Thursday, June 6, 2013

Finals Are Nearly Upon Me

                                            classic metacarpal fracture

I'll have to disrupt my temporary obsession with taking down Walmart to prepare for finals, which are imminent. My first final this year is on Saturday afternoon, of all times, which is a lovely way to spoil a perfectly good weekend.  I then have two finals on Monday and two on Wednesday. I don't have to go through the motions of a final in my Strings class because the professor said the time would be better spent preparing for my violin senior recital, which will happen next February. The time will actually be spent preparing for my most difficult final exam, but my Strings professor doesn't need to know that.

The only final that scares me at all is the one for my "Physics of Fractures" course. It's my very last final, which is good because I have more to with which to prepare for it. It's not good, because I have more time to stress out over it. Regardless, it will be finished for better or for worse in less than a week. The stakes are high, as the difference between an A and a B could have tremendous financial implications in terms of graduate awards.

The "Physics of Fractures" class is  usually a first-year (or even a second-year in some schools) medical school course. My academic advisor wanted me to take it, knowing it was a huge gamble. It could either ruin my GPA or  boost my graduate standing in terms of the degree of difficulty of my overall course program.  Getting a B certainly won't ruin my chances of getting into med school, as even in med school I could easily afford to get a B in the class without even a chance of being tossed from a program, but getting less than an A would destroy my 4.0 GPA and take me out of the running for any major graduate awards.  Since my parents can afford to pay for my med school tuition and had planned to do so anyway, it was probably worth the risk to take the course, but right now it's giving my stomach major butterflies. I think everyone in the class feels the same way for different reasons. My mastery if the subject matter is as solid as is that of any other student in the class, but anyone can blow a final.  I don't know why I would walk into the classroom and forget everything I've ever learned, but I don't wish to be overconfident. The one consolation is that no matter what my performance is on the final, the lowest possible grade I can get in the course is a B.

After I take the final Wednesday, you can ask me anything you want about the various aspects of fracturing any bone in the human body and I should be able to give you an answer as thorough as anyone could give who has not completed a residency in orthopedic medicine. It actually would be useful information even were I to go into law. If I were a prosecuting attorney, for example, in a child abuse case, I could use the information to take apart an expert witness who is providing shaky testimony for the defense as to how a fracture of a bone in a child's body occurred; the ability to ask the proper follow-up questions to shady testimony would be powerful. I could and still might call a rebuttal witness, but taking a witness apart on the stand would have a greater impact.. Another attorney would have to be thoroughly schooled by an orthopedic physician  surgeon, and even then might not have the ability to ask decimating folllow-up questions. If I were practicing civil law, it would give me an excellent foundation for determining whether to take a tort case in which a fracture was involved, or whether to take on the defense of such.

It's not a wasted class at all. It's just risky.  I'm younger by at least four years than anyone else in the class. Many are taking it as a grad course in order to have a second shot at getting into med school.

Meanwhile, I'm relying  upon Pepto-Bismol as my primary source of nutrition. This, too, shall pass.


  1. Should you decide to stay with medicine, do you think you'd be interested in pursuing orthopedics? I always wonder why certain doctors decided to pursue certain specialties.
    Dr. B, for example, I am dying to ask him why he chose gastroenterology and not something more, to use his word, "sexy". He could have been anything. Not that what he chose is simplistic or beneath him, I am tremendously grateful that he chose GI. But, he has a fairly interesting academic history, he graduated with Phi Beta Kappa honors, and I wonder what exactly made him realize that gastroenterology is what he wanted to do for 40 + years.

    You have a lot of inspiration, in terms of medical specialties both relating to yourself and people who are very close to you. Maybe this is all too far ahead in the future, but if you were starting your fellowship now what specialty would you decide to pursue?

  2. I have a lot of time to change my mind, but my basic plan would be for a residency in something in terms of pathology or maybe radiology. Ultimately it might lead to research rather than practice, or, if I found I could stomach it, even forensic medicine.

    I'm not sure how long it's been this way, but for quite a few years, what program a med school graduate ends up in is tied to the National Resident Matching Program. In year four of med school, time is built in for students to fly all over the country interviewing with prospective programs. (One might think skype interviewing would have taken off, but they want prospective residents to actually see the place, and they want to meet them in the flesh.)

