Medical School: Getting In, Staying In, Staying Human

by Keith Russell Ablow MD

Overview

Medical School: Getting In, Staying In, Staying Human by Keith Russell Ablow, M.D., is the best basic guide to getting into, and staying in, medical school.

*Deciding if medicine is right for you
*Planning ahead in high school
*College curriculum suggestions
*Avoiding "pre-med syndrome"
*Preparing for the MCAT (with an update on new sections)
*Sidestepping application traps
*Sample essays from successful applicants
*Interviewing well
*Getting financial aid
*Information for minority, older, second-time, and foreign applicants
*Medical school abroad
*Coping in medical school

Product Details

ISBN-13:	9781429991964
Publisher:	St. Martin's Publishing Group
Publication date:	07/22/2014
Sold by:	Macmillan
Format:	eBook
Pages:	168
File size:	234 KB

About the Author

Keith Russell Ablow, M.D., a graduate of the Johns Hopkins University School of Medicine, is the author of Medical School. He is also the co-author, with J. Raymond DePaulo, Jr., M.D., of How to Cope with Depression: A Complete Guide for You and Your Family.

Keith Russell Ablow received his medical degree from the Johns Hopkins School of Medicine and completed his psychiatric residence at New England Medical Center in Boston. A forensic psychiatrist, he serves as an expert witness in legal cases involving violence and has evaluated and treated murderers, gang members and sexual offenders for the Commonwealth of Massachusetts. His essays on psychiatry and society have appeared in the Baltimore Sun, the Boston Herald, Discover, USA Today, U.S. News&World Report and the Washington Post. He is the author of several works of nonfiction, including Medical School: Getting In, Staying In, Staying Human, and of the novels Denial, Projection and Compulsion, and Psychopath. Ablow lives in the Boston area.

Read an Excerpt

Medical School

Getting in, Staying in, Staying Human

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By Keith Russell Ablow

St. Martin's Press

Copyright © 1990 Keith Russell Ablow, M.D.
All rights reserved.
ISBN: 978-1-4299-9196-4

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CHAPTER 1

DECIDING TO BE A PHYSICIAN

In the practical decisions of life it will scarcely ever be possible to go through all the arguments in favor of or against one possible decision, and one will, therefore, always have to act on insufficient evidence. ... Even the most important decisions in life must always contain this inevitable element of irrationality.

— Werner Heisenberg

ALL ABOUT PATIENCE

One of the most valuable skills an individual can possess, and which, unfortunately, usually comes later in life, is patience. Patience, to my mind, means being honest enough with yourself to put off important decisions until you have gathered sufficient information to make them wisely.

The temptation to choose medicine as a career early on — perhaps during your sophomore or junior year in high school — comes from all the transient rewards you would receive by committing to a field so quickly. You could start enjoying the praise of your parents and their friends right away. You could avoid all those career counseling workshops at your high school or college. And, you wouldn't be subject to the frowns you might well have received from your teachers if you had told them that you didn't know what you wanted to become.

But, be careful. Such rewards don't last very long. They're hardly worth agonizing through premedical courses you really have no interest in. And they're certainly no bargain if they're followed by a career you hate waking up to every morning. It's important to be honest with yourself at every step of the process of becoming a physician. If you have doubts, rest assured that they are normal. Whether in high school, college, or medical school there are ways, discussed throughout this book, to gather any additional information you need to make a well-grounded judgment about where you should be headed.

Until you have all the information you need to feel comfortable, you may find it easier to tell others that you "have an interest in medicine." Explain to them that you want to make very sure that your profession will be enjoyable and fulfilling for you. The people who truly care about you won't flash any frowns. And, even if they do let slip an occasional disappointed sigh, remember that you alone will have to pay the price for hasty commitments. Keep your eyes open. Explore.

KEEPING PARENTAL AND PEER INFLUENCE IN PERSPECTIVE

My parents are very honest people. So honest, in fact, that I can often read their happiness, disappointment, or anger just by a determined glance past their glasses. So they didn't have to say anything at all in order for me to tell they were disappointed when, during my junior year at Brown, I questioned my earlier decision to become a physician and began to look into careers other than medicine.

It wasn't that they didn't want me to be happy. It wasn't that I would be abandoning any family tradition in medicine — there is none. What it was was a very understandable reaction to a possible loss. For a few years already, after all, they had expected that their son would become a doctor. He would someday be secure financially, enjoy the respect of the community, perhaps even teach at a university. The thought of losing all that hurt, and it showed in their eyes.

Your parents are probably no different than mine. Many of them may never have had the opportunity to receive a professional education. With the chance they have given you to study medicine, they may think that you are callous or unappreciative if you choose another path. They may even feel that they have failed in attempting to ensure the success of the next generation. If either of your parents is a physician, he or she may see your indecision as a negative judgment on him or herself.

