1) Waiting time is exploration time.
I can not stress how important this can be. A lot of medical schools give you an hour or more where you have nothing to do but wait for your next appointment. Get out of the admissions office and explore! If you have 10-15 minutes before your appointment, that's one thing. However, sitting around comparing applications with a bunch of applicants is not going to help you get in or help you judge a school. True, a lot of medical students will pop in and out while you are hanging out in the office, but these are students who are going to tell you mainly the positive stuff about their school. Go find some disgruntled students! This is potentially the school you will have to study at for the next four or more years. You will have plenty of time to ask questions and talk to some students/applicants during the tour and meal periods. You will NOT have another opportunity to wander around and see things off the beaten path like research facilities and other things that you might be interested in. Further more, you might have the luck of learning something that could help you explain your interest in the school you are interviewing at , or something that you will be able to otherwise connect to your application. Learn as much about the school as you can, wander! Even better, you have the wonderful opportunity to possibly meet someone who could seriously help you get accepted. I once got stuck in an elevator for 10 minutes with on of the Associate Deans, and on another occasion I happened to stumble upon the Dean of Admissions, something that lead to an hour and a half friendly chat.
2) Staying an extra night has its advantages.
Interviews are all about showing the admissions committee that you are a good fit. Your stats and application gets you an interview, but your interview is, in general, essential for an acceptance. Staying an extra night, either before or after your interview, provides you with excellent opportunities. For one, you have another opportunity to wander around and meet people/learn things, as I mentioned above. For two, you have an enormous opportunity to socialize with students, especially if you happen to be spending Friday night there. While I suppose there is the very unlikely opportunity of meeting a student member of the admissions committee, the bigger benefit is you get to interact with students on a completely social level. This is a great insight into how students really feel and if you fit with their style. In addition, once I had a couple students actually plug for me with the admissions committee. I was extremely flattered, regardless of if it changed anyone's opinion of me.
3) Know something about your interviewer.
Generally, you are given the names of your interviewer at the start of the day, when you arrive. Naturally, you will attempt to be early anyways, so use that time to go find a computer. If you have an internet friendly phone, that'd work too. I have never had a problem using a medical school's library, simply explain that you are interviewing and it should be all right. So how does this advantage you? I'm not saying you should walk into your interview and say "I know where you went to school and where you live." A little too forward. Rather, you can use it to your advantage by steering your responses to reflect mutual interests and realms of knowledge. For example, say you are interested in public health and your interviewer is actively publishing on the topic. You would be able to have an in depth discussion on this topic. Also, it can be useful for when you are inevitably asked if you have any questions. If your interviewer is a cancer researcher and you have an interested in opportunities in the field, or just general questions about their research, feel free to bring it up. Highlighting mutual interests can never hurt you, but it certainly can help you. Adcoms are looking for students that fit with their philosophy, and your interviewer is a part of that philosophy. You want to be able to relate to your interviewer, because it will certainly make the interview less stressful if nothing else, even if the connection is that you were both from the same State and you contrast your State with where the medical school is. If you are asked how you know something, simply admit that you asked or looked something up on them. I've actually been complimented several times for taking the initiative of looking something up.
4) Dress conservatively, but don't hesitate to be fashionable or to stand out a little.
You definitely want to be professional at interviews, but don't hesitate to drop the white button downs for a shade of blue or the color that best suits you. I noticed at my first interview that I was the only one out of 20 students to wear something besides a white button down. I was consistently selected out of the group throughout by those leading conversations, demonstrations, etc. By my last interview, more than half of the interviewees were wearing something besides white. Coincidence?
5) Send thank you letters, assume they won't help you.
Don't fret about whether or not that a letter is going to help you or hurt you. Unless there is a specific request for letters, it will not affect your application negatively. They receive a bajillion of them, you will not seem pretentious or trying to brown nose. Most likely, by the time your have sent your letter and it is received, any notations on your application by your interviewer will have been submitted. There is a slight possibility of it helping you during later evaluations, I suppose, but don't count on it. Not sending them is not going to affect you for the same reasons. However, if you end up going to that school and you did not send a thank you letter, you might feel a bit guilty for not thanking them. After all, they were probably instrumental in getting you accepted. I know I do, and I fully intend to apologize if I went to one of the several schools I chose not to send thank you letters to, several of which I've been accepted to.
6) If given the option, schedule interviews as late as possible in the day.
For one, you will be more awake and alert than you would be for that 8:00 AM check in after tossing and turning all night. More importantly, you will have had hours to experience and learn about the school, quite possibly having done the tour and info sessions. This is an enormous advantage in tailoring your "Why this school" questions, which is sometimes a bit hard when you've only read about it.
7) Consider a chemical method of putting yourself to sleep the night before.
It can be really hard falling asleep for a variety of reasons. Jet lag, large time difference, staying with a noisy student, etc. All of this could seriously hurt you the next day. I know that at one particular interview, I was so exhausted that my picture they took is terrible (I had a lazy eye from being so tired), and I did very poorly at the interview. I also asked some pretty dumb questions, because I just couldn't sleep straight. Think about taking a light dosage of sleeping pills, or even a tad of ethanol (make sure you shower in the morning. A beer or two shouldn't leave an odor, but why risk it!).
8) Other little things
Smile, especially when meeting your interviewer
Don't try and smile the entire interview, it will look fake if it isn't natural
Learn to be humble and still get your message across
Thank them for any praise, be humble about it
I grew up on military bases, so I have always chosen to address my interviewers as Ma'am or Sir. Yes sir, etc. It seems like a lot of my interviewers were ex-military, as well.
Ask good questions. Even if they are standard, the best questions are the one's you didn't read on a list of "good questions." They come from yourself
Don't be afraid to pause before answering, especially if it is a new question.
Friday, January 30, 2009
It's an odd feeling
I had a uncomfortable experience recently, and its the first time that it has ever happened to me. I was dancing with a girl in one of my dance classes, and we were covering a style of dance that I had never done before. She was getting a little frustrated and clearly hoping for a new partner by the time we took a break, but we got to talking about medical school. She told me that she was a pre-med (year younger than me by the way), and was applying next year. I then told her that I had been accepted to medical school and how my interview process had been going. Her attitude towards me instantly shift 180 degrees. She was suddenly more friendly, enthusiastic, and forgiving of my mistakes. In fact, SHE started apologizing, even though it was clearly my lack of experience rather than hers. I was shocked, and I realize that this is probably only the first of many times in my life that my career in medicine is going to alter people's behavior and opinion of me. This kind of prestige is supposed to be a good thing, right? It's what a lot of people want when they apply for medical school.
It really bothered me.
It really bothered me.
Thursday, January 29, 2009
"Commandments" of SDN
So SDN has the potential to be a great resource for pre-meds. Alas, the forums of the student doctor network are full of eccentricities and neuroticism. Here's a joking list of commandments for those who dare to venture into this abyss.
1) Thou shall not troll
2) Thou shall not discuss MD vs DO
3) Thou shall not say MCATs
4) Thou shall not start the same stupid threads
4.5) Thou shall make liberal use of the search function
5) Thou shall not discuss under represented minorities
6) Thou shall wait till August to change thy title to medical student
7) Thou shall not post in class threads until thy art a member of said class
8) Thou shall consume great quantities of salt when partaking of SDN
9) He that speaketh of Prestige shall be stoned
10) Thou shall not seek to identify LizzyM
11) Thou shall not fret over one C+
12) He that speaketh of money or lifestyle shall be stoned
13) Thou shall limit thy post to 1500 characters.
14) Thou shall send thank you letters
14.5) Thou shall not send thank you letters
15) Thou shall limit thyself to one utterance of "We're going to be doctors"
16) Thou shall not ask if medical school is hard
Friday, January 23, 2009
My beef with DO students
I'd like to preface this with my intentions first, because discussing DOs is always a dangerous thing for someone on the MD track. I have complete respect for DO practitioners and their Art. I think no less of DOs, nor do I think they make worse doctors in any way. I have had the pleasure to interact with almost as many DO's as MDs, and they have performed just as well and I learned just as much. I can say this without bias, because it was not for a long time after my interactions with them that I even learned that they were DOs. My beef is with the younger generation of DO students (some of them, at least). The field of Osteopathic Medicine has fought long and hard for its right to be considered equal in the medical field. However, I have seen more and more behavior revolving around the idea that DOs are better than MDs, rather than both fields being equal in worth and quality. I hate hypocrisy, though I don't claim to be free from it. Three particular behaviors particularly irk me.
1) DO students and pre-DOs that claim that DOs are somehow better at treating patients as people, focusing on the patient rather than the disease, and are better at primary care because of it.
This is a bunch of subjective nonsense. There is no evidence to prove or even support this. Look at a veteran DO and a veteran MD and tell me if you notice any difference, besides personal choices of bedside manner. A good doctor of any degree does what works, and discards what doesn't. This is how one becomes a better doctor. There is no secret gift that DOs obtain at their school that can not be learned by MDs. Assuming some part of DO training does give them some sort of better grasp of medical art, an MD would see this, enquire about it, and begin to implement it. This is how medicine works, by continually learning and improving yourself. I personally don't think there IS some kind of training that makes newly minted DOs better at treating patients. What I think it is happening is that young DOs or DO students are eager and exceptionally friendly to patients (just as young MDs and MD students are). Patients are receptive to this eager use of the Art of medicine, and then say that this particular student is the best or most caring doctor they have had. They then assume this means that DOs are all better at patient relationships because of this. This isn't a fair assumption, as I said MD students and freshly minted doctors have an equal level of excitement that rubs off on patients. We are all young and eager to do what we have spent our whole lives preparing for. I have spoken to many veteran and retiring doctors, and what I always get out of it is this: "I was blessed to have a job that I could love for xx number of years, but I am tiring of it, and its time for me to quit." You will not be as fresh and excited your first day in the field when it is your last. I have watched my father since I was a child, and he has become more calloused by the long hard years of a dedicated practitioner. He still does his job with the same level of professionalism as he always had, but he doesn't leave a long shift the way he used to.
