Dr. Sanjeet Rangarajan, Assistant Professor of Otolaryngology - Head and Neck Surgery at the University of Tennessee Health Science Center, Memphis, Tennessee.
In this Primer, Dr Rangarajan first tells us what the Study of Medicine is, a brief history of Medicine, Impact of Technology on Medicine, hot areas of research, the skills needed to study Medicine, and the available opportunities when you graduate.
Hi-Fives from the Podcast are:
Episode Title: What is the Study of Medicine? With Dr. Sanjeet Rangarajan of the University of Tennessee Health Science Center.
Episode summary introduction: The goal of this series is to serve as a primer for High Schoolers about a Major, through our conversations with Faculty Experts in the various US Colleges and Universities.
We continue this series with the Study of Medicine, with Dr. Sanjeet Rangarajan, Assistant Professor in the Department of Otolaryngology - Head and Neck Surgery at the University of Tennessee Health Science Center.
In particular, we discuss the following with him:
Topics discussed in this episode:
Our Guest: Dr. Sanjeet Rangarajan is the Assistant Professor in the Department of Otolaryngology - Head and Neck Surgery at the University of Tennessee Health Science Center. Prof. Rangarajan earned his Bachelor’s and Master’s in BioMedical Engineering from Vanderbilt University, Nashville, Tennessee.
Memorable Quote: “...it is a bit of a hard road, and it takes some time. And so any like anything that takes time, it takes focus, and I think that staying disciplined, serves you well” Dr. Rangarajan on the characteristics needed to study and practice medicine.
Episode Transcript: Please visit Episode’s Transcript.
Suggestions for you: STEM Podcasts.
Transcript of the episode’s audio.
<Start Snippet> Dr Rangarajan 0:15
There are so many different ways to help people and help societies and help each other through this field that really anybody despite or regardless of their skill level or or their, you know, early exposure to medicine or whether or not they have family members in medicine. I think I think that there's something for everyone in this field.
That is Dr. Sanjeet Rangarajan, Assistant Professor of Otolaryngology - Head and Neck Surgery at the University of Tennessee Health Science Center, Memphis, Tennessee.
Hello, I am your host, Venkat Raman.
Today’s episode is on the Study of Medicine, in our series on “College Majors” to serve as a Primer for High Schoolers.
Dr. Sanjeet Rangarajan joins us on our podcast to give us an Introduction to the Study of Medicine.
Venkat Raman 1:18
In this Podcast, Dr Rangarajan first tells us what the Study of Medicine is, brief history of Medicine, Impact of Technology on Medicine, Hot areas of research, the skills needed to study Medicine, and the available opportunities when you graduate.
Venkat Raman 1:38
Before we jump into the podcast, here are the High-Fives, Five Highlights from the podcast:
[Study of Medicine]
You know, traditionally medical school has been a four year postgraduate degree degree program. And currently today there's two main medical granting programs.
[Technology in Medicine]
Obviously, our ability to diagnose and treat disease has changed quite a bit as well. And I think a couple of the areas that have resulted in this change have been the study of genomic so or genetics, essentially.
[Emerging Areas of Medicine]
I would say that the practice of even family medicine has changed due to the emergence of big data and artificial intelligence. I think that you know, even though they will continue to practice to manage the chronic health problems of the population, the tools in which they're using are also changing.
Well, I think the number one thing is that you have to care about people or care about others. And I think you could probably say, the same thing for a lot of fields. But obviously, the study of medicine comes so close to the human condition that I think first and foremost, you have to care about other human beings.
[High School Preparation]
The job of a high school student as it pertains to medicine is to understand you know who they are and start to understand what their strengths and weaknesses are.
Venkat Raman 3:24
These were the Hi5s, brought to you by College Matters. Alma Matters.
Subscribe wherever you get your podcasts.
Venkat Raman 3:35
Now, without further ado, here’s the podcast with Dr Rangarajan!
Venkat Raman 3:43
Sanjeet, let me welcome you back to our podcast. Thanks for making the time again, this time you come in as a doctor and making a house call, a sad joke. But no, I really am looking forward to this conversation, especially for youngsters out there. Talk a little bit about "What is Medicine?" You know, you know, obviously everyone knows who are doctors. But what does it take to become one. And I think just stepping through the process and all the opportunities would be a great thing. So thank you for making the time.
Yeah, thanks for having me on. I think we'll have a nice discussion because I think that the understanding of what medicine is has really expanded and changed over the last, you know, several 100 years and hopefully I'll be able to paint a picture of a field that in some ways, maybe what people think and others maybe not what they think so.
