21/11/2006, 10:24 PM
A Sample:
I have always been a planner. I knew from a young age that I wanted to be a physician, so I planned my early education with this goal in mind, even choosing to take Latin in high school to have a better grasp on medical language. I entered a direct acceptance program, guaranteeing myself a place in medical school after finishing my undergraduate studies, and leaving as little as possible to chance. To my surprise, it would actually be a random patient encounter–and not my meticulous design–that determined the kind of physician I would become.
Halfway through my third year of medical school, I was still unsure of what field I wanted to pursue for residency. One of my first patients during my medicine clerkship was a young woman with anemia. I sorted through numerous lab results, poured over peripheral smears, and even personally performed a bone marrow biopsy. Our evaluation led us to a diagnosis of myelodysplastic syndrome. The challenge of delving into the pathophysiology and learning how to make the diagnosis inspired me to pursue a residency in internal medicine. As chance would have it, during my acting internship in hematology as a fourth year student, this young woman was again my patient. Her MDS had converted to acute myelogenous leukemia, and I admitted her for induction chemotherapy. During that month I saw a variety of cases, from AML and lymphoma to thrombotic thrombocytopenic purpura and anthracycline-induced cardiomyopathy. Initially it was the pathophysiology of these diseases that attracted me to internal medicine and hematology/oncology in particular. However, after developing a bond with this young woman, I found myself drawn in by the amazing relationships patients had with their oncologists as well.
My interest in hematology and oncology was further confirmed during my residency, when I spent a significant amount of time on the oncology service and in the outpatient practices. I had the opportunity to see patients at different points along the disease spectrum – shocked at diagnosis, frustrated during the complications, devastated at relapse, and hopeful for remission. With these experiences I have gained understanding of the natural evolution of these disease processes and the toll it takes on the patient both physically and emotionally. The idea of treating both aspects of a person appeals to both my medical and psychology backgrounds.
One of the most rewarding aspects of my experience in medicine thus far is that my research project involves the very same patients I see clinically. The immunosuppressive effects of the various treatments for hematologic malignancies are well known, and a number of patients receiving these treatments will unfortunately develop severe sepsis. My colleagues and I are studying the utility of lactic acid and systemic inflammatory response syndrome criteria in predicting patients in need of more aggressive intervention. Our ultimate goal is for earlier identification of at-risk patients, allowing for potentially life-saving treatments and monitoring before the development of overt severe sepsis. My interests also include immunology and infectious disease, so this project is especially appealing to me.
In thinking about my career up to this point, I was surprised to realize what a role chance seems to have played in leading me to pursue a fellowship in hematology and oncology. I am grateful that I have experienced this, but now it is time to start planning again. Having trained in strong academic institutions, I know this is where I want to stay. From my mentors I have realized that an academic career in hematology and oncology allows the fulfilling combination of treating patients, educating housestaff, and participating in patient-oriented research. In the future, I would like to participate in translational research, with a specific focus on new targeted therapies for malignancies. Both careful planning and chance have led me to hematology and oncology, and I am excited by the prospect of a career that will be both personally and intellectually stimulating for years to come.
I have always been a planner. I knew from a young age that I wanted to be a physician, so I planned my early education with this goal in mind, even choosing to take Latin in high school to have a better grasp on medical language. I entered a direct acceptance program, guaranteeing myself a place in medical school after finishing my undergraduate studies, and leaving as little as possible to chance. To my surprise, it would actually be a random patient encounter–and not my meticulous design–that determined the kind of physician I would become.
Halfway through my third year of medical school, I was still unsure of what field I wanted to pursue for residency. One of my first patients during my medicine clerkship was a young woman with anemia. I sorted through numerous lab results, poured over peripheral smears, and even personally performed a bone marrow biopsy. Our evaluation led us to a diagnosis of myelodysplastic syndrome. The challenge of delving into the pathophysiology and learning how to make the diagnosis inspired me to pursue a residency in internal medicine. As chance would have it, during my acting internship in hematology as a fourth year student, this young woman was again my patient. Her MDS had converted to acute myelogenous leukemia, and I admitted her for induction chemotherapy. During that month I saw a variety of cases, from AML and lymphoma to thrombotic thrombocytopenic purpura and anthracycline-induced cardiomyopathy. Initially it was the pathophysiology of these diseases that attracted me to internal medicine and hematology/oncology in particular. However, after developing a bond with this young woman, I found myself drawn in by the amazing relationships patients had with their oncologists as well.
My interest in hematology and oncology was further confirmed during my residency, when I spent a significant amount of time on the oncology service and in the outpatient practices. I had the opportunity to see patients at different points along the disease spectrum – shocked at diagnosis, frustrated during the complications, devastated at relapse, and hopeful for remission. With these experiences I have gained understanding of the natural evolution of these disease processes and the toll it takes on the patient both physically and emotionally. The idea of treating both aspects of a person appeals to both my medical and psychology backgrounds.
One of the most rewarding aspects of my experience in medicine thus far is that my research project involves the very same patients I see clinically. The immunosuppressive effects of the various treatments for hematologic malignancies are well known, and a number of patients receiving these treatments will unfortunately develop severe sepsis. My colleagues and I are studying the utility of lactic acid and systemic inflammatory response syndrome criteria in predicting patients in need of more aggressive intervention. Our ultimate goal is for earlier identification of at-risk patients, allowing for potentially life-saving treatments and monitoring before the development of overt severe sepsis. My interests also include immunology and infectious disease, so this project is especially appealing to me.
In thinking about my career up to this point, I was surprised to realize what a role chance seems to have played in leading me to pursue a fellowship in hematology and oncology. I am grateful that I have experienced this, but now it is time to start planning again. Having trained in strong academic institutions, I know this is where I want to stay. From my mentors I have realized that an academic career in hematology and oncology allows the fulfilling combination of treating patients, educating housestaff, and participating in patient-oriented research. In the future, I would like to participate in translational research, with a specific focus on new targeted therapies for malignancies. Both careful planning and chance have led me to hematology and oncology, and I am excited by the prospect of a career that will be both personally and intellectually stimulating for years to come.
