getting into medical school and then...

The Emergency Department

noreply@blogger.com (Unknown) — Sat, 16 Feb 2013 02:48:00 +0000

Although the underlying story is true, I made several changes to preserve the anonymity of the patient and their family.

Your Mother

Imagine your mother is 85. Imagine she is almost deaf, but she learned to read lips if you speak slow. Now imagine she also has some health problems. For example, over the many years her blood vessels became clogged up to the point of her heart becoming so weak it started failing. So her ankles swell up, making it hard for her to put her shoes on. She also gets short of breath after getting up from bed, walking to the bathroom, brushing her teeth or grooming herself. Nevertheless, the picture is not all gloomy. She does live by herself in her own apartment, even if by a big stretch. She still remembers who you and your other nine siblings are.

During a routine visit. her GP tells her to go to ED because of persistent fatigue, lack of appetite and vague abdominal pain. The young doctor at the hospital, who impressed both your mother and yourself by his courteousness, swift diagnosis and reassuring words, tells you she has digitalis toxicity, meaning the level of the drug she takes for her heart is dangerously high in her blood. This is something her cardiologist and other doctors missed.

You have just settled in, at least mentally. You waited to be seen by the emergency department doc; then waited some more to see the nice young doctor. You established a good connection with him, but you he cannot follow your mother because she "belongs" to another hospital. This concept improves care of patients that were recently (in the last 12 months or so) treated at another hospital, expediting their transfer. Consequently you have to leave. Your mother is sent to another hospital where the process is repeated all over again with another emergency doctor, gowns, tests and finally a geriatrician (specialist of the elderly) sees her and explains to you the course of action. But she stays in the Emergency room.

The emergency room

24-hour lighting in a hallway full of strangers, but lacking a single window. A constant stimulation of light, noise and movement that does not let anyone fall asleep, know what time of day it is or what happened since they last closed their eyes.

You are so exhausted from this runaround that you have to sleep and you go away for the night.You tell the medical staff to call you if anything happens, because you live only 15 minutes away.

The next morning your mother is all but OK. She is attached to her gurney, her speech is slurred and she is confused. She looks at you with eyes full of terror, like a hunted animal, and repeats the same words; words that will only start fading in your mind as you drive home the following evening...

"They tied me. They tied me. They tied me..."

You ask the nurses, trying to control the rage, what happened and they reply that your mother got a little haldol (a potent traquilizer with significant side-effects, especially for older people like your mother).
Why??? Why weren't you called? You specifically said you will take care of anything.

Moreover, a little haldol would not have the effect that you are currently seeing. Oh, but we also gave her a little bit of ativan. They tell you she became agitated and started scratching the personnel. This 50 lbs lady was apparently able to overcome two well built orderlies that just passed by you.

The story goes on. When you settle down a little from the anger you demand she be detached because you want her to be able to walk. And then you notice she has a diaper, one that is full of liquid stool, which is not typical for her. In fact, she was never incontinent at home. After a verbal argument with the personnel you learn she was automatically put in a diaper because she was restrained - its simple math. It is a very overcrowded, overworked and understaffed environment, they explain apologetically. A nurse approaches you and quietly whispers that your mother, or any patient for that matter, should not have stayed in the emergency department for as long as she did, but there is no place for her to go to.

As the day unfolds, you get to meet your mother's co-patient, one who's gurney was put just in front of your mother's against the wall so the rails were actually touching. This man looks very thin, cachectic even, his wrinkled pale face distorted with pain. Even through his own agony, he tells you how your mother begged him for a knife or scissors during the night to free herself. You catch yourself having a very scary and unwelcome thought. Looking at the suffering man next to your mother you ask yourself if he might be the one who could put those tools to good use.

Early in the afternoon you also have the pleasure of a visit by a middle-aged woman in business attire who pokes her head into your impromptu corner and, without an introduction, start asking questions:

Are you the daughter of Miss Wilderton?

Yes.

Doesn't she live in the Bay area?

Yes.

At this point you get irritated enough to ask: Who are you exactly?

I'm the liaison nurse. And your mother is not supposed to be treated here because her area is served by another hospital, - that last one is said with some aversion.

We actually did go to the hospital closest to our home, and they transferred her here. She was always treated here for all her health problems. All the tests, her chart and her specialists are all here. Those are your thoughts, but you are not going to voice any of them out because you are too tired to argue over meaningless details. Besides, you have to use all your might to convince your mother, who is now untied and starting to come back to her usual self not to sign herself out of this place where she is supposed to get better.

The Ward

Towards the end of day 3, your mother is finally brought up to what you think is her destination. What you learn after speaking to the young energetic resident who visits your mother soon after she settles in is that in fact she is not on the geriatric floor, because half of the beds are taken up by patients who would be sent to a long-term care facility, except... you guessed it - there are no beds. What this means to you and your mother is that she is admitted to the internal medicine ward, where patients with complicated medical illnesses are investigated and treated.

By comparison your mother's condition is a 'no-brainer' and in a perverted way that only a proud teaching hospital ward can tolerate your mother becomes a boring patient. Comparatively speaking, she is a low-intervetion, low educational-value patient, which, therefore, requires minimum maintenance. Sounds crass? Don't take my word for it.

Review of PDF Expert by Readdle (for Medical students, Residents and Doctors)

noreply@blogger.com (Unknown) — Mon, 03 Sep 2012 23:01:00 +0000

Screenshot by Readdle

Note: This article talks about an app for Apple's iPad.
Note 2: I would like to express a big thank you to Readdle for providing me with a review copy of PDF expert.
Note 3: I have no intention of expressing any kind of gratitude to Apple as I am yet to get anything from them for free or even low cost.

Once upon a time, as a medical student and a future aspiring physician you had to read numerous books. And then some more. Harrison's Principles of Internal Medicine (2 volumes, 4012 pages, 13.4 lbs!), Guyton's Physiology (1120 pages, 6.1 lbs), The CPS (2960 pages, 8.8lbs), Robbins & Cotran Pathologic Basis of Disease (1464 pages, 7 lbs), etc... The list is endless, but it has one thing in common: each of these books could easily become a deadly weapon or a weightlifters dream. Whichever one of the two options you will find more attractive, you will certainly hate carrying those books around to school, library or your favourite coffee shop. I can guarantee you will just as much hate reading them because of how difficult it is to keep one open and how blue and sore your hands or legs will become after having to the hold the book on your lap. As if the weight wasn't enough of a hurdle, you will very soon realize that the most frequent way you will read these books is by looking things up, not systematically combing from start to finish. But the whole process will take you hours and will be about 50% successful. You will soon stop counting the number of times you had a question; attempted to find the answer in the book; failed miserably; tried to throw the book in frustration; dislocated your shoulder during the attempt; fired up your browser and read the article on Wikipedia.

As most of you have probably heard, several universities, hospitals and government organizations, even the military, are starting to implement content management systems based on the iPad. And that is very good for Apple's stock, indeed. However, how can we, as medical students, residents and budding staff take advantage of the digital revolution?

In this review I'd like to go over my personal favourite and only application I use to read PDF's on my iPad (if you'd like to read about the Digital Age Setup for the Prepared Medical Student, click here), Readdle's PDF Expert.

If you fire up the App Store on your iPad, with the search for "pdf reader", this is what you get:

App Store listing for PDF reader, 406! titles

As you can see, you have 406 choices. Although some of them are free, even the first page gives you a good idea of the price range, which goes up to a steep 9.99$. Depending on personal preference, you can try out several apps. However, I feel that without trial versions I had to rely on reviews of these apps on the internet, not wanting to throw away money at 10$ chunks for an electronic test drive. The problem I experienced with all the reviews is that none of them actually addressed in detail my needs: details about the reading experience for large PDFs, annotating them in the context of medical education, and using the online storage synchronization features. Another interesting thing you will notice is the App I am touting as the best is not even in the top search list (it is on the 2nd page, though)

I don't pretend to have done an extensive review of all the apps to provide you with EBAS (Evidence Based App Selection), but most people would agree that there are only a handful of apps that have been reviewed and are considered to be the alternatives for PDF Expert. You can read the article on iMedicalApps (Part 1, Part 2). In my article I am not even mentioning names of other Apps, because all I want to do is to show you why I found PDF Expert to do exactly what I wanted it to do. I will not go over every bell and whistle (of which there are many) in the app.

Now, to the screenshot intensive part of the review.

Main screen aka Welcome Simplicity

PDF Expert main screen

I like the default screen because it is simple to use. The most important for me is to see the files inside the folder. With a very nice icon, most of the titles above are easily readable, with the most important info like size and date also readily apparent. You can also notice that longer names are cut off and unfortunately do not scroll. Maybe next update? (This view is of network storage from my Dropbox folder, however it is no different from viewing files stored locally on the iPad - an advantage in its own)

File edit screen

File edit screen with non-contiguous selection

Clicking the edit button in the top right corner will change the screen to the one pictured above. From within this screen I can easily perform typical file operations like select, move, delete and add folder. The second screenshot above depicts three non-contiguous files selected.

