Half of First Year is Gone

I blinked and the first half of my first year has flown by.  I intended to write more frequently, but I have been so busy it just didn't happen.  What are my impressions so far?

1. It isn't that bad!  Before I started, I was warned over and over just how completely impossible and daunting medical school is.  I was extremely nervous about this, because everyone worries about doing well.  After half a year I can tell you that it just isn't that bad.  Don't get me wrong, it is difficult, but not in the way I was expecting.  The concepts that we are learning aren't very difficult to comprehend, however the difficulty lies in the amount of information you have to learn and the extreme level of detail that you need to achieve.
2. Be prepared for long hours.  The first six months is like a boot camp.  Some people figure out things pretty quickly and are able to eventually spend less time than at the beginning.  For me, I am still working on finding the best approach to maximizing my grades.  I have tried many different approaches and each time I have spent a ton of hours.  I still haven't reached my goals yet, but I have seen a constant improvement which means I am moving in the right direction.  The hard part of medical school is learning how to learn.  The most important thing is not to quit trying and changing things when you don't get the result you are expecting.  You have to be humble and willing to admit that your approach may not be the best.
3. Pick only one student group to participate with.  There are so many student groups that want your participation that you could easily become overwhelmed doing extracurricular functions.  This is a huge trap and it robs you of valuable study time.  I think people should be involved in at least one group though.  It is a nice social outlet, especially if you spend all your time studying.
4. Find an organization system.  Whether it be a calendar, a to-do list.  There are so many assignments, labs, activities, and other items that happen within a week that it impossible to keep track of it unless you have it organized.  What works for me is a sequential list ordered by when it is due (date + time).  Every day I look at that list and make sure I have completed the top items before moving on.  I didn't start doing this until I missed the deadline for a paper I was supposed to write.  I knew about the paper, but thought the due date was later.   That really hurt my grade and was the wrong way to learn my lesson.  Learn from me and just start out doing that.  You will thank me.
5. Anatomy sucks the first few times.  After that you just stop thinking about it.   I joined the cadaver team so that I could do all the dissections.  I wanted to do this, because I learn better by doing and seeing than by memorizing a picture.  The first time I was nervous about how I would react to a cadaver.  Once we started the first dissection the nervousness went away pretty quickly.  After that I would only get a headache after about 2 hours of constantly smelling the formalehyde.  Take some Ibuprofin just in case.
6. Formaldehyde - It stinks.  Don't make the mistake of wearing your street clothes to a dissection.  They let you wear a lab coat over your clothes, or you can wear scrubs.  Take the scrubs option.  Get a pair of scrubs that you will burn later and use only those.  The worst thing in the world is to be studying later at the library and to keep getting whiffs of formaldehyde from when it seeped into your clothes.
7. Avoid the temptation to complain.  It is almost a past-time for undergraduate students to complain about their class.  "Why are we doing calculus?  I will never use this in the REAL world..."   So far I haven't seen anything that I won't ever use in the "real" world.  Yes there are probably a few things I will use rarely, but it is all applicable and important.  Try to enjoy all of the material.  It will make it that much easier to remember when you have to study it again for the Steps.

Those are the impressions that immediately come to mind.  I have immensely enjoyed my experience so far.  I am always up for answering questions, and can't write about something else if someone is interested.  If you are still trying to get in, don't get in.  It is worth it!

Over Joy

As I sat in the Library reviewing my Physics notes, I heard that distinctive note from my phone informing me that a new email had arrived to my inbox.  I quickly flipped over to take a look and felt my blood run cold when I saw who it was from.

MedAdmissions

The dreaded moment had finally arrived.  I was about to find out if my dream would finally come true, or if I would be forced to spend yet another year of my life trying to prove that I am worthy of the medical vocation.

I called my wife over to share the moment with me.  Initially she looked at me with a confused look.  Why was I interrupting her study?  Finally she acceded to my wishes and walked over.  I pointed to the screen, and then clicked to open the email.

On behalf of the Executive Dean, I am very pleased to offer you an acceptance...

I literally felt my body start to shake.  I was in disbelief, so I started to read the email again to make sure.