Anyways, the bottom line is this for me. If DO students can say that they are better at relating to patients than MD students, then I can say the reason is because they are closer to average intelligence (citing GPAs and MCAT scores), and thus find it easier to relate to patients because of it. Neither statement is fair or correct, so DO students please stop trying to insist you are better than MDs. We've accepted you as equals, why don't you do the same?
2) MD turncoats that become avenging angels of Osteopathy, and vice versa.
These people REALLY get my goat. It absolutely drives me nuts when someone wants nothing to do with DO schools, talks about nothing except MD schools, and then, when they don't get into allopathic schools, they are suddenly the champions of DOs. It tends to be these folks that commit 1) the most. I have no problem with you justifying that DO schools are just as good, because they are just as good at training doctors. However, when you start running around promoting the DO philosophy, saying how you couldn't think about doing anything but DO medicine, or even dare to try and talk down about MD students, you cross the line. I can accept that some students might fall in love with the DO philosophy after being exposed to it, but if you haven't even started school yet, or you are fresh into it, please don't come to me with that! You haven't even learned the extent of the DO philosophy, and you are going to go around trying to rub it into my face? Please!
The opposite goes as well. I know a bunch of students who were totally all about the DO gig, did nothing but talk and research DOs, etc. Then, they manage to get into an MD school, and all of the sudden its all about fit. It just so happens that they ALWAYS fit better at the MD school rather than the 8 DO schools they were accepted to. Always? Really? That's really interesting how you fit at the type of medicine that many pre-meds cling to as being superior. If you know you like osteopathy, go down that path. If you know you like allopathy, go down that path. If you are unsure, apply to both and keep an open mind. But don't you dare flip flop on me! This isn't a presidential debate people!
These people REALLY get my goat. It absolutely drives me nuts when someone wants nothing to do with DO schools, talks about nothing except MD schools, and then, when they don't get into allopathic schools, they are suddenly the champions of DOs. It tends to be these folks that commit 1) the most. I have no problem with you justifying that DO schools are just as good, because they are just as good at training doctors. However, when you start running around promoting the DO philosophy, saying how you couldn't think about doing anything but DO medicine, or even dare to try and talk down about MD students, you cross the line. I can accept that some students might fall in love with the DO philosophy after being exposed to it, but if you haven't even started school yet, or you are fresh into it, please don't come to me with that! You haven't even learned the extent of the DO philosophy, and you are going to go around trying to rub it into my face? Please!
The opposite goes as well. I know a bunch of students who were totally all about the DO gig, did nothing but talk and research DOs, etc. Then, they manage to get into an MD school, and all of the sudden its all about fit. It just so happens that they ALWAYS fit better at the MD school rather than the 8 DO schools they were accepted to. Always? Really? That's really interesting how you fit at the type of medicine that many pre-meds cling to as being superior. If you know you like osteopathy, go down that path. If you know you like allopathy, go down that path. If you are unsure, apply to both and keep an open mind. But don't you dare flip flop on me! This isn't a presidential debate people!
These guys annoy me too. After all the battling and struggling to become equal, they have refused to reciprocate. The AMA gave their students the right to apply for Allopathic residencies, and even recently came out with a resolution prohibiting discrimination against DOs on the basis of their degree. And yet, MDs still can't apply for osteopathic residencies. This is absolutely unfair! You want equality? Its a two way street!
Thursday, January 22, 2009
Kaplan should pay their MCAT teachers more
So I work for Kaplan as an MCAT teacher, and the other day something occurred to me. It was right after I declined another course to teach this semester, and a discussion with my boss on how he was struggling to find someone to teach it. I realized that MCAT teachers are getting a bit ripped off. I personally am ok with the money and don't really care, because I'm doing it for the teaching experience rather than because I want more money. However, there are 4 MCAT teachers and like 20 SAT teacher at my Kaplan site. We all get paid the same, despite the fact that MCAT teachers are more scarce (and we teach approximately the same number of students as the SAT folk, because our classes are much larger). It also takes a lot more work to teach a class room for pre-meds, though admittedly with a little prep and if you follow the material religiously you could probably fudge your knowledge. MCAT students pay more than twice that of most other test prep takers at Kaplan as well. And yet, Kaplan MCAT teachers don't get a cut of this. I'm surprised that this has never come up, because quite honestly each MCAT teacher is more valuable and difficult to come by than SAT teachers. We tend to have more education as well, since SAT teachers can start teaching at age 18, but few 18 year olds are prepared or capable of teaching the MCAT. Like I said, I don't care that much, but it does seem a little unfair.
Monday, January 19, 2009
Question 9: What are the pre-requisites for medical school
The pre-reqs for medical school vary from school to school. According to the Medical School Admissions Requirements (MSAR), the following numbers of school in the US, Canada, and Puerto Rico require the following courses:
Physics -120
Inorganic/General Chemistry- 119
Organic Chemistry- 121
English- 84
Biology- 85
Biology/Zoology-40
Calculus - 17
College Mathematics - 35
Behavioral Sciences - 9
Humanities - 14
Biochemistry- 13
out of 129 schools polled.
This however, does not give you the exact number of semesters required for each course. The most common recommended list is:
One year (2 semesters) of General/Inorganic Chemistry and labs
One year of General Physics and labs
One year of General Biology and labs
One year of Organic Chemistry and labs
None of these labs may be taken online, and all of these courses are needed to be optimally prepared for the MCAT.
In addition:
2 English courses, with writing portions
1 Calculus class and 1 statistics class.
I also recommend a semester of biochemistry and genetics. Neither of these courses are commonly required, but both of them are extremely useful as reviews for both the MCAT and medical school. I would also definitely suggest that you buy an MSAR the year that you apply and check the requirements for each school that you applied to. You do not have to have all of these requirements done before you apply, only by the first day of classes at medical school. I would strongly recommend that you not try to get around these requirements, and finish anything that you need in you Spring semester.
Here is a link that claims to have compiled all the math requirements for schools that have them:
http://www.brynmawr.edu/healthpro/documents/MedSchoolMath_Requirements_2009.pdf
Physics -120
Inorganic/General Chemistry- 119
Organic Chemistry- 121
English- 84
Biology- 85
Biology/Zoology-40
Calculus - 17
College Mathematics - 35
Behavioral Sciences - 9
Humanities - 14
Biochemistry- 13
out of 129 schools polled.
This however, does not give you the exact number of semesters required for each course. The most common recommended list is:
One year (2 semesters) of General/Inorganic Chemistry and labs
One year of General Physics and labs
One year of General Biology and labs
One year of Organic Chemistry and labs
None of these labs may be taken online, and all of these courses are needed to be optimally prepared for the MCAT.
In addition:
2 English courses, with writing portions
1 Calculus class and 1 statistics class.
I also recommend a semester of biochemistry and genetics. Neither of these courses are commonly required, but both of them are extremely useful as reviews for both the MCAT and medical school. I would also definitely suggest that you buy an MSAR the year that you apply and check the requirements for each school that you applied to. You do not have to have all of these requirements done before you apply, only by the first day of classes at medical school. I would strongly recommend that you not try to get around these requirements, and finish anything that you need in you Spring semester.
Here is a link that claims to have compiled all the math requirements for schools that have them:
http://www.brynmawr.edu/healthpro/documents/MedSchoolMath_Requirements_2009.pdf
Question 8: Should I take AP credit?
For those who are sure that they are going to pursue the pre-med track, I am a profound supporter of not accepting any AP credit. This is not to say that I don't think AP and Advanced classes in high school are valuable. Quite the contrary, I think that the classes themselves are enormously beneficial. The bottom line is, though, that a ton of AP credits will never make an adcom whistle and be impressed (my opinion). It might not directly hurt you on the admissions road, but it will not make you more competitive either. I understand the benefit of being able to jump into sophomore year classes, especially if you intend to double major, but here are my biggest reasons for not accepting AP credit.
1) You miss out on a GPA inflater.
This is my biggest plug for taking AP classes but not the credit. AP classes are very closely related to most of their namesakes in college. By taking AP Chemistry, you are setting yourself up to be very well prepared for General/Inorganic Chemistry your Freshman year. GPA is enormously important part of your application, and this is a great way to improve yours. This is especially true for your Science GPA, even if you are a science major. If you took AP Physics, Chem, and Bio, you have 6 science classes that are going to be a lot easier to get an A in. That's a huge boost to your GPA, and a great GPA buffer if you ever have troubles down the road with grades and get a couple C's. I personally would advocate dropping all AP credit that you get, but I definitely suggest that you at least drop the med school pre-requisites. Getting A's in every one of them (because you had already learned it in high school), will go a long way in showing that you are capable of tackling the basic sciences in medical school.