Venkat Raman 4:46
Awesome. Okay, so let's jump into it right into the thing. And maybe start with What is What is the Study of Medicine? What does it entail?
Sure. So I think when people think about what it means to study medicine or to practice medicine, you know, immediately think about somebody who has attended medical school. And so, you know, traditionally medical school has been a four year postgraduate degree degree program. And currently today there's two main medical granting programs, two different types. One is the allopathic medical schools which award the MD or doctor Doctorate of Medicine, and others that award the DO degree which is the doctor of osteopathy. I would argue that the practice of medicine in 2021 is such a team based sport that really medicine is practiced by by many different individuals who, you know, take part in what is today's modern medical industry. And so, you know, even folks like mid level providers, which encompass physician assistants and nurse practitioners, I think you get the argument that they also practice medicine but strictly, you know, talking classically, the study of medicine is basically a four year you know, graduate degree program, awarding the MD or DO degrees.
Venkat Raman 6:28
Maybe you can shed a little light on the two streams, you talked about the allopathic and the DO so maybe a little bit of explanation on those.
Yeah, so in many ways, they are very, very similar. I think the allopathic schools, which award the MD are, in some ways, more commonly known, they've been around a lot longer. I think, you know, I'll talk maybe about the ways in which the two programs are similar. Sure, both are, again, four year postgraduate professional degree programs. The they both can lead to residency subspecialty training in a variety of fields. Really all fields, I mean, you'll find that physicians in whether it be family medicine, or neurosurgery, or obstetrics and gynecology, you'll find both MDs and you know, DOs in both areas. Now, osteopathy, which is really short for osteopathic medicine really started to surface in the United States in the late 1800s. And osteopathy really stemmed from the idea that the understanding of the cause of pathologic conditions is of utmost importance. And you could make potentially the same argument for allopathic schools of medicine. But there is, in some parts of at least, the training, there's just a difference in philosophy and tech, how doctors of osteopathy come to understand the basis of disease. So it's less there's, there's really not much difference in the end product, you know, both MDs and DOs, can become board certified in a variety of professional fields. But there are some small, small differences in the type of training, or I should say, the way in which they're trained. And so, hopefully that makes sense. You know, I think they're just different different types of educational programs that can ultimately lead to the same results.
Venkat Raman 8:50
You started to talk a little bit about the history of medicine or medical education. You know, give us give us a little sketch of that, in the United States, at least.
Yeah, so I mean, Medicine has obviously been around as as long as people themselves and you know, when we think about ancient medicine, we think about things like the Hippocratic Oath, or we think about things like the Hippocratic Oath, which originated in, you know, ancient Greece, but when we're thinking about the first medical schools in the United States, you know, the, I believe the first medical school was actually in Philadelphia at the University of Pennsylvania and Pennsylvania Hospital is actually still standing there on Ninth Street in in Philadelphia. And then, of course, you know, the old some of the other old medical schools, including Harvard and Columbia, and Johns Hopkins and Dartmouth, and, you know, early on, there were very few medical schools. But again, the earliest ones cropped up on the east coast of the United States in the former colonies, and over the course of The next, you know, 300 years or almost 300 years, there's a series of changes to the correct the type of training and you know, how we train medical students. And both in the postgraduate degree program, which is, you know, the medical school as well as the post medical school training programs, which are residencies, etc.
Venkat Raman 10:23
I remember reading, maybe it was about the 1918 flu that, you know, the medicine, you know, getting a degree in medicine was pretty straightforward. None of the rigor that you see today or, you know, in the past 50 years, so certainly has transformed, I think, in terms of how medical education is, sort of disseminated.
Yeah, I think that the you know, it was it was pretty straightforward. And, again, there were so few medical schools that, you know, there wasn't a need for a lot of oversight from a national standpoint, and I think a series of things happened over the course of, you know, a couple 100 years, you know, the formation of the American Association of Medical Colleges are Association of American Medical Colleges, which is the AMC, which is still in existence today, that was created to provide some oversight and develop some educational standards for medical schools. And then later on in the early 1900s, the Flexner Report, which was issued by Abraham Flexner. Really, it reported on the standards that were currently in place at American medical schools, and what what resulted from that was actually, that many non university based medical schools, so basically independent medical schools, they had to close and so so then, you know, basically, you had a situation in which you had all of the medical schools in the country that were associated with, you know, generally larger universities. And that was really when we started seeing, you know, the start of additional guidelines for residency programs, and then the LCME, which is essentially a committee on medical education that is still in existence today. And so, as there has been more oversight and how we train future physicians, we have also seen an increase in the competitiveness of getting into medical schools as well, just just because, you know, the schools are under such a high burden to produce excellent graduates that they all go, you know, put in a lot of extra, you know, effort and resources into attracting, you know, what they would say is are the best and brightest.
