Friday, February 27, 2009

Filing the FAFSA

If I end up going to Colorado, I will be paying about $50,000 for tuition and fees for the 2009-2010 academic year, plus around $20,000 for living expenses. Multiply that by 4 years and I'm looking at a minimum potential debt of $270,000 by the time I finish medical school. Needless to say, I won't be paying for my medical education with cash upfront.

Almost all medical students have to apply for financial aid of some sort or another, and I can be fairly confident in saying that all medical students who do need financial aid apply through the Free Application for Federal Student Aide application (http://www.fafsa.ed.gov).

Filing the FAFSA seems a lot scarier than it actually is. The FAFSA is completed and submitted entirely online. Apparently, there are professional "preparers" who help you prepare your FAFSA for a fee. I am lucky to have had help from my father, who is good with finances. They say on the FAFSA website that it should take under an hour to fill out the application (if you have all the necessary information at hand); I did indeed finish my FAFSA application in less than an hour, and I feel very relieved that it's out of the way.

Colorado interview summary

I flew into Denver on Saturday morning for a Monday interview. My intention was to give myself a couple days to explore a bit, since I could potentially be living here next year. But I also discovered that arriving a few days early was advantageous because it gave me time to acclimate to the altitude. I had headaches for the first day - not debilitating, but bad enough so I wasn't at the top of my game. A little rest and a lot of water, and I was good to go on Monday morning.

I stayed at the Crystal Inn, which is conveniently located midway between the School of Medicine and the airport. They also partner with the School of Medicine, offering free shuttle service to and from the airport, and also to and from the campus on interview day. Very convenient and reasonably priced.

Introduction
Interview day started at 8:00 am. There were about 30 applicants, the majority of us from out of state. We fidgeted nervously in the small auditorium, a life-size cardboard cutout of Barack Obama standing at the podium, waiting for the program to start. We first got a brief introduction on the history of the Anschutz Medical Campus from the Dean of Admissions. This is a brand new medical school, so new that the University of Colorado only moved in last January. They bought the land from the Army for $1 under the condition that the Fitzsimmons Army Medical Center be preserved. This was where Eisenhower received treatment when he had a heart attack; apparently, Fitzsimmons was known as the "White House of the West."

Pre-Interviews
We were given a five-minute break after the introduction. A couple current medical students passed me as a group of us applicants walked down the hall to go to the bathroom: "Hang in there, guys, you're almost there!" It was a small gesture, but it made me feel better. A group of faculty interviewers were waiting for us when we returned from the bathroom. My first interviewer actually approached me and introduced herself, no doubt recognizing me by the photo included in my application. I was impressed by their friendly welcome and genuine excitement, not just on the part of my own interviewer but by all of the faculty.

Interview #1
Dr. XXX is a pleasant woman in her mid-50's, a pediatrician and geneticist. She started the interview with a relaxed, conversational tone, remarking how unlikely it was for a student from California to hear of a small East Coast liberal arts college, much less go there. The interview progressed with get-to-know-you questions with a decidedly friendly tone. I didn't let that lull me into a false sense of security, though: I was still "on," or as my friend calls it, frontal lobe inhibited.

Dr. XXX did ask me if I have given thought to what kind of medicine I want to specialize in. When I gave her my standard response ("Neurology or neuroradiology would be a natural extension of my career, but I'm keeping my mind open to all possibilities."), she suggested neurology with a sub-specialty in pediatrics. An interesting idea... I told her I would keep it in mind.

Before ending the interview, Dr. XXX gave me an opportunity to mention anything that isn't reflected in the application. Naturally, I brought up my recent medical relief mission to Honduras. This seemed to impress her as she asked a lot of follow up questions about my experience. How did I get connected with that organization? What did I actually do down there? What about the experience was most rewarding to me? Then the interview ended rather suddenly since we were out of time.

I left with a very, very good feeling. I knew that my first interview went well.

