Tuesday, January 31, 2012

A Warm Day in January

Today, the temperature reached 53 degrees Farenheit. It's January 31st, and I'm writing this in a small town snugged up against Michigan's western coast. Normally, it's very cold right now; I can't remember it EVER being this warm at this time of year. It's so warm, the below picture shows the open sunroof that I was comfortably enjoying as I drove our car to the shop to have them fix a chronically leaky tire.
As crazy as this warmth is, variations in weather such as these are exactly what I've come to expect growing up in Michigan. We got over a foot of snow two days ago, all of which has melted by now, and we'll probably have another blizzard this weekend... Gotta love the lake effect.

In other news, I was reading out of my Biochemistry book today when I found the following diagram of a mitochondrion accompanied by the below blurb:
"The inner membrane of a single liver mitochondrion may have more than 10,000 sets of electron-transfer systems (respiratory chains) and ATP synthase molecules, distributed over the membrane surface. The mitochondria of heart muscle, which have more profuse cristae and thus a much larger area of inner membrane, contain more than three times as many sets of electron-transfer systems as liver mitochondria."(1)
This made me think about how oftentimes people are so enthralled with the knowledge we have and how far we have come in our ability to create order in the world around us, particularly in the form of awesome technology, such as that being use to write (and read!) this blog post. I fall into this category far too often. As I read this statement about the complexity and variability of mitochondria - just one small (albeit important) piece of our bodies - I realized something: a person who has become prideful in his or her ability to create needs only to look inside him-/herself to find humility. The complexity and number of structure/function relationships at work within us is truly astounding.
For some perspective, here's an example of just one of the above-mentioned 10,000 electron-transfer systems commonly found on the inner mitochondrial membrane of hepatic cells. I followed it with a 3D representation of the ATP synthase complex (the lower-left intermembrane protein in the system shown) as well as a corresponding ribbon diagram for added nerdalicious wow factor:
(1) Lehninger, Principles of Biochemistry, 5th Edition.

Sunday, January 29, 2012

For yOur Convenience

I stopped by the grocery store on my way home from work on Friday to get some potatoes. We got this nifty little gadget that lets us make "healthy" potato chips in the microwave. Not as flavorful as the fried variety, but it does the trick if you're just looking for a low-fat snack to munch on and keep you awake while studying.

Anyway, I pulled up to the side entrance to the store. It's the only one that has a bike rack nearby. After parking and locking my bike up, I found the entrance doors locked:
The sign states that the doors would be locked after 9:00pm, and it was already about 9:45pm. That really didn't bother me; after all, many places try to minimize how many entry/exit points that the staff has to keep track of during off hours. What kind of made me laugh was that they tried to pass it off as having been done for MY convenience. Below is the sign blown up a bit:
Now, I know they worded it this way on purpose; it makes it seem like it's a convenience to the customer to have the entrance open during daytime hours, as though that is a courtesy to the customer rather than what would be expected and normal. To me, it seemed more of an inconvenience for those of us who are forced to live during the crazy off-hours that necessitate later-night grocery trips for two potatoes (one regular, one sweet) than a convenience for the daytime shoppers. I chuckled at the intentional backwards thinking, snapped my photo, and walked around to the front entrance to purchase my taters.

Oh, and in case you're wondering, here's a picture of the chips we proceeded to make that night with our nifty microwave-potato-chip-making setup:
Tasty and healthy!
That is, until you add the chip dip...
Tasty > Healthy = WINNING.

Friday, January 27, 2012

MCAT Question of the Day

This is my dog, Naiya. She looks smart, right? Right, if you're playing along with the stereotype that glasses = higher-than-average intelligence. Luckily Naiya's intelligence (my wife dubbed this photo "Collegiate Naiya") doesn't stop at her looks; she knows more than 50 words in BOTH English and Spanish. That's right - I trained her to do tons of tricks and recognize many objects and actions in both languages. This was done in part to spite the know-it-all dog trainer who told me to "never EVER teach your dog two words for the same thing because it would just confuse them," and partly because I just thought it would be awesome if my dog could learn two completely separate commands for the same thing.

Back to my original point: Naiya looks smart while also being smart, and she didn't get that way without practice. The same holds true of tens of thousands of premed students out there getting ready to take the MCAT. So, I thought I'd share a website for if you're preparing for the MCAT and want to not only appear smart, but actually be smart too: MCAT Question of the Day.

MCAT Question of the Day is true to its name. It gives you an original, well-thought-out question each day. It even allows you to have the day's question sent directly to your inbox - an especially helpful feature, as not every busy premed will remember to check a website each day for an update. Overall, it's a good habit to get into, as it provides some constancy to your studying and gives you a daily refresher into topics that you might not have seen in months or years, but which could prove very valuable once you're sitting in that musty testing center being remotely monitored via security camera as you solve projectile motion problems while sweat drips down your back and your neighbor's labored breathing patterns and muttered exclamations of "What is going ON...!?!" go unnoticed thanks to the damp foam plugs jammed into your ears...

So check out MCAT Question of the Day, and good luck studying!