Venkat Raman 12:49
You said at the outset, medicine is changing, evolving, and a lot of things, you know, definition, you know, the definitions have changed as well. And I'm, I'm imagining that technology, and instrumentation has a lot to do with that. So maybe you can speak to that as a starting point for the next set of discussions.
Yeah, sure. So, I mean, anyone who's been to the doctor recently knows that some of the technologies that you'll see in your, you know, average physician's office, a lot of it wasn't around 10 or 15 years ago. So some people may be used to checking their test results in through an online Porter, I'm sorry, through an online portal, or, you know, using their smartphone or to converse with their physician. Or maybe they may go to the office and check in on an iPad. If you think about it, you know, that these things were around more than 10 years ago. And so, but clearly, they've found their place in the modern practice of medicine. But, you know, the role of technology goes beyond just how patients interact with their physicians.
A lot of the way we practice medicine has also changed as well. And I think, you know, one of the most, you know, obvious and potentially well known effects of that modernization of medicine is the electronic medical record, which, you know, now, physicians are required to use electronic medical records, almost without exception, I think, you know, you'll find very few physicians now using paper medical records and, and, and so that, in turn, leads to a cap changes, right, so physicians have to sometimes spend additional time documenting, you know, their visits in electronic medical record may take more time. Know that use paper charts. In the same way you Those notes become part of the medical legal record. And so, you know, we, we have to pay a good amount of attention. So you have this whole field of electronic medical record development that has cropped up. And I think that's what have been one of the big places where things have changed for physicians practicing medicine.
Obviously, our ability to diagnose and treat disease has changed quite a bit as well. And I think a couple of the areas that have resulted in this change have been the study of genomics or genetics, essentially, we understand a lot more about chronic diseases like cystic fibrosis and cancer and rheumatologic diseases. I think a lot of that has changed just because we understand the human genome. And we understand that simple mutations in genes lead to basically the development of these diseases. And so that is something again, that, you know, really wasn't here and the as late as the early 1990s. I mean, any of us who were around during that time, remember the excitement that came about with the completion of the Human Genome product, the Human Genome Project, and if you remember back, the cloning of Dolly the sheep, right, as well, I mean, some of these, these things seemed like science fiction when they were first reported on. But now, you know, the things that we really thought were huge leaps in understanding are now fairly commonplace for us now.
And you know, I'm a surgeon and technology has really changed the way that I practice medicine, everything that I do is actually performed with small, tiny video cameras. And I use, you know, very high definition 4k monitors in the operating room. And we use electromagnets to track our instruments, you know, to the millimeter. And, I mean, we have all kinds of incredible technology that just changes really every couple of years, which is pretty incredible.
Venkat Raman 17:18
You know, other than basics that people might be thinking about, what are the kinds of areas that are emerging, you know, across disciplines and such?
Yeah, no, that's a great question. So I'm gonna get back to something I alluded to, earlier in that, you know, we have always thought about the practice of medicine as being limited to physicians. And then we also have thought that when you become a physician, and you finish medical school that you practice, as a doctor, you know, you go to that and go to the office and you see patients and you work in or you go to the operating room and you perform surgery. And those, you know, fairly rigid lines have been starting to blur for several decades now.
Many folks who have tried to have children understand the difficulty that can come with something like infertility. Now, we have maternal fetal medicine and things like in vitro fertilization, and we have fields of medicine that are, you know, very specialized to help patients who are having trouble having children and they utilize really the latest technology and the latest understanding into how to work around those difficulties.
I would say that there are several areas within cardiology so people who have cardiac arrhythmias or have structural problems with their heart can visit an electrophysiologist or a structural cardiologist who can use tiny catheters and essentially reprogram the way the the heartbeats. I mean, that's putting it simplistically, but that's actually you know, what they do.
Neurologist neurologists and neurosurgeons work together to treat the symptoms of Parkinson's disease by using deep brain stimulation, they insert a small electrode into the part of the brain that's malfunctioning in our label, they're able to deliver fine electrical pulses and, you know, take away people's tremors that have been, you know, present for years.
