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Student Spotlight: Tony Manning, M3

                                                                                                                                                                                 

Originally from Malvern, Tony Manning graduated from UCA – where he met his wife, Hannah, and made some decisions about what he didn’t want to be.  We are lucky to have him as one of our third group of junior medical students that started on the Northwest Campus in July.  

 

 

VF:  Tell us about your wife.

TM:  She’s 6 months younger than me.  She teaches 3rd graders in Rogers, which means she has a lot more patience than I do.  She is a whole foot shorter than me – she’s 5’3, I’m 6’3.  She’s from Bryant, so we probably saw each other in high school, but we didn’t meet until college.

First job ever?

Washing cars.  Learned how to drive and wash cars at age 14.  …I washed cars all summer, and spent every penny on a drum set.  They came in a box, disassembled.  For about a year I annoyed the heck out of my sisters and family.  Now it sounds okay, not just noise anymore. .. I play at Cross Church in Fayetteville.

What books are on your nightstand?

Tony Dungee’s Quiet Strength.  It’s been there awhile, so it’s obviously not getting read!  It’s about how he coached with Christian principles, and about the suicide of his son.   Also The Checklist Manifesto by Atul Gawande about medical practice, ethics, that sort of thing.

Best advice you ever took?

Marry up!

Best advice you didn’t take?

The surgeons I worked for told me not to go to med school.  They told me to go to dental school.  They don’t have the troubles with the insurance companies…I crushed somebody’s dreams, right? 

Okay, I’ll change it to: “Keep up with your reading!”

What made you want to be a doctor?

I’ve always liked science and my sisters [are in the medical field] – one is an occupational therapist, one a speech therapist.  I did an interview with my uncle…  He was a physical therapist and not very happy doing it.  He just hated it.  So I decided not to do it.  I looked at what I could do with biology. I did some research in college – knew I didn’t want to do that for the rest of my life.  Being in a lab as an extrovert – no! 

What’s something people don’t know about you?

I never tell people this because it sounds pretentious, but I’ve never made a B in a class…

Highschool?  Undergrad?    Never??? 

I’ve made a B on a test before, but not a final grade.  I had very encouraging parents.  In high school they said they could either pay for college or pay for a car.  If you get a scholarship, then you get a car.  That was a pretty easy deal to make!

What would your life look like if you hadn’t gone to med school?

… I would have been an architect.  I still love building things. My parents get on to me because I use circular saws and things, and they don’t want me injuring my hands – because they need a retirement someday!  I’ve always loved building things, I still have Lego’s – a huge tub – and I contemplate getting them out and playing with them as a break from medical school. 

Who is your mentor and how have they helped you?

Since I’ve gotten up here my mentor for medicine has been Dr. Jeff Bell.  He’s given me advice on where to go next year for residency and what I need to do to be a good surgeon. And something else they teach you in private practice is how to run a business. 

In Little Rock, it was Drs. Rick Houk and John Dietrich.  The two of them along with their wives led a couples’ bible study.  The way they balance family and practice medicine with a spiritual mindset is incredible, and the advice they gave us on how to make it through medical school and residency has been very valuable. 

 

 

Who inspires you to be a better doctor?

…As far as being a patient doctor, it’s my wife.  She’s incredibly patient with her students.  A lot of our preceptors are good communicators. You can learn a lot about medicine from a book.  You can learn how to diagnose strep throat or gall bladder disease, but you can’t learn how to tell a wife that her husband went into surgery and his heart just stopped.  Dr. Jeff Keller and Dr. Mike Bolding (Internal Medicine) at Washington Regional.  Just a lot of preceptors teaching us the intangible parts of medicine.

Do you feel like you would have learned that as well in LR? 

Probably would have learned it.  The one on one time you get here probably helps with that.  And I think that academic medicine and private practice are just very different entities. I won’t say we wouldn’t have learned it in Little Rock, but I think we might pick it up easier up here.

One of our graduated med students said he felt like he was a partner with his preceptors.  Do you find that to be true?

Oh, yeah.  Especially internal medicine and family medicine.  A lot of times you see a patient, develop a treatment plan, and obviously it’s not 100% correct, but they let you have a say in what you do.  And they confirm or tweak and whatever.  But we feel like an active part of the treatment which is nice.