File edit dialog allowing you to rename, delete, share or view revisions

Clicking on the arrow to the right of the file in the edit mode brings up the pop-up menu above which allows you to rename the file, email it to a friend and surprisingly, pull out revisions of the file from Dropbox.

Connecting to Dropbox and keeping your docs UpToDate

Although I advocate for using the Dropbox sync method, simply because it has been working for me for several years without a hitch, as you can see from the screenshot below you can use a variety of services to satisfy your taste or space requirements. Even the most recent contender, Google Drive is already there.

Sync options available natively

After adding your favorite online storage, you have the option of either browsing it like a normal folder structure from within the network tab on left of the main screen or choosing to sync a whole folder to your iPad.

Sync folder screen

Choosing to sync the folder will add it to your home screen and mark the files inside with a little green sign indicating the files are being synced, not dissimilar to the one used by Dropbox on your computer. This makes for a consistent and simple workflow that doesn't require you to learn new things to start using PDF Expert.

The other option you have is while browsing your Dropbox folder to simply tap a file you want to read and the following screen pops up.

Loading file progress bar

As the progress bar runs down to the end, the file you tapped opens up. One minor annoyance I have with this method is that the whole folder structure from you main Dropbox folder is recreated just for this one file. Eg. if your file is located in Dropbox -> Medical -> Useful articles -> To Read, then the folder Medical will appear on you main screen, inside will be Useful articles. You will have to click through to To Read in order to find the one PDF file you downloaded. I would have preferred to set a predefined folder to dump the downloads or simply store them on the main screen and let me reorganize it.

Reading documents like a big boy

The most important part of the review, or the function this App was built for, is where it shines the most . With an easy tap, you remove all unnecessary elements, leaving only the text (Screen 1 below). As you flick pages, a brief reminder with the current/total page number appears and then fades so as not to interfere with your document (Screen 2 below).

The reading experience

Current/Total page reminder briefly appears at top left when you flip pages

As I read multiple articles and books on my iPad, having essentially forgone getting physical medical textbooks, I realized that although it is doable to read without zooming, I feel like I am squinting. Depending on your sight and annoyance by not seeing well, you will either not care or love the simple but essential feature I am going to mention: persistent zoom. This means that the zoom level is maintained between pages as you are reading the article. Moreover, switching from bottom right corner brings you right into top left for continuous and coherent flow. Also, navigation is intuitive as well - all you have to do is tap the right or left part of the screen and zoom will scroll past the visible segment. Again, this means that in the typical two column article:

I zoom on the left most one
Scroll down it as if I was reading a webpage
When I reach the bottom, I tap the right side of screen and tap the top of screen to scroll back up (this last bit could have been automated by PDF Expert, unless you drag around the page)
I find myself at the top of the right column at the perfect zoom level, ready to scroll down
When I'm at the bottom of the right column, I tap right side again and find myself at the same zoom level on the next page over the left most column.

Another feature I greatly enjoy when reading lengthy documents is the support for bookmarks, you can click on the open book icon (see below) to show all the bookmarks and annotations in the document.

Annotation - Colour me Highlight

Depending on your learning style, you will rarely highlight a keyword in an article, or highlight everything that has ink in it. Well, digital can be a blessing to both groups. And the implementation of highlighting in PDF Expert is the reason why I decided to use it. It seems natural to me to be reading a book with the highlighter in my hand or nearby on the desk, ready to be used as I come across an important passage. What I've found with all other Apps is that you could only do one or the other - read or annotate, which did not make sense to me. When turning on highlighting in PDF Expert, you choose the highlighter and a color and then read your document. Holding your finger over text for a little bit longer than a simple drag will start the highlighter, brief taps, on the other hand, allow you to navigate and flip pages. Also worth mentioning, highlighting will snap to text, so if you are suffering from alcohol withdrawal while reading the article on PE management, your secret will be safe with PDF Expert. Also worth mentioning is your annotations will show up once you open up the file on your computer in Adobe or other PDF readers. Das is good!

Let me reiterate, the simplicity of the highlighting feature in PDF Expert not only made me use it as my main PDF reader, but actually started me on annotating PDFs electronically. This allows me to open up a previously annotated PDF and flip through my highlights to quickly recall the gist of the article.

I obviously skipped many of the other annotation features, however, as I said, this is a practical review and not a user manual. Of some value is the note function that allows you to add those cute postet icons arbitrarily on the page with your text that appears in a popup when the icon is clicked.

The editing toolbar

Highlight colors rainbow

Add a note with a popup text

You can alternatively select the text in normal reading mode and then choose the edit you want to apply

Searching inside and outside

Searching is actually a twofold function. You can:

Search within a document
Search within your PDF Expert library. This search allows you to search either file names or file contents.

Search and find within a file

Search all the files stored in PDF Expert

Editing documents

Once again, simplicity is the name of the game. All you have to do is open a document, and click on the 4 squares in the top menu bar. And boom! You can delete and rearrange pages as you like.

Bird's eye view on your document

Edit toolbar allows you to rearrange and delete individual pages

Security

This option will finds its admirers among researchers who store patient sensitive information on their iPad. Although PDF Expert does not seem to allow you to encrypt or protect files on an individual basis, it allows you to set a password to open up the app, which should prevent Curious George from snooping around your 20 year old healthy single DD+ breast implant patient database.

Presenting your PDFs with a projector

This is a feature I am yet to use. Nevertheless, I feel like it has great potential. If you don't feel like paying Apple for Keynote just to avoid bringing your laptop to presentations (Please don't tell me you make presentations on your iPad - it has about the same level of sophistication as a two year old with a couple of crayons) then saving your presentations to PDF and loading them up to PDF Expert could actually also save you some change (no pun intended).

Forms

Again, I haven't used this feature, but it seems about borderline relevant to mention at the end. As you figured out from the subtitle, you can fill out forms. Now if you have a school/hospital/organization that fancies electronic PDF forms AND you have set up your iPad to print on your home printer (unless your employers also accept electronic forms, which is much rarer than just distributing them) then you are set to go for another feature adventure with the PDF Expert.

Closing remarks

In the tradition of this site, this review is biased, non-inclusive and very graphical. Despite that, I feel the utility of this program justifies the cost for any medical professional using an iPad. Although I would like some minor improvements in the App, like the reading flow automation when zoomed in and drag and drop support for moving files, the features one would buy the app for are simple and efficient. The best qualifier of the usefulness of this app is the fact I use it everyday for my articles, books and references.

I will update the review as I discover new features.

Why being a doctor might not be so peachy after all

noreply@blogger.com (Unknown) — Sun, 29 May 2011 04:51:00 +0000

Photo by Vicki & Chuck Rogers

From a typical acceptance letter:

Dear Premed,

It is with great pleasure that the Best Medical School admission committee would like to inform you that due to your exceptional dossier you were selected to the class of 201X... Blah-blah accepted this, blah-blah honored that...

You are so excited seeing positive words instead of the usual formally worded but apprehensively alike rejection jargon that you almost pee yourself right in front of your computer. Maybe not that excited, but close enough that you cannot even finish reading the rest of letter. Now the worries are over. Unless your letter was sent from the Caribbean, England, Australia or any other country than Canada for that matter. Let us assume you did get in a Canadian medical school. The hardest part is getting in...
Believe it or not, but this post brewed in my drafting drawer for almost one year. Partly it is due to me becoming more preoccupied with mitochondrial diseases and pelvic girdle muscle innervation, partly because what I am about to discuss will probably not have the impact I want it to. Neverthless, this afternoon I decided to post something, so here we go.

Most people, myself included, think that their sole objective is to obtain the aforementioned letter. We tend to assume that after you are in, everything's easy-breezy. Not without a reason, flunking medical school is indeed possible, but you probably have to try really hard. I've also heard horror stories of utterly incompetent residents who nevertheless made it through and now distribute their MD-laden cards. Moreover, once training is over everyone will, if they so wish, have a stable job in the 95^th income percentile, excluding CEO's and big names, which are rather the exception. So to sum up we have a streamlined course to a guaranteed high paying job and a privileged place in society. However, let me tell you several reasons why becoming a doctor might not be so peachy.

