Month: August 2014

A Day of a Medical Student

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Medical school offers a lot of unique experiences, a lot of them are amazing some are frustrating (studying and feeling like you haven’t made progress, something we all go through). But, so far it’s pretty rewarding. To give you an idea of how my life now works, here’s a write up of one of my days.

I wake up about about 6:30 AM (just to clarify, I’m absolutely not a morning person). I must be sure to arrive at school by 7:45 AM if I plan on filling my coffee mug, and having my keister in the lecture hall by 8 AM. My school offers complimentary coffee  if you know where to find it. I tried, with moderate success, to preview the slides for the day of Gross Anatomy lecture and prep for another anatomy dissection for the afternoon. The anatomy lecture lasts for a few hours, we covered the back, spine, shoulder, upper arms, and forearms in the last couple of weeks. We are responsible for knowing muscles and their: actions, origins, insertions, innervations, vasculature and the infamous brachial plexus — I should also mention that we’re also responsible for knowing the bones on our own, we’re assigned a “bone box” with an assortment of bones to self study as on our own time. On that particular day, we were on the forearm and the muscles of the hand, this also included common fractures such as the Colle’s fracture and the Boxer’s fracture. The former fracture common to athletes like football players who fall with a flexed wrist, where their distal radius breaks at the styloid process and/or ‘simply’ stops making contacting with the collective wrist bones. The latter fracture is somewhat of a misnomer, it’s a fracture of the 5th or so digit (pinky) usually seen in people who were fighting, it’s a misnomer because an actual trained boxer probably knows how to punch someone without fracturing their fingers in the first place. At noon I devour lunch with my classmates, and typically mentally brace for dissection lab. On that day, we were the second team to work so we had free time to study before going in to finish the rest of the planned dissection — the dissection went well for both teams.

Overall, the tricky part about anatomy is figuring out how to squeeze it all in your head in a meaningful way. Our medical school tries to emulate Step 1 by giving 2nd or 3rd order questions, i.e. a clinical vignette wherein we have to both figure out what the question is asking and answer the question (long story short, they’ll never ask you a straight forward question). Lab is a tricky challenge, as you not only have to prepare for lab for yourself but also for your team; the worse you perform the worse your teams performs. For the first couple of weeks I was pretty stick from the formaldehyde, I’ve always had asthma so it really got to me. But, I just kept going into lab to grow accustomed to it, once a lot of the fat was removed the smell dissipates a bit, so things are better — though, I expect the allergies to come back once we dice into the viscera. I ended up finishing the day at about 5 PM, as we stayed a little longer to make sure we’d be on track for Wednesday dissection.

After finishing dissection, I had to change from my stinky scrubs to clean scrubs because I was to shadow in the trauma unit at 6 PM that evening. I didn’t bring enough food, so I had to engulf more food from a local Subway, then rush back to the hospital (fortunately, there’s a lot of food options close by). I went to the main desk of the hospital and picked up the phone to page my resident, someone came and we hung out in the trauma waiting room where the doctors wait to be paged. That night, I was on with trauma consult, this means that patients come in with bad conditions that may require surgery and they have to be delegated out to other departments (ortho, general surgery, etc). That day, my resident assumed it’d be slow in comparison to the weekend, where people have a penchant for getting injured the most.

It did certainly start off slow, we even had enough time to grab a coffee and the resident gave me advice on residency. The only case we had to worry about was an elderly person who had fallen and had fractured their hip, this fracture didn’t come up on X-ray weeks before and had shown up on a CAT scan when they came in with complaints of not being able to ambulate.

Then, that all changed when suddenly all the available trauma bays were full.

A young women who was injured by a car with severe bilateral hip dislocations and multiple fractures, they was wearing a neck brace because they weren’t sure if they also suffered spinal injuries. As you may have imagined, they was extreme pain with intermittent and understandably bawling and screaming that they couldn’t feel their legs, their ankles were twisted, and there was random spats of blood in the trauma bay. A sheet was tightly tied to their hip to keep everything in place. X-ray techs used the portable X-ray to get an idea of how bad it was, we later went back to the trauma waiting room to view the images on computer, it was terrible and they’d require decompression (aligning the bones back in place) by a team of ortho surgeons. The good news is that they didn’t have pneuothorax, but there was a question of if air had entered their viscera and was internally bleeding as one would expect with such a horrible accident. The initial CAT scan argued against this, however, the images was sent up to a team of radiologists in the hospital just to follow up.

While this was all happening we’d jump back and forth between the trauma bays to attend to two motorcyclists who were struck by a car. The driver, had a Colle’s fracture and a huge hematoma on the sternum where presumably the handle bar had blowed into the chest; it was also likely that their had a fractured hip. The passenger was ejected, flying over him onto the too of the car, they also had injuries. Glancing at the monitors we could see that, despite their injuries, they were hemodynamically stable and just in an extreme amount of pain. The drive couldn’t remember the accident, so they were sent up for a CT scan to ensure their head was okay.

