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Premed Q and A

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Often, my motivation to write and my time to do it aren’t in concert. So, sorry I’ve been slacking off on blogging. I’ve traded writing time for doing better in my coursework time. Though, I assume are here for premed stuff — some might even notice it’s just a random dude’s blog. Over the years, because I’m no longer abreast in premed issues and news, I’ve sort of drifted away from premed posts. Neither the less, when I was glancing through my blog stats “search results” (see below) I decided to take a crack at a few premed issues. Out of the interest of time, I decided to chose three:

  • premed memory survival strategies for nontraditional
  • feeling sad after MCAT
  • did horrible on mcat first time

Search Query:

Premed memory survival strategies for nontraditional (premeds)

I’m going to interpret this query as, “Knowing what you know now as a medical student, and thinking back as a premed, what are some strategies for survival?”

Find a mentor – easier said than done, this is super hard, but the pay off is worth it. I sort of flailed about in college, switching majors several times, my interests in subjects would ebb and flow. I would flip-flop between a dedicated student, to taking time off to work and attend school part time. At no point did I think “premed”, that is until I met my mentor. Thinking back at the time, there were several people reaching out to attempt to mentor me, I failed to recognize their efforts of the people who tried. My biggest advice, in this area, is to put yourself out there. Now, being on the reverse side, I’ve tried to reach out to mentor. Sometimes, mentoring has been rather rewarding — it’s been great to give people that little nudge in the right direction into matriculation. A few who I met online this way I’d now even consider friends. However, I imagine like most mentoring relationships, it’s usually not this way. Case in point, my first year of critiquing personal statements for medical school about 1/3 (20 out of the original group of 60) were lost to follow-up. In other words, they just gave up on revising their drafts and fell off the face of the planet. To be fair, I do make very direct critiques, I don’t think it’s useful to waste people’s time being obtuse in a time crunch (aka medical school applications). Negative experiences with mentees may lead to a natural down regulation of a mentors’ willingness to expose themselves to risk. Having use to work at a university, I’ve seen many professors get burned after investing time (and possibly their credibility) into mentees that went AWOL. So, with that being said here’s my advice that I wish I had as a premed:

  • Don’t be surprised if someone you want as a mentor is a little reluctant to make a connection with you. First, it may require a brief period of proving yourself, i.e. don’t be astonished if you’re placed on “mentee parole” for weeks if not months. Some people would say to avoid a mentor who takes so long to warm up, there may be some merit to that. However, those slow to engage introverted types are often the commitment types — slower courting periods means time to get to know you prior to committing. I’ve had rather inspirational fast talking mentors totally flop on their commitments — maybe, you can even argue they’re so over-committed that they have no time for one additional commitment.
  • Find a counselor who believes in you, but won’t blow smoke up your butt. I’ve had several interactions with assigned college counselors, the first convinced me that I ought to aim a little lower, another without seeing my transcripts projected how I must be doing badly in my courses (I actually had a good GPA). I assume there’s some great college counselors out there, if you know them then stay with them. If you live in a counselor desert, widen your search. Also, there are some counseling services for premeds. As a premed, I’ve never paid for any services, so I can’t make any fair judgment calls. But, I suggest ProMEDeus, only because they were really helpful when I needed some help on how to negotiate for a better financial aid package — a disclosure: I’m biased as I’ve since become friends with one of the CEOs. They’re really good if you’re feeling in the dumps, and just need someone in your corner. Also, though I never paid for her services, the owner of MDAdmit did shoot me some good advice during my application cold feet times. She did write a damn good guide to medical school admittance, arguable if you can’t find a counselor at all then this book (the book link is best found in the link above) will do the job — in my case it did a better job than any counselor.
  • Understand that those who are good at getting you through college, or through a project, aren’t necessarily experienced enough to help you make the right “final-quarter” decisions to get admitted into medschool. Yes, everyone wants what is best for you, though it may not seem like it at the time. However, that doesn’t meant that good intentions are met by tangible rewards. At the end of the day, the person who’s most positively or negatively effected by your admittance (or lack thereof) is you. So, remember, at the end of the day it’s you that needs to do whatever needs to get done.

Search query: 

  • feeling sad after MCAT
  • did horrible on MCAT first time

For this search query, I’m not sure if the person was talking about their practice exam or their final score. For the final exam I was fortunate, I took the test once and never again. However, during my first (timed) practice exam, I remember having the urge to vomit from the stress. Afterwards, during the grading, I recall having a panic attack when I saw how abysmal I had performed. I still remember thinking to myself, “I should give this up…there’s no way I can even get close to 30 [then, getting a 30 was equivalent to getting an average national matriculation score in the new MCAT]. My advice to you, if you haven’t taken the real MCAT yet, is to make sure your worst scores come from your practice.

