a
decision based upon personality. At UT Southwestern I had seen graduate
students and technicians labor under a variety of faculty, some with
particularly nasty personalities. I knew that picking a mentor that I
could work with comfortably was very important to my long term success
and happiness. Experimental Pathology had a good curriculum for MD/PhDs
without too many required classes. In some ways, I expected more
required coursework in graduate school, but when I consider my medical
school work as a part of my overall education I’ve certainly spent
plenty of hours in the classroom. I think the most important factor is
knowing how to learn, and learning the classical basics as well as
cutting edge research, since research is such a rapidly developing
enterprise.
I
decided I’d find another faculty member in Experimental Pathology for my
second rotation between first and second year. That way, if it didn’t
work out, I could go back to work for Dr. Herzog and stay in
Experimental Pathology, which had an attractively short list of course
requirements. This decision was especially important since the MD/PhD
program required me to pick a graduate program by the end of that
summer.
I met
Dr. David Walker in my medical school Pathology lab, where he was my lab
instructor. He had us all write a one page essay on why we were in
medical school. After reading mine, he asked if I was interested in
doing a rotation with him. I told him I would read up on his research
and get back to him. I was relatively new to the field of rickettsiology,
but Dr. Walker’s prestige in the field was apparent. Not only that, the
lab was obviously funded and full of nice, friendly people with
agreeable personalities. A graduate student in my lab at UT Southwestern
had told me once to “choose a mentor, not a project” because your
project can change, but you have to be able to work with your mentor.
You need a good mentor to aid your development as a scientist.
I felt
like, in my discussions with Dr. Walker and my work in his lab, that I
had found the best mentor I could possibly imagine. Even though he was
extremely busy with his chairman responsibilities, he was incredibly
available to me. He required me to work through my thought processes and
really trained me to think like a scientist. He has a quick wit, a great
sense of humor, but seriousness about his work as well. In my case, I
felt like I didn’t have to make any concessions between choosing a
research field and a mentor I was comfortable with. I focused on finding
a mentor I was comfortable with, who was doing research I would find
interesting. As it turned out, I fell in love with rickettsiology during
my rotation, so I was able to do work that I loved for a terrific
mentor. Dr. Herzog would’ve been a great mentor, too, but his work was
more basic, signal transduction research, which didn’t excite me as
much. Also his lab was smaller, and I was used to working in larger,
well funded labs. I also found the higher level of funding more
comforting as a student requiring support over a number of years. I
don’t feel that my relationship with Dr. Herzog suffered at all.
My
qualifying exam was by far my worst experience at UTMB. While the
curriculum requirements of Experimental Pathology were not great, I did
not learn until much later that it possessed one of the most rigorous
qualifying exams on campus. Consisting of a timed written exam, followed
by a proposal writing and defense not in your area of expertise, it was
considerably more difficult than the simple proposal defenses or take
home written exams of other departments on campus. The written exam was
challenging but somewhat enjoyable. I decided to write my proposal to
study quorum sensing in Bartonella, another intracellular pathogen which
I desired to learn more about. Viewing the exam as a learning
opportunity, I threw myself into the work of writing the proposal.
My
original proposal fell victim, however, to a fatal flaw in that it
turned into a fishing expedition and I failed to recognize it. A lot of
research in the quorum sensing field has been done using broad
proteomics techniques and other related technologies that are very apt
for discovery-based research but not the best for hypothesis driven
research. While my proposal was certainly fine for the task, one of my
committee members decided it was a fishing expedition, plain and simple,
and he slowly began to pick my proposal apart. This mushroomed into a
requirement that I do a serious rewrite.
This
was a great blow to my ego, for certain. I was aggravated because the
methods that I had proposed were clearly justified in the literature. I
spent a week trying to regroup and figure out how to incorporate my exam
committee’s comments into my work. I was angry because I felt that no
faculty member on my committee had advocated for my point of view. When
I addressed this with Dr. Herzog, he asked me why I thought anyone would
be advocating for my point of view besides myself. This was a harsh
reality check that I needed, somehow, to put things into perspective. I
was going to have to do this myself. Also, the year I took the exam it
was scheduled later than usual and ran an interminably long 4 months. By
August, I was exhausted mentally and physically. It ruined my birthday
that year. To say I was downtrodden would be an understatement. I would
say that I’ve been seriously depressed three times in graduate school.
