Hybrid Vigor

A Primer for Applying

2007-05-12T16:52:00.001-05:00

Dear Friend/Family/Colleague:

You are receiving this letter because someone you know is about to apply to medical school. The entire lengthy process is riddled with intricacies, misperceptions, variables, and unknowns that make it unlikely you realize the full extent of what this person is about to do. I’m sure that you will try to empathize over the next year, but some things in life must be lived to be understood. Even my own knowledge base, seasoned over a long application cycle and qualified enough to enter medical school this fall has already become outdated with changes to the MCAT and the application process. Nonetheless, I will try to inform you as best I can.

A pre-medical student is born the instant they make the decision to apply to medical school. For most, this happens years before they ever start filling out application forms and taking tests. Making good grades is an obvious undertaking, but they must also be significantly involved in extracurricular activities, all while befriending busy professors to write raving letters of recommendation. All this extra work makes them an “average” applicant. Thus, for the pre-med you know, the application process began long ago.

The initial step in applying to medical school is the Medical College Admissions Test (MCAT, pronounced “em-cat”, not “em-cats”). For most people, this test is prepared for months beforehand, often utilizing expensive test-prep classes (>$1000), and on top of a full work/school/life load. Like most standardized tests that can be studied for, it does little to measure actual intelligence, but does reflect baseline knowledge in the sciences and reading comprehension needed for medical school, particularly in the first year. There is a weak correlation between MCAT score and USMLE scores (the licensing exam for MD’s) and even less predictability with being a good doctor. The full details of this 8-hour monstrosity could fill pages, but suffice it to say that the test itself is needlessly long (one quarter of the test, the writing portion, is generally not considered by medical schools), expensive (>$250), and just another “weed out” step in narrowing down the applicant pool into only the most studious and determined applicants. In my day, the exam was only held twice a year, leading to a great amount of anxiety on test day, but thankfully it is now being offered multiple times per annum.

Assuming your acquaintance has made it this far in the process and taken the test, next up comes the actual application mediated through the American Medical College Application Service (AMCAS) beginning in June, the year before they are to start med school. This is the pre-med’s first official foray into the needless bureaucracy that is the American medical system and a continuation of the expensive journey into medical school. All coursework and activities must be meticulously detailed in the AMCAS application. As this information will be sent to schools in a standardized format, pre-meds will strive to polish their resumes as best they can. More importantly, however, the AMCAS also collects a personal statement, also known as the application essay, which asks the question “why are you interested in medicine.” Herein lies one of the greatest challenges facing any aspiring physician – to put into words a lifetime of experiences that led them to pursue their career path. The personal statement can make or break an application, especially for the “average” applicant since there are thousands of others who likely have the same exceptional grades and activities. Using the cliche “I’ve always wanted to be a doctor since my parents bought me a Playskool doctor set” might as well be asking for a rejection because the admissions committee sees hundreds of these essays every year. No, this essay must be special. It must reflect who they are as a person. It must grab the reader’s attention and compel them to offer the writer an interview. Not surprisingly, finding a unique way to say “I want to help people” can be difficult. It will take a long time to write, with multiple revisions and criticisms. If your applicant is on the ball, it will be completed before AMCAS even begins to accept applications in June. Whatever you do, don’t question why they are spending so much time/stressing on an application because this step weighs heavily on the rest of their careers and lives. Applying early is a crucial advantage in a cutthroat process, where any edge should be employed.

Before hitting the Submit button on their internet browser, pre-meds must select their list of medical schools. Unlike college, where everywhere basically teaches the same material in the same way, each medical school has a distinct personality and should really only be chosen after some consideration. US News and World Report rankings is not the best of guides, as they are based mostly on revenue from research grants, not necessarily educational practice. Different schools will appeal to different applicants based on their interests. It is difficult to say one school is “better” than another, especially given that all Allopathic medical schools require national certification. In this regard, there are only varying degrees of good.

Although your pre-med may be very smart and accomplished, applying to the very top schools is not always a wise investment. Most applicants to every school will come from the top of their classes nationwide. No, Harvard will not accept them just because everyone says, “she’d make such a great doctor and she’s SOOO smart!” Even a 4.0 GPA and a high MCAT score is no guarantee to any medical school, many such applicants find themselves applying again in the next year (especially if their personalities are unappealing during the interview). The list of schools must also be chosen prudently because each additional school costs $30. I applied to an average number of schools, fifteen, which cost me approximately $500. In return for this exorbitant fee, which you must pay, AMCAS will check your transcript for accuracy (that applicants enter themselves) and send all the information in a nice, neat electronic file to each medical school. That’s right, for about an hour’s worth of work on their part and minimal production time/cost, they take what most student’s can save over an entire summer - but I digress and this fee pales in comparison to the next step in the application process. Did I mention that AMCAS processing takes about a month (if you’re early)? If your pre-med’s spirit and bank accounts are not exhausted by now, they soon will be.

Once AMCAS finishes their part, medical schools will begin collecting the primary applications and processing them in what amounts to another month of waiting. Mind you, each school will do things differently (see above about researching schools), but most will be willing to offer you their own, secondary application, for an additional fee of course. For each school selected in the AMCAS, pre-meds can expect to pay anywhere between $50-$120 for the pleasure of writing additional essays on exciting topics like “Why do you want to be a physician?(yes, they ask it again and heaven forbid you put the same answer as your primary application)”, “What makes you special?” or “Why do you want to come to School X?”. If they’re lucky, they’ll be able to recycle essays between schools, but expect lots of long nights and stress while they come up with answers that must not only be well-written, but sound original and fresh. If they applied to 15 schools like I did, it becomes very time consuming and expensive for this step alone (~$2000).

In another long pause after the frenzy to return secondary applications – remember, early is better – pre-meds will try to recover some lost money and time. Soon, interview season will be upon them. Don’t expect any particular reason why or when school’s schedule interviews. As I mentioned before, even excellent applicants don’t get interviews everywhere. An application may sit at a school from July to January the next year, presumed as a rejection, only to be called up for an interview. The logic behind each medical school’s admissions decision to interview (and accept) is a well-guarded secret. If you haven’t noticed odd behavior already, your pre-med will likely to obsessively check their email accounts every couple of hours/minutes for any word from schools. Small letters in the mail are generally rejection letters, get used to the sight of them arriving even if they’re a “better-than average” applicant. (Note: sometimes schools will offer interviews via snail-mail, but they will usually accompany an email).

A brief commentary on chances of admission: It is important for you to remain realistic during the application process. Making it any step beyond the secondary application is an achievement. A few exceptional students will be very fortunate in the process and garner numerous invitations and eventual acceptances. This is not the norm. Almost half of all applicants nationally will not be accepted anywhere and more applicants are applying every year. Many applicants get only a few, if any, interview invitations. At any medical school, expect only 1 in 5 applications on average to get an interview. Of these, only 1 in 3 or 4 will be accepted, for an overall acceptance rate between 3-10%. It may be tempting to stop worrying after receiving interview invitations, its not over until you see an acceptance letter in hand. In each of the waiting periods, be patient and supportive, but don’t assume that an acceptance is coming, chances are against them.

Assuming your pre-med is lucky enough to get an interview invitation so begins another round of expensive and time consuming preparation. Interviews are usually done on the pre-med’s own (you stay at home) and in proper business attire (more $$$). The cost of tickets and hotel can cost hundreds per trip. In these nerve-wracking situations, they can be expected to answer questions like “Why do you want to be a doctor (yes, they ask it again)” or “Tell me about yourself.” Unfortunately, there is a high degree of variability in interviews – some interviewers are nice, while others can put on a full-out grilling session, even at the same school. This is another reason why applying is often called a “crapshoot.” Applicants must prepare themselves to answer questions about medicine in general and also weaknesses in their application without sounded too rehearsed, although they are likely to have answered the same questions everywhere they interviewed. The day can be long or short, depending on the school, but almost always awkward formal – it’s a face to face meeting with the competition. However, they can be fun as pre-meds are usually Type A personalities with interesting backgrounds or else they wouldn’t have made it this far. Interviews are generally extended from September to February, don’t read too much into the timing.

