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The making of a young doctor

Family physician struggled before everything came together

By Peggy Peck
MedPage Today Senior Editor

Editor's note: CNN.com has a business partnership with MedPageToday.com, which provides custom health content.

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Dr. Jason Komitau started thinking about becoming a doctor when he got a Fisher-Price medical kit.

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TOLEDO, Ohio (MedPage Today) -- The medical year begins on July 1, the day that medical school graduates finish their training as resident physicians and stream out into the real world of shingles and stethoscopes.

Every year some 10,000 men and women emerge from their residencies as newly minted physicians. This year, Dr. Jason Komitau is one of those new doctors.

Komitau, 31, said his professional journey started when he was 4 or 5 and got his first Fisher-Price medical kit.

"That's when I started thinking about being a doctor."

But the road from the toy stethoscope to full-fledged family physician was not easy. Indeed, it was tortuous, filled with rejection after rejection and seemingly shattered dreams. Some students sail through with apparent ease. Some like Komitau founder. Yet dogged perseverance paid off.

As a schoolboy, Komitau overcame two potential social problems. He was a year younger than his classmates and was small for his chronological age. He made up for these perceived deficits by "pretty much working harder than everyone else," a tactic that paid off with top academic honors that he began to rack up in elementary school and continued to accumulate through high school.

Along the way he always chose accelerated tracks that offered advanced courses in biology, chemistry and physics, which he thought would prepare him for the eventual rigors of medical school.

Lure of the grease paint

But Lakewood High School, one of the largest in Ohio, is also known for its drama program and Komitau said he was hooked on theater, especially musical comedy. He won the role of Cornelius in "Hello, Dolly" but his favorite role was Nathan Detroit in "Guys and Dolls."

"It was just a great, great role," Komitau said. So, great, in fact that it made him consider the possibility that he might be more interested in playing a doctor, than actually being a doctor.

"I'd be lying if I said that I've never thought about what it would have been like to move to New York to audition for shows," he said.

Interestingly, Komitau was born in New York City but moved with parents, Shaye and David Komitau, and baby brother, Scott, to Lakewood, Ohio, in 1983.

One sign of his newly divided loyalties was his decision to major in biology and minor in drama at Washington University in St. Louis, Missouri. During his first two years he mixed chorale performances, drama classes and biology labs with time spent volunteering with an emergency response team at the university.

Plan B

By his junior year at college, he was once again firmly committed to medicine, just in time for him to encounter a major obstacle to his medical career: the Medical College Admission Test, or MCAT, which is the standardized test required for admission to medical schools.

That's when the serious trouble began.

"I guess you could say that I've never been very strong in standardized tests," Komitau explained.

Indeed, when he first took the MCAT in his junior year the results were disappointing. His score, he knew, would not get him into medical school, which was especially frustrating since he believed his college grades -- a B-plus average -- demonstrated that he could hold his own in a highly competitive academic setting.

By senior year, when a second round of MCATs still left him with a low score, Komitau started to formulate "a Plan B." Advisers at Washington University suggested that he enroll in a master's program to "take more courses and get more good grades."

That seemed like a good suggestion, but despite a generous scholarship, four years at Washington University had depleted his funds and left him with a significant debt.

"I decided to move back home, so that I could enroll in the master's program at Cleveland State University, which was much less expensive and where I was also able to qualify for a stipend."

There was another attraction at Cleveland State: the graduate school there relied on advisers and mentors from the local business community, which included researchers from the Cleveland Clinic.

"Three Cleveland Clinic researchers met with the masters' students and I called all three of them," he recalled. One of those researchers, Dr. Christine Moravec, returned his call.

Moravec was conducting heart failure research at the Cleveland Clinic and she invited Komitau to participate.

It was a fortuitous relationship for Komitau. His paper describing his research into a protein called tumor necrosis factor and its role in the development of heart failure was accepted for presentation at the American College of Cardiology annual scientific meeting, a feat that he was confident would supply the needed edge to get him into medical school.

But another round of MCATs and more applications still produced no positive results. He had a master's, but still no M.D. and the prospects for getting one seemed slim.

A foot in the door

At that moment, Moravec suggested that he apply to Medical College of Ohio in Toledo, where she knew an assistant dean. Komitau took her advice and happily moved a step closer to his dream. "I wasn't accepted, but every year the school tells 10 applicants that they can come to the school and take some of the physiology and microbiology courses offered in the first year of medical school," Komitau said.

The idea behind the special status program, he said, is "to find out if applicants can really make the grade in medical school." At the end of the year, "all the special status students again apply to the school -- same as other applicants -- with the only difference being that I was now physically in Toledo."

One of the 10 special status students was accepted.

"It wasn't me," he said.

"I was wait-listed. I waited through the rest of May, June and July, and then in August I got accepted."

Once he was in the door, "everything changed," he said. "It all came together. I'm not saying it has been easy, because it has been very hard work, but it is just the way I always imagined it would be."

And, there was a bonus. "I organized an a cappella choral group with medical students, residents and instructors," he said.

Cradle to grave medicine

Medical students spend most of their first two years studying basic science, but at Medical College of Ohio they are also assigned to spend a day a month shadowing a physician. Komitau was assigned to Dr. Coral Matus, a family physician at the W.W. Knight Family Practice Center. "That's when I knew I wanted to be a family physician. It just felt right, I fit right in."

He said he plans to concentrate on preventive medicine, making the point that people need to maintain their bodies at least as well as they maintain their cars. "If a regular oil change is good for the car, a regular checkup is good for the body," he said.

Family physicians must complete three years of residency training after medical school. They must then pass a certification examination, and agree to re-certify every six years to prove their competency in "cradle to grave" primary care medicine.

When he graduated from medical school he asked for and was assigned to the residency program at W.W. Knight, and he finished the program as co-chief resident.

His final months in Toledo have been a whirlwind of activity: In April he lined up a job as a family physician in Erie, Pennsylvania, where he will join two other family physicians in a primary care network associated with Hamot Medical Center.

A month later he married Jamie Kontra and squeezed in a week's honeymoon before heading back to finish up his residency program in Toledo. His days off were spent picking out a new car and a new home. "It will be great, Jamie is still living with her family back in Cleveland and I'm here in Toledo. We close on our house on Thursday and we'll finally live together."

But as he works his final days in Toledo, Komitau said he is filled with bittersweet memories. "I keep thinking about how long I struggled to get here," he said.

Now, he is realizing the rewards of that struggle. "The other day one of the patients that I've been taking care of for the last three years was in for a checkup," he said. "This is a high-functioning, retarded adult. When I entered the room he looked very down, so I asked if anything was wrong. He shook his head, but his caretaker said 'He's just feeling a little down. I told him you are leaving.'

"I said he should cheer up because there will be other doctors to take care of him, but then he told me, 'You're the best doctor I ever had.' "

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