Interview with Sydney Miller, OMS-III, Student Director for NRMP Talks About Challenges Faced During the Pandemic

September 8, 2020

NBOME caught up with Sydney Miller on Zoom to talk about her experience with COMLEX-USA, her new role as Student Director on the NRMP Board of Directors, and what’s next on her Road to DO Licensure. Originally from Commerce, MI, Sydney is a third-year medical student at Michigan State University College of Osteopathic Medicine, which has recently become a satellite testing center for COMLEX-USA. She just started her clinical rotations a few weeks ago and is currently working in a family medicine clinic.

NBOME:  What inspired you to become a physician and what drew you toward becoming a DO, specifically?

SM: I had a lot of different interests as an undergrad, but I finally decided I wanted to become a doctor because I wanted to help patients, not only as a physician treating their conditions, but also serving as a teacher, advocate, and overall coordinator of care. I wanted a career where I could use my love of science and my soft side too, which is why I chose osteopathic medicine. We don’t just treat patients’ medical conditions, but we also try to discover what in their community is contributing to their health. What makes the person who they are—I was really drawn to that. I also like public health, and felt as a physician you can pull some of that in, especially as a DO. I want to be a doctor that my community can rely on.

NBOME: Looking back at how you prepared for COMLEX-USA Level 1, would you have done anything differently or taken a different approach to studying? 

SM: I just took COMLEX-USA Level 1 in June and one thing that was crazy about my prep was that my exam was canceled multiple times.  I had to become more adaptable. I had a set plan where I was going to study XYZ for this many days and take these specific practice tests leading up to my exam, but when I found out it was canceled, I had to be even more flexible.

Overall, I wouldn’t change too many things about how I studied. During the two years leading up to my COMLEX-USA exam, I used a few resources consistently. One thing I’d suggest is trying to blend learning the specific details with understanding the bigger picture. It’s important to make sure you aren’t losing sight of what a patient might actually present with—if someone comes in with these symptoms, what are some things that would be on your mind?

NBOME: As a medical student in the midst of a pandemic, do you feel this experience is helping you be more flexible or do you feel as though the stress is holding you back? 
SM: It’s a little bit of both. I try to look at it as, ‘okay, this is a new challenge.’ It also puts into perspective that COMLEX-USA is just another step in the road to becoming a doctor, which helps to lessen the pressure of performing super well. It’s true, you want to do well, but COVID-19 helped prove that there are elements you can’t control—like when you take the exam.  You have to learn to be more flexible, do the best you can, study hard, and achieve what you can the day of your exam.

Something I saw over the last two weeks of working in my family medicine clinic is people are scared—they are so stressed. They come to their doctor not just for things like ‘can you refill my blood pressure medications,’ but for, ‘I just need to talk to somebody. Can you just hear me out because I have these concerns?’ Even just talking to a doctor who knows their medical history and their family can help a lot of people get through this crazy time.

It took time for me to adjust to doing all of this differently too, and we have to realize not every day is going to be perfect. Some days I was very stressed. Moving into clerkship, a lot of original plans at the hospital had to change, but that’s the case right now in every field. You just have to take it day-by-day.

NBOME: Was that the most difficult part of preparing for COMLEX-USA in the middle of a pandemic?

SM: The hardest part was just being in isolation. I’m a busybody—I like to be out and about and I normally study at a coffee shop or at school because I like to have other people around me. I’m not much of an at-home studier, so I learned to study really hard and then take breaks, go outside and do fun things in between. Not being able to be around people while trying to keep a positive mindset in the midst of so much uncertainty was the hardest part for me.

NBOME: Part of managing stress is definitely continuing to do the things you love. How have you managed to fit in time for your hobbies and other activities while studying?  What else did you do to help keep your stress levels in check?

SM: Though I couldn’t play beach volleyball with my classmates, I’d still go for a walk almost every day, and force myself to take an hour or two off, no matter how stressed I was or how much I had to get done. I’d just schedule it into my day—40 questions in the morning, some educational videos, another 40 questions, then an hour off. There’s not too much hiking where I am, but I’d go for walks and try out new recipes to keep myself entertained. It’s important for me to put time-off into my schedule to go listen to music, lay in the hammock, catch some sun, and do things outside.

It took me some time to figure out what works for me and what doesn’t. Find something that helps take your mind off of studying, something that makes you feel at peace. For me, it’s being outside and being around other people. Talking to people both inside and outside of medicine has helped give me perspective.

Especially during the first two years of school, find ways to take time off and develop coping mechanisms. At my college, we have a counseling department that’s there for just medical students. Using resources like that early on, before you start studying for COMLEX-USA and start feeling anxious or depressed, can really help support your mental health.

