What should I study in college if I want to become a doctor?

Whatever you love. I have classmates who majored in everything under the sun, including:

• French
• Biochemistry
• Piano performance
• Material science engineering
• Math
• Biology
• Chemistry
• English
• Neuroscience

Take courses in whatever you’re interested in. I would push more for classes that teach you how to think rather than memorize copious quantities of information, but that’s a personal bias. At the end of the day, as long as you have the pre-med requirements fulfilled, it doesn’t matter all too much[1].

A few recommendations on stuff to consider taking:

• biochemistry: It’s not required by a lot of schools, but I’d recommend it as an intro to the intricate meshwork that is organic chemistry and how the human body functions. This subject is often doled out in bits and pieces in med school, and in some ways it’s given short shrift, so a formal course can be rather valuable.
• ethics: A very difficult course in terms of thought, but so, so valuable in real life. A 1-year-old baby comes into the ER from near drowning and the attending physician realizes the mother is mentally unsound due to untreated schizophrenia–no easy solutions there.
• computer science: It’s amazing just how technologically incompetent the average medical student is. And by amazing I mean completely f***ing scary. Don’t be one of those people. Please?
• immunology: It’s rapidly becoming a pretty hot field in terms of research, and the extent to which the immune system can mess up the body is just as much cause for concern as how to maintain the integrity with which it defends the body. Probably not super-high yield, but I feel like this is a rare exception to the rule below that’s worth having a formal introduction to.

Stuff to avoid (in my opinion):

• physiology, anatomy, pathology…basically, stuff that you would take anyways in med school. It’s pointless to waste tuition to learn the same material twice. And no, the fact that you’re reviewing the material generally doesn’t make it any easier the second time around–med school will require you to learn so much more than the collegiate version of a course that the disparity makes it doubly useless.

[1] That said, there are schools that have requirements beyond the basics, so check with whatever schools you plan to apply to and make sure you can get those courses in.

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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.

1. You really have to love medicine. If I offered you $100 million to quit medicine forever, you should be able to say no without looking back. I realize that sounds absurd, but my point is: if any amount of money will sway you, chances are you’re doing this for the wrong reason. Keep things in perspective: you beat out thousands of other applicants to win your spot in your class. Why did you bother fighting for a spot that would keep you out of the money-making world for 7+ years if you’re either a) after money or b) not really passionate about it? Never forget why you applied.
2. Most of the people who enter med school are a little behind on maturity. I’m definitely guilty of this, and chances are, you are too. Think about it–most med students are hardcore nerds/smart-alecks who spent time studying when they could’ve been hanging out with their friends and learning social norms. Generally speaking, we have a bit less overall “life experience”. I’m not joking when I say I have classmates who complained about seeing penises in anatomy because they’d never seen one before and wished they’d had a gentler introduction. Take-home message: be understanding of classmates–at some point you’re going to seem immature too, and you’ll have to rely on someone to be patient with you. A healthy tolerance for drama (particularly of the romantic variety) helps.
3. You have to find new ways to study. The chances that the same study habits that carried you through college will work in med school are slim–there’s just too much material, and the first step is accepting that, honestly, there’s no way you’re going to know it all. That’s a sore spot for people who’ve been academically successful all their lives, but it’s the plain truth. So find what lets you memorize and understand the high-yield material. Above all, don’t be afraid to reach out for help!
4. Try not to piss people off. I don’t care how tempting it is–take the high road. When you enter med school, you become a professional, and you are judged as such 24/7 regardless of the situation. You just can’t afford to upset someone with more authority than you this early in your career, and for that matter, annoying your future colleagues is an obvious bad call as well. If you disagree with something, bring it up through tactful channels. Request relatively private meetings (but don’t be afraid to ask if people can come with you!), be cordial in e-mails, and re-read everything from multiple angles to make sure it can’t be taken the wrong way by someone in a bad mood. Practice good communication skills, and it’ll get you far!
5. It’s easy to forget the human aspect. Drowning in information all day, it was easy to lose sight from time to time of the fact that all this book-learning is being done for the sake of helping others. Don’t let being a social butterfly take away from your studies, but don’t be the lone wolf either! Take the extra effort to say hi to everyone, give them a hug/high-five, ask them about their day, etc. Med school’s a tough experience, and you want as much mutual support from friends as possible. Who better to understand what you’re going through than your classmates?
6. It’s hard to take care of yourself. Eat healthy. Exercise. SLEEP. Everyone tells you to do this, but shoots, it’s not easy. Hint: it helps a ton if you learn how to time-manage properly! It seems to me like medicine is ironically a field where its practitioners have to fight to find the time to practice what they preach, and as a student adjusting to a whole ‘nother city, culture, and schedule, to call it tough would be giving it rather short shrift. I guess when it comes down to it, just remember to have fun with the whole experience, or else it’ll drive you up the wall. Make time to hang out with friends, call up old pals to catch up, etc. Part of taking care of yourself is keeping your sense of humor, so remember to laugh and love life. Being a med student is a very blessed position, don’t ever forget it!
7. Open-mindedness is key. I came into med school all gung-ho about going for ER residencies, and while I’m still really in love with the field, I’m starting to consider trauma surgery too, and for 10 minutes at a time when our ophtho prof shows us a sweet operation video, I consider ophthalmology. Seeing my neurology professors lecture is like experiencing poetry in motion, and after finishing that class I’m utterly in love with neuro too. You might know what you’re interested in, and that’s great, but just remember how broad medicine is. A wonderful professor gave me this piece of advice: “When you’re on surgery, be the best surgery student you can be. When you’re on peds, be the best pediatric student you can be. And so on and so forth. It doesn’t matter how little interest you walk into a rotation with, you owe it to the patients and the rest of the team to be at your best. Besides, how are you going to figure out how much you like or dislike something without giving it a legitimate try?”
8. Hacks and resourcefulness will save time, effort, and money. Don’t wanna blow your dough on textbooks? Find out what your library carries. Interested in research? Introduce yourself to cool profs right after their lecture and then e-mail them while their memory of you is still fresh. Food budget getting tight? Search your e-mail for local events with free food. Stayed up late at school studying and don’t feel like going home? Remember where the comfy sofas and shower facilities are and keep a change of clothes at school (some deodorant helps too). Don’t want to spend $100+ repairing your cracked iPhone screen? Get the local tech nerd to do it for you with a $13 replacement off of eBay. You get the idea.
9. People will automatically trust you, and treat you differently. Family will start bombarding you with medical questions, friends will text you with ailments even though they’re thousands of miles away and you can’t even do a basic physical, and strangers will approach you with a trust that you will probably find shocking. Get used to it. Everyone sees you as a professional, and really, the best you can do as a medical student is to tell them what you know and humbly admit just how much you don’t. Don’t abuse anyone’s trust. Don’t act like you know something when you don’t, it’ll just bite you in the butt later, and the stories that go around about arrogant med students trying to show up their peers are mindblowing. If one of your classmates does this, don’t bother trying to one-up them, it’s just not worth it–they’ll usually get their comeuppance when it comes to reviews anyways.
10. MOST IMPORTANT OF ALL: teach. The word “doctor” does not mean “healer”, “provider of cures”, “surgeon”, or anything specific to the field of medicine. In Latin it means “teacher”, and its origin was the verb “docre”, which means “to teach”. The first line of the Hippocratic oath is not “Do no harm”, as popularly believed–the first line pledges honor to the person who taught the practitioner, and includes a vow to teach others. So educate yourself. Help educate your classmates. Educate your future patients. If someone asks you a question about medicine, don’t just slap it off as “something you’ll learn later”. Take the opportunity to find out, review, and follow up. Be patient. Be gentle. Remember that outside of a test scenario you’re getting asked by someone who doesn’t know the answer, and they’re genuinely curious.

