Learn about medicine and how to become a physician in our articles for pre-medical students (including the MCAT), medical students, resident physicians, and practicing physicians.
By Amy Rakowczyk, SDN Staff Writer
When my husband and I arrived in our new city of Columbus, Ohio for him to begin his medical training, we didn’t know what to expect, but we knew we wanted one thing for sure: to find other people in our same situation and develop some friendships.
My husband is prior military, so we had grown accustomed to joining “Family Support Groups” at each new military station. It was like a ready-made family, already created for you, all you had to do was show up.
Poker, one may reasonably argue, is a game of sheer luck; he (or she) who happens upon the most desirable combination of cards will likely win the round of bets. However, as seasoned players know, the art of poker lies in its psychology. The ability of the player to keep an emotionless persona not just when dealt an appealing hand but especially when dealt a bad one—the poker face—is how competitors can trick each other to win in high stakes situations regardless of their cards.
I find at times medical school to be like a big poker game, with its players the medical students. The stakes are plentiful: a “bet” of a couple hundred thousand dollars that a medical degree will be obtained, a desired specialty (though I am in awe how some of us have already chosen or eliminated fields within months of donning the white coat), a coveted residency program, a preferred lifestyle, and more. With our futures on the line, it is thus natural that we all play our cards to the best of our abilities.
Central to the skillset of every physician is the differential diagnosis; this is the process by which new patients are evaluated to establish the most likely diagnosis. Similarly, the first clinical year of medical school is like a differential for each student, except instead of a medical diagnosis, students are seeking to determine which specialty they will choose. This column explores this differential: experiences from each rotation by a current third year student.
As I write this article, I am thinking about how to compress all that I’ve seen and experienced the last several weeks into a few paragraphs. I’m not sure I’ll be able to do it justice, and if I wrote out all my thoughts it would probably exceed the page limits and the reader’s concentration. So I’m going to focus on a few aspects of this first month of being a third year medical student, and I suspect several themes will reappear and be expanded in future posts.
Central to the skillset of every physician is the differential diagnosis. This is a list of possible diagnoses that helps guide clinical decision-making. By asking specific questions, performing a focused physical exam, and ordering lab tests, all through the lens of the differential, physicians are able to rule in or rule out each item on the list. The differential is not fixed, however; it is a fluid list that can be rearranged or completely changed at any time given new information. This information often comes in the form of an extra piece of history from the patient, a new finding from an imaging study, or frequently, from several lab tests coming back negative.
Here’s a scenario I am asked about a lot: It’s a month before Step 1 and a student is doing lousy on UWorld questions. Or sometimes a student tells me they just took a NBME practice test and dropped from their previous score. Step 1 is getting closer and panic sets in. What should the student do? Bump their test date out a few weeks? Find a new resource? Maybe just quit medicine all together?
This scenario happens to everyone to some degree as Step 1 nears. And although the panic reaction is understandable, poor performance on practice questions before Step 1 is actually a very good thing in many cases. There are three important reasons not to worry too much about wrong answers to practice questions, which I will explain in this post.
As with any high stakes exam, it’s not surprising that there are a number of rumors circulating around the MCAT exam. So we are busting three of the top myths about the MCAT scores and score scale.
Myth #1: The MCAT exam is graded on a curve.
There is no curve associated with the MCAT exam. Instead, the MCAT exam is scaled and equated so that scores have the same meaning, no matter when you test. What does that mean, you ask? There are many different test forms that are produced for a testing year, any of which you could see on your exam day. The forms of the exam are designed to measure the same basic concepts and skills, but each form contains different sets of questions. While care is taken to make sure that each form is about equivalent in difficulty, one form may be slightly more or less difficult than another. We adjust for these differences in the difficulty of test questions when we convert the number of questions you answer correctly to the MCAT score scale. This ensures that scores have the same meaning across test administrations and testing years.
Applying to medical school is a humbling experience, even if you have a successful application cycle. No matter how great your pre-medical advisor is or how many articles you have read about the process, you are still bound to have a few missteps that will leave you doubting yourself as a potential MD or DO candidate. It has been nearly a year since I submitted my primary AMCAS application, and as I reflect on the application cycle, several moments stand out to me as essential lessons to learn before you begin your own application process:
It was during my third-year pediatrics rotation that the doubts started creeping in. I really … Read more
Dr. Anthony Youn is a board certified plastic surgeon, author, and television personality. He graduated from Michigan State University College of Human Medicine, completed his general surgery and plastic surgery residencies at Grand Rapids, and finished up with an aesthetic plastic surgery fellowship in Los Angeles. He now works at his private practice, Youn Plastic Surgery, PLLC, in Troy, Michigan.
