Away Rotations Part 2

Continuation of Part 1… now you’ve finally arrived at your designated away institution! Hopefully by now you have heard from your institution about what to expect for the first day, but if not, I would email the chief resident of service or the secretary about one week prior to your start day to at least figure out where and when to meet the team on day 1. You can get all of the other logistics after that. For my first away, I also spent my first day there (I arrived a day early) to get the lay of the land around where I was staying and where the hospital was. Make sure to set your alarm and get everything ready for your first day.

General Tips

  1. First one in, last one out — this one is probably the most commonly given advice for away students. This is highly variable on what you are doing but you should aim to be the first one on your team who shows up and the last one to leave. Sometimes, that might not happen (some residents will really insist that you leave), but try your best. The point of this is that you should never be late, you should never leave early, and you should never miss anything (AKA try to be present, always). At the start of the day, I would always get there first to print the list for the team and start collecting overnight events/vitals/labs for everyone. If you are fast at prerounding, you won’t really even be showing up THAT much earlier… for me, usually 15min before the intern showed up was what I set myself to. At the end of the day, make sure that everything has been tied up and ready to go — all notes are done, all consults have been seen, nothing pending. This brings me to the next point…
  2. Know everyone on your list, even if you’re not assigned to — I’ve found that starting off, most teams won’t let you do too much because they need to gauge where you are, which is why if you show that you can handle the entire service, you’re already off at a great start. I spent any free moment I had during the day reading about my patients, learning their latest labs/imaging/etc., so that I was the most up-to-date on everyone. You’ll never know when you can throw out a nugget that no one was expecting, and then you’ll just look extra prepared. And before I left everyday, I would do another run through the list just to make sure I knew the latest on everyone and generally what I could expect overnight.
  3. Take call — I’m not sure if every service will assign call, but if you have the chance to, you should offer to take call. With my specialty, call tended to be home call, which meant I usually gave the residents my phone number and they would call me if anything was worth coming in for. Even if you are never actually called, at least you showed effort by volunteering. This includes showing up on the weekend.
  4. Ask “how can I help”, not “is there anything to do?” — Residents always want to say “no” to the last one, so don’t let them! Also, the more you find out how you can help, the better you will get at figuring out yourself what needs to be done, which brings me to the next point…
  5. Anticipate needs and be prepared — This, I think, was what really makes you stand out. You should always be thinking several steps ahead of what’s happening. If you don’t know how to do that, ask first to learn. Have everything you need on hand for rounds. Since I was on a surgical rotation, my pockets were literally full of staple removers, suture removers, gauze, tape of all kinds, baci, steristrips, etc. In the OR, you should at least know the procedure well enough that you can figure out what comes next. Do you need skin hooks or a certain kind of retractor? Do you need scissors? If you can figure out these things before it’s asked of you, it just makes you look extra good.
  6. Make your residents look good AKA be a good team player — It’s not always about making yourself look good, it’s about being in a team. When your resident is operating in front of the attending, do whatever you can to make it stupidly easy for them. Grab things for your resident so they don’t need to waste time getting it. If you know an answer and the resident doesn’t, absolutely DO NOT show off in front of an attending unless asked. Say good things about your residents (if they are honest) if an attending asks.
  7. There is no “free time” — If you find that you have free time on your rotation, you’re doing it wrong. I’m not saying you need to be a machine, except that’s what I’m saying. Even if there’s no work to be done, you should be reading about something – your patients, conditions, surgeries, recent literature, etc. You never know when you’ll be asked about something.
  8. Be professional/polite but also be yourself and try to feel the program — Because away rotations are sometimes considered month-long interviews, you need to be polite to everyone you meet (you never know when something might get back to someone). But at the same time, you should also be yourself and see where you belong in that program. For example, on my second away I was really cautious at first, but I found that by letting myself go a bit, I could still be polite and at the same time made friends with a bunch of the scrub nurses and anesthesiologists so that by the end, they were telling my attendings how much they loved working with me, and honestly, I missed them! It made me feel like I really belonged in that program, and that’s the kind of feeling you want to leave with.

