Archive for category Medical School
Risk Averse
Posted by medaholic in Medical School, Thoughts on February 26, 2010

http://www.flickr.com/photos/west-park/3414758732/
Inspired by a post on Risk Taking and Failure written by a friend.
One of the most important skills everyone should learn is how to take risks. I’m not talking about foolish or rash decision making but of calculated and beneficial risks. For the most part, I credit a lot of my success to my willingness to take action in the face of uncertainty. Winning scholarships, getting job positions, finding opportunities, getting into medical school are all things I have benefited from taking good risks.
In many careers, calculated risk taking has many benefits. Business opportunities if coupled with entrepreneurial spirit and hard work can result in large financial gain. New artistic direction can be what separates you from the crowd. Having the courage to start a conversation with someone you don’t know may blossom into an important relationship. However, medicine often discourages risk taking, often to the point that erring on the side of caution is preferred.
Any risk will always have a chance of failure. You should only take risks if the odds are in your favor or if the reward far outweighs the cost. And that is exactly the problem in taking risks when it comes to medicine – the cost of failure is high.
A wrong mistake can lead to crippling disability. An erroneous slip can lead to a malpractice lawsuit or a license suspension. One lab test missed or improper history can mean life or death. For example, even if the benefits of immediate treatment means a speedy recover, if a diagnosis is made and treatment started without confirming the diagnosis, the results may be disastrous.
That is why we are taught to be thorough in our history taking and physical examinations. That is why checking up on patients is so important, so that no alarm signs slip go unmissed. That is why a differential diagnosis should be long and comprehensive, even if some items are highly unlikely. That is why extensive lab tests, imaging and consults are required. Don’t jump to conclusions. Be thorough even if it is going to cost you time and money. As a generalized rule, doctors err on the side of caution.
I think that is something I quite miss from my life before medical school. The chance to take risks and face the outcomes and consequences. I could aimed for all sorts of goals because I knew had the ability to rebound from my failures. I could push myself to my limits, be committed in several activities and try new endeavors. But now, I have a duty and a privilege to my future patients. To do well in my studies and become a good doctor. Instead of pursuing other interests, I have a job that I should do to the best of my abilities.
Perhaps I am over-exaggerating my situation to prove a point. It’s a bit like growing up. In yours twenties, you don’t have much to lose. If someone offered you one chance to win a million dollars on a 10:1 coin flip, would you take it? If you win, you get $1,000,000 but if you lose, you have to shell up $100,000. Mathematically, agreeing to the bet would be a no brainer. Now add twenty years to the same scenario, a house, a mortgage to pay, a car, a spouse, kids and bills that you are just scraping by with, your decision to take that bet drastically changes. If you win, a million dollars that could result in retirement but if you lose that money, how are you going to pay next month’s rent? Provide for your family? Would you still take that risk?
[I realize that the possibility of going into $100,000 of debt in your twenties is a great setback. You could even argue that when you're 40 and you have a stable job, you are more in a position to lose $100,000 than when you are just starting your career, but these numbers are just an arbitrary scenario and I hope you got the main point I was trying to make]
Possibility is traded away in return for stability. Predictable outcomes are favored when what you risk losing is greater than the gain. When you become responsible for other people, especially in a job like medicine where a doctor-patient relationship is so important, I would feel really bad if I made a risky decision that negatively affected someone else.
So although risk-taking is a valuable trait to have, I often think being risk averse is also an equally important trait to have especially in medicine. Being paranoid and nit-picky, which is excessive at times, may one day save a life. Someone’s obsessive need for perfection or his insecure fear of failure can make a positive difference.
What are your thoughts on risk taking and risk aversion?
Choosing a Specialty
Posted by medaholic in Medical School on February 13, 2010
The major concern of most premedical students is whether or not they will be admitted to medical school. They fret over getting the best grades on their term papers, labs and exams. They often spend a summer studying for the MCAT while working in a research lab. They also volunteer on the side and remain committed to extracurricular activities they have picked up.
However, once students enter medical school their previous academic worries are replaced with the one question, “What kind of a doctor will I be?”
Failing out of medical school is an uncommon event. Most people who have made it this far will have developed the work ethics and study habits to pass. There are also staff and administration that will do their best to help you graduate, whether that be from financial difficulties or stress. Most schools have maternity leave policies and accommodate students taking a year off. Getting through medical school for the most part is straightforward. I believe the hard part is finding yourself amidst the medical culture that becomes all pervasive.
During your undergraduate studies, so much time is spent working towards being admitted into medical school that not much thought is given to what kind of a doctor you want to be. For one, it’s hard to truly understand the differences between all the specialties, especially if you have never had any exposure to them. Many students may think that surgery sounds cool and prestigious, but few know the grueling realities and lifestyles associated with it and likewise for the many other specialties of medicine.
In the first two preclinical years, medical students are exposed to the many areas of medicine in the classroom. They get snippets into the diseases and types of patients found in each but never a complete picture.
