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Physician Suicide, Organizational Justice and the “Cry of pain” Model: Hopelessness, Helplessness and Defeat

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doctororbust:

A great post.

Originally posted on Disrupted Physician:

They can be a terror to your mind and show you how to hold your tongue
They got mystery written all over their forehead
They kill babies in the crib and say only the good die young
They don’t believe in mercy
Judgement on them is something that you’ll never see
They can exalt you up or bring you down main route
Turn you into anything that they want you to be–Bob Dylan, Foot of Pride


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Although no reliable statistics yet exist, anecdotal reports suggest a marked rise in physician suicide in recent years. From the reports I am receiving it is a lot more than the oft cited “medical school class” of 400 per year.

This necessitates an evaluation of predisposing risk factors such as substance abuse and depression, but also requires a critical examination of what external forces may be involved in the descent from suicidal ideation to suicidal…

View original 4,152 more words

Medical Training Culture — A Quick Reply

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This article is in reply to the well articulated piece Tulane MD/PhD candidate (Stiletto + Stethoscopes): http://stilettosplusstethoscopes.com/2015/03/12/loneliness-is-the-poverty-of-self-solitude-is-the-richness-of-self-may-sarton/. She made excellent points, so be sure to check it out (it’s likely better than this article).

My response to their article isn’t as polished, I’d even say my response is downright clumsy. But, for what it lacks in style and refinement hopefully you’ll  find will be brimming with honesty. And really, the purpose of this piece is merely to keep the conversation going. You my find this piece to be more acerbic and pessimistic then my usual writing, but this dialogue needs to happen. The point of this piece isn’t to scare premeds out of medical school applications, instead it’s to normalize the feelings that are politically incorrect to ever mention in front of your student body.

Understandably, human gross anatomy and the first year of medical school is a formative and seminal event for every physician in training.

But in all seriousness, how is skinning, lopping of their breast, meticulously scrapping out their fat, bisecting their genitals and dismembering a human not supposed to be a traumatizing experience in medical school? For the love of Pete, I’ve held a severed leg in my hands.

Gross Anatomy is and starting medical school is hard, and not just because of the amount of material.

Neither the less, most people get through it. I succeeded by distracting myself with the awe and appreciation that someone would give up their body for medicine as our first ‘patient’ — so that we can be a physicians. I believe an important bond is formed between our first patient and ourselves. This is mostly a bond of responsibility. Responsibility turns into guilt when we feel we didn’t hold up our end of the bargain. I mean imagine the guilt associated with knowing that someone (and their family) gave their body to you and you feel you didn’t give it your all, whether that be because of class load (30+ equivalent undergraduate units, a considerable chunk of it not being all that clinically relevant but extremely easy to test), hopefully you’re passing all of your classes, burn out and depression, or personal reasons such as ‘untimely’ deaths or illnesses of closed loved ones. Some just feel bad for “not enjoying ” like everyone else seemingly are. I’ve seen students try to express themselves, hoping to find some sympathy from their colleagues only to be shutdown for not being “into it enough“, albeit an inadvertent discouragement.  This is the first layer of guilt some of us experience, wondering if you’re worthy of what we’re tasked to do.

There was one person who I believe dealt with it in a healthy way, crying from time to time. I respected them a lot for this, for their strength. Admittedly, I learned of murmurs of others who found this person to be “weird” or “overly emotional”.

You’ll quickly learn how to stuff your emotions into the closet — hopefully, you learn when to open that closet as well.

For my first semester of medical school I struggled with the moral dilemma of visiting a recently diagnosed cousin with terminal cancer. I need not defend my actions or intentions, I selfishly decided to not travel during my midterms as I knew without a doubt she’d likely die in the interim. I find myself on the right side of history but on the wrong in morality — for this I can admit my hypocrisy as I’d never fault another student for making the same decision to stay and take their exams. Everyone, including my terminal and now deceased cousin, comforted me by telling me to stay and thus transgression was forgiven by others. It’s no secret that medical students and physicians in training miss a plethora of things: deaths, funerals, wakes, and births. I suppose the part most people don’t know is how quickly these things most be given up or put on hold, at times I wonder what things I’ll later miss or the people who think I forgot about them in their time of need.

