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.

Real Life is My Favorite RGP

After my Bio-Chem class today, it sort of hit me.  I really enjoy this daily struggle to try and improve myself.  During my class we were going over the kinetics of enzyme catalyzed reactions and I was really digging what the professor was teaching.  Later, as I was driving to work, I realized that only three years ago I wouldn't have been able to even follow the lecture.  That was cool, really cool.

Every day my goal is to be better than the day before, and usually I feel disappointed that I did not meet that goal.  When you are stuck in the moment it is easy to lose sight of the progress you are making.  It isn't until you look back over a roadmap of months or years when you finally see that all that sacrifice and effort has really paid off.

Each day we have the opportunity to confront our weaknesses and try to overcome them, which will hopefully lead to a better life.  Maybe it is ironic that I consider my weaknesses to be apathy, laziness, and procrastination.  My only saving grace is that when I have a goal I really try to run after it, however I feel like those three weaknesses really derail me from reaching my goals as quickly as I'd like.  I also have extremely outlandish goals, so if you are on the outside looking in you would think I am an extremely hard worker.  I have never really seen it like that.  If I compare what I have done to other people, then I would probably look pretty good in that aspect, but personally I still feel like I don't try hard enough.  I tend to relax earlier than necessary, and I probably take too many walk breaks during my long study sessions.

I know that point of view seems obsessive, but it works for me.  I am positive that I would not have made it this far if I didn't think like this.  There was a time when I couldn't sit for more than ten minutes to study.  It was a constant point of frustration for me, because I really wanted to dominate the material.  My mind would flip between thoughts so quickly that I would find myself reading a textbook, but in actuality daydreaming about something entirely different.  Through daily effort, I have been able to extend this study time to roughly 1 hour blocks.  A huge improvement, but still nowhere near what I need it to be.

I have also noticed that this inattentiveness has also extended itself into my personal hobby, which I could describe as "collecting hobbies".  I bet you are wondering what that means.  It is a phenomenon that runs like clockwork.  I will discover something I find interesting and I will do nothing but that one thing until I have figured it out.  I am always amazed by people who gravitate towards one singular hobby and do it for years without getting bored.  For some reason once I have it figured out and have been able adequately reproduce whatever that hobby calls for, I am bored and no longer care for it anymore.  This has led me to try knitting, cross stitching, home brewing, gardening, woodworking, luthiery, playing various instruments,  engraving, calligraphy, creative writing, sports, etc. etc.  The list is massive and never-ending.  I still wonder why I am like this.

Another thing I tend to do is constantly examine other people and wonder how they lives their lives the way they do.  I have noticed that the vast majority of people reach a certain age and suddenly decide that their life is "good enough".  From my observations this generally occurs immediately after High School, upon graduation from college, or after marriage.  Lets say the average age is around 25 years old.  The average life expectancy for people in the United States is currently 78 years, so that leaves 53 years of a static repetitive non-progressive life.  Think about that for just a second.  Doesn't that scare you?  It blows my MIND when I think about it.  What could I accomplish in 53 years if I kept improving every single day?

This apathetic behavior also manifests when people have children.  It seems almost counter intuitive to me, that parents give up on improving themselves as soon as they have children so that they can "raise" their children.   It is so hypocritical to me when a parent admonishes their child to get an education and be successful, to set goals and improve themselves, yet they aren't willing to do it in their own lives.  Living for prime time TV and weekend sports is not my definition of success or happiness.  It is merely another form of drug addiction, where you get an endorphin rush by trying to associate with the success of someone who is actually making it happen.

Entertainment has become the center of our culture and most people are too stupid to even realized how chained they really are.  I watched my grandmother spend 30 years glued to a television and when she died she didn't even know who I was.  Her brain was turned to mush because she never used it, and her body crumbled alongside.  She was hypnotized by the fantasies unfolding before her and could never escape the temptation so that she could be fulfilled in her own life.  This mass hypnosis has manifest itself in our society with the various health issues we are currently having.  The overwhelming numbers of diabetics, and obese people (not to mention many other health issues) all stems from one singular problem, and that is a problem with lifestyle.  Overeating, couch surfing, and inactivity for years leads to this end result. However, when people reach this state, they want to operate under the misinformed idea that they can take a "magic pill" and continue to abuse their bodies.  I call this a slow measured suicide.

I have just realized how long this mind dump has gotten.  This will probably be TLDR; for most people, but it's my blog so nyah!  Maybe I'll follow up with a part 2, if anyone can stomach it.

