Why I Write a Medical Blog

A reader asked: Why do I keep up with this blog?  What motivates me to write stuff that will help people?

I have thought about this question for a while. Some days when I cannot think of anything to write and can only see the lack of viewers, I get discouraged from writing at all.

However, I know that even if one person stumbles upon this blog and gets something of value from it, I have helped someone out there.

Information is powerful and there are hundreds of people out there looking for information regarding medicine. After getting into medical school successfully, I have some good and bad experiences that I can share to help prospective students. I have gone through the admissions and interviews process. And it was challenging at times without guidance. I hope I can be resource people trust.

Another reason for starting this blog is because of the re-occurring questions I see on premed/med student forums regarding the application process. I know there is a need for these questions to be answered clearly. A lot of replies in the forums are helpful but a lot that are downright wrong. Providing accurate information is prevents people from being mislead.

When I started this blog, I asked what will be different about my blog from the thousands of med blogs out there? I couldn’t come up with a solid answer, but I decided to start it anyways. I don’t know where I’m headed but sometimes I think the best thing is to get somewhere is to just do it and learn in the process. One reason that motivated me is how the web is still in its infancy. It has exploded into the world  truly only a decade ago and it’s evolving and changing the way we interact with other humans.

If you are a medical blog reader, you will realize that there is a dialogue going on about our health care system on the internet never seen before. People are using their spare time to discuss insurance coverage, reduction of medical mistakes and how to educate better doctors. People care about these issues enough that they will talk to strangers for hours on them. That is a powerful driving force can shape our health care system to be better; this is the idea of open source collaboration.

I also have a more selfish reason to blog. A mentor once said to me, “if you are serious anything, you must write it down.” So I write because I am want to learn more about medicine. Writing helps me present my thoughts clearly. Writing consistently is also good practice. It is an essential skill that everyone should improve on. All doctors need clear writing (and handwriting) to present their findings to colleagues, patients and the public.

The last reason I write is to remember this unique time of my life. I write here to record the amazing and heartbreaking lives of people around me. I want to remember my first patient, my failures and my process of becoming a physician. I want to remind myself to keep the traits of compassion, optimism and helping others during this long journey.

And that is why I write. Not to have a monologue but to communicate with the world. If you have any ideas or comments, I would love to hear from you. Even though we may never meet each other in person - we as two anonymous people on the internet - can still connect in a meaningful way.

Why You Shouldn't Join the Pre-Med Club

Premed clubs (PMC) re scams. Or that’s how I’ve always seen them. I acknowledge that they do host useful events and speakers once in a while, but to the average member they’re a bunch of con artists and here’s why.

  1. They overcharge you - During clubs sign-up they usually charge their members a higher fee, despite having large memberships. Running a premed club is low cost and here they are racking in $20 from hundreds of people that join.  And what do you get for the expensive initiation fee? Usually just a bland t-shirt that you would be embarrassed to wear. What services do they provide? Practically nothing that a person can’t get for free.
  2. They prey on your fears - The people who will would join a pre-med club are those who are considering a field of medicine. Many premeds in fear that they won’t be competitive for medical school get tricked into joining the club. They believe this will help their application and the premed club exploits this to trick everyone who is thinking of medicine to join, making it seem like a must to enter medical school. In reality, admissions committees know what these clubs and give little notice to such clubs.
  3. The club leaders get all the benefit and the members none - So while you write down on your application that you were in the premed club, the group leaders are writing that they managed a group of 500 students and organized educational seminars. What contributions did you do? None. It’s all politics in the PMC and all the gunners know it. They will sweet talk you into voting them and then sit at the top and laugh. It’s a pyramid scam, all the benefit flows to the top and the bottom is left with nothing.
  4. Members are obnoxious - why would you want to surround yourself with hardcore pre-med students who would backstab you to improve their admission chances? These are the people who will ask you about your GPA and MCAT scores after you get them back. They will probe into your life, trying to find what extracurricular activities you do so they know what they’re up against. They will ask you for information and a second later use it against you. Keep your friends close and your enemies closer - premed club members live by this motto. Stay far away.
  5. Most members don’t make it into medical school - For a group that’s so die hard on getting into medical school, the PMC has a low success rate. The majority of the leaders are not the role models they should be. They have bad grades and bad personalities. Many decide don’t apply to medical school and those who do, plenty are rejected. PMC are full of doctor wannabes that don’t want to do the necessary work to get there.