Interview #2
I was a little bit worried about my second interview, going into it. The Dean of Admissions, during her introductory talk to the entire group of applicants, lauded the accomplishments, rankings, and awards of her medical school. She specifically mentioned Dr. YYY, a retired neurologist who was involved in ground-breaking fetal stem cell research in Parkinson's disease in the early 1990's, and noted that two applicants would be interviewing with him. Given that my essays discussed my Grandpa Don and his Parkinson's disease, it's likely that the admissions office matched us based on similar interests.

Dr. YYY started the interview with a disclaimer: "Now, we have a limited amount of time and a lot of ground to cover. We're going to jump around a lot. I want you to know that I am not your adversary, rather your advocate to the admissions committee." He then added in a less crisp tone of voice: "Also, if we have time, please remind me to tell the story I have for you." This was rather cryptic, but I acknowledged him and waited for the interview to begin.

As I soon discovered, this was the type of medical school interview that my family-friends who are doctors prepared me for. Throughout the interview, Dr. YYY sometimes cut me off in the middle of an answer after he was satisfied (or not) with my response, often to a completely unrelated topic. I didn't let the brisk pace of the interview faze me, and I tried to maintain a respectful, humble, and confident tone.

How did you become interested in medicine?
I talked about my grandfather who had Parkinson's disease, watching his deterioration as I grew up, and wanting, in a general sense, to do something to help him.
Is this the first time you have applied to medical school?
Yes, sir.
You have never applied to medical school before?
No, sir. My response seemed to have surprised him.
Why not?
A lot of reasons. It wasn't the right time in my life, right after college. I wasn't ready emotionally. This was a reference to one of the essays that I wrote for Colorado's secondary application. He didn't follow up on it since, from my essay, it's clear that I am ready for medical school now.
So you decided instead to go to graduate school. Why?
I explained that, being exposed for the first time to biology research, and with my grandfather's continued decline, I saw that a major breakthrough in treating - or even curing - Parkinson's disease would come by way of knowledge gained from research. I downplayed this as somewhat idealistic, hoping to avoid coming across as naive. "Don't underestimate the influence of grandfathers," Dr. YYY replied, to my surprise. He then told me a story of a good friend of his, whose grandfather died of cancer. She went on to become a chemist - a remarkable achievement for a woman in the post-WWII era, and eventually won the Nobel Prize in Medicine for her contribution to drug research, including development of the AIDS drug AZT. The moral, Dr. YYY said, is that grandfathers matter. When I got home, after doing a little research, I found that his friend is Gertrude Elion, who shared the 1988 Nobel Prize in Medicine. The interview then jumped back into its original pace.
What do you think is the best way to improve our health care system? Did you read Atul Gawande's article in The New Yorker, "Getting There From Here"?
This article examines the predicament that Americans face with our health care system and discuss precedents in other countries such as Great Britain, France, and Canada, for enacting universal health coverage. Each country arrived at universal health care in different ways, due to the vagaries of history, resulting in disparate health care systems with their own idiosyncrasies - yet all providing universal coverage. The moral of the story is that sweeping changes are made incrementally within the framework of pre-existing systems, and that approach is likely the one that we must take here in America.
In college, do you think that running ever got in the way of your academics?
No sir, quite the opposite. The coach and team culture were very supportive of academics. Running injected a routine to college life that helped me academically.
What was the best thing that ever happened to you?
The question took me by surprise. I took what seemed to me like a very long time, but was in reality probably only about 15-20 seconds, to think about such an all-encompassing question. Finally, I answered: When my parents had my little sister.
Why?
I took another 15-20 seconds to think. Because through my little sister, taking care of her and being a role model for her, I learned what it means to love. In retrospect, I realize that this was an impossible question designed less to discover a meaningful turning point in my life and more to test my character and insight.
What was the worst thing that ever happened to you?
Leaving my graduate program. This, too, was a loaded question, designed to see how I handle the challenges that life throws at us and what I have learned from them. Dr. YYY and I explored the circumstances of my situation, and the motivations behind my decisions. I stressed that, as difficult as that experience was, it led me to where I am today. "I'm glad it worked out for you," Dr. YYY remarked before moving on.
What diversity will you bring here?
Another loaded question! This is a common-enough question that some of the other schools even asked on their secondary application. I have diversity of experience but not much else. I fumbled my way through a response to that effect. Dr. YYY pressed a little bit more, but I hesitated.
Would you like to move on?
Yes, please. I was grateful that Dr. YYY gave me a pass on that question but wondered in the back of my mind whether I had wounded myself by taking it. There's no time for second-guessing yourself in the middle of an interview, though, and we continued.
I see you have presented several times at scientific meetings and have a publication from graduate school. Do you have any more publications on the way?
Yes, I'm working on several publications right now.
Will you be first-author on any of them?
Yes, on two papers. I was surprised, though, that Dr. YYY did not inquire into the nature of those papers.
Is there anything else you want to tell me that will help me better understand your application?
I took this as my opportunity to re-frame a few poor undergraduate grades. Dr. YYY looked at me wryly and said, "If that's it then you have nothing to be worried about. I got a C in calculus, and I turned out fine." What a relief!
Is there anything else that you want to add to your application?
Like with Dr. XXX, here I told Dr. YYY about my medical relief mission to Honduras.
Do you speak Spanish?
Fluently enough, conversational. The indigenous people of the Miskito Coast speak a local dialect, I explained, but I did help translate between the English-speaking and Spanish-speaking members of the team. As I read on the School of Medicine website, immigration is a major issue in Colorado. Illegal immigrants from Mexico tend to pass through Arizona into Colorado, since Arizona's immigrant laws are much more strict than Colorado's. So, I imagine that speaking Spanish is quite an asset for practicing medicine in Colorado and that my answer served me well.