You know, these are just a couple of the examples of places where things are changing but, you know, things may also not be so obvious. So you know, family medicine, people may, you know, think that the folk, that the people may think that the doctor that they visited for years as a as a pediatric patient, or maybe later on in life, as you know, people will see an internal medicine doctor, a family medicine doctor, I would say that the practice of even family medicine has changed due to the emergence of big data and artificial intelligence, I think that, you know, even though they will continue to practice, to manage the chronic health problems of the population.
The tools in which they're using are also changing, this is getting back to our, you know, I, you know, our discussion on the role of technology. And the tools that they're using are changing so much that, in effect also changes the specialty, I think, you know, because family medicine and internal medicine doctors, they have to be doctors, but they also have to be data scientists, right, they have to understand these big collections of data and understand how to utilize research that is also constantly changing, to better their patient populations. And so, you know, while maternal fetal medicine and, you know, areas of neurosurgery, cardiology, these are some of the things that we've mentioned that I would say, are emerging areas within medicine, I think, you know, you'll find those changes, even at, you know, pretty much every every specialty area.
Now, another thing is, you know, people who complete medical school who do the four year degree and may or may not complete residency training, there are places for physicians to work that don't necessarily involve care, you know, because physicians are needed in companies and startups, physicians are at insurance companies. I think we've seen physicians are becoming more represented in politics and in government. And so, you know, the practice of medicine or becoming a physician can be taken well beyond the clinic or the hospital setting as well. And I think for anyone who is considering a medicine or going into medical school, can really serve themselves well to stay extremely open minded, not just as to what specialty they plan to pursue, but also how they envision the rest of their career looking, because I think the sky is the limit for medicine as well. And it's not something that necessarily will get talked about very often.
Venkat Raman 22:51
That's a that's a great point. I mean, and public policy or health policy, you know, is another big, obviously, area. And we've seen that in the last couple of years now.
Venkat Raman 23:06
So Sanjeet, I think, all the high schoolers out there who are interested in pursuing medicine, or think they want to pursue medicine. What kind of skills do you think I needed to be good at this? And obviously, there are different roles to play. So, you know, maybe you could speak to that?
Sure, so I think the number one thing is that you have to care about people or care about others. And I think you could probably say, the same thing for a lot of fields. But obviously, the study of medicine comes so close to the human condition that I think, first and foremost, you have to care about other human beings. I think most people would probably put themselves into that category. So I think, you know, right off the bat, we don't have to exclude anybody if they're considering medicine. So I think that that's good.
The second thing, though, is I think you need to be disciplined. You have to be disciplined for a few reasons. The first is that and I think we'll talk a little bit more specifically later about the process to get into medical school and to complete the medical training. But it is a bit of a hard road and it takes some time. And so any like anything that takes time, it takes focus, and I think that staying disciplined, serves you well not only in the process of getting in and completing medical school, but when treating patients it also requires a good amount of discipline as well because often you'll find yourself having to, you know, spend extra time with a patient or you may find yourself you know later at night in the operating room and and ultimately when you're in those situations in which patient care is is that At the center of what you're doing, you have to put patient care first. It doesn't mean that you can't have a great life. And it doesn't mean that you can't, you know, succeed in and accomplish everything else that you want to in your life. But it does mean that, you know, when you're dealing with patients in those, you know, minutes and hours, you have to put them first. And so that takes, you know, a reasonable amount of discipline. So, you know, I think those two things really fit all different types of physicians. But, you know, as you mentioned, depending on the specialty, there are certainly you know, certain things that if you have the skills, then it can help you.
So, the first is let's talk about surgeons and anybody who's doing procedures. So, you know, while this would include things, specialties like orthopedic surgery, and neurosurgery and otolaryngology, which is ear, nose and throat surgery, it also includes specialties like interventional cardiology, or interventional neurology, I mean, these are all sub specialties that require some fine motor skills. And, you know, and what I'll say about that is, is if you can, you know, if you have those fine motor skills, then learning these crafts comes easier to, but if but if you don't, it doesn't necessarily have to exclude you, it just means that you have to rely a little bit more on that discipline to take the time to practice. Because I think, you know, many of us would argue that these are skills that, you know, you don't have to be born with, they can be taught and they can be learned, and so, you know, fine motor skills, and essentially being able to, you know, do things like sew or, you know, draw straight line and things like that. I mean, those are things that can be useful if you want to aspire to be a surgeon.
I think whether you're a surgeon or a non surgical specialty, I think, you know, there's a healthy amount of reading that you have to do to become and stay a physician. And I think that, if you like to read, that's certainly a plus it will make the job, you know, that much easier.