First, when I returned to the lab after the second year of medical
school and taking the Step 1 boards, and all of my medical school
friends entered their clinical rotations. Second, when I had to go
through my qualifying exam rewrite. Finally, this past Spring when my
medical school class graduated and many of them left to go to residency.
Each of these moments has left me feeling somewhat isolated and out of
step with my peers, but usually I’ve adjusted over a month or two.
Ultimately, I prevailed over my qualifying exam. In pouring over review
after review and digging into classic articles, I stumbled upon a
hypothesis which suddenly seemed clear as day. I rewrote my proposal to
test this hypothesis, and my committee absolutely loved it. They loved
it almost as egregiously as they had hated my original proposal. I was
particularly dumbfounded because the most fundamental change was that
instead of looking for a signal molecule, I was testing if something in
particular was a signal molecule. One committee member asked me why this
proposal was so much better than my first version. I suggested that the
fact that I had developed a hypothesis, some technical changes, the fact
that it was more directed, the fact that I was more confident, all
might’ve contributed but he kept saying that none of those factors were
as significant as I seemed to think. I wasn’t going to argue with the
passing grade, and he never elaborated. I’m left with the impression
that the commitment to a well formulated hypothesis, and a good
experimental plan to test it, were key to my success.
Within
the department, I would say I’m a pretty well known and well liked
person. I’ve always made it a point to treat secretaries and other
program support staff with respect and kindness, not just because they
deserve it, but because it’s good politics. They control so many aspects
of our lives behind the scenes, whenever a student bad mouths or is rude
to one of them it boggles my mind. My mentor is the departmental chair,
so I’d say we have a good relationship. Our departmental trainee
seminars provide a good way to meet faculty, so do some of our classes
and coursework. One change I have noticed over the years is that it
seems the new crops of graduate students are far less friendly than they
were when I arrived.
When I
came to UTMB, the upper classmen in the graduate school (and medical
school) were very friendly. They would invite us to go to happy hour,
share important resources (good books, classes to take and not to take,
etc) with us, and invite us to parties, all very nice hospitable things
to do. It seems like since I have been here, and UTMB’s national
prestige has increased, the incoming students have in general become
more egocentric, less friendly, and more competitive than before. I
think that in particular, as an MD/PhD, I have been singled out by some
students for particular ridicule and disdain. I have a few theories on
the negative perceptions of MD/PhD students by some graduate students.
Several times, a graduate student told me one time that they had thought
about applying for MD/PhD programs but didn’t for any number of reasons,
so I wondered if there might be some regret or sour grapes on their
behalf. Also, I know many graduate students resent the fact that our
tuition is paid by the MD/PhD program while they must pay tuition. There
is also a resentment of medical students by the graduate students, who
perceive medical students as less intellectual yet ultimately
compensated to far greater degree than most PhDs. There is also a
perception that medical students look down on graduate students but in
my experience this has never been the case. My medical school classmates
have always respected my drive and determination to get the MD/PhD and
have often complimented my research. I’ve never received any positive
feedback on my pursuit of the MD from my graduate school classmates.
The
resentment I’ve experienced has been manifest in several different ways.
One is my propensity to get badgered during my student seminars. I’ve
noticed that I, in general, get interrupted far more often than other
student speakers and asked repeated, probing questions often in a
condescending tone. At first I thought I was being overly sensitive, and
I do have a tendency to sometimes gloss over details in my talks which I
think are self-evident. However, several faculty have approached me at
different times and asked me why a certain student has a problem with
me. In another incident, a fellow student brought a text book to a
lecture I was giving to first year students and began to badger me over
semantics after we had all agreed to not question each other during our
lectures. There is one second year student right now who will not even
acknowledge me in the hallway – will not make eye contact, will not say
hello even when addressed – it is an open hostility which I cannot
understand.