Not everyone is a medical zombie, not everyone tries to wear a suit of armor to hide their feelings. I can’t recount the number of times people who I assumed “had it all together” confided to me nearly in tears about the stress, anxiety, and feelings of inadequacy. There’s been even a rare conversation or two when students have admitted to me about thoughts of taking their lives, or as the called it sometimes “I just want to off myself”, during the first semester but not wanting to be outed as “depressed” or lose respect. Some dropped out (once you’ve made up your mind it’s a wise decision), while others have (bravely) taken psychological medical leave with intent to return when they’re ready. Fortunately, my program recognizes mental health as a health concern not a competency one, sadly; I can’t say this is a universal policy among programs or our potential residency spots. It’s a sad day when medical students and physicians can have guilt about their own mental health status, but with uncertainty of being discriminated against we should expect physicians in training to not seek help when they need to.

You’ll quickly learn how tied your hands will be later.

At the clinic I quickly learned that a knowledgable provider prescriptions’ in no way guarantees or even implies that the patient will receive said treatment or medication. Having insurance doesn’t mean coverage. I recall one conversation a physician had with a long time patient:

Doctor: actually, there is a medicine has a 95% cure rate for your condition

Patient: OH MY GOD SIGN ME UP!

Doctor: the only problem is it costs too much and you’re insurance won’t cover it, unless you get more sick. But, then if you’re too sick they won’t cover it either… It’s typically denied, but I’ll try it anyways.

Patient: …wow, so there’s a cure and I can’t get it?….

Doctor (to me): better get ready for this kind of stuff.

It’s a bitter pill to swallow that all we learn about drugs and diseases can be overturned by a swift “denied” stamp by a clerk. However, at the end of the day a person need be blamed, and that clerk will be no where to be found. Remember not the best treatment, but the covered treatment — even if it’s an inferior treatment. And let’s face it, when it comes to billing people can incorrectly assume that doctors are behind a scheme to over bill (sometimes with deadly results) — this is despite the gradual shift away from fee-per-service and into capitation. It looks like, for now, we’ll just have to enjoy the orphaned guilt not taken up by billing. When I sit in the bus towards I hear patients lament at how incompetent and irresponsible doctors are, including blaming doctors for lobby wait times. Fortunately, I haven’t deluded myself into thinking physicians are universally respected. Clearly, when people prefer Jennifer McCartney about vaccinations over their physician something is misplaced.

Never the less, I’m not disheartened by the realities of medicine, or the culture. Though not at the pace I’d like, I see the culture changing as we speak. In fact, I feel more empowered as I slowly gain a grasp of what “we signed up for” and I’d rather be part of the fight then on the sidelines — let’s hope it stays that way. There are tone of positive things about medicine, you only need to check the rest of my blog for upbeat posts. But really, if you’re going to marry medicine you better be willing to accept the good and the ugly or you’re in for a rude awakening.

And, I’d be irresponsible if I didn’t level with you.

I LIVE!!! — And Plans for The Future

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Hello Everyone,

Sorry for the absence, medical school had me a little occupied. There are a lot of tests and competency evaluations in medical school, especially within the first couple of years — though, let’s face it medicine means a career of learning and evaluation. This post will include some details about my class load, a general synopsis of what’s going on. Another point of this post will be to talk about the summer, a critical time for students transition from first to second year in medical school.

I don’t want to freak any premeds out, but there’s a rumor that circulates quickly during the first year of medical school that you have to do certain things to even have a fighting chance at obtaining a residency later. Besides the obvious Step 1 score, there’s a lot of talk if being busy during summer “secret requirement” of residency programs later. Those with concerns aren’t just being neurotic, graduate medical education is capped and not everyone finds a residency across the country (for brevity I’m excluding this conversation to MD match system). This means that about 5% of US senior MD candidates don’t initially match, though there is another match system ironically called SOAP — this 5% could also merit another debate for another day. With that all said, the word of advice that I’ve heard from upper classmates and faculty is that you don’t need to worry about using your first summer for residency. Actually, I’m of the opinion that your number one goal during medical school, especially in the first year, is maintaining your sanity (in public at the very least). You taking off time might mean a fresher you and better you. In short, for you summer do what’s good for you.