Mid-rotation — At about halfway through your rotation, you should try to get at least an informal evaluation by a resident and an attending (multiples if possible). Ask them to be honest, and most importantly, ask them how you can improve. It never feels good to be told that one is “bad” in any way, but you want to be the best you can be so let them give you pointers NOW while you still have time to show them you can change. For example, on my first rotation I was told that I seemed a little unprepared for surgeries. While that upset me a little bit because I thought I wasn’t, clearly I wasn’t studying enough, so I took the next few weeks to really read up as much as I could for surgeries. By the end of the rotation, that same resident told me I ended with the same knowledge as at least a PGY2 level.

End of rotation

  1. If you have to give a presentation — make sure you pick a topic that at least some of the senior residents, who likely have seen other medical students rotate through, approve of. Usually, I try to pick a topic related to a patient that I’ve seen at some point so that you can have some clinical context. I did not repeat a single talk I gave, which meant I had to research for three; in the end, I’m not too upset about that because it meant that I learned A TON about three areas in my field, score! Pick sources that are in the literature, ideally from big-name journals if you can. Make sure you thoroughly read the articles and understand the experiments. Don’t make your powerpoint all words. Have summary slides. Run your presentation by a resident if possible before presenting to attendings.
  2. Ask for more feedback — When you’re done, you want to gauge how you did. Try to schedule meetings with attendings a week before your last week so you’re not just chasing them down to ask for feedback. This is the time to…
  3. Consider asking for a LOR — If you think you made a good impression, and it should not be hard to figure that out because hopefully you’ve been getting feedback along the way, you can consider asking for a letter. There’s a bunch of stuff out there about who to ask; in the end, I think you should ask whoever knew you the best and would write you the best letter, be that a chairman or not. Make sure that if you do ask for a letter, you have everything ready (personal statement draft at the very least and a CV).
  4. If you have an interview while you are there — Treat this like any other interview. Dress nice and look good. Make sure you’ve prepped before about the basic questions (“tell me about yourself”, “why this specialty”, “why this program”). Practice your answers. Be confident but be yourself. Be polite and professional to everyone you meet.

Whew, that was long and hopefully comprehensive. If you have any questions, leave them down below!

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Away Rotations Part 1

These days, it seems like a bunch of medical students are doing away rotations. They offer a bunch of benefits (and harms) — exploring a new city, a new hospital, moving closer to a loved one for at least a little while, and sometimes, they can help you match at a residency program. Now I say sometimes, because if you’re planning on going there, you need to be on your A+ game. Having just finished two away rotations fairly successfully (I think), I’m writing this post to offer some advice to those who are interested in doing away rotations.

I’ll be breaking this post up into two parts — first, what to do before you get to your away institution, and then part two will be what to do once you are there.

Should I do an away rotation? This is something for you (and your adviser) to discuss. For most of the uber competitive specialties, it’s almost “required” for you to do an away rotation. For the less competitive fields, many argue that away rotations end up hurting more than helping. If you are dead set on going to a certain program for whatever reasons (e.g. your fiancee has a job in that city), you probably should do an away rotation. Otherwise, I think most people do not need to do an away rotation.

How do I apply? VSAS, affiliated with AAMC, is the site that most institutions use for away rotations. I say most because there are some institutions that have their own application for away rotators (off the top of my head, I know that University of Alabama and Thomas Jefferson University do). You log in with your same ID and password for you AMCAS if you happen to remember that. You can find a variety of different rotations from your typical 4 week sub-internship to more “fun” rotations like medical disaster management. Most institutions open up their applications in May; however, you can look at what they require earlier than that. Almost every school requires its own immunization form (some require titers, others just documentation that you have had a vaccine), and some require combinations of background checks, urine drug screens, LORs, etc. Make sure you have everything prepared as soon as possible since away rotation applications are reviewed on a rolling basis.

I’m not sure what the “right” answer is for how many to apply to. I was planning on doing two, and maybe three, so I applied to five institutions. I got accepted at all of them (to my knowledge, it’s not usually “hard” to get accepted at away rotations) and then picked the ones that worked best with my schedule (some institutions overlap their rotations with others, so you need to plan accordingly). Make sure that if you accept an offer or reject an offer that you do so in a timely fashion to be professional (at least 2-3 weeks in advance of start date). It appears that most places get back to you within one month of applying.