Before you become a doctor, there are many many many obstacles in the way. But we both know you just got more excited...
Your self-esteem may suffer when you realize that the event you organized and worked almost a year on was previously put together by a girl in your class as a weekend thing.
Although you might want to become X or Y specialist, the hard truth is you may have to settle with family medicine. To add insult to injury, the more competitive the specialty is, the sooner you will have to go "all in" on it to even have a shot.
Medical school may destroy your family life if you had one. Or you will feel you are becoming a crappy doctor. Or you will lose that voice that tells you what kind of doctor you are becoming.
To follow up on the previous point: regardless of the specialty you will choose, you will likely miss many important family events.
For various reasons, you will be so much in debt that you will remember all those people that told you doing something else will be so much better to make money.
Doctors work a lot. Surprisingly enough, the more you'll work - the more you'll make. If astronomic numbers attract you - endless hours of works should as well.
Watch one of the current medical shows and secretly or even subconsciously fantasize about working in a big hospital where the latest and greatest is done? Well, you might need to spend an extra couple of years after the 4 years of medical school and 5 years of residency to get a fellowship. Yep, that makes 11 years or 132 months or 4015 days which is roughly 13% of your life that you will work for nothing/peanuts. You will do ALL THE WORK for somebody else who will bill and get all the credit.
This one is one of my favorites: once you invest all your energy into getting into medical school, make all those sacrifices and start getting to the actually difficult stuff in the hospitals (or even before that) - you will start having doubts. You will consider really hard if you made the right choice. Oh, trust me, I know what you're thinking. It will be you and I know what I'm talking about. Wait for the punchline. Since you got in and you are in that self-selected group of people who endure and persevere, you will realize it would be IMPRACTICAL to quit now. Just imagine explaining to all your friends you bragged so hard about getting in how you are not really a wuss and you're not quitting because you can't take it, but because its not what you really want to do in life. And mom and dad, who were so proud of you on that memorable day that you told them you are going to be.... You get my drift. And so you will go on, no matter what your conclusions will be. Although not frequent, some people every year will fall victims to this sad and unhappy life.
Thought about being a doctor as saving lives? Yet another disappointment. You will be filling out 10 papers for every doctor deed you do. Insurance form here, a chart and a consult there and before you know it - you are the world's most famous person. Or at least that is what you feel after signing your name so many times.
Another one of those what-ifs. Only after getting through at least a couple years of medical school, but most likely by the end of your third year, you will figure that you really like specialty X. Unfortunately, specialty X will be filled with personalities that are clearly incompatible with your own. That could mean they are all douchebags and arrogant pricks, while you are a nerd. Or the reverse. It could mean they all are greedy and you are a humanitarian. Again, it may sound I am talking out of my ass, but that is one of those things you figure out for yourself only after having "been there, done that". The key is that your own interest in a medical specialty is not related to people's personalities in that specialty. What this realization will mean is that either you do what you like and become miserable (as opposed to what you see in House, you WILL HAVE to work with other people) or you choose what you don't like and have really good conversations during your lunch hour. Wait, I meant 10 minutes. Wrong again, 5 minutes every other day, while you are walking from the ward to the Emerg to check out that patient you just discharged yesterday.

I could go on and on, but it is clear that where there are cons there are pros. I am not trying to reduce my competition, I am just trying to counterbalance those naive dreams I used to have and probably some of you might.

Poll: You and the admissions process

noreply@blogger.com (Unknown) — Sun, 29 May 2011 03:40:00 +0000

Photo by kozumel

Thinking of Medical school in the Caribbean? Think again says NY.

noreply@blogger.com (Unknown) — Tue, 28 Dec 2010 00:56:00 +0000

Photo by atran.photography

Originally, I was going to post a series of interesting news about medical students in Canada. Indeed, during my search I came across at least a couple of things I wanted to discuss with you. That was until I came across a really relevant article in the NY Times. As I have written previously about the Caribbean schools - even that little guide stirred some debate in the comments. It seems everything is changing these days - MCAT requirements and autobiographical sketches being dropped in favor of other methods of selection (more on that in a later article), MCAT itself being in the process of being changed, MMI's replacing the traditional interviews, emphasis in medical schools switching from specialist medicine to general practice... Well, now the New York state schools are getting on board of the anti-Caribbean train (somehow, I am not surprised). Read the article and let me know what you think in the comments section:

Do you think Caribbean graduates are less competent? If so, why?
Should the Caribbean continue to supply U.S. with doctors? If not, where would you realistically get the difference?

Medical Schools in Region Fight Caribbean Flow

For a generation, medical schools in the Caribbean have attracted thousands of American students to their tiny island havens by promising that during their third and fourth years, the students would get crucial training in United States hospitals, especially in New York State. [more after the jump]

Poll: How far are you really willing to move for medschool

noreply@blogger.com (Unknown) — Wed, 15 Dec 2010 03:13:00 +0000

Photo by kozumel

3 things every medical school is looking for in an applicant

noreply@blogger.com (Unknown) — Wed, 15 Dec 2010 03:01:00 +0000

Photo by clry2

When you apply to medical school, the majority of you will consider it a success if you get admitted regardless of where you will have to spend the next four years. Sure, a small proportion will actually have to (ehm-ehm) make a choice, an even smaller group will be so set on a specific school that they will actually refuse an acceptance from anywhere else, a minute bunch will not even apply country-wide. For the rest of us, admissions will indeed be a victory, because any Canadian university grants the same MD degree that will allow you to work anywhere in North America and then some.

Keeping that in mind, you have to understand that admissions committees, aka the people that will ruin your life, aka the people that will make you wet your pants from joy are considering many more candidates than they can accept. Obvious? Great!

First, some background. As you might know, admissions committees are made of people who's single task is to select from a pool of cut-throat over-achiever candidates the ones that a) will not drop out; and b) will become (substitute the adjective of the year) physicians. Just by looking at the application numbers over at the Association of Faculties of Medicine of Canada official stats page, you can see this is not an easy job. Now you just need to figure out what they are looking for. Most school's websites have vaguely-worded-vomit-inducing cliches about good person this, empathetic doctor that. Does that help you in any way to prepare for the admissions process? Probably not. However, fret not, I will give you the three things every medical school is looking for in a student.

People who can handle intensive workloads while being able to maintain some sort of life outside school. Read this again. There is no mention of science, biomedical science or science related orientation of your studies. I feel there is a need to stress that you absolutely have to choose whatever it is that will make you want to do it on your free time - this way you will get those grades.
I do understand, however, that this is the toughest criteria to negotiate for most of us. Every formal evaluation is geared toward ranking your abilities in this field: your GPA, your MCAT score and your extracurricular accomplishments. Since I am yet to find where the hot tub time machine is, the only advice I can give you is make sure you choose your undergrad according to what you like to do, start preparing early or be prepared to spend a longer than usual time achieving your goals.

There are two important nuances you should know. First, what you really need is to get the bare minimum for the schools that have strict cut-off criteria. This will advance you into the next step of the selection, where the other 2 points come in handy. Obviously, that 45T sounds really neat the next time you're picking up a girl in a bar, but it is by no means necessary.
Second, some schools take a more holistic approach to their admissions process, which means that you will have leeway to demonstrate your ability to perform in different than academic ways. What do I mean by different? You could, for example, complete your Msc in Experimental Surgery while coaching your high-school's soccer team. Or take on a hobby, like guitar or photography and get involved with the local community, take on gigs in small clubs or do weddings. The key here is that you will succeed in something you enjoy.

Every school is looking for a particular 'breed' of medical student. For example, some schools will give preferential treatment to athletes, or graduates from particular programs, residents of certain areas, etc. Although this information is not always explicitly classified, often you will not be able to obtain it directly from the secretary of the admissions office. You can try to be subtle about it, and ask them indirect questions. Here are a couple to get you started:

What kind of candidates were admitted to the class of last year?
What was the geographic/age/any other stat you dare to ask representation in the last year admission?
What is your approach to mature candidates?
Etc.

Personalities fitting the current wind of change. This one is a bit trickier than it might seem. The point of this third and probably most important criterion is to make you aware that each medical school prides itself with its selection of candidates. The committee selects Future Physicians. If you look at their description of this title, the usual nauseating facade about being a good person will probably appear useless. However, if you dig deeper, you will realize that almost every candidate is compared to a template of some sort. During the MMI's (Multiple Mini-Interviews), which most schools use, and even the traditional interview CV-autobio-sketch questioning period the goal is to see how close You fit their template.
As an example, I can say that in a hypothetical school X, the focus is on person oriented care. In this vein, their school prides itself in graduating the largest proportion of GP's in the country (or even the Universe). Many of their students' accomplishments involve community work locally. Even the news strip on their main page features Dr. M. receiving a prize for his outstanding accomplishments with underprivileged populations. I could go on, but I hope you get the idea. Now comes the important stuff.

Note that this is my opinion and mine only. Follow my advice at your own risk. You, of course, already knew that.

You want to make yourself appealing for the current wind of change. For this hypothetical school X it would probably harm your application to over-emphasize how much you want to be a pediatric cardiothoracic sugeron and how much research you had done to improve post quadruple bypass complications in diabetic morbidly obese individuals with congenital airway abnormalities. However, another school that highlights its research funding might equally easily overlook your community accomplishments.

In the end, your best bet is contacting students or recent graduates and asking them several specific questions.

How Modality Inc sticks you in the...

noreply@blogger.com (Unknown) — Mon, 05 Apr 2010 16:32:00 +0000

Modality

This will be my take on 3 apps from the Modality Inc factory of junk: Rohen's Photographic Anatomy Flash Cards, Clemente's Anatomy Flash Cards and Moore's Clinical Anatomy Flash Cards.