2) Some schools don't accept AP credit for pre-reqs, or only accept it conditionally
There are a number of schools that jut plain don't accept AP credit as legitimate fulfillment of the pre-reqs under any circumstances. Meaning, if you don't take the classes in college, you will not be allowed to matriculate at these schools, even if they accept you. I know a friend who had to withdraw his application from a couple schools because of this (he still was accepted elsewhere thankfully). I can't offer a full explanation as to why this is, but I assume it has something to do with them really want to check your basic science skills, especially for non-science majors. Most of the schools that don't accept AP credit are willing to strike a deal with you. Basically, you can still fulfill the pre-req requirements that you have AP credit for by taking a higher level science course in that area. So if you took AP credit for General Bio 1, you can take Cell Biology or Genetics (assuming it isn't a pre-req) to fill it. This is fine and dandy if you happen to be taking those classes anyways, but for non-science majors this is a pretty big burden. Even for science majors, it can be a hassle if you don't have any classes to fill, say, your Physics requirement. Why risk hurting your GPA on higher level classes that you don't want to take, or don't need to take? If you aren't interested in the class, forcing yourself to take it is dangerous to your GPA. Plus, you have to smash the classes into an already packed course load.
I would just like to note that I am only talking about pre-requisite courses here. AP philosophy isn't going to hurt you, as long as you get a Bachelor's degree.
3) Pre-requisite courses are a great preliminary review for the MCAT
The MCAT is more or less a review of the science pre-requisites, with some verbal thrown in. By not taking the pre-reqs in college, thats another year or more before you review some of that material (especially physics, it seems most people take it their sophomore year of college). Relearning the material one more time is just another layer of understanding that you tack on. It isn't enough MCAT prep in itself, granted, but every little bit is cumulative in your mind, and I personally felt that I was a lot more prepared going into the beginning of my MCAT studying than a lot of my AP heavy friends.
4) Graduating early isn't necessarily a good thing.
Granted, one semester early would be a nice extra long vacation, but I do not recommend graduating a year early, unless you are planning on waiting a year before medical school. Quite simply, graduating in three years means that, at the time of your application, you would have only had two years of college life to fill up your resume, rather than three (assuming you are applying at the end of your junior year like most students who aren't taking any time off). That's a lot of time lost to get involved in activities that look good on your resume, help direct your life interests, and potentially good make you a more well rounded or experience person. Admissions Committees are looking for maturity, so the younger you are the more you have to prove it to them (I know several 19 year old applicants with Top 10 level scores and grades, but have been waitlisted or rejected everywhere). They are also looking for people with life experiences, passions, goals, and a firm knowledge of why they want to go into medicine. I know that I, personally, had some of the most meaningful and important experiences of my undergraduate years in my junior year. I know that I would be an entirely different person without them, and quite likely I would not have been as competitive an applicant if I hadn't been able to draw from those experiences for my interviews or applications. For those of you who feel like they want to become a physician ASAP, so they can start practicing and making money, you aren't losing anything. Most physicians retire before they are absolutely incapable of practicing medicine, so unless you are planning to work until the day you die, its not like you can't make up that income by retiring at 66 instead of 65.
1) You miss out on a GPA inflater.
This is my biggest plug for taking AP classes but not the credit. AP classes are very closely related to most of their namesakes in college. By taking AP Chemistry, you are setting yourself up to be very well prepared for General/Inorganic Chemistry your Freshman year. GPA is enormously important part of your application, and this is a great way to improve yours. This is especially true for your Science GPA, even if you are a science major. If you took AP Physics, Chem, and Bio, you have 6 science classes that are going to be a lot easier to get an A in. That's a huge boost to your GPA, and a great GPA buffer if you ever have troubles down the road with grades and get a couple C's. I personally would advocate dropping all AP credit that you get, but I definitely suggest that you at least drop the med school pre-requisites. Getting A's in every one of them (because you had already learned it in high school), will go a long way in showing that you are capable of tackling the basic sciences in medical school.
2) Some schools don't accept AP credit for pre-reqs, or only accept it conditionally
There are a number of schools that jut plain don't accept AP credit as legitimate fulfillment of the pre-reqs under any circumstances. Meaning, if you don't take the classes in college, you will not be allowed to matriculate at these schools, even if they accept you. I know a friend who had to withdraw his application from a couple schools because of this (he still was accepted elsewhere thankfully). I can't offer a full explanation as to why this is, but I assume it has something to do with them really want to check your basic science skills, especially for non-science majors. Most of the schools that don't accept AP credit are willing to strike a deal with you. Basically, you can still fulfill the pre-req requirements that you have AP credit for by taking a higher level science course in that area. So if you took AP credit for General Bio 1, you can take Cell Biology or Genetics (assuming it isn't a pre-req) to fill it. This is fine and dandy if you happen to be taking those classes anyways, but for non-science majors this is a pretty big burden. Even for science majors, it can be a hassle if you don't have any classes to fill, say, your Physics requirement. Why risk hurting your GPA on higher level classes that you don't want to take, or don't need to take? If you aren't interested in the class, forcing yourself to take it is dangerous to your GPA. Plus, you have to smash the classes into an already packed course load.
I would just like to note that I am only talking about pre-requisite courses here. AP philosophy isn't going to hurt you, as long as you get a Bachelor's degree.
3) Pre-requisite courses are a great preliminary review for the MCAT
The MCAT is more or less a review of the science pre-requisites, with some verbal thrown in. By not taking the pre-reqs in college, thats another year or more before you review some of that material (especially physics, it seems most people take it their sophomore year of college). Relearning the material one more time is just another layer of understanding that you tack on. It isn't enough MCAT prep in itself, granted, but every little bit is cumulative in your mind, and I personally felt that I was a lot more prepared going into the beginning of my MCAT studying than a lot of my AP heavy friends.
4) Graduating early isn't necessarily a good thing.
Granted, one semester early would be a nice extra long vacation, but I do not recommend graduating a year early, unless you are planning on waiting a year before medical school. Quite simply, graduating in three years means that, at the time of your application, you would have only had two years of college life to fill up your resume, rather than three (assuming you are applying at the end of your junior year like most students who aren't taking any time off). That's a lot of time lost to get involved in activities that look good on your resume, help direct your life interests, and potentially good make you a more well rounded or experience person. Admissions Committees are looking for maturity, so the younger you are the more you have to prove it to them (I know several 19 year old applicants with Top 10 level scores and grades, but have been waitlisted or rejected everywhere). They are also looking for people with life experiences, passions, goals, and a firm knowledge of why they want to go into medicine. I know that I, personally, had some of the most meaningful and important experiences of my undergraduate years in my junior year. I know that I would be an entirely different person without them, and quite likely I would not have been as competitive an applicant if I hadn't been able to draw from those experiences for my interviews or applications. For those of you who feel like they want to become a physician ASAP, so they can start practicing and making money, you aren't losing anything. Most physicians retire before they are absolutely incapable of practicing medicine, so unless you are planning to work until the day you die, its not like you can't make up that income by retiring at 66 instead of 65.
Sunday, January 18, 2009
The two biggest problems for future physicians (part 1)
It's time that we took a trip back to the questions that I posed back in my first post: What makes/is good medicine and what makes/is a good doctor? Making good medicine and being good doctors in the future is going to, in my opinion, revolve around tackling two big problems here in the US.
1) Equal access to health care.
2) Obesity
1) Equal access to health care.
2) Obesity
As far as equal opportunity to obtain health care goes, I think that the underlying problem has to do with the consumerist nature of our country. There is a desire for "McMedicine", quick, cheap, and easy fixes. Unfortunately, the most quick fixes aren't cheap. Even the ones that are, when overused, have a rapidly mounting cost. This cost isn't just a monetary one, there is a detrimental effect on the health of the entire country by over use of quick and easy fixes. We are addicted to interventional medicine. Preventative medicine? Bed rest and chicken soup? No way! Who has time? I'll just pop some antibiotics (gee, hope I remember to take them all!) and be on my way. The simple truth is as long as we abuse the powers of intervention, we will never have guaranteed health care. Any system that is overused with be toppled by the pressure. Money is finite, therefore health care is finite. And yet, how can we stop people from overusing medical treatments.
At the same time, we are only setting ourselves up for bigger, badder bugs. Overuse and misuse of pharmaceuticals is directing evolution towards multi-drug resistant diseases. Evolution hasn't stopped just because we discovered its properties. It's amazing how much medicine has changed in the last 100 years. I don't mean just the equipment, science, and treatments. I'm talking about the whole concept of medicine, and who it should serve. 100 years ago, you could be imprisoned on an quarantine island in order to protect the public from whatever disease you had. Your rights were utterly revoked for the good of the population. That was good medicine back then, even though it might bother us now. A doctor's purpose was to rid humanity of disease, not a person. The medical community was at war with disease like TB, Typhoid, Dengue Fever, and many others. It was a battle that focused on the disease within people, not diseased people. If a few patients had to be trampled in the process, it was worth it for the greater good. When small pox was eradicated by global vaccination efforts, the fact that 1-2% of those vaccinated were going to die was worth defeating a disease that had a mortality rate ranging from 30%-90%. Now adays, we have people who refuse the vaccinations offered to their children, and are allowed to send those children to public schools. In many states, we can't even arrest an HIV patient who willingly infects people. I'm not saying that we need to go to the extremes that were once acceptable at the dawn of Modern Medicine, but I think we need to take some lessons from their book. Preventative medicine, especially vaccines, are what save lives. Sanitation and vaccines are what has resulted in the increase of our average life span, not normal interventional medicine. Certainly, surgeries and medications save individual patients here and there, but overall interventional medicine has been most effective in the relief of suffering, where as preventative medicine has resulted in the massive extension of human life. It is still a wonderful calling, but most doctors improve lives more than they save them. The exception are those involved in public health programs that emphasize prevention.
