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Radio Silence


Have you ever had a period in life where you had to be quiet about something? I’ve recently had one of those times where I’ve gone silent due to life, life, life and more life. This picture is of me when I was practicing medicine. Since my last post the following things have occurred:

・I stopped practicing operating room anesthesiology

・I started writing music and embraced my passions as a songwriter and musician

・I became a mom who drops kids off to school and deals with a screaming toddler 24/7

・I became FREE in all senses of the word

This is a departure from what the status quo in medicine and in life. We are taught to be born, grow up, work, work, work and more work to pay our debts and then die. We are to run around, stay in traffic, not see our family and we expect to be happy. We expect that the money we are getting should be enough, but often end our days feeling that something is missing.

My decision to leave the operating room was one of being honest with myself and my needs. I have a specialty in Pain management and much prefer practicing in this capacity. I thought this was why I needed to go, and while certainly this was part of it, something else was bothering me. I’ve always had a longing to write music and impact the world through the healing power of music. Once I pursued medicine however, I suppressed my desires and passions. I figured after I trained, I could pick it back up. Then I pushed that to after Boards were finished. Finally, my dreams were relegated to retirement.

In my pursuit of making money and “taking care of business”, I threw my dreams away. I looked up one day and 20 years passed. I didn’t make progress in the thing I loved, but I did accomplish some amazing things including dual Board certification and being good at my career. When I took inventory, I realized I was dying inside and not fulfilled with my role in the OR.

So, against conventional wisdom, I started working on my passion, writing songs, playing music, singing, producing- all things I convinced myself I couldn’t do, or that I wasn’t good enough to do. I don’t have a “safety net” and most people are like- “are you crazy?”, but I have to do what I know is the best move for me. My family life is alive and thriving, I’m better overall, especially mentally, and I’m doing another thing that I feel that I’m put on this earth for.

People ask if I feel I wasted my training. This makes me shake my head a little. I don’t believe anything is wasted. All experiences inform us in some way. I still very much have my training, experience and 7 years of practice. Nothing is ever wasted and yes I still have opportunities to practice medicine. Currently my focus is shifting to prioritize my other callings in life outside of medicine.

My message is simple and is this: Don’t throw away who you are to be a doctor. Become a doctor with ALL that you are. If you love to dance- please keep dancing. Even in residency, make sure you warm up and find classes you can attend. Yes, you may sacrifice the day to day practicing of what gives you joy while you are in training, but it is VITAL that you don’t STOP doing it all together.

I gave half-baked effort to music my whole career while I gave 1000% to medicine. Ironically, music is what I always loved deep down. Now it’s my turn to give myself to making music and to improving my musicianship. I couldn’t be happier with where I am. I believe we are multidimensional and that we are breathing to accomplish certain goals. Some people are suited for one career, while others accomplish multiple pursuits. It’s all good and vital and needed.

So premeds and trainees: PLEASE BE YOU to the fullest. You can’t do everything at the same time, but please keep your passions alive. Make time for them. Medicine will make room for them eventually and depending on how important they are in your life, you will find a way to make room. I had to stop practicing a specialty I didn’t love in order to practice another specialty in a way that accommodates music. My choices now prioritize what I truly love and it feels awesome. Remember, YOU practice medicine and make sure it doesn’t practice YOU.

I am here to provide guidance through the medical school application process and beyond. As a former admission committee member and graduate of the UC system, I know first hand what it takes to make it to and through training and beyond. I am passionate about helping students like you to navigate this process.

If you want access to a course and materials that guide you through the medical school application process, email me at premedconsultants@gmail.com.

Remember, BE YOU!

Candice Williams, MD

Premed Consultants

Uncertainty: How do you deal with it?

Hello all,

Summer is upon us and for many, this means you are starting the application cycle, filling out applications, taking the MCAT or starting residency. Things are new, you are embarking on a new journey and not sure how things will pan out. How do I know? I’ve been there and oddly enough, I’m there now.

You see, just because you become an attending, it doesn’t mean that is the end of life changing and needing to shift. Sadly, I have to break it to you that things can and will change and it’s normal to feel unsure or uncertain. I’d like to share with you my situation and how I’m coping with uncertainty as a working anesthesiologist, spouse and mom.

Long ago in the dark ages of residency, I was trying to envision a future where I kept my passions alive (music, family) AND working as an anesthesiologist. It seemed impossible as I was barely keeping my head above water with working and being a new mom. I just saw a dark future and really had to visualize better times to make it through. Along the way I had many jobs, bounced around and experienced many disappointments with my working situations and environments. I didn’t anticipate ever having to quit, change jobs or move anywhere. In residency and as a medical student, I thought you just get a job and stay there and everything is perfect and happily ever after. I came to find out that instead, I was experimenting and finding what is the best fit for me and my family.