While we were waiting for the CT scan, they resident asked me to go get histories on the female who was dragged under the car. We have a class called Introduction to Clinical Medicine, here we practiced taking histories; not that I thought I’d be using it so quickly. Now on pain medications, but still obviously in discomfort I approached them, asked their name and took their history and jetted back to my resident to report. Apparently satisfied, the resident asked me to go find the motorcyclist getting a CT and get the drivers history as well. Hospitals aren’t the easiest to navigate, and I probably looked like a lost puppy, but I did eventually find him and got his history as well. Then I had to track down the resident and their attending and report the history so they could document it, no one was upset so it must have worked out.

The beeper went off yet again, this time an inmate had tried to unsuccessfully suicide attempt. We bypassed the two guards, to approach our shackled patient in bed lying in wait for medical attention. This person had several contusions on their forehead, as earlier that day they were banging their head against the wall and several more bruises on their neck where the sheet they used to try to hang themselves had caught. We got the history this time together, their complained of pain and complained of blurry vision. The blurry vision worried the resident, the guard sitting in my view then made the universal binocular hand gesture, so I blurted out “Do you wear glasses?”, and they said “Yes”. This person was also on a slew of psych medications, and probably needed social work more than medial attention (I hope they get it), having worked with inmates previously I really feel for the spiral of events that may of lead them to here.

We then rushed up with the attending to go talk to radiology about their patient who was currently in surgery to decompress one patients hip. The attending there spotted some air in their viscera, and so surgery was paged immediately and one attending went to go update to let ortho know that they’d have to watch for internal bleeding.

Soon, the resident then said, “Remember that women with the infection? Can you go get a history from them?”. I had forgot about that woman, just like how I forgot to mention their in this story because the whole night was a blur. This patient had hurt their foot, and had come in with severe swelling of their foot. But, after interviewing them we learned that their now infected foot was accompanied by pain deep under their knee (DVT?). I reported back to my resident, noted the pain and we spoke of the possible DVT (this they was already watching for) and the new symptom polyuria that coincided with the infection before they came in.

By the time we had done all of this, it was now 10 PM. The gentleman and the passenger on the motorcycle were both stable, and hanging out in the ER for observation. The women who was drug under the car had their hips set back in place, and would be ready for follow up surgeries later, by the way they could move their toes so they were lucky to escape serious nerve damage. My shift was over, I was invited back for more by the residents and I shuffled out of there and rode the train home being too tired and lazy to change out of my scrubs, took a shower and woke up at 6:30 AM to start another day.

Disclaimer: certain information was changed in the story to protect patient and physician privacy.

 

 

 

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5 Tips on Getting into Medschool — as posted on Accepted.com

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Reflections on Getting Accepted to Medical School

Are You Trying to Navigate the Med School Application Process?

A few weeks ago I was asked to write an article for Accepted.com on my past reflections on premed life as a current medical student. It actually took a few weeks for me to fulfill this request, as I was moving to Boston from California. Some of it I wrote while on the airplane, the rest I eventually finished in bit pieces in Boston, writing a sentence here and there between white coat ceremony and after classes. So, with that, here’s the article as reposted from their site:

In general, all the cliche tips you’ve heard are true: get good grades, you need an ‘acceptable’ MCAT, definitely get patient experience, and you’ll likely need some extracurriculars. All of these things about this pseudo check-list are true, it’s just a matter of figuring out a strategy to execute it. It’s also important to take a 10,000 feet look at the process of trying to get into medical school: you just want to get in, but medical schools are looking for people who can add to their program.

1.    Find a mentor as soon as possible, it’s never too late.
2.   Go at your own pace (grades, scheduling and taking the MCAT, and extracurricular activity).
3.   Gain marketable skills during your undergrad.
4.   Have the right attitude.
5.   Understand how the admissions process works overall and for the specific programs you’re applying to.

Finding a Mentor

Finding a mentor is easier for some more than others. If you already have connections, then it’s a rather straight forward process since all you need to do is reach out to who you already know. This mentor doesn’t have necessarily have to be a medical doctor, they should just know or be willing to get to know the difficulties you’ll face. Statistically speaking, since you’re in college you’ll probably have more access to a PhD professor than a MD or DO, it’s okay to start there. My mentor was my old physiology professor, I later worked on several projects with this individual. Because my mentor was an active researcher in electrophysiology it allowed for me to gain marketable skills and later find a job after graduation in the office of research at my old university. This made it easier for me to develop a set of traits and experience that may come of value to my matriculating class. I think people put too much emphasis on finding a physician mentor, while it’s great to have a physician as one, it’s important not to neglect your other resources. If you don’t know where to start, try checking out your universities “Office of Undergraduate Research” (or something analogous to it) as they typically specialize in aligning undergraduates with research mentors. I highly suggest research mentors because of the amount of depth and involvement that will be required for both you and your mentor — the deeper your involvement the easier it is to argue to medical schools just how you’d add to their program. Research certainly isn’t required (for most programs), but it’s a lot easier to explain what you did if you were part of a research team than say passively shadowing a physician. A good mentor will know your personality traits (the good and the bad) and will be able to work with you, helping you to become your own person and not necessarily a miniature version of them. Another trait of a good mentor is that they’ll often push you further when you’re all but ready to give up, not to torture you but because they know you’re capable of it.