Some schools will start accepting students soon after they start interviewing and are known as “rolling admissions schools.” Others, like many of the top schools, will make their applicants wait until March 15^th to hear if they are accepted, waitlisted, or rejected, known as “non-rolling admissions.” Some schools will not even send any kind of notification at all, leaving many pre-meds to wonder indefinitely. In perhaps the worst kind of torture this process can put you through, a pre-med can be put on the waiting list of the school they want to attend and held in limbo until the first day of school. At any given moment, even well into next July or August and after plans have been made to attend another school, a student may be accepted off the waitlist. Therefore, a pre-med applicant may never really know where they are going to school up until the day they actually attend somewhere – often over a year after they initially submitted their primary AMCAS application. Don’t expect definitive answers from your pre-med since there are many things to consider like cost (including financial aid with its own application process), location, and teaching style. I hope at this point you are beginning to understand my initial statement above regarding the complexity and strain involved in the application process.

If your pre-med does get accepted to medical school – any medical school – they are to be thoroughly congratulated. They beat the odds and the thousands of people clawing for a spot. A common trend these days is for applicants to take a few years off before school to add another dimension to their application. I highly recommend this approach for students because it gives them a chance to live life and get a break from school before the onslaught of med school itself.

After all this expense, effort, and drama, the “pre-med student” evolves into a “med-student.” Keep in mind that most pre-meds and med-students have a marginal knowledge of actual medicine. Even after medical school, we’re not very qualified to practice medicine on our own until after years of residency. So, hold off on your impulse to start asking questions about that burning sensation you’ve been meaning to see a real doctor about. Also keep in mind that the progression to medical student and eventual doctor is not a guarantee of financial success. Medicine is not what it used to be. The bureaucracy and hoops to jump through only continue during a physician’s career, which is probably why they make us do it when we enter the profession – they want to see if we are willing to put up with it. Many doctors will graduate with six-figure debts, live modestly, and lead stressful lives well into their 30’s and 40’s - something to consider before advocating a hand in marriage to any future doctor. Many experts agree that our healthcare system is in disrepair. Due to absurd insurance rates and frivolous lawsuits, physicians are leaving their practices in droves, resulting in a deepening healthcare crisis. Physician’s wages are determined by a pencil pusher at an HMO and may decrease with a change in US policy. Despite this bleak market outlook, pre-meds will still strive at great lengths to enter into medical school.

My strongest advice is to not assume too many things and to be patient with your pre-med during the application process. Ask questions and be prepared for uncertain answers. They will need your support through it all and even beyond. The stresses of becoming a doctor are great. Medical students have some of the highest depression rates among any profession. After all the drudgery, conformity, and expense, the original, bright-eyed, and optimistic person you know may be gone. I can only hope that I don’t go that way myself.

This letter is by no means comprehensive and maybe a little dated, but I doubt that much as changed in a year. I hope it serves as a primer for one of the most difficult years of anyone’s life – many people would agree that the hardest part about medical school is getting in. As a further resource, I recommend the Student Doctor Network (www.studentdoctor.net) forums as a place to ask for more information. Many applicants, including myself, have relied on this site while applying, especially when most of the people around me didn’t fully understand what was going on.

Good luck to you and your pre-med.

Sincerely,

Locus Potus

Nom de plum

Name Change

2007-01-29T19:51:00.000-05:00

I felt like there were too many science/medical blogs that started with "Musings of..." so I decided to think of something a little more original. I'm going with a term I learned back in Intro Bio, called "hybrid vigor", which refers to "increased strength of different characteristics in hybrids; the possibility to obtain a "better" individual by combining the virtues of its parents." I like this term because I am a mix of two disparate parental cultures and moreover, a physician-scientist is by definition a hybrid creature. Thanks to Blogger for making the transition so easy!

How to blow up a satellite

2007-01-19T19:47:00.000-05:00

I caught this article from Nature (Satellite kill creates space hazard) about a recent mission by the Chinese space agency to destroy one of its own defunct satellites in order to test anti-satellite missile technology. While they were able to destroy the satellite, scientists worry the shrapnel generated from the blast could pose a dangerous threat for other orbiting objects, including their own functional satellites.

I think the people at NASA and the Chinese equivalent have been watching too much Star Trek. The solution is pretty easy. Why not just incapacitate it by pointing it in the wrong direction, hijack it, or, even better, use a "soft" modality like insta-foam to render it useless? Like the article says, all you need is a basic guidance system with a digital camera. When the missile comes close, it shoots out its foam which covers the satellite of choice and then solidifies. Kind of like a cosmic foam party (see right). Sounds too low-tech? Just, check out the Mars Landers and their airbags they used to "crash" onto the surface of the Red Planet.

Saban Leaves the Dolphins for 'Bama

2007-01-14T22:57:00.000-05:00

Another public figure lies to the public. Nick Saban, now the former head coach of the Miami Dolphins, has left his post to assume the head coaching job at the University of Alabama.

The reasons I'm writing about this are the following: 1) To highlight the fact that you can not always believe what people say (including scientists/physicians/hacks) regardless of their position and 2) to demonstrate discrepancies in journalism today (which bears impact on science and medicine).

First, that for the weeks leading up to Saban's decision to leave the Dolphins, he was adamantly denying that he had any interest in Alabama. This was after he had made the mistake to say that he had "given it some consideration." He did such a good job of looking right into the camera and saying no, that even I started to believe him. Silly me. Turns out he was just deflecting attention so as to not upset his Miami employers and employees. He joins the line up of yet another public figure who, when necessary, will lie to cover his own ass.

Which brings me to my next point and perhaps the most illuminating topic, which is the press coverage surrounding Saban's departure. I was blown away by the constant questioning and skepticism about Saban's feelings since it was first announced. Poor Saban couldn't get away from the lines of questioning and the periodicals written about his interest in Alabama. Even more shocking was the cover story of ESPN.com when Saban officially announced his decision, titled "Liar Liar" by Pat Forde.

Where did these reporters come from!? Where was the same intense scrutiny in the lead up to the war in Iraq? Why have so few journalists and journalism organizations been so explicit in their disbelief and condemnation of President Bush and his abomination of a invasion based on WMD? I wonder if sports writers have more "cojones" to call someone out when they screw up or if the press turns in their journalistic license when they enter the White House press room. I really think that this is an example of the disparity that exists between our coverage of the government and all other affairs (even celeb gossip can be more scathing than the latest review of our politicians).

I hope that the journalists covering the war and politics take a page from their own print, the sports page that is, to be more critical and dogged in their reporting. Moreover, I hope they start to investigate the other areas in which this administration has gone awry, including redirecting funding away from scientific research towards defense spending. This already happened before the President committed us to a war that is costing us billions of dollars on a strained economy. Keep in mind that since Nixon declared his "War on Cancer" campaign, the US has spent roughly $200 billion on cancer research, which is less than we have already spent on the current war, with no end in sight and escalating violence. I say that again: more for war in three years than over thirty years on cancer. We now spend about $5 billion a year on cancer research, which is about the amount spent on a single month in Iraq. Think of all the milestone breakthroughs in apoptosis, angiogenesis, chemotherapy, etc. that we have generated from the money we have spent on research. That money is now being spent on trying to subdue a civil war.

