Wednesday, December 27, 2006

The Trail's A-Blazin

A belated Happy Holidays to all those out there, and I hope Santa treated you well! The past week or so has just been flat-out nice. Some sleeping in, a trip up to Chicago, starting back up as a medical assistant, and a Rams game (they even won in OT). This past Sunday, me and a HS friend headed up to St. Louis to check out the Rams/Redskins. That Steven Jackson kid's all right. Oh, and the seats were sweet - corner of the end zone only ten rows back. Got to see Mr. Jackson run into our end zone during OT and win the game. Too bad a capacity crowd didn't see the same thing - the dome didn't sell out, first time since 1995.

Getting back to work as an MA, even only after 2 days, made this past semester disappear. And by disappear, I mean that it made me forget about the insane amounts of time put into both anatomy and research. While it is still work, I definitely would rather be in the clinic than in class. Plus getting paid vs. going into debt (*cough* med school) is always a plus. Stupid thing is that the little bit I've earned this summer/winter will probably count against me somewhat in my financial aid apps. As I've mentioned previously, my more recent clinical experiences have been huge in letting me know what I want and given me a lot to talk about during interviews. In other words, it's good to get back to the clinic - keeps me motivated and all that good stuff. On that note, M1/M2 clinical opportunities have become important in my med school search. With all the business of learning medicine, it'd be nice to get some patient interaction and clinical experience (before my M3/M4 rotations), since it's what brought me there in the first place. The place I interviewed at last week has quite a few options in terms of this: various free clinics that are mostly student run (aka I see patients as a pseudo-doctor starting my first year) in different areas of Chicagoland. The diversity in terms of patient demographics and medical conditions are a couple of things that draw me to Chicago for med school - that, and Chicago itself...

About this past interview - I definitely got asked a couple of ethical/hypothetical questions. One should be expected, if it even happens. However, three from one interviewer was a bit surprising. One of them even involved a journal article and some accompanying graph. The hypothetical interview went better than the other interview though. The other interviewer only had access to my secondary, and aside from some getting to know you and secondary questions, she seemed kind of disinterested towards me. Not too much I can do now though - hopefully her evaluation reflects differently, because I got a great feeling from this school and it's probably one of my top choices right now.

In keeping with the post title, I already mentioned the Rams trip. Being on the interview trail the past couple of months, I've taken my fair share of trips. Hopefully, there will be one more trip on account of another Chicagoland med school (check this for where I just interviewed and where I'm still waiting)... But I digress. In my travels around the Midwest, I've picked up on a couple of things. My car does this thing where it likes to try and overheat after extended periods of driving. To put this in context, on a trip back from Alabama this past summer, my car definitely tried to overheat for most of the trip - something that was barely prevented by driving through summer heat with the windows down and heater blowing full blast. Oh, and the coolant reservoir was steaming and overflowing. Turns out the water pump and thermostat needed to be replaced. Fine fine, take my money, fix my car. Seems like things were fixed - I'm able to drive around in stop and go traffic and able to fly out of stop signs again. There's still a weird bubbling/gurgling sound coming from the engine compartment. But the car doesn't overheat, so whatever. Psych! Enter longer trips followed by stop/go, mysteriously self-filling reservoir, and warmer than normal engine temps. Now, it doesn't run warmer than normal all the time, only on two interviews (out of nine) and on one other occasion. Ideas anyone???

On the interview trail, when not on the road or at a med school, I can be found in a hotel. A couple of highlights... The Radisson in Wauwatosa, WI has Sleep Number beds in their rooms. When a 21 year old kid walks into the room after a 4 hour drive, said kid is going to play with the Sleep Number remote. For 10 minutes. Never did find my Sleep Number, but at least I got to set the 2 sides of the bed to different numbers. The Holiday Inn in Countryside, IL has a free breakfast. Mind you, not a continental one, but a buffet. A buffet with lots of good food. Those that know me know that this was definitely taken advantage of. Also, this hotel has quite a few business-types pass through it. Apparently rolling out of bed in warmup pants and a hoodie is not the "in" thing to do for these peeps. Nope, it's everyone in all-out suits and ties. Come on guys, it's 6:30. And what if you get gravy/jam/coffee on the suit? Apparently this is a recurring theme, as I found the same thing at the Marriott Medical District in Chicago. No free breakfast, it's a $10 buffet, but you get an omelet with the buffet. The Allerton Crowne Plaza in Chicago (on Michigan Ave) is a nice hotel all around. Minus the $40 for valet parking, lack of free internet, and smallish rooms, it really is a nice (albeit expensive) hotel. When you find the wall separating the bathroom from the main room to be an accordion-style sliding door, you might be at the Sleep Inn in North Chicago. If you have to go to the front desk to borrow an iron, then it's definitely the Sleep Inn.

