Penance

In college, several of my friends would ask me why I am a Christian, and my answer has always been that I believe in God’s love and mercy for humanity and that I desire to spread this good news through my actions and in how I treat other people.  His unconditional love cannot be fully understood or appreciated, let alone mirrored by me or any one of us.  However, this ideal is inspiring, and I consider it a privilege to work toward this for my entire life.  Toward the end of college, a series of unique and challenging life experiences as well as further reading of some thoughtful works of literature allowed me to more fully embody this calling and seek the holy sacrament of Confirmation.

I immediately think of the perhaps trite but nevertheless beautiful verse from 1 Corinthians: Love is patient, love is kind…it keeps no record of wrongslove never fails.  I have found that I am incredibly susceptible to feeling guilty about the slightest transgression, and sometimes even a perceived transgression with no real sin committed.  This guilt readily turns into fear of the act of reconciliation.  However, the parable of the prodigal’s son—in which the father unconditionally welcomes his son who had previously “betrayed” him—re-inspires hope in the renewal of my relationship with God.  My parents, who have always dealt me tough love, reflect this same sort of affection for me.  Although they and I are not perfect, in the end, we are one together in a family, and I rest in faith with their forever open arms.

While I have only received the sacrament a handful of times since Baptism, each time I visit a spiritual director my humility deepens as I recognize more and more the profundity of God’s love and how it is greater than my ability to sin.  We should most certainly seek to pray and ask for forgiveness on our own more often.  Yet going to Confession is virtuous through the physical demonstration of seeking a rebirth in Christ’s love.  The sacrament is one way that we as humans may participate in the journey of glorifying God and share the opportunity to embrace God’s love with our community.

The Gift of Confirmation

Baptism and Confirmation are two sacraments categorized within the “initiation” stage of our lifelong process of receiving God’s grace.  Baptism endows citizenship to Heaven while Confirmation calls us to live and bear witness to the Christian life.  In hindsight, I recognize how my heart was turned back in the fall of 2016 to receive the sacrament of Confirmation before matriculating into medical school.  Although I had not viewed Catholic rituals as monotonous or without reason, prior to this school year, I could never really provide substantial explanation to my friends who questioned my weekly decision to attend Mass.  It is clarifying and humbling to recognize now that the Holy Eucharist, just as Confirmation, is a privilege and gift from the Father, provided to us in a physical form which we may recognize and experience, yet possessing divine power to nourish our souls.  Moreover, Confirmation may be thought of as an “anointing for service.”  Confirmation represents a profound transformation in assuming a new identity in Christ and in the lives of others I encounter.  In my view, the Hippocratic Oath, which is said when receiving the white coat as a physician-in-training, is complementary to this greater call to service.  While I am ecstatic to soon begin to help others through healing, I contextualize this vocational pursuit within my greater love for God and His greater love for humanity.  I pray that He will work through me as a future physician and daughter in Christ.

My updated perspective on the BA/MD program experience

I wrote a post during my freshman year–now in hindsight, it was prematurely written–about being a student in a BA/MD program.  After having recently graduated from Rice as a student in the program affiliated with BCM, I have some additional (a wiser?) perspective to share.  You can also read some of my thoughts on accepted.com.

During high school

My senior year of high school was very untraditional since it served as my medical school application year.  The BA/MD application process is quite involved and really deserves a post of its own.  However, some of my short-and-sweet takeaways are as follows.

I have spoken with many students who had different mindsets in applying.  Some are 200% confident in their aspiration to become physicians, while others are considerably interested but may end up changing their minds in college.  Your mindset will dictate your approach to applying.  Imho, you should think about applying to BA/MD programs in the same way you think about applying to colleges, regardless of your mindset.  They unofficially fall into tiers on the basis of undergraduate and medical school ranking, academic resources, research opportunities, local environment, etc.  Here is a complete list of them.  Which programs best fit your needs?  Do you want to primarily pursue medical research?  Do you want a traditional undergraduate experience with a heavy sports culture?  Do you want a culturally diverse surrounding city?  Keep in mind that you will typically be spending 6-8 years in the same city.  Also keep in mind that you will have unique access to the medical school’s opportunities as an undergraduate in the program.  Categorize the programs as you would universities.  Which programs are “safety,” “target,” and “reach”?  Note that no BA/MD program is a “safety” on its own, but perhaps is a relative “safety” compared to other programs.