So I want more preventative medicine and less interventional medicine, what's my plan do you ask? Education. I personally believe that a physician's calling to educate spans both his students and his patients. We must integrate once again into the mainstream psyche that medicine heals and medicine hurts, and that prevention is the best way to healthy living. Washing hands does a lot more good, in the long run, than taking a pill. It's ok to be sick! Sickness, nine times out of ten, makes you stronger. It's good for you to have a fever and need to be in bed for a couple days, your body is flexing its lymph muscles!
At the same time, though, we can't blame patients for the health care crisis without taking some of the responsibility on as well. It is up to us as future physicians to resolve the one of the biggest medical issues of our time, how to reconcile the needs of the individual and the needs of the population. How much care is good medicine? Is it good medicine for the patient, or for the population. Is it possible to have good medicine for both at the same time. Is increasing the life span of HIV patients good for the population? Can we ethically not try and increase their life span as much as possible? Fun stuff, I just hope there is an answer. The rallying cry of today's medical world is "individualized care". The ultimate break from the population focus of the past century. The benefits to individuals stand to be immense. At the same time, though, we can't forget that our duty is to the community as well as our specific patients. There must be a compromise for optimal health.
Another thing that we as physicians must do, is never forget that we are treating people, that we must be very careful with concepts such as "acceptable losses". As more and more machines and tests are placed in between doctors and patients, one of the most important parts of medicine is at risk. There is healing in medical Art as well as Science, and when we stop interacting as people caring for people, we degrade our profession. I honestly believe that one of the main reasons that Complementary and Alternative Medicine has become so widespread in our culture, is because of the fact that it is a result of an imperfect system of medical treatment. As science has come to be held above all other things, many physicians seem to have lost the time necessary to treat using the Art of medicine. The success of many alternative practitioners is based on the fact that they CAN practice the art. They have the time that a busy physician with 40 patients to see in the next hour does not. They can listen to worries, have time to discuss them. The members of the CAM community can make friends with and present themselves as people to their patients at a level that most physicians are to busy to do.
Not all patients who come to a doctor are physically sick. We, as humans, have a tendency to fear the unknown. When a new dimple or pain appears on our body, we begin to fear that it is worse than it usually is. It gnaws at us, and we seek comfort in the vast knowledge of medical practitioners. The reason that we revere Hippocrates and his style of medicine, rather than his rivals', the Cnidians, is because the school of Cos was well aware of the need to be caring, friendly, and truly concerned with the patient. They could not cure much, but they were very good at predicting what was going to happen and identifying the disease. They cut through the unknown and brought knowledge, even if it was knowledge was death. Regardless of the outcome, they did their practice with caring and understanding. I have seen old ladies be brought in on ambulances because of a toothache. They would talk to the doctor for a few minutes and then leave happy with no medication. Sometimes, people just need a few minutes of a doctors time, a few minutes of someone who is concerned with their well being. Some people, having received knowledge of their illness, leave almost proud of their new found knowledge. If we are to fix medicine, we must understand this simple fact of human nature: Being sick scares us. Knowing why excites us.
I was shadowing my father a long time ago, and we visited a man complaining of knee pain without any visible cause of it. My father knelt down, felt the knee, and told the man that he was going to be fine and to ice it. He left happy. I asked my father if he really needed to feel the knee, and he said "No, but that was the cure." He then proceeded to give me some of the best advice I will probably ever get on the Art of medicine:
Always find an excuse to touch your patient.
I'll talk about the second biggest problem, obesity, on another occasion. Now go touch some patients!
One last semester
It's scary how fast these last three and a half years have gone by. I remember with terrifying clarity what it was like my freshman year. As eager as I am to enter the medical world, I shudder to think how fast it could go by.
I have to say that I am very satisfied with my academic career at my undergraduate university, and I am content to live it out with one slow semester. No more 22+ credit hours with 3 labs for me. Instead I've diverted my time towards working and a pending honors thesis, and will be dancing (literally) my way through this last semester. I don't think I will be working any less than I ever had, really. 40 hours of work a week and 12 credit hours, even when 9 of them are dance credits, is still pretty rough. I guess I've been blessed with the fact that I enjoy the busyness (this should be a word if it isn't) of it all. It was miserable at times, but it always felt good after pulling an all nighter to write a 20 page lab report. After working so hard for so many semesters, I really don't want to forget how, anyways. I think this is one of the biggest reasons that you need to love your major, and make sure you love medicine. Life is so much easier when you enjoy putting yourself through the grinder that is higher learning!
I'm so grateful to my undergraduate university for all of the opportunities I've had. Research, funding for projects, community service, heck I even got a letter from the President of my University. I hope that I can pay them back for it all. I intend to get the Dean of my Honors college, as well as my other letter writers, something nice to show how much I appreciate it. If I can offer two things of wisdom to you, oh ye undergraduates, it be these:
1) A large university does not preclude you from making good connections. There are a proportional number of slackers, and then some, in any large university when compared to a smaller one. Most of my office hour visitations were solo.
2) A letter from a familiar person is the way to go. And make sure that you give them big packets of information from you. Your whole life story. I was told by one of the members of the adcom (she had come to our school for a tour, and I was selected as one of the students to represent us) that a letter that shows that they know something about you is tops. She said that "We get so many letters from famous academics, who simply say this student came to class, got an A, and asked questions." I would recommend one or two big wigs in every packet, but makes sure that they read your information packet before you put them in the one you are going to send to schools! I got complimented multiple times about my letters, and I am so grateful to my writers for taking the time and interest in me to do me such a boon as they did.
I have to say that I am very satisfied with my academic career at my undergraduate university, and I am content to live it out with one slow semester. No more 22+ credit hours with 3 labs for me. Instead I've diverted my time towards working and a pending honors thesis, and will be dancing (literally) my way through this last semester. I don't think I will be working any less than I ever had, really. 40 hours of work a week and 12 credit hours, even when 9 of them are dance credits, is still pretty rough. I guess I've been blessed with the fact that I enjoy the busyness (this should be a word if it isn't) of it all. It was miserable at times, but it always felt good after pulling an all nighter to write a 20 page lab report. After working so hard for so many semesters, I really don't want to forget how, anyways. I think this is one of the biggest reasons that you need to love your major, and make sure you love medicine. Life is so much easier when you enjoy putting yourself through the grinder that is higher learning!
I'm so grateful to my undergraduate university for all of the opportunities I've had. Research, funding for projects, community service, heck I even got a letter from the President of my University. I hope that I can pay them back for it all. I intend to get the Dean of my Honors college, as well as my other letter writers, something nice to show how much I appreciate it. If I can offer two things of wisdom to you, oh ye undergraduates, it be these:
1) A large university does not preclude you from making good connections. There are a proportional number of slackers, and then some, in any large university when compared to a smaller one. Most of my office hour visitations were solo.
2) A letter from a familiar person is the way to go. And make sure that you give them big packets of information from you. Your whole life story. I was told by one of the members of the adcom (she had come to our school for a tour, and I was selected as one of the students to represent us) that a letter that shows that they know something about you is tops. She said that "We get so many letters from famous academics, who simply say this student came to class, got an A, and asked questions." I would recommend one or two big wigs in every packet, but makes sure that they read your information packet before you put them in the one you are going to send to schools! I got complimented multiple times about my letters, and I am so grateful to my writers for taking the time and interest in me to do me such a boon as they did.
Question 7: Advice on Activities?
Rather than suggest specific things that you could do to pad your resume, let me offer some overall tips:
1) The basics
To begin any pre-med resume, you have to have the things that most medical schools expect a pre-med to have done. They want to see that you have done community service, because this shows that you are interested in helping others and have compassion. They want to see that you have had leadership experience, because you will be in charge of a number of nursing, techs, etc, and good leadership is necessary when you are dealing with people's health or lives. They want to see that you have done clinical volunteering, so that you have seen doctors and patients interacting and are interested in helping people medically. They want to see that you have shadowed doctors (probably less important than the volunteering), so that you have a better grasp of what you are getting yourself into. I personally would recommend at least one year of clinical work or volunteering. It would be best if you started this year no later than your junior year, so that it doesn't ring of last minute resume buffing (salt shaker alert here, this is just the common consensus among pre-meds that I know). If you do your year of volunteering at the beginning of your Freshman year, I would recommend that you punctuate the remaining years with shadowing and short term medical stuff like a blood drive or two, so you don't have to explain why you suddenly stopped all medical related activities. The last "basic" is always useful, but only absolutely necessary when applying to heavy-weight research schools, and that is research. Off the top of my head I believe that 93% of acceptances at U of Michigan were given to students with research experience last year. Similar stats occur at other research schools. It doesn't have to be medically related research, so long as you were part of the creation of new knowledge. Publications are nice, so I would suggest getting started on this early in your undergrad years.
Remember, you can list activities that you began before college, so long as you continued them in college. Everything else must be after high school to be most effective. I cannot offer much advice to non-traditional applicants, but I would assume that the rules are a bit more relaxed for you, especially if you were, say, a Fullbright scholar ten years ago.
2) Have something that will make your readers say "Gee, I want to meet this applicant!"
