This is Amazing!!!

Harvard Cell Animation

Thanks ADoc2Be! I love this beyond words!

Interviews - Post 1

So now I'm taking requests. Someone asked me to write about the interview process... and oh, boy do I have a lot to say about it. Much more than could possibly fit in one post... so maybe this will have to be the first of a few posts...

Here's My Thoughts...

1) On manners. Holy crap, I have seen some DOOZIES! For Christ's sake! Mind your manners. Do I sound like your mom? I'm guessing some applicant's mom's didn't spend much time on this topic... so lets do a quick recap. Most schools have a "no assholes" rule... and these things will definitely disqualify you.

-Elevators... these work better if you let people OUT before you try to get IN. Yes, we know your excited, but don't trample the faculty

-Cussing- So I have the mouth of a sailor under normal circumstances... but not on my interview day. Not to staff, faculty, nor to students. Don't get too comfortable. Everyone can hear you

-No complaining! For god's sake I don't care if you only eat omega-3 grass fed beef. Shut up and eat the bun and the pickle. No one wants to hear it on an interview.... not to mention you come off like a giant asshole.

-Bragging to other applicants about your Yale interview and 42 MCAT? Tacky.

-So you hate this school and the city and it's your last choice and you are hoping to GOD that you get into Mt. Sinai instead? By talking about it you are breaking the "no assholes" rule.

2) On outfits. Oh, the horror. Almost every applicant (guy or girl) is wearing a black suit and a white shirt. Every guy wears a red "power tie". Yes, I got the memo that you are supposed to dress conservative. That means take out your tongue ring, cover up your tattoos, and leave your zoot suit at home. It DOES NOT mean that you have to dress for a funeral. My friends and I talked about this before our interviews and we vowed to be conservative yet to be ourselves and stand out. And guess what? We all got complimented for dressing DIFFERENTLY. I wore a charcoal Tahari pantsuit (conservative, yes?) with a blue and purple embroidered tunic underneath. On another interview I wore the same suit with a pink silk shirt and a chunky shell necklace. My friend "T" wore a beautiful grey suit with a medium blue shirt and yellow tie. My friend "K" wore ivory dress pants with dark red patent leather heels and a beautiful sweater. Everyone looked professional and conservative, but we all stood out from the other applicants. Think about it. What would YOU want to see after interviewing 128 penguin college grads in black suits and white shirts?

While I'm on the subject, please make sure your outfit "fits". As in, your interviewer isn't staring at your pink bra through your gaping blouse buttons, and your lateral malleolus isn't visible because your pants are too short.

3) On TALKING - so we all know your going to get questions from your interviewer... but that's not what I want to talk about. I want to talk about the questions YOU are going to ask your interviewer. Because you better. You better act interested and involved and so thrilled to be there that you just can't stand it. Your goal is to make your interviewer excited about talking to you. You need them to remember you when it's time for them to write their review about you. You don't want some professor scratching his head trying to remember which penguin you were and what the hell he should write about you. I've found that the best way to be remembered is to make the interviewer feel GOOD. If they are having fun, they will remember you. I don't care if you have the most crotchety old geezer interviewing you... you can turn the situation around. Start asking them questions. About THEM! For instance, "So what brought you to this school?" or "What made you decide to go into oncology?". Best option, look around for something to comment on. Pictures of grandkids? Ask about them. A Navaho blanket on the office wall? Mention how you saw one just like it on the Antiques Road Show that appraised for $40k. Anything. Make conversation and make it authentic. Remember, everyone's favorite subject is themselves. Get them talking. They'll remember you, and that's less time that YOU will be in the hotseat answering questions about that C+ you got in O-Chem.

Let's Talk About ADCOM's

I've been getting some wonderful emails from non-trad pre-meds who are wondering HOW ON EARTH to get into med school with a (super) sketchy academic background. I should know, since I'm an expert on sketchy academics. Let's talk about what it takes to get into medical school if you have some SERIOUS academic deficiencies.

The trick is knowing how the system works.

Many pre-meds think "Well, my GPA is ridiculously low, but my MCAT is ok, and I have six years of research that should outweigh my low GPA. I mean, undergrad was so long ago. I've matured since then. Not to mention, I have tons of clinical work, and I know I interview well... so this should work!" Right? WRONG!