Don't get angry. Try to understand that parents make large investments in their children, but have frustratingly little control on the return once their sons and daughters begin to make independent decisions. Explain that you are not making a choice between being lazy and working hard, but, rather, choosing which field can most completely command your deep devotion. Invite them to explore with you the various careers you might be considering. Don't let them feel that they are losing their investment; make them partners.

In addition to your parents, your friends will almost certainly offer their perspectives on whether you should be a doctor. Keep in mind that your high school or college contemporaries probably have no more information about the medical profession than you do. They are often poor judges of whether your talents and tastes or, for that matter, your grades and scores are well-suited for a particular career. Listen, and thank them for their interest in your future, but don't turn on or turn off to medicine based on their well-intentioned friendly advice.

On the other hand, always be willing to listen. It may indeed be your parents who rightly point out that many of your interests seem to mesh with the medical profession. Or it might be a close friend who first asks you directly whether you're "premed" because you want to be or because your father wants you to be. There are some individuals with special insight into you as a person. They can be valuable resources, but only if you take the additional step of thinking critically about what they have to say.

GATHERING INFORMATION

During the early phase of deciding to be a physician, a realistic goal is to get a flavor of medicine as a career. Understand that a final verdict on your happiness as a healer may not, even with the best-researched decision, come until you are further along in the educational process. You will find increasingly wide windows through which to look into the medical profession as you progress through premedical and medical education. There are, however, keyholes it would be wise to peek through long before you send for your applications.

Private physicians are an invaluable resource. Most, especially those who have gotten to know you as a patient or neighbor, will be willing, even flattered, to discuss the medical profession with you. Call, make an appointment, and ask the tough questions. Ask what a typical day is like, what kinds of hours he or she puts in, whether he feels fulfilled when his head hits the pillow at night, what he might have done differently, what opportunities are still open to him. And don't be afraid to ask if you seem well-suited for medicine. Remember, though, filter what you hear on a very fine screen.

If you feel that physicians you know personally may not be candid with you in their appraisals of the medical profession, call doctors outside of your hometown. You may want to contact the American Medical Association or the public relations office of a nearby hospital. They can often suggest a physician who would be willing to meet with a student considering a career in medicine. Or, if you come across an interesting newspaper or magazine article on medicine written by an MD, you can contact the author. He or she may not have the time to bat all your ideas around with you, but you might come away with some valuable advice.

In addition to talking your thoughts through with medical professionals, you should try to arrange a day or two to "shadow" willing physicians. Doctors work in diverse environments including hospitals, private offices, and research laboratories. Each setting has its own flavor, and you can begin to appreciate the breadth of the profession by spending time in more than one environment. You may even be able to find a single physician who, because he divides his time between patient care and laboratory research, can help you learn about multiple facets of medicine.

One potential obstacle you may encounter, perhaps unknowingly, is what I like to call the "postmed syndrome." Successful physicians are notorious for letting the rigors of medical training slip their minds as more and more years pass. To get an immediate viewpoint on what premedical and medical education is like, contact the Dean of Student Affairs at the medical school nearest your home. Request the names of a few students with whom you could speak. And, again, ask tough questions. Has it been worth it? Would you do it over again? How does family life fit into your plans? What are the qualities you like about your classmates and instructors? What are the qualities you least like?

I don't think that any of the physicians and students I spoke with before medical school offered his or her time hesitantly. Most medical students and doctors will have given much thought to the long road they have traveled and have yet to travel. They enjoy offering an interested individual some of what they have learned. Listen carefully and you may avoid critical mistakes.

After gathering information in these limited ways, you may want to commit more time — a summer or longer — to work in a local hospital or to participate in medical research. The chapters that follow will explain the best ways to set up such a summer experience. Of course, if you follow the suggestions above, you'll already know a few medical professionals who may be willing to help you find a stimulating environment in which to work. Don't be shy.

WHAT TO EXPECT OF THE EDUCATIONAL PROCESS

One of the most important understandings to which you will come is that premedical education and the first two years of medical education bear little or no resemblance to the practice of medicine. This makes the insight you gain from physicians and medical students even more important. They can help to provide the motivation necessary for you to excel academically now or in coming years. There are things about the educational process itself, however, that may bear on your decision to pursue a medical career.

The requirements for entry to medical school generally include one year of introductory biology, one year of physics, and one year each of inorganic and organic chemistry. Many schools require, or strongly suggest, additional courses in English and math. While the specifics of structuring a successful premedical program are presented in Chapter 3, you should already realize that "being premed" means not being a lot of other things. With so much science to learn there is less time for deep exploration of the humanities. Science can be dry. Organic chemistry is more factual than it is intellectual, and physics requires abstract mathematical modes of thought which are wholly alien to literary analysis. You may or may not love such courses. You must be able to tolerate them. They have nothing to do with doctoring, but they have everything, under the present system, to do with getting the chance to learn how to doctor. Moreover, if the best you can do is tolerate your premedical coursework, resenting all the while the fact that you are sacrificing other disciplines you love, your college years may well be unhappy ones. Stop to think how much weight you put on final goals relative to your contentment while achieving them. How important is your happiness on the road to a career? Can you achieve the necessary grades in courses you don't enjoy?

