How I Studied for the MCAT Without a Prep Class

I took my MCAT on Saturday 05/11/19, almost 5 years to the day since I graduated from Arizona State University with my undergraduate degrees. Since I work full-time and support myself financially, an MCAT prep course was not a feasible option for me. I did all of my prep with a $300 set of Kaplan MCAT prep books, a free NextStep MCAT prep bundle, and 2 official MCAT practice tests from AMCAS. My score report came in the morning exactly a month from test day: 509!

Figure Out How to Study

Before you start doing anything, I recommend you take the VARK Assessment to figure out how you learn. You need to study the best way for you. I have a pre-med friend who tried studying by taking notes, but she’s an auditory learner so the information wasn’t sticking. She had to stop wasting her time on the “traditional” study methods and develop a method that was best for her.

Familiarize Yourself with the Test

The MCAT is a long test. You need to understand the format, the timing, and the way the test is designed before you tackle studying the content. Strategy is important too!

Develop a Study Schedule

I used NextStep MCAT prep’s free bundle to develop a daily schedule. They also had a half-length diagnostic test to better design my schedule to focus on weak areas. I didn’t stick to it as well as I should have, but it was an important tool.

STUDY, STUDY, STUDY

This is not your average standardized test. There is a ton of material to learn. You need to study smarter and harder. In addition to a serious amount of content, you’ll need to develop strategy and build stamina.

My exact study plan took several days to work through any one chapter of my prep book. I would read a chapter, highlighting as I went. The next day I would take detailed notes and go through the practice questions within the chapter. The day after that I watched and notated Khan Academy videos. On any one day I would usually be working on a portion of any two chapters under different subjects. Spreading out each chapter and switching between subjects helped keep the information in my memory.

Another important tip I learned was to track my “demon list.” A demon list should contain concepts with which you regularly struggle. For instance, I tended to confuse microtubules and microfilaments. Keep track of these concepts and review frequently.

Take Practice Tests

The best way to get a feel for the real test is to take practice exams, mimicking conditions on Test Day. Dr. Ryan Gray’s MCAT podcast suggested around 6 tests. I took a diagnostic half-test with an initial score of 489. I then took 1 full-length Next Step MCAT test (provided for free). The Kaplan books come with 3 full-length tests. I finished the final two weeks of prep with 2 official MCAT practice exams.

The MCAT is a massive test. Pre-meds tend to place a lot of emphasis on obtaining the highest score possible. Keep in mind that a bad MCAT score isn’t the rest of the world. Before you consider skipping the prep classes, take a realistic look at your schedule and your study habits. If a class is what you really need, I don’t recommend skipping it, but know that you can get a good score with the right tools and hard work. Good luck!

Presenting Research Posters

A few months ago I presented my second poster at a medical conference. The first was at American Heart Association (AHA) 2018 Scientific Sessions in Chicago. This past one was the American College of Cardiology (ACC) 2019 Scientific Sessions. As a pre-med, standing among residents, fellows, and attendings can be nerve-wracking and intimidating. Presenting two poster does not make me an expert by any means, but I’d like to share some tips!

#1 Review, Review, Review

To present a topic, you should know the ins and outs of what you’re presenting. Know the trends of data, the specifics of procedures, and other important general ideas should be easy to recite off the top of your head.

#2 Know Imaging on Your Poster

As pre-meds, we don’t have as much experience with specific procedures. If you’re using imaging like X-rays, CTs, or ultrasounds, review the images. Many physicians at the conference will zero in on those images.

#3 Discuss Common Questions with Your Attending

Anticipate questions that are likely asked about your research. The most common one I’ve heard is “Can you tell me about your poster?” Prepare a little elevator speech summarizing your research.

#4 Be Confident!

My mentor likes to say “no one knows more about a poster than the person who wrote it.” You are the expert on your poster. Remember that when people call you into question.

I hope these tips help. Presenting posters always makes me nervous. I hope my experiences improve with time. Please feel free to share your tips. Happy presenting!

The List

Compiling a medical school list is as much of a strategy as studying for the MCAT. After months of research, studying, and comparing requirements, I have a tentative list of medical schools to apply to for the upcoming cycle. The AAMC application opens on May 1, 2019. Though I don’t have my MCAT score, I have a general idea of my personal stats.