Disclaimer: I can only talk about Rohen's cards and Netter's Flash Cards, but since the previews (on the maker website/iTunes app store) are similar and the maker is one and the same, I will assume homogeneity between the three apps.

It is outraging to me how unbelievably unprofessional Modality had become. At the hefty price of 24.99 - a third of the cost of the FULL textbook (Moore, Clemente, Rohen or even Netter) - you get about 5% content of the physical volumes. With blatant mistakes. Conducive to learning, as my teachers would put it. My gripes:

- Mislabeled structures. Ex: Mislabeled penile urethra and corpus cavernosum. What if I wanted to learn ahead and would actually memorize this?
- Lack of structures: Whereas Rohen the book (which I own) has on average 20-40 labels per diagram, this piece of app has 2-3. The images are often 40-70% of the complete image in the hard-copy - this makes it sometimes very hard to figure out where you are, since you are missing key landmarks (a testimony that the program was created by programmers, not medical professionals). I have a good feeling that had they put the full image, we would be able to figure out a way to navigate it with the iPhone gestures. For that price I would appreciate to have at least 10-12 labels. Remember: this is not a 5$ app.
- Lack of details: no information on the structures at the 'back of the card'
- No landscape, really??!!

Conclusion: The trio of apps from Modality Inc. is not worth your money. It will not save you time by making your heavy books portable, rather it will give you an illusion of knowledge. I can only recommend the Netter's Flash cards, which were produced - at least so it feels - by a completely different team, in the times when apps were not mass-stamped to reach economies of scale, but created to advance knowledge and produce more qualified med students.

Couldn't resist

noreply@blogger.com (Unknown) — Tue, 16 Mar 2010 03:37:00 +0000

http://s1.b3ta.com/host/creative/1279/1264637379/blutack.jpg

Some meaningful posts coming soon. I couldn't resist this one, especially in light of recent problems with not even a year old piece of equipment from Apple. Thank God for 1 year warranties.

Poll: What is (was) your plan B?

noreply@blogger.com (Unknown) — Thu, 28 Jan 2010 04:31:00 +0000

Photo by kozumel

The *Other* category had the following answers:

Become a science teacher
Military
I would apply to pharmacy/graduate studies and apply med again each year
Public Health (ideally for the WHO)
Computer science

So you like the beach? (or how to get into the Caribbean medical schools)

noreply@blogger.com (Unknown) — Mon, 04 Jan 2010 00:04:00 +0000

Photo by Coast Guard BM

First and foremost, Happy New 2010 Year!

I know that I had specifically said that this website would be concerned only with Canadian medical school application and student experience, but let us face it - some less fortunate folks will not be able to get in. No matter what candidate, regardless of their merit, despite their MCAT scores, GPA's and - the odds of getting in are never 100% (if you don't believe me, read this post by P.L.). As my recent poll showed (link coming soon), some will keep reapplying, but there are only so many times you can waste your money and time. Some will go into research, some will go into public health or choose a related medical career. Nobody, however, at least among the 61 people who responded, said they will try the Caribbean schools. I never considered the option myself, but I feel now that the more choices you have, the more freedom you end up with. Coincidentally, I found an interesting post about the Caribbean medical school applications by Asad Raza, a Toronto undegrad graduate who studied at one of the Caribbean schools.
Here it is in its entirety:

Hello to all,

I am really enjoying answering all of your questions. However there seems to be one question that is asked the most. It is:

"My GPA is *.**, my MCAT is ****, what are my chances of getting accepted into *** med school in the Caribbean."

Here is the answer to this very common question:

Admission to a medical school in the Caribbean varies depending on the school.

The newer medical schools that have opened up in the past 5 or 6 years tend to accept anyone that applies. This may be hard to believe, but it is true. The schools are desperate for students and are willing to give anyone a chance.

This can be a dangerous thing, because some of these schools are terrible. No real teaching, no real facilities, no cadavers, no USMLE pass rate, no established clinical rotation program, no graduates, no history of residency placement and of course no history of state licensure.

A student from U.S. or Canada who has had much difficulty in obtaining admission into a medical school in their country may 'jump' at the opportunity to attend an offshore school, especially if admission is so easy. But the consequences of attending such newer schools can be disastrous. This also applies to some of the 'older' Caribbean med schools that have made very few improvements over the course of their 20 years of existence in the Caribbean.

There are only about 4 or 5 established medical schools in the Caribbean with a proven record of residency placement and state licensure. It only takes about a couple of hours of research on the internet to figure out which ones those are.

Now as far as admission is concerned, in my firm opinion there are only 2 schools in the Caribbean that will actually reject an applicant (St George and Saba). St George because they are a 'real' University and Saba because enrollment is limited due to the very small size of the island.

There may be some disagreement from others with regard to my statement above. But I have rotated with dozens of students from several other Caribbean med schools and those students have all verified this.

If you want some specific numbers, I would say that a GPA of 2.5 or more is enough for admission to most of these med schools. A far cry from the 3.7 GPA you need up here in Canada. MCAT is optional.

It is a rather opposite concept with Caribbean Med schools as compared to U.S./Canada med schools.

In the U.S. and Canada, admission is the most difficult thing. But once you are in, it is smooth sailing.

In contrast, with Caribbean Med schools, admission is a joke. But once you are in, you are pretty much in a very difficult process, one that involves an enormous amount of self-teaching, self-planning and self-discipline. You are on your own!

At many of the Caribbean Med schools, during first two years on the island you have to teach yourself the basic sciences. Then there are some very difficult board exams you must pass - USMLE Step 1, USMLE Step 2, USMLE Step 2 CS and USMLE Step 3.

During the third and fourth years, depending on what school you go to, you have to set up some or all or your clinical rotations and go from state to state to complete them.

Then there is the entire process of applying for a residency and competing with thousands of other IMG's from all over the world. In addition, if you are a non-U.S. citizen you have to deal with the problems of trying to get a work visa (either J-1 or H-1B). If you are Canadian, then you have the biggest nightmare of all, because you can pretty much kiss Canada goodbye.

So as you can see, admission is the least of your worries.

Some of the better Caribbean med schools, will help their students through the 4 year journey somewhat. But most do not.

The only schools in the Caribbean that I recommend are: SGU, Saba, AUC, Ross, UAG and UWI.

Hope this helps. Feel free to post additional questions.

Finally, for Canadian applicants specifically, Asad has a whole F.A.Q. page with loads of detailed info you might find useful. Below are a few of the questions he answers:

I going to transfer to a Canadian Medical School
I am going to get a residency in Canada
I am going to come back to Canada, after doing a residency in the United States
It is important to do ALL your clinical rotations (cores and electives) in the U.S.
How much loan can I get for Medical school and from what source

Everything you wanted to know about medical school but were afraid to ask me directly

noreply@blogger.com (Unknown) — Sun, 06 Dec 2009 02:32:00 +0000

Photo by Tambako the Jaguar

The following is a growing set of questions you asked me. Well, technically, you asked Google, and Google told you to see me*. So here it is, without any particular order or priority.

* Queries are taken directly as is from my stats page.

... check back in a couple of days, more to come...

Q: Should students be allowed to apply to medical schools after rejection?

A: Of course not, why have losers succeed by sheer luck? I am the only exception, since I was rejected several times before being admitted.

Q: I don't know how i got into medical school

A: Oh, really? And I thought medical schools sent everyone detailed explanations of how they picked them.

Q: How to write a personal statement for medical school to explain why you had an f

A: I have mentioned it here. Use my advice to increase your chances of getting in to near 100%.

Q: Getting into medical school with a second degree

A: Absolutely. Just make absolutely sure you can stand 4 years of school alongside competitive youngsters who are not yet fed up with university (i.e. have no other hobbies than studying), 2+ years of being somebody's bitch, and finally becoming one yourself (let us hope not).

Q: If i receive a 12 on the mcat, will i not be accepted into med school?

A: (ran to pee himself from laughter in the bathtub)

Q: 30 year olds getting into medical school

A: Happens. Monkeys get in too. You will sometimes see them in the hospital wearing the lab coat, a mask and a hair cap (but if you look closely, you can notice the tail sticking out of the back). Ok, ok, now seriously, if immature, arrogant and frankly insecure people can get in, why couldn't you?

Q: i got into medicine but failed a subject in my last semester

A: As you will learn when you get in, many of your mentors, heads of departments and other highly decorated physicians have failed at some point of the basic science years of training. Does that mean you will waste ~ 2 years of your life if you accomplish this long-awaited goal of yours? Draw your own conclusions, I'm not your mommy.

Q: getting caugth looking at other person's exam at mcgill med 1 test

A: (I will assmue taht you are a very curious person and this question is hypopethicacical)

Q: vacation muhc nurses

A: what the !@%$#%@????!!! I mean, of course, MUHC nurses deserve a vacation. Maybe they will prepare for the MCAT and get into medical school during that wonderful time off...

