Guest post: Keeping it Real: How to Excel in Graduate School

The purpose of this blog is to share personal accounts of MD/PhD training, and I’m excited to expand the perspectives presented here with guests posts. This post is by Alex Yang, who also contributed the blog’s first guest post.

Keeping it Real: How to Excel in Graduate School

Alex Yang, PhD

As I am writing this piece, I have just finished my PhD years, and I am awaiting to start clerkships in medical school as soon as I’m able. Although challenging, my PhD years have been extremely rewarding. I was able to share my work in an international conference in Colorado, receive my own F30 NIH funding, publish a first-author manuscript in Nature Metabolism, and make lifelong friends. Some of you might be interested in graduate school, pursuing graduate school, or currently in graduate school right now. I want to personally share with you my top three tips for success for all of you.

1. Choosing a mentor

 I think the number one decision that influences your success in graduate school is choosing the right mentor for you. While it is true that the right mentor is different for everyone, there are some general rules you should follow in my experience to choose the right one for you. Depending on the department, there are minimum number of rotations to do before you commit to a lab. I strongly suggest you take up all of the rotations even if you feel strongly about one lab. It will increase your experiences as a scientist, and even if you don’t end up joining the lab, it can open doors for future collaborations as well.

When the time comes to make a decision, there are a lot of factors that might end up crossing your mind: environment, personnel, funding, and the actual science. While different people might have differing opinions, I strongly suggest prioritizing the lab environment and funding of the lab over the actual science in the lab. A PhD is challenging enough as it is. Don’t make it even harder on yourself joining a lab struggling to fund itself even if the science interests you the most. You are not bound by the subject matter that you study during your PhD. Most people I know enter another subject matter as a post-doc. What is important is that you receive the best training under the best environment possible as a PhD student. So, if it comes down to it, choose the environment over the science. Who knows? You might fall in love with the science like I did over time. I was not initially interested in adipocyte biology. Over the years though, I cannot imagine researching anything else besides adipocytes.

2. Work on multiple projects at once

For MD-PhD students and even normal PhD students, time is of the essence. We all hear horror stories of 6-8 years PhDs. That’s not ideal for any graduate student. While some circumstances are unavoidable, there are things directly under your control. We all know the failure rate of science is extremely high. Probably 95-99 % of science is failure. What we can do to hedge ourselves against failure is to work on multiple projects at once. Even if one fails, you have others going at the same time. This might be extremely hard to do and to balance your time, but it’ll be worth it when the failures start to mount.

For me personally, I was able to finish my PhD in 3.5 years. Even for a MD-PhD student, that’s relatively quick. I was extremely lucky to do so of course. However, luck favors the prepared. In the beginning, I worked on 3 different projects simultaneously. One project completely failed, another project was slowed by mass spectrometry difficulties, and my third project evolved into my thesis. As a result of diversifying my projects and not sticking to one project, I was able to find a project that successfully worked and was able to graduate quickly.

3. Be aware of your mental health

Science is hard. Failure is not easy to accept, yet we fail everyday as scientists. Compound the failure you experience in lab with the failure you might experience in your personal life and that can result in mental hardships. Graduate students are 3-6x more likely to experience depression and anxiety compared the general population. It’s time to address the problem and end the stigma of mental health problems. Mental health is your health. If you are feeling burned out, tell your mentor and seek professional health as hard as it might be.

For me personally, despite my successes in graduate school, I experienced symptoms of depression and anxiety during the last 6 months of my graduate school as I worked on my thesis. The stress of writing a review paper, finishing my experiments, writing my thesis, and preparing to defend compounded with my own personal problems. I started to feel burned out and had to seek professional help. Today, I am glad to say I’ve recovered and look forward to my future. I am mentally healthy now, and I owe that to the professionals that helped me through it. If you are struggling, don’t hesitate to seek out help.

