September/October 2015 by PreMedLife Magazine

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The Magazine For Pre-Medical Students

September/October 2015

BACK TO L O O H SC

WHAT SUCCESSFUL PREMEDS DO FRESHMAN YEAR THE NEW MCAT TOPIC THAT NOBODY IS TALKING ABOUT

There’s bee a lot of chatter about the new test but here’s something you haven’t heard

PREMEDLIFE.COM

During the first year of undergrad there are things you need to start thinking about

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Contents|

September/October 2015 “The transition from high school to college can be tough. Many freshman students have trouble getting organized and staying organize.” p. 24

19 BACK TO SCHOOL

WHAT SUCCESSFUL PREMEDS DO DURING FRESHMAN YEAR

ADVICE TO MY SOPHOMORE SELF ABOUT GETTING INTO MED SCHOOL

QUESTIONS EVERY PREMED JUNIOR SHOULD ASK

AS YOU BEGIN YOUR VERY FIRST YEAR OF YOUR COLLEGE CAREER, THERE ARE MANY THINGS RUNNING THROUGH YOUR MIND.

GETTING ADMITTED INTO MEDICAL SCHOOL IS NO EASY FEAT. HERE’S ONE STUDENT’S TAKE ON THINGS.

JUNIOR YEAR CAN BE INCREDIBLY DIFFICULT. THERE ARE A COUPLE OF IMPORTANT QUESTIONS TO ASK TO SET YOURSELF UP WELL FOR THE NEXT COUPLE OF YEARS.

September/October 2015 | PreMedLife Magazine |3

Contents

SEPTEMBER/OCTOBER 2015

Here are some words to

l motivate premed seniors to make it through their final year in undergrad.

The New MCAT Topic That Nobody Is Talking About

There has been a lot of chatter about the new MCAT. But there’s something you probably haven’t heard. When the AAMC revised the MCAT in April, there was much fanfare and hype about two new subjects.

The Seniority Paradox

If you are being given the chance to interview, it means that the school already likes you as an applicant and wants to make sure that what they see on paper translates into a real human being.

WHAT’S INSIDE...

Inspirational Quotes for Premed Seniors

The medical school application process is inarguably a tedious one. There are primary and secondary applications to fill out. There’s the MCAT to dominate, your list of personal experiences to fine tune, and your personal statement to draft.

If You Didn’t Write It Down, It Didn’t Happen

Medical school has often been likened to a marathon. Both take a lot of time, both leave you feeling exhausted and yet accomplished. While one leaves you with a “26.2” sticker on the back of your car for bragging rights, and one gives you permission to be addressed as “Dr. _______,” both are considered impressive 4 | PreMedLife Magazine | September/October 2015 accomplished.

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Digital

SEPTEMBER/OCTOBER 2015

Sabotaging Your Changes of Getting Into Medical School There are a couple of things that you can do during your time in college or after college that may negatively impact your chances of getting medical school.

What’s on Premedlife.com? 10 Things I Would Tell My High School Self

You’ve been dreaming of being a medical doctor for a long time-some of you all the way since high school.

A Look at Becoming a Naturopathic Physician

If you want to be a doctor who is an expert in prevention and natural therapies, here’s a look at what it takes.

How to Not Get Distracted By Things You Cannot Control Most of us who are trying to pursue medicine fall into a specific type of student who likes to always be on top of his/ her work and be in control of whatever situation we are put into.

GO BEYOND THE PAGE

You’ll find the icon on selected pages throughout the issue. That’s your signal to grab your smart phone or tablet and go deeper with the content on that page. Here’s how: 1. Download the free Layar app from the Apple or Android store or at layar.com 2. Launch the app and scan any page displaying the icon. 3. Premedlife videos and other bonus content will instantly appear on your device.

6 | PreMedLife Magazine | September/October 2015

March/April 2015 | PreMedLife Magazine |19

From the

Publisher

PREMEDLIFE the lifestyle magazine for premedical students www.premedlife.com

Founder & Publisher | Tasheema Prince Executive Director | Jonathan Pearson

BACK TO “BUSINESS” “Conserve your forces and energies by keeping them concentrated at their strongest point. You may gain more by finding a rich mine and mining it deeper, than by flitting from one shallow mine to another - intensity defeats extensity every time.” - Robert Green Yes, some of you are saying that this issue’s opening is rather “heavy” for your precious pre-med minds to ponder. But the fact of the matter is, when I read Law 23 from

Robert Green’s The 48 Laws of Power, I thought about when I was a pre-med and thought I wish someone would have told me that when I was going through the motions of being a pre-medical student. So, I am telling you! As a pre-med, you may find yourself being pulled in so many different directions, at so many different times, by so many different things. It is utterly important that you remain focused on the goal at hand. “Concentrate on a single goal, a single task, and beat it into submission.” Yes, the goal of getting into medical school and pursuing a career in medicine has many moving parts, but you must remain committed to what you set out to do in the first place. There will be ups and there will be downs along the way - that’s all part of the process and that’s all part of what will become your story. With the new academic year upon us, we are always excited to see the new, the old and the in between pre-medical students who are excited about taking another step along the journey. That’s why, in our back-to-school issues, as always, we’ve included articles for all students, no matter what part of the process you may be at. We also love hearing from our readers about how they’re feeling about the new school year, so send us an email to let us know how back-to-school is going for you. As always, we here are PreMedLife wish you all the best success this year.

