AHA 2018 Poster Presentation

I have finally returned from my adventures in Chicago! This past Sunday I presented my very first research poster at the 2018 American Heart Association Scientific Sessions. Despite some hiccups in obtaining data, I stood in front of my poster during my designated presentation time – one of the only pre-meds presenting. Though the AHA is primarily focused on interventional cardiology (rather than the specialty I work in), I had some interesting questions and feel like I held my own.

The three day session has a huge variety of events. Admission includes large lectures and sessions by the world’s leading cardiologists, discussions of new and future research, presentations on current research, small session tips on networking and career choices, demonstrations of new technology and medications, as well as outside events.

After waiting for about an hour to get my badge, I headed to a “Main Event” lecture entitled “Hey Doc, My Watch Says I Have AF, What Now?”. I was surprised that I was able to understand the information being presented. I was disappointed that only one lecture pertained to EKG monitoring with the Apple Watch and similar devices. I stayed for the majority of the 2 hour lectures. Using the AHA Conference App, I participated in polls and asked questions. I appreciated how smooth it was, though many presenters did not have time to answer more than one question.

I explored the Science and Technology Hall, where reps from pharmaceutical and medical device companies showed off their new toys. I watched an automatic device deliver chest compressions, played an iPhone game where I could stent patients, and scanned over research and textbooks for sale. There’s an EKG learning program that I’m very interested in purchasing, but didn’t want to buy anything until I talked to my attending.

I didn’t spend all day at the conference, especially because Boyfriend came with me. I didn’t want to bore him any longer. We came back the next morning for my presentation. Thousands of posters are presented each day. I stood next to residents, fellows, and foreign doctors. We asked each other questions more than anything else and chatted about the conference. Many doctors I spoke to were not familiar with catheter ablation of A fib, so I felt more like an “expert.”

Here are some tips if you’re going to your first research conference for a poster presentation!

1) Buy your ticket early.

It’s quite expensive for non-members to attend events like these. However, students are usually offered a lower price. In addition, buying tickets earlier can mean cheaper prices.

2) Use your hospital and/or school’s printing services.

I paid $115 to have AHA print and deliver my poster to the conference. I was unaware that my hospital had a library with a printing service. I could have easily had them print it for free, then hand-carry it to the conference. Next year I’ll know to save me some money.

3) Consider where you’ll stay.

Conferences like these usually make deals with local hotels. Don’t be fooled, the hotels are still horrendously expensive! Fortunately, my hotel was paid for by my very generous attending physician. Others may not be so lucky. The main convenience with staying at an AHA hotel is that the buses at the hotel can take you directly to the conference. You are not required to stay at one of those hotels.

Let me know if you have any questions about my experience or my research!

American Heart Association Scientific Sessions

I’ll be in Chicago this weekend for the AHA Scientific Sessions. You can contact me on Instagram at futuredoctorfoodie. If you’ll be in attendance, I’ll be presenting my research on a poster on Sunday around 10:30 AM!

For those of you who are unable to attend, I’ll be posting about it once I get back!

The Dreaded MCAT

The MCAT is the standardized test required for entrance to medical school. After major revisions a few years back, the test is now an anxiety-inducing 8 hour trial, testing the major sciences, psychology/sociology, and reading comprehension. Pre-meds dread this test. If your score is “too low” you might start to worry about your “stats”.

I’ve never struggled with standardized tests, but after a recent experience I’m starting to understand their concern. The other day I signed up for the free Next Step MCAT bundle, which provides diagnostic testing. (Prior to diagnostic testing, I recommend you do your research about the test, your learning style, and the resources available). Without doing much studying, I scored a 493.

I should definitely mention that I haven’t actually started studying for the MCAT. I took the diagnostic exam without a proper review. This is definitely not going to be close to my score once I actually start studying. I wanted to know which subjects to focus on. My CARS is quite strong. My psych/sociology needs a bit of review, but I’m comfortable with that area as well. Unfortunately, my biological and chemical systems section scores were dismal.