I’ve been accepted; now what? My biggest stress prior to going away was finding housing. Oy, what a nightmare. Here are some of my tips:

  1. Rotating room — this website was designed for away rotators. You can trust that most of these places are fairly reliable since you cannot list unless you have a university-affiliated email address. You can search by institution and then by hospital. I used this service to both find a place for me to sublet and to list my own apartment. I had no issues with either of them. I did not think many people would want to stay in my apartment, but I actually got four inquiries, so I can only guess that lots of students use this site!
  2. Craigslist — everyone knows craigslist, right? Unfortunately, one of the places I went to rotate at did not offer much on rotating room, so I was forced to resort to craigslist. You have to be smart on this website is all I have to say. To weed out sketchy people, I look for good grammar/spelling in the post, lots of pictures of the actual room you will be renting, and at least some information about the people who live there (roommates or whoever you’re subletting from).
  3. Use your connections — I ended up not being successful with this but one of my classmates was able to find both of his places through his church network. If you know friends (or friends of friends), ask around and see if anything is available. Residents are also good resources since they come from all over. If your school has an alumni network that you can get in touch with, that is another place you can look for someone to stay with.

Once I found my housing, I tried to figure out logistics. The way I ended up doing payment was I paid half of my rent (through paypal) upfront to “save” my room, and then I paid the remainder once I arrived at the location. I also asked for additional information like laundry, parking, where to buy groceries, etc. We also discussed rules of subletting, how to pick up keys, etc. The last thing you want to worry about on an away rotation is housing, believe me, so try to get this all sorted out before you go up there.

Transportation — at one of my rotations, I was going to be located within walking distance to the hospital, so I opted to fly there. At the other rotation, I would spend time at several institutions, all separated by at least 10 minutes, so I knew I would have to bring a car down. I don’t have much advice on this except plan, plan, plan.

Packing — I have such a love-hate relationship with packing. On the one hand, the planner geek in me goes crazy. On the other… well, the planner geek in me goes crazy. I always start out with looking up the weather for where I’m going to go, and then I try to think of what I expect my rotation to be like. Since I am applying for a surgical specialty, I had a feeling I would spend a majority of my time in scrubs, so I packed less “nice” clothes and packed my trusty Dansko shoes and two clean scrubs (I wasn’t sure if I would be able to wear their hospital scrubs or what so I wanted to be prepared). I packed a couple of what I call “normal people clothes” to wear if I ever had time off, and more on that later but I do not recommend wasting luggage space with this if you can. Do not forget your white coat, obviously, and try to get it as clean as possible. My white coat picked up some nasty stains over third year, so I actually went and bought a new one online to bring to my away rotations. Bring medical supplies as needed — I left my reflex hammer at home since I doubted I would require it (and I did not). And then otherwise, make sure to pack you usual toiletries, medicines, etc. Some places will interview you while you are there — if you can, ask your rotation coordinator about this sneakily, although most tell you upfront. If you are going to interview, make sure you pack interview attire!

Since I rotated over the summer, I knew I wanted to pick warmer weather clothing. I tried to pick colors that would complement, so the palette I ended up going for was roughly black, camel, pink, cobalt blue, yellow, and kelly green. For shoes, I brought flip flops for casual wear, clogs for the OR, and then two pairs of comfortable shoes that I could wear both for the clinic and outside the hospital (I went with brown loafer flats and black flats).

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Feel free to ask any other questions below about aways! Part 2 will go into the meat of rotating away, so stay tuned.

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. :)

Enough clinical exposure?

Something I thought I was lacking going into the admissions process was clinical exposure, mainly because I know friends who have been volunteering in the hospital since high school, and I am in a school inundated by CCE interns. I did some shadowing, I was in the clinics a few times, but I won’t lie, my biggest clinical exposure and drawing force to medicine was of course my own hospitalization. Some on SDN argue that’s a cop-out, but I think if you approach it in a certain way, you can argue it’s still a valuable clinical experience (for example, I was at a teaching hospital, so I actually interacted a lot with medical students, residents, and of course attendings, and I got to see the hierarchy, rounds, interactions between staff, etc.).

I never did hospital volunteering because it simply did not interest me enough to commit my limited time toward (more on this in a future post). It’s not that I don’t like helping people; I just wanted to give my time toward an activity I knew I would enjoy (like ABG!). So that severely limited my clinical options. I wish I could’ve done CCE but I didn’t have a car (another limit — couldn’t do EMT or anything else). So I counted on shadowing and trying to get the most out of my shadowing experiences.

