Pre-medical

Research Doing Research

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I never visited a premed advisor about my decision to apply to medical school. I didn’t have very good experience with advisors, in fact in community college I was told to settle for something more within my means. When I finally told other self declared premeds, as a late entry non traditional I was discounted as a smuck. I was ignorant to the premed code: I wasn’t a SDN zealot, I didn’t own a small library of inspirational books about medicine, I didn’t care about nor did I look up medical school rankings etc. I was unusually stoic about the whole ordeal, it’s hard to explain why, I’m just not that interested in those types of things. I’ve always been that way. Fortunately, this article isn’t about analyzing my quirky patterns. Instead, this article was written in response to a question I received about research. Instead, I’ll try glean my experience as an undergraduate researcher and my later work with aligning undergraduates into research projects.

Fun fact, of the entering class of Boston University Medical School of 2013 ~90% had undergraduate research experience. — MSAR

Initial StepsFind Out What Opportunities are Surrounding You

The first step in a survival situation is to assess your surroundings and see what you have to work with. It’s easier for some than others to find a lab, depending on your undergraduate institution, it’s easier to find a lab to join if you’re at a known research institution. On the other hand, unless you’re a co-principal (or primary) investigator then you should also expect to not have much influence over the project. This is especially true at larger institutions where your lab mates likely be graduate students or even post doctoral. At a small institution you may have a harder time finding a lab, but you may have more influence if that lab is smaller and (bonus) it may require more responsibility from even undergraduate researchers. Larger programs/labs will usually subdivide their labor for efficiency, smaller labs will usually put more weight on each member who’ll need to be a jack of all trades. The more impact you have on a lab the better your medical school application and the more you have to talk about during the interview because you weren’t just mindlessly running a gel nor were you a glorified dishwasher (albeit, an important dishwasher). I don’t think one way is better than the other, there’s ups and downs and a lot of grey in between. Instead, just keep in mind that there’s probably an opportunity at your institution (no matter the size) and if not then you can probably find something at a neighboring university (though, the grant process will be more precarious, you know if you want to eat).

So, before doing anything else, you’ll need to decide:

1. Do you want/need money?

It may seem like a silly question, but sometimes the opportunity cost is worth the profit loss — e.g. if you can get on a murine diabetes study, and you’re the co-principal investigator, then think of the experience itself as an investment. However, bills don’t get paid off of merit, so it’s totally realistic to seek grants, scholarships or stipends.

2. How far are the deadlines for stipends/grants/etc?

If you’re too late to apply for stipend programs, and if you can afford it, I’d strongly suggest joining a lab first. It’s a lot easier to apply for money when you already have a lab — my research stipend came after I already found a lab and I was already there for a years time. This may sound strange until you know how institutional research money works:

Each program most allocate a certain amount, typically if they don’t use that money they must self-report it to the state. The state will then take what wasn’t used into account for what’s needed for next years budget, i.e. if the school doesn’t use “it” it’ll possibly loss “it”. If you have a money surplus, and even if the programs have private investors it’s hard to ask for more money for undergraduate research. So, schools are very wary about offering stipends and grants to “at-risk” undergraduates who likely won’t complete their end of the bargain, so the people who are established have a better shot because you know they’ll likely finish.

Prior to finding a lab, a lot of well-intended undergraduates flake out on their research plans — I’ve seen it myself. So, when a student already has a lab it’s much easier to apply for programs.

Here is an example of the information you should find at your own institution, compiled by Accepted.com:

Screen Shot 2015-02-10 at 2.51.11 PM

http://blog.accepted.com/2015/01/26/pre-med-summer-undergraduate-research-programs/

Satisfying Requirements vs. Maximizing Requirements

So, why bother doing research? Do you want to do it because you want to satisfy the requirements for a medical school or because you want to maximize your science experience prior to matriculating? While it may be true that maximizing your application would likely include research. The the reverse is not true, that is satisfying the perceived research expectation will not maximize your application. There are probably a number of reasons for this, most of it because just as I was ignorant about the premed tenants, premeds tend to have a mutual misunderstanding for the nature of research. You must understand, there are people just as serious about getting into a prestigious research lab as you are about wearing a white coat and stethoscope. Of course there are the future Noble Laureates, also known as the MD/PhD candidates who already know both sides of the coin, for them this will probably just be me preaching to the choir. If my point seems cynical, try seeing it from another perspective, imagine if you met a fellow premed who said “I’m only doing these pesky hospital hours so I can finally get into medical school”. That’s sort of how I feel when people are downtrodden on research and medical school. So, if you haven’t chucked a shoe at the screen in protest, let’s precede to my tips about maximizing your research experience as an undergraduate.

