Wiggle your big toe

Well, now that my first semester of medical school is over, I can look back and tell myself, “Hey, that wasn’t so bad.” In actuality, it was very hard; one of the hardest things I have ever done. And that was just semester one. I still have ten more to go. So when I think about how hard it was to just get through one class, it’s even harder to convince myself that I can get through next semester, where I have 10 classes. And then another semester after that. And then boards. And then residency. It’s extraordinarily overwhelming at times to think of everything I still have yet to even begin, and all that I must do if I want to become a doctor. So this brings me to the title, “wiggle your big toe.”

The line is from the Tarantino movie Kill Bill vol. 1. The main character has just woken up from a several-year coma and wants to get revenge on whoever put her in it; however, being bed ridden for so long, she can’t walk. So, while sitting there, she reminds herself that she has so much she has to do for herself, but first thing is first: she needs to wiggle her big toe. She can and will accomplish everything she wants to, but she needs to be able to walk. And before she can walk, she needs to wiggle her big toe.

For better or worse, I often resort to movie or book characters when in need of inspiration, and this part of the movie really spoke to me these last few month. You really have to dive right into medical school, which can make it extremely daunting at first, which is why it is so necessary to try to focus on little bits at a time. It is always important to remember the big picture; you are here to become a doctor. But in order to do that you have to pass this one class, and to pass this class, you have to do well on this test. And now that I’m finally into the swing of things, the big picture doesn’t seem so daunting to accomplish.

My very first week, I was terrified at the amount of information I was expected to cover. Now that I just finished my last anatomy test, I thought 750 pages of material were totally reasonable for two weeks of studying. This transformation seems absurd to me still, that somehow I find myself capable of doing more in a week than I used to do in a semester of undergrad. It is because I able to just focus on one impossible task at a time, take everything day by day, and not let the big picture immobilize me from accomplishing the little things I need to do.

So now, I’ve passed anatomy. I have one semester of med school under my belt. I have discovered I can do this, no matter how hard it seems at times. And no matter what, I know the most important thing is to concentrate on the task at hand, without losing sight of the bigger picture. If I take it one test at a time for long enough, the tests will be over and I will be a doctor.

I have wiggled my big toe. The hard part is over. Now lets get these other piggies wiggling.

My First Patients

We all lined up outside the room, white coats on, looking almost like real doctors. We discussed what it would be like to each other, anxiously and nervously awaiting this inaugural part of medical school. When the door opened, we filed in, ready to meet our first patients. But there was nothing we would do for them. They were already dead.

The very first class of medical school is gross anatomy, where you learn every little detail of the human body. The key aspects of this class are not only being able to describe structures in the body, but also being able to identify them. Pictures are models are good for studying purposes; however, seeing something pointed out to you in a book or clearly visible on a model is much different than seeing something in a real person, and since we are working to become doctors, seeing real people is probably a bit more relevant. Now, it wouldn’t be practically (and also a bit immoral) to use live people as studying subjects for their insides, so we must resort to the next best thing: cadavers. These people, and their families, make the choice to forgo their funeral and become our teaching models. They have willing donated themselves for the soul purpose of letting several classes of people to learn the most fundamental part of medicine.

At my school, anatomy is done during the summer, and it is the only class we take. Every day consists of lectures of a specific section of the body followed by several hours of lab, where we go over the lecture material covered in lecture that morning. Now, whoever came up with the “drinking from a fire hose” metaphor about medical school was spot-on. The material we are expected to learn is not necessarily hard or complicated, but the issue is the depth of understanding about the material we are expected to have in the incredibly short amount of time. To put it in perspective, we recently finished the head and neck unit, which consisted of learning every bone, muscle, artery, vein, lymphatic component, and nerve, along with all of the actions of these components, all of which we covered in just over two weeks. So the transition to medical school is essentially learning how to become a sponge for information.

During the craziness of learning the minutiae of anatomy, we are also learning how to apply this back to why we are in medical school: taking care of people. This brings me back to anatomy lab, which is a constant reminder that everything we are doing will inevitably fail, and that each patient will end up like one of our donors. When I walk into that lab, in addition to learning what nerve travels inside the cheek at a certain level, I can’t help into glancing into the eyes of the donor, and thinking about what kind of person he was like when he was alive. Was he a father? Was he a doctor? Or maybe he was a garbage man? In the end, it doesn’t really matter who he was, because right now he is the best learning tool for me so that I can help others stall this fate just a little bit longer. Because of him, I get to be a doctor, which is the best gift I can possibly receive this summer.

And so I am unable to save my first patients. But because of them, one day soon I will be able to save countless others. Because of them, I will be a doctor.

