It's All About the Benjamins

I got my financial aid package from UIC the other day, and my first reaction was "damn." This shit's expensive. I knew this going in, but it hit home when I started reading through their estimated costs of attendance. Four years at UIC and I'm looking at at least $190k. And that's at a state school based on last year's numbers. If I go to a private, I'm looking at $220k to $260k - there's a few that might be worth that to me. Thing that sucks is that Illinois has some of the more expensive state schools.

Don't worry, I got a $1k scholarship. I'll take any money I can get, but a little bit more would be nice for a kid who's probably going to graduate summa cum laude. Yeah, the full-ride scholarship(s) are probably given as recruiting efforts to those kids with acceptances to Harvard, Penn, Yale, Stanford, and Johns Hopkins. These same kids have probably published three papers in Nature, volunteered at African AIDS clinics every summer, taken 20 hours each semester, have a 3.9+ GPA and a 37+ MCAT. Now I know that society in general doesn't look too favorably on giving future physicians money. I understand that. I understand that there are thousands of other med students in similar situations. It still sucks and is still a little unnerving.

Bumps in the Road

With less than two months until I can call myself an Illinois alum, I've started thinking of how I got to where I am today. Two main events have stuck out: a meeting with a premed advisor and shadowing Dr. Parks.

As sophomore year was wrapping up, I met with my premed advisor to make sure I was getting the right prereqs taken care of and to get an overview of the application process and timeline. As things were wrapping up, I asked her what she thought of me as an applicant (she sits on the UIC adcom). After I'd talked about what I'd put on my app, she said I probably wouldn't make the cut for UIC and would be a maybe for SIU. Damn, that was a slap in the face. To be told that I might not be able to do what I want. It was this and my shadowing stuff that got me all into ECs and, IMO, into med school.

Among other ECs I tried to add on to my application, one was shadowing. Shadowing, as I've mentioned earlier, was *the* thing that let me know I wanted in on medicine. Before shadowing, medicine was a logical choice for me: like science, like helping, choose medicine. Still, for my first two years in college, I had my doubts about entering medicine. After the first couple days shadowing, I finally had the feeling of "hell yeah, this is what I want to do." Pretty much an awesome feeling.

Funny how things work out. Get told I might not get to do medicine. Get ass into gear and find shadowing. Shadow and find out that I really do want medicine and how much I actually want it. Enter junior year going all out on ECs, don't mind them, and get great stuff to talk about in med school interviews. Fast forward almost two years later, and I've got six acceptances, two of which include SIU and UIC.

Roving Trucks

It's that time of day again. You know, when those wonderful white pickups emblazoned with the Illinois "I" are about. Ah yes, these trucks grace us with their ubiquitous presence and the world is a better place for them.

I am, of course, referring to campus parking. Hooray. They're around to enforce meters, parking zones, and everything else parking. I can see the reason for having and enforcing meters that are right on campus, aka right next to the quads: gotta turn those spots over. But when the meters are a good 15 minute walk away from central campus and there are a dozen empty spaces, it's a different story. I mean come on, you're just enjoying yourself at that point.

Yep. I've gotten my share of tickets like anyone else. I can deal with, and sometimes pay, the main campus meters for the reasons I've already mentioned. But getting ones at the tennis courts when there are a shitton of open spaces just irks me. There is one ticket that pisses me off more than others though. I was playing tennis and saw a parking truck getting close. So I head out to throw some change in the meter, the "parking officer" stops, I tell him I'm feeding the meter, and he continues along. Hoo-rah. Just avoided a ticket. Psych. Three months later I get a ticket in the mail, sent to my home address. And for some extra salt in that wound, since I didn't pay it in 72 hours, the fine's increased.

Yeah, yeah. There's a simple solution: pay the meter. To this I say no. Both Champaign and UI make too much from parking. I'm keeping my quarters.

Learnings

It's about 2 months into the semester, and I'm to have learned some stuff by this point. And learn I have.

Physiology
Learned how various stimuli from the environment becomes information that's sent to your brain. The recurring theme is that all stimuli eventually get converted to action potentials firing at the brain. The cool stuff is how all this happens: light, sound waves, smell, taste, and tactile sensations go through different mechanisms to become or cause other cells to fire APs. Cardiovascular and respiratory physiology involve more physics than I thought they would. The body has some pretty sweet ways of regulating these systems. The way by which the heart generates both its own pacemaker and contractile currents, also cool. Oo, and I know what those little squigglies on EKGs stand for now. Couldn't read any pathological EKGs, but I'm not focusing on that. Just starting renal physiology.