There is no such thing as a guaranteed acceptance. I know people who were accepted at Top 10 schools, only to be rejected post-interview from their state school that they were highly competitive at in terms of academics. A 4.0 and a 45T alone isn't going to get you accepted everywhere, though I wouldn't go so far as to say as it wouldn't get you anywhere. For the rest of us mortals, though, extracurriculars are the best way to make ourselves stand out from the pack. As such, have an activity that is really unique, because these things can be quite strong selling points. For me, it was being involved in some post-post-post-post modern dance performances. You have plenty of time to pick up something that is off the beaten pre-med path, so have an interest that isn't what you would normally find in a room full of scientists. There's a reason that the top schools are always telling us how their students are marathon runners, Olympic competitors, composers, singers, and the like. For one, its just plain cool and impressive, and so those are the students they highlight. However, even the students who aren't quite as stand alone as that will often have things that are still pretty interesting to hear about. This desire for interesting applicants occurs at every medical school, and an interesting activity might land you an interview at your dream school. I'm not saying that you should fill your resume with nothing but outlandish activities, but one or two ice breakers will be very helpful.
2) Combine your interests and talents with your activities
This goes hand in hand with my first point, but it can really improve your extracurriculars when you combine your activities. Say you go volunteer at the VA or at a hospice, and on the side you take violin lessons. Why not go play your violin at the VA or hospice? If you want to help out a community service, why not run in a charity marathon if you happen to be a runner? Avid painter? Teach a painting class to inner city youth, or paint a mural for a community center. Be creative, it will mean a lot more to the people you help as well as the person reviewing your application.
3) Represent your message
If you want to go into academic medicine, research, public health, etc, make sure that you can justify it. If you tell your interviewer that you absolutely love teaching, but you haven't done anything teaching related (according to your resume), you risk making yourself look like you are trying to just be impressive. If you are interested in something and are going to state that it is part of your goals or beliefs, you should make sure that you are an active part of realizing them. If you are a staunch believer in helping the underprivileged, and intend to do so in your medical career, get out there and work at a soup kitchen or at a shelter. If you've never done anything to prove your interest in something, then how can the interviewer believe that you are telling the truth. This goes back to the whole point of having to justify that you are sure you want to do medicine by having medical experience.
4) Do things that are important to you, rather than simply trying to buff up your resume
You are trying to represent who you are, when you apply to medical school. A lot of medical admissions is just based on feel and fit. If you seem to connect well with the school and student philosophy, you are much more likely to get in. It is tempting to try and just pick out things that you feel will increase your competitiveness, but in the end you aren't doing yourself justice. I truly believe that my dancing was a bigger influence on my admissions cycle than most other things. I'm passionate about it, and it has let me do a lot more than simply clocking hours at community service event that I have no interest in. Speaking of community service, the majority of mine is education and inner city related, because I'm passionate about those things. Passion is your strongest ally on the application path. The admissions committee wants to see what you are really made of, what really makes you tick. You will do better at activities that you love doing, and you will be making yourself well rounded. As I've mentioned in a previous post, I personally feel that interviews are all about assessing your ability to utilize the art of medicine. Patients are people. As a doctor, the more well rounded you are, the better you will be able to interact and relate with your patients. This isn't about doctors treating patients, its about people treating people. A well rounded list of activities that are not entirely cookie cutter pre-med will do you more good personally and career wise than a bazillion hours of volunteering. Show your individuality and show your passion. If there isn't some kind of medically related experience that you can find that fits into your passions, you probably are in the wrong field.
1) The basics
To begin any pre-med resume, you have to have the things that most medical schools expect a pre-med to have done. They want to see that you have done community service, because this shows that you are interested in helping others and have compassion. They want to see that you have had leadership experience, because you will be in charge of a number of nursing, techs, etc, and good leadership is necessary when you are dealing with people's health or lives. They want to see that you have done clinical volunteering, so that you have seen doctors and patients interacting and are interested in helping people medically. They want to see that you have shadowed doctors (probably less important than the volunteering), so that you have a better grasp of what you are getting yourself into. I personally would recommend at least one year of clinical work or volunteering. It would be best if you started this year no later than your junior year, so that it doesn't ring of last minute resume buffing (salt shaker alert here, this is just the common consensus among pre-meds that I know). If you do your year of volunteering at the beginning of your Freshman year, I would recommend that you punctuate the remaining years with shadowing and short term medical stuff like a blood drive or two, so you don't have to explain why you suddenly stopped all medical related activities. The last "basic" is always useful, but only absolutely necessary when applying to heavy-weight research schools, and that is research. Off the top of my head I believe that 93% of acceptances at U of Michigan were given to students with research experience last year. Similar stats occur at other research schools. It doesn't have to be medically related research, so long as you were part of the creation of new knowledge. Publications are nice, so I would suggest getting started on this early in your undergrad years.
Remember, you can list activities that you began before college, so long as you continued them in college. Everything else must be after high school to be most effective. I cannot offer much advice to non-traditional applicants, but I would assume that the rules are a bit more relaxed for you, especially if you were, say, a Fullbright scholar ten years ago.
2) Have something that will make your readers say "Gee, I want to meet this applicant!"
There is no such thing as a guaranteed acceptance. I know people who were accepted at Top 10 schools, only to be rejected post-interview from their state school that they were highly competitive at in terms of academics. A 4.0 and a 45T alone isn't going to get you accepted everywhere, though I wouldn't go so far as to say as it wouldn't get you anywhere. For the rest of us mortals, though, extracurriculars are the best way to make ourselves stand out from the pack. As such, have an activity that is really unique, because these things can be quite strong selling points. For me, it was being involved in some post-post-post-post modern dance performances. You have plenty of time to pick up something that is off the beaten pre-med path, so have an interest that isn't what you would normally find in a room full of scientists. There's a reason that the top schools are always telling us how their students are marathon runners, Olympic competitors, composers, singers, and the like. For one, its just plain cool and impressive, and so those are the students they highlight. However, even the students who aren't quite as stand alone as that will often have things that are still pretty interesting to hear about. This desire for interesting applicants occurs at every medical school, and an interesting activity might land you an interview at your dream school. I'm not saying that you should fill your resume with nothing but outlandish activities, but one or two ice breakers will be very helpful.
2) Combine your interests and talents with your activities
This goes hand in hand with my first point, but it can really improve your extracurriculars when you combine your activities. Say you go volunteer at the VA or at a hospice, and on the side you take violin lessons. Why not go play your violin at the VA or hospice? If you want to help out a community service, why not run in a charity marathon if you happen to be a runner? Avid painter? Teach a painting class to inner city youth, or paint a mural for a community center. Be creative, it will mean a lot more to the people you help as well as the person reviewing your application.
3) Represent your message
If you want to go into academic medicine, research, public health, etc, make sure that you can justify it. If you tell your interviewer that you absolutely love teaching, but you haven't done anything teaching related (according to your resume), you risk making yourself look like you are trying to just be impressive. If you are interested in something and are going to state that it is part of your goals or beliefs, you should make sure that you are an active part of realizing them. If you are a staunch believer in helping the underprivileged, and intend to do so in your medical career, get out there and work at a soup kitchen or at a shelter. If you've never done anything to prove your interest in something, then how can the interviewer believe that you are telling the truth. This goes back to the whole point of having to justify that you are sure you want to do medicine by having medical experience.
4) Do things that are important to you, rather than simply trying to buff up your resume
You are trying to represent who you are, when you apply to medical school. A lot of medical admissions is just based on feel and fit. If you seem to connect well with the school and student philosophy, you are much more likely to get in. It is tempting to try and just pick out things that you feel will increase your competitiveness, but in the end you aren't doing yourself justice. I truly believe that my dancing was a bigger influence on my admissions cycle than most other things. I'm passionate about it, and it has let me do a lot more than simply clocking hours at community service event that I have no interest in. Speaking of community service, the majority of mine is education and inner city related, because I'm passionate about those things. Passion is your strongest ally on the application path. The admissions committee wants to see what you are really made of, what really makes you tick. You will do better at activities that you love doing, and you will be making yourself well rounded. As I've mentioned in a previous post, I personally feel that interviews are all about assessing your ability to utilize the art of medicine. Patients are people. As a doctor, the more well rounded you are, the better you will be able to interact and relate with your patients. This isn't about doctors treating patients, its about people treating people. A well rounded list of activities that are not entirely cookie cutter pre-med will do you more good personally and career wise than a bazillion hours of volunteering. Show your individuality and show your passion. If there isn't some kind of medically related experience that you can find that fits into your passions, you probably are in the wrong field.
5) Be a go getter!
Opportunities might knock, but it's best to pursue them! Good things don't come to those who wait, you must go to the good things. If there is something you want to do, find someone to help you do it, pursue it, modify it, or direct you in the right direction. Just because it hasn't been done before or doesn't exist doesn't mean you shouldn't do it. Med schools like innovation and people who are founders of things. Even if it's just a new program in a previous student organization. You must take the initiative, the dean of your college isn't going to show up at your door with your dream activity!
Question 6: What is the best medical school?
Salt shaker alert on this one, my opinion is certainly not the only one.
