June 1, 2020 9 min read
At the End of the Road
It’s currently Week 10 and I am approaching the last few weeks of Spring 2020 and the last few weeks of my time in the Honor Collegium 50— Creating Your Roadmap. HC 50 is essentially a guide for personal reflection and has given us the tools to jump start a journey of self-discovery as we navigate college life, career goals and prepare to make our first step in the world. With this course and the guidance of UCLA's Scholars Program, we’ve reflected and we’ve explored what it is we want to do and constructed our very own Roadmap that will lead us to a fulfilling career— one that is centered around our Interests, Foundations, Subjective Truths, passions, goals, and dreams.
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Now that we’ve reached the end of this class, we were assigned to have a conversation with someone who has lived the Roadmap that we have constructed for ourselves. My hopes of helping the world around me paired with a fascination of growth and development formed my aspirations to become a Pediatric Physician.
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For this interview, I reached out to my old pediatrician at St. Jude’s Heritage, Dr. Marienelle Banez. I wanted to interview her 1) because she has know me since I was about 5 or 6 years old and 2) because she is an alumni from UCLA and was in my same position years ago. With numerous calls to her office, a few emails, some help at FedEx to message her through FAX, and some Zoom technical difficulties, we somehow managed to have a conversation. I am incredibly thankful that she took some time out of her day to help me out.
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I also reached out to Dr. Jindra Tetangco, a pediatrician in Cavite, Philippines, and the Vice Chair of the Pediatric Department at De la Salle University Medical Center. Due to the 15 hour time difference, I was not able to speak with her directly, but have included her emailed responses to my questions in the blog as well.
Image from Clipart Library
This blog is a long one… But here is a quick list of questions I asked both doctors to help you navigate through the post. I hope this summary of my conversation with these two amazing doctors can help other pre-med students navigate their career goals and give a glimpse of what it’s like as a medical student and, the joys of finally becoming a practicing physician.
Interview with Dr. Banez:
1. Why did you chose to work specifically in pediatrics?
2. What was the biggest obstacle you faced in your medical journey and how did you get through it?
Interview with Dr. Jindra Tetangco:
1. Why did you decide to pursue medicine and eventually a specialty in pediatrics?
2. What was the biggest obstacle you faced in your medical journey and how did you get through it?
3. How did you balance your work with your personal life?
5. Do you have any advice for students who want to pursue a career in medicine?
Interview with Dr. Banez
1. Why did you chose to work specifically in pediatrics?
When it came time for Dr. Banez to select her specialty in med school, she had narrowed it down to ophthalmology and pediatrics. She had been accepted to residency programs for both specialties, the ophthalmology program in New York and the pediatrics program in Southern California. As she was deciding which path to pursue, Dr. Banez had realized that every class she took had to do with pediatrics.
After graduating med school in 1995, Dr. Banez pursued the pediatrics path and joined the residency program at the Children’s Hospital of Orange County. In retrospect, she believes that everything fell into place and now loves her job as a pediatrician. She loves having a relationship with her patients and seeing them grow up— from as early as 2 weeks after birth, into adolescence and as high school graduates. But watching the growth of her patients doesn’t always end once they turn 18. “Sometimes I see people after they graduate high school,” she said, “and some even come back after graduating college. And they have kids of their own and bring them in. I’ve been in the field for that it kind of goes full circle.”
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2. What was the biggest obstacle you faced in your medical journey and how did you get through it?
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During her medical career, she said there weren’t many obstacles, but she remembered a two month period where she had lost her niece, brother and mother:
“It’s hard knowing the medical part of it and understanding what she’s going through. Knowing too much of it compared to the rest of the family and all of the questions were funneled through me. So that was hard, still having to work and having to still take care of my family. For a while it was just hard to stay focused… It took a few years to kind of get over that.
“As for work, it’s a career that I enjoy very much… the upside to this— we’re in a global pandemic and there was a recession 2007/2008. People were losing their jobs. But they still needed health care professionals. I’m still here, so for job stability, it’s a pretty good job to have.”
"I would never push it on anybody [to do medicine]. I'ts a decision you have to make, because once you make it, it makes it easier [and] at least in the long run you'll be happy"
As a student, Dr. Banez said that one of the hardest things was applying for med school. She had to do the application process on her own, without much guidance from her parents. Finances were also a concern, but she encouraged me by saying she had never met any one that shied away from the medical career because school would be too expensive. On top of that, there is a lot of competition to get into med school: “We’re the top echelon, the best of the best. It’s very competitive and there are not a lot of schools in California.” She recalled being waitlisted at many med schools in California, including UCLA, and didn’t accept other offers in hopes that a spot would open up. Nonetheless, Dr. Banez decided to go to Tufts University School of Medicine in Massachusetts.
With the competitiveness of med school admissions, Dr. Banez reminded me that you can always transfer if you feel that the program is not a good fit for you. She stressed that you have to make the decision to pursue medicine on your own It’s a lot of work and no one should put that pressure on you. But if anything, her story has just shown me that things will work out, even if it’s not how you anticipated it to be.
3. What is residency like?
As pre-med undergrads, our priority is getting into med school. We’ve heard about the structure of med school (two years learning in lectures then going into your clinical studies and building bedside etiquette in your third and fourth years). But what’s residency like? What is it like to get a specialty? Many doctors go on to get a specialty in residency, so I think it’s helpful as you prepare for med school to know that final step before your independent practice: What is residency like?