The interview with Dr. YYY ended quickly just as my interview with Dr. XXX had ended. I left the room feeling good about the experience, for the most part. I'm unsure about how my answers to some of the questions (like diversity and health care) came across, but I am also confident that I presented myself in the best possible light, highlighting my strengths, and giving it my best effort.

Saturday, February 21, 2009

Oregon Health & Science University: Rejected

I got the thin envelope from Oregon this afternoon. I knew it was coming:
[I]t is the admissions policy of the School of Medicine to give preference to... residents of Oregon, WICHE-certified residents of Montana and Wyoming, MD/PhD and MD/MPH candidates, non-resident applicants with superior achievements in academics and other related experiences and non-resident applicants from diverse backgrounds. This year the number of qualified applicants in the aforementioned groups significantly exceeded the available placements.

Honestly, though, I feel more a sense of relief from finally knowing than dejection from being turned down. Of course, that may have something to do with the fact that I've already been accepted to a good medical school where I know I can be happy.

Thursday, February 19, 2009

Fair trafficking rules of medical school admission

I woke up early today and stopped by the post office on my way to work to mail my signed paperwork and deposit check reserving my spot in the University of Colorado School of Medicine class of 2013. It sounds very final, but it's not. In fact, it's quite possible that I might not know where I'll be going to medical school for several months yet. The uncertainty is bearable because I know that, regardless of what happens, I am already in.

Medical school applicants and admissions committees abide by a set of rules that are designed to facilitate the process of figuring out who goes where. Granted, I haven't yet gone through the entire process, but my perspective at this time is that these rules actually do work well.

I can accept as many offers of admission as I like, so long as by a certain date (this year, May 15), I withdraw my acceptance to all schools but one. Likewise, admissions committees are required, by a certain date (this year, March 30), to make enough offers of admission to fill their freshman class. As applicants withdraw their acceptances, admissions committees then make more offers of admission until the freshman class is filled. This means that, even if I haven't yet heard from a school by March 15, I might still be offered admission.

