“Diversity” in med school

The big “day” has arrived; I’m finally in med school in my first year. It’s incredible. For all the awful thoughts I had leading up to (thinking I wouldn’t have any friends, I might fail out, it was the wrong choice), it’s been only fantastic.

Yes, I am lagging on Europe posts. Yes, they will come.

Yesterday was “Day 2” of our “fake” classes (we’re still in orientation). Our lecturer opened with this quote from Thomas Jefferson: “…but health, without which there is no happiness. An attention to health, then, should take place of every other object.” The point was that health is, well, important. Beyond that, we (students, me, lecturer) mostly moved on. My friend I was sitting next to, however, couldn’t settle on that quote. He brought it up as it was happening, and then later last night he brought it up again (I don’t understand how someone could think so long on a quote, but okay, I will go there). So we ended up discussing it, and this discussion brought up some unique points/observations:

  1. Definition debates exist for a reason — what does it mean to be happy? Content? Joyful? (we already chose physical and mental as the types of health)
  2. I’m more “S” than I thought (we just took an MBTI). See my “argument” later.
  3. Re: the title of this post — almost every medical school asks on their secondaries, what can you bring to contribute to the diversity of our school? It was very easy for me to answer that I would bring a patient’s perspective to my colleagues. At the time, I didn’t realize how important that was. I knew on some level that being a patient would give me a unique view on the practice of medicine, but it wasn’t obvious to me how different it would be and that I might actually bring something to the table until our discussion last night (the other two students were, to my knowledge, pretty healthy). The guy I was arguing with was pretty convinced that it was possible to be happy even without health. I agree, but I think it’s a narrow, naive, idealistic way of viewing it. Sure, I can be happy. In fact, I don’t know a single person who would say I’m not a happy girl. But the kind, quality, and level of happiness I feel is definitively limited by my body’s condition, always, and it’s something I never forget. As much as I tried to explain it to them what it feels like to live every day of your life knowing you (1) will never be cured and (2) are always limited in what you can do, I don’t think you quite get it unless you too are sick. So the third guy (other friend present) finally brought up this quote from F. Scott Fitzgerald: “It occurred to me that there was no difference between men, in intelligence or race, so profound as the difference between the sick and the well.” Apt.

As for my S argument, here goes. Assume the state of happiness one feels is on a sliding scale of points, where you can be 0 (neutral), +100 if you are super happy, and -100 if you are super upset. As a healthy person, you have the potential to access +100 and -100 (if we put those at the extremes). Maybe you don’t ever realize that potential, and the maximum you ever hit is +25, but you COULD hit +100. Now say you are sick. You can only hit +50 max now. Why? Several reasons. Maybe you’ve been beyond +50 before, doing something awesome like skydiving or riding a rollercoaster or getting to eat whatever you want, but now because of your health, you can’t do it anymore so you can no longer access +50 and beyond. Or, and this is a bit abstract, you just can’t go beyond +50 anymore because when your condition changed, your perspective changed. I mentioned in a previous post that patients, or at least I, try to rationalize what’s happening to me and cope with it by occasionally poking fun at my disease/body or often engaging in what could only be called morbid humor. In that state of shifting what you think is now “funny”/”okay”, your framework changes. You just CAN’T access +100 anymore. Everything shifts. What might be a +10 for a healthy person (like graduating high school) is a +40 for me because I didn’t think it would happen given my health. What might be a -30 for a healthy person (like getting a minor surgical procedure, getting a flu shot, getting your blood drawn) is a 0 or even a +5 for me because I’m used to this routine but I also think it’s cool (+).

So I’m a happy, sick person. I tend to usually be on the + side of things. I gained a lot from my disease in terms of “worldly perspective” so I know how to make myself happy — maybe I average +30. But I also know that if we went to Disneyland, I still can’t ride the rollercoasters so maybe the max I might get out of Disney is +50 whereas a healthy person could go to +60.

Overall, what I learned from last night is that it really is important to have people of a variety of opinions and backgrounds in your med school class because you will be learning much from them about how you want to practice medicine. People might moan and groan at that diversity essay (I did) but it’s there for a reason.