I personally do not think there is one best medical school in the USA or anywhere, rather that there is a best medical school for you. The problem with saying who is better than who is the question of how to rank them. There are probably a half dozen legitimate ways to rank medical schools on the web, the most popular of them being the two used by USA Today. Harvard, Johns Hopkins, and Washington University Saint Louis are ranked tops in this list. The problem arises because everyone is not looking for the same things in a medical school. For example, I would argue that, if you polled 100 random strangers that are not related to the medical field in any way, you would find that Johns Hopkins is considered to be more prestigious than Harvard, and that WashU is probably not even in the top 10. On the other hand, let us just consider the average opinion of residency directors. Harvard and JH continue to stand at the top, but other schools further down the list reorient themselves. What about research dollars? Then the question arises about who's research dollars, and do we consider the total amount, or the amount per researcher at a specific school? More reorientation. This list would be totally useless to someone not interested in research or maybe even academic medicine. There's another list for those interest in care only. And it just gets more and more complicated.
This is why I say that there isn't just one top medical school, it varies from person to person. Some people might want to practice in California and thus UCLA or Stanford might top their list, since people tend to do residency and practice in the region that they went to medical school (on average). Perhaps someone absolutely hates the cold, and so only apply to medical school in the South. I strongly encourage that, rather than just taking ranking or prestige alone into account, create a list of priorities, and allow yourself to make a decision based on your interview experience and how the school "felt" to you. Plenty of people turn down Top 10 schools to go to other schools, and not just for financial reasons. They felt that they fit better, or that a different school had a teaching style or atmosphere that was better suited to their personality. I would also suggest not choosing a "top school" or trying to rank your schools until you have been accepted. Otherwise, all of your carefully made plans might be thrown in disarray, depending on admission decisions. That's a lot of emotional effort spent on something you have very little control over.
I personally do not think there is one best medical school in the USA or anywhere, rather that there is a best medical school for you. The problem with saying who is better than who is the question of how to rank them. There are probably a half dozen legitimate ways to rank medical schools on the web, the most popular of them being the two used by USA Today. Harvard, Johns Hopkins, and Washington University Saint Louis are ranked tops in this list. The problem arises because everyone is not looking for the same things in a medical school. For example, I would argue that, if you polled 100 random strangers that are not related to the medical field in any way, you would find that Johns Hopkins is considered to be more prestigious than Harvard, and that WashU is probably not even in the top 10. On the other hand, let us just consider the average opinion of residency directors. Harvard and JH continue to stand at the top, but other schools further down the list reorient themselves. What about research dollars? Then the question arises about who's research dollars, and do we consider the total amount, or the amount per researcher at a specific school? More reorientation. This list would be totally useless to someone not interested in research or maybe even academic medicine. There's another list for those interest in care only. And it just gets more and more complicated.
This is why I say that there isn't just one top medical school, it varies from person to person. Some people might want to practice in California and thus UCLA or Stanford might top their list, since people tend to do residency and practice in the region that they went to medical school (on average). Perhaps someone absolutely hates the cold, and so only apply to medical school in the South. I strongly encourage that, rather than just taking ranking or prestige alone into account, create a list of priorities, and allow yourself to make a decision based on your interview experience and how the school "felt" to you. Plenty of people turn down Top 10 schools to go to other schools, and not just for financial reasons. They felt that they fit better, or that a different school had a teaching style or atmosphere that was better suited to their personality. I would also suggest not choosing a "top school" or trying to rank your schools until you have been accepted. Otherwise, all of your carefully made plans might be thrown in disarray, depending on admission decisions. That's a lot of emotional effort spent on something you have very little control over.
Question 5: Am I too old for Medical School?
Absolutely not! Medical schools regularly graduate students that are in their 30's, 40's, and older. Granted, the older you are, the less time you will have to practice a physician/pay off your loans, but medical school admissions are age-blind. This means that your age itself will not be a discriminating factor. In fact, you may find it easier to get into medical school after several or more years out of college. One of the biggest factors in admissions is maturity and life experiences. Having another career full of responsibilities could be a great asset, as long as you convince the committee on your reasons for applying to medical school and shifting careers. The average age of first year medical students is 24, though this is probably slightly skewed by those who are over 30's and over. Regardless, a healthy number of medical students take a year or two off to do research, travel, perform community service, or just work. As long as you can validate your reasons, it will not hurt you, and has a very likely chance of helping you.
Question 4: Picking a Major
This actually covers a bunch of questions I get hit with a lot, so lets just start from the top.
1) Do I have to pick a science major?
The answer is no. Any major that you wish to take in college, so long as it is a bachelor's. There are plenty of non science majors that get into the top schools as well as the bottom, though it seems to me that less get into the top than into the bottom. I would say that being a non-science major can be a blessing and a curse. It is most definitely true that majoring in a subject like interpretive dance is going to make you stand out and interesting. However, this is only going to benefit you if you can still compete in terms of science GPA and MCAT scores with your science major competitors. Being a nonscience major means that you are only going to be taking the science pre-requisites for medical school, unless you go out of your way that is. This means that your science GPA is dependant on only a few classes compared to someone who took analytical biophysicalchemistry and all of its pre-reqs. If you ace those courses, that is to your benefit, but if you get crunched on even one, it will make a bigger dent in your science GPA. As for the MCAT, you will have had less training in this kind of analytical thinking, and you will be a lot more rusty at it too. This means you are probably going to have to work even harder to make the grade. That being said, if you do, your nonscience major is going to put you at an advantage on paper. I recommend either taking a science major and non science minor, or vice versa in order to get the best of both worlds. I would NOT recommend taking a science major and minor, because this is redundant. Minors, in my opinion, are only valuable if they are highly different from your major, unique, or fill a significant gap in your education. Taking a Chemistry major and Biology minor isn't that helpful.
2) What major will help me most on the MCAT?
Major salt shaker alert here, but my personal belief is that biochemistry or a similar major is the most helpful. This is because the MCAT is primarily chemistry and biology. The biological sciences is all biology and organic chem, where as the physical sciences is half general chemistry. This means that a good half of the MCAT is covered continuously by your major. Cell Biology, taken your sophomore or junior year, is an enormous advantage, second only to animal physiology, in Biological Sciences. Physical chemistry, taken in the junior year at my school, is a huge review of general chemistry. Biophysical chemistry reviewed some physics, and biochemistry takes a good pot shot at the organic chem and biology covered on the MCAT. If you could find a major that was dubbed Biophysicalchemistry, that might even be better, since you'd get more physics. I didn't really find any courses that were a big boost on verbal reasoning, but I have heard that reading things like the Economist are useful.
3) Should I take the Pre-Med major offered at my school?
Some schools still offer this major, though it is being phased out at many schools. I strongly urge you against taking it. For one, it is an absolutely useless major if you change your mind or are not accepted to medical school. It is also a relatively easy major that basically just covers a little more than the normal pre-med requisites. I have heard that medical admissions folk don't like it for that reason, and because it is felt that it shows a lack of interest in science and a bit of desperation. Get a Biology degree. I have seen dozens of them at interviews, but I have never seen a pre-med major at one.
4) Is Nursing/Pre-nursing/Physician Assistant a good pre-med major?
No! These are absolutely off limits if you can help it. It shows a lack of commitment in your desire to be a doctor. Basically it tells the admissions committee that your back up is to go into this field, rather than being willing to improve yourself and reapplying next year. For this and probably other reasons, adcoms seem to have a serious dislike, and if you get an interview they will definitely ask you about this and your commitment to medicine. I've never seen one of these majors at an interview either. I would also recommend checking with AMCAS if it is even possible to major in these. The problem is that you need a BACHELOR'S degree to go to medical school. To my knowledge, most nursing and other degrees are not bachelor's. I doubt that medical schools will make an exeption.
5) Do schools take into mind course load and difficulty of my major?
Yes, just like schools consider the difficulty of your undergraduate university, they also take into account how many classes you took, the level/difficulty of them, and how well you did. I have heard that a medical school course load is comparable to 25-30 credits a semester. Being able to take 22 credits and do well will be noted. Also, if you took a really tough major, they will take this into account when comparing you to more fluffy majors. However, there are limits. Don't expect a 3.9 in a fluff major to be beaten down by a 3.4 in a hard one.
Above all, I suggest that you pick a major that you like. You will do better in it, make more connections with professors for research and letters of recommendation, and you will be more passionate about it when it comes up at interviews. Do something you love in undergraduate, just like you should only do medicine if you love it.
1) Do I have to pick a science major?
The answer is no. Any major that you wish to take in college, so long as it is a bachelor's. There are plenty of non science majors that get into the top schools as well as the bottom, though it seems to me that less get into the top than into the bottom. I would say that being a non-science major can be a blessing and a curse. It is most definitely true that majoring in a subject like interpretive dance is going to make you stand out and interesting. However, this is only going to benefit you if you can still compete in terms of science GPA and MCAT scores with your science major competitors. Being a nonscience major means that you are only going to be taking the science pre-requisites for medical school, unless you go out of your way that is. This means that your science GPA is dependant on only a few classes compared to someone who took analytical biophysicalchemistry and all of its pre-reqs. If you ace those courses, that is to your benefit, but if you get crunched on even one, it will make a bigger dent in your science GPA. As for the MCAT, you will have had less training in this kind of analytical thinking, and you will be a lot more rusty at it too. This means you are probably going to have to work even harder to make the grade. That being said, if you do, your nonscience major is going to put you at an advantage on paper. I recommend either taking a science major and non science minor, or vice versa in order to get the best of both worlds. I would NOT recommend taking a science major and minor, because this is redundant. Minors, in my opinion, are only valuable if they are highly different from your major, unique, or fill a significant gap in your education. Taking a Chemistry major and Biology minor isn't that helpful.
2) What major will help me most on the MCAT?