I think that internists and family medicine doctors and obstetricians and others who spend a considerable amount of time in the clinic with their patients, they are well suited to be, you know, good conversationalist, and people who can really relate to patients well, you know, no matter what their issues are, and I think, you know, in surgery, we certainly do that, too. But again, we spend a lot of time in the operating room where the patient is asleep. So, you know, I think folks who really like to get to know patients and their families, you know, that having that skill and being able to relate to people would be served Well, you know, in some of those other specialties as well.
In the emergency room, I think that, you know, being able to think on your feet and being able to come to decisions quickly, is something that would serve you well.
I think if you like to deliberate and solve very complex problems that require a lot of consideration than something like pathology, or rheumatology or some of these other fields may be a good fit.
There's a lot of things that go into what area of medicine is better suited to someone that another. There's, you know, considerable differences and also different ways to practice as well. So, you know, whether, if you're a neurosurgeon in a private practice environment versus an academic practice environment versus an employed hospital environment, it can be very different your day to day life may be very different, different.
Venkat Raman 29:14
Do you think that most of these skills, I know some of them are people skills, but most of these are teachable? learnable?
I definitely think so. Like I said, I think that if you care about people and your discipline, then really anybody can learn the skills needed to be not just an average position, but an excellent physician. I, you know, see many people who will tell you themselves that they didn't feel like they had the talent or the skills to become a physician, but some of them are now the leaders in their field and I think it comes down to their dedication to their specialty, their craft, and so I would encourage all high school students and Beyond to, to really explore medicine as a potential field. And if they're interested in it, and they're willing to make the commitment and have that discipline, then they can learn everything that they need to be a shining star in their fields. I have no doubt about that.
Venkat Raman 30:22
Say, as somebody has just finished their undergrad and have gotten into some medical school, what what does that look like? What are the next four years look like? Just in terms of the types of study that they'd have to undertake?
Sure, so as it stands right now, most medical schools are a four year curriculum. There are some there are few exceptions to that. But we'll just focus on the standard four year curriculum for the purposes of today's talk. Yeah, the the first two years of medical school are called the preclinical years and they are centered on the type of teaching and learning that most undergraduate schools are accustomed to at this point. So they are reading textbooks, they are going to lectures, they are learning about the human body in its normal state as well as the pathologic foundation of disease. So first, generally medical students are learning, you know, how does the human body function when it's normal? So they're participating in anatomy classes and physiology classes and an assortment of other coursework that helps them understand how is the body supposed to work?
The second part of that is, how does the body look and work when something's not going right, and many medical schools will take a systems based approach. So you know, medical students will spend time learning how the cardiovascular system works, and then how the immunologic system works or the digestive system. Others will, will change the curriculum and focus on particular body areas. So for instance, the head and neck, well, in the head of neck, you can have a variety of issues they can they can be cancers, they can be blood issues, they can be nervous system issues. And so so some medical schools will focus on a particular part of the body and then, you know, teach everything that has to do with that part, when it comes to, again, the pathologic basis of disease.
So, so that's kind of in a nutshell, what you learn the first two years of medical school, you certainly learn other physician soft skills, like how to take a medical interview, how to write a good medical note, how does the health system work? How do you interpret, you know, medical studies and understand good data from bad data? You know, that's, that's the, that's the first few years of medical school.
The second two years of medical school, there's essentially two priorities. The first is to get in the hospital or the clinic. And you know, essentially, you enter the medical practice system at this point. And as a medical students are now integrating everything that you've learned over the previous two years, and seeing how it relates to the actual practice of medicine, because what you find is that what you learn in the book is on the simplistic side, and that there's, you know, several sides to the same coin. So So those last two years are really spent in the hospital and the office working and understanding everything that you learned the first two years and the second, the second priority of the second objective, for this second two years of medical school is to identify essentially, what the rest of your career is going to look like. And, and that really comes down to making a decision as to what happens after medical school. The vast majority will go on to a residency training program that will train them in one or more. Basically, specialty programs so you can go on and become a pediatrician or you can go on and become a neuro neurology neurologist, or or anything in between.