Monday, January 23, 2012

The Epitome of A Nontraditional Med School Applicant's Schedule

Right now I am experiencing that zombie-like state of lethargy that precedes severe jet lag. However, I have not flown anywhere, nor have I spent a large amount of time traveling recently... Let me explain.

I work full time in HR for a company that makes a variety of products; feel free to see the About Me section for more mundane facts. I also am in charge of all things photo-/video-/multimedia-related. This means that when a video is required for three of the products that are only made on 3rd shift, I am their go-to guy. The end result is one tired nontraditional premed applicant sitting on his living room floor typing a blog post to stay awake because he knows that if he goes to sleep he won't wake up for way too many hours and will probably sleep right through the beginning of his normal shift later this afternoon.

I went in to work at 8pm Sunday evening and didn't leave until 8:15am this morning - just in time to bike to my Biochemistry lecture (of which I'm pretty sure I only retained about 10%). I'm still debating about whether or not I should go to the Anatomy lecture that I am auditing at noon. Regardless, I have to be back at work by 1:00pm for four HOURS of conference calls followed by four hours of editing the aforementioned product video...

The biggest plus to all of this is that I also worked Saturday morning. I know it doesn't seem like a plus, but this made the past twelve hours technically fall onto the seventh consecutive day that I worked in this pay period, which means that for the past twelve hours I got paid double-time. Ues, sometimes it is fun to be hourly. Plus, I convinced my wife to let us put all the money I earned this past weekend toward a future splurge on a big screen tv. My nine-year-old big-tubed 27-incher has definitely seen better days...

Before I forget, check out this awesome comic by Dr. Fizzy, inspired by me! Seeing that more than made my day, which until now has been a bit trying...

If nothing else, today is but a smidgen of what I might be able to expect someday during residency: lack of sleep combined with a frenzied work pace while you try to maintain a professional appearance and retain knowledge, all at the same time. Granted, the stakes are much lower at the moment, and it's not like I've been awake for multiple days in a row at this point, but I'm definitely feeling the weight of the epitome of a nontraditional premedical applicant's schedule.

Friday, January 20, 2012

The Best Bad Thing Ever

Tonight, the wife and I took a break from studying and PARtook in what we dubbed The Best Bad Thing Ever, or TBBTE. What you see in the above picture is a layer of tortilla chips smothered in shredded cheddar cheese topped with a sprinkling of mozzarella, followed by a healthy (yeah right) slathering of Sweet Baby Ray's barbecue sauce. Really, it's phenomenal. If you haven't tried it, you NEED to. It really is the best bad thing ever.

Oh, and the turtles are our salt and pepper shakers. They have magnetic lips. Wife probably thinks I put them in the photo for romance, when I really did it for scale. They're about 6 inches long when joined at the lips, so yeah... That's a big plate of TBBTE. After two minutes and twenty-five seconds of bubbling microwave goodness, we sat down to a nice midnight snack while watching some tv on the good ol' iPad, as shown below:
Yeah, it was a good night. Now, off to bed, as Biochem is just eight short hours away... Haha, coincidentally, we are studying lipid metabolism at the moment. Oh, irony...

Thursday, January 19, 2012


For those of you who read via rss feed or email subscription (as well as those that are simply unobservant), I've added a Contact Me section to the blog. You can access it by clicking here or by clicking the "Contact Me" tab just below the blog's title. It's an easy way to make a comment that you don't necessarily want public. Feel free to shoot me a note or any questions you might have about the whole med school process. I promise to get back to any questions or comments within 24 hours, no matter what. Yikes - big promise, I know, but I mean it! Even if I'm slammed and don't have time to write back right away, I promise to at least let you know that I want to do you justice with a good response that will be forthcoming.

I also promise to not share your email address with anyone, and rest assured that the service I chose to implement in the Contact page can also be trusted. Also know that I love communicating with and hearing back from my readers. It's incredibly encouraging to hear about it when other people read and enjoy my writing, or to hear thanks for something I've posted that has helped someone else along their own (already wincing at the over-used buzzword) "journey."

My philosophy is that nobody knows with whom they will end up working someday. Someone that I help by giving study tips or answering questions about their personal statement might end up being a fellow doctor that I rely on in the operating room. For that matter, he or she could end up discovering a cure for a disease or doing an operation that saves a member of my family. This acutally happened with one of my wife's professors; one of his former students went on to become a doctor and ended up saving that professor's daughter's life after a car accident.

I intend to continue this philosophy throughout med school, freely giving help to anyone that asks, even if it makes it so they end up doing better than I do. I will just do my best, and I think that will be enough. This might be naive, but I don't care. Regardless, none of this is possible without effective communication, so feel free to use the new tool and contact me directly.

Tuesday, January 17, 2012

A Cartoon Guide to Becoming a Doctor - Purely Awesome

It's not very often that I have this many good things to say about another human being, but Dr. Fizzy McFizz deserves all my accolades and more. You see, the holder of this pseudonym authored one of the best comedic works of my time - A Cartoon Guide to Becoming a Doctor. She is an accomplished doctor, wife, mother, author, and active blogger.