On behalf of the Executive Dean, I am very pleased to offer you an acceptance...

The words had not changed, yet my mind still could not comprehend.  My body continued to shake uncontrollably, and my wife embraced me from behind.  She was already crying, which caused me to cry too.  These were tears of joy, tears of disbelief, tears of pent up emotion that craved release!  I can't imagine what the other people, who beheld such an odd spectacle, were thinking at that moment.

My wife rushed off to call everyone and relate the good news.  I sat there in a daze, still trembling as emotion and adrenaline coursed through my body.  I realized at that moment that over the past seven years I had convinced myself that it would probably never happen, yet I was stubborn enough to keep trying in the face of the impossible.  Now I was confronted with reality, that it was possible, and the door to my dream had finally opened.

In retrospect, as I think about this now, I have never been so excited, happy, and relieved to have been given permission to start something.  Something that will take more effort, time, and dedication than anything I have ever tried in my life.  It is ironic, because many people would think it is over, but no...that was just the beginning, the first step on a road of training that will last at least 8 years.

This moment will forever be engraved in my mind.  I payed a high price to reach this starting point, but looking back on my credentials they are only average at best.  I can't help but believe that a miracle was enacted on my behalf.  I would love to take credit for this, but the truth is I must defer to the athlete who has just scored a touchdown and raises his hands to point heavenward.  I personally know several applicants with way better stats than me that were rejected.  Somehow God saw fit to turn the hearts of the Admissions Committee in my favor.  In turn I would also like to raise my hands heavenward and point to Him, because I can really see no reason why I am better than anyone else.

The blessing of God, have given me reason to be overjoyed and grateful at the same time.  At least once a day a surreal moment overwhelms me, sending me back to that email once again just to make sure;

On behalf of the Executive Dean, I am very pleased to offer you an acceptance...

The Vagaries of Change

A Beatiful Sign Close to My New Home

Things have changed since I last posted.  I quit my job and moved 850 miles away from my home.  The day I took the MCAT my wife shared a surprise with me when I got home.  She told me that she had been accepted into a Graduate program at Tulane University.  I was absolutely shocked by this, because it was something I never expected.  Somehow, in less than two months I was able to find a new place to live, a new job, and relocate to an entirely new city.

I am now settled in and we have established our new rythm of life, however things are different.  For one, living arrangements are vastly different from before.  I went from a three bedroom house with a nice yard, to a tiny 1 bedroom apartment.  When my neighbors have friends over, I can hear it.  They often wake me up in the middle of the night, which is something that never used to happen before.  The hallway often carries suspicious odors that whisper to me their nighttime activities.  I never realized that living in an apartment would mean being more intimate with your neighbors...you literally share everything with them, whether  you want to or not.

The smallness of our apartment and the need to walk everywhere has also drawn my wife and I closer together as well.  We have been spending much more time together, and I am now thinking that bigger is not necessarily better.  Most people dream of having a big house, but I am not so sure I want one now.  I don't like that family members can hide from each other by going to other rooms in the house.  I especially don't like the maintenance duties of a large house.  Cleaning, upkeep, and yardwork take up so much time.  Now these are things I don't have to worry about, and I love it!

A View From my Morning Commute

My work routine has changed as well.  After moving here, I decided that I would bike to work everyday instead of driving the car.  Many things contributed to making this decision, such as traffic, expensive parking rates, and my lack of knowledge of the city, however, the main reason is because I was really craving a way to lose weight.  As an aspiring Physician I think that it would be hypocritical to meet patients as an overweight person.  If I am going to preach the high principles of healthy living, then I must also follow those principles as well.  My problem is that I hate going to the gym, especially when I have to do it by myself.  Forcing myself to bike to work accomplishes several things at once.  It allows me to learn the city, it provides me with a means of transportation, and it ensures that I get a healthy dose of exercise every single day.  With a 22 mile round trip I have already managed to lose 10 pounds in two weeks.

