The Medical Thread

[BigRedBeta]

I applied to 7 which was definitely on the low side. And I only finished secondaries to four...

Knowing what I know now, I know that's way LOW. It didn't hurt me (I only interviewed at my top two, turning down an interview for my third choice, and withdrawing from my 4th when I got accepted to my top two within a week of each other.) but it's not a good way to go for most everyone else.

You should apply to out of state publics for sure. While there is a certainly some major in-state advantages, very few schools are entirely limited to only in-state residents (though some are - like Arizona). I'm most familiar with Kansas and Nebraska and both admit about 15-20% of their class from OOS, depending on the year. Nebraska (my school) even has tuition waivers for OOS students, so you only end up paying in-state tuition. Not all the OOS students get one for their first years, but most have them by the second, and all by the third year. That's a BIG deal. I definitely remember getting my $100k phone call letting me know that I was only going to have to pay in-state for the four years.

Your efforts should definitely be focused on your in-state schools - apply to all of them, because that's where you have the best chance of getting in, but it doesn't make any sense to limit yourself to those only. I'd look in in either the MSAR and the USNWR for the GPA and MCAT scores of the entering classes from the year previous. As an OOS student, you need to make sure that you're above average. I have a friend who uses a self created "index score" (it might be on SDN) as a good measure of how your grades and MCAT score line up. Basically it's GPA x10 + MCAT, so the highest possible score is an 85, but obviously that's unattainable. But if a school has a 3.6 avg GPA and a 31 MCAT, that's a 67, and the formula, though slightly crude weighs things pretty well. I agree with my friends assessment that a .1 point in GPA is about the same as a point on the MCAT. He's since gone on to include modifiers for race (because that does play such a huge role in med school admissions) and a couple other things, but the general formula still works.

So when applying out of state, definitely go for it if there's a school who matches your index and you're interested in attending (that's a big part obviously). You won't wow them if you're on the mark, but hopefully you can get an interview and wow them then. If you are significantly above their index, then it's a no brainer. You should apply.

Obviously, private schools need to be part of your list as well. Some may give a slight in-state advantage but no where near as large as many state schools.

[SoEnchanting]

Oh man BigRedBeta that IM shelf was TERRIBLE! Check your email later LOL...

[BigRedBeta]

I'm looking forward to hearing about it...I'm currently starting to freak about our OSCE...

[blackngoldengrl]

Definitely apply to out of state schools, espeically if: they are close to you or in your region (PA, IN, KY, IA, MI?), they are private, or if your undergrad sends people there every year or often enough. Also, it's money- they'll get more from you than from an in-stater. Private schools aren't bound by state residency, so it's all about you.

(I'll put in a personal plug for Maryland ( ). I know that we take a good percentage of students from out of state, and depending on your credentials, they can provide decent money to offset the difference in tuition.)

I applied to Cincy b/c I thought it looked good on paper and the secondary app. was cheap! I ended up getting in, despite being from out of state, which I thought was cool b/c their instate percentage was >90%.

And one more thing..."KappaMD" made me think you already had a degree. Don't jinx yourself

Good luck!

[BigRedBeta]

Sooooo....update from the other med students?

SoEnchanting, hope your score for that IM shelf worked out okay. I did really well (for me anyways).

I really disliked psych. I don't like switching medications around just to switch medications around. The actual therapy work though is interesting, too bad the MD's just hand it off to the PhD's. Child and Adolescent psych was good too, in part because it seems like most of the kids actually did get better.

Currently on OB/GYN, just finishing up my (incredibly slow) week of GYN ONC. Our department really puts an effort on teaching, the residents are great, and for the most part the patients have been wonderful too (which I find a little surprising being a male student). Really enjoying the mix of surgery, clinic, and procedures that the specialty offers. I can see why men would get into the field. I just wouldn't want to spend my days focused from knees to navels. Also, I want the moment when my fingers are in a vagina to be the high point of my day...

Have benign GYN Surgery next week and then I finish up with Labor and Delivery, so I end 3rd year with a sleep deprived fizzle. I'll be working at the busiest L&D service in the city (about 3500 births a year) that gets all the suburban couples coming in the door. Expected to be in at 5am every day for pre-rounds, and have a q3 call schedule...sweet.