Q: when will mcat become illegal

A: Keep it coming guys, it just keeps getting better and better.

Q: poor diagnostic how to do well on mcat

A: Here is a selection of quality information to satisfy your curiosity: #1 (MCAT Strategies), #2 (MCAT Books) and #3 (Free MCAT tools). Good luck.

... check back in a couple of days, more to come...

On inspiration and creativity in medicine

noreply@blogger.com (Unknown) — Fri, 06 Nov 2009 23:07:00 +0000

Photo by Sebastiaan ter Burg

Inspiration seems to be the theme of the month for me, so I thought I would share an inspirational moment with you. Below is a 20 minute speech by Ken Robinson, who, as I learned recently, is one of the best speakers you will ever hear. Although he talks about education in general and its relation to creativity, this talk got me thinking about premedical and medical education.

As we strive to achieve the highest GPAs, excel in every possible and impossible endeavor we undertake and maintain at least a semblance of human contact, many will take a safe path to success. We will take courses we know will yield us the highest return for our investment. We will choose to study instead of seeing are friends. We will stay on the beaten path; that means that people in sciences will be reticent to take arts classes and vice versa. There is, however, a drawback to such strategies. Even though they undeniably give us a shot at actually getting accepted into medical school, they strip us of our potential for creativity. And for most of us, medical school will not be the place where it would start to develop, rather a place where it would completely die off unless it was exercised previously. With the habits of studying till exhaustion, being in the top 10%, feeling like any exam is too easy, - all these attitudes transported into medical school create an enormous potential for burnout and a definitive creativity killer. In order to maintain and develop your creativity, you have to be both critical and curious. Challenge authority. Always ask yourself 'why?' about anything and everything. Never settle for 'that is just the way it is' or tell yourself 'it will become clear later, when I really need to think about it'.

Another interesting point is most medical schools have rigorous structure in the curriculum. Understandably so, they have to pass the accreditation in order to grant MD dipomas in Canada, and a structured curriculum is a definite prerequisite for a passing grade. However, by using the traditional 2+2 (preclinical/clinical years) and the organ systems overview approach these schools divide something that occurs simultaneously within one minute in the brain of a staff physician into 24 months of class, labs, interactive presentations, didactic lectures, patient testimonies, hospital visits and maybe some situational simulations. Is that an oversimplification or is it just right? If everyone else who graduated previously practice now and have no apparent problems, should we content ourselves with that much, or, perhaps, that little? I know I did not mention the small groups. I did so intentionally, because I want to discuss the whole problem based learning in another post, going over all the pros and cons. My point was only to show you that it is easier to think of congestive heart failure complicated by pulmonary edema when you are learning about the cardiovascular system. How about when it is a 55 year old lady who is delivered into your emergency room because she has trouble breathing?

Poll: What do you think about the MMI's (multiple mini-interviews)?

noreply@blogger.com (Unknown) — Sun, 25 Oct 2009 10:00:00 +0000

Photo by kozumel

As it stands right now, I think the MMI's are the only specific and sensitive way to weed out people who are into medicine for the wrong reasons. You cannot prepare for the situations, thus you will be forced to act genuinely. If you think people can fake it, you underestimate the level of stress associated with the situations. They might ask you to talk to "your friend" in one, but most of them will be difficult and nerve wrecking.

Wisdom from Dr Patch Adams

noreply@blogger.com (Unknown) — Tue, 20 Oct 2009 02:32:00 +0000

Photo by Mark Blevis

I was very fortunate to be able to attend a lecture given by one the world's most caring doctors. He, who's name made Robin Williams 20 million dollars, he who told us that he could not stand his first year in peds because his view of medicine was so staggeringly different. I am, of course, talking about Dr. Hunter Campbell Adams, more commonly known as Patch Adams.

Although there were many great things in that speech, I wanted to share a couple because of their impact on me personally.
First, Dr. Adams was asked about which character inspired the most his clown roles. Without a second of hesitation, he answered that it was an adult with Down's syndrome. To illustrate his reasoning, he gave us an example of a pediatric burns ward, where you would look at a child and see the awful damage that a 75% surface area third degree burn did to him. You would almost feel the tremendous pain he is suffering. You might even feel pity. However, it is almost indisputable that you would be deeply affected. An adult with Down's syndrome, on the other hand, would only see a child. Using Dr Adams' words, he would "unconditionally love" the child. This example reminded me about all those delightful "adult" behaviors and thoughts we acquire in the process of maturing and entering the realm of grown-ups. Where we are more preoccupied with making the Halloween party than spending an extra 5 minutes with a patient, where we get used to human suffering, and, ultimately, when we start to know what real suffering is so well that we can tell. This example reminded just how full of shit we are sometimes. It reminded me that sometimes simple is better. It reminded me to never forget.You can take whatever you want from this example, but I urge you to at least ask yourself how would you want people to perceive you with a severe burn...

The other interesting thing was about the medical elective course called Humanistic Medicine: Constructing Your Humanism, that Dr Adams set up in his Gesundheit Institute. Like most universities, my own has their take on making doctors more human. We get speakers, small groups, invited patients - all talking about humanity and its impact on patient outcomes. Although it has some relevance, for a very long time, even before being admitted and more so afterward, I started becoming convinced of the almost complete uselessness of this exercise. It informs, but it does not transform. Coming back to Patch, in his course about humanism he brings the students on the busiest street in the city at rush hour and requires them to start a friendly conversation with every single person passing by. This is teaching humanity. He takes them out of town, and makes them appreciate nature and their own thoughts, Sounds silly? If you think about it, being nice to others and keeping your cool in such isolation after our typical overstimulated overbooked urban life is a sign of the capacity to have a more meaningful relationship with yourself (and by extension with others) than the shallow, common, superficial pretend-interaction that I regretfully saw all too often in the hospitals.

Poll: Do you have access to online journals?

noreply@blogger.com (Unknown) — Tue, 15 Sep 2009 22:25:00 +0000

Photo by kozumel

Choosing a medical specialty

noreply@blogger.com (Unknown) — Tue, 08 Sep 2009 22:22:00 +0000

It is an unfortunate truth of experiential reality that choices are not clear-cut, and the event window for choice may vanish before the information enabling the choice is present.

Eluki bes Shahar

For those lucky enough to have the need to contemplate this...

Ref: http://aggiepie.files.wordpress.com/2008/05/12medicalspecialtystereotypesfull.jpg

Ref: http://www.huffingtonpost.com/dr-peter-rost/want-to-become-a-doctor_b_20148.html (via BMJ?)

All jokes aside, researching which specialties you prefer early on in your medical school years has its advantages. These include the pre-clinical years as much as the later, more exciting time spent in the hospital rotations.

For pre-clinicals, you will want to get a mentor who practices in the specialty you are interested in. This will allow you to be in the hospital early on, with no pressure to perform. You'd be surprised how much you will notice when you are not concerned with evaluations/patient responsibility. You also, more importantly, get to see the "collective body" of the specialists. There are definite stereotypical traits attributable to some specialties more than to others. The common example would be a more commanding or dominating personality for surgery. Does that mean you cannot be a calm, mellow surgeon? Absolutely not! But the law of life is that you will find it much harder to be the exception.

For the clinical years, there is a lot more to do. For example, if you decide to aim for dermatology, you might want to make sure you get an invitation to Stockholm for their annual ceremony, or at least put in the extra effort to beef up your application. Another example would be doing extra electives at rural sites to get experience in self-reliance for a great career in family medicine. If you like a particular program, it is usually good to get an elective there. According to CaRMS, some universities openly state they have preferential treatment for people with whom their faculty is familiar from such electives.

For a competitive specialty, you would probably want to get involved in research in a related field. The reasons are twofold. Firstly, what better way to put your foot where your mouth is when it is time to back up your claim of interest in the specialty. Some elite residency programs in the States require you to have done research, published, or even to have a Msc degree. Secondly, don't neglect the opportunity to get to know the program director of your Oh-So-Desired-Specialty if you get a summer grant in their lab/hospital clinic. Although I will elaborate on it in later post, I would caution you from molecular biology research unless you absolutely love it and know exactly what you want to do. Most likely you are going to be a practicing clinician, so stick to the clinical.

Some residencies, it turns out, are more competitive and select from an extensive pool of medical graduates for a minute number of spots. You'll immediately recognize that this early preparation for one critical point in your life vaguely reminds you something...However, your competition just received a serious upgrade from the last time you had to prove you are better than the average Joe to the medical school admissions committee.

And finally, some serious tools:

Careers in Medicine via AAMC (usually your career advising office will email you a password)
Medical Specialty Aptitude Test
The Ultimate Guide to Choosing a Medical Specialty via Amazon
(The best book I found on the subject, although by no means perfect. In fact, much of it is focused on US specifics, which are somewhat irrelevant for hardcore Canadians like us. Don't feel insulted if you are from outside of Canada, I did mention in the prelude to this blog that I write for and about Canadian medical school applicants/students)
Your colleagues in upper years. Corner one and question them about their rotations in a given specialty. If you are extroverted enough, you could probably get away with leeching on to them for a day in the hospital. From my experience, there is much more amicability and much less cut-throat attitudes in medical school than there are in premed.