Admission committees can smell the premed club bull****. In fact, most university students can too. Spend that time doing better things and finding better extracurricular activities.

Having said all those nasty things: I realize that there are some truly genuine and nice people in the PMC. In fact, some do make it into medical school but I want to point out that they are the exception. These people would have made it there with or without being in a PMC.

Similarly, for totally clueless students the seminars, talks and information sessions are helpful. But it’s nothing that can’t be found on the Internet or from asking medical students or even senior students. If you want to join a club that has a high statistics for getting into medical try tutoring. For some reason, the tutoring club - which was quite small with less than fifty members - had quite a lot of successful applicants. Perhaps someone can explain this phenomenon?

What Extracurricular Activities Should I Do?

The typical pre-med day involves studying, getting good grades, making connections with professors, and doing amazing extracurricular activities that will somehow separate you from all the other medical school applicants. This naturally leads to the question, which extracurricular activities will increase my chances to get into medical school? You might hear from another pre-med that you have to do research or volunteer in a hospital in order to be accepted into medical school. Friends and family may suggest that you do some overseas volunteer/aid work in a third-world country to stand out and have something to talk about in the interview. The truth is, there is no “one” activity that will increase your chances the most. We are humans after all, not machines. We play musical instruments and exercise because we enjoy these activities, not because we get more “points” added to our application for doing them. Having said that, I will try to clarify what medical schools are looking for when they look at your CV / sketch / activities list.

To start off, almost all admission committees view extracurricular activities in three categories. (1) Clinical, (2) Research and (3) Other / Personal Interests. There is obviously a method to their madness. Theses three broad categories in a snapshot help the admissions committee assess if the applicant is fit for a life of medicine. How can they admit a student if he or she has never stepped inside a hospital and observed how current health care is practiced? Or similarly, medical schools do not want applicants who do not have any hobbies and who have no sense of teamwork. When the schools look at your extracurricular activities they are trying their best to evaluate your character, traits and experiences to see if you will be fit for medicine.

1) Clinical - Having a clinical exposure before you apply to medicine makes a lot of sense. Even if you’re not a hardcore pre-med gunner trying to beef up his application, observing the roles of doctors and health care workers in a clinical environment can be eye opening. You can see if this is something you want to do in the future. You will see the glamorous side of medicine and how satisfying saving lives and helping other people can be. You will also see the bad-side, the blood, the sick, the tears and the fears. Many of my friends who were considering medical school changed their plans after some clinical exposure. Even though their grades were good, some realized medicine wasn’t what they thought it was to be. Some saw the constant pressure and stress doctors were under and realized they wouldn’t be able to handle it. Others fainted at the sight of blood. Still others realized they wanted a regular family life and a stable day job where they could get off work at reasonable hours and pick up their kids from school.

Furthermore, clinical experience demonstrates to medical schools that you have considered the path of medicine seriously. Your grandeur of medicine isn’t just from Grey’s Anatomy, ER and House but that you actually took the time to watch medicine practiced in real life. It shows that you have “tested” the waters and that you might actually be able to swim in it.

Which brings me to the question, what type of clinical exposures are there? For starters, the easiest place would be a hospital. All hospitals have volunteers, ranging from maintaining hospital beds, running the gift shop, all the way to interacting with patients. You might be asked to find patient families or transport patients in wheelchairs. Not all clinical experiences are limited to big hospitals. It can be as simple as working in a clinic or a pharmacy. The point is to get some exposure to health care and how it works.