    Students list their top 10 choices (I believe it's still 10) while programs list the the candidates they desire in order of preference. A computer algorithm makes matches as fairly as possible. There's no way it can be completely fair in weighting students' choices against medical institutions' choices, and I've heard if it's weighted in any direction, it's in favor of the medical institution's choices, but still, it's as objective as it can be. Everything is announced on the third Friday onf March in 4th year of med school. Then if a student does not get a match, he or she gets a list of program openings not filled and scrambles for a placement. Almost everyone gets something, but not necessarily what he or she wanted. Scott got his first choice.

    Some students put all their eggs in one basket so to speak. They want a particular specialty at all costs, so every program they apply for is in that specialty. Others want a certain geographical region or even a specific city, so they apply for different programs in that area. Most people list probably two prospective specialties.

    After year one of a residency, also known as an internship, an MD is, upon submitting documentation to a state, a licensed physician. At that point, a post-first-year resident can opt out of his or her program and try to find another one, maybe work for a few years in an ER or an area really needy in terms of doctors as a general practitioner. (Many people confuse family practice specialists with GPs. They're not the same at all. A family practice physician has completed a residency in family practice (duh), while a GP has simply completed med school and a year of internship.

    Residencies are generally from three to five years. Scott's is a three-year program, but he's going to gain added specialties if things work out for him by completing two fellowships, one in pulmonary medicine and one in surgery. He's in a dual internal medicine/surgery program now, which usually isn't allowed. No one has to complete a fellowship, but it gives a physician added training and an advantage in either starting or joining a practice.

    Is Dr. B. a white male? Depending upon his age, that may have worked against him. It seems like he probably went through when affirmative action was heavily in effect. It's still subtly in effect. Medical schools and hospital programs like diversity. He also may have looked around in med school to see who among specialists was happy and who was either miserable or bat-shit crazy. Neurosurgery is considered among the most prestigious of specialties, but there are a whole lot of neurosurgeons who fall into the miserable and bat-shit crazy categories.

    Ask him how he ended up in gastroenterology. Is he a pediatric specialist, or is his specialty not age-specific?

  3. Yeah, I've heard all about "The Scramble" or whatever they call it for when you don't get picked up right away. There seems to be a lot of tradition to medical practice, tradition that has lasted for hundreds of years, it definitely adds to the mystique of it all. Of course, I'm slighted because I've only been exposed to high quality hospitals, such as Johns Hopkins and CHOP.

    Dr. B is a white male. He graduated medical school in the early 70's, which I don't believe was during a time that was essentially big on encouraging diversity. He's also a Notre Dame and Cornell graduate, so that had to have given him a big advantage. He is a pediatric gastro.

  4. My dad said the early 70's would have placed a resident in early affirmative action territory. (This was fairly immediately post-civil rights law passage time.) Being a white male would not have worked in his favor. Still, he had a lot going for him with Notre Dame being highly impressive to some and Cornell being highly impressive to nearly everyone. (Even though Notre Dame is a highly repected institution, anti-Catholic bias existed then and still does , though to a much lesser degree.

    My dad was not helped in the least by his BYU undergrad degree, but he lucked into University of California, San Francisco for med school with high MSATs and was fortunate to have graduated extremely high in his class, which got him a residency at Stanford.

    I hate to be this way, but since I have so many other things working against me, I'm hoping for a little nepotism, as Stanford would be my first choice as a med school or law school. I'm hoping Matthew doesn't want stanford, as I don't know that they would take both of us, and despite my superior qualifications on paper 9we haven't taken MSATs but I'll kick his butt on that just as I did on SATs. We'll both (if I don't blow my "Physics of Fractures" final) have 4.0s, but mine will be with a much more impressive course load, and with essentially a triple major by the time I throw violin performance into the mix, but he's so damned personablethat his interview will have the panel drooling. He also has the NCAA division I athlete thing going in his favor.