Be confident in how you will respond to the question of why you want to become a physician.  Be able to support your answer with several clarifying experiences.  The program directors and your interviewers know that you are only 17 or 18 years old, so you are not expected to wow them with years of research or clinical experience.  Instead, be able to tell your story, and how your trajectory is headed toward a life in the medical field.

Programs have different interview styles: one-on-one, group, and panel.  You should be prepared for all of them.  The interviews involving multiple students were always most intimidating for me, since it wasn’t unusual for many students to have research publications or letters of recommendation from renowned physicians and scientists (I didn’t!).  There were two students who had patents, and another who had scrubbed into 20+ neurosurgeries.  Everyone is putting his or her best foot forward, so do not be intimidated!  Programs want accomplished students, but more importantly they want humble, down-to-earth people who they feel can take most advantage of the additional flexibility afforded during the undergraduate years.  Don’t be afraid to share what you’ve done in high school.  But also take interest in the stories of your peers, and celebrate their accomplishments.  They will likely be your colleagues in a decade!  Start to build your network now!

During college

Explore your interests, but pick your major wisely.  In college we are bombarded with new areas of study and interact with hundreds of students with different academic interests.  You are encouraged to take advantage of the additional flexibility afforded by the BA/MD program, since you will not be participating in the extensive application process of other medical school applicants further down the road.  Nonetheless, even though you may not be required to take all of the pre-med classes through your program, I recommend that you take them anyway.  Early exposure to the fundamental concepts of biological structures and processes will stick in your brain, and you will learn some study skills (e.g. how to memorize a lot of information and how to apply elementary concepts in complicated scenarios) which will prove useful for medical school.  I am confident that I will have to adopt new study skills in medical school, since we are all told that medical school is like drinking out of a firehose.  However, take a jumpstart on this during college.

Keep track of your overall and science GPAs each semester.  I made a spreadsheet for doing so and used it not only to predict my grades but also to plan ahead for my courses the following semester.

Talk to peers in your program and share information.  You will be spending up to eight years with these people, so make friends early!

Have fun (but not too much)!  In high school, I spent little to no time socializing, so some relief from the medical school application process provided me with extra time to relax and also to get more involved within my future medical school.

I am happy to address questions about specific programs, but as a disclaimer, I only really know Rice’s program very well!  Good luck!  🙂

Academic tips for Rice undergrad (no bs)

I’m graduating from Rice in less than a week!  In the hopes of reaching a few current or prospective students who may find this post useful, I want to make a few recommendations to help maximize your Rice undergrad academic experience, based on what went well and what went poorly for me.  Read everything with a grain of salt.  I hope I don’t trigger anyone.  This list is by no means exhaustive.  It’s also not cliche or vague.  I tried to write in chronological order.  Finally, please don’t hesitate to reach out if you want more information, clarification, etc.  I’m always happy to help!