The truth is that ADCOMS don't review every application and they don't take into consideration the applicant's whole big picture. It's not that they don't think that your six years of research should outweigh your GPA. The problem is that your low GPA and MCAT aren't getting you to the "second round" so to speak of the application process. Your application isn't even making it someone's desk. ADCOMs get thousands upon thousands of applications. Usually there are only a handful of reviewers (who are busy physicians themselves). They can't possibly read every application.

Applications get read by one of two* ways...

.

1) By score. ALL applications are given a preliminary score. Every school's scoring system is different, but essentially it revolves around GPA and MCAT. For instance, one school I interviewed at outright told the applicants their scoring method for review. These numbers are arbitrary... just for demonstration purposes (please don't email me and ask if they are real and what school!) They take the GPA (say 3.2) and convert it to a two digit# (32). They then add that to your MCAT score (say 31). Your score would be 63. The school used a cut-off (say above a score of 60) to decide which applications to review in depth. From those reviewed in depth, a certain number will be selected for interviews. So you can see how if you are weak in your MCAT but strong in GPA (like a GPA of 3.7 and MCAT of 24) you could still get a full review. But if you are mediocre in both areas (or REALLY weak in one area), you'll never get reviewed no matter if you're an Olympian, Rhodes Scholar, Brad Pitt, etc.

2) The second way you can get a full review is by recommendation. And not just by anyone. This means that someone that the ADCOM values (not YOUR mentor, college professor or hometown doctor calling to say how great you are) has requested a full review of your application. This is usually a professor in that medical school, a donor to that medical school, a top doc in one of their affiliated hospitals, or someone else of consequence to the ADCOM. In some schools, such as mine, a med student can ask the ADCOM to review the application of a candidate they like.

*Ok, I lied. There is one more way you can get a review. That's if you yourself are high profile (ie. an Olympian, Rhodes Scholar, or Brad Pitt). I didn't make that an official category... I guess I figure the Brad Pitt's of the world should have to figure some things out on their own.

So the point of all this? If you can't get your application through the system via route #1 because your academics are too sketchy, you sure as heck better start making friends (route #2). My best advice is to find THE med school that you want to go to (this should be a reasonable school.... probably not Harvard... but hey, anything is possible)... and GO THERE. Move across the country, get your Master's degree there, do research at their teaching hospital, teach their undergrads, sweep their floors, do something (ANYTHING) that demonstrates your abilities and puts you in touch with the right people. After you've proven yourself (after about a year) you can start asking for favors and poking around looking for ways to get in.

Not only is this how I got into med school, its how MANY people get into med school.

Last Anatomy Lab

I thought this day would never come. Tomorrow is my last, LaSt, LAST, ever, EvEr, EVER anatomy lab. And I'm never going back.

Ella, The Patient Has the Disease... Not You

Today in genetics class a family came to present their son... who had PKU. PKU patients are unable to break down phenylalanine... and must observe a VERY restricted diet for their entire lives. They essentially cannot ingest any excess protein. Ever. No dairy, no meat, no beans, no cheese, NADA. Food must be purchased from special "low-protein" manufacturers. Severe mental retardation can occur if they don't follow this diet. Imagine trying to raise a child with such severe dietary restrictions. No cupcakes. No eggs. No hot-dogs. No roast beef sandwiches.

Then, in the middle of the presentation, I got hungry. Like REALLY hungry. Stomach growling, shaky, hypoglycemic hungry. Must have been all that talk about food restriction. I wanted to pull out my crackers... but I figured that might be bad form... since this little kiddo was running around the auditorium. What if he saw my peanut butter Ritz and decided he wanted one? What if I induced some crazy craving in him? What if he went nuts screaming about peanut butter crackers? What if his parents called me out in front of the whole auditorium and loudly said "Excuse me, could you please put those away?" I could only think about how I feel every time I try to go low carb for a while... and how much I crave crackers. Especially with almond butter. How I feel when I am on a diet and somebody tempts me with an Epoisses cheese plate and fresh baked french bread. Finally I couldn't take it anymore... I snuck one at a time when the kid was at the other side of the auditorium.

So I'm jealous...

