tnqd

The Untold Life of a Med Student

It’s 6:30.  I have eaten dinner – a microwavable meal – and have half a pot of coffee to get me through the night.  I have been up since about 6 am studying, with bouts of lecture punctuating my day.  I will study until roughly midnight, go to bed, then do it all again tomorrow.

This is my life.  This is the glamour of being a 2nd year med student. 

Some days it really sucks.

I recently caught up with a buddy who goes to another medical school.  We talked about our experiences and the perception people have when they learn we are in medical school.  Non-medical personal might as well be the muggles of our world.  They look in with curiosity and the assumption that, like Grey’s Anatomy, my life is awash in beautiful women, drama, and the type of lifelong friendships one always dreams of.  Unfortunately that couldn’t be further from the truth.  Right now most of my life is spent reading medical texts.

The constant studying would be forgivable if we only studied the interesting parts of medicine.  But on this particular night I have spent an hour reading about different types of transfusion reactions.  Before that I dove into the intricacies of different psychiatric medications, teasing out which double as sedatives, which help with neuropathic pains, and which I can use for an incontinent patient.  The truth is that a good portion of medicine is, well… boring.  Unfortunately most diseases we learn about are not House-like medical mysteries.   

What about the patients I do get to see?  They are far from the idealized patients displayed on T.V.  Many are elderly or in poor health with multiple comorbid conditions.  For every rare presentation there are 20 pneumonias, 15 heart failures, and 10 COPDs (that is probably an understatement).  On T.V. patients appear composed; in real life they are likely to have multiple orifices with fluids coming out.  Needless to say, most patients do not appear like they just got done with their Glamour Shots.  

I love medicine, I honestly and truly do.  But sometimes I hate how much it controls my life.  I have a stack of books that are awaiting my attention, half written stories that need to be finished, and tons of bicycling adventures needing to be had.  Not to mention all of the travel opportunities, friends and family that have been neglected over the last years.       

I don’t mean to complain.  I am extremely lucky to be where I am.  I really do feel fortunate to be on a career path I love, especially when so many don’t end up in medical school.  But sometimes I am frustrated by the completely inaccurate portrayal of medicine.  I feel like these unfortunate stereotypes are only getting worse as people see healthcare costs rising and vilify doctors as the cause.  Half of my Thanksgiving was spent justifying a system that I am not even a part of yet.  

In all honesty, being a doctor isn’t like what’s on T.V.  It is hard work, day in and day out, as is the road to get there.  But for every complaint above there are ten more reasons that I love it.  I am proud to be on this road and I can’t wait to one day help patients.  This is a rewarding path filled with excitement and daily revelations.  

But I’ll be damned if it doesn’t suck sometimes.

Worth the Sacrifice?

Lately I have been feeling like medicine isn’t worth all the sacrifices in life and I have also lost a lot of confidence since I failed an exam for the first time. Any advice to someone who feels like they’ve lost hope? -anon

I’ve had this question sitting in my inbox for several weeks now. Sorry anon! I had a hard time coming up with a new answer to this question, which I seem to get a lot. TNQD wrote a post on this subject recently with some good questions to ask yourself to find out if the sacrifice really is worth it to you .

In short, I think that if you feel like medicine isn’t worth all the sacrifices, then don’t plunge into it yet. At least take some time and figure out your life.

You will regret jumping in to a pursuit you hate much more than delaying it for a semester or a few years. Plus there’s that whole med-school-is-disgustingly-expensive thing to take into account. I’m not sure why all the pre-meds have got it in their minds that if they take time off to figure out their interests, or if they pursue different paths for a little while, then they never can go back towards medicine. It’s just not true. 

Also, there are SO many options besides being a doctor that allow you to have a career in medicine. All career pursuits will require some sacrifice, so you need to figure out what’s acceptable to you and find the path that fits you best. Cranquis just shared why he might have considered a career as a PA instead of an MD if he had known about these options. 

Now if one failed test is your reason for giving up, that’s LAME. If I had quit after my first failed test, I never would have made it past organic chemistry. Bad grades happen. Learn from them and move on. You gotta put the past behind you. 

And as for losing hope, I have written a lot on how to cultivate motivation and avoid depression and burnout. Take a vacation. If you still feel hopeless at the end, you’re probably depressed. If you feel refreshed and ready to start anew at the end, you were probably just a little burned out. But beyond all encouragement I could give you, I think my best advice would be to just go slow. Don’t rush into medicine. Be absolutely sure it’s where you’re supposed to be. 

