Medical Career Map 1– Daniel Livingston, MD
July 19, 2017
Daniel Livingston (Country of origin: USA) graduated from Pécs in 2010. He is board certified in Internal Medicine/Hospital medicine (aka: Hospitalist)…with Community Health Network in Indianapolis, Indiana.
Where has life taken you since you’ve been away from Pécs?
I lived and worked in Ireland for 6 months following graduation from Pécs before securing a 3-year Internal Medicine residency back home in Indianapolis. From there I directly signed on to a full time position with one of the four larger hospital networks in the city where I have continued to grow professionally.
In retrospect, why Pécs? How did you hear/learn about us?
I should be good at answering this question since it’s invariably one of the first I encounter when telling my story. In my early undergraduate years, when medical school was still a distant consideration, my Hungarian aunt encouraged me to study abroad - in Hungary, of course. This sparked my imagination. As a sheltered kid from the Midwest I knew that flying away from the nest would broaden my future horizons. So, on July 5th, 2004 I made the phone call to the US recruiter located in Los Angeles. He stated the application deadline for that year was dangerously close, so without further ado I immediately flew to LA that very next weekend to sit for the entrance exam. A week later I heard that Pécs was still accepting applicants. In a fury, I scrambled to obtain a passport, student visa from the embassy in NY, and travel arrangements for late August. Bug-eyed and jet-lagged I arrived to Budapest on September 1st with my aunt and distant relatives from Pécs greeting me at the gate in a very unfamiliar language. At that very moment I knew I was not in Kansas anymore.
After graduation was your diploma accepted automatically or you did you have to take a differentiation exam?
Yes. With an EU diploma I was able to obtain a position in Ireland without taking an additional exam. In order to obtain a residency in the US, however, I sat for the USMLE in my final year of medical school.
How do you value your diploma?
With pride. The large Latin version is framed and hanging in my home office as a reminder of the enriching journey – both personally and professionally – that lead to this prized accomplishment.
Has the medical education in Pécs prepared you for work in your home country/ in a foreign country?
It is said that in medical school you learn the language of medicine, and in residency you learn how to speak that language. Short answer to this question: Yes. Pécs offers a rigorous curriculum that challenges even the best of students, and arms you knowledge to move forward a medical career. In my case, however, it would have behoved me to study for the USMLE alongside my studies in Pécs due to the nature of that exam.
What do you consider the strengths/weaknesses of the medical education in Pécs?
Strengths: theory. Prof. Szeberényi’s Molecular Cell Biology was rigorously theoretical and rightfully so, as this knowledge underpins every bit of medicine from understanding disease processes to recognizing targeted pharmaceuticals (e.g. monoclonal antibodies).
Weakness: practice on the floor (e.g. diagnosis and treatment management, treatment algorithms, rounding and work flows). A medical student should be in the trenches from year 1 to contextualize theory and see how it is applied in practice, with theory being the hook on which to hang practical knowledge. I’m sure there are logistical and traditional reasons for this lack of early clinical exposure, and this is not unique to Pécs. Lack of practice in medical school placed me on the back foot early on in residency, but after several months I caught up to my peers.
What was your biggest success so far?
Settling down and buying a flat. After years of traveling to and fro, navigating from school to training programs and sitting for exams, things have comfortably settled.
What does your average workday look like? What motivates you during work?
I am contracted to work 12-hour overnight shifts from 1900-0700 for 17 weeks of the year in a busy urban hospital in downtown Indianapolis (1 week on, 2 weeks off). The overnight hospital shift is responsible for admitting patients overnight (range of admissions is 3 to 20 patients) and field calls from nursing staff on the floor for any questions or concerns related to the 90 or so patients in-house. The ER will call with a request to admit a patient and I’ll see the patient to determine if they need to stay, then begin the clinical workup and initiate treatment. Or, if a patient is crashing upstairs then I’m called to assess. I admit and treat patients in the ICU, run codes, and perform various procedures (e.g. intubation, central lines, chest tubes) when necessary. In the past, these patients wouldn’t see a doctor until morning rounds. This way, new patient’s and distressed patients see a hospital physician right away, regardless of whether it’s 9pm or 4am. This is all in an effort to speed up the patient’s hospital stay and treatment regimen. What’s fun about my job is that each patient is a “clean slate”, a new puzzle to figure out.
Does the concept of “free time” ring a bell to you? How do you chill out?
Hmmm. What’s free time? Every day is met with a list of tasks for personal life (e.g. buy toilet paper) and work life (e.g. follow up on labs from a patient I admitted to the hospital yesterday). Burnout is a major problem amongst physicians and doesn’t seem to be abating. Regulating a balance between life and work is a skill in time and priority management which I learned to hone in medical school for survival and essentially continue to this day.
During your studies what were the specialities you considered? How do you remember those times?
As a typical medical student I consider every specialty known to allopathic medicine. For various reasons I remained true to Internal Medicine mainly because of the breadth of pathology it offers and the opportunity to learn from other subspecialists.
Did you have an idol/mentor among your professors/lecturers during your studies? How did that person influence your choice of path?
Professor Illés Zsolt of Neurology with whom I performed my thesis. He taught us from day one the subtleties of taking an anamnesis before even speaking: to quietly observe details of a patient’s presentation from their gait and facial expression to scuff marks on their shoes. His humble demeanour and sharp clinical acumen where marvellous.
Were you involved in any social activities during your studies?
Student council president of the international students. It all started on day 1 of instruction when nobody raised their hand to volunteer as group leader. I moved into organizing for the entire class of 2010, then in collaboration with the Hungarian student government furthered development of the English & German Student Council.
What’s your most pleasant memory from you Pécs studies? What do you miss from Pécs times?
It’s criminal to ask for just one pleasant memory J Organizing the first real big International Evening in 2009 (the last one at the POTE Aula before the event has been moved to the Expo Centre – the editor), which has swelled into an annual sensation.
Have you revisited Pécs since graduation?
Several times. In fact, I’m planning to return for Christmas this year.