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Feel free to comment and/or make suggestions!

Answer dedicated to Anna Parks, UCSF class of 2014. Best of luck, Anna, I’ll always be rooting for you.

It’s been brought to my attention that there are numerous online services that throw themselves at pre-meds, all promising top-notch personal statement support and advice, all for a seemingly “nominal” fee. I am hereby informing you, with utmost confidence, that they are all scams.

My first tip-off to this was a comment on my post about how to ace the personal statement. Don Osborne of Inquarta.com commented about aspects of personal statements that he, as someone who has read many of them, would enjoy seeing. Nothing in his comment was anything I hadn’t already addressed in my post, and it was a clear attempt at simple link-baiting, but I figured I would give the man the benefit of the doubt and check out his website. The first thing I notice upon arriving there is that he too, has a post on “How to write a winning personal statement”. Interesting, I thought. I click through to give it a read, and to my surprise, it copies every idea I presented in my post, in almost the same order, and the only thing that’s different is the wording. And then I notice that he published it a mere 3 days after I published mine. Fair enough, I’m a believer in coincidence, maybe we just had the same brainfart. I then click through to his staff bios and suffer a sinking feeling as I come to the inevitable conclusion that not a single person working for that company has any right to be giving medical school personal statement advice–not a one had ever applied for or attended medical school. And yet their website (which is crap, btw, and hasn’t even bothered to update since 2008) offers articles with headlines like “How to become a doctor”. Incredible. What the fuck, Don, you had so little expertise on board that you stole from a med student’s blog? Seriously?

Now wait a minute, Jae, you say. Looks like Don’s worked for Princeton Review teaching MCAT Verbal, that’s legit, right?

Um, no. I worked for Princeton Review teaching MCAT orgo while my friends handled gen chem, bio, and physics (we basically ran the Palo Alto office that summer), and I can assure you teaching MCAT for a test prep company gives you about as much “expertise” in med school admissions as learning how to play the board game Sorry (see what I did there?). And at a hefty $4k for Inquarta’s package, sorry is exactly what you’ll be when you realize just how badly you got screwed. The sad part is, Inquarta’s on the cheaper end of the spectrum.