How to Prepare for the 2015 MCAT

HOW TO STUDY FOR THE NEW MCAT?! I’ll be the first class/group of students taking it and given that there is hardly any practice material or study tests out there for this new test, how should I go about studying? When is the best time (in terms of how many months before I take the test) should I start studying? What time of year is probably the best time to take the test, given you’ve had adequate preparation? Thank you!

Hey there,

I can see your plight.  Preparing for something no one has taken before can be daunting, especially without guidance.  However, I want to point out that every student taking the MCAT in 2015 will be on the same page.  In some ways it is a more honest portrayal of what the MCAT was meant to be - an assessment test.  With the advent of the test prep industry it became less about what you know and more about how many tips and tricks your could memorize out of review books.  In some ways I think what the AAMC is doing is admirable and will hopefully produce better students in the long run.

With that said, the AAMC is not going to let you head blindly into this test.  They recently partnered with Sal Khan, of the Khan Academy, to produce a series of prep videos for the 2015 MCAT.  Better yet, these videos are free! (You can get them here.)  That is a pretty sweet deals - free prep materials from the people who make the test!

What about your timeline?  I would not start preparing more than 3 months out.  That is how most current MCAT courses are set up.  Any longer and you will risk losing information (i.e. it will be hard to keep fresh on information you studied six months out).  However I would suggest spending time now to really learn the material in your classes.  Many, myself included, breeze through physics by memorizing the equations and don’t bother with the concepts.  That hurt me later because I had to relearn lots of basic physics.  Make good notes now, learn the material well, and strive for more than a grade.  This will make your MCAT study process a million times easier.  

Many will debate the best time to take it, though at the end of your junior year is most common.  I took mine in March so that if I needed to retake it I could and still be able to apply in the fall application cycle.  When you take it will be based on your readiness, study schedule, class schedule, etc.  It would be wise to remember that it takes 4-6 weeks for results.  Make sure you will have it well before you plan to submit your application. 

One final tip: practice tests, practice tests, practice tests.  I am almost positive that the AAMC is going to put out practice tests for the new MCAT.  I would suggest doing as many practice tests as possible.  It may even be worthwhile to do some questions from the current test format, just to get a feel for what their question style is like.  Also, I would guess that shortly after the AAMC releases a practice test many test prep companies will release some that duplicate the question stem format, section subjects, time limits, etc.  It may be worth it to do some of those.  The MCAT is a marathon, you need to practice running the distance before taking it, otherwise you will fatigue.

All the best,

TNQD

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If the road to being a doctor were a disney musical….

On Doubt and Why it's Often Healthy

If you’re a premed or medical student, and you haven’t gone through the stages of feelings seen in the gifs below at some point during your journey, you’re probably not doing it right.

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Everyone goes through these stages of being a premed, in one way or another. Some are better at hiding it than others, but we all panic. We all have these moments of doubt and utter exhaustion where we question if it’s really worth it. If we’ll ever make it. That’s normal. 100% normal. It doesn’t mean that you’re weak or that you are not cut out to be a doctor. In fact, I would be more worried about the people who don’t experience these moments, because it likely means that they either A) are entirely too arrogant and self-absorbed to understand the gravity and sanctity of the work they are about to commit the rest of their lives to or B) have some sort of emotional block going on that comes with its own set of unique issues. 

Doubt also means that you are capable of questioning your own decisions and of self-reflection. Being introspective is a crucial quality in a doctor because we are often asked to make very difficult decisions and are trusted with an enormous amount of responsibility, which is both a burden and a unique privilege. It’s not something to be taken lightly. Consequently, it’s almost instinctive to panic and to have doubts when presented with such a long and arduous path which appears to have little room for error and shows few signs of getting any easier as the years go on. You just can’t let it cripple you and prevent you from moving forward. If medicine is what you truly love and are dedicated to wholeheartedly, you’re gonna make it. You will. It may not be the easiest or most direct path, you may have detours along the way, but you’re gonna make it. And you’re gonna be stronger and hopefully an even better doctor for all the struggles you’ve endured and all the doubt you’ve persevered through over the years.  

I believe in you, and you should too!

-TNQD

The "Why Can't I?" Mentality

When I first applied to my medical school I called them and asked if I could simultaneously do an MPH and MD degree.  I was told “No.”  Within 6 months I was enrolled in both the MPH and MD programs.

