Site Makeover, June 2013

Whew. It’s been a long ride through med school. Haven’t touched this blog since 2011, and most of my writing time has been spent on Quora answering questions about medicine. I’ve started backing off from Quora lately, so I need another outlet for my writing inclinations, and I figured I might as well use this opportunity to more or less start from scratch. I’m not sure what direction I’ll go in terms of new content for this blog, but my general interests lie in education, research, ethics, informatics, and UI design, so I’ll probably stumble through some stuff related to those topics.

I’ve decided to remove comments entirely from the site as well; aside from the aesthetic detractions seen by having the comment form being prominently displayed on the screen, it’s generally not worth the effort to keep up with them. Even with services like Akismet, the form just invites spammers, so signal-to-noise ratio is pretty low as well. If you’ve got any feedback you’d really like me to know about, just use the contact form in the menu and it’ll go straight to my inbox (no guarantees on replies, obviously).

If you have a suggestion for a post, by all means, please shoot me a message.
If you’re looking for older posts of mine and can’t find them, I apologize, some of them got lost when I rebuilt the site–on the bright side, if you shoot me a message, I can write a new post on the topic!

Hey Jae: how important is research?

I’m currently a sophomore at Stanford. My question is about research experience. I noticed that you have a lot of research/publication experience. How important are they?

It’s difficult to state how “important” research and publications are. Sure, they look good, and if you end up applying to research-oriented medical schools, then having research experience will certainly be an advantage, but even at those schools, research is never the end-all-be-all determinant of how good an applicant is; it’s just one facet. In my case, I didn’t have much clinical experience in terms of shadowing and whatnot, so my application depended heavily on my research, and some might say overly so–I actually got asked quite often on the interview trail why I wasn’t applying M.D./Ph.D. (fortunately, it was a question I was well prepared for, since my mentor and labmates had all asked me the same thing a million times).

The primary question to consider is not how important research is, but rather, how much you enjoy research. Don’t you dare start thinking of research as some sort of achievement you need to check off before applying, because it’s not. If you’ve never done it before, then definitely explore it, but only continue if you find that you enjoy the process. If you force yourself, it’ll only be miserable, and believe me, classwork, other extracurriculars, or hanging out with friends are far better ways to spend your valuable (and limited) time compared to a job you hate.

That said, research is a pretty broad term. If you look hard enough, you will probably find a really cool research topic that jives with your interests, whether it’s rainforest development, ethics, microfinance, etc. If you have trouble with your search, ask upperclassmen, TAs, and professors for help–Stanford is full of resources to help guide undergraduates, as are most other universities.

How can undergraduates get the opportunity to publish?

It’s pretty simple: just find a project you enjoy working on (with a mentor you like and trust), and spend a lot of time working. Oh, and ask about publishing opportunities from the get-go so that your mentor can help guide you along the way–this is part of the art to determining whether a lab/project/mentor is a good fit for you. If you’re looking at research labs and want to get a feel for potential publication opportunities, just find the lab’s website and check out how many publications they produce each year–the more, the better. The slight caveat is that large labs tend to produce more, but large labs also mean less personal time with the mentor, since you have to compete for his/her time. Keep this balance in mind. Also, each subject has a variable rate at which publishable results can be obtained. The nice part is, admissions committees are well aware of the fact that generally speaking, clinical research has a slightly higher publication rate than basic science research.

Overall, if you put in the time and effort and produce results, chances are you’ll find yourself with the opportunity to publish, whether it’s in the local literary journal, scientific magazine, or peer-reviewed journal. Be patient and diligent!

And did you work in the same lab for two years (and published multiple pieces on the same research)?

Yep, I worked in the same lab from sophomore year to senior year, but I did switch projects once, so my publications were technically from 2 different projects.

When is a good time to start research?