Currently, my class load are medical courses (fun fact: we are the last class year to have this curriculum, the future classes will have a more guided lesson through medicine):

1. Physiology – we just finished circulatory and gastrointestinal. Now we’re moving onto pulmonary and renal. We will end the semester with endocrinology with a unit to itself. For neurology, we had a separate and dedicated neuroanatomy/neuroscience block earlier this winter.

2. Genetics – just finished this course. If I learned anything from this course is that when I’m a physician I will both 1) appreciate that I learned more about genetics and 2) understand that genetic counselors have a large role to play in both short term diagnosis and long term patient education. My program really explored some interesting topics such as sexuality, rare diseases, and ethical dilemmas I will later face from genetic test results.

3. Immunology – we will start this next week. I expect alphabet soup.

4. Clinical Medicine – we have clinic or hospital (or both) hours assigned to us. The first year it’s four hours per week, the second year it’s up to eight, and well the 3rd year you’re just abducted by the hospital. Right now, what you do during your hours depends on who you’re attending is. One reason why I chose this program was because of the early exposure to “doctoring” and the fact that it’s a safety net hospital system. For various reasons we’ll leave unaddressed in this post, a lot of the patients “unwanted” at other institutions are our primary patient population. We do a variety of things, from standing around to randomly helping during a procedure — they don’t call it a teaching hospital for nothing. Most of our time is spent talking with patients, taking their histories and learning more about their story. You learn a lot from patients : you learn that the cute little old grandma-eusqe patient that you like also just quit heroin for years prior, how some people writhing in pain from cancer worry more about their families than their diagnosis, or see even those embroidered with intimidating prison tattoos can still weep in the face of chronic depression and disease. I’m learning a lot about humans, it gets me through the week.

Summer Research Plans

The summer of the first year is a wonderful time. Some feel pressured to keep busy, but I don’t think that’s necessary. They’ll be plenty of time for research later and clinical experience, in fact by that time you’ll probably be more useful of a team member. So, if you’re into traveling (or vice versa, want to curl up for the summer with a book, go for it!). Some students do a lot of things during the school year and nothing during the summer. For myself, the load of medical school was enough so I’m using my summer for my ‘side goals':

1) Find something to motivate me (I’m goal orientated)

2) Raise money for summer rent and food

3) Become better (useful)

The first two are constant pursuits, the latter is the latest goal I’ve stapled onto my agenda. I think the biggest motivator right now for improvement, besides the obvious clinical applications, are my classmates. It’s really hard to overstate how awesome they are, in how they think, the questions they pose that I did not. It’s not a competition you see, I just really bask in awe at times at their individual geniuses and focuses. As such, it makes me want to work harder so I too can add something.

For myself, I’m planning to get involved in cardiology research for the summer: atrial fibrillation. The great news is that I solved my summer bill problems (and then some) with a stipend I’ll receive for it. So, this month I’m working reading up on atrial fibrillation so that I can submit my proposal. I interviewed a few weeks ago for the research grant, it had a number of steps to undertake because it’s funded through the NIH and the American Heart Association. Fortunately, I passed that phase, and all that’s left is for me to submit the proposal start working with patients that have already been screened from the hard work of another arm of the project done by others. Coincidentally, the turning point for me going into medicine was a cardiology related death of my grandmother, so I’m happy to turn my attention towards heart disease. About the timeline of the research, it’ll be conducted mostly during the summer. However, project and grant requires a longer commitment, so I’ll continue the work in my second year as well — by the way, although it’s unlikely for myself, some students with field changing results choose to take their second year off to publish etc. Though, I think the end point of this research is to add to some patient literature, so it should be an interesting trip.