A Different Approach

Now that I am in the midst of studying for the MCAT again, I have decided to reevaluate my approach and make some modifications.  Last year when I studied for this test I focused on assimilating as much information, and running through as many questions as possible.  This seemed to be an okay approach, but I still did not do as well as I wanted to.  This year I have decided to switch my approach.  Instead of trying to slam through tons of information as quickly as possible, I will do my review carefully with one thing in mind.  As I do the example questions, and practice tests I will extensively study why I have missed each problem and then categorize them into two different categories.

The first category will be for "silly" mistakes.  That label is sort of a misnomer, since any mistake technically isn't silly.  I expect to see a pattern emerge for the type of questions I miss in this category.  Most likely it will be due to a particular approach, missed conversion or not carefully reading what the question is asking. The second category will be for deficient knowledge.  These questions I will have to take, and review the particular subject matter that I am deficient on so that my knowledge base is complete going into test day.

The reason I decided to do this is because I feel like I subconsciously avoided subjects I didn't like or understand, and I rushed through many questions I missed with the simple explanation of "Oh that was dumb, I should have seen that stupid mistake.  I'll get it right next time lol."  In hindsight this is not a very good approach to studying for the MCAT, which is a test that purposely gives trick questions to test your knowledge.

I have already started this approach with my Chemistry review and after getting through 2/3 of the first chapter I am getting problems right, that used to challenge me.  This is all because I took the time to really look into why I missed the problem, and then carefully document it.  The going is slow right now, but I have a suspicion that these common "tricks" are going to keep popping up again and again.  Actually I know they will, since this will be the third time I will sit for the exam ><

I no longer believe that I am missing any of the fundamental knowledge necessary to take this exam.  Now I just need to refine my test-taking skills so that when I go into the test in May, I am ready to take the MCAT as they present it.

Medical School

This year I worked hard to make it into Medical School, but alas it did not happen.  I scored one point below my average this time on the MCAT for a 29.  I was pretty happy with that, but I think it was a naive score to "settle" for.  Over the last year I have taken more courses, and I feel like I know so much more than before.

I decided to pick up this blog again more to document my struggle to get into medical school than anything.  I have been working towards this for almost five years now, and have been extremely serious for the last two and a half years.  I wish I was more serious from the outset, but that is water under the bridge now.

It is now mid-January and I need to start studying to take the MCAT a third time.  Most people have told me that 29 is good enough and that I shouldn't "risk" taking it again.  Honestly I am not satisfied with that number and I believe I can do much, much better.  Last year I had a pretty good study schedule, but I think I will be even more aggressive this time around.  It is going to require a sacrifice of nights and weekends, but I am okay with this.

The bitterness of getting rejected this year somehow galvanized my spirit into wanting to try even harder.  I want to prove to myself that I am able.  I want to prove to everyone who thinks I am full of crap, that I am not just "talk".   I have made solid steps, but I feel like it isn't enough.  The last 2.5 years I have maintained a 4.0 GPA, but somehow I feel like it is "too little too late".  Or course that is the self doubt seeping in. 

Last year I recorded a 7 point improvement from my first MCAT.  That is a huge difference when you think about it.  I know people who have taken the test several times and each time only had a variance of one or two points.  With the hard work I have put in over the last year, I feel confident that I can push it up another seven points.  That would put me at a 36, which is a score that a lot of the top tier schools would be impressed with.  I know my GPA would keep me out of those schools, but my goal isn't ivy league.  My goal is to be in Medical School, and I think that is very attainable with what I have already done.

When I called the admissions board after my rejection I also found out that I needed to Shadow more physicians.  Somehow I thought that being a medical interpreter in a clinic was just as good as shadowing, but I was wrong.  I am probably most bitter about this "weakness" than anything else in my application.  I still find it hard to believe that interpreting between doctors and patients in a clinical environment isn't as good as or even better than simple shadowing.  Deep down, I feel like I got shafted on this aspect and I will probably go to my grave believing that this assessment was extremely obtuse and short sighted.

With that being said, I also have to be practical about the whole thing, so guess what I will be focusing on this year?  You got it!  I will be shadowing as many physicians as possible.  In my next post I want to post a tentative study schedule that I will follow, that will allow me to maximize my time usage and help me attain the highest grade possible.

Folks!  For the next 5 months I am going to be LIVING the MCAT.