2018 The Inner Machinations of my mind are an Enigma

1/4/18

To whom this may concern,

There’s nothing quite like the motivation you get at the start of a new year. The perfect time to look back on what you’ve accomplished, but more importantly, look forward to what you hope to achieve. For many of you, such would be to apply to, and ultimately get into medical school.

It’s not an easy task. In fact, it’s really flippin hard. I don’t have to remind you about the countless hours you pouring into your, MCAT, volunteering, research, and la di dah the list goes on. All that effort just to get your ducks in order to apply. Don’t even get me started on the actual application process.

But don’t panic, there’s hope. I was in your shoes one year ago. In fact, I was in your shoes two years ago as well, for I failed to get into medical school during my first cycle.

In hindsight, that first round was an anxiety driven shit show. I applied to 16 schools, got 2 interviews, and got waitlisted at one of those schools. I stayed on said waitlist for 8 gut-wrenching months before they finally put me out of my misery in the form of a rejection letter. So I paused, took a real good look on my application (and also at myself), turned some things around, did some traveling, and applied again.

Fast forward one year, and this current cycle was more than I could have dreamed for. I applied to 26 schools, received 4 interviews, which then turned into 4 acceptances. Better yet, one of those choices happened to be my top choice, my home state school, the University of Washington School of Medicine. 

The reason I tell you this is not to boast. I tell you to exemplify just how much you can improve once you know what to improve. The number one struggle that applicants face throughout the medical school admissions process is that they lack real feedback. It’s pretty much non-existent. Imagine how it feels to get invited to an interview, walk out feeling like you did well, only to get a rejection 3 weeks later, with no explanation or reasoning. It can be a huge blow to your self-esteem. I know it was for me. 

So what’s my point? My point is that I’ve been around the block. I’ve made all the mistakes along the way, but I learned, I adapted, and I stayed the course. My goal now is to pass off all that knowledge to you. To act as your guide, mentor, counselor, coach, consultant, whatever the hell you want to call it. My goal is to help you get into medical school. That is my new years resolution.

In these upcoming months, I aim to update this blog with frequent posts. Consistency is something that I’ve struggled with for awhile now, so it is now also your job to hold me accountable.

I am to cover topics like extracurriculars, MCAT, AMCAS, AACOMAS, secondaries, LORs, interviewing skills, and everything in between. Ideally, the reader that would benefit most from this would be people who are getting ready to apply in the 2018 cycle. However, it never hurts to learn this stuff earlier.

Happy new year and stay tuned ya filthy animals. 

-Randy

 


Note: I’ll also be posting intermittent stories from my experience as an ER scribe. I’ll find a better way to organize this at a later time.

1/6/18

Friday night in the ER.

I arrived to the ER at 6pm, expecting somewhat of a busy night. My job as a medical scribe allows me to chart for doctors as they see their patients. In essence, I am able to observe and learn from all the cases without taking on any real responsibilities.

I was working with Dr F tonight, who was one of my favorite. He’s got a mixture of that no bullshit attitude, as well as the reserved competence that can only be forged after a 20 year career in emergency medicine. He wants what’s best for the patient, but he’s also not afraid to tell them that the stuff they read on webMD is completely horseshit.  

Our night started with a 40 year old male complaining of chest pain. To preface this, the majority of chest pain that we see are musculoskeletal related, with no real cardiac problems. Another handful will have some cardiac disease that’s not life threatening. Then there’s the small majority that’s very, very sick. At 40 years old, you’re supposed to have a fully working heart, so I didn’t think too much at first, but as soon as we walked in the room you can tell that this patient belonged in the latter.

Sitting hunched over, he was gasping for air with a blanket of sweat covering his whole body. He was surrounded by 2 nurses and a tech who was trying to get EKG leads on his chest which he kept ripping off. The respiratory therapist tried to apply a breathing mask but he was fighting her as well. Pleads of “Sir you need to get this on so you can breath” were met with “fuck that I don’t want to use that shit”

Dr F took the reigns and proceeded to get to work. “Look man you gotta stop fighting us so we can help you”. He calmed the patient down as best he could, then began directing out the orders for an intubation tray. Looking toward the patient, he communicated how obnoxiously high his blood pressure obnoxiously high his blood pressure was and quickly edging towards respiratory failure. The urgent beeping of the vitals monitor affirmed this fact. His girlfriend was not helping, as every time she walked in she would begin hysterically shrieking, to the point where someone had to escort her back out.

