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Behavioral Science, Complementary Medicine, Events, Medical Education, Stanford News

Advice for young docs from psychiatrist David Spiegel: Find a mentor and pursue your passion

Spiegel in office - smallThe takeaway from Stanford David Spiegel‘s recent lunchtime discussion, part of the Psychiatry and Behavioral Science Grand Rounds, was simple: You can’t make it on your own; accept, welcome and offer assistance. To succeed as an academic psychiatrist, it isn’t necessary to come from a line of psychiatrists, as Spiegel, MD, does, he said.

But junior physicians do need mentors, those who know the formal and informal rules of the system and who are willing to make time and lend a hand, a practice Spiegel attributed to his mentor, Irvin Yalom, emeritus professor of psychiatry and behavioral sciences.

Spiegel said that early in his career, he would initially get discouraged when papers or grants would be rejected. Then, he came across a statistic that few hockey players make it out of their first year in the National Hockey League with all of their teeth. It was an “a-ha” moment for the second-generation psychiatrist (Spiegel’s parents were both psychiatrists). Despite hard work, even the best scientists encounter challenges and adversity.

Now, Spiegel is the Jack, Lulu and Sam Willson Professor and a professor of psychiatry and behavioral sciences. He directs the Stanford Center on Stress and Health and is also medical director for the Stanford Center for Integrative Medicine.

Spiegel offered additional advice to the 80-or-so people who gathered to hear him: Disregard convention and explore your interests. “You will do your best work if you’re doing something you’re passionate about,” he said.

Despite the prevalence of psychotherapy, and then of community psychiatry, Spiegel said he stuck by his interest in hypnosis, despite its poor reputation. By conducting statistically sound studies, he developed a body of work demonstrating that hypnosis has real, replicable benefits. This work stood up to critical skeptics and helped secure his tenured position at Stanford, Spiegel said.

Stanford then, and now, has accepted work that expands the bounds of disciplines, as long as it stands up to scientific scrutiny, Spiegel said. “Do whatever the hell you want to do, but be scientific and empirical about it. If you can demonstrate it works, fine,” Spiegel said. He concluded with this parting phrase: “Data rocks!”

Previously: “Tranceformation:” David Spiegel on how hypnosis can change your brain’s perception of your body, Starting a new career in academic medicine? Here’s a bible for the bedside: The Academic Medicine Handbook, Exploring the science of hypnosis with Stanford’s David Spiegel and Stanford psychiatrist David Spiegel’s path west
Photo by L.A. Cicero

Medical Education, Research, SMS Unplugged

Research in medical school: The need to align incentives with value (part 2)

Research in medical school: The need to align incentives with value (part 2)

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

This is the second post in a three-part series on research in medical school. Part one is available here, and a third post will run on June 24.

5713991403_99bbdea4e1_zIn my last post, I discussed points brought up by Ezekiel Emanuel, MD, PhD, and John Ioannidis, MD, about research in medicine. The takeaway was that students are strongly incentivized to do research during their training, but those incentives don’t necessarily reward high-quality work. Furthermore, they don’t directly contribute to clinical skills and becoming an effective practitioner. As a result, students may be spending time and effort on projects that fail to maximize value for both themselves and for the medical system at large.

This inefficiency has several consequences. At the individual level, it means students spend more time in training (arguably 30-40 percent more), accrue more debt, and lack the opportunity to pursue other interests. At a societal level, it may contribute to the growing physician shortage and potentially limits the productivity of highly talented and well educated people.

The stakes are high when it comes to designing a system of medical education. After my last post, I spoke to several other medical students about the subject, and many of them felt that research requirements don’t align with their eventual goals. This got me thinking about how we can improve things, but before proposing any solutions, it’s important to understand the mentality that led to the status quo. So in this post, I want to delve deeper into why there are such strong incentives for research in medical training.

In reading and thinking more about the subject, I’ve identified four reasons. The most commonly cited one is that research is a means to a pedagogical end. It’s a way to teach students how to think critically about a problem, analyze available solutions, test those approaches, and then synthesize the resulting information. It’s the scientific method at work, and doctors have to use that method every day.

While true, this alone doesn’t justify medical training’s emphasis on research. It’s possible to develop those same skills through many intellectual pursuits, whether it’s working on a policy platform, developing a health education and outreach program, or even working in a corporate job, among other possibilities.