Tasheema Prince Tasheema Prince Publisher Follow me on Twitter: @PrinceSheem Email me at: tprince@premedlife.com

Executive Vice President | Monique Terc Contributing Editor | Njeri McKenzie Online Marketing Consultant | Portia Chu Contributing Writers Seemal Awan, Erin Fortner, J.D., EMT, Austin Greer Find us on Twitter @premedlife Find us on Facebook.com/premedlife Here’s How to Reach Us: Kisho Media, LLC P.O. Box 7049 New York, NY 10116 Main Office (347) 857-7491 Have a Story Idea? Email us at editor@premedlife.com Want to Subscribe? Visit www.premedlife.com and sign-up to our mailing list to receive an email when the latest issue is available online Want to Join Forces? (a.k.a. Partner With Us) Email us at info@premedlife.com Advertising Inquiries? Email advertise@premedlife.com PreMedLife magazine is published six times per year by Kisho Media, LLC. and copies are provided to select colleges and universities free of charge. The information in PreMedLife magazine is believed to be accurate, but in some instances, may represent opinion or judgment. Consult your pre-medical/pre-health advisor with any questions you may have about the medical school admissions process and related topics. Unless otherwise noted, all articles, photographs, artwork, and images may not be duplicated or reprinted without express written permission from Kisho Media, LLC. PreMedLife magazine and Kisho Media, LLC. are not liable for typographical or production errors or the accuracy of information provided by advertisers. PreMedLife magazine reserves the right to refuse any advertising. All inquires may be sent to: Kisho Media, LLC. P.O. Box 7049 New York, NY 10116 To reach us by phone call (347) 857-7491 or email us at info@premedlife.com.

8 | PreMedLife Magazine | September/October 2015

M I NOS CAN ACH IEVE ANYTHING. We make sure they get to college. Federal Student Aid provides more than $150 billion each year in grants, loans, and work-study funds to make college possible for anyone with the mind to get there. Learn more about money for college at StudentAid.gov.

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S T U D E N T A D V I S O RY B O A R D

The PreMedLife Student Advisory Board is an exemplary group of premed students from a variety of backgrounds who have a wide range of accomplishments. They will help keep us informed about what we need to know to make PreMedLife magazine the go-to resource for aspiring doctors.

Tisha Berg UCLA Extension

Viven Chen University of Miami

Samantha Culver University of Vermont

Caitlin Draper University of Arkansas

Jared Eaves The University of Texas at Austin

Austin Greer Indiana Wesleyan University

Charis Guinto Evangel University

Hannah Hoekstra University of Minnesota

Lisa Lachhman Pace University

Austin Newsman Georgia State University

James Rock Slippery Rock University

Tyra Turner Agnes Scott College

10 | PreMedLife Magazine | September/October 2015

March/April 2015 | PreMedLife Magazine |19

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Premedical students who get more time to take the MCAT do not per-

NEWS

form better than students who take the MCAT under the standard time constraints. {PAGE 15}

istockphoto / XiXinXing

New Paper Offers Solutions To The Impending Latino Physician Shortage

The growth in the proportion of Latino-identified medical school applicants and matriculants is slow, according to commentary published in the journal Academic Medicine. The commentary, led by John Paul Sanchez, MD, MPH, assistant dean for diversity and inclusion at Rutgers New Jersey Medical School, is in response to the paper “Latino physicians in the United States, 1980-2010: A thirty-year overview from the censuses” and offers a number of solutions for developing the Latino physician workforce. Background information provided in the commentary points out that the low numbers associated with this group of students is even seen when the definition of underrepresented racial and ethnic groups in medicine has been broadened to include not only Latinos who are mainland Puerto Rican, U.S.-born Mexicans, and U.S.-born Cubans, but also Latinos who are from any Spanish-speaking country. Specifically, between 2002 and 2011, the

proportion of Latino applicants grew minimally from 7.3% to 7.9%, and the proportion of accepted applicants increased slightly from 6.8% (1,193/17,592) to 8.4% (1,701/20,176). “More research is needed to understand the demographic characteristics (e.g., the nativity, gender, socioeconomic status, place of residence, educational experiences) of applicants and matriculants, the changes in their demographics over this same time period, and the impact of these characteristics on institutional climate, culture, and patient care. The paper notes the importance of early intervention and calls for academic health centers (AHC) to get involved by working with K-12 educators. “AHCs may “grow their own” cadre of Latino physicians by supporting teacher preparation and offering after-school and weekend programs that enhance academic proficiency and/or part interest in careers in medicine and science,” the authors wrote. “Medical schools also need to begin or increase recruitment