I’d like to conclude that I have no idea what my opinion is on that quote. I’m pretty sure I agree with it, but I haven’t thought about it enough nor do I care to) to make a conclusion. I only argued to extensively to play devil’s advocate, which is something I enjoy doing (a callback to my high school debate days). What are your thoughts? Do you need to be healthy to be happy?

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Professor relationships and LORs

^Not those kinds of professor relationships!

It’s almost been a year since my application cycle started, and as expected a bunch of my premed friends are gearing up for the new application cycle. I’m hoping to address the different aspects of the application as they happen, but I already know I’ll fail at that. I think the easiest was dealing with letters of recommendations (LORs), so here I go! Again, I’m not some kind of amazing authority on medical school applications, but I hope this will help someone. Also, I did not go to a school with a premed committee or a committee letter (thanks, public university), so I can’t help anyone with that! Sorry. :(

What do I Need?
Generally, it’s recommended to get two letters from science professors and one from a non-science professor. Usually this means a professor who has taught you in a class. Different schools require different letters (for example, Albert Einstein wanted a letter from each science department), so even if you say, “oh, but THIS school doesn’t require that!”, it’s probably safer to prep for the worst case scenario. Sometimes you can get out of the requirements if you explain your circumstances (like I had to for Einstein) such as being out of school for a few years. On top of the “safe” letters to get, you should get a few extras to speak about you as someone more than a studying machine. Good ones are from research PIs, volunteer coordinators, your boss. Not so good ones are from friends, family members, and TAs/graduate students. NB on the graduate student letter — sometimes grad students will be stuck writing the letters, but you should still (1) ask the professor, and (2) make sure the professor co-signs the letter. I’m torn on letters from physicians/medical professionals. If you really think they can write you a good one, then go for it, but I tend to believe most are too busy to write an amazing letter. If you can combine any of these extra letters with your professor letters, that’s even better (a professor I TAed with also taught me in a class). More letters don’t really hurt you but bear in mind that AMCAS can only hold ten letters max, and many schools cap the number of LORs they can receive at ~5.

Another reason it’s important to have extras is sometimes professors flake. Therefore, in addition to the two science, one non-science, I’d have some back-ups.

Who do I ask?
Ask professors who know you well. There are many posts on SDN about getting letters from famous researchers/doctors, and the consensus is always only if s/he knows you well. A professor should be able to see you, recognize you, and write more about you than “this student got an A in my class” (even if it’s a hard class). If you are in a situation where you know a graduate student better than a professor (e.g. if you work under a grad student or a postdoc in a lab and barely see your PI), you should STILL ask the PI but also ask the person you work under if s/he’d be willing to co-write a letter with the PI (generally this means s/he will be the one writing the letter).

How do I get to Know my Prof?: Classes
Ah, one of the common #premedproblems: I’m in a class of 500 students, how do I stand out?

1) Plan ahead! – If you started college knowing you were premed, you hopefully have had a few years to establish some good relationships… if in that time you haven’t gotten close to ANY of your professors, you’re probably not only doing something wrong, you’re also not really getting the full college experience. Professors are awesome people to talk to and learn from. If you plan ahead, you should plan your classes based on what letters you seek. Many science majors leave their humanities general education requirements till the end to take, but how do you guarantee you’ll get your non-science letter then? I always arranged my schedule so that I would not only get great professors but also have multiple classes/quarters/experiences with them.

2) Go to office hours – This is so self-explanatory but I’m always surprised more students don’t do this. I made going to OH so regular that I scheduled it into my calendar as if it were a class. If you fall into the unfortunate circumstance in which a professor has OH when you have class or some other binding commitment, check tip #3. Common problems/complaints: I don’t have any questions to ask. That’s okay, just sit there and if other people are asking questions, you can follow their example (help answer, add follow-up questions). There’s so many students; how do I stand out? I guarantee that if you go the first week and/or go consistently (as opposed to just the weeks before exams), there will be days when there are less students, and that is when you can shine. Furthermore, it says something of you if you are going all the time, even if you aren’t really standing out (at least you’re putting your face out there). I’m the only student there, and it’s so awkward! Here’s something important to remember: professors are people too! (what?!) Start with small-talk if you must — ask about how their day’s/week’s been, what they like to do for fun, their kids, etc. Feel free to share about yourself too. One of the professors I’m closest to our conversations first began with “OMG I’m about to take the MCAT, and I know nothing about bones… help! Teach me/recommend books/OMGPANIC” (in an osteoporosis class so somewhat relevant), and now we’re so close that I’ve had dinners over at his house. As someone who’s TAed before, office hours can be really boring so even if a student comes in to talk about the most inane topic in the world, which to me would be anything sportsy, it’s better than sitting around doing nothing. So don’t be scared of office hours!