The second reason is that medical schools are typically part of a research university. As the name implies, one of their primary purposes is to do research – institutional prestige relies heavily on academic output. As members of this community, medical students are expected to participate.

But once again, this line of thinking doesn’t entirely explain why medical training should prioritize research to such a great extent. Consider two other professional schools at a university – business and law. Most students in these programs go on to become practitioners (just like most medical students go on to become practicing physicians). Students have the opportunity to conduct research, but the emphasis is on pursuing extracurricular activities relevant to their career plans.

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Medical Education, Medicine and Literature, Patient Care, Pediatrics

Stanford Storytellers: Medical students write a children’s book to comfort and educate

Stanford Storytellers: Medical students write a children's book to comfort and educate

hospitalcolorThis spring, four Stanford medical students wrote a children’s book, Stanford Storytellers, which uses imagination to help children understand and feel comfortable in the hospital.

Authors Afaaf ShakirMichael Nedelman, Karen Hong, and Zahra Sayyid, along with illustrator Emma Steinkellner, a Stanford undergraduate, came together through a call for interested Stanford Medicine students to collaborate on a children’s book in honor of this year’s Medicine and the Muse symposium’s keynote speaker, Perri Klass, MD. Klass is a professor of journalism and pediatrics at New York University and a children’s author who is involved with Reach Out and Read, a non-profit encouraging early childhood literacy in pediatric clinics.

“Funny enough,” Nedelman told me, “all the med students who showed up to the [book] meeting were my classmates – third-years who should’ve probably been falling asleep on a couch somewhere. Things really clicked when we found Emma, whose visual style was perfect for the project.” I recently spoke with Nedelman and the other group members over email, as coordinating their busy schedules was like herding cats!

Where does your perspective on a hospitalized child’s experience come from? 

Hong: I’m currently on my pediatrics rotation and I see a lot of children who would get some reassurance from a book like ours. Just today, I was talking to a little boy who really wanted to take his IV out. You have to keep your arm straight for days on end and deal with the uncomfortable feeling of having a needle in your arm – who would want that if they didn’t understand why it’s there? We talked about how the clear plastic tube delivers a magic “potion” into his system to fight off his infection and it was amazing how fast his attitude changed. This isn’t always the case with every patient but it’s nice to see the power of imagination at work.

Sayyid: I remember distinctly the first book series that I couldn’t put down: Lurlene McDaniel’s young adult books, which focused mainly on girls who were struggling with chronic illnesses and death. Each of her stories focused on a different girl with a different disease, almost all of which were fatal. Although I luckily did not experience much time in the hospital as a child, I remember reading those stories and thinking, “Wow, this could have been me.”

Shakir: I grew up in a house with two pediatrician parents, which meant I never went to a doctor’s office, let alone a hospital. It wasn’t until I came to medical school that I realized that kids without physician parents have a totally different take on medicine than I did. It’s completely unfamiliar to them, and things aren’t often explained in a way that a kid can understand. That perspective has fueled me to empower patients (both adults and kids) with knowledge about their care and their bodies. In addition, being in medical school gives us the unique perspective of being young in our training (the ‘kids’ of medicine) where things are still new and strange, but also being medical ambassadors for our patients. We have enough knowledge to explain concepts without forgetting what it was like to not understand them. Writing this book has been a great reminder of the importance of that communication.

hallwayWho do you hope will read the book? How do you hope it will be distributed?

Nedelman: There are lots of people I’d love to see connect with the book: The 5-year-old chemo patient, seeing the hospital through a new lens. Or his classmates, who may not understand why he always seems to be missing class. Or the attending physician, perhaps with young kids, who understands that a little bit of imagination can really help reframe an unfamiliar and at times uncomfortable experience.

Shakir: Our ultimate hope is that our book reaches the children we are writing it for. We intentionally made our protagonist a character who was easily accessible to as many kids as possible.

Nedelman: We don’t know what condition this character has; it’s all in first-person so even the child’s gender is interpretable by the reader. And even though our protagonist is seen flying, floating in space, and rolling in a wheelchair, we actually never see this character walking around.