Post-baccalaureate or “post-bacc” programs, for short, are often discussed among pre-med students. While post-bacc programs can benefit students with many types of backgrounds, they are not for everyone–and knowing this ahead of time is important, as the cost for these programs is anywhere between $20,000-$40,000. This article covers just what post-baccs are, as well as important information on who should consider such a program and what students should ask about before actually signing on the dotted line.
While getting accepted into medical school is more difficult than ever in America, there are … Read more
The tradition of long hours on the floor is an old one in American medical training. And criticism of this tradition is of long standing too. The controversy over the grueling residency schedules is not a new one, but neither is it one that has been successfully resolved. It can still spark off strong feelings in both the proponents and opponents of cutting back on the length of residency shifts and/or the time off between shifts for professionals engaged in this important stage in their medical education. What’s more, it is a topic which has pitted respected healthcare institutions such as the Harvard School for Public Health and the American Academy of Family Physicians against one another, so much so that this issue is not likely to be resolved anytime soon.
One of the continuing challenges for medical schools both here in the United States and around the world is to find ways to select the students who will have the best chance of successfully completing their education. The goal of a good medical education, after all, is to train students who go on to become doctors, helping to fill the enormous global demand for well-trained, competent physicians. What might surprise many students, however, is how many different ways medical colleges around the world have come up with to find these ideal candidates–and how widely medical education varies from one country to another.
We all know medical school interviews are important. But did you know, according to a survey of medical school admissions committees conducted by the American Association of Medical Colleges (AAMC), interviews are the most important factor used to decide which applicants gain acceptance (Dunleavy DM, et al. Medical School Admissions: More than Grades and Test Scores. AIB. 11 (6), 2011)? The most important factor! Fortunately, interview techniques can be learned and, when practiced, improved. This article addresses the five biggest mistakes I have seen pre-meds make regarding interviews during my over 10+ years as a Harvard pre-med tutor and admissions consultant.
Whew! It’s been a long year and I am itching for a much-needed, well-deserved break. Thankfully, summer is here to save me. I can’t wait to talk about my summer plans and all the ways to spend the summer between first and second year (also sadly known as your last summer ever). I think it will be beneficial to recap what I’ve discovered this past year!
An Ongoing Dialogue Between Medicine and Law It is no wonder why medical schools across … Read more
At the end of the school year, hopefully you will find a little bit of … Read more
With one or more years between undergraduate study and a medical school education becoming more common, many medical students must now figure out how to transition from their gap years back into the classroom. Some students worry that they will have forgotten how to study effectively, while others worry about transitioning from the relatively stress-free environment of a gap year to the rigor of medical school. If you are a newly-minted medical student trying to prepare for your first year of medical school after some time away from academic life, consider making your transition smoother with these tips:
If you are in medical school, you have been making choices for a long time now, from what to major in as an undergraduate to what volunteer work during your gap year will give you the best chances at getting a coveted med school slot. But now that you are in medical school, one of the most important decisions still lies ahead: what kind of residency should you choose? This is an incredibly important choice that will shape the rest of your career. A good decision now will make it more likely that you will be satisfied with your professional life down the road.
The choice can be a difficult one. What things should you consider before you decide? Read on to find out more about the steps you should take in order to match to a residency that will leave you both personally and professionally satisfied.
Sara E. Gottfried, MD, is a board certified obstetrician and gynecologist; founder and CEO of Gottfried Center for Integrative Medicine, Inc.; and volunteer clinical faculty at University of California at San Francisco Department of Obstetrics and Gynecology. Gottfried received a bachelor’s degree in engineering cum laude from the University of Washington (1988), followed by a Doctorate of Medicine with a focus on public health and integrative medicine from Harvard Medical School and Massachusetts Institute of Technology Physician Scientist Training Program (1994). Dr. Gottfried completed a residency in obstetrics and gynecology at UCSF (1994-98).