Brent Schnipke

Brent Schnipke, MD is a physician and writer based in Dayton, OH. He graduated medical school in 2018 and completed his psychiatry residency at Wright State University Boonshoft School of Medicine. He currently practices in Dayton, OH. His professional interests include medical humanities, mental health, and medical education.

Answering The Most Common Question in Medical Education

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Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.
Doctors-in-training have heard this question thousands of times, beginning the moment they announced their intentions to pursue a career as a physician: The question, of course, is some variant of “What kind of doctor do you want to be?” Before I interviewed for medical school, I was told to answer noncommittally; it was suggested that, if I already knew what kind of doctor I planned to become, it would imply the clinical years weren’t important to me. I was told to leave it open-ended so as not to rule any specialty out too early. I see the value in that—looking back, how could I have possibly had a good idea, given my limited clinical exposure before medical school? Even for students that do have clinical experience, it’s easy to imagine they could change their minds and, regardless, should be open to learning from the clinical years. Similarly, we were told not to answer too definitively during third year either—the idea being that if we tell an attending what we want to do, and it isn’t the specialty we are currently working with, we will be permanently alienating ourselves from that profession.

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A Portrait of Obstetrics & Gynecology

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Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.
Having finished my first rotation, Women’s Health Clerkship, I’d like to offer a short look into the specialty, sharing some of my observations the last few weeks. As I have said often over the past two months, I believe this was the perfect rotation to kick off third year. OB/GYNs have a wide scope of practice, and their field contains elements of many other specialties. During this rotation I was exposed to clinical medicine, by which I mean the art of seeing patients in a clinical setting, spending a few minutes with each, and using history and physical exam skills to offer a diagnosis and treatment plan. I was also exposed to surgery. I hadn’t realized just how surgical of a specialty it is, or at least can be, depending on how a doctor chooses to practice. (More on that later.) I also saw some inpatient medicine, managing patients in a hospital setting and consulting with other specialties as needed. And of course, OB/GYNs have a very unique aspect of medicine that is theirs alone: the labor & delivery floor. This breadth of practice settings was an excellent introduction to many aspects of medicine that I’m only beginning to understand.

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Beginning Clinical Rotations–An Exercise in Humility

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Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.
As I write this article, I am thinking about how to compress all that I’ve seen and experienced the last several weeks into a few paragraphs. I’m not sure I’ll be able to do it justice, and if I wrote out all my thoughts it would probably exceed the page limits and the reader’s concentration. So I’m going to focus on a few aspects of this first month of being a third year medical student, and I suspect several themes will reappear and be expanded in future posts.

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Column Intro: The Third Year Differential

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Central to the skillset of every physician is the differential diagnosis. This is a list of possible diagnoses that helps guide clinical decision-making. By asking specific questions, performing a focused physical exam, and ordering lab tests, all through the lens of the differential, physicians are able to rule in or rule out each item on the list. The differential is not fixed, however; it is a fluid list that can be rearranged or completely changed at any time given new information. This information often comes in the form of an extra piece of history from the patient, a new finding from an imaging study, or frequently, from several lab tests coming back negative.

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5 Steps to a Better CARS Score

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Better CARS score

The Medical College Admissions Test (MCAT) is one of the most well-known entrance exams in all of higher education. It is known for many things: difficulty, length, bizarre scoring systems, and the breadth of subjects covered – everything from basic human psychology to nucleophilic substitution reactions to electrical circuits to the life cycle of plants are fair game on this test. The test is designed to look for several basic abilities and aptitudes of medical school applicants; among these are problem-solving skills, basic grasp of scientific knowledge, and understanding of human relationships. One aptitude that the MCAT particularly focuses on is the ability to quickly synthesize large amounts of information and data and make decisions based on the conclusions; this skill is extremely valuable for physicians in medical practice, but also important for students to succeed in medical school. This skill is tested on each section of the MCAT, but is also almost the sole skill tested on one section in particular: Critical Analysis and Reasoning Skills (CARS), formerly known as Verbal Reasoning.