All of this upheaval has been difficult, yet instructive as well.  I have learned that sometimes we need a drastic change that will take us out of our comfort zone.  In the short month I have been here I have totally revolutionized my lifestyle.  I look back on who I was before and I am amazed at the change that has happened in only one month.  Most people battle to keep things from changing, because that way they never have to face a scary or uncertain situation.  It is those situations, that makes us grow the most.  The more of them I experience, the more I look forward to it.

All of this has caused me to evaluate my personal goals as well.  Last year I was so sure I would get accepted into Medical School that I was rocked when the rejection came.  This year, I decided I have to prepare for it.  I must have a contingency plan in place so that I can smoothly transition into plan-B instead of being caught unprepared.  I was scared to quit my current profession before, because the stability that an Engineering income provides is very comforting, however I have realized I am reaching a point where I need to go the extra mile if I am really serious about Medicine.  If I am not accepted this cycle I will be going to Graduate school starting in January to study Neuroscience.  I have finished all the pre-med courses that I can take at a community college.  The only thing left ot me now is some GPA redemption by going through a Graduate program.  GPA redemption isn't my only goal, because I also want to study something that I find interesting while also continuing to prepare me for Medical School.

Change can be scary, but change is necessary.  The saddest thing to me is to see someone who has done the same thing, in the same place, for thirty years or more.  I know there are probably many reasons for this, but to me it looks like they were scared to go further, so they decided that where they were at was "good enough".  The possible risk to go further was too much for them so they settled.  I hope that I never settle in my life.  I hope that when I reach my goal of becoming a Physician that I will go even further from there.  I never want to be satisfied with where I am at, because the alternative is scarier than any nightmare I could ever dream up.

Being Successful

Sort of cliche, but sports are an appropriate metaphor for success

I often think about success, and say to myself "Wouldn't it be great?"  I don't think I have the traditional definition of success where the end result is tons of money, a hot car, trophy wife, and a white picket fence with a two story house.  No I am always impressed by true success.  Success that people reach where they look back after a long journey and say to themselves "I made it!"

One thing I have noticed about success is that I hear other people speak of those who have achieved it in hushed tones of envy.  "Oh if I was only as LUCKY as them."  or "I could never do that, he's a GENIUS." or "It's just not FAIR" or "I just don't have the TALENT they have".  These people always look at a fully realized successful person and assume that they have always been that way.  They totally ignore the journey  that person had to take in order to become successful.  They completely ignore the hard work, the agonizing moments, the long tear-filled nights, the times of self-doubt, the times when they believed they couldn't go on...yet they did.

I find my favorite success stories by reading through blogs.  I love reading about the journeys people take to become better athletes, to learn a new hobby, or to reclaim their lives from obesity.  Every day "average" people decide that they are going to do something great.  They are going to go from a sedentary life to running the Ironman in Hawaii.  Maybe it is someone who is going to get on a bike and ride from Alaska all the way down to the tip of Argentina.  How about a person who decides that their life has been ruined by complacency and that they are going to lose a tremendous amount of weight one day at a time?

For me, I always have to start at the first post when I read those blogs.  I want to know about the days when it was impossible.  I want to read about the times when they felt weak, unable, and inadequate.  It is because I feel like this all too often, and I hope that one day someone is going to read my blog and realize that they can do it too.  I want to say now, that I FEEL like I will never become a doctor.  The cards are stacked against me.  I have an average MCAT, and substandard GPA, and I have been out of college for more than 8 years.

It is impossible for me, but I have something that all the lazy apathetic people don't have.  I just can't find it within myself to give up.  For some reason, after I was laid out flat by rejection after five years of preparation I got back up and said, "Lets try again."  Even after everyone online said, "No, it is impossible for you, you just don't have the right stats."  I closed my ears and decided to keep going.

When I start my residency, I want to look back at this post and remember what it was like when it was impossible.  Because I know what will happen when I get into medical school.  People will start saying those things about me.  "Oh it is because he is so SMART." or "I wish I was as LUCKY as him."  But it isn't true.