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Medical Education, Research, Videos

Students draw inspiration from Jimmy Kimmel Live! to up the cool factor of research careers

Students draw inspiration from Jimmy Kimmel Live! to up the cool factor of research careers

To better understand how teens feel about scientific research and to make a career in health or medicine a more desirable occupation among adolescents, University of Chicago researchers and a group of high-school students from Chicago Public Schools took a page out of the Jimmy Kimmel Live! playbook.

Using the model of Kimmel’s “Lie Witness News” segment, the predominantly minority teens asked their peers what they think about research. The project was part of the NIH-funded TEACH STRIVES program, which aims to prepare and inspire Chicago public school students to pursue careers in health-related research. Samantha Ngooi, a project manager with TEACH STRIVES, and Vineet Arora, MD, a principal investigator with the program, discuss the students’ project in a recent KevinMD post:

What did these students find when they asked their peers about research? Well, not surprisingly [the] term “research” had a largely negative connotation — “lots of paperwork,” “lab rats.” However, our teens went one step further. They found studies that would be of interest to them — about things they cared about, such as teen health with cell phone use. When presented with research that linked cell phone use at night with depression, teens on the street were inspired to learn more. Unfortunately, this idea that research is esoteric and irrelevant is common amongst teenagers. Ask your average teenager what they aspire to be and more often than not a “researcher” will not be a contender. In fact, data suggests that few high-achieving high school students are considering a career in research, let alone healthcare research.

Why is this important? To make breakthroughs in science and medicine for the future, we need a healthy pipeline of diverse, talented teens to consider entering research careers in STEM fields…

Watch above to see the full video.

Previously: High schoolers share thoughts from Stanford’s Med School 101, At Med School 101, teens learn that it’s “so cool to be a doctor” and Stanford’s RISE program gives high-schoolers a scientific boost

In the News, Medical Education, Research, Science, Stanford News

Medical students explore the wide, wide world of research at annual Stanford symposium

Medical students explore the wide, wide world of research at annual Stanford symposium

Research SymposiumTraining medical students in research skills has long been a focus at Stanford. To get an inside glimpse of how this works, read my story on the Stanford Medical Student Research Symposium, an annual event where students present poster boards of their research for judging by faculty.

The depth and breadth of individual research accomplished by medical students who, at the same time are juggling classroom and clinical education, is impressive. The faculty representative at the event explained the educational process to me:

“Stanford tries really hard to open doors in the area of scientific research and give students a little nudge to go through,” said Laurence Baker, PhD, director of the Scholarly Concentration program, a required program of study for medical students that promotes in-depth learning and scholarship. Each of Stanford’s medical students are required to complete at least one quarter’s worth of research, but most do more, he said.

“We train the kind of doctors who become leaders,” Baker said. “Whether that involves publishing, clinical work, research or patenting — education in scientific research is a key element of training.”

My story also provides a taste of the conversation between one of the students who used the Veterans Administration database to conduct his research of opioid drug use and a judge of the event, who plays the dual role of evaluator and teacher. She provides both constructive criticism and encouragement to the budding physician-scientist:

In a dress shirt and tie, Raymond Deng, a third-year medical student, stood next to a poster describing his research on opioid use among veterans. “I’m interested in addiction medicine,” he said. “Prescription drug abuse is huge.” He was discussing his findings with Sonoo Thadaney, director of the Program in Bedside Medicine… Thadaney, the symposium judge, listened intently to his description, nodding her head in encouragement. “Why did you pick this study?” she said, clipboard in hand. “Personal reasons,” Deng said, adding that someone in his life has a heroin addiction, and that an epidemic in prescription drug abuse has been shown to have contributed to an increase in heroin use. She nodded again. “The great thing with data like this is that the data itself can bring up questions that we didn’t think of,” she said. “If the Googles and the Yahoos of the world can use data like this for research, so can we. Great work. Go crazy with it.”

Previously: Contemporary health issues focus of Stanford med students research presentation, As part of annual tradition, budding physician-scientists display their work and New class of physician-scientists showcase research.
Photo by Norbert von der Groeben

Medical Education, Medical Schools, Research, SMS Unplugged

Flip it up: How the flipped classroom boosts faculty interest in teaching

Flip it up: How the flipped classroom boosts faculty interest in teaching

flipped classroom

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

Recently, the flipped classroom — a model of instruction in which didactic content is delivered outside the classroom (usually online), and in-person class time is used for active learning — has infiltrated the educational landscape from kindergarten to professional school.