Although Dr. Walker is very busy, he does keep tabs on my research and
holds weekly trainee lab meetings when he is in town. I also have a sort
of “co-mentor” in the lab, Dr. Yu, who oversees my day to day work
although I am given a great degree of freedom. Our labs are very well
funded, and I have secured fellowship funding for myself as well. I’m
allowed to purchase virtually whatever I might need. I’m very satisfied
with these relationships and the resources available to me, they’re a
part of the reason why I chose the lab
Another reason I was attracted to the lab is the way publication credit
is handled. Dr. Walker adheres to the ethical standards of publication
which were taught in our ethics class, and I am free to publish my work
as a first author with appropriate attribution to others in the lab as
coauthors. As such, I have published several first author papers during
my graduate training so far.
I’ve
assembled a terrific committee. We have only met once so far, but they
gave me some excellent feedback. I would say everyone on my committee is
on board with my project, goals, and most specifically my timeline for
graduation. I’m under a lot of time pressure due to the structure of the
MD/PhD program, and they are mindful of this. I interact primarily with
the MD/PhD office and haven’t had too many dealings with the GSBS. I
have served on several committees with Dean Cooper and he is a genuinely
nice individual with a great interest in striving to improve the GSBS
and its graduates.
My
career goal since I became aware of the MD/PhD as a career path has been
to go into academic medicine as a clinician scientist. Early in medical
school I figured that my interest in infectious disease as well as
patient care would lead me into the infectious disease subspecialty of
internal medicine. However, working closely with very accomplished
physician-scientists during my time here who are pathologists has led me
to consider pathology as my medical specialty. As my interests have
become focused in molecular pathogenesis, it seems the skill set would
be a better match, perhaps. Also, the lifestyle benefits and increasing
demand (and compensation) for pathologists is attractive. Now that I am
engaged, future time for family and raising children is much more
important to me than it was when I started school. Consequently, the
better hours and ability to more easily blend my research and clinical
responsibilities in pathology have become more important.
I’ve
had a pretty active life outside of graduate school. During medical
school I was able to socialize with my classmates on the weekends. I
have taken up the hobby of homebrewing in the past year which allows me
to blend my knowledge and love of microbiology with an end product which
others can enjoy. I bought an old house which I am constantly working on
renovating when I have time. I wish I was able to afford, in both time
and money, an occasional nice vacation. This is one thing I envy of my
friends in the simple working world – their ability to take a couple of
nice, week long vacations every year.
Good
days and bad days are almost entirely dictated by the fickle nature of
science. It is very satisfying when I get a good result, or make some
headway in my research. This usually spurs me to work even longer hours
or come in on the weekends to obtain or confirm good data. Ironically,
bad days when nothing seems to work or disappointing data arrives also
tend to spur such bursts of work, although in a somewhat darker mood.
Days when manuscripts are finally accepted, or published, are some of
the absolute best.
I have
attended several conferences. The best was the American Society of
Rickettsiology conference in Maryland in 2003. It was at an absolutely
beautiful resort. Since rickettsiology is such a small field, I got to
meet many of the people whose papers I had been reading for the past few
years. The socialization with other like minded graduate students was
also excellent, and it allowed me to meet and screen people to fill the
“off-campus” slot on my dissertation committee. I also attended the
American Society of Microbiology meeting in New Orleans in 2004. It was
a pretty large disappointment, in that it was humongous, very few people
were interested in obligate intracellular pathogens. Other than a few
poster sessions, I didn’t get much out of it, and there were so many
people there it was alienating. I did see a few old colleagues I hadn’t
seen in awhile. Still, if I go back, I’ll make sure it’s with a larger
group from my lab so I at least have colleagues to associate with
outside of the proceedings. I’ve also attended one Internal Medicine
conference to present my research. The lukewarm reaction to somewhat
nonclinical research such as mine has also played a role in nudging me
towards pathology.
I am
getting married next spring, something that I truly didn’t anticipate
when I arrived here five years ago. It is going to be challenging to
move my fiancé into my house which was purchased with a bachelor in
mind. She’ll have to commute to work in Houston because she can’t find a
job in her professional field in Galveston. We certainly don’t plan on
having children before graduation, however.