Go at your own pace, don’t rush into failure

It’s easy to get sucked up into following another’s pace. Don’t be afraid to slow down, and be sure to get help when you need it — rushing to apply when you’re not ready, or trying to plow through the organic chemistry series isn’t the best strategy if things aren’t going your way (unless you’re applying for DO remember that your retakes at best are averaged together with the old scores). You have to be flexible about your abilities at the moment and pragmatic about what you can accomplish. That’s not to say you can’t get past the MCAT, but maybe trying to rush to take it so you can apply isn’t the best strategy. I’ve seen a lot of friends lose their chance to apply to medical school because they tried to sprint through the requirements or stack up too many extracurriculars concurrently. Take your time, this is your life, one or two years won’t really make a big difference in the long-run; take on challenges at a pace you can handle, you need not emulate anyone else or follow other premeds “suggested timeline.” Really, the only timeline you need to worry about is applying early during your application season, everything before that should be a personal journey. For myself, I didn’t go straight into the university I actually found myself working for years and considered dropping out of college completely because I had a career going at a young age. I later decided to go back, and went to a university and graduated in 5 years with a major, minor, and research under my belt. I took my time, and found my own path, with the help from mentors and several friends, and I ignored people whenever they questioned my timeline. Realize that a lot of people who you think are “rocking it” and will “surely get in” won’t, part of this is probably because of rushing and doing badly or burning out while doing well.

This also means that it’s better to do several things exceptionally than to do 100-mediocre things. In my old lab we used to host premeds who were ‘interested’ in research, but it soon became obvious where their heart was when they’d stop showing up once they got what they wanted, wouldn’t finish their assignments, or would put minimal effort into what they considered to be “scut work”. At that point, for example in lab, you’re probably unnoticeably sabotaging the lab. So, keep in mind that if you’re involved in activities you may be hurting more than helping by participating. If you hurt the organization more than help then don’t expect either a transformative experience or a letter of recommendation. So, if you can’t commit, and things are going too fast for your pace, slow down and figure out your priorities and only commit to things that you can help.

Gain some marketable skills

I wasn’t sure if I’d get into medical school, so I was terrified to graduate without any marketable skills. In other words, try to “specialize” in college. Unfortunately, not everyone will have an appreciation for your pipetting prowess or that you took labs like the thousands of others — so don’t be fooled into thinking that just because you’re a premed you’re automatically skilled because you’ve titrated a few times (some people get their PhD on titrations). If you get into research, it’s rather straightforward, you’d likely gain skills because you’d have to grow more proficient than the average premed because the success of your lab is riding on it. If you’re not a research orientated person, learning how to start service orientated clubs for example is an excellent skill, as is learning how to fundraise. What helped me in this process was to keep a resume and a CV, this way I was always objective when it came to “why” I was doing something. This also makes writing your applications for medical school dramatically easier, as you already understand your motivation and your objectives. Most premeds have a problem filling out the AMCAS application, though if you’re used to applying for jobs (jobs that require a degree) then  it’s not an extraordinary process.

Have the right attitude — once you think of it as “scut work” all is lost

“Scut work” is a amorphous phrase, one person’s ‘scut work’ is another’s dedicated career. You may feel wiping out vomit and feces is below you, but besides the lessons in humility it’s also a lesson in relativity and often a lesson in team work. You may wonder what mopping the floor with disinfectant has to do with you becoming a physician. Well, in that case a lot, because you’re helping to prevent MRSA infections in the hospital, lessening the load of the staff etc. You may feel washing lab ware  is beneath you, after all you just shadowed a neurosurgeon on Friday, but I’ve seen months of data lost (plus the lives of mice wasted) because premeds thought rinsing out the soap at the bottom of our glassware wasn’t important enough of a task for them. Yes, shadowing the surgeon was probably conceptually cooler, but how much did you really do besides observe? Often, it’s really the “scut work” that is where you can have the most impact. Besides, if you can’t wash glassware, or pipette properly, why would you be given harder tasks that you seem to not able to handle?

Once you start seeing things as “scut work” you’ve probably already missed the lesson, and the lesson is typically team work. Yes, I’ve gotten coffee for my lab mates and professor, but at the same time my lab mates and professor have brought me food and coffee because they knew I couldn’t leave my work space until dusk.

At the end of the day, hypothetically if you didn’t get into medical school and you abhorred your extracurriculars, than you probably weren’t doing it for the right reasons.