That being said, I know people in different medical school programs (mine included) where people proclaimed to have bombed the MCAT only to go onto do very well on a re-take. On the other hand, I know people who’ve re-taken the exam numerous times and have yet to break that magical statical threshold. And lastly, I know a minority who have bombed the MCAT, never got that “threshold score” but still found matriculation. Thus, it’s hard to interpret one facet of the application going south, i.e. the MCAT not going so well and perhaps the rest of the application being absolute gold. With that being said, getting a bad MCAT score does close a few doors. The rest of the doors are left slightly ajar, i.e. you can go into them but it just doesn’t seem all that inviting. But really, if you had a bad MCAT you have a few options:

  1. You decide, score be damned, you’re applying anyways. Cue the 80’s music montage of you training and studying for the MCAT to overcome your circumstances — in the 80’s any challenge was surmountable by a montage. The bad part about the re-take is that you’re re-taking it, and really no one enjoys the MCAT except the people getting paid to administer it. The good part is that, if you do it right, you’ll only be studying for your weak points. I won’t be an “optimism troll” and say that’ll make everything feel better. But, at least you’re learning how to trouble-shoot your short comings on the hardest admissions exam in the solar system [fact!]. And honestly, if you’re admitted into medical school just about none of what you struggled with on the exam will matter. Correction, none of the content you struggled with will matter. However, what will matter is the lessons you took away from the exam, a lot of them are lessons on “how you learn best” combined with learning what academic “hunger” means. Sometimes, what you messed up on was obvious, often it’s not. But, the worst mistake you can make is underestimating what went wrong and overestimating how little you need to do to address your issues.
  2. If you decided to re-take it, be sure to know why things didn’t go well the first time(s). The worst mistake you can make it not having a humble wake up call, and you decide to reschedule the test ASAP without any real thought about strategy. Statistically, most people get around the exact same score. But, the MCAT isn’t an intelligence barometer, it’s just a test of how well you can take a test. Before, I could give specific ranges and tips, now I can’t because the scores have changed. But, in general, score improvements come from three ends of the spectrum (triangle spectrum-thingy): a) content b) test strategy c) timing. If you’re scoring well below the national average (of all test takers, not necessarily of those who matriculate) then you need to likely work on all three categories, but you’ll have to make some choices in where you can gain the most points — you might need an official course. If you’re scoring at the national average or slightly above, but not quite at matriculation score, then it’s probably not a content review problem from what I hear — a class would probably help you for testing strategy, self studying would also be reasonable. If you’re scoring at the matriculation score during the practice exams, but always fall short during the real deal, it’s definitely not a content problem and more of a test strategy/timing one — don’t waste time reviewing content all over again, instead handle what’s messing with you on test day. In general, at some point you probably know a lot more content then you think you do, it’s just a matter of learning how to apply it in the MCAT format.
  3. You decide to re-take after some time off. Time off can either make you stronger or weaker, all depending on how you decide to rationalize. Some would see time off as a pure negative experiences, an experience where they only get further from their goal. Others, find a more optimistic interpretation, “If you still want to go to medical school then you really mean it”. I fall into the latter category. It’s very easy to fall into a groove, i.e. be gun-ho about being a premed when everything seems in sync. It’s a lot harder, I think, when you fall out of sync and you realize at the end of the day it doesn’t matter if you go or not to anyone else but you. Yes, you parents and close ones may nag you, or you may project their inquisitiveness has nagging — when it comes to goals, when not taken to the extreme, it’s typically better to have tiger parents than cuddly ones. But, one day your friends and family who prodded you will be gone, you’ll be alone with your decision. There’s a lot of ups-and-downs to medical education (and education continues well into practice), it’s a lot easier to deal with my bouts of medschool dumps knowing that I own my decision. So, if you need time off, don’t take it as a failure. Go get some industrial experience, find love, travel, take a larger role in your community, focus on being happy and adding good memories into your reminiscence savings account. If you decide to revisit the idea of medschool then you’ll be very happy you had time to address all of this, once you’re in medschool your time belongs to medical education.
  4. You decided to not re-take it. Maybe you have an inside application slot, maybe you prefer to wrestle crocodiles with nothing more than a little elbow-grease. Whatever your reasons, it’s yours to make. Despite my moniker, doctor or bust, I don’t think anyone should actually have a do or die mentality about medical school. Going to medical school, trying to get in, and even finishing all depend on how happy you are with your decisions. And although I think you shouldn’t let this one exam hold you back, deciding to do something else is always a good idea if it means you’re happier in the end. If you’re waiting, and hoping, that medical school will turn life around you’re probably in for a big surprise. Trust me, medical school isn’t a place people go to have their self esteem or outlook on life repaired — if anything, medical school and medical education is exceptional at bringing all of your self-doubts and personal misgivings to light.