These are my top tips for you to succeed in graduate school. Every journey is different, but if you take these tips at heart, I think it will truly make your experience in graduate school better. If you want more advice, Hanna and I are more than welcome to answer any questions and give you advice. We are both active on Twitter she is @MDPhDtoBe and mine is @MDPhDinProgress. Since we are both interested in hepatology, class of 2022, and have such similar account names, I consider her my Twitter twin. It has been an honor to contribute to her blog not once but now twice. Don’t be afraid to reach out to us!

About Alex

I’m a 7th year MD/PhD student at Wayne State University studying genetic mechanisms of fatty liver disease. In my spare time I like to cook, exercise, play video games, and write. Check me out on twitter @MDPhDinProgress.

I’m now a PhD 🎓

So a cool thing happened this summer…

Instagram | @MDPhDToBe

After 6 years…

Instagram | @MDPhDToBe

And countless western blots, qPCRs, and experiments performed…

I wrote my PhD dissertation.

And defended my PhD.

And now I have a pretty cool piece of paper!

Instagram | @MDPhDToBe

Thank you, thank you, thank youuuuu to all of the absolutely amazing people who helped me reach this huge goal, including but not limited to my PhD advisor, my labmates, my family, my partner, my friends, and my cats. 😸

Time to get that MD.

Almost Docs: How I Found an Online Community

This was originally shared on (which no longer exists???) in May 2018. Twitter is a great place for connecting with other folks in the medical profession, so I thought I’d share it here!

I didn’t know much about MD/PhD programs as an undergraduate. I found some resources online and met with the program director at my school, but I didn’t really have easy access to any current MD/PhD students to go to for advice as I was preparing to apply to medical school. I also didn’t know many pre-meds or join any pre-med clubs. I hadn’t planned on going to medical school until late into undergrad, so I didn’t have a supportive group that would be going through the same grueling process that I was about to undertake. So I went to social media.

The summer I applied to medical school, I made a Twitter account specifically for connecting with the medical community. Twitter was an ideal platform for this purpose because of the short character limits for posts, the ability to make public posts and follow others who do not necessarily have to follow you back, the easy ability to retweet (or share) another account’s post on your own timeline, hashtags to connect posts to those of related content, and handles that allow you to establish your identity while also maintaining anonymity if desired (for example, I started being known as only pre-MD/PhD Life). While other social media sites have incorporated some of these aspects, Twitter remains the best site I’ve found for a robust discussion within a broad community.

I began by finding other pre-med accounts to follow. I did this by searching for those that had “pre-med” in their name or bio and then going through their following list to find others. Soon some started to follow me back. We would comment in response to each other’s posts and encourage each other when things didn’t go as planned. Some of these people I’ve even met in real life. Many of these people have since started med school, finished grad school, and are now in residency, and it’s been an absolute joy to see them progress through their training. I’m glad to learn from this community that has supported me since my early days of pursuing medicine.

Yet, here I am, 5 years in and still in the graduate phase on my MD/PhD program, which is one of the challenging things about this training pathway. As a MD/PhD student, the people who started med school the same time as me could nearly be practicing physicians by the time I step into the clinic as a 3rd year medical student! Therefore, I needed to have a community of physician-scientist trainees who could understand the more unique aspects of our training that those in other tracks could not. There were a few of us who found each other on Twitter, but it was harder to find those who could provide insight from further along the training path in my early days on Twitter. I joined a local MD/PhD trainee community upon beginning my program, but that still didn’t give me a global perspective on what it’s like to be a physician-scientist in training.

There’s an added benefit when trainees from different institutions come together. They can learn about the different ways their programs ultimately train them for a career as a physician-scientist. For example, mine starts in the PhD portion, others start with med school and transition to the PhD two years in, and some have even moved part of the clinical rotations to before the PhD. There may be things that other programs do to help their students develop into physician-scientists that mine doesn’t and vice versa. Such a community can provide support and diverse insights, which can help identify ways by which our training and medicine in general can be improved.