Know how the admissions process works

There’s a ton of advice floating around, some of it is legit, most of it is garbage. There’s a certain website, who’s name I won’t mention, that is ripe full of useless or misleading advice. Some advice you’ll get will be bad because people are ignorant of the process because they’ve personally have never went through it, but they’ll consider themselves self appointed experts because they’ve read enough anecdotes. Instead, go with people with admission experience and keep up with the latest AAMC news, and of course your specific programs’ guidelines and advice. The AAMC isn’t an evil agency as some would make it out to be; they’re rather invested in making sure you have the best shot possible at getting in — though, you wouldn’t know it by how some people act about the process of applying to medical school. Applying to medical school isn’t necessarily a mysterious process, but it sure will be if you didn’t do your own homework. Make sure not to be pulled into 20 different directions, stick to a few good sources (including the crown jewel aka the AAMC website), and don’t dilute your efforts too much by taking disparate advice from others. — even those who’ve applied many years ago are likely out of touch with what is required or expected of you currently, so it’s very important that you secure your future by doing your own background research. In the end, if you don’t get in no one will be accountable or more affected than you.

And lastly, it’s okay to be pragmatic, but don’t give up hope because of a bad grade or MCAT score. For the most part, courses and the MCAT can be retaken. Sure, it’s ideal to get past them with flying colors, but life doesn’t work that way usually. A test of your commitment is not only getting past these things, but learning how to do what it takes to get past them. This may mean you can’t apply to all Ivy Leagues, or that you’ll have to make a few detours. But, one C (or even D) won’t exile you from medicine, nor will a bad MCAT score — nor does it imply that you couldn’t survive medical school. You might find yourself taking a few detours, but in the end if you’re satisfied than that’s all that matters. Getting into medical school isn’t that transformative, but the journey to get there is, and if your endgame is just to get in without trying to better yourself then it’ll make applying just that much harder.

– See the original post: http://blog.accepted.com/2014/08/21/reflections-on-getting-accepted-to-medical-school/?utm_content=7507417&utm_medium=social&utm_source=twitter#sthash.A5tbkTM9.dpuf

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PreMD Tracker Application — (Strong) Suggested Download

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gpa act unnamed

I’ve never been so furious about a phone application. Why? Because it didn’t come out when I was applying to medical school. When I was applying to medical school, I scoured the internet, data mined multiple AAMC pages and devoured books about admissions wherever I could find them. Well, the good news for you (if you’re a premed) is that you won’t have to go through so much trouble. Yes, you should still do your homework like checking up on AAMC updates, but you don’t have to feel lost in the nebulous world of medical school applications like all of us were before this application. So, what is this application I kept harping about? It’s called PreMD Tracker, and it’s available (exclusively, for now) on the Android Market. The hint of the function of the application is in the name alone, it allows you to make a self check list to monitor your progress in assembling your medical school application. In the application you can both record and find additional information pertaining to that subject (using links from the AAMC) on: 

  • GPA
  • Letters of Recommendation
  • MCAT Scores
  • BCPM grade point average calculator
  • Volunteering Experiences and Hour Records
  • Upload your CV

The application is massive, and has many menus with additional information. In fact, I honestly feel that you could literally leave my site and download it immediately and never have to read my blog again because there’s so much there — I’m okay with this, if you promise to apply to medical school while using this application. Anyways, I was so intrigued by this application and who’d go through all the trouble to make this application that I arranged a phone call with one of the creators. It turns out that the creators both were friends from undergrad at Johns Hopkins who later went onto successfully apply to medical school. Though, they like myself, found the admissions process to be rather daunting and unapproachable at first. After they had gained admittance into their respective institutions, they decided to share what they’ve learned about the admissions process and make an application during their deferred year off. However, neither of them were programmers so they had to learn how to design, program, and put the application on an application market — note this wasn’t just a medical school admissions activity stuffer for these guys, as they were already admitted and just wanted to tackle the challenge of launching an epic project. 

The application is still coming along, and they hope to expand the phone application to the Apple Market Place, but more rancor is required to motivate these busy medical students to take time off their studies to push more programming out. Also, right now it’s free, so just take advantage of it because they made it free for download because they wanted people to benefit from it without feeling anxious about pricing — how and if this will remain free is a big question in my mind, as a medical students time is worth its weight in gold (if time were in fact weighable). 

With all that said, here’s a link to download the application:

https://play.google.com/store/apps/details?id=com.eiron.premdapptracker&hl=en

 

 

 

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Received First “Pass” in Medschool

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I’ve been in medical school for just a few weeks, I thought I’d leave some highlights and help document my own memories:

Intubated dummy

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Intubation is an emergency procedure usually done in the emergency room to secure the airway of someone who can’t breath on their own and you have some trepidation about them drowning in their own secretions. My medical school, more specifically emergency medicine interest group at my program,  had an open opportunity to anyone who dared to try to intubate an anatomical dummy. A few weeks before I started medical school I got caught up in the show Boston Med, in that episode a fresh MD intern tried to intubate a patient and failed to do so — I know this is a skill you need down because time is the essence in both saving the figurative patient and reducing co-morbidites. So, what better than to get an idea of how hard this procedure is then by trying it as a first year with absolutely no training except the crash course 30 second mini lecture I received beforehand. The procedure is straightforward, but not without it’s caveats:

1. Place laryngoscope into oral cavity, hooking the tool towards the basement of the tongue. Ultimately, the purpose is to reflect the tongue out of the way.