Although I came to UTMB because it was the only school where I was
ultimately accepted, I am glad I didn’t have a chance to go anywhere
else. I wouldn’t trade my experiences here for the world. It is a
wonderful place full of good, hard working people. Although I will
likely leave for residency training, I imagine there is a very good
chance I will attempt to return to be on the faculty here in the future.
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 Experiencing
the Humanities
My decision
to pursue a graduate degree in the medical humanities began as a sort of
subsidiary consideration. I had long intended to go to medical school –
from high school I chose to attend Baylor University, in part based on
the strength of its premedical program, and throughout college I
remained steadfast in pursuit of this goal, taking the required
premedical coursework and making sure to do all of the other things
necessary to get into medical school. However, as I grew closer to
achieving this goal, I became cognizant of a lingering and increasingly
distracting disturbance in the back of my mind. Medical school, and a
career as a physician alone, would not, could not be enough. Coincident
with my premedical preparations, I had also become aware of a new, and
at times overwhelming, passion at Baylor – the liberal arts. It was my
inability to set aside my love for literature, philosophy, history, and
the like as mere hobby that ultimately convinced me that I must find a
way to make these other dimensions a part of my professional life. I
became convinced that a full professional life for me could only be one
that split time between medicine and the humanities. I became determined
to find a way to do both.
However, as
I embarked upon the medical school interview trail, I realized that my
wishes might be more difficult to satisfy than I had previously
believed. Almost no school, especially among the several I was visiting
in Texas, possessed a combined degree program of the type for which I
was searching. Some of those affiliated with undergraduate institutions
suggested that I might be able to create something that might meet my
needs, most likely on the side, an extracurricular endeavor, but these
promises often seemed sort of empty. I do not believe I was being
intentionally deceived – those interviewers all seemed excited with my
enthusiasm and were eager to inform me of the many opportunities their
institutions likely possessed. However, they also conveyed that such an
independent undertaking would likely be an arduous one, time-consuming
and difficult to arrange. I left many of these schools conflicted,
excited to have potential opportunities, but dismayed to have no more
guarantees of these possibilities than the assurances of interviewers
who may or may not have truly appreciated the reality of these options.
When I
interviewed at UTMB, I expected to find similar circumstances – a school
that would be eager to try to accommodate my unique needs, but one that
may have difficulty meeting such good intentions as well. I thought this
right up until the moment when Dr. Ron Carson, the Director of the
Institute for the Medical Humanities (IMH), addressed the body of
interviewees at our orientation that morning and revealed the existence
of an MD/PhD Program in Medical Humanities. Later that day I returned to
Baylor encouraged, reluctant to get my hopes up until I knew that I had
been accepted to UTMB’s medical school, but also relieved that that
which I had longed for and sought after really existed. I ranked UTMB as
my first choice, and, when I was accepted the following spring, made
immediate preparations to pursue entrance to the graduate program as
well. Medical school without the humanities seemed impossible to me;
discovering UTMB and the IMH meant I would not have to make such a
choice. When, over a year later, I was finally accepted to the MD/PhD
Program, I was elated. The essentials of my life were falling into
place, as they had to if I was to continue down this path at all.
For me, entrance to the MD/PhD Program was an all or nothing event;
either I would be admitted or else I would have to completely reevaluate
my professional direction. Fortunately the former occurred, allowing me
to continue to where I am today.
I am now beginning my sixth year here at UTMB. My first two and a half
years were spent in medical training, and I have been in graduate school
at the IMH for these last two and a half years.
The first two years of the PhD curriculum at the IMH consist entirely of
formal coursework. During these years I took the following courses:
Humanism and the Humanities, Bioethics and Law, Religion and Medicine,
Humanism and the Medical Humanities, Literature and Medicine, American
Doctor-Writers, Foundations of Bioethics, Clinical Ethics, Traditions of
Health Care in the U.S., Practicum, Narratives of Illness, Nature and
Genetics, Ethics of Scientific Research, Traditions of Medical Ethics,
Philosophy and Medicine, Narrative Ethics, and Ethics of Health Policy.
