THE ULTIMATE MEDICAL GIFT GUIDE

How is it already the holidays? I feel like I just started intern year! I've had six months of intern year under my belt and with that time, I've come to find some really useful gadgets and items that have made my life easier and wanted to share with everyone just in time for the holiday season. If you're having trouble finding a gift for the medical professional in your life, look below for some ideas!

GUEST BLOG: THE HIGHEST OF HIGHS AND LOWEST OF LOWS, A MS4 PERSPECTIVE AFTER FAILING TO MATCH

*The Highest of Highs and Lowest of Lows*

A 4^th year Medical Students Perspective after Failing to Match

*Trigger warning: suicidal thoughts*

Before I get started with writing, I just wanted it to be known that I was asked by a dear friend and colleague to write this for her blog. Full disclosure: writing has never been a gift of mine, but what follows is coming from a place of honesty and truthfulness. I hope someone out there can learn from my experience and mistakes. And for those of us that felt the devastation and heart break that I felt on that day, hopefully you know you are not alone.

Match Day is synonymous with a celebration for most medical students from the moment we enter medical school. It is the day you learn where you get to pick up and move to next in the chapter of learning the art and science of practicing medicine. It is what people have spent many nights dreaming about for countless years − when all the hard work, sleepless nights, exorbitant amounts of stress all go away because it paid off. The sacrifices of missed family vacations, weddings, birthdays, parties all makes a little bit of sense for that moment in time. Well, what happens when that day goes from what is supposed to be one of the happiest moments of your medical career to one of the worst days of your life in the blink of an eye?

Making Myself 100% For the Transition to Residency [MERCK MANUAL STUDENT STORIES]

Finally. Residency.

I have to be completely honest when I say that I never actually expected this day to come. I had a countdown on my watch for graduation and I remember when the days were in the triple digits. Having graduated this past weekend, I am so thankful and grateful for the opportunity to continue my education into residency. Knowing that the next five years of residency will be tough, I decided to spend the last couple of free months making myself, “100% for Residency.” What exactly does that mean? It means that I want to make sure that I’m the best version of myself going into intern year whether it be mentally, physically, or emotionally. Here are the ways I am doing that:

The Best Tools for a General Surgery Away Rotation [Merck Manual Student Stories]

Hello guys! Now that I have matched into a general surgery residency, I feel like I can discuss all of the great tools that contributed to successful away rotations in general surgery. I believe the biggest tool that you can possess is a great work ethic because many of these surgical away rotations are grueling. Residents and attendings may expect you to be an acting intern, rounding and presenting patients, studying for OR cases, performing techniques, and working the same number of hours as residents. The following tools can also add to your experience, so continue reading for some of my favorite things on my away rotations!

YANGSWEARABOUTS MATCH SERIES: GENERAL SURGERY

Hi guys! I was invited by one of my favorite Instagrammers/Bloggers, YangsWearAbouts, to write for her Match Series! This series features fourth-year medical students who successfully match into their respective specialties. Since the beginning of its conception last year, I've always dreamed about writing for this series. To decrease the repetitiveness, my journey through the residency application process is summarized in this piece! Follow the link below for my general surgery residency application process!

Click here for the ups and downs of my general surgery residency application!

My Match Experience: Why I Chose General Surgery [Merck Manual Student Stories]

It’s been about three weeks since I found out that I matched into my number one general surgery program and I am still on an absolute high. There were so many moments in medical school where I kept asking myself, “Is this going to be worth it someday?” For all of you still questioning this, IT IS SO WORTH IT.

You question a lot when you apply to medical school. You question a lot when you’re studying for your first set of boards. You question yourself on what specialty you’ll ultimately choose. You question yourself more times than you can count during the residency application process.

Continued on Merck Manuals Student Stories!

A PREFACE TO MY MATCH POST: THE APPLICATION AND MATCH PROCESS

Hi guys! Long time no blog. As I was writing my biggest blog post about matching, I realized that I never provided background information about the match process. Many of you guys are premed or in the early years of medical school and I remember being completely oblivious to the residency process. To be completely honest, it was a learning process even up until Match day! This post serves as a guide to the process of medical school up until the beginning of residency. *Note: all of my posts will be from a DO medical student point of view. My MD student counterparts experience similar circumstances.

My Match Experience: The Moment I Matched [MERCK MANUAL STUDENT STORIES]

Honestly, where do I even begin this post? The moment I found out I matched was honestly such a blur. The hours that followed were a blur. Honestly, I think I’m finally coming down from all of the excitement and it’s been nearly a week!

Continued on Merck Manuals Student Stories!

How I’m Making the Best of My Last Rotations [Merck Manual Student Stories]

It completely boggles my mind that I have roughly four months until I graduate! I recently completed all of my audition rotations and have several interviews left before I submit my residency rank list. So, where exactly does that leave me now? Isn’t this the time when fourth years experience “senioritis” and do “easy” rotations?

Continued on Merck Manual Student Stories!

FOURTH YEAR UPDATE: FIVE MONTHS TO GO

Hi guys! Long time no post on this blog! I've been writing for Merck Manuals Med Student Stories so head on over there for my latest musings.

I wanted to do a special post here because my life has slowed down quite drastically as 2017 said its last goodbyes. I feel like I've grown so much over the last six months and I wanted to keep you guys updated on where my life is now in medical school.

The Residency Rank List: How Will I Choose the Right Place? [Merck Manual Student Stories]

About seven months ago, I remember looking at “January 2018” as being the month I could finally rest easy because all of my audition rotations and interviews would be done. It boggles my mind that that month is less than a month away. And while all of my auditions and interviews will be done, I forgot about one of the most important things that happens in January–submitting your rank list.

...

Continued on Merck Manuals Student Stories!