In case you’re curious how to find a research position in medical school, it’s actually a lot easier than in college. Of course, the opportunities available to you will depend on what medical school you attend. Though, even if your program doesn’t have the clinical or bench research that you want to work with you can always do an externship program — though a lot of the institutions prefer to internally fund their students than others. For myself, I used the time honored tradition of just pestered a cardiologist I found with emails until we could meet. I was awarded for my persistence with an invitation to join in the summer.  When I chose my school, one of the reasons was because I already looked up some labs I thought were interesting or cool to me. My main source of healthcare has been clinical trials, I had been enrolled in them for over a decade (in fact, I’ve donated quite a few chromosomes towards the cause of pharmagenetics). So as a former patient, I have a big belief in the importance of medical research and I’m happy to be on this side of the court yard where I can hopefully have more influence.

Community Service

I need to figure out how to serve my community here in Boston. I’ve lived here for less than a year, and I’m still learning which way is north and where the food is. But, as time goes on I can’t forget that service is one of my main driving forces. I think I just have this fear of being useless, though we can probe into my sanity and self esteem in another post. Luckily for me, part of my research grant includes the requirement that I mentor and “show the ropes” to a trope of premeds who’ll receive a scholarship (from universities across the country, including Puerto Rico) to live in Boston for the summer and learn about research. I believe they’re selecting 10-12 (I’ve seen some of the list so far) people from several thousand applications, interestingly their selection criteria isn’t that different from picking medical school invites. The big goal of the program is to give a chance to those with the mental abilities but lacking opportunity — robust plants that just needed some water and sunlight. We’ll lead them through journal club discussions, and other exercises, and answer random premed questions — aka mentorship arm of the program.

At some point in the summer I’ll figure out how to take a vacation. I have very easy vacations: I go watch jazz or go to drink coffee, I’m easily satisfied. But, I think it’s important to emphasize that you can easily take the summer off during medical school and it likely wouldn’t have much impact on your residency application. But, if there’s something you just want to try or dabble in, the summer is a good time to go for it. Though, if you need to raise money for the summer, then accomplishing your goals and getting rent money is a good way to go about it. If you want more access to scholarship money then be sure to enter your medical school email into interest groups, the research or activity you’re doing might coincide with the requirements for a grant if you’re lucky.

 

The 2015 MCAT, Now The Only MCAT

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It’s 2015, there is now the new MCAT, good luck to all of the new generation taking it. It’s something we all go through, so no matter how you do it’s a feat that you’re taking it. A lot of people start off as premeds, and then perhaps find something else that suits them better. But, people who take the MCAT have pretty much signed the premed contract with their blood. It’s a surreal experience when it eventually hits you that you’re be sitting for the exam a few weeks, and it will literally help shape your destiny. I took mine a few years back, a two years before I applied to medical school so I was one of the last to have the essays included. They eventually removed the essay portion, it was a pain to interpret if it even meant anything. Besides that, there are different forms of communication, and perhaps speed writing essays isn’t the most useful metric for who’ll make a good doctor. Personally, I liked the essay portion because it was a nice intermission between more rigorous sections. At the time, I was a paid contributing writer, so I didn’t practice essays for the MCAT. So, because I’ve never attempted them before it felt less draconian and repetitive as reading passages and clicking answer selections.

Though, I remember having a terrible week coming into the MCAT, including the night before the exam. Somehow, I had angered the MCAT gods that week, that night before dogs across my neighborhood barked from about 3:30-6 AM. So, instead of sleeping in for the MCAT, I was watching the History channel (this was way back when the history channel actually showed history, and MTV already had lost interest in music etc). During my exam, I was tired, delirious, and just ready to plow through the MCAT so I could go to a bar and celebrate my last day seeing the MCAT. If I think back about one of my essays, I was so giddy, I recall I wrote about hamburgers. When I finished the exam, for a brief second, I thought about not sending my score as you have that option. But, I thought, “NEVER AGAIN!”, and I pressed submit. I always feel lousy after exams, even if I’m prepared. A month later, I found out my independent dual readers at the AMCAS liked my hamburger rhetoric and I received a reasonable ‘matriculating score’, and I’m very proud I wrote about hamburgers. You’ll have your own experience, including some bad days and good days.

