And the Hits Just Keep on Comin’

Recently, on an undisclosed date, The Eventual Doc ventured to Boston for his very first interview, at Boston University. If you recall, this was not only his first interview of the application cycle, it was, in fact, his first interview out of three cycles. So this is what you might call a Very Big Deal to him. The drive was fairly pleasant, actually. Driving through Vermont and New Hampshire, the leaves were a fiery, golden blanket across the landscape, and with a few This American Life podcasts saved to his iPod, little in the way of traffic, and nearly ideal driving weather, The Eventual Doc made excellent time.

Just as he reached the outskirts of Boston, however, his Palm Prē buzzed to indicate an incoming email. A glance at the email subject, which was all The Eventual Doc could read (as he is a Very Safe Driver, and doesn’t text or email on the road) indicated that the Dartmouth Medical School admissions office had reached a decision on his application. With the GPS device indicating at least another 10 minutes before he reached the hotel, The Eventual Doc excitedly imagined parking at the hotel, flipping open the phone, and reading the email in which Dartmouth would exclaim that they’d never seen as impressive a student as he, won’t he please come on down at his earliest convenience to interview.

This, of course, was decidedly not what the email said.

The Eventual Doc was assured that his application was considered with care, but that wherever he went to medical school, it wouldn’t be there. One more down.

The interview at Boston University was great. Having been a GMS student, it wasn’t necessary for him to attend a full interview day, sparing him the student-led tour, lunch, etc. Actually, he was pretty bummed about not getting a free lunch. But otherwise, the prospect of a one-and-done interview day was a pleasant surprise, and that would mean he could return home to Snowville, NY much earlier than he’d feared. Then he got the Red Folder.

Ah, the Red Folder. Countless times, The Eventual Doc had seen herds of somberly-clad interviewees on the medical campus at BU, clutching their Red Folders nervously. He had never seen the inside of one, but imagined it had to contain untold treasures, and that the mere fact of holding one admitted a person to an elite, secret club, like the Masons, or Scientologists. Turns out, it just contained some facts and figures about the school, some financial aid information, and the like. Nothing too spectacular, and no magic membership to the BUSM Cabal. Still, he found himself unconsciously holding it so that the embossed “Boston University School of Medicine” was conspicuously visible wherever he went.

Secretly, he imagined mothers leaning over their children and whispering, “See? That man there is Going Places. He’s On His Way to doing Great Things.” Old men would look on admiringly as The Eventual Doc passed, nodding in approval. Of course, in reality, he appeared, more than anything, just like those herds of self-conscious interviewees he had jealously despised the year before. But damn it, he finally had his Red Folder.

He learned that his interviewer would be none other than Dr. Wonderful, whom he knew by reputation and occasional interactions to be very nice and easy to speak to. The interview was extremely conversational, not in the least stressful, and left him with a cautious optimism for his chances at gaining acceptance there. That said, Dr. Wonderful candidly warned The Eventual Doc that nothing was certain, and that she could offer no guarantees or even any indication of which direction the decision may go. This will be a long winter.

Before he left, he remembered that he had a logo blanket he’d been awarded by his employer, DrugCorp. He left it beside a pile of blankets in the shape of a sleeping homeless person; it was getting cold, and surely others needed it more than The Eventual Doc. He didn’t want to wake the pile of blankets, so he just left it there. Would it be appreciated? He didn’t know.

Upon arriving in Snowville, The Eventual Doc settled down to his computer to check his email, and then status pages for his medical school applications. UVM had apparently taken advantage of his trip to Boston to update his status; rejected.