I shadowed only two specialties (officially) — endocrinology and cardiothoracic surgery. Unofficially, I also “witnessed”/observed primary care and of course, nephrology. I got my endocrinology stint through a club I was in, and I found my CT surgery opportunity by emailing doctors. I enjoyed every minute I spent in the clinics. As I noted several times in my interviews, it was obvious medicine was my love — I had no issues waking up at 4am three times a week to watch a 6+ hour long surgery, I skipped classes several times (when I could) to be in the hospital instead, and I came out of every experience with a huge smile on my face.

My friend C (someone I respect highly — and I am in love with his better-half T too) directed me to a shadowing “checklist”, a rough “guideline” of what kind of experiences one should hope to garner to have enough clinical exposure. Fortunately, even in my limited shadowing experiences, I passed (“you’re golden”). I guess the two fields I picked just luckily offered a lot (endocrinology: saw a lot of diabetics and therefore dealt with all kinds of issues related to preventative medicine/obesity/insurance, CT surgery: saw lots of blood among other things). Also, the surgeon I shadowed was hilarious. I didn’t accidentally follow him into the bathroom ONLY because he told me a story on the first day about how medical students used to tail him into the bathroom (so I became extra careful of watching where he was going). And since so many of the hospital staff thought I was a medical student, he sometimes pretended I was and would PIMP me in front of the others. As expected, I rarely knew the answers (in fact I usually couldn’t even follow what he was saying). The actual students (other residents) thoroughly enjoyed this (they also knew I was only an undergrad). -_-; I did get one question right once about reading an EKG (I have my excellent physiology professor to thank for that), and the surgeon was happily shocked.

How to Shadow
I’m not some pro on shadowing, but I can try my best. I think the main thing is to approach every opportunity with an open mind. Don’t see shadowing as just a time to see patients, see it as a time to witness the inner-workings of the hospital. Try to interact with the nurses, the receptionists, anyone you might run into. I learned a lot just by opening my eyes and ears. Similarly, be friendly and polite with everyone you see because opportunities are a-lurking. Quite a few medical students were willing to sit down with me and chat about school and applying between rounds, and the surgeon I was with hooked me up with other surgeons too (I didn’t end up pursuing those opportunities since my time was already limited, but I was thankful he did that).

Dress professionally on the first day (or be sure to ask how you should dress), and on the first day find out how you should dress in the future. The endocrinologist did not care what I wore. I obviously wore scrubs in the OR.

Journal. I had a pocket Moleskine with me every time. When we saw patients in endo, I obviously wasn’t whipping out my notebook, but between patients I would jot down notes about what I had seen (my early pages were filled with “what is TSH?” “Hashimoto’s something something” “Graves??” and other confused comments; eventually, I got it down). In surgery it was easier because I wasn’t allowed to touch or do anything (so I could write down what I was watching). Even if you aren’t actively recording what you see, it’s good to get home, reflect, and record what you witnessed overall. These experiences can come back to help you (maybe a story to mention in a personal statement or an interview).

Check early on what your doctor expects out of you. Some doctors don’t like it when premeds interrupt their meetings with patients, but the endocrinologist I shadowed welcomed me to ask the patient questions and talk to him/her about his/her disease. You also want to avoid running into HIPAA/privacy violations. My notes NEVER said anything about the patient’s identity beyond “patient 1 of [date]” so even if I tried, I couldn’t bring up specific details other than what I remembered about their appearances (and we all know memory is fallible).

“That’s great… but how do I find a doctor to shadow?”
1) Easiest: ask your own doctor. Once my doctors found out I was premed, they couldn’t wait to have me around (and because I’m sickly, I have so many doctors, yay!). Again, I didn’t end up taking these opportunities, although this was because most of my doctors are at home on the east coast, and I spent most of my time at school on the west coast so logistically… not possible.

2) Check your school for any “hookups”. My undergrad has several premed organizations that all offer some kind of shadowing/mentorship program. Even if it’s only for a few days in the clinic, you can set the groundwork for future opportunities. Look to see what your school has, and apply broadly for these programs.

3) Contact doctors yourself. Like most things to “put you ahead”, I’ve found that sometimes you just need to gun, be aggressive, and do things yourself. On SDN they frequently advertise calling doctors’ offices and asking if it’s possible to shadow. Fortunately, I went to an undergrad affiliated with huge medical centers, so I just emailed out a hundreds of doctors (not literally but close) in hopes of scoring a few. Most did not reply, and of those who did, many said no. But all it took was one successful hit, and I got excellent experiences out of it. Generally, I attached my resume and emailed some kind of cover letter describing my interest in their specialty, my interest in medicine, and what I was hoping to gain from my experience.