As a current medical student, I generally agree with advocates for using the approach in medical education. For example, Stanford’s Charles Prober, MD, senior associate dean of medical education, argues in a New England Journal of Medicine commentary that the opportunity for enhanced time-efficiency, student self-pacing, and classroom time freed up for more interactive learning make the flipped classroom a potentially attractive approach for educating physicians. I say “potentially” because, like anything else, the flipped classroom is a good approach only if it is done well. For me as a learner — even a modern, Millennial learner — I’d much rather attend an engaging lecture or study a well-written textbook than watch a lousy online video or struggle through a poorly facilitated interactive classroom session.

So I have to admit I harbored some skepticism when, about about a year ago, Prober invited me to become involved the Re-Imagining Undergraduate Medical Education Initiative, an ambitious project to create a new, flipped classroom-based microbiology and immunology curriculum in collaboration with four other U.S. medical schools, which Scope covered last year.

Although I was excited to have a role in such a large-scale project, I worried that the hype of the flipped classroom trend would overshadow what I thought should be the priority: training our future doctors with the highest quality education — not just the flashiest.

Happily, my worries have proved unfounded. I have seen the faculty and staff from the five schools work tirelessly to produce an impressively high-quality final product. In fact, I have even come to believe that the flipped classroom model intrinsically helps incentivize medical faculty members to prioritize teaching.

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Humor, Medical Education, Medicine and Society

University of Glasgow medical student makes learning anatomy a feast for the senses

Areo Oli_Mike McCormick_560

If you’ve ever heard the phrase “you are what you eat” and playfully wondered which part of you is composed of coffee and sweets, take a peek at the gallery of artwork called CandyAnatomy. These candy creations are the work of Mike McCormick, a medical student at the University of Glasgow. Recently, I reached out to McCormick to learn more about his inventive works of art and how they came to be. Here’s what he had to say.

How did CandyAnatomy begin?

CandyAnatomy was born out of the realization that I could be as nerdy as I wanted and the only repercussion was that it might make me a better doctor. [While getting] my previous degree, Physiology (Hons) at the University of Edinburgh, I’m pretty sure I would be laughed out of town for being so embarrassing, but medicine rewards absorbing as much information as you can. I would draw muscles, nerves and blood supply with a sharpie on my arm; convert anything I could to mimic a biological system; and candy was just so full of possibilities that would also make tasty snacks!

Do your creations help you learn the material you study in medical school, or does the art serve another purpose?

Yes, the creations do make it easier for me to learn the subject. I take time to consider what sweets most resemble the cells or structures in question; this helps me remember. Good examples might be the Aero Bubbles, whose high surface area resembles alveoli, or using a jelly snake to remind me about serpentine receptors.

Why did you choose to use candy in your artwork? Do you have a sweet tooth?

Ha, ha – honestly I’m a child of two dentists, so candy is probably forbidden! But… I’m showing candy can be used for something other than eating, so perhaps that’s setting a better example from a dental perspective! I actually just use the candy because the colors make for a very vibrant image, people want to eat them, and because I don’t actually eat them they will last longer before they go out of date. I’ve used a little SavouryAnatomy, but it doesn’t last very long!

What inspired the artwork (featured above) “Aero-Oli”?

I had been searching for an idea to detail the site of gaseous exchange. We had been doing a few weeks of respiratory anatomy and pathology, and I didn’t just want to produce two lungs out of candy, as it’s not very eye-catching. When shopping, I spotted the Aero Bubbles and I just had to [use them]. I like this image because it explores the structure [at different magnifications, much] like switching the power of a microscope. It shows the smooth muscle around the bronchioles that play an important role in asthma, and it also details the capillary network (surrounding the alveoli) that oxygenates the blood and removes waste products.

Thinking about your future, what area of medicine are you planning to pursue?

In the future I’m considering becoming a surgeon because I like working with my hands, dissecting and learning anatomy. However, pediatrics might be another alternative as clearly CandyAnatomy would be a good way to explain medical situations to children.

