Week 4: Insight into the Road to Becoming an MD and Congenital Heart Disease

As someone who had considered going to med school as my “back-up plan” for a PhD, it has been interesting to see firsthand the process through which med students go on their way to practicing medicine. I had generally known that the process is med school, internship, residency, then fellowship, but had not really understood what it actually means to go through these many years of training until these past 4 weeks in the clinic and especially after this week.

I find it impressive to observe the range of rankings and experiences from interns on their first day, to residents, to senior fellows on their way out to attending positions, and to see even the knowledge gap between new fellows and senior fellows. This past week I was able to spend time learning about cardiac CT imaging with one of the brand-new fellows (ranging from calcium scores to assessing TAVR function), and was able to sit in on one of the daily lunch conferences for fellows, which was more focused on proper hospital protocols and documentation and specific skills in the Cath Lab, as opposed to med student lectures focused on basic medicine. Sitting in on rounds in the cardiac ward, I have been extremely impressed by the knowledge base of first year interns, and by how confident and knowledgeable the residents are. Although I know they have been through years of rigorous training to get to that point, I hope that someday in my training as a PhD student I could emulate the high and thorough level of understanding that medical students have in my own field.

In the last part of my week, I observed clinics with one of the clinicians specializing in Adult Congenital Heart Disease. Given that my PhD work is with dilated cardiomyopathy, I found this particularly fascinating to see. There was a stark difference in age between these patients and normal cardiology patients, with most being in their 20-30s, and, overall, they were in much better health despite having various congenital heart conditions. It was interesting to learn about the various surgical procedures to fix the patients’ conditions, ranging from surgeries in the first year of life (such as for patients born missing a valve or with multiple unlivable heart defects at once) to simple catheter surgeries performed after a few decades of life (for an coarctation of the aorta). Although I was not able to see any patients with dilated cardiomyopathy, I feel like this experience has given me a better understanding of how congenital heart conditions are handled both surgically and long-term, and gave me some interesting lessons about cardiac development and atypical anatomy!