None of them who say that noticed the tears streaming down my face.  None of them were with me when I was defeated.  None of them sat with me during the long study sessions I had to do AFTER I had already worked a full day at the office.  None of them were there when I had to turn my wife down for date night so that I could do well on a test.  None of them used their vacation time to study those final two weeks for the MCAT instead of going to Peru for some fun.  The only thing they see is the end result, the fruits of my labor, what happens AFTER all the sacrifices.  So they simply dismiss it with a casual statement, because it makes them feel better for giving up on their own dreams.  That is the real truth, and that is why when I am successful I want to look back and remember how high the price was.

I also hope I can inspire someone, somehow.  I want them to read about my journey and realize that Doctors, Lawyers, Engineers, Businessmen, or whatever you choose to be has no bearing on your intellect.  It has to do with how much time you spend practicing, improving, sacrificing and moving towards your goal.  An elite athlete practices for years so that one day he can stand on the big stage and compete in front of thousands.  It is no different for the highest levels of success in any arena.

I did not improve on my MCAT score this year.  Conventional wisdom says, that after 2 tries you should quit.  That a 29 is "good enough".  You know what?  It isn't good enough for me.  After three tries, guess what?  I am going to start studying again.  Because it is all stuff I NEED to know.  Because I know I can do better, and because I want to do better....for me.

I think that the key component to success is the ability to maintain discipline.  By managing to put for a solid effort every single day over a long period of time someone inches ever closer to the success that they have in mind.  Writing a novel does not happen in a one week flurry if intense activity.  It consists of research, writing, revising, and often times throwing away large portions of script that have to be redone.  Losing weight does not happen in a week, even if commercials tell you it does.  It happens over a long period of time after someone has changed their lifestyle and committed themselves to a new discipline of diet and exercise.  My own success, hinges on daily efforts of reviewing material I have learned in the past, keeping up with current advances in medicine, and constantly striving to involve myself in the opportunities that exist to participate in volunteering or research.

Today my goals seem impossible, but I can see that every day I am inching ever closer to what I truly want.  Once I reach the starting line of Medical School I am looking forward to raising the bar even higher and making a new set of goals that will further define my new success story.

Shadowing a Surgeon - Part 1

This is almost an exact replica of the OR I shadowed In

NOTE: I am writing this to record my recollection of this event, so it will most likely be a long read.  I completely understand if you don't make it through.  I feel that it is necessary to write down this astounding experience before it begins to fade from my memory.

On Friday I showed up to the hospital bright and early to shadow a Neuro-Spinal specialist.  I honestly did not know what to expect, and I was a little bewildered by how relaxed they were.  When I arrived, I called the department office and they let me in.  A few seconds later I was standing there alone and unattended.  Knowing I only had about half an hour before I had to meet the doctor, I tracked down a nurse who got me set up with a locker for my belongings and some scrubs to change into.  Normally when I go into a new work place, I am used to being micromanaged, followed everywhere and lectured endlessly so as to ensure that if anything goes wrong, they can be assured that I can take the blame.  It was refreshing to be given an implicit level of professional trust from the outset.

Once I was all suited up I wandered around confused, but I found the OR the doctor was scheduled to work and decided I would wait for him there.  Fortunately there was a window for me to look in, and I took note of how everyone was dressed.  I am glad I did this, because it would have been embarrassing to immediately get kicked out of the OR upon walking in.  After looking around, I found a mask, rubber gloves, some shoe covers, and a cloth surgical cap that I promptly donned before walking into the room.

It didn't take them long to ask who I was and what I was doing there.  Of course I went through the litany, "I am a pre-med student, and I will be shadowing Dr. XXXX today."  Apparently that was good enough, and they quickly went back to their various tasks of prepping the OR for the upcoming surgery.  Soon the patient was wheeled in, a kindly looking elderly woman.

The nurses were very kind and attentive to her, letting her know exactly what was happening and instructing her as necessary.  For me it is always the small details that really stick out and make an impression.  I specifically remember one instance where, as the nurse was telling the patient to breath through the mask she set her hand on the patient's arm and lightly patted her in a comforting manner.  That told me that this nurse was someone who really cared about what she was doing, she was someone who wanted the best outcome for the patient, and she was still able to display compassion when it was necessary.  That is someone I could  work with every single day, if I could.  To me medicine represents a perfect outlet for my compassion, and to see someone else display this trait so openly made me realize that I am not wrong in making this drastic career change.  Maybe many people will think that this is too idealistic and naive of a viewpoint, but I will have to simply disagree.