at institutions with significant Latino student bodies such as at Hispanic-servicing institutions and community colleges.” What are the next steps? Dr. Sanchez and his team stated this: “The number of Latinos is rapidly growing—nearly one in three individuals in the United States will be Latino by 2050—thus, there is an urgent need for U.S. AHCs to proactively meet the needs of this population. Research on the outcomes of and best practices among our Latino physician pipeline programs is overdue. Hispanic-identified organizations, leaders, and health professionals must be engaged to inspire and recommend institutional innovation and excellence. Sánchez and colleagues call attention to the shortage of Latino physicians that has persisted for 30 years. We call on our colleagues to build the next generation of the Latino physician workforce and to develop the skills and knowledge of all health care professionals to address Latino health care and disparities. ¡

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Shadowing Program Benefits Pre-Medical Students In Arkansas Physician shadowing program achieves a number of goals, according to an article published in the Journal of the Arkansas Medical Society. The Alumni/Student Pre-Med Shadowing Program, which is available to students at Hendrix College in Arkansas, was started as a way to help students who were applying to medical school connect with physicians in Arkansas who were also alumni of the school. “Our thought was that a shadowing program would be a good way for Hendrix pre-med students to get exposure to different fields of medicine with help from alumni practicing in those fields,” said Dr. Hayden Franks. “The idea also represented a way to help alumni physicians reconnect with their alma mater.” The program pairs pre-medical students with working physicians in various specialties. Like other programs which foster the relationship between physicians and medical school wanna bes, Hendrix

College’s shadowing program offers students an outstanding opportunity to get a first=hand look at a career in medicine. According to the article, the first year of the program saw 51 students who were matched with 32 doctors in the area and the rate steady, with 55 students and 40 doctors being involved most recently. One student, Ples Spradley, who participated in the program for multiple years had quite a positive experience while participating in the program. “Shadowing confirmed that medicine is a field that requires constant learning. That is exciting to me,” said Spradley. “In each experience, I noticed the caring nature of the physicians during interactions with patients and witnessed relief and comfort on patients’ faces when they received good news from their doctor. The common theme was an intellectual, challenging environment with caring people who make meaningful differences in the lives of patients.” ¡

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M C AT

The New MCAT Topic That Nobody Is Talking About There has been a lot of chatter about the new MCAT. But there’s something you probably haven’t heard.

Looking for proper controls Every researcher knows that an experiment has to have proper controls. There’s no way to tell if your treatment had any effect if you don’t have a baseline to compare against. While this isn’t new for the MCAT, the degree to which it is being tested is. We also need to be aware of the difference between positive and negative controls. A negative control is how we typically think of a “control group”. That is, a group that gets no treatment at all. Researchers need to see what happens when we don’t use the treatment or experimental effect. By contrast, a “positive” control is a group that does get a treatment, but not an experimental one. The positive control group gets a treatment that we already know works, sometimes referred to as the “gold standard.” Researchers need to do both positive and negative controls when doing biomedical research, especially when the research has a psychosocial component. As an example, consider a case in which research-

ers are investigating a new pain medication. The negative control group would receive the standard sugar pill placebo. The experimental group would receive the new drug. And the positive control group would receive a drug already proven to reduce pain – aspirin, for example. On the MCAT, test takers would be expected to look for some sort of discussion of these control groups in the passage. If the discussion is missing, then there’s a pretty serious flaw in the study. Which leads us to: Spotting limitations in experimental procedures Many times the questions on the MCAT will have the researchers making conclusions that are much too broad for the given data. To succeed on the exam, you’ll need to spot when researchers reach too far. As mentioned earlier, the simplest example is a lack of controls. Missing a control group is such a serious flaw in an experimental design, that almost no conclusions can then be drawn based on the data. More common, however, is when the data set is reasonable, yet not strong enough to make the sorts of conclusions the questions will present. The two big issues the MCAT likes to test are p-values and correlation/causation flaws. In the latter case, we must remember that data showing correlations (whenever A shows up, B also does) do not directly prove causation (A causes B). In a recent official sample passage from the AAMC, the test showed that parents with anxiety problems tended to have children with anxiety problems. The test then asks us whether or not we can conclude a genetic causation link here. Needless to say, the answer is “no” (I won’t say more to avoid spoiling that question). The p-value is a statistical tool that determines how likely it is that the results of an experiment are pure chance. Suppose we are testing the pain medication mentioned earlier. We find that the average pain relief report for users of the new experimental drug is 10% more relief than with aspirin. That

sounds good, but we have to make sure this is significant, so we test the p-value for our data. If the value is, say, 0.01 then that means there is only a 1% probability that our findings are totally random. There’s a 99% likelihood that our findings are not just due to random chance.