To help facilitate this discussion, the hashtag #DoubleDocs was recently adopted by the physician-scientist trainee community to connect trainees from undergraduate to residency and beyond. It was designed to be inclusive to both MD and DO trainees as well as those who have chosen to pursue a PhD and those who pursue other paths for research training. It does not mean double doctorates, but docs who are doubly in the research and medical worlds. What is special about this hashtag is that it rose organically from the physician-scientist trainee community as a way to stay connected. Unlike other hashtags, it is intended to have a specific focus on the training aspect of physician-scientists.

Taking this a step further, I, along with my colleagues in the American Physician Scientists Association, utilized Twitter’s list feature to make it easier for physician-scientist trainees to find each other. On the APSA twitter account (@A_P_S_A), we now have public lists for students at different stages and pathways of training including pre-med, MD/DO students, MD/DO-PhD students, Residents and Fellows, and established physician-scientists who can be resources for trainees. People can subscribe to these lists to find the Twitter accounts of other #DoubleDocs.

In the span of a few days from the start of this hashtag, I made nearly 100 new connections to trainees across the globe that have a similar career goal and unique training path, which highlights the power of Twitter to bring people together. Social media can get a bad rep, but it can also be quite useful! #DoubleDocs is just one hashtag, but so many others exist that can help people find a community!

If you like my writing, please consider following my blog. There’s a link near the top of the side bar to do so. Also, feel free to like my Facebook page (MD, PhD To Be), follow me on Twitter (@MDPhDToBe), and follow me on Instagram (MDPhDToBe). I am trying my best to remain active in each of these channels throughout my training! Any questions, comments, or requests for future blog posts can of course be directed to me from any of these locations or directly emailed to me at via the connect page. Thank you for reading!

Almost Docs: 10 Reasons Why Being a Medical Student is Awesome

This was originally shared on (which doesn’t exist anymore???) in April 2014. I’m sharing this again because it’s important to remind ourselves that what we’re doing is actually really great!

In a recent medical school class, one of my lecturers told us, “The best days of medical school are the day you get in and the day you graduate.”

We all laughed, but it was sort of a painful laugh as we hesitantly looked around the room to see how others reacted to the thought…

The underlying message of that statement that we all know too well is medical school is hard. It is way more work than you’d ever think you’d handle, which means a lot less sleep and a lot more stress. It separates you from your friends and family. The time you once had for things you enjoy seems to be sucked away. You may even find yourself in the wee hours of the night after weeks of sleep deprivation cramming for a few exams and questioning why you’re putting yourself through all of this.

And yet, it’s awesome.

It may not seem that way when you look around at your piles of books, notecards, lecture notes, empty energy drink cans, ramen packets, and building debt, but in comparison to other things, it’s pretty great.

Not convinced? Here’s 10 reasons to make you believe otherwise.

#1. You never have to worry about finding something to do.

Your to-do list is never ending, but it’s so much better than sitting around twiddling your thumbs. If you don’t believe me, set aside a free day to not work on anything for school and see how crazy it makes you.

#2. You get to do a variety of things.

Sick of studying for one M1 class? Study for another class or work on stuff for research if you’re a MD/PhD student like me. Research bringing you down? Go back to studying for your medical school classes. Don’t want to learn about the renal system any more? Good because the test is done and the class has moved on to endocrine system. You have so many things to do and study that you can always change up what you do to keep things exciting while continuing to be productive!

#3. You learn to get the most out of your time.

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Do all the things.

Planning out your research so you have an incubation step during the time you have to go to class, a seminar, or TA? Of course. Studying notecards during centrifuge steps? Duh. Reading papers during breaks in classes? Always. Going through lecture notes on the bus? Yup. Add on normal people things like buying groceries, doing laundry, and paying bills and you’ve really got to multi-task. This way you’re forced to learn how to optimize your time and get as much done as you physically can.

#4. You may even get to defy the boundaries of time.