How do I find a research lab?

  • Bring it up during office hours after a great final exam/performance. The most typical way is simply by rubbing elbows, i.e. doing well in a challenging course and showing a legit interest in the subject matter. I was invited to my physiology lab where I received my science lynching initiation this very way.
  • Join/find organizations that foster research for undergraduates. Most universities have an underfunded department that no one knows about called the “Office of Undergraduate Research” or something similar. This office usually acts as a nexus, providing a way for professors and students to find each other, find funding, and conferences. If you’re in a club that is STEMS related try talking to the program coordinator if they’re a professor, typically they’ll be able to easily align you with possible faculty to take you under their wing.
  • Ask graduate students and undergraduates already doing research at your university. They’ll have the best insider information, though you’ll have to take some things with a grain of salt. They should be able to let you know which labs have space and need someone to start from the bottom.

How long do I have to do research for it to “count”? And, do I have to publish?

  • I’ve heard all types of opinions about this. I was invited to an admissions question and answer session at Stanford, from there I poised the question directly. The reply to the myself and the audience was they’d be satisfied with 8 months to a year. I’ve heard other schools say about a year would be ideal if you were to bother doing research at all.
  • I think all schools will more or less universally agree that publishing a non-retracted article is always a perk — however, most people accepted into medical school have not published. I’d even argue going into research with the intent to publish “something!!!” is the wrong mindset, and defeats the idea of research. This is because for most people, that mere resume boaster for you is likely a life and death situation for someone heading towards their thesis defense. So, you should be realistic about your goals. If you’re dead set on getting a publication I’d encourage you to try either clinical trials opportunities, or labs with large teams, as these entities are usually on the applied science side of things and publish a lot faster. If you join a pure research lab your team might be aiming to publish in Nature, in which case you might have to stay on for your masters or a few years post graduate to guarantee a publication. This is because in many pure science labs collecting data, performing procedures, and even processing data usually isn’t enough to guarantee you’ll be an author on a paper. For some labs you are not an author unless you literally write up a significant portion of the paper submitted, or fulfill other arbitrary amorphous requirements. Research labs can be notoriously cut throat about accolades, and that’s why you should ask other students first about what the work conditions are before joining a lab if possible. Fortunately, medical schools already about lab politics, so you can easily make up for lack of publications by presenting the project at different science conferences. Therefore, instead of focusing on getting your name on something, focus on getting the experience and the confidence.
  • You should be aware of what stage the project is in, is it still being drafted as a research protocol? Maybe it’s still in it’s literature review stages. On the other hand, maybe you’re on the receiving end of years of hard work that preceded your presence and you’ll be one of the twenty authors. Again, this is only possible to figure out if you asked other students of that lab — try buying them coffee or better beer, that worked well on me.

How do I join a lab if I have a low GPA? 

  • Start with acknowledging that you’re interested in a lab, for example an electrophysiology lab. Now, if you have a low GPA they might be a little weary about letting you touch their samples. I’ve heard of one student forgetting to shut the refrigerator for one lab’s samples, they lab lost about twenty years of data. I’ve never seen a professor look so depressed, and rightfully so. Thus, don’t be surprised if you’re on a probationary period at the beginning. Start with asking to just help in any way possible, this could literally mean starting off by scrubbing glassware.

How do I move from lab glassware lackey to co-investigator? 