Recently I’ve once again realized it’s time to shift and return to my specialty of pain management as I’ve been practicing OR anesthesia in a great group for the past year. I’ve had such a challenge finding the right environment to practice in while staying in the place I want to live. Many have suggested – just open a practice – as if it’s that easy. I will write more on this later as the current landscape in medicine requires so much of independent physicians that its designed to make it hard to survive. I’ve doggedly insisted on not moving and on not having a practice because of the work, money, time and commitment involved. I wanted to pursue locum tenens (temporary work) but this didn’t pan out either.

So now I’m left in an uncertain place. I know I need to move on and practice in my specialty, but there’s no opportunities that fit my needs or that fit my practice style. So- I’m continuing to pray, soul search and open myself to more opportunities. I’m exploring more practices in other locations and I’m simultaneously drawing up plans for a solo practice.

I’m writing mission statements and really envisioning what an ideal Pain practice would be. I am passionate about being part of the solution of the opioid crisis and I am a believer in non opioid adjunctive pain medications, interventional pain procedures, physical therapy, occupational therapy, mental health strategies, exercise, regenerative medicine and other strategies that emphasize a multimodal approach to pain management. I’m in a place with a lot of competition and I am currently assessing the landscape I’m in and feasibility of opening a practice that will thrive and serve patients well.

So, I’m right in the thick of it. I don’t have an answer today, but trust me I know what it’s like to be uncertain and not knowing the future. I trust that God knows what is best and that I will find my way. I am trusting that for all of you as well.

Stay strong, keep pushing, studying and striving to be your personal best no matter what stage you are in. It can and WILL get better.

Email me at premedconsultants@gmail.com or reply to this post about your uncertainty and where you are right now. This is a safe space and we should be able to share with each other. I’m here for a listening ear and to answer any questions you have about the path to becoming a physician.

All the best in your endeavors,

Candice Williams, MD D. ABA
Premed Consultants

Hurry up and wait…..

Hey there premeds, medical students and residents,

I thought of you today as I waited an hour to start my cases. Sure, I was able to eat some oatmeal and drink tea – it’s rare in private practice to eat these days so that was welcome. However, it can be painful to rush to work in a car for an hour, run inside sweating, see your patient, set up and get ready…all to know you won’t start for an hour and you will be rushed as soon as the surgeon arrives. Such is the life of an anesthesiologist I guess.

But life is this way for all of us right? We hurry to be 10 when we are 5. We hurry to be grown and out of the house. We rush to get to college, then medical school, residency. We say – “I can’t wait until X happens, then life will be great then.” We also say the evil phrase “I should have done ____ by now.”

Let’s be careful not to get caught up in rushing. The next thing we know, our lives will be over. So while we have the chance, while we are waiting, lets enjoy the ride. So what does that mean for you?

As a premed, enjoy learning biology, microbiology, pharmacology or biochemistry. Soak in the learning. Enjoy your time being able to schedule the day away and study on your own. It’s lonely yes, but you can meet up with friends and have dinner. Most of you won’t have children and a family at this point in your lives. It’s nice to relish in relative freedom.

In medical school you are sooooo rushing to be a resident. You are like – I am getting the hang of this and want to be a doctor already. I want to get through this and have so many years ahead. Let’s go! Well, enjoy not having all the responsibility or being blamed for something. At least it’s not ultimately your fault, whatever happens. I’m not saying enjoy being called heymedstudent (all one word), or being berated. No, that isn’t fun. But the learning and adventure of learning from others is kind of cool.

In residency, you sooooo soooo want out of the pain, sleep deprivation and just all out terribleness of being a resident. When you are on your own, you call the shots, you make the choice. It will be great and best of all, you will be rich finally!!!

Hahahaaa, says the salty attending writing this piece. As an attending, guess what? You get to hurry up and wait. Hurry to work, see patients and ultimately there is no one to look back to in order to make decisions. Each step you took from premed, to med student to resident helped make the physician you are today. And rich? If you planned well and have no debt, more power to you. Most of us are swimming in all kinds of debt.

So in the waiting to be whatever you are pursuing – what to do?

Smell the roses, enjoy the good things, don’t despair. If you are working to get in med school, be sure to eat right, get fit and take care to keep your hobbies. As a matter a fact, do these at every stage. Then if you are an old crusty attending like me, you work on being efficient in your waiting time. You work on projects, build businesses, play music (my personal passion) and help premeds and students like you.

