Hanna Renaldi's Blog: Amy Ho: An ER Resident Who Connects with Patients and Society [Episode 203]

I would like to share with you the email that made me believe that today’s guest, Dr. Amy Faith Ho, a third year ER resident, will be simply outstanding:

I love the mission of your site, and the Match was something that endlessly agonized me (see my article in Forbes). It is a great passion of mine to mentor junior residents, med students and premeds and I’ve also done a TEDx Talk on the topic for college students, but would love to talk about how I came into medicine (and how for me, scores weren’t the end-all-be-all).

I was a policy hack who wanted to save the world and went to med school as a reconnaissance mission to understand healthcare as an industry better. I surprisingly ended up falling in love with the clinical practice of emergency medicine, so I did residency, but stayed highly involved in healthcare policy. I’ve now worked on US Congress as a healthcare fellow, been a leader in multiple national organizations and been a nationally featured writer and speaker (see examples at amyfaithho.com).

I wish someone when I was in college would’ve told me that 0.1 point difference on your GPA wasn’t the end of the world (because at the time, it sure felt like it)! Would really love to share the message with your readers.

Welcome, Amy!

Can you tell us your backstory – how did you decide to go to into medicine? [2:14]

I’m from suburban Texas – I was a high school debater and loved everything about policy. I got interested in health policy and the healthcare industry – I thought the whole system was insanity, and I wanted to fix it. I looked at law, policy, public administration – and I concluded that if you want to change health policy, you need to understand health care, so I went to medical school. And then I fell in love with clinical medicine and realized I can’t imagine not incorporating patient care into my career.

Was there a specific moment when you realized you wanted to be a doctor? [5:15]

It’s hard to have that moment until you actually work with patients during the clinical years of med school. The patients I remember are all ones that had non-medical things that connected me – I remember a patient who kept asking to speak to her son, and I looked him up to let him know his mother was in the hospital. I don’t remember a more grateful patient.

Were you still planning the policy route? [8:08]

Yes, until very late in med school.

I decided on emergency med after shadowing in the ER late in med school and doing that rotation in fourth year – then I declared for emergency.

I like the diagnostic challenge: making big decisions with little information in a small amount of time.

For me as a health policy wonk, it’s also great and interesting to see care at this level: we see everyone.

Looking back, what was the most challenging part of the med school application process for you? [11:02]

The personal statement, no doubt!

Most of the other parts of the application process are more objective: you have a sense of what scores you need, etc. But the personal statement is wide open. It plays on your own insecurities. So that’s what I agonized over the most.

In your TEDx Talk at the U of Chicago you spoke very persuasively about the relationship of numbers and words. Or more accurately the differences between them. You also talked about the power of letters, “which become words, which become sentences, which become stories, which become connection.” How did you use that insight in drafting your med school or residency personal statement? [13:30]

I asked myself what were the moments that touched me. These were often non-medical moments – a patient who was grateful to me for something non-medical that I did.

Putting yourself in other people’s shoes – that’s what I mean by connection. It’s your job to catch on and understand – and those moments of understanding can be crucial to being a good clinician.

What did you like best about UT Southwestern, where you went to med school? [15:40]

It was an amazing clinical experience. Because it’s a large county hospital, we see people with no insurance, including truly indigent people who haven’t had care in a long time. You see interesting pathologies – but it also opens your eyes.

Is there anything you’d change? [17:20]

When I started residency at the University of Chicago, I realized there are more liberal programs and schools that do “medicine-and.” For me as someone who is interested in writing and interested in policy, that would have been appealing to me.

How did you maintain your policy involvement in med school? [19:30]

I joined the American Medical Association – they have a robust student and resident section. I got to draft resolutions and serve on the board of the lobbying arm – it gave me exposure to how that works.

When you’re a student, there’s always someone older who’s eager to impart wisdom and mentor. Just getting involved is important!

In Oct 2013, you wrote a wonderful article for KevinMD called “Being a good medical student doesn’t mean you’ll be a good doctor.” What are some of the distinctions? [22:00]

Being a med student means making the right presentations, giving the right answers to your attending, etc. Sometimes there are conflicting interests between that and providing the best care for your patients, which is your goal as a doctor.

One example is the shelf exam that you take at the end of each rotation. Med students leave early to study for the exam. But being a good doctor means staying late, if needed.

You mentioned an earlier interest in surgery? [24:38]

I just wasn’t sure. There’s a lifestyle component to it, as well. An attending took me aside and said that if I loved surgery more than anything else, I should go for it, but otherwise, to think twice.

How do you maintain a healthy perspective, given the pressures of med school, residency, etc? [26:20]

It’s tough, but one beautiful thing about the medical path is that the end is always in sight – versus the corporate ladder which is more nebulously defined.

The system is built to get you there and trained. You need to show up and do your part.

I spoke with a physician recently who shared his concern that students are too hyper-focused on the USMLE exams, and that they’re missing out on other opportunities and training as a result. What do you think? [28:33]

There can be some tunnel vision – all focused on the monster you have to slay (the Step 1 exam). But it’s important to realize there are multiple avenues to your goal. If you want to become a plastic surgeon and you need to do really well on the exam, but then you just do OK on Step 1, you could still do general surgery and then a fellowship. There are multiple avenues.

One thing that stands out in everything I read or watched in preparing for today’s call is your commitment to seeing each and every patient as a human being – a son, daughter, father, mother – a real human being no matter what they are doing in your ER. How do you maintain that perspective in a harried ER in one of the most violent neighborhoods in the country where you say all the violence can make your trauma bay more like a morgue? [29:50]

This is where understanding how the world works helps. I’d never met a gang member until residency.

They live in a low resource/high risk life. You get a sense of how important it is not to blame individuals, and to start to understand the systems.

It’s also important not to get burned out. Obviously I can’t solve gang violence. But I try to work on harm reduction in small ways.

Where do you see your career taking you? [34:45]

I have a position lined up as assistant medical director at a big county hospital in Texas. I believe keeping a foot in the clinical world is very important.

I like to translate medicine for the common man – so for me, that means writing. I work with medical organizations and consulting firms on public health issues. And I’ve been doing more media.

When do you find the time for all of this? [36:05]

Creative multitasking! But one of the beauties of ER medicine is that you can stack your shifts, so you can arrange some time off.

Is there anything else you wish I had asked you about? [36:50]

There’s an incredible trend right now in technology and how that affects medical training. I really encourage people to use twitter, blogs, etc to use asynchronous learning. There’s a hashtag #FOAMED – it stands for Free Open Access Med.

Any advice for premeds or students preparing for the match? [38:10]

Remember the big picture: you’re going to save lives!