Away Rotations: How to Save Money on the Road [Merck Manual Student Stories]

I can’t describe how happy I am to be home in Minnesota, which means one thing–I’M DONE WITH AUDITION ROTATIONS! If you’ve been following my journey the past four months (on here or Instagram), you may have noticed that I have been quite the busy bee. Since the end of July, I’ve moved out of my apartment, been to Philly, rotated in Ohio, West Virginia, Ohio, Michigan, and back to Ohio. It’s been a crazy four months, but I have learned so much about independence, being at different hospitals, and living on a budget! I thought it would be good to continue my series of fourth-year advice by imparting some tips on how to save money during this very expensive time.

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Read more at Merck Manual Student Stories!

HIATUS

Hi guys! As many of you might know, I am currently on the residency application trail and I will be putting a lot of my social media on hold. My number one priority is to be the best applicant as possible and I hope to return as soon as applications are over. However, I've kept some of my favorite DIYs and posts so you guys can still enjoy them! If you have any questions, feel free to email me at coffeeandscrubsblog@gmail.com.

I can't say enough about how grateful I am to have shared my experiences and hope to continue to share with you guys in residency!

-Amanda

ROUNDING OFF THIRD YEAR

 

Scrubs: Medelita

I always start off blogs, get halfway through one, and decide to do something else so I apologize for not providing original content for the past couple of months. But I wanted to give a huge thanks to the recent guest bloggers for doing their thang and giving you guys an insight into things I am not all too familiar with (check out the previous posts for the PA profession, dermatology, and how to excel in your application to med school)!

GUEST BLOGGER PART 2: Applying to Medical School: What to Expect When You’re Expecting…An Acceptance by Dan

Applying to Medical School: What to Expect When You’re Expecting…An Acceptance by Dan (the Man)

So you want to be a doctor? If you answered yes, then congratulations on passing the first step to being a doctor. Was that easy? If you answered yes, then congratulations on lying to yourself. But in all seriousness, if you’ve reached this point in your medical career, you should feel proud of yourself because you’ve achieved a great deal. Only a small percentage of freshman pre-med students get to this point. Now all you have to do is find a way to brag about all of that without sounding too full of yourself.

Warning:

I’ve said this before and I’ll say it again: don’t listen to people on the internet. Not even me. Everyone has different experiences and some sources out there only serve to bring you down (I’m talking to you, Student-Doctor Network. Bunch of trolls over there). I’ve applied once to one school (ya know, for shiggles) and twice to many schools, so I would say I’m experienced but not an expert. These are just my stories. Ultimately if you want to be a physician, it will happen.

  

Aspects of the AMCAS application:

The AMCAS is the primary application that gets sent to all medical schools with all of your credentials and qualifications. It’s analogous to the Common App from your high school days. It allows you to apply to all of the schools in the US except schools in Texas. I can imagine they weren’t too happy about that episode of SpongeBob so this was their retaliation. The AMCAS stands for American Medical College Application Service in case you cared. I envy the person whose biggest concern about the application is what the acronym means.

• Beyond the basic background information on home and age, the application begins with delving into your family education and income.
• Grades. You get to enter them yourselves, but if you try to lie, the Association will hunt you down and delay your application until the end of days. Don’t worry about credit conversions, though. They’ll take care of all that for you if you’re on the trimester system or if your school has unusual credit values. From this they also recalculate your GPA, which in some cases will be slightly different than what your institution tells you. The GPA will be considered based on both your cumulative GPA and on factoring in just the science courses. Attached is a helpful document on how to calculate GPA. Don’t forget to ask your school’s registrar to send your transcript.
• MCAT score(s). Heh.
• Experiences. This is where they give you 15 slots to write about anything and everything you’ve done in a quick 1-paragraph blurb. For some people, this is not enough space, but if you’re like me, less is more. You’ll be asked starting and ending dates for each and cumulative hours contributed. You’re also asked to elaborate further on three of your experiences. Use this space wisely.
• The personal statement. Can you cram your entire life story into 1-2 pages? I want to stress that this is very important. It doesn’t need to be a tearjerker (both my parents are still alive and so are most of my grandparents), but it does need to articulate why you want to go into medicine. This is your opportunity to talk about things that don’t appear anywhere else on your application, so avoid repeating the summaries of your experiences and accomplishments.
•  Letters of Recommendation. Generally schools will ask for 3-4, but you can send additional letters if you feel they speak about your character from a unique perspective. The main rule of thumb is 2 science professors and 1 non-science professor/work advisor. These don’t need to be in before submitting your application, but need to be in before schools will consider you for interviews.
• Finally, schools you’re applying to. My personal recommendation is to try to float this number around 10-12 with 2-3 reach schools and 2-3 safe schools. A reach school is defined as a school that you wouldn’t associate with the word “swag.” For some, 10-12 schools seems a little low, but the theory is that being qualified at one school means you’re qualified at many schools. Likewise, if you’re not qualified anywhere, increasing school numbers will not make you more qualified. Applying to fewer schools is good too if you know what you want. You don’t have to take this advice. It’s ok; I literally cannot take it personally if you don’t.

  

Photo of me and a pizza because every hipster blog needs pizza

Timing: Seriously, this is really important

The AMCAS opens in early May, which allows you a month to start putting together your credentials. When it comes to personal statements, you might want to start sooner and use the time to have a bunch of people read it over and criticize your use of “then” and “than.” For letters of rec, you should give your letter writers a month or so to say something nice about you. Preferably, you want to ask your writers before finals rolls around and The Defenders premieres on Netflix. June 1^st is the first official day you can submit your application and it’s highly recommended you submit within the first day of opening. The confirmation process can take a while and is done on a rolling basis. If you submit early, your application can be turned around in a day or two compared to the weeks you may be waiting if you submit a month later. Because schools review applications on a rolling basis, the earlier your application is reviewed the fewer people you’ll be competing with. I’ve made a graph to illustrate my point. The X-axis is on a log scale and the bar graph resembles a middle finger being pointed at you. You want to be more towards the thumb-end of the applications to avoid delays.

