EAST LANSING -- Fifth grade is a time for pizza parties and whoopee cushions, but for fifth-grader Ethan Ruhland, it was a time to write a letter to himself and map out the rest of his life.

His mother, Gemma Ruhland, still has that letter and read it just last week. Some of the goals are different -- Ruhland had his sights on Harvard Medical School at the time -- but many are the same.

"He said he wanted to be a doctor so he can help people," said his mother, a nurse for a group of oral surgeons in Bingham Farms. "That hasn't changed. He's always been a kind-soul kid."

Football was a passion then and remains so for Ruhland, a Michigan State fifth-year senior center. Football would have won over medicine when Ruhland was an MSU freshman and thought he had to pick between the two.

Now medical school is just months away. But first, Ruhland will start the most important stretch of his football career Saturday at Indiana.

Years of balancing extreme demands has reached a culmination of sorts for the 6-foot-5, 290-pound Lake Orion High product. Before embarking in earnest on a career he first mentioned in second grade, Ruhland has a shot to experience some of what he envisioned for his playing career.

He is expected to start at center in place of Travis Jackson, who was lost for the season with a broken leg in last week's loss to Ohio State. As the season goes on, Ruhland will be in a three-man competition for two spots -- center and left guard -- with Jack Allen and Blake Treadwell.

"We're all kind of the big cheese coming out of high school," said Ruhland, who was ranked the No. 29 offensive guard in the nation for the class of 2008 by Rivals.com. "So you want to play. But I definitely, for the majority of my time here ... there's always frustrations, whether it's with yourself, the way you're playing.

"But it's all for the betterment of the team. Whatever I can do. And this is an opportunity. It comes at the expense of one of my best friends getting hurt, but I need to step up."

Ruhland has started one other game, last season against Minnesota with Jackson ailing. He has been in the playing rotation since he was a redshirt freshman in 2009 but has not had the kind of steady role that may now await him.

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Ruhland is MSU's new starting center, before heading off to medical school