Laryngoscope
Laryngoscope

2. Push and lift the laryngoscope, being sure not to roll the tool backwards as this will either break the patients teeth (best case scenario) or crack the maxilla (bad news).  The point of this movement is to expose the trachea (the vocal chords end up being a dead give away, no pun intended).

3. Once you’ve located the trachea, you stick a tube with a balloon attached down their trachea, you must be sure to not insert the tube down the esophagus (ultra bad news). Within the tube there’s a stiff, but pliable, rod that will keep the tube from collapsing as you’re trying to gently/aggressively shove the tube down the trachea. Once you’ve done that, you put about 10 cc of air into the tube to both keep the tube in place and prevent fluids from the patient from regurgitating up and going into the lungs (also bad news).

4. Then while holding onto the tube, you pull out the rod, and place either an attachment to bag to manually ventilate for the patient or the ventilation machine.

It’s pretty straightforward, though performing it is another story. I failed the first time, I wasn’t aggressive enough to expose/open the trachea. I then took a mental break and tried it again, this time I got it but after a brief struggle. Finally, after gathering my experience and thoughts I tried again and this time I intubated right away! I’ll definitely will be practicing this more in my 3rd year in the clinical skills laboratory. I never really thought of myself as a hands on person, despite constantly working with my hands, but I liked it and I’m excited for my future emergency room rotation on the wards as a 3rd year.

Signed up to shadow trauma surgeon

You never really know what you’ll do by the time you finish medical school, at least that’s what I’ve been told repeatedly. I suppose this hit home the most when, during my interview, one physician spoke to us about her own experience in medical school until now. At first, she couldn’t see herself doing anything but primary care, now she’s a trauma surgeon. She said to us during our interview, “If you come to this school be sure to contact me if we’re interested in shadowing in trauma”. So, I did followed through and contacted her, I have my first shift sometime next week. Let’s see who that goes, my primary goal is to not get in the way.

Gross Anatomy

The naming of gross anatomy proves that science people do have a sense of humor. Interestingly, it’s not so much the person or the physical anatomy that grosses medical students out. Instead, it’s that we’re inclined to like people and I won’t lie, a lot of us are quite sensitive emotionally (at least it’s that way in our class). The person who donates their body is the most beautiful and inspiring person you’ll never meet (unfortunately, postmoterm). For medical students this is a rite of passage, we all deal with the emotional and psychological impact in our own way. For me, it was with a pint of ice cream — though, I didn’t finish the ice cream yet as I was too tired to physically raise the spoon to my face. Last week we prepped the donor (and ourselves), this week we started dissection on her. Like most medical schools I’d imagine, we started with the back as they have huge muscle groups and there’s a lot of room for error due to the nature of the back, they have you start with the back first so you can learn how to work a scalpel. This is a huge effort, and requires a lot of team work. There are 8 members in my team, but only 4 of us are there  for a session — but we are one unit. One team starts, then another team comes and finishes. In between, there’s something called “transition of care”, this is analogous (and purposely so) to patient hand offs in the hospital. Each day there is a team leader (from the 4 person cell) who’s responsible for making sure the next team leader (of the other 4 person cell) knows what’s going on and what issues have come up. If we don’t finish our objectives, it’s the whole teams responsibility to self schedule a team to finish the work before the next dissection assignments. Today, I was part of the first team and all of my awesome team members worked together and achieved our goal today.

We Start Seeing Patients this Week

A lot of medical schools try to get their medical students into clinical thinking as soon as possible, typically with mock patient interviews from skilled patient actors. Our 3rd week into medical school we’re already schedule to start doing rounds with either residents are MS4 medical students and seeing real patients. Our responsibility is to take their medical and social history (probably from the nth time), and present out information to our superiors. I’ve already received my white coat, but it’s not in my possession because I gave it back to the school to get it embroidered as required. I’ll get it back this week before I start seeing patients. Around the same time I’ll be receiving my stethoscope and otolarynscope, both of which I probably won’t realistically know how or need to use for some time. For now, my focus will be on seeing patients, and learning how to build a report while gaining skills at getting an accurate and informative history from patient interviews. I’m a little nervous about missing information more than anything.

Survived My First Medical School Exam

The school crunched what would be a semester in undergraduate of Histology into 5 days (literally) followed by an exam. As I’ve never formally taking Histology I was a little apprehensive about this, as were many of my classmates, many of whom have never had experience in the subject matter either — though, it should be noted that some of my classmates were savvy enough to have taken a masters post bacc course (or post bacc with no degree) Histology course for 7 weeks prior to this. I mention this because if you’re of those people who’re doing post bacc work you should know you’re work isn’t going to waste, those people were comfortable with the cram session. For the rest of us, it was a gratifying torture, but we got through it. My school is a pass/fail school, though we can personally see our own scores so we can know how we’re doing. I passed with a comfortable margin, in fact the class average was rather high considering the circumstances. I should mention that the biggest difference between medical school and undergraduate work is that you really need to work with others to make things work, there’s just too much for you to think you can cover by yourself in too short of a period of time. I go through this period by planning studying groups, crashing study groups, and showing up to office hours. Without my class I’m not sure if I’d be sitting so comfortably right now as I write this blog, instead I’d likely be panicking and wondering if I’ll make it — turns out the signs are positive.