Previously: Image of the Week: A playful take on the human respiratory systemImage of the Week: VeggieanatomyImage of the Week: Quilled anatomyKitchen anatomy: Brain carved from a watermelon and Virtual dissection table helps teach human anatomy
Via Laughing Squid
Artwork courtesy of Mike McCormick

Cardiovascular Medicine, Medical Education, Research, Stanford News

Stanford med student/HHMI fellow testing new way to deliver treatment to heart

Stanford med student/HHMI fellow testing new way to deliver treatment to heart

Jensen and Woo 560

The human heart has fascinated second-year medical student Christopher Jensen ever since he first flipped through anatomy books as a child. Now, the Howard Hughes Medical Institute (HHMI) has given Jensen a special opportunity to pursue his passion.

Jensen is one of 68 medical students from across the U.S. chosen to take part in the HHMI Medical Research Fellows Program. This program gives medical students a chance to try their hand at research by offering them funding, mentorship and a full year to explore the medical research project of their choice.

Recently, I spoke with Jensen about his interest in the heart and his HHMI project. “I was homeschooled,” Jensen told me. “My parents bought me books on biology and I thought that anatomy – the heart in particular – was fascinating.”

Later, when Jensen studied biology at school, his interest grew: “The more I learned about the heart, the more I wanted to understand it better. I was in awe and wonder of how this one organ could supply blood for the whole body.”

Jensen’s curiosity about the heart led him to Stanford where he met his HHMI mentor, Y. Joseph Woo, MD, chair of Stanford’s Department of Cardiothoracic Surgery. “When I saw Woo’s work I was enthralled,” Jensen said.

Jensen’s one-year research project with Woo will focus on a growth factor, called Neuregulin-1ß, that plays an essential role in the development of heart, skin and brain cells. “We’ve already demonstrated neuregulin’s ability to rescue and regenerate heart muscle immediately after a heart attack,” Jensen told me.

In these studies, Neuregulin-1ß is given during surgery as an injection to the heart. This delivery method prevents neuregulin from acting on the entire body (which could have negative side effects) but it limits this treatment to surgical procedures. Jensen’s goal is to develop a non-surgical way to target heart cells with the neuregulin treatment so it can quickly be given to a patient after they have a heart attack.

Over the next year, Jensen and Woo will test a special hydrogel that could provide a way to transport neuregulin through the veins to targeted tissues in the heart. The hydrogel, Jensen explained, forms a gummy, slow-dissolving solid when it reaches the heart. This therapy could help cardiac surgeons target heart cells with Neuregulin-1ß for long periods of time whenever the treatment is needed. “This would be a phenomenal advancement and could pave the way for minimally invasive therapies in the hospital,” Jensen said.

“I’m excited about this research,” Jensen told me. “It could lead to other work in the field or a career in cardiac surgery and research.” It also possible that, one day, it could lead to a therapy to treat patients suffering from heart failure.

Previously: A new era for stem cells in cardiac medicine? A simple, effective way to generate patient-specific heart muscle cells
Photo courtesy of Christopher Jensen

Medical Education, Medical Schools, SMS Unplugged

An extra year of medical school? Sign me up

An extra year of medical school? Sign me up

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category. 

sandglassesThe process of training to become a physician is a complex and mysterious process to most outsiders, but there are two things that everybody seems to know: 1) how expensive it is, and 2) how long it takes. (One of the first things people ask when I tell them I’m a first-year medical student is, “So, how many years do you have left?”)

Because these issues represent major barriers to entry to the medical profession, some medical schools have begun piloting MD degree programs that are designed to be completed in three years rather than the traditional four. The benefits are easy to see: By shortening the training by one year, students save on a year of expensive medical school tuition and are also able to contribute to the health-care workforce one year sooner.

In a climate where much of the discussion is about how we can shorten and streamline medical education, many people are surprised to hear that I, like many of my Stanford classmates, will actually likely choose to take an extra year during medical school – for research, service, or an additional degree. Given that I also spent two years working between college and starting at Stanford, my inefficient path will have added three or four extra years on to my education when all is said and done.

Am I foolish for condemning myself to years and years of training before actually starting my “real life” as a doctor? For me, the thought process behind extending my training an extra year is actually very simple: I just really like being in medical school. How many other opportunities will I have to take classes in medicine, law, and statistical programming – all in the same term? When else in my life will I be able to soak up wide-ranging experiences from general pediatrics to neurosurgery, without committing to either?