4) Other networking. Do you have friends who shadow? Do you volunteer in a hospital? Do you work in a lab? Chances are that even if you don’t know a doctor, you probably know people who know doctors (mm). So ask them if they can give you some contact information. My current PI is also a psychiatrist, and he has offered several times to allow me to come by and see his patients or to set me up with some other medical faculty. My friend ES shadowed a hand surgeon whom she met from her volunteer gig at a rehab facility.

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.

Travel Tips: At the Airport

Like the last post on packing, again I am writing how to fly while in the airport. :) Nice.

I forgot to mention this before. I am not an expert on booking tickets since my mom usually does it (she does some magic with frequent flyer miles + Expedia points). However, here are some things I do know:

1) FREQUENT FLYER PROGRAMS are a must! Sign up for as many as you can. I’m in at least three. I can’t tell you how many cross-country flights I’ve gotten for free thanks to these programs. LOVE.

2) Check lots of sites. I like Kayak and Orbitz. I like Kayak because you can usually find the cheapest flights on there. I like Orbitz because you can book the flights through the site, and I think it’s slightly more reliable. I like both because you can do flexible travel dates. However, like I said, my mom tends to book through Expedia, even though we both know that it’s usually a little more expensive. Not quite sure what the logic is there. Also for those in California, be sure to check Southwest Airlines. I’m not sure if they’re as cheap in the rest of the country but they tend to give the cheapest whenever you are flying to/fro/within California.

3) I hear that you can find the cheapest flights on Tuesdays? (Update on 8/8/2012: this is definitely true… I was able to get round-trip tickets across coasts for less than $200 on a Tuesday!)

Before Security
1) Arrive early! – This is SO IMPORTANT and makes the rest of the trip smooth. Generally, arrive one hour before a domestic flight and two hours before an international. If you know what you’re doing, you can probably afford a little less time, but missing your flight is never fun. So arrive EARLY.

2) Check in – I don’t check in beforehand because I usually have to check-in luggage = still need to go through the line = don’t save any time. You can, however, check-in beforehand, usually online 24 hours before your flights. Be sure to print out your boarding pass if you do!!!

If you’re like me, you’ll check in at the airline. Even if there’s a line, hopefully you arrived early enough that this won’t matter. I have my confirmation # on my phone, punch it into the self-check in machine, check in any luggage, and voila, it’s done! If you are checking in luggage, remember that there’s a 50lb limit. I find most airlines can give you ~2lb cushion room (I’ve been allowed to board with 53lb before) but I wouldn’t risk it. This is something you should factor in when you are packing (oops, didn’t mention it in the previous post). Clothes can be surprisingly heavy! Hence why I suggested wearing as much as you can.

3) Preparing for security – Please go in the right line (can change depending on what seats you have, if you have kids, etc.). Please have your boarding pass + travel documents (passport/license) available before you reach the TSA checker. Please pay attention!

Also, you should make sure you no longer have any “illegal” liquids around. Sometimes I bring water bottles with me to hydrate before a flight since if I don’t, I faint upon landing. But I need to remember to dispose of the water before going through security. (And if you plan on taking out your liquids, you should start gathering/preparing them. TSA provides big ziplock baggies for you to put your liquids in. Again, I don’t follow this rule. Even though I was stopped the last time I passed through Dulles, this time I wasn’t. So arbitrary!)

Security
1) Get in the shortest line OR the line you notice is moving the fastest OR whichever one the TSA end up assigning to you. If you can pick, choose the one moving the fastest. I’ve mistakenly gone into the shorter one only to get stuck behind a family with a ton of kids, and those are always slow because there’s so much luggage, so many people to keep track of, chaos!

2) While you are in line BEFORE you reach the silver conveyor belt, START TAKING OFF YOUR CLOTHES. Yes. Take off your shoes NOW. Take off your belts/jewelry NOW. TAKE OFF YOUR COATS NOW. Stick them in the trays/bins — even if you don’t have access to the silver belt yet, the trays are usually open, so grab one and start putting your stuff away. If you’re already waiting in line, don’t DO nothing. Be productive, start stripping, and make it faster for the rest of us! This should be your first gray bin on the sliding belt (will say why later).