Major salt shaker alert here, but my personal belief is that biochemistry or a similar major is the most helpful. This is because the MCAT is primarily chemistry and biology. The biological sciences is all biology and organic chem, where as the physical sciences is half general chemistry. This means that a good half of the MCAT is covered continuously by your major. Cell Biology, taken your sophomore or junior year, is an enormous advantage, second only to animal physiology, in Biological Sciences. Physical chemistry, taken in the junior year at my school, is a huge review of general chemistry. Biophysical chemistry reviewed some physics, and biochemistry takes a good pot shot at the organic chem and biology covered on the MCAT. If you could find a major that was dubbed Biophysicalchemistry, that might even be better, since you'd get more physics. I didn't really find any courses that were a big boost on verbal reasoning, but I have heard that reading things like the Economist are useful.
3) Should I take the Pre-Med major offered at my school?
Some schools still offer this major, though it is being phased out at many schools. I strongly urge you against taking it. For one, it is an absolutely useless major if you change your mind or are not accepted to medical school. It is also a relatively easy major that basically just covers a little more than the normal pre-med requisites. I have heard that medical admissions folk don't like it for that reason, and because it is felt that it shows a lack of interest in science and a bit of desperation. Get a Biology degree. I have seen dozens of them at interviews, but I have never seen a pre-med major at one.
4) Is Nursing/Pre-nursing/Physician Assistant a good pre-med major?
No! These are absolutely off limits if you can help it. It shows a lack of commitment in your desire to be a doctor. Basically it tells the admissions committee that your back up is to go into this field, rather than being willing to improve yourself and reapplying next year. For this and probably other reasons, adcoms seem to have a serious dislike, and if you get an interview they will definitely ask you about this and your commitment to medicine. I've never seen one of these majors at an interview either. I would also recommend checking with AMCAS if it is even possible to major in these. The problem is that you need a BACHELOR'S degree to go to medical school. To my knowledge, most nursing and other degrees are not bachelor's. I doubt that medical schools will make an exeption.
5) Do schools take into mind course load and difficulty of my major?
Yes, just like schools consider the difficulty of your undergraduate university, they also take into account how many classes you took, the level/difficulty of them, and how well you did. I have heard that a medical school course load is comparable to 25-30 credits a semester. Being able to take 22 credits and do well will be noted. Also, if you took a really tough major, they will take this into account when comparing you to more fluffy majors. However, there are limits. Don't expect a 3.9 in a fluff major to be beaten down by a 3.4 in a hard one.
Above all, I suggest that you pick a major that you like. You will do better in it, make more connections with professors for research and letters of recommendation, and you will be more passionate about it when it comes up at interviews. Do something you love in undergraduate, just like you should only do medicine if you love it.
Question 3: This application cycle is stressing me out, what can I do?
So, I admit that this winter has been a bit of a pain, because I have had free time. What did I do with it? Worry, like any good pre-med. I worried about getting in to this school or that, regretted doing one thing or not doing it, wondered if I had done something or another where would I be right now, etc. For all of you worried about getting into your top choice, or even into a medical school, I'd like to share a story my father shared with me.My father graduated from Wayne State Medical School with honors about 30 years ago. He applied to ortho surgery residencies, and was flat out rejected everywhere during the Match and Scramble. Distraught, he was speaking with a friend about his application. His friend read his Dean's letter, and asked why my father had repeated a whole semester of medical school.
My father had not repeated a semester.
Turns out, the Dean's letter was not his. There had been a mixup, and my father had gotten someone else's letter with the same last name (In addition, that guy also got my dad's picture spot on the graduation wall, which I noticed when I interviewed there). This guy had failed his clinicals, and had overall done pretty poorly. This devastated my father, because despite all of the apologies that the Dean's of Wayne offered, there was nothing that they could do. All the residency spots in ortho were taken, and my father's military service contract was activated.Eventually, my dad wound up in Trauma. He's been practicing it since then, and he's loved it. In his 30's, his hips began to wear out because of a defect. He can barely stand for prolonged periods of time. If he had done Ortho, he would no longer be able to practice without surgery and rehab. In the end, he landed what he needed to be happy and to provide for his family. He hammered into me that it wasn't what he had wanted or hoped for. In the end, though, he ended up where he needed to be. It helped me out, and I hope it helps some of you out too.
My father had not repeated a semester.
Turns out, the Dean's letter was not his. There had been a mixup, and my father had gotten someone else's letter with the same last name (In addition, that guy also got my dad's picture spot on the graduation wall, which I noticed when I interviewed there). This guy had failed his clinicals, and had overall done pretty poorly. This devastated my father, because despite all of the apologies that the Dean's of Wayne offered, there was nothing that they could do. All the residency spots in ortho were taken, and my father's military service contract was activated.Eventually, my dad wound up in Trauma. He's been practicing it since then, and he's loved it. In his 30's, his hips began to wear out because of a defect. He can barely stand for prolonged periods of time. If he had done Ortho, he would no longer be able to practice without surgery and rehab. In the end, he landed what he needed to be happy and to provide for his family. He hammered into me that it wasn't what he had wanted or hoped for. In the end, though, he ended up where he needed to be. It helped me out, and I hope it helps some of you out too.
Question 2: What should I look for in a University for Pre-Med
A shout out to all of you pre-pre-meds (high schoolers) out there, since its that time of the year where a lot of seniors are looking at universities. I'd just like to preface this with a big
SALT SHAKER ALERT!
What I am about to say is my thoughts on the topic. Some of what I mentioned is highly contested throughout the pre-med community, and plenty people go separate paths to end up in medical school.
I think the biggest things to get into medical school, aside from GPA and MCAT scores, are that you have had interesting and meaningful experiences in:
1) Community Service
2) Medically related volunteering/work
3) Research (most important for those wanting to go to a research heavy school)
Everything else that you do outside of these three areas is what makes you unique, interesting, and can only improve your chances. I personally feel that one of my strongest features when applying was my dancing experiences. These three things, especially 1 and 2, are critical to many schools, because it shows both a tendency towards compassion and charity, as well as provides you with a basis to prove why you want to go to medical school. Because of this, here are my personal recommendations on selecting a school.
1) Has a research program that is large enough to sustain undergraduate participation.
Look for schools that have undergraduate thesis projects, undergraduate fellowship positions, etc. A school with Research 1 designation is great, because that means there are tons of research projects going on. If you never publish or present a paper, that's fine. However, doing so can be a major boost, especially if you are author or co-author, or even 29th author of a paper that makes it into a major journal like Nature. It does not necessarily have to be medically related research, but I would recommend it if you are contemplating MD/PhD.
2) A moderately well known school.
I personally would recommend limiting your choices to one of the top 200 or so schools. You want a school that has had a decent number of pre-meds, because this increases the chances of an admissions committee knowing something about the opportunities available at your school. It also increases your chances of getting good advising from a pre-med office. I am a member of the faction that believes that prestige is not a significant factor in the admissions process. Having gone to a public school that isn't even ranked in the Top 100, I have interviewed at a number of the Top 20, 10, and 5 schools. I personally believe that your own merits outweigh the name of your school significantly. This is not to say that I believe a 3.5 is the same as one school than another. Admissions committees often have "experts" on a given school, or look at statistics like the average GPA and MCAT score of pre-meds in past years. Thus, a 3.5 at Princeton might be more impressive than a 3.5 at John Doe public school, simply because the average GPA and MCAT score at Princeton is a 3.5/33, and a 3.5/28 at John Doe. Clearly, it was harder to earn a 3.5 and 33 at Princeton than a 3.5 and 33 at John Doe (though, the equal MCAT scores would somewhat minimize this). Suffice it to say that a 3.5 and 28 at Harvard isn't going to beat out a 3.8 and 31 at John Doe, all other things being equal. This being said, I feel that opportunities at the more prestigious undergrad schools outside of academics are excellent. However, I feel that any big public school like OSU, ASU, etc will have similar opportunities by virtue of their sheer size. Any school that made it in the top 200 should have enough of everything for you to succeed if you are good enough. If you are good enough at one place, you are good enough anywhere, so long as you aren't handicapped.
3) A School with a medical school or that is near one.
The inside man always has an advantage. If you went to Harvard College, you will have a stronger shot at Harvard Med. This is because you have three years to build relationships with the medical school, do research under doctors affiliated (and thus get letters) with the school, and become an expert on that school. The opportunity to work with doctors at any medical school probably increases your chances everywhere. There is always the chance that they will be recognized, and its a great way to get insight in academic medicine.
4) Go to a school near a reasonably sized city.
Cities have a lot going for them by virtue of their huge populations. There are all sorts of activities available in research, community service, and just fun things that will make you a more well rounded and interesting person. Being near a city means you will also be near at least a few good hospitals or clinics. This saves you on travel time and ease of access, as it is likely students from your school have already built connections with nearby schools.
5)If you want to get into academic medicine, I strongly recommend some form of teaching or tutoring.
Showing that you have an interest in teaching and academia is best done through these sort of activities. They are also very likely to give you some excellent talking points about being a life long learner. Overall, teaching is just a great extra curricular, and it will probably help you relate to interviewers (many who are academic physicians).
SALT SHAKER ALERT!
What I am about to say is my thoughts on the topic. Some of what I mentioned is highly contested throughout the pre-med community, and plenty people go separate paths to end up in medical school.