On the road, here's what I've come up with. If you think driving through Illinois is bad, head over to Iowa. More of the same, minus the occasional towns like Effingham, Champaign, or Mt. Vernon, plus more cornfields. At least things get kind of interesting in the southern and northwestern parts of Illinois. So as not to totally bash Iowa, their med students know how to show a kid a good time. I spent more on fast food than I did on my night out with their kids - free drinks from quite a few people from quite a few bars. And while having Friday exams (every week) sucks for them, it meant that 3:00 was go-time for both me and them... Tennessee's got some variety going for it, in terms of real hills - a bit of a rarity in Illinois. North Chicago is a town, not a geographic description. Having said that, there's not a whole lot going on - a navy base, Abbott labs, a med school, and that's about it. And it's 45-60 minutes into downtown Chicago if you're lucky.

So out of all my travels, I've come to appreciate some variety in the scenery as I drive, or at least some traffic (of the moving faster than 70 mph variety) to keep me awake. Free breakfasts are appreciated, and even more so when it's a buffet with good food. And the biggie - I want to live in Chicago, be it the Illinois Medical District area or actually downtown. Here's to the getting the chance to choose between the two, and maybe even a certain near-west suburban school.

Sunday, December 17, 2006

It's A Beautiful Day in the Neighborhood

It really is too - 60˚ a week before Christmas isn't too bad. I'm back home now, and it's kind of weird readjusting to "home life" vs. college life. But I'll never complain about the free laundry and food. Hell, sometimes even both of these things are done for me. Now if it would stay nice and not cold when I'm in Chicago this week. Weather and med school interviews aside, today was a pretty sweet sports day, for such fans out there. Football-wise I checked out the Bears and Rams games, basketball had me check in on the SIU and Illinois games. Tomorrow's MNF game should be pretty exciting: Colts/Bengals. Hell, they had over 60 points combined by halftime last year. Now you may have noticed that I have two teams from two different sports. If I had to choose, it would be the Rams and the Illini. The Bears are a closer decision vs Rams than the Salukis are to the Illini. Oh, and if you haven't figured out from by basketball choice and blogger name - I go to U of I...

A couple of things I noticed while vegging out in front of a TV and eating continuously... Illinois's up first. Brian Randle can shoot 3s now, who knew? I swear everytime I was at a game last year, unless he dunked he either tore through the net or flat-out bricked his jump shots. And about his jump shots, he had no real range. Not so much this year - he's apparently got some range and added a "close miss" shot to his repertoire. That and the kid is still a freakish athlete and can play defense. I've been pleasantly surprised by Brian Carlwell - a true freshman center. In his limited playing time, he's done pretty well. He's shown flashes of being able to compete in the future, and I think he'll be a better 5-man than Pruitt. Dub-C. Other wise known as War-ren Car-ter... This kid can ball. Never thought I would've said that based on his play the past few years, but he just knows how to score. Hell, I look up at the scoreboard sometimes and wonder where those points came from, because it doesn't seem like he's working that hard to score. The Rams, while their offense isn't what it was six years ago is still decent. However, this isn't the Martz show anymore, and we actually have some sort of commitment to the run. Enter Steven Jackson - this guy's just flat out big and the offense runs through him - he probably averages 25+ touches a game. Back in the day, the offense was "unknown QB" throwing to one of five receivers running fly patterns. This led to sky-high numbers for said QB and Faulk racking up some ridiculous numbers with all this attention to the air show. However, I'm still kind of amazed at how Faulk put up the numbers he did with fewer touches than Jackson currently gets now. SIU and da Bears - these teams know how to play defense. The Bears have fallen off kind of recently in this regard, but that'll happen when you lose Tommie Harris and Mike Brown. I'm not saying they're the only reason, but it certainly doesn't help losing two of your bigger people up the middle. Oh, and Rex Grossman had a monster game today - I wonder which QB is going to show up in the playoffs. Granted he did this against a Bucs team that almost came back to win, but I still wonder what the Bears are going to do in the playoffs. SIU - this team should make a video Tom Emanski-style of how to play team defense. They've consistently been one of the better defensive teams in the country. If they played in a BCS conference, I'm sure more people would recognize this fact. Well, probably not as well in the ACC with Duke and the Tar-Hansbrough-Heels, but still. The MVC isn't doing too bad though - wins against LSU, Syracuse, Minnesota, Wisconsin, and Iowa isn't too shabby. Wichita State is also ESPN/USA Today #10, AP #8. Oh and on a final note - I've got double reason to root for SIU and against Indiana tonight. SIU because 1.)they're a local team for me 2.) they're playing Indiana. Against Indiana because 1.)they're a Big Ten team 2.)they took Eric Gordon after he verbally committed to Illinois - the hell with you Kelvin Sampson. I hope he hates you as a coach and subsequently leaves early.

Tuesday, December 12, 2006

Adventures in Anatomy

There it is. How I learned me some anatomy. There's actually a box of flashcards hanging around somewhere in my room and/or loft, but I only used them once so I don't count those. Having said that, I actually used all this stuff. From bottom to top: lecture notes, laboratory guide, anatomy atlas, previous lecture exams. Now the lecturer for the class was kinda cooky and out there - he definitely had his mannerisms that were mocked repeatedly. Hell, he even has his own facebook group. One might think that since I led in with the preceding, the following would go something like this "he was weird, but dammit - he knew how to teach anatomy." Not so much. The best things I got out of lecture were being mildly entertained and wondering how some of his anecdotes were even remotely related to anatomy. Why did I keep going? Well Curious George, I got points for attending lecture - ah the wonders of lame attendance incentives.