Whether you’re balancing medical school and graduate school classes, being a teaching assistant, and doing research like me, or simply dealing with the heavy load of medical school itself, there’s definitely more to do in the day than you have time for, but somehow, you can find a way to make it all work out.

Channeling my inner Hermione, I’ve had to do just that with the grad school and medical school allowing you to register for classes that sometimes meet at the same time. Luckily, I can get by without a time turner since the medical school podcasts the lectures instead and therefore maximize the number of classes that I can take at once. If your school podcasts your lectures, you can surely do the same!

#5. You don’t have to worry about finding a job for a very long time.

Where am I going to be for the next 4 years as an MD student or 8 years as an MD/PhD student? Right here. What am I going to be doing? Exactly what I’m doing now. You’ve made it through the competitive admissions process, so you don’t need to be job searching like your fellow college graduates.

#6. You learn to understand more about others than they seem to understand about themselves. 

Patients may not always tell us everything that we need to know, and we’re taught early to figure out what they’re not telling us from their history and their tendencies during your interaction. You learn to see the subtleties in a person’s ways and learn how to interact with them to get the best outcome in their health. But this can carry on to your personal relationships and help you understand more about the people you deal with day in and day out as well.

#7. You don’t have to take any more lib eds.

Yeah that’s right. No more wasting time with classes that you have to sit through thinking, “When am I ever going to need to know this?” Now the answer is “When you’re a doctor.”

#8. You get to tell people that you’re a medical student.

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What medical students do.

This usually impresses people and only sometimes makes them think you’re crazy.

#9. You get to meet a lot of cool people.

 Try talking to your parents or friends back home about signaling pathways that lead to T cell activation or the pharmacologic mechanism of any drug and they’ll probably just blankly stare back at you. But talk to your medical school friends about the same thing and they’ll not only understand but they’ll keep the conversation going. Medical school teaches us a sort of new language that most people don’t know but luckily your peers do. Seriously, look around the room and bask in the awe (and sometimes the terror) that you are surrounded by future doctors.

Taking it a step further, if you’re also in graduate school like me, you also get to know a lot of graduate students who are on their way to being doctors of a different type. These people share your love of discovery and become your support system through the struggle that is the PhD. Who knows, maybe one of them will even make a breakthrough discovery that changes the way we look at biology or treat disease. These are awesome people to know and you really can’t make it through without them.

#10. You get to learn a lot of cool things.

 The human body is frustratingly – yet beautifully – complex and you get to spend your life learning about it. Lucky you. While the amount that you’re expected to know about it can be overwhelming at times (and by times I mean always), you are incredibly fortunate to be living in a time when we know as much as we do. Can you believe that there was a time that we didn’t know how the heart, lungs, or kidneys worked? A time when we didn’t realize that something as simple as washing hands would decrease spread of infectious disease particularly in hospital settings? Sure, we have a long way to go, but we’ve already come such a far way, and you get to benefit from the hard work of others who once struggled to discover what you’re now learning.

So Amaze
So amaze. Wow.

If you like my writing, please consider following my blog. There’s a link near the top of the side bar to do so. Also, feel free to like my Facebook page (MD, PhD To Be), follow me on Twitter (@MDPhDToBe), and follow me on Instagram (MDPhDToBe). I am trying my best to remain active in each of these channels throughout my training! Any questions, comments, or requests for future blog posts can of course be directed to me from any of these locations or directly emailed to me at via the connect page. Thank you for reading!

Almost Docs: What it’s like to advocate for healthcare

This was originally published on (which doesn’t exist anymore???) in August 2017. I’m sharing it here again to help others know how they can get involved in healthcare advocacy.

Make your voice heard.

With the ongoing healthcare debate, we are told again and again how valuable our voices are as docs and almost docs. But how?

One way is to call your representatives. Another is to visit them.