  • I recall, one premed joined our lab this way, he started by washing the glassware. They were actually terrible at cleaning the glassware, and we lost about a month of data because our samples were always contaminated with soap scum or hard water stains. Therefore, you need to be the Karate Kid about whatever ‘menial’ task you’re given, because while it may not be ‘science-y’ to you it’s probably integral to the project as a whole. After you’ve proven your responsibility show initiative by presenting new articles with your analysis at lab meetings (labs frequently do weekly literature reviews), if that’s too scary start off sharing articles with your research team. But, you should be able to explain why it pertains to the lab and your current methodology. Basically, do whatever you can to show you’re hungry for more. For myself, my grades was palatable, I just had to prove myself because I was the only undergraduate in the lab. I presented a literature review/timeline I had worked on by myself for a few months, this literature review helped snowball other projects in our lab — and I won my co-investigator page.
  • If you want to be a co-investigator you should prove that you’re able to hold up your end of the bargain, for example you’ll want to attend free workshops about writing a research protocol, animal use and research, methodology, lab skills etc. This could also be as easy as completing your universities human protections (CITI) and/or animal protection certifications from reading a few modules and taking some online quizzes through your university. The training is usually free, although you could pay a fee to gain certifications, these carry a lot of weight if you go into other labs and want to prove your worth — stick to the free stuff as a premed.

If I hate research am I doomed?

  • Absolutely not, in fact a lot of schools don’t expect you to have undergraduate research, as a premed you’re busy with a hundred other things. But, instead you might want to consider what is it about research you don’t like. For example, if you hate the tedious tracking of data then you probably don’t want to be on a tail end of a clinical trial, that’s a sea of forms and data. If you don’t have loads of patience you probably should avoid ‘theoretical’ science labs etc. Don’t discount research, it’s just a good chance you haven’t found your fit.

What is my research background?

I’ve mainly dealt with electrophysiology, you can have a blast reading about it more on Wikipedia for more electrophysiology if you’re interested:

Electrophysiology Study: Effects of Extracellular ATP on Mammalian Muscle

In this project I was a co-principal investigator. Responsibilities included micro surgical preparation of muscle samples. A microscope was used to place micro electrodes into muscle tissue. Muscle tissue electrical signals were then amplified, and then properties such as conductivity and capacitance were assessed.  The data was then extrapolated and interpreted to describe the activity of the muscle cells in ex vivo such as capacitance, ionic conductance and ultimately excitability.  Various agonists such as ATP in low doses was shown to help excite muscle by inhibiting chloride channels, antagonists of P2Y1 purgenic receptor was blocked these responses.   

Electrophysiology proof of concept study: Measuring Action Potentials in Muscle using Electro-potential Sensitive Dye Di-8-ANEPPS ((4-{2-[6-(dibutylamino)-2-naphthalenyl]-ethenyl}-1-(3-sulfopropyl)pyridinium)

Was responsible helping for determining if the electro potential dye Di-8-ANEPPS could be used practically to measure action potentials in resected mammalian mouse disassociated fibers. My task was to perform electrophysiological measurements of sarcolemma action potentials, with toxins and with agonists.

Electrophysiology study of diseased muscle: Huntington’s Disease, the Correlation with Electrical Muscle Membrane Properties

For this project I was partly responsible for the maintenance, and Huntington symptom score assessment for mice.  My tasks also included maintaining gathering comparative electrophysiological control samples. 

I’ve also worn a hat as a Institutional Review Board and Animal Care and Use Committee member, where I help with ethical reviews of protocols, and inspections of research labs to keep the USDA and NIH appeased and furry creatures treated fairly. I also picked up an interim position where I’m paid off a grant to help organize research conferences and coordinate undergraduates with research opportunities. Just something to keep me occupied before medical school starts, helps to pay the bills of course.

Well, till next time.

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Letters of Recommendation: How Do I Get Em’

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credibility-gap

Contact me on twitter: https://twitter.com/masterofsleep

Welcome back,

Applying for medical school is an odd process, especially if you’re a nontraditional applicant. For myself, I rushed to complete the premed requirements and my major/minor/undergrad research. After being molested by academia, you’re thrown into the hardest entrance exam in on the planet (no hyperbole) for 5-6 hours. Then you are asked to complete several other Herculean feats to complete your medical school application, abbreviated as the AMCAS:

  • Primary Application
  • Scores: MCAT, and GPAs (two separate undergraduate GPAs will be calculated by AMCAS), a masters degree will not shroud undergraduate GPAs, it will however show improvement.
  • Personal statement:  bust out your feather quill to write the best personal statement you’ve ever written — no, the one you wrote before won’t do either.
  • Work Activity Section: I’ve already covered this in another article.
  • Letters of Recommendation: this article will focus on obtaining a letter.

