Super Star Blogs!

A Day in The Life of an Intensivist

The very first day of my problem based course in medical school, our Dean of Medical Education went around the table and guessed what each of us would end up doing for the remainder of our medical careers. When he got to me, he said, “Dale, you’ll be a critical care intensivist.” I smiled in agreement although I had absolutely no idea what that was. 11 years later, as a practicing Pulmonary & Critical Care Intensivist, I know exactly what that is. Dr. Hosakawa was right.

During my residency training, I was determined to focus my career on things pertaining to business and entrepreneurship within medicine. I had applied to and was accepted into a Health Service Research Fellowship and was one step away from matriculating into one of the nation’s best MBA programs. Then I did my ICU rotation. Where I trained, the ICU was a beast to deal with. Q3 call (i.e. every 3rd night we stayed in the ICU for a 30 hour shift) with some of the world’s most complicated medical patients. The loud beeps, oddly shaped machines, and unconscious patients were enough to give me nightmares. But the rush of the code, the gratification of revival, and the smile on a patient’s face were more than enough to give me pleasant dreams. After seven straight weeks of q3 call in the ICU, the decision had been made. I’d go on to do my pulmonary & critical care fellowship while at the same time, working to bring my entrepreneurial visions to fruition (but that’s a story for another time).

When my doctor hat is on, my greatest joy comes from being in the Intensive Care Unit (ICU). There’s an understanding that the “buck stops here.” When everyone else has done what they can for the patient, if things aren’t going well, that patient will likely end up in the ICU. Everyone looks to you, and if you and your team can’t figure it out….

My typical ICU day begins at 6am. That’s when I wake up 😉 (not when I get to work). By 6:50am I’m on the road and at work around 7:30am. Some people would say that’s a long car ride, but it’s just time for personal growth as I listen to tons of audiobooks in attempt to be my very best. From 7:30am to 8am, I do a cursory review of the patients in the ICU to make sure there were no major issues overnight or anything that needs to be handled immediately (e.g. actively dying patient). Then at 8am, the games begin.

One of the things I love most about my job is I get to teach residents, fellows, and medical students. I also allow premeds to shadow (so if you’re in the Dallas area send me a message on PreMed StAR). Mornings rounds begin at 8am as the team gathers around a large table. Typically, the post-call resident (the one who worked overnight taking care of patients) then presents their patients. We get all sorts of things in the ICU. Heart attacks, ILD flares (somebody look that up and post a comment/reply to this blog explaining what it is to everyone), pulmonary embolisms, septic shock, etc. It’s really exciting to sit down at that table and have no idea what the resident is going to tell me. It’s almost like playing detective.

We typically do our sit-down rounds from 8am to around 9am. This is when we hear the case presentations of the new patients, look at labs, EKG, X-Rays, and all other supporting data that helps of take care of our patients. It’s an ideal time to do short lectures/chalk talks to teach the new physicians various pearls in caring for critical patients. Often times we teach in the form of “pimping”. No we’re not putting them out on a corner. Pimping is a method of teaching in which we choose a trainee and ask them question after question after question. When intense enough it’ll make anyone sweat. Personally, I’m not much of a “pimp” myself because I remember the anxiety that comes along with the string of questions, but it is an effective way to teach. Trust me, when you’re pimped in front of your peers, you’ll remember the answers to the questions you missed and read up ahead of time to make sure you’re ready for the next session. However, there are plenty of other effective methods that can be used to teach.

From 9am to about 11am, we do our walk rounds. During this time, we get up and walk through the ICU. Before we enter each patient’s room, the resident presents the events that occurred overnight. We then look over vital signs, consultant notes and ask the nursing staff if there are things they need us to know or orders we need to write for them. Next, we enter the patient room to examine them, look over the various life support machines (e.g. ventilator, dialysis machine, etc.), and ensure the IV medications are appropriate. Once walk rounds are over, the trainees usually do any procedures we need done and if they need any extra assistance, I’m there to help. The rest of the day is spent putting out fires (e.g. code blues, respiratory codes), writing notes, and doing more teaching.

There are few things I enjoy more than serving critically ill patients. The life of a physician is wonderful and once you find the perfect field for you, there is plenty of joy to be found. Perhaps next time I’ll share my passion for entrepreneurship in a blog.

My question to you this week is; What field of medicine are you interested in and why? Post your comments below so others can learn more about you!  

Congratulations to Jonathan! Premed of the Week!

1. Tell us a little bit about yourself.   I am entering my senior year as a full time student at the University of St. Thomas where I will be receiving a degree in Biology under the pre-medical program. Like myself, everyone who pursues a career in medicine has a unique story about how they achieved their dream. The hardships and the lows are what motivate me in this competitive field. From having teachers laugh in front of me when discussing my goals, to not being given a chance due to my speech impediment when I was younger or because of my background. This causes the release of adrenaline to prove many wrong and is one of my motivations to not quit on this enduring journey to becoming a physician.