 

 

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Interview Tips for Medschool Applicants

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Hello All,

Just finishing up the second week of medical school, it’s been a really busy week. I have a test coming up on Monday, we’re covering a semester (or quarter) of histology within a week — though, we’ll revisit it again in more depth next year. We”re the first year they’ve tried experimenting with this “crash course” in medical histology so that everything, coincidentally we’ll also be the last as they’re switching to system based curriculum for entering students next year. Though, it should be noted that our second year is clearly system and diagnostics based. Regardless, a medical school will make you a doctor, but it’s our job to try to get the best out of the experience to later to good physicians. Some of you have been given a chance to attend a medical school interview, if so congratulations! If not, there’s still plenty of time to receive an interview, some people in my class were invited rather late and accepted almost the week before school so keep pushing through. And remember, if you don’t get in then improve your application and re-apply.

So, with that aside, here are some interview tips (this list got longer than I expected, sorry not much time to edit it down!):

Preparation

1. Do a ridiculous amount of homework for your interview: check the local news online, check their website for their local interest groups and try to see how you’d fit into their program and mission.

2. Know your application better than anyone on Earth. Nothing is worse than coming off as a fraud, and the easiest way to do that is to appear like you fluffed your application. Know your application, know why you participated in X groups, why you took a gap year, understand your influences and weak points. They can only go off what ever you’ve presented them with, don’t let them know you better than you know yourself as it won’t go well.

3. Practice coming up with main themes for you answers for the interview. You can try doing a few mock ones if you wish, I’m lazy and shy about those types of things so I just came up with main themes and practiced by myself (lack practicing for a speech). Though, to be fair, I’ve given a lot of speeches and talks so it’d probably be better to just try with others. There are plenty of books with “sample” interview questions, just pick one up and go through it to come up with your own answers. Also, just search Youtube for interview tips, some of it is baloney but it’ll get your gears turning.

Logistics and Transportation

4. Purchase airplane tickets at least 6 weeks prior to the interview, after that they rates really will jack up. Note that the rates change throughout the day, so check multiple times (or set alerts for price deals etc). You probably won’t rack up enough miles to make use of any frequent flyer program, they tend to do a good job of keeping you away from cashing in, so don’t get too picky about riding on a certain airline.

5. Rental cars are pretty pricey to hang onto during an interview, but they offer a lot of flexibility. If I were interviewing again, I would have rented a car less and probably have just used Uber (with a back up plan of using a cab). Though, depending on how far out you stay from the school while visiting a rental car may be the most logical way to go.

6. Show up and find the place you’re supposed to arrive at about 45 minutes to a hour early. It’s okay to ask the staff if you’re in the right place, after you’ve confirmed just hang out and have a seat and try not to bother the staff. Be extra friendly, the staff and faculty at medical schools are infinitely closer than your undergraduate experience so treat everyone you meet (even the janitor) as if they’re potentially the dean of admissions. If you’re early and nice to everyone it’ll help cut down on the nervousness, at least it did for me.

Fashion

7. If you’re a male, learn how to tie your tie. There’s no shame if you don’t, but if all you have to depend on is your pre-tied tie done by your uncle three years ago then you’re setting yourself up for stress during you interviews. It’s not hard if you practice it a few times in the mirror — you can find plenty of videos on Youtube. Also, don’t dare go to your interview without going to a tailor to get your pants and suit cuffs hemmed to fit you. This is the secret to looking professional: you can start off with a relatively cheap $100 suit and pay another 20-30 for tailoring and the result will make it look like a $1000 suit. You don’t want to go looking like you’re wearing your dad’s suit. You don’t need to go get a customer tailored suit, just go to a cheap place that’s been around for a while and ask them for suggestions about fit. Ideally, when you sit your paints should reveal your socks by a few inches and not drape over your shoes when you walk or sit. The cuffs of your white collared shirt should show just barely by perhaps half a centimeter when you’re wearing your suit-jacket, furthermore the jacket should be long enough to stop at your wrist but not after your wrist widens to your hands. However, the caveat here is that if you don’t at least try to start with a suit that fits you in the chest and back especially, then you’ll likely spend another few hundred dollars to get those sections tailored as it takes a lot of work and a skilled hand. If you’re fashionably inept then consider bringing a “professionally dressed” fashioned coordinated friend with you. If you have a thin frame, I’d suggest going with an Italian cut (slim fitting) in the standard medical school charcoal — it’s significantly cheaper to tailor a suit that almost fits you, hemming is usually the cheapest and most bang for you buck thing you can do. And of course, don’t neglect on your shoes, but don’t splurge either however don’t come into the place with squeaky clogs either. You whole goal should be to look like a respectable doctor, after all you will be one soon right?