Let me break down for you exactly why you should never use an admissions coaching service:

• They’re after your money, not your acceptance. It’s true: they have no vested interest in you actually becoming accepted, and are simply preying on your fear. Remember that no one can give you any sort of guarantee, so essentially what you’re doing is throwing money at a problem and hoping that works–think this will work on a patient?
• They have no medical people. The reason for this is simple: no one in medicine has the time to sit there and read personal statements as a part-time job, we’re too busy studying or treating patients, and when we’re not doing that, we’re chasing sleep. Sure, we’ll read for our friends/family, but seriously? Someone could die if I don’t learn how to diagnose this disease, so a complete stranger’s essay isn’t even going to make it onto my list of priorities unless there’s some extremely compelling reason. So if these companies have no medical people on board, how can they possibly offer solid advice about any aspect of med school? Simple. THEY CAN’T. Whatever they tell you will be hearsay and secondhand, and it can’t even begin to compare to a firsthand account.
• Their qualifications suck. There. I said it. I don’t care if someone’s read a million personal statements, worked for Princeton Review/Kaplan, been on the admissions committee for an MBA program, has a Ph.D. in English, whatever–if they don’t have exact, personal and firsthand knowledge of going through the medical admissions process, they are useless to you. Quite frankly, the louder they tout their seemingly-related-but-not-quite credentials, the bigger phonies they are.
• They tell you to do the wrong things. Many will offer banks of “personal statements that worked”, while others will straight-up offer to write your essay for you. While the latter is obviously a poor choice, the former is a surprisingly insidious idea that’s also bad–because what you’re seeing is what other people wrote about, what other people are passionate about, what other people are driven by. This time would be much better spent figuring out you.
• Testimonials are a poor standard of measurement. Particularly on the company’s website. Of course they’d pick the best ones that make them sound good. Of course they’d filter for positive ones. Of course they could just be making all of them up. It’s the Internet. What you’re getting is their version of the testimonials.
• You’re better off using friends/family. These people care about you. These people know you. And they’re free. Surely you have at least one friend who’s talented at writing who can help you? Any applicant who trusts a stranger to give them better service than their own personal network should stop applying the moment they make that choice–because I can tell you right now that kind of attitude doesn’t work in med school. There’s an expected trust of your colleagues, and if you can’t trust them, they sure as hell won’t trust you, and you’re gonna be one lonely, pathetic student.

I’m seriously, seriously hoping this is a wake-up call for anyone considering admissions coaching. Don’t do it. You and your wallet will both thank me later.

Cheers,

~Jae

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At this point I suppose some pre-meds are wondering, “Well what the hell qualifies you to give advice, then?” The difference between me and an admissions coach is that I fully admit to being fallible. That said, I’ve been in your shoes. I’ve made it into medical school. My undergrad mentor served on the admissions committees for both Harvard Medical School and Stanford School of Medicine. My classmates serve on the admissions committee for Baylor College of Medicine. If it’s between me and a business, I daresay I have the purer motives for giving you advice.

If someone has a relatively low undergraduate GPA, is it better to go for a master’s degree in a science/public health specialty (and do really well) or take more science classes (to raise the GPA) prior to applying to medical school?

This is an extremely tough question, and it’s taken me much longer than usual to think about it. I’ve polled friends, and there doesn’t seem to be a consensus either way. So the truthful answer: I don’t know.

I have a dear friend who went the master’s degree route to direct attention away from his weak undergrad GPA, and it worked out well for him–accepted to an M.D./Ph.D. program, no less. Then again, he graduated with both a B.S. and M.S. in 4 years, was scientifically published, and had solid recommendations, so an additional degree was certainly not the only thing going for him. Did I mention he also sang a cappella and helped manage a free clinic for the underserved?

I have to say that this choice is best left to your judgment, and that I wish you the best of luck regardless of what you choose. Some things I would encourage you to consider:

• what’s the difference that extra science courses will make in your GPA? If it’s the difference between a 3.4 and a 3.5, this is considerably less impressive than the difference between a 2.9 and 3.0.
• how much time/money will each option take? Admissions committees do seem to have some preference for people who take a year or two off after undergrad to pursue other interests, but is it worth the extra cost of grabbing another degree?
• are you just pursuing an M.S. or M.P.H. for the sake of looking good to a committee, or are you actually interested in going in depth in the field? If it’s the former, are there other things you could do to strengthen your application, whether it’s research, other work experience, fellowships abroad, etc.?

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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!
It’s scary going into sophomore year hoping that everything will work out for premed. I have absolutely no idea what my reaction will be like to the classes. Since I didn’t take chem this year, I’m basically planning to jump straight into all the premed reqs next year hoping that I will end up going for it. I have older premed friends who recommend not using the classes to gauge whether I want to be premed or not though. It’s confusing…help?

They’re absolutely right: don’t use premed classes to gauge whether or not you want to become a doctor. Think of them more as exercises and practice in the skills you’ll need as a physician. Bio will train you to memorize lots of information, chem (organic) will teach you to be flexible and creative in coming up with solutions to problems, and physics makes you think in analytical fashion about how to apply what you know to a new situation/problem. I’m gonna be honest: gen chem can kind of suck, but think of it as the otherwise adorable child of organic chem and physics, as it were. All the pre-reqs are just hoops everyone has to jump through, and really, what you ought to be doing is taking the time to learn how to think in different disciplines.

I realize that sounds unbelievably philosophical. Let me try to ground it a bit. Let’s say you have a patient come in with a set of symptoms you think is caused by Bacteria A, B, or C (a very realistic scenario, to be honest; for any given condition there are at least 10 things that could be the cause). You order lab tests on the patient’s blood, and get back a set of data. You’ve memorized what the lab results should be for each bug thanks to your training in bio courses, so now using the analytical style from physics/gen chem, you take what you know and confidently rule out Bacteria B.