After successfully submitting your application, the AMCAS will distribute secondaries in July or August, which should be turned around in 2 weeks or less. Interviews will roll in hopefully between August and March if all goes well. If you applied early and have a good application, you’re looking at interviews before November and acceptance within 8 weeks after. Later interviews generally have a lower chance of acceptance, but it’s not a death sentence. In April, applicants who have multiple acceptances have to commit to just one school. This is theoretically when people get moved off the wait-list. Hopefully by this point the schools will guide you towards the door for the first day of classes.

Money: Hitting you where it hurts

Let’s talk money. Unless you qualify for FAP (Fee Assistance Program. I am not making this up), you will be expected to pay a lot of money just to be given the opportunity to pay more money. The MCAT test is $310, which makes it worthwhile to take only once. The actual application will cost $160 and comes with one school. Each additional school you want to send an application to will cost you $38, which makes applying to a lot of schools an expensive endeavor. After the primary comes the secondaries, which will come in like a barrage of arrows. Each secondary will cost anywhere from $0 to $150 in addition to requiring essays on why you like each school. Applying to a lot of schools gets very expensive. If you do qualify for FAP, the AAMC will reduce the MCAT fee, give you access to the MSAR (more on that later), and comp your application and first 16 school applications. That’s a lot of money.

How to decide where to apply: Stats and the MSAR

Let’s start by defining the MSAR, the Medical School Admissions Requirement. This is an online resource that compiles the GPA and MCAT ranges of all schools in the US. This allows you to sort by your desired scores as well as look into each school’s mission statement, student body size, gender distribution, etc. The question is what score is good enough? Do you apply to schools where your scores are just below the median, at the median, or above the median? Honestly, I couldn’t tell you. Rejection is common from schools where your score is more than competitive and sometimes you’ll find someone whose scores were less than competitive get into a school. Don’t underestimate the importance of a good personal statement and activity summary. Final note: it’s worth your time to look into the legitimacy of the schools you want to attend. Is that school accredited by the AAMC? Has it lost that accreditation recently? How low of a GPA/MCAT combo are they willing to take? What do the school’s residency match rates look like for the specialties you’re interested in? Is tuition going to be expensive? What percentage of applicants do they accept? Anyone of these factors alone shouldn’t deter you from wanting to attend a school, but if the answers to these questions would also describe a Kardashian, you should be skeptical.

MD or DO?

While the two degrees differ in philosophy in minor ways, in most functional capacities the two function exactly the same. Both allow you to pursue any specialty and match with MD residencies and will require you to pass the same boards.

I sit in the camp of students who believes a good DO school is better than a bad MD school. The judgment comes from the idea that MD degrees have been longer established and that DO schools have more lax requirements. If your goal is to become a physician and serve your community, it’s important to keep an open mind to the possibilities. I also wanted to add a note to be wary of the MD schools that send you unsolicited emails to get you to apply. Caribbean weather sounds nice and all, but for-profit institutions seem to have an agenda for accepting anyone willing to go an additional $250,000 in debt. (For comparison purposes, the average non-Caribbean graduate has about $153,000 of debt.)

  

Activities and experiences

Breakdown time! No, not an emotional breakdown. Let’s breakdown what experiences to talk about and how to highlight what you’ve learned. For those lucky enough to still have time to pursue new experiences, listen up. There are a few major experience categories: volunteering (medical and non-medical), paid work (medical and non-medical), research, awards, artistic endeavors, clinical shadowing, extra curricular, leadership, teaching, etc. You don’t have to have something in every category, but try to think of something for most of them and try to pursue other ones if you have time. Each school ranks the importance of each experience differently, so a Jesuit school may put a greater focus on non-medical volunteering while a large public institution might like research a lot more. The mission statement of each school will give you an idea.

You’ll be given space to write in detail about three significant experiences and I would say to avoid having all three of them highlight the same thing. If you have three important medical experiences, for example, you may want to only highlight one and use one for a leadership experience and one for a hobby. The idea is that you talk about how each experience, no matter how unrelated, has contributed to your success as a medical applicant. Take my example for how to write about being a concert violinist, which you could argue has nothing to do with medicine:

Learning the violin has given me the opportunity to work alongside a group of talented individuals to create something larger than myself. Being a part of an ensemble helps me understand how each part, no matter how seemingly insignificant, can contribute to something beautiful. Succeeding in an orchestra ensemble requires discipline in daily practice, but also requires versatility as a musician. The required musical repertoire spans many time periods and often requires quickly learning on the spot. The violin has taught me not only how to lead others, but how to take directions and criticism. This has been an important part in my growth as a musician and as a scholar.

Working in large orchestras has also allowed me to travel the world and gain important cultural perspectives, some of which were vastly different than my own. I have played a series of concerts in Oahu, Hawaii where I learned Polynesian culture, and I have also toured South Africa, which broadened my global perspective immensely. In preparation for our tour of South Africa, I studied Apartheid extensively, the effects of which I was later able to observe during my travels.

Secondaries: Essays for dayz

Secondaries are additional essays or questions schools want you to answer about their specific programs. Some schools make it mandatory to turn those around within two weeks of offering while others only heavily imply the two-week deadline. There will be a lot of secondaries, so prioritize which schools you’re most invested in. It used to be you needed a minimum GPA and MCAT to be offered a secondary, but almost all schools have since taken to offering secondaries to all applicants. Some secondaries will only ask for your money and no essays. That sounds great now, but when the time comes you’ll feel cheated by the fact that you’ve added nothing to your application and have to bribe your way into just being considered an applicant. Anyways, do your research on the programs and get really invested. Read the mission statement, look into what type of groups or programs you’d take advantage of. If you can’t imagine what it would be like living in snowy, frigid Minnesota in the middle of winter, it’s ok to not respond to that secondary. Depending on your life and Pokemon Go event schedule, you may not even have time to complete them all.

  

What’s it like to be a reapplicant?

Good. I’m a little hungry, but no complaints.

