In order to help pre-health undergraduates gain a bit more perspective on their career paths, we interviewed several health professionals for advice. They were asked, "If you had to do it all over again, what would you do differently?" Although it is difficult to characterize entire health fields by hearing from only a few professionals, it is still believed undergraduates will draw useful insights from these stories.

// Elizabeth Tarlov, MS, RN
When Elizabeth Tarlov entered college, she had no plans to pursue a health-associated profession. Yet one serendipitous day when she was partly done with college and traveling home for the holidays on an airplane, her future turned in a new direction.

"You know how they give out magazines?" she says with a slight smile. "They had a magazine called Working Woman," she continues. "I said, sure, I'll take a look. I opened it up, and there was this article describing the field of nurse midwifery, which was fairly new at the time. And I was fascinated."

"I was interested in women's health issues, but I never imagined myself as a health care provider. I was really fascinated by what these people did, so I arranged the next summer to go and work with a group of midwives to find out more of what it was about." This volunteer internship was to become a pivotal experience in Tarlov's professional life.

"Working with the midwives, I knew instantly, almost instantly, that this was something I was really into."

She subsequently graduated with her degree in American Studies, clearly not a typical pre-nursing major. After a few more changes of plans and a special nursing program for "career-changers," what had started with merely opening up a magazine led to her eventual career in nursing. "It was the intellectual challenge of the clinical practice, combined with the human level of the interaction you have with the clients, that really appealed to me. And really that has stayed with me."

Tarlov is a family nurse practitioner, and now she is also pursuing a PhD in public health. Although not currently practicing nursing because of her studies, Tarlov, like other advanced degree nurses in her specialty, has seen and treated all kinds of people for general healthcare needs during her career.

"We see our own caseload of patients," Tarlov explains. "We're trained to do things that are very similar to what a physician does, like taking medical histories, doing physical examinations, making diagnoses, and treating certain kinds of health problems." For almost twenty years Tarlov has done just that in a number of primary care settings.

Looking back, she describes only one thing she wishes she had done differently. Most nurse practitioners get their Bachelor's degree in nursing, go out to work, and then come back to school for their Master's degree. Since she graduated from a combined nursing/nurse practitioner program, however, she went straight to working as a nurse practitioner. "I never worked in a hospital, and there've been times when I wished I had."

"All of my knowledge is related to people who are walking and talking and coming into the office. I don't provide care for and don't know anything about providing care for critically ill people who are in the hospital. My specialty is with primary care, so that's fine, but I think I would be better off if I had had some background in acute care."

Besides this reflection, however, Tarlov would not change her other past decisions if given the opportunity.

"I wouldn't change my undergraduate degree," she says with certainty. "Knowing something about other areas, I think, really enhances you, not only as a person but also in your career." She suggests that pre-health majors take many courses in other areas. "I think that a well-rounded person is a better person in the exam room."

With that recommendation, Tarlov adds one more piece of advice for undergraduates figuring out their future. If they cannot rely solely on serendipitous occasions to puch them in the right professional direction, what can they do?

"Would I have arrived at this career if I hadn't opened that magazine?" she wonders. "Probably not quite when I did."

"I had always been interested in women's health, and fascinated by childbirth and that whole process, but it was just kind of an interest. Like if you should like baseball, or something. But you're not planning on being a major leaguer. So reading that article made me all of a sudden able to put an identifiable career together with an interest."

"Drawing from that, think about what kinds of things interest you-not in an academic sense, necessarily. Just what are you into?"

"When you see something in a magazine, what is it that grabs your interest? Of fifteen articles to read, what do you go for? You know there are a lot of other articles in that [magazine],.and I gravitated toward that one." Evidently internships and deeper experiences may follow. -PW

// Carol Einhorn, MS, RN
Carol Einhorn is currently the head gerontological nurse practicioner in the Geriatric Center of Veterans Affair Medical Center. After attending the Diploma Nursing School for three years she received a Bachelor's Degree in Nursing in 1980 and a Master's Degree in Geriatric Nursing in 1987. While working in the continence center at Northwestern Memorial Hospital in the Department of Urology, she discovered the growing field of Geriatrics and realized her aspirations were to serve the elderly population.

After providing her educational background, there was a definitive shift in the direction of the interview. It was apparent from the way she straightened up in her chair and spoke with more intent that she was clearly interested in explaining the values of the nursing profession. In response to the one pivotal question, "Is all the schooling worth it?" she did not answer with merely a simple "yes" but rather pointed out the fact that the years in nursing school more thoroughly develop lifelong patient interaction skills than most other health schools. Unlike the practice of other esteemed health professionals, she emphatically stressed that nurse professionals treat patients, their environments, and families as whole entities and go beyond merely diagnosing the disease.

While working as a clinical nurse specialist at Northwestern Memorial Hospital, she felt somewhat limited in what she was allowed to accomplish. Despite her diligent efforts, "[she] accomplished her goals and embraced the opportunities to change direction." For those already established in the nursing field, she stresses that one must recognize the limitations in a work environment, and that in order for both the workplace and oneself to develop, separation may be needed.

From a more practical point of view, she advised pre-nursing students to focus their efforts not only on academics but also on getting more clinical experience. To advance in the nursing field one must have a solid foundation in clinical experience such as hands-on volunteer work. -YL

// Corinna Dan, RN
Corinna Dan is a public health nurse with the Communicable Disease Division of the Chicago Department of Public Health. Unlike clinic and field nurses, she holds a more supervisory role, administering programs and educating other health professionals. She is developing a program to address the problem of Hepatitis C in the city.