Applying to these schools is expensive, so I’m limiting myself to 13-15 schools for this cycle. I’m still debating on whether I want to apply to the Texas Application System.

Factors I Considered:

  • Location
  • Accept All Types of Credits (online, AP, community college)
  • Global Health Component
  • School’s Preference for In-state/Out-of-State Students
  • Team-Based Care
  • Problem-Based Learning

Factors I Did Not Consider:

  • School Rankings
  • Residency Matching
  • Underprivileged Students Programs (I don’t qualify)

I looked for schools where I have support systems and where I felt I could live without too much “culture shock”, if you will. This means many of my schools are located around the Southwest. Being located in the Southwest does not guarantee admission of course. A school in Utah stated that they basically left only 8 slots for out-of-state students. I’m not applying there with such slim chances.

Being a non-trad also changes my profile. My classes come from a variety of backgrounds, which some schools do not accept as pre-requisites. I took time going through MSAR (AAMC’s cheap service with all of the AAMC school statistics) eliminating schools that didn’t accept my credits. For example, Johns Hopkins expresses a strong preference for traditional applicants (in addition to high GPA and MCAT preferences). They do not accept online courses, so I can’t apply there. (Their admissions team was rude to me anyway.)

Here’s the List:

  1. University of Arizona Phoenix
  2. University of Arizona Tucson
  3. Chicago Med- Rosalind Franklin College of Medicine
  4. University of Colorado
  5. University of Southern California
  6. University of California San Diego
  7. Baylor University
  8. University of Kentucky
  9. Wake Forest University
  10. Tufts University
  11. Thomas Jefferson University
  12. Albert Einstein College of Medicine
  13. Duke University

Schools 10-13 might be considered “reach” schools, but I have reasons for choosing them. There’s always a chance that I score high enough on my MCAT to make it past the admissions filters.

I’ve got 2 Texas schools as well, which I don’t think makes it worth it to apply to the separate Texas application service… Of course, the list might change once I get my MCAT scores, but we’ll have to wait until June before I know anything.

What do you think of my school list? Are you applying to any of the same schools? Share your lists with me!!

Happy Holidays, You Might Have Cancer

It was the day before Thanksgiving. The menu was planned, the shopping done. I planned on baking pies and chopping vegetables once I got home. Only a few patients to see that day, one a new patient. Usually my NP doesn’t see new patients, as initial evaluation is left to the physician.

She was flustered about seeing this patient she’s never met. Rushing into clinic to see the NP usually means something is urgent. This particular patient was highly symptomatic following a procedure by another provider. Unable to provide an explanation for her sudden shortness of breath, that provider referred her to our clinic.

The sudden onset and change in her symptoms frightened the patient and her husband. A young woman who enjoyed exercising was panting after walking less than 10 feet. Looking over the results from labwork, procedures, and imaging didn’t reveal a clear picture. She looked at us, pleading for answers with big, round eyes. She held her hand tight as her husband helped answer questions so she could catch her breath.

Imaging showed an abnormality, not explained by the most common diagnosis. The suspicion arose for cancer, though more testing would be needed. By the way her face fell, she had obviously not considered such a disastrous possibility. Her procedure was supposed to be simple and easy. From a cardiac perspective, it had been successful. Now she and her healthcare providers were forced to contemplate more malignant causes.

Despite working in a medical clinic, I’m not accustomed to seeing my patients die. We primarily see patients with atrial fibrillation, a treatable and manageable disease not likely to be the sole cause of death. The interventional team has to worry about death from heart attacks, while the heart failure team deals with high risk transplant candidates or LVAD patients. Cancer is usually handled by outside physicians specializing in other bodily systems and/or oncologists.

Right before the holidays, even the most remote possibility of cancer seemed devastating. It was difficult to hold myself together for the patient’s sake.

One of the research physicians suggested that I begin hospice volunteering. Despite all my research and reading book after book about death, I have little experience with confronting the ultimate partner to medicine. Perhaps it’s best I heed his advice.