But in all seriousness, the first thing I did after ordering a Crave Case from White Castle was call the schools and ask what they wanted to see improved in my next application. The biggest advice I heard was to be a resident of the state school I wanted to attend. (Nice try, Iowa. I’m not falling for that one.) GPA can’t be fixed easily, but the MCAT can be retaken if you think you can do significantly better (maybe 3 or 4 points better). As far as experiences go, I would say diversify as much as possible. If your clinical experience was weak, shadow physicians for a few weeks or become a scribe. If you like research and not making minimum wage, try to get a job as a lab tech. Ultimately though, I would say to just do you. If you’re a musician, take the time to join a community orchestra. If you want to teach English in Japan, do it. If you want to teach high school kids how to fight ninjas, watch Iron Fist. If you’re a marathon runner, sit down once in a while. Take the chance to live life as if you were given a second chance. The schools will be measuring your reapplication status on personal growth as well. If you spend the year spinning your tires, they may not look at that too favorably. Would I have liked to have gotten into school the first time? Yes. Do I think time off has prepared me for medical school? Eh, who’s to say? Have I enjoyed my time away from school? You bet.

  

Interviews: blabbering with eye contact

There are a few different styles of interviews, but generally the schedule goes like this: you arrive to the school early in the morning looking super fly. (Guys, get a nice looking suit and tie with no bells and whistles. Ladies, keep doing you. I don’t know. I’ve never seen a woman look poorly dressed at these things.) There will be the dean there to greet you and introduce the school. You’ll be shuffled off to other rooms for your interviews with both students and physicians. After lunch, the admissions department will tell you about various programs and resources on campus. They will then take you on a tour and send on your way. Out of my 10 applications in the first round, I had two interviews. The next time around, I had one interview before gaining an acceptance and shutting down my applications to avoid the rejections. These numbers are hardly statistical and may be totally different for you.

Types of Interviews

This is not an exhaustive list, but these are some of the more common types. My experiences were very laid-back and the conversation was casual. If you’ve gotten to this point, hopefully you’ve learned a thing or two about managing pressure.

• One of the more common types is the traditional one-on-one interview. These are generally 15-30 minutes long and vary in amount of interviewers. These can be blinded or unblinded, meaning the interviewer may or may not have your scores and personal statement in front of them. These are the easiest to prepare for because so many questions are recycled and can be found online. Always have an answer to “So tell me about yourself."
• There’s also the panel interview where a group of physicians and students ask you questions and judge you individually. I can’t say I’ve seen this or would know what to do in this situation. The idea is to remove biases between raters by having every rater judge you at once.
• There’s the MMI or Multiple Mini Interviews. Think speed dating except with medical professionals and the date always ends with a handshake. These types are supposed to be unexpected and hard to prepare for with topics ranging from ethical/moral dilemmas, problem solving, self-reflection/beating yourself up, acting, and team objectives. As with all interviews, be yourself and try to have a good time. In my MMI, I cracked a lot of jokes and I knew everyone else was being true to themselves because nobody laughed. Under any other circumstances, I would’ve thought this was fun.

Conclusion:

Applying to medical school can be stressful and the waiting can be unbearable, but I’m hoping my tips and perspective put you a little more at ease. You may not get in your first application. That’s becoming very common. Take your time and have fun along the way.

GUEST BLOGGER: How to Study for the MCAT Without Tearing Out a Tree Stump by My Brother Dan

Happy Sunday morning! So happy to have my brother, Dan, write a little piece on how he studied for the MCAT. I hate to admit this as an older sister but my brother has always been an inspiration to me. No matter how much advice I'd given him for applying to medical school, he always reassured me that he would do it his way and would succeed- and he was right. Despite not having been accepted the first round of applications, he took the opportunity to beef up his resume, get married to the love of his life, and enjoy the perks of a gap year.

I have to admit, when I was reading this last night (before the inevitable daylight savings clock change), I was laughing by butt off by how humorous and real this was. My brother plans on writing another blog on how he applied to medical school. Hope you guys enjoy a little humor on this Sunday morning!

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My favorite photo I've ever taken of my brother

Studying for the MCAT is not unlike studying for other tests. There’s tons of material to know, multiple choice questions to comb through, and Netflix when you inevitably give up on working on the first two. My goal was to try to gather the cheapest and most effective group of study materials I could find. If you asked Past-Dan why he couldn’t afford more expensive study materials, he might say something about how college is so expensive, but Present-Dan will admit that the new Pokemon game just came out and that was obviously the better purchase. I’ve probably sunk more time into that game than I spent studying, but I digress.

Background: I’ve studied and taken the MCAT twice during the lead-up to medical school, which I will begin this fall. The first time was the old format in spring of 2014 and the new format in spring of 2016. I scored a 29 on the old test (roughly the 78%) and a 512 on the new (roughly the 88%).

That MCAT grind during college

What is the MCAT and why is it so important?

• The MCAT is the entrance exam for medical school, similar to how the ACT/SAT get you into undergrad. It’s roughly 7.5 hours or 1.40 seasons of Sherlock.
• The old format was out of 45 with a median of 25 and a good score in the 28-32 range. A standard deviation is about 6 points. The test was based on biological science, physical science, and verbal reasoning.
• The new format is out of 528 with a median of 500 and a good score in the 504-512 range. A standard deviation is about 10 points. The test was based on the three sections above with the addition of psychology/sociology and a greater emphasis on biochemistry, anatomy, and ethics.
• Factored in with the GPA, these numbers allow medical schools to screen for applicants quantitatively.

How I studied: Round One

I originally began my studies about 4 months before my 2014 exam while in the spring semester of my junior year of college. Some may think that’s too short of a time period while others may say that’s too long. I thought it was just enough time for me to put on a blond wig and crawl into bed with some bears. I studied mostly out of a hand-me-down Examkrackers books given to me by my sister, but supplemented the holes in my understanding with class notes from the semester prior. The majority of the studying was done in the evenings and weekends between classwork and crying. I spent my time reading from the books and materials and paraphrasing the info into another notebook. I skipped practice exams until about a month and a half before the exam to avoid psyching myself out.