  1. If you have the slightest notion of being “pre-something” before matriculating, please make a tentative four-year plan and factor in the core prerequisite classes for the majors you are considering as well as those for graduate school.  I especially recommend this if you want to major in an engineering or a natural sciences discipline.  It is easy to become side-tracked early on with fun new interests and change your academic trajectory, but some temporary decisions may be poorly thought out and leave you scrambling at the end of your four years at Rice.  Another thing to keep in mind: department websites are not updated regularly with courses that are offered consistently every semester.
  2. If you decide you want to apply to medical school, pick your major wisely.  Your GPA (science and cumulative) is the top priority that schools consider, and I would recommend picking a range of classes each semester that will help you keep it high, i.e. organic chemistry should be taken with one or two additional easier science classes and a non-science class to give your brain a break.  Bioengineering, Biochemistry & Cell Biology, and Chemistry are going to be the traditionally hardest majors, although the requirements for these majors coincide with many pre-med requirements.  Kinesiology, Biological Sciences, Ecology and Evolutionary Biology, Cognitive Sciences, and Psychology are typically easier but require additional schedule planning.  Pick a major you will be happy studying, whether it is one of these or one that is traditionally unrelated to medicine (Sociology is fairly common), but please do not be naive and neglect to factor in the difficulty and time required of classes like organic chemistry and physics!
  3. Declare your major early!  You will have better luck getting into the classes you will need to graduate.  You likely will also have a more focused mindset in attacking your major-specific workload and honing your extracurricular activities.  The process of switching majors is a bit cumbersome but nowhere near too much to handle if necessary.
  4. Dabble in a lot of extracurricular activities, but decide on 2-3 long-term commitments by your sophomore year.  Opportunities for leadership will present themselves more readily if you stick with these pursuits for longer periods of time.
  5. I recommend that you pursue research as one of these activities.  Every post-graduate career platform is enhanced with research experience.  Moreover, try to get involved in research with potential for publication or presentation.  As a pre-med, look beyond the hedges and consider labs in the Texas Medical Center.  The research questions may be of greater interest to you, and the professional connections may be more relevant to your career aspirations.
  6. Work at Rice’s Baker Institute for Public Policy in some capacity (for pay, unpaid internship, or course credit).  I guarantee you will find a niche at this place regardless of your major or extracurricular interests.  You will also have unparalleled opportunities to meet prominent leaders in public service.  And you will become more aware of what’s going on in the world, whether you are interested or not.
  7. Do something professionally and personally meaningful every summer!  Here are some opportunities I’ve been a part of and highly recommend: Rice’s summer courses, Global Medical Brigades, Jesse Jones Leadership Center’s Summer in D.C. Research Internship, and Baylor College of Medicine’s DeBakey Summer Surgery Program.
  8. These courses were some of my favorite and the most useful for me at Rice.  The professors were excellent.  None that I have recommended are excruciatingly difficult.  They are as follows: medical Spanish courses including the clinical apprenticeship (Abad: SPAN 321/322/323), Leading People in Organizations (Obodaru: BUSI 310), Medical Terminology (Jones: HEAL 132), Immunology (Novotny: BIOC 372), Biology of Infectious Diseases (Rudolf: BIOC/EBIO 331), Nutrition (Anding: HEAL 103), Anatomy (Schell: KINE 300), Introduction to Public Policy (Baker Institute Fellows: POST 201), and Bioengineering & Cardiac Surgery (Grande-Allen: BIOE 615, requires special registration).
  9. Utilize Rice’s academic and career advising offices, but your best resources are your peers.  Don’t be afraid to ask them about specific classes, professors, application tips, etc.
  10. Beer Bike, Willy Week, public parties, Baker 13, and more may be fun but are not worth poor academic performance and mediocre extracurricular experience.  While I agree that you will more often remember the ragers and intoxicating memories (pun semi-intended) than a bad course grade in a year from now, a bad grade could carry unintended consequences related to your work ethic or competitive potential when applying for something in the future.  I am not an advocate for having no social life, but I really do advise that you try to seek greater fulfillment in your academic experiences and to have faith that there will be rewards to exercising delayed gratification.

A different perspective on the medical humanities

Throughout high school and early in college, I was enticed to pursue formal study of the medical humanities. I believed that this interdisciplinary field would afford me immense practical value by improving my ability to tackle complex and interrelated issues associated with the human dimension of medical practice.

Although I still recognize that history, culture, philosophy, and behavior simply cannot be divorced from healthcare, I realize that I was trying way too hard to force the application of the strengths of these diverse disciplines into a medical context. I readily admit that becoming an excellent physician has always been my primary goal. But I was perhaps naively trying to fit these other fields somewhere within my greater pursuit and consequently issuing them subordinate rather than fully complementary roles.

Arguably, classroom instruction of the medical humanities misses the point. I assert that the most relevant social consciousness and aptitude needed to serve others as an excellent caretaker may be learned only from personal experience. Furthermore, I echo the movement of institutions of higher education like Rice toward increasing the number of opportunities for experiential learning. While I am excited about our new medical humanities minor, I find that the practicum component is considerably more valuable than the coursework (I’m not pursuing this minor though). For instance, my medical Spanish internship at Ben Taub this semester has been invaluable to my understanding of the patient’s experience at a public hospital. Having only committed eight hours thus far, I am confident nonetheless that I have learned more about how citizenship status, income level, language, and compassion influence quality of care than I could have in any number of classes.

An approach that overcommits to the interdisciplinary experience, in my view, dilutes the purity of age-old theories and classical examples of application within the humanities, social sciences, and arts. I wish I had taken more political science classes in college and challenged myself to think from a perspective completely external to my drive toward a medical career. Fortunately I am in a public policy course this semester and have the opportunity each week to assume the role of economist, politician, or activist when studying such diverse topics as women’s role in the Middle East and drug trafficking.