Lecture aside, I enjoyed lab quite a bit, save for the smell. Like I mentioned earlier, once in a cadaver lab and you'll never forget that smell. The TA for my section was damn cool. It didn't hurt that she was an undergrad in my neuroscience lab the year before. I definitely took advantage of said familiarity and proceeded to give her shit throughout the semester. It was a two-way street that made lab more entertaining. This type of banter happened throughout my lab section, not just between me and the TA, and good times were had by all. Not only were the two people in my small group chill, the entire lab section was pretty cool. We all got along really well and had fun...well, as good a time as can be had when there are a couple of cadavers in the room. The lab practicals were kind of interesting, minus having to study for them. Pretty much, you'll come to a station and two things will be tagged for you to identify. These tags can be on plastic models, joint preps, bones, arm preps (euphemism for severed arm on a tray), or cadavers depending on the unit being studied. You get 90 seconds to identify the structures, and then it's on to the next station.

So, a couple of things I've learned from anatomy (aside from these). Things never look like they do in the atlas. It can be surprisingly easy to confuse nerves, veins, and arteries. I use a lot of mnemonics when memorizing stuff. UOUVI - the top to bottom order of some arteries on the inside of the pelvis. PSLAiPi - the order of arteries from top to bottom as one moves down the brain stem. This one's not mine, but it still works - Oh Oh Oh To Touch and Feel Very Green Vegetables, Ah Heaven. Obviously, those are the cranial nerves. There is a lot going on in the skull, and even though I got an A in the class I question my knowledge of this structure. The more range of motion an area has, the more stuff is going on. There is a lot happening in the pelvis. As I've said previously - I did enjoy the class, even with all the work. Hopefully physiology next semester follows a similar pattern.

Sunday, December 10, 2006

Up and Coming

In the life of Illinaisa, the next month will consist of no school. So, what will be done to fill all this newfound free time? Well for one, there will be considerable hibernation for the first few days back at home. This will be accompanied by copious amounts of time spent installed in front of a combination of computer and TV screens. After emerging from said hibernation, I will move onto being somewhat productive and earning me some money, because money is what makes the world go round. I like going round. Aside from that, I really loved my medical assistant job from this past summer, and so I'll be coming back to work with Dr. Parks and his clinic. Outside of working and sleeping (wow, that sounds boring) I've got a lot of relaxing to do, an NFL game to go to, a wedding, and an interview coming up. Overall, should be a nice break.

It's Beginning To Look A Lot Like Christmas

It's finals week in the land of the college student and I am, well, taking no exams this week. For the first time in my college career, I had classes where I was able to either a.) opt out of the final if I was happy with my exam averages or b.) opt out because of how well I had done throughout the semester. My bact. patho. class was the average opt out option (scores of 78, 80, 50). Yeah the 50 hurt a bit, especially as someone who isn't used to doing poorly. But, after getting that exam back it didn't bother me too much. Neither did the fact that I could get a B+ out of the class without taking the final. In the past, I would've taken the final looking for the A, but as I've said, GPA's not as big a deal anymore...and it feels pretty sweet. My anatomy class was the performance opt out, and I like the idea behind it. "Oh, you've done this well throughout the class, sure we'll give you credit for knowing your stuff and let you opt out." Having said that, I've learned a lot in anatomy and minus all the work, I enjoyed the class quite a bit. We'll see if I'm still saying that during the med school edition of anatomy...

So not having exams during finals week = things looking like Christmas. That, and the fact that I've gotten a few more acceptances over the past few weeks. I've always heard and believed in releasing acceptances and/or interview invites if you know you wouldn't go to that school. But, I only applied to those schools that I would actually go to, so now with a couple of acceptances I can't withdraw just yet. I'm going to wait until I hear back about financial aid packages and from a few more schools. About waiting on schools, there's only one more interview I would go to if invited, and I'm waiting on final decisions from a few schools. So overall, some more waiting before I decide where I'll spend the next four years... :)

Friday, December 8, 2006

What Have I Gotten Myself Into?

I'm sure that it's a natural feeling for anyone waiting to start med school, but it's still kind of unsettling. Now knowing that I'm going to be a doctor, I've woken up a couple mornings and wondered if I can be a doctor, if even a competent one. Don't get me wrong, I'm still super-psyched and enthused about getting in and I will work my ass off in med school. I know that adcoms wouldn't admit those they don't think will make it. I also know that the American medical education system is set up to make sure that decent practicing physicians are produced, but I still can't help but wonder sometimes. I mean hell, I just finished studying for my anatomy exams tomorrow and the fact that I can't remember various neuro structures makes me think. "But if I can't remember all the venous sinuses of the skull, how can I be a doctor?" Yeah, I know it's an stupid thing to worry about, but the feeling still pops up. Here's to those superior and inferior sagittal and petrosal sinuses. And here's to the ones that I'll forget before my practicals tomorrow.