In addition to the educational side, I am an avid photographer and heavily involved in fitness. I love to lift weights, play basketball while training and educating friends and clients about living a healthier life, without entirely giving up all the delicious food and desserts.

2. Who was your favorite teacher in school and how did he or she impact you?  My favorite teacher would have to be a tie because they both have helped my so much in my pre-medical journey. They are Dr. Amin and Dr. Ribes. They both have the heart to elevate students to their potential and assist the student in accomplishing their goals. Dr. Amin would be harsh and criticize you to the point where you are depressed and want to drop out of the university and find another career path. But when he is done he will make a plan for the student can improve and grow as an individual. For Dr. Ribes, he also helped with making a plan for the student to succeed and will give advice that is best for the student, not from the eyes of the professor, but as a father and someone who has witnessed the same pre-med to medical school journey time and time again.

3. When did you first decide you wanted to become a doctor and why?   Becoming a physician was just a thought in high school because I was always fascinated with how the body works. While I lift weights and especially when I do powerlifting, I think about what is causing the lactic acid buildup the next day after a workout? Or how much rest is really necessary between sets for my muscles to get sufficient oxygen to have peak performance? While in college, my reasoning changed a bit. Seeing that my culture is underrepresented in the medical field, I want to be a role model, and more importantly a voice for the younger generation, to end the cycle of hispanics dropping out of high school and working jobs that cannot maintain a healthy family.

4. What area of medicine are you interested in?  Since I currently work in the emergency department as a scribe, it is a toss up between emergency medicine and family medicine. But I do plan on undergoing a fellowship in sports medicine to work with athletes and sports related injuries and prevention.

5. What’s the coolest experience you’ve had so far on your premedical journey?  Besides the random and crazy stories from my time in the emergency department, the coolest, or most eye-opening experience as a pre-medical student was when I volunteered at HOPE Clinic. This non-profit clinic is run on volunteers and is huge on nondiscrimination, making people of all shapes and color welcome; they offer around 15 different languages as all the employees speak at least 2 languages and many translators on site. With the increasing cost of healthcare, people cannot afford to be sick. At HOPE Clinic, they worry about treating the patient instead of the dollar signs. They offer payment plans, reduced plans, or even free visits and prescriptions depending on the patient’s income and situation. This showed me that in medicine, one must have heart and compassion and goes beyond the general and overly used, “I want to be a doctor because I like to help people” motto.

6. What is your favorite book?  At the moment, Kaplan’s 7 book MCAT review since I have the exam coming up pretty soon.

7. Tell us one thing interesting about you that most people don’t know.  I am very interested in movie production. On how the music such as that of Frank Sinatra and how it blends into a particular scene and how the use of technology changed the way movies are made. Which is one reason why there are so many reboots being made to make the scenes more realistic.

That’s a Dumb Question!

You’ve heard it over and over again. “There is no such thing as a dumb question.” But is this true?

I am guessing most of us do not believe this to be true. We’ve all heard someone ask that question that makes us drop our jaw in awe. “Did they just really ask that?!?” “What did they mean by that question?” The type of questions one asks tend to speak volumes about them. Anyone can look up an answer but what they ask reveals their innermost thoughts. The “no such thing as a dumb question” statement is really intended to encourage engagement and question asking but I am not sure many people truly believe this. Even if there were no such thing as a dumb question, there is such a thing as an inappropriate question. That is usually evident by the receiver’s reaction. As premeds, med students, interns, residents and even attendings, you ask questions on a daily basis. Questions are very necessary for growth and understanding. Here are some question types we sometimes use that may leave an unintended negative judgement from the hearer of the question.

1. The Lazy Question: I’ll be the first to admit that I myself am guilty of this once in a while. We sometimes ask a basic question although the answer is sitting right in front of us. For example, after a long work week I will sometimes go to a restaurant. Instead of simply reading the menu, I sometimes ask the server to tell me what’s on there. Not cool. As a premed, if a professor has provided you with instructions on a project, it is best to read what he or she has given you before asking questions they have already answered. It is always appropriate to ask a question to clarify your understanding but unwise to ask something you have easy access to resolving on your own.

Quick Tip: Try to ask informed questions. These often open with, “You wrote that …” or “I see in your instructions …” or “In my reading, I noticed…”. This lets that person know you have done your research ahead of time.

2. Wrong Person Question: You probably shouldn’t ask a mechanic about the newest fashion trends or your grandmother about the newest rap group unless they are into those things. Although usually subtler, asking questions to the wrong person is very commonly done. As an attending, I am now more conscious of this but I am certain I was guilty of this one as well during my training. This is something you may also want to avoid when on the interview trail. You will have the opportunity to ask a ton of questions on each interview. You should not be asking your interviewer about fun things to do around campus or what books to buy. Reserve these types of questions for the students you meet.

Quick Tip: On the interview trail, make sure to categorize your questions based on who is best suitable to answer that question. Learn a little about that person and what they do if you want to impress them.