My concern is that I need to spend more time preparing for the exam than I expected. I was going to start my study plan in January 2019 for my May 2019 test date. Considering I got an email from the Next Step team warning me about my score… it looks like I’ll need to move up the time table. Right now I’m starting with the backlog of MCAT practice questions in my email. Hopefully I’ll be able to find more specific areas within the sciences to focus on. Then I’ll start the Khan Academy videos and prep books. Ultimately I intend on a Next Step prep class. What I need is a schedule. Does anyone have any study schedule recommendations?

Ochem Woes

Many of you saw on my Instagram that I was taking summer Ochem I. Taking it over the course of 1 month (4 hour classes 4 times per week) was really not advisable. I was looking forward to this semester’s Ochem II class, because the pace was more suited to my learning style.

My professor taught quite slow for my tastes, but the expectations were clear and the information was much easier to process. Unfortunately, my professor had to have surgery and will now be out for the remainder of the semester. A substitute teacher has been assigned to us – a physics and engineering professor with a background in chemistry. Without the syllabus, the previous professor’s powerpoints or materials, and no knowledge of what we have learned, this professor has strived to teach us.

My classmates and I have been frustrated, as the professor’s teaching method is a strong shift away from relevant materials toward seemingly hare-brained physics lectures. They take their frustration out on him, when it isn’t his fault.

Supposedly next week, we will have 2 new teachers. The first person will teach lecture. Some of my classmates have been in his class before, and there are mixed reviews. My lab professor will be the same professor who taught me over the summer. I’m not sure whether this is good or bad yet…

Regardless, I need to finish this class in order to complete my pre-requisites. They cannot cancel this class and I refuse to withdraw. Anyone have any tips on how to deal with inconsistent classes like this?

Shadowing: MS Clinic

I’ve probably only spent 6-9 hours scribing for the neurology clinic. The provider I worked with is older than the average physician. His expertise lies in the treatment of multiple sclerosis (MS). MS is an auto-immune disease in which the body attacks the myelinating sheaths over the nerves of the nervous system. It can be diagnosed with lesions apparent on brain imaging, but symptoms vary. Usually there is some component of chronic pain, disability due to lack of coordination or difficulty with motor movement, and fatigue.

MS is often confused with fibromyalgia (which is a clinical diagnosis not based on brain imaging). Patients with chronic pain are often over-diagnosed with MS. Though the reasoning may be unclear, it may be a last-ditch effort to diagnose a patient with something, anything that could lead to a treatment plan. Extensive work by Dr. Andrew Solomon has explored how often MS is incorrectly attributed to patients and how to improve diagnosis (as well as how to address the misdiagnosis with patients).

Chronic pain patients get a bad reputation. Some of the negative labels attributed to them are “crazy,” “attention-seeking,” or even “drug-seeking.” I have an aversion to treating chronic pain, which I suspect many pre-meds may have as well. Chronic pain is difficult to attribute to a diagnosis, difficult to treat, and nearly impossible to cure. I’m sure this aversion will resolve with more extensive shadowing and understanding of the physical factors at play.

The provider I worked with is one of the greatest people I’ve ever met, especially as a physician. There are very few people who can make such a strong, empathetic connection with patients. Clinic with him is not like a doctor’s visit, but an engaging conversation in which he and the patient discuss health and treatment options. He is first and foremost a teacher, to patients and staff.

He does not flinch in the face of complicated medical histories, patient pain and emotional struggles, or patient non-compliance. He and his patient come to a truly mutual decision regarding their health and treatment.  He does not shame patients for refusing a certain medication or procedure. The patient only has to explain their reasoning. Whatever it is, he will accept it, as long as they are willing to explain their refusal. The patient feels like they are the one deciding, not the doctor.

I wish I could properly convey the experience of his clinic. He openly admitted to treating me like a resident. In exchange for scribing, he felt he should offer me an opportunity for education. He asked questions and encouraged me to ask questions. All my fear about the lack of neurology knowledge went away. I left more confident and energized. My only disappointment is that I haven’t been able to return for more shadowing.