So here’s how things stand for The Eventual Doc:

1. Warren Alpert (Brown)
   
2. Tufts
   
3. Boston University [Hooray!!!]
   
4. Yale
   
5. University of Michigan
   
6. Washington University in St. Louis
   
7. Dartmouth
   
8. Medical University of South Carolina
   
9. University of North Carolina
   
10. Mayo
    
11. University of Vermont
    
12. University of Rochester
    
13. Georgetown
    
14. Baylor
    
15. SUNY Stony Brook
    
16. Duke
    

Things are certainly not looking good. Before the cycle began, The Eventual Doc had imagined the doors to highly-ranked medical schools swinging open to welcome him. Now, he’s hoping to get an invite to at least one more.

 

Undergraduate GPA: An Intractable Problem?

Today I sat down and looked over my UG transcripts. As most of the schools to which I’ve applied have been relatively silent, it’s given me plenty of time to start worrying about whether or not my application may have already been closed, whether I’ll even find out before the end of the cycle, and why it got rejected. Granted, there’s no reason for me to believe, at this stage of the game, that I’m already out of the running at these schools. Nevertheless, the experience of cycles past feeds a growing discomfort that I can’t seem to fully shake.

The most damning aspect of my application is my undergraduate GPA, which, as I mentioned in a previous post, is an unimpressive 2.82. Granted, that GPA is the one AMCAS calculated, and AMCAS has a habit of reporting one’s grades in as unflattering a light as is possible. Nevertheless, that’s the sort of UG GPA that will tend to land my application in the circular file without even so much as a glance at its contents.

For someone like me, where the strength of my application is my subsequent SMP GPA and MCAT score, this poses a problem.

So what am I to do? At this point, I have ~170 undergraduate credit hours. Any additional credits I take at this point will result in only a very modest improvement in GPA. To get to a 3.0 by AMCAS’ standards, I’d have to log 34 credit hours of undergraduate coursework, and not get anything under a 4.0 doing it. Is this realistic, as a near-middle aged applicant working full-time? After all, that’s at least two 18-credit semesters. I mean, it’s not the end of the world, as that’s a fairly decent course load for your average undergrad pre-med, but I’m not exactly young anymore; I’ve got a lot of time to make up for, and not so much in which to do it.

That is, in part, what motivated me to pursue the M.A. in Medical Sciences program at Boston University. My supposition was that earning a 4.0 in a program comprised primarily of medical school courses would demonstrate my ability not only to handle medical school, but flourish. I get that GPA and MCAT, while an admittedly imperfect predictor of medical school success, are currently two of the best tools we have. But should my UG GPA still be considered a better indicator than my grades in actual med school courses? I think not, but then, I’m biased.

So this brings to mind some questions that I’ve been kicking around in my head for some time now: Is it time to rethink AMCAS’ approach to non-traditional students (i.e., create a new “Non-trad” designation)? Is this best addressed at the level of individual medical schools? Is there a way to more holistically evaluate such applicants without placing an undue burden on medical school admissions offices? How much weight should be given to so-called Special Masters Programs?

Please feel free to sound off in the comments with your thoughts.

Oh, Snap! Interview Invite #1!

So today I finally received my very first interview invite! Boston University School of Medicine has invited me to interview toward the end of this month. I was at work when the email hit my inbox, so I had to be somewhat subdued, but believe me, I was practically doing cartwheels when I got the news.

Why so excited, you might ask? Well, first of all, it’s BU: Great school, great city. Additionally, I would, at the very least, know my way around the campus. I have made friends of several faculty, and I’m familiar with the first-year curriculum. Hell, I’ve already finished three-quarters of the M1 curriculum. I would love to go here.

Second, this is my first invite of the cycle. After the first three rejections (Mayo, Duke (who still hasn’t returned my email regarding appeal), and Georgetown), this helped to take the edge off a bit. I’m hoping some momentum will build from this, but regardless, I’ve got at least one invite. I just need to parlay that into one acceptance.

Third, and most important, this is my first invite ever. In three cycles, this is the first time a school as even gone so far as to invite me for an interview. First thing I did, I called Mrs. Eventual, and then Ma Eventual, to let them know that I do, in fact, have a snowball’s chance in Hell of getting into medical school. An American one, no less!

