Friday, June 26, 2009

How To Gain Research Experience?

How does one obtain good research credentials? I have been given a somewhat unique opportunity by my undergraduate institution. Instead of graduating early I had a chance to complete a Master’s degree in biochemistry. Therefore I graduated with both BS and MS. I gained a lot of basic research experience by working in the lab on evenings, weekends and summers.

My Master’s degree allowed me to get a good job at a major pharmaceutical company. By the time I applied to medical schools I had a year of industrial experience behind my belt. It was enormously helpful for my interviews.

My school was unique in that it did not charge me extra for my Master’s degree. I finished it in four years along with my Bachelor’s. Considering that MS costs about $40,000/yr and takes 1-2 years to complete, it was a terrific deal. I would not be willing to pay this money to get research exposure. Neither should anyone in my opinion. Use “free” sources like get a job in the industry. It is an invaluable source of experience because unlike academia, research in the industry FLIES FAST! If you are still in college then volunteer in a research lab. Perhaps they will even pay you some money, but do not expect much unless you bring in some grants or stipends yourself.

Below are some great programs that pay stipends and give you terrific exposure to science and research:

REU: Research Experience for Undergraduates
This program is funded by the National Science Foundation. It operates on university campuses in the summer. REU recruits students from all over America. The program pays $4000 stipend plus provides room and board. It’s a 10-week intense research experience. You decide on an independent research project to complete during this time. You are supervised by a research advisor, and two REU advisors. You will learn how to make research presentations. You will also become familiar with science opportunities beyond the lab: in politics, business, and teaching. It’s a fantastic resource and looks great on your resume. I enjoyed it tremendously. My REU project evolved into my Master’s thesis.

NIH Summer Internship in Biomedical Research
This is another fantastic summer research opportunity for college students as well as medical students new to research. NIH is located in Bethesda, MD. Its research campuses surround two major hospitals. This provides participants with unique biomedical research opportunities. For example, if you are interested in retroviruses as vehicles for gene therapy, you have a unique opportunity to work with a clinical team who can test it in patients. Of course, MD degree is required to do ANY work with human subjects. Your opportunities would be somewhat limited without MD. This was one of the reasons I did basic research instead.

Your undergraduate institution probably offers small research awards to support your laboratory endeavors. Don't be shy and apply for as many as you can. Writing grant proposals is a wonderful way to learn science related to your research project. For example, my research project focused on solving an X-ray structure of a bacterial protein. To write a grant proposal I had to learn as much as I could about the latest antibiotics. This knowledge in tern came in handy at interviews. Reading broadly in science helps you build depth of professional knowledge and competence.

What direction should you pursue in your research? A lot of exciting developments happened in molecular biology in recent years. Epigenetics and embryogenesis are fascinating fields with high degree of relevance to medicine. I did research in protein structure and function. It offers a great diversity of experience. In the past six years I worked in metabolic diseases, inflammatory diseases, neural degeneration, infectious diseases and cancer. I don’t know as much about any one area as a more focused expert would, but I understand how proteins work – very useful in modern medicine!

At Harvard I will be pursuing the latest in neural prosthesis technology. MGH is home to one of only two laboratories in the world that are developing practical neural enhancement devices for patients with paralysis, speech and hearing impediments. My husband does related kind of brain research called brain modeling at Boston University: http://cns.bu.edu/~ogiogas/
I found that my background in protein engineering is very helpful to help me navigate in this research area. The broad diversity of therapeutic areas I exposed to is invaluable in getting ahead of the learning curve in a new field.

Ultimately let your interest guide you in exploring research opportunities. It is very important to stick with whatever you choose to pursue. It is entirely possible that you will spend years in the laboratory with no publications. Do not despair, and do not leave the lab. Consistent exposure to the field earns you expertise, which you cannot obtain in any other way. Schools like Harvard are looking for students with an ability to become experts. They respect in-depth knowledge of any science field.