A number of medical organizations coordinate annual advocacy days on Capitol Hill for their members to attend. The benefit of meeting in person with Congressional representatives and their staff is that it can help us put a face on the healthcare workforce and establish ourselves as experts in the care of patients. It can create lasting relationships with these representatives that gives us the power to speak for our patients.

This year was my third time attending one of these advocacy days held by the American College of Physicians. Yet, I can still remember the uncertainty I felt as I arrived at Washington, DC as a first-year student. Who am I to speak on what ails our healthcare system? What if I don’t know the exact policies?

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Illinois medical students and residents excited to learn how to be better advocates.

Luckily, the first day was designed to get me up to speed. I received outlines for each issue we were advocating for, including current related bills we should ask our representatives to support. I listened to policy experts speak about the issues and how to best speak about them. I watched example discussions with representatives, so that I had some idea of how things would go.

I also joined a team. We were sorted by location so that we would meet together with our local representatives. Our team was comprised of medical students, residents, and attendings from downstate Illinois, including some with previous experience advocating in DC. The meetings the next day were already scheduled, and we planned who was speaking and what topics would be covered at each meeting. As a medical student, I would speak on an issue most relevant to me – funding for graduate medical education.

The next day we headed to Capitol Hill. I found myself in a Senator’s office, speaking with his healthcare staff member. I told him my concerns for matching and emphasized the growing need for more physicians. Then, with a quick look at my notes, I asked that the Senator supports S.577, the Resident Physician Shortage Act, to increase the number of residency positions.

As we left the meeting, my group of advocates took a picture to share of our experience, and I later followed up with an email. After a few more similar meetings, my involvement in our advocacy day was formally ended. However, it does not have to be and will not be the end of my advocacy.

If you ever get a chance to speak with your representatives on healthcare, I highly recommend it!

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The US Capitol.

If you like my writing, please consider following my blog. There’s a link near the top of the side bar to do so. Also, feel free to like my Facebook page (MD, PhD To Be), follow me on Twitter (@MDPhDToBe), and follow me on Instagram (MDPhDToBe). I am trying my best to remain active in each of these channels throughout my training! Any questions, comments, or requests for future blog posts can of course be directed to me from any of these locations or directly emailed to me at via the connect page. Thank you for reading!

Almost Docs: Interview with Jean Smelker, MD, MPH

This was originally published on (which doesn’t exist anymore???) in May 2014. Jean passed away in September 2016. I am sharing this again here in her memory.

I first had the pleasure of meeting Jean Smelker nearly a year ago. I had just finished undergrad and was on my way to start medical school and graduate school in the fall. Jean, a retired pediatrician with a soft voice and a beaming smile, was so excited to hear about my journey (though I’m sure I was more excited to hear about her’s.)

You see, Jean went to medical school in the early 1950’s, a time when women physicians were rare. In fact, she was the sole woman in her medical school class of 75. In addition to her training as a MD, she earned a master’s degree in immunology and a master’s degree in public health, which came in handy as she served as director of two Children and Youth (C&Y) Projects throughout her career (one in Kansas, the other Minnesota) that provided comprehensive health services for children living in low incomes areas.

Jean Smelker
Jean at medical school graduation with her father (United Press Telephoto, 1954).

She proved to be very bright and ahead of her time, becoming known as a progressive and holistic physician. Her philosophy that “We do what is best for the patients and make it work” became a guiding principle for the Minnesota C&Y project, and she was renowned for her use of hypnosis to treat warts.

On top of her serving as director of these projects and later commuting between Minnesota and Ohio for work, she managed to raise her children with her psychiatrist husband Ed who pioneered the study and care of patients with PTSD. Of course, being able to balance successful careers with raising children such as they did is an amazing feat in itself!

Jean is a personal inspiration and role model, and so it is my honor to share some of her story here on The Almost Doctor’s Channel with hopes that she will inspire many other almost docs as well.

Hanna Erickson: First of all, how did you decide to do medicine? Did you have any specific role models in medicine that you looked up to? How did you prepare yourself for medical school and what was the application process like?