How I studied: Round Two

With the format change occurring after I took the first exam, I took my sweet ol’ time with prepping for Round Two. The new exam involved significantly more material, so I was going to take significantly more time to study for it. I actually liked the idea that there was more material to know if only because that indicated there was less of an emphasis on the nitty-gritty details of acid-base redox. I was carrying a full-time job and a part-time job, so I decided 8 months was the Goldilocks time. Was all that time necessary? No. Did my Bulbasaur need EV training? Yes. My primary resource was Khan Academy.  I was fortunate enough to have two jobs that allowed me to watch videos in the background. I would then try to repeat the information in my head until I had a chance to mentally regurgitate a childish interpretation of the material into my notebook. I took a practice exam 3 weeks before and 2 weeks before. The main thing I changed between my first and second exams was the emphasis I put on practicing passages. Even though I felt I knew the material, the challenge was in integrating my knowledge with what the exam was asking of me.

Main Resources:

• Examkrackers book set: individual books for each section of the test and a few practice tests.
• Khan Academy: hundreds of videos and practice sections on all of the topics. This resource at the time was the only one officially supported by the AAMC. (and was also free online. Thank you, Sal Khan. If you’re ever in town, let me buy you a sandwich.)
•  Social support: Don’t underestimate how valuable talking to someone is. I’m talking about anyone and not just other people studying for the test. I spent a lot of time talking to my wife about the material and she doesn’t study the sciences. It was just nice having someone there to give me cookies.
• Pull-up bar: I got really distracted and I thought it would be a good idea to get ripped while studying. I couldn’t do many pull-ups, so I strategically spent less time being distracted.
• Study Tip: Don’t listen to advice on the internet. Aside from consulting a school’s website for a general score range, don’t put too much focus on other people’s experiences with the test and admissions. How can I say to not listen to advice on the internet and proceed to give you advice over the internet? I’ll tell you right now that listening to me might not do you any good. That’s ok. Relax and you’ll do fine. Or not. What do I know?

Using Khan Academy

Many students studying for the MCAT struggle with where to begin and how to keep momentum moving. For that reason, online Kaplan courses have been popular for having students adhere to a schedule and giving structured guidance to the process. Khan Academy offers you a similar structure in studying, but for free. I set loose deadlines for when I wanted to complete each segment of videos and took the corresponding sections of practice passages whenever I felt my confidence level was too high and I needed to be knocked down a peg. There were plenty of practice passages, and more than enough material to drown me in science. I placed my focus on understanding the passage rather than focusing completing passages within the recommended time range. While Khan Academy lacked full-length exams, both Kaplan and AAMC offered truncated practice exams for free that I found more stressful than the actual exam. If for whatever reason you felt there wasn’t enough material on Khan Academy, the AAMC also offers practice passages for a small fee.

Test time advice

• Plan your study schedule to finish early. I finished studying the material two months before my exam and spent the remaining time practicing passages. I avoided studying the day before the exam and spent my day disc golfing.
• Get a full night’s sleep. I went to bed a full 9 hours before I needed to get up. Unfortunately I let my nerves get the best of me and only had two quality hours of sleep during that time. Don’t do that. I must’ve slept for 4 hours after that test, though.
• Test morning should involve no surprises. I woke up, had some eggs and tea for breakfast, and packed a ham sandwich for the exam. Easy. The exam building was down the street from my house and I visited the place the day before. The most surprising part of my morning was listening to The Martian on audiobook and finding out Mark Watney killed Dumbledore.
• Take your time. You may finish some sections early. You may not use your full break time. You may decide you peed your pants already and don’t need to take that bathroom break as planned. I would recommend working up until the last minute with everything and relaxing if there’s a spare moment. I ended up meditating before going into my final two sections after lunch. I walked back into the test room feeling rested and confidant and knocked the last sections out of the park.
• Pretend someone who doesn’t think you know what you’re talking about is reading the critical reading section to you. Try it. As soon as you imagine someone doubts your ability to get the right answer, you’ll feel the need to prove him/her wrong. It works best with someone you’re trying to impress. For me, that was my wife. She’s so smart.

 

Conclusions

Preparation for this test may be the most challenging thing you’ve ever done. If that’s the case, then you might need more challenging experiences to dilute the pool. While this test was made to be a tape measure for your qualifications as a medical professional, it should become increasingly apparent that it is more a measure of your ability to manage stress and make progress. Yes, the test is difficult, but to believe you are anything less than capable only hinders your growth as a scholar. Smile and relish the challenge because there’s nothing unusual about yelling at your computer.

GUEST BLOGGER: TEAWITHMD AND FINDING YOUR FUTURE CAREER

Finding Your Future Career

First off, huge thanks to Amanda for letting me share my thoughts with you guys on this lovely blog! My name is Joyce and I'm a dermatology resident in New York City. I run a skincare and beauty blog at teawithMD.com where I mostly write about skin and medicine (with occasional travel and fashion thrown in!), but I also have a Path to MD series dedicated to premeds navigating the long journey of becoming a physician. I remember being in those shoes not long ago and I felt so lost ... so often. I hope that some of you may find reading about my experiences and advice useful!

This post is going to center around how to choose your future specialty, a topic near and dear to my heart because it defined my fourth year of medical school. In fact, the very first post of my revamped Tea with MD blog was written about this subject. It was March 18, 2013, and I had just attended Stanford's Match Day ceremony. I felt so nervous and lost about what field I was going to apply in the next year, so I talked it out in a blogpost. Little did I know at that time that I was going to do a complete 180, just a few months later, switching into dermatology, and having the most stressful year of my life applying. If you're curious about that story, you can read more here. Now that it is all behind me and I'm more than halfway done with dermatology residency, here are some of the things that I personally think will help you out when making the huge decision of what you want to do with your life.

