Tim's Blog

As I started eighth trimester here at NUHS, my fellow students who had just completed eighth would pat those of us on the shoulder beginning this course load with empathy (or was it sympathy?) and mumble a few words of encouragement. Well, after completing midterms week and surviving (albeit with a few bumps and bruises), I felt pretty good and as though I had accomplished traversing exactly half of eighth trimester! Only 6 more weeks to go from here and it's all downhill right? Nope! 

I found that the work had only really started. I generally am pretty happy with my organizational skills. I tend to fill my schedule's deadlines at the start of each trimester and check in from week to week so I know what class to concentrate my efforts toward to maximize time. In other words, I'm not a procrastinator and that has helped with completing various tasks I need to successfully navigate the naturopathic medicine program's workload. This trimester is different however. 

Here's a breakdown of upcoming projects, papers, presentations that are due over the coming weeks (not counting finals week). So, over the next three weeks I have the following work to complete for each listed class: 

Doctor Patient Relationship

• Referenced Paper - The Nature of Patient Interaction when Suffering 

Jurisprudence

• 20 Minute Presentation - What is Naturopathic Medicine?
• Naturopathic Practice - Fact Sheet on a practice/doctor/therapies
• Naturopathic Practice - Patient Handout on a specific condition
• Update Hypothetical Practice Website with assigned information

Advanced Botanical Prescribing

• 20 Minute Presentation (with handouts) on botanicals utilized for Cardio-Vascular Conditions
• Personal Study Plan for the NPLEX Part II Botanical Section 

Internal Medicine/Emergency Medicine

• 20 Minute Presentation (with handouts) - Autoimmune Diseases and vaccines (including adjuvants for the vaccines) 

Functional Medicine

• 20 Minute Presentation (with handouts) - Testing for Foreign Materials in Dental Appliances and Fillings; Explore for cross-reactions with oral microbes and dental work based upon recent research 

This list doesn't count Dermatology and Special Populations classes with their content and workload! This may seem like a lot of work with the addition of time in class, quizzes (both in class and online), cases assigned as well as work. Yet, at the same time, having been in the working world with multiple project deadlines, these fixed concrete dates allow me to plan and take care of the work that needs to be done, even if time does seem to contract as deadlines approach. This is absolutely the busiest, most task filled, time constrictive trimester I have had here at National, especially with the new work hours. At the same time, the classes are engaging, challenging and building upon previous concepts so the work doesn't seem as tedious and making progress is an enriching feeling! 

No food pics this week.  I'll do my best to whip up a new recipe or rehash something into an appetizing tidbit. 

Here's a pic of the campus during the transition to spring! Just a little snow left on the ground in mid-March with warmer weather on its way!  Hoping for an easy transition this year and many outdoor adventures in April! 

Until next week, may your deadlines be extended and you have plenty of time to do the best work ever seen!

While shopping at a "big box" retailer this week for some items I needed around the house, I was presented with a situation that, while not shocking given the volume of customers for that business, gave me a good reason to think about the type of practice I want and another point on why I chose to practice naturopathic medicine. Keep in mind that while the first part of the story may sound a bit like I'm griping, I'm sharing this incident to reinforce why I am choosing to become a naturopathic doctor. :)

The store was huge and packed with weekend shoppers, like me, who wanted to get errands completed and back home as quickly as possible. I was at the checkout and an item was mispriced. The clerk called for the mislabeled item's department over the store intercom for a price check. No answer came from the department, so the clerk asked someone else at the front counter to make a quick run and check the price.

The clerk then turned to me and asked me politely to step aside for the next customer to be checked out. While I was reluctant to move, I understood that others simply wanted to get their errands finished so they could relax at home. So, I moved out of the way for the next three customers to pay for their items as the mispriced item was researched. Once the price was corrected, the clerk asked me for my payment; I paid, and was given a cursory "thank you" while being handed the bag full of merchandise.

The most shocking thing to me during this experience was no apology for the mispriced item, and no apology or explanation for asking me to step aside for the error on the part of the store. I was simply another body in the line and my mispriced item was preventing the line's movement. The store needed to keep the line moving. This is done by tracking the number of customers per hour that the clerks bring through their line. If a clerk doesn't have "x" number of customers per hour, then they are retrained, reprimanded or disciplined until they lose a sense of customer service and concentrate more on "keeping the line moving."

As I processed this experience, this made me remember one of the reasons I chose naturopathic medicine. I am becoming an ND because each patient is an individual and not a number or statistic, nor one of six patients I need to see each hour to satisfy numbers for an insurance or reimbursement program. I am choosing to learn this trade, this profession, this practice, so that I can get to know my patients along with their pathologies, motivations, compliances, and best path to a healthier life where at all possible.