Jean Smelker: I started out in Occupational Therapy.  I was 16, it was the end of WWII.  It was interesting, but the courses didn’t go very deep – just when they got interesting, we started on something else.  I thought I wanted something “more scientific.”  I switched to Bacteriology at the end of my Freshman Year.  It was certainly interesting, with a lot of changes because of WWII.  Things were happening very fast, new developments. In my senior year I decided to go on to Immunology for my M.Sc., where changes were even faster.  I loved it, but I wasn’t sure I was cut out to do pure research.  Every time we did an experiment, I could think of half a dozen ways to proceed – but one team member (on a PhD track) could think of a dozen ways to go.  (He was very smart.)  And, I was not certain I wanted to work with the same half a dozen people, behind a test tube, the rest of my life.

Then, one day, my Dad came home from a meeting with some of his Faculty buddies.  Dr. Ralph Knouf of Comparative Anatomy said, “If Jean ever needs a referral to Medical School, I would gladly give her one” and I thought and thought about it.  (That was December, I had just finished the Comparative Anatomy course.)  Did I want an M.D. rather than a Ph.D?  I applied, and got my acceptance on Valentines Day. (To which my Mother said, “Well, I guess that’s the kind of Valentines you’ll be getting from now on.”  Was her idea of going to college to get a “Mrs.”? Probably.  My younger sister was about to be married – and I was on the way to being an ‘old maid’ I guess.)  This sounds sort of haphazard today, but there really was a lot of thinking going on about the decision.

No, I didn’t have any role models.  There was one woman physician who had died recently.  I remember she had a pretty winter coat (this was Ohio) but I really didn’t know anything about her!  My childhood pediatrician came closer to being a role model, Dr. Earl Baxter.  His daughter was a couple of years ahead of me in University School. (Ohio State.)  I am sure that being a faculty kid and being in the University milieu was more influential, really.  Interviews in those days were quite a lot different too, of course.  I remember being asked – in a very persistent way, “If your own kid was very ill and one of your patients (kid) was very ill, what would you do? ” That kind of question wouldn’t cut it today, thank goodness.  (I think I later lived the answer to that question, more than once.)

So, I had a B.Sc. and a M.Sc., going into Medical School.  I was a lab assistant for the Medical Bacteriology class – where I met my husband to be.  And I had taken the Medical/Dental Chemistry sequence at University of Michigan one summer, as part of my M.Sc. So, I had a sort of head start, that first year.

HE: What was medical school like? How did being female alter your experience? Do you feel that your teachers and/or your peers treated you differently than your male counterparts?

JS: In 1950 there were still a lot of ex G.I.’s coming into Medical School.  I was the only woman in my class of 75.  The class next to me had 3 women – Eileen Ferrell, Catherine Panis and LeMoyne Unkefer.  The only time I can remember when it made a significant difference was the day we had two choices in a lab course – gastric analysis and the 3-hour urinary glucose tolerance test.  I had to do the quite uncomfortable gastric analysis – because there were NO Women’s Bathrooms in the ENTIRE Kinsman Hall!

The rest of the time, I think one had to ignore the male/female thing.  I know there were things, but being the only one, it didn’t pay to notice.  I was lucky because my husband’s medical fraternity brothers accepted me, so I could study with them and they looked out for me. It was the lab assistants, etc., who were more likely to try to sneak in a pinch or two. And, I think I liked it the way it was – not much change because of my sex.  I had gotten accustomed to that in Grad School, I think.

HE: What was your favorite part of medical school? Your least favorite part?

JS: I think a defining part of Medical School was the “Physical Diagnosis” course in the Spring Quarter of Sophomore Year.  I had often felt really privileged to be taking the Medical School courses as I went along, but this course taught subtle things that doctors are taught that make you a doctor for the rest of your life.  It separated me from all my long time “girl” friends. It was the real beginning of what made me an M.D. instead of a Ph.D.  And, I didn’t realize it until some time afterwards.