I think the biggest things to get into medical school, aside from GPA and MCAT scores, are that you have had interesting and meaningful experiences in:
1) Community Service
2) Medically related volunteering/work
3) Research (most important for those wanting to go to a research heavy school)
Everything else that you do outside of these three areas is what makes you unique, interesting, and can only improve your chances. I personally feel that one of my strongest features when applying was my dancing experiences. These three things, especially 1 and 2, are critical to many schools, because it shows both a tendency towards compassion and charity, as well as provides you with a basis to prove why you want to go to medical school. Because of this, here are my personal recommendations on selecting a school.
1) Has a research program that is large enough to sustain undergraduate participation.
Look for schools that have undergraduate thesis projects, undergraduate fellowship positions, etc. A school with Research 1 designation is great, because that means there are tons of research projects going on. If you never publish or present a paper, that's fine. However, doing so can be a major boost, especially if you are author or co-author, or even 29th author of a paper that makes it into a major journal like Nature. It does not necessarily have to be medically related research, but I would recommend it if you are contemplating MD/PhD.
2) A moderately well known school.
I personally would recommend limiting your choices to one of the top 200 or so schools. You want a school that has had a decent number of pre-meds, because this increases the chances of an admissions committee knowing something about the opportunities available at your school. It also increases your chances of getting good advising from a pre-med office. I am a member of the faction that believes that prestige is not a significant factor in the admissions process. Having gone to a public school that isn't even ranked in the Top 100, I have interviewed at a number of the Top 20, 10, and 5 schools. I personally believe that your own merits outweigh the name of your school significantly. This is not to say that I believe a 3.5 is the same as one school than another. Admissions committees often have "experts" on a given school, or look at statistics like the average GPA and MCAT score of pre-meds in past years. Thus, a 3.5 at Princeton might be more impressive than a 3.5 at John Doe public school, simply because the average GPA and MCAT score at Princeton is a 3.5/33, and a 3.5/28 at John Doe. Clearly, it was harder to earn a 3.5 and 33 at Princeton than a 3.5 and 33 at John Doe (though, the equal MCAT scores would somewhat minimize this). Suffice it to say that a 3.5 and 28 at Harvard isn't going to beat out a 3.8 and 31 at John Doe, all other things being equal. This being said, I feel that opportunities at the more prestigious undergrad schools outside of academics are excellent. However, I feel that any big public school like OSU, ASU, etc will have similar opportunities by virtue of their sheer size. Any school that made it in the top 200 should have enough of everything for you to succeed if you are good enough. If you are good enough at one place, you are good enough anywhere, so long as you aren't handicapped.
3) A School with a medical school or that is near one.
The inside man always has an advantage. If you went to Harvard College, you will have a stronger shot at Harvard Med. This is because you have three years to build relationships with the medical school, do research under doctors affiliated (and thus get letters) with the school, and become an expert on that school. The opportunity to work with doctors at any medical school probably increases your chances everywhere. There is always the chance that they will be recognized, and its a great way to get insight in academic medicine.
4) Go to a school near a reasonably sized city.
Cities have a lot going for them by virtue of their huge populations. There are all sorts of activities available in research, community service, and just fun things that will make you a more well rounded and interesting person. Being near a city means you will also be near at least a few good hospitals or clinics. This saves you on travel time and ease of access, as it is likely students from your school have already built connections with nearby schools.
5)If you want to get into academic medicine, I strongly recommend some form of teaching or tutoring.
Showing that you have an interest in teaching and academia is best done through these sort of activities. They are also very likely to give you some excellent talking points about being a life long learner. Overall, teaching is just a great extra curricular, and it will probably help you relate to interviewers (many who are academic physicians).
Question 1: What should I read to prepare for medical school?
So I get this question a lot from both pre-meds and those who I lovingly dub pre-pre-meds (high schoolers). The bottom line is, you can not prepare for medical school on an academic level. Cramming a biochemistry or anatomy book into your skull is not going to significantly improve your performance in medical school. Chances are, most of what you read won't be covered, or will be covered from such a different angle that your knowledge could be cumbersome. I recommend a different kind of reading. Rather than trying to study for medical school classes, try studying medicine and doctoring from a more philosophical and social perspective. The bonus of doing this is that it will help you better decide if you want the kind of life that most doctors have had, and it will prepare you mentally for the things that others have experienced before you (both good and bad). It probably won't hurt your interviewing skills either by letting you talk intelligently about the Art of Medicine (which is all they are looking for, in my opinions. If you got an interview, they probably thought you were smart enough to tackle the Science, but whether or not you fit into a school's idea of how a practitioner of the Art should be is what will make or break you- Salt Shaker Alert!).
On this note, some recommended reading. My all time favorite book is On Doctoring. It's a compilation of poetry, memoirs, and philosophies of various doctors over several hundreds of years. The first editor's name is Richard C. Reynolds, if you are having trouble finding it.
Other than that, any good memoir book will do (though I warn you some of the books are a little pretentious in my opinion). Some of the most highly acclaimed books that I know of are:
The House of God, and other books written by Samuel Shem/Stephen Bergman
Better, by Atul Gawande
The Man Who Mistook His Wife For a Hat, by Oliver Sacks
There are dozens of others out there, and if anyone else has some recommendations feel free to let me know.
On this note, some recommended reading. My all time favorite book is On Doctoring. It's a compilation of poetry, memoirs, and philosophies of various doctors over several hundreds of years. The first editor's name is Richard C. Reynolds, if you are having trouble finding it.
Other than that, any good memoir book will do (though I warn you some of the books are a little pretentious in my opinion). Some of the most highly acclaimed books that I know of are:
The House of God, and other books written by Samuel Shem/Stephen Bergman
Better, by Atul Gawande
The Man Who Mistook His Wife For a Hat, by Oliver Sacks
There are dozens of others out there, and if anyone else has some recommendations feel free to let me know.
The Warm Up
Hey all, and welcome to my blog. You can call me Dancing D, and I would like to tell you why I am writing this blog. It's quite simple really, I enjoy teaching. Now, teaching comes in many forms. You can teach in front of a classroom or teach by example. You can teach as a tour guide, or as a tutor. Teaching, to me, is best described as the transmission of all knowledge. I have always enjoyed being on both the receiving and transmitting end of teaching, and it is for this reason that I am writing this blog (or maybe I just like to talk :D). For the moment, I will focus on common questions, or questions that I am asked. I hope that something you read on this blog is informative, but I offer this warning:
Keep your salt shaker with you!
All topics and questions that I address I will do so to the limits of my ability, knowledge, and experience. However, I am not infinitely aware, and my answers are based on what I have experienced. For this reason, I ask that you take everything that I or any other medical blogger writes with a grain of salt. What I have done to get where I am may not work for you, nor is it certainly the only way to do what I have done. Take my answers as general advice, rather than gospel truth.
So who am I, that you should listen to me? Well, I am a senior at a major public school, majoring in biochemistry and minoring in dance, and I will be attending medical school in the Fall. Where? That will be decided in the coming months, and I will be sure to let you all know when the dust settles. The AMCAS application process is complicated, but that's a topic for another post. I am interested in academic medicine, and I hope that I will someday teach either on a lecture basis or clinically. I have an enormous interest in Medical History and bioethics, and am considering either a Master's or PhD in the field (to be determined by where I go). Because of this, I will most likely come back to these two questions on a number of occasions:
1) What is/makes good medicine?
2) What is/makes a good doctor?
I am also interested in molecular genetics and biology. It is most likely that I will end up doing research in one of these areas. Outside of academics, I love to dance (as you can probably guess). I am particularly fond of ballet, modern, and latin dancing. My first and foremost criteria for medical schools was if there was a nearby latin club! I also enjoy traveling, learning about new cultures and people, and history in general. Other than medical history, my favorite subjects are Roman and Greek history. Hiking and skiing are my favorite summer and winter pastimes, and I'm a lover of Science Fiction (not the laser beam and space ship stuff, though that has a place in my heart too. I'm talking about the stuff used as a forum for political, social, and cultural discussion).
And with that, on to business!
Keep your salt shaker with you!
All topics and questions that I address I will do so to the limits of my ability, knowledge, and experience. However, I am not infinitely aware, and my answers are based on what I have experienced. For this reason, I ask that you take everything that I or any other medical blogger writes with a grain of salt. What I have done to get where I am may not work for you, nor is it certainly the only way to do what I have done. Take my answers as general advice, rather than gospel truth.
So who am I, that you should listen to me? Well, I am a senior at a major public school, majoring in biochemistry and minoring in dance, and I will be attending medical school in the Fall. Where? That will be decided in the coming months, and I will be sure to let you all know when the dust settles. The AMCAS application process is complicated, but that's a topic for another post. I am interested in academic medicine, and I hope that I will someday teach either on a lecture basis or clinically. I have an enormous interest in Medical History and bioethics, and am considering either a Master's or PhD in the field (to be determined by where I go). Because of this, I will most likely come back to these two questions on a number of occasions:
1) What is/makes good medicine?
2) What is/makes a good doctor?
I am also interested in molecular genetics and biology. It is most likely that I will end up doing research in one of these areas. Outside of academics, I love to dance (as you can probably guess). I am particularly fond of ballet, modern, and latin dancing. My first and foremost criteria for medical schools was if there was a nearby latin club! I also enjoy traveling, learning about new cultures and people, and history in general. Other than medical history, my favorite subjects are Roman and Greek history. Hiking and skiing are my favorite summer and winter pastimes, and I'm a lover of Science Fiction (not the laser beam and space ship stuff, though that has a place in my heart too. I'm talking about the stuff used as a forum for political, social, and cultural discussion).
And with that, on to business!
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