A very small minority of medical students will grant graduate and we'll go on to non clinical fields. So things I mentioned previously, they'll go on to work for a drug or medical device company, or they'll work for an insurance company, or maybe they'll do a second degree do an MBA or Master of Public Health or, or maybe they'll go into research. So, you know, there's a, there's a subsection of of medical school graduates who do not go on to medical to residency programs by design. But in a nutshell, that's what happens during medical school. Now, there are a couple of things that have to happen during the course of medical school. The first is, there are a series of medical board licensure examinations, and I completed allopathic training. So I'm more familiar with the allopathic boards or system. But generally there is a, an examination that has to be taken at the end of the first two years of medical school, and then a second one that takes place after the third between the third and completion of the fourth year of medical school. In the past, there was also a third exam called the clinical skills exam, which assessed in person medical, interviewing and clinical skills. And that was also assessed by the Board of Medical Examiners. As with all academic programs, the requirements for medical board licensure are constantly changing. And so, you know, some of the requirements and scoring systems for these different examinations will likely be different by the time our audience reaches the completion of medical school, but, but that's essentially what four years in medical school looks like.
Venkat Raman 36:46
In the interest of rewinding further so now, these high schoolers that get into college coming into undergraduate programs, with with some desire or intention of doing what's called pre med, right, what kind of background or foundation do you think they need to have, at the end of their high school? Is there something specific or it can be pretty broad?
I think it can be really broad, I think, you know, in high school, it is important to explore a wide variety of interests, you know, if you enjoy playing sports, then play sports, if you enjoy the robotics program, then participate in the robotics program. And, and I think really, the job of a high school students as it pertains to medicine is to understand, you know, who they are, and start to understand what their, you know, strengths and weaknesses are and, and maybe give some thought to what they want to do with the rest of their life. And I think, you know, if there's a early inclination that, you know, a high school student wants to become a physician one day, then that's great. And if there are opportunities to explore that, then, you know, I would certainly encourage him.
Ultimately, I think, you know, people who are looking to apply to college need to remember that colleges are trying to target and give admission to really a wide variety of students from different backgrounds with different interests. And I think that the most compelling thing that someone can do really, at any stage in their education, is be able to explain why they participate in something and what that means them, I think that's so much more compelling than, you know, saying, Well, I want to go to medical school. So I did this, I think, if you love something, that that's what you should pursue as a medical school, as a, as a high school student, and, and I think in turn, you know, eventually, some of those interests will lead to interest in college.
When we look at prospective medical school applicants from college, I think what's most important to us is, again, trying to understand whether the applicant has explored something they love and have had the dedication, the discipline to pursue it, and, and really explore it to that most of their levels. So, you know, it goes back to that I that idea. I said, you know, the, one of the main things that people should have is discipline, and I think if you can demonstrate that, you know, regardless of what it is, I think that that can be, you know, really important. So I would encourage all high school students to explore their interests broadly, and to really throw themselves into whatever it is that they enjoy doing.
Venkat Raman 40:00
So once they get to college and the pursuit of the pre med program or pre med related studies, what kind of things should they be doing? What's what's needed to get ready for the next process of getting into med school?
Sure, so, you know, again, these are some requirements that are constantly, you know, changing somewhat. But in general, to go to medical school, you have to complete several prerequisites. And generally these are prerequisites in the physical sciences. So Biology, Chemistry, Organic Chemistry and Physics. There are certain prerequisites that must be met prior to application to medical school.
Medical schools do want to see that people have pursued a fairly broad curriculum, though, as well. So you know, things like English or foreign language or economics or other coursework is often I think, the main in school medical students, I'm sorry, but schools want to see some consistent patterns of success. So I think that, you know, whether you major in economics, or you major in biology, or you major in performative dance, they want to know that You excelled in your area. So prospective medical students need to identify what prerequisites are currently required by medical schools, again, they'll be similar to the ones I've already listed and make sure that they complete those.
There is an entrance examination called the MCAT, which most of our audience has probably heard of. It's a standardized test that, again, has undergone several changes over the years in terms of the way it is scored, and the number of sections and the number of questions. But again, it generally tests knowledge of those prerequisites, which I already mentioned, there is an English comprehension component as well. So again, you know, it's not all, not all sciences, although it does tend to, you know, center on, again, those physical sciences. And so I'm sure, I'm sure Venkat, I'm sure you've have some some good advice for how to handle standardized tests. And I would say that this is no exception to that. So completion and passing of the MCAT is also a prerequisite.
Some of the things that may be less obvious, medical schools want to know that, that the student has given some really careful thought to their pursuit of medicine, and that, and that can be demonstrated in several different ways, participating in shadowing programs. So basically, going to a physician's office or the operating room and just simply observing it all in just being present and watching and learning from watching. That helps in two ways, I think, one, it helps the prospective student understand if they really truly enjoy what it is that physicians do. And two, it helps them demonstrate to programs that, hey, I've given this some thought, and I've actually spent some time watching what it is that a physician does. And, and I can I can talk to you about why I enjoyed that experience. I mean, I think that, you know, it really helps in two ways. And I would say that, that really anybody seriously considering medicine needs to needs to do this. Because I think, you know, understanding and convincing yourself that this is the field for you, is an important part of this process. So that's one way in which one thing that you know, prospective students will need.