Now the problem is that you’re still not sure between Bacteria A and C. Shit. They’re really similar, and your hospital is limited in resources for lab tests, so what do you do? Again remembering from the mass quantity of data in your head, you remember that there are, in fact, multiple antibiotics that can take care of both buggers. Sweet. So how do you decide which one to give? This is where the flexibility you learned in organic chem combines beautifully with the analytical skills you learned in physics. You have to take into account the patient’s insurance, the cost of each drug, the duration of the therapy, the patient’s allergies, etc, etc. After considering a multitude of drug possibilities, you prescribe BallerDrug, a cheap solution that is fully paid for by the patient’s insurance and that only requires a week of dosing, and has a low incidence of allergic shock. Legit.

Are you starting to see what I mean? Think of each pre-med class set as training in a methodology of thinking. Does this make the classes themselves any less difficult? Not particularly, but shoots, if you think something’s hard, it’s going to be hard no matter how awesome you are, so stay positive. Rock the classes, and you’ll get a solid grounding in problem-solving, a skill for which a lot of medical students are still on the beginning end of the learning curve.

Remember this: it takes practice to master a new way of thought. Getting easily discouraged is not allowed. Everyone takes blows to their egos with bad grades from time to time (fact: my first set of college grades included a fat C+). What makes the difference between an ordinary student and a great one is that the former will say, “Screw this.” The latter will say, “Screw this, I’m gonna do better next time.” and asks for meetings with the profs/TA’s to understand where his/her understanding of the material wasn’t enough.

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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,
I was talking to an academic advisor and she recommended that if GPA is a concern (which it may be lol), I could major in something other than biology, but fulfill the premed requirements. With med school in mind. Any thoughts?

That advice: bull.

Changing one’s major does not necessarily imply a boost to GPA or med school admission chances. If science classes have you looking for “GPA buffer” classes, majoring outside of a stereotypical “premed major” won’t really save you–med school apps all calculate science GPA and overall GPA separately…and you can bet which one they pay a smidge more attention to.

Let’s think here: if we look at options purely from a numerical standpoint, we can break it down into the following:

• X = # units in premed requirements
• Y = # units in premed major, not counting overlap from X
• Z = # units in a completely unrelated major with no overlapping courses
• Z > Y >= X, generally speaking

This gives us the following possible permutations:

• X + Y = completed premed major, with premed requirements fulfilled. Even with other general graduation requirements, this should leave you with a decent chunk of time left in your college career to do with as you please.
• X + Z = non-premed major, with premed requirements fulfilled. Simply doing the math should tell you that this option will always cost you more time/units/planning than just going with X+Y. Is it worth it? Up to you.

Personally, I just went with a simple bio major. Why? It gave me a lot of time to work on other stuff like research, a computer science minor, social life, teaching, etc. Basically, in my case, it gave me nearly a year and a half do whatever I wanted. So much freedom after getting the do-a-major-so-you-don’t-have-to-worry-about-graduating-with-a-degree thing out of the way!

I understand this is a personal choice and I respect that. All I’m saying is, don’t listen to advice that doesn’t have at least some logic behind it. If anyone tries to sway you with the argument that having a non-stereotypical-premed major will make you really stand out and thus improve your admission chances, that’s nonsense too. Quite frankly, no one in med school gives a flying hoot what your major is as long as you’ve got the required coursework. Sure, it can make for some interesting conversation during an interview, but that shouldn’t be the one thing you’re banking on to get you accepted. For the record, we held a survey at the very beginning of the school year and it turns out the grand majority of my classmates graduated with premed majors. Admittedly, I’ve got classmates who are English majors. Another who’s a pianist. Another who somehow magically balances med school with being a mother of 4. Those are amazing parts of their identities, and I am so happy that I go to school with such a talented motley crew. But I somehow doubt that those traits are the biggest reason they got into med school, ya know? I suspect those special characteristics rounded out an equally amazing foundation. Just food for thought.

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“Hey Jae” is a new 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.

(1) THINK, DAMNIT.

Allow me to wax philosophical for a minute.

When you start, do NOT immediately try to write something about yourself. I’m all for getting random thoughts and ideas down on paper, but don’t start hammering out a first draft from the get-go!

Hold your eagerness/nervousness in check and just think, damnit. This is, quite literally, an essay that can determine your future. It deserves some respectful introspective contemplation. Think about why exactly you want to spend a small fortune and nearly a decade of your life, and what you will bring to the profession. Quite frankly, if you don’t already question whether you really want to be a doctor or not, you’re either not thinking hard enough or you’re naive, neither of which improves your odds. Ignorance is not a sin, but it is one hell of an inconvenience, so let me give you this fact: over half a dozen people in my class left in the first eight months. Being accepted to medical school was what they worked for years to earn, spent thousands of dollars on–an opportunity hordes of other pre-meds would’ve been happy to take. Cogitate on that for a moment. If there is anything else you could possibly see yourself pursuing as a career, do that instead. Please?

(2) What drives you?

Start by identifying your passion(s)–what makes you tick drop everything else for the sake of making it happen? This is your hook, so don’t just reply “medicine”. What exactly about medicine makes you think its the career of your dreams? What is your vision of how you will impact medicine in 10, 20, 30 years? Dream big, and build those castles in the sky. The whole point of the admissions process is to determine whether you’ve really got what it takes to build foundations underneath them.