Link to this funny cartoon of 12 medical specialty stereotypes: http://theunderweardrawer.blogspot.com/2011/03/12-medical-specialty-stereotypes-2011.html

1. Personal interest. This goes without saying but sometimes when you're a type A medical student who is used to always striving for the best, you get blinders on and you don't take a step back to see whether or not you actually ENJOY what you're doing. Do you like the day to day tasks that come with a certain specialty? Do you feel intellectually stimulated by the research done in this field? Do you enjoy studying the topics of your field? (Because trust me you will be studying A LOT for the rest of your life...:P) I find myself actually being excited to go to lecture and grand rounds to learn more about the skin. I even sign up for voluntary conferences and workshops on the weekends because I want to learn more and do more in dermatology and I genuinely enjoy the subject matter. I surprise myself sometimes! Don't trick yourself into doing a field for prestige or money because you will be the one suffering and questioning your choice years down the line.

2. Mentorship. One thing I've stressed over and over again is how important it is to have a good mentor in medical school. Find someone who is living the life you want to live when you are his or her age, and see if you can imagine yourself in that medical field. A mentor can help you explore a field through shadowing, doing research, helping you write letters of recommendation, or even making phone calls or writing emails on your behalf. If you find someone you really click with, explore that field and see if you like it for yourself.

3. Relationship with Patients. In medical school do you prefer short interactions with patients like in the emergency room or do you prefer following patients long term in outpatient clinic? Different fields have very different relationships with patients, whether it's seeing them everyday for a month as an internist in the hospital or following a patient's psoriasis for years in the clinic setting. Do you like seeing adults or kids? Also, what type of patients do you want to see? Do you want to treat sick patients (hematology/oncology, radiation oncology, etc.) or relatively healthy ones (ob/gyn, general pediatrics, dermatology)? One is not better than the other - it's a matter of personal preference. In medical school I felt drawn to the relationship pediatric oncologists have with their patients and patients' families, but at the end of the day after doing rotations, I realized that I have a hard time separating work and personal life. The sad cases I saw in the hospital really affected me and I couldn't turn it off after I went home at the end of the day. So that wasn't a good fit for me personally. Explore what relationship you enjoy with your patients during rotations, and go from there.

4. Lifestyle. For some reason "lifestyle" seems to be the dirty word you're not supposed to mention when deciding on career path, but I think it SHOULD be one of the factors that you think about. Wanting to have good work-life balance is not a shameful thing. If having a family and kids is your top priority, think about whether you can balance that with a field that requires you to be in the hospital 11 hours a day. The other thing I tell medical students is imagine what lifestyle you want when you're in your 30's, 40's, 50's, and beyond. It may be exhilarating to stay up several nights in a row in the OR in your 20's, but think about whether you can sustain that and stay happy in your later years too. If you can, then go for it! I have so much respect for people who feel passionate about their fields. Sometimes it's hard to imagine what you want in life decades later, so that goes back to point #2 about mentorship. Find someone you identify with and see what his or her life looks decades later. Is that something you want for yourself? 

5. Hands on experience. The initial branching point for many is procedural vs. not. Do you like working with your hands and doing procedures? Do you enjoy being in the operating room? If you enjoy doing surgery, aside from going into a surgical field, you can also consider subspecialties within more medical fields such as interventional cardiology, GI, interventional radiology, or even Mohs surgery within dermatology. Shadow different physicians and get a sense of what their day to day responsibilities are.

This is in no ways a complete list of everything you should consider, but it's a good place to start. For me personally, going through rotations was the best way to find out what I loved and didn't love. I didn't love my surgery rotation or being in the OR, and I knew I wanted to take care of people who were not chronically very ill. Some of my favorite rotations were in internal medicine, ophthalmology, dermatology, and reproductive endocrinology and infertility. I enjoyed the ob part of my ob/gyn rotation but didn't love the gyn or the gyn surgery parts, so that took out reproductive endocrinology & infertility as an option. I enjoyed internal medicine because I was the sub-I and I had a chance to make my own plans; however I was not a fan of spending more time with a computer than my patients. I loved ophtho and was almost going to apply in it but I realized when I finally shadowed in the OR that I was not a huge fan of microsurgery and the microscope gave me a headache. I fell in love with dermatology when I did the rotation during the end of my third year; it combined medicine with office procedures and I found the science very interesting (more on why I chose derm here). Now that I'm halfway through derm residency I find myself liking the field more every single day and feeling thankful that I had made this decision even though it was a hard one to make.

So good luck to you, wherever you are in your stage of training. We are really lucky to be able to be doctors, even with all the tough days. I hope this was helpful and don't forget to check out some of my other posts on getting into residency and choosing a residency program!

For more information: You can find me blogging at www.teawithMD.com, or on Instagram, Facebook, Twitter, or YouTube!

GUEST BLOGGER: BECOMING A PHYSICIAN ASSISTANT BY @CHASINGAMYBLOG

My name is Amy and I am a board-certified Critical Care and Pulmonology Physician Assistant practicing in Miami, Florida.

The first time I met a PA, or Physician Assistant, I was 19 and a sophomore in college. I had been pre-law for my first two years and I was at a bit of an impasse. I had come to the realization that I did not want to be a lawyer, but I felt stuck. By this point, I knew that I wanted to go into medicine, but was afraid I was too late to the party. Then, I met the aforementioned PA. She was intelligent, competent, driven, and worked her dream job. She was a Physician Assistant in orthopedic surgery, and she was living out her passion every single day! While I knew immediately that orthopedics was not for me (ortho surgery is hard labor, ya’ll), I was instantly sold on the PA profession.

If you’re like I was, unsure of exactly where you might fit into this thing called medicine… let me tell you a little about my exciting profession!

Physician Assistants are nationally certified, state-licensed medical providers. We prescribe medication, treat medical conditions, perform procedures, and first assist in surgery. And the best part… drum roll please… We get to change specialties anytime we want! Since we are board-certified as generalists, we can work in any specialty at any time. I have friends who work both in the ER and also cosmetic dermatology simultaneously! The possibilities are truly endless!

