Interview: Dr. Eicher

What’s your elevator pitch?

I am 31 years old and from New York, although I have been living in California for the last five years. I decided on the medicine path as a senior in college, so I didn’t go directly into med school. I definitely think of myself as a more “non-traditional” student, not just because my background is in the social sciences but also because my interest in medicine is really just one facet to my life. I am not what one might picture as your classic, tightly buttoned physician. I studied sociology in college and I fell in love with medicine for the people, not for the science.

Why Family Medicine?

I spent all of my pre-clinical years focused on pursuing emergency medicine, while also considering surgery and ob/gyn. Family medicine was actually at the bottom of my list! But I started my clerkships with FM, and I fell in love with it immediately. I realized that emergency medicine was absolutely not for me once I noticed how hard it was for me to leave clerkships and not know what happened with the patients I had seen.

By fall of my third year, I was 100% on the Family Medicine path. My main motivator to be in medicine is because healthcare and social justice are inextricably linked. Family medicine is one of the fields most closely tied to activism and advocacy. Plus, I really loved all of my clerkships, and I felt that FM was the best way to keep all my skills sharp and be able to see the breadth of patients that I want to work with.

I think FM gets a bad rap from a lot of med students, and it shouldn’t – it is the most versatile specialty and it really gives you so much room to be creative in your practice.

Were you advised against FM?

No, but I did have many physicians in other specialties questioning my decision. I have had preceptors ask me “do you want to be poor?” and other similarly rude and degrading comments. For anyone who knows me and knows what a good family medicine practice looks like, I got nothing but support.

What would you say to medical students still trying to choose between FM and another path?

The best advice I ever got was to think about the bread and butter of a specialty and if you could still find joy in it. So let’s say the “mundane” part of family medicine are maintenance visits for patients with diabetes or hypertension. I absolutely find excitement and fulfillment in meeting with those patients, knowing them over many years, and getting to talk to them about their lives, their physical health, mental health, etc. I don’t think I will ever get sick of connecting with people on that level – and I just didn’t feel the same way about doing thousands of lap choles or whatever.

Your specialty is your specialty for life – FM gives you so many different options and ways to practice. That just isn’t available in a lot of other specialties. And finally, this is your one life and you worked so hard to get here – if you love family medicine, do not let anyone tell you otherwise. All the prestige and money in the world isn’t going to make you happy and fulfilled if you don’t love what you are doing day to day.

Did you apply to both MD and DO programs?

I applied to both and I didn’t really consider the distinction, especially because the 2020 match was the first combined one. At all of my interviews, I made it a point to ask what that program had available to me for osteopathic training; if they didn’t have any, I asked if they would support me in finding options to do so. It was important to me that I felt supported as an osteopathic physician, even if the program itself wasn’t osteopathic.

I would recommend that all DO students do this – look and see how many DOs are there, and even more importantly, directly ask the PD/faculty how they would support you as a DO. Family med is a pretty DO friendly specialty, and there’s only a few programs I know of that really don’t consider DOs, so I would definitely not limit yourself to former AOA programs just because you think you wouldn’t be able to compete at an ACGME program.

Did ACGME programs have DO support?

Most of them said “we think of you the same as our MD applicants, it is no different.” My preferred response, which I heard less often, was “we will find space for you to learn and practice OMT,” or “we are working on expanding that part of our program.” A few places I interviewed were former AOA, so they already had a good amount of osteopathic training built in. I would say about half of the programs I asked this gave me a generic supportive “we treat you all the same” answer, and the other half had solutions or were more interested in helping me find training.

How did you narrow down programs to apply to?

I started by geography – I knew I wanted to either stay on the west coast or go back home to New York. Especially in family medicine, there are so many programs, sorting by geography is a safe starting point.

However, there are a lot of amazing programs I found out about later that I had never even considered because I was so focused on location, and I wish I had done a bit more research. After location, I was looking for a program that had abortion training, a strong focus on social justice, and served a diverse patient population. When applying, I didn’t realize that procedural training varies so widely between programs, but it definitely does – I only competitively ranked programs that had strong procedural training.

How did you find out about programs later on?

I actually heard about other programs on Twitter! I didn’t look that hard beforehand, but being on Twitter I have seen so many residents and students at other programs that seem very in line with what I was looking for in a program. Honestly, I think a Google search is always helpful. There are threads on Reddit, etc about programs and what they focus on. Social media has been an amazing tool to see what is out there and get perspective on programs.

Did anything complicate your interview process?

I did a very late audition rotation (ended in early November), which forced me to schedule a lot of my interviews a bit later in the season. I would definitely recommend trying to finish sub-internship by October(*editor’s note: if non-home rotations are permitted this year).