As President of your class government, you serve as a liaison between students and administration/staff across all three MSU COM campuses. How do you find balance? 

SM:  I am very lucky that the other students I work with on class government have been amazing, and I have mentors and our administration who have been so supportive. I always have people to turn to if I need help.

It was an adjustment, timewise, though—‘how do I manage having three meetings today and an exam in four days to study for?’ Yet, I know when I have meetings, it makes me appreciate the time I have by myself to study. When I’m bored of studying, then I have the meetings. They each make me appreciate the other a little more.

NBOME: I’m sure you’ve encountered some challenges in this role—what were they and how did you come up with solutions?

SM:  It’s almost impossible to come up with solutions to problems that work for everyone. We can’t fix everyone’s problems, and there’s no single solution that everyone’s going to be happy with. I try to listen to feedback from my classmates and advocate for changes that will do the most good for the most people.

I have mentors and staff at MSUCOM who are receptive to feedback, so if something comes up that I don’t know how to deal with, I immediately run down to their offices and say ‘please help me, how do we attack this?’ I listen to feedback from them and the students so together we can make useful changes and a positive impact.

NBOME: Congratulations on your new role as Student Director on NRMP’s Board of Directors too! We understand you’ll be providing NRMP with an osteopathic student perspective on current initiatives and brainstorming ways to help improve the residency match process. What drew you to this role?

SM: Thank you! I was interested in this position first of all because it’s a national position dealing with problems across the country for medical students. As president of my class, I was focused on the problems my immediate community faced. I wanted to take it to a bigger scale to learn more about the process and advocate for DO students to have a seat at the table now that we have a single match.

As a medical student, the one thing you know you want at the end of your four years is to match into a residency program—it’s the biggest step in your professional career.  I wanted to learn more about that process and contribute to it in a way that helps all students, DO students especially.

There’s a lot of mystery in what being a DO student is like and I’m excited to share that with the board and talk about my experiences. There’s a new wave in medicine of ‘how can we improve this–how can we do better?’ I thought this would be a cool place to get involved.

NBOME: What are some of the topics you would like to explore further with the NRMP? 

SM: I was thinking of ways residency program directors can look at applicants more holistically, taking into account all parts of the individual—not just their scores. I want to help come up with a streamlined process that allows them to better analyze the thousands of applications they get each year. I don’t have a perfect answer for what should be important, but I want to work with RPDs or directors of medical education at hospitals and students to try and come up with a holistic process. It’s important for RPDs to select students based on more than just a score.

With respect to licensing examinations going to a Pass/Fail format: there are positives and negatives to Pass/Fail. Some students have shared that they worked hard to do well on this exam and want their score to reflect that. How can we come up with a middle ground that benefits both students and RPDs?

There is also the issue of students not reporting Match violations by programs. So if they are at an interview and the interviewer asks the student where they rank that program on their list, students feel afraid to report it for fear of potential backlash. I want to be part of developing a process that enables students to report these violations without fear of retribution.

NBOME: You’ve had the opportunity to explore so many different specialty areas through your rotations. Based on this, do you have a plan for zeroing in on a specialty?

SM: Because I have to do rotations in a lot of different areas and have so many interests on top of that, there are very few things I’ve encountered that I’ve felt weren’t for me. Right now, I’m leaning towards family medicine, internal medicine, or emergency medicine because you see a little bit of everything. I’m trying to keep an open mind and go into every rotation acting as if this is exactly what I want to be doing, all while asking myself, ‘Could I see myself doing this? Do I fit in here? Do I feel like I could contribute?’

I’m hoping to figure it out by going there, experiencing the day-to-day, and seeing what being a resident in that field really looks like. I also need to think about what my lifestyle looks like so I can find a field that matches those needs. I’m trying not to think about it too hard, but in the end, I’ll have to go with my gut.

NBOME: What advice would you give to COM students following in your footsteps?

SM: Find ways to make yourself happy outside of school, and try to develop coping skills for when things get tough—because things will get tough. Studying for long hours isn’t fun. Working long hours as a student or resident isn’t always easy, but if you can figure out ways to minimize your stress, you can succeed.

Work to get to know the people around you and form relationships with the people in your class. Medical school is a unique experience and the people who understand that best are your classmates. The best part about medical school is the community I’m so lucky to have. Having other people I can call on when I need them is what helps me get through stressful times when I’m feeling overwhelmed.

Some people want to study all the time and not take breaks. That’s what works for them, but that’s not what works for me. It’s taken me a little bit of time for me to confidently say, ‘this is how I study and this is how I’m going spend my time off.’ Not doing the same thing as everybody else doesn’t mean it is wrong.  Find what works for you and stick to it. That will take time and that’s okay. You don’t have to have it all figured out right away. Take it day-by-day and do your best.