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istockphoto / CurvaBezier

WHEN THE AAMC REVISED THE MCAT in April 2015, there was much fanfare and hype about two new subjects on the test: biochemistry and psychology. Seemingly under the radar, the AAMC actually added another new topic to the exam that most students are unaware of: experimental design. The MCAT has always included questions that tangentially asked about how an experiment was put together, but never before has this area been so explicitly and so heavily tested. The two new “scientific inquiry and reasoning skills” on the exam – “reasoning about the design and execution of research” and “data-based and statistical reasoning” – comprise between 35 and 40 questions on the new test. To put that in perspective, that’s more questions than physics and organic chemistry, combined. So, what do they actually mean when they talk about testing experimental design? Broadly, that means three things:

Solving “calculation” questions without doing any calculation

istockphoto / CurvaBezier

Finally, data-based reasoning often involves doing calculation-based questions. The test may ask us to do calculations related to physics, general chemistry, biochemistry, or even biology. Although we won’t see many, they can be exceptionally time-consuming and frustrating. After all, you could spend several precious minutes solving a math problem, only to get a number that isn’t even among the answer choices! So when it comes to managing tough calculations, you need to do two things: look at the units and estimate aggressively. When it comes to the units, the MCAT loves to give us questions with choices using two different units. For example, a choice might ask about the tension in a muscle and give two answer choices in Newtons and two answer choices in joules. While the unprepared test-taker would just dive right into equations, the savvy student will first eliminated the two choices given in joules. We know that joules are a measure of energy, but tension is a force. It’s measured in N, not J. At that point, it’s often the best test-management choice to simply take your best guess and move on, so as to conserve precious time. Your goal is to work smarter, not harder on test day. Second, the calculations should only be done after estimating aggressively. If you’re doing a limiting reagent problem with stoichiometry and they tell you that you have 364 g of sucrose, we wouldn’t round that off to 365 g or even 360 g. Instead, we would see that the molecular weight of glucose is around 342 g/mol, and round off “364 g of sucrose” as “about 1 mole”. Numerical answer choices are always spread fairly far apart, allowing us to do that kind of rounding off without sacrificing accuracy. So how do I practice these skills? The only way to develop the expertise you need is to practice, practice, practice! To that end, you should start by going to http://www.aamc.org and picking up a copy of the official practice that the AAMC offers. That includes the Official Guide as well as the Sample Test. Most students find, however, that the limited resources offered by the AAMC are not enough. They want the opportunity to practice multiple full exams and full sections under timed conditions. To that end, students often find success with the packages of full length exams available at nextstepmcat.com. ¡

Finally, we should note that when it comes to the p-value, smaller is better. A p-value of 0.0001 means there’s only a 0.01% chance that the results are random, and a 99.99% chance that the null hypothesis (data is random) is false. The rule of thumb here is that the p-value must be 0.05 or smaller for an experiment to have meaningful data. The AAMC

is fond of giving us an experiment that has a p-value of 0.1 (or higher!) and expecting us to recognize that the data doesn’t show a statistically significant link. Without that validation, even if their appears to be a relationship, the numbers don’t support it and we cannot say it is true.

Bryan Schnedeker is the National MCAT Director at Next Step Test Preparation, a company that specializes in 1-on-1 tutoring for the MCAT. Bryan has taught the MCAT for over a decade and has scored a 44 on the test himself.

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S T U D E N T C O LU M N

THE SENIORITY PARADOX

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I found myself staring into a bowl of cereal in my boxers the other night wondering where time has taken me. Soon, I will be starting my senior year of college. In theory, I have gathered enough experience, made enough mistakes, and taken enough tests to be considered an expert on being a PreMed. On my first day of college, I guessed that between my first day of freshman year and the days leading up to my senior year I would learn the majority of knowledge concerning science. Not only was I obscurely wrong, but I learned just the opposite: science is nearly infinite, with details that would require a lifetime to learn. In fact, most seniors come to the same conclusion and face a serious question: If science is infinite, what does that make medicine? It made me wonder whether the past few years spent with my nose in books have been useful. Certainly I have learned plenty of challenging scientific information, but to say that four years of being a PreMed amount to a handful of scientific knowledge and nothing else seems to miss the point. I have learned a lot as a PreMed – information that is not necessarily bound in a book, but instead somewhere in between all of that. Somewhere between the confines of line after line of chemistry, physics, and biology, PreMeds will learn about life’s gifts. Saying the phrase “Life’s gifts” seems to have positive connotations. However, the bits of unsaid knowledge that you seem to pick up between lectures and late nights are a balance between easy and difficult to accept. Life as a PreMed is more like the strange uncle at a Christmas party that you haven’t seen in several years: sometimes the gifts he gives are funny and heartwarming, and sometimes they are strange and unwanted. As a senior, I feel obligated to share the “gifts” I have been given, and would guess that most seniors would feel the same. GIFT #1: YOUR WORK DESERVES YOUR HEART Unite your passions with your work. Many people think this means to work at enjoying their homework and lecture experiences a little more. However, that is only half of the picture. Your work as a PreMed also pertains to the relationships you hold, the conversations that you have, and the things you do for fun. In a sense, do everything as if it were the last time you were doing it. Just as you should pour your heart into studying, you should pour your heart into people, goofing off, and sleeping. GIFT #2: YOU’RE NEVER AS GOOD AS YOU THINK; YOU’RE NEVER AS BAD AS YOU THINK What I wish somebody would have explained is how dangerous a lack of confidence can be, and how equally dangerous a lack of humility is. Live your journey somewhere in the quite confidence of your ability – neither too outward