For females, you don’t need to dress like a puritan or anything, just dress professionally equivalent to your male counter parts. I’d suggest not wearing shoes that “click clack” too much, as they’re both distracting for you and everyone else during the long interview day. Be sure to wear shoes that won’t bloody your ankles (or make adequate preparations in the heel for padding if you have choice). I won’t suggest much more about how to dress, especially as I never saw one female incorrectly dressed for the interview (guys on the other hand, that was a crap-shot). Just be sure that you can be confident in whatever you wear.

There are a lot of people in my class with tattoos (arms, back, etc.), while it’s okay to have them it’s also considerate to cover them for your interview. After you’re in, sure rock that tattoo of Satin devouring kittens, but at the beginning just try to be respectful of others’ beliefs. I personally think tattoos are awesome, but as a first impression don’t make it into a philosophical battle of the merit of tattoos and bias.

The Interview

8. Be yourself (hopefully that has positive implications) — it’s much too tiring to be something else in my opinion. This translates to standing up for yourself and your opinions during interviews. If you have an opinion, and a rational manner of defending it then by all means it’s okay to disagree with an interviewer. However, you don’t need to pick fights or win battles, just be okay with being fine with “agree to disagree”. If they convince you, fine, but don’t just be a yes “wo(man)”.

9. It’s okay to ask the interviewer questions about the program, about their position etc. You’ll have to “imagine” that you’ll get into multiple programs and you’re just trying to evaluate the best one, this will keep you objective (but, don’t be arrogant about it). There’s a fine but discernible line between arrogance and confidence. In fact, ending the interview with no questions is a passive way to tell people you’re that interested, but don’t ask questions you could have/should have easily found out if you just did a little research. The better your questions, the more they’ll know you care and have given their program careful consideration.

10. Write down the interviewers’ names, this will make it easier for you to write them correspondence later if you choose to do so.

Post Interview

11. Jot down things you liked and disliked about the program immediately while it’s fresh. This way, if you do write a letter to the school (letter of intent, I didn’t write any so I can’t help you there) to let them know your intent of matriculating if accepted you can write legit things as opposed to blowing smoke up their butts’. If you receive multiple acceptances having this list is incredible when it comes to weighing the pros and cons of the program. I kept notes throughout the day, but I wrote them in another language so no one else could peak at what I wrote; if you don’t have that advantage then just write sloppy short hand that only you can read. These notes can in handy actually even during the interview when I was able to address brand new things I found out during the tour about their patient population etc.

12. Don’t, don’t, don’t, don’t become complacent because you’ve landed a few interviews. Until you’ve landed your acceptance it’s best to treat every interview like it’s the most important interview in the world, heck if afterwards you should be serious about them. If you’ve already gained an acceptance, unless your dead set on going to that program, consider continuing to a few more interviews as you might learn something new about other programs. It’s also decent experience for what you’ll need to do next for residency interviews (though, those are probably a lot more fun).

13. Be humble. Congratulations, you’ve interviewed and whether you get it or not, it’s a monumental step. But, there are those who aren’t accepted for one reason or another, be sure to remember that not too long ago you were just as nervous and unsure as them.

Remember, if you’re invited to an interview then the probably already are at least interested in you (and may even sort of like you). All you need to do is either win a few people over who may not be sure about you and/or prove that you’re not a phony and all the stuff you said on your applications are congruent with who you actually are.

Good Luck!!!!

 

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Open Letter to My First Patient

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As I massaged the lotion on your skin, I glanced at your nicely kept clean long nails. You can learn a lot about people from their hands, they often reveal more than we ever let on. These hands that were once as smooth as mine, but have grown weathered and experienced with age. I can only wonder who else had the chance to hold your hand: your children, lover, and parents when you were but a child trepidatiously crossing the street. As I stroked your fingers and palms with moisturizer your long elegant cold fingers betray your secret, you were certainly an graceful woman. While holding your hand, I can only wonder what type of wonderful person you were while you were still alive, before you decided to donate your body to our course. Glancing at your face I can still see the pride and wit imprinted in your wrinkles, I’m certain if we had met before you’d have much to teach me and many ways to make me laugh. I will soon know you in a different way, that even those who knew you when your vessel was full would have known. I’m not sure why you’ve decided to donate your body so I can become a doctor, allowing for me to have this intimate experience with you, but I will never forget you because you are my first patient.

You must have been a wonderful person, and I’ll never be able to thank you for letting me get to know you. And although I’m not to sure about the idea of an after life, I can only hope that one day to get the chance to meet you because you’re the most beautiful person I’ve yet to meet.

MD candidate

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Survived First Week of Medschool!

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Hello Everyone,

It’s Saturday morning, I have some  ‘down time’ before my mandatory Basic Life Support course, so I thought I’d update my blog about my first week of medical school. If you haven’t started medical school yet, I imagine your week of orientation will be somewhat similar to mine (plus or minus pomp and circumstance).