PA school is generally a Master’s degree, although there are some PhD programs. When applying to PA school, you must have a bachelor’s degree, certain pre-requisite coursework, a strong GPA, extracurricular activities, and hands-on patient care experience. My greatest advice to anyone pursuing a PA career would be to get a job working with patients as early as possible! Some of my classmates were accepted with relatively average GPAs because they had such extensive, impressive patient care experience. If you don’t believe you will have a stellar GPA upon graduation, this is one way you can help yourself tremendously.

PA school is between 24 and 36 months, depending on the program. The first 12-15 months is didactic (like the first two years of med school) and the second year is clinical (like the last two of med school). Each program requires the completion of 7 core rotations including emergency med, internal med, family med, pediatrics, psychiatry, OBGYN and general surgery. Most programs also offer a few elective rotations. I chose Dermatology and cardiothoracic surgery for mine.

PA school is a whirlwind experience with very little time off! But, it is SO worth it! In just two short years I was able to hold a heart in the palm of my hand, save a life, deliver a baby, and comfort families in their worst hour. It is so incredibly rewarding. With the demands that the industry places on providers these days, often times there is very little time slotted for each patient. But, as a PA working with a physician, we are an extension of their healing hands. We are able to take a little more time with each patient to make sure they are t

reated, comforted, and happy with their care. After all, isn’t that why we chose medicine in the first place? To make a difference, no matter large or small. 

You can follow my journey @chasingamy24, and feel free to DM me any questions you have about anything PA!

MINT OREO CHOCOLATE CHIP COOKIES (AKA THE WAY TO WIN OVER ANY PERSON)

So I once had an unusually weird internal med rotation where I felt like I couldn't connect with any of the residents or attendings so I decided to use my ultimate weapon to impress- these cookies. They may not know my name when they pass me in the hospital but they all remember me as the girl who brought in "those cookies." I SWEAR by these cookies.

They may look weird but if you seriously want to impress, make these cookies for your preceptor, residents, nurses, or that cutie you've been eyeing (LOL).

I modified this recipe from Lovintheoven.com. So here we go:


Mint Oreo Chocolate Chip Cookies

Makes: A LOT OF COOKIES. Probably around 30ish.

Parchment paper
2 sticks of softened butter

3/4 cup sugar
3/4 cup brown sugar
2 eggs
2 teaspoon vanilla
2 1/2 cup all-purpose flour
1 teaspoon baking soda
1 teaspoon salt
18 frozen sliced pieces of Mint Oreo Cookies
1.5-2 cups chocolate chips (preferably dark or semi-sweet) depending on your taste

Preparation:

1. Let the butter come to room temperature. I'd suggest taking the butter out of the fridge about an hour before baking. 

2. Put the Oreo cookies in the freezer at least half an hour before baking.

Instructions:
1. Preheat oven to 325 degrees F. Take the oreos out of the freezer, and slice them (gently) into sixths. Discard any small crumbs (nom nom!) because crumbs will make your cookie a grayish tint.

2. Cream butter and sugars until well combined in a large bowl. Do not over-beat if using a hand mixer. Add eggs and vanilla until well mixed.

3. Place flour, baking soda and salt into a bowl and stir (preferably with a whisk) to combine. Slowly add dry ingredients to wet ingredients (in thirds) and stir in oreos and chocolate chips until just combined careful enough not to break the oreos. 

4. Scoop about half a golfball-size piece of dough onto a baking sheet lined with parchment paper. Place dough in freezer for 3-4 minutes. Bake for 9-10 minutes until slightly golden brown on the sides. *The cookies should look and feel like they're underbaked. Let cool on baking sheet for 5 minutes before transferring to cooling rack (if you can resist it!).

And that's it! Hope you guys win over some hearts :)

Amanda

MY STEP 1 STUDY PLAN

I have to admit, I have been putting off this particular blog for awhile for more reasons than I can name but mostly because I wasn't sure if I wanted to influence what people did for one of the most important tests you could ever take. I have decided to detail what I did for my boards and hope that you guys take everything with a grain of salt and develop a plan that suits your learning style.

Background: I did fairly decent on class exams but I am not naturally a good test taker (I.e. I have to work quite a bit to maintain my grades). Knowing that this would be a struggle, I gathered the resources I found the most helpful during classes and utilized them during boards.

An Overview of Medical School Boards:

• MD's take the USMLE. DO's have to take COMLEX but can also take USMLE. 
• These exams take place following the 2nd year of medical school
• Both exams are roughly 8 hours long and arguably the most important exam in determining which specialties you can/cannot do
• If you pass, you cannot retake the exam for a higher score. If you fail, you may retake it depending on your school's policies

Studying during class/months before boards
I did minor studying the months before board exam time because I wanted to really focus on class material. I still believe that learning class material is going to benefit you more than sitting and doing 100s of questions 6 months out from the exam. I do suggest doing some questions daily but on the subjects you are currently studying in class.

Definitely utilize Pathoma and Sketchy throughout your classwork so you can familiarize yourself with the resources come board time.

****** BUT FIRST. Download my Sketchy Medical and Pathoma checklists!

Resources I used:

• Doctors in Training (DIT): 240+ videos that walk you through First Aid for USMLE
• Sketchy Medical (Pharm and Micro): AMAZING and helped me score in the 90+ percentile in pharm and micro
• Pathoma: absolutely a must and I can guarantee you this is all you need for pathology
• First Aid for USMLE 2016: the bible for Step 1
• Question banks: UWorld and COMBANK

Alotted time for studying: approximately 60 days (beginning of April to June 10th). My USMLE test date was June 4th and my COMLEX was June 10th

Daily schedule (subjected to change depending on my feels that day)

• 8am: wake up, eat breakfast, pack lunch and dinner
• 8:30am-10am: take a 50 question exam on either UWorld or COMBANK
• Break
• 10:30a-1pm: go over questions and summaries
• Lunch
• 2pm-7pm: watch 7-8 DIT videos and any correlated Pathoma or Sketchy videos 
• Workout
• Dinner
• 8pm-10:30pm: review material from the day

There were a total of 240 DIT videos and I finished them 2.5-3 weeks out from my test dates. After I finished them, I upped my questions to 75-125 a day. See below for specifics.