After the patient was anesthetized the nurse proceeded to double up the patient's legs, which would immediately straighten out when she let go.  After a few attempts she quickly looked over at me and said, "Come over here and help me.  You hold her legs, while I put this Foley in."  Not knowing what a "Foley" was, I innocently walked over and held the patient's ankles, pushing her legs into a butterfly position.  The nurse quickly raised the patient's gown as I now realized what she was going to do.  I had a front row seat to see my first catheter insertion, which means I was spared nothing when it came to "presentation" of the patient's body.  My first instinct was to look away in embarrassment, but I quickly quenched this sentiment, because I wanted to know how it was done.  I calmly forced myself to look on, despite my discomfort, and saw the Nurse quickly and efficiently insert the Foley.  It was on the next step of this process, that I was in for a little surprise.  Grabbing a syringe filled with saline solution she inserted it into a side valve on the catheter and began to inject.  Unfortunately she did make the connection completely and I was greeted with a face full of spray.  I thought I would be horrified, but strangely I found the whole event amusing.  I have to admit I was extremely happy  I was wearing the mask.

With my participation complete, I resumed my vigil in the corner of the OR, trying to stay out of the way as much as possible.  The whole prep took about half an hour before the surgeon made his grand entrance (yes I deliberately made that sound overly dramatic).  He greeted his staff in a friendly manner and I was pleased to see that there was a playful banter that existed within the team.  I could see that they worked well with each other, and that they enjoyed working together as a team.

After working in corporations for the last 8 years, I am used to seeing discord, backbiting, false sincerity, and above all avoidance of any sort of responsibility.  Here I was confronted with a group of people who were about to take someone's life into their hands.  Each one had a very specific role to fulfill to ensure the success of today's surgery.  If anything went wrong, there would be no way to obfuscate the mistake with a self excusing email that would pass the blame to some other unsuspecting coworker.  They would have to face it, resolve it immediately, and deal with the consequences that would result from it.  It was heartening to realize that incompetence could not survive in this environment.

The surgeon soon greeted me and gave me an introduction to the procedure they would perform.  There was a 50 inch flat screen monitor on the wall with MRIs of the patient's spine.  He showed me where the vertebral foramen on the L3 and L4 vertebrae had closed in,  so it was compressing the spinal cord and causing loss of feeling in the lower extremities.  Since the spinal cord passes through the vertebral foramen, he was going to enlarge the foramen again, so that the spinal cord would not be constricted anymore. 

To my recollection, the surgery took about two to three hours total, not including the prep time.  Several things stand out vividly in my mind.  First, the technology that was put to use was incredible.  Within the room there were three hanging flat screen screens, that were on moveable arms so that they could be adjusted to give view to whoever needed to see.  These were in addition to the 50 inch wall screen I already mentioned.  There were two large OR lights, that were in the center of these screens that extended out on retractable looking arms.  Within those bright lights was a camera that would give a feed into those screens.  So by merely standing in the back, I was still given a front row view into exactly what the surgeon was doing.

As a preface to describing the actual procedure, I want to describe how I felt at this point.  I have never seen a surgery so I had no idea what to expect.  More importantly, I had no idea how I would react to this experience.  I have heard of people becoming nauseous, passing out, and all manner of other horrible reactions.  As the surgery began I have to admit I was extremely amped up on adrenaline.  It was all very unreasonable, because it was all self-induced based on my uncertainty about my own reaction.  It was like a self-induced recursive reaction (if that makes nay sense at all :P ).  To combat any possible adverse effects I made sure to bounce from leg to leg, and to keep my legs slightly bent.

The vast majority of the surgery seemed to be "digging" through the various tissues to actually reach the site that they wanted to fix.  The surgeon used a cauterization tool (a laser scalpel?) to burn through the layers of dermis, and underlying adipose and muscle tissue.  The smell of burnt flesh was initially uncomfortable until I forgot about it in my fascination with what was going on.