Since I cannot predict the future, I don't know exactly how I will practice. I will do my best to stay away from a high volume practice model. I know that any business needs a break-even point and profitability to keep the doors open. I am certain that I can build a practice schedule that will allow time with my patients up front to get to know them along with shorter duration follow-up appointments. As we progress together on the healing path, our meetings, if all goes well, will become more economical with time length. We can accomplish all we need and plan our next steps until the day comes when as many of our patients as possible will be able to exit our practice as healthier individuals and not as patients.

Here's my whole food pic for the week. This is wild caught Ahi Tuna marinated in lemon juice and capers. The sides are my roasted root veggies from last week (carrots, parsnips, beets…all organic) along with steamed organic baby spinach.

Doc Rosco's Lemon Juice and Caper Wild Caught Ahi Tuna

Ingredients

• 4-6 oz. Wild Caught Ahi Tuna Steak
• 6 oz. Organic Lemon Juice
• Capers (to taste)

Instructions

• Marinate the tuna in the lemon juice for two hours, turning every 30 minutes in an oven-safe baking dish. Add capers to taste during the marinating. 
• Preheat oven to 350º Fahrenheit. Place baking dish with tuna, lemon juice and capers in the oven. 
• Check at 30 minutes and tuna should be done.

Midterm week(s) is the time of the trimester devoid of reflection. Midterms is the time to hunker down, rehash covered concepts, make sure the latest lectures are covered, and the first round of papers have been completed and turned in either electronically or as hard copies. 

This past week or so has consisted of a combination of study, online quizzes, classroom quizzes, papers and now...midterms! That being said, this week's entry will be a bit abbreviated as I have just finished a paper on the style of practice I plan to exercise with my patients, and whether that style is informative, collaborative, deliberative, or paternalistic. Once I have turned that paper in electronically (very convenient), I will complete my "mop up" studying for a dermatology midterm tomorrow.

I define mop up studying as covering the concepts that I don't have a firm grasp upon as an exam approaches. While I study for exams, as I feel I have mastered a topic or concept, I move away from that concept and take on another topic. While I review as exam day approaches, I take the concepts that I'm not as comfortable with and spend a bit more time with them to help reinforce any "weak spots" in my learning for that exam. Takes a little more preparation ahead of time, yet I can spread out my study and not feel as compelled to cram for exams.

Once I complete the final study for Dermatology, I will move to Advanced Botanical Prescribing and study the botanicals suited for the respiratory tract in preparation for that midterm later this week. This is a busy time over the next couple of weeks and at the same time, whether from three years of practice at this point, the joining of the concepts and improvement in efficiency, or pure enjoyment of my classes, studying just doesn't seem like the chore it was back in the fall of 2010. The light is at the end of the tunnel, and I'm pretty sure it's not a train.

Until next week, I'll leave you with a handy and easy recipe for making a nice root veggie side dish for the week. This dish provides plenty of carotenoids, minerals and fiber! Root Veggie Guy gives it the thumbs up!

Roasted Root Veggies 

Ingredients

• 3 Organic Parsnips
• 3 Organic Carrots (Large)
• 1 Large Organic Beet

Instructions 

• Preheat oven to 350 degrees.
• Slice the Parsnips and Carrots (1/8 inch thick).
• Dice the Beet (1/4 cubes).
• Add to a large cooking sheet or casserole dish.
• Cook for 60 minutes, turning every 15 minutes.

Makes about 5 servings (enough for lunch Mon-Fri).

Hi, everyone! 

This week I started a new part-time job as part of my plan to save a bit of money prior to graduation. I will be working about 15-20 hours per week at a local health food store. This part of my plan will allow me to continue my courses right now, complete all class work, then in a few months, complete my studies in student clinic and main clinic here at NUHS. 

This job is well suited in that the store is within walking distance of both campus and my apartment, so I can save on fuel expenses. The working hours are flexible to accommodate my class schedule as it changes from trimester to trimester and a few of my fellow students currently work in the store. Another benefit is that working in a health food store assists with keeping my mind sharp on the nutrients in certain foods, understanding customers' requests when they describe a specific supplement, mineral or nutritive product they need based upon a physiological requirement. 

The reality of graduating from medical school encompasses the costs of moving, setting up shop or joining a practice as well as being able to "pay the bills" after graduation. The months after graduation and prior to sitting for NPLEX II (or the second round of national board exams) can be quite lean, based upon the experiences shared with me from recent grads. I am taking action now to help alleviate the challenge of those first few months after graduating. 