Confronting “Bad Faith” in Medicine

 

Image result for bad faith when religious belief undermines modern medicine

This month’s reading focused on a sensitive topic – religion. When people mention religion and medicine, most people jump to abortion; however, there’s a frightening array of issues that involve religion in the setting of modern medicine. Bad Faith: When Religious Belief Undermines Modern Medicine covers these topics in depth. The preventable deaths caused by “faith healings” is the main focus of this book.

Several church groups and religious organizations shun the advancements of modern medicine on the basis of faith. Most notably, “Christian Scientists” refuse all medical treatments except those to set broken bones and a few other necessary treatments. Vaccinations, surgeries, antibiotics, and most medications are strictly forbidden by the Church. Instead, they seek “treatment” in the form of prayer.

Religious belief is a touchy subject. Many providers have difficulty understanding why people would refuse life-saving care in favor of prayer. There is little debate in how adults can choose to treat themselves. If a Jehovah’s Witness refuses a much-needed blood transfusion, that is their choice to make. This is the same for any patient, whether or not they choose this for religious reasons. Legal adults of sound mind are able to sign AMA (against medical advice) forms.

The greater problem lies in the children of these “faith-healers.” On the basis of their religious belief, parents deny their children medical care – which lawmakers refer to as “medical neglect. In the state of Arizona, there are multiple religious protections in place, including protections to avoid vaccinating school-age children. Although anti-vaxxers (religious or otherwise) have been refuted repeatedly due to overwhelming evidence in support of vaccinations, many continue to refuse to vaccinate their children against potentially deadly diseases.

It is my strong opinion that every adult person should be able to dictate their care. They have the right to refuse medical treatment and care. That belief, however, should not automatically apply to their children. An infant or a child cannot consent to medical care. In the medical community, we rely on the patient’s parents or guardians to provide that consent. The issue is that children cannot refuse medical care either, which unfortunately falls to the responsibility of the parents. The default practice should be, then, to provide care when children are sick and in emergencies, regardless of parental consent. The type of care provided may be subject to religious relief (such as avoiding blood transfusions), but parents should not be able to refuse care completely. Naturally that creates the issue of where the boundary lies. Providers and medical staff often end up court-ordering care for pediatric patients, which depends on the decision of a judge.

“Faith healers” can specifically refer to Christian Scientist “practitioners” who provide “care” in the form of prayers. The quotations are there because these people in no way provide actual medical care. Under Arizona law, these people are exempt from medical licensing. They can provide “care” yet they are not liable for the outcome of their “patients,” nor are they regulated in any way. This lack of accountability is something a physician would never dream of, a point made in Paul Offit’s book.

Doctors can be part of the problem as well. Per Arizona law, doctors and medical personnel can refuse to provide services based on their religious beliefs. This means refusing to prescribe birth control, perform abortions, collect umbilical cord blood (for stem cells), and end-of-life care. Notice that most of these cases are related to women’s health. (If you have the time, read Justice Ruth Bader Ginsburg’s scathing dissent of the Hobby Lobby ruling and the importance of reproductive rights). One pharmacist made headlines for refusing to provide a patient with abortion-inducing medication (even though the fetus had already died inside her.) Physicians and other healthcare providers should be required to perform and provide the services needed of them.

In the same way that providers would have to respect a patient’s religious belief, providers should respect their lack of religious belief.  Jehovah’s Witnesses do not believe in blood transfusions. I disagree with this, but I would respect that adult patient’s wishes. By the same logic, a patient requesting an abortion (for any reason) should be able to receive that procedure safely from a doctor, regardless of whether the doctor personally objects. A doctor’s personal conflicts, political leanings, or religious beliefs have no place in patient care. The physician is not a god, is not a judge of people’s moral actions. The physician’s duty is to provide the care needed.

I don’t have anything against religion in particular. In fact, Mr Offit’s book makes several points about the importance of faith. He even uses the New Testament and Jesus’ treatment of children to support medical care and protection for children. I would also like to note that some of the cases mentioned in the book involved religions and religious leaders who explicitly recommended medical care for the sick and dying, which individuals chose to ignore. The issue isn’t religion, but how religious belief becomes warped and causes harm in the realm of medicine.

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!