Diamond Coated Burr Bit

Once the bone of the spine had been reached a new phase of the surgery began.  The surgeon started using a diamond coated bur bit to drill start removing bone.  Up until this point my conception of surgery, was that it was very fine and meticulous, but the usage of this tool was savage and intrusive.  The rotation of drill, suction, drill, suction, became rhythmic for ten to fifteen minutes as he quickly worked his way through the lamina of the spine.  Once he approached the meninges, the membrane protecting the spinal cord, he switched tools from the mechanical device, to a manually operated tool that I am guessing was a Rongeur.  Basically it was a surgical wrench for grasping and tearing away bone.  He did this so that he would not drill through the membrane, which would have been a huge mistake, and quite the headache to fix.  Using this tool, he methodically pulled out bone, piece by piece and exposed more and more of the spinal meninges.  Once done with L3, he drilled over to L4 and repeated the process.

All of this I watched on the monitors, and he periodically spoke up to instruct me on what he was doing.  He pointed out specific parts of the anatomy, and thankfully indicated where the head and feet were.  It sounds obvious, but if he hadn't done that, I wouldn't have realized that the head and foot were interpolated on the screen (e.g. -- it was opposite on the viewing screen from how the patient was laying on the table.)  My only complaint about this procedure was that I was behind the surgery, and he had music going while operating which made hearing what he said very difficult.  I feel like I lost some key points of instruction, but seeing as I was just an extra observer the fact that I was able to intrude on their environment and still receive patient instruction is more than enough for me.  I am very grateful they allowed me to participate.

The surgery finished up with a quick and careful closing up of the spine.  At various points I noticed the nurses would take counts of the linens used for cleaning the blood, and the needles used for suturing the wound.   It was a very organized and practical step, that seems like common sense, but obviously has been ignored in the past seeing as some of those items have been left in patients before.

Having completed the surgery the surgeon helped re-situate the patient on a gurney to take her to recovery, while the anesthesiologist started to bring her out of sedation.  As she regained consciousness I noticed the surgeon had already left the room, and I had about half an hour until the next surgery.  I took advantage of the time to run to the lounge and grab a snack, because it didn't look like lunch would be coming any time soon.  From 7:30am until about 12:00 o clock I was in the operating room watching the pre-op and the surgery.  I didn't know how long the next surgery would be, but I didn't want to miss a moment.

In closing to this chapter of my shadowing experience I want to recount my final interaction with the surgeon.  As he closed up the patient he turned back and asked, "What did you think?"  Already experiencing a complete sensory overload my only answer was "That was awesome!"  I could see his cheeks raise up in a smile behind his mask and he began to teach, this time I could hear everything.

"My rule is that the surgery should be fun.  The more interesting and fun the case is, the more I want to do it.  If I get a referral I evaluate by two criteria.  Number one -- Is it fun?  Number two -- Is it imperative?  If it is yes to both, I'll take the case.  If I say no to both questions, I'll refer it to one of my partners...and if it is yes to one or the other I have to decide whether or not to take it."

Obviously the bit about passing it off to a partner was a joke, but I understood the lesson he wanted to convey.  He was promoting a love of your job, enjoying what you do, and taking pride in it.  I don't think he understood just how deeply that resonated with me.  I will always be grateful that he took the time to pass that one on to me.  I was never serious about surgery, because I thought you don't get to spend time with patients....my time with this Surgeon taught me just how wrong I really was.

Next time I will talk about the second part of my day, and reveal to you just how wrong I was regarding patient interaction.  Stay tuned!

Details and more Details

Often times getting accepted into medical school is distilled down into taking the MCAT and sending in your application.  It sounds pretty simple, but there are many details that you have to account for along the way, so that you can ensure your success.

The current detail that I am running after is finding shadowing opportunities.  Last year's cycle I was told that my six years of medical interpreting at the local clinic wasn't a truly representative experience for the American Medical system, so their recommendation was to find more shadowing opportunities.