Thursday, December 7, 2006

Ooo! Hey You, Mr. Med School - Look at Me! Please?

All righty, took the MCAT and rocked the first three years of undergrad. Send off those grades and MCAT scores, med school here I come. Well, sort of. The following are my 2¢ about applying to allopathic (M.D.) programs. I would imagine that the osteopathic (D.O.) process is pretty similar though. You apply through AMCAS, a centralized service that collects information about you and distributes out to schools of your choosing, for a fee of course. About the schools you choose to apply to, the MSAR is a great resource to get a quick overview of schools, their average stats, and requirements. As for the average number of schools applied to - I've always heard fifteen. Include schools where you are competitive numbers wise (aka around their avgs), a few reaches, and a few safety schools. About the last category, all med schools are competitive to get into, so don't blow off these schools. And as for the categorical classifications, adcoms really do look at the whole application, but numbers do play a pretty big role. Your numbers can make or break your screening for a secondary or interview, along with a final (post-interview) admissions decision. Numbers, like so many other factors, will not get you in by themselves. They can, however, keep you out. The stuff that goes on your AMCAS (primary) includes biographical stuff, all the classes you've taken, listings and descriptions of your extracurriculars, and a personal statement. Also included are your GPA and MCAT. The personal statement is just that: your story to medicine, anyway you want to tell it. This is one of the more important essays that you will write as a premed, so please put some time and thought into it. And have other people look over it, for the usual grammar and spelling checks. But also, having other people read it makes sure that your essay makes sense to an outsider. There are things that may make sense to you the writer, but not always to the outside reader. Now the extracurriculars, this is your chance to let Adcoms know what you've been up to outside of class. As long as the title of the activity is descriptive, use the allotted space to describe why the activity is important to you and what you got out of it - don't just reiterate the mission statement of the club/organization/activity. Also, feel free to include the stuff you do in your free time (personally, that included mentioning Tae Kwon Do, football, tennis, video games). Now all the classes you've taken also get listed on your primary. The way this gets done is by you manually entering them. Someone over in Washington, D.C. has the unenviable job of taking transcripts from your undergrad and wherever else you may have taken classes and making sure everything matches up. The reason for this is so that schools don't have to do this themselves. For this reason, I'd recommend getting yourself a copy of your transcripts and entering them verbatim into your primary, because that's what the verifiers are going to be checking your app against anyway.

A couple of notes about timing - get your stuff in as soon as possible. As soon as you have your final grades from your junior year, send your transcripts off to AMCAS. As soon as you feel comfortable with your personal statement and the rest of the primary, hit the submit button. I say this because getting verified takes a while (anywhere from three to eight weeks depending on when you submit). Until you're verified, med schools don't know you exist. When you do finally get verified, you will hopefully receive a flood of secondaries. Secondaries are applications sent from the actual med schools to you requesting letters of recommendation, (sometimes) more information, more essays, and of course more money. About the letters of recommendation, I would have those lined up before your junior year ends, because waiting on those will delay your files at schools from becoming complete and being reviewed. A good file of letters to have will include two science profs, a nonscience prof, a clinical exposure letter, and if you've done it, a research letter. Letters of rec, along with your interview, are used to evaluate you as a person, as a potential physician, and in whatever activity the letter is from. Thankfully, my research letter was rumored to have hit highly on all these point, as has been reported to me at several interviews.

So with your primary, secondaries, letters of recommendation, and lots of money sent out you will be considered complete at the schools you've applied to. If you thought waiting to get AMCAS verified was bad, you're not going to like the next stage of the process (*hint - noone does). The waiting at this point can go from as short as a few weeks to as long as months. Specifically, it consists of schools reviewing applications and deciding who to interview. About the waiting, the reason you want to get all your stuff in early is because most schools use a rolling admissions system. So, the earlier you are complete, the more seats are open in med schools. Upon getting interview invites - congratulate yourself, because that's a huge hurdle to overcome. At this point, schools are seriously considering you for admission and think you're great on paper. All those being looked at closely get interviewed so that med schools can get a sense of you as a person. This is the final step in the application process (unless you get put on waitlist) and can have varying impacts on your final decision - two things which I'll touch on later.