The old MCAT was around for over 20-years, and this allowed for the AAMC to gather a lot of data about correlation (but not necessarily causation) of the data. The old MCAT had a maximum score of 45, with 3 sections each worth 15 points, and for most of the exam’s shelf-life an essay. For all people who take the MCAT, the national average was about 24 points. The average matriculant for US MD programs had gradual creep up, from about 29 to 31 towards the end of the exam when message boards, tutors, and prep companies had the MCAT down to a science (no pun intended). Please note that because we’re talking only of averages we’re throwing out a lot of higher or lower scores that go into medical school and did just fine, an average score and a person’s score are not the same thing. We survived the MCAT, I can only imagine how those before felt with their paper test (I like paper tests). But, one thing is certain you’ll survive the new one, good luck and do your best!

At the end of the day, it’s just part of your application. So a bad score won’t doom you but a great score won’t buy you an acceptance either.

 

 

Interview with Recently Accepted Class of 2019

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Hello!

It’s winter in Boston, I hope all is well for everyone. Now, again, at my school applicants are interviewing. It’s a curious sight, I remember making the trip before, peering off into the classroom when I could to get an idea of who these mythical creatures called medical students were. So, it’s strange to be on the other side of the window. Anyways, nostalgia aside, I wanted to share with you an interview with a recently accepted applicant (see below). I believe we met on Twitter, when I was editing and critiquing personal statements in my downtime. I distinctly remember her personal statement, so I’m excited to see her progress from a hopeful applicant to an accepted medical student with a full scholarship.

So, here’s the interview:

  1. Can you tell us a little bit about yourself? — e.g. major, participation in college, post graduate work or activities, continued and concluded work/projects, notable experiences.

My family is originally from Peru, my father completed medical school in Lima and we immigrated to the United States when my father got a pediatrics residency offer in New York. I grew up and attended school in Texas, where I majored in Biology and minored in Psychology. I was very fortunate to have several mentors along the way who really pushed me towards research and am grateful our paper was accepted a few months before applying to medical school. I worked in two very different labs in undergrad, a summer in an entomology lab and a neuroscience lab my junior and senior year. Although I considered medicine, I originally planned on pursuing a PhD in Neuroscience/Neuropharmacology, so my focus in undergrad was research and teaching (I worked as a Teaching Assistant for Cell Biology lab and Supplemental Instruction Leader for Analytical Chemistry) and did not really have very much clinical volunteering (at least compared to my ‘intense’ pre-med peers).

My main extracurricular was Colleges Against Cancer (CAC), where I helped start Relay For Life at my university. Unfortunately, it seems that people in my life keep struggling with cancer. My first awareness of the disease was when my fifth grade teacher went through breast cancer treatment. In college, I discovered my lab mate was a lymphoma survivor (we co-founded our CAC chapter), my godfather battling colon cancer and losing my first research advisor to pancreatic cancer, and recently losing family members to lymphoma and glioblastoma. Although I have no idea what it says, I believe that my evaluation letter from my American Cancer Society staff partner had significant weight in the strength of my application.

There are people that seem to know they were destined for a career in medicine since they were fetuses. To say I am 100% certain that I should become doctor would be inaccurate, sometimes I still question if I have the desire pursue a career that in practice seems increasingly more centered on costs and paperwork, and less focused on quality and prevention. Seeing my father practice medicine in a private practice setting was off-putting to me, especially as I developed a real knack for teaching early in my undergraduate career. However my somewhat cynical, not idealist view that our current healthcare system is ‘broken’ is one of the many things that fuels me to strive for change. My senior year (after much introspection), I realized that academic medicine was a great way to consolidate helping with others while teaching and decided to apply to medical school. Since I still needed time to study for the MCAT, I decided would take a total of two years off before matriculating in medical school (which thankfully I will next fall!).

  1. Applying to medical school is pretty difficult, besides the prereqs, a lot of steps have to be made correctly on a timely manner. How did you prepare for the applying to medical school, anything in retrospect you would have done differently now that you understand how the process works?