So, yeah, our journalists (and politicians), who are supposed to represent the voice of the people really dropped the ball on this one big time.

Bad Science: Fated to Get Cancer?

2007-01-08T19:50:00.000-05:00

There was a recent article that came out of Cancer Research UK, a charity dedicated to raising awareness about cancer prevention titled "More than a quarter of Britons think cancer is a matter of fate," which was then reported on by Agence France-Presse in a reported titled "Cancer is Due to 'Fate'; Britons believe." Each of these publications describes the findings of a survey asking a cross-section of the population if they believe that "they could do anything to reduce their risk of cancer or whether getting the disease was just fate." Overall, they report, 23% of the population believe it is a matter of fate and that their lifestyle choices did not play a role in determining whether or not they get cancer.

I noticed that this story has gotten picked up by a number of members of the medical-science blogosphere and it seems as though there are a number of differing opinions about the interpretation of this study. If there is confusion amongst us, then I'm certain that there is even more confusion among the general public about what exactly this all means. Here, I would like to offer some of my own thoughts on the matter and how it illustrates a number of key points that I often see arising in the field and how it can lead to disagreement.

1) Source: Before we even get to the results of the survey, and even before we make conclusions, we have to examine the source of the information. As a charity driven by donations from people concerned about cancer, I doubt that Cancer Research UK is an unbiased arbiter in the information collection business. I am not surprised that the survey they conduct results in data that supports the need for their own organization. This is why polling services are used by a majority of interests groups, so that they can not be blamed for influencing the results.
Moreover, the original source is a press release and the coverage is based upon the scant information provided in it. This brings up two important faults: a) we do not have access to the original data and methods (see below) and that there was no oversight in the way the survey was conducted (no peer-review) and b) the information has been processed by two people who probably have very little experience in reporting scientific results. I don't know about you, but most of the humanities majors I knew in college loathed their science work [the rant on teaching science in college will be saved for a later time] and would probably have a hard time fairly making conclusions about a report that has an unclear experimental method (again, see below).

2) Experimental Design: What was the exact question posed to Brits in this study? We don't have this information. The wording of such surveys is extremely important, especially when the wording can influence the responses of the participants. Without the wording, we can not know for sure if this report was clear and unbiased. For this and the reasons above, I usually don't read these kinds of report expecting to learn something.

3) Results are open to interpretation: In perhaps my biggest gripe about this report, I feel that the results, as described, are ambiguous. For this, I will draw on a hypothetical example, illustrated below:

In this scenario, we have a total population of 200 people. We assume that the occurrence of spontaneous cancer is low, about 1%. Splitting the groups into smokers (ie lifestyle choice) and non-smokers of 100 each, we would expect that 1 person from each group would get cancer, regardless of any lifestyle choices. We can say that fate was not on their side because there was nothing they could do.

Assuming that smoking raises your risk 10 times, we then would expect 10 out of 100 smokers to develop cancer for a total of 11.

This is where the results become a point of debate. What makes the 1 person in the non-smoking group get cancer - is it fate? In this case, lets assume yes. The difference between her and the 99 other non-smokers was simply a stroke of bad luck. And the 1 smoker who gets cancer who would have gotten cancer anyway? Again, lets say that fate was responsible. Then there are the 10 additional people who got cancer in the smoking group. What made these 10+1 people instead of the other 89 "healthy" smokers is unclear and attributed to chance, or fate* in this case.

As other bloggers correctly indicate, no physician can tell a patient with certainty whether they will get cancer, smoking or not. In fact and to be fair, there is a greater chance that a smoker will not develop cancer (89) than actually get it (11). Making the assumptions above, it is fate that separates the 1 from the 99 in the non-smokers and the 11 from the 89 in the smokers group. Looking at it from this angle, it is valid to claim that fate is responsible for who gets cancer and who doesn't.

But to say that it is fate that dictates the 10 smoking-caused cancers vs. the 1 spontaneous tumor in either group is simply not true. It is the lifestyle choice itself that has given rise to the 10 additional malignancies. Therefore, we can no longer state that fate alone is responsible for cancer, irrespective of behavior.

Conclusion:
These kinds of studies may lead to confusing results. We can go back and forth on this all day depending on our interpretation, but ultimately it is the experiment and conclusions drawn are flawed from the get-go. We need to be cautious of our source of information and not let these press releases do more damage than good when their results are not scientifically sound.

* A note on "fate": Simply because something is unknown, does not mean it is due to fate or chance. There are many phenomena that we do not quite understand completely and tumorigenesis is one of them. Many things that used to be considered fate or luck now have scientific explanations. Take, for instance, the people who can have repeated unprotected sexual intercourse with an HIV+ partner without acquiring the virus (akin to not developing cancer despite smoking). An uninformed observer would say that these people are not fated to get AIDS. However, in reality, these many of these people are descendants from survivors of the Bubonic Plague in Europe. The disease selected for a genetic polymorphism that made some people resistant to viral infection and this allele remains today. I suspect that the susceptibility of some people (the 10) over others (the 89) will soon become clear in time with a biologic rational rather than pure fate.

Bye Bye Banners!

2007-01-05T23:01:00.000-05:00

I was listening to one of my favorite podcasts, Answer Bitch from E! Online, and heard their discussion about fan sites of celebrities getting shut down because the advertisements on their webpages were generating revenue. Since you can't use a person's image for profit without their consent, the websites were in violation of legal doctrine.

Similarly, I don't want for anyone to claim that I used some bit of information/picture for my own profit from the banners on this blog. Therefore, I'm deleting the GoogleAds from this site and will never put ads from other sources.

Moreover, I feel like I shouldn't be pressured (even if its a minute influence) to write for profit. Since Blogger! is free, there are no overhead costs that I need to cover with ad revenue.

That is all.

Book Report: Next by Michael Crichton

2007-01-05T22:15:00.000-05:00

Tite: Next
Author: Michael Crichton, MD
Amazon View

From the guy that brought us Jurassic Park, Sphere (one of my favorite books ever), and Congo (all turned into movies) comes his latest novel, Next. He's also the guy that inspired the show ER. I had forgotten about his medical background and sort of figured since I hadn't heard about him in a while that he was done with. The cover also reminded me about the movie 12 Monkeys and I thought it was going to be about the same thing. But then I go home for winter break and my dad starts talking to me about this book hes reading about gene therapies, cell lines, and transgenic animals. This kind of stuff is right up my alley since its the type of work I do in lab. I figured I had to readthis book since medical science is rarely used for popular fiction.

Overall, I thought the book was pretty good - not great, but good. I think I would have enjoyed it more had I not realized the errors in the science, which is what I'm going to talk about in this blog entry.
NOTE-SPOILER WARNING: If you don't want to know the ending, then don't read the rest...

Problems with the main story line: The primary story involves a cancer patient (Burnett [striking resemblance to the commonly used Burkitt's lymphoma cell line]) who signs up to be a research participant. Crichton glosses over the exact methodology the PI used, but in the end, the PI generates a cell line from Mr. Burnett that produces abundant qualities of a anti-cancer cytokine (molecule). Without telling the patient, the PI sells the cell line to a biotech company and doesn't compensate Mr. Burnett. In retaliation, Burnett plots to contaminate the biotech's stocks of the cell line. When he does this, the biotech hires a bounty hunter (after filing a law suit) to get the cells back. Here's where Crighton starts going wrong in his science. Since Burnett disappears, the bounty hunter goes after Burnett's daughter and her son because they are "genetically identical to their father." Now, you don't need to be a geneticists to know what is wrong with this statement. The daughter is obviously a cross between her father AND her mother, so she would not be genetically identical and thus nullify the claims in the lawsuit. There's only a 50% chance that she happened to inherit her father's genes that possessed the ability to produce cytokine producing cells. Moreover, neither the daughter nor the grandson had cancer and therefore, their bodies would not have been "challenged" in the same way as Mr. Burnett. Their cells would likely not produce much cytokine (if producing alot of cytokines was normal in their bodies due to their genetic make-up, Mr. Burnett likely wouldn't have developed cancer at all, therefore, cytokine production is a response to cancer). Finally, there is a technical problem with just taking biopies from people. Cell lines are incredibly difficult to generate and since their cells were normal, it would have been even more unlikely for them to generate a successful clone. If they did transform the cells (some kind of immortalization procedure), then the law suit would be null because the genetics had been changed. So, in all, Crighton missed many points that he should have known from his research in genetics.