This is where I'm currently at - the interview stage. Interview days will consist of obviously your interviews, med school tours, information sessions, and usually a free lunch. *Please* be courteous to everyone on interview day from fellow applicants to the custodians: you never know who's watching or who knows who. In addition to schools getting to know their applicants, this a chance for applicants to get a feel for the school and if they would fit in there. Since tours are usually given by med students, ask them questions to your heart's delight - they're the best sources of information about the school. But, back to the business at hand: interviews. You may have anywhere from one to three interviews. Your interviewers could range from med students, science faculty, attending physicians, or those on the admissions committees. Styles of interviews can range from several one on ones to panel interviews with either one applicant and several interviewers or several applicants and several interviewers. Also, your interviewers may or may not have looked at your file prior to interviewing (open vs. closed file). Regardless, my interview prep consisted of having answers to why medicine, why do you want to go to "x" school, ethical questions, and checking out previous interviewees' questions. Also know your primary and secondary front and back because anything is fair game to be asked about. Even if it's a closed-file interview, if you highlighted certain things in your applications, make sure to do just that in your interview also. Oh, and towards the end of the interview, you'll be asked if you have any questions. You always have questions. Even if you know the answer, ask it - it shows interest in the school. Interviews can range from fifteen to sixty minutes and from laid-back conversational style to grillings about you and your app to just wanting to get to know you. Just carry yourself with confidence without being the ass who thinks they're the greatest thing since sliced bread and then some. If you stumble over a question, move on and don't worry about it - nothing you can do now. Often, they just want to see how you react and how you handle working through difficult questions, it's not necessarily the answer that matters. Now the interview can consist as part of an overall admissions evaluation and decision to the determining factor in your admissions decision. Also, your interviewers can present you to the admissions committee, fill out a subjective evaluation of you, or give you a score - any style of which gets factored into your admission decision. The final admission decision usually takes into account all aspects of your app: primary (which includes your GPA & MCAT), secondary, letters of rec, interview evaluations.

After interviewing, guess what? More waiting. Once decision dates roll around, schools can decide to outright accept you, waitlist you, or reject you. The first and last types of decisions are pretty self-explanatory. The waitlist means that you wait until May 15 rolls around, when those holding multiple acceptances must relinquish all but one of them. It is at this point when med schools now have seats to fill and they start drawing from their ranked waitlists to fill their classes. If on waitlists, schools like to hear what you've been up to during your senior year, from grades, to activities, to research publications. These updates show that you're interested in the school and may even serve to move you higher on schools' waitlists. If on a waitlist, you can hear something from schools anytime from May 15th to the day before classes start.

As I mentioned earlier, I'm still in the interviewing stage of the application process right now. I've been fortunate and am grateful for multiple interview invites and acceptances. At this point, I'm now only interviewing at schools that I would seriously consider going to over schools that I've been accepted at as a courtesy to others applying. I've withdrawn from two schools, so as to hopefully make two other premeds' spring semesters a little less stressful by knowing that they are going to med school next year.

So, that's how I've gotten to where I am and where I'm at right now. I'm going to be a doctor :D We'll see how things play out from here...

Year Three, Part III

As I alluded to here, there is something that happened this past summer that was pretty significant for me. I came back to my hometown to shadow the same family practice guy (Dr. Parks) from summer 2005. In addition to hanging out at the clinic, I got to shadow two surgeons in the OR and the clinic. The OR was just flat out cool. I may not have known what was going on all the time, but it was pretty exciting to see what was going on. Seeing somebody's real, live abdominal cavity exposed was a phenomenal experience.

As sweet as the surgery experiences were, they were trumped. After shadowing Dr. Parks for a few weeks, he offered me a position as a medical assistant. I was elated at the offer and took it in a heartbeat. Initially, my job started out by accompanying Dr. Parks on his morning (read: 5 AM) hospital rounds and making and entering SOAP notes into patients' charts. After a few days, his regular clinical medical assistant took a vacation, and I was offered the chance to cover for him also. Best vacation not taken by me, ever. Yeah, I still worked with SOAP notes. But, I got to work with patients...a lot. I took care of patients before and after being seen by Dr. Parks - taking vitals, noting presenting complaints, and working with them/explaining to them Dr. Parks' orders. I loved this job and am looking forward to working there over winter break (a little money never hurt either). I loved the patient interaction, the nurses were great to work with, and I've learned a decent amount about medicine (as much as can be learned as an MA).

The highlights of my time as an MA this summer involved the patients. There was one patient, CLS, who I first met on morning rounds. He'd been dealing with chronic diarrhea and infections in his large intestine. Eventually the recommendation was made for him to have part of his colon removed, albeit after some treatment for his gross malnutrition. However, it's always the patient's call, and he wanted it done now, not later. So the surgery proceeded against his doctors' recommendations. I sat in and watched his surgery and being in the OR again was pretty cool. After the surgery, I saw him again on rounds as he recovered and after a week he was well enough to return home. Over the course of the next six weeks I saw CLS as an outpatient and got to see him improve greatly. Being able to follow a patient from preop, through surgery, postop, and in office followups was an amazing experience. Watching him and picturing myself as that guy who gets him from dealing with months of diarrhea to being able to talk about his turnips was both a phenomenal opportunity and an exciting thought.

As great as summer 2005 was in letting me know that medicine is what I want, summer 2006 was that much greater. I loved being immersed in a medical environment, especially working with patients. It was icing on the cake in that it solidified medicine as my career choice - I loved the job and am ridiculously excited about eventually practicing medicine.

Back to the Future

With some of the stuff that I've done in the past being out there, I figure a little something of the present couldn't hurt.

For those curious, the past couple months have consisted of school, research, and med school interviews. Now the first two are not so much fun. But, minus the stress and prep leading up to it, the interviews have been a good time actually. Bitching and moaning about the whole process and its associated waiting and seeming randomness with other applicants is funner than one would think. I’m now also a believer of the mantra that interviewing gets easier with practice - things just got easier and more natural for me…gotta see it to believe it I guess.