The premedical years can be highly pressurized. More students than can be admitted to medical school want to go, and you may be faced with intensely competitive, genuinely serious, young men and women as classmates. You will spend long laboratory sessions with them. You will be in study groups with them. You will be graded on a curve with them. The premedical years are not years through which you can coast. Even the most talented students work hard. If that sounds like a nightmare to you, think of something else to study.

Don't be fooled by the "light at the end of the tunnel" mirage. Many of my friends at Brown thought that the toughest years were over once they were accepted to medical school. Wrong. The preclinical years at many American medical schools are much more demanding than any premedical program. The work is harder, the hours are longer (class may last from 9 a.m. to 5 p.m. every day), and the competition is stiffer. While some medical schools have integrated glimpses of clinical medicine into their first year curriculum, most of the substance of the first year is hard, basic science — biochemistry, anatomy, physiology. If you understand that you won't be touching a stethoscope for quite some time, you may find the process less frustrating.

Very few students enjoy the first year of medical school. Many of them call it the worst year of their lives. For those who only tolerated premedical science courses, the first year of medical school is a bitter pill. The sociology course they lived for is over. There are no classroom debates about politics or religion. What they find are textbooks and slides and cadavers. In the second year and thereafter, the courses are more relevant. Disease processes are introduced and contact with patients is increased. By the third year, all the students' time is spent working in the hospital setting — assisting in surgery, learning the intricacies of diagnosis, becoming proficient at physical examination. The training for one's life work begins in earnest, and it can be invigorating. But it is not easy. The goal of becoming a competent physician translates to large amounts of time spent assimilating facts and figures about various disease states. There are nights without sleep spent caring for patients.

Following your completion of medical school, most states require that you work as a medical resident in a hospital for two to six years, depending on the particular area of medicine that you would like to enter. Your income during these years may be only $25,000, and your work week may reach 100 hours. While these years provide experience which serves as the foundation for physicians' careers, most residents find at least some periods of their training extremely stressful. If you harbor doubts about your direction, you must clear them before signing on for such a concentrated and demanding program.

You will have to decide yourself, with the limited amount of information you have, whether the payback will be worth the investment. If you enjoy studying science and if you thrive on competition, your investment will be a more pleasant and less risky one. But if you're bored with science and become unhappy when competition is stiff, stop several times during the years to come and think whether it's all worth it to you. Remember that your assessment will be more difficult since the work required in college and medical school doesn't reflect the reality of medical practice. Your goal in becoming a physician is to help people, not to memorize tables of useless anatomical minutiae. Hating anatomy, organic chemistry, or even your surgical rotation doesn't mean you won't love being a pediatrician.

INCOME, PROFESSIONAL FLEXIBILITY, AND JOB SATISFACTION OF PHYSICIANS

According to the American Medical Association, the average net income (before taxes) of physicians in the United States was $132,300 in 1987. An average generally means that many individuals fell below, and many stood above, the reported value. There are doctors who earn less than $40,000. Some earn $500,000. Much of the discrepancy arises from choices medical professionals make as various opportunities arise. Those who feel comfortable in an academic environment may be willing to forego a large income in order to teach or do research. Some dedicated individuals may choose to practice in poor or sparsely populated areas. Others may give higher priority to financial success. Such physicians may structure large, lucrative practices, often in specialties such as plastic surgery or ophthalmology, which allow them to earn as much as executives of the largest corporations in America. As things stand today, the money is there if you want it and are willing to work for it.

Along with relative financial security, the physician enjoys great professional flexibility. Graduating MDs may choose from specialty training in systems as diverse as the brain (neurology and neurosurgery), the female reproductive system (obstetrics and gynecology), and the skeleton (orthopedic surgery). There are more than 20 recognized medical specialties, and new areas are developing all the time. The young physician may also opt for a career that includes medical research, hospital administration, or teaching. It is possible to participate in public health work or government programs. Law firms and the finance industry increasingly utilize graduating physicians as advisors on issues involving medicine and the law or medicine and technology.

(Continues...)

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Excerpted from Medical School by Keith Russell Ablow. Copyright © 1990 Keith Russell Ablow, M.D.. Excerpted by permission of St. Martin's Press.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents

Contents

TITLE PAGE,
COPYRIGHT NOTICE,
DEDICATION,
ACKNOWLEDGMENTS,
FOREWORD,
PREFACE,
1. Deciding to Be a Physician,
2. Laying the Groundwork in High School,
3. Premedical Education,
4. The Medical College Admission Test (MCAT),
5. Applying to Medical School,
6. The Medical School Essay,
7. The Interview,
8. Once You Make It,
9. If You Don't Make It,
10. Attending Medical School,
CONCLUSIONS,
GLOSSARY,
APPENDIX,
COPYRIGHT,