What I liked alot were the issues raised by advances in genetic technologies. I think that these issues are what make the book worth reading. Even though I work with genetics daily, many of these concerns were things I hadn't even thought about nor are they discussed in our pursuit of advancing knowledge. I will write some seperate posts about the problems we face in the future of genetics.

Blog: Long road to medical school

2007-01-02T23:19:00.000-05:00

I like to follow the rule: Never give advice that you wouldn't follow yourself.

I apply the same thing when I recommend readings to people, blogs included. So, any blogs that I profile on here will be blogs that I read. For the personal blogs, I will usually have read the ENTIRE thing before posting it on here. Of course, I could see that changing in the future as my time grows shorter. But for now, I like reading medical student blogs to see what their life is like and to get a better sense of blogging (the good and the bad).

I just got done reading Old MD Girl's blog called "The Long Road to Medical School." [Link is on the right] I was glad to find this one because she is also an MD/PhD student. The amount of information regarding the MD/PhD program is pretty sparse. There are alot of MD blogs out there and hers reads like most of the rest of them out there. There tends to be a fair amount of bitching that goes on there, but hey, its her blog and she can do what she wants with it. Moreover, its easy to be critical when I'm not suffering through med school also.
She started her program at 29, which makes me feel better about starting at 25. Heck, there are people that start medical school in their 40's! There are also horror stories about grad students who take 10 years to graduate - in less time, most MudPhuds can get two degrees!

Anyway, shes a student at Penn's MSTP. A little bit feminist, which is cool. I just wish she would be a little more consistent in her opinions (doesn't mind terms like slave labor or calling people pussies). God bless her for keeping up an almost 1 blog a day average, thats some stamina right there. Its not one of my favorites, so I'm putting it in the "Other Blogs You Might Like" Category. The ones I like and read regularly are in the "Recommended Blogs" section.

Reference List of Words

2007-01-02T22:26:00.000-05:00

MudPhud - Shorthand/slang term for person holding both MD and PhD degrees. Also, MudFud.
MSTP - Medical Scientist Training Program; NIH-funded dual degree (MD/PhD) program.
Pre-Med - Person who aspires to enter into medical school.
PI - Abbreviation for Principal Investigator.
Principal Investigator - usually the head of a lab who directs the research
SDN - Student Doctor Network (excellent resource for medical school information).

Note: this post will continue to be edited as I go along and I feel the need to add terms.

Pre-Meds Gone Wiki!

2007-01-02T21:34:00.000-05:00

I spent part of this winter vacation satisfying an itch to learn about Wiki websites (Wiki means "fast" in Hawaiian). Basically, these are websites whose content can be edited by anyone. While this may seem like a dangerous proposal, it has been immensely successful with the generation of Wikipedia (encyclopedia) and Wiktionary (dictionary). The contributors to these sites are usually anonymous and often deliver better information (and more current) than an actual book. It should be noted that oversight is maintained by readers/contributors, so the fact checking is not always 100%, but I still think its pretty good. Whenever I have a question about some entity, I google the term, and usually the Wikipedia entry is one to the top results.
To me, I find this medium of information exchange a revolution for the internet. As Time magazine recognizes in its Person of the Year (a mirror is on the cover), YOU are now in charge of your experiences. Gone are the days when you are forced to sit on the sidelines and let other people make decisions about the information your are fed. If you see something wrong or something you would like to change on a Wiki website, all you have to do is click Edit, make a few keystrokes, and you're done!

Now, what does this have to do with science and medicine? Well, I was thinking to myself a few months ago about the medical school admissions process and how it might be improved. For starters, it would be great if we could channel the collective efforts of the hundreds, if not thousands of anxious pre-meds that scour the internet every year for every bit of information the can about medical schools.

For those who don't know, medical schools are very different from undergraduate colleges, in that experience in med school can be starkly different between schools, whereas in undergrad (with some exceptions) is pretty much the same wherever you go. Each medical school has its own personality and like to do things differently from the others. The nuances of each school make it hard to generalize about medical schools. This means that every year, thousands of would-be pre-meds must search high and low for tid-bits of information wherever they can - internet, word of mouth, books, etc. This is also means that EVERY year, the SAME questions get asked on the Student Doctor Network Pre-Medical Forums. You get alot of: "Does School X have rolling admissions?", "When does School Y have interviews?", "How many people does School Z accept?", etc. etc.

So, I thought, there has to be a better way of doing this. Why not take advantage of the advent of Wiki websites to have a place were folks can deposit the information they find so that life is easier for everyone? After learning the basics of the Wiki WYSIWYG language (I have some experience in Web design and programming, but it was easy to pick-up regardless), I set about thinking of every single bit of information that might be necessary in the admissions process of a particular school. Starting with general info, like the name, where its located, places nearby, etc. I then broke down the pre-interview, interview, and acceptance stages into seperate categories.

As you can see in the Blank Template on SDN, the list of attributes grew to be quite extensive. For good measure, I even added Google Maps functionality for convenience. Its then I realized just how much information about a school actually exists - and its different for EACH school. I'll leave it up to others to go in and fill out the information from the backbone template.

Its an unusual way to make a website, especially since there is essentially no content in the beginning - it will take some time for people to make enough significant contributions. But once its there, the information can be used for some time and updated as necessary. I'm excited to see how it all plays out. I'm also working on re-working the rest of the Pre-Med Wiki, so that it is a little more comprehensive and conducive for a Wiki website (it is currently based on a mini-book, written two years ago).

Who Blogs? And Why?

2007-01-01T23:41:00.000-05:00

I found this article from Slate talking about the type of people that blog.

I think blogging is an interesting phenomenon, especially the rate that it has pervaded our society. Sadly, I know that many blogs are junk. I heard on the news the other day that the average blog readership is at about 1 (author included). So, for the most part, people are really just writing to themselves. The Slate article confirms that many people think of their blog as a kind of journal that provides an account of their experiences.
I'll admit that my blog readership is low, probably not much higher than 1 (thanks for the comment Mo). This is because I'm holding off on "advertising" until I know I will keep at this thing for a while and until I know that there is actually some content on here worth reading. I have a number of blog entries that are still in the "draft" stage that I want to polish off sometime in the future.

Another thing is that I'm trying to define my message and who my audience might be. I would like to think that I would follow in the path of Blog A-Listers Top 100 Bloggers - that is to say the bloggers who actually have people read what they write:

Most A-listers are men over 30; have published before; are in it primarily to change public opinions and not to share their experiences; know only a fraction of their readers; and don't conceal their identities.

The only thing is that I am not over 30 , will be sharing my experiences in an effort to raise awareness about science careers, and my identity is concealed (I guess I won't be making the Top 100). I have published before (student newspaper commentary and scientific publications), would like to change public opinions (to get people to start thinking analytically), and don't know any of you readers. I'm don't tell anyone I blog because I don't really want people I know reading this because I feel it might skew my comments for fear of offending someone.

