Long Weekends and Friday Night

Last week was our white coat ceremony.  It was lovely and my parents came and we hung out with my boyfriends parents so the whole weekend was one big family fest.  It was awesome seeing my parents and I was super sad when they left.  What didn't happen was studying.  Now, I did probably get in about 4 hours or so of studying over the entire weekend, which any medical student will tell you is peanuts.  The sad truth is I've spent most of this week catching up (as have most of my classmates).  Super unfun times for us all.  However, the silver lining is this weekend is a holiday weekend which means we have an extra day.  Now most people's minds go like this: "yay!  I have a day off!!"  for me the thought process is more like this, "Ha ha ha (continue maniacal laugh) they can't make me learn any thing if we don't have to be at school!!!!."  So, while it's not really a day off, it is a day where they can't shove hours and hours of more material down our throats.  Which makes me envision those geese that get force fed so they develop delicious fatty livers.  That's how I feel most of the time.  Like a tortured, force fed goose.  At least my school makes a special effort to make sure we have natural light in our study spaces.

I would like to close with a conversation between my friend (F) and I (Me) at the end of the day Friday.

M: What are you up to this weekend

F: Flying to california to see my girlfriend.  

M: What are you doing in cali?

F: Studying mostly but we might actually get in a whole 22 minutes of tv too.  You know, on the internet so there are no commercials.  What are you doing this weekend?

M: Studying mostly, but also moving.  My boyfriend wanted me to come into the city tonight for drinks but I think it's a bit much with trying to catch up from last weekend and also moving

F: Yeah, going all the way to the city for drinks sounds pretty awful.

M: Totally, way too much time and effort.  That's what I told my boyfriend, but he's not in med school so it's difficult explaining these things some times.

F: Yeah, he'll learn to just not even ask.  Asking just makes you sad.

M: Totally.

End

The MCAT really was useful!!

I just wanted to write a quick little post about how the MCAT really does come back in med school.

When you study for the MCAT, the studying is more about dissecting questions and coming up with the correct answer based on basic information than it it is about stuffing facts into your brain.  You have to be aware of words like ALWAYS, NEVER, NOT, ect.  For pre-meds suffering through the MCAT, I promise all your work and toil will not go down the toilet when you get to med school.  Med school exams are not comprised of simple questions.  You have to be able to break down the terminology, decide what is really important in the question and what isn't.  (ie. you see the name of some random disease you have never heard of in the question, but you need to replace it with "some pathology" in your head to make the question make sense).  This isn't because the professors are trying to trick you (once you are in, they are all on your side, they want you to graduate and become a good doctor), it's because, for the rest of your life, you will need to be thinking through complex, multi-step questions. 

As many of us are preparing for this first exam, I keep hearing people say "oh I feel like this is MCAT time all over again."  Most of us probably lived out 3-5 months of really intense study time.  You will need to sustain that when you are in med school, so not only is the MCAT good practice for dissecting questions, it's good training for developing effective study skills.  Remember, med school is about organizing a lot of material in your brain in a short amount of time and then being able to turn it around and apply it to real-world situations.  Sound familiar?

Med School, The analogy

Someone in my class posted this video on our facebook page as an analogy to how we feel trying to learn all this content.  Couldn't help but share:

MS1, day 1

Today was the official first day of classes at med school.  I think we were all expecting an easy day with course introductions, lab protocol instructions and the like.  The beginning of the day was pretty relaxed.  We started out spending 30 minutes hearing about histology, then went upstairs to meet our "first patients."  I was surprised as I was quite nervous in the moments before they removed the shroud even though I have seen 3 dissected cadavers and countless surgeries.  After lunch we had 2 hours of anatomy lecture.  The first lecture was pretty low key.... just basic anatomical terms.  The second lecture was where the pace picked up.  We learned a lot of material in one short hour.  It was the most fascinating, engaging lecture I have ever attended.  Our professor is awesome.  Even so, everyone was in a bit of a daze at the end, and my brain was more than fried.  My plans for an easy, low key weekend are shot, and I will definitely be spending the weekend in library.