Another big “pre-med” clinical activity is shadowing. Shadowing is - like the name implies - following the doctor around as he does his practice. And just like a shadow you are to follow him closely, never leading the way, and never ever to be in their way. If the doctor is nice and not too busy, they usually take an interest in you, asking you about yourself and why you’re considering medicine. Most will give out their collected wisdom including the pros and cons of their jobs. As for the type of doctor you can shadow, that’s completely up to you. A good place to start is your very own family physician or doctor, who will most likely be more than willing to take you up on your offer. You can also ask family friends who are in the medical field. If you volunteer at a hospital for a longer period of time, you may get to know the doctors there and may have another possibility to shadow. Cold calling doctors in a phonebook though may be a bit more difficult, is not unheard of. A note about observing surgeries is that it’s usually not permitted, mainly because for safety and decreasing the chances for infection. I once shadowed an anathesiologist and I got to stay in the OR until the patient was knocked out and left shortly before surgery began. Some teaching hospitals may have observation windows that allow students to see surgeries performed.

Shadowing is not an activity where you contributed something useful like in volunteering. Instead, it’s a opportunity for you to understand the medical profession and the intricacies of how real medicine is practiced. In fact, shadowing doesn’t end after getting into medical school. Most medical students will shadow to better understand the different specialities in order to help them on their choice of residency programs.

Clinical volunteering shows admission committees that you have an interest in medicine and that you have given it some serious considerations. Also, if you did help out in a clinical setting, they will be looking for areas where you showed attributes of being a good doctor such as good communication skills, caring, compassion, advocacy, empathetic, ethical and kind.

2) Research - the second large category admission committees in medical schools look at is research. Medicine is an applied science and many new breakthroughs come through basic research and clinical trials. Research is a big component of medicine. It dictates what protocols to perform and which drugs to administer. It helps us understand infectious diseases and treatments to them. And since accepted medical knowledge is increasing at an astonishing rate, having a research background is valuable to all physicians.

I would like to point out that research is not a MUST needed to get into medical school. I have classmates who have never stepped into a lab outside of class. The majority of the class have no publications to their names. Research is not absolutely required to get into medical school and that makes sense because not all doctors will be researchers. Having no research background will not hurt your medical school application. Instead, your application must showcase your other abilities and what you can bring to the medical class.

Now on the other side, there are plenty of students in my class that have done research. Some have their masters, a few PhD’s in biochemistry. Out of those who have done research, many are published first authors. And while not having research will not hurt your application, having done research is a big plus to your application.

So that brings me to the question, should I do research because it will make me a more competitive applicant? I believe the answer is a clear NO. You should not do research if you know you hate it. Now, if you have a slight interest in research, you should give it a try, but by no means does anyone expect you to come out with several publications and a thesis. You should only do research if you think you will enjoy it!

For the people who decide not to do any research, they may feel that they are at a disadvantage, but that’s not true. You’re only at a disadvantage if you don’t do anything with all that “non-research time”. Many applicants who pursue a research position put in a lot of time during the school year and their summers. They would have put in hundreds of hours into their project, learning experimental techniques and writing up their findings. For their hard work and demonstrated intellect, these applicants should have an advantage. If you are a non-research applicant, you are only disadvantaged if you don’t use your time wisely.  With all that time during the school year and especially the summer, you could use it to volunteer and pursue other endeavors. You could use that time to teach lower-income kids or organize community-based events.

Now if you do decide on doing some research before medical school, you will have to proactively seek opportunities. No research job will fall into your lap, you will have to email profs, meet with them and demonstrate to them why you will be a good student. [Coming soon: A guide to getting a research job]

Overall, research is an integral part of medicine and medical schools want students who have that intellect and curiosity to discover new things. Academic medicine also has the aim of transforming bench side findings to real bedside cures. You will demonstrate to medical schools that can contribute to the knowledge of medicine in the future by having some research.

3) Other / Personal Interest - The last category of activities admission committees look at is everything else that doesn’t quite fit in clinical and research activities. This includes sports, musical instruments, artwork, school clubs and groups, religious and cultural affiliations, employment, hobbies, past-time activities… you get the point. To the admissions committees, all these activities show two things, (1) that you are a “well-rounded” applicant and (2) your personality / character.