Please, for crying out loud, write something original. Seriously, I don’t care if it’s true:

• Don’t write about how you’ve wanted to be a doctor since you were a teenager/child/fetus. Not only is this thesis commonplace, and therefore boring, I honestly find it extremely insulting. Why? Because nothing in the world really prepares you for the emotional, physical, and mental rigors of medical school. Med school is not the heavenly ideation pre-meds often dream it is; if it was, people wouldn’t quit. If it was, people wouldn’t have mental breakdowns. If it was, the percentage of docs saying that they wouldn’t do it again (if they could go back in time) would be way lower. Honestly, it’s kind of hellish. You study more than you’ve ever studied in your life. You stress more because if you screw up, someone might actually die someday. Emotionally, something will eventually crack you as you begin to see incurable patients. The list goes on. As much as every doctor tries not to be jaded, can you see why the bright-eyed notion of “just knowing” you’ve always wanted to be a physician could be downright aggravating? Show some respect for the challenging realities of the medical profession.
• Don’t write about how you or a relative underwent a traumatic medical experience that inspired you to be a healing force in the world. I’m perfectly aware I’m touching on an emotional hotspot with this advice, and that it’s probably going to piss people off. Let’s put it this way: I did this. If I could do it again, I would do it differently. Everyone has bad medical experiences if they live long enough, so please, get over yourself (I mean that in the kindest way possible >.<). In the grand scheme of things, one physician more or less is not going to make a particularly large dent in the healthcare needs of the 6 billion+ people in the world, and if everyone who had a relative die of cancer chose medical school, the average IQ would top 130 and we wouldn’t have the shortage of healthcare providers that we do now. If you’re going to write about a medical experience, don’t make it your sole focus–weave it into the framework of how you plan to use that experience to improve healthcare.
• Don’t write that you come from a proud family of doctors and you want to follow in their footsteps. This just makes the reader think you haven’t the brains to think for yourself. I don’t care if you’ve spent hundreds of hours shadowing dozens of doctors–you’ll still sound like you’re choosing medicine because it’s what family expects you to do, instead of you really wanting it. It kills any chance you have of sounding charismatic, and instead you come off as annoyingly naive. =__=;

Basically, from the moment someone starts reading, you have about 30 seconds to impress them enough to keep reading, so don’t write on the same premise as a thousand other applicants. It’s trite, mundane, and uninteresting. If a significant part of why you want to be a physician happens to stem from a relatively common theme, fine, that’s not the end of the world–spend fewer words discussing your inspiration and quickly shift gears to specifics about you that will convince the reader they’ve got a genuinely special story in their hands. It’s your response to adversity that will make you stand out, not the fact that you’ve faced it.

(3) What have you done to fuel your passion?

So. You’ve told me what you’re really into, what gets your juices going. Maybe you’ve said you’re really interested in the evolving interface between medicine and technology. Or maybe you’re in love with the idea of joining the CDC’s crack team of epidemiologists. Or your dream is to improve the treatment of AIDS in inner city slums. Awesome! You’ve identified your mountain.

…what’ve you done to start climbing? Are you just pontificating or are you being realistic? If you don’t write about any computer science experience, epidemiology research, AIDS fundraising work, or something along those lines, my skepticism will start increasing. The medical community can be idealistic and appreciate hope, but if your personal statement and resume don’t seem to match, you can bet your readers’ bullshit alarms will start going off loud and clear.

Now, that said, a caveat: if you have extenuating circumstances that have prevented you from being able to start climbing, explain them. Put your heart into it, and appeal to your reader’s sense of compassion. True story: a student with a 28 MCAT was accepted to an extremely prestigious private medical school. On first glance at her numbers, you might wonder why they didn’t throw out her application immediately. Her statement, though, told the tale of a brave young woman who was working full time outside of class so she could support her four younger siblings. Of course she didn’t have the time to properly study for the MCAT–expensive prep books and courses were also out of the question when that money could feed a sister or brother for months. Upon acceptance, she quickly rose to the top of the class. A truly. incredible. applicant.

Second caveat: don’t repeat anything that’s said in the rest of the application. This is something I see so often, done for the sake of “emphasis”. The personal statement just becomes another resume. Fact: you’ll seem like you have nothing else in your arsenal, and at the end of the day, you’re beating a dead horse. If you’re going to write about an activity in your personal statement, don’t give away the thunder before the reader even gets there. The application process gives you so little space to squeeze in everything you want to share about your life–you don’t have the luxury of repetition. Hit the relevant high points in the extracurriculars section and then expound on those points in the essay.

(4) Unify.

I don’t want to sound like a high school English teacher, but assuming you’ve managed to intrigue the reader beyond the first five sentences and kept them furiously reading to the point where they develop nystagmus, at the end you absolutely need something to tie it all together. By the time the reader hits the end of your statement, they should have a caricature of you in their head, a distinct voice they can imagine reading the essay aloud, and the last few sentences are your one shot at combining the different elements of yourself into a complete persona. In other words, if your reader ever meets you, you want them to be saying, “You’re just like I’d imagined!” If you haven’t done this, you need to keep writing.

Loosely speaking, you utilize pathos in talking about your passions, logos in explaining how you’ve pursued them and how they’ve driven you to the field of medicine, and your ending is your biggest opportunity to show you have some legit ethos to balance it all out.