Dan did not follow a straight road to get where she is now. Although she had always loved science up to college, especially biology, circumstances made her choose a different direction at the time.

"At the beginning of my sophomore year I decided that I wanted to study abroad for a year," she explains. "The school I went to had a great exchange program, so I wanted to take advantage of that." Her biology advisor, though, simply rejected her plans as impossible, saying she could never finish her required lab hours.

"So I changed my major to Asian Studies and I went to Japan for a year."

"See, on my father's side, I have a lot of Japanese relatives, so it was really important to me to learn Japanese and to go to Japan. So important that, although I always enjoyed science, I was going to change my major. At the time, I was thinking, 'Forget [biology] then, I'll just do what I want to do.'"

As a result Dan finished her degree in Asian Studies and afterward lived in Japan for a few years. As personally useful as the experience was, she found her career path in Japan not worthwhile, and so Dan eventually moved back to Chicago. After interacting with many nurses as part of a new job, she decided she was going to become one. In fact, she was going to enter nursing school as soon as possible; it was November of '95 and she wanted to enter the following fall. With just her Asian studies degree she had many prerequisites to finish, which meant she practically would have to earn another degree. So she did, taking all the required courses at Malcolm X and College of DuPage while working a part-time job.

Even though Dan liked the subject matter, she makes it clear that getting her prerequisites done in such a compressed time span was difficult. "I ended up going to an ophthalmologist because I couldn't see clearly at two o'clock in the morning when I was trying to read these anatomy books."

"And he's like, your problem is that's when you need to go to bed," she laughs.

She was accepted into Rush University where she obtained her nursing degree, so her work paid off. Since then she has worked at a community health clinic before moving to the Department of Public Health.

Given her roundabout path, what would she do differently if she could do it all over again?

"I firmly believe that we build upon our life experiences, so I don't believe that I could have gotten where I am if I hadn't gone where I went first," Dan declares. Then she pauses a bit, pondering more about that question.

"In hindsight I'd like to kick that biology advisor," she adds. She says it humorously, but definitely in a frank and honest kind of way. "I feel like my advisor fell down on the job." (This advising incident was not at UIC, fortunately.)

"He didn't say, maybe you'd like to think about a biology career that isn't as laboratory-based, like nursing. I feel like that was the main turning point of why I didn't go into nursing sooner."

Based on this, Dan has general advice for undergraduates who are wrestling with questions about a planned scientific career.

"Look at other alternatives within the field of science, within all of the science professions. There are lots of different things people can do that are really interesting-hospital-related, public health-related." She suggests that undergraduates visit career or guidance counselors for help. She would not let an advisor stop her from pursuing an entire range of careers.

"If they are getting frustrated with their idea of what science is-if you're getting frustrated about what you decided you want to do, go out and look because science is so much broader." -PW

// Mary Ann Cooper, MD
As a doctor of emergency medicine at the University of Illinois at Chicago Medical Center, Dr. Mary Anne Cooper has a passion for treating her patients. What she finds most rewarding about being an ER doctor is teaching patients how to deal with their ailments and live a better life. Since finishing her residency in 1978, she has had a satisfying career. She says all the schooling was worth it, and the way she speaks reveals deep enthusiasm for what she does. Cooper has much advice when it comes to pursuing a career one can be passionate about.

If she had the chance to do everything over again, Cooper names two things she would do differently.

First she would pursue an undergraduate degree in electrical engineering if she were able, since her current research interests are in lightning. Next, she would learn how to be more tactful in her comments, mentioning the saying: "God gave us two ears and one mouth for a reason-we are to listen more than we speak-good rule to follow."

Beyond this Cooper has many useful pieces of advice for pre-medicine and pre-health undergraduates.

"Don't let others tell you 'can't' do something-I can't tell you the number of times people tried to 'nay say' me-from buying a car on my own, to buying a house on my own to traveling by myself, to being a doctor, to starting my research program."

When thinking about what health specialty to work in, she suggests: "Figure out if you are a people person (pediatrics, internal medicine, psych, emergency medicine, psychiatry) or more of a loner (pathology, radiology), if you are a thinker (internal medicine areas) or doer (surgery, EM), etc."

"Focus on your passion, career, or research, and learn when to say 'No' to distracters and detractors, like too much committee work, etc."

"Don't waste your time on a boyfriend or girlfriend or spouse who does not support you and your passions and work emotionally. You don't need the conflict or energy drain."

"Have balance in life. Schedule sleep, fun, study, family, exercise, good food, and work so that you make sure you have some of each. When you get discouraged and can't seem to go on, remember it's sometimes because you need a good night's sleep more than anything else, or a night off!"

"Take time to love people, keep friends, smile, and understand others' points of view. In the long run when you're old, few people will remember your accomplishments and programs you founded-more will remember the comment you made in the middle of the night that changed their outlook on life and medical practice, your example, your love, your support, your ethics, your approach to patients and coworkers."

"Have patience with yourself and others. Some things like picking a career take time. Some things cannot be rushed. Do your research; gather your facts and data. Make good decisions." -PW

Yoomee is a second-year student. Pius is a second-year student majoring in Bioengineering with aspirations of entering the field of medicine.