3. Poor Timing Question: Kids always say it, “Are we there yet?” This question can be rather annoying unless it is asked at the right time (when you really are almost there). If an instructor informs the audience that a particular area will be covered later in the lecture then questions on that topic should be reserved for that time otherwise that instructor will be doing a whole lot of repeating. This may bring frustration to the instructor who may be pressed for time as well as others around you.

Quick Tip: Patience is the key here. You may have a good question in mind but if it will likely be covered later then reserve it till then or ask it at the end. If you are not sure if they will cover it start the question by saying “You may cover this later…” or “Will you be discussing…”. Be respectful of that person’s time.

4. He/She Just Asked That Question: Pay attention. I always felt bad for students who repeated a question that was just asked in class because it made me think either (1) they were not listening in class or (2) they showed up late to class and missed the question. I suspect the professor was also thinking the same thing as was the person who asked the original question. It is completely understandable if this occurs once, but if a student consistently does this it’ll eventually hurt them.

Quick Tip: Simply pay attention. If you show up late for class or meeting and are not sure if your question was already asked, you may want to reserve it to the end or (if in the appropriate setting) ask your neighbor if it was already discussed.

5. I Don’t Want to Be Here Question: Be prepared, because throughout your training there will be plenty of places you do not want to be. Sometimes it will be because you are bored or sometimes it is because you would rather be elsewhere (like studying). You may be doing research, shadowing, or volunteering in something that does not interest you in the slightest bit. Your only way out sometimes seems to be by asking a question. I have watched so many of my colleagues get bad grades and evaluations because they appeared so disinterested in the rotation and solidified this by the type of questions they asked. “How long will this next case be?” “Do I need to be here the whole time?” Don’t get me wrong, if you really need to be elsewhere and are able to craft a good question that is fine but be wise about this because some people are more sensitive to this than others.

Quick Tip: Fake it till you make it. Many premeds give it away that they really don’t want to be there. This is part of life. Some of my best learning has taken place attending mandatory events or activities I really did not want to be at. You may be surprised that some of your thoughts were misconceptions. If your time will be better served elsewhere, be real with that person and tell them exactly why you need to be dismissed rather than being sly with a “I don’t want to be here”-type question.

And finally, just for laughs check this out:

https://www.youtube.com/watch?v=RLt1HoAPniM

Written By Dr. Daniel

Image Credit Pixabay

Congratulations to Will! Premed of the Week!

1. Tell us a little bit about yourself.   I’m a nontraditional full time student. I’m also a full time 911 paramedic. I’ve been a paramedic for over 15 years. I work in NYC, but I attend school and live in PA. So my commute is approximately 1100 miles per week between school, work and home. Personally, I’m proudly raising my daughter Hannah, who is 4 years old and I compete in MMA/boxing.

2. Who was your favorite teacher in school and how did he or she impact you?  My favorite teacher is my Calculus Professor, Dr. Noblet. Taking this course during the summer has been more than challenging for me, but she had been very helpful and encouraging. She has a true passion for teaching, and it shows whenever she is in front of the classroom. She expects nothing less than 110% effort in all of her students. And to have someone believe in me that much gives me even more motivation to succeed. Dr Noblet is a wonderful person and professor.

3. When did you first decide you wanted to become a doctor and why?  Becoming a doctor wasn’t something that I decided on. Cliche aside, its something that I was meant too be. My greatest joy and passion comes from treating and helping the sick. My mother told me that from since is was able to walk, whenever someone got hurt or was crying, I would look for ways to take care of their boo-boo. As I got older, I had many operations performed on me. But regardless of what was going on with me physically, I always wanted to help to person beside me. I would ask the doctors 1000 questions a day about treatments. why this and why that. I’ve always had a love for the science of helping people. Learning how to care for people. And the practical application of treating people. I believe that physicians are literally the hands and instruments of God. The impact that a Doctor can have on a patient is profound. I experience that on a smaller scale as a Paramedic. I desire to care for a patient from the time they walk into the hospital to the time they walk out.

4. What area of medicine are you interested in?  Because of my work background, I have an inclination towards emergency medicine. But I like to work with my hands building things. So I find myself very much interested in Orthopedic Surgery.

5. What’s the coolest experience you’ve had so far on your premedical journey?  My coolest moment occurred outside of the classroom. I was sent to an ob-comp inside an apartment building during the winter. When my partner and I got to the patient, she was in a unlit apartment laying on the floor. Her water has already broken and she was in labor. As we were preparing to deliver the child, I saw that the child was breached. The child’s left foot was out and we noticed that the child showed signs of poor circulation. Further examination showed that the umbilical chord was wrapped around the child’s neck. The Fire department arrived and all the firefighters shined their lights upon us. My partner went to stabilize the mother as I delivered the baby. Once delivered, the child was in respiratory arrest, so we began resuscitation efforts. Thankly, both the child and the mother were both fine. A week later, I received a letter at my job, written by the patient. She thanked me and said that she named her child after me. I was so humbled and honored.