And, as occurred during my undergraduate training, a few primary areas
of interest emerged during these years. These include narrative and
medicine (literature and medicine, narratives of illness, and narrative
ethics), clinical ethics, the history and practice of moral medical
education, and the practical work of doctoring. It is in these areas
that I foresee doing the majority of the scholarly work in my career and
upon which I focused my qualifying examinations and will focus my
dissertation work.
The
specific topics of my five qualifying examination questions included
narrative ethics, narratives of illness, virtue ethics, moral
imagination, and the history of ethics education in medicine. Qualifying
examinations at the IMH are a rigorous undertaking. Students typically
allow a semester or so to prepare, studying with their committee
members, developing topics and formulating reading lists, and becoming
sufficiently comfortable with the material to undertake the final
examinations. The exam itself consists of two parts: a written exam,
during which students have five days to answer five questions as
formulated by their advisors, and an oral defense, which occurs after
the written exam and allows the student and his/her committee members to
further discuss the topics, challenging assumptions and further
developing ideas and thought processes. The purposes of the examination
are many, but of primary import for me was the opportunity to hone my
areas of interest and to allow an extended and self-guided time during
which I could explore these topics. The exams provided an amazing
introduction to my dissertation work by allowing me to undertake an
extended, organized, and rigorous investigation of my own personal
medical humanities. Having just completed these examinations a few
months ago, I am now working on my dissertation, a process that seemed
unfathomable before my qualifying exam preparations.
The
beginnings of my life at the IMH required orientation to a certain
degree of culture shock. Having just arrived from the rigorous,
regimented, and pragmatic world of undergraduate medical education, I
had grown accustomed to a certain way of thinking, of believing, of
acting. My formal humanities education threw all of this into disarray
and uncertainty, forcing me to reconcile medical and humanistic frames
of mind that often seemed in direct conflict or competition. Primary
among these reconciliations was an increasing comfort with ambiguity, an
understanding of the plurality of values at stake in the medical
relationships between health care professionals, patients, and families,
and an appreciation of the various ways in which problems could be
contextualized and approached.
As I
expected when I set out upon this path so many years ago, the humanities
have become and will always be an integral part of my life as an
academic and as a health care professional. My work was a doctor will
always be irrevocably informed and affected by my education and the ways
I’ve come to think. I also intend to teach and write as a strict and
academic humanist, although I know that this too will also be shaped by
my education and career as a doctor. For me, the medical humanities have
become far more than the mere application of the humanities to medicine,
and/or vice versa. Rather, they are inextricably linked, and, for me,
one cannot really exist without the other. It is for this reason that it
was essential to undertake these dual degrees simultaneously. Alone,
they might not have yielded the symbiotic effects for which I now value
them both so highly. I am thankful for the opportunity I’ve been given
to be an MD/PhD student. I cannot imagine my education and professional
development otherwise.
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 I
spent my teens and early twenties deciding to
become a doctor. Years of soul-searching,
volunteering in hospitals, talking to family and
friends, and comparing visions of possible
alternate futures lead me step by step from
extra biology classes in high school to the
white coat ceremony. Looking back now, the
decision to attend medical school took up a
substantial part of my life. I struggled with it
and the process is necessarily now part of who I
am.
I decided to attend graduate school in minutes.
I happened upon a link to the Institute for the
Medical Humanities while looking through UTMB’s
website in preparation for a medical school
interview. I remember finding a list of graduate
courses offered at the IMH – Narratives of
Illness, Traditions of American Medicine,
Clinical Ethics, Interpretation of Texts. By the
time I had read to the end of the page I knew I
would apply. It seems like, and was, a
relatively huge change of plans. Yet I had such
an easy time making the decision that it didn’t
seem then, and still doesn’t, seem like a
decision at all. It was love at first site.
There was no decision to be made.