Time has had its way of giving me perspective. When I turned 40, I realized I shouldn’t have wished all that time away, crying, lamenting, complaining. It didn’t help and still doesn’t help. Instead, use the time you are waiting to get to where you want to be in order to build yourself in some way. Learn something new, build yourself spiritually, mentally and physically. One day – you will make it “there”. Don’t put off enjoying your life until tomorrow. Live it fully today.

Till next time,

Candice Williams, MD

Premed Consultants

How did Operation Varsity Blues make you feel?

Hello there medical community,

I’ve been waiting to comment on the college admissions scandal, aka Operation Varsity Blues, as it struck a chord with me immediately upon hearing the charges and accusations. This is a sensitive subject, and the opinions shared here are simply my own thoughts on the scandal and higher education. You may choose to agree or disagree with my point of view, but I feel it is important to share as a physician of color and advocate for students.

Everyone thinks the system is built solely on merit, but as suspected, this story is one that shows that is not always so. I for one resented the assertion that someone with wealth could simply bribe their way into institutions that I and several colleagues spent years preparing for and working our tails off in order to get in and graduate from. UC Berkeley, my alma mater, was named in the scandal, as well as UCLA, my medical alma mater. These schools were literally hell to get into and make it through, especially as an underrepresented minority student from inner city Los Angeles. I was told in no uncertain terms many times while on campus, that I did not belong there. I was questioned on many occasions why I needed to take Organic Chemistry, or if I was on a sports team. I was pretty out of shape for any sport, so these comments were difficult to take at 17 years old. While the scandal is about money and someone buying their way in, my feelings immediately went towards the students who couldn’t buy their way in AND who were told they didn’t belong, myself included.

During a silent protest that I participated in while on the campus of UC Berkeley that was to bring to light that the voice of African American students on campus was not being heard, various insults were hurled at us calling us Nigger, saying the only reason you got in is affirmative action and the most hurtful – a professor told us that this campus was not designed for people like you.

These words stuck with me. Although they stung, I was determined to prove the campus was for people just like me. I graduated with a Molecular Biology Degree, music minor and was well prepared for my future career in medicine. I conquered that place and as a practicing anesthesiologist and pain specialist, I seriously consider the question – “Who is the University of California designed for?”

The answer is that these campuses are designed for the diverse student body that reflects the population the state of California. I and my black colleagues had every right to be there because we worked hard and earned it – not because our mom or dad paid someone to let us in.

I’ve heard the argument of “race doesn’t matter” in admissions assumes that a meritocracy would be inherently fair. This isn’t fair if those with resources to get the grades needed are only from certain ethnicities while others are purposefully left out. It’s definitely not equitable if some with money are allowed to simply buy their way in. This scandal has caused many to lose faith in the system – the one that says – if you work hard, you can gain admission.

On the cusp of decision day for UC Berkeley and many other schools, I reflect on the lack of diversity, especially concerning students of color and it’s disturbing to me. There are so few African American students admitted that will attend both UC Berkeley and UCLA (medical school included) compared to the population in the state. A couple of years ago, I attended a welcome event for students accepted into UC Berkeley in Southern California. I saw 1 African American student at this large reception with at least 200 students. I was disappointed, but realized that in this day and age, many students are opting for other environments other that UC, such as historically black colleges or private universities.

It was often assumed I didn’t belong in undergrad and in medical school just because of the color of my skin, but someone else who is another race inherently is assumed to belong. I think of so many students of color who are treated as if they are taking away spots from the “good” students, with the assumption that every African American student has a 1.0 GPA and just walked in the door with no credentials. These ideas are often freely shared on SDN (Student Doctor Network) and other premed sites. This was an unhealthy place for me as a premedical student and eventually I learned to make other communities and connections. These assertions are patently false. This experience prompted the creation of Premed Consultants and this blog.

Sadly, racism, classism and discrimination are rampant in higher education and there is an idea that certain students are deserving and others are not. In regards to medicine, medical schools in particular need to put their actions where their statements are and truly make strides to ensure they are treasuring diversity, treating students well and as if they belong, no matter their culture. If this occurs, maybe UC Schools wouldn’t have as much trouble in their recruiting efforts amongst some ethnic groups.

I hope this admissions scandal brings these conversations to light and helps everyone understand the importance of diversity and transparency in higher education. No one should be able to buy, lie or cheat their way into a school at any level of education.

What are your feelings about the admissions scandal? Should the students have their degrees taken away? Should parents be solely responsible? Should universities be held liable?