Have you shadowed in neurology clinic? How was your experience?

Mock Multiple Mini-Interview

Through some connections with a volunteer group, I was one of several students invited to participate in a mock interview at my top choice medical school. The school uses the Multiple Mini-Interview (MMI) format, which is a closed application interview process. The interviewee rotates between several stations. Outside the door to each room is a prompt. There are 2 minutes to read and prepare the prompt. The interviewee then enters the room, introduces and greets the interviewer, then discusses the prompt for a timed 7 minutes. After 7 minutes are up, the interviewee leaves the room and has a minute to go to the next station.

This is becoming a more common interview process for medical schools. The interviewers don’t know anything about you, except what you tell them and how you present yourself. I think this gives an advantage to non-trads like myself, as we don’t often have the luxury of relying on GPA and MCAT scores to glide through the admissions process. (That’s not saying we don’t have good GPAs or MCATs, just that it looks different than the traditional pre-med application).

We only had 3 stations, as it was a practice interview. I wore my hair back in a bun, a solid black business dress, and black pumps. I would have worn my suit, but I found out it is now too large to fit me. The dress was several sizes too big as well, but it was less noticeable (especially given that my suit skirt wouldn’t stay up – not the kind of impression you want to make!). The prompts were all from last year, which is why they are allowed to use them in the practice interviews. It’s also why I’m not subject to any confidentiality agreement, as I would be with an actual interview.

My first station offered an imaginary prompt something along the lines of this:

You are a member of the Student Disciplinary Committee at your medical school. Recently it has become public knowledge that several students of the medical school are part of a Facebook group that posts offensive content, even naming some of the medical students. You had no prior knowledge of this group, nor were you involved. Determine appropriate punishment of these students.

This was my worst station. I had an answer, but it only took me 2-3 minutes to speak. While my interviewer appreciated some of my consideration for the victims of the online bullying, she wanted me to address multiple points of view for punishment. I also didn’t think to propose preventative solutions to keep it from happening in the future.

The second station was probably my best, likely because it involved a question of patient care:

You have a patient from El Salvador who speaks limited English. He is in between jobs and lives temporarily with relatives. He has uncontrolled Type II Diabetes. He is distrustful of healthcare providers because he is in the country illegally. How would you treat this patient?

The beginning of the prompt introduced the idea that healthcare was a basic human right which could not be achieved without removing obstacles such as poverty. I first established that I agreed that his status as an illegal immigrant did not mean he doesn’t “deserve” healthcare. I discussed how I would address his multiple issues (communication, affording medications, etc.) by suggesting resources that I have in my current clinic (such as social workers, samples, etc.). I felt I was able to supply a multi-faceted response that took up our time.

The third prompt seemed the easiest, but I realized afterwards that I had missed some good opportunities to promote myself:

Lead a two-way dialogue on any topic you’d like. Maintain the conversation for the entire 7 minutes.

I knew my interviewer (which is very unlikely to happen during the actual interview). He knows I’m a foodie, so we I started asking him about his favorite foods, which got us on the topic of China. His notes later said I should have mentioned my pre-med journey. When we discussed China, I mentioned my prior cholecystectomy. I knew I should have begun talking about how it had started me down the path of medicine and yet I let it pass. I won’t be making that mistake in the future.

Overall, I learned two major lessons about the MMI:

1) Tie in your personal experience whenever you can! Remember this is a closed application interview. They don’t know anything about you, so you have to tell them. Explain your decisions and logic based on past experiences. My feedback from the interviewers praised my personal references, or else addressed the lack of drawing from that experience.

2) Keep talking. It’ll take some time for me to develop the skill to round out my arguments/positions, but there should never be a long period of silence in your interview. The interviewers usually have follow-up questions, but my first station did not. After 3 minutes, I couldn’t think of anything else to say. She should have marked off my score (but didn’t because she’s a sweetheart).

Which type of interview would you prefer: MMI or traditional?