about yourself nor too disregarding. Nobody balances the two perfectly, including some of best doctors in the world, but they will help you become more rounded as a future doctor. GIFT #3: IT’S ONLY A TEST A single bad grade can make all the hours and hard work put into a test seem insignificant. At this point, you are one post-test panic and some absurd medical school entrance statistic away from giving up. Here is the statistic that you should probably read instead: studies suggest 100% of people in the world are incredibly human. Fortunately, everybody makes mistakes. Unfortunately, even the greatest doctors do too. I have come to learn that test performance could never define the doctor you will be. Sometimes being a PreMed is more about how you respond to mistakes. If you get a bad grade, be secure in who you are. After all, you are one step closer to the good life. GIFT #4: YOU WILL ALWAYS LEARN Instead of having it figured out, I am realizing that I have only learned enough about science and life to ask deeper questions. Accepting the wisdom that comes with experience is a paradox. In other words, being a senior is not a final destination, but merely a ticket to bigger and better places of discovery. It is both a beautiful and hard realization to think that we are called to seek, to discover, and to enjoy life’s gifts for a lifetime. Just when you think you have learned something for good, it gets a little more complicated and demands a little more self-attention. If science is nearly infinite, then medicine’s intricacies require us to play a game of chess that never quite ends. If that is so, then being a PreMed merely prepares us to play the game. We strategize, we plan, and we attack. Still, one thing is for certain: experience gives us gifts – gifts that can be funny and heartwarming, or ones that you might wish you could rewrap and give back to your strange uncle from time to time. ¡

Austin Greer is a 4th year student at Indiana Wesleyan University and a current Student Advisory Board Member for PreMedLife.

September/October 2015 | PreMedLife Magazine |19

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THE BACK TO SCHOOL ISSUE

September/October 2015 | PreMedLife Magazine |21

FRESHMANS

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WHAT SUCCESSFUL PREMEDS DO FRESHMAN YEAR As you being your very first year of your college career, there are many things running through your mind. You want to be a doctor. You want to get into medical school. No, you’re going to be a doctor. You’re going to get into medical school. That’s it. Your freshman year in college is an opportunity to make the right steps in the right direction.

s a Freshman it is really hard to try and get everything lined up for the next couple of years especially since you are just starting a new school. I remember it being really hard to figure out what I needed to do during my first year in college to prepare myself as a Premed student. >>>

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FIRST THINGS FIRST: DO REALLY WELL IN YOUR CLASSES The classes that you take during your first year provide a foundation for the rest of your courses in years to come. If you do not work hard to understand what you are learning in those classes, you will have trouble when you take harder classes. If I could go back and tell myself one thing, it would be to spend a lot of time making sure that I understood the basics which include your classes during your Freshman year. It is hard to do well during your first year when you are not sure how to even handle all the classes you are taking. A great way to do this is to stay organized because it is really easy to forget things and get unorganized when there are a lot of distractions happening.

STAY ORGANIZED Many freshman students have trouble getting organized and staying organized. They are used to high school where the teachers are constantly reminding you what you need to do and when to do it. College is all about independence and this is why many students do not do well initially because they are not used to so much independence. The best thing for this is to pick one way that you would like to stay organized. I am a big believer in organizers and planners. What I would do is list each assignment for each class on the day that I got the assignment and then make another list of things I needed to do that day. Once I would finish a task, I would cross it out in blue and then if I was unable to complete a task that day I would circle it in red so that the next day I would see the item circled and remember I needed to finish a task from yesterday.

“MANY FRESHMAN STUDENTS HAVE TROUBLE GETTING ORGANIZED. IN HIGH SCHOOL, THEY WERE USED TO CONSTANT REMINDERS FROM TEACHERS.” ACCEPT THAT YOU WILL MAKE MISTAKES Most of use who are pursuing premed came into college with strong backgrounds from high school and we all did pretty well in high school. With that background, sometimes it was hard for me to accept that I could do poorly in a subject. Rather than accepting my mistakes and making sure I did not make them again, I would get very frustrated and not let the mistakes go. This was not healthy and it took me some time to realize that mistakes are the only way that we learn and to let myself learn from the mistakes that I make. Realizing early on that

you will make mistakes is an important part of the process. If you do see yourself running into a bunch of mistakes, try and take some time to figure out what the root of the problem is. Always ask others in your class that are doing well what they are doing to do well or talk to the Teacher’s Assistant or the Professor to get a better idea of what you should be doing. The TA and Professor are there for your help and it is surprising how few students actually ask for help. ¡

MAKE USE OF WEEKENDS I remember looking forward to the weekends because that was when I could catch up on my sleep and relax more. But if I could do undergrad all over again, I would tell myself to be a little more hardworking on the weekends. If I could have done more work on the weekends then I could relax more during the week and not stress to get my work done. It is nice to relax on the weekends and not worry about work but the weekends when I was the most productive was when I would start getting work done at 8 am and then go until 1pm and then take a lunch break and get some work done and then take the night off.