6. What is your favorite book?  I have so many, but my absolute favorite is the Alchemist.

7. Tell us one thing interesting about you that most people don’t know.  I love riding motorcycles.

A Guide To Completing Secondary Applications

By Josten Overall and Nick Arlas | July 21, 2017

It seems like all of the pre-meds we run into these days are all in full-on secondary mode, and if you’re reading this you might be too. If you haven’t received secondaries yet, don’t panic! It’s just a matter of time before these apps start showing up in your inbox!  It can be a stressful time, as the onslaught of additional apps seems to come all at once post-verification by AAMC. At first it’s exciting, then a bit unsettling, and finally it can be overwhelming. Remember, the secondary application is a critically important part of every medical school application. This is your opportunity to sell yourself on why you’re a great fit for each school that invites you to fill out a secondary. While your primary app is your introduction to medical school programs by highlighting your metrics, work and volunteer experience, the secondary application is your opportunity to persuade each program why you are a candidate whom they should interview. Here is our list of top tips for writing strong, powerful secondary essays!

1. Know the school:

As a medical school applicant, it can be challenging to remember key details about each school to which you apply; however, it is important to understand the school’s mission statement and other unique aspects about the program or curriculum. Having a good understanding of the school and being able to identify why you specifically applied to that school, will help you answer questions that ask about “fit,” “how you identify with the mission statement,” and “how will you contribute to the class and community once accepted.” To do this, visit the school’s homepage and spend some time clicking around. We strongly recommend that you do your research before diving into a secondary app. You may find a specific opportunity that you are excited about, such as a student-run free clinic, a research institute, or a volunteer opportunity. These are things you should mention in your essay, and it shows the school that you actually want to go there and that you know what you’re talking about.

2. Take breaks!

If you ever find yourself hitting a mental roadblock while writing secondaries, remember that it’s more than okay and often necessary to take breaks! Leaving the mental and physical space in which you write your secondary essays, will allow you to recharge and return to your writing space with an open mind and new-and-improved ideas. Taking a break to grab a snack, go on a quick walk, or do something else that you love, will allow you to make productive use of your time, and not become too overwhelmed by the writing process.

3. Provide concrete examples:

Many secondary essay questions will ask you to describe a previous experience or role how that applies to your interest in medicine or to your future success as a medical school student. While you may describe the general details of why that experience was significant, describing a specific example and how that impacted you will may your message even more powerful. For example, you may detail some of the work that you did on a medical mission abroad; however, describing a specific scenario of a significant interaction you had with a patient, colleague or community member, will paint a more vivid picture of what you contributed to and learned from that unique experience. Many applying students will share similar volunteer, work, research and outreach experiences, so using a personal narrative or example will allow your essay to shine!

4. Have others review your work:

Just as when you were writing your personal statement for your primary application, receiving feedback is an important part of writing your secondary essays. You may have also learned that having multiple peers, mentors, or academic faculty review your personal statement can be overwhelming. Each person who reads your essays will have different perspectives on what works well and what doesn’t; you must take any suggestions with a grain of salt. If there was someone who helped you put your best self forward in your personal statement, they are a good person to consult for your secondary apps as well. Reach out to reviewers who can help you make sure every word counts, and that you are conveying exactly what you mean. Over time, you may find that you have become quite adept at secondary essays, and feel that you no longer need to reach out for support. If so, know that you now have the confidence and skill to write some great secondaries!

5. Recycle, but with caution:

A classic mistake that you’ve probably heard is that someone copy/pastes an essay and forgets to change the school name. One of the authors (cough Nick cough) accidently repeated two sentences in separate questions for the same school by doing this. With so many of the prompts overlapping or asking the exact same question, it is important to recycle your responses but to do so carefully. Done right this will save you time, but it can lead to rushing the process which makes you more likely to make the copy/paste mistake. To avoid this, read all of your essays carefully, and customize each one. For example, you will come across an essay about what your experiences are for the upcoming year, and this one is ripe for recycling. However, each school will ask it slightly differently, and have different character requirements. Use the framework from earlier essays, and build out a custom response for each subsequent secondary that asks the same or a similar question.

6. Response time is important:

Secondary season is a rough time for everyone going through the app cycle, but this is a time to really push yourself. It will be a true test of your endurance, especially if you are balancing other commitments like work or school. Set yourself up with a scheduled time each day to work on your secondaries, and push yourself to have a quick turn around time. Interviews are granted on a rolling basis and it is in your interest to have your application in as early as possible. Prioritize the schools that you are most interested in and work your way down the list. Celebrate the victory of each submission and know that they will get easier as you complete more of them and can draw on material that you’ve already created (see tip #5).

7. Use forums for specific information, but do not dwell:

Much like a surgeon you want to know exactly what you looking for when spending time on SDN. Navigate for the school specific thread and use Control-F to search key terms related to your inquiry. Do not get sucked in to whether people have heard back about interview invites, as it does not help you and can be an added source of anxiety during an already stressful time.