The first day of school I met my classmates, faculty and staff. This was also the same day of my white coat ceremony and my undertaking of the Hippocratic Oath. There are several renditions of the oath, we took a modern version that was customized for our institution. In the same day, we went on organized scavenger hunts to receive a few course syllabi, pins for our white coat, lockers, medical student ID badges etc. The syllabus in medical school is a cast iron contract of exactly what you need to know (and also implies what you may not need to know by lack of mention). In general, the big difference between undergrad and the medical school syllabus is that some syllabi and slides may constitute all of the reading material for the course (besides supplemental reading) — this is hard to understand until you have the syllabus in your possession, this is also why ‘pre-studying’ before medical school starts is more or less a waste of time because you really need the syllabus to get started. The first day ended with our ceremony and the oath, plus plenty of photo opportunities for proud parents and spouses. Most of us then optionally  gave our white coats back so that they could be embroidered, we’ll start seeing patients in two weeks, so we want to make ourselves identifiable.

The rest of the week was really a blur of orientation, talks from top doctors about the state of health care, and team building experiences (these were actually really fun). On the second day of school we had Introduction to Clinical Medicine. They invited a patient to do an interview with our instructor, we were all on the edge of our seats because the patient was real and rather amazing. We started medical histology using virtual microscopy (i.e. digitized images that allow for zooming and can be viewed from any computer with the software), we also had our first group discussion (these are mandatory). Interestingly, a lot of courses do not have mandatory attendance, so some students decide to sleep in every now and then (or perpetually). I’m sure I’ll consider staying home when there’s several feet of snow outside, but for now, I like my classmates so much that one of my main drivers is to hang out with them. I may be able to survive medical school alone, but in order to thrive I’m learning how to tackle this challenge as a group; after all, we’re all going to be doctors, and doctors work in teams. The school uses pass/fail grades to make us less likely to slit each others’ throats like people tend to do in undergrad.

Our class system for MS1 is traditional, i.e. we do the fundamentals first. So my class schedule for the semester boils down to:

  • Human Anatomy (starts next week, just picked up scrubs for it)
  • Biochemistry/Molecular Biology
  • Human Behavior in Medicine (psychology course for physicians seeing patients)
  • Introduction to Clinical Medicine (we’ll start doing rounds in a few weeks to interview patients in the hospital and present cases to upper classmates)

Lastly, there’s a lot of opportunity for extracurricular, service, and medical exposure. I just signed to shadow a trauma surgeon in a few weeks, and one student advisory position. Others are already trying to create their own clubs or create their own opportunity by starting programs they think our institution is missing. The wonderful thing about my medical school is that they encourage you to be the same person you were, with the same interests that you had, before you matriculated. This should make sense, because most medical schools want to know what you’ll “add to their program” if you were accepted. My class is composed of 166 members (out of 11,700~ applicants), from 22 countries, some are married, some have children, some identify as LGBT, almost everyone has research experience, and the majority of us are bilingual — we have a lot of things in common, but enough differences among us to make every person an individual.

So far, it looks like they didn’t make a mistake, and I won’t get a letter saying “Sorry, we made a mistake with you”. Thus, this week was a good week!

 

 

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In Boston for the Next 4-Years (at least?)

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Hello Everyone,

Thanks for your patience, while I’ve been away for a little. To make sure I didn’t have down time in posting I released some articles I had in the draft box, so hopefully my absence wasn’t noticed at all by my readers.

If you applying to medical school right now good luck! Premeds not applying to medical school, enjoy your summer (even if you’re taking classes, trust me, enjoy your summer!). As you may already know, I was a premed up until recently, I applied last year and had a very fruitful application season (acceptances). As a consequence, I just moved from perpetually hot and sunny California (near LA) to the  perpetually shifting weather in Boston.

Dry dust bowl, most of Pacific-West states are nothing more than irrigated deserts.
Photo from the plane: Dry dust bowl, most of Pacific-West states are nothing more than irrigated deserts.

 

The last time, and well only time, I’ve been in Boston was for my interview nearly 9-months ago. At that time, I stayed with a M3 host. Well, sort of, he actually wasn’t home for my entire stay as he was on away rotation elsewhere in the state by the time I had arrived. Never the less, he invited me to stay with his room mates as his doppleganger — his roommates were obviously awesome as well. So, the one of the first things I did was get into contact with him! We finally have met, drank a beer and broke bread. He’s an M4 now, and will be graduating by the time I finish my first year. I’ll swing by his house to pick up some much needed dishware, conveniently his roommate wants him to get rid of some of it.

Next on my check list was to celebrate the fact that I was in Boston the same way as I did before: beer. As you may notice, being accepted as permitted me to up my celebratory brews.

Before and After
Before and After

Besides that, I also made sure to enjoy my last weekend as a free man. So, I spent most of this week walking around Boston with my roommate and a few others. I can definitely get used to this more scenic city, best part is everything is pretty much in walking distance.

Hanging out by the pond.
Hanging out by the pond.

Tomorrow my parents will be coming out to Boston for the White Coat Ceremony — it has occurred to them that this is probably an important day, at least symbolically. Monday, I start orientation for medical school; incidentally, my bed arrives on Monday (2-day shipping my *ss Amazon!). So, I’m sleeping on a hardwood floor cushioned by a rug and garments to brace my body for the painful lay down. Good news, I’m going to medical school, beds and comfort are for suckers!

 

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