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SOPHOMORES

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26 | PreMedLife Magazine | September/October 2015

Advice To My Sophomore Self About Getting Into Medical School Getting admitted into medical school is no easy feat. There are a lot of ups and there may be some downs. I’m in medical school now, but I’ve looked back and here’s what I would tell myself during my second year of college. Everyone likes to say that Junior year is the hardest year but I felt that Sophomore year was just as difficult. Freshman year I was taking a bunch of electives and one or two science/math classes so it did not feel like I had to learn a lot of difficult concepts there was just a lot of busy work from the electives. However, Sophomore year there were more classes that were difficult to grasp and a lot of extra work from labs. I just felt like I was constantly drowning with the amount of reading and understanding that needed to be done. Know that you need to work hard For some reason, I always imagined that college would be easy but I felt like there was always something to do and I could not take a break during college. I was always stressing myself out and thought that was the only way to do well. But something that I wish I could tell myself is to not forget to give yourself some time to relax after working hard. Everything ends up falling into place somehow. Make a routine of exercise Freshman year I kind of forgot about going to the gym even though I was an intense runner in high school. But because I had so much work to do during Sophomore year, I felt like I did not have time to go to the gym. This was not true because although I did not have a lot of time, I wish I could have made gym a really big part of my life because those habits carry through for the rest of your life. Every time I would exercise, I felt much better and could get my work done more efficiently but sometimes remembering this when I had a lot of work was difficult to do. Participate in activities not just for “show” I always thought that I should only participate in activities because they would look good for medical school applications. But after a while I stopped doing stuff to impress medical school admission boards and did activities because I wanted to and thought they would help me grow as a student. I realized during medical school

interviews, I was asked about these types of activities more so than the regular premed associations that all premed students join. Trust yourself I think as a Sophomore you still are unsure of yourself and it is hard to convince yourself that you may be doing things right. Even though I did pretty well during my Freshman year, I kept doubting how I should be doing my work and kept getting sucked into trying what other students were trying. Instead of wasting time trying out too many different things, I should have just stuck to what actually worked for me and only try new things when I was not succeeding. Because Sophomore year is pretty early in your undergraduate career, confidence may be hard to come by but remember to trust yourself, especially your gut instincts. Accept your mistakes but learn from them I think I mention this a lot every time I write and that is because this is very important. Most people, including myself, have a very hard time letting go of some of the mistakes that we make. After a mistake is made, nothing can be done after that mistake except taking time to step back and understanding what happened and learning from that mistake. You will make mistakes, some small and some big, but it is not the breadth of the mistake that defines it but rather it is the way that you come back from the mistakes that defines your character. Next time you make a mistake, take a second to see how you reacted from it and try and change the way you reacted. Sophomore year is deceptive because you think you are past your Freshman year when mistakes are made but this is the opposite of what is actually true. Sophomore year has a lot of pitfalls and can take you down the wrong path. Just stay proactive and remind yourself what your goals are and stay true to those goals. But remember that if you do stray away from the path, it is okay to get back on the path. ¡

September/October 2015 | PreMedLife Magazine |27

JUNIORS

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Questions Every Premed Junior Should Ask Junior year can be incredibly difficult especially if you are planning on taking the MCAT during that year or the summer after Junior year. There are a couple of very important questions to ask yourself especially during the summer before or right before starting Junior year to set yourself up well for the next couple of years. WHEN AM I TAKING THE MCAT? The MCAT as we all know is a very big part of your premed career and in order to get into medical school you need to do well. So it is a great idea to start thinking about when would be a good time you would like to schedule your MCAT. The MCAT does require for you to have taken the major course subjects prior to the test so that you are prepared best for it. So the first thing you want to see is when you will be done with Biology, Chemistry, Organic Chemistry, and Physics. It would not be a good idea to take the MCAT when you still have all of Physics I and II to take. But if you really need to take the MCAT at the end of say your third year in undergrad, Try and take it a couple of weeks at least after the end of the semester. This will give you some time to decompress after a stressful semester and then also further review information more so than during your regular semester.

It is also important to realize that there is a “just right” time to take your MCAT and what this means is to not give yourself too much or too little time because both instances can cause problems. Many students give themselves a whole year to study after graduating but they end up doing poorly because they could not study well enough for a whole year. And then there is the other end of the spectrum, students who take it with minimal preparation just to get a good “baseline” which is not a good idea at all. Always make sure to fully prepare prior to taking the MCAT. WHERE WOULD I LIKE TO APPLY TO MEDICAL SCHOOL? Many premeds think that this is not an important part of the medical school application process but they find that in the end they do wish that they had thought about this prior to the summer when applying for medical schools. The reason for this is because students may attend several medical school fairs during their junior year and they ended up being sort of a waste because the students did not have a good idea of where they wanted to go. They figured that they would just go wherever they get in but if they had a better idea of where they wanted to go then they would have been able to take full advantage of the medical school fairs.