The big take-away is that you shouldn’t let me, or your score, talk you out of medical school. But, be realistic and pragmatic about your own situation. A few years ago, when I was actively editing people’s personal statements, I stumbled onto a lot of premeds who’d easily get in if they just had some time off to address extra-premed problems: bills (some premeds have a large role in supporting the household, so missing a salary means immediate sufferings of those around us), family illnesses (some suddenly become primary care givers to their siblings), financial (it’s a rigged system). Yes, some people overcome all of these, go onto right self-help books, and perhaps appear in Oprah. But, it’s stupid to assume that a “meat-grinder” is broken because a few pieces make it through the blades unscathed. So, sometimes taking a break to re-evaluate or to reset your foundations is the best you can do.

Best Wishes to Applicants

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Through the medical education onslaught it’s easy for me to lose appreciation for how it felt to apply to medical school. It’s funny how quickly you lose touch with time and reality. But, right now there’s a new batch of premedical applicants applying. And if you’re one of them this cycle, then my hat’s off to you! Regardless if you received an interview, I congratulate you on just clicking the submit button — there’s a world of a difference between intending to apply to medical school and being committed as an applicant. There’s a whole lot of reasons, but most people never get the opportunity to apply. So, if you are good luck and focus on being well!

I think interviewees start arriving, at our program, in a few weeks. This Monday there’s a free dinner an opportunity to learn how we can help in the admissions process. Last year, I participated in the admissions days, it was fun and I think I’ll do it again. It’ll be fun to see bright, hopeful, and lively faces around the medical campus again. The first time I saw interviewees as a medical student, awkwardly enough, was while I was holding someone’s severed leg — you build lots of hallmark moments in the first year. I was lucky to meet a few more during a less odd social setting. Last year, I even met someone who reads my blog, that was a pretty cool situation. [if you’re reading this thanks for reading, and hope you got in somewhere!]

My Medschool Updates

So, as a second year medical student, we just finished our first block of classes (Pharmacology, Pathology, Infectious Disease and a deluge of Drugs). We had the final exam this morning, it went well, so I’m happy. I used Sketchy Medical School, i.e. Sketchy Micro, for most of the microbe stuff. It was great. Also, I found a pretty decent study schedule/groove. My schedule isn’t so bad this year. I wake up at about 9-9:30 AM, I watch almost all lectures from home at 2x speed. You see, going to school by public transportation rips 1-1.5 hours out of my day. In the time it takes for me to transport myself, I could have already finished watching the day’s lectures. With my current agenda: I then leave my house to study, for about 5 hours a day I study alone or with a friend. I return home, get my fair share of cat videos watched, eat and preview for the next day of studying. I really enjoyed this schedule, because I had a lot of free time and time to get work done, hopefully it’ll work just as well for this coming Pulmonary Disease/Drugs block.

Besides the normal courses, our clinical training starts back up next week. Honestly, I have no idea what this entails in detail. I assume, it’s sort of like a role-playing-game, every time we level up in ability we’re given new challenges we couldn’t have handled before. Most of my time will be spent at a community clinic. Concurrently, I contacted a physician I worked with this summer in cardiology, my plan is to spend some time in both ambulatory and inpatient service cardiology — I really enjoyed the previous experience. Aside from that, not sure if I’ll be accepted, but I just applied to two community service programs with other friends/classmates. I’m really crossing my fingers, I knew about one particular outreach program before I even applied to this school, in fact it was the very reason I found out about this medical school in the first place. If things work out, I’ll update you.

Today, I just gave a mock medical school interview via Skype. It was fun. They sent me their AMCAS application, personal statement, and some secondary applications. My job is to read all of it, and make a mock interview out. Turns out, it’s epically faster to read someone’s applicant rather than to write it, it didn’t take very long to go through their application. I have a much better working memory than when I started school, so that helps. And, now that I know a few people who are on the admissions committee I have an even better understanding of what they’re trying to accomplish during the interview. Personally, I really like interviewing and I find it to be the easiest part, it’s a lot less hum-drum than cranking out application essays — in the past it was rare that I wouldn’t get a job if I scored an interview, and I was accepted at all programs where I interviewed. I consider myself an introvert, that’s a big reason why with my free time I’d rather be drinking coffee [alone] and writing, but I can turn on the interpersonal skills when needed. If you’d like some tips on how to tackle your shyness for the interview feel free to email me.

