Month: April 2014
“Hey..I think you should take a seat” — these are the words no one wants to hear from their doctor.
I heard them — and as life would have it the timing was perfect, just when I started studying for the MCAT.
He went on to explain, “Your liver enzymes are elevated about 4-5x the normal amount. At first we ignored it because you’re otherwise healthy, so then, we re-tested it after another visit –and it was still elevated. This is unusual, as you’re otherwise healthy, and you exercise.”
We, the doctor and I, then went down a list of ways to insult your liver. Given my age, there were only a few ways to have bloated liver enzymes levels:
- Hepatitis A-C: I have no prior IV drug use (nor current if you’re wondering), no prostitution (besides intellectual), and I’ve never had a tattoo. Though, I have volunteered in prison, so I had to leave this possibility open. We tested for Hepatitis, the great news was a diagnosis was knocked off the list: clear of Hepatitis.
- Cirrhosis of the liver: we ruled this out rather quickly, though I drink, my habits weren’t enough to scar the liver. Though, there was also a chance for “out of the blue” idiopathic Cirrhosis, but the rest of my liver enzymes didn’t fit this diagnosis.
- Nonalcoholic fatty liver: this was ruled out pretty fast.
- Several other system inflammations: all of them were ruled out, as I had no indicators for inflammation.
As my physician and I whittled down the list, it soon became apparent to me he had already completed the check-list by himself, perhaps even several times. The real reason why I was asked to sit down soon became pretty obvious:
- Neoplastic growth (cancer) that happens to be secreting enzymes on its own: it was a remote possibility he admitted. A possibility that my doctor had hoped to jettison once I came in to give a better history. He asserted this wasn’t very likely, but we had to rule it out given that everything else was negative. Besides, I had been a asthma drug test subject for over a decade, perhaps I would add a new symptom to their speedy commercial disclaimer once the drug was released.
So, that was my first several months of the MCAT studying, trying to figure out if 1) I had cancer 2) if I were diagnosed with cancer would I continue to apply to medical school and 3) if I should tell anyone. The wasn’t much I could do about the first point, after a little mopping around. It wasn’t a particularly fun period of time as I was still recovering from the suicide of a friend and the death of a family member. But, eventually I mustered my MCAT motivation, I realized I either ‘sick’ or I wasn’t — so I decided to move along with applying to medical school as planned. And since, all of this was unsure, I decided to keep it to myself. And so, I didn’t tell my friends or family.
I’ve been close to death several times in my life with asthma, I’ve even slipped into death, only to be revived (a story for another day). But, this was different for me, because with asthma it was always an immediate emergency, this time it was like an invisible timer. I thought about my life, my friends, and how much they meant to me. As the weeks went on, and we couldn’t find a reason for my liver enzymes still, I decided to use the best of my apparent dwindling time: spending time with friends, calling people I haven’t seen in years, and trying to be a better son and brother. I’m not used to expressing my emotions openly, so I told them good bye in my own way, in the guise that in the future I’ll be moving away to medical school if admitted. I went to eat with my research mentor, told him how much he meant to me. All along, I kept studying for the MCAT — no, it’s better to say I can’t myself occupied by studying for the MCAT.
Fortunately, one day, I remembered that I have a degree in Exercise Physiology (i.e. physiology under extreme conditions) and a minor in Physiology, so I decided to go out on a limb and do some research using Pubmed about liver insults — this time focusing purely on the exercise physiology. I recalled learning that the liver most process the products of muscle break down, and recycling various energy (potential) molecules. Supporting my hypothesis, I found one paper that explicitly expressed that research investigators should be wary of recruiting subjects who are exercising vigorously because their liver enzymes will be much higher than normal (4-5x more, like mine).
I then decided to put a mental bet on my self diagnosis, it was either I was right or I’m in a heap of trouble. I then emailed the paper, and my reasoning by email to the physician — I even thought of a way to test for my diagnosis: stop exercising and watch my liver enzymes. If they dropped I was right and I’m going to live (for now), if they still elevated I’d best get my last will and testament in plus life insurance. He emailed me back almost immediately, he liked my idea and decided to try it. Good news: I didn’t have cancer.
And let me tell you, I’m pretty happy I was right — but, you never really know when life will just “happen”, so expect a lot of curve balls. I went onto take the MCAT, and did well enough to get in, though I never expected to lose so much time from studying with trying to study my own case.
Reach me at twitter @doctororbust
Certainty — there is such an irony in the word “certainty”, as few things in life are ever certain.