Still, I am somewhat discouraged by the fact that the only positive response I’ve received thus far is from the school whose SMP I attended, and that response came a full two-and-a-half months after submission of my secondary application. Yikes. The jury is still out as to whether success on the MCAT and in an SMP can translate into appeal at a wider range of medical schools.

I admit, I’m playing against a stacked deck. I recognize that I haven’t really applied very broadly, but in fact concentrated most of my applications at some very highly-ranked schools. It’s not exactly a recipe for success. At the same time, however, I think that it’s important that someone test the power for a program such as the one at BU to “remake” a person, academically. Why not me? As reach-heavy as my application is, there are nevertheless a few schools at which I have a reasonable shot. So long as I don’t blow those schools, I have a real opportunity here to find out what options a non-trad really has to shine after a decidedly unspectacular undergraduate performance.

Stay tuned for more updates. This promises to be a momentous week!

2009 Application Cycle Update

Today is a crap day. So far, Duke, Mayo, and now Georgetown have opted to pass on my application.

I’m really upset about Georgetown; not only was I excited by this school, but I also thought that, since Georgetown has its own SMP and knows how to properly weigh SMP grades, it would be a decent barometer of my chances at other med schools. If that’s the case, then I am well and truly screwed.

1. Warren Alpert (Brown)
2. Tufts
3. Boston University
4. Yale (heh)
5. University of Michigan (my father’s alma mater)
6. Washington University in St. Louis
7. Dartmouth
8. Medical University of South Carolina (more for the fiancee than for me)
9. University of North Carolina
10. Mayo
11. University of Vermont
12. University of Rochester
13. Georgetown
14. Baylor
15. SUNY Stony Brook
16. Duke

The time may have come to start thinking about adding some safety schools. I need a coffee and a beer.

Other Pursuits, and Musings on Behavioral Modification

I realized today that I’ve been so keyed-up about this application cycle that I’ve really neglected other pursuits; I’ve become a very unhealthy person, and it’s started to bother me immensely. I’m not the most out-of-shape person I know, but it should immediately be obvious to anyone who’s ever had the great misfortune to see me shirtless that I could use a trip around the block or two. But, like, literal trips around the block. Also, a tan would be helpful. And salad. Additionally, I’ve fallen behind on my personal reading, and playing music. The latter two I’m working to remedy by, well, just doing them. But changing unhealthful behaviors has proven to be an intractable challenge.

Some time ago, I had the brilliant idea that I would train for and run a marathon. Such a decision, I’ve found, is really easy to make. What is not so easy, however, is the extended application of willpower to get out the door and put feet to pavement. It’s much like the inverse of quitting smoking (which is another decision upon which I’ve been woefully poor in acting). With smoking, the short-term gain of satisfying a nicotine craving far outweighs the health cost of that individual cigarette, which is one of the reasons quitting is so hard. If every time I lit up, someone punched me in the face, I’m willing to bet quitting would be a quick affair. As it is now, it is hard to connect one individual cigarette with the eventual development of emphysema, chronic bronchitis, heart disease, lung cancer, &c., &c. Similarly, the short-term misery of conditioning my body to tolerate running (especially in an Upstate New York winter) dwarfs its contribution to the eventual high of finishing a marathon.

I think this is probably one of the major difficulties in changing behaviors like smoking, poor eating, and sedentary lifestyle. The investment of willpower and sacrifice of immediate minor pleasure required to effect such changes is felt far more acutely than the eventual benefit. We’re pretty amazing creatures, humans, especially in terms of our ability to pursue goal-directed behavior over an extended period of time. But that ability is nevertheless limited, and we often succumb to the same pitfalls as other organisms, for whom survival depends upon far shorter-term decision-making and activity. I’m sure if I hired Mike Tyson to punch me in the face every time I lit up, ate a cheeseburger, skipped a run, or sat on the couch watching TV for extended periods, I would be one healthy, lean, fit dude. Maybe not at first – I’d no doubt test Mike, just to show him who’s boss – but eventually (and, I suspect, quickly), the short-term consequences of these unhealthful behaviors would motivate me strongly toward more healthful choices.