DESCRIBING YOUR RESEARCH effectively and intelligently is very important during the interviews. It is your moment to show you know what you’re talking about. You need to have three prompts ready before you begin interviewing:

1. Your one-sentence talk
2. Your 2-minute talk
3. A page long bullet point list of interesting things about your research project

Wednesday, June 24, 2009

Selecting Medical Schools on AMCAS

I’m posting this in response to a very good question that I received from one of this year’s applicants. Selecting what schools to add to your list is a very important point! You don’t want to miss the ones you would like, but did not have enough time to research. You don’t want to spend a fortune applying either. I’ll share some of the biggest mistakes I made while going through this process. I hope this would help you make better choices.

Initially, I had 15 medical schools on my list. All of them are in the US, and all of them I really liked. I learned about them mostly through research conferences and reading their website. Harvard Medical School has been my dream for the past six years, but I would have been happy with any of the schools on the list. Below is my original list:

Yale
Brown
Duke
BU
Dartmouth
UPenn
Harvard
Johns Hopkins
Tufts
Wash U in St. Louis
UCSD
UCSF
Cornell
Stanford
Columbia

Mistake #1: do not apply to "out-of-state" schools!
I heard so many good things about UCSF and UCSD that it did not even occur to me to think that these are California state schools. I’m from Massachusetts. Unless your MCAT score is 45, and your GPA is 4.0 your chances of getting into Stanford are better than either UCSF and UCSD. If those are indeed your numbers, then you probably want to go to Stanford anyway.

Mistake #2: do not apply to schools that you rejected previously
If they rejected you - it's a different story. If your application changed significantly from previous years, then by all means you should apply. Personal example: as a senior in college I declined offer of admissions to Tufts (through early admissions program). They did not show me that love again when I applied regular action!

If you rejected their offer of admissions - they already know that you don't want to attend their school. They will not accept you.

Thus, I applied to these 15 schools and sat there nervously awaiting interview offers. September 2nd was a happy day - I received four interview offers. By early October I had seven. At the same time, some of my classmates had ten to fifteen. It scared me. I proceeded to add another 7 schools to my list in OCTOBER:

U Pittsburg
Mayo
U Washington
Vanderbuilt
U Chicago
U Michigan
Baylor

Mistake #3: do not succumb to pressure and add more schools to your list!
I interviewed at roughly half of the places on my original list. Of the schools I added in October, only ONE invited me for an interview. Later I actually ended up being accepted to it, but truth to be told it was a huge waste of money. I strongly advise against doing this :)

I learned later that a lot of my friends had laundry lists of "safety" schools. This does not make sense to me -- why add schools that you don't want to attend? What kind of "safety" is it if you end up at the place you don't like? No, add the schools that you like. You will do better research on these schools. You will write better secondaries. You will perform better on interviews. All because you will be motivated by "I really want to go here!"

Mistake #4: do not apply to schools you would never go to
I applied to Baylor and Vanderbuilt driven solely by their ranking on US News&World Report. In retrospect, I was doing this under pressure. I would never be able to live in a red state. I would not want to go to these schools. This fact alone affected the quality of the secondaries I sent to these places. If you have a significant other (I’m married) be sure to discuss your choices with him or her.

Of the 8 schools that interviewed me I was accepted into 5: BU, Dartmouth, Yale, Pittsburgh, and Harvard. 3 waitlisted me: UPenn, Brown, and Duke. I was never rejected post-interview.

You can expect that on average you will be interviewed at half the places you apply to, and that you’ll be accepted to half of those. Of my original fifteen schools, I had one dream school and one safety school. The rest were just really good schools.

mdapplicants.com is a fantastic resource to compare your school lists and numbers to other applicants. Two things to keep in mind. One: most members on MDapplicants don’t add dates to their profiles. This is annoying and makes things difficult to keep track of. Two: profiles on MDapplicants tend to represent “top” applicants. They do not represent a random population sample.

With this said, if you want to see a fantastic MDapplicants profile, please see here. I’ve never seen a better organized and helpful profile.

Here is another good resource to look at: a Blog run by Dr. Lee Ann Michelson called Harvardocs. It features a lot of helpful information and is very clear.