In fact, so long as an applicant has not matriculated (e.g. formally started a program by going to orientation or classes), an applicant is free to switch from one school to another. This has even been known to happen on the day before the first day of classes. What this means to me is that, hypothetically, I could move up to Denver expecting to start medical school up there only to find out at the last minute that UCSD is offering me admission. What would I do in that situation? We'll cross that bridge when we come to it.

Friday, February 13, 2009

Congratulations on your acceptance to the University of Colorado Denver School of Medicine

The acceptance e-mail:

Congratulations! We are pleased to inform you that the University of Colorado Denver School of Medicine Admissions Committee is offering you a place in the freshman class matriculating in August 2009. This offer is an indication of the high regard that the school holds, not only for your past academic and personal accomplishments, but also for our assessment of your capability as a future physician. We look forward to your being a member of the class and to a mutually rewarding relationship both during your four years as a medical student at the University of Colorado and throughout your career. You should know that this offer of admission is contingent upon two criminal background checks, one by AMCAS and one in June 2009 which is standard for all incoming Health Sciences Center students.

We expect our medical students to develop clinical competence, a broad interest in disease prevention and health maintenance, a dedication to the relief of human suffering, and recognition of their individual responsibility for achieving these goals. We hope that you will accept this offer and that you will matriculate into the Class of 2013. Please let us know within two weeks whether or not you will attend the University of Colorado Denver School of Medicine.

ACCEPTED!!! COLORADO!!!

I got into Colorado! I'm going to be a doctor! I'm going to be a doctor! The feeling of finally getting into the first medical school, after months and months - or even years and years - of driving toward that goal, is a feeling nothing short of euphoric. Like when I cut my thumb and had to go to the emergency room when I was 8 years old, it took a little while for me to move beyond the shock of reality. I'm going to be a doctor!

The acceptance came by e-mail. Yes, medical school admissions offices have entered the 21st century and send out acceptance letters by e-mail, now. This does nothing to help quell the rapidly growing epidemic of compulsive e-mail checking, a condition from which I continue to suffer. My excitement after the Colorado interview fed into this compulsion, even though I didn't rationally expect a decision so soon after interviewing. Still, I woke up Friday morning, February 13th, five days after interview day at Colorado, thinking to myself, "Maybe today..."

The subject read "Congratulations..." and then there was lots of shouting and jumping up and down. My parents got the first phone call. My voice was unexpectedly calm when I told them the big news. In my defense, I was still in shock. My boss, who has been so supportive of me throughout the application process, got the second call. I spent the next hour or so calling my family, friends, and mentors. I am fortunate to have a whole host people supporting me through this arduous and emotionally taxing process of applying to medical school.

When I finally left for work, my head was still up in the clouds. In the car, alone with only NPR and my thoughts to listen to, I finally had time to process what had just happened. While Carl Kassell talked about failing banks and default mortgages, I laughed aloud in bubbly disbelief that I had really, really gotten into medical school. I even fought back happy tears.

The entire day was a breathless celebration: phone calls, e-mails, and exclamation points. That's as it should be on the day when you get into medical school.

Sunday, February 1, 2009

Interview at Drexel: Summary

I stayed with a first-year medical student, who I found through a friend-of-a-friend-of-a-friend. His apartment was right across the street from the medical school, making it very convenient to just walk over the morning of the interview. He was very hospitable but holed himself up in his room all night studying for a test. I arrived late and was hungry, but my host told me that there is nothing - literally nothing - within walking distance, not even a convenient store. So instead, I heated up a can of soup and ate a banana I had stashed away.

Interview day started at 9am, but I got there an hour early to eat breakfast at the student cafeteria. The omelet was pretty good but settled heavy because of nerves. There were 15 of us total, not counting one or two who showed up late because of traffic. We all sat awkwardly around a conference room table, some keeping quiet and some making nervous small talk. I was rather amused watching how each person handled the stress, knowing full well that people-watching was how I handled my own.