Honestly, I read a lot of blogs and from there searched for books. Hannah’s (@MDPhDtoBe) blog (side note: I met her a few months ago and she is an incredible human) and this one were probably the two I referenced the most. I used two books (one which you have mentioned in your own blog) the Medical School Admissions Guide and Cracking Med School Admissions, both which gave interesting examples of personal statements and suggested timelines. After the MCAT, the two most challenging parts of the application were the Personal Statement and the Activities Section (also, insanely time consuming). Looking back I would have kept better records on my activities because I ended up spending a lot of time tracking down faculty/staff for their contact information and wracking my brain to guesstimate how many hours I spend on all of my activities. Something important that I reflected throughout the interview process was to try not compare yourself with other applicants. It’s difficult when you’re in a room filled with brilliant, driven people, but reminding yourself that you have your own story, that everyone’s journey to medicine is different is good perspective to have because it’s easy to become intimidated and not think you’re good enough. You have made it this far, be proud (never arrogant) of your accomplishments!

  1. Last year I edited your personal statement, how was the experience for you and how did it help?

The personal statement was very challenging for me to write. I probably went through ten drafts of my personal statement before I felt “satisfied”. Mr. @doctororbust kindly agreed to look over my personal statement and gave me great feedback, particularly with the flow of my ideas. Most of the people I asked to edit my personal statement were very familiar with my story and everything I had done throughout undergrad, so having someone who was completely impartial was extremely useful and I am extremely grateful for the direction my personal statement took after you reviewed it! Forever grateful.. this brings up another point, do not be afraid of asking for help. There are kind people in this world who genuinely want you to succeed :)

  1. What were some things that surprised you about the application process? — this could be either positive or negative or even just an observation.

Overall, the application process was a journey. Equally beautiful and frustrating. Writing the personal statement was somewhat revelatory and defining. Creating a narrative that portrays you and your passion for this career in 5,300 characters is nothing short of daunting. I think I did not expect the application to take so long. I tried to finish it up as soon as I could. I am surprised to have gotten three out-of-state public university interview offers, so I wouldn’t discourage someone to not apply out of state, however make sure you do your research and write a compelling narrative on why you want to attend a specific school. If you can attend a recruitment fair, take advantage and stay in touch with people. An admissions staff member I met at a recruitment fair arranged for me to meet with a pediatric psychiatrist after my interview because I mentioned this was a strong particular interest of mine. As much as medical schools are interviewing you, you are also interviewing them to see where you will be the best fit and if they are granting you an interview, it is likely they will accomodate you to make you feel welcome. As I mentioned, I strongly considered pursuing a PhD, and debated applying to MSTP (MD/PhD) programs. Ultimately, I decided not to apply since I did not believe my MCAT was very competitive for MTSP programs. However, in my interviews and after talking to a few MSTP minority students, my MCAT score was higher than one (by 3 points) and exactly the same as the other MSTP student. Although I do not believe in holding myself to a “low standard” because I am considered a minority in this country, I do feel a slight sense of curiosity of what would have happened if I had applied to combined programs.

  1. How many schools did you apply to? If you don’t mind disclosing it, can you share what school you decided to attend?

I initially intended to apply to more, but I ended up completing 13 allopathic medical school applications. To date, I’ve had two rejections, five interview invitations and acceptance offers from the University of Minnesota-Twin Cities and the University of Wisconsin- Madison. If I do not get any more interview offers, my last one will be at the University of Illinois-Chicago in February! Since I did also complete an application through TMDSAS, I’ve ranked UT Southwestern and UTHSCSA and will have to wait for ‘match day’ on February 2rd (Texas is special).

For schools that are a part of AAMC, I legally have until April 30th to make my final decision… However, during winter break when I was in Peru, I found a letter from the University of Wisconsin School of Medicine and Public Health saying I have received a full tuition scholarship!!! I am about 99.99% certain I will accept this offer because frankly I loved the students I met, the interviewees (we did a group one with 2 medical students and 3 other applicants), and the city of Madison. I am beyond thrilled to have this incredible opportunity, as I am flawed and far from a perfect applicant (as in I have a C in calculus and several Bs early on in my transcript.. but I worked hard to bring those grades up!).