Tuesday, June 23, 2009

What Medical Schools Are Looking For

If you look up “What Medical Schools Are Looking For” on Google you will get 8,330,000 entries. You’d think that among some eight million entries you can find the much coveted answer. I found that most answers are too vague and unhelpful. “Be yourself” is not something that could help me build an impressive AMCAS profile!

I decided to look for answers from people who were on admissions committees at the schools I was interested in. Below I will share some information I found useful.

New England Journal of Medicine published two very interesting and helpful perspective articles on what schools were looking for in their applicants.

One was written by Dr. Jules Dienstag titled "Relevance and Rigor in Premedical Education". I cannot offer the entire article on the blog for copyright reasons, but you can get it here. Dr. Dienstag is the dean of medical education at Harvard Medical School and sits on their admissions committee. You can trust his opinion. If you find his article online look for supplementary information link – it’s a fifteen page word document which delineates Harvard admissions guidelines. A gold mine!!!

The second helpful article published in the New England Journal of Medicine is titled “From All Walks of Life – Nontraditional Medical Students and the Future of Medicine”. I highly recommend reading this article even if you are not a non-traditional applicant (I wasn’t). It’s written by Dr. Sandeep Jauhar, an MD/PhD from Albert Einstein College of Medicine. You should primarily focus on what he thinks non-traditional applicants bring to the table. Realize that you don’t need to be a non-traditional applicant to be mature, informed, curious, etc. When you write your secondaries – this is the language to use! Finally, there was one book I read that was helpful in writing secondaries. It’s titled “How Doctors Think” by Dr. Gerome Groopman from Harvard Medical School.

Friday, June 19, 2009

Atul Gawande: The Cost Conundrum

“The Cost Conundrum” is the name of the article written by Dr. Atul Gawande in the June 1st issue of The New Yorker. It tells a story of a healthcare problem that plagues the small border town of McAllen, Texas. In 2006, Medicare paid fifteen thousand dollars for each inhabitant of McAllen. Considering that on average McAlleners earn only thirteen thousand dollars per capita, Gawande says, this figure is astounding. He writes about his visit to McAllen and the describes his observations of what factors are driving up the unusually high cost of the town's health care.

You can find the article on the New Yorker website: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

It’s a great story to reference in your interview answers. The more of these you read, the more successful your interview will be.

Thursday, June 18, 2009

Less Than Ten: Surgeons With Amputated Fingers

In 1982 Dr. Paul Brown published an article in the Journal of Hand Surgery titled “Less Than 10 – Surgeons With Amputated Fingers”. Over the years Dr. Brown spoke with 140 men and women in surgical scrubs who were practicing their craft with less than ten digits. The severity of their losses ranged from a single missing phalange to an entire hand cut off in a sawmill accident. Astonishingly, only two of the 140 surgeons reported any hindrance resulting from their loss. Perhaps even more astonishing was that some surgeons having lost a finger by accident proceeded to amputate more! This, they said, made their hand smaller and more agile.

This is a picture from Dr. Brown's article showing the hand of Sir Sidney Sunderland, a neurosurgeon. Strikingly, his right hand is missing two phalanges of his index finger! With this hand, Dr. Sunderland apparently performed neurological surgery without noting much of a hindrance.

Dr. Brown’s article provides an interesting approach to questions like “What do you think is the most important factor that makes a good physician?” He describes interviewing surgeons who overwhelmingly thought missing fingers did not affect their performance. Some surgeons were missing several phalanges as a result of a congenital defect – they were born this way. Imagine you were applying to medical school with seven fingers in hopes of becoming an eye surgeon! They must have thought that “perfect ten” is not what makes a great physician. So what was it then?

The thesis of “Less Than Ten” is that surgeons did not hesitate to return to surgery after sustaining severe trauma to their operating hand. They loved their craft and were so dedicated to it that it did not occur to them to quit. Of the two surgeons who no longer practiced, one had lost all innervation to his dominant hand after it was completely amputated. The other surgeon (and I think this is very telling) had thoughts of quitting before he suffered the trauma.