Good question. Answer: whenever you’re ready to. Be warned that research will typically take up ~10-15 hours a week, so make sure you’re ready to make that commitment and juggle your schoolwork, other extracurriculars, social life, and sanity. I think the most impressive example I can think of comes from the time I hired Scott–he showed up to the interview with a printout his weekly schedule marked with all the hours each day he could potentially dedicate to our lab–the guy actually gave up his acappella group (Fleet Street) for us. David and I were blown away, and we told our boss that we had to take him even though he was a junior and hence would only be able to give 1 year to the lab (as opposed to sophomore candidates, who can give 1.5-2, which is generally favored for project continuity).

Mind you, don’t go nuts and spend so much time in lab that you don’t have a life. If you find yourself doing this, you’re doing it wrong. :-)

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“Hey Jae” is a series that publicly answers questions from pre-med students. I get these from time to time through facebook, e-mail, etc., so I figured if one person’s wondering, more likely are too. Feel free to pose a question of your own through my contact page! As always, best of luck.

A reflection on life, death, and the role of the medical student

I never quite imagined that I would have my first one-on-one end-of-life talk with a patient’s family during my very first month on the wards. After a few weeks, I had gotten used to patients mistakenly referring to me as “doctor”; I’d even given up on correcting them. What did it matter? To them, I was just another member of their medical team, and whether I had on a short or long white coat didn’t seem to mean anything as long as they got their questions answered in friendly fashion. But when the younger sister of one very elderly Mr. K took me aside immediately after I’d left the patient’s room, I was caught entirely off guard. I will never forget the next five words:

“How bad is it, doc?”

I froze, stunned. I had never considered that anyone would ask me, a lowly medical student, a question so critical. Family meetings were the sort of thing attending physicians were supposed to handle. I quickly developed a healthy respect for the power of the white coat.

“Has he got much time left?”

Still frozen. They don’t teach these skills in classes. Rather, they try, but it’s utterly futile, and everyone knows it.

I didn’t want to mess this up. This woman’s face was clearly on the verge of tears. Her concern etched her 86-year-old face deeper than time had ever been able to.

“Just tell me, doc. I can take it. I’ve had this sort of talk before with him multiple times now, and heck, we know we’re a long-living family. We’ve outlived all our friends, and now we’ve just got each other. Honestly, neither of us cares if we go tomorrow or years from now. We’re just waiting to die, and it’s up to God when it happens.”

I finally found my tongue. I began to explain what had brought Mr. K to the hospital: he had become very weak due to anemia and had a fall. Fortunately, there were no broken bones, but he needed a few units of blood transfused so that his body could sufficiently circulate oxygen and nutrients. It was likely that he was continuously losing some blood through his GI tract, since he had a several-month-long history of some blood in his stools, but he didn’t want a colonoscopy since he knew his time was coming anyway. I reassured the sister that after receiving blood, Mr. K was doing much better, and while he may still be bleeding internally, he was, for the time being, stable–we had done everything we could do for him given his wishes.

The sister slowly nodded her understanding, and the concern began to fade from her face…but it didn’t completely disappear. I got the feeling that my job wasn’t done. I asked what was on her mind. She looked back at me, and after a bit of hesitation, admitted that she didn’t actually know the specifics of how things would happen if her brother passed away. She’d made arrangements with a funeral home and knew to call them once her brother passed away, but didn’t know how she herself would be contacted when it happened, or who would do it.

I quickly pulled out my notes and took down her contact information, assuring her several times that I would place it prominently in my hospital note to ensure that she was informed immediately by future doctors if anything happened to Mr. K in the hospital.

I cannot express in words how gratifying it was to watch the look of relief wash over the sister’s face, and how happy I was to see her crack a smile as she shook my hand and said, “Thank you, doc. I really appreciate it.”

She turned around, entered Mr. K’s room, and sat down in the available chair; I heard them begin to chat about childhood memories. As I stood in the hallway looking in, I couldn’t help but think for a moment that all of the hell I’d endured for med school was worth it. I’d just been granted the privilege of trust. I’d just been the person who delivered a bit of peace and comfort. And despite not having “M.D.” after my name, I’d somehow managed to muddle my way through this one.