I think that there are a number of BIG mistakes that alot of bloggers make when constructing their messages. I will try to avoid this by only commenting on issues pertinent to medicine and science. Many of the med-student blogs I read like to comment on their personal lives (ie dating, lifestyle, etc) that I find particularly boring. I am also open to criticism, in fact I encourage it because a difference of opinion is a great way to realize flaws in both arguments and thus, the way people can come to an agreement.

Anyway, I guess in the end I'm not 100% sure why I do this, but will continue to give it more thought. Oh yeah, I find that some blog entries can get TOO long. So I'll go ahead and follow my own advice and keep them to about 1/2 page. A page at the most!

Bodies: The Exhibit

2006-12-30T19:37:00.001-05:00

Dead bodies as entertainment. Not exactly a novel idea, but its something that has become pretty popular recently. You may have heard of it or, if the exhibit happens to be in a nearby city, perhaps you have had a chance to go and view Bodies: The Exhibit and/or Body Worlds. Basically, people have donated their bodies to be preserved by a process called plastination, whereby the body is filled with a plastic-based preservative. The effect is that the bones, muscles, and other tissues are are preserved almost completely. I'll leave alone the debate over whether or not an exhibit like this is ethical and why the general public finds corpses so captivating. However, when I went, I was surprised to see parents bringing their little kids along (less than 3 years old). I guess people like the opportunity to experience the mystery and intrigue surrounding anatomy class in medical school using cadavers.

As I mentioned before, the preservation methods are quite good. The exhibit is a mix of partially dissected bodies (showing an organ system) along with individual bones or organs in viewing cases for clarity. The complete bodies are positioned in some kind of active motion, like shooting a basketball or a runner in stride.

It was a cool prelude to actual anatomy class, which I'll get to experience next year. The up close view was a tease for someone like me. I will find it much more interesting in a hands-on environment (there were a number of times that I just wanted to pick something up and get a better look or know how it feels). The Nervous System section was a bit intimidating because I saw how fine and delicate the nerves are that permeate the body. Around your belly button, a number of nerves burst out of your spine and radiate outwards. I fully expect me and my fellow students to tear through a number of these while digging through muscle and fascia during dissection. I only hope we don't demolish too many of the ones we are supposed to identify! [Note: this is the reason why some med schools offer pro-sections, dissections done by a professional]
I was particularly interested in the examples of cancer. Their gross anatomy is highly reminiscent of the tumors I see in lab in our mice. I also liked the examples of developing fetuses with the different bone stains. You can really see how the bones (especially in the head and hands/feet) start out as separate entities and they grow together in place or can even fuse together. The developmental abnormalities, while tragic, were pretty cool to see (abdominal hernia and Siamese twins).
In all, I came away from the tour with even more anticipation for starting school. It was cool to know that while many people may get to see these preserved bodies, at some point I'll get to see things in real life, pulsing and breathing. If you get the chance, you should go.

Graduate School Survival Guide

2006-12-30T19:23:00.000-05:00

Thanks to Ronald T. Azuma for putting together this informative and humorous survival guide for graduate school. I won't copy and paste his entire guide (not sure if thats even legal, much less ethical), but if his website ever goes down just let me know and I can post it here since I have a saved copy on my computer.

Graduate School Survival Guide

I think there are some points to garner from reading this. First, that you should be really sure about your decision to pursue a PhD (MD or not). Second, to know that academia is fraught with politics, so organization, communication, and planning are vital to your success. Take a tip from your business buddies and learn about networking early on in your career - those contacts will be useful in the long run! Third, be sure to show initiative.

Lord of the Rings: An Allegory for a PhD

2006-12-30T19:11:00.000-05:00

Its good to know that there are others out there struggling as much as you in the graduate years. I'll try to keep posting 'em as I find 'em.

Source: http://www.jacobite.org.uk/dave/odd/lotr.html

The story starts with Frodo: a young hobbit, quite bright, a bit dissatisfied with what he's learnt so far and with his mates back home who just seem to want to get jobs and settle down and drink beer. He's also very much in awe of his tutor and mentor, the very senior professor Gandalf, so when Gandalf suggests he take on a short project for him (carrying the Ring to Rivendell), he agrees.

Frodo very quickly encounters the shadowy forces of fear and despair which will haunt the rest of his journey and leave permanent scars on his psyche, but he also makes some useful friends. In particular, he spends an evening down the pub with Aragorn, who has been wandering the world for many years as Gandalf's postdoc and becomes his adviser when Gandalf isn't around.

After Frodo has completed his first project, Gandalf (along with head of department Elrond) proposes that the work should be extended. He assembles a large research group, including visiting students Gimli and Legolas, the foreign postdoc Boromir, and several of Frodo's own friends from his undergraduate days. Frodo agrees to tackle this larger project, though he has mixed feelings about it. ("'I will take the Ring', he said, 'although I do not know the way.'")

Very rapidly, things go wrong. First, Gandalf disappears and has no more interaction with Frodo until everything is over. (Frodo assumes his supervisor is dead: in fact, he's simply found a more interesting topic and is working on that instead.) At his first international conference in Lorien, Frodo is cross-questioned terrifyingly by Galadriel, and betrayed by Boromir, who is anxious to get the credit for the work himself. Frodo cuts himself off from the rest of his team: from now on, he will only discuss his work with Sam, an old friend who doesn't really understand what it's all about, but in any case is prepared to give Frodo credit for being rather cleverer than he is. Then he sets out towards Mordor.

The last and darkest period of Frodo's journey clearly represents the writing-up stage, as he struggles towards Mount Doom (submission), finding his burden growing heavier and heavier yet more and more a part of himself; more and more terrified of failure; plagued by the figure of Gollum, the student who carried the Ring before him but never wrote up and still hangs around as a burnt-out, jealous shadow; talking less and less even to Sam. When he submits the Ring to the fire, it is in desperate confusion rather than with confidence, and for a while the world seems empty.

Eventually it is over: the Ring is gone, everyone congratulates him, and for a few days he can convince himself that his troubles are over. But there is one more obstacle to overcome: months later, back in the Shire, he must confront the external examiner Saruman, an old enemy of Gandalf, who seeks to humiliate and destroy his rival's protege. With the help of his friends and colleagues, Frodo passes through this ordeal, but discovers at the end that victory has no value left for him. While his friends return to settling down and finding jobs and starting families, Frodo remains in limbo; finally, along with Gandalf, Elrond and many others, he joins the brain drain across the Western ocean to the new land beyond.

Good Tidings

2006-12-18T23:27:00.000-05:00

Man, after a crappy day in the lab its good to come home to some good news. My official letter of acceptance came in the mail. Unlike rejection letters, this is one small envelope I have been looking forward to receiving for a long time. I'm not going to open it though - I think I'll wrap it up and let my mom open it for Christmas (she's a big reason I decided to become a doctor, and even moreso to a physician-scientist).

I also made travel arrangements for another MD/PhD interview I have coming up in January. The nice thing is that they are paying for all my expenses on the trip. Like most schools, I was able to select a list of faculty members I would be interested in meeting. Although I originally found it a pain in the ass, I am now glad I took the time to do it. A large part of any MD/PhD experience will be decided by who you work for, so its important to identify some potential PI's beforehand. You don't want to wind up at a school and realize that there are few, if any, PI's that work in your field of interest. Luckily, this school had alot of successful PIs doing the kind of work I'm interested in (cancer biology/modeling) - more than I had known about before. Shows how a little research can be revealing.