I respect all pre-medical students who choose to study a major within biology or chemistry, and I ultimately chose to do so myself, admittedly most out of convenience since there was considerable overlap with the course requirements for medical school. However, it’s extremely unfortunate that many are deterred from pursuing a completely different major because it lies beyond their immediate academic knowledge or approach for problem-solving and decision-making. Moreover, it has become a necessity to maintain near-perfect grades in order to get accepted into medical school, and the vast majority of students, including myself, have been disincentivized from taking academic risks that may jeopardize our admissions package. Only a few people know that I actually entered Rice as a political science major and was primarily deterred from continuing with a pre-law curriculum as a pre-med because it was extremely difficult to achieve the grades I needed. Performing well in these political science classes was challenging because 1) I couldn’t extract myself from the all-to-pervasive competitive environment and 2) I didn’t have the time or leniency to incur failure after failure as a result of struggling to study, solve problems, and make decisions from a completely new frame of thought. I hope I may have inspired some open dialogue about these issues with my honesty.

I end with an important consideration for anyone pursuing or practicing medicine. When I am a physician, I must be able to take a step back and stop “being the doctor.” We are biased when we study the medical humanities because the goal is most often to be more understanding as doctors. Certainly there are professional standards for maintaining the physician-patient relationship, but I believe we are the best caretakers when we humble ourselves before our patients and relate to their experiences from our own outside of medicine.

Re-post: Accepted’s Med School Webinar on 2/9/2017

Hi everyone! I informally serve as an ambassador for Accepted.com, so here’s some useful information about an upcoming webinar:

Low stats got you down? Don’t let your low MCAT score or GPA get the best of you… Learn how to get accepted to medical school, despite less-than-perfect stats!

Join Accepted for their upcoming webinar, Get Accepted to Medical School with Low Stats on Thursday, February 9th at 5pm PT/8pm ET

Sign up here! —> http://reports.accepted.com/med/low_stats_webinar

Anki: A smart studying tool

In a previous studying tips post, I mentioned finding a method of spaced repetition that works for you.  Start to incorporate spaced repetition into your studying habits as early in your academic career as you can!  It becomes a habit and can actually be really gratifying once you start to remember information more easily.

I use Anki.  You can download it for free on your computer here.  The iPhone app costs ~$25, but I highly recommend buying it so you can flip through flashcards whenever you have idle time (i.e. waiting in line).

My tutorial will be VERY simple.  I will share the two methods of making flashcards that I believe afford the most bang for your buck.  I highly recommend watching videos (especially Jamie’s on TheStrivetoFit YouTube channel and med student Scott Blaine’s which also talks about OneNote) for step-by-step guides.

  1. Cloze fill-in-the-blank flashcards: A) type both the key term/question and what you want to be able to remember about it into the “Text” box, B) select what you want to be able to recall and press the […] button, and C) click “Add” at the bottom — and you’re done!  You can also add multiple blanks to each card by highlighting multiple phrases separately and clicking the same […] button.  Same numbers after “c” will create multiple blanks within the same flashcard; different numbers will create separate flashcards from multiple blanks.cloze
  2. Image Occlusion for diagrams and charts: A) download the add-on here and install it into your desktop program, B) copy the image onto your clipboard and click the icon on the far right in the above screen to get the screen below, C) drag the rectangle shape to box out areas you would like to be able to recall, and D) click any of the three options you see at the bottom depending on how much information you would like to view when finishing up studying each flashcard.control system.jpg

Hope this helps. 🙂  Good luck studying!  And remember, it’s not enough just to make the flashcards.  You must also study them every day.

I’m not a college athlete, but I’m still getting coached.

How do you react to failure?  Most of us feel embarrassed and defeated.  It knocks the wind out of us and makes us want to hide away from the world for a while.

I’ve found that this reaction is going to occur regardless of your mindset.  However, I’ve also found that my role models, those really good people, always do two things: 1) admit to this disappointment wholeheartedly without becoming overly emotional, and 2) seek out similar uncomfortable opportunities to strengthen their weak muscles.  Experts in their fields recognize that mastery is a dynamic rather than static process.  This becomes especially important when a field (like medicine) is constantly evolving.