Here we go.....

Shock and Awe

Two weeks ago, I found out I got my dream gap-year job: I was going to be a full time research assistant for a prominent surgeon at Hospital for Special Surgery.  For a pre-med with dreams of ortho, this is the most ideal job ever.  I would get to watch surgeries, I would do research, and I would get to network with some of the best orthopedic surgeons in the country.

A week and 6 days ago, I found out I was accepted to medical school.  After about 24 hours of deliberating, freaking out, and generally trying to convince myself that this was, in fact, reality, I accepted my position at New York Medical College, and informed my no-longer-future employers of my regrets.  

It is amazing how one e-mail can change the entire trajectory of an entire year.  I was in the middle of re-applying to medical school, and luckily, had only spent money on my primary application.  Mike and I had accepted the reality of continuing to live in a studio apartment for another year, and I was going to work full-time and finish my master's degree in exercise physiology.  We were going to take leisurely weekend trips upstate, and spend the year completing little projects that would ultimately lead us to entry into this next phase of our lives.  Now, we have signed a paper stating that we will be out of our Upper West Side apartment by August, we are looking for a home in the suburbs, and I will be a medical student in less than a week.  It feels sort of like walking across a nice bridge, knowing that you will get to the icy river after a leisurely hike, and when you get there, you are aware of the steps you will take to ease yourself into the frigid waters for a nice refreshing swim. Then a gust of wind pushes you off the bridge and you land in the water, reeling from the impact, and your partner has nothing to do but jump in after you.

All of this said, I am thrilled with the turn of events.  

Run baby run

I decided about a month ago that I would start running.  I hate running, but I feel I need to add cardio to my life.  It's hard to continue to convince myself that yoga and the occasional dance class will suffice a exercise when I am constantly being told by every researcher, trainer, and professor in my master's program that it, in fact, is not.  I'm well aware of the benefits of cardiovascular training: increased metabolic rate, increased muscle tone, decreased fat composition, decreased heart rate, decreased risk of cardiovascular disease, better mood, etc etc.  I am also, now, well aware that yoga and dance do not provide the necessary duration or intensity necessary for them to be considered good cardiovascular training.  However, I have avoided activities like running, swimming, cycling because I find them torturous and incredibly boring.

So, why running?  It's free, it's one of the more efficient ways of getting in my cardio, I can do it anywhere, it's high impact so it increases my bone density, and I can catch up on the news while doing it.  All good reasons.  Maybe one day I'll even come to enjoy running, like when people in an arranged marriage eventually fall in love.

Now here's the masochistic part.  I haven't started running yet (though I did buy shoes and a whole bunch of socks), but have registered for my first half-marathon (in October).  I've also told as many people as possible that I will be participating in this half marathon so that I can't back out without being heavily shamed.  Why?  Because if I don't have a goal in mind, then I won't start, nor will I continue to torture myself with this boring, repetitive exercise.  I've been fit all of my life.  I mean, as an adult, I've been fit as part of my occupation: as a dancer and dance teacher, then as a yoga instructor, now as an exercise physiology grad student.  I'm also just vain enough to be willing to torture my self for the sake of wanting to look hot.  I should be able to do this, if not for my heart and lungs then at least for my ass and legs.  In fact, if I can prepare myself for the MCAT (4 hours 20 minutes of testing, 4 hours and 50 minutes total) in three months, then surely I can train for a half marathon in five months.  So, that's the plan.  Start doing a new form of exercise that I've never liked, train for a race that I know next to nothing about, and be ready to run 13.2 miles in a real race in five months.  Excellent.