Do NOT:

• Say, “In conclusion”, or give a summary. You’re not in 5th grade anymore. Show some creativity.
• Use a cultural or cliche statement/quote to connect. First of all, this type of writing is an insult to both your and your readers’ intelligence, and second, your reader could be someone unaccustomed to your idioms–a huge chance of misinterpretation. I’ve yet to see someone pull this off, and it just makes me roll my eyes.
• Be satisfied with an essay that, when you send it out to friends/family for feedback, doesn’t elicit a “Damn, that was solid.” response from at least 2 people. “Pretty good!”, “Nice!”, “I liked it!” are not good enough; if they’re not followed by supportive criticisms, they’re actually signs you need to pick other people to read–people who aren’t afraid to jab at weaknesses in your writing.

Be brutally honest and ask yourself:

• Would I want to meet me if I read this essay?
• Do I leave the reader believing in my potential to change medicine for the better?
• Do I seem to match a stereotype, or do I really stand out as awesome?

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This post just took ~10 hours to write. If you can spare a moment, please, leave your thoughts in the comments about whether this was helpful or not. Is there anything you wish I’d touched upon? That I could write more in detail about? That I’m flat-out wrong about? Any and all thoughts are welcome!

1) Not enough doctors are involved in the creation process. I am pointing the finger at every physician, medical student, and pre-med who sees a computer as nothing more than a terminal for the web and some word processing, maybe a few powerpoints and PDFs here and there, maybe a few games. Who has always just taken broken computers into the shop and paid exhorbitant prices, or gotten a friend, or just “someone else” to deal with the problem because they can afford it, “don’t have the time”, or “don’t know anything about computers”.

This is a huge. fucking. problem. The grand majority of healthcare professionals are not really computer literate, and that doesn’t seem to be changing anytime soon. True story: I fixed a classmate’s computer the other day when a boot file got corrupted. It took ~5 min to run a disk check and solve it. I got the fix off Google. Does this make me some sort of computer genius? Hell no. Truth: I didn’t have access to internet in my home until senior year of high school. It was 56K dial-up. If I can troubleshoot a computer, so can you. All it takes it takes is a bit of “get-up-and-go(ogle)”.

How, if physicians aren’t comfortable with computers, if they can’t imagine the possibilities, can they help make the next generation of software that will serve their patients? Let’s face it, EMRs are here to stay, and the more physicians become tech-savvy, the better the quality of healthcare will become. Even if a physician doesn’t help create the software, if they can provide competent feedback about its pitfalls and strengths, that alone would bolster the status quo immensely.

2) Software tries too hard. Take a look at any EMR that exists today. I guarantee you every single one will present the physician with hundreds, thousands of data points. Every single one will try to list every single condition, symptom, test for every possible scenario. This is in(s)ane. All it does is create an overwhelming interface that the physician wastes time looking over, hoping they marked everything correctly. Or they mark a few things and don’t bother with the rest, which is arguably worse.

Simplify, simplify, simplify. We don’t go through 12 years of grade school, 4 years of college, 4 years of med school, 3+ years of residency, and then X number of years in fellowships to have all the stuff we memorized be spoonfed to us again. There are an enormous number of situations where leaving the physician a well-placed text input area to just type their observations, or having a button to record audio clips would be a hundred times more useful than another list of all the causes of [insert condition here]. Stop giving us more lists, and give us the freedom to use all that training.

3) Software is designed for billing. Every single EMR is designed around billing people. And indeed, why shouldn’t it be, you ask? It is, after all, how we make our bread and butter.

Issue: the fundamental cornerstone of software is that it will do what you designed it to do. Look at Google. It was designed to search. The revenue from ads came after they’d perfected their search product and people actually found it useful. Medical software is completely backwards–it’s made for money first and patients second. It’s being used more because hospitals buy the hype, and less for the reason that it’s actually well-made and a genuine improvement to the workflow. This needs to change. It’s the reason why there are no analytics, it’s the reason why user interfaces suck, and it’s the reason EMRs are slowing down healthcare with administrative burden rather than speeding it up.

4) Competing companies don’t make products that are compatible. They’re so caught up in gouging the medical field for incompetent software that, again, they don’t think of the patient. True story: at a very well-funded private hospital in California, a child presented to the ER one night. At a follow-up with his pediatrician a few days later, the pediatrician discovered that because the hospital’s ER and clinic utilized software from competing EMR companies, she couldn’t access her patient’s ER treatment record. She had to walk over to the ER, present her credentials, and have the record printed out for her because faxing patient records was an unacceptable security risk. Imagine if, instead of two different departments, this scenario had taken place with two different hospitals. In two different states. See where I’m going with this? It’s not hard to see that patient data often just falls through the cracks.

Companies need to focus on delivering systems that are capable of crosstalk–this would deliver a much more comprehensive and smooth patient outcome. They need to see past their profit-driven myopia and focus on the bigger goal of patient care. For that, (3) needs to change first. Whether that will happen sooner rather than later is something that remains to be seen, but I’m certainly not holding my breath.

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Ranting aside, I’m really hoping that in the future I get the chance to help create an EMR that properly addresses these issues, but for now, I guess these will serve as my notes of what to avoid…

Am I wrong about something? Did I miss anything? Sound off below!