Fewer people, however, like to hear about their weaknesses from another person.  Over the years, I have come to accept that listening to criticisms, even those that are constructive, from others can be very challenging and necessitating pride-swallowing.  However, it’s easier to be patient and eager to adapt to feedback when you place the comments you receive in the context of a greater pursuit, i.e. becoming a better physician so you can better take care of your patients, regardless of the other person’s intention for giving you criticisms.

John and Ann Doerr made an extremely generous donation to Rice to found the Doerr Institute for New Leaders.  How incredible of an opportunity to receive this same training as that which CEOs of Fortune 500 companies receive!

My “coaching” experience officially began yesterday at my first session.  With only one semester left at Rice, it is a privilege to take advantage of this course before crossing Main St. for my next chapter.  My professional coach and I reviewed my emotional intelligence assessment, openly discussed areas in which I may approve, and established tangible goals all just by talking!  I entered the session with an open mind, sat through the session with occasional laughter about my idiosyncrasies we discussed, and left the session motivated to tackle the tangibles within the next couple of days.  It was cathartic without any venting, and productive without any embarrassment.  Why don’t more people do this sort of thing!

Dr. Gawande discusses how coaching should more readily be exercised in surgical training and even throughout a career in surgery in The New Yorker (I told my coach to read this article so he could understand my future career field better, hehe).  Some of my favorite quotes from the article are as follows:

“Expertise is thought to be not a static condition but one that doctors must build and sustain for themselves.” (especially when patient lives must always be of utmost concern)

“Good coaches know how to break down performance into its critical individual components.”

“For society, too, there are uncomfortable difficulties: we may not be ready to accept—or pay for—a cadre of people who identify the flaws in the professionals upon whom we rely, and yet hold in confidence what they see. Coaching done well may be the most effective intervention designed for human performance.”

I really encourage everyone to dig deeper for your inner humility, look to others for advice, and accept comments you receive with strength and grace.  Although having a professional coach this semester is a fantastic opportunity to work with someone who has a lot of experience in corporate leadership and mentoring, I can really practice what I’m writing about with anyone else.

The Importance of Mentorship in Surgery

I am so honored to have my perspective on mentorship in surgery featured through Women in Thoracic Surgery!  Please check it out here: http://wtsnet.org/wts-medical-student-perspective/.  You should also read about the experiences of two other medical students as they journey into the field (much further along than I!).

I dedicate this writing to my mentors.  Thank you for all that you teach me and your help in pushing me to grow into a better future caregiver and person!

“Everyone” in France is now an organ donor

Beginning in 2017, France has converted its organ donor registry to an opt-out system. But you are still permitted to refuse donation (according to The Guardian there are currently 150,000 people signed up for the “refusal register”).

The implications of this policy change are huge! Surgeons almost always cite the organ shortage crisis as the principal barrier to transplantation for the majority of patients in need. As of today, there are nearly 120,000 Americans in need of a lifesaving organ transplant (U.S. DHHS). Only slightly more than half are active candidates (on the waiting list). Only 25% of those in need receive a transplant, based on the annual statistic from 2016. And there are only 13,000 Americans signed up as donors. What?! This is so discouraging.

I say this in a position of tremendous health blessings and can’t imagine the strength required of patients and families for which receiving an organ (or multiple) is their only hope. Despite the numerous second chances for French patients that are bound to arise from the policy, I can’t fight the moral reservations I have about this new opt-out system.

The Guardian writes that “the new law presumes consent for organs to be removed, even if it goes against the wishes of the family.” Individual autonomy over one’s body, and who has “ownership” after death if an individual’s wishes are unclear, seemingly contradicts France’s policy stance. Yet strategies such as presumptive communication are used in other medical specialties. I’ve most recently seen them employed by pediatricians to emphasize the routineness of childhood vaccination. Technically, everyone still has a choice in making their health decisions.

There are many reasons for the organ shortage crisis. Maybe cultural or religious differences make people unwilling to donate. Or perhaps people are willing to donate, but the inconvenience of having to sign up prevents potential donors from initiating the process. But perhaps the hardest reason to explain: a combination of fear, discomfort, and/or ambivalence about giving up your organs. Even if you could save eight lives after you yourself pass away? Is this a selfish perspective?

Surgery is gratifying in its immediate, results-oriented, and personalized nature. But transplant surgeons are intimately involved in this very complicated political, cultural, and social dilemma. This is why health policy captures my fascination. There is so much potential to help people beyond our own medical practices. Even if we don’t enact a perfect policy (it’s impossible anyway).