8. You can still add schools to your application:

You are still able to add schools to your primary application, and those of you that have applied to a small number of schools might consider increasing your chances by adding some more schools. It’s still relatively early in the cycle, so take a look at the MSAR and apply to as many schools as you can afford. Note: you should only apply to schools that you would actually go to if you were accepted.

9. Money stuff and when to ignore a secondary:

You may find that you applied to a school that you actually are not interested in, and know that it is OK to ignore a secondary invitation and decide not to apply to a school after all. At nearly $100 dollars a pop, knowing that it’s all right to let a few go can help you save for airfare and interview travel expenses. You should feel comfortable ignoring a secondary if you are no longer interested in the school.

10. Remember you are running your own race, and it’s a marathon!

By now you’re probably getting a play-by-play from all your premed friends about how the app cycle and secondaries are progressing. Ignore the noise and focus on your applications. It is crucial that you stay disciplined, work on them every day, and take comfort in knowing that this challenging time is not going to last forever. If you keep your blinders on and run your own race, you will be in a better spot than if you spend time worrying about what other people are doing.

Best of luck to all of you!

Top 5 Tips to Build a Valuable Network

You’re only as strong as your network, and that’s as far as success will take you. Unfortunately, this is something many people do not learn early enough in life, or do not take seriously. In America, we are made to believe that if you have confidence in yourself, you can accomplish anything…That’s not necessarily true. Yes, confidence is part of the equation, but we typically accomplish more together than alone.

I have been amazed by the feedback we’ve received from PreMed StAR students pertaining to how much this community means to them. Multiple students have reached out to us and noted that this network has added extreme benefit to their premed journey. Each time I read one of these messages, I am pleased because I know these individuals are understanding the significance of team, community, and network!

It is important that you strategically grow your network. The people closest to me all bring something of unique value to the table. No two are exactly alike. They are all serious about their life’s work (not job, but work…there’s a difference) and they are all generous. These are the type of people you want in your network if you desire to accomplish great things, and these are five tips to help you build such connections.

1) Explore: You can’t grow your network if you’re not willing to meet new people. This is the first barrier that you must overcome. If you want to grow your network, you have to want to grow your network. In order to do that, you must step out of your comfort zone to meet new people. Also, a key part of exploring is meeting different people. A network full of people just like you isn’t nearly as valuable as a diverse network with people of varied backgrounds, experiences, careers, etc. Be willing to explore, meet new people, and learn new things.

2) Give More Than You Receive: This is perhaps the most important aspect to building a valuable network. In today’s society, we are told to focused on self. We are taught that we should go out and “get ours”, don’t worry about other people. That is a mistake. At the heart of everything you do, benefiting others should be the primary driver. The byproduct of helping others is they will see that you genuinely care, and in your time of need, they will be honored to stand by your side.

3) Listen: This is the little secret that drives many people straight up the ladder of success. Have you ever been in a meeting where one person is talking and talking……and talking. I don’t mean that annoying guy or gal who everyone knows is off their rocker, but rather, the person who is able to trick people into thinking he or she has the best ideas in the room. I’ll share this little truth with you, more often than you may realize, the intelligent and devoted individuals who actively and intensely listen then speak are the real movers and shakers. You can’t know what people need if you don’t listen to them. You can’t solve a problem if you can’t describe the problem. If you master the art of listening, you can more effectively accomplish tip number two above.

4) Invite: A mistake that many people make is trying to jump on board other peoples’ train too early. When I say invite, I don’t mean invite yourself to their function; on the contrary, I mean invite them to your function. The fear of rejection too often prohibits us from inviting people to join our activities and into our lives. Yes, we do get rejected many times, but this isn’t because people don’t want to be around us; it’s just that people are busy. If you think someone is worthy enough for you to invite them somewhere, that means other people probably agree and have also invited them somewhere. Don’t be afraid to extend an invitation. Just make sure you pick up the tab.

5) Confirm Via Connect: In 2017 part of networking means connecting on social media. It’s a really strange thing actually. If you’re not connected with me on Facebook then we mustn’t really be friends. That’s obviously not true, but that’s how many people feel. As a premedical student, of course I would suggest you connect with other premeds on PreMed StAR. The simple action of sending a connect request to somebody when they are not present shows that you were thinking about them.

Build a valuable network. You might not think it’s worth your time to start working on this today, but tomorrow you’ll want to have it. One last piece of advice, always remember that the network is not about you. It’s about leveraging each other so you can serve others. That’s why we’re here, to help others!

Let me know which of the five is your favorite, and what other tips you have!

Congratulations to Kirsten! Premed of the Week!

1. Tell us a little bit about yourself.  My name is Kirsten, but call me Kirsti. I major in Biology with a chemistry and a studio art minor. I grew up in Idaho and I’ve been skiing since I was 2 years old. I moved to upstate New York my senior year of high school, and I began my college career at SUNY Plattsburgh. I loved my friends and many of my professors, however ultimately the school wasn’t for me. I recently transferred to Union College where I will start classes in the fall, but to be honest I’m super nervous to start all over again!