Utilizing Doctors in Training
I don't believe you need this to succeed on the exam. I used it as a tool to walk me through First Aid for USMLE because it explains it page by page using mnemonics and visual aids. I realized early that I can't memorize by reading so watching these videos helped me a lot with getting concepts down.

Tip: when it comes to the pathology, micro, or pharm videos, I ended up opting to watch Pathoma, Sketchy Micro, and Sketchy Pharm in place of these because I knew I would learn better through these resources. I would then watch the DIT videos on these subjects on 2x speed to make sure I didn't miss out on any cool mnemonics.

Daily Practice Questions and Review
At the beginning, I did 50 random, timed questions in the morning (alternating between UWorld and COMBANK) and spent 2-3 hours reviewing them with First Aid. I upped these to 75-125 questions a day. Initially, I used an Excel sheet to type up my questions but this took entirely way too long. I ended up solely taking notes in my First Aid and Sketchy Micro/Pharm book. Ideally you don't want to spend too much time on reviewing questions and this is something I wish I could've realized earlier. But do make sure you are reviewing them adequately!

I did half of UWorld and completed all of COMBANK (a total of 3000+ question)

Full Length Practice Exams
Our school requires you to pass a practice COMSAE (a practice COMLEX) in order to sit for the real boards. We took this one month out from my real exam. These practice exams are only half the questions of a real test (i.e. 200 questions). Timeline for when I took practice exams

• 5.5 weeks prior to COMLEX
• 4 weeks prior to COMLEX
• 2 weeks prior to COMLEX

I took two practice USMLE's at some point but I don't recall when.

Why I didn't end up taking the USMLE
I studied for the USMLE up until two weeks from my exam. Although I was passing, I was not happy with my practice scores and really weighed my options at that point. I consulted several third year students on what to do and the majority suggested I try doing really well on one exam instead of doing mediocre on two. I also had the misfortune of dealing with a breakup during this time so ultimately I decided to devote the rest of my time to COMLEX. I have no regrets at all about this decision.

USMLE vs. COMLEX
See my friend's blog post about this here because he does a heck of a job better than me! I believe that if you get down micro, pharm, physiology, and pathology, you will do well on both of these exams.

The day before the exam
I had to travel a bit to my testing site but I laid in my hotel bed with ice cream, Nerds rope, nail polish, and Netflix the day before my exam and I don't think I could've been more relaxed! I ended up sleeping 9+ hours the night before and was well-rested. The only things I looked at the day before was my Sketchy book and OMT viscerosomatic levels and Chapman points.

Test Day

• If you have to travel to your test site and staying at a hotel the night before, check out your test site location the night prior so you know where it is
• Arrive early, you will have to go through security and identification measures. Sometimes they will allow you to start early
• Wear comfortable clothes. I wore leggings and a zip up sweater with my hair tied up so it wouldn't get in the way
• Bring snacks and a lunch that won't spoil if it sits around (although many people lose their appetite!)
• Bring water, Advil, and a caffeinated beverage if you need it! Also if you're like me, take your allergy medications
• Make sure you are looking at the clock often to keep pace 
• Take your mandatory lunch break to cool down and refuel
• Treat yoself after the exam (for me a nice alcoholic beverage ;)

So how did I do?
Initially I was surprised and then sad and then happy about my score. I fell a little short of my goal and although I won't say my exact score, I am still competitive in the specialties I want (emergency medicine and general surgery).

My opinion on the COMLEX
I honestly felt that the exam did not do a very good job of testing what I knew. I walked out of the exam feeling like I could have taken it 3 weeks prior and gotten the same score. I believe that learning how to take the exam was more beneficial than actually studying material for the exam. So if I could provide one huge advice: practice questions practice questions practice questions!

The topics I found easiest to answer were pharm and micro because simply, there are only so many ways you can ask questions about these. The dean at our school gave us a chart in the beginning that showed a higher correlation between a good score and pharm, micro, and physiology. I think this is very true for COMLEX.

Some tricks, tips, and myths

• Board studying is truly a marathon and you will find yourself getting frustrated but it is better to take the day off to cool down and go 100% the next day. There were many days I would spend 12+ hours in one seat and forced myself to get up and exercise because I knew I was hitting a wall.
• Exercise as much as you can
• Not only will it allow you to take a break, it will also boost your energy and clear your mind. I watched a lot of Pathoma and Sketchy while walking on the treadmill.
• Always get adequate sleep
• It is not worth getting 5 hours a night if you can't concentrate the next day. I consistently slept 7 hours a night during board studying.
• "My friend scored in the 99th percentile and said they did _____"
• You are going to hear so many tips from people once boards rolls around but ideally you want to get advice from someone who tests similarly to you. Ask how they did in class because it might not be ideal to take advice from someone who has a photographic memory or tests differently. 
• How many resources should I use? 
• The less the better, typically. Do what you feel is comfortable because it can be overwhelming how many resources there are
• Give yourself a half day to a day of "catch up" time a week
• Just in case you fall behind on studying or to do weekly chores
• Crockpot meals are your best friend during boards haha
• Take plenty of timed tests
• The COMLEX in particular has a weird timing system where you take the first 200 questions within a 4 hour time slot and you have to pace yourself the entire time. I would recommend finishing the first block of 50 questions in 50 minutes and giving yourself the last 10 minutes to review your marked questions
• Take the day off the day before your exam and give yourself some "me" time! 

Woof, that was quite the blog post! Let me know below if you have any other questions!

Amanda