If I had more readers, I might be motivated to follow some sort of plan based upon the fear of public humiliation through failure. As it is, this is much like writing to my secret diary, where the only person I have to worry about is my mom. Perhaps one of you would be kind enough to break my perfect record of posts, unsullied by comments. Let me know what has worked for you in changing behaviors. How have you stayed motivated, and overcome your poor, primitive, immediate-gratification-loving inner animal?

New Developments? Sadly, no.

It’s been some time since my last post. This is not least because there just haven’t been any new developments. For some schools, no news is good news, I suppose (e.g., Boston University, where I specifically elected for my application to be evaluated without waiting for this year’s MCAT scores). At those schools, rejections have already been doled out for my complete date and beyond, while acceptances have not yet quite reached my date. For others, however, this is not the case. At most of the schools to which I’ve applied, my effective completion date is September 1, or thereabout, coinciding with the release date of my scores. That being the case, I’m still (barely) within the 3-week post-submission range, and it is therefore way too early to predict what will happen.

The only school from whom I’ve heard is Duke. When I say I’ve “heard” from Duke, however, it’s more like if I went over to Mrs. Eventual’s Facebook page to learn that she’s dumping me. Their system is set up such that you get an email if they have decided to interview you, but if not, then you have to check the status page to learn the disappointing news. Money quote?

While we recognize that this decision may be disappointing, it is in no way a reflection of your potential as a future physician.

One immediately wonders what it is of which it is a reflection.

At any rate, after release of the most recent MCAT, I called their admissions office to enquire anout their appeal process (some schools–though admittedly few–have processes by which one may appeal an admissions decision), and was advised to contact Brenda Armstrong, the Director of Admissions. I still haven’t heard a response, and suspect I am receiving the digital equivalent of the cold shoulder. Ah, well.

While it would have been nice to hear an invitation for an interview for my first response this cycle, I must nevertheless accept that I won’t get into every school to which I apply. I may not even get into most. I’m just shooting for any. After all, I can only attend one, anyway.

Taibbi’s Take on Health Care Reform

I must admit that I’m getting worn-out by the political grand-standing that has come to dominate the health-care reform debate. Though I identify myself as a liberal, and am certainly disgusted with some of the right-wing pushback on reform efforts, I have to admit that I’m not particularly fond of the way the Democrats have handled this, either.

Matt Taibbi has a lengthy op-ed in the current issue of Rolling Stone that’s worth a look, though I warn you that it makes for some sobering reading. Money quote, however, comes right at the beginning:

Let’s start with the obvious: America has not only the worst but the dumbest health care system in the developed world.

Hat tip, Neuron Culture

Fried Kidney

Though they will disagree, I can quite confidently say that my dogs (all three) are spoiled rotten. Yet I can’t complain, considering that both myself and the future-Mrs. Eventual indulge them far too much, in spite of our knowledge that we are spoiling them. We simply can’t help ourselves; we’re overcome with a sense of panic whenever one of them so much as looks as us pleadingly. We must learn the source of the discontent and rectify it immediately.

(It is entirely possible that I’m projecting this upon Mrs. Eventual. She may be immune to their pleadings. Which would probably explain the fact that I have become the de facto Go-To Guy for their every need. )

I mention this because I am otherwise unable to explain how a trip to buy groceries for we human-folk resulted in the purchase of this lovely item:

I believe I derived nearly as much enjoyment out of this lovely as the dogs did, though I must confess my enjoyment was largely restricted to the preparation thereof. Try as I might, I couldn’t bring myself to eat much of it (just a taste, really), though I am assured that some find kidney to be an absolute treat.