2. Who was your favorite teacher in school and how did he or she impact you?  Honestly my favorite teacher has been life itself. Okay don’t roll your eyes, I promise this isn’t just a lame and cliche cop-out of the prompt; I’ll explain: When I was 10 years old a nauseating stomachache began to plague me and I often felt like a blunt knife was stabbing my abdomen. This made being a kid and going to school extremely hard. I am now almost 21 and I still have this stomachache along with multiple new symptoms that accumulated along the way, and none of the specialists I’ve seen so far have offered an effective diagnosis. I was often accused of fabricating my pain to get out of class or when my homework was late. I sometimes wished someone could feel what I felt so they could know how much I cared and that I wasn’t lazy – I was hurting. I have always been ambitious despite my challenges and by junior year of high school I realized I needed to pick myself up in order to succeed. I didn’t need other people to understand or sympathize and I began to realize pity was not going to help me. I befriended hard work, motivation, and determination and I finally understand why the phrase “you are not your illness” is a wonderfully overused chesnut.

3. When did you first decide you wanted to become a doctor and why?  If you had asked 7 year old me what I wanted to dress up as for career day in elementary school I would have asked for a white coat and stethoscope, so in theory I actually always knew I wanted to be a doctor.

After contracting my mystery illness I found myself in many different doctor’s offices over the years and I went through a plethora of tests. I found the whole process so interesting. No amount of questions about what they were testing for, why, and how the test worked would satisfy my growing curiosity about medicine and the human body. I now see my illness as sort of a blessing as I know much of the medical system inside and out from the patient’s perspective. I have also experienced many different types of pain all over my body and I feel this will help me understand and empathize with my future patients in a way no textbook or psychology class can teach. So now I kind of have to follow my dream, right?

4. What area of medicine are you interested in?  Surgery all the way! Probably plastic surgery because it’s so artistic and I can’t think of a better career than being able to work with my hands every day.

5. What’s the coolest experience you’ve had so far on your premedical journey?  My college adviser had been so kind as to set me up with a mentor who is an anesthesiologist. He took me into as many surgeries as I requested and I was lucky enough to see a wide range of surgical specialties. Although I am not interested in anesthesiology for my future career, my mentor absolutely LOVED his job. There was not a day he wasn’t excited to be in the OR by 7 am even after working for so many years. One day while prepping for a case, eagerly drawing all sorts of drugs into syringes, he looked over at me and said, “ I love this sh*t!

6. What is your favorite book?  The Power of Now by Eckhart Tolle because Tolle is THE BEST.

7. Tell us one thing interesting about you that most people don’t know.  I was an acrobat for about 5 years and for a little while I would have been perfectly happy running away with the circus.

Top 5 Reasons Why Students Drop-out of Medical School

I write this blog in order to prepare premedical students for the road ahead. I want you to understand common obstacles facing medical students so you can be better prepared to overcome them. Medical training is akin to a rollercoaster pulling you through the highest of highs and the lowest of lows. On one hand, medical school is extremely challenging but rest assured, it is very tough to get dismissed from medical school. Plain and simple, most US medical schools are extremely supportive and want you to succeed. Students often get many chances to prove themselves before they are booted out of medical school. Despite this, the four-year graduation rate for M.D. students dropped from 96% in the 1990s to 81% in the 2009-2010 matriculating class. So, what is causing students to drop-out you ask? Here are five reasons why students drop out of medical school.

1. Unprepared or Overconfident: No matter who you are, medical school comes with a steep learning curve. You can never be fully prepared for medical school but simply being prepared is good enough. Being underprepared or overconfident can be dangerous. By unprepared, I am not referring to academic challenges. Those who have made it this far have already proven they are academically gifted enough to succeed. Some students who struggle are unprepared in their expectations of medical school. A student who is easily distracted should not reside an hour away from school next to a nightclub. Do not tempt yourself like that. Students should not expect to sleep-in daily or be regulars at happy hour. One thing that sets unprepared and overconfident students apart is their failure to gather crucial information. Often times, these were students who were overly arrogant and felt that by asking questions they would show a sign of weakness. While other students know the big exam was moved to a different lecture hall, Mr./Ms. Unprepared will show up to the wrong hall and miss the exam.

As soon as that “acceptance” letter arrives in the mail, students should begin searching for housing, planning finances, understanding the curriculum, and networking with other students. You don’t want to be dealing with these while med school has already started.

2. Family Stress: A close friend of mine battled with this daily in medical school. Her husband was not very happy that she was studying late into the evenings. It saddened her terribly that she missed her daughter’s first day at school and then her dance recital. These things took a toll on her and by our 3rd block she called it quits. To this day, she still looks back and wonders “what if” she had stuck through and became a doctor but in the end, she feels she made the best decision at that time. There are others who unfortunately have loved ones fall sick during their schooling. Life is very unpredictable and sometimes the decision to take a break makes sense but hopefully one will hang tough or return when they are ready.

