Inspired by a couple of Buddhist monks

This idea of… presence… the idea that one has to consider the person sitting across from them and not just the pathology. It’s damn difficult to be sure – the experienced clinicians seamlessly switch between seeing a person they’re having a conversation with and seeing the list of pathology of the patient. It’s difficult to be both personable and coldly rational simultaneously. The person in front of you is having the worst day of their life and is allowing you in in their most vulnerable moment. The patient has signs and symptoms and a diagnosis and a treatment plan.

Also inspired by the talk the monks gave: “Armor dents. Clay molds.” – by armoring yourself you’ll just take hit after hit until eventually the armor shatters, and you along with it. Molding to situations, adapting to them, being with the people you’re caring for improves resiliency.

 

My Match Story

Who I am: US IMG.

My background: BA psychology/neuroscience concentration. Didn’t have the GPA or the MCAT scores to get into a US medical school. Applied Caribbean.

• Did not get into SGU straight away – they put me in their Charter Foundation Program: passed.
• Withdrew from anatomy first term – ex-girlfriend passed away.
• Retook anatomy next term – passed.
• Passed all other classes.
• Step 1: 22x
• Did well in clinicals – very strong LORs.
• Step 2 CS: Pass, first attempt
• Step 2 CK: 21x
• Applied broadly – for neurology and internal medicine.
• 9 total interviews: 1 prelim, 4 IM, 4 neurology (3 categorical, 1 advanced) – Interviewed well (IMO, hehe)
• Partially matched on March 14 – Advanced without prelim.
• SOAP begins: send out the 45. No calls first day.
• Day 2 of SOAP: One call from transitional year program in FL, very nice conversation (14 slots up for grabs). Radio silence the rest of the day. Late evening – email for a facetime interview with MI transitional year program the following morning (8 slots up for grabs), also a call from a NY IM-Prelim program (4 slots up for grabs).
• Phone interview evening of Day 2 with NY IM-prelim PD: “You have fantastic letters of rec.” Hook, line, sinker… or so I thought.
• Day 3 of SOAP, AM: Pleasant facetime interview with PD of MI program (8 slots up for grabs). A few hours of anxious waiting.
• Round 1 of SOAP: NOT A SINGLE OFFER. ZERO. MI program fills completely in round one. FL program fills all but 3 slots. NY program fills all but 1 slot.
• PD’s start calling, FL program first: “anything?” “negative” “OK, putting you back in.” Then NY: “Anything?” “nope.” “hmm, really…” (obvious shock in voice) “Dr. XX I’m devastated.” “I know, I know. Just relax.”

– 3PM rolls around (Round 2): 2 offers pop up (THANK THE GODS!!!!!) – FL and NY. Accept NY, reject FL after consulting with deans. Wanted NY anyway.

And here I am today: matched to a university neuro program, of which I am the only IMG they took in their entering class of 3. Prelim at a well-regarded NY hospital.

Moral: Someone like me, with all my bumps and bruises and middling performance still made it out. Uphill battle, but battle still won. Never say die.

Future applicants: feel free to message me if you need a pep talk or a sympathetic ear 🙂

Pardon the interruption…

I know, I know. In my oft-repeated style I forgot about this blog. I’ll try and update soon when I can catch a breath (and there aren’t many of those in Term 4).

Pro tips

Another term is (almost) done.

The last final for this term was yesterday morning. The grades for the other major final of this term were posted yesterday afternoon (success! w00T!) and I have no “love letters” from the University. Life is good.

I say that this term is “almost” done because this Sunday we have this thing called the “Basic Sciences Comprehensive Examination I”. The funny thing about this BSCE I is that it’s been listed on the master schedule for forever but we were given no information about it. I have no idea what it’s going to be like even though I have some idea of what it will contain. The word in the wings is all that’s required for the BSCE I is a passing mark. Furthermore, if one does not get a passing mark, it’s rumored that one isn’t allowed to sit the USMLE I (scary!!!) That being said, this is an exam you can’t prepare for: there’s no conceivable way to review two terms worth of material in… 48 hours, now? 