“What do you plan to do with a degree like
that?” I heard my father trying to decide what
tone of voice to take. I knew what he was
thinking. God, she’s almost there – I thought we
were done with this. I remembered all the times
I’d expressed doubts about medical school. I
really wanted to be a teacher. I really wanted
to go into law, or policy. I really, secretly,
wanted to write. These felt like confessions to
me, like somewhat subversive hobbies I would
necessarily have to give up to do what I
ultimately felt called to do – practice
medicine. After all the years of struggling I
felt that I wanted the instant, personal, face
to face reward of making a difference in an
individual’s life. Yet I still felt strongly
that I could, perhaps, contribute something to
the field of medicine outside of the clinic –
something more abstract, more lasting. I felt
like the things that drew me to medicine were
issues that needed attention in the surrounding
social and political context before they could
ever be translated into better care at the
bedside. And although I had already given myself
to medicine, I still anticipated the
claustrophobia of the examining room. A graduate
degree felt like an open window into the world
of research, policy and education, and thanks to
the option of a combined MD/PhD program, I no
longer had to leave part of myself behind in
choosing a career.
I don’t remember if I had any strong feelings
one way or the other about UTMB as a candidate
medical school before I found the IMH. I was not
searching for graduate schools at the time, and
I didn’t apply to any other graduate program. I
came to UTMB to work with the faculty in my
department, and although I’ve since had many
valuable experiences with other things that the
campus has to offer, I still think of the IMH as
the reason I’m here.
To my knowledge, UTMB offers the only MD/PhD
program in the Medical Humanities in the
country. Other schools with strong bioethics or
humanities departments have rumored to allow
medical students to work toward graduate degrees
in these fields, but not within the framework of
a structured, funded, combined degree program
such as ours. If this option did not
exist at UTMB, I feel sure I would not be
working toward a PhD. I’m looking ahead toward
my fifth year in the program now, and I still
feel grateful for whatever karma or serendipity
led me to that web page so many years ago.
Although I can’t speak for the other students in
our department, I feel fairly confident that our
collective experience in the GSBS at UTMB
differs significantly from that of students in
the natural sciences. For one thing, we have our
own curriculum and rarely, if ever, take courses
outside of our department. Although we operate
with a relatively small faculty that can, due to
logistics, only offer a few courses each
semester, the scope and depth of our coursework
more than adequately prepares us for the
dissertation process and the issues we may face
in the field. The true strength of the graduate
program at the IMH, in my opinion, is the
individual and collective commitment on the part
of the faculty to education. As a student I have
consistently received their support and
professional courtesy, and have never felt
trapped by excessive direction or abandoned to
my own devices. Even despite the additional
burden of my status as an MD\PhD student with an
odd schedule and commitments to other schools,
I’ve never experienced anything other than
respect and competent, professional
smoothing-out of the inevitable administrative
tangles.
As I look ahead to comprehensive exams and my
dissertation, I’m struck by the extent to which
the combined degree program has shaped my
academic development both in medicine and the
humanities. Having spent a year in graduate
classes reading about the history of medicine
and clinical ethics, I entered medical school
with an eye toward professional and social as
well as clinical issues. Now back in graduate
school, I recognize that the perspective I
gained in medical school, in classes but
especially on the wards, has not only shaped my
research interests but heightened my awareness
of the importance of these issues. Although at
times I feel as though I live in two worlds, or
even that I’m two different people, I’m also
unable to separate my medical and graduate
academic development. These two aspects of my
intellectual identity have grown and changed
together and in reaction to one another.
A significant issue for many MD/PhD students
seems to center around the way they plan to
split their time between two relatively distinct
activities: practice and research. I’ve heard
some of my classmates express their conviction
that one person can’t possibly do both things
well, and that many clinician researchers end up
spending most of their time in the lab,
regardless of whatever good intentions they had
to practice medicine as students. Of course I
can’t speak for my colleagues in the natural
sciences, but as I begin to imagine my own
career more clearly, I see myself actively
engaged in medicine and research. I hope to
enter the field of adolescent pediatrics, which
I believe fits my interests clinically as well
as provides a rich context for exploring the
ethical and social issues surrounding children,
parents, teenagers, and health care. Of course I
believe that my graduate degree will make me a
better doctor. But that’s far from all it will
do. By exploring the issues facing my patient
population through theoretical and empirical
bioethics research, actively participating in
policy debates, and leading premedical and
medical students through their own exploration
of these issues, I believe I can do more than
care for my patients individually. I believe I
can advance the field through careful and
rigorous scholarship.
University of Texas at Austin
Age 27
Female
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