Anyone else?

[cheerfulgreek]

One year of school done for me. I'm going to enjoy the hell out of this summer.

[AKA_Monet]

Originally Posted by BigRedBeta

I really disliked psych. I don't like switching medications around just to switch medications around. The actual therapy work though is interesting, too bad the MD's just hand it off to the PhD's. Child and Adolescent psych was good too, in part because it seems like most of the kids actually did get better.

I thought you guys hate the Ph.D.'s... LOL

What was it besides switching meds that you did not like about psych? Just asking? There is a new field called behavioral genetics that has a lot of neurology involved... And there is a nice article in Newsweek about children that are severely emotionally disturbed and their treatment. They basically say their amygdala is malformed or has a birth defect that exacerbates their behavioral processing... And they also point out that the meds are not studied in clinical trials with children.

[BigRedBeta]

I didn't like the fact that some of the providers (not just MD's but also NP's and PA's) I was with made changes to medications when the patient was experiencing some improvement (but not total) after only 4 weeks - even if they were handling the side effects okay (though they had some) and had room to go up on doses. Several times the provider literally said, "I think we're doing okay, but we might get better results if we switch it up". When you throw in the amount of time to taper off the meds, start the new one, wait the appropriate 4-6 weeks to see a response, adjust the dose from there, it's nearly a 2 month process.

The most egregious moment was when a woman came in saying, quote "I feel great, I can't remember the last time I felt this good, I'm not having any side effects at all", and the NP then spent the rest of the appointment telling this woman what they'd do if she did start having side effects. He seriously went over the side effect profile of Drug A (which she was on), told her they'd go to Drug B, went over the side effects of that med, went on to explain that Drug C was in a different class, went over the side effects of that pill, and ended up on Drug D and the possibility that at that point they might have to reconsider her diagnosis because she'd be refractory to treatment at that point. It was seriously like he looked at his watch, saw that only two minutes had been spent finding out that she was doing great and decided that he needed to fill the remaining 18 minutes of the visit talking about something. The thing is that this was at the County Health Dept, and this woman wasn't extremely high functioning before her illness, so I know she left absolutely confused about the single side effect she was supposed to be watching for in regards to the drug she was on.

As for the PhD's...most of the animosity I've seen between MD's and PhD's is in the basic bench sciences - PhD's think MD's are a bunch of frauds who claim to love science but either aren't smart enough or aren't passionate enough about it to do it the way it deserves while the MD's think the PhD's are a bunch of anti-social losers who are way to carried away about the theory and not enough about the application or what goes on in the clinical setting which is where patients actually get better...

[AKA_Monet]

Originally Posted by BigRedBeta

As for the PhD's...most of the animosity I've seen between MD's and PhD's is in the basic bench sciences - PhD's think MD's are a bunch of frauds who claim to love science but either aren't smart enough or aren't passionate enough about it to do it the way it deserves while the MD's think the PhD's are a bunch of anti-social losers who are way to carried away about the theory and not enough about the application or what goes on in the clinical setting which is where patients actually get better...

Don't know that much about prescribing folks the correct drug and dealing with the side effect symptoms. As someone who has suffered a strong side effect and an adverse reaction, I am just happy the ER physicians figured it out and I was able to have some relief...

As far as your observation, doctor--I agree. LOL. But, I have seen it work and when it does, much is accomplished... It should not be that animosity. I never walked into a basic science lab thinking the physician was clueless, in fact, they were my best pupils when I've had to teach them a technique. Whereas, other Ph.D.--yeah, they are some asshats that are clueless about the benefits of the greater society. I am sorry you are encountering that...

I usually get the physicians wondering why I did not go to med school. I tell them my dad was a dentist, and then ask them, what do you do when you find out a patient is allergic to penicillin, and you ASKED her what her allergies were, so this patient sues you for malpractice (a day out your life) and on the claim, it says "allergic to ALL the 'cillins' " Ampicillin, Amoxicillin, Penicillin--ALL of them!!!

I had a whole row of residents fallin' out over that one...