Blessings to all,

Candice Williams, MD

Premed Consultants

Buying My Time Back: Lessons from Renting my Home

Check out my blog post on buying my time back through renting my home. https://www.buymytimeback.com/wife-mother-doctor-musician-in-real-estate/

This post is related to the prior one, “It’s About Time” where I talk about the process of choosing myself and my needs above the system. I wrote this post to share a different aspect of my story at the request of a dear friend and all around smart guy. Addam Driver is a software engineer, musician, real estate mogul and expert in buying his time back. He writes about this and other insights at http://www.buymytimeback.com

It’s About Time

Hello All,

It’s been quite some time since I’ve written. In all honesty, I’ve been contemplating what to write about, and what would helpful to students. I’ve been spending time concentrating on being a good physician, wife, mother and adjusting to life changes.

During the early part of my blogging, I moved and transitioned my family back to our original home. It took a lot of sacrifices and required me to not only quit my job, but to decide to leave a less than ideal situation in order to do so. Things appeared not quite right early on, but I stayed in order to keep the peace for my family’s sake. Eventually, the toxic environment took a toll on my health and well being, and I would argue that of my family as well. This year, I decided it was about time to put myself and my family first.

This meant that I had to have the courage to leave a seemingly cush, coveted job that was “comfortable” with guaranteed salary and choose one in which I was paid only when I worked. I gave up benefits, pensions and loads of “stability”. What I traded it for was my sanity and my freedom. I needed an environment where I was free to be creative in other pursuits and where I was not tolerated, but celebrated. This was not without sacrifice. I gave up so much, and I had to re-immerse myself in my core specialty of anesthesiology. I was practicing pain medicine for the prior 2-3 years, and yes, this is a different specialty entirely. It involves clinic, continuity of care and procedures that you need specialized training to do. I enjoyed this work and the training, but the environment just wasn’t right for me.

After I left, I joined a group that provides intra-operative anesthesia services. I hadn’t worked in this capacity for a couple of years and jumping over this hurdle seemed like I was scaling Mt. Everest! With a supportive boss and fantastic colleagues, I was able to bridge this seemingly unsurmountable gap and become an OR anesthesiologist once again. It never left, but truly it was like riding a bike.

I did this for myself, my sanity, and my family. We needed to move back home and my job environment was truly toxic for me. I had to choose life and choose myself. This took grit and sacrifice, but so far it has been well worth it. I tell this story from the perspective of what it is like to be a physician and the realities. Even as an attending physician, you still have to find your place and the right fit for your career and interests.

What are the takeaways from my story? There are several –

  1. Don’t be afraid to choose yourself. Your profession will be there, but if you aren’t ok, you won’t be. Make decisions based on your core beliefs and those that serve your needs. When you are in training, this can be difficult to do. Don’t forget to seek help and especially mental health services.
  2. Training in a subspecialty gives flexibility. In anesthesiology, pain medicine gives the option for work in the procedure suite, the clinic, or in the operating room as well. Research is also another way to add dimension to your specialty and to your work. There are academic positions, private practice opportunities and jobs at large conglomerates. Do your research and consider what environment is best for you.
  3. Whenever there is transition or change, there is sacrifice involved. Sometimes this requires courage, doing some things that are uncomfortable and there is definitely a period of transition. Give yourself grace to adjust.
  4. If something is wrong, admit it. Don’t simply stay in a job because you need to pay your bills or because you have to. Save up, prepare yourself and make plans to transition. You owe it to yourself to be happy, healthy and whole.

I hope sharing my story helps some of you out there realize that there is light at the end of the tunnel. One day, you will be able to make these types of decisions. Being a physician gives you the freedom to choose and to change. I can be an independent contractor, own a business, be a consultant and do many things that feed my soul. Don’t listen to those who say it doesn’t get better than medical school or residency. It does get better. When you have the chance to make career decisions, make sure you choose for yourself and get informed about your options. It’s important to choose for yourself and your own wellness.

Enjoy your family and friends in this holiday season,

Candice Williams, MD. DBA

Premed Consultants

 

Go For It!!!

Hey everyone,

It’s been awhile, but I’ve been reflecting about what to write next. To be transparent, I’ve been thinking about what to address that would help people most. I’ve been pretty reflective lately. What I came away with is this – If I were to speak to my former self, I would tell myself to “Go For It”!