  1. What will you do as you wait to start?

I am happily continuing to work for a medical non-profit association in Washington, DC and tutor Biology, Chemistry, Biochemistry and Spanish while I wait to start medical school next fall! Taking time off school was the best decision I made to solidify my decision to apply to medical school. If you have any questions about anything, please feel free to send me a tweet @brainyloma! Best of luck!

***

End Interview

Thank you @brainyloma, please check her Twitter out if you have more questions.

2014 DoctorORbust Blog In Review

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Happy New Year!

WordPress sends a summary for the year to their authors, thought I’d share how this blog turned out to you all (you can scroll to the bottom for that). I’d like to take time to really thank you all, whether you’re a new or dedicated reader, your readership means a lot to me as I share and document my own experience. A year ago I was still in interview season, receiving my fair share of acceptances and rejections for medical school and I wasn’t yet accepted into the program I’m at now. Since medical school has started life started moving rather very quickly, at some points it was quicker than I would prefer. Neither the less, I am thankful for the opportunities already afforded to me thus far and those in my horizon.

My life changed a lot since I moved from Southern California to Boston.
My life changed a lot since I moved from Southern California to Boston.

To all my readers I only wish you the best for 2015. And while I hope 2015 went your way, always remember the words of the 14 Dalai Lama:

“Remember that sometimes not getting what you want is a wonderful stroke of luck.” 

The WordPress.com stats helper monkeys prepared a 2014 annual report for this blog.

Here’s an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 42,000 times in 2014. If it were a concert at Sydney Opera House, it would take about 16 sold-out performances for that many people to see it.

Click here to see the complete report.

Protests and Die Ins

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The planning stages of the protest, Boston is the home of public dissent.

 

Cloth shoes and just below freezing don’t mix. A friend, another medical student, reminded me of that some months ago; I own warm boots that I had erroneously chosen not to wear the night of the protest.  Though, medical school has sapped a lot of my free time away, I’ve slowly kept up with developing cases of Eric Garner, John Crawford, Tamil Rice, among others to be killed while unarmed by the police in the US. I planned on going with other classmates that night of the protest, but we were never able to make the logistics happen in the crowded square. The event was going to coincide with the Christmas tree lighting at Boston Commons, a popular outdoor park for both tourist and locals.

I had arrived early to the protest, the police had wardened off a group of protesters; thus allowing them to protest yet preventing myself and others from joining them. As a consequence the ratio of protester to people in disgust of the protest was tipped in favor of our opponents who mocked our “inappropriateness” to stage a protest around Christmas. Is it more polite to abhor social injustice after the presents are opened? Fortunately, the ranks were soon bolstered as other neighboring students from Harvard, Northeastern, UMass (and of course my own institution). Understanding we lacked organization because of the protester quarantine we relocated to the corners of the park and organized a coordinated march. As we marched, others joined us, at last the numbers were burgeoning. At first it was just the young and hopeful, soon the young were joined by the old, and between them chanting in chorus with families of different races. That day I was reminded that as humans our first instinct is to not be the nail sticking out that gets hammered down, so it’s easier to express dissent when you know you’re not the only one. Soon, the police realized the protest had grown larger than they anticipated, so additional police were called and a helicopter requested. Neither the less, there was no violence that night from either side.

When the protest grew.
When the protest grew.

A few days after this event, five us of decided to try to string together an event as a social protest. Very soon we learned that other medical schools were already conjuring up the same plan, so we decided to host our “White Coat Die In” on the same day as others. This gave us about 3 days to organize the event. Fortunately, everything fell into place to make a coordinated 45 minute event: the university gave us space on short notice (we even got a thumbs up from the dean of medicine) and no security problems, by luck of the draw I gave opening remarks, and we had words from other organizers and one BUSM higher up. Attending was excellent: medical students (nearly 100), dental, and public health students also joined in protest in solidarity. A reporter from reached out to us, and the event was reported in Al Jazeera. The planning committee as grown, and we’re now working with other established groups to bring forth increased awareness and possible future curriculum changes.

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