I have already exhausted my personal contacts and have been forced to rely on recommendations of friends.  This has probably been one of the most difficult things I have had to do.  My schedule is very inflexible due to my full time job and the fact that most physicians (that I know) work a traditional schedule.  I also find it hard to ask other people favors.  I personally would rather be in the position to grant a favor, rather than accept one.

Fortunately I have been able to rework my weekly schedule into four days of 10 hour shifts, instead of five days of 8 hour shifts.  I am now able to pursue a more aggressive plan for securing a steady shadowing gig.  The final roadblock for me now, is to find a physician who is willing to let me follow them around.

Update: Not even an hour after I posted this, I heard back from one of the physicians I have contacted.  It looks like tomorrow I get to shadow in the OR at a Neuro Clinic.  I am very excited to take part in this.

If You Climb, You Might Fall

Last week I took a practice test to see how my preparations were coming and I was not pleased.  The final score was....wait for it....a 23.  That is one point higher than the first time I took it and six points lower than last year's test.  You can imagine, that with the MCAT only 1 and a half months away that caused me to panic greatly.

There are several ways I can interpret this outcome.  I can interpret it to say that I have taken a huge step back in my accumulated knowledge and have forgotten almost everything.  However, I don't think this is the correct interpretation.  I am positive I know much more than I did last year, so I have to examine the source of the test and where my deficiencies lie.

In my current preparations I have finished reviewing all but two chapters of the Berkeley Review test prep materials.  It is a very dense and difficult review, but I think it is more than adequate to help prepare for the MCAT.  The test I took, to show my progress, was a free diagnostic test from Kaplan.  I did remarkably poor in the Physics section, and ironically it had a lot of questions from the two chapters I had not finished reviewing.  What are the chances that the majority of questions would come from 2 of the 10 chapters that physics covers?  I thought that was a little skewed, but I also have to think that on test day, if the same thing happens I would still be screwed so maybe it is a moot point.

Being a free diagnostic test I did some research on it through Google and found several accounts where someone scored remarkably poor yet did very well on the actual test.  I began to suspect that the difficultly level on this diagnostic is much higher than the actual test in order to funnel more people into the Kaplan program.

With that being said, I still came out with some positives.  I plan to take a different diagnostic next week to see if my suspicion is correct.  Out of all the problems, there wasn't anything I didn't "know" per-se, but there were several problems that I knew how to do, yet couldn't remember the formula to do what I needed to do.  That is definitely something I can remedy, and it is certainly something that is not allowable on test day.

Because I am a theoretical thinker, I have never put much stock in memorizing huge amounts of information.  Since we have such a huge resource of data recall at our very fingertips that sort of exercise is unnecessary if you know how to find and apply theory to the necessary information.  In physics I would usually memorize one or two key equations which would allow me to derive any subsequent equations on test day.  It saves study time, and if you can derive the equations I believe you truly understand the fundamental concepts more intimately than someone who merely memorized formulae and variables by rote.

The theoretical approach is no good when approaching a test like the MCAT.  Yes, the test is designed to reveal how well you can think critically, how well you can apply information instead of regurgitate it, but when it comes to the calculation portions that is not true, because you do not have enough time to derive and then apply the solution.  Part of my past failures can be attributed to my desire to calculate the exact solution to "make sure" I was 100% correct, rather than estimating, answering, and moving on in a timely fashion.  The difference in time between both approaches is probably on the order of 1 - 2 minutes per question...which can add up quickly.

With this in mind, I have decided to use the brute force method.  I am simply going to slam as many physics formulas and chemistry reactions into my head as possible so that I will have a quick recall system ready on test day.  It is not my preferred method, but I have to admit that when pressed for time it will be an invaluable tool.  If I can immediately recall every physics equation, and quickly indicate what type of reaction is taking place I think my physical sciences score is going to shoot through the roof.

Another thing that accounts for my low score is that this is my first timed passage of my review.  I have been taking everything slow and measured up until this point to make sure I truly understand the concepts I am reviewing.  Now I am transitioning into the timed portion, and it is obvious that I am simply out of practice with regards to pacing and quickly moving through passages.  I did not run out of time during the practice test, but there were four or five calculation question I knew how to calculate, but "marked" for later because I felt pressed for time.  I know that practice will alleviate the panic I felt on those questions.