The Biggest Test You’ll Ever Take (In College)

Today marks the one-year anniversary of my MCAT day, and I’m feeling a little nostalgic so I thought I would make a post about how to tackle this test. For most, including myself, the MCAT seemed like the biggest hurdle in my way to get into medical school. It seems so daunting, and there is so much pressure to do well, but it does not need to be nearly as intimidating as most make it out to be. So, here is some advice on the Medical College Admissions Test:

First of all, you must understand that this test is a marathon, not a sprint. It tests not only your understanding of basic science knowledge, but also your ability to study for a huge standardized test, since you will have to take a bunch of those in medical school. If you know all of the material cold, you could probably manage a 30 (this is the old scoring. I don’t know how the 2015 changes will affect what is considered a “good” score). Anything beyond that requires the ability to take this test specifically. Therefore, my number one piece of advice to score well on the MCAT is to TAKE PRACTICE TESTS. The AAMC offers a number of them for a small fee on their website. Take all of them. But only take them after you have studied. While studying, find a good study source that has lots of practice questions built in (I know the Berkeley Review is essentially 50% practice questions). The AAMC practice tests are the best metric to tell you how you will do on the real thing, since they are the ones who make the test. They will also help you get a feel for how the real thing is structured.

Secondly, give yourself plenty of time to study, and don’t take the test until you are certain you will hit your target score. The AAMC recommends 300 hours of study time. This works out to about 4 months of studying for several hours every day. Personally, I studied for almost 5 months, 6 days a week, with a few days off here and there. This is how long it took me to feel good about how I was scoring and got me into my target score range, and I was very happy with my score. It is a big time commitment to study for this test, especially while still in school. What helped me the most was to make a study schedule, so all of my studying every day was extremely focused and I never felt overwhelmed by the immensity of all the information I was expected to know.

Finally, I have some tips and tricks for the whole MCAT and for each of the sections on the current MCAT. I don’t know much about the new social science sections, but I can tell you from the experimental passages I got on my MCAT day, the questions were a lot of common sense and information you could absorb from any into to sociology/psychology class.

MCAT day: Try to arrive at the testing center early. You don’t want to add any stress that comes with being late to this already anxiety-ridden day. It takes a little while to get checked in, and I found it nice to be one of the first ones in the room. You can’t take anything except your ID into the room with you, and everything else goes into a locker, so keep that in mind as well. They will give you a pencil and a piece of scrap paper for you to use, and you can ask for ear plugs, which are nice since not everyone starts and takes breaks at the same time, which means the constant sound of movement and the door opening and closing can be annoying and distracting. When I first sat down, I wrote down “66, 58, 50, 42, 36, 28, 20” at the top of my paper, which represented how much time I had left in the section I was on after I completed each passage. After I finished the passage, I would cross of the number and move on, which helped me gauge how much time I had left. Time seemed to move pretty quickly, and I know a lot of people have problems getting through the sections, so make sure you pace yourself. Don’t skip any questions because you might not have time to come back, and you don’t lose points for guessing. Most importantly, don’t get too hung up on a complicated question, because they’re all worth the same amount. After all, you could get three easy questions correct in the amount of time you spend trying work out a complex problem.

Physical Science: The hardest part of this section for me was working through the problems quickly and without a calculator. To help prep, try not using a calculator during your chemistry and physics classes, especially on the simpler problems, and absolutely do not use a calculator while studying for the MCAT. On my MCAT day, someone showed up with a calculator and was sorely disappointed when he found out he couldn’t use it (and I bet he was pretty disappointed with his score, too). For this section, I also took a couple of minutes at the beginning of the section to write out some of the chemistry and physics formulas I thought I might use (Henderson-Hasselbalch, kinetics equations, etc.).

Verbal Reasoning: This section was pretty easy for me to study, since I was an English major and spent a lot of time reading sections of literature in the arts and humanities. For this section, what is most important is seeing the passage through the eyes of the author, not your own interpretation of the material. This can be especially difficult for science majors who spend a lot of time searching for the objective “Truth.” There will probably not be just one right answer for a lot of these questions. In fact, all of the answers may be correct, but you must find the one that is most in line with the author’s own view. I didn’t waste my time with some of the strategies that test-prep companies advertise. The most helpful thing for me was to time myself while doing practice problems (I think I used Exam Krackers verbal book. It had a ton of passages.) Also, as with everything else with this test, practice problems will make the difference between a great score and a good score.

Biological Science: This section is much less memorizing material and much more interpreting research results. I think the general consensus is the questions in this section are more like what you will find in AAMC practice tests 10 and 11. It will be helpful to have a lot of science classes done before taking this test, especially cellular bio, genetics, and microbiology. I didn’t spend too much time studying Organic Chemistry beyond what had direct application to biology (for example, I didn’t look at synthesis problems). This tends to be everyone’s best section on the MCAT, since we are all going into a biological science field, so don’t stress too much over this section beyond taking lots and lots of practice problems.

As I said before, the MCAT is a marathon. Begin studying as soon as you get into college by doing your very best in your science courses and aim for mastery of the material, not just a good GPA. The less learning you have to do come MCAT prep time, the more efficient your studying will be. This is one of the most important chances you have to make yourself a competitive applicant for medical school, so take it seriously. For some, this can make or break your application. With that said, if you aren’t happy with your score, don’t be afraid to retake it and know that this test is not the only part of your application that medical schools look at.

