Tel Aviv: Accepted!

It is with great pleasure that, upon the recommendation of the Admissions Committee, the Tel Aviv University Sackler School of Medicine - New York State/American Program wishes to offer you a place in the Class of 2013

Very exciting!!!

I knew that I would choose Colorado over Tel Aviv even before I got this letter. Regardless, it feels good to have the "right of refusal," as one friend put it, as well as confidence from knowing that I had options, as another friend framed my admittedly enviable position.

My interview with Dr. XXX, an alumnus of Tel Aviv practicing in San Diego County, was even more relaxed than my UCSD interviews. The most probing questions he asked were related to how serious I was in applying to Tel Aviv and how likely I was to complete the program should I matriculate. Can I handle the language barrier and culture shock? Do I have a support network in Israel, or could I function well half a world away from home?

Dr. XXX stated outright, in fact, that the admissions committee understands that Sackler is a backup school for many if not most applicants, and that those who are accepted to a program in the United States tend to stay in the country. Knowing this makes it a bit easier to turn down Tel Aviv. But, if I had not been accepted into any program in America, I would have been thrilled to go to Tel Aviv for medical school.

UCSD Decision: Still Waiting

The admissions committee didn't end up discussing my application on Monday, which means that I have to wait another two weeks. As my friend who is a second-year medical student said, "Boo application process!" I agree. But as agonizing as this waiting is, another two weeks (April 7th) won't kill me.

UCSD Decision: March 24?

If my application was discussed in today's meeting, I will hear back from UCSD tomorrow. I'm nervous and hopeful. Regardless of what happens, and whether I find out now or in a few weeks, I have to keep reminding myself that things usually have a way of working themselves out.

UCSD Interview #2

I had about an hour of free time between my first and second interviews. I used that time to do some research on Dr. YYY - to find out what his specialty is, what kind of research he does. A quick PubMed search in the library gave me a whole list of his publications on alcohol and opioid abuse. It occurred to me that I was able to do this so easily because I have the home court advantage here at UCSD.

Finding Dr. YYY's office was frustrating, but I arrived on time in spite of the rat's maze that is the VA Medical Center. Dr. YYY asked me to wait for a few minutes. This gave me some time to take some meditative deep breaths and contemplate a tropical scenery painting hanging on the wall. Dr. YYY greeted me warmly and apologized for keeping me waiting. Like Dr. XXX, he began the interview in a conversational tone, though not quite as carefree.

Soon, he did start asking me real questions, ones that I have already faced and answered satisfactorily in previous interviews.

• How did you end up at a small liberal arts college on the East Coast?
• What attracted you to that school?
• Since you took all my pre-med courses in undergraduate, did you go into college intending to become a doctor?
• Is this the first time you have applied to medical school?
• Why did you decide to go to graduate school instead of medical school?
• Why did you go to graduate school straight out of college?
• Why did you leave graduate school with a terminal Master's?
• What was your plan when you left your program?
• What made you decide to go back to medicine?

This sounds like a lot of very direct questioning, but Dr. YYY had a way of asking them in a friendly manner, as if it were idle curiosity and not evaluative. These questions were peppered in between mostly unrelated topics. We spent a good deal of time talking about running, not because he is a runner himself, rather because his son ran track & field in high school. I could tell that he was very proud of his son's accomplishments. "Is that your son?" I asked in the middle of a sentence, pointing to a screen saver picture that popped up on his computer. He smiled and said yes, and we continued talking about personal bests and different track events.

At the end of the interview, Dr. YYY asked me if I had any questions for him. I asked him about the impact of the California state budget on the educational experience at UCSD, and he was very good at answering this concern. I also asked him about his own personal experience with UCSD. Dr. YYY wrapped up the interview by giving me his e-mail address and saying "Please contact me if you have any more questions. I'd be happy to help."

That was definitely a good sign, a good way to end the interview. I was impressed that he made himself so accessible. I left the interview feeling good about the intangibles, e.g. rapport and ease of conversation, but feeling less good about the quantifiable aspects of the interview. I felt like I didn't answer his direct questions as well as I had answered them in my Colorado interviews. I am far from objective in this matter, though. It is possible that Dr. YYY had an entirely different perspective of my interview performance.