I also got my GRE Subject Test score back from ETS. Yes, I was considering applying to graduate school this year, so I decided to take the tests in case I applied. I did pretty well overall considering I've been out of school for a while and my study preparation was erratic. I think I'm going to put my comments about the test, test prep, and what the results mean into a separate post because it deserves more attention.

Difference between MD and PhD

2006-12-18T23:21:00.000-05:00

I found this good, although not entirely accurate post, over on the SDN forums.

By ScottishChap
M.D. - harder to get into, easier to get through, science classes just scratch the surface, can get by by memorizing like a parrot, not treated as a colleague, expensive, independent thought is dangerous, program lasts 4 years, instructors can't mess with the class mean without repercussions, students whine a lot more, students assume all Ph.D. students are unhappy med school rejects. Overall: subject matter is one inch deep and 10 miles wide.

Ph.D. - easier to get into, harder to get through, science classes take it as deep as current knowledge permits, will fail if all you do is memorize, treated more as a colleague, inexpensive, independent thought is rewarded, program lasts 3-7 years, instructors can make exams hard enough that the mean is 40% without repercussions, students whine much less, students assume all M.D. students are snooty and arrogant. Overall: subject matter is 10 miles deep and one inch wide.

Now, where does that leave us MD/PhDs??

In review

2006-12-13T23:46:00.000-05:00

Good news today: my manuscript was approved by the journal's editors for peer-review. I'm crossing my fingers that the reviewers will like what I've written!

Getting Scooped

2006-12-13T19:49:00.000-05:00

Success in academic medicine is largely measured by publications. In fact, we live by the code: Publish or Perish. This means that you either show your abilities in research by publishing articles in peer-reviewed journals or else you will be deemed unproductive, incompetent, and ultimately irrelevant in the eyes of your colleagues.

There is TREMENDOUS pressure to publish. Not only are you concerned that about showing some productivity (it can be years between publications), but you will also be intimately worried about the possibility of someone beating you to the punch and publishing the same findings first. Researchers call this "getting scooped." This is bad news because it means your research project has just gone from being cutting-edge to yesterday's news. Novelty is lost and it looks like the other guys thought of it first (regardless if you did or not), so they can then claim all the credit.

It may seem uncommon, given the immensity of science, that two or more groups would be working on the exact same research project at the exact same time. Heck, it might even seem counterproductive for research dollars to be spent investigating the same thing. [Note: I'll save the debate about competition in science for another post.] However, it actually happens all the time. Just think of Elisha Gray. Who is Elisha Gray? Exactly. He's the guy that got scooped by Alexander Graham Bell in inventing the telephone. Bell made it to the patent office only a few hours before Gray. Point of the story: Don't be like Gray, don't get scooped. Of course, this means living in perpetual fear whenever you start a project because you are worried about whether someone will have already started on it and thus have a head start on you. Or, there are always those people out there who work day and night, sacrificing body and soul, in pursuit of scooping other people (aka Gunners).

Although most academians claim to be collegial, I know few who are entirely open with their ideas and data, simply because of the possibility of being scooped. There will always be the eager grad student/post-doc/PI sniffing around for the latest great idea to steal and publish without recognizing the origin (unless of course she praises himself for her ingenuity). As an aspiring researcher, you should be mindful of this fact because you don't want to share more information than you want to, but you still want to maintain collaborations. I'll admit its a tricky balancing act that will take some time to learn and you'll probably get burned a few times before you know when to pipe-up.

Interviews Coming Up

2006-12-12T19:32:00.000-05:00

Two interview invites in one week! I was surprised by one of them since it was from a school that had rejected me from their MSTP program, I figured I was out of the running for that school (private). The invite was for a MD-only program. I have heard many good things about this school, including its skyrocketing amounts of NIH funding being brought in during the past few years. It is also a school that has a modified Pass/Fail and Problem-Based-Learning (PBL) curriculum, which are very big draws for a person like me. But since it was MD-only, it would mean I would have to pay my way through school - this I didn't like. However, we are talking a difference of 4 years vs. 7-8 years in a MSTP program - it could be argued that the post-graduation income during that 3-4 year difference would make up for the cost of paying for school. It was something worth spending a little bit of time thinking about. Whats more, the school offers a 5-year program (tuition paid during MD and a stipend during a research year) that is also an attractive potential alternative to an MD/PhD (the program was created to accelerate physician-scientists' training). I figure that I'll go and check it out.

The second school is a large and successful public university and the interview is for their MD/PhD program. I'll admit that I'm nervous about potentially being one of the few non-in-state students in the medical school class and I wonder if the school's emphasis on public health affects the research side of medicine (and education). They have offered to pay for all expenses during the interview, which is nice. I have a couple of weeks to decide to go or not and I think it is worth being sure before I take these nice peoples' money and time.

Weird Dream

2006-12-12T19:07:00.000-05:00

I had a dream last night that I was interviewing for medical school at a well-known university and surrounded by uber-competitive, Type A, overachieving, all ducks in a row, T's crossed, and i's dotted kind of students. I felt uncomfortable being around these strangers that were so gung-ho about everything they did in life. Somewhere between my staying with a student host and the actual interview, I ran away, confused and upset but then I woke up.

I'm having more of these kind of strange dreams lately in the lead up to medical school. Reading House of God probably got my psyche thinking about my return to school or it could be attributable to the stress involved in interviewing ( I have one coming up). Its definitely going to be a shock starting actual school again, given the different type of learning that is required in medical school compared to life in the lab. Its also going to be weird being around overzealous premeds-turned-med students, whose ilk I typically avoided as an undergrad. These gunner-types are at every medical school, utterly devoid of personality, but have managed to slip through the system and now are set on getting into the most competitive residency. Right now, it looks like I'll be going to a school that is Pass/Fail - so that is helping me alleviate my fears.

Book Report: House of God

2006-12-12T15:38:00.000-05:00

There are a number of things that we do on the path to becoming physicians. Many of them, like taking the MCAT, passing organic chemistry, and submitting an AMCAS application can be considered "Rites of Passage." Among the litany of hoops that we jump through, reading the House of God by Samuel Shem is perhaps one of the most important things an aspiring doctor can do before starting medical school. Although a bit dated, the description of the realities doctors must face is essential for anyone considering the profession. Grey's Anatomy, ER, Scrubs, etc. really don't capture many of the horrors that real doctors must endure during their training. This includes dealing with incoherent patients, incompetent colleagues, and an endless stream of work that keeps you elbows deep in the body cavities of "gomers" (old people). Moreover, the stressful lifestyle begins to take a toll on your personality and relationships with others. The main character, Dr. Roy Basch, is a "red-hot" graduate of a prestigious medcial school and enters his first year of a internal medicine internship with all the best intentions. Through the relentless workload, overzealous and out-of-touch-with-reality Slurpers (kiss assess), and his own depression he loses himself and converts into a jaded and cynical doctor that hates himself and everyone else around him. The transformation is startling but understandable given the circumstances. The system just considers it "the way things are done" and doesn't take into account that times have changed and so have the demands of doctors. Something is definitely wrong with the way doctors are taught to take care of people.

I read the book because, like I mentioned above, it is a Rite of Passage that pre-meds go through - for good reason. The LAWS of the House of God are still quoted by practicing physicians and are worth knowing/thinking about. In particular, it is worth spending some time pondering the role of medicine in staving off death, but at what cost? Can treating a disease make things worse? What role do doctors play in death and controlling the autonomy of a patient over their own life? Although the book was written back in the 70's, we still don't have definitive answers to these questions, but more and more technologies are coming online that will let us prolong life without the necessary ethical considerations in place for administering end of life care.