I highly recommend reading this article. I finally got uploaded this article through my domain. Please take a look at it, it's rather fascinating! http://science1on1.com/LessThan10.html

Monday, June 15, 2009

Practice Interview Questions

Rehearsing Q&A is the most effective way to improve your performance on your interview day. Ask your parents, friends or spouse to pose as the interviewer and have them read questions to you out loud. Try and maintain eye contact with the person you’re talking to, but don’t give them a deadly stare. Find a video camera and tape yourself answering questions while sitting on your office chair wearing your suit. Get ready for some embarrassing surprises! I realized that I was nodding to myself like mad whenever I spoke, that sitting down the back of my suit somehow rose up, and that my hands were glued to my knees like a third-grader’s. It was the single most informative instance of feedback on my interview performance I ever received.

Finding interview questions to practice with is not easy. I started by using the Studentdoctor resource where I found lists of questions from students who already interviewed: http://more.studentdoctor.net/schoollist.php?type=2

However I found that it can be somewhat annoying to navigate. You have to click on a large number of individual student responses to come up with a list of ten non-redundant questions. But it’s a good start.

I used studentdoctor questions in order to come up with my own. I also edited the list as I went through my interview season and gathered more feedback on my performance. I arranged the questions in groups:

1. WEIRD QUESTIONS
2. STRENGTH/WEAKNESS QUESTIONS
3. SCHOOL-SPECIFIC QUESTIONS
4. HEALTHCARE QUESTIONS
5. HAPPY or PROUD MOMENT/SAD MOMENT QUESTIONS
6. ACTIVITIES/CLASSES QUESTIONS
7. LEADERSHIP QUESTIONS
8. RESEARCH QUESTIONS
9. WHY MEDICINE?

If you think of your application in terms of these categories, you can organize your interview to highlight a particular theme of about your candidacy. Write down your answers but do not memorize them – you don’t want to sound robotic. Just become comfortable and familiar with them.

Below are some example questions that I put together. Some of them are borrowed from Studentdoctor resource, some I was asked, and some I just made up.

WEIRD QUESTIONS
  • If you were a superhero, what super power would you have and why?
  • Have you ever experienced a situation where your integrity was compromised
  • What is your favorite color
  • What is your favorite type of food and why?
  • Why didn't you stay with a student host?
  • Do you lift weights?
  • Why do you think we need sleep?
  • What do you do for fun?
  • What do you do to keep yourself healthy?
  • Where does your sense of morality come from?
Don’t worry if you get an odd question. Steer the discussion back to the theme of your application. For example, “What superhero power do you want to have?” You could say “well I want to fly all over the world and see how doctors live and work in other courtiers”.

STRENGTH/WEAKNESS QUESTIONS
  • Do you think you would do well in the (school X) System?
  • Why should (school X) choose you?
  • What is the ONE important lesson you have learned from all your clinical experiences?
  • What should I tell the admissions committee about you?
  • If somebody on the admissions committee said to me “well she’s good but I’ve seen better” what would you like me to answer to that?
  • What do you want to talk about?
  • Is there anything else that we should cover about you (at the end)?
  • What qualities should a physician possess?
  • Name three qualities important to being a physician that you already possess, and another three that you don’t just yet, but that you believe you will strive to gain in medical school?
  • What do you want to talk about?
  • What is your weakness?
  • When you look in the mirror, what do you like and not like about yourself.
  • What do you think will be your biggest challenge in becoming a doctor?
  • What is your weakness?
  • What is one of your weaknesses?
  • If there were one reason for us to not accept you, what would it be?
  • If (school X) didn't accept you, why do you think that would be?
Take every opportunity to talk about your strengths. If you are given a wide opening (like “what do you want to talk about”) talk about your strengths! Say “I’d like to tell you about myself and what brought me here today”. And dive right into your strengths! You should have three major strengths worked out, look at the first few pages of “Better” by Dr. Atul Gawande to help you with ideas.

Coming up with a “good” weakness can be a huge problem. If you resort to something along the lines of “I work too hard” or “I take on too many projects” get ready for some sour responses. It’s been done too many times. Think about embarrassing but funny situations – are you clumsy at the lab bench? Do you have a fear of public speaking? If you don’t have a weakness that’s funny then you can borrow a story from Frank Vertosick’s “When The Air Hits Your Brain”. Don’t draw attention to bad grades or poor MCATs. Your weakness has to be a weakness, but a non-essential one. It helps if it’s funny.

