It’s now been just over 3 years since I first started this blog. It’s amazing not only to see how much this blog has grown and evolved over the years, but also in reflecting, I’m fascinated by how much I have changed as well. I’ve written or thought things several years ago that I do not believe at all anymore. Most of these changes in thought are related to my views on medicine, health care and where I see my future in medicine. It’s funny to look back and see how much I have grown. Perhaps the funnier thing is that as I learn more and more, my views are only going to continue to shift. I wonder where they will settle?

The statistics for this blog suggest that it’s reaching quite a few people (we’re average about 400 unique visitors a day), but the cooler thing to me are the funny stories I hear. One of my friends from undergrad mentioned hearing someone talk about this blog at his McMaster MMI interview. Another undergrad friend of mine recently told me how she was at her UofT interview this year, asked one of the 2nd year med students if they knew me, and another applicant piped up saying “of course, everyone knows Josh!”. Apparently my friend had to explain that she actually knew me in real life. Haha. It’s crazy how access to the Internet has not only revolutionized access to information, but revolutionized the impact we can have on people miles away. If this blog has helped you in any way over the past 3 years, that’s awesome, and I’m really glad.

Now that the 3 year anniversary of MedHopeful has just passed, I thought it would be fun to look at how this blog as evolved. Before I get into these key moments and milestones in our short history, I want to thank you, the readers, for being a part of this experience and journey with us. I hope you continue to stick with us no matter if you are a “medhopeful” or not. It’s been a great ride, let’s keep the fantastic journey going!

The Beginning – July 2008

I started this blog just over 3 years ago because I just felt like I needed a place to write. I wrote random notes on Facebook when I figured I might as well have been blogging instead. I was planning to apply to medical school that fall, so I decided I might as well keep a bit of a journal for myself on my progress. I also had many ideas on undergrad admissions and scholarships that I believe worked for me, and I wanted to share them with other students. I really enjoy teaching, mentoring and sharing what I know. I didn’t really have a plan for this blog, I just said what the heck, let’s try this.

York University Strike – November 2008

When York University went on strike for a few months, I had a lot of free time. I had basically no real commitments – no student could because for all we knew, the strike could be over within a week. So what did I do? I honestly spent most of my time on NBA Fantasy and on this blog. You can tell from looking at the archives that the three months York was on strike were the three most productive months at MedHopeful in terms of blog posts. I was average about a post every other day during that period. And I’d like to think I was writing some pretty high quality advice posts too. I continued to give advice on scholarships, studying, and overall random personal development concepts that have helped shape me.

I’d like to think the York strike was a blessing in disguises. Some of my most popular blog posts ever were written during that period. It gave me the time to really create a foundation for this blog, and since then, it’s really bloomed.

Med School Interviews – February 2009

Over January and February 2009, I started receiving med school interview invites. My blog posts became less about providing advice and more about tracking my interview progress as the idea of medical school started to become more real. Over the next few months I reflected on my interview experiences. As the York strike ended, so did my free time, and I started to blog less.

Med School Acceptance – May 2009

On May 15, I received some news that completely changed my future – I got into med school at the University of Toronto. A lot happened that day, and it’s a fun read if you haven’t read it yet.

I had three months of summer before med school started, and while I didn’t blog that much, it was at this point that I started blogging my thoughts about the medical school admissions process.

The Start of Med School September 2009

I spent the first few months of med school busy adjusting to my new learning environment and not really blogging much. After reflecting on the first few weeks of med school, I just stopped doing that. The first semester of med school was tough – anatomy, histology, embryology – needless to say, it was probably the most challenging and least interesting semester so far.

Med school is busy and I started lacking the time (and perhaps even the inspiration) to write quality posts anymore. I don’t think people realize this, but it takes hours (at least for me) to write a quality advice post. I still tried to write when I could, but it was tough for those previously mentioned reasons.

MedHopeful becomes a Collaborative – April 2010

In April 2010, Shelly Luu, a med school classmate of mine, joined me in running MedHopeful. She brought of fresh life to the blog, not only in terms of writing and perspective, but also in increasing our web presence and helping us build traffic through accounts on Twitter, Premed101, etc.