So, I’m often asked about the subject of “Letters of Recommendation” (LOR, or LORs when plural), I’ll tell you how I handled them in this article and attempt to answer the following three FAQs:

  1. From who do I get them from, and how important are LORs?
  2. How do you I ask letters for a recommendation?
  3. When do you need to start thinking about letters of recommendation and what is the timeline?
  • From who do I get them from, and how important are LORs?

Most medical schools accept two types of letters individual letters and/or committee letters. If  you are traditional premed then go with whatever your premed adviser suggests as the standard protocol for other premeds from your university who have been accepted. From what people tell me, that usually entails obtaining a committee letter if you’re a traditional premed. However, as a nontraditional I had no idea if my university actually has a premed committee, nor did I care to receive premed advising as a late entry nontraditional. Thus I obtained individual letters from various professors — so this article will focus primarily on individual letters. In my own case, having individual letters seemed to work out because I was offered four acceptances by mid winter. There are probably pros and cons to either form, for example committee letters are probably logistically a lot easier to obtain and they probably know what to write to make you look like a good applicant. The downside (just to play devil’s advocate) is that you’re really hedging all of your bets on the committee who probably don’t know you very well personally besides the occasional meeting. The upside of the individual letters is that if you chose you writer wisely you’ll end up with a very exceptional personalized letter. But you could also chose the worst person to write a letter for you, and on top of that you’d have to handle all the logistics of making sure your letters go to AMCAS on time on a case per case basis. Before committing to schools be sure to check with each school’s policy because sometimes they do have very specific requirements.

In my case, my individual letters were:

  1.  Human Physiology Professor and my research principal investigator
  2. Chemical Engineering Professor and the chair of my research scholars program
  3. Chemistry Professor and research adviser for research scholars program
  4. Political Science Professor who I volunteered with for prison education programs
  5. The dean of my major

I chose writers who could vouch for what I felt were my strengths like work ethic and science background (letters 1, 2,3,4), my commitment at bettering my community (letter 4), and someone who could vouch for my patient experience (letter 5). If you have individual letters coming in, use them to compliment your AMCAS. My principal investigator worked together quite intimately, so they also had no problem ameliorating my perceived shortcomings for the admissions committee. I had all but one of them upload the letter electronically after I gave them a written tutorial about how to upload it to be sure it arrived on time.

Either way you choose, individual or committee letter(s),  there’s no way you can guarantee the admissions committee will see the writer’s arguments for your admission as satisfying or cogent. It’s hard to quantify how important LORs are, because we have to consider a lot of variables such as the rest of your application and letter quality, but I’ll just say in my case my letters came up favorably during all of during my interviews (unless they were not given access to the LOR prior to the interview). So, I think it’s probably safe to assume they’re important and shouldn’t be thrown together haphazardly, the quality and amount of effort you put into obtaining good LORs will correlate to better LORs.

  • How do you I ask letters for a recommendation?

You may be in school or out of school, either way the strategy isn’t that different. Now, I work with professors everyday for work, and I see how busy they are and how to get through to them. Check online, go to their office hours. Bring transcripts with overall GPA, classes you want them to see highlighted, plus any other recent accolades. Tell them why you want a letter from them specifically, when you intend to apply, and when you’ll need the letter by. If they agree give them at least 6 weeks (make the window too short and they’ll refuse, too long and you’ll never get a letter finished). Even if you obtain a verbal confirmation that they’ll write you a letter, be sure to follow up with a formal request for both your records by email, it’ll help keep the record straight for both of you. Remember, your letter writer probably doesn’t have time to write you letter, but they’ve kindly agreed to postpone their other responsibilities for you.[[ (quick reference): [insert Corran letter] I asked for all of my letters in person.]]