If you’d like to read more medical school interviews, at least my experience of it, then you can read more right below:

Tips on Interview Day

What my medical school interviews were like

Blog Updates

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Hit 100 countries, thanks for all the support!

Good luck and enjoy your day!

Thanks for reading

Updates in Life

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Across the street from my new place
Across the street from my house


I hope everyone reading is doing well. Right about now, premeds are applying to medical school. Good luck! In the end, whether this cycle yields an acceptance or not, remember to take a wellness break. New medical students are starting up, hopefully you had that wellness break. The more people you’re friends with the easier first year will be — don’t forget about that wellness and time for yourself.

Medical School Stuff

For me, my second year of medical school just started a couple of weeks ago. If you’re interested in the schedule, you can read it here. After about two weeks into the semester we had our first exam, it covered 43 lectures including group discussion material. During this time you practically breath Power Point slides as you have to go through a couple thousand in a few weeks. Though, it’s not as bad as it sounds as the material is more clinically relevant, it’s more interesting than the first year. It’s a lot of material, but if you make a daily effort to keep up it’s rather manageable because we no longer have to juggle disparate courses like in the first year. This is also the year that we have to take our first board exam, but I won’t have much to say on that subject for a couple of months. By the way, my first exam on pharmacology, pathology and some infectious disease went fine.


Found A Place to Live

So, several weeks ago, the house I live in was sold. As you may have imagined, this created quite a predicament for your author because housing in Boston is ridiculous. We are somewhere near 3rd in the country for cost of housing — if you’re living in SF and reading this, you have my condolences. Here, it’s not just the prices, the finding roommate process can be a little daunting and even sometimes ridiculous. One advertisement demanded a Linkedin profile be sent, another explicitly said “wealthy applicants only”, and yet many others asked for short essays of “why do I want to live with you”. Other potential places were a little too eclectic: some demanded you participate in a commune (no sarcasm), posts that had 2-3 paragraphs about their cat were ignored. In the end, I found a place just a block or so from my current one. Somehow, the price ended up being slightly cheaper than what I’m paying now, and my new roommates will be a post doc and a graphic designer. I had a big goal of staying in my area, because it’s right outside of greater Boston — it’s a little oasis away from the hectic blazing sirens near our hospital (and student housing).

Finally, I just have to say thanks for reading and keeping me in your best wishes!

Second Year Starts in Less Than 48 Hours!

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Well, the summer is almost over, and it’s just about been a year since I moved to Boston from Southern California. Boston is still going through a latent US speculative property inflation trend — fancy talk for “the rent is too damn high”.

1st year in a nutshell
1st year in a nutshell

Anyways, second year starts this Wednesday. My summer is coming to a close. I spent most of my summer at an ambulatory cardiovascular clinic, with occasional visits to various inpatient cardiology rounds, and topped off with a random visit to a level 4 bio-safety lab (the places where they make zombie viruses in movies). It was an awesome opportunity given to me by the American Heart Association and NIH for a proposal I was working on with my PI last winter, and I’m very appreciative of this formative paid experience to work with patients (extensively), nurses, EPIC (our EHR), and physicians every day. From patients I’ve received lots of enthusiastic handshakes, a few hugs, and even a drawing. Best of all, I gained a physician mentor and made really close friends.

In the first year, it’s easy to drown under the tsunami of one-off facts you’ll need to have in your back pocket at any given time. Though, I suppose, they’ll always be a new tsunami to worry about. Speaking of that tsunami, the first years students will be starting soon. I’m not an authority on how to best first year, in fact, I struggled like many others did just to get through it. I expected medical school to be hard, and honestly it’s a little gratifying to see that it’s just as hard as quoted. I’ve enjoyed my humble pie. There were classes I did great in, some not so well, and I learned a lot in the process. Hopefully, I’ll be able to use those lessons wisely in the second year and onward.

Our schedule is going to be very different than the first year. Incidentally, we’re the last to have that 1st year schedule at our school as they’re changing the curriculum. The first year was a traditional system, you have a lot of disparate courses at once: have biochemistry, anatomy, neuroscience/anatomy, public health, and the list goes on and on. A lot of schools are moving towards “integration”, i.e. the very opposite of the traditional system where students were tasked with forming their own euphonies on the connections between disparate courses. Hopefully you did, some surely didn’t. Here, second years have more of a systems based approach, i.e. we’ll have a pulmonary block, cardiovascular block, hematology block. The big difference, so I’ve been told, is that we’ll now focus more on the disease and treatment than the science (first year work). For all intents and purposes, one could argue we’re learning more practical things — probably with an immeasurable amount of things I’ll need to unlearn/relearn properly later in our careers.