1 – You can take your time deciding. EVERY Stanford freshman class is chock-full of premeds. Seriously. It’s kind of ridiculous–if my memory serves, 70%+ of the people in my class came in expressing at least some interest in pre-med, which is nuts. How many stuck with it? I’m not entirely sure, but I believe ~20% of the class graduated having fulfilled pre-med requirements. A pretty huge drop, huh? And you can bet a bunch of people who graduated pre-med didn’t start that way, so who cares if you came in with no interest in becoming a doctor? Granted, it’s something of an advantage to know earlier simply for planning purposes, so for those of you who came in as die-hard pre-meds…congrats? But for those of you who didn’t, big whoop. ^_^

2 – Hum Bio vs. Bio major. this is a huge debate, but I’ll try to break it down as simple as possible…

Human Biology:

• who does it: people who like the “fuzzy” aspects of science–i.e. really like learning about social issues of science
• declaring: a mountain of paperwork justifying every elective choice you make
• core: 10. freaking. units. per. quarter. At the most popular timeslots of the day. Do you have any idea how annoying it is to schedule stuff around that?
• electives: pretty cool, admittedly. I took a class where I never attended lecture, hw took ~15 min/week, and I crammed for the final in one night. Grade? A-. Oh, and did I mention it took care of two GERs?
• flexibility/speed: what other major at Stanford requires paperwork just to change what electives you’re planning on taking? I feel like Hum Bio people were always complaining about their scheduling issues.
• exemplifying moment: a Hum Bio friend was telling me about how she spent a lecture learned all about the sickle-cell mutation, its rates, its underlying reason for continuously existing, etc. I told her that we learned about it in the bio core too. But in like, 5 minutes, without looking at any of the social impact.

Biology:

• who does it: people who just want to learn the facts, straight-up
• declaring: 1 sheet of paper if you don’t do a track; 2 if you do
• core: 5 units per quarter. I was starting on my elective units by spring quarter sophomore year.
• electives: also pretty cool–especially once you reach out to some of the ones in the medical school
• flexibility/speed: if you don’t do a track, awesome. I mean, come on, it’s only 24 units of electives, you could find a way to finish all that in 2 quarters if you were really so inclined.
• exemplifying moment: realizing that my departmental graduation ceremony ended approximately 2000 hours before the humbio one because we had fewer people. So, literally in the end, we were the ones who didn’t have to spend as much time baking in the hot summer sun. *smug smile*

I admit it: I hate writing papers, I don’t really care that much about the social aspects of science when, quite frankly, you’re bombarded with it in med school anyways, and I despise useless paperwork. Go with bio–I guarantee it will give you less headache. Wanna know something? No one in any med school admissions committee cares what your major is. I have French majors in my class. Professional pianists. People who majored in nothing remotely related to science. And yet, they’re in med school. Shocking? Shouldn’t be. Keep it simple and go with whatever major best suits your needs, because it really doesn’t matter what it is. IMHO, for the Stanford pre-med, it happens to be bio.

3 – Use pass/fail to your advantage. Figure out how many units and what classes you can take pass/fail and play to your strengths. You don’t have to take every pre-med class for a letter grade, and if you’re smart? You won’t. *Most* admissions committees are NOT going to look carefully and care if you took orgo lab pass/fail, so if you know hammering out Chem 36/130 lab reports isn’t going to be your forte, take the “P” on your transcript and just enjoy the reduced stress. This can apply to other classes too. Use the extra time you gain to get some extra research work done, play ping-pong, sleep, or put in some extra studying to make sure you get that A in a class you know you can rock. As long as the fair majority of your transcript is letter grades, you’re set.

4 – Don’t try to graduate early (unless you have pressing financial motivation). Trust me. After graduating everyone looks back on the golden days of Stanford and if you have any sense of sanity you will wonder why on earth anyone would want to shorten their time in the haven that is the Farm. *wistful smile*

5 – Don’t take classes based (too much) on subject matter you’re going to be learning in med school anyways. You know the ones I’m talking about. Surgery 101. Bio 112/212. Stuff along those lines. People often justify these choices by saying, “Oh, but it’ll be good because once I get into med school the stuff will be like review!” Those people are idiots. I know pre-meds aren’t banking geniuses, but really–why on earth would you pay the insane tuition to take the same subject matter twice? That’s such a waste, you might as well have just applied to med school in another country straight out of high school and saved yourself the time/money/effort. Look–just do your pre-med & major requirements, and then spend the rest of your time exploring other classes! Stanford has an unbeatable array of coursework, so take advantage! Consider a minor in something completely unrelated to bio/chem/humbio. Kick back with some swing in Richard Powers’ social dance classes. If you plan to practice in the U.S., spruce up your medical Spanish. Try Drama 103 and show off that sense of humor with some improv. Or maybe a kickboxing/tennis/fencing/etc. class at Arrillaga? Feeling the wanderlust? Go abroad for a quarter! (or two!) Can’t make that commitment? How about a Bing Overseas Seminar? My point is this: learn to value classes that teach you new skills and/or new ways of thinking about problems, because ultimately, that’s what going to make you stand out as a physician–how you tackle problems. Think Patch Adams.