[cheerfulgreek]

I've known a friend of the family's since I was a kid. She's my mom's friend. She's had these two prairie dogs since I was a kid and I used to go over to her house to play with them all the time. Well, recently, one of them died, so she got three more. Well, anyway my mom called me this past weekend and told me that one of the prairie dogs she had gotten hadn't been eating properly. She had taken him to the vet for the 1st time about 3 months ago.

Anyway, their teeth grow throughout the life of the prairie dog similar to the way they do in rabbits. Well, the growth is normally kept in check by normal wearing action by chewing and grinding of opposing teeth. Well, to make a long story short, like I was saying, she took her pet to her local vet to have his teeth trimmed down a bit. The vet was supposed to anesthetize the prairie dog, but for some odd reason he didn't. After the procedure, he brought the pet back out to her, and told her that anesthesia wasn't needed. What also made it look bad, was his little nose was bleeding too. I don't know what would have caused that though. Anyway, that's not the big problem. That was over a month ago, and now his teeth are growing in a different direction causing major problems in his eating habits. The vet charged her $30.00. She didn't want to go back to that vet, so she'd been calling around to different vets to see if they could fix the problem, but none of them like dealing with prairie dogs. (they're illegal) not to have but to transport or purchase. Anyway, she did end up finding one. The vet she found charges $120.00. She had the procedure done again, properly this time. The problem is the teeth are still growing in the wrong direction. I told my mom that she's either going to have to pay $120.00/month to continue the trimming because I doubt they're going to grow back the right way now. They're eventually going to grow to the point where he won't be able to eat or drink properly. She's probably going to have to put him down. Some vet.

Unlike people, animals are unable to describe their symptoms and signs. I read some of the ealier posts, and was reading about some of the medications that are prescribed to patients. What I've posted above reminds me of how things can go wrong. Like when we go to the doctor, we assume that the drugs that are prescribed to us have been carefully tested to make sure they're both safe and effective. Most of the time they are, but sometimes the drugs can cause more problems then they solve. Probably because the FDA hasn't adequately monitored the pharmaceutical industry.

[SoEnchanting]

Originally Posted by BigRedBeta

I really disliked psych. I don't like switching medications around just to switch medications around. The actual therapy work though is interesting, too bad the MD's just hand it off to the PhD's. Child and Adolescent psych was good too, in part because it seems like most of the kids actually did get better.

Originally Posted by AKA_Monet

I thought you guys hate the Ph.D.'s... LOL

I think I was really lucky with my Psych rotation. With the exception of a few random days at the hospital doing admissions and **shudder** ECT, I spent the most of my time with a child/adolescent psych who made all his appts 30-60 minutes. I got to see a lof of therapy, where some of my rotation partners did not. They just saw med refills, and.. well that's about it. Anything else was handled by their counselor. That stinks. I wasn't aware there was any love lost between the two fields, though. Maybe we're sheltered here...

[AGDee]

I spent 13 years as an Occupational Therapist with 9 of them in child/adolescent psych and the other 4 with adult.. mostly inpatient although I worked partial day treatment in adolescent for quite a while. I concur that the child/adolescent psych is much more rewarding. The bottom line is this: In adult psych, most of the problems are more biochemical (schizophrenia, bipolar, clinical depression) so it's "medicate, medicate, medicate" whereas with the kids, while a few are biochemical, more are having situational problems like coping with abuse, dysfunctional families, etc., so therapy is more useful and many of them can work through things and develop healthier coping strategies. Their thought processes are easier to work with also. While therapy definitely helps in conjunction with medication for the more biochemically oriented, it's geared more toward coping with mental illness, the importance of staying on meds, when to call your doctor, etc. Additionally, given the type of disorder, their thought processes are more difficulty to work with in a therapeutic way. Until Mr. Doe stops seeing hallucinations, it's going to be pretty difficult to do much "talk" therapy. Yet, they only get to stay inpatient for 3-5 days these days and that isn't enough time to get anywhere. They used to stay in for two months so you had that whole time to work with the meds, observe differences and side effects first hand, etc. The best psychiatrists I worked with were the adolescent psychiatrists because they were more versed in talk therapy too. They didn't just medicate. I would think it would get boring to just medicate all the time, but that's what a lot of them do.