I highly recommend that anyone considering a career as a doctor pick the book up, read it, and consider if you still want to be a physician. Like the Med School Hell blog, it will open your eyes to the career path that you are considering. Thankfully, there are now laws in place to prevent the insane workload imposed on recent intern/resident graduates - but these restrictions are not always followed.

Relevance Rating: 10/10.

Blog: Respectful Insolence

2006-12-10T17:35:00.000-05:00

I'll admit that I'm new to this blogging thing and that there are a number of other, more experienced bloggers out there. One good one is written by Orac, an MD/PhD graduate now at the junior faculty level (finished grad school, postdoc, and has started a lab of his own) called "Respectful Insolence." He's got some great posts on the life of a physician-scientist and I'll link to some that overlap with the aim of this blog (no need reading the same thing twice, right?). A link to his blog is on the right.

Don't Smoke

2006-12-04T22:19:00.000-05:00

If I ever need to be reminded of the world of medicine I'm about to enter, all I have to do is take the Patient elevators at work instead of the ones usually used by Staff. Today, I saw my first laryngectomy (I had to look it up) and it caught me off guard. Its not the kind of thing you see everyday. I didn't stare, but I did catch a good look. More than likely, it was due to some kind of esphogeal cancer - smoking is the likely culprit, but I cant be sure. I think that seeing the hole did more to dissuade me from smoking than all the Truth commercials I've ever seen.

Please don't smoke, it doesn't always kill you.

(Image source: www.microsurgeon.org)

91% Nerd - Need I Say More?

2006-11-29T19:20:00.000-05:00

9% scored higher (more nerdy), and
91% scored lower (less nerdy).
What does this mean? Your nerdiness is:
Supreme Nerd. Apply for a professorship at MIT now!!!.

I'll keep this in mind when I'm applying for a job at MIT in ten years.

The Mighty Mouse

2006-11-27T22:31:00.000-05:00

In the lab, I've been involved in the generation and characterization of a number of mouse models. Long story short, I've been around literally hundreds, if not thousands of mice breeding them, injecting them with stuff, checking for tumors, and if sick, euthanizing (CO2 inhalation) and dissecting them for analysis. I've had mice bite, pee, and poop on my hands (with gloves). I've been fingers deep in mouse guts with my face inches away from the body cavity trying to spot some interesting feature. I do it so often that I hardly think about it anymore.

Why is it then that a veritable "mouse guy" would be so afraid of a mouse in my house? (Disclaimer: I live in a huge old house with a big backyard that is prime breeding grounds for vermin; I'm not a dirty person, in general.) They manage to elude my mouse traps better than Houdini himself. The peanut butter trick has not been working. Usually, I just find their remnants (droppings), but occasionally I have a show-down with one of the critters. This usually involves my voice going up a few octaves, some expletives, an increase in blood pressure and heart rate, and a quick exit in the opposite direction. Why these feral rodents elicit such a contrasting response than my domesticated mice is still a mystery. Maybe its the psychological impression that wild mice are "dirty" whereas lab mice are kept in sterile housing with their bedding changed regularly (they spend most of their day either grooming or sleeping). Maybe its because they show up when I least expect them. Maybe I should just become a mouse myself.

Q&A: Why do researchers use mice for experiments?

2006-11-27T22:04:00.000-05:00

Q: Why do cancer researchers use mice for their experiments?

A: The reason we use mice is because they are (in order of importance) 1) much easier to do experiments on mice than with humans (Imagine: "You want to do what with my spleen?"), 2) closely related in their genome/anatomy/biology to humans (known as homology) - so the theory is "if it works in mice, it probably works the same way in humans", 3) inbred so that the genetic differences between individual mice are minor (its important to know the reason you see an effect is because of your experiment, not a a difference in the mouse itself), 4) small and we can fit multiple mice in a cage for efficiency, and 5) we can acquire them at relatively easily.

When we experimentally induce cancer in mice we call them "models" because they represent (although not exactly) a living system that we can use to find out some information about the disease. Much of the research going on now in the cancer field is to figure out what genes are altered when cancer forms and then to make those same DNA-level changes in mice (known as a transgenic mouse model). This strategy has had some moderately good success in generating mouse models of pancreatic, lung, colon, breast, and some hematologic (i.e. blood-related) cancers.

Cons:
- It goes without saying that there are still huge differences between mice and humans. This includes genetics, lifespan, lifestyle, etc. Not everything that works in mice works in humans.
- If left on their own, humans and mice develop a different spectrum of cancers. Humans most often develop solid tumors (prostate, colon, breast, pancreas, etc), whereas mice develop myeloid and lymphoid tumors (leukemias and lymphomas). No one is quite sure why this happens, but some people believe it has much to do with the length of telomeres (protective"caps" on the ends of chromosomes).
- The development of cancer is rarely as straightforward as a single/handful of genetic changes we create in the lab. Remember, people usually get cancer in the latter part of their lives - they have lived long enough that they have accumulated many mutations that normally are bearable until the straw that breaks the camel's back and cancer develops (smoking speeds up this process). Therefore, its very difficult to recreate ALL of these genetic events to get and EXACT recapitulation of what goes on in real life.

I'll try to find a good review article and post it on here when I get a chance.

Book Report: Justification

2006-11-27T20:58:00.000-05:00

Although a few of the more seasoned physicians (and scientists) might scoff at my excitement and anticipation at starting in a long, long MSTP program, I'll go ahead an admit that I'm riding a high at this point in my life. The great beyond on the horizon of my career beckons and all I can do now is look forward for things to actually start. As I wrote before, I have some time on my hands and like to take my mind off my research for a while. Among the things I plan on doing in the next six months before school starts is a great deal of reading. Right now, my mind is pretty interested in finding out more just what the hell I signed up for when I went around telling everyone I wanted to be a doctor. Obviously, I've had a lot of experience before applying to med school, but now that this sucker is actually going down, I want to know more about the road ahead.

So, I've picked up a number of books on what it means to be a doctor. Most of them are recommended reads for people interested in medicine. Every once in a while, when I actually finish reading one of these books, I'll write a brief description about it in posts titled "Book Report" (original, I know). If you're not interested, just skip these posts and continue to think I'm an idiot. We'll see how long this keeps up, or for that matter, how long I can keep at this blog without moving on to something else - as often happens with the wandering mind that god stuck me with. Here it goes...

Where I Stand

2006-11-27T19:55:00.000-05:00

I figured it might be worth mentioning a little more background information about me. I think it has something to do with my scientific training - we are taught to be skeptics, to resist accepting information without knowing the source (unfortunately, a number of quack drug companies take advantage of the fact that not everyone follows this rule).

As I mentioned before I was recently accepted to medical school and, to boot, graduate school as well. More specifically, I was accepted into a Medical Scientist Training Program (MSTP), which means that I will be going to medical school for a MD as well as graduate school for a PhD (also known as a MD/PhD program). I'll be starting school at the end of next summer (MSTP students typically start earlier than thier MD-only counterparts to begin exploring their research options before the onslaught of medical school). It typically takes 6-8 years to complete the program. Moreover, we are actually paid to go to school, that is, our tuition is paid for and we receive a stipend for living expenses. I'll comment more on the rationale behind this in a later post, but for now you'd be right to assume that I am becoming a professional student (somewhat of an oxymoron, I know).

Before I get talking about med/grad school, let me tell you a little bit about where I am coming from. Right now, I'm finishing up after spending some time out of school. Taking "time off" is a common strategy taken by pre-meds these days as it confers a number of benefits on the applicant and medical schools really like the maturity "non-traditional" (not straight from undergrad) incoming students have.