3) Make appointments – Say you have a class when your prof of target (hah) has office hours. Or you want to talk about something more personal/private (maybe you’re failing a class and you don’t want others to know), or you really feel like you just can’t stand out in a crowd, or you’re just shy. Make an appointment to meet with him/her in private. Just shoot an email over with your availabilities and a general idea of what you want to talk to about. If you are just using this session to try to get closer to them, I recommend picking a topic as vague as “career advice” and then discussing whatever premed problems you might have at the meeting. This’ll not only plant a seed in your prof’s mind that you are premed, it’s also a very easy topic to discuss (throw some premeds together and surely the conversation will steer this way).

4) Before/after class – This is way harder but you can try talking to your profs before/after class. Oftentimes, students attack professors after class so you need to be just as aggressive if you want to reach them first, but most profs do set aside time after class to chat a bit with their students.

5) Maintain the relationship after the class – Chances are you will take the class with your prof before you end up asking them for an LOR. You can either ask them for a letter right after you’ve finished the class, or you can wait closer to application time to ask. I recommend the latter because this gives you more time to build your relationship; HOWEVER, bear in mind it’s harder to do this if you’re not actually regularly seeing your prof, so if you decide to go this route, you need to be ready to be aggressive again. Try to take multiple classes with your prof. Try to find other opportunities to work with your prof (in a lab, as a TA/grader). If you can’t do any of these, make use of #3 (or stalk your professor’s office hours the next quarter/semester). Even if you’re busy, you can surely find an hour or two to spare every few weeks to chat and catch up with your professor (esp. since you are investing this time into your future). I actually think it’s easier to do this because there’ll be more time between your meetings, so you can have more to catch up on/discuss.

How do I get to Know my Prof?: Lab
1) Meet up – I have to put this first because it’s the easiest but most overlooked one. It’s a fact that most PIs don’t lurk in the lab, so undergrads tend to feel isolated from their PIs and then get confused how to ask a stranger for a letter. So why not just meet up with your prof? Sure, they are busy writing grants, but you can always stop by to chat. If you need something to discuss, ask about research (duh). As an undergrad, you’re not expected to be super knowledgable about what the lab is studying, so you can even ask what you think are “dumb” questions. You can ask about other projects in the lab since you usually probably are only on one project. You can ask for more papers to read. You can discuss your “future” with them as in #3 above. You can give them progress reports on how you’ve been doing.

2) Be more than a lab slave – This is tough since it’s not really in your control but try to stand out in the lab too. If you are doing good work, you will be rewarded. I slowly climbed the “lab ladder” from a basic undergrad making solutions to going to weekly group meetings with my PI (these weren’t fun since I was often just yelled at but still!). If you can, go to journal clubs. Go to lab meetings!!! Basically, make time outside of just working in the lab to go to the same things that your PI would be going to. It’s another way of just showing your face to your PI, maybe sounding a little intelligent or striking some kind of conversation, and also showing that you care about your research (which ideally you should if you’re in that job).

3) Ask your grad student/postdoc for help – If you’ve been working in a lab long enough and if you’ve been a good little undergrad, you probably have demonstrated your worth to the grad student/postdoc you work under. You might even be friends with him/her. It’s very easy to just slip in conversation one day that you are looking to ask your PI for a letter of rec soon and that you need “help” (usually just the “Oh, noez, I need a letter…” comment will trigger the next reaction). Most grad students/postdocs will leap to helping you, be it by offering to write the letter or putting in a good word to your PI or giving you tips on how to talk to your PI.

How do I get to Know my Prof?: Misc
The general rule of the medical school game is be aggressive. Whatever that means to you, make it work.