On the topic of med school, I’m in - and it feels pretty damn good :D I’ve even got some choices. A decade and a couple hundred thousand dollars from now, I might just have this doctoring thing figured out. Until then, I’ll have to settle for sometimes knowing what’s going on in medical shows and if I’m lucky, being able to point out things that are wrong.

About school, I’m pretty sure one of my exams yesterday was an exercise in bullshitting, because that’s what I spent the majority of my time doing. And for once in my undergrad, I didn’t really care. I mean, I’ll still study and whatnot, but if some exam decides to tear me a new one, it’s not that big a deal…at least not for another 8 months. Hell, as long as I don’t get any Cs, med schools, for the most part, are done caring about GPA, meaning that so am I - and it feels pretty good.

And since everyone loves a little premed learning here’s a couple of things I’ve learned so far. Fun words to throw around in anatomy: peduncle, tubercle/tuberosity, calcaneus, gastrocnemius, pterygoid, mastoid, caruncle, fundus, sartorius. If you tear your ACL or rupture your Achilles, it’s gotta be pretty violent because that shit is pretty strong, even on cadavers. Oh, and the skull has holes. A lot of them. Stuff goes through these holes. Once in a cadaver lab and you will *never* forget that smell. When you’re a fetus, your lower body pretty much gets shafted in terms of nice, oxygenated blood. Bacterial pathogenesis: bacteria sometimes good, sometimes bad. Bacteria can be little thiefs by using your own stuff against you. Bacteria living in cells - a bitch to get rid of. Sneaky bacteria that never show themselves outside of cells are ninja-like and just might kill you. The ballsy bacteria which can get into and live in your bloodstream *will* kill you. Medical ethics - here are two sides of a moral argument…you decide. Just don’t break the law, piss anyone off, or kill anyone. Immunology - something binds something which signals something to do something. Oh wait, it matters how well, when, with whom, where, and why things bind. Vaccines are good. Viruses are pretty hard to deal with. Neurogenesis research - the brain makes new neurons, who knew? Figure out why and how this happens. Maybe I’ll get more learned with physiology and endocrinology next semester.

Some real world stuff - it’s always a good feeling when your landlord tapes a notice to your door telling you the following. “Valuable stuff: leave it behind over Christmas break and it will probably get stolen.” Thanks, guys. That’s why I gave you a security deposit. And about my apartment, I refute the theory of heat rising. Actually, I take that back. After living in a loft (aka second and third levels of my apartment), heat only rises if it’s summer. When it’s winter, heat does *not* rise - it stays on the first level of the apartment. I’ll defend that thesis to the death.

Year Three, Part II

All right, so I know I want to be a doctor. I've gotten my ass in gear and started doing things to help me get into med school. Oh yeah, there's this thing called the MCAT. You've gotta take it if you want to apply to med school. Also known as Mm, College After Three Years. Yes, that's MCATY, but it's a pretty accurate description. Remember those prereqs I talked about earlier? Say hello to the final over all of those, in the span of a Saturday.

At least for the paper MCAT, my testing day started around 7:30 - when I got to the testing site. Sidenote about the paper MCAT, I don't think I would like taking this test on a computer, which they're moving to for 2007. Also for some reason, they feel the need to fingerprint you before you can take the test. At least they use this cool ink that doesn't leave anything on your fingers. Anyway, testing started around 8:40 and I was done for the day around 4:40. Strangely enough, the day flew by. The MCAT's broken down like this: 200+ questions split into three sections of Verbal Reasoning, Biological Sciences, Physical Sciences, with two writing samples thrown in. Verbal consists of reading 10 or so passages in 85 minutes with 60 questions. Bio goes over organic chemistry, and you guessed it, biology: 77 questions, 100 minutes. PS goes over physics and general chemistry, same breakdown as bio. A writing sample consists of an ambiguous prompt being given, you being asked to support, attack, and argue which is right - 30 minutes each and there are two of these puppies. About the actual questions - yeah it's a decent amount of material to review. But, equally as important as knowing your stuff is knowing *how* to take the MCAT. For one, it's not just straight up regurgitation of facts. The vast majority of the science questions are going to involve reading some sort of passage and answering questions based on what you can gather/infer from the passage and what you know. Another thing is that timing is a ridiculously valuable commodity on the MCAT. When I took my first practice test, I didn't finish verbal (had two passage that hadn't been read yet) and definitely had to rush towards the end of the other two. So, time management is huge on the MCAT. Lastly, please take a practice test or two before the real thing. It helps you figure out timing and gets you used to the question style - which for me, was different than my undergrad exam style.

I mentioned taking practice tests as part of my prep. I opted to take a Kaplan class for my MCAT prep. Kaplan offers practice exams, review books, and obviously the class. There are those who do prep through Kaplan or Princeton and those who do it on their own. Personally, I needed something to keep me reviewing at a reasonable rate, so I took a class. Now, I don't know if it was worth the $1500 I spent on it, but it definitely helped. Also, whatever prep you decide to use, get some sort of review series/book(s) - your undergrad notes are just too detailed for what you need to know on the MCAT. So my second semester junior year was pretty busy for me: MCAT prep, classes, research, and all the ECs I'd been doing from first semester. But when it got down to the two weeks before the MCAT, I pretty much dropped everything else. Up until that point my prep consisted of looking over stuff from the review class and book just so it would be floating around come April. The last two weeks for me were spent 1.) going through the review books, practice problems, and working on stuff that I had trouble with 2.) taking practice tests.