At her residency program at CHOC, Dr. Banez said she was on a three day cycle:
Day 1 you were on-call, Day 2 you do your rounds and finally you get 24 hours to rest on Day 3. She warned me that in your first years of residency you are treated as a “Scut Monkey.” You’re going to be running around running lab tests and doing the jobs that no one else wanted to do. Talk about the Hustle right?
But she loved residency, getting to think on her feet and was fortunate enough to have a mentor that prepared her for independent practice by the time she was a third year resident. Once you’ve upgraded from a “Scut Monkey” in your third-fourth year, your main job is to present your patient to your attending. Here’s her advice:
“Your biggest friend in residency is the nurse. You can’t come in and think you know better than them because they’re always there. Always ask the nurse how your patient did over night.” She said that you always have to do your rounds before your attending comes in and to use that information from the nurses as you prepare to present your patient. "
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When you present, she said, “You have to be organized. You have to be percise.” She called it S.O.A.P: Subjective, Objective, Assessment and Plan. As you prepare your presentation, make sure to read and research the diesease or illness that the patient may have. Know the symptoms. Because the attending will likely have you do a Differential Analysis where you give the top 3 possible diagnosis, identify which is most likely and why. If you show the attending that you read and that you prepare, you’ll do well.
4. How do you balance work with your personal life?
As pediatrician, it was no surprise to me when she said that her own kids (as well has her husband) grounded her. She made sure she was there for her kids’ games, meets and all their activities.
“I made it a point that my kids were important. When I did that, it became easier to come to work knowing that there’s going to be a time to where I need to stop seeing patients because I need to do something with my kids. And I found a job that gives me really good flexibility. I don’t work in a hospital for the very reason that I can be on shift call (rather than on-call) and I don’t work on the weekends.”
With some planning and flexibility with her shifts, Dr. Banez and her husband figured out a way to be there for their kids. She brought them to school and worked in the mornings while her husband was there to pick them up from school and bring them to practices. She’d leave work to attend and pick them up at games so her husband could work later in the day. “It was like a revolving door,” she told me.
One advice she had to doctors, particularly female doctors, was to work part-time even if you’re pregnant. This takes a lot and, trust me I was shocked when she said that too! But hear her out. Dr. Banez remembered vividly a moment where she talked with a doctor that had taken a 5 year leave to be with her family. However, when it came back, she had to compete with all the new residents and med students that graduated. Medicine is continually and rapidly evolving; it’s difficult to get back in when you haven’t practiced for years. From that moment she told herself, “I would always at least work part time, even if I was pregnant.”
But again, Dr. Banez didn’t prioritize one over the other. It was a balancing act. She recalled having to give up her fellowship to move with her husband in Australia, but believes that
Image from Restoration and Remediation
"It was like pathways. You make decisions and you do a little turn here and there. But if it is your path and your fate, you're going to get there somehow
Interview with Dr. Tetangco
1. Why did you decide to pursue medicine and eventually a specialty in pediatrics?
I think being a doctor is both a calling and a decision. You have to have a passion for medicine before you can decide to pursue it as a career. Without that eagerness within your heart & mind, each day in med school becomes an ordeal. I felt that calling since my school age years and decided to be a doctor.
Why pediatrics? I love playing & talking with kids. Without that quality, you will never survive this specialty.
2. What was the biggest obstacle you faced in your medical journey and how did you get through it?
Medical students are always in the survival mode academically. Obstacles I faced was mostly in relation to achieving acceptable grades. Time management is always the solution, i.e. 90% study time, 10% breathing time.
3. How did you balance your work with your personal life (as a medical student and now as a practicing physician)?
In med school, personal life takes on hold. You don’t get to attend family gatherings nor vacations, weekends are still spent reading textbooks. Studying with friends is actually the equivalent of personal life in med school. Now as a practicing pediatrician, my dictum is never to bring work at home. My home serves as my sanctuary, no paperworks, no distractions save for calls from the hospital for admissions.
4. What do you do as an educator at De La Salle Medical and Health Science Institute? How do you balance this job with your independent practice?
I am both a clinician and an academician with clear cut delineations of tasks and responsibilities for each role. As an educator, I teach future doctors on all levels in the college of medicine. I also teach my co-faculty members as I am a member of the Medical Education Unit in charge of teachers’ training. Time management is again the secret to managing the many hats I wear.
5. Do you have any advice for students who want to pursue medicine?
My advise? Heed the call if you feel it. Nurture that calling before you enter the challenging world of medicine. With that passion in your heart & mind and the support of your family & friends, YOU WILL BECOME DOCTORS!
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As I soaked all of this information from Dr. Banez, I honestly felt a little scared about this path. Can I handle the difficulties she talked about and the balancing act between work and family? Can I stand the pressures of applying and attending med school (let alone residency)? I don’t know to be honest. I know that I will always put in the work, to keep learning and to keep trying to be better at what I do. Hearing her say why she loves her job—that she sees kids grow from babies to high school graduates— made me more certain that I want to pursue pediatrics.
I’m only a first year undergrad. I still have much to learn, material wise and much to learn about myself. But I want to reiterate the final thing Dr. Banez said: “If it is your path and your fate, you’re going to get there somehow.” And like Dr. Tetcango said, it’s going to take a whole village to get you there. To all the pre-med’s out there, we’ve got a long journey ahead of us. But we’ll keep pushing, keep working, keep learning. And I can’t wait to feel the joy when we finally get there.