Endocrinology
Signalling cascades. Learn to love them. Er, tolerate them until memorized and then slowly forget them. There are lots of ways for hormones to affect receptors, and subsequently lots of ways for said binding to affect cells. The big picture is interesting though. The pituitary is pretty much the head honcho as far as hormones are concerned. It produces hormones which regulate other glands' hormonal production which then have local and/or systemic affects. Learned about common receptors and their immediate signalling cascades. Learned about how the pituitary itself is regulated and the hormones it produces. Learned about the male and female reproductive systems. Cool thing learned: as a developing embryo, if you're lacking two hormones, you develop a female reproductive tract. That is, we develop female parts by default. Similar situation with development of certain brain areas. Currently working through pregnancy lectures.

Even though these classes are only at an undergrad level, I'm still gaining greater appreciation for all the stuff that happens in our bodies, especially when we get down to the molecular level. I'm impressed by the regulatory mechanisms in place to keep things going. That and how, for the most part, none of it goes awry. The energy and time of thinking about all this stuff is definitely greater than that required for these processes to actually occur. AKA, during the time it took me to learn how the heart generates its different currents through various ion channels, my actual heart will have done it thousands of times.

Burn In Hell

Wow.

What a sack of shit. That's pretty much all I've got.

Reading Rainbow

A little while ago, I finished reading "The House of God" by Samuel Shem. The book's considered a classic as far as medical books go, and I figured I'd check it out. It's a satire on medical residency, specifically the intern year, and has been likened to "Catch-22" for residency. It gets to be really depressing at times and has made me think a bit about what I'm getting into. The main characters get pretty jaded and cynical pretty fast - medicine is not what the interns was expecting. One of the interns even commits suicide.

Minus all the depression business, the book is pretty entertaining too. For one thing, the book goes into detail about the interns' sexual affairs with the nurses, one of which includes an orgy. A couple of observations are made: young people always die, old people are referred to as gomers (Get Out Of My ER), turfing (diverting patients to other doctors' services) is a legitimate medical treatment. There are laws that develop as intern year progresses which always hold true, regardless of how cynical or depressing they may be: gomers go to ground (always fall), gomers never die, the only good admission is a dead admission, the delivery of good medical care is to do as little as possible, show me a medical student who only triples my work and I will kiss his feet. These laws may be overexaggerations, but they still make readers aware of some of the negatives of medicine.

Overall, the book and other med-related blogs have got me thinking about my idealistic pre-med notion of medicine. The degree to which this conception will hold true, if at all, remains to be seen. However, the fact that I've questioned whether it's all worth it and still want to do it has to count for something. Still, all this thinking is starting to dissuade me from the "nonlifestyle specialties," e.g. those with longer hours, high amounts of call, lower earnings, higher litigation rates. These nonlifestyle specialties have been declining in popularity, while the lifestyle ones are gaining even more popularity. Don't get me wrong, I'm not going into medicine for the money. But at the same time, if after 4 years of college, 4 years of med school, 3-5+ years of residency I find two specialties of equal personal interest, the one with 50 hours/week, minimal call, and low litigation rate is going to be more appealing than the other with 70 hours/week and constant call.

But whatever, I have no idea what specialty I want to go into, and luckily don't have to know for at least a little bit longer. But if I find I really love surgery or internal medicine on my M3/M4 rotations, then so be it. In the meantime, I'll be doing some more reading and enjoying the spring weather that just hit Collegetown, IL.

Tale of the Tape

As of today, here's how things have gone down.

MCAT
MCAT fee: $210
MCAT class: $1500
Comments: Obviously have to take the MCAT. Kaplan class is good for study materials, practice exams, giving structure to studying. Questionable value of price to product.

Schools
Schools applied to: 15
Rejections: 5 (1 post interview)
Pre-interview hold: 1
Interviews: 9
Waitlists: 2
Acceptances: 6
Withdrawals: 1 (pre-interview), 3 (post-acceptance)
Comments: Looks like it's narrowed down to one, maybe two schools, unless I get an insane scholarship somewhere (unlikely).

