We would like to introduce Nathan M. Gartland, PharmD, the author of Pharm.D. To M.D. Please check out our book review here!
When did you first decide to become a pharmacist?
I was first introduced to the idea of becoming a pharmacist when I saw the impact that medications could have on an individual’s wellbeing. I was fascinated by the reality that a tiny molecule, synthetic or natural, could dramatically improve a patient’s quality of life through the wonders of chemical manipulation. While I did enjoy the science behind drug development, I wanted to merge medical proficiency with the patient experience. As a pharmacist, I would have the opportunity to serve my community while having the opportunity to study the intricacies of medication. I began my pharmacy career at Duquesne University School of Pharmacy where I underwent two years of accelerated undergraduate education followed by four years of graduate-level pharmacy curriculum. I graduated in 2020 and have since decided to broaden my understanding of pathology by attending medical school.
What made you decide to transition careers from a pharmacist to becoming a physician? Why?
While I thoroughly enjoyed my pharmacy training, I had always felt that something had been missing. As I progressed through my clinical coursework, I began to take a special interest in the pathogenesis of disease along with attempting to make differential diagnoses. At the risk of overgeneralizing, most of the pharmacy profession involves the optimization of care, rather than the diagnostic component. I loved the idea of working with labs, imaging studies, and clinical symptoms to attempt to identify a particular disease. Not to mention that physicians have the opportunity to perform hands-on procedures which allows for direct intervention, as opposed to strictly pharmacologic correction. My anticipated goal is to blend my new diagnostic training as a physician with my previous pharmacotherapy proficiency to provide the best possible care for the patients I serve.
How would you describe the process? The journey in your own words?
The process of applying to medical school is long and arduous. I think almost every medical school applicant would agree with me on that. For a non-traditional pharmacy student, I would argue that it was even more difficult. Pharmacy students often lack the necessary resources and personal guidance that traditional applicants utilize. We are not enrolled in a pre-health program, have no access to committee letters, and are not coached by academic advisors who provide vital information concerning our competitiveness as an applicant. To put things in perspective, if applying to medical school was compared to a 100-meter dash, the pharmacy student is often still tying their shoes while the race has already started. To be fair, having a pharmacy educational background does help with the “wow factor” associated with applying to medical school. Applying as a pharmacy student is rather unique and interviewers are often very curious to know why you are choosing to make the switch. However, getting to that stage in the application process is without hurdles. Particularly, balancing graduate-level courses and clinical rotation responsibilities all while attempting to check off the laundry list of application requirements. Needless to say, the pharmacy student turned aspiring medical school applicant will have a lot on their plate!
What challenges did you encounter during the process?
Some challenges that I faced specifically included my lack of personal guidance along the way. All my insight from the application process came from trial and error along with plenty of online research. I had very little appreciation of how important the MCAT was to the application process. What may seem like common sense to a traditional applicant is often foreign territory for pharmacy students who are operating in their bubble of pharmacy education. I never appreciated the time commitment required for MCAT preparation, had little to no understanding of application timing principles, and hardly any idea of what made for an objectively strong application. These very principles, although minute, can make or break a student’s application cycle!
In order to make ones-self a qualified applicant, pharmacy students will likely have to dedicate their very limited time outside of school to build their application. Unfortunately, the rigors of graduate pharmacy education wait for no one. I often felt as if I was living two separate lives as I attempted to balance my school responsibilities with my medical school ambitions. For example, during my 5th year of pharmacy school, I was concurrently taking 22 credit hours’ worth of graduate-level courses, including “therapeutics of the critically ill, Special Populations in Clinical Pharmacy, along with physics II, just to name a few. I completed this all while studying for the MCAT, working 15-20 hours a week as a pharmacy intern, applying to clinical pharmacy rotations, serving as the president of a professional fraternity, and pre-writing my AMCAS “primary application”. When I tell you I didn’t get more than 5 hours of sleep a night, I am not joking around!
What were the easier aspects of this transitioning process?