I just liked the whole experience, exciting new material all of the time.  I remember our Dermatology instructor especially. He was really good.  He had a lot of slides and his descriptions were top notch.  By the end of each class, if you looked around the room, everybody was scratching!  The worst was our Physiology instructor.  He was German with a VERY strong accent.  For the whole first week we thought he was saying, “squirrel muscle” instead of skeletal muscle.  That was his specialty and the course lacked depth. When we got to Boards, thank goodness I had the Physiol. Chemistry from University of Michigan to fall back on.

I really didn’t have many ‘unfavorite’ parts, as I said – it all seemed such a treat that so many others didn’t enjoy.  I hated being on call more during internship (in a pre-Vatican Roman Catholic Hospital) after I got pregnant as a sort of ‘punishment’ – even though I had done extra covering for a couple fellow interns who got ill.  (I was so fortunate in having classmates who always treated me fairly.)

HE: How did you keep yourself going throughout medical school?

JS: As I look back, I think one of the things that kept me going was observing my husband, who was two years ahead of me.  He was always an important role model, although our specialty choices and much else, was very different.  But it helped me move ahead, having some idea of what was coming.

HE: How did you decide on your specialty?

JS: Deciding on a specialty was a subtle thing.  It wasn’t until some years later that I really figured out what was going on.  I was the oldest of 4 girls – and from an early age, ‘responsible’ for us all, in a way.  My sister 2 years younger (a tennis champion and very independent) who was not a ‘follower’ took some extra skill.  The third sister was a sweety. A month after her 8th birthday and a month before my 14th birthday, she died suddenly of typhoid fever.  (Her friend lived in the country and there was a little stream they often played in – this was 1943.)  It was a huge thing for the family, of course, but it wasn’t until a number of years later that I realized the role that played in my choosing Pediatrics.

Other circumstances played a part, of course.  It was easier for women to get into at the time, of course.  The Family Practice residences were just gearing up, but I didn’t see how I could possibly learn everything for every age group that that would require.  Also, with my husband specializing in Psychiatry, city life seemed ordained and the Family Practice residencies had a lot of rural tilt.  (If it had been 30 years later, I think I would have opted for some time in third world countries.)

HE: What was your career like? Where did you work?

JS: Choosing the inner city Federal “Children and Youth Projects” was a perfect fit, after some years in private practice.  I was the “Clinical” Director of the C&Y project in Topeka, Kansas, which went to the Health Department and then the Director of the University of Minnesota sub-project of the Minneapolis Health Departments C & Y Project – the only Director of two different C&Y’s!

When we first moved to Topeka, KS we planned to stay for just a year.  I did some Child Health Conferences for the Health Department that summer and then ‘covered’ for a “GP” who had a rural practice about 12 miles west of Topeka.  That was a riot.  The local Grange had built an office with a waiting room, two exam rooms, – a pump in one of the rooms- and an ‘outhouse.’  I went two mornings a week and an evening, to keep the practice running for him.  It was a fantastic chance to follow several generations and do research in familial diseases.

When it became apparent that we would stay more than a year, Ed went on the Menninger Foundations faculty and I joined a Pediatrician in Topeka who was waiting for a long term partner.  One of the difficult things for me was that the permanent partner arrived just as my daughter was born – and I had to decide – did I want to go into practice by myself, or what?

I did, we stayed in Topeka 15 years instead of one and I had the chance to head up the C&Y Project for nearly 3 years, until we moved to Minneapolis.  My husband had the choice of moving to New Hampshire, Washington D.C. or Minnesota.  Our children were just starting High School and Junior High School.  We thought it might be tough for me to get a spot in small town New Hampshire and Washington might be okay – for awhile. We both had an easy time picking Minnesota.  We moved in 1970, both into spots that we loved.