So the MCAT's not so bad, you've just gotta know your stuff and know how to take the test. And work your ass off. It was a pretty good feeling walking out of that building knowing I was done with that damn test and all the prep. Now I just have to wait two months for my scores.

Year Three, Part I

Now junior year should be included as part of the prep work for med school applications and MCAT, but I've separated it out for personal reasons.

Between school years, there's this thing called summer. And if you're premed, you should probably be doing something during it. Like I mentioned earlier, my first two were spent volunteering at a hometown hospital. Don't get me wrong, this was an outstanding experience: I loved the techs I worked with and they loved having me (who doesn't like free labor?). I got to see a different side of medicine, through techs' eyes. I enjoyed running xray films, checking out CTs, and sitting in on nuc med. The techs were more than happy to teach me bits and pieces along the way. One of the coolest things someone's said to me came from an xray tech who said that "You'd make a good ER doc - you've got the laid back personality they seem to have." Self-promotion aside, the nuc med tech (Skip) and I were pretty tight and he is one of the wiser people I've met in my 21 years of life.

As one might surmise by this point, the summer between sophomore and junior year probably had something happen that I consider pretty important. Like I said, I was volunteering at a local hospital during summer 2005. That and this activity to be disclosed, however, were a backup plan. I was looking to work ( :-O money? nooo...) at a local hospital on one of the wards and was looking to a friend's father for a reference. It so happens that this person is a family practitioner. After exchanging emails, he said he'd be happy to serve as a reference. However, he also noted that he'd be happy to have me shadow him in his clinic. I figured if the hospital thing fell through that I'd fall back to volunteering and maybe take him up on shadowing. After a month of not hearing back from the hospital, I went back to volunteering and decided what the hell, why not shadow.

Hands down, best decision. Ever. After the first couple of days, it was just just like *bam.* And by bam, I mean "Whoa. Yeah, this is it. This is what I want to do with my life. I want to wake up and do this." Does it sound lame shadowing 13 hours/week for a summer, when said shadowing involves standing next to a wall (well-dressed, I might add) and observing? Some might say so. But when this lame activity is something I don't mind getting up early for and actually look forward to then that's good news. In addition to getting to hang around the clinic and see what a doctor's daily life was kinda like, I also followed him out for nursing home rounds and to a free clinic. At the latter, he let me interview patients before they were seen and that was pretty cool...especially when he was able to look at my notes and had nothing to add to my observations. Granted, that didn't occur too often, but still. And while at his regular clinic, I also conducted a mini-clinical (note: *very* small) study about prescription compliance. While the study was kinda cool, just talking to the patients was enough for me. If the doc trusted me enough to be around them, then the patients trusted me and opened up about whatever I asked - this was a phenomenal feeling. Along those lines, I was amazed at how no patients really objected to having some random kid in the room while they discussed their medical problems and lives. Overall, I learned a lot about medicine (informally) and about myself.

There it is. Shadowing. In addition to the extracurriculars I mentioned earlier, this is one thing every premed should do, as it both adds clinical experience and lets you get a more intimate look of what you're getting yourself into. After all, entering medicine is no light decision. I'm not saying that to sound like a badass or anything, it's just the truth. I mean you've got four years of undergrad where you have to worry about your grades and building up an application for med school. If you get in, then the next four years go something like this, from what I've been able to gather at this point. Your first two years are spent having a shitton of information thrown at you a lot faster than it ever was in undergrad. After said two years, you then get tested on this information on USMLE Step I (the first part of your board exams). After second year, you get no summer since you start clinical rotations. Again, going off what I've heard - you rotate through the major services such as surgery, psych, ob/gyn, pediatrics, internal medicine, family practice both to gain relevant clinical experience and let you know what you want to do in medicine. Fourth year you finish up required rotations, take elective rotations, and start applying for residency - kinda similar to applying for med school, which I'll talk about later. Residency: training in the specialty that you want to go into, ranging from three years in family medicine to upwards of seven for surgery. Oh, you want to sub-specialize? Hello fellowship and another couple of years of training. In addition to the time commitment and work, you'll be going into significant debt for med school and making not so much during residency. Like I said, not a decision to be made lightly.

So shadowing for me was the kicker (in addition to another activity to be named later) for letting me know that I'm making the right decision in medicine and that it really is what I want to do. Hell, I've mentioned shadowing and this future activity at every interview I've been to. Not because it's what they want to hear, but because it's my story. Well, I guess it's what they want to hear, but you know what I mean. Going into college, medicine was a logical choice. "Hey, I like science. Huh, I want to help people. Ooo, medicine." But shadowing gave me that gut-feeling that put out any doubt of medicine as a career choice. It made my junior year that much better, knowing that I was working toward something that I wanted to do.