The most exhilarating part was that for once, what I said had mattered to someone other than myself. As the medical student on the team, it’s rare to feel that anything I say is important. I often feel like I’m just repeating things said by my residents/attending, and honestly, it has yet to actually affect patient care, so I have little stake in anything other than for the sake of my grade/evaluations, which I don’t really care a whole lot about (my philosophy is that I’m here to constantly learn, not just work for a number that “defines” me). But just this once–what I said and how I said it made a real difference.

I think moments like this are what prevent me from becoming jaded. I was talking with my upper-level resident the other day, and she was telling me how frustrating it can be to know that patients frequently have diseases that can’t be reversed. But no matter how grave the medical scenario, there are shining moments where you know you touched someone’s life for the better, and those make up for all the rest of the drudgery. It’s times like this that remind me that medicine is perhaps the field where balancing between science and art is not only conducive to success, but rather, critical.

One of the major influencing factors in me joining medicine was the prolonged illness and death of a close family member, and I still remember all too well how painful it was. I know how horrible it feels to lose someone, no matter how “prepared” you are. I left the hospital on this particular day with my head held just a bit higher, feeling that just maybe, I’d been able to put a bit of positive energy into a family’s medical care.

Hey Jae: Do medical students have jobs outside of school?

Do medical students have paid jobs when school is in session? I would think that some would work to help pay off their tuition costs.

Yes and no. Many people do some form of work-study financial aid in school where they find jobs as librarians, TAs, research assistants, manual laborers, etc. Others arrange their own gigs, whether it’s playing in a band or tutoring the local university students or designing web pages. But honestly, many don’t do either, simply because they feel the time investment is either something they cannot afford to make if they wish to maintain their desired level of academic achievement, or they just want to use that time for self-care (social life, cooking, baking, exercise, hobbies, sleep, you get the idea). Here’s a simple decision tree to consider:

  • Do you really have time to work? In other words, will you still keep up your academics, social life, sleep schedule, and exercise?
    • If no, stop. Go play some frisbee and enjoy your life as it is.
    • If yes, continue.
  • Are you sure? Will you stay sane?
    • If no, stop. Go eat some chocolate and let the soothing effects take place.
    • If yes, continue.
  • What are your skills?
    • If research, consider seeking a lab that allows you to work flexibly. Chances are that this will be an extremely difficult job to maintain.
    • If teaching, see if you can find an MCAT program to teach for, or a tutoring arrangement (these often pay $50+/hour), or a TA position.
    • If bartending, look for a bar that doesn’t have you doubling as the bar-back.
    • If music, try to score gigs to play around town.
    • If muscles, then consult with your anatomy lab–chances are they’ll need help from time to time moving bodies and equipment.
    • If programming, let people know you’re into code/web design/etc.
    • If art/photography, consider selling your pieces/work. Chances are you’ll have classmates who get married, and they’ll need a wedding photographer.
    • If something not on this list, be creative and come up with something.
    • If none of the above, look for a simple, non-intensive task, such as librarian. This position has the bonus of giving you study time when people aren’t bugging you about books.

Keep in mind that all of this changes from year to year, particularly once you begin clinical rotations, which are basically a full-time job in and of themselves. I think tutoring is probably the most flexible and gives the best money/hour, but do whatever floats your boat–and remember: not working while in med school is perfectly acceptable, and in many cases, a healthy thing. You really have to weigh whether the (usually minor, in the grand scheme of things) decrease in debt is worth whatever sacrifices the job(s) require.

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“Hey Jae” is a series that publicly answers questions from pre-med students. I get these from time to time through facebook, e-mail, etc., so I figured if one person’s wondering, more likely are too. Feel free to pose a question of your own through my contact page! As always, best of luck. :-)

Hey Jae: Should I give up on pre-med if my GPA is too low?

I am a sophomore in college and after one and a half years of being a pre-med, my GPA so far is 3.1, which is very low, I know. I don’t know if I should give up pre-med, since my gpa is too low to get in anywhere. But I always liked to become a doctor, I feel that giving up is not worth it. but on the other hand, my GPA is way too low. I wonder if you have any idea what should I do? I still want to continue but I am afraid that my gpa is too low to get into anywhere.

I think before reading anything that I write, you really need to look at this: Making the Decision to Go To Medical School.