IS MEDICAL SCHOOL THE CHOICE FOR ME? It is recommended that as you are nearing the start of writing your applications, just make sure your revisit your desire to attend medical school. Some people go through the whole application process and then after performing interviews realized that medicine is not for them. This is better than the alternative which is going through medical school and realizing that it is not for you. However, it is always a good idea to make sure this is the path for you. Medicine is a grueling career and you may hear this from a lot of different people. But it is just a good idea to make sure this is what you still want to do because you will be putting in a lot of money, time, and effort in the process of medical school applications. It is easy to just see the positive aspects of medicine which includes how you feel when taking care of patients but there can be a lot of negative aspects of medicine which are not highlighted such as the long hours, time away from family, and constant hours spent studying. Just take the time to realize this side of medicine also before you continue on this journey because this journey is not a cakewalk and takes a lot out of you as a person. If you are not committed to the field 100%, it will be easier to walk away from the journey when adversity strikes.

28 | PreMedLife Magazine | September/October 2015

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SENIORS

30 | PreMedLife Magazine | September/October 2015

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5 Inspirational Quotes for Senior Premeds If you are starting your senior year as a pre-medical student, you’re closer to your dreams than every before.

So you’re finally here. You’ve finally made it. If you are in your final year of college, chances are you’ve either already completed your medical school application and have move on to the next step in the process or you’re awaiting the start of your post-baccalaureate studies. Or, the other option which more and more pre-meds are taking, opting for a gap year. Regardless of what you’re doing, one thing is for sure - it’s your last and final year of undergrad. By now, many seniors in college have done a lot. They have learned from mistakes, grown from achievements, and made it to their last year. At this point of the road to becoming a doctor, aside from your academic and extracurricular performance, you must keep your head in the game. It is important that you stay focused and keep on the right path. To help you do this, we bring to you some of what we think are the most inspirational and motivational quotes to help you make it through your last year in college. We hope you ponder on them, use them to keep you pushing forward, and sharpen you mental state.

Success is the sum of small efforts, repeated day in and day out. -Robert Collier

A little more persistence, a little more effort, and what seemed hopeless failure may turn to glorious success. -Elbert Hubbard

If you can’t fly, then run, if you can’t run then walk, if you can’t walk then crawl, but whatever you do, you have to keep moving forward. -Martin Luther King, Jr.

The three great essentials to achieve anything worthwhile are , first, hard work; second, stick-toitiveness; third, common sense. -Thomas Edison

Consider the postage stamp: Its usefulness consists in the ability to stick to one thing till it gets there. -Josh Billings

September/October 2015 | PreMedLife Magazine |31

Premedlife WRITE EVERYTHING DOWN S T U D E N T C O LU M N

In this series of articles on malpractice liability for premed EMTs, we’ll look at one of the most important and least favorite tasks of many health care providers – documentation. A better understanding of the purposes for documentation will help make this task a priority for the premed EMT. Even if you’re not volunteering as an EMT, you can benefit from improving upon documentation skills prior to medical school. When I was in law school, one of the most memorable adages law professors drilled into our minds was, “If you didn’t write it down, it didn’t happen!” This detailed attention to properly document events and conversations carried over into my practice of law. It was not uncommon to meet with clients and then spend an hour afterward recording the details of the meeting in a memo. Similarly, documentation in healthcare is a necessary component of competent practice. A nationwide study by Dr. Steffie Woolhandler and Dr. David Himmelstein in the peer-reviewed International Journal of Health Services analyzed confidential data from the 2008 Health Tracking Physician Survey of a nationally represented sample of 4,720 physicians that practiced at least 20 hours per week. The results were that the average U.S. doctor spends 8.7 hours per week or 16.6% of his or her working time on paperwork. In addition to clinical work, other studies have also pointed out that a significant part of your job as a physician will involve documentation. Documentation serves to record the clinical care and assessment of patients in their medical record. For premed EMTs, patient care reports (PCRs) will be filled out which include information such as the patient’s signs and symptoms, the EMS assessment of the patient’s condition, and interventions or treatment. PCRs for pre-hospital care can provide vital information for the continued treatment in the receiving facility. If it’s not possible to provide a completed PCR to the next level provider, any information obtained should still be communicated. An example would be changes in vital signs while en route to the hospital. Note: For premed EMTs, check your local EMS laws and regulations to find