Also, I was living and rotating in California while interviewing mostly in New York, which got pretty expensive and stressful at times. But overall my interview process was fairly smooth. I did end up stacking interviews – four in a week was my record – to cut down on travel, and that was honestly not really worth it, I was so burned out by the end of that week.

How many programs did you apply to?

I applied to about 45, which is a lot for family medicine. However, most people at my school try to match in California, so my advisor told me to apply to more programs because New York isn’t a known quantity for their graduates. Given how many interviews I was offered, I think I could have applied to about 30 and still had plenty to choose from. I definitely over-applied and didn’t research all the programs I applied to ahead of time, which led to me getting invites at places I was not interested in at all. I feel bad about that, it was definitely not a great strategy.

How many interviews did you have and did you rank them all?

I ended up accepting 11 interviews and ranking 10. My top three were all places I had rotated at.

Are you considering future training (beyond residency) or considering a fellowship?

I am considering fellowships in women’s health, addiction medicine, integrative medicine, and palliative care – so, a lot! I don’t know if I would want to go directly into any of them right from residency, but there is so much I want to do. The awesome thing about family med is I get to do a little of all of that without fellowship training, so even if I decide not to pursue fellowship all of the above will still be part of my practice.

You mentioned abortion training, and your Twitter bio indicates a passion for family planning and abortion care. Tell us more.

I’ve always been very passionate about the right to bodily autonomy. I can’t think of anything more personal than the decision to become a parent, and I don’t think anyone should weigh in on that choice for anyone else. Comprehensive family planning is a human right and it was really important to me to find a residency program where I would learn to provide that service to my patients.

I was an active member of Medical Students for Choice and have always cared about this issue, but now that I am at a point in my life where I actively want to become a parent, I feel more strongly than ever that this should be a choice and not an obligation. I was briefly pregnant in OMS3 but miscarried at seven weeks, and oddly that experience just further affirmed to me how important it is that nobody be forced to continue a pregnancy if they don’t want to.

Imagining your post-residency self are you considering academic, rural or urban practice? Full spectrum or multi-spectrum, tell us what professional life looks like in five years!

Given where my family is and my husband’s career options, I definitely see myself staying in an urban environment. I would love to work as faculty at a residency program, and have the option to work both outpatient and inpatient. I’d also love to have a clinic to provide gender-affirming therapy for adolescents, and definitely a shift or two a week at Planned Parenthood. I want to continue providing prenatal care for my patients, but I’m not sure that OB will remain a big part of my practice, mostly because of where I imagine I’ll be living.

Finally, for the 2021 Match it looks like interviews will be virtual. What concerns do you have about this for your peers-to-be?

This worries me a lot because I already felt that the one day interview experience was barely enough to get a good feel for a place; and that feeling was so crucial. One of my top 3 programs on paper ended up being around number 9 on my rank list because when I went in person I really hated the vibe, which isn’t something you can accurately gauge over Zoom.

I think the onus is definitely on the programs to find a way to convey their culture well digitally, and there absolutely has to be major change in how the application process goes. I think there is a ton of room for improvement on this process as it is, and I am hoping that changes made to accommodate the COVID crisis might lead to positive change for the future also. If there aren’t caps on applications and interviews, I think the virtual 2021 match is going to be a mess.

I also hope that med schools will be able to provide their students with safe spaces to digitally interview from, to accommodate those who may not live in ideal interview conditions. In family medicine I am a little less concerned about this, but I know that in some programs there is definitely bias regarding applicants with children, etc. If all interviews will be digital, then I think all medical schools need to step up to provide quiet, neutral spaces with strong internet connections for their students to interview from.

How have videogames helped you deal with all the stress of packing and moving?

My husband got me a refurbished Nintendo switch and a copy of AC:NH for match day. I have never played Animal Crossing before, but I definitely dove deep into it. As of the day of this interivew I have logged over 200 hours in that game. For me, it’s definitely been an escape – from the stress and fear of the pandemic and the chaos going on because of it, but also from the couch I’ve been quarantined on. It gave me a sense of control and a place to go, and that’s been very comforting. Plus, my vacation got canceled, so getting to spend 200+ hours on a digital tropical island is about the best I can do right now.

On Twitter you shared a helpful thread on Personal Statements. What’s your future plans re: tweetorials as a resident?

I’ve actually been trying to think of some good medicine tweetorials to do, and I haven’t been able to! I think I have been out of the clinical scene way too long. I know I will be a lot busier in residency than I am now, but I’ll have a 50 minute commute on the subway, so I will hopefully remain active.

I really love to teach and I think the Tweetorial format is really useful; plus, I learn a lot by trying to explain something in simple, Twitter-friendly language. So I am looking forward to busting some out!

Family medicine is an underrated, underexposed specialty, and I love using Twitter as a platform to get med students excited about it. I definitely plan to continue doing so as a resident.