UCSD Interview #1

The office of admissions didn't give us applicants our interview schedules until literally 15 minutes before the first interview. One person had to take the shuttle bus down to the Hillcrest campus. I got lucky and had both of my interviews in the VA Medical Center, which is just a five minute walk from the admissions office.

I couldn't have been more lucky to get Dr. XXX as my first interviewer. He had a calming voice and demeanor that helped set me at ease when I most needed it. He started the interview by talking about the UCSD program, as if he were trying to anticipate questions that I might ask him later. "The way I see it is that at this point we're beyond the evaluative stage," he said. Good to know, I thought. I let him talk, since that's what he seemed to want, and also as he proved to be very informative, but at the same time I grew increasingly concerned that I was not maximizing this time to convince him that I belong at UCSD.

The entire interview was conversational, though Dr. XXX did ask me a few direct questions about my application. The first direct question was about my experience working with magnetoencephalography (MEG), which is a technology that measures tiny magnetic fields emanating from the brain and infers brain activity from that information. "Why hasn't MEG caught on? Why isn't it being used clinically?" I told Dr. XXX that the fundamental hurdle facing MEG as a clinically relevant tool is the complexity and unreliability of its data analysis. A magnetic field is generated when a current flows in a straight line, such as during an action potential along axons. The problem is that, if two action potentials travel parallel to each other but in opposite directions, the magnetic fields that each action potential creates would cancel the other out. Another problem limiting the usefulness of MEG is that you can only really measure magnetic fields generated close to the brain surface - in the cortex, but not in deeper brain structures like the thalamus or striatum.

This entire MEG-related interaction lasted only about 2-3 minutes. Dr. XXX did seem genuinely curious about a rather obscure experience in my application, but I got the sense that the secondary purpose of the question was to evaluate how I discussed my past research experience.

The conversation then shifted to running and triathlons. I got the sense that Dr. XXX knew that this subject would make me more comfortable. He showed me a picture on his wall of him finishing a triathlon while holding the hands of his two children. "They don't let you do that anymore," he said. I asked, "Did you do triathlons in medical school?" It turns out that he did, and that he surfed. "Sounds like you had a well-rounded life while in medical school." Dr. XXX actually went to medical school here at UCSD, so this fact was very relevant to me. He also got married during his fourth year.

Toward the end of the interview, I found an opportunity to tell him about my recent medical relief mission to Honduras, since it isn't included in my application. Dr. XXX raised his eyebrows and said that he in fact participates in a very similar program in Fiji. He then explained to me how the cultural history of the island has created a sort of health care crisis. There are essentially two separate populations on Fiji: native islanders and Indians brought over during British colonial rule. There is a distrust between the two groups such that the native islanders won't even accept medical care from someone of Indian ethnicity; most doctors there are Indian. People in Fiji also have to deal with tropical diseases, and recently there was a big flooding problem. So, Dr. XXX talked about his experiences volunteering with the Loloma Foundation (I pulled out a pen in the middle of the interview and wrote down the name of the organization). I felt good that this was yet another topic on which we had something in common.

I left the interview with a decidedly positive feeling. If we really are "beyond the evaluative stage," then this interview was about personality and making connections. I think I did that very well with that in both the running and international volunteer work parts of the interview. Still, it's difficult to get a sense of how this interview will impact the committee's decision.

Impact of the California state budget on medical education

One question on my mind while interviewing at UCSD was how the California state budget woes could impact my medical education. This question was partly addressed by the dean's opening presentation. Before the budget deadlock, the School of Medicine was set to break ground on a new medical training facility in January 2009. That of course did not happen. It's unclear, now, when construction will begin. How does that impact me? Minimally, I would guess. Even if the new medical training facility were finished on schedule, I would be well into my clinical years by the time it opened.

I also asked this question to my second interviewer. "It'll affect the faculty more than the students," he said. There's a hiring freeze in effect, which means that we can expect the status quo until it's lifted. "The status quo here isn't all that bad." Dr. YYY also said that the hiring freeze will impact the School of Pharmacology since it is new and growing. The thought occurred to me that medical students take Principles of Pharmacology in the first year alongside pharmacology students.

These are definitely issues to be aware of, but when it comes down to whether my medical education might suffer because of the economy or state budget issues, I'm not all that concerned.