The last is that just like with college, medical schools want to fill their classes with a very diverse student body. And they want to have people from all different backgrounds from all different locations, and with a lot of different types of skills and experiences. And so anything that the student finds compelling, whether it's, you know, a service project or you know, or a sport, you know, again, medical schools are going to be looking at that too. So you want to be as well rounded as an applicant as possible. I think the mistake I see prospective students making sometimes is diving too headfirst into to medicine while they're still an undergraduate student, and not not building a much more well rounded application, and I think that that can that can really hurt some people, if they're, if they're not careful.
Venkat Raman 45:19
Anything else that you would want to advise to counsel, all these folks?
I think that medicine is a really great field, I think it allows for a lot of variety, which I think, you know, is really what a lot of young people want. I mean, I think there's so many different ways to help people and help societies and help each other through this field that really anybody despite, or regardless of their skill level, or, or their, you know, early exposure to medicine, or whether or not they have family members in medicine, I think I think that there's something for everyone in this field. Again, if they care about people and are disciplined, and they're willing to, you know, pursue this goal, I think that it can be a very fulfilling career.
Venkat Raman 46:17
Okay, so before we sign off here, I thought I could spend a little time talking about you, and your practice of medicine. So maybe we can start with I know, I know that you did engineering, undergrad and masters, biomedical engineering, and, and then you went off into medicine.
So tell us a little bit about why you got into medicine.
Sure. So I think that, you know, like any maybe perspective engineering students who may be listening, or anyone who's maybe even considering engineering versus medicine, I always enjoyed solving problems. I found that as a high school student, and some of the things that I participated in, in high school, and I found that to be further true as I pursued a career in engineering in college, and I think that engineering school gives us great opportunity to learn how to solve those problems, and especially some very difficult ones. But I during the summers home for medical, I'm sorry, during the summers home from college, I worked in the automotive industry. And because I was from Detroit, and I found that while I really enjoyed solving problems, that the end result was that I was, you know, helping with a new model year of a vehicle or helping to improve an engine part or, or something like that.
And I found that I wasn't very fulfilled by the final and design product of the problems that I was solving. And I was in a biomedical engineering program at the time. And so things like systems physiology and health related course, courses were part of my curriculum. And so I had some exposure to medicine, just through my college curriculum. And so I started to think about this into my junior and senior year of college and thinking that maybe, maybe medicine, if I pursued it, it would allow me to continue to solve these problems, but effect change on a level that I was seeking.
And so I took on some early shadowing opportunities while I was an undergraduate student. And I came to meet and get to know some really talented physicians who cared a lot about what they did and cared a lot about their patients, and consequently, actually made very significant impacts on their respective fields. And they really made a big impression on me and helped me. It helped open my eyes to the possibility of pursuing medicine as a career for myself.
And in many ways, I still, I still keep in touch with those mentors and look at those mentors as examples of, you know, still ways in which I can push myself even more. And so as time went on, and as I shadowed these physicians in undergraduate school, and I started to get more and more experience in medicine, I realized that, you know, that problem solving that I came to love in engineering could be combined with, you know, the study of medicine and so that I could get the fulfillment I was looking for as well.
And so from, you know, from a 30,000 foot view, that's really how I made that mental pivot to medicine from engineering and I'll say that if you're an engineer, just because you pursue medical school or business school or any, you know, postgraduate degree doesn't mean you're no longer an engineer, I think in many ways, the way I approach the practice of medicine and the way I think about patients and, and their problems, I think about it very much like an engineer what and many of my research and academic interests also continue to lie at the intersection of engineering and medicine.
So in no way was was those you know, four years of undergraduate engineering, education wasted. I think that if anything, it really prepared me for the rigors of medical school and helped give me a framework in which I could understand and solve problems in healthcare and medicine. So I think it was a it was a great transition for me. It's certainly not for everybody, but I don't think that anybody is disqualified just because they you know, go full force 100% into a given field.
Venkat Raman 51:07
So what do you do today?