In case you’re curious about the schedule for our second year medical school here’s a non all inclusive list of modules, our school year ends April 1st of next year giving us time to focus on our board exam (Step 1):

– Pharmacology and Infectious Diseases (affectionately called “Bugs and Drugs”)

– Pulmonary

– Cardiovascular

– Neurology

– Psychiatry

– Endocrinology

– Dermatology

– Hematology

– Rheumatology

– Renal (The Kidneys Strike Back!)

– Gastrointestinal

– Reproduction

– Oncology

Good luck incoming students, and current applicants! I’m going to get back to work, i.e. eat, go through some patients’ charts, and drink lots of coffee.

Best wishes!

This Summer Has Been About the Heart

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Sorry, I’ve been busy lately. I’m sure a lot of people have, premeds are applying for medical school right now. Newly minted MD’s just started their internship year last week. Right now, medical students are doing a variety of things with their ‘last’ summer. For myself, and many others, it’s clinical research. During the school year, I was sort of in an emotional rut. Medical school is really rewarding, but it’s also very taxing on your interpersonal relationships (with people not in medical school). For, example when my cousin died of terminal cancer I couldn’t find the time between exam blocks, less lose momentum, to fly back to California and then back to Boston while juggling exams. Instead, all I could do is use the “training” I was given on consoling families and patients over the phone — it was surprisingly effect. After a while, I just felt buried under classwork and charts to memorize, reviewing membrane potentials, memorizing what phosphorylates what, how many blocks your kid should stack by age 3, and learning just why everyone despises (and rightly so) the trigeminal nerve. My best time during the first year was spent with patients, it was the time that I felt pretty happy. So, I decided a while back that instead of lying around in my depression cave, I’d instead spend my summer with patients — to be more particular with patients who have heart problems, getting me closer to the sun (cardiovascular disease has killed many in my family).

Cardiac Inpatient

Lately, it’s been Monday-Thursday ambulatory cardiology (research), with the occasional Friday mornings tagging along with the cardiology team for their rounds on the cardiology wards — I’m the most inexperienced out of the team: a 3rd or 4th year medical student, two residents, one cardiology fellow, one attending, and a pharmacist. Rounds are a staple, especially at teaching hospitals, and it’s worth noting now that rounds will be however the person in charge allows it to be. The rounds of my experience are straight forward. Someone, a resident or medical student assigned to the patient. The person who has that patient does the presentation. The presenter will give a ‘quick’ history and feedback: chief complaint, pertinent history (health and social), details in labs/scans, and pertinent negatives (helps with differential diagnoses), most likely diagnoses, and finally management strategy. Labs and scans are brought up on computers on a cart, the attending or fellow typically asks a few more questions about things that weren’t clear, or specific findings on transthoracic echocardiogram or ECG. Finally, once everyone (the attending) is satisfied the whole team does the ceremonial hand sanitization (or the occasional sanitize then glove) and enter the patients room.

The most interesting part is that, you never know who you’ll see in the room. It might be a widowed grandfather and retired mechanic, a former nurse, a an inmate cuffed to the gurney with their guard escorts — sometimes you see the worse, people who remind you of people you know and those younger than you. Patients are remarkably tolerate of rounds, unfortunately many of them are probably used to it by now because they’re hospitalized so much. The chief complaint and history are then again discussed, this time with the patient being able to put their input in. Unfortunately, not every patient takes advantage of this period, perhaps patients don’t know medicine is moving away from paternalism and inviting the patient into the mix. I’m not really sure, but there’s a variety in patient responses and their levels of health literacy. As such, there’s always a variety of outcomes for this patients. Some outcomes are good, like being discharged on a false alarm via an occult finding. But, often it’s not very good news. The strange thing about news is that, good news is easy to comprehend for patients while bad news is typically not. You can give the exact same explanation to a patient with identical diseases, one patient will suit up to fight the big fight, some will be underwhelmed and tell you they don’t have time to sit around in the hospital bed over the weekend.

Cardiac (Ambulatory)

In contrast to the inpatient service, these patients are doing leaps and bounds better. When I see patients here, I leave my white coat and stethoscope and home. When I see patients in this capacity, we’re one on one and we speak for 30 minutes to an hour and a half (all depending on the patients verbose nature). I appreciate this time, because unfortunately I’ll never get to speak with patients for so long later when I actually am a doctor. Because of the nature of my research project, we end up really diving into their lives. In a medical setting, it’s rather astounding what people will tell you in confidence. We discuss their disease, we talk about their medications, about their living situation, their ambitions and goals. Part of my project involves a chart review (which I currently should be doing), but beforehand I tend to not look at the patients chart except to screen them for the study. This strategy only works because I do not have to worry about addressing their concerns or treatment. I like to hear from them first, before I bias my recording of their answers with my assumptions. Though, for more difficult interviews I need to pull up their chart to make sense of things on my notes mid-interview. I’ve learned some interesting things from patients:

1. Some patients confuse their lack of symptoms, thanks to treatment, as lack of disease

2. As a consequence of the first realization, some people skip their medicines intended to be taken on schedule because they “Don’t need it as much”

3. Some patients actually have no idea what they have, even if it’s been diagnosed for years

4. Patients often don’t make lifestyle modifications because the seriousness of their situation isn’t understood (e.g. some people have no idea they were hospitalized just 3 months prior due to heart failure)

5. Some patients are remarkably on top of their disease management, and it’s immediately obvious “who” does after learning who (at the same age and income level) can still make it up a flight of stairs or watching an elderly gentlemen prove his health by performing exercises

6. Some patients come with their family in tow, it’s likely a cultural thing. I like it, it can make some parts of what I need to do more difficult (getting the patient to answer without bias or outside input). It also makes some things easier, especially since some symptoms are better observed by others than by one’s self

7. People grow accustomed to not being happy, and start to find that the new normal. As a consequence, when I try to learn about the negative things in their life, they put things in relative terms, and give me a cheerful interpretation to an otherwise bad situation. A lot of them just chalk it up to getting older. Sometimes it is simply normal wear and tear, sometimes it’s just life catching up with them, and sometimes people are just unlucky

Oh yes, there’s one more cool perk about this gig, like drawings from patients:

Patient Gift

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Report on Patients and Journal Club

So, my research mentor for this project is an attending physician. My partner and I work together to update them on our progress, or lack thereof, and we make suggestions on what we can tweak on our process to make things better. I’ll take the time to say that the success and enjoyment of research is chiefly based on your team, I’m lucky my partner and my mentor became (I’d like to think) good friends and work well together. Once a week or so, we meet to discuss the research articles in our niche of cardiology. My partner and I take turns leading the hour long discussion, spending an ornate amount of time with the statistical methods and research design. Part of my scholar program requires me to help run an undergraduate version mid week, so I also help with that as well (these presentations are about 12-15 minutes each, and fortunately I don’t need to present in these anymore). The undergraduates in the program are impressive, I think there were 7,000 applicants and they selected 12 or so. I admire their ambition. Technically, I’m one of their co-mentors, though I’m not sure of how good of a job I do with that — I’m not exactly dripping with wisdom.

It was a good experience to go from ambulatory to inpatient, especially in broadening my understanding of the patients’ story on cardiac disease progression (both in physiology and seeing learning to see past their diseases).  It’s too early for me to say I’ll definitely be a cardiologist, but let’s just say it’s the leading the specialty decision race. Either way, I suppose, everyone has a heart. So, it’s going to be useful to learn these lessons now. I’ll probably forget them later, but I think it’s better to have know and have forgotten than have never known at all.

Why Medicine? — My Ridiculous Answer

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Hello All,

For premeds, applications for medical school just opened a few weeks ago. If you’re applying this cycle, or for that matter any cycle, submit your applications as soon as possible — find a balance between a high quality application and fatal perfectionism. Anyways good luck!

As for me, and how I’m using my summer, I’ve been toiling away and trying to keep busy. It’s my last summer, at least my last summer on the books. Some people take the summer off, I just didn’t for a number of reasons. For me, I’ve been so busy with medical school that I forgot why I wanted to go to medical school and who I was before it. Indeed, I even started to feel this guilt about not being the person I was originally that got me into medical school. So, I’ve taken some time to remind myself of who I was and who I am — this also means I’m taking time aside to remember, “Why Medicine?”

Stuff I’ve been up to:

1. Working with elderly atrial fibrillation/stroke risk patients with my team for our cardiology research project.

When I was still sitting on the fence about medical school or a PhD (to follow after my mentor), my grandmother died of a pulmonary embolism during surgery to remove a stent. We were really close, so this was a big setback for me. My grandmother was physically and mentally disabled, she couldn’t read nor write, nor did she have any real grasp of math. But, she was a swell lady. Before her death, she got married to my step-grandfather, who’s also mentally disabled. When she died, it was a very hard event for everyone. I, well, I was furious and distraught. I was also already an emotional wreck at the time because a friend just died from suicide just a month prior. One of the most painful things was to get into medical school and not have her come to my white coat ceremony.

In case you’re wondering about my original grandfather, I never met him on the account of him dying from a heart attack prior to my birth. So, the heart and I have some unfinished business.