I always hear friends, family and peers saying things like “I wish I could do x,” or “I could never be good at y.”  Those types of statements confuse me.  I often wish I could do x or be better at y too, but then I follow that up with a critical question:

“Why can’t I?”

I think in almost every situation that is an honest question to ask.  You may not like the answer, but you should always ask the question.  For example, I sometimes wish I could be in the NBA.  Then I ask, “why can’t I?” and the answer becomes clear - because I am 5'8" and a terrible shooter.  Had I began practicing at the age of 5 the situation might be different, but no amount of practice now (at 26) could get me to the point I could be in the NBA.  That’s ok; that’s called being a realist.

But let’s go back to my original example.  I was told I couldn’t be simultaneously enrolled in both the MPH and MD programs at my school, so naturally I asked, “why can’t I?”  I went through many scenarios: I could fail at one, I could fail at both, etc.  But really those weren’t reasons I couldn’t do it, they were fears.  Could they kick me out of medical school?  If I failed all of my classes yes, but that wasn’t likely to happen.  Certainly they couldn’t kick me out just for enrolling in more classes.  So I tested the waters, got through my first semester of medical school and decided I probably could handle double enrollment. 

If I hadn’t thought to ask “why can’t I?” I never would have dual enrolled and I would have missed out on a lot of opportunities.  This question has led to a lot of successes in my life.  "Why can’t I start a blog for pre-med and medical students?“  "Why can’t I serve on my state medical society’s reference committee?”  "Why can’t I publish an opinion piece in a medical journal?“

This may be the single most important question I have ever asked.

Like I said, sometimes you come up against a real reason you can’t pursue or succeed at what you want.  "Why can’t I fly?”  Well because you don’t have physiologic properties that allow you to do so.  "Why can’t I ride across my state on a bike?“  To that question there may not be a good answer, which is why I rode 500+ miles across my state a couple summers back.  

My point is this: most people quit before they think about trying, let alone before they try.  Many people are content to be corralled by the limitations their peers place on them.  Even more people are corralled by the limitations they place on themselves.  You probably can’t cure cancer.  But you can make a living being an artist, pursue a second career, run a marathon, become a great doctor, etc.

What ever you want to do, just ask, "why can’t I?”

You may be pleasantly surprised at the answer.

-TNQD

“Your thoughts? My dad doesn’t think I should become a doctor because I’m a "girl and it’ll be too hard” and I’ll “never find a husband” and I’ll be better off with a lower paying job and “marrying someone rich.” >___>“

Well, no offense to your dad, but that is some sexist bullshit.  I may not have ovaries but for the remainder of this post I will tuck my testicles back in solidarity.

Apparently you are not privy to the myriad of recent studies talking about the changing face of medicine.  According to the AAMC the medical school class of 2010-2011 was almost 50:50 in terms of gender.  Some schools are actually accepting more women than men, though the recent averages seem to be about 50% of each.  To say that women can’t hack it in med school is completely ignoring the factual data.

Now let me break it down for you.  Don’t ever let anyone, and I mean anyone, tell you what you can and cannot do.  I don’t care if you are a woman or a man with no legs (who just ran in the freaking Olympics!).  No one is going to have your interests at heart better than you.  If you want to be a doctor then do it!  Will it make it harder to find a husband?  I don’t know, several of my fellow classmates are either married or have boyfriends.  Several of the upper class (wo)men have gotten married in the course of school (some even had kids!).  

Med school will be hard, but your brain works just as well as any man’s.  What will determine your success is your drive and determination, not whether or not you have a Y chromosome.  And if you don’t want to take my word for it, check out these links.

Viewpoint: Women in Medicine and Science in 2020: Beyond the Glass Ceiling

Changing the Face of Medicine

U.S. Medical School Applicants and Students 1982-1983 to 2011-2012 

Experience is the Best Teacher

This is a powerpoint that a few other AED (Alpha Epsilon Delta Health Pre-professional Honor Society) officers who applied to medical school this cycle and myself compiled for our chapter in conjunction with a Q&A session. Our goal was to help members with applying to medical school and to remove some of the uncertainty and scariness surrounding this rather long process. I thought I’d share it with you all in hopes it might do the same for our premed TNQD followers.