The MCAT will change

noreply@blogger.com (Unknown) — Wed, 12 Aug 2009 18:57:00 +0000

Photo by David Reece

Before I talk about the changes, I would like to digress for a little bit. Although the MCAT season is almost over, quite a few of my good friends have either just recently come back from AAMC-land or will be going there soon. With so much MCAT in my life this summer, despite my strong desire to erase the memories of my own test taking, I felt a post about the elephant in the room was appropriate. I am sure that either you or somebody around exclaimed at least once "This MCAT is stupid! It tests all those little things. Why on Earth would I need to know the Krebs cycle or Heisenberg's uncertainty principle? If this is the case, the following article would soothe your mind and clear your conscience if you had spent time studying for it.
This Science publication discusses the capacity of the MCAT to assess thinking abilities versus rote learning and minute details. As my recent poll indicated, not all of you have access to online journals, thus I will provide the gist of it. The authors use a neat classification system to compare the biology sections of MCAT, standard undergrad tests, first year medical tests, the GRE and the AP biology on their ability to test critical thinking skills or higher psychological learning levels. As you might have guessed

The MCAT also has the lowest percentage of knowledge-level questions [...] and the highest average raw question rating of any of [...] five exam sources

(ASSESSMENT: Application of Bloom's Taxonomy Debunks the "MCAT Myth". Alex Y. Zheng, Janessa K. Lawhorn, Thomas Lumley, and Scott Freeman (25 January 2008). Science 319 (5862), 414.)

Next time somebody tells you the MCAT is a dumb test for antisocial high IQ outcasts, tell them Bloom knows better.

Now, to the actual topic of the post. The MCAT had recently changed, yet this is only the beginning. In January 2007, the AAMC turned the pre-med world upside down. The eager and tenacious cohort of students taking the test ended up with a shorter, computerized, version given more frequently, with faster results communication. Some content changed, but the changes were relatively insignificant. Well, that was two and a half years ago.

According to a recent article in Science (I love Science!), there is a discrepancy between how medical schools determine the applicants' aptitude for success in medicine compared to how current medical students at those same institutions are tested. Although I'd strongly recommend reading the article, but I will again provide the main message here: the MCAT might soon be testing competencies, as opposed to the traditional premedical undergraduate curriculum. (Science for Future Physicians. Sharon Long and Robert Alpern (5 June 2009). Science 324 (5932), 1241.).

If you thought "What does Science know! They are not the ones making the MCAT", you were absolutely right. Right? Actually, not quite. The AAMC is currently conducting a study geared to address the growing concern about the inadequacy of current focus on courses instead of competencies. Sounds familiar? According to AAMC's document, a new MCAT will be announced no earlier than 2013. The Fifth Comprehensive MCAT review or the MR5, as the AAMC lovingly calls it, will establish what kind of changes future premeds will face. If you would like a glimpse at this competencies idea, scroll about halfway through the following document (Scientific Foundations for Future Physicians). For a time-line and general interest, read this one as well (Overview of the MCAT project).

For the time being, this will be my last post about the MCAT. Stay tuned for the continuation of the admissions process tips. Just in time for the new applications cycle.

Who are you ? (poll summary, July 10-17, 2009)

noreply@blogger.com (Unknown) — Sat, 18 Jul 2009 02:50:00 +0000

Photo by kozumel

WHO ARE YOU?

Pre-med	11 (78%)
Medical student	2 (14%)
MD	0 (0%)
I am not in the medical field	1 (7%)

Votes: 14

Medical school personal statement tips from the opposite side

noreply@blogger.com (Unknown) — Sun, 12 Jul 2009 00:02:00 +0000

Photo by ButterflySha

Things you should do for a guaranteed acceptance?

Forget to edit out another school's name in your essay. In the same train of thought, you should not be bothered by actually answering each school's specific questions. Instead, simply write a generic essay about what you think they should know and send it to all schools.
Have multiple grammatical and syntactic mistakes. Here are a few specific tips:

Avoid run-on sentences they are hard to read.

Never use no double negatives.

Use the semicolon properly, always where it is appropriate; and never where it is not.

Reserve the apostrophe for it's proper use and omit it where it is not needed.

full list

Make it crystal clear that you don't really care if they accept you, since they are not your first choice anyways. To be sure the admission committee knows 'who's the man', state that they should feel honored that you even applied.
Write things that are not true, in great amounts, providing lots of colorful details. For example, mention you like Mozart and play piano, since it sounds much better than spending every other night playing Wii and listening to Kurt Cobain and Marilyn Manson.
Make an emphasis on the how's, not the why's. For example, spend a whole paragraph describing exactly what you did during your volunteering (preferably providing a detailed schedule), and omit what you took out of it. Feelings and introspection are for sissies.
Do not be afraid to brag. You did it, right? Why should you be ashamed of your own accomplishments?! Besides, every doctor I know is arrogant, this type of personality trait seems to give you that special extra edge before the admissions committee.
Pick a controversial topic and make sure to take an uncompromising, unilateral stand on it. For example, say that you are for saving lives and that Jehovah's witnesses are all a bunch of unenlightened inbred retards in regards to blood transfusions. The ad coms will love a doctor who can defend his convictions when he is confronted by patients.
If you have a bad grade/MCAT score, please do yourself a favor and use your essay to explain why. It would be such a shame if the ad coms did not know that the "F" in intro to fairy tales was your sister's fault - she just had to get pregnant at thirteen and get dumped by her boyfriend when you were taking that course/MCAT. As you see from my example, you get extra points if you blame your failure on someone else.
Never let anyone else read your essay, because they either do not know you well OR they know very little about the admissions process. Their advice will not bring anything you haven't thought of for your application. If you do find somebody who possesses knowledge about both yourself and the application, make an extra effort to hide your essay from them. Obviously, they (or their friends/family) are also applying and they will use whatever you give them for their own draft. Consequently, it is a good idea to submit as soon as you finish typing the first draft - that way you can claim intellectual property on your literary masterpiece should there be a dispute.
Here are some excellent reasons for becoming a doctor to use in your essay:

Because my parents/close relatives are doctors.
Because I loved ER/House/Scrubs/Grey's Anatomy and want to be just like them.
Because I knew since I was little that all I wanted to do is be a doctor.
Because I love people.
Because I want to help people.
Because as a doctor I will have employment security.
Because I always wanted to give orders to other people and have them actually listen to me.
Because I promised my girlfriend/boyfriend and now I don't want to back out.
Because... Well, I don't really know why, I just thought it seemed cool and I ought to try it.
etc...

Buy a "Collection of the Best in the World Essays That Got Their Writers into Medical School" type of book, look for the most creative one, type it up (at this point you may use your name, if you wish; additionaly, you may wish to change some facts to make the story closer to your own life, but that is absolutely optional) and submit it.
Use the thesaurus, for Christ's sake (because common everyday words just do not impress ad coms nowadays)! Here are a couple of words to get you started:

gargantuan instead of large/huge
interminable instead of endless/very long
pulchritude instead of beauty
tyro instead of beginner/novice

Finally, under no circumstances should you visit or use the information provided below:

http://books.google.com/books?id=W3gfDobI3MUC&lpg=PA87&ots=2E2NqxBWpX&dq=kaplan%2010%20mistakes%20to%20avoid%20personal%20statement&pg=PA87
http://books.google.com/books?id=B6kS0Zcj0e4C&lpg=PA101&ots=a-gfTevBue&dq=kaplan%2010%20mistakes%20to%20avoid%20personal%20statement&pg=PA101
http://www.essayedge.com/medical/essayadvice/course/ (this one requires a registration, so do not even bother wasting your time)
http://www.petersons.com/common/article.asp?id=1009&path=gr.gs.advice&sponsor=1

In conclusion, if you have anything else you think others would benefit from, KEEP IT TO YOURSELF. There are only so many spots for medical students in Canada, and you want to be one of them, right?

The Ups and Downs of Applying for Medical School

noreply@blogger.com (Unknown) — Sun, 14 Jun 2009 03:46:00 +0000

Photo by Pat Rioux

Today is a special occasion, because we have a guest post. P.L. has written about his hurdles with what is the main theme of the day on my blog, 24/7/356. Please be kind, constructive and critical - leave comments, so he might write again... (remark by premedc)
--

I’m sure most of you have heard the expression “Being a doctor isn’t easy”. Doctors not only have to work crazy hours, not only are they responsible for the lives of their patients, but they have to do all of this and at the same time manage their time effectively so that they can have time with their family and friends. Easy right? Well I’m sure the fact that the divorce rate for physicians is 10-20% higher than the general population is a testament to exactly how difficult it really is. But the purpose of this post is not to dissuade you from wanting to be a physician or to tell you about the hardships that physicians have to face, because the reality is that you are not physicians yet. Instead I’m going to talk to you about the application process to medical school and how some future physicians learn how hard their job is before even being accepted to medical school. I will be talking to you about my own experiences applying to medical school and maybe you can learn something worthwhile from my wild roller coaster ride.