2. Last week, I volunteered for the Special Olympics.

I felt like rubbish most of the year, so I needed to do something for myself, to see something of pure “good”. You see, I was so busy with school I didn’t get to do the things that got me into medial school. I sort of felt like a fraud. These kids and adults, or rather athletes, trained for months to compete. And their results were born out in the events included that included: shot-put, standing long jumps, 400 relay, and the 4 by 1, to name a few. It was actually a great competition, and I’m definitely going to try to find time to this again next year.

I met some awesome and confident athletes, they really helped motivate me to not be afraid to work harder.

3. Tomorrow morning, I’ll go with other medical students to teach high students about emergency medical procedures, and some advising about getting into medical school (from our perspective).

I’m not really sure about the details of the program, I just sort of haphazardly agreed to it because it sounded awesome. So, I’m not really sure what will happen, but learning on the fly is something we all get used to.

Why aren’t I in Hawaii for my last summer as a student?

I often find myself trying to repent by performing labors. You may wonder what is it that I want to repent. In my previous life, before blogging, was I an international jewel thief? A deadly double agent, but with a heart of gold? A Columbian drug lord? An evil water barren? No, nothing as gratuitous or even that interesting. Instead, I was just a patient most of my life. And, perhaps hypocritically, at those times [as a child till a teenager] I saw myself as a lost cause, and poor use of medical resources. My health was especially taxing on my family, my single mom maintained an unhealthy abusive relationship to ensure I had health insurance. My older brother I grew up with didn’t get the attention he needed, because the sickly child gets favor. A book smart kid, who grew up with a useless body. I really thought I was a waste back then, fortunately a few life events changed my views. Anyways, I’m now on this ridiculous quest to make my life mean something. Thus, I’m not sure if I can say that my reasons for loving to interact with patients is altruistic, I need them as much as they’ll need me — hopefully, me working on self improvement will mean they get more out of this relationship.

I’ll take a vacation when I feel I’ve earned one, and I’ve already taken a long enough vacation as a nontraditional who only later applied to medical school.

Kind of stupid, huh? I never told you my reasons would be logical. But, that’s my story, and one of the mean reasons I need to become a physician: people saving my life has to mean something, so I must invent a reason why they did. Sure, there are other factors, I want to help people, recent deaths around me, the challenge — some of these events almost broke me. However, at the heart of my motivation, I’m just trying to have a meaning [in a subjective sense].

So far, I think I’ve made a good choice in how to pay it forward and pay it back.

Research, I Missed It — Also Known as Funding Summer

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So, I get to approach patients from a different perspective, this summer I will work with patients for research purposes. I imagine this is coming for most medical students. During the summer, we aren’t funded — as far as financial aid is considered, we just disappear off the face of the earth, then we reappear out of the blue in the fall (to their credit, this is totally feasible at a quantum level). Thus, we do things during the summer to make ends meet. Some just have pared expenses, and have enough to scrape by for the summer. Others, they return to their home state or stay with nearby relatives because it works out budget wise. Many do research projects, paid (CNA) nursing exposure program, others traveled to foreign countries on stipends, and some give an extra hand as a student doctor at satellite community clinics.

The very fortunate, they do a well deserved nothing. If you’re one of those people, please, party a little harder in my honor as I live vicariously through you. 

For myself, I think I’ve mentioned it before that I’ll start working on a cardiology project. I wanted to avoid the stress of trying to find a summer project, so I contacted the doctor I’m working with now early in the fall quarter. This may sound sort of ridiculous, but I did it early because I knew that most of the deadlines for scholarships come in February. And, it’s a lot easier to accomplish research related stuff like funding, required medical human research training (a lot of online modules and quizzes), writing a proposal etc. I’m a lazy person, so I knew I had to space these tasks out or I’d feel overwhelmed. Most projects involving people or animals will involve those steps, with the only big modification being the level or type of online ethics training they’ll need to do. There are different ethics training you can do, NIH, CITI, depending on the place you’re at. However, that CITI one is usually considered gold currency between institutions. The reason why I’m saying all of this is because I was fortunate to have a lot of my old ones roll over, because I had to do a lot of them for work before (you always use the same account for ethics training, it’s ethical!).

To back things up a bit, and to make a point, I think you should make it a point to do research only if:

1) You found/know where to find money.

Finding money is a big deal in research, no matter the purity of intent, plenty of great ideas go unfunded. Also, unless you’re helping the unfortunate, you shouldn’t be afraid to not want to eat Cup Noodles ever again when trying to raise money for the summer. In undergrad, I did a lot of free research work/labor, sometimes paid usually not. Admittedly, it was a lot of the unpaid portions that probably help catapult me into medical school. Therefore, I can entertain the argument that there’s more to research than your stipend. Indeed. And, if you can find a landlord that accepts “good spirit” as a form of payment and I’m with you. But, life is unpredictable and you can’t determine when you’ll have a random expense you didn’t see coming (in my situation, just found out my landlord is selling the house so it’s time to hit the market, again 😞.