  5. Sometimes you have to take what you can get, nepotism or not. I don't think there is any entirely fair way to give every applicant an equal chance, anyway. Specifically when you figure in diversity. They purposely choose to pick the atypical applicant. As far as residencies and fellowships go, everything that happens now for you is impacting your future programs and such. It's hard not to be neurotic about it. Hence one of the reasons why I have not taken my SAT's yet. Dr. B did not get the positions he got because he graduated from mediocre institutions. People try to say that it doesn't matter, but it does.

    1. It's like my SAT. My family does not get the importance of doing well on an SAT. I don't think that aiming for a 2000 is perfectionism. I think that it will make me a stronger applicant for Temple, when the time comes for application. I ended up chickening out and not going last weekend because I know I'm not ready. I hate that I even signed up to take the SAT just to say I was doing something with my life. I wish they would realize that it is as important as everyone says it is.

    2. Did you take a preparatory class? I took the SAT cold and got marginally high scores. Then I took a prep class and tested again and nailed the thing. I highly recommend the class. Even if you just take what you can of it and leave if you have to because you're not feeling OK, it's better than nothing.

    3. My Aunt Tracy and Uncle Bryan are both teachers so they have contacts. There is a girl who is on summer break from Princeton that is tutoring over the summer. I am planning on switching to her once my current tutor goes back to work full time.

      I did look into Kaplan, like you suggested, but my mom said it was too much money. That's a long convoluted story that goes hand in hand with my last comment. It's easy for my family to under appreciate the SAT, mostly because their jobs aren't really college level jobs. My StepDad has been working for the same water purifying plant for over 40 years. He started working there at 17 straight out of high school. Tracy has been at the same daycare center since she was my age. And my mom has an Associates degree in early childhood development, though now she just sells mobile offices to construction sites. So, it's hard for them to take me seriously, because the little college grade education that my mom received ended up not paying out in the long run. I could definitely reach my goal score if I beef up in the math section.

    4. A tutor is a good alternative, but you'll want to buy someone's preparatory book to use as a base or even get one from the public library. Sometimes they're considered reference materials and can't be checked out, but you could still photocopy pertinenet sections. also, you could get aused one on Amazonvery cheaply. I would send you my old one but my mom gave it away to an underprivileged student. My course wasn't Kaplan because the university in my town offered a course that was cheaper.

      It seems you're already quite prepared in the verbal areas, although it's a good thing to take a close look at the vocabulary section in one of the preparatory books. The SAT will throw some weird words at you, sort of like the vocabulary equivalent of the stuff you hear in the late rounds of the Scripps-Howard National Spelling Bee.

      Math is where you'll probably want to spend the bulk of your time. It's still possible without AP high school math to do well. They re-normed the SAT in '96 because so much larger a percentage of the student population was taking the test that it dropped the mean. The re-norming was to raise the mean back to 500. (It's not that we're stupider than the previous generations; it's just that kids are taking it who in the past would have gone straight to JC or elsewhere without even considering it. College is becoming more the path of least resistance.)

      Anyway, my mom's best friend took the SAT in something like 1980 when she hadn't even had a single high school math class (a long story, too long to get into here) and scored 620 on the math, which is about the equivalent to 700 now, and was higher than GW Bush scored with his prep school education (Andover, i believe). She's good with numbers even though she hadn't taken math, and the test is multiple choice. The wrong answers aren't random numbers, though. The makers of the test know where the mistakes are likely to be made, and use answers containing those mistakes. A perfect score is probably impossible with no high school math (and you HAVE had a couple of years of math, unlike my mom's best friend), but a highly respectable score is certainly possible. And if you compensate with high verbal and writing scores, you're there.

      I'm very lucky to have parents who considered college the only option. Sometimes I don't think about it and don't appreciate it. It would have been a real problem for my brother or me, though, if either of us had hated school and had wanted something non-college-oriented. I guess it can work either way.

    5. I bought the SAT book from the college board and that came with an online guide with practice tests. All in all I think there are about 20 of them. Which is good because I am trying to "desensitize" myself from test anxiety.

      HS was completely different. I respond well to structure and guidance... I really am the type of person that needs a boss, or a mentor. I don't function well with freedom.

  6. Under your circumstances, a tutor sounds like a good option.