Study like a runner not a ballet dancer

This round, I've been trying to think about preparing for the MCAT the same way I would train for a marathon.  The problem is I know almost nothing about training for marathons.  I do know that academics and athletics share common features: in order to do well, you must put in the work; overtraining can lead to reduced performance and burnout, and you need to take active rests.  Even though I've been an athlete for most of my life, I did not learn any of this in my years of ballet training.  In fact most ballet dancers (and teachers) are kind of idiots when it comes to smart training as the notion of extremes without logical reason is passed on generation to generation.  In my years of idiocy, I failed to recognize things like two technique classes in a day are not necessarily better than one (your ankle hurts? maybe you need to take even more technique classes! 6 per week just isn't enough), taking a break might actually enhance performance every once in a while (but if I take a week off, it'll take a month to get back what I lost!), and eating will benefit your training (I'm hungry, but if I eat the sandwich, then I'll get fat).  In my undergraduate studies, I went with my ballet dancer mentality of "more is always better" even though, like in ballet, this theory was never actually demonstrated to work, except in rare cases.  I failed to recognize that there is a threshold that anyone reaches and once you surpass that threshold the only way to go is down where you eventually crash and burn in a pile of burnout.  Taking a rest, stopping to recover for half a day, and admitting that I needed to cut back was not hard core, and clearly, only hard core people win.

My folly was to fail to recognize that smart people are actually the people who win.  What I have learned in graduate school, is that you must train in cycles, that there need to be active rest periods, and that one needs to plan so that peak performance occurs when it counts.  (Thank you exercise physiology course work) So, after a very long tangent, we come by to my attempt to approach my MCAT studying like one would approach a marathon: gradually increasing with variations along the way with efforts culminating in peak performance.  In addition to this overall approach, I've recognized that cross training is also important.  When I was dancing, I did Pilates and later, yoga (I never said I was a complete fool).  For the MCAT, well, I also do yoga.  The problem with academia is one can get trapped in this mindset of "I can't lose that hour, I need it for studying!!"  Often, this thought comes after 3 hours of being largely unproductive, except for maybe in updating my facebook status a bunch of times and watching videos of cute puppies on youtube.  For anyone, if this starts to happen, it's much better to take an hour, get some exercise (or eat ice cream, I don't know, to each his own).  In my case, yoga is perfect cross training for academics.  I physically get exercise, I stretch out all the parts that start to hurt after 6 hours of not leaving the couch except to pee and eat, and, most importantly, I take my mind to a place of calm focus.  For an hour I decisively do not think except for maybe the occasional "you want us to hold that for how long?!" or "action potential...gah... shut up brain...... downward dog..... the equation for volta....shhhh.....baby cobra...."

In summary, this method has appeared to work.  It still takes a level of discipline and hard-coreness (After all, the hour study break isn't beneficial if it turns into a half day study break) but it is much more manageable.  Rather than hopping between extremes of intense study marathons and drunken binges, as per college, or doing nothing but studying or working all the time (even though studying often consisted of looking at one page for a really long time and thinking about how much I didn't want to be studying), a la last year's MCAT disaster, I am trying to combine an effort walk the middle path (yes, I'm using honkey yoga language, I'm a yoga instructor, what do you expect) with the sensibility of a runner doing smart training.

Necessary Shortcuts

Times have been desperate lately so I have done a couple things I never thought I would: hire a cleaning lady and order from Fresh Direct.  Something I have never been able to shake is my annoyance at people who pay someone to do work they should do themselves.  I was brought up by parents who never hired people to complete their household chores.  Cleaning, laundry, gardening, mowing etc. were not to be pawned off on paid help.  As a child, I have somewhat fond memories of helping my parents with dusting, washing dishes, and vacuuming.  As an adult, I have maintained the ideal that one should, at the very least, be able to keep a clean house.  Doing my own laundry, cleaning my own bathroom, cooking my own food are basic adult tasks that, in my mind, there is absolutely no excuse to not to do myself.  Now perhaps one might think, well surely one of your parents didn't?  No, both my parents worked more than full time jobs, and my mother was constantly traveling for work, leaving my father with 3 kids and a full time job to manage while she was in DC, China, South Africa, Alaska etc.  My grand parents worked full time, raised children, and also raised/butchered their own meat, milked cows, and grew their own vegetables.  My parents and grandparents, somehow, managed just fine without hired help, therefore, I should too, right?