6 – If you’re going to work, find a job you love doing. If the calling center “calls to you”, great. If it’s dorm staff that floats your boat, make sure you can handle 3AM fire alarms, drunks, and stupid drama with a smile on your face.If you’re going to do research, do it because you’re genuinely interested–not because you want to be the so-called “model applicant”. My buddy David and I spent a good deal of time recruiting/interviewing for our lab back at Stanford, and the people who really stood out did so because of their earnest desire to join and learn, not just gain another line on their resume. Anyone who went through high school has at least some ability to detect BS, and at a place like Stanford, expect those sensors to be extra sharp, at least if you’re planning on joining the Nadeau lab. Now, that said, consider doing your research in the med school. You’d be engaging in clinically relevant work at a leading medical institution, and potentially even get to interact with the patients you work with, which is a huge plus for experience. Also–let’s be real, the rate of publication in a clinical lab can often dominate a basic science lab–although they’re in journals with lower impact factors, your name on any paper is still a pretty sweet reward for the work you put in, AND it looks good to admissions committees.

7 – Find a good great spectacular advisor/mentor. I can’t stress how incredibly important this is–it can literally make or break you, particularly when it comes to strong recommendations. If your advisor is not working out for you, give some heavy thought to switching. This is YOUR 4 years, and you have the right to be happy with the person overseeing your work. If that means politely changing labs or major advisors, so be it. But do it with class. With grace. With gratitude, because no matter what, your old mentor did spend some time with you, even if it was only to sign off on your forms. If you’re serious about being pre-med, you need to exercise professionalism, and it’s never a good idea to piss anyone off this early in your career.

8 – On that note, don’t forget to be social/nice in general. If you get to med school and you’re the awkward guy/gal who doesn’t really know how to hold a conversation, no one’s going to like you. If you’re obnoxious, no one’s going to even look at you twice. Far from it, we’ll just laugh when you get smacked down on your first rotation because the nurses you pissed off by treating them like crap screw with whatever you’re assigned to do. Sooner or later, you’re going to learn that interpersonal skills are absolutely crucial in the healthcare profession, and in a field where people’s lives are on the line, tempers can flare. Stanford pre-meds have this huge reputation for being high-strung nervous wrecks or timidly emo–please do your part to turn that image around? Be chill and content with life. Honestly, if your desire to be a doctor doesn’t strongly rotate around money, a sense of elitism, familial pressure, or something foolishly superficial…this shouldn’t even be a challenge for you. What you love and are passionate about should NOT heavily stress you out.

9 – Don’t be afraid to ask for help. What do you think doctors do on a daily basis? They consult with other doctors–because another might catch something the first didn’t. In medicine, it’s not about you. It’s about the patient. And when someone’s life is in your hands and you’re not sure about a diagnosis, you sure as hell better not just wing it and make up BS. So don’t develop those bad habits in the first place. Swallow your pride, and go to those often empty office hours. Talk to/e-mail the professor. Work with your TA. Study with your classmates (the people are the best part of Stanford!). Ask your upperclassmen the best quarters to take certain classes. Check in with the pre-med advisors–measure their advice (anyone’s advice, really) with a critical eye, but at least get their opinion to help formulate yours. Make it a point to meet with your major advisor once a quarter. The more you do all this in person, the better. I don’t care if it’s raining outside in the middle of winter quarter and you’d rather be snuggled up in bed reading Harry Potter than bike the 100 feet to the quad. You think anyone’s going to care during your surgery rotation that you want the weekend off? That you’d rather show up at 11 AM for rounds instead of 5 AM? Tough luck–suck it up and just learn to enjoy the small victories in life. I know it sounds harsh, but it’s realistic.

10 – Learn computers. Take some computer science courses. And I don’t mean just fulfilling your GER with CS105. Whether you like it or not, computing is going to be an even bigger part of the medical world than it already is in just a few short years, and the more you learn programming, the more it’s going to make you really stand out as a valuable resource in the medical community. It’s incredible just how much the ability to make a website is considered a novel, incredible thing amongst medical students–truth be told, most of my classmates struggled to connect to the wireless network at school. It’s pathetic how tech un-savvy people in medicine generally are, and it’s the biggest reason the field has stagnated over the past few decades. We need to change that. You need to change that. So step outside what might be your comfort zone and sign up for something beyond CS106A (remember, pass/fail can be your friend!). Tackle the puzzles of algorithmic thinking in CS103. Struggle with code in CS107. Get that group together and rock Bunnyworld in CS108. In the end, you’ll be glad you did. I’ve never regretted pursuing a CS minor–it’s made me a much stronger thinker, and the skills I gained let me do things like code up custom flashcard databases that help me study for anatomy. How nifty is that? Being at the interface of tech and medicine is exactly where you want to be as a pre-med, particularly in the years to come. Going to a school with the #1 CS department in the nation and not taking advantage of it would be like refusing a free 7-course meal cooked by Chef Ramsey.

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So there you go. The 10 most important things to keep in mind as a pre-med at Stanford. Take what you will from my list, but remember that any choice is ultimately yours. I just wanted to pass down what I wish I’d known in my younger years.

Oh, and one last thought–there’s an unspoken rule I forgot to mention: take care of yourself. You can’t take care of another human being if you yourself are in bad shape. Make the time to hit the gym. Go running when the urge hits you. Spend time chatting with friends. If something really bad happens and you need a professional to talk to, the second floor of Vaden allows a certain number of free confidential therapist visits, so make use of those (screw the stigma, I think psychiatrists are awesome–having a trained individual help you wrestle with your thoughts is intense but incredibly relieving).

If you’ve got any questions/comments/concerns, leave ‘em below. Gratzi for reading!