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Dr. Sandeep Jauhar, Author of Doctored

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sandeep jauhar

What made you decide to write your new book, Doctored? What were you hoping to accomplish?
When I was growing up, my mother wanted me to become a doctor. She told me, “I want people to stand when you walk into a room.” When I started my first job as a cardiologist, I realized I had been isolated from the changes occurring in medicine. I was a fellow in cardiology; I was learning about the human body, the heart, the physiology, and the therapeutics, but not about the culture of practice. I was shocked to see how unhappy many of my colleagues were. The unhappiness wasn’t just about paperwork, patients going on the Internet, malpractice, the usual things you hear about – it was a deeper, more existential problem. The problem was the systems of medicine didn’t allow them to be the kind of doctor they wanted to be – the same kind I wanted to be. When I entered medical school, I had this fantasy that I was going to reform the profession somehow. I didn’t know how, but I thought I would, somehow. When I got out, I started seeing physicians who were unhappy. I think their unhappiness was a response to this loss of ideals. I think a lot of physicians have had to compromise their ideals because of a diseased system. That’s why I wrote the book. I wanted to write about it and put it out there.

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Book Review–Doctored: The Disillusionment of an American Physician, by Dr. Sandeep Jauhar

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book review doctored

“It is our obligation to remove the biases that stand in the way of good medicine. We need to assure no consideration of economic self-interest will prevent us from giving our patients the safest, most effective, and most economically responsible health care possible.” So spoke the president of the American College of Cardiology to a group of inductees in 2005. In the audience sat many young doctors, including Dr. Sandeep Jauhar, a New York cardiologist struggling with many aspects of the American healthcare system. The convocation speech is filled with platitudes such as this one, and virtually no doctor, especially at the outset of his/her training, would disagree with these sentiments. The struggle, writes Jauhar, is to actually make convocation speeches come to life. How do we keep these sentiments from just being banal and clichéd statements and instead enact them, creating a real impact in the way we practice medicine? This question and the effects of our failure to answer form a central theme in Jauhar’s memoir Doctored.

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The Changing Culture of Medical Education

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Transitioning to medical school is a significant change for most students; this naturally makes it a source of excitement, anxiety, stress, and even fear. Being a successful college student will not necessarily translate to success in graduate/professional school, although many of the same or similar strategies will help. Ultimately, adjusting to medical school is going to depend on the individual student and their school; each curriculum will present unique challenges and each student will handle them in a unique way. Although curricula vary among schools, some concepts are similar across the board. Perhaps the most uniform component of twenty-first century medical school curricula is the fact that they are constantly seeking to improve; thus the adage that “change is life’s only constant” seems to be true, at least of medical schools.

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Five Simple Tips for a Better Personal Statement

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The personal statement is, for many, one of the most dreaded aspects of the medical school application. It can be quite intimidating to be given a blank space so large, with the expectation that you will use it to answer a simple yet complex question: “Why do you want to go to medical school?” This question can be difficult to answer in the form of a personal statement because it is so open-ended; even students who “know” the answer for themselves may feel worried that they are not structuring the personal statement correctly, or are not saying everything that they feel admissions committees want to see. There is also the issue of deficiencies or weaknesses elsewhere in the application; the personal statement is supposed to be a platform for addressing these, but many students struggle to write about these openly and tie this into the rest of the personal statement.

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Marriage in Medical School: A Memoir (So Far)

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During my senior year of college, I asked my girlfriend to marry me. We had been together for almost three years and planned to get married the following summer, since we were both graduating in the spring. The timing seemed perfect to start our new life together. There was just one minor problem: in the fall, I was planning to begin medical school.
While engaged, we dealt with a mixture of apprehension and excitement about marriage. The typical questions asked by engaged couples–questions like, “Where will we live? What will our source of income be? How will we make time to see family? How will our relationship change?”–were the same questions we asked, except with the additional uncertainty of medical school. We had learned how to juggle our relationship with the demands of college, but we were unsure about how it would change while I dealt with the great challenge of medical school. (Neither of us were oblivious to the “horror stories” surrounding medical school and its required time commitment).

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