Applications
AAMC Primary: 1 sent to 15 schools ($580)
School Secondaries: 15 ($1050)
Sending off letters of rec, transcripts: $192
Comments: Yeah, not the cheapest app process ever.

Interviews
Hotels: 7 ($802)
Gas: ~$370
Comments: See latter portion of this.

Overall, things have pretty much wound down. Waiting on an offer from one school and also waiting to see what financial aid packages look like. Otherwise, I'm pretty sure I know where I'll be for med school...

And You May Bend Over...Now

Uncool.

In an exam where time is such a big factor, having the above happen to me would have burned off quite a bit of it. When I was prepping for the MCAT, I tried my damndest to take nine and only nine minutes per passage/questions, and then move on. Even doing this on test day, I only finished Verbal Reasoning with less than a minute left. To start off with, some of the passages they use for VR are just weird. Some are on topics I just don't care about. And sometimes paragraphs are omitted just to make things more interesting. All of the above: not necessarily enjoyed, but to be expected. Having questions that actually don't make sense with the passage is just wrong. Really, it's sad - people supposedly reviewing the MCAT and not catching such a gross mistake. Kinda like the original NBA 2K, where you could dunk free throws, except a lot more stressful.

What does the good ole AAMC have to say about this? Take the score we give you, or take it again. Eh, no. I wouldn't be happy about having my VR graded on some modified scale, with no assurance of fairness while thousands of other MCATers don't have to deal with this. No special asterisk on med school apps denoting that something nonstandard happened. Take it again? Oh yeah, sure. I disvalue my time and enjoyed prepping for one MCAT that I want to do it again. Ooor, since the AAMC screwed up, they could let you see your score, let you decide if you want to keep it or not, and then let you proceed from there.

You would think that with $210 per test and 70,000 people taking the test per year, one could figure out a decent solution, or at least hire some mad test proofreaders.

Knowledge Is Power

Or at least that's what I've been told. That is, unless you're an EABAGTSSB (to be elaborated on later).

In bigger lectures, I tend to focus my seating efforts around the same general area - usually towards the middle-back of the hall. Having said this, I'm not the only one with this idea and I usually end up around the same people. With physiology, there are two pairs of guys who sit close enough to me that I can overhear some of their conversations. The lecturer usually likes to ask questions before he gets into great detail with various topics. These questions are more or less rhetorical and he's trying to get us in a certain "frame of mind" - whatever that means. Every now and then I'll have an idea of what he's looking for, but I've definitely been proved wrong.

Now come question time, these guys proceed to answer the prof's questions. Every time. They don't answer so as to get called on, but quietly to each other in a "pssh, I know the answer and can't believe nobody else does" kind of manner. Entertains and pisses me off at the same time. If you knew your shit, you wouldn't be wrong all the time. I have no problem with people knowing more than me nor do I have a problem with people venturing a legitimate guess every now and then. It's when some jackass thinks he's the end-all, be-all, greatest thing since sliced bread (EABAGTSSB). These EABAGTSSBs take no heed of the fact that they're always wrong and consequently never think they can be wrong. That attitude not only pisses me off, but scares me.

Now when these EABAGTSSBs become doctors and whatnot, are they going to know everything? Of course not. It's when they come up on something they're unfamiliar with that scares me. What's going to happen is they're just going to assume what they think is right and scoff at the notion of consulting others or referring patients out. Odds are that such a decision will not end well for the patient involved. I'd like to think I know a little bit of the med-related stuff I've studied so far: biochem, micro, immuno, bacterial path, anatomy, physio, endocrinology. But put me in a clinical situation and I know I'm out of my league most of the time - I know my limits. Knowing limits is what made this cool, it's unexpected. These kids figure they've taken a few weeks of undergrad cardiac physiology and they're on par with any cardiologist. Throw in the thoracic unit of undergrad anatomy and they're CT surgeons. Yeah.

Now, how do I know these kids are going to be doctors? Oh, that's because one day they decided to talk about what med schools they're deciding between. In an upper level biology class, this shouldn't be unexpected. What's uncool is when they talk about it loud enough that I can hear them over my music. Pompous asses. Congratulations, nobody else cares. Combine these kids' God complexes with their pretentiousness and you've got some overconfident, elitist, semi-competent MDs. I mean, it feels good to have gotten into med school, but by that same token I don't go announcing it to everyone I see either.

Either way, it's kind of unnerving to see what some of my future classmates/colleagues are going to be like.