This chaotic symphony continued for about five minutes, with the patient thrashing while a team of 5 surrounded him shuffling to work out the necessary steps to keep him alive. Finally, the intubation tray was ready to go. The sedation medicine kicked in and the whole room began to breathe a sigh of relief as his flailing arms went limp. From the tray, Dr F grabbed a polished laryngoscope shaped like an icepick and inserted into his throat. In two sharp movements and a peak at the glidescope monitor, the tube was in. The sounds of the cardiac monitor soothed into a slow steady rhythm as tension left the room. This guy was going to be okay, for now. We walked into the hall.

It was a busy night and there were patients lined up on stretchers in the hallways. Almost 45 minutes had past, and I realized that this was the first patient that we saw. The lobby was starting to get packed, and so on to the next patient we went. Chief complaint – seeing visions.


1/9/18

Premed Arms Race

“You had to do how many hours?”

The doc I was working with looked at me incredulously. I tried explaining to him that in order to get into medical school these days, students were “encouraged” to seek out and gain an array of extracurricular activities, from shadowing to volunteering, research to teaching. All in the name of becoming a holistic applicant. HIs response was “shit, well I’m glad I didn’t have to jump through all those damn hoops”.

As a student, I didn’t know any different. To me, getting these extracurriculars was how it’s supposed to be done. At the time, I never viewed them as jumping through hoops. To my starry-eyed premed self, these experiences felt like a way to demonstrate my commitment toward the field of medicine, and to be sure about my decision to become a doctor. But on the flip side, does it really 100 hours of shadowing, 600 hours of volunteering, and 1000 hours of research to affirm this decision? That’s the million dollar question.

Starting off with just numbers, it’s hard to argue against the increasing competition of medical school admissions. Last year, there was about 51k applicants competing for around 22k spots. Compare this to 2004 where there were only 33k competing for 16k spots. Also, from 2002 to 2017, the average GPA of matriculants also increased from 3.61 to 3.71. So not only are there more people applying for medical school, these students have all reached a higher caliber. (stats taken from Medbros video, I was too lazy to do my own research)

So how did this happen? My claim, and some have agreed with me, is what I call the “pre-med arms race”. Back in the day, you were able to get into medical school with a decent GPA, somewhat decent MCAT score, and maybe a bit of volunteering here and there. Schools got competitive, so then the average GPA and MCAT scores began to rise. When those two metrics plateaued, applicants needed a way to distinguish themselves. One day, Joe Schmoe was daydreaming in biology and decided hey, why not help my biology professor with research, other candidates won’t have that and it will give me a leg up on my application. So he did research, and he got in. When Paul sees how Joe succeeded in his application, he tried the same idea, and got in himself. So the trend caught on, and before you know it research became an unspoken requirement for applicants. So on and so forth. Instead of stockpiling nuclear weapons, people were collecting extracurriculars to prove that they were the better candidate.

Now, to finish up my argument: does being able to pipette 96 wells in warp speed translate into a better future physician? Shit no, but does it demonstrate commitment? You bet. It shows that you want it more badly than the guy sitting next to you. Medical training is long, and schools want to invest in the strong and gritty eggs that are most likely to pull through. So what’s the secret trick? This might blow your mind, but… finding something you’re actually interested in. Don’t pick the first research lab that’s hiring. Shop around and find something genuinely interesting. Don’t ever just go through the motions. That becomes even more detrimental when you get asked about it during the interview, and everyone can tell you don’t give a shit about PCRing zebrafish poop.  


1/12/18

Quantum Leap 

We live in a society that is transcended by the idea of the quantum leap. What do I mean? Turn on the TV. In any romcom, you see a guy who gets his dream girl in the span of two hours. Go back and watch Rocky, he starts out in the gutters and becomes world famous. Of course, for the sake of entertainment (and sake of your time), they bypass the thousands of hours of commitment it takes in order to reach that point.

The same should be said about pursuing anything worthwhile. Whether that be starting your own company, becoming a doctor, or getting in shape. It takes daily persistence, it takes habitual excellence. There is no one single moment to reach greatness. Instead of a leap, it’s a million tiny steps toward the right direction, chipping away at it until one day you look down and see how far you’ve come.

If it were easy, everybody would do it.