So today, I am an Academic otolaryngologist had a neck surgeon, it's a, so I did a five year residency, post medical school, in ear, nose and throat surgery at The Ohio State University. And afterwards, I did a fellowship in Ryan ology and endoscopic skull base surgery. And Rhinology is the study of the disorders of the sinuses and nose. And, and skull base surgery is essentially the treatment of diseases and disorders in the front of the front of the brain, basically, the intersection between the brain cavity and the sinuses and the eyes. And so I do a lot of brain tumor removal surgically with my neurosurgery colleagues. And we actually work entirely through the nose, which is actually a fairly new paradigm for treatment and so, so essentially, Putting it simply, I'm, I'm, I'm a sinus nose and brain tumor doctor, and I work in academic medicine at the University of Tennessee Health Science Center in Memphis, Tennessee. And you know, I've mentioned academic medicine a few times what that means is, I work for a university. My job is split between seeing patients and performing surgeries, as well as performing research and teaching the next generation of otolaryngologist. So I have a cohort of 25 resident trainees that are learning my craft from me.
Venkat Raman 52:56
When did you realize that you are good at this stuff? I mean, you know, you know, when we do these things, at some point you it comes naturally or you feel in your bones or, metaphorically speaking? Sure. When did you feel that? Or was that just a process?
You know, it's a, I think it's a process. And it's still an ongoing process. I think that, you know, again, like I mentioned, medicine, and really everything within it is constantly changing. So, you know, you're a lifelong lifelong learner in this field, show, you know, I'm constantly figuring out what I'm good at, and what I'm not good at, and what I need to get better at. I think that's a natural thing for every physician in practice, I can say that, you know, you never truly know if you're going to be good at surgery until you're almost actively doing it as a resident. And I think that that can be a little bit of a scary thought. But this goes back to the idea that I think that any of these skills can be taught. So again, yeah, discipline, you can learn it. So you may not find out that you're good at it until you're a surgical resident. And if you find that you're not that good at it, then it means that you're going to have to work all that much harder, so that you can be you know, a good surgeon and treat your patients well. So, and then many people close that gap. I mean, it may sound like a rare thing for someone to figure out that hey, this doesn't come naturally to me, but that actually happens all the time. And people do just fine just with some extra work. So I'll say that I was I was pleasantly pleased. I was pleased when I entered residency and found that the physical act of doing surgery, surgery came, you know, fairly easily to me. But I didn't it took me a few years to realize that I was particularly good at endoscopic sinus and skull base surgery, which is what I eventually did my fellowship in in otolaryngology. your residency, you learn all about how to, you know, treat head and neck cancer surgically. We are professional voice surgeons, we help people with disease of their voicebox. We have, we have narratologists within our field, which are basically surgeons who only focus on the ear. We have facial plastic surgeons, and you know, these are all areas that I was I was trained in, but I, but I learned that I was particularly good at the endoscopic or basically, using a small telescope and performing surgeries in the telescope through the nose, I found that I was particularly good in that area. And so I naturally gravitated towards mentors who also practice that particular type of surgery. And, you know, they also encouraged me to pursue a fellowship. And, you know, I owe a lot to them. For, you know, where I ended up.
Venkat Raman 55:58
So one last question. What do you find is the most satisfying part of what you're doing?
So I'm going to be completely honest, I take a lot of pride in my medical surgical practice and treating patients and you know, certainly, it's always a great feeling when you help someone feel better, or you help a family member, you know, when you get those great medical outcomes, but, but I really think the favorite part of my job is actually my residents and the teaching I do from day to day. I think, like I said, when you become a physician, there are many different practice environments. You can practice on your own in private practice, or practice with other partners at a hospital. But I chose academic medicine because I really enjoy working with our residents and surgeons and training and seeing them close those learning gaps. And, you know, again, they may realize and I may realize that, you know, maybe they're good at something, or maybe they're not good at something, and, and seeing everybody close the gap over the course of five years by graduation is really the most satisfying and fulfilling part of what I do every day.
Venkat Raman 57:10
Awesome. So Sanjeev this has been fantastic. Thank you so much for not only taking the time, but you know, describing this in so much detail. I know. It took us a little while getting you on the spot. I know you're a busy guy, but really appreciate you still taking the time and doing this and share in the interest of you know, spreading the word and helping others. I think helping all these high schoolers make up their mind, so it'd be a great thing. So thank you again, I'm sure we'll talk more. But for now, take care be safe.
I'll talk to you soon. Thanks. Take care and enjoyed it.
Venkat Raman 57:50
Yep, thank you. Bye,
Hope you enjoyed our podcast on the Study of Medicine with Dr Sanjeet Rangarajan of the University of Tennessee Health Center.
Dr Rangarajan gives us a great overview of the Study of Medicine, Impact of Technology on Medicine, the emerging research areas, the preparation needed in school and college to go to Medical School.
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