Also, seriously, TAKE OFF THOSE JACKETS/BELTS!!!!! (I’ve been behind too many people who forget.)

3) Hopefully by now you’ve reached the silver belt. Grab more bins, and take out anything else (liquids, laptops, etc.). I hear if you have digital film, you can tell the TSA agents to check it separately. TAKE OUT YOUR LAPTOP! If you carry your laptop in a sleeve like I do, you don’t even need to take the laptop out of the sleeve. Saves on packing/unpacking time.

4) Be sure to push all your items through onto the sliding part BEFORE you walk through the security check.

5) Walk through security when they tell you to. If you have to be body-scanned, follow their directions, stand with your legs apart and your arms over your head. Honestly, it’s not scary. Afterward, they have you wait (not sure for what), and then they let you go. If you have to get pat down, again, don’t panic. Just be normal because I’m sure you’re not a terrorist. I’ve been called for a pat-down before (supposedly it was “randomly chosen”), and it was not a big deal at all. If you have nothing to hide, then you have nothing to be nervous about.

6) RIGHT AFTER YOU’RE DONE, race over to that conveyor belt. If your stuff has already come out, start grabbing at it. Since the clothes went through first (ah, now you see), I can put on my shoes, coats, belts, whatever. Then put away anything you took out. If you’re fast enough, you won’t need to pull your things to the side. However, if you think you’ll take a while (maybe if you’re wearing boots, have elaborate belts/jackets, and have a ton of items you took out), then be considerate, grab your stuff, and go to the side to reassemble everything.

7) Check everything to make sure you grabbed all your items… because too many people have left cellphones at the security check!

Before Boarding
1) Check where to go – Make sure you get to the right gate/terminal/whatever in order to board your flight. Sometimes what they print on the boarding pass is incorrect/changed, so check the big screens to be sure.

2) Food/drinks? – If you have time to spare (read: you’ve found your gate AND you know they aren’t boarding), go ahead and grab some food/drinks if you need it. This should ONLY be if you have time to spare. I take a lot of early morning flights from west to east (due to the time difference), so I end up not being able to eat breakfast often. Since this is a recipe for fainting, I force myself to grab something before my flight.

3) Bathroom? – Are you on a long flight? Is it likely you’ll need to go to the bathroom? Do it now because chances are the airport bathrooms are way nicer than whatever is on the plane!

4) Boarding! – Board when your zone or whatever is called. Before you get in line, be sure you’ve assembled everything properly (one “big” item, one little item total for carry-on). I tend to “cheat” in that I have one roller carrier as my big item, one tote bag, and my purse. So I have to stuff my purse into the tote bag before getting on the plane. It’s not a big deal, but just make sure you do it so again you aren’t holding up the line. :)

Travel Tips: Packing

I am a frequent flier. This happens when you live on one coast but attend school on the other. It also happens when you’re applying to medical school. As a frequent flier, I have garnered a few travel tips that I want to share. Furthermore, there is nothing more frustrating to someone who’s up at 4AM (like me right now), sleep-deprived and grouchy, than people who hold up the line at the airport! This will be split in a few different posts.

Part 1: Packing
The first thing to consider is luggage. This is always a very easy decision for me: Are you going to need big liquids? (e.g. shampoo/conditioner, contact lens solution, whatever) If yes, then you need your check-in baggage. If no, then you want to pack light and go simple in your carry-on baggage. Situations in which I *never* check-in: med school interviews, trips of three or less days, flights lasting less than a 2 hours. Situations in which I *always* check-in: flying home for breaks. These days, it costs money to check-in baggage (bane of my life), so I try to avoid this when possible.

Once you’ve figured that out, we start packing. The goal of this game is to be MINIMALISTIC.

1) Clothes – I’m a girl so some of this might not apply to males (sorry!). Check the weather, and pack weather-appropriate clothing. For this current trip, I saw that it will rain (80% chance) for around two days, so I have my raincoat + umbrella + good shoes. The weather’s not always right but it’s a good start. Pack “flexible” clothes — e.g. jeans that you can wear with multiple outfits, layers. Don’t forget clean underwear and socks. I always bring more than enough because you never know what might happen. Don’t just throw everything in; be sure to fold it nicely. As someone who worked in retail for a few years, I’m quite a pro, but you can become one too with practice. The more compact you fold things, the more room you save.