The easiest part concerning the switch was certainly going on medical school interviews. Pharmacy schools, similar to other graduate-level programs, do a fantastic job fostering professionalism in their students. As a pharmacy student, I was pleasantly surprised by how easy it was to interview! Interviewing for medical school can often make applicants anxious, but I found the process to be the most natural part of the entire application cycle. For example, these interactions often felt just like the pharmacist-physician consults I would conduct while on hospital rotations. Fortunately, as pharmacy students, we tend to have a better understanding of various healthcare topics and can appreciate the workflow of rounding with a medical team. Because of the unique clinical rotation experiences we conduct in our final year of pharmacy school, students get plenty of life experience that facilitates personal confidence and professional interviewing skills. This is not to say that other applicants lack these qualities, but pharmacy students are required to build these skills whether they are applying to medical school or not! While there are certainly exceptions, most pharmacy students will be very comfortable during the interview stage of the medical school application process.
If you had to advise someone who is considering/going through this process, what would you tell them?
I wrote “PharmD to MD,” a self-published guide available on amazon to answer this very question! The book discusses every step of the application process and serves as a comprehensive guide for pharmacy students to successfully apply to medical school. In short, if a pharmacy student is interested in applying to medical school, it is imperative that they take the MCAT first before committing an excessive amount of time to application building. I recommend that they take their MCAT during the summer between professional years two and three. Doing so affords the student ample time for a retake, should they not perform as well as they would like. If their score was acceptable after the first attempt, they will have approximately one year to strengthen their application with shadowing hours, finish up research projects, and organize their clinical rotation schedule to accommodate interviews. “PharmD to MD” also addresses various application strategies including school list optimization, application timing, APPE rotation considerations, pharmacy licensure principles, the financial costs of making the transition, and so much more!
If you had to do it again, would you still do it? Why or why not?
I have absolutely no regrets about making the switch and would do it again without hesitation! Keep in mind that there are certainly easier ways to get into medical school but taking the pharmacy route was still worth it. I wouldn’t be where I am today without my pharmacy background and I am so thankful for everything I have learned along the way.
What information/advice do you wish you had known prior to beginning medical school?
How did your experience as a pharmacist affect you in medical school?
For those who are unfamiliar with the medical school curriculum, the first two years of school are considered the “didactic” portion while the later third and fourth years are strictly clinical rotations. I am only in my second year so I won’t be able to comment on the clinical years quite yet. As a pharmacist in the didactic component of medical school, I have found it to be very advantageous. I am not exclusively referring to the ease of pharmacology courses but also having graduate school experience. What I am referring to is my understanding of the rigors of this particular education, an appreciation for the study hours required to tackle the massive volume of content, and my time management qualities. Medical school is not only challenging because of the complexity of the material we must learn, but it requires disciplined time management skills. I have seen many students who have had a difficult adjustment period starting medical school because they have never been challenged like this before. As a pharmacy graduate, I’ve seen many of the diseases we learn about in clinical practice, understand the basic treatment approaches, and know just how long it will take for me to learn higher-level concepts. These skills take time to develop, and not every traditional medical student will have an appreciation for how challenging medical school really is.
What surprised you the most about your pharmacy studies? Medical school studies?
Everyone always asks me “which one was harder?” My answer is always “Both!” The rigors and complexity of the information are very similar. Pharmacy school focuses on pharmacokinetic principles, dosing recommendations, and drugs of choice followed by second and third-line agents. My pharmacy education covered most of the diseases we have discussed in medical school excluding components of surgical intervention, diagnostics, and histopathology. I think the biggest difference between the two graduate-level programs is the competitiveness of your peers. While pharmacy school is challenging, many of my peers did not have ambitions for competitive pharmacy positions when they finished. Aside from those interested in pharmacy residencies, most ended up in community pharmacy and did not have to participate in a match program! Alternatively, in medical school, everyone who graduates must match into a residency program to practice. This adds a level of competitiveness that makes the experience different from my prior pharmacy education. This is not to say that medical students aren’t collaborative but the thought of competing for one-two residency spots in a competitive field cannot be overlooked! Regardless, I have had a wonderful experience throughout both education programs!