Now, let’s break this down. At the time of this writing, you just completed your first semester of sophomore year. With work, it is perfectly possible to raise your GPA to something more competitive by the time you’re applying–anywhere in the range of 3.5-3.8 is not out of the question, which, when paired with a strong MCAT and extracurriculars, will make for a good application. Based on my personal experience, I’m guessing that overall GPA matters slightly less than science GPA, so start by calculating that to get a feel for where your strengths are. If your science GPA is a 3.8, then there’s less to worry about. On the other hand, if your science is a 2.3, then…you may need to think more carefully about how to improve your science scores.

With regards to classes–where are your grades suffering? Chem? Bio? Physics? If it’s continuously all three, then this may be a problem with regards to your doctoral aspirations. If however, it’s just in your basic introductory classes, then you may just be having a hard time with the learning curve and need to employ a different study strategy. I distinctly recall being miserable in my early organic chem classes until I switched textbooks, at which point my grades skyrocketed to the top of the class and I ended up TAing the subject for 2 years.

So start by analyzing yourself in depth. Take a good long look at where your weaknesses are, come up with a plan to get better (get friends to help you with this!), and then iterate on the plan, adding improvements/tweaks as necessary. There is rarely such a thing as talent–just skills that everyone has taken thousands of hours to hone. I would be saying something considerably different if you were a senior, but now seems a bit early to contemplate the notion of quitting, particularly when you’ve only begun to delve into some of the deeper sciences as a college student. To be blunt, it actually does worry me a bit that you’re thinking of quitting so easily–it only gets harder from here on out. So do whatever it takes to boost your self-confidence–and if, a few years from now, grades are still a problem, then we’ll chat again. Fair?

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“Hey Jae” is a series that publicly answers questions from pre-med students. I get these from time to time through facebook, e-mail, etc., so I figured if one person’s wondering, more likely are too. Feel free to pose a question of your own through my contact page! As always, best of luck. :-)

Hey Jae: Is it ok to take pre-med classes at a community college?

I was wondering if it is OK to take a course sequence (orgo I and II) in the summer in a community college near my home, instead of taking them during regular school year in my college? Do you think that the admission committee will dislike that option?

As long as you have your pre-med requirements fulfilled, and you’ve done pretty well in them grade-wise, I don’t think any adcom actually cares where you got them done.

My logic is this: while it’s often (mistakenly) perceived that students take courses at local colleges solely to boost their GPA, if you take courses at a community college and get straight A’s, but do poorly on the matching portion of the MCAT, then it quickly becomes clear that you didn’t actually learn much. Conversely, if you get B’s but seriously kick ass on the MCAT, then maybe you just had a tough curve or some bad luck in the class–but who cares, you obviously know the material.

So in some sense, it’s a matter of knowing where on the spectrum you’ll likely end up. As long as you can get the requirements done, learn the material, and show it with confidence on the MCAT, I’d go with whatever option works best for you. Chances are that summer courses at a community college will be a cheaper and more convenient option for many pre-meds, with the added bonus of freeing up some units during the school year.

In general for this sort of thing, worry less about the prestige of your institution and more about learning the material properly. People in any field like to see results, not just a fancy name on a diploma. Remember that Bill Gates never finished college. :-)

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“Hey Jae” is a series that publicly answers questions from pre-med students. I get these from time to time through facebook, e-mail, etc., so I figured if one person’s wondering, more likely are too. Feel free to pose a question of your own through my contact page! As always, best of luck. :-)

Hey Jae: what’s the best mentality to have as a pre-med?

It’s pretty simple, actually, and I think what I’m about to share is applicable to any field, whether it’s medicine or engineering or art.

Every morning, look in the mirror and ask yourself, “Is what I’m going to do today going to make me happy?”

If the answer’s “No” for more than a week, either change your attitude or change what you’re doing, because one of those two is wrong.

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“Hey Jae” is a series that publicly answers questions from pre-med students. I get these from time to time through facebook, e-mail, etc., so I figured if one person’s wondering, more likely are too. Feel free to pose a question of your own through my contact page! As always, best of luck. :-)