Overcoming the Educational Hurdles in Medicine

Although my main focus is on the financial end for physicians, I recently ran across an outstanding new company that is pioneering a niche focus in helping aspiring physicians get past the hurdles presented to them in medical school that can derail them before they ever even earn their first paycheck.

My focus of this article is a brief Q&A with Dr. J. Victor Tovar, the Founder of ProMedeus, LLC, a consulting firm that specializes in academic support services for students who are having academic difficulty or those who want to prevent it.

Q: What was the motivation to generate this type of service?

A: My personal and professional experience during medical school with academic difficulty was frustrating but rewarding in so many ways looking back. During medical school I experienced what approximately 2% to 3% of medical students experience every year — academic difficulty or attrition. The Liaison Committee on Medical Education (LCME) defines attrition as:

• Student has been dismissed due to academic failure

• Student withdrew in poor academic standing

• Student withdrew or was dismissed for other reasons

• Student transferred to other school.

I sought advice from a professional firm or a physician who could guide me through this but failed to find a mentor. I was referred to some resources at school and this was helpful but I wished there had been a group of professionals offering a holistic and individualized approach and expertise on academic difficulty and attrition.

I remember being disappointed in the fact that I could not find someone who could offer individualized and holistic academic support services. I would have paid anything to have a team of professionals focused on helping me be successful. I would have also been interested in a group of professionals offering preventive services. On another note, it would have been great to have team of professionals teaching me the skills and strategy needed to be successful in medical school.

In my past and current searches to find something similar to this, I found nothing. In my search then and now I realized many companies were focusing on getting a pre-med student into med school. These companies were targeting the pre-med student clients, offering advice on applications, personal statement and resume assistance and interview coaching. Also many companies focus on USMLE board review courses.

I saw a big gap in the industry as many companies out there focused more on med school acceptance but no one was showing interest in helping the newly accepted med student prevent or deal with academic attrition. People make the assumption that if you make it to med school you innately know exactly what to do to be successful and that may not be true.

The new med student has a major dilemma: "I made it to med school now how do I stay in med school and, by the way, everyone expects me to do so!?"

Academically, medical school is completely different from college, so one must learn a new way of thinking and studying. You must develop a learning plan that incorporates higher order thinking, critical thinking skills and problem solving. Also a study and exam strategy needs to be in place before you start med school.

As a successful practicing physician and a survivor of academic attrition, I saw a tremendous need to help prevent academic attrition or help med students who actually experience academic difficulty. We developed a small needs assessment survey and sent it out to med students in Kentucky and found that many students felt they had a need for those services. In fact, the actual number of medical students experiencing academic difficulty likely exceeds 2% to 3%.

In 2012 we developed a brief survey to gain a better understanding of perceptions of currently available academic support services for medical students and to determine whether there is a need for more or improved academic support services for at risk students. For this survey, academic difficulty was defined as anything that puts you at risk of not successfully completing medical school. Examples include unsatisfactory grades and/or clinical performance, behavioral issues, failure to pass national exams (e.g. USMLE), difficulty studying for exams or preparing for clinical clerkships, test-taking anxiety, or suboptimal prioritization or time management skills.

There were 63 participants from two medical schools in Kentucky. Out of these medical students, 34.9% reported knowing six to 10 out of 100 students who had or were currently having academic difficulty, 44.4% reported personally experiencing academic difficulty while in medical school, and 31.8% of med students reported that if they experienced academic difficulty they were not aware of good resources readily available to help them.

In 1997, the Bowman Gray School of Medicine at Wake Forest University performed a study that found 5.5% of their medical students were having academic difficulty in year one, 10.3% had difficulty in year two and an additional 1% in year three (Cariaga-Lo, et. al. 1997). That same study, and others, revealed that minority medical students were more likely to experience academic difficulty.

Q: What do you see being the biggest road block to medical school candidates academically?

A: When talking to other people about our firm, many stories have surfaced throughout the last two years from people who know someone close to them who went to medical school and was dismissed due to poor academic performance. However, med students are afraid to seek help for fear of being marginalized and experience what has been termed as the “impostor phenomenon.”

Most med students who experience academic difficulty have the mental capacity to succeed but run into a vicious downward spiral, including performance anxiety and avoidance behavior, which results in isolation from peers and faculty. Failing students have a generalized reluctance to approach academic personnel for support despite their recognition of its importance. The competitive nature of most academic environments makes it difficult for academically challenged students to seek help if they need it.

We hope to change that taboo and make academic support easy, affordable and accessible to anyone who needs it.

Q: What is the biggest strength of ProMedeus?

A: What makes us different from traditional support services:

• We have physician, former resident and med student perspectives (someone who has "walked the walk") and most academic support services lack that

• Individualized/holistic approach: academic difficulty solutions should not use a one-size fits all approach

• Accessibility (web-based services give us and clients much flexibility)

• We are self-sustaining, so less influenced or affected by academic grants/budgets, etc.

• A “place” where students can talk freely to experts without worry. Confidentiality is paramount in this environment and without “blowback” that concern students when talking to university officials and faculty

• A team of experts that will consult to establish an overall plan for academic success for the student

• Psycho-educational testing to determine the existence of undetected learning issues that are affecting performance with suggested learning plan for student (and administration — depending in circumstances)

• Learning skill evaluation and guidance

• Professionalism maturation evaluation and guidance

• The experienced administrative perspective that has worked with thousands of students and has uses outcomes measures, surveys, and research to guide counsel

• Licensed professionals used at all levels of decision making and student guidance

• A business driven from the philosophical ideals of prevention, inclusion and proactive intervention.

Another important and essential goal we have at ProMedeus is to establish academic partnerships to collaborate with medical schools/residency programs and develop a mutually beneficial relationship that focuses on medical student/resident success.

Q: Given your specialty, any advice to medical students?

A: So much to say in a few sentences, but we are currently finishing the first draft of a book that will address many of the issues medical students face. This book will serve as the basis for our services.

The best, all-encompassing piece of advice I can give medical students is to never give up on their career goals.

For further information, you can read more at http://www.promedeus.org/

Jon C. Ylinen is a Financial Advisor with North Star Resource Group and offers securities and investment advisory services through CRI Securities, LLC. and Securian Financial Services, Inc., Members FINRA/SIPC. CRI Securities, LLC. is affiliated with Securian Financial Services, Inc. and North Star Resource Group. North Star Resource group is not affiliated with Securian Financial Services, Inc. but is independently owned and operated. Securian Financial Services, Inc., CRI Securities, LLC and North Star Resource Group are not affiliated with, nor endorse, ProMedus, LLC The answers provided are general in nature and are not intended to be specific recommendations. Please consult a financial professional for specific advice in relation to your individual circumstances. This should not be considered as tax, specific loan repayment for an individual or legal advice.672446/ DOFU 5-2013