My first observation was the lobed appearance of the kidney. Several species have lobed kidneys, such as the cow, though notably humans do not (with the exception of the human fetal kidney, which does). It is, of course, one thing to read about such things in a textbook, but quite another to look at it directly. The second observation was the density of the organ. For its size, it was unexpectedly heavy.

Cutting into the kidney was fairly difficult, and even with a fairly sharp chef’s knife, it took some doing to cut it in half.

I attempted to cut it roughly in half, longitudinally. You can see above that the hilus of the kidney is to the upper left of that slab. All the white stuff is lots of fat and tough connective tissue of the renal pelvis. The other half I cut roughly into lobes, but I did save a transverse slice, at the extreme upper left of the cutting board.

I was very surprised to find how clear the delineation between renal cortex and medulla was. Not having ever cut into a kidney (that I can remember), I suppose I had assumed that the differences illustrated in textbooks were more for the sake of clarity. But there they were, gorgeous renal medullary pyramids, clear as day. I was lucky, too, in that the transverse section included a section through an arcuate artery, the artery that runs along the border between the renal cortex and medulla, and from which arise the interlobular arteries.

I was having an absolute ball, but eventually Mrs. Eventual got fed up with me and told me I was being weird. So I finished cutting up the kidney, melted some butter, and fried them up. The scent is akin to cooking mushrooms, in my opinion. Very earthy, not entirely unpleasant, though not my favorite. Perhaps some aromatics would have helped, but dogs can’t eat onions, so I was out of luck. There was a fair amount of blood that oozed out of the pieces, as well, and mixed with the butter to create an odoriferous thick brown sauce that, had I not known its provenance, might have been pretty tasty.

The finished product appeared even less appetizing than when I began, but I had promised myself and everyone within earshot that I would try at least a little taste, so I had a reputation to uphold. It was… good, actually. Not an explosion of flavor that completely blew my mind, but rather a pleasant, unoffensive flavor. Though I hadn’t overcooked it, the texture still turned me off, and I couldn’t bring myself to swallow it (Oh, grow up).

Dogs aren’t sticklers for presentation, so I just threw the mess onto a paper towel-covered plate, and brought it to their bowls. Having given each two pieces, I bagged and froze the rest for another day.

If you have the chance, an extra dollar or two in your grocery budget, and at least one dog who’s been super-good lately, I recommend you give this a try. It was a lot of fun, and though Mrs. Eventual didn’t stick around for a discussion of the finer details of renal anatomy, it was nevertheless an enjoyable adventure, and another look at an organ that I spent an awful long time looking at microscopically.

Things I Like

If, by some stretch of the imagination, you happen to be in the Boston area, and also reading my blog, then I would be remiss if I did not take advantage of this fleeting influence if I did not recommend you get your ass to Flour Bakery & Cafe, at 1595 Washington St.

Just a brief walk from the Boston University med campus, this small South End joint gets pretty packed right around lunchtime, but it’s well-worth the wait. Their sandwiches are a bit pricey, but also worth their weight in gold. The coffee is improbably good. Then there is an impressive assortment of brownies, brioches, croissants, tarts, tartlets, cookies, &c., &c. My usual order there is a medium house coffee with a lemon ginger scone, to go.

Ambiance is, I suppose, a little achingly hip, and I am left with the impression that it is the kind of place where young, attractive, overly perky employees are glad to help you out as you order from the hand-written chalk-pen menu on the wall, but that, if asked, would tell you that they think Starbucks is for posers. They would tell you this, of course (and, keep in mind, this is just my impression), with absolutely no sense of irony. Nevertheless, it’s pleasant enough, the food is certainly good enough to back up whatever hip cred they’ve got, and it’s close to the medical school.

Boston University

By January 2007, it was pretty clear that I wasn’t getting into med school. It was my own fault, of course, as in addition to a crappy UG GPA, I had pretty clearly allowed my ambition to get ahead of me, and applied to several schools to which I had no business applying. Let’s just say that I’m sure the University of Michigan had a good laugh when my application came in.