The Start of 2nd Year of Med School – September 2010

To be honest, nothing particularly important happened throughout my second year of medical school in terms of the blog. I averaged a couple of random blog posts a month as usual.

I had probably more personal evolution than anything. I spent my first year trying to find my place in medicine, sometimes even unsure if I should even be here. I jumped around from neurology to cardiology and all over the place. The only thing I felt pretty sure about was that I didn’t want to do any form of surgery. It just doesn’t interest me.

By the time my second year of medical school started, I decided I wasn’t particularly interested in a very specific part of the body and saw myself becoming a generalist. I also came to terms with my passions for innovation, entrepreneurship and program development. I became attracted to satisfying these interests through engaging in system change and quality improvement in health care. I spent all of this past year thinking that family medicine would be the best route to satisfy all of this. I figured the family medicine lifestyle would give me the most flexibility to pursue a lot of these side interests on top of my clinical commitments as a physician.

Eye-Opening Summer Internship – June 2011

This summer I am completing a 10 week internship at UHN’s Centre for Innovation in Complex Care (CICC). I entered this internship with my eyes set on family medicine, and as I sit here typing this, my experience this summer has significantly shifted me towards pursuing internal medicine.

I had a 4 main goals entering this internship: 1) develop a better understanding of how the Ontario health care system works, 2) build my network, develop mentoring relationships, and support my career development, 3) develop new skills and improve upon old ones, and 4) do work that is meaningful, has value, and provides positive impact.

My experience here has completely shattered any expectations I had or goals I set for myself. My understanding of our provincial health care system and the challenges we face today has been completely changed – and in a good way. I have become to understand the complexity of our health care system and why progress and improvement is so difficult. While the complexity can makes things frustration, I find something fascinating and motivating about trying to create positive change and improvement in such a complex system. The importance of leadership, team work, and understanding overall human behaviour in improving systems has never been more clear.

One of the fascinating aspects of my project is that much of the knowledge I have acquired has come from interviewing individuals from all sectors of the health care system for my project. From front line health care providers to high level management, from community care to hospital care, I have gained unique perspectives from across the continuum of care. And getting this insight through discussion is a lot more fun (and in many ways more productive and insightful) than from simply reading. The desire I have seen to improve quality of care for patients by stakeholders across this entire continuum is truly inspiring and makes me hopeful for what will be achieved. These experiences have significantly expanded my network in medicine and health care, and have created a foundation for me to pursue a career in an area that I’m very interested in and excited about. I am very grateful for the relationships I have developed through this experience.

In terms of skill development, I’ve had the opportunity for workshops on stakeholder mapping and brainstorming. Thanks to the diversity of the team I work with, I have learned many skills outside my normal career path. I’ve learned simple but important concepts around the way we simply email others to open channels of communication. I have had the opportunity to improve on my presentation and speaking skills. Several weeks ago, I had the opportunity to present at monthly rounds on some of my own past research and my thoughts on the issue of physician home visits to a group that included one of the physician leaders I most admire.

Most of all, I am very glad that I am doing work that I find both internally and externally meaningful. Without divulging into details yet, I really believe that the work we are doing is providing real value and is going to lay the foundation for some key future projects. For me, this is just the beginning of my foray into the area of health care innovation, system change and quality improvement. I plan on staying involved both with this project and the overall field in the long run. I am excited to see what will come out of all of this and where things will head.

Clerkship and Beyond – August 2011

On August 22, I officially start my third year of medical school. After three weeks of class, I will begin working clinically full time as a clerk, starting with a pediatrics rotation. To be honest, I am loving summer and the work I am doing right now, so much so, that I’m not even thinking about clerkship. I’m going to let that wave hit me as it comes.

What’s going to happen over the next few years? What residency will I end up doing? Where will I be living a few years from now? I have an idea of what I would like to happen, but absolutely zero certainty over what will happen. All I can say is, I am excited to see what my next reflection post looks like 3 years from now.