To be sure, I don’t view these experiences as being part of the “most direct path” to becoming a competent, successful physician. But from a selfish perspective, they might help me better find a career path that suits me well. And from a societal perspective, I like to think that these larger life experiences will help to shape and define my unique set of values, philosophies, and skills as a caregiver to people in need – a framework that goes beyond the highly standardized requirements for medical training.

This is not to say that years of additional time are the best thing for everyone. I admire and envy those people who already know what they want to do and how they want to do it, and three-year MD programs offer those people a chance to make much-needed contributions to society as quickly as possible. However, to the degree that longer programs allow us the flexibility and independence to develop ourselves, I believe that they are an invaluable option for many aspiring doctors.

Nathaniel Fleming is a first-year medical student and a native Oregonian. His interests include health policy and clinical research. 

Photo by Leland Francisco 

Medical Education, Medical Schools, Stanford News

Cracking medical school admissions: Stanford students use their expertise to help others

Cracking medical school admissions: Stanford students use their expertise to help others

Rachel-Rizal-003-172x250Rishi-Mediratta-001-196x300Thousands of high-school and college students are anxious about getting into medical school one day, and Rachel Rizal and Rishi Mediratta, both fourth-year students at Stanford, know what keeps these aspiring doctors up at night. For the past several years, Rizal and Mediratta have acted as admissions counselors for their many pre-med friends and acquaintances and offered professional admissions consulting – and now they’ve written and published a book, Cracking Med School Admissions, based on their blog.

I had the chance to sit down and speak with the friendly pair outside of Stanford Hospital one breezy spring day. Both are moving into new career phases: Rizal is broadening her knowledge of business through an administrative position in Stanford Health Care, and Mediratta will be completing his pediatrics residency at Stanford. They credited their co-authors of the 100-page book, Devin Nambiar and Stanford student James Xie, who weren’t able to join us.

They told me the most popular entries on their blog have been ones that focused on common application mistakes, acing the interview, and that ever-vexing question, what to wear. And the takeaway message from all? Hopeful students need to be humble, empathetic, and above all, good communicators.

How did Cracking Med School Admissions come about?

Rizal: We’re a team of med students who love advising to the point where we were exchanging emails and asking, “Oh, how do you advise this person for letters of recommendation, how do you advise this computer science major?” So we thought, “Let’s write a book!” We wanted the book to be fun and very readable, so we did it in a Q&A format. If there’s a question where we have different perspectives then we give different examples. We have checklists, and we have sample essays from people who got into great schools.

Mediratta: We’ve been advising undergrads and high school students for a long time [and] every fall and spring we speak to post-bacs who are applying to medical school. There are so many questions that they ask after a presentation [that] you get a sense of what common questions are, and common difficulties.

What are some important insights about admissions? 

Rizal: Most med schools in California are turning more to this Multi-Mini interview process where it’s speed interviewing… Instead of speaking to two people for thirty minutes to an hour, it’s like a round robin and every ten minutes you get a different interviewer with a different question… It’s a lot of fun. I sometimes sit on the reviews for Stanford and we have that process.

Mediratta: I think medical school admissions are going to start favoring students who can think on their feet, see two sides to an issue: ‘These are the pros, these are the cons, and I would choose this approach.’ It really forces students to think for themselves… People will learn the medicine, but if you get people who are already strong communicators… it makes for a really strong doctor.

How do academic and extracurricular experiences fit into the application? 

Mediratta: A lot of people will write more about the hospital or different organizations they worked at, but they don’t write about what they’ve learned from the actual process… Lots of times their experiences come together and point in a certain direction, and it’s often when you reflect on it that you realize that.

Rizal: One question we get asked a lot is, “So I have all this clinical experience, but I also have this hobby of biking around the world [- and what should I about that]?” One girl we advised last year really loved fashion and created her own clothing line and then had to figure out how to market it. It’s important to highlight that in your application because it makes you interesting… More importantly, it really shows different aspects of your personality that could relate to medicine. For example, there are a lot of students who do teaching before they go into med school, and in order to be a teacher in a class you have to have patience and great communication, and really be able to understand – and although that’s not really medicine that’s very applicable to time in the clinics.

Mediratta: We have friends who have majored in both the sciences and non-sciences. It’s all about taking a step back and figuring out what your passion is. If you’re passionate about public health, did you pursue work in college or after college? Did you take some time off? That really demonstrates passion for that career.

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