When you get that “acceptance” letter, make sure to begin preparing your friends, significant other, and family on what they can expect from you over the next four years.

3. Burned Bridges: Be very careful with what you say and how you treat others (especially around a medical campus and on the internet). You can never judge a book by its cover. If you do, that book just may make life miserable for you. I still remember a buddy of mine who had a firecracker personality. I played basketball with this guy a few times a week. Let’s just say I witnessed a number of altercations between him and other medical students on the court. What many of the first-year students did not know was that this guy was a chief resident and in a few years, rose to a very high position in the medical school. When students make mistakes, or perform poorly in medical school, a committee typically presides over their case. It would be very unfortunate if one of those committee members is someone that student has burned bridges with. In today’s global age, the medical community is tighter than ever. Therefore, there are only a few degrees of separation between everyone.

Once you get that acceptance letter make sure you stay on your best behavior. Remember, that person you are talking to could be your upper resident, faculty, or boss one day. Here is a hint for you during your interview trail. Be friendly to everyone because you do not know who you are engaging and who is watching you. While I took premeds on their interview tours I made sure to speak to the dean about the students who I found to be friendly and especially those who were courteous with the nurses and the cleaning staff. Those to me were the team players.

4. Illness: This is one of the saddest reasons to say goodbye to a classmate. It feels as though everyone expects medical students and physicians to be supermen and superwomen. Well, it’s not so when it comes to being sick. As med students, you are exposed to many unique bugs. Med school also has a way of turning students into transient hypochondriacs as they learn about the pathophysiology behind diseases. Stressors may push susceptible individuals towards depression and substance abuse. In fact, a recent study showed that 27.2% of medical students had depression or symptoms of it and 15.7% sought psychiatric treatment. Schools are doing more these days to address this problem but students must be bold enough to seek help before it gets too late.

Once you get that acceptance letter to medical school, make sure you see your doctor and do your best to get a clean health bill of health or learn coping strategies to deal with stress and adversity. Never ever be afraid to seek help.

5. Wrong Career Choice: Believe it or not, after spending years as a premed and matriculating into medical schools some students realize medicine is just not for them. Our first day dissecting cadavers in Anatomy proved to be too much for a classmate of mine. She fainted and eventually gained consciousness only to see a room full of students and professors surrounding her. This unfortunately shook and discouraged her drive to become a doctor but I believe she eventually gained enough courage to rejoin us. A very intelligent friend of mine left med school to obtain his PhD as he thought he could touch more lives through his research. Yet another friend of mine completed her medical school, residency, and GI fellowship only to leave a very promising academic career at a well-known institution to become a beautician. She felt medicine was more a dream of her parents and not something she was truly passionate about.

When you get accepted to medical school, do a lot of soul searching and make sure this is what you really want to do.

References

1. Caulfield M, Redden G, Sondheimer H. Graduation rates and attrition factors for U.S. medical school students. Association of American Medical Colleges. Analysis in Brief 2014;14:1–2.

2. Rotensterin LS, Ramos MA, Torre M, Segal JB, Peluso MJ, Guille C, Sen S, Mata DA. Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students: A Systematic Review and Meta-Analysis. JAMA. 2016

Written by Dr. Daniel

Image Credit Pixabay

5 Things You Should Know Before Looking for Extracurriculars 

Extracurriculars are an important part of any premedical student’s journey to medical school. Beside test scores and GPA, your extracurricular activities are one of the most important components of your medical school applications. Your involvements and activities become one of the best ways for schools to gain insight on who you are as a person and what kind of student (and future doctor) you might be.

Admittedly, you are probably juggling school, work, and other commitments that prevent you from being able to jump on any project that catches your interest. Here are five things to consider before looking for another extracurricular activity.

1) Reflect on what you’ve done before moving forward

This is arguably one of the most important things to consider before looking for new internships or volunteer opportunities. Be sure to take some time to reflect on ALL of your involvements over the past few years and write them down. (Tip: Fill out your PreMedStar profile to keep your involvements catalogued for future reference.) Once you’ve taken the time to get everything noted down, take a step back and look at your CV as if your were an admissions officer. Pay close attention to the types of activities and dates of duration. Types of activities can be anything ranging from clinical experience, research experience, community service, campus involvement, leadership positions, etc. Medical school admissions is becoming much more of a holistic screening process. Ideally, you want to demonstrate that you are a well-rounded and broadly interested/experienced person. Do you notice that all of your activities fall within one category of involvement? Are any of your categories filled with outdated activities? Do your hours of engagements fall much lower in one category compared to others? These types of questions may help point out any gaps or critical components missing from your extracurricular involvements.

I want to point out that there is no formula for doing all of the right pre-med activities. If any of your activities are unorthodox or unique, highlight them. Pursuing a career in medicine is a huge commitment. Be sure to support your candidacy as a medical student through your involvements. You want to make sure you have sufficient exposure (total hours/duration committed) to research, direct patient care, and leadership experience while also not limiting yourself to just those involvements.