Anyway, all that being said for those SGU Term 1 students who are playing along and following my inane ramblings here are a few tips for Term 2:

1. LEARN YOUR CYTOKINES FOR IMMUNOLOGY OVER THE BREAK. I know Immunology is a 2 credit class but honestly you’ll work harder for these two credits than you ever have. Lecture is not helpful because the professor assumes you already know what she’s talking about. A lot of people will recommend Lippincott’s Immunology or Problem-Based Immunology (an out of print book written by the professor. Copies can be found on SGU Post) but I had both of these books and didn’t use them. For as much as people swore by Problem-Based Immunology I didn’t find it helpful because there were questions but no solutions, so I couldn’t verify my thought process. To that end, find a term 2 friend and get the Immuno notes from them. Read it all over the break. All of it. Especially your cytokines. 
2. BRS is your friend. BRS Physiology (Costanzo), specifically. If you don’t have a copy, get a copy. Unlike Term 1, the Physiology & Neuroscience departments provide summary notes for you but the drawback is that these summary notes are comprehensive (close to 100 pages in length sometimes). You don’t have time to read it all, so BRS Physio is a good place to start. BRS Neuroanatomy is also good to have on hand but it’s not ordered the same as the Neuroscience class so you’ll have to hunt for the relevant bits.
3. The only other book you really need in paper format is the Haines Neuroanatomy Atlas. Spend the money for the latest edition (It’s like a $5 difference between old and new on Amazon) OR find a quality second-hand copy.
4. Don’t sweat CPM or Parasitology.
5. Genetics is well taught.
6. You can skip or Sonic most of the classes. I personally would recommend not doing so, but it’s possible to do well without ever setting foot in the lecture hall.
7. Get a FULL PD kit. I know people will say “oh, you don’t need a blood pressure cuff” because you only use it once in Physio lab but a new question they’re trying to phase in on the OSPE II is being able to take a blood pressure and pulse in 2.5 minutes. I didn’t have a BP cuff so I had to borrow one from an upper termer, but I know I’m going to need one for this upcoming term.
8. Your PD kit doesn’t have to be top-of-the-line, and in point of fact it shouldn’t because once you leave the island you’ll never use it again. The only thing I would suggest spending any bit of money on is the stethoscope because that will be yours for a long time =). The rest, go cheap if you must OR try and score some secondhand equipment.
9. Try and enjoy your break. Term 2 is draining.

I can’t think of anything else right now, either school related or personally-related. Although I am excited to finally get off this rock for a few weeks…. and then I’m stuck here for SIX MONTHS….

From dormancy to action…

(Long overdue update)

Remember back in grade school where Assignment Number One in English class after returning from break was the obligatory “How I Spent My Summer Vacation” essay? I can write my essay in two words: at home.

My original plan for the summer was to travel with SGU to India to participate in the medical selective which is offered there. In a nutshell, SGU students shadow physicians around a hospital and observe how they practice. Students are also permitted some hands-on experience such as performing routine blood draws. In my case, this didn’t happen. There were no blood draws, no crazy 3AM surgery calls, no assisting the OB-GYN, and no real (read: true-to-form, Delhi-belly real) Indian food.

Just me. And my brother. Stuck at home. All. Summer. (OK, that’s  a bit of a lie – explained below)

My younger brother tore his ACL in a soccer match and after his repair surgery needed me around to get things done (hence, no India selective). Once his physical therapy/physical rehabilitation started I was increasingly less needed, which was a welcome breath of fresh air. I spent the remainder of the summer volunteering with Habitat For Humanity which was something I’d never done before. I really enjoyed volunteering for Habitat. There’s something extremely satisfying about physically demanding work, especially when medicine has me clearly tracking to become a desk jockey.

Summer went quickly between Habitat volunteering, lifting, doing little bits of studying for Term 2 here and there, and of course the obligatory gaming sessions. Hilariously, for my birthday, my parents got the bright idea to take a family vacation to Jamaica. I protested this idea: I mean, come on I spend most of my time in the tropics anyway! Despite this, it was nice to spend time with my family all of us together before we all went off in different directions: my little brother heading off to college, I heading to Grenada, leaving only my parents and my little sister at home.

And then Term 2 started…

Term 2 can best be described as a hurricane: it starts off slowly and deceptively simply and then all of a sudden slams you with a ton of complex material. I’ll go through some pointers in my next update… but for now, I have my midterms starting Monday, so this very-disjointed update will have to do.

Ladies & Gentlemen, pardon the interruption…

I know it’s been nearly a month since my last post. In truth, I kind of forgot about this blog (sorry!) I got caught up in school
and life developments and writing fell by the wayside. So… now to fill you all in on nearly a month’s worth of stuff in as succinct a form as I can…

For starters, I’m repeating Anatomy this term. Last term I got taken on the midterm exam, had a veritable panic attack and subsequent cerebral shut down. In my state of reduced functioning, I missed the pass mark on the midterm by a few points and consequently was advised (in truth, more “forced”) to decel. It will take me an extra term to graduate, but that’s certainly preferable to failing Anatomy and getting dismissed from the school.