SCHOOL-SPECIFIC QUESTIONS
  • Why school X?
  • Why do you think school X is the right place for you?
  • What other schools did you apply to?
  • Why did you apply to school X?
Read the school website to answer these questions. Scan their news feed for big grants (usually NIH) and recent award laureates and recipients. Read about two or three people you’d like to do research with. Perhaps the school has a unique educational system (like Yale) or location that appeals to you. At top schools, geographic location should not even come up. They expect that if your dream is to attend their school, you will happily pack your bags and move to Siberia if needed.

HEALTHCARE QUESTIONS
  • What are your thoughts on socialized medicine?
  • What is the greatest impact you plan on having in the medical field? How would you go about doing this?
  • Tell me how you would fix the health care system.
  • Name three current controversies in the field of medicine that you are interested in, and explain your stance and future considerations regarding the debate.
  • Why shouldn't healthcare be paid for by the government
Read NEJM or JAMA to understand the current healthcare issues. NEJM has online broadcasts of conferences and panel discussions of healthcare. Those are short (20-30 minutes) and easy to digest. You will learn interesting opinions about healthcare in US. It would be great if you learned about the healthcare system of at least one more country.

HAPPY or PROUD MOMENT/SAD MOMENT QUESTIONS
  • What were the happiest and saddest moments of your life?
  • What was your proudest moment?
  • Compare life in foreign country to experience in the U.S.
  • What is the greatest challenge you have faced?

If you're going to tell a sad story, make sure to end it with something positive. At Pittsburgh I told a sad story from my childhood. The atmosphere in the room became palpably dense and the uncomfortable silence duly followed. I smiled and said, “Well, uh, that was depressing!” and we both laughed and relaxed. However, when I interviewed at Boston University my interviewer apparently enjoyed sad stories because they kept asking me questions about it. I dropped many leads into more positive topics, but my interviewer chose to ignore them. Beware of those situations!

ACTIVITIES/CLASSES QUESTIONS
  • Tell me about this class you took (interviewers really knew my application in detail)
  • Explain (points to AMCAS activity) and what you learned from it.
  • Tell me about x and y activities listed on your AMCAS / essays?
  • Let's go through your AMCAS application...ECs and background info.
  • How did you find about your undergrad school coming from a foreign country?
  • Tell me about your university. I've never heard of it (said in a most condescending manner).
  • Tell me about your MCAT preparation and your feelings about the result
  • Where else are you applying? (named and asked about specific schools)
  • Looking at the healthcare system today, are there any problems you may have to deal with when you start practicing?
Google your awards and activities. Of course, Google yourself before you start interviewing. Most of my interviewers immediately reached over to their computer and Googled my file right in front of me. It can be intimidating! Know your application inside out and have something interesting to say about every activity.

LEADERSHIP QUESTIONS
  • Describe the leadership positions you have held.
  • What challenges did you face as a student group officer?
RESEARCH QUESTIONS
  • Tell me about your research.
  • How to go about setting up an experiment related to my research.
  • Explain your research to me like I was a molecular biologist, (it was Mol Bio research)
  • What research are you interested in
  • To discuss my interest in research and why I didn't apply to MD/PhD
  • How would you apply your current (basic science) research to medicine?
  • How does your research apply to medicine or how would you translate it?
  • What was your favorite research experience and why?
  • How does your research fit in with your medical vision?
  • Tell me-in layman's terms- about your research?
WHY MEDICINE?
  • What do you want to do in 5 years?
  • What other schools did you apply to?
  • Why is medical school right for you?
  • Take me through a perfect day in your life ten years from now.
  • If you could change one thing about our society, what would it be?
  • How do you know you want to do medicine, apart from those few clinical volunteering experiences? (tip: be assertive, and give a strong answer; don't shrug it off as a weakness)
  • Explain your experiences and how you decided on medicine
  • Tell me about your family (here try to include something about your family background that made you want to go into medicine)?
  • What are your short term and long-term goals following completion of medical school?
  • Flash forward to twenty years from now....Tell me what your day will be like?
  • Why do you want to be a doctor?
  • Where do you see yourself in 10 years?
  • How has all your activities prepared you for a career in medicine?