Of those girls. You know the ones. The ones in class who sit there... ever so calm and collected... knitting. Yes folks, I'm jealous of the girls that knit. There's several in class. They don't take notes. Well, I don't take notes either... but not for any cool reason like knitting. I don't take notes because it's too boring and I won't read them anyways. I'm just, well, doing nothing.... just thinking up a million new ideas every 10 seconds and listening to lecture. I guess I'm an auditory learner. I'd love to have something else interesting to do. When I was an epidemiologist I had to review tons of ID cases. Which was ever so boring, and took me FOREVER. But I noticed that if I piled on a few more senses... like simultaneously drinking tea, listening to an audio book, face-booking, AND reviewing cases... I could get them cranked out significantly more efficiently. Now maybe all that wouldn't work for making it through lecture... but knitting.... that's another story. It all looks so soothing... beautiful yarn, complicated stitches, back and forth... and then poof! The next day the fuchsia yarn turns into a cute sweater... that she's WEARING. Then I'm envious all over again. She can make CLOTHES while sitting in med school. If only I could do that with shoes....

Boyfriend as Psychiatrist

Ahhh. Dating a psychiatrist. Well, I guess we're past dating because we own a home together... but just for fun, I'll say we're dating. So of course you've heard that all psychiatrists are crazy. Well let me clear up that rumor right now. It's true. My boyfriend is nuts. In a good way. Most of the time.

The cool thing about dating a psychiatrist is that he is acutely insightful about everything he does wrong. For instance if I say angrily, "How many friggin' times do I have to tell you....If you don't RINSE the sponge with hot water and SQUEEZE it dry, it gets moldy. Do you SMELL that? Do you want to eat off a plate cleaned with THAT?" He'll say "Ok, you're right. That sounds logical. I'll try to be better. I'm not promising anything... but I'll do my best to remember." Ok, so this kind of psychiatrist talk gets under my skin a little... cause it seems a little condescending but what can you really say to that answer??... However, it sure beats "Yo bitch, if you'd do the damn dishes yourself we wouldn't have this problem"

Additionally, what's cool is that he always sticks up for me by labeling others with Axis I disorders to make me feel better. For instance, if I am complaining about how Alisha is too boy crazy and a drama queen... he'll be like "Well, she's classical histrionic. Hypersexual type." Or if I complain that somebody stood me up twice for a meeting and didn't call he'll say "He's so ADD he can barely function"

Ok, the part that sucks is that when you're dating a relatively insightful person... you're supposed to be insightful and reflective too. On demand. Which I'm not. I'm much more of a "go to bed pissed, wake up a little grumpy, forget about it an hour later and never think about it again type of person". I am definitely NOT a "lets talk about this, what could I do better, here's what you could do better, yes in retrospect a good compromise would be, kiss and make up" type of person. And dating someone who is a "lets talk about" kind of person can make you feel incredibly immature when you just prefer to skulk and steam for a little while, then forget about. Because the disconnect leads to "I really don't think we properly resolved that problem last month. I think we should talk about it again and make a list of the things we should do better" from him... and all I'm thinking is "uh....what argument????"

There IS Such a Thing as a Free Lunch

10 Ways to get a Free Meal in Medicine...

1. Resident recruitment dinners

2. Pharmaceutical dinners

3. Club meetings at lunchtime (technically this would be lunch I guess)

4. Hang out near the doctor's lounge... someone will invite you in

5. Clinical trials investigator's meetings

6. Dean's hours

7. Department weekly meetings (Cardiology has AWESOME food. Big budget I guess)

8. Interview meals

9. Journal Club

10. Academic Conferences

You can pretty much LIVE this way... my boyfriend brings home PILES of food after conferences or things left over from a journal club. Tonight we're going to a resident recruitment dinner. Yay!

Sympathetic Crying

I'm a sympathetic crier. And a sympathetic vomiter. And a sympathic sleeper (I can't STAND seeing someone cozy sleeping while I have to study. I instantly fall asleep). But today I'm talking about crying. Because I think I've just recently discovered that I am WAYYYY too sensitive. Not in a "she said something mean about me" kind of way. Rather, I let myself get emotionally wrapped up in my patients. Or any patients. I have the syndrome. Thinking that what's happening to my patients is actually happening to me.

For instance, in genetics class we have patient presentations. Patients with genetic diseases come with their parents to discuss their experience with the disease process. I'm practically in tears the whole time. And once the parent starts crying I really lose it. Today a mom started crying when she discussed finding out that two of her children had the same genetic disease. She started, then I started. Not full on snot and tears, but enough to where I feel the hard lump in my throat, my eyes get watery and my nose a little flushed.