A little "whole foods diet" update for this week for you. The new way of eating is going well with a couple of hiccups. I fudged and had some chocolate-covered peanuts (I know! Milk chocolate with perhaps the most inflammatory food...peanuts!). At the same time, I have been enjoying some incredible smoothies with a good friend as well as making "lettuce wraps" out of everything from chicken to squash with butter lettuce leaves. Here's a quick pic of my simple organic chicken lettuce wraps with some hot sauce on the leaves (in other words, whatever I have in the cupboard or fridge gets thrown in a pan or the oven and added to the lettuce leaves to make a lettuce wrap, hehe). Nice!

Chicken Lettuce Wraps

Ingredients

• 2 lbs. Organic Chicken Breast (boneless, skinless)
• 1 large whole organic onion (diced)
• 4 cloves organic garlic (minced)
• 1 head butter lettuce (organic if you can get it)
• Soy Sauce
• Hot Sauce that you like (peppers, vinegar, salt, water) 

Instructions

1. Dice and sauté the chicken in a wok or saucepan.
2. Dice and add the onion and garlic once the chicken is nearly done.
3. Add soy sauce to taste.
4. Remove from heat and serve with lettuce leaves and hot sauce!

This week, I will discuss a few financial considerations of attending naturopathic medical school, regardless of which university you choose to attend. This is a direct look at the money side of attending school. It will be a bit more direct writing style. Please let me know your thoughts on this subject or if I can cover more topics in this style in the blog.

First consideration: Be certain of your reasons for becoming a naturopathic doctor. 

As nurturing and inclusive as our medicine is with regard to the health of body, mind and spirit, or the whole person; we are not a medicine of "woo-woo" or one devoid of a solid scientific foundation. Be certain that you are prepared to invest up to $200,000 for a rigorous science-based education for four years.  

Our professors train us to connect with our patients on more than a clinical, lab value basis. Indeed, the best way to help our patients is to get a full understanding of their health history, family history, lifestyle and motivations. Yet, at the culmination of each patient encounter we are healers who need to understand how the human body works from the mitochondrial level up to the emotional state of our patients and how they express themselves to us during the encounter. As a naturopathic medical student, each of us is expected to know the science behind the body, mind, and spirit connection. This is a hard and rewarding experience. 

So, be prepared for challenging, rewarding and frustrating times as you work through the basic sciences on your path to the clinical training later in your education that entwines all the principles of naturopathic philosophy combined with the hard science of the human machine. 

Second Consideration: Understand the long-term implications of a medical school loan. 

Most students that I know are paying for their naturopathic medical education with the help of federal student loans. Most of us will have significant loan balances at the end of our time here at NUHS. Many students will have balances close to or exceeding $200,000. 

Before deciding to attend naturopathic medical school, especially as a non-traditional older student, I needed to weigh the cost of attending school with the timeframe to repay the loans. That timeframe is typically between 10 years and 30 years. By the time I graduate, I will be 45 years old. I took into account that I can practice as a doctor as long as I am competent and able to perform my duties as long as patients trust my standard of care. If I take the full 30 years to repay my loan, I will be 75 years old when my loans are repaid. Many who read this blog are in their mid-20's and most likely already have some student loans from their undergraduate education. This will be a significant debt that will be a driver for a future practice or employment with a medical group. This is a reality.

With regard to my experience and decision, I knew that upon starting medical school I was building a financial debt that would take a good portion of the remainder of my life to repay. I have decided to approach the cost of my medical education as an investment that will provide return in the success of my future practice. This is a business expense that is the foundation of my future practice much as the cost of a building and shelves is the basis for a local convenience store opening in a neighborhood. I am required now to keep this foundation solid by learning and building upon the knowledge, experience, successes, and failures to help my future patients and their families be as healthy as possible within my scope of practice; or refer them to the appropriate specialist for more specific care.

I have written a bit more directly this week than I normally do, yet I feel that each person who decides to become a naturopathic doctor needs to take a hard, honest look at the financial implications of choosing our field of medicine as an occupation (or lifestyle). I hope in some way, if you are deciding on attending naturopathic medical school that you examine your true motivations, reasons and financial impact of becoming a naturopathic doctor. I will continue these topics as well as my typical ramblings as I finish up school here at NUHS.

For the record, once I decided to become a naturopathic doctor and earn my degree here at NUHS, I haven't looked back. I took a full inventory of my motivations: desire to help others, ability to earn a decent living while repaying the loans, and self-fulfillment of choosing this field as an occupation. After this solid review and understanding the expectation that the general public has for doctors, especially naturopathic doctors, who are held to high personal standard; I was willing to make the sacrifices, take the risks, and challenges. I accepted that I would experience success, failure, joy, and disappointment during this time and I have had my share of each. I wouldn't trade a moment since the summer of 2009 when I made my decision nor would I trade any of the moments I am yet to experience regardless of outcome.

Talk to you all next week!