The AMCAS submission date is here and now premeds can actually submit the applications they have been obsessing over. If this is you, my advice is to continue to work on your application, have it proofread and make sure you put your best foot forward. Score the best you can on the MCAT. A ballpark score should be well above 500. Interestingly, 500 is near 50th percentile, but 508 is 75th percentile and where you should aim to score at the least. If you have the requisite numbers (GPA at last 3.3 science and MCAT score 508) AND you have a STRONG and INFORMED motivation for medicine – I say “Go For It!”

What if you’ve already made it through this hurdle and you are a 3rd year medical student. All you’ve ever wanted to be is an orthopedic surgeon. You even did research at the NIH in bone growth. You are doing your best and busting your jump on rotations and you are exhausted. When it comes time for sub internships you feel intimidated. You need a letter from the head of orthopedics to help you match. You are intimidated because you are the only woman, or you are an underrepresented minority or maybe you realize that matching ortho is just plain hard. When it comes time to do sub I’s you do ER as a back up. When it comes rank time, you are afraid to rank ortho because you think the odds are stacked against you. This is the time that I tell you to “Go For It” and don’t settle for less than what you want out of a specialty. Having a backup is great and is prudent, but don’t settle for another field because you feel you aren’t good enough. You can do this!!!

Lastly, to my residents- who are just plain tired and too exhausted to care about much, You also should “Go For It” in going for chief resident, or in trying to land your dream job or faculty position. Have confidence in yourself. You can do this! I remind myself every day that as a physician, I’m blessed because I have options, and this profession is rich with opportunity. From clinical practice, research, public, private practice and in between, administration, consulting – being a physician opens up a world that is literally yours for the taking. Make sure not to shrink back and be sure to “Go For It”!!!!

Candice Williams MD, D. ABA

What did you do today?

I get asked this all the time. My kids come up and say, “Mom, how was your day? What did you do?” I usually tell them some combination of – I helped people feel better, or if feeling snarky, may say that I poked people in the back.

So what do Interventional Anesthesiologists do? Anesthesiology is defined by the American Society of Anesthesiology  as the practice of medicine dedicated to the relief of pain and total care of the surgical patient before, during and after surgery. I was trained in Anesthesiology as a core residency, then specialized in Pain Management, which required an additional year of training beyond residency, called Fellowship. The American Society of Regional Anesthesiology defines a pain management specialist as a “physician with special training in evaluation, diagnosis, and treatment of all different types of pain. Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these.”

So my day looked like this today. The patients I previously saw in clinic, diagnosed their pain complaint and root cause (diagnosis) and prescribed an intervention (treatment) came to see me in the interventional suite today. I saw each patient, asked about their pain location, reviewed their imaging again and examined them. I ensured they didn’t eat or drink for a certain period, that they stopped aspirin and anti-inflammatory medications to prevent bleeding and reviewed any co-morbid conditions that may be affected by the therapy or by steroids. I also review allergies to ensure they are not allergic to any medications that could be given. After a discussion of the risks, benefits and alternatives of the therapy and obtaining their permission, I performed a range of pain related procedures involving injections to the lumbar and cervical spine, targeting the nerves that give sensation to the joints lining the sides of the cervical or lumbar spine (medial branches) with diagnostic injections or ablation of these nerves for pain relief, or joint injections to the joint between the sacrum and the back of the pelvis.

Cervical Epidural Injection

During each injection, the patients are monitored for their vital signs at a regular interval and an X ray machine (fluoroscope) is used to give pictures of their spines or structures to be injected. Most of my procedures today were done with local anesthetic to numb the area. A small number of patients receive intravenous sedation due to need for anxiety medication. In this case as a registered nurse administers the medication under my direction.

Afterwards, I assess each patient, examine them again, give them post procedure instructions and encourage them to continue other modalities to help with pain such as physical therapy, acupuncture and stretching. The key in most cases of spine related pain is to keep moving. Of course there are other more complex pain syndromes such as cancer pain or complex regional pain syndrome that are beyond the scope of this discussion.

Some patients had good relief after prior treatments, some had varying results. I see my role as helping them overcome a hurdle of their pain that is limiting them, so that can exercise, do physical therapy and improve their overall back or neck health. In light of the opioid crisis, providing interventions as an alternative to pain medications assists in getting patients off opioids and avoids some of the consequences such as addiction, overdose and even death. Steroid based treatments, some of which I perform, are not perfect, have their side effects and risks, but when used responsibly, can be a helpful adjunct to treating certain spine related pain problems.

So, I had a good day. Everyone did well and I feel proud to help each and every patient to overcome their pain and to lead healthier lives.

 

Till next time,

Candice Williams, MD

Interventional Anesthesiologist

Premed Consultant