Now that I am coming to the end of my preclinical studies, I still feel as confused as ever as to which specialty I will end up choosing. It is always a concern that is lingering in my thoughts. What if I want to do a competitive specialty such as radiology, ophthalmology or plastics? Will I be too late to consider them because I have not done any research or networking in these fields? Or even the fields I think will be unlikely, such as psychiatry or OBGYN, how will I know if I actually don’t like them or not? Will lifestyle and pay be a factor in my final decision?
Hopefully, by next year I will have an answer or a rough idea. But take heed premedical students, your questions of What are my chances of getting into medical school will soon be replaced with What medical specialty should I choose? Your worries and concerns don’t fade away after entering medical school, it just becomes different. Every phase of life has its own challenges and rewards.
Never Bored
Posted by medaholic in Medical School, Thoughts on February 4, 2010

http://www.flickr.com/photos/ericouano/163139402/
Although I was busy during my undergraduate studies, I can still remember days or weeks where I would be bored with school. If I was particularly on top of my school work, I would often take the weekend off and do absolutely nothing productive and instead something fun. I would slack for weeks at a time and know that I could catch up. I remember studying for chemistry intensely until I knew the periodic table and each element’s properties down cold. There were tests where I could recite dozens of physic formulas without the need for a cheat sheet. I remember having to find extra work to do to challenge myself, get involved in clubs, and push myself to go beyond class expectations.
On the contrary, nowadays it seems like work always has a way finding me. It’s rare to have a spare moment just to read leisurely or contemplate about life’s big mysteries. There’s always more diseases to study, new terms to look up, clinical opportunities to be involved with. And I know as soon as clerkship starts and residency, it’s only going to get busier.
Medicine is challenging. Compounded with my initial dislike for rote memorization – though it has improved a lot – I often find learning everything overwhelming. When I peruse the titles on the library shelves, there seems to be a textbook for every imaginable disease possible, irregardless of how obscure they may be. There’s such a variety of subjects to learn, ranging from anatomy to epidemiology to each specific specialty. For a curious person like myself who likes to know everything about anything, I find it hard to have the same confidence of knowledge as I did in undergrad. Even for common conditions such as hypertension or diabetes, there is a wealth of knowledge out there that keeps changing.
I knew what I was signing up for when I decided to go to medical school. Long hours, grunt work and a whole lot to learn. It can get draining, mentally, emotionally and physically. There will be days where going to the washroom and taking a nice hot shower will become a luxury. Sleepless nights, angry patients, grieving families. Life long learning until the day you stop practicing.
Medicine can be pretty tough, but boring? There’s rarely a dull moment. There’s always something to do, something to learn, something to challenge you. It’s a trade-off I can live with.
The Difficult Patient
Posted by medaholic in Medical School on February 3, 2010
I was doing an ER shift today when I came across my first difficult patient. Mr. K was a 50 year old divorced man who came in irritably on a stretcher having passed out from COPD exacerbation. He was shaking all over and showed a distrust for the medical system: the paramedics that brought him in, the nurses, the entire system.
Nothing destroys a relationship with a patient faster than distrust and I realized it was going to be a tough situation as soon as I took his history. “Jesus ****ing Christ, Why are you asking me again! I’ve already told you guys ten times what my medical history is like! Just do what you need to do and get me out of here.”
It was uncomfortable, after discussing with my preceptor, to go ask more follow-up questions and do a physical exam. I felt defeated and flustered. What knowledge and competence I had about his condition evaporated once his bitter criticism hit me. For the most part, the limited patient encounters I had before were generally positive with them being encouraging and understanding that I was still a medical student. There’s always two sides to a coin.
After the shift while walking home, this difficult patient encounter lingered in my mind. I guess sooner or later, every medical student becomes a bit more cynical and pessimistic. Their young idealism and optimism is replaced with harsh reality, death and disease. And although I remain positive about medicine, there are hard lessons and growing pains to be experienced. Even though it is difficult, I will continue to respect and treat my patients with dignity, irregardless of religion, race, age, disease or attitude.
Medicine is interesting in this respect. It not only builds knowledge, but also character. You slowly begin to realize what kind of a person and eventually what kind of a doctor you will become with each patient encounter. I hope I can become a doctor my patients trust.
Anatomy Lab Munchies
Posted by medaholic in Medical School on January 12, 2010
There’s something strange about the embalming chemicals in the anatomy lab. I’m always starving when I come out of the anatomy lab. And it seems that this is a common experience amongst medical students. It’s kind of disturbing that you would feel hungry after cutting human tissue for the last hour or so.
I guess just another peculiarity of med school.
The Taste of Failure
Posted by medaholic in Medical School, Thoughts on January 7, 2010

http://www.flickr.com/photos/stephenhackett/2660248865/
Failing is a bitter medicine to swallow but like medicine, it is ultimately good for you. And even though I’ve accumulated my share of mistakes over the years and I am not really affected too much by it these days, there are still incidents and failed attempts that bruise my ego and leave me questioning my abilities.
I was recently reminded of these feelings of frustration and self doubt when I received a series of rejection letters from a few jobs and scholarships. It has been a while since I last ran into such “bad luck.” Sometimes the competition is just too fierce and sometimes it’s just the luck of the draw.