Now I see a lot of threads on the internet that butchered the “well-rounded” applicant theme. A lot of people think they have to be involved with 10 different clubs and have diversified interests to be considered well-rounded. They need to play 3 musical instruments, 4 different sports, and converse in 5 different languages to be considered well-rounded. They need to keep adding activities to their list to be more competitive. This is not true!

First and foremost, the point of having any extracurricular activity is to show that your life isn’t just about school. You need to have a life outside of your books and classrooms. You are more than a GPA and MCAT score, you are a human with thoughts and feelings. Medical schools don’t want a class of bookworms who are holed up in the library all day. Yes, they want smart and hard working people, but they won’t want one-dimensional people. They want people who will bring diversity to their class and make it exciting. Students that professors can talk with and find interesting.

For example, something as simple as playing in the school’s sport intramurals or speaking a second language at home is something worth putting down. Put down things you enjoy doing. One thing that keeps getting pounded into our heads by professors and physicians at our medical school is that you need to find time for yourself. Medicine is such a demanding career that it becomes too easy for your job to consume you entirely. Find activities you enjoy and that you can do to relieve stress. Medical schools want people who can work hard yet not be burnt out at the end of all the training.  Having some personal interests down is essential to showing to medical schools that you are more than a one-dimensional robot.

Also, the well rounded applicant isn’t a laundry list of activities. A lot of first year pre-meds during clubs week get carried away and join way too many clubs, many of which have no interest to them. They only participate in clubs because they think it will look good on their applications. They usually join a bunch of cultural clubs, a lot of volunteer groups and several dozen interests group. They are “resume-padders” and admission committees can sniff these people out a mile away. Also, don’t waste your money on a premed club membership fee. Don’t be a resume-padder. Focus your activities to YOUR interests and things that represent who you are.

It’s good to be involved with a lot of different activities but it’s not good to spread yourself thin. If you find your grades are slipping and school is getting out of control because of these “clubs” and volunteering activities, you have to do some self evaluation. If you feel overwhelmed by the amount of work needed to be done, don’t be afraid to drop extracurricular activities. Remember, you are volunteering your own FREE time to do these activities. If you find something not useful to you, don’t do it. I once applied to a “research” position with a professor that ended up being a data-entry job. I would read patient data and scan them into a computer. Even though you had to apply to the job and be interviewed, after the first session, I said no thanks and decided I could spend my time much better. Use your time wisely and don’t be afraid to say no. Because no amount of extracurricular activities will make up for a poor GPA and low MCAT score on your application. So school first, then extracurriculars, but don’t be just all about school.

When choosing extracurricular activities, the most important part is to choose activties you are interested in and that represent you. If you enjoy teaching, a tutoring job or working with ESL students would both be meaningful and representative of you. You also won’t find doing your job tedious if you enjoy it. No longer will it feel like you are being dragged to another 2-hour session, but instead you will look forward to each session. If you’re interested in a lot of different things, you will have to prioritize. Which activities do you enjoy more. Would you rather be on a varsity team or be in a culture club. A good way to assess how much one person can take on is to add the activities on slowly. Instead of joining twenty clubs at the beginning of the year, pick a few that you know you would enjoy. It could be the badminton club or a movies appreciation club, whatever it is, pick a few and stick with it. Try to get to know the people there and contribute. And afterwards, if you think you can manage, add more clubs and activities. Don’t worry about joining late, all groups are always looking for new people, no matter what time of the year.

I have found myself that I can manage about 5-6 different activities on top of my school work. That includes a part-time job, some volunteering with new students (note: volunteering doesn’t have to be only at a hospital), a sports oriented club (for the exercise), a student help group (where I had a leadership position) and a personal self interest club. During relaxed parts of the year, I would do more. At exam time, I would cut back. Having a group of friends outside the classroom also helped relax after a tough week of school.

The second reason why schools look at extracurricular activities is so they can get to know you. They want to see what type of person you are and what interests you have. Schools want to see leadership, organization, good communication skills, conflict-resolution abilities, dedication, and passion. Whether it is student government, club executive positions or work responsibilities, schools want to see these good attributes. They want students who will be positive influences in both the classroom and the community outside.