Topics covered include:

  • Stats for allopathic and osteopathic medical schools
  • Timeline for applying
  • Cost of applying
  • Coursework prerequisites
  • AMCAS tips
  • MCAT tips
  • Tips for secondaries
  • Tips for interviews
  • Strategic planning
  • Resources

“Applicants Tell All” Presentation

The NotQuiteDoctor's Time Management Advice

Can you tell us about your scheduling/time management? Thank you! and Happy New Year!

Sure.  I don’t really know how to answer this because I am not time management wizard, but I have found a few things that help.

First off, this program called Self Control is a godsend.  It blocks websites you find distracting, like tumblr for example.  I use it regularly to make sure I don’t let myself wander.  We all know how that is…. “let me just see if so-and-so replied to my facebook message…” then an hour later after you are caught up on the newsfeed drama you have gotten nowhere on studying.  This program helps with that.

Next, set a timer.  For awhile I would set a timer on my phone and every time I got up for a snack, went to the bathroom, answered the phone, etc. I would stop the timer and then restart it when I went back to studying.  That is an amazingly insightful experience.  It will help you realize how much of your study time isn’t being used for study time.

As a follow up to the previous recommendation, remove the distractions   I now keep my phone on silent or in the other room.  I set goals for my snack breaks (i.e. study for the next hour then 15 minute break).  I also set goals for larger breaks.  Usually there is some show I am into (last block it was Breaking Bad) and so I will make a deal with myself.  Study hard for three hours or until a set time and then allow yourself a longer break to watch your show, or read on a book, or knit or what ever it is you may love.

When you consistently meet that goal, increase it (if you need to, this advice is really for med students who have to increase their ability to sit and study for long periods of time as they come closer to studying for Step 1).  If 3 hours is easy, try 4.  This works really well for me since my tests are every 8 weeks.  That means the closer I get to the test the more I have to study.

I also recommend taking days off.  The biggest goal of time management is getting your work accomplished with time to spare.  That spare time should be used to enjoy life.  If you live inside of books 7 days a week it will be miserable… trust me on this.  Try to find ways to take time off.  Maybe that is only half a Saturday or Wednesday nights.  Just make sure to get away from the studying and have you time. 

Best of luck and happy new year,

TNQD

First Week of Med School Nearly Complete!

I feel like I’m just poking my head out of the fox hole to glance around at the outside world for a moment. I wanted to give you guys an update on how things are going, but I’m pretty overwhelmed at the moment. Once I get into a solid studying pattern and schedule I’ll hopefully have more time to blog about life as a M1. They certainly waste no time. At orientation, one of our anatomy professors told us not to worry, we were only already 2 weeks behind on studying at the outset of the semester. We thought he was kidding. For the past 4 days I’ve done nothing but go to class, study, eat, shower, and sleep. Studying in groups has helped since you definitely need to be around other people who understand this lifestyle in order to commiserate and get through. The M2s say it gets easier, and I’m hoping they’re right, because anatomy lab is rough. The smell is the worst, and it clings to you all day, sometimes even after showering. We have a 200+ lbs. cadaver that we’re rolling back and forth every day…that hurts your shoulders and back at the end of lab, which are suffering enough abuse from hauling your life (text books, Netters atlas, iPad, 20 snacks for the formaldehyde munchies, various chargers, notebooks, markers, water bottle, wallet, etc.) around with you in a bag all day. Also yesterday I had to be the lead dissector on our lady’s face/neck when looking for the brachial plexus and a bunch of other nerves above the clavicle, so that was a little shiver-inducing. Eventually you learn to distance yourself I guess.

The first day was by far the worst in lab since our cadaver seemed so, well, human. She has pastel pink toe nails and underwent a unilateral mastectomy sometime in the past. Our group calls her Lucy to remind us that she once had a name, and loved ones, and should be treated with respect and care. Sometimes when I’m near hurling and feel disgusted about what we’re doing, I try to remember what our professor said: “This is what they wanted and chose to do with their earthly remains. They want you to learn from them so you can save others. Make their selfless sacrifice worth it.” And I thank her. Not verbally but I just think, “Thank you, Lucy.” And I try to make sure she’s covered properly. The other day I brushed a bunch of flecks of fascia from her hair before re-covering her head. I felt like it was the least that I could do for her, after all she is doing for us.

All Good Things...

I am writing to say goodbye.

Almost 3 years ago I started this blog with no idea what it would turn in to.  Since then I have shared some of my greatest victories and toughest losses.  But due to life circumstances my reign as TNQD is coming to an end.