About my junior year. In working towards getting into medical school, I had decided to do research. I'd been told that it's a pretty big plus to have on your application, so I decided to go after some of that. Ah yes, the theme of doing things you're interested in. My intro psych class was pretty interesting to me, so I decided to look around for a neuro-related lab. I interviewed with two labs and decided that one was doing cooler stuff than the other one. And so began my work in neuroscience. Why research? Well, neurogenesis just sounded cool to me, so I wanted a part of that. And now in retrospect, it's not a bad idea to at least have some experience in the field through which many medical advancements are made, aka research and academic medicine. Coincidentally, the lab I work in has quite a few M.D./Ph.D. candidates in it, and I don't know how they do it. But anyway, research involves being able to approach a problem, formulate hypotheses, and testing their validity, and then modifying your actions appropriately. *Gasp,* this is not unlike things you will be doing as a doctor with patients. Again, this is in retrospect, because I definitely didn't think about all these things when I was looking for research, I just wanted the coolest sounding lab (again, neurogenesis just sounded sweet). Having said that, I'm grateful for and happy about the experience and things I've learned and continue to learn from research and how it relates to medicine.

And with my shadowing experience kicking my ass and telling me to do what I can to help my application, I became more active in the organizations I was members to. I volunteered more often for the premed club I was in and ditto for the EMS club. And shocker here, I had fun getting more involved and walked away with things to talk about. The best effect of the shadowing experience is it gave me light at the end of tunnel, albeit a very long tunnel. Biochem is a good example. Sure I bitched and moaned about having to learn the Krebs cycle, glycolysis, gluconeogenesis, and oxidative phosphorylation (*enter nightmares of NAD/NADH and cytochromes). But I knew that it was a means to an end. Granted, it was still not fun - but at least I knew it would get me somewhere, hopefully.

Wednesday, December 6, 2006

Years One and Two

The first two years of college for me in terms of getting ready for med school involved classes, volunteering, and the same stuff I liked in high school. It goes without saying, but getting good grades during college is a good thing - as far as med school is concerned. One, because it helps your GPA. As premeds, we do obsess about this crazy little number, but only because it is one of two big numbers admissions committees look at and also obsess about. The second reason getting good grades in premed coursework is also beneficial is because it helps with the MCAT, the second important number schools look at. Believe me, you do not want to have to learn redox reactions, electrostatics, and renal physiology during your MCAT semester junior year, while you've got other classes going on also. IMO, your MCAT semester should be all about reviewing, not learning the material you need to. But I digress. This is about the first two years. Classes: take them and do well. Also, aside from the med school prerequisites, take classes (i.e. major) in something that you're interested in. Naturally, most people wanting to do medicine have some interest in biology, and if that's your thing then go for it. But if you are all about Classic Civ, then by all means major in that. Med schools don't really care what you major in so long as you do well in your major and your pre-reqs. Speaking of pre-reqs, they'll usually include at least the following: a year each of biology, chemistry, physics, and organic chemistry, each with lab. Random other things some school might require: psych, calc, statistics, english/comp/rhet.

Now as for non-class stuff, please have at it. One of the most common things to do is volunteer, and usually at a hospital. Again, volunteering - a good thing. Schools like to see that you do things outside of class and also that you're getting some clinical exposure. Clinical exposure is pretty important in that it conveys you have some idea of what goes on in medicine, aside from all the business of Scrubs, House, and Grey's (all shows which yours truly claims viewership to). I volunteered at a hospital in my college town starting my second semester freshman year, something I kept up through college. I also volunteered at my hometown hospital for my first two college summers. In addition to demonstrating commitment (aka staying with something longer than a week) another thing you'll get out of staying with something for an extended period of time are anecdotes and experiences you can actually talk about in your applications and interviews later on. Outside of the hospital, I was involved in the premed club (mostly for the different volunteer activities), EMS club, and a program teaching grade-schoolers chemistry. Now while I spent the majority of my volunteer time in a hospital, this doesn't mean that that's all you're confined to. Similar to the whole college major thing, do what you're interested in. I for one, wanted to get an idea of what went on in a hospital and in different departments, so that's what I did. If you're a hands-on person, you've got Habitat for Humanity; if you're a counselor, crisis lines are a possibility.

Also, definitely keep up with the stuff that you were interested in during high school. Myself, I trained in Tae Kwon Do in high school. Buuut, I never finished my black belt there. So my freshman year was spent, among other things, retraining and getting ready for my black belt test at the end of the year. Not only did it give me something other than winter break and spring break to look forward to, nothing really beat working on a punching bag, pad work, and some sparring to burn off some energy. Again, do what you like. Makes sense, but some people just don't do it.

And Off We Go

Well, so here I am. I'm a college senior and you guessed it, I want to be a doctor. This is mostly going to be about how I got here and what happens next, with random opinions and anecdotes thrown in as I see fit. I've been reading other people's med related blogs and figured all the cool kids are doing it, and hey - I wanna be cool. I'm starting this mostly for myself and if people actually end up reading this, then all the better. Stay tuned.