And recently a prominent physician at my school was murdered. I didn't know him AT ALL beyond simply seeing him in the hospital. But I lost SLEEP over this, folks. And we all know how precious sleep is these days.

I guess I'm just wondering if this gets better?

First Time Being a Rockstar

Yesterday I went to visit my preceptor, the bariatric surgeon. One of his patients was having what they thought were complications from a procedure... so he sent her over to the ER. She had a gastric bypass 10 years ago... then a resectioning about 6 months ago. She started having complications so they put in a stent and a drain on the mid-axillary line. But that was a couple months ago. Today, the patient's chief complaint was that she was having increasing pain on inspiration, and the docs were thinking that possibly the stent slipped... or maybe she had an infection where the drain was.

When we visited the patient, the drain seemed to be ok. No obvious signs of infection, no pus, no fluid accumulation. Also the Chest Xray showed the stent was in place. So the doc was basically planning on waiting for the lab results and CT scan to come in.

So then my preceptor says to me "Do you have any questions you'd like to ask, doctor?" (LOVE it, by the way, when I get called doctor)

Which I did. So I asked the patient if she was having simply pain on inspiration... or if she was also having trouble catching her breath. She thought about it and said both. Which started recently. I suggested that she might have pneumonia. To which the doc said... "Maybe"

Before I left the doc said to call tomorrow for the results. I called today and he'd left me a message. I was right. Pneumonia. YAY!!!!! Well... yay for me not her.

Help

I'm having an anatomy breakdown....

Eyeballs

If you know anything about me, you should know that eyes skeeve me out. I don't like foreign objects in eyes (especially pencils, fish hooks, etc), I hate "retinal tears" and the idea of a buckle (ohhhhhhhhh, god.......)... and frankly, I'm a -10 in both eyes and would rather be eaten alive by maggots than to go get lasik (which I am an "ideal" candidate for). I do manage to put my contact lenses in in the morning, and to take them out at night... but that's about the extent of my strength. Beyond that... there's hyperventilation, weak knees, all-over shakiness, increased pulse, and a distinct feeling of nausea.

I'm not sure of the source of this irrational fear... Maybe because as a young child my ophthalmologist yelled at me when I couldn't put in my first pair of contacts, then he grabbed my face and stuck them in my eyeballs? Or all those "eye trauma" pictures in EMT books I sneaked pics of as a kid... (while all the other kids were sneaking looks at porn, I was looking at trauma... go figure)... Or maybe it's from when I was a firefighter and one of my first calls was a little girl who zipped her eyeball into her hoodie. Hell I don't know.

So why oh WHY did I go to lab today? Today when we dissected the eyeball? So I could see the frontal bone of the skull being crushed by a hammer to access the orbit? No. So I could see my lab mates skin the eyelids and remove the rectus muscles? So I could poke the optic nerve? Nope... not those reasons either.

I went with the sick idea that maybe... just maybe... participating in the dissection would toughen me up a little. You know "what doesn't destroy you makes you stronger?" Well, that was a big fat negative. I tried to be tough for the first 20 minutes... then I was destroyed. Grossed out. I didn't even DO anything. Oh, my lab group hates me I'm sure... but I just couldn't. It was just.... EEEEWWWWWEEEEEE.

Genetics

A new class... yay! I'm really ready for a change of gears... hopefully this will be cool. So far so bad though... I actually fell asleep during the first lecture set. Hopefully it will get more exciting...

18 Specialties For D.O.'s

Here's a list of the 18 Specialties that D.O.'s can become board certified in (not counting sub-specialties):

1. Anesthesiology

2. Emergency Medicine

3. Dermatology

4. Family

5. Internal (plus 11 sub-specialties - Cardio, Allergy, ID, GI, Oncology, etc.)

6. Neurology and Psychiatry

7.Neuromusculoskeletal

8. Nuclear Med

9. OB/GYN

10. Ophthalmology

11. Orthopedics

12.Pathology

13.Peds

14. PMnR

15. Preventative

16. Proctology

17. Radiology

18. Surgery

Not to mention, DO's can apply to allopathic residencies and then apply for board certification in those as well....