Though, there is some overarching truths inherent to every premeds journey, or certainties: prerequisites, volunteering, and some type of leadership and/or some other types of enrichment experience. And, again we edge closer to certainty as we mature along our premed journeys’, after all there’s a lot less certainty of a freshman premed continuing on into medical school than a premed senior/post graduate. The reasons are pretty blatant, and don’t need much exploration: the premed journey whittles down a lot of people, regardless of your beautiful mind and/or heart, and by the time you reach the end you’re probably a ‘decent’ applicant if you stuck with it and life didn’t molest you too obtrusively. A lot of great people never make it to taking Organic Chemistry, the gnarled and tattered survivors go onto take the MCAT. The socially emaciated, #MCATPTSD desiccated husks of people, formerly known as a premed, then goes onto enter the must brutal game of musical chairs i.e. the AMCAS. At that time, if you chose to apply then you are now an applicant — this nebulous “friend” zone where you’re still a premed, but you are “certainly” a premed after you’ve pressed the SUBMIT button on the AMCAS.
Before pressing the submit button, early in a premed’s career the title “premed” is one often wore in honor. For the medical school applicant premed, this is probably the most fearful time in their life, and the title suddenly bears great weight. In fact, there’s likely a strong correlation to how many people expect you to become a doctor your perceived Atlas boulder on your neck. Indeed, I’d argue there’s even some type of transcendental comradery that is threaded between applicants and accepted medical students (and even doctors), a mutual respect borne through similar experience regardless of outcome.
Let me assuage your concerns, it’s perfectly normal to be apprehensive about applying to medical school, there is no shame in it. Indeed, it’s better to have every doubt you can conjure up prior to being accepted into medical school — and even then the doubts probably won’t stop stirring. This is probably especially true if your parents have geared you up to be a premed since you were a fetus because this is likely the first time you realized the destination of your train tracks. There was little certainty when you started your career as a premed that you’d end your undergraduate career as one (if traditional), and there is little certainty that when you press submit you’ll get in. And really, there is a maturity involved in re-evaluating your life, after all the true path to medicine forged you own way.
But, there is one sure way to be certain you won’t get in, by sabotaging yourself (perhaps unconsciously) by putting in a low grade application effort on the AMCAS or self-selecting out. And its fine to decide to do something else, this is in no way a failure, the most important thing is that you consciously choose and don’t let the sands of fate do as they may.
Though know there is one certainty: the only way to get into medical school is to apply to medical school.
Thanks for keeping up with my blog. To all the premeds out there taking their MCAT, writing a PS, and slaving away at the prerequisites my hats off to you! To my medical school friends, good luck on your coming USLME (or COMPLEX).
I created a dedicated email for questions, feedback, concerns etc: email@example.com.
As you may already know, I have a few hats, I work as an ethical compliance associate (I don’t like the word officer) for the IRB and the ACUC (human and animal research respectively, yes I do realize the irony) — this is mostly for graduate students. I also have a job helping to coordinate research grants, conferences, and doing odd jobs to increase the amount of undergraduate research at my alma mater. If you didn’t know, surprise! Long story short, I get a lot of emails every day, from either the USDA, my institution, combative principle investigators, or panicking graduate students. So, I decided it was about time to make a email account just for the blog. Please feel free to ask me things there if you wanted to keep it private.
Post Step 1 USLME interview with Johns Hopkins MD candidate (M2) sometime in May
I have a good friend from my alma mater who’s now attending Johns Hopkins, and is currently a M2 (second year medical student). She’s currently caved up in a hole studying for Step 1, and she’s agreed to share her lessons and experiences as an M2 getting ready to move onto her next steps — clerkship. If you have any questions, write them to me at firstname.lastname@example.org. I’ll select the best 7, and 3 of my own to ask her. Her test is in mid May, so I’ll take questions until May 9th. If you do not clarify if you’d like your identify revealed then I’ll assume you wanted to ask anonymously.
Personal Statements — I’ll accept them again from May 1st until May 20th.
I agreed to take one person past the deadline, so, what’s the point of playing favorites? I understand that some people have some PS emergencies, seeing as how applications open up in June, it would be reasonable for me to open up my reading schedule in May. So, from May 1st until May 20th I will start accepting PS again. So, send them to email@example.com, I’ve dedicated an email for your guys so that they won’t get buried under my other normal work/personal email. While, I won’t actually give any feedback until May 1st, feel free to send them earlier as I would read them earlier and thus have time to give more feedback. Warning, I give very honest feedback =). But, so far the few people last cycle who’s PS that I did critique (and they followed my suggestions) they did in fact matriculate into medical school — I was showered with gifts of kind words — a perfect ending for both of us. While I make no guarantees, I can tell you I’m really vested into you getting in, or rather helping you put your best foot forward so that you can get yourself in.