WRONG!  Unfortunately, my graduate school schedule combined with MCAT prep, my boyfriend's insane work schedule, and my springtime flu has left us reduced to a pair of invalids.  Our apartment had gotten to the point where it was unsanitary, our fridge was bare, and my stock pile of emergency food had dwindled.  I could literally see the dust and cat hair floating around and, had I not already been taking large quantities of cold medicine, would have needed some kind of antihistamine intervention in order to exist comfortably in our apartment.  Mike hasn't been home to eat, and I have resorted to eating 2 meals a day ordered from seamless web which means I've been eating nothing but Thai noodles and oatmeal for the past two weeks.  The laundry pile is simply unmentionable.  Luckily, I have a large collection of underwear.  Things could have gone to a whole new level of bad.

The solution?  First, hire a cleaning lady.  Never will I completely rid myself of cleaning lady guilt.  I firmly believe that if you are physically capable of cleaning your own house then you should, and that children should learn how to clean up their own damn mess.  Life is not about avoiding all of the icky parts.  Everyone should get down on their hands and knees and put in a little elbow grease.  However, I decided that my MCAT score is more important than my ideals so out the window they went.  I will pick them up later when the thought of scrubbing my toilet doesn't make me want to cry.  I think the lesson here for any student or busy person is each decision should be viewed as such: if I do (don't do) x and I do poorly on my exam (presentation, report, etc), will I look back and regret my decision?  If the answer is yes, find a way around it.  I don't have a day to lose to cleaning, so the cleaning lady came.  Parents, grandparents, you are made of tougher stuff than me.

Next issue, food.  Somehow, my twisted logic allows me to order prepared food, but not groceries.  This is less am ingrained ideals thing, and more a budgetary thing.  I have never ordered from Fresh Direct because it is more expensive than me dragging my butt to Trader Joe's and maybe ordering out one night a week.  The flaw, of course, is that Fresh Direct IS cheaper than me ordering two meals a day every day.  Next lesson, the next best thing is ok.  Make compromises, you will still save time and money in the long run.  

The point of this whole entry (which I shouldn't even be doing) is that sometimes, you just have to give in.  School, large standardized exams, and jobs with crazy work loads put you into a unique situation where your work follows you everywhere you go.  Days off are dictated by how much work there is to do and how much time you have to do it.  For people who are trying to get into medical school, the process is so competitive, we must put in every thing we have in order to succeed.  If we don't, and then don't get in/do well(my situation this past cycle), we regret not trying harder.  If I had a day off, I would clearly use that time to take care of my business.  The problem is, as a student, when you literally lose track of what day it is because you do nothing but study and work all the time, every day, there is no way to wring out that half-day necessary to maintain a reasonable standard of living.  Every student will reach this level of desperation at one point or another.  That point, when you forget what going out is, when the only difference between Saturday and Wednesday is your class schedule, and when things like makeup, jeans, and nice hair are the time-indulgent luxuries of others.  The key is balance.  Find a way to budget in a few shortcuts so that you can keep your stress at a manageable level.  Finals, theses, MCAT, school applications are all reasonable things to be slightly stressed out about.  Your dirty bathroom is not.  Let someone else take care of it for you.  Use a little of that bought time to go on a walk, take a yoga class, or write something that won't be graded.  Do what you need to do to manage your stress and work load, rather than your laundry pile.  There is plenty of time later to scrub your own toilet.  

I told you so!!!!!

It's funny. I was thinking a lot today about the things I wish I had known the first time around applying to medical school and taking the pre-reqs, except most of the things I came up with I did know at the time but was too lazy or stubborn to follow the advice of some other person writing about what they wish they would have known..... and so the cycle repeats. So here is what I kind of already knew but wish I had known:

1) It's much better to take your time and do well than to rush and do poorly.