First item on the agenda was a Powerpoint presentation on the history of Drexel college of medicine. Then, we were given a tour of the medical school. The complex is relatively new, even with some construction still in progress. When we were down in the anatomy lab, surrounded by cadavers, we heard an ominous thud-thud. All the applicants looked around at each other. "That has never happened before!" our tour guide apologized, then she explained to us that they were driving piles for a new simulator for first and second year medical students, to be completed in 2010 or 2011.

We also stopped in two classrooms that demonstrated their two programs, one called Interdisciplinary Foundations of Medicine (IFM), which is lecture-based, and the other called Program for Integrated Learning (PIL), which is small group learning structured around case studies. I am particularly intrigued by the PIL, because I think that I retain more information when it's put in context, and because I spent my undergraduate years learning in small groups.

The PIL students were in the middle of discussing a case study when we walked in; they were so absorbed that the discussion continued without skipping a beat until the faculty moderator interrupted them to talk to us. I asked a lot of questions, of course. Most pragmatically, they tell us that there is no statistical difference in USMLE Step 1 performance between IFM and PIL students. Still, I would prefer to see the data myself and still feel a nagging discomfort about whether such a radical departure from the traditional medical curriculum could adequately prepare me for the Step 1. Fortunately, deciding between IFM and PIL is something I don't need to worry about until later.

After the tour, we were given a "surprise" essay to be completed before the day was done. These days with online pre-med forums, admissions committees can't keep secrets. It was to be hand-written, and space was limited to half a page.

Next, we had a student interview over lunch. The student who interviewed me was very laid back and easy to talk to. She conducted the interview more like a social conversation, but also throwing in some standard interview-type questions to keep the conversation rolling: "What do you do for fun, in your free time?" and, "If I asked your three best friends, separately, each to describe you in one word, which words would they choose?" Interestingly, student interviewers at Drexel have full input on the admissions committee.

The rest of the conversation followed naturally from my responses about running, San Diego (she spent some time there), traveling, etc... Then she asked me if I had any questions for her about Drexel (I had already asked her about her own background and how she ended up at Drexel). The most important question that I asked was this: "I have heard a lot of great things about Drexel, and not to be negative, but is there anything about Drexel that you don't like or disappoints you?" Aside from the cafeteria food, she answered that some people do not like doing their clerkships all over the state of PA. Earlier in the day, though, I learned that housing is automatically provided if a hospital is located more than 40 miles away; also, if there are extenuating circumstances, one can request to stay in the Philadelphia area.

After lunch and the student interview, I waited for my faculty interview, scheduled at 1pm. My interviewer was a half hour late, though, because a meeting went over. Dr. XXX was started the interview by saying, "Let's jump straight to the parts in your application that the committee is going to have questions about. It was an open interview, I saw, which means that the interviewer has full access to my entire AMCAS file, including grades and MCAT scores. I decided to take her cue and answered her directly about the aspects of my application that need more explaining.

Dr. XXX went through my entire academic record with a fine-toothed comb, starting at my thought process in deciding to go to a small East Coast liberal arts college. Why did I major in biology? Why did I go to graduate school in neuroscience? Why straight out of college? Why did I leave my graduate program? Why did I move back to San Diego? Why did I get a job rather than find a new Ph.D. program? How did I come back to medicine? What precipitated that decision?

In summary, Dr. XXX's interview was a very methodical exploration not just of my academic history but of my motivations and thought processes behind each and every decision and turning point in my career.

At the end, she opened it up to questions. My first question was this: "Are you satisfied with my answers to your questions?" She said yes, without hesitating. Next, I asked her about her personal experience with Drexel. This was very informative, as she has in essence spent her entire career at this institution, through all its transformations.

Thus ended my interview at Drexel. Decisions in 6-8 weeks.