AAMC Reporter, November 2000:The Road Less Taken:Nontraditional Medical Students Make the Grade

VOLUME 10, NUMBER 2

JORDAN J. COHEN, M.D., PRESIDENT

NOVEMBER 2000

The Road Less Taken: Nontraditional Medical Students Make the Grade

By Jennifer Proctor

Ana Benitez-Graham, now a first-year medical student at Duke University, visits her childhood home in Bejucos, Mexico.

While most future medical students were acing high school chemistry and biology, Ana Benitez-Graham was laboring as a migrant farmer. While premed college students were studying for the MCAT, Max Aguilera-Hellweg was studying with world-renowned photographer Annie Leibovitz. And as students his age were preparing for gross anatomy, Kennedy Cosgrove was embarking on a career as a journalist with one of the nation's most prestigious newspapers.

The three are just a handful of a growing number of nontraditional medical students to whom the practice of medicine is a second career. Max Aguilera-Hellweg will turn 45 this month. He traveled the globe for 26 years as a freelance photographer for such publications as Life, GQ, Esquire, and Time, but now he's in the middle of the most challenging journey of his life. He's the oldest first-year medical student at the Tulane University School of Medicine.

"Now I'm just another guy trying to learn gross anatomy," says Aguilera-Hellweg, who describes himself as a "huge muscle of curiosity." His curiosity for medicine was sparked by his opportunity to photograph a surgery in progress. "Very few people get to see the operating room from the inside; when I did, it was like going to the moon," he says. Throughout his life, Aguilera-Hellweg hasn't sat back and wondered about what interested him; he explored it. He directed films, published short stories, and ran a marathon.

After his experience in the operating room, Aguilera-Hellweg finagled his way into shooting more medical stories. He toted his camera into operating and exam rooms and compiled a book of surgery photographs. But Aguilera-Hellweg still couldn't quench his curiosity. "I thought: 'Do I want to make a movie about doctors, or do I want to be a doctor?' I was starving for primary experiences, and I wanted to be the guy saving the other guy's life," Aguilera-Hellweg says.

He couldn't just hop on the first plane to New Orleans, though. Since he began his photography career fresh out of high school, Aguilera-Hellweg, at 39, had to go to college before he could even apply to medical school. "I flunked out of trigonometry in high school, so you can imagine how I felt when I faced calculus in premed," he says.

Aguilera-Hellweg continued his photography as he studied at Columbia University. He admits it wasn't easy, but his curiosity about everything, including physics and organic chemistry, helped him get through college and the MCAT. He also credits his organizational skills, will-power, and self-discipline - traits that are vital to both a successful freelance photographer and an aspiring physician.

This year, Aguilera-Hellweg moved from the Big Apple to the Big Easy, and has given up his photography career entirely to dedicate himself to his studies at Tulane. The schedule is rigorous. Aguilera-Hellweg is up studying at 4 a.m., and he doesn't turn his light out until midnight.

He says medical school is harder than he ever imagined, but he's proven to himself that it's not "intellectually out of reach." "Every day it's like climbing Mount Everest, only it takes longer," Aguilera-Hellweg says. "Still, in the end, I get to be a doctor."

Farmer to Pharmacist to Physician

While completing her final year of pharmacy studies and conducting pharmaceutical research, Ana Benitez- Graham decided to pursue a career in medicine. "I strongly felt the need to reach beyond the boundaries of my insular world of research and become more directly involved in the healing process."

As a child, her interest in healing was sparked by her grandmother, a natural healer in Benitez-Graham's native village in Mexico. Upon moving to the United States, she and her family traveled for two years and worked as migrant farmers in Washington, Texas, and Florida. In 1985, the family settled in Austin, Texas, and Benitez-Graham pursued her education.

Benitez-Graham, now a first-year student at Duke University School of Medicine, wants to be a neurosurgeon. She plans to serve lower-income communities by providing as much free or low-cost surgery as she can. "I think that by becoming a neurosurgeon I can satisfy my professional yearnings and give something back to the community," Benitez-Graham says. When people warn her about the extraordinary demands of the specialty, she responds, "I know what back-breaking work is."