Doesn't seem so limiting now, eh?

Whoa.... psychiatrists and neurologists... relax. The AOA lists them that way. Don't shoot the messenger.

Well since we're on the subject....

I put my DO vs. MD link on the side, had a few comments, and others are posting about it again. Here's Ella's version of the straight dope.

Moment of truth: If I had to do this again. I would have gone to DO school.

GASP!

Not because I don't love my school or my program. I love where I'm at. But I could have gone to DO school years ago. I could have been a doctor by now, half way done with residency. I didn't do it out of pride. Pretty much pride only. Because I wanted to be an MD, and because I didn't want to "defend" my education to others. Which is a pretty BS reason to waste years of your life.

Additionally, I think I would have had a different peer group. More alternative routes to med school, more diverse backgrounds, and more older students. Which is something I do feel that I miss out on here.

I really don't think the education is any different. And while there is undeniable residual stigma associated with osteopathic schools... I think it's lessening. All the time I hear MDs say how cool the DO physical manipulation is. And how so-n-so is a DO and is amazingly good. And I promise... very soon osteopathic schools will have the exact same academic criteria for admission. Some of the best osteo schools are already there (like the Texas program). Others are building their reputations.

Consider it. Or don't... and spend however many extra years of your life stressing about how you can POSSIBLY become an MD.

Be Nice To Med Students

We had an admissions meeting this week, and I found out that med students at my school play a "significant" role in choosing who is accepted.

Quote from our Dean.. "Acceptance is based on three equal votes. One from the Ad Com, one from the Faculty, and one student vote. And depending on the faculty member, sometimes the student vote counts more"

Esentially, students at my school can influence someone's acceptance in three ways:

1. An admissions "vote" after interviewing a candidate

2. A recommendation submitted on behalf of a candidate

3. A "blackball" ......aka you are NOT getting in ....

So make sure you are extra nice to med students during your interviews.

CELLULAR BIOCHEM DONE!!!

Well, my first med school class is officially over! Too bad it's not anatomy. So Monday I start Genetics. Yay! Will let you know when I receive an official "Pass"

P=MD Baby

UPDATE: PASSED... it's official!

Texting

Last night my lab partner text me. The following conversation ensued. I thought it was cute... so I'm posting:

Him: Do you have any problem with me taking home our skull to study this weekend?

Me: Damn. I was really hoping I could get it first. (Sighs reluctantly)... Ok, but you owe me BIG time. Just don't use it for a Halloween decoration, ok?

Him: Seriously? If you want it I can leave it in the lab and just go in over the weekend.

Me: Ok, that was a JOKE. Don't you know me at all? Can you really picture me bringing home a human SKULL? YUCK!

Him: LOL, I just wanted to check because I don't want to get any of your crazy eyes

FYI: My lab partners think that I have "crazy eyes"... which apparently are the worst thing you can get next to a visit from the Grim Reaper.

Here's a Clip of the REAL Patch Adams. Nutty, but Adorable.

Patch Adams on Medical Technology

Reverse Psychology

Last night I went to a pharm dinner at an awesome restaurant. My boyfriend and I occasionally hit up these dinners bc it's a cool way to get info on random drugs ... plus you get free dinner from a fancy place that we're normally way too broke to ever go to.

Usually, we expect that the presentation will be highly biased and will promote whatever drug as the new best thing since penicillin. So we go in with our secret decoder rings on to filter out all the BS.

And, yes, I'm aware of all the ethical issues surrounding pharm dinners and perks, and frankly I think its BS. As a physician in training I think I'm savvy enough to know that walking into a drug company meeting I'm not going to find a comprehensive, unbiased description of XYZ drug or condition. And I mean really, the pen thing??? Get real. (although I totally understand doing away with gifts and incentives like trips to Europe for writing 400 scripts in a month, etc.)

But last night we discovered that Eli Lilly is up to a new trick. They didn't try to push a drug on us. In fact, they didn't even MENTION a drug. I don't even know WHAT drug they were promoting. Basically a physician speaker came in a presented current research (not from Eli Lilly either) on metabolic disease prevalence among those with mental illness. We actually learned something. Didn't feel pressures. Didn't need our decoder rings. Had a great dinner. For free.

Eli Lilly, if this is an attempt at reverse psychology... nice work.