I think this applies to pretty much every freshman pre-med, post-bac, and person who decided half way through college they wanted to be a doctor. For me, this applied less to courses, and more to my extra curricular activities. I was so focused on having an amazing resume, that I didn't leave time for the studying, and ended up crazy and with less than a 4.0. For freshman, bio and chem together are HARD, even after you have been in college for a while. I don't know what nut job thought it would be a good idea to make a bunch of 18 year olds who are living in a new place, adjusting to washing their own clothes, discovering the joys of fake IDs and no curfews, and have no nagging parent for the first time ever take two classes that can essentially decide their fate in the medical school application process in three or more years. Chill out freshmen! Drink beer, sleep in on a tuesday, and learn that febreeze does not equal clean laundry before you put this burden on yourselves! Post-bacs, school is an adjustment. If you haven't been in school for a while, it doesn't hurt to ease back in with a math class or something before diving in head first with no arm floaties after not having seen water for years.

2) Use your MCAT books to study for your pre-reqs.

Many people get into their pre-req classes and get super confused about something at some point. The MCAT prep books are nice because they break things down and simplify them. I cannot tell you how many times, while studying for the MCAT, I thought to myself, "oooohhhhhhhhh that's what they meant!!! Well why didn't someone just say so!." Looking at the simplified content in the MCAT book then learning the more complex information in the text book would have made my life so so so much easier. Also, looking at MCAT questions while you are taking the courses gets you ahead of the game with your MCAT prep.

3) Do not take the MCAT unless you are ready to take the MCAT

I actually did follow this advice last year and am glad I did. As I got closer to the test date I paid AAMC $70 to move the date one month back, worth every penny. This year I thought ahead and didn't register until after I had mentally pushed back my date. Trust me, you most likely will not stick to your study plan and you should secretly plan at least two weeks of flex time (sort of like when you set your alarm clock to be five minutes fast so that when you wake up dazed and confused, you trick yourself into getting up ten minutes earlier).

4) Studying for the MCAT is like training for a marathon (I think, I've never actually trained for a marathon, but from what I understand about training for marathons, the MCAT is like training for a marathon) you mustn't peak too early

This is EXACTLY what happened last year. I peaked too early then watched my scores slip in my practice tests. The last two practice exams I took actually predicted my score perfectly, I just wish I could have hung with the scores 2-4 tests prior. I think what happens is you lose steam and focus. This is just a theory, but it makes total sense. I'll let you know what happens this time around.

5) Don't waste your money on Kaplan

Kaplan is great if you have absolutely no discipline, but if you have no self discipline, maybe medical school isn't the wisest choice. The forums on sites like student doctor network and mom md have great information. Use them. Instead of spending thousands of dollars on a course, spend 500 on several different books, test them out, and find a book that works with your learning style. I personally, like ExamKrackers. Focus more on the content and your basic test taking skills and less on the super strategies that the prep companies sell. Strategy is good, but not if it is so complicated, you have to spend extra time learning the strategy.

6) You have enough time to exercise. The half hour once a day won't kill you.

This is super super important. If you need to save time, save it in ways like not watching as much tv, going home an hour earlier than you normally would from a party, not drinking too much at parties so you don't lose a day to a hangover, ordering food, studying on the train..... Exercise is not the area to cut. First, you don't want to be one of those people who gets fat during their MCAT prep (and then can't fit into your post-college graduation suit when you have your first med school interview then almost cry when you are at JCrew and can't figure out if the skirt the next size up fits you properly...). Also, the MCAT is 5+ hours long. It takes a certain amount of body strength to not fall over after sitting in a hard chair for many many hours.

7) Turn your AMCAS in JUNE FIRST!!!!

Most medical schools have some form of rolling admission, so you want them to see your application first. Enough said.