2) Figure out what you’re passionate about

Ideally, everything you list as an involvement will also be something you’re interested in. The idea is that over the course of your time in university, or the years leading up to your application, you will have explored different interests and dedicated significant amounts of time to the activities you’re most passionate about. Signing up for an activity that you are passionate about will feel much less like a requirement and be more enjoyable and beneficial to you in the long run. Never sign up for something just because you feel like you need to. It’s normal and expected that somewhere along the line you will find a volunteer opportunity that doesn’t align with your interests. Get everything you can out of the opportunity and move forward knowing that you’ve put in a genuine effort and explored the opportunity.

3) Be realistic about the time you can commit

Your premedical years can be one of the most taxing and stressful times of your life.Your amount of free time each week is most likely limited by school, work, and other outstanding commitments. Before jumping into a bunch of new activities, be realistic in reflecting on the amount of time you can actually commit. You can’t rush your way into gaining experience. I’ve had multiple pre-med advisers and medical admissions officers tell me that the journey to medical school isn’t a sprint- they’re looking for the marathoners. For example, it’s not enough to say you have significant research experience when you’ve only committed one quarter to working in a research lab. Realistically, every internships/volunteer experience is different. Some of them may be designed to fit within the timespan of a summer or winter break. Besides these exceptions, here is the general rule I was told. You typically want at least one year of commitment. Two years shows significant commitment, and three plus years even more. As mentioned before, you can’t rush experience. If you know you can’t commit to a weekly activity, look for something that is every other week or once a month and plan on staying with them longer to gain that hands on experience over time.

4) Get creative in your hunt

There are tons of people looking for the same opportunities as you. Don’t get discouraged if you aren’t able to find what you’re looking for right away. I’ve had a few friends on PreMedStar ask for tips on how to find clinical/research experience. I will probably make another blog exploring this topic in further detail, but for now here is my shortlist of ways to find what you want. After graduating from university I found it extremely difficult to find new clinical volunteer opportunities as most of the positions I found were prioritized for undergraduates. I had to get creative. I began to search for opportunities that were not affiliated my university or those near by. Never underestimate the power of networking- reach out to people you already know who are in the field you are interested in gaining experience in. If that doesn’t work, look elsewhere. I found a surprising amount of opportunities on LinkedIn, volunteermatch.com, craigslist, and random google searches for positions. If you are persistent and put yourself out there someone is bound to respond.

5) Don’t be afraid to try new things

My last piece of advice is don’t be afraid to try new things. Jumping into a new field may be daunting at first, but there is no way you can come out of an opportunity knowing less than you did before. Explore all of your interests. Look for new things that get you excited and spark your creativity and curiosity. Take advantage of this time to really figure out who you are and what interests you. Most importantly, enjoy your journey and make it a good one. 


How to Sleep Better to Perform Better

How much sleep do you get each night? Is that enough? I’m willing to bet that most of you could use a little more. Thinking back to my premedical days, I could have used a lot more. Those of us with Type ‘A’ personalities often believe that we accomplish more when we sleep less.   That’s not necessarily true for a few reasons: (1) Sleep helps consolidate and solidify our memories (2) Sleep helps us reduce stress levels, and (3) Sleep helps decrease inflammation.

Certainly, there are many more benefits of proper sleep hygiene, however these should remind us not to fall into the trap of believing sleep is a waste of time (something which I often think to myself). Knowing these truths, how can you improve your sleep hygiene and in turn, improve your performance as a premedical student?

1) Daily Exercise: As little as 15 minutes of exercise a day can improve the quality of your sleep. There’s just something special about a decent workout that relaxes your body and makes it easier to sleep well. Perhaps it’s the physical fatigue or just a placebo effect of sorts, but regardless, it works!

2) Adhere to a Sleep Schedule: Among the more important things you can do is stick to a schedule. Having a set bedtime isn’t only for children. Many of the most successful businessmen and women adhere to a strict sleep schedule. It is often said that it takes 3 weeks for something to become habit, so force yourself to go to bed at a specific time for 3 weeks, and expect your internal clock to take it from there. Note, this includes weekends.

3) Bed Time Routine: Having a consistent bed time routine will help you adhere to your sleep schedule. It will also allow you to relax before going to bed. Make sure your bedtime activities are distinct from your other activities and strictly associated with sleep time. For example, some people have a cup o hot chocolate and read for 10 minutes prior to bed each night. It’s typically a good idea to avoid television or any other electronic device. Just dim the lights, read a little, say your prayers, and go night night.

Sleep plays an important role in your success as a premedical student. In order for you to perform at your best, you need quality sleep in adequate amounts. Don’t feel guilty to get in that bed a little earlier than usual, and don’t feel guilty if you don’t fall asleep on that chemistry book.

So, let me ask you this, do you get enough sleep each night? If not, what can you do to fix that problem?

Image credit: Pixabay

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