Getting into UCSD: no unforced errors

At the end of the interview day, a guy from the admissions office came in and gave the group some practical information, most importantly when we might expect to get a decision. The committee meets every other Monday, we were told, with the next meeting on March 23rd and the following meeting on April 6th. Most likely, we would be discussed in the later meeting. Decisions would be sent out the following day, phone calls for acceptances and e-mails for those who are placed in the "acceptable pool of applicants."

The big catch: we were invited to contact the admissions office and request to be moved up to the earlier meeting. "I really want to know now!" I thought. Should I request an earlier review? This felt oddly like some sadistic social experiment. I decided to ask the opinion of my co-worker who has served on admissions committees. "Don't mess with them," he advised. "Remember, this is a process of elimination, 6000 applications for a hundred or so spots." The game, now, is to lie low and not stick out from the crowd in a bad way. No unforced errors.

Undergraduate : Sippy Cup :: Medical School :

A. Big Gulp
B. Keg
C. Fire Hose
D. Milk Bottle

UCSD Interview: General Information

Interview day started at 8 am with an introductory presentation by the dean of admissions to a total of 7 interviewees, including myself. She gave us some pertinent information about the program and some statistics about the admissions process. Particularly heartening is that UCSD looks well upon the non-traditional applicant such as myself. The mean age of entering first-year students is 24.

• >5500 Primary applications
• ~Secondary applications
• 600 interviews
• ~300 offers of acceptance
• 134 students in the entering class

The dean also said that 225 offers of acceptance have already been made for those 134 slots but stressed that the admissions committee is still making offers of acceptance. In other words, I'm not just wasting my time interviewing for a spot on their waiting list. UCSD's waiting list is non-ranked, and they euphemistically call it the "acceptable pool of applicants."

Medical schools are able to make more than twice the number of offers as they have room in their entering class because applicants tend to accept offers to multiple schools. Medical schools actually have access to that information: the dean said that one applicant who they accepted holds acceptances to more than a dozen other medical schools. The chances that that person ends up at UCSD is pretty slim. All applicants are required to hold an acceptance to only one medical school by May 15, so around that time there is a "national shuffle" of medical school applicants as they formally turn down their multiple offers. So, additional acceptances are offered to applicants placed in this acceptable pool around May and June, and even into July.

Curriculum
I also got some interesting information about the curriculum. UCSD is on the quarter system with one predominant class per quarter and several smaller classes that are less intensive; most medical schools are on a semester schedule. I asked some students if they felt that being on the quarter system in any way impacted their medical education. The general response I got was that no, it didn't, except maybe for having more frequent tests.

UCSD medical students are evaluated on a strict pass/fail system. Other medical schools also tend to use pass/fail, but it's common to taint that by introducing "honors" or "high honors."

One quirk about the UCSD curriculum is that human anatomy is taken during second rather than the first year. This is in contrast to all other programs that I've seen. Talking to some current medical students about this, it seems that the rationale is to move from microscopic to macroscopic, learning topics such as pharmacology and cell/molecular biology before the rote memorization of human anatomy. None of the students voiced any complaints about taking human anatomy second year. As much as human anatomy is a rite of passage for first-year medical students, I imagine it might feel strange postponing that experience until second year. This is not a deal-breaker, though, and not necessarily even a negative.

UCSD requires students to complete an independent study project (ISP) prior to graduation. They provide an enormous amount of flexibility as to its topic so that it really can be anything I choose. I was wondering whether I might even be able to use the ISP to continue my work in my current lab. It's a possibility worth exploring, but I also see the value of finding new topics that interest me.

Third-year clerkships take place at six different locations around San Diego County:

1. Hillcrest
2. VA
3. Thornton
4. Children's
5. Balboa Naval
6. Scripps-Mercy

In general the placements are random, though we were told that the dean's office is very good about working with each individual student's needs and may be able to fulfill requests for placement at a given location.

Student Run Free Clinic
Perhaps the most distinctive aspect of the UCSD experience is the Student Run Free Clinic program. The office of admissions goes to great lengths to highlight this program. It is what it sounds like: a clinic that is for the most part run by students. There's a hierarchy of mentorship, of course, with older students having supervisory responsibilities and an attending physician ultimately responsible for all patients that go through the clinic. What particularly appeals to me about this program is the unique opportunity to gain clinical experience - working directly with real patients - even in the first year of medical school. The first two years of all medical schools are heavily weighted in lectures and coursework. Basic clinical skills are taught to a limited degree in the first year, with some schools devoting more time to it than others, but this is no substitute for genuine patient interaction and the experience provided by the Free Clinic.