Benitez-Graham often spent 12-hour days in the field with her parents and siblings picking apples, cantaloupes, and oranges. High school, let alone medical school, was not a likely option, nor was it encouraged. Her parents viewed an elementary school education as sufficient. Nevertheless, at 14, Benitez-Graham started attending school regularly and learned English while she worked 40-hour weeks to help support her family.

Benitez-Graham continued working full time while she attended college in Texas. Not only was she able to pay for the bulk of her tuition and accept only minimal financial aid, but she also excelled academically. Benitez-Graham was awarded an NIH minority research training program position as well as a National Industry internship, and her studies were published in national journals.

Benitez-Graham's will to succeed helped her maintain a positive outlook as she faced more difficult challenges on the way to medical school. First, she operated on three to four hours of sleep a night while taking classes to complete her pharmacy degree, working a full-time job, and studying for the MCAT.

After all of her hard work, disappointing news was almost heart- breaking. Although she was wait-listed, Benitez-Graham wasn't accepted at any of the medical schools to which she had applied. Her MCAT scores were too low; if she wanted to go to medical school, Benitez-Graham knew she would have to study even harder.

Armed with her experience, and by this point a practicing pharmacist, she got ready to start the whole process over again. While she was 16 weeks pregnant with her first child, Benitez-Graham took the MCAT again. Even though she was so nauseated and uncomfortable during the test that she began to wonder if she could "get a break," she raised her scores considerably.

Benitez-Graham chose to attend Duke, and, thus far, medical school has proven to be everything that she hoped for. When she surveys her classmates, Benitez-Graham, now 28, sees people who are both younger than herself (the average age at Duke for entering medical students is 22) and come from much different backgrounds. "No matter if they were poor or rich, my classmates all seem to come from a family and community in which there was a large emphasis on education. My motivation to pursue education had to come from within."

In a new town, Benitez-Graham and her husband have a new life with a new daughter, Gywneth Ivy. Benitez-Graham modestly reflects on her path: "I've been tested and had some difficult times, but I've accomplished a lot."

The Psychiatric Ward Is Mightier than the Pen

Kennedy Cosgrove, M.D., is in his first year of a psychiatry residency at the University of Washington Health Center. One of the skills he brings to his patients is his ability to ask the right questions. Perhaps he picked this up in his years as a sportswriter for the Los Angeles Times. "I have an appreciation for the narrative of people's lives," Dr. Cosgrove says.

Dr. Cosgrove worked on his college newspaper and completed two summer journalism internships. Upon graduation from UCLA with a degree in English and creative writing, he moved directly into an internship and then a job with the Times.

The idea of being a doctor may seem unusual for someone who spent his days covering high school basketball, college softball, soccer, and all the sports in between. But Dr. Cosgrove had always been interested in science and even spent a period in college as a premed major, although a career in writing won out.

After a few years of journalism, medicine began to rally for Dr. Cosgrove's attentions. So he gave up sportswriting and took a lower-paying research job. He moved back in with his mother and began studying for the MCAT and the extensive medical school application process.

"There are a lot of hoops you have to jump through to do this," Dr. Cosgrove says. Hoops, he says, that are worth it. He began medical school and public health studies and gave up his "balanced life for one that is physically and mentally all-consuming." Writing had to take a back seat. The transition wasn't an easy one, but Dr. Cosgrove knew medicine was what he wanted to do with his life.

Despite the lack of money and sleep that comes with residency, Dr. Cosgrove says that it is great to have patients say "thank you" and really mean it. Doctors dramatically impact people's quality of life, and that's exciting, he adds. But that doesn't mean he's giving up writing altogether: Dr. Cosgrove hopes to be able to practice medicine two-thirds of the time and pursue his writing with the rest of his working hours.

Dr. Cosgrove, now 31, says that his journalism career gave him a broader perspective on life and the ability to better relate to those he cares for. "I know what you have to do to make a living, and I can bring my experience to my patients."