For instance, with any highly specialized skill schools can learn a lot about you. If you are a  competitive varsity athlete or a accomplished pianist, medical schools can see that you are dedicated to an activity and that you aim for excellence. They see that you are hard working and you practiced consistently to achieve your goals. Schools can see your character through the things you do. Simialarly, if you have been a community-organizer or a fundraiser for health issues, medical schools can see that you’re concerned about the people around you and that you want to make a difference.

Closing Remarks - I have written about what schools look for when they look at your autobiographical sketch or your list of activities. They are looking for characteristic traits that will make you suitable for a life of medicine. They want people who can work hard and play hard when the time is right. They want people who will be positive impacts on their communities and have the self-discipline to accomplish their goals.

To answer the first question of what extracurricular activities should I do: The answer is different for everyone, we’re all different and we have our own interests and hobbies. Choose a few things that you are interested in and do your best in them. Don’t force yourself to do stuff because you think it will help you get into medical school, do what you are passionate about. If you want to increase your chances of getting into medical school, in whatever you do, do your best and show that you have the characteristics and traits of what it takes to be a good doctor.

Homogeneous Classmates

If someone was to ask me what I thought about medical school so far, my one-word answer would be interesting. The material we cover each day is fascinating both in basic sciences and its clinical applications. The teaching style is also diverse ranging from lectures, small group work, anatomy labs and clinical shadowing where we are currently doing some role-playing (playing doctor all over again). I am only beginning to realize the limitless of medicine. If you’re afraid of being bored in a career of medicine, I guarantee there is no way to sail and master all of it.

After a month of school, I’ve gotten to know a bit more about my classmates. They are an interesting bunch. Some go out to bars and parties 3-4 days a week. Others, I only see in the classroom. During small group learning sessions, it’s not too uncommon to find a peer has a master’s degree on the subject of the day. A few have just defended their thesis and some are partway through their MPH (Master of Public Health). Some play football, hockey and soccer and some have no athletic background. Several students can play songs by Liszt and Chopin on the piano beautifully and another student plays online-poker to pay for his tuition. It’s an interesting mix. You can sense the talent in the class. You can smell the ambition.

I have found again and again that becoming a doctor isn’t all about being smart. Granted you have to be at a certain level of intelligence to get into medical school and pass the premedical curriculum, a bigger factor is dedication and drive. It is only with great inner motivation will someone choose to spend their twenties and possibly thirties in a library studying. Only true dedication will push a person to complete 30-hour shifts and go on call 1 in 3.  To anyone else finishing your ER shift at 5am, runing home to drive the kids to school and teaching class at 8am, while pregnant, would be considered insanity. To my preceptor: I am amazed at your abilities.

To anyone thinking of becoming a doctor, carefully consider your commitment. The road is long (10 years+ of minimum education) and an average of $150,000 dollars of debt after graduating. Rising overhead costs and chances of malpractice lawsuits and the risk of patients dieing is all part of medicine. It’s not all about saving patients and curing diseases, there are a lot of disadvantages to a career in medicine. Even as a first year student, I realize that entering medicine is not like a small dip in the swimming pool. It’s much closer to jumping off a cliff into the unknown waters below, both frightening and exhilarating .

Medical School Parties and Medical Student Partyers

Along with the first few classes of medical school are the medical school parties. These social events mainly for classmates to know each other also act as a way to relieve some stress and have some fun before the serious business begins.

Over the past weeks, I’ve observed that medical students throw crazy parties. I went to a relatively relaxed undergrad where things got pretty loud from Thursday night to Saturday night. But medical school seems to be a whole other animal.

Perhaps med students are just having their last ounce of fun before the workload hits, but I think it’s because the students are older, have gotten over that awkward stand-at-a-party stage and know how to have a good time. They have studied more, drank more, smoked more, talked more and are at different stage in their lives. They stand at the end of their old undergrad days and can see the long road in medical education ahead. Perhaps, that is a reason to cherish every moment. To live life as if you’re invincible and that everyday could be your last.