Overall, same process as last time:
– I’ll read 3 drafts, if you make them within that time frame.
– I will do content/context editing. You’ll have to find yourself a grammar Olympian — but, if I see something outrageous I may make a change. Always have your best mentor/reader do the last check before submitting to the AMCAS, just a FYI.
– Give me 3 business days to respond to your draft, label it Personal Statement, with your name in the title. I’ll use the track changes/comments options in Microsoft Word to make comments, I’ll then return the paper to you for your revisions.
And lastly, I’ve baked cheesecake from scratch
This is probably more of my own personal accomplishment, then anything that benefits you…unless I invite you out to eat. This may happen.
As you probably already know, I applied for medical school last year, interviewed and was accepted. I will be starting in August — white coat ceremony is on day 1 of school!
If you’re curious how it feels, well, pretty damn good. I’m not accustomed to hard work begetting rewards, I had grown up with a empirical truth that hard work correlated to nothing more than hard times — thus, you best enjoy the journey — and so far I did. People often ask me a few questions:
Q: did you party like a rock star after getting into medical school?
I wasn’t showered in confetti, I didn’t go streaking down the street (I sort of imagined that’s how I’d celebrate, but alas now’s not a good time to pick up a misdemeanor), I didn’t take an extravagant excursions to Borneo, nor did I go spelunking. How do I celebrate? In a small way, for example “Man, maybe I shouldn’t buy this shirt..wait I got into medical school”. Those small rewards for myself are enough, because like many college students, I was trying to rival a monk on making due without for years — so, now I’m easy to please. Though, I’m amendable to my readers celebrating vicariously for me.
Q: given the smashing debt, why go into medicine at all?
It’s no secret that medical education is expensive in the US. The average medical student walks out about 180K in debt (not counting their previous debt from getting into medical school in the first place). I really had to ask myself this question, because well I turned down a full tuition scholarship to one medical school, and almost 100K from another. Now, I’m left waiting for my financial aid to be process at BU, and I’m not sure if I’ll be paying the bill by myself or with scholarships. I’ll let you all know soon how that worked out financially. Now, this may seem counter intuitive, especially considering how much I spent on applying. But, I think if anyone is going to use that annoying YOLO, it should be a medical student. You see, I grew up thinking I’d never do much for myself, in fact I thought as a child I’d be a trash man like my mom’s boyfriend — I even considered the utility of going to college, being the first to go. So, now that I’m going, I decided to just go for it. The person who inspired me to take that chance was my research mentor, and pseudo older brother.
Now feelings aside it’s an investment, because even if I spent 180K on lottery tickets tomorrow, I’m still statistically very unlikely to receive a return that makes the investment worthwhile. I believe that a good ratio of your pay to investment of education is your expected salary versus the investment, obviously you’d like to make more than you spent. So, for example, if you paid 60K for a masters I’d think you’d like to make around that amount annually to stay financially solvent (because I am expected to pay this money back). With that example, you may pay for 60K masters and make 20K for 10 years, this would be a great intellectual and personal investment but perhaps not a financial one. On the other hand, if you paid 150K for a BA in Underwater Basket Weaving, then you may be in for a rough ride if you don’t have a follow up plan. I don’t expect to buy a island in the Caribbean, put showgirls through college, or play golf with the mayor. Heck, I grew up with one solid dream, that is make enough so I have: running water, power, and have a home (because at some point in my life I’ve not had one or more of those). Besides, how many people actually get paid to do what they want to do? So I feel pretty lucky.
I’ll keep you updated about my financial aid package (or lack thereof) in the coming weeks, should be coming soon. Be ready for the possible massive face palm, or the lackluster celebration on my part. On the side note, I think there’s something almost liberating about owing a 1/5 of a million dollars — it really puts every day expenses into perspective, and I find myself rewarding myself a little more than I used to.
#doctorbust find me on twitter @doctorORbust
So, you’ve gone and done it now — you decided to apply to medical school. You’ve have/or you will put in your primary application early, right? Right? And now’s a good time as ever to consider the secondary application period. To orientate you:
- Primary applications – due early June (changes slightly year to year)
- Secondary applications – due early July – end of application period (varies by school, in general get them back within 2 weeks of reception)
- Interview(s) – early September until spring of the next year
*the dates are dynamic, keep track of your year.
What’s the benefit of hammering out the secondary early?