In time, the C&Y Federal Projects went local.  We were able to improve Maternal and Child Health statistics for American Indian children and youth in our catchment area, to start not only Family Planning services, but also OB services, with the same results.  Finally we were able – in 1976 – to start a program for all ages with the help of the University of Minnesota.  This comprehensive program still exists.

In the mid 1980s, the Pediatrics Department in Minneapolis was in a muddle, with no Department head, and a friend had been forced to retire. I didn’t want the same sort of possibilities to happen to me. I had been very ill with Trigeminal Neuralgia and taken a 6 weeks sabbatical.  (My first, ever.) I was well again on a great new medication (Neurontin) but the new Vice President for Health Sciences offered me a job doing clinical work only at the Community University Health Care Center for the following year.

I had been the Director of the Center from the summer of 1970 until I became ill in the fall of 1984, and I had my M.P.H. in Health Management and Health Policy from the University of Michigan, so I told this new VP ‘thank you, but no thank you.’ I did not think such a position was workable in a situation where I had been “boss” for so long. I negotiated a full year of salary and another year of half salary with Health Sciences so that I could work with Dr. Olness’ group in Minneapolis. This was, perhaps, the most draining period of my entire career and I probably could have parlayed it for more than I did.  On the other hand, the work with Dr. Olness’ group was by far, the most creative.

My last 5 years was spent commuting from Cleveland, Ohio to our home in Minneapolis, MN. I was on the faculty at Case Western University and flew home 2 or so times a month. I had learned Brain Wave biofeedback and other forms of biofeedback when we lived in Topeka, Kansas – (at the Menninger Foundation.) Dr. Karen Olness was the Chief of our Service and we did many interesting things at Rainbow Babies and Childrens Hospital.

The stint at Case, in Cleveland, was really great.  I had a lovely 1850 “workers Cottage” in Ohio City (Cleveland) and had time to make a beautiful garden.  I ‘commuted’ home by air, 1-3 times a month. It was a good thing for a woman of my generation to manage a home by myself, as I had gone from my father’s house to my husband’s. It was perfect and I learned a lot. I worked at Case, in Cleveland, from July 1987 until July 1992 (or 93??) I retired a little early because my leg injury from age 12 was becoming a problem. (Surgery in 1948 lacked a lot – wish I had today’s improvements.)

HE: How did you balance work and raising a family?

JS: Getting good help is key. I can’t remember this being really a problem. I had a husband who always did his share without being reminded and kids who were alert, interested and creative. Certainly, getting good help cut into my income, but I always felt I had plenty, anyway. I was doing interesting work, I was doing useful work – what more could one want?

HE: If you had to do it again, would you still choose to do medicine? If so, would you pick the same specialty?

JS: First, I would always lean towards those most in need.  And my M.P.H. in Health Management/Health Policy (Univ. of Michigan) would play a part as would my early training in Self Regulation at the Menningeer School in Topeka, Kansas.  I would like to pick a catchment area where we could go in, with a team that could change the maternal and child health statistics in that area for the better.  This team would include a Masters level Nutritionist, a Masters level Health Educator, Community Health Workers, a PhD psychologist, Pediatric and OB people, probably including Nurse Practitioners, and other folks necessary to run a clinical operation. Also, the capacity for Dental services.

I would use the model of the Federal Children and Youth Projects, where I was able to direct two of the 58 Projects.  These Projects had a vision of health care delivery that has not been surpassed.  The maternal and child health statistics would show improvement and the cost would be well below the going rate.

I would love doing some of the usual, regular routine of Pediatric Care – checkups were never a bore with children, the challenge of illness in the usual population – and enough time for administration to keep the vision going.  Along with administration and routine pediatric care, I would like to have a defined piece of care time to do Brain Wave Biofeedback with a referral population. (I would do other pieces of self regulation within the regular pediatric care.)  So, yes – the same specialty, brought very much up to date.

HE: What advice do you have for the new generation of physicians?

JS: Enjoy learning – it will lead you.

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