When One Degree Is Not Enough - With a Twist

There are three ways a New York Medical College student can cram in more knowledge in less time: undertaking M.D./Ph.D. and M.D./M.P.H. degree programs or enduring the Six Year, Combined Primary Care-M.D./Internal Medicine Residency Program. Representatives of each concentration readily reveal how and why they took on these challenges.

For Robert Bernstein, it’s all about solving puzzles-how can we put this back together again? he wonders. With plastic surgery, of course. So after spending an entire decade in school, Bernstein will take the M.D./Ph.D. 2000 degrees and begin a general surgical residency at Stony Brook in Long Island. His nine-year grind worked this way: two years of classes in medical school, five years of research in physiology (“cardiovascular research just made sense”) and two years of rotations to finish medical school.

Robert Bernstein

Why so long? “Research projects take the time required. You set your own timetable,” he explains. “In the graduate school you don’t move on until you’ve reached a certain stage in research.” The plastics decision followed two events: “After I sewed up someone I was complimented for it. It was also the burn unit [at Westchester Medical Center]. It was the most disturbing thing I’ve ever seen and I loved it. Burns are incredibly painful-physically and psychologically-and disfiguring. Actually, it all ties in with physiology-the patient’s fluid balance and temperature regulation since the body has lost its skin, and afterwards, scar reconstruction. There is a lot of research potential working with burns,” he says. Has the long haul been worth it? “I would do it again exactly the way I did it. That’s the best you can say about an experience,” says the 30-year-old father of a baby girl.

The only doctor in Nikolaus Kashey’s family was Alois Alzheimer, his great grandfather’s uncle for whom the disease is named. Born in Vienna and raised in New York City, Kashey was slated to get his M.D./M.P.H. degree this year, but decided to take a year off and work with under-resourced communities that don't readily receive health care. 

Nikolaus Kashey

He spent half the year working for inner city shelters and a TB study in New York City, the other half on public health projects in Latin American countries. This interruption in his education evinces his “idealistic approach to medicine,” he says. “It’s the way I was raised. I really would like to spend a couple of months each year practicing abroad.”

Kashey will apply for a combined medicine/pediatrics residency in 2001, but it is clear that his heart is in international health. “I’m really glad I did the M.P.H.,” he says. “Striking out on a different path gives you some control of your destiny, a sense of individuality which you tend to lose in medical school-at least in your career path. The M.P.H. [in general public health] also provides something that is sorely lacking in medical school. Physicians need to know how the whole managed care system works, how the economy and payment structure work, which are becoming more and more important. Medical school teaches you how to care for a patient in the office. Public health teaches you to care for an entire community,” says the 27-year-old Kashey, who is currently working in the pediatric unit of a public hospital in Honduras.

Gennie Yee and two others who complete the rigorous six-year combined primary care internal medicine residency program at Saint Vincents this year have accrued more than savings of time and money. “Actually, I think it makes things easier because you don’t have to spend time catching up on what you forgot. Besides, I just love the Saint Vincents program. You learn good clinical skills and there is a bunch of happy residents here,” Yee says.

Gennie Yee

Begun in 1992 in conjunction with the university’s primary care initiative, the six-year program combines the fourth year of school with the first year of residency. All 18 students who preceded Yee successfully completed the program, designed and administered by the Center for Primary Care Education and Research on the Valhalla campus, with a satellite office at Saint Vincents.

“You have to know early on in the third year if you want to do it,” says Yee, whose B.A. degree in genetics and political science from the University of California at Berkley stemmed from a desire to be well rounded in her studies. “I thought about going to medical school in college, but I became positive I wanted to do it after I went to Mexico between my third and fourth years. I worked in a clinic, the Mexico Medical Caravan-it wasn’t a van-spending most of my time with a young ob/gyn. Her interaction with the patients is what convinced me,” Yee says. “I see the same thing at Saint Vincents, when patients tell me they keep coming back because of the good care.”