Next week I am going to post my score for the follow up practice test.  If it still sits around a 23, I may have to consider postponing my MCAT date.  Until then, stay tuned.

The Difference Between a Dream and a Fantasy

Is This a Dream or Fantasy? Image by Karezoid Michal Karcz

 As I was speaking to my wife yesterday something very profound flew out of my mouth.  At the time I did not give it much thought, but as I mulled it over later I grew to appreciate how significant it was.  I think my subconscious was using my effort to comfort my wife to teach me something instead.

"The difference between a dream and a fantasy is that a dream is realizable."

The reason that statement is so profound to me, is that before I vocalized it, I had never made a distinction between dreams and fantasies.  I have a very active imagination and one of my favorite activities is to give it free reign to express itself.  I end up thinking along many different paths, oftentimes fanciful and impractical.  I suspect that allowing this type of thought is the root of creativity, so I have never wanted to inhibit this tendency.  This means that I have always been a "dreamer".

"Dreamers" get a bad rap sometimes.  They are often accused of chasing after something impossible to achieve, something impractical, or "silly".  I think that there is a certain level of hypocrisy injected into judgements like this, because children in the USA are often told,

"When you grow up you can be ANYTHING you want."

When the child reaches a certain age, and starts to manifest their interest in certain areas the litany changes.  Soon they are told they should go to college and study something "practical", or they are told that their chances of success in a certain field are too small because of the high amount of competition.  I think that such a drastic change in message has a crippling effect on someone who dreams.  Forced to settle for something less than their dream, they begin to fantasize.

I bought into those lies when I began my undergraduate studies.  I had no idea what I wanted to do with my life, and worse I had no idea what I was interested in studying so I took the practical approach.  I thought about the professions that payed well and were in high demand and decided on Computer Science.  That is a pretty safe call, right?

Fast forward to two years after I graduated and I was absolutely miserable.  The realization that a CS degree was essentially meaningless in my chosen profession was a huge blow to me.  Technology firms stand by the litany of "Experience over all", meaning if you have enough "experience" on your resume then you must be qualified.  I have noticed that this is extremely misleading, because many people have a tendency to lie on their resume.  I cannot count the number of "hotshot" resumes I have read, only to be met with incompetence when I performed the interview, or worse yet when I was overruled and was forced to work along someone who is merely an amateur at best.  I could never understand why there is such a professional disconnect in the IT industry.  Unqualified lawyers are not allowed to practice law, nor are unqualified physicians allowed to practice medicine, yet in IT as long as you put down you have "experience" you are good to go.

My discontent with my chosen field led me to fantasize.  I wanted to hop on a bike and ride across the United States, vicariously living from day to day (Crazy Guy on a Bike).  I wanted to buy some land and go live off grid, experiencing the freedom that only nature can give you (Wilderness Survival).  I began finding solace in long training runs, with the idea of possibly running a marathon (Daily Mile).  Inevitably the theme was always the same.  I wanted to escape, and I was seeking a way out through ethereal unrealizable fantasies.  The fact that they were unreachable only intensified my discontent, and I am pretty sure it ended up drastically affecting my attitude and performance at work.

I don't know if I can put my finger on it exactly, but a combination of things worked together to galvanize me into finally pursuing a dream.  My wife and her father are physicians so I had been learning more and more about the profession through my interactions with them.  I soon realized that working as a physician would give my life the purposeful meaning that it was missing, the professionally competent peers I was seeking, and an outlet for my fantasizing mind.  On that day, and I do remember the exact day, in 2007 a dream was born.

I knew that it would take work, persistence, and time, however, I also knew that it was something I could reach if I were willing to work hard enough, and long enough.  From 2007 - 2013, I have slowly chipped away at the pre-requisites I needed one night course at a time.  Now I sit here, nearly at the end of the road and look back at what I have done in disbelief.  I could have never come so far with a fantasy, but a dream...well that is something worth living for.