2) The subject/purpose really matters to you.

A seminal event for me, was the death of my grandmother. She was a second mother to me. Her death was untimely. But,  who’s death is timely? She died of a pulmonary embolism during surgery to remove a stent, secondary to the stent that had built up plaque on it — in fact, these stents come with huge contraindications. Understanding that my grandmother, who grew up physically cripple and illiterate but full of spirit and love, essentially drowned in her own fluids until her heart finally failed never sat right with me. It was also the lynch pin event that sealed me to sign my soul away into medicine. For myself, I wondered what life would have been if I were a physician in training instead of chasing my curiosity. I suppose, now I feel the answer lies somewhere in between. So, I’m doing research in cardiology.

Started training and sat in several meetings to prepare for the project.

For the project, last week I had a required session for electronic health records training, the system we use is called EPIC. This is just a computer system for patient charts/hospital records, physician notes, prescriptions, surgical histories, labs etc. — part of my project involves going through a lot of charts. Boston has the most physicians per capita in the US, number two I believe is New York, and so we have a lot of hospitals and clinics. Beyond that, a lot of large hospitals have interconnected health records. So, when I’m at the community clinic I see primary care physicians using EPIC; they use it to chart and look up patient medical histories after (while) interviewing. Even while shadowing at the main hospital, EPIC is also used at the hospitals where I shadow. In other words, I will have to learn how to use it, might as well do it now.

Part of my project, or rather part of my grant, involves co-mentoring and running journal clubs for 10 undergraduates who were invited to Boston University (with free housing and a research stipend). I just saw the schedule, apparently we have a journal club meeting every week, and we’ll take them out on the town several times to seduce them into science. The rest of my days will be spent doing my project.

I won’t bore you too much with the details of my research, other than saying it’s a project in atrial fibrillation (AF). I’ll be recruiting patients, and possibly analyzing (preliminary results) extensive ECG records. So, to prepare for that the principal investigator (cardiologist) and with my research partner (fellow classmate/friend) and I, spent most of the early morning discussing AF: epidemiology, socioeconomic factors, statistics, etiology, genomics, physiology, and finally the impact on patients as people. He gave us a tour of the parts of the hospital we’ll be working. Our hospital is a medical complex, so there’s several buildings, and many floors and buildings built later than others. As such, it’s like maneuvering through a catacomb, underground dungeon included. We met several physicians, nurses, spoke to several coordinators, and many other friendly faces.

Tomorrow, I’ll help the undergraduates move into their dorms. I so rarely go to the undergraduate campus, so it’ll be an adventure. But, before that I’ll meet with my research partner and we’ll practice running the research consents past each other. We figured if we stammered through it with each other we’d better feign competence when working with patients. This weekend we’ll be spent reading the eight research papers our PI just sent us, and of course making sure to take time out for a beer.

To summarize, or distill something useful from this post:

1. If you know what you want to do have things lined up so that you may apply for grants and scholarships (scholar programs) early, it’ll remove a lot of the last minute scramble. Keep in mind that a lot of deadlines come in February of the year you start medical school, so it’s easy to miss these if you’re not aware of them.

2. Don’t be afraid of the occasional double booking of plans, as long as you don’t commit it’s okay, because some plans fall through (PI ran out of funding, or something like that). Don’t try to double dip, but do make a plan A and B. My plan A was this opportunity, my plan B was an amyloid cardiology project. I was honest with my plan B, I told them that I had plan A, and they told me to come to them if plan A fell through.

3. Don’t be afraid to apply for outside funding as well, especially since institutional money (usually as spread out as possible) won’t be given to everyone who applies. Also, I enjoyed feeling removed from the competitive pool when people were wondering who got funding and who didn’t. I applied for several scholarships and didn’t hear anything back from any (including a Tylenol grant). But, applying to medical school means being rejected by a lot of places and hopefully gaining acceptance somewhere. So, it didn’t feel that bad to hold out for help since I wasn’t facing any real deadlines yet about earning money. In the end, I received a NIH partnered with American Heart Association grant/scholar program. It’s important to say that I didn’t just solo mission, I also used the resources given to us by our school and followed tips about who to talk to when I got the chance.

So, even though I have a lot of work ahead of me, some coursework, meetings on meetings, patient screenings, and data splurges, I’m just happy I have money for both rent (including enough to search for a new place) and security that I can fly to see my parents and friends this year.

Thanks for reading!