Now granted this isn’t our entire medical class and only a fraction, having medical students that know how to party is not a bad thing. You might say it is irresponsible to have our future doctors abuse alcohol, smoke and yell obscenely. Instead they should be in a library studying their sciences and thinking of ways to fix our health care system. Or they could better spend that time volunteering at a hospital or teaching inner-city kids or “insert cliche pre-med extracurricular activity.”

But the bottomline is: Medical students are regular people too. They watch TV, surf the internet, travel. Some are health freaks, some are fat. They want to make friends, succeed in their work, have a good time. Hosting and going to parties are no different. If anything, medical students that know how to party and have a good time may end up as better doctors.

This point didn’t hit me until one of our classmates at a party was puking from too much alcohol. Surprisingly, the first people to check up on him and to help him out weren’t the people you would have considered to be good doctors. You know who I am talking about, the ones that spend most of their time studying, they have a flawless record of good behavior. They don’t cuss, drink, smoke, gamble. No, it was the people who would be labeled as “party-ers” and “bad students” that were the most responsible. The loudest and most outrageous students were the ones who took action first.

These were the students that acted like real doctors in the situation. They got their hands dirty. They were the ones talking to the half-passed out person, asking them if they were ok and how they were feeling. They were the ones who wiped the mess up and helped the person vomit even if it meant getting some on their nice clothes. They took charge of the situation, asked people to back up and give some space, fetched the water and blankets and helped find a place for the sick to rest. These are the people I would want to take care of me.

As for the people that you would typically think would make good doctors, they stood back and just watched. Some commented, “I’m glad I’m not that person” and others said “I would be ashamed if I drank that much and made such a fool out of myself.”

Medicine is half science, half art. For the first two years, medical students will learn the inner workings of our bodies and how our cells, tissues and organs interact. They will be required to know how the pH of the body fluctuates and the effects of chemicals and drugs on our bodies. But throughout this time, they will also be learn how to communicate clearly, how to listen and how to interact with a patient. The art and skills of “doctors.”

Partying medical students may seem reckless spending their time at social events and their money on booze. But they have a perspective that most others lack. They know how to socialize with others and make connections in a short time. They know how to make people feel comfortable and welcome. They have first-hand experience of what it’s like to have your face in the gutters (toilet bowl) and I am sure this experience will be with them when they become real doctors. They will have empathy (an understanding) for their patients and will have compassion (action) to help them.

A medical class is diverse as pointed out in my last post. Every class will have its share of bookworms and party animals. Each one was admitted because the admissions committee saw potential in them to become great physicians and surgeons. Each person has something different to bring into the medical community.

To summarize my main point: There’s more to each person than meets the eye.

First Week of Medical School

The first week of medical school has been quite an experience like no other. I am at a lost for words to describe it, so instead I will use numbers and statistics to best capture my feelings.

Number of applicants: 1388
Applicants Interviewed: 451
Total Positions Available: 150
Final class size: 150

Mean GPA of entering class: 3.8
Mean MCAT score for each section: 11
Mean Writing Sample: Q

Number of students with a BSc or BA: 117
Number of students with a Masters: 7

Number of students with a PhD: 3

Number of students with an B.Eng: 2
Number of students with a Theology Degree:1
Number of students with incomplete degrees: 11
Number of students with an M.D: 150 hopeful

First Day of Medical School

Today was the first “official” day of medical school. I got to meet a few more of my classmates, the names and faces are still not sticking. I might have to go study facebook to remember them. One thing different from undergrad and medical school is the talent of the class.

No longer are these unsuspecting first year undergrads unprepared for an academic workload. All these individuals are bright, motivated and hardworking. They all had stellar grades, good MCAT scores and meaningful extracurriculars.

It’s probably just the new-school jitters, but it’s always unsettling not knowing where you stand in the class. I might be at the top of the class or I can very well be at the bottom of the barrel. Only time (and the first test/exam) will tell.