As a physician in training, is it possible for you to still practice as a pharmacist as well? If so, would you do so?
Absolutely! Remember when I talked about time management? Well, you can take those skills to the extreme and work on the side as a pharmacist. I currently have two different jobs as a pharmacist where I work approximately 15-20 hours a week depending on my exam schedule. I actually enjoy the work because it allows me to use my pharmacy training in practice keeping me mentally sharp. The additional income also helps significantly with my daily expenses. I wouldn’t recommend that all students work throughout medical school, especially if their grades are taking a hit. Your number one priority is to make yourself as competitive as possible for your future residency, so please don’t let a job get in the way of that!
As you will be the proud holder of dual degrees, would having a MD render your PharmD inactive?
At the risk of falling into a legal battle, I am under the impression that as long as I uphold my pharmacy licensure requirements (fulfilling Continued Education Credits) my pharmacy license will remain valid. This is likely a state-specific feature. However, I would need to be careful to not participate in a conflict of interest. For instance, it would be unethical and illegal for me to write prescriptions with my physician license, then subsequently fill the prescription at my place of pharmacy employment! My pharmacy license would most likely remain active but I probably wouldn’t be able to practice. Please note that I am not a legal expert! For more information, please contact your state pharmacy board.
How do you balance work and your life outside of work?
You are an author in addition to your professional career. What inspired you to write Pharm.D. to M.D.?
I wrote the book because I remember how challenging it was to apply to medical school without any established resources considering my pharmacy education track. Information was certainly available online but was often scattered and sometimes even contradictory. Just after finishing my application cycle, I had a few days off from my pharmacy rotations and I wrote out a “mini-manuscript” detailing all of my mistakes while compiling the resources I used. It was only during medical school that I revisited the piece and explored the possibility of self-publication. I had the idea and finally had the time so I went for it! My primary motivation was to help future students make this frightening switch and limit some of the hassles of doing so.
Going back to balancing life and work, how has adding the role of author affected this balance?
From your perspective, what is the biggest problem in healthcare today? Please explain.
Without getting too political, I think that the profession of healthcare is at war with misinformation. While I certainly want my future patients to be knowledgeable about public health and pathology, there seems to be a movement against conventional medical practices. I think it is important for patients to be their own self-advocate and as informed as possible, but it can be frustrating when we encounter resistance, often motivated by questionable resources online. These resources often lack physician input, and value “clicks” over the viewers’ personal health. As a future physician, I think it is important that people are aware of some of the risks associated with following medical instructions from blog posts compared to your practicing doctor. It is important that we handle these delicate situations with respect, and provide our patients with the necessary information to make informed decisions!
In your position now, knowing what you do, what would you say to yourself back when you started your career as a pharmacist and physician in training?
I would tell myself to buckle up because I was in it for the long haul! Never could I have imagined that I would be going away to college for a decade in the pursuit of not one, but two doctorates. I would tell myself to enjoy every moment because believe it or not, it goes by too fast! I would also tell myself, like I would tell anybody reading this, to follow your dreams. A bit clique but the wisdom is impactful. There was a point in pharmacy school where I didn’t think I could do it. I almost gave up on this dream of being a physician and I am so glad that I didn’t! For more information, please check out my book “Pharm.D. to M.D.” which is available on Amazon. Also, please review my new website “The Physician Pharmacist.”
Please do not hesitate to reach out with any further questions or concerns!
-Nathan M. Gartland, PharmD
About the author:
Nathan M. Gartland, PharmD is a licensed and practicing pharmacist in New York State, as well as a second-year allopathic medical student. After successfully completing the medical school application cycle, Nathan is working to empower other pharmacy students and graduates alike to extend their education beyond the traditional limit.
He is currently interested in pursuing a career in emergency medicine or neurological surgery.
Nathan lives in Western New York with his girlfriend, Julia, and their new labrador puppy, Winston.