If you put in your primary early, you’ll have about a month or so to work on secondary essay drafts. The caveat here is that you won’t actually have received any secondaries by the time you ought to be drafting them — talk about cognitive dissonance, eh? So, what’s the trick here? Well, the secret is to know what to expect. Case in point, because I already knew what to expect I already had drafts to use for secondaries completed in May (because my PS was pretty much finalized by the beginning of May). This meant that I was able to respond to some secondary applications within days of reception, this seemed to have worked out, I was offered one interview less than a week after sending in my secondary in July. Thus, by the time I was working on more secondaries, I had landed several interviews already — this saved me some pesos because I was able to rescind my interests in some secondary applications, therefore saving several hundred dollars.
How long are the prompts?
Unlike the primary, you will respond to each school individually. This also means that each program will have their own prompts, and character limits. In general though, they range from several hundred characters (a fat paragraph) to “write as much as you’d like” 10,000 characters. In general, the less characters per entry the more prompts you’d expect to receive, the vice versa is true as well. I did secondaries somewhere in the teens, with the exception of one school, all of them had multiple short entries (i.e. 6-8 entries). Some of them have an optional entry as well, interestingly, I skipped the optional entry for BU because I couldn’t think of anything worth writing that I hadn’t already covered without being redundant — it worked out.
You’ll also probably find that you’ll have various versions of the same essay, the only difference will be the character count (i.e. short, medium, long entries). The short entries are much harder to write in my opinion, because they should contain a lot of bang for the buck, it’s easy to blabber on and on with a long entry. But, with that said, never blabber on and on.
What types of things do the prompts ask?
In general, the prompts asks for more clarification of things you probably already have briefly touched on during the primary application. The important thing to understand is that, while each school does generate their own secondary, after you do enough of them, you’ll find that you probably have already hashed out 1/2 or 2/3 of the entries, because you already have something drafted similar. Here’s a good link from http://www.accepted.com, they profile the Johns Hopkins secondary prompts from 2013.
Bank these prompts, go search the school you’re applying to for more secondaries. It may astonish you, but most schools are rather transparent about giving away their past secondary essay prompts — believe it or not, they don’t want the process to be the reason you don’t get in!
Do’s and Don’ts
– Don’t shoehorn a secondary from another program into the secondary you’re applying to. Follow their prompt to the T, if you don’t answer every clause in their prompt then you’ve failed to answer the prompt. Likewise, answering a question that had nothing to do with the prompt is a dead give away that you’re recycling.
– Do customize each secondary, so that any traces of “general answer” is stricken away. Have a friend re-read your secondary, to make sure you don’t slip in the wrong information from another school. Everyone borrows from their other drafts/prompts, it’s pretty accepted, and well expected. But, do make the effort so pretend like that was your only time ever answering that question.
– Don’t let the quality drop too much from the primary to secondary — it’s easy to turn in a great primary, you have all the time in the world. A good secondary is rushed, but should still feel complete. Don’t try to write a Pulitzer Prize entry, but if your writing quality drops too much they may wonder who wrote your primary entries.
– Do attempt to be somewhat consistent in your writing quality.
– Don’t return a secondary late, it shows your lack of comparative interest in their program.
– Do return a secondary within 1-2 weeks of reception, just make sure it’s quality.
– Don’t turn in a secondary without proofreading — you’ll mess up anyways, but you’ll feel a little better.
Well, thanks for having me! And you can find me on twitter at @doctorORbust
First, I like to thank you all for taking the time to read my blog. Because of supportive readers, like yourself, I’ve been able to reach out to 56 countries (and territories).
The Country by List Order of views:
United States, Canada, Japan, United Kingdom, Germany, Lebanon, Israel, Australia, Russian Federation, Pakistan, Singapore, Netherlands, Slovakia, Puerto Rico, Finland, Indonesia, Mexico, Philippines, Saudi Arabia, Republic of Korea, Ghana, Malaysia, Italy, India, Romania, Sweden, Qatar, Hong Kong, Ireland, France, Switzerland, Taiwan, Norway, New Zealand, Nigeria, Kuwait, South Africa, United Arab Emirates, Barbados, Austria, Cambodia, Bosnia and Herzegovina Guinea, Bangladesh, Serbia, Mauritius, Oman, Viet Nam, Thailand, Guatemala, Poland, Saint Kitts and Nevis, Nepal, Guyana, Dominica, and last but not least Bulgaria.
A 1/5th of my readers are reading from abroad. I can’t emphasize how rewarding it is to know that in the tumultuous world of global politics, the one unifying element is an international goal to become a doctor. Best of wishes to all my readers across the world, and across borders and IP addresses. One day, I hope we can all hang out for a massive medical conference, followed up by lots of partying =).