out if a full PCR report must be submitted to the hospital within a certain window of time such as 24 hours. A 2002 New Jersey court’s unpublished opinion in DeTarquino v. the City of New Jersey highlights the importance of documentation for premed EMTs. After an altercation with police officers, DeTarquino vomited during the course of EMS treatment and transport. However, this fact was not documented in the PCR. The hospital that received the young man discharged him and returned him to police custody after an evaluation. While at the police station, DeTarquino suffered a grand mal seizure, was transported to a trauma center, and was later pronounced brain dead from an epidural hematoma. DeTarquino’s family brought suit alleging, among other things, the ambulance service and the individual EMS providers were negligent in their documentation. The state’s court of appeals agreed with the family’s argument. Had the EMS crew documented that the patient vomited in transport, the initial hospital would probably have considered evaluating DeTarquino for a serious head injury. The appellate court held that the state EMS Act immunity provisions did not protect providers from negligent documentation – only negligent care. While DeTarquino’s case is only applicable in New Jersey, it is useful in highlighting the impor-

tance of accurate and timely record keeping and how future courts in other states may view negligent documentation. In addition to patient safety reasons, documentation can serve to support a health care provider’s defense in the event of a malpractice allegation or lawsuit. Overall, the DeTarquino case shows both the clinical and legal importance of thorough and timely documentation. Documentation (such as in the PCR) also plays a crucial role when it comes to billing and reimbursement for services rendered. For instance, Medicare is the single largest payer for ambulance services. Most EMS organizations receive 30-50% of their revenue from ambulance service charges. However, Medicare will only pay for ambulance services when the patient cannot safely be transported by other means such as a taxi, car, bus, or van. Thus, proper documentation for billing purposes is essential in getting a timely payment. Like many fellow premed EMTs, I’m applying for membership as a volunteer EMT at a volunteer station house. The issue of paying attention to financial realties and bottom lines cannot be underestimated. Lastly, keeping proper documentation is simply following the law. Legal and ethical compliance is critical to the integrity of health care providers at an individual and organizational level. Keep these documentation tips in mind: 1.) Write an accurate record of your time with the patient 2.) Record the patient’s narrative as well as your clinical impressions 3.) Remember to check appropriate boxes and other fill-in sections 4.) Make sure your handwriting is legible 5.) Assess and document more than one set of vital signs. Always remember: if you don’t write it down, it didn’t happen! ¡ Erin Fortner, J.D., EMT, is a licensed attorney in Georgia where she practiced pharmaceutical product liability law and was a special victims unit prosecutor.

32 | PreMedLife Magazine | September/October 2015

If you didn’t write it down, it didn’t happen

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I N C LO S I N G

Ajibike Lapite She is a proud member of Princeton University’s Class of 2014. Ajibike had a concentration in molecular biology and a certificate in global health & policy. She is excited to return to Louisiana as a MD/MPH Candidate at Tulane School of Medicine (c/o 2018).

On completing her first year of med school... I am not longer a first year medical student. Two weeks ago, I completed my third neuroscience examination and with that, my first year curriculum at TUSOM. I’m giddy albeit apprehensive. The end of first year does not, unfortunately, mark the beginning of summer. Here at TUSOM, we complete first year with neuroscience (this is a six week course that terminates early May) and swiftly plunge into second year material. Next week marks the end of the immunology/inflammation block and our brief introduction to pharmacology and pathology. And that is why I am both excited but terrified. The immunology/inflammation block concludes with an examination on May 29th (my birthday–huzzah!?) and then I am free until the first week of August. I. cannot. wait. for. summer. On what kind of learner she is... I would call myself primarily an auditory learner. And so, a quality lecturer is my best friend. Listening to a lecture 2x is a much more efficient way for me to study than other means. Of course, not all lectures are delivered in the way that I would prefer and in those cases, I fall to my backup learning style: read & write. In such cases, I transcribe lecture slides in my own words and I use a textbook to supplement the information. I rather not read textbooks but a well-organized textbook is much better (in my opinion) than a set of muddled lectures. I use flashcards to master the information that I need to simply memorize / quickly drill.

AJIBIKE LAPITE WRITES ABOUT her medical school experience on a personal blog called “Stilettos + Stethoscopes.

On taking Biochemistry at TUSOM... We take biochemistry alongside genetics, histology, and physiology — these courses are taught in blocks divided by organ systems. Our professor has a lot of resources for us: course synopses (essentially a mini-textbook tailored for our course), recordings of the course synopses (I really pity the person who had to do these readings), lectures, and a question bank. I heard a lot of hype about biochemistry in medical school and I wish that I could have told Ajibike from months prior to calm down. Biochemistry is a do-able course; it’s heavily memorization based but it is do-able. So if you are worried (as I was), don’t worry! You’ll get through it. It won’t be fun (all the time) but you’ll survive! Republished with permission from Stilettos + Stethoscopes.

36 | PreMedLife Magazine | September/October 2015

Image courtesy of Ajibike-Lapite

On if she could “do-over” Anatomy... This is not a course that I would want to repeat — it certainly has not been my favorite course — but I could do-over, I would have put more effort into my shelf preparation. I stumbled upon USMLE Road Map Gross Anatomy which would have been extremely useful if I used it earlier in the game, but maybe I can use it for USMLE 1? Also, Gray’s Anatomy Review is a question book comprised of difficult and comprehensive questions. I started to use this in my last block of anatomy and I could have sworn I saw almost identical questions on my exam!

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