I’ve been keeping myself busy with involvement in several clubs and tutoring Biochemistry… This of course, is all secondary to spending much more time with Anatomy.

One of the advantages to taking only Anatomy this term is that I now have enough time to do what I didn’t do last term, namely go into the wet lab more often and spend more time doing the Gray’s Anatomy Review questions. All first termers at SGU are advised to do these questions at least twice through before both the midterm and final, not least because the head of our Anatomy department wrote the book! Last term, I had difficulty juggling Anatomy/Histology/Biochemistry and so doing these questions several times over fell by the wayside. Wet lab, too. Given that my last name starts with a “B”, my group activities like Histology lab and Biochem small group were first thing in the morning. Those would finish up by 10 AM and if I went to the wet lab after that it would usually be so crowded I would waste my time and not see a damn thing. This term, without the commitment to those small groups, I can go into the wet lab early in the morning when there’s no one there and really take my time and look things over carefully.

On that point… it’s a very humbling experience to be alone in the wet lab with a bunch of cadavers. It’s the realization that a member of the formerly living made the altruistic choice to donate his or her body to us medical students. I’m not sure how I’d feel about a bunch of bumbling first term medical students rooting around my viscera, but all the same given that others have so kindly donated their bodies for us to use I feel compelled to do the same when it’s my time to go.

On the point of death….
…
…
…
…
Two weeks ago, my ex-girlfriend passed away from acute promyelocytic leukemia. It came out of nowhere, ravaged her body, shut down her major organs, and caused cerebral hemorrhaging. Her parents ultimately decided to take her off the respirator because she wouldn’t have wanted to survive, not live mind you, SURVIVE, as an empty shell of herself. I’d dated her for almost three years prior to this point, and we’d broken up last August. She told me that she didn’t see our relationship “going anywhere” and that she didn’t want to “wait for me to finish medical school”. I understand her reasoning, and for the record, I’m not angry or spiteful or anything about it… I came to terms with our breakup. It’s the fact that someone can be wrenched from this earth with such fury and violence and tradecraft fails to stop this process… and I’m not one to betray emotionality or powerlessness. Too often medicine professes to “have all the answers” and when it fails, you start wondering about the path you’ve chosen. Doctors are cited as being too coldly rational when the family of the suffering is an emotional wreck but I’ll tell you the only way to function in such a situation is to be emotionally distant. Emotions mess with rational decision making. It takes real skill to be coldly rational and personally tactful simultaneously, and that’s a skill very few physicians possess.

Of course I was a wreck when I found out this news. Thank God, though, for the SGU community – several close friends helped me through this difficult period and I’ve managed to make my peace. Her funeral was last Saturday and although I couldn’t physically be there a condolence letter I had written her parents was displayed…. so at the very least I was there in spirit.

On break…

Home I am, this is the 50th post, and all I have on my agenda for the next month is taking it easy and preparing for next term.

Success!

Results are in!

GPA3.2 or better: CHECK!

PMSCE score 70% or better: CHECK!

I’M HEADED TO SGU, BABY!

Grenada

Status report

Midterm grades are in. Result: I’m still here.

More later.

Iatrogenics…

My mind is full of medical, or rather, pre-medical knowledge right now, and this is the first word that came to mind. Something iatrogenic is, by definition, “an illness caused by medical examination or treatment”. It follows, therefore, that iatrogenics related to medical school (if we take the word as a stepping stone) can be defined: caffeine abuse, sleep deprivation, irregular eating schedules, nutritionally inadequate meals, crankiness, isolation, and homesickness.

The last two are particular sinister and, I find, uniquely SGU-related phenomena (at least in my case). Yes I attended college in Boston, some distance from home, but I always had that escape route available to me. If I needed to go home for whatever reason (mostly just to get away from school and clear my head) I could do so. Here, I don’t have that option. Initially, everyone’s excited about being in the Caribbean and living next to the beach and how it’s all going to be  a grand old time and then the reality sets in: power outages, water outages, internet outages, bus stoppages, a herculean effort of the will required for accomplishing the most basic of tasks, the unending swarm of mosquitoes, heavy rain at inopportune times… All the above can be dealt with quite readily, however, as these are mostly global problems that affect everyone. We FTMers are hardest hit because SGU, ever so kindly, decided to “forget” about the upkeep and maintenance of the Grand Anse dorms.  Waking up the occasional morning without running water and needing a shower in order to be functional for the day begets crankiness. Crankiness begets people shunning you because you’re bitchy. People shunning you begets isolation, albeit quasi-temporary.

Needed  a vent.