I started looking for alternatives. By this point, I was well and truly committed to getting in to an allopathic med school (I may tackle the allo vs. osteo discussion another time. For the purposes of the present post, however, osteo was definitely not an option for me.), come Hell or high water. I found out about Boston University’s Master of Medical Sciences program, offered through the Division of Graduate Medical Sciences at the BU School of Medicine. I had the MED admissions office send my application up to the GMS office, and heard back in March that I had been accepted to the program.

Why BU? That’s a good question. I know that there are plenty of great Special Masters Programs (SMPs) out there, and I’m sure I’d have had a great experience at any of them, yet BU was the only one to which I applied. Upon reflection, I’m aware of an inexplicable fondness for Boston that I possessed even then. Loved the Red Sox, loved the city, loved the people, loved the history, &c., &c. I just knew that I wanted to be there.

Surprisingly, I got in. Unfortunately, due to some financial and personal reasons, I was unable to go that year, so I deferred for one year, and entered in 2008.

The program is amazing, first of all. It’s what it says it is, nothing more, with no frills, bells, whistles, &c., and certainly no hand-holding. You want something, you not only have to ask for it, but you need to figure out that you want it in the first place, and where to get it.I guess you could interpret this one of two ways: The first is that they are utterly unconcerned with you and your success. The second, and I think more likely, is that they give their students the benefit of the doubt; everyone’s an adult, they figure, and that brings with it some responsibilities. The faculty are great, especially the Biochemistry faculty, and if you’re willing to put in some effort, you can make yourself some important allies in the MED admissions committee.

One of my few complaints is that the course selection for MAMS students is pretty limited. This isn’t really a very big deal, as the program is basically designed to cover some very specific bases in a short period of time, but at the same time, it would be nice to be able to explore some of the other classes offered through the Division of GMS. Also, the information that you will received from the GMS office can be fragmented, so that at any one time, you may have only a general idea of what you need to be doing. The process for graduation and thesis work, for example, are two pretty important things that aren’t especially well-explained in advance. It’s crucial that you actively seek information in order to stay on top of things.

My complaint with the courses is that, in contrast with some other curricula about which I’ve read, the classes at BU lack a certain degree of integration. Physiology and Histology have begun moving toward a more integrated state, but overall it still feels as though I took several disparate courses, rather than a unified program. Others may disagree, so YMMV. Whatever the case, there were a few points at which the seams between two classes such as Histo and Physio really showed (they either had different names for the same structure, or recognized different stages of certain processes).

The program is a four-semester program, though this can be accomplished in ~one year (using the two summer semesters to write the thesis), as I did. Some of the courses, such as Physiology, Histology, Endocrinology, &c., are taken alongside medical students, while others (Introduction to Medical Pharmacology, Biostatistics with Computers) are strictly GMS courses. The obvious advantage of this is that when you finish the program, you have a body of academic work that is, more or less, directly comparable to that of the medical students.

Thesis requirement can be satisfied through lab work (of which there is plenty in Boston, as you might imagine), or through a library research thesis. The latter takes less time, of course, but a lab thesis has the dual advantages of (1) providing valuable lab research experience and (2) offering a letter grade. Library theses, for better or for worse, are graded pass-fail only. Either way one goes, the onus for finding a topic, thesis advisor, &c, lies entirely on the shoulders of the student.

My honest opinion is that BU MAMS completely changed my life. It gave me the opportunity to demonstrate that I’m not the same person as I once was, and the opportunity to meet and receive instruction from some of the faculty there is well worth the price of admission. It allowed me to show that not only could I handle the rigors of a medical school curriculum, but could thrive. Though it’s questionable how much help a program will be in the wider sense (i.e., sure, maybe it helps me at BUSM, but could it potentially get me into a school like Brown?), it has nevertheless given me a renewed hope:

Maybe, just maybe, this mofo is gettin’ into med school this year.