I can still remember being denied admissions to my top choices for university programs, all seven of them. And I still remember the countless hours I spent filling out applications for scholarships I never did win or jobs that never got back to me. I vividly remember getting rejected from medical school the first time I applied; I was devastated. Or being rejected the second time the next year, it wasn’t any easier.
Failing is a part of life. It’s easy to forget that sometimes, especially when you compare yourself to people around you. As humans, we often choose to see only what we want to see. While we often praise the success of others, we rarely focus on our own strengths and tend to focus on our own shortcomings. We tend to ignore the importance of making mistakes and how our successes often arises from tough situations.
It’s good to be reminded once in a while what failure tastes like. It’s like a strong smelling ginger that awakens your sense of complacency. And although not everything will always go my way, I remain optimistic. Because looking back now, my current achievements and success was built on overcoming my own failures. I became a more responsible student after my rejection letters. I became a more patient person as I waited to enter the medical profession. I will be a better person because of my failures.
As a wise personality from my childhood once said, “Take chances, make mistakes, get messy!”
Why the MCAT is Necessary
Posted by medaholic in MCAT, Medical School on August 2, 2009
A lot of people complain about the MCAT. I know I wasn’t too keen to study for it. I hated grueling through long verbal passages and needing to practice writing “MCAT-styled” essays. But in the back of my mind, I always thought of the MCAT as an essential and important test to have taken regardless of your score.
The Journey, not just the destination – I’m a firm believer that the process matters just as much as the results in anything we do. There is always such a strong emphasis of getting a good score in the MCAT and needing to meet cut-offs and school requirements that not many pay attention to how they study for the MCAT.
I can only speak from personal experience but I know that studying for the MCAT definitely made me a better student. And it wasn’t because I got a “good” score. Instead, it was during the process of preparing for the MCAT that I was able to develop effective study habits and disciplined time management.
More than another hoop to jump through – Many people see the MCAT as just another obstacle between them and medical school. It’s a thing you just do to get it over with. I urge you to take this opportunity to improve yourself and become a better student and hopefully one day a better doctor. With every challenge and difficult circumstance we face in life, there is also an opportunity for change and growth.
Really analyze how you study, how you learn and what peaks your interest. Find your strengths and weaknesses and nurture and compensate for them. If you were never the type of student to have a focused time-schedule, now may be the best opportunity to try it out. I know I played around with several different learning styles before I settled down on the best one for me.
Life-long Skills - Build your stamina and endurance. Practice learning and reading for fun. Learn something new each day. Learn how to tolerate stressful situations and doing things in a limited amount of time. One practical habit I acquired after writing the MCAT was to read the news everyday. I started out reading the news to get ideas for the MCAT essay. I now read it to learn more about our world.
A lot of premeds always ask me how to get into medical school. And when I tell them about the MCAT and what type of a test it is, the majority fear or dread writing the exam. They wish they would rather not have to write it. I disagree.
The MCAT is as much of a discovery process as it is a proof of your critical thinking abilities and test readiness. It’s the type of test where you CAN study for and prepare yourself accordingly. It’s not just testing your inherent intelligence but also how much you prepared to take it. If you haven’t taken the MCAT, I’m not sure if you are ready for the rigors of medical school.
Up to that point, how many 5 hour exams would you have written? Would you know how to study effectively and efficiently? Would you have the endurance and persistence that medicine requires?
That’s why I think the MCAT is not only necessary for standardizing scores, it is an essential part of the medical school admissions process. It’s a badge of honor, a reward for your hard work. Work hard for the MCAT and I guarantee that you will learn more than just physical sciences and biology. In partaking in this exam, one of which thousands have gone before, you are completing another rite of passage of medicine. Cause face it, there will be many more exams after this one, you might as well get the most out of it.
Second Rate
Posted by medaholic in Admissions, Medical School on June 28, 2009
Sorry for the lack of updates. I have just started YET another summer of research and there’s an awful lot to learn. I have also been doing some traveling here and there and enjoying one of my last summers.
The Waitlist
I know firsthand from talking to my classmates that a lot of medical students that were accepted off the waitlist often feel like they are second-rate students. They weren’t good enough for the first round of selections and they only got in because the school had a quota to fill.
They call this the alternate syndrome.
The Solution
To any applicant accepted off the wailist, let me reiterate and repeat that regardless of your background, degree or ranking by the admissions committee: everyone is starting at the same starting line
Medical school is a brand new start. A clean slate for everyone. If you keep comparing yourself to others and what they have already done, you will miss the picture of what you are about to do! Medical school is an interesting and challenging period and each individual handles it differently.
Some of the best undergraduates end up being below-average medical students while waitlisted students excel. Your past matters only up to a point. When you begin medical school, your efforts and dedication from there on will determine how far you will go.There really is no difference between the 100th ranked student and the 101st who just happens to be on the waitlist.
So if you just got off the waitlist, congratulations! You are going to be a medical student and eventually a doctor. What do you call a medical student that graduated at the bottom of his class? A doctor. Don’t let this alternate syndrome mentality prevent you from trying and being your best.