[SoEnchanting]

Originally Posted by BigRedBeta

Sooooo....update from the other med students?

SoEnchanting, hope your score for that IM shelf worked out okay. I did really well (for me anyways).

Hey there! I am proud to say that I just completed the first week of my 4th year of medical school! I would say I did decent on the IM shelf in Feb., but not as well as I would have liked. I just don't think 8 weeks is enough time to get everything solid. I had 6 weeks of Pediatrics after that, which was much crazier than I had anticipated. And then I finished the year with Ob/gyn - by far the busiest rotation I've had this year. I dunno if it was bad luck (or good depending on how you looked at it), or whatever, but my call nights were insane. It was a lot of fun though, and I agree the mix of clinic and surgery time was nice.

I'm on another 4 week rotation now, with all inpatient medicine. There is just something about 4th year rotations that make them better! I took the CS a few weeks ago in Atlanta - it seemed too easy to be true, so I'll hold my comments on that until I get my score back. Taking the CK in July, so that's pretty much my focus of the next few weeks. That and figuring out LORs, personal statement, ERAS stuff - man, can you believe graduation is just over the horizon!

Originally Posted by BigRedBeta

Also, I want the moment when my fingers are in a vagina to be the high point of my day...

LMAO!

Originally Posted by BigRedBeta

Expected to be in at 5am every day for pre-rounds, and have a q3 call schedule...sweet.

Sounds about right.. All I can say is hang in there. The good news it's so busy that it flies by really, really fast.

[BigRedBeta]

Originally Posted by SoEnchanting

Hey there! I am proud to say that I just completed the first week of my 4th year of medical school! I would say I did decent on the IM shelf in Feb., but not as well as I would have liked. I just don't think 8 weeks is enough time to get everything solid. I had 6 weeks of Pediatrics after that, which was much crazier than I had anticipated. And then I finished the year with Ob/gyn - by far the busiest rotation I've had this year. I dunno if it was bad luck (or good depending on how you looked at it), or whatever, but my call nights were insane. It was a lot of fun though, and I agree the mix of clinic and surgery time was nice.

I'm on another 4 week rotation now, with all inpatient medicine. There is just something about 4th year rotations that make them better! I took the CS a few weeks ago in Atlanta - it seemed too easy to be true, so I'll hold my comments on that until I get my score back. Taking the CK in July, so that's pretty much my focus of the next few weeks. That and figuring out LORs, personal statement, ERAS stuff - man, can you believe graduation is just over the horizon!

Six weeks of peds? Yikes - that's a lot to learn in so short a period.

I am looking forward towards OB a little bit. I had a couple deliveries while I was on family so I have some idea what to expect. Plus the resident on that service is AWESOME, so that'll be good.

I plan on taking both CK and CS in November, I've scheduled a month working with our student run clinic for that four weeks, so with only 8 clinic nights the whole month, I figured it'd be a great time. I'm waiting to hear from an away rotation at the moment which will totally alter my schedule if I don't get it. Considering it's in August, it's super frustrating that I haven't gotten a response one way or the other yet...

Other than that, hard to believe that I have less than 3 weeks of 3rd year left. Looking back it's been a really crazy year, and it's unbelievable the amount of stuff I've learned (and forgotten)...but it's definitely been a year that's reaffirmed my desire to be a doctor.

[cheerfulgreek]

I have a question for BigRedBeta. Last night I was watching the Discovery Channel and it was talking about how fetal cells may be able to keep breast cancer from developing. I don't remember everything, just some of the things that grabbed my attention. It said that fetal cells surviving in a mother's tissues may fight off breast tumors. I myself also read that women with children have a lower risk of getting breast cancer than childless women. It also said that during pregnancy, a small number of fetal stem cells cross the placenta into the mother's bloodstream and can survive for decades in her skin, liver, brain, and some other organ that I can't remember. I think it was the spleen. But anyway, it was just basically saying that fetal cells repair damage to some of the tissues. Have you heard of anything like this in your field of study?