How do I ask?
Hopefully you’ve established a good enough relationship that you already know your prof will gladly write you a letter. But the first rule is ASK EARLY!!! I asked 1-2 months in advance. Gear up with a site like Interfolio so you can store your letters (not affiliated with them but I used their service when I was applying so I know it best). Professors are busy people, and some will write numerous LORs for premeds, so you want to be at the top of that list. By the way, another advantage to getting close to your prof is that if you DO ask late, your prof will most likely move you up the queue if s/he knows you better. I had to ask one of my profs for a letter because I was worried another one wasn’t coming, and he told me that even though he had a few from students who had asked before me, he would move me up because he actually knew who I was.

Send an email to request a private meeting. You shouldn’t ask them for a LOR in the email so if they ask you what the meeting is for, give them a vague answer again (“my future~”). I know you’ve been meeting with your prof regularly, so this won’t be a problem! Next, you need to prep your LOR PACKET. What is an LOR packet? It’s all the information you can give your prof about you to assist in the letter-writing process. In my packet (which was essentially a folder) I included: a copy of my personal statement (it can be the roughest draft in the world as long as it’s not overtaken by grammar/spelling errors and says something about why you want to be a doctor), my resume, an unofficial transcript (basically I printed my grades/classes), instructions for the letter (Interfolio will give you a sheet to print out), a stamped envelope (in case your prof decides to mail in the letter but most will just upload it electronically), a post-it saying “thank you!” (or something like that) in my handwriting to give a personal touch, and a letter to the prof. The letter to the prof included things like when I wanted the letter by (this is super important — so important that I bolded it), what my relationship was like with the prof (in what context we knew each other like what classes we took together), and a bit about my college experiences. If you have anything else to include (old papers, etc.), throw them into the packet.

Do NOT forget your packet at the meeting. When you go into the meeting, you can have a typical meet-up (catch up, whatever your ritual is with your prof), and then you should shift/direct the conversation to your letter. Ask your prof if s/he would be willing to write a STRONG LOR for you to go to medical school. Keywords: willing, strong, medical school. Since your prof loves you and knows you so well, s/he will exclaim “of course!” and then probably ask you for some more information. If s/he doesn’t, this is still when you whip out your packet to hand over. Stress when you want the letter by — I would pick a date in early June so that you can be complete at most schools early, and IN CASE your prof is late, your app isn’t *severely* impacted. Thank her/him profusely.

Now what?
Wait patiently for your letter (work on other parts of your app?). If you haven’t heard in ~1 month, you should consider bugging your prof gently. If it is a few weeks prior to when you want your letter and you still haven’t heard, definitely bug your prof. You can either do that in person or via email. I’ve read a few suggestions on how to do this… some just point-blank ask where the letter is, others send an updated personal statement or updated grades, and a few on SDN have pre-emptively sent “thank you” letters.

If you are in a situation in which you really need a letter and your prof is unresponsive, you need to work with your back-ups… FAST. My friend ES and I both had to do this, and thankfully we *had* back-ups, but this is another reason why you need to plan in advance. If you don’t have a back-up, TRY your hardest to build up a relationship as best as you can with someone now (and keep bugging your prof).

And for future follow-ups: always have a personal thank-you letter + a small gift (what I suggest). You should also update your profs as to your progress (especially when you get into your first med school!), where you end up deciding on attending, etc. By now, since you’ve built such a close relationship with your prof, this should come naturally to you. :)

End of the Interview Trail

It’s finally the end of the interview season for me (unless by some miracle Columbia decides to invite me). This means that I will be flooded by more rejections in my inbox in the coming weeks, but that’s okay because I already have acceptances. :) Here are some of my thoughts on how it’s been. It’ll probably be a premonition for my future “end of applying” post, which will be more comprehensive depending on how motivated I am.

General Thoughts:
1) The people you meet at medical school interviews are really cool. My friend ES and I were discussing this a few days ago. The “typical premeds” you meet in college (especially at the start of it) are… annoying, to put it lightly. They’re all pretty naive, they’re stressed all the time, they tend to have an arrogance complex, etc. Now I’m not saying I’m not like that because I’m pretty sure I also am a “typical premed” but some of the traits come out more in others. Anyway, in short it can be frustrating to be around premeds all the time (take this from someone who went to a school populated by premeds and was in a premed fraternity). Therefore I was pretty surprised to see whom I met at interviews. They were all pretty friendly (some so outgoing that even I was impressed [my friends all know that I’m pretty extroverted] but even the quiet ones had hearts of gold) but most of all, they had SO intriguing backgrounds. I met several ex-military members, a jazz singer, a security escort for celebrities (including Lindsay Lohan), a religious studies guy who randomly switched to premed after taking a cognitive science class on spirituality, several awesome athletes, some old friends from my high school days, and a professional cake decorator. It really shows you what it takes for admissions committees to decide you stand out enough to extend that interview invite.