Don’t worry though, TheNotQuiteDoctor is not going anywhere.  As a blog this will continue.  In fact, the last few months I have been gathering writers to contribute.  It is their hard work that has kept this blog afloat.  Upon my request, one has offered to take my spot.  She will be the next iteration of TNQD and serve as a source of pre-med/med wisdom.  She, and the other writers who have been contributing, will ensure that this blog lives on. 

My life has gotten more complex in the last year as I have begun writing for news outlets and larger medical blogs.  My research has been advancing and I am being pulled into larger projects.  Plus the ever present step 1 looms over all that I do.  This all has happened while I continue to balance being a medical student and graduate student.  There are times in life where you reach your limits - and this is mine.

This also feels like a natural time for me to step down.  I have overcome many of the problems I came here to vent about.  My love life seems in perfect order.  I am satisfied with my schoolwork and I have been exercising regularly.  I honestly feel happy, healthy, and balanced.    

My replacement will be transitioning into the blog throughout March (more likely closer to the end, and I will be around until then).  I know you will show her the same kindness you have shown me.  We have created a supportive community here, for students of all fields and all walks of life.  I sincerely hope you continue to participate and grow this blog in the years to come.

Thank you all for all the support you have given me.  Honestly, you, my faithful readers, have provided some of the kindest words and sincerest well wishes.  I am thankful for each of you.  

All the best in everything you do,

TNQD

Is Med School Worth It Financially?

Is going premed and eventually going to medical school worth it, financially? All I’ve ever wanted to be is a doctor, but I am terrified I cannot afford this journey.

That is a good question, and one that many great thinkers are pondering.  At what point will we reach a tipping point where going to medical school is cost prohibitive?  Furthermore, how can we ensure that, even currently, primary care specialties are not cost prohibitive?  These are all things being debated in the medical literature.  Many solutions have been put forward but none have definitely stood to rigorous testing (at least not to the point of being widely adopted).

Getting at your question, I do not think we have currently hit the point of the medical route being “not worth it.”  I think you also have to evaluate what “worth it” means.  It is becoming harder and harder to be an extremely wealthy doctor, but doctors are far from being broke.  I would rather do something I love for a good living than to get rich doing something I hate.  It will be up to you to decide what kind of lifestyle you are looking to have.

There are many things you can do to control the costs of medical school.  I advise everyone to apply for any and all scholarships possible.  My tuition (just tuition, not including living expenses, books, etc.) is approximately $28,000 for my state school.  I have applied for every scholarship I qualify for and I am currently getting about $11,000 in scholarships.  That’s free money!  All I had to do was fill out an application and write some essays.  That’s almost a 40% reduction in cost of attendance for very little work on my part.  Will everyone get those scholarships?  No.  But so many don’t ever even try that often scholarships aren’t as competitive as you think.

You could also pursue other avenues for stem costs, such as the military, Health Services Corps, or the Indian Health Service program (perhaps one of the least politically correct government organizations).  These all offer loan repayment or cover all tuition in exchange for a set time period of service.  Perhaps the best deal is the Public Service Loan Forgiveness Program.  After 10 years of working at a not for profit hospital your medical school loans can be forgiven.  This is a good deal for two reasons, first you can count your residency towards these 10 years and second there are many great hospitals that are not for profit.  Furthermore the 10 years is cumulative and does not have to be spent at the same institution.  That’s a pretty good deal.  

To help lower the overall costs of medical school you can, and should, find ways to be financially responsible.  Go to the cheapest med school you are accepted to.  That will usually be your state school.  Ultimately medicine is the same regardless of the school you train at.  You should also live frugally in med school.  You won’t have lots of time to play an Xbox One or watch a big screen T.V. - so don’t buy them.  Evaluate if you really need a new computer or if yours can be cleaned up a bit and work for a few more years.  Buy your books used.  All of these are simple suggestions that save money.  Remember that in med school every dollar you spend has to be paid back with interest.  That’s like paying back $1.50 for ever $1 you spend (or some variation depending on length of payback, interest rates, etc. - but you get the idea).

Is med school worth it?  Only you can decide that.  It is expensive, but there are ways to help mitigate the costs.  However, in exchange for that cost you are never going to starve or go bankrupt (if you are at least semi intelligent with your investments).  You will probably always be able to find a job.  And you will get to do something you love.  There are many people out there who would give a lot more than tuition costs in order to have that opportunity.

All the best,

TNQD