So, beginning about May of this year, I started getting my application ready for applying to medical schools through AMCAS (the centralized application service used by most medical schools). I'll post more later about the hellish process that it takes to get into medical school. For now, just keep in mind that applying in 2006 is for entry into school in 2007. I designated that I wanted to apply to MD/PhD programs, wrote the necessary essays, and hit Submit while praying that I hadn't overlooked a glaring mistake that would cause schools to laugh at my application before throwing it in the trash bin (there is NO going back once an application is submitted). Submitting that primary application with your personal statement is one of the many Rites of Passage for pre-meds. I happened to get an interview relatively early on (October) at an MSTP program and three weeks later, I got a phone call telling me that I had been unanimously decided on by the committee members (one of the happiest moments of my life).

After a deep sigh of relief and tears of joy being shed by a number of family members and friends (myself included), I realized that I was no longer a "pre-med" and could therefore abandon the incessant anxiety that has lingers at the back of the minds of premeds since the moment they decide on a career in medicine. This meant that I could stop religiously checking my email every 5 minutes for some kind of word from medical schools. This newfound time presents to me the opportunity to direct my efforts toward something like this blog.

During this time, I'll be posting on here alot about the things that got me up to this point, trying not to be repetitive with the wealth of information already available (of which I will refer to often), providing my personal perspective and insight on school, research, and health care/science. It is only natural for a scientist to be analytical and the methodology behind the process of becoming a doctor offers many areas for scrutiny. From then on, I'll keep the interested reason along for the ride hoping not to lose you or myself along the way.

The Addictive Personality of a Scientist

2006-11-25T10:01:00.000-05:00

I expect to post a number of times about my decision to pursue a combined degree program (MD/PhD). Basically, I am interested in both science and medicine and I expect to use both in my career, so thats why I'm going to school for both. I'll talk about my interest in medicine later, but I wanted to post this great article from 1990 in Science, talking about the personality of a scientist. For me and most of my friends who like to be holed up in a lab somewhere at ungodly hours in the night, we fit the description pretty well.

Science

30 November 1990

Volume 250

Number 4985

The Addictive Personality

Science: Dr. Noitall, you are the world’s greatest authority on addition, the seer that everyone consults, the man who got Sherlock Homes to kick his cocaine habit.

Dr.Noitall: A vast understatement of my true worth.

Science: Could you describe the addictive personality?

Dr.Noitall: An addictive person is one who has a compulsion to behave in ways that his or her family members consider detrimental to their interest. An addictive person will frequently conceal the extent of his addiction, will lie to his family about it, is immune to logical arguments to correct the error of his ways, and foregoes income that would require abandoning their addiction.

Science: Are we talking about a dope addict or alcoholic?

Dr.Noitall: No, I am describing a scientist. It is well known that work habits of scientists are addictive, leaving their spouses in tears, their children pleading, “Come home, Mommy (or Daddy),” and involve long hours in hostile instrument laboratories or cold rooms, exposed to noxious gases and radioactivity-conditions that no sane person would choose.

Science: But surely these individuals are paid handsomely for undergoing these hazardous conditions.

Dr.Noitall: This is the peculiar paradox. The profession is poorly paid because there are hundreds of applicants for every good position. Because of the psychic income that is exploited by our oppressive society, a scientist will accept pay that would make a movie star weep.

Science: But many of these individuals are academics who have the advantages of long summers off and light teaching loads.

Dr.Noitall: Academic freedom is the freedom not to take a vacation. Far from taking summers off, these individuals would rather develop films in the darkroom than sit on the beaches of Waikiki.

Science: But surely these individuals have a record of stable homes, paying their bills and other behavior not typical of an addict.

Dr.Noitall: That depends on how you define good behavior. These individuals tend to curl up with a copy of the Physical Review Letters, Journal of the American Chemical Society, or Journal of Biological Chemistry, rather than doing household chores or acting like good Americans who stay glued to the television set.

Science: So far, however you merely described an individual who works to keep his job.

Dr.Noitall: No, these individuals are definitely masochistic. They volunteer to serve on review panels that send them hundreds of incredibly detailed project proposals which must be read and evaluated. They sit through endless thesis defenses, volunteer to edit journals and serve on visiting committees for other schools when they have too much to do at home. They then complain bitterly that they are too busy.

Science: Is it apparent that these individuals could do well in other occupations?

Dr.Noitall: They are addicted to scientific logic, which makes it impossible for them to act like a trial lawyer who sues the city of New York for negligence when a drunken man falls off a subway platform, or a politician who claims one can increase services and pay lower taxes, or a movie star who testifies before Congress on carcinogens but does not know the difference between valium and valine.

Science: Is there any behavioral characteristic that can explain this obsessive conduct?

Dr.Noitall: Basically scientists have failed to grow up. They are all children, eternally curious, eternally trying to find out how the pieces of the puzzle fit together, eternally asking Why, and then irritatingly asking Why again when they get the answer to the first question.

Science: But can’t this addiction be cured by some new program or drugs and therapy?

Dr.Noitall: There is no evidence of hereditary characteristics of family environment to produce a scientist; therefore we have few handles on the potential cures, but the most glaring fact is that society cannot afford to cure these individuals. Their obsession is responsible for most of the progress of mankind and therefore the last thing we need at this moment is to turn these addictive scientists into well-adjusted television watchers. It is well worth giving them the tiny bit more money they need to stay addicted to science and to attract new compulsive personalities to their work. Society is addicted to scientists as scientists are addicted to science. – Daniel E. Koshland, Jr.

The Inner Life of the Cell (Video)

2006-11-25T09:38:00.000-05:00

A really cool (for nerds like myself) video of some of the cellular processes in the cell. I must have watched it 10 times. It reminds me of being a kid and going to Epcot center in Orlando, where they had a Body Worlds exhibit (not to be confused with the current Body Worlds dead body show) that showed a similar "microscopic eye" view of the body. It was one of the first events that I remember that made me want to be a doctor. Anyway, here is the video, check it out.

A blog primer

2006-11-25T09:31:00.000-05:00

Writing has never been my strong point - one of the reasons I'm writing this blog is to get better at composing my thoughts and articulating the main points. Expect for there to be lots of spelling errors, cursing, repeated phrases, and lines of thought that seem to go nowhere. I'm hoping that the posts will eventually improve, but we'll see.

Some you will "get" my sense of humor, others won't. I can be pretty cynical at times, but I think its just being objective. I tend to look at things a little differently than most people, something that I'll talk more about later. I'm very opinionated and willing to speak my mind - expect more than a few posts on politics and policy. You should also note that everything on here is just an opinion and not fact. Feel free to disagree or share your own thoughts. If you have something that would be worth posting on this blog (experience or insight), send it to me. Of course, I would reference the source (like a good scientist).

I'm going to start off anonymous, just because its one of those things that I could change my mind later to no effect, whereas its hard to go back once I've gone public with my identity. I'm hoping that it will allow me to be a little more open with my comments and that I won't piss off anyone.

You can also thank me for not using a dark background on this blog with white text. After reading a half dozen other blogs and having my retinas feel like they are on fire, I promised myself that I wouldn't punish the reader by having to suffer though that. [Blog entries are created in a normal text box with black text on a white background, I think alot of bloggers forget that their end product comes out so hard to read].

All these things start the same

2006-11-25T09:17:00.000-05:00

I was accepted to medical school two weeks ago, so begins the rest of my life.

My mind is hardly absent of thoughts. I'll be using this blog to capture some of the finer and less than finer moments of the coming years, which I can only imagine to be exhilarating, frightening, challenging, and rewarding all at the same time. At some point, I know I'll look back at this time and laugh at everything I didn't know I was in for. For the time being, all I can do is look ahead at the path before me, know that others have been on this route (and survived), and that this is exactly what I want to do.

SP