2) The interview is just as much about (if not moreso) the schools trying to impress you. I think many of us go into the interview (especially earlier in the cycle) thinking that we need to put on our best faces and try to impress the admissions committee into accepting us. This is partially true but I also noticed that a lot of the interview session is about the school selling itself to you too. After basically every interview I went to (even the schools that I hadn’t been too impressed with on paper), I thought I had found a new top choice (they do a really good job!). Also, the interviews that I attended after I had already held one acceptance (and therefore didn’t feel as compelled to sell myself) seemed to have gone significantly better. I think this suggests that confidence is key; when I viewed my latter interviews more as me interviewing the school to see if it was a good fit, I seemed to have done better.

3) Practice doesn’t really work for me. I should’ve known this from my high school experience on debate team, Model UN, and various other speeches. I’m not very good at practicing speech… I end up sounding fake, rehearsed, and insincere. My strength has always been that I stand out in person but maybe not so much on paper. By practicing, I was losing what my key selling point was. I felt so awkward at my first interviews for which I did extensive research on the school, wrote notes on what I wanted to emphasize, and practiced and timed my answers to some questions I thought I’d get based on what I read on SDN’s Interview Feedback. I’m not surprised that I got waitlisted at those schools. When I started letting myself be me at the interviews, I did significantly better.

Lessons for Future Applicants: – DISCLAIMER: I AM NOT THE PERFECT APPLICANT SO TAKE EVERYTHING WITH A HANDFUL OF SALT!
1) Be yourself. (This should be pretty obvious but somehow, us premeds still ignore it.)

2) Have confidence. Usually the biggest cut in the applicant pool is from applying to the interview invite, so if you already got to the interview stage, the schools pretty much want you, and you’d have to do something totally awful to get rejected (from my experience). If you’re just mediocre, you’ll probably get waitlisted. So be confident, and get accepted!

3) Hopefully you are enrolled in some frequent flier programs like I suggested in a previous post. This’ll help you save a lot of money when flying to and fro. If you’re lucky in picking where you applied, you won’t be flying too much but usually people apply all over.

4) Try to lump your interviews together if possible (especially if they’ll be in the same region). This will save on costs and also prevent you from constantly bouncing back and forth between “normal life” and “interview/on-the-go life”, which to me was pretty stressful. Scheduling is key. Also, “in the area” notices for schools that allow them can be pretty useful.

5) Prep beforehand enough so that you can go in feeling confident but not so much that you sound rehearsed. For example, you should at least know about specific programs at the school that you are attracted to so you don’t sound like someone who doesn’t care about the school. You should also definitely know how to answer “why medicine” in a concise way. But you shouldn’t sound like you’re reading from a book. Be natural!

6) For girls: if you are wearing heels (which you probably are), it’s ALWAYS good to pack flats just in case. Even if you are a pro heel walker, some schools just have really nasty campuses that will be difficult to walk on in heels. I saw many girls switch in and out of flats so you won’t look weird at all.

7) Try to stay with a student host. Not only will it save you a ton of money, it’s a great way to get some insight into the school before your interview. I think part of the reason I did so well at one of my interviews was because I adored my student host, and we clicked very well and spent long conversations discussing medicine, the school, etc. This showed in my interview, probably giving the interviewers the impression that I “fit in” with the school environment but also that I cared enough about the school to be genuinely enthusiastic about it.

8) Orient yourself with the interview day as much as possible before you go so you aren’t caught unaware (for example by surprise panel interviews or the few interviews that are closed-file). Also learn where the important buildings are (like where you’re supposed to meet), and MAKE SURE you have the admissions committee’s number in case of emergencies! I was almost late to one of mine because for the life of me, I couldn’t find both the parking structure and the building I was supposed to report to, and unfortunately my smart phone was dying (hah) so I couldn’t even find a number to call for help.