Monthly Archives: February 2010

Rowan Paul: On Sports Medicine, Medical School, and Graduate Internships

This interview delves into the world of Primary Care Sports Medicine with San Francisco’s own Rowan Paul, M.D. Rowan is a graduate of Brown University and Albany Medical College, and did his residency at Stanford University and a fellowship at the University of Utah. Today, he works as a Primary Care Sports Medicine Physician at California Pacific Orthopaedic and Sports Medicine (CPOSM) in San Francisco. In this interview, Rowan describes his experiences searching through medical specialties through volunteer work, fellowships, and graduate studies. His words of wisdom – to search long and hard for the job and specialty that are right for you – are true for all professionals and will resonate with today’s recent graduates and employees.
What prompted your first interests in Sports Medicine?

I have always been interested in science and the natural world. I did three years of research at Brown in an amazing bat flight lab studying neuroscience --specifically, the vestibular systems of bats. After many lonely nights alone with the bats, I realized I craved human-to-human interaction, so I started thinking about medicine.

When did you decide to pursue your medical degree? Has it always been a dream of yours, or did it take shape throughout your college years?

I did some clinical research in HIV with intravenous drug injectors between undergraduate and medical school at Brown University’s Miriam hospital – while still deciding if I wanted to be a physician. I did a lot of travelling and medically-related community service at both Mother Theresa’s home for the destitute and dying in Calcutta, India,as well as a school that taught tolerance for children of all castes including the “untouchable caste” in Kathmandu, Nepal. These powerful experiences convinced me I wanted to be a physician.

When you entered medical school, did you know what type of doctor you would become? Or did your ideas change and evolve with your advanced education?

I had an image of a doctor that did a little bit of everything for everyone. I wanted to be able to go anywhere in the world and be able to help people of all ages with all conditions. I also was interested in a field that was rooted in prevention rather than reactive treatment. This led me to Family Medicine and then Primary Care Sports Medicine.

Is there a pivotal moment during school (undergraduate or graduate studies), during an internship, or during a conversation with someone that led you to this area of work?

In medical school I did a rotation in Seattle with primary care sports medicine physician Greg Nakamoto. I realized then that I could combine my interests in preventative health, exercise, family medicine and orthopaedics by becoming this particular type of sports medicine physician.

It’s now been several years since you’ve left academia. What does your daily schedule look like now?

My day involves both clinical work in the office as well as off-site sports medicine. In the clinic I see patients of all ages who are active or trying to be active. They often have orthopaedic, surgical or non-surgical, or sports medicine issues that are hindering their athletic goals. I see everyone from the Olympic-level cyclist who is trying to break through a training plateau or a geriatric patient that is trying to stay active as a cyclist but suffers from severe arthritis.

How many people do you work with? What is your office like?

I work directly with eleven very talented Orthopaedic surgeons at CPOSM and with a family physician, massage therapist and pilates instructor at the San Francisco ballet, along with many assistants. All the doctors are “partners” although our practice is structured as a medical corporation (CPOSM) so I guess technically we are all employees of that corporation. Thankfully, we all have a lot of control of our schedules and vacation time.

What is unique about your job that you didn’t otherwise anticipate while in school? In what ways is your career or job the same or different than your academic experience?

I am not a surgeon, but I am a sports medicine specialist. My patients really enjoy seeing me because I offer a bridge between their primary care physicians and the surgeons. I can offer an unbiased opinion of whether they need surgery or not and if not right away, I can work with them to heal them non-operatively. Most people are hesitant to take a surgical route so I feel I can alleviate their fears and they can be confident that they have exhausted all non-operative routes first before going the route of surgery if appropriate.

What are the best things about your job?

The patients-- they are all motivated to get better which makes my job much easier and more rewarding.
The other physicians. We have a great synergistic relationship and they are all fun loving and easy going while being very skilled, prestigious partners. And lastly,the field of primary care sports medicine. It melds my personal and professional interests so work doesn’t feel like “work!”

What do you wish you had learned about your career field while you were in school?

Medical School is a whirlwind with limited time for exposure to all the different types of medicine. As a result, I never had a sports medicine rotation until I found out about it in third year and had to schedule my own elective in it. Also, M.D. school is heavily focused on therapeutic health but I think more of the curriculum should be focused on preventive health. Other countries have more successfully leveraged preventative health focused care in a climate with limited resources.

What are three skills that you learned on the job that you didn’t learn in school?

First, how to navigate through the insurance quagmire that is unfortunately our fractured health care system. Secondly, how to build relationships with referring physicians around the area, and third, how to keep current in my field without being actively taught by attending physicians.

What are the most difficult aspects of your job?

The most difficult thing is battling insurance companies to approve necessary treatments for my patients. It’s frustrating to have a someone with no clinical experience tell me that my patient doesn’t need a potentially life-saving treatment. Also equally frustrating - making sure the medical record of all my patients are complete and accurate. And lastly, the business of medicine. I wish medicine was not for profit and thus strive to give my patients cost-effective care.

When thinking about the transition from academia to work life, what took the most getting used to? What strategies did you use to adjust to the differences?

Taking on the medical risk where previously the universities and teaching attending physicians did. Since the buck stops with me now, I spend more conscious time thinking about risk reduction. I usually try and practice medicine justly and try to give full disclosure to my patients so there are few surprises.

How do you define success in the workplace? Are you able to set your own goals?

In medicine, I think that if you can be happy practicing in the field that you want to be in, with your ideal patient population, and with people that you love to work with, while also thriving in your personal life, then you are being successful in the workplace.

That’s quite an accomplishment! Do you feel like you’ve met these criteria?

I feel lucky that I have found all of these things in my first year in practice. My proudest work-related accomplishment is being able to help my toughest patients who have struggled for years to accomplish their active lifestyle goals but have been held back by injury or pain. I get to witness the chain reaction of improved health, mood, and productivity that comes from working in Sports Medicine.

What does “work-life balance” mean to you, and how do you maintain a work-life balance?

Medicine can be a vacuum of a career where the hours and energy that it demands can tear apart your personal life and really change you as a person. I vowed never to let this happen to me. I purposefully picked primary care sports medicine because I can integrate my personal interests with my career interests with far fewer hours per week than many other specialties. I find that I come home invigorated by my job helps me maintain a healthy lifestyle. In addition, I am able to bring my personal interests in an active, balanced lifestyle for preventative health into all my encounters with my patients. I believe it makes me a stronger physician and helps me lead by example with my patients.

What advice do you have for recent college grads and new employees? Any words of encouragement or advice?

Don’t feel pressured into medicine. Search deeply within yourself by doing activities such as volunteering in many different medical settings that can help you decide if medicine is right for you. Only start medical school when you are energized and really ready. You will get much more out of the experience and enjoy it much more. If medicine is the right fit for you it can be one of the most rewarding careers.

If you do go the medical route, search long and hard through all the different specialties and sub-specialties. Medical school will only expose you to a precious few yet you are expected to know which one is right for you. Do elective rotations to expose you to any you are interested in, even if they are only a few days long. It is an important decision that can make or break whether you have a happy rewarding career or a miserable one.

Lastly, don’t feel pressured by those around you to go into a certain field medical or otherwise. In the end, it is you who have to go to work every day. Your field and specialty has to be a great fit for you. Picture yourself 30 years later. Can you see yourself LOVING your job still? If not, it may not be the right choice for you.

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“Career Focus” is a series of interviews with young professionals in San Francisco exploring different job fields and professions and the journey from academia into the working world. Previous interviews have coveredPharmaceutical Consulting and Web Development and Technology Consulting.

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