If possible make in person verbal requests, bring nothing with you but a succinct explanation of why you want a letter from them, and verbally confirm they can write you a “strong” letter of recommendation. If they agree to write you a strong letter then tell them you’ll follow up with a written email with your transcripts/stats, and means by which they can submit the letter. Some professors will tell you directly, “I don’t think I can write you a strong letter”. It doesn’t necessarily mean they curse your existence, they’re probably being honest because it translates to “I don’t know you enough to write you a strong letter”. On the other hand, in the unlikely event that they actually despise the day you were born and have a picture of you on their dart board, you wouldn’t want one from them anyways right? Don’t take it personally if they refuse, they’re likely doing you a favor by saying “no” either way. If they say they can not write you a strong letter of recommendation thank them and move on.

Follow up with a very easy to read email. Now, I assume your writer will be an excellent reader, but they don’t have time to read through a gregarious lengthy email. Furthermore, they’re putting their “street cred” at risk as a professional by attaching their name to yours, so it’s quite an honor to receive a strong letter of recommendation, make sure you’re doing your part to make it easier on your letter writer. So keep it short and sweet and unambiguous, so be sure to include in the formal written request:

  • Let them know the exact name you used to registered for AMCAS as well as your AAMC ID#. Remind them the letter requires an official letterhead.
  • First and foremost, thank them for agreeing to write you a strong letter by a specified date — letters will likely roll in late if you rush the writer without prepping them properly or allow the responsibility to fall onto them to ensure timely completion.
  • Give a  very brief narrative about you and your intentions (a short paragraph).
  • Stats: give them a summary of your GPA/CV, favorable or not. For their peace of mind include a PDF attachment of your transcripts/CV, let them know it’s attached and the correct title if you have multiple attachments. Highlight the pros of your stats, offer to talk more in depth in person about personal circumstances that may of left bruises on your transcripts.
  • Concretely tell your writer what types of things you’d like them to address.*
  • Give them a concrete way to submit the application. This will mean giving them the physical address of the AMCAS letters service if they want to go snail-mail, or providing them the links and steps to upload your letters online. If your letter writer finishes the letter and can not send it because of poor instructions it’s not the fault of the writer.

Don’t be surprised or insulted if the professor who agrees to write you a strong letter first requests for you to draft a letter of recommendation for yourself then submit it to them to modify as template (it’s very common in the research world). Above all else you should always know your strengths and weaknesses of your application. Use this knowledge form a draft that shows your good points and rationalizes the humps on your application without making excuses. There’s a good chance that the LOR they actually send will appear nothing like your draft, but the highlights you wanted will likely still be captured.

  • When do you need to start thinking about letters of recommendation and what is the timeline?

You should start thinking about who would make a good candidate for strong letters as soon as possible. The sooner you understand the strengths and weaknesses of your application the sooner you can start pulling together your writers. If you’re afraid of writers forgetting about you later, let them know about how you’d like a letter later, and send them an email as a record to confirm the confirmation. When it comes time to ask them later, you could pull that record up to help refresh their memory.

Give your writers ample time to compose a good letter for you, if you try to drop a bombshell on them at the last second don’t be surprised if you get a mediocre letter or if they outright refuse out of principle alone. You can turn in your primary AMCAS application prior to receiving any letters, however schools will not invite you post secondary application unless you’ve submitted your LORs they request for their program. So, it’s important to consider the timeline when you’re requested strong LORs. I approached my writers formally in April (primary applications open in June) and I gave them a deadline of the 3rd week of May. This gave my writers enough time to compose the letters, and enough time for me to discretely nudge my writers when they were falling behind.

In closing…

The amount of preparation and methodology you chose to use to obtain your LORs will have a correlation to the LOR quality submitted. If you put in the minimal amount of effort then expect a minimal LOR. Also remember, your writer (especially professors) are putting their reputation on the line, so be courteous and respectful. Be sure to thank your writers after the process, and keep them up to date on your progress or lack-thereof (as a tutor I really loved when students got back to me about grades or when I wrote a rare LOR for them). Be honest, respectful and appreciative while constructing your professional network with your writers.

Have something to add about your experience with committee letters or individual?  If so, feel free to share.

Thanks for reading, and feel free to contact me anytime https://twitter.com/masterofsleep

*updated on 12/18/13 Added something about the letterhead. Thanks  SDN user.