Wednesday, June 10, 2009

HMS Labcast

I really like this website: http://podcast.hms.harvard.edu/
It has wonderful fun material on the latest and greatest research at the medical school!

Here is a few questions that were featured in episode 9 "How To Make a Doctor". They came from regular Bostonians who were curious about what it is they teach to students at the medical school? I thought these would be good questions to think about how to connect with people (your patients and your interviewers):

Q: How do medical schools teach doctors compassion?
Q: Are you teaching doctors people skills?
Q: Are you teaching students communication and compassion skills?
Q: How do you get students to see life as a process of learning?
Q: Considering the vast amount of information out there, what should the students be learning?

To help medical students address these questions, Harvard medical school encourages students to undertake an independent project, whether in the laboratory or in global health, or community health. These is talk that in a few years becoming engaged in a project like this would become a requirement for Harvard medical school students. Yale medical school students are already required to write a research thesis in order to graduate.

Thursday, June 4, 2009

Atul Grover on Medicine in Public Policy

I enjoyed listening to this interview with Dr. Atul Grover, who teaches at Georgetown and Johns Hopkins. It was published on aspiringdocs.org on June 4th. He talks about the importance of diversity among medical professionals both in public medicine (where the role of diversity is perhaps more obvious than in other areas of healthcare) and academic medicine. I wish I heard this interview before I interviewed at medical schools.
Interview with Dr. Atul Grover is posted here:
http://www.aspiringdocs.org/site/c.luIUL9MUJtE/b.5200531/k.1426/Meet_the_Experts_Podcasts__Atul_Grover.htm

I also recommend reading "Better" by another Atul (!), Dr. Atul Gawande, which covers interesting issues of public policy and medicine. I greatly enjoyed his first book, "Complications", but "Better" definitely has more of a public policy angle. Both books are fantastically easy to read. Recommend.

Tuesday, June 2, 2009

Dean Tosteson Dies a 84

Daniel C Tosteson, Dean of Harvard Medical School from 1977 to 1997 died on May 27th. He is responsible for the emergence and the success of the New Pathways program at HMS which I am privileged to participate in. An article about him published on the HMS website is quite good: http://webweekly.hms.harvard.edu/archive/2009/052809/comm_news_tosteson.html

Incidentally, most students who come to Harvard Medical School for an interview are very likely to either have a meeting, or an interview, or otherwise walk through the Tosteson medical Education Center. Look for it when you visit, it faces the main road Ave Louis Pasteur.

Monday, June 1, 2009

Vaccinations for Medical School

Official vaccination records are due at HMS health office by June 15th. They want to know that you've had all of your required vaccinations, a recent TB test, and a blood titer to prove that you actually have antibodies to that stuff you were vaccinated for. I wish I knew this at least a year in advance because it's hard to get all of this stuff done in a month :(

But I suppose it's a good thing that the school is so strict about vaccinations (most schools would accept mere records of vaccination without requiring expensive antibody tests) since I'll be working in a hospital for a long time and will likely become exposed to lots of nasty diseases. Next week I'm marching into my doc's office, armed with twelve forms that have to be filled out and signed by him.

***
I just finished all of my vaccinations for medical school (06/11/2009). Because HMS requires that you prove you have antibodies (a record of vaccinations is not enough, this is not like college) it took me a month and a half and three visits to the health center to get everything ready. Make sure that you budget enough time to finish this part, you need to do this with your physician!

Required immunizations:
Measles/Mumps/Rubella
Hepatitis B
Chickenpox (varicella) - record of disease is not sufficient
Meningoccal vaccine
Tetanus-diphtheria booster - fresh one is required every 10 years
Fresh TB test
Polio (optional)

Plan on three visits with your primary care physician: 1) go over the paperwork, figure out what's missing 2) do the blood titer and wait for results 3) finish going over the paperwork with your primary care physician and get his signatures on every page.
 
Real Time Web Analytics My Zimbio
Top Stories