How do you like the longitudinal curriculum setup?

It’s okay.  I’ve got a little bit of ADD anyway, but when I’m changing subjects every week sometimes it’s tough to keep up.  It’s nice that there aren’t too many tests throughout the semester because you can focus on the clinics.  It’s not so nice in the same vein because they all come at you at once…which is in two weeks… which is why I look a little haggard.  Overall, it’s a good system…

Were you concerned initially?

Yeah, I was.  Not about the curriculum, but not getting the [case] exposure like in Little Rock.   And that’s proven to just not be the case.  We get to see different things – things that we were told by our professors that we would never see. We get a different exposure – it’s equivalent if not better. 

How do you feel about the mid-term shelf exams [on the Northwest Campus]?

They are a good barometer for where we are.  The grade doesn’t count.  I like that we do those.  If it doesn’t do anything but scare you, that’s fine.   I would have passed at mid-term, but not where I would have liked to be. 

Tell me about continuity clinic.

It’s working out really well actually. Saw a guy today for the third time.   This was for a lab follow up.  And family medicine clinic in general is where we do most of our hands-on work. Typically the complaints aren’t terribly complex, but you can get a good history and get the diagnosis and treatment correct and get confirmation from the resident.  It’s a really nice hands-on activity. 

Readers Digest version:  Can you explain to a first year med student what longitudinal means?  How it is different [from the block method]?

In Little Rock, you spend 12 weeks on surgery – all you’re studying is surgery.  It’s your focus.  6 weeks pediatrics, four weeks urology, etc…one thing at a time.  That’s your sole focus.  With the longitudinal curriculum, one semester you have the Surgery/Surgical Subspecialties/Internal Medicine group.  You complete a week of surgery, a week of specialties, a week of [internal] medicine, then cycle back for the whole semester.  For the peds, ob-gyn, and psychiatry group, it’s a day a week of each.  So the studying is a little more difficult, but you sacrifice easy studying (if there is such a thing) for some integration.  If you see a patient in medicine to treat with fluids, antibiotics, etc., later you could see the same patient in surgery.  It’s easier to make the connection while things are fresh on your mind. 

 

How often do you see your classmates?

We see each other every Friday afternoon for lecture – the 8 in internal medicine group at 1:00 for the internal medicine lecture, and then all 15 of us get together at 2:00 for a lecture with Dr. Smith.  It’s about patient interaction, how to be a good doctor, a thoughtful doctor, one who is willing to question themselves so you don’t get overconfident or stuck in a rut.  The lecture last Friday was about the future of standards in medicine –   about how payment is based on performance and whether the patient had a good experience and that sort of thing.  More of the part of medicine you don’t learn anywhere else.

Any situation where your preceptor had more confidence in you than you did?

[Laughs.] The first time doing gall bladder surgery.  Before med school, I was running the camera a hundred times.  The first time Dr. Keller put down the instruments and said “Give me the camera, you’re gonna do the dissection… “   That was, yeah.   Clearly he had more confidence than I did. But it worked out.  They’re okay.  Gall bladder out, patient alive, we’re all on the right track.

What’s been your favorite clerkship experience so far?

I have to say general surgery, because that’s what I want to do.  To learn hands-on, not be afraid to ask why.  It’s a joke you can teach a monkey to do the technical part, but knowing why you do it, when, why you don’t operate, that’s a big part of it. 

Have you had a patient pass away?

Yes.  In fact the first week on surgery, we did a procedure on a patient who was chronically ill… it was a situation where if you did the surgery there was a good chance the patient could die.  If you didn’t, there was still a good chance they could die.  The procedure went relatively well, but the patient coded in the ICU shortly after.  It was my first time to see a code — my first week on surgery, the first time to see my preceptor interact with a family.  He had to tell the family that the patient was not going to make it.  He did an incredible job.

You went into the waiting room with him to talk to the family?

Yes.  I was in surgery, through recovery, through the whole thing, then in ICU, and then talking to the family…it was a very good learning experience.

That’s some of the things you talk about in the Friday afternoon sessions?

Yes.  Plus what have you seen that you want to be?  Want have you seen that you do not want to be?  Good or bad.  It helps us learn.  ¤