The biggest thing that I have taken away from my experience applying to medical school is that the actual process of applying can affect you and influence you in ways you cannot begin to imagine. Most of the people I speak to about applying to Medical School all have the same thought in mind. They all believe that they have gained valuable life experiences from their ECs and from their time in school. This may very well be true but it’s unfortunate that I haven’t come across many people who tell me that they have learned as much from the application process than I have. Maybe this is because most people haven’t gone through as many hardships as I have during the past two years in my attempt to get into Medical School or maybe it’s because some people haven’t taken away as much as they should have from the application process.

Two years ago I began my adventure. I knew my 3.4/4.3 GPA wasn’t stellar and I knew my 27P MCAT was below average, but I was never the kind of person that gives up easily so I proceeded to continue with my applications to medical schools. Well I don’t have to tell you what the outcome was. I was devastated, but after receiving rejection letter after rejection letter I knew that I wasn’t living up to my potential and that I could honestly do better for myself. I channelled all my anger and focused it on doing the best I could do at school. I stopped hanging out with friends, I stopped watching TV and my entire life became school. In my last semester at Concordia University I accomplished a feat I knew I was capable of but never actually did it before. I got straight A+s and ended my Bachelor Degree with a 3.7/4.3 GPA which was far from my 3.4 GPA that I had a year previously. I knew that this was a glimmer of hope for my aspirations to get into medical school, but by no means did I get my hopes up. I knew that in order to give myself the best chance to get where I wanted to be, I had to do a second undergrad degree instead of continuing upward with my education and doing a Master’s. This was definitely not an easy decision for me, but the thing I kept coming back to was the fact that I knew that I had more left in me and I knew that by doing another Undergrad degree I was giving myself a fresh start to prove to myself and everyone else that I can really do this. So I applied to Anatomy and Cell Biology at McGill and was accepted and thus began a new chapter in my adventure.

But doing another undergraduate degree was not the only obstacle I had to face. I knew that my MCAT score was another big factor in my multiple rejections and I knew that a retake was the only option. So I devoted my entire summer to studying again for the beast. It wasn’t easy to sit inside for the second summer in a row while all of my friends were going out and enjoying the beautiful summer weather. However, I knew that this was a sacrifice I had to make. I took the MCAT in the middle of August and by the middle of September I received my results. I improved my score significantly from a 27P to a 31Q, and although I knew that I could have done even better I was satisfied that my work had paid off and that I had brought my MCAT score to a competitive level.

The next obstacle I had to face was actually applying all over again. I focused myself and really spent a lot of time on my Autobiographical sketch. I got feedback from friends and family and in the end I was extremely satisfied with the final result. I sent it in along with my updated MCAT mark, and updated transcripts, and crossed my fingers. I knew that in all likelihood I was going to receive the same rejection letter that I had received a year prior, but deep down I hoped that McGill would see my perseverance, determination and improvement and that they would at least give me the opportunity to show my face and show them who I really am. Then on February 27th, 2009 I received an unexpected email. “The Admissions Office has reviewed your application as a Fall 2009 MDCM (Quebec) applicant and, based on your overall dossier, has selected you as a candidate for interviews.” I experienced a mix of emotions from shock to joy to crying tears of happiness. I still had another hurdle to get over, but I got another inch closer to my goal and for that moment I really caught a glimpse of what it might be like at the finish line.

As much as I was enjoying the celebration, the party was about to come to an end. I knew that I had 3 weeks to prepare for one of the most important days of my life and I wasn’t sure if I had enough time. From doing practice MMIs to doing mock traditional interviews to meeting with friends over coffee and doing mock interviews with them, I did it all. I searched deep to find answers to the tough questions like “Why do you want to be a doctor?” and “Tell me about yourself”. I gained confidence and my spirits were high. I did the interview and upon initial thought I honestly believed that I did very well. However, these thoughts were very short-lived. On April 7, 2009 I received the exact same letter that I had received a year before. The date was different but the words and the outcome were the exact same. My world came crashing down and now I write to you in the same place as I was one year ago. WRONG! I am most definitely not in the same place. The outcome may be the same, but there is no way I could have learned the lessons that I did without going through this tumultuous experience. I have learned that I have more determination and perseverance than I thought I ever could have had. I learned that by being rejected and making mistakes you can actually learn more than by being perfect. I learned that if being a doctor is something I really want to do then I am not going to let a bunch of people sitting around a little table tell me that I can’t. I learned that only you can be your own worst enemy, I learned that anything is possible if you really put your mind to it. I learned that sometimes short term sacrifices need to be made in order to get something worthwhile in the long term. And last but certainly not least, I learned that the people who said “Being a doctor isn’t easy” were most definitely spot on but failed to read the fine print that said “Applying to be a doctor isn’t any easier”.

By P.L.

Medical school application process (or the Ten Steps of Medical Admissions Application)

noreply@blogger.com (Unknown) — Tue, 09 Jun 2009 03:00:00 +0000

Photo by _mubblegum_

So, you bought a stethoscope and want to order those business cards with the coveted M.D. on them next to your name? Well, applications to medical schools sound like a good idea to begin with. I feel a little odd writing a whole article about what might be more than obvious to you over-zealous mega-achievers. However, I also feel some of you will severely underestimate the importance of spending enough time on the actual application process (as opposed to the years of preparation that go into having something to write on that application). For shortness' sake, let us assume you have accumulated enough padding for your CV, took the MCAT and aced it, and you feel mature enough to become a doctor (I will write about that one soon, when I discuss the interviews). Here are the Ten Steps of Successful Medical School Applications (this is a quick guide, so don't blame for not being thorough):

First - Official
Sounds simple. It is. Make sure you learn by heart the admissions website of every university you apply to. This means taking the time to list for yourself all the requirements. Circle all the deadlines on your calendar. Learn about things that are important to you (the duration of the program, for example, since there are 3-year programs leading to the same MD degree).

Second - Unofficial
Be proactive, not reactive. Do not wait for the rejection letter to learn something you should have known. Use the internet. Seach Google. Make sure you fish out everything you can on the subject of "your-school-of-choice medicine application". See how it contradicts/complements/confirms the information you gathered in step one. One of the best resources for Canadian applicants is the forum of Canadian Premed and Medical Schools.

Third - Word of mouth
This one requires some social skills. Ask your friends who applied there or know somebody who did. Were there any quirks? Oftentimes, you will come across information that is not available on the official website, information people learned on their own experience. Information they will not share but with their good friends, such as you. If you are smart, you will cut short the wisdom gaining process and learn on others' experience, not your own. At this time, you can get some invaluable pointers at what the admission committee of that specific school is looking for.

Fourth - Clarification
Having formed your own idea of how you fit into the grand scheme of things at the Best Medical School, you will be primed for asking them questions. Preferably several times and on different occasions. Most likely there will come up an issue that is still unresolved after the above steps. You want an example? Sure : do they absolutely need 2 references from professors? Most likely, nobody except the admission committee personnel (please carefully mark my words: secretaries do not count) will be able to answer these definitively. You will need to call them, come in (if you are in the same city) or keep calling again. A good idea would be to ask your friend to call and ask for a different person (there are usually at least a couple of ad com officers). If you suddenly start feeling guilt for the extra work you will cause the poor office people working so hard to get you closer to actually having a legitimate reason to use your stethoscope - remember that you are paying them. The application fees got you covered.

Fifth - Personal review
This is a quick reality check. After getting all the information written down and broken down on a per school basis, set it aside. Let it sit for a while. Do something else and come back to it a week later (hence the suggestion to start applications early - you cannot skim on things like this). You will not believe what kind of things you might have missed. In case you did, go back up the list and repeat until you are completely satisfied with yourself.

NOTE: A post about worst application screw-ups coming soon. Prepare for a good laugh. Update: put on your laughing caps - it's here.

Sixth - Close person review
This is more pertinent to the creative part of your application, i.e. the Personal Statement, aka the Biographical Sketch aka the Biggest Bullshit of Your Life. Did I really say that? I guess I did. It does not matter since you should not be listening to an anonymous person who probably did not even get past the submit button on medical school applications anyway. Ok, ok, joke over.

Although I will write a post about the PS relatively soon, I think its worth to mention this important step right now. Make sure a close person (friend, family) reviews your application briefly and your PS thoroughly. Give them a list of pertinent questions (more about this later) and ask them to use the Review feature in Microsoft Word.

Seventh - Personal review
Now, when you have real person feedback on your application - make sure you use it. Compare the edited with the original. Decide which parts are better and make the final draft from the best parts of the two. This is going to be hard, but you have to integrate everything, don't just accept all the comments, as well as don't discard them altogether because they say you sound too arrogant when you say you already knew what you needed to know to decide you wanted to be a doctor when you were 3 years old. Be humble, but be aware that your friend/relative might not be as informed/enlightened about the intricacies of the PS requirements.