8) Treat your time completing your secondary applications the same way you treat studying: with high high priority.

If you are on family vacation, pretend like the MCAT or a big final is in one week (Yes, the beach is nice but you'll be back. Cape Cod is ideal for this practice. Remember, you're better off inside than on the bay side. The water is too cold and there are no waves. Really, you are saving yourself great disappointment by staying indoors and slaving away on your computer. Use your sacrifice to guilt your fellow travelers into bringing you lobster, and drink heavily in the evenings. Hangovers may prevent you from retaining information while studying, but they don't prevent you from laying on the couch and writing awkward essays over and over again. In fact, a hangover might be further motivation to stay indoors as the sun will make you feel like a vampire, not the sexy kind that sparkles, but the kind that feels like a knife in being jammed into his eye when the sun comes out.). If you are on vacation some place super awesome, too bad, you should still work on those secondaries. Remember statement 7.

8) Never give up hope

Just when you think you are doomed to failure, you may be surprised. Don't stop sending update letters, and making sure your application is complete just because you haven't heard anything. You never know. I almost peed my pants when I saw my interview invite in January. Clearly, surprises are no good, especially when your apartment (and a change of clothes)is 45 minutes away by subway. Always be a hoping.

9) Have a backup plan

Not everyone gets in their first time and that's ok. Have a plan for what you will do if you don't get in. If that is grad school, go ahead and apply (even if you've had a thousand med school interviews), if it's getting a job, start networking and honing your resume. You don't want to panic when May comes around and you have no idea what you are going to do with yourself for the next year. Have a backup plan that you love, then waiting another year for application success won't seem so bad, and if you do get into med school then who cares about that ole back up plan. Toss it!

"There is a plan"

I was wait listed to New York Medical College yesterday. I absolutely did not respond the way I anticipated. Instead of being a little happy (after all it is not a rejection), I found myself exceedingly upset for the majority of the day. An ultimate rejection would mean that I finish my masters degree (which would mean I would eventually get an MS, MD behind my name), I would have another year to enjoy my mid-twenties in New York, would ultimately be a more competitive applicant and might even gain admission to an even better school. All positives right? Apparently not. In a way, wait list means extended torture. Instead of mourning failure on first attempt and moving on to second attempt, it means maybe not failing, maybe starting school a year earlier, and maybe not having to worry about an entire new application process. Maybe sucks.

The most common response from my friends and family was "don't worry, there is another plan for you," or "there is something even better in store for you," or the like. That is the absolutely WORST thing to say! It is understood that everyone is saying these things out of love, but comments like that really really do not help. First, I'm agnostic/border-line atheist and don't believe in plans, or everything in the universe working out for the best, or things being meant to be. I believe we make our own destinies. Second, even if I did believe some kind of greater plan, you don't know what my plan is, so don't tell me that what is going to happen is better than the current situation. For all you know, I get rejected in round 2, have a nervous breakdown, and get hit by a car. Something bad happening does not necessarily mean something better is going to happen later. I do not trust in the universe, I trust in myself, and frankly I feel pretty shitty about myself so that doesn't really help either.

So what is the solution? First, wait list is not the end of the world. I had already accepted that I would not get into med school this year, so I need to return to that frame of mind. Second, the next application cycle will be better. I will have my application in a month and a half earlier, hopefully have a better MCAT score, and will have a year's worth of research experience behind me. Third, wait list is not rejection. It's wait list. I just need to make sure I use this year productively and I enjoy my time as a non-med student and take advantage of the situation. This is how I make the new plan better. The difference is that it is my plan, not god's or the universe's or the flying spaghetti monster's, mine. Dealing with situations like this means making a decision to do better, not assuming that everything is going to work out.

In close, being wait listed sucks. There is no way around the torture that is the dreaded wait list. Friends and family of people going through this, be supportive, but don't be delusional. False hope is the worst kind so don't give it.