In closing, I apologize to those taking the MCAT in 2015 and beyond. This advice does not encompass everything you will have to go through in your studying. It also looks like your test will be much longer (almost twice as long, in fact) than the test I took. I wish you all the best of luck in this stage of your journey to become doctors. 

Let the Games Begin! And May the Odds Be Ever In Your Favor…

Well today is the first day of a new application season so I thought I should post a few tips for those getting ready to fill out the application. Remember, you want to make sure this is the best representation of you as an applicant, so spend as much time as you can getting this perfect.

  1. Apply Early. And I mean it. I believe you can submit June first. Do it. Spend this month filling everything out and get that application in ASAP. You would not believe how busy the people at AAMC are around mid June. This year, for those who submitted mid to late June had to wait 8 weeks for their applications to be processed. Also, a mediocre early application has a better chance of getting you an interview than a stellar late app. In addition, after you submit your primary AMCAS or AACOMAS app, start prewriting your secondaries. Each school will require you to write 3-7 school-specific essays and the prompts don’t change much year to year, so scour the Internet and see if you can find them (a great place is studentdoctor.net).
  2. Apply Broadly: Medical school admissions are pretty much a crapshoot for the average applicant. Roughly 40% of all those who apply get accepted, which is why it is necessary to apply to a lot of different schools. I heard somewhere that the average number of schools applicants apply to is 15. With that said, don’t apply somewhere you can’t imagine yourself going. You don’t want to have your only acceptance at a school you hate. My best advice is buy the MSAR for MD schools as take a look at the school information on the AACOMAS website, along with going through the specific schools’ websites. You will find a wealth of information and hopefully get a sense of whether or not you will fit in, although most of that will come from your interview day. You also need to look the scores and types of experiences that this school looks for. Do they emphasize research or community service? Is their average MCAT a 28 or a 34? Be realistic with yourself on your chances of getting into a school, but don’t be afraid to reach for the stars. Remember, you will hopefully only do this once.
  3. MCAT: Try to schedule your MCAT so you will have your scores by the end of June; that way, if a retake is necessary, you will still have time to take it again without a horribly late application. The MCAT is a big test, so make sure you are prepared when you take it because you really only want to go through that stress once. A great way to see if you are prepared is by taking the practice tests offered by AAMC. They are extremely predictive so you’re actual score will probably be within 1-2 points of your averages on the practice tests.
  4. Letters of Recommendation: Before getting these, think about who has gotten to know you the most. You want to find people who can really show the admission committees that you deserve to go to their school and you will work hard. So when you do ask for those letters, ask them if they think they can write you a GOOD letter; if they say no, it’s better than a bad letter ruining your app.
  5. Extra Curricular Activities: You are given space for 15 ECs. You do not have to use every single one. For each one, you need to concisely explain what you did and why it’s relevant. You may also choose up to three to be your “most meaningful” activities. For these, you are given extra space to explain. Choose these wisely because medical schools will look these at more carefully.
  6. Secondary Applications: As I said before, each school will require you to write specific essays for them. Try to get some of these done ahead of time, especially if you are applying to a lot of schools. The general consensus seems to be to get these turned around in less than two weeks, so you don’t want the pressure of getting 30 essays done in less than two weeks. Schools take these very seriously, so make sure you have several people look over them and give them your very best effort.
  7. Relax. This is an extremely long process full of “hurry up and wait” moments. You will rush to get your app in and then wait several weeks to get it processed. Then the secondaries from schools will poor in and you will get those turned around and then wait months for interviews. Then you will wait more to get a decision. But it will be worth it when you finally have that acceptance letter in your hand. Just try your best not to check your inbox every 5 minutes for the second half of the year like I did and enjoy your last few months before school starts. 

The Road(s) Not Taken

“Two roads diverged in a wood and I –

I took the one less traveled by,

And that has made all the difference.”

Robert Frost

Now that my Medical School application season has come to a close, I can’t help by reflect on all the roads I passed up on traveling along the way to just being accepted. Applying to medical school is such a long, long, long process, and so much of my time has been devoted to just “getting in” that I have so rarely taken the time to reflect on all of the decisions that have lead me to this point. I’d like to think that every time I chose a road it was the right one, but the truth is that I don’t know, because I can’t know what my life would be like if I hadn’t made the choice to go down the road to Medical School. I do know that the decisions I have made have made all the difference, because here I am, accepted and waiting to start. The first hurdle is crossed, and now I am standing on the threshold of another, even more arduous than before – Medical School.

So here I am, in the same place Robert Frost was, telling myself that this road I have traveled is making all the difference, without knowing what all those other roads had in store for me. Here I am, preparing to dedicate the next 4 years of my life to more school, and for some reason I couldn’t be more excited. It doesn’t matter that I don’t know what my life would have been like had I taken a different path, because I am about to fulfill the dream I have been working towards for the last 4 years, and has been 22 years in the making. After spending countless hours agonizing over organic chemistry textbooks and having to stay in on Friday nights while my friends went out and had fun because getting that A felt like life or death, I have finally received that letter in the mail telling me that I will be a medical student. I am about to start my journey to becoming a doctor.