Eighth - Adviser/counselor review
Same old song about using what you pay for. Please be smart and go to your Career Office/Student Services and book an appointment with an adviser to look over your PS, CV or any other two letter acronym document you may submit.

Ninth - Personal review
At this point, you are probably so fed up with the applications, that you will punch the next person who says medical school, MCAT, accepted, interview or references. Nevertheless. Just like in step five, put the application aside. Do something fun and come back refreshed. See that silly word you missed? How about that date? Did you really think the admissions committe will believe you volunteered for Doctors Without Borders when you were 5 years old? What? Oh, its a typo. That's right, they will be understanding. The admissions committee will definitely understand how much effort you spent on their application when they throw it in the trash bin.

Tenth - Last checkup
Just before you are about to click that last button, print the last paper, pass the no-turning-back point - stop. I know how much you are going to hate me for this, how much I will be ridiculed, but I am still saying it: Go back to step one and complete this guide all over again. This time, quickly and without time-consuming parts (seek only people you can reach quickly, i.e. forgo the adivser this time).

In conclusion, I would like to remind you that the better you prepare you first application, the less likely you will need to think of a second one. Just like with the MCAT, volunteering, school and life in general, the effort you put may not grant you instant gratification, but it sure as hell will make you Birthday-Christmas-Marriage happy when you are accepted.

Voice of reason or crowd panic? (Swine flu thoughts)

noreply@blogger.com (Unknown) — Sat, 23 May 2009 03:23:00 +0000

Undoubtedly, you have heard of the Swine Flu. Unfortunately, you have heard of it a little too often. Ad nauseam, I would say, but then you'd ask if this was a symptom. It seems that fear campaigns bring media the most popularity, and this meant they could not pass up such a golden opportunity. From every direction we are flooded with fear-breaking headlines like the following:

I do not want to throw statistics at you, neither do I wish to link to hundreds of jargon-heavy empirical research articles to prove my point. What I do want you to do, however, is to use your own common sense. Analyze information provided to you not only by the immediate presentation, but by integrating your past knowledge, your life experience as well as by simply looking up important things that seem to be missing. Read, understand, take a step back. Look at the big picture. Think. Do what Socrates did. Here is a sample of questions you might want answered before you barricade yourself in your custom made bunker with 30 years' worth of food and water.

How many people got sick? survived? died? from this H1N1 swine flu.
How infectious is it?
How does the swine flu compare to other things that are not reported in this article, e.g. influenza in terms of virulence?

Just to finish on a rather entertaining, yet certainly not serious, idea (except if you are from Mexico):

Found on http://snooz3r.tumblr.com/post/101960469/symptoms

How and why I got into medical school

noreply@blogger.com (Unknown) — Mon, 04 May 2009 01:44:00 +0000

Photo by dandy_fsj

To paraphrase the famous expression "You don't know what you got, until it's gone" more appropriately for this post - "You don't know what you'll have until it's yours".

While I was still in the premed camp, I used to dream about the time these life-changing words would be addressed to me - "Congratulations, you have been selected..." and dreading yet another "Dear candidate, despite your excellent dossier, you were not selected..." (I have received more than a couple of those). For years, I used to speak in the conditional "If I become I doctor...". It sort of became a reflex, a second nature of mine. And during those years I thought of the moment of getting my acceptance as a sharp 90 degree turn you sometimes encounter on the country side or Canadian urban centres. When you see it ahead, you have to slow down and make sure you stay in your lane. In the same way I thought I would change my life trajectory when the new and better stretch of my life appeared in front of me. Many exciting events in mind were tied to Being Accepted. "I will do this... I will try that...". But all ended with "if only I was accepted" - although I was never superstitious, the grandeur of the subject made me almost religious when discussing it. Which, by the way, shows just how feeble the whole thing was. As the list of things to do or to try grew, so did the weight and the importance of the aftermath. It became harder and harder for me to bear the possibility of rejection, with so much value attached to this one event, not even entirely under my control. Also, as I put on hold many if not all of the things I really wanted to do, I became less and less happy. But I did not notice this, I was too preoccupied with my thoughts.

This was then.
A couple of years ago, my life had changed drastically, and I had to adjust. Living through tough times gave me a good nudge to mature. I realized clearer than ever two important things. First, using my road metaphor from above, to win a race you need to gain a lot of momentum. Similarly, you need to set aside (note: not forget) all the dreams about the your future as a medical student, resident or even doctor, and focus on the now. I hate clichés, but applying the following was what got me admitted "Live in the moment" (or, if you need extra motivation: "Live as if there was no tomorrow"). Momentum, as you know, requires applying force, not thought (alternatively, you can increase in mass, but the Surgeon General says it is bad for your heart, so I will stick to force). I looked back at my life and saw so many "what if"s and so little "have done"s. This gave me the motivation to act: research, learn and excel in many things I talk about in my other posts (and also some EC's I might mention if you behave).

Second, and probably even more important, I had a philosophical insight (yes, that deep). What I mean to say is (again, metaphorically) if you have enough momentum to become a successful candidate, you are most likely going darn fast. And you will never make a 90 degree curve. You will likely fly off the road right into the bushes, skid on your rear until you stop or hit a tree. Your life does not change when you get into medical school. You will be the same person, with the same friends and the same ideals/achievements you had several seconds ago, when you were only a premed. This was so important for me to understand because it changed the way I looked at my goals. Did I still think getting into medicine was my dream? Absolutely! Did I still want it as much as I did before? Certainly! However, I did not put my life on hold for after I got in.

Study but also party. Invest but also enjoy. Sacrifice, but do it wisely. Aim high, but never look down at anyone.

More odd ways of preparing for the MCAT

noreply@blogger.com (Unknown) — Sun, 26 Apr 2009 03:42:00 +0000

Photo by Cynergist

This, folks, will be the last post in my MCAT series. On the one hand, I feel like a million bucks not having to think about that horrendous test ever again. On the other hand, I do sympathize with my readers who, temporarily, are still forced to depend on the AAMC with their future. In any case, here are my last bits on the Medical College Admissions Test.

Make a trip to your school's library (site).
You will probably find wonderful things there. Mark Twain and Stephen King aside, libraries in the medical faculties in particular seem very keen on buying prep books or even sample tests. As inconvenient as using a book on reserve may be, it just might be worth it if you have the official AAMC practice test in front of you (That's 35$ value each!). You may even get lucky and be able to take out a prep book that goes for 100+ $. Absolutely gratis. Don't believe me? Here are a couple of quick links:
- University of Toronto library search for MCAT
- Queen's University library search for MCAT
REMARK: Obviously, try to fish out the newest stuff. But, dumb marketing aside, 2010 versions are not better than 2009 versions. In fact, the extent of the improvement in such upgrades is usually limited in its use to 5-year-olds who like colorful cartoons or flashy boxes with bold text.
Attend a lecture.
Using the website of your university, look for the schedule of the courses you are interested in. Most MCAT-essential courses will be taught during the summer, specifically to allow You to take advantage of them. The horror of most premeds, aka org chem or calculator dread, aka physics, and many more are all scheduled during the sunny days of your vacation. "But I'm in my second/third/fourth year! I already took those!! Why would I risk getting a bad grade!!!??" - You will argue. Smiling, I will nod and say "Who said anything about registering?" Remember, your purpose is not to get a grade on your transcript, but rather to refresh your knowledge and understand concepts. Who else is better placed to clearly explain torque, the Wittig Reaction or chromosomal disjunction than a university professor? (I might have just contradicted myself in my thoughts, recalling some of my undergraduate professors)

There is, however, a little inconvenience in this method: most of the materials are accessible online only to registered students. However, I instantly see 2 ways to remedy this hiccup: use your old college physics/org chem/bio books. What you need is somebody to explain the material, you can get all the printed stuff you need off the net. Or you can make a friend in the class and ask him to email you the materials. Obviously, you will not be able to write the exams. But do you really need to? Your goal is the MCAT, not the transcript. Practice using the AAMC tests.
Use the internet. Or not.
I mean you can use whatever you have to your advantage. How far is 'whatever'? Well, that is up for you to decide. I am merely listing tools that are available and that will yield results. Given my liberal (when compared to the greedy gremlins at RIAA and MPAA) views on peer-to-peer networks, I believe it is also worth mentioning bittorrent. Or even a well constructed search on Google. Please interpret this correctly: I do not want to argue for or against copyright laws, lawsuits, piracy or any of the other controversial issues (the above reference was a fitting expression of disgruntlement against corporate bullying rather than a cheer for piracy). I just want to let my readers know that these tools exist and can be used to study for the MCAT. Also, a worthwhile reminder: illegal actions entail consequences. Make sure you are willing to take them. Especially if you want to become a physician.

Now you must be fully equipped for the MCAT. Next posts will talk about applications. cv's, interviews, etc.