Office of Student Affairs
The Office of Student Affairs also gave a presentation. I was very impressed by the lengths to which UCSD goes to make life just a little easier for their students. There are organized events such as outings to the theater or opera, or wine and cheese social mixers that include both students and faculty. When I toured Drexel and Colorado, I didn't get the impression that their students had nearly as much in the way of such life-balancing experiences provided by the school.

The mentoring system, too, is extensive and structured. All incoming first-year students are paired with a faculty mentor, in a casual-type relationship, and with a second-year Big Sib. Third- and fourth-year students can become "senior mentors" to the Big Sibs, which creates a sort of "family tree" of medical students. This structure is rather common across medical schools, probably because such a social arrangement is effective in supporting students throughout medical school. Students also choose a faculty mentor for their ISP, and finally, students choose another faculty adviser at the end of their third year specifically to help them navigate the process of applying to residency programs.

UC Irvine: Rejected

On the same day as my UCSD interview, UC Irvine sent me their rejection. It was waiting for me in my inbox when I returned from the interview. Yes, my e-mail inbox. It struck me as cheap and unprofessional that, after pouring so much time and energy into my application, they didn't even have the common courtesy to send me a formal letter of rejection through regular mail. I hope that other medical schools don't follow their poor example.

UCSD Interview: Nerves

My UCSD interview is coming up quickly: next Tuesday, St. Patrick's Day. I should wear a green tie. Or not. I'm getting kind of nervous, not quite the same breed of nerves that I felt before Colorado but a little edgier.

I keep reminding myself how fortunate I am to have so many people within UCSD actively pushing my application forward. A coworker asked me, "Do you know who your interviewers are?" Medical school applicants typically don't find out who their faculty interviewers are until the morning of the interview. It's better that way, in my opinion, because otherwise a whole Pandora's box opens, with applicants obsessively researching their interviewers' academic careers and memorizing their curriculum vitae. I told my coworker, no, I don't know who they are, and she offered to try to find out for me. I'll take any little advantage I can get! Well, I didn't get that particular advantage, but her friend on the admissions committee instead gave me this advice, which, from my perspective, is much more valuable:

1. Be relaxed. Most interviewers are not going to give you a hard time.
2. The ability to relate to another person you just met is important.
3. Know yourself: a) destined for primary care; b) destined for research; c) interested in a specific program.
4. Know your application: what about it is special; what about it is typical for students accepted to the school; what about it is less than typical for the school. Be able to talk with passion about the first category. Be able to succinctly answer questions about the former in a positive way.
5. Prepare questions, but do not ask questions about things that are readily obtained from the website or catalog; rather ask questions that draw upon the interviewer's personal experience.

George Washington: Rejected

Another rejection. Though I'm used to it by now, and less fazed because I have already gotten into a good program, I am rather disappointed that I won't at least have the option to live in DC close to my older sister. It would've been a fun city to live in while going to medical school.

University application for financial aid

Each medical school has their own university-specific application for institutional aid. Today I turned in Colorado's University Application for Financial Aid. This application is for institutional grants and scholarships to supplement FAFSA support. The form was very short, just a few pages, plus a copy of the first two pages of my 2008-2009 tax return. I also submitted a form saying, in effect, that my 2009-2010 income will be less than my 2008-2009 income. For incoming medical students who had a job prior to matriculation (like myself), this is necessarily the case.

This is the mountain I want to be on

A good friend told me a story of a guy who was afraid of heights. He decided to climb a mountain to conquer his fear and brought along a friend to help him through this journey. The guy did climb a mountain, and he did make it to the summit, but a blizzard hit while he and his friend were up there. Huddled in the tent together, the friend asked the guy who had been afraid of heights, "Are you happy right now?" The guy answered, "No, but I'm still glad that I climbed the mountain."

Medical school is my mountain. If a friend were to ask me sometime during the next four years if I'm happy, there's a very good chance that I'll answer "No." Not right in this moment, but this is where I want to be.