With jackets/colder climates, I try to wear as much as possible so that I don’t have to pack it. If you are packing light, travel is not the time to be super fashionable, so bring jackets you know you will wear multiple times and get good use out of (even if they’re not super attractive).

2) Toiletries – If you’ve already decided to check-in, this is pretty easy: just grab what you need. I go all out with shampoo/conditioner/heat protectant (my hair is so fragile!), body wash, loofa, contact lens solution, toothpaste, face wash, different moisturizers, sunblock, etc. I put all the wet stuff in multiple bags (ziplock bags, then into those plastic shopping bags, all tied up) just in case anything leaks. This is pretty easy. If you are NOT checking-in, things get more complicated. Only take the essentials. Are you staying in a hotel? They usually provide shampoo, soap, and lotion, so don’t bring those. Go to CVS, and learn to love the trial size aisle (but don’t go crazy).

In terms of packing… I have mixed feelings. Supposedly, you should pack them so that they can go into a gallon-sized ziplock bag, and you have to present it at security. For all the flights I’ve been on since this became the law (20+), I’ve been fine just leaving them in my suitcase. HOWEVER, one time I got stuck at Dulles because they *insisted* that everything came out. Since then, I still keep everything in my suitcase, but if you’re running behind schedule, take it out! Don’t let security hold you up! (more on this later)

3) Shoes – I hate packing shoes… they just take up so much unnecessary room. Thus, I always try to pack lightly in this category. Consider: what’s the weather like? Are you going to be walking a lot? Will there be any special occasions? Are there disgusting showers? I try to wear the bulkiest shoes through the airport so I don’t have to squeeze it into my luggage. In the summer I always bring my Rainbow flip flops because they are ridiculously comfortable (I’ve walked in the streets of Portugal and NYC with them). Flip flops are small and very easy to tuck into little crevices (flats too). If I’m going to be walking a lot and the weather is a little on the colder side, I bring my sneakers, which I usually wear. If my feet are definitely going to get wet/cold for a few days, I wear boots. For interviews, I always pack my heels too — don’t be the weirdo wearing heels at the airport! (although props to you if you can rock it — I saw a girl in super high wedges and a dress at the LAX terminal once, and she was defintely the best dressed of us there!) Unless you’re going on a long trip, don’t pack more than a few pairs of shoes (less than 5). Are you really going to change up your shoes that much?

4) Medicine – Yeah, I’m lame, but let’s not forget that I’m a patient too, so this is important. This will definitely not apply to the majority of you, but if you are on any medications, travel is not the time to experiment with going off of them. As I’m leaving the house this is one of the first things I think of when I’m trying to recall if I brought everything. I try to bring all of my prescription pills in one container instead of bringing a thousand with me, so I pour approximate amounts into one bottle. I also throw in some vitamins, sleep meds, and Tylenol (the only pain-reliever I’m allowed to take) into the mix. Unfortunately, I have no experience with liquids or sharps, but I’m pretty sure you just need to show a prescription to security (when I was on EPO, I obviously was not flying around).

5) Electronics – I always bring my laptop in its sleeve (easy to whip out at security). I bring my DSLR ~80% of the time, usually with a light lens strapped to it (although if I’m “ambitious”, I’ll bring all of them). I bring my phone. I usually carry these in my carry-on because you can’t trust the baggage people with your precious electronics (my mom’s had her laptop ruined before). Because I’m hauling them with me, I try to go light. I pack all of my chargers away except my laptop one. Also, I charge everything to full before I leave (that way things are less likely to die on you). If I had a tablet, I might consider bringing it, but that’s highly unlikely since I sleep on the plane.

6) Travel documents – Passport/driver’s license are NECESSITIES. They also should be easily accessible so you aren’t digging around for them at security. If you prefer checking in beforehand, bring your boarding pass. My mom always says to check in first, but I have never found this to actually save me any time so I don’t.

7) Misc – Wallet? Sunglasses? Book? (yay)

Oh, looks like I’m boarding now. Well, I can’t think of anything I’ve forgotten for this trip, and I can’t think of anything I’ve forgotten for this list. Happy packing, and stay tuned for how to go through security, survive a flight, etc.!