I received A Cartoon Guide to Becoming a Doctor as a Christmas present from my parents. If you know anyone who is going to be a doctor, already is a doctor, or even just knows someone who fits either of those categories, this is a great gift for him/her/it. A lot of the humor may fall into the category of an inside joke, but much of it is just funny if you're at all familiar with what it takes to become a doctor. Let's face it, if a joke about a med student camping in the woods to make ends meet and reciting "Fumarate, Malate, Succinate..." from within his tent (or the stages of needing to pee during a surgery, as an alternate example) doesn't make you chuckle, it's most likely because you've never had to memorize the Citric Acid Cycle or stay sterile for hours at a time - in which case, you're probably the winner. Trust me.

Anyway, if you know someone who would like the eBook version of this comedic gem, use this link. If you would prefer to give a splendidly-bound paperback copy, this link's for you. Either way, you're giving hours of gold to whatever recipient you choose. I've already bought two copies and given them to friends that have already commented on how awesome it is after having gone home immediately to read it cover-to-cover fifteen times. Yes, exaggeration, but STILL. If you want to make someone involved in the process of becoming a doctor VERY happy, this is a good gift.

Friday, January 13, 2012

How to Study for the MCAT

A screenshot of the Mental Case flashcard software for Mac OS X.

4/15/13 UPDATE: All of my MCAT flashcards are now priced at $14.99 for 3,499 cards.

6/30/12 UPDATE: All of the MCAT Flashcards I created when preparing for the MCAT are now available for purchase from my online store here.

This post is for anyone interested in information / advice / helpful tips for effectively preparing for the MCAT, but will also cover a really great tool for studying in general - an app called Mental Case. It's by far the best study tool available to students who have an Apple device (computer, iPad, iPhone, or iPod Touch). I've been asked by several people for some tips or suggestions on how to prepare for the MCAT, so hopefully this will help you if that's something you need.

I'll start with a number of disclaimers:

Disclaimer #1: While you don't need an iPad to follow this method of MCAT preparation, having one is a definite plus - both in preparing for the MCAT and for life beyond it. Nobody likes carrying around thousands of paper notecards bound in six-inch bundles when they can have everything instantly accessible in a thin little device.

Disclaimer #2: This is by no means the ONLY way to go about preparing for the MCAT. It has simply worked really well for me; I used it, did well on the MCAT, and got into med school. THAT being said, it might be more appropriate for some people than others. It helped me carry my study materials with me, which allowed me to study more frequently than I would have been able to if I had used large, cumbersome study materials all the time.

Disclaimer #3a: Do NOT attempt this method of preparation if you are not a highly self-motivated individual (though I suppose the same might be said about medical school in general...). If you need to be in a classroom of people and need that competitive atmosphere to spur yourself on to success, I would recommend forking over the $1,200 to take a Kaplan prep course over a semester or two. This method is for the busy, possibly working and/or nontraditional do-it-yourselfer. It would also work well for busy students that weren't able to have an easy academic year while preparing for the MCAT.

Disclaimer #3b: Just because you don't have an iPad (or might not be able to invest in one) that doesn't mean this won't work for you. The only difference will be the old-fashioned method of flashcards instead of using Mental Case, as described below. Also, as I will mention later, the software is available for Mac laptops for only $20, so that's definitely another iPad-less route.

Basically, I WOULD recommend this preparation method for anyone who:

1.) Has a limited amount of free time (like your average non-trad who's in class in the mornings, working nights and studying late nights) or needs to cram their studying into broken, sporadic chunks of time,
2.) Hates carrying / can't carry around massive amounts of notecards and studying materials, or
3.) Loves using the benefits of technology to enhance their learning experience. It's my firm belief that physicians of the future will be required to incorporate technology to do their jobs effectively, so why not start now?

I separated my approach to preparing for the MCAT into three phases: an initial Assessment phase followed by two Study phases: Preparation and Practice.

  • Assessment:

    Before I even started studying for the MCAT, I wanted to get a baseline measurement of my level of preparedness. To do this, I took the free practice MCAT offered by AMCAS. This is actually an old MCAT exam that's no longer in use. It's the exact same in quality and format as any of the paid practice tests, except it's free. All of the practice MCATs offered online are in the same format as the computerized MCAT taken at testing centers around the world.

    The results of the practice tests are incredibly useful. From my baseline test, I was able to identify the areas in which I was exceptionally shaky. When I took my baseline test, it had been seven years since I had studied the Physics and Inorganic Chemistry covered on the MCAT, so I knew I probably wouldn't score very high. Additionally, I had not even taken the Biology or some of the lab-based Organic Chemistry. The best thing about the practice test is that it breaks down each subject into subtopics or categories - like Atomic Structure, Acids and Bases, Thermodynamics, Newtonian Mechanics, etc., all within the Physics and Inorganic Chemistry section. It tells you how many you got right and wrong within each section. It also shows you the steps for how to do any problem so that you can easily and quickly correct any bad habits you might have.

    If your assessment test score is low, don't worry. I got a cumulative score of 25 on my first practice test. The one good thing about the science portions of the MCAT is that studying will drastically improve your score. The same is not usually true of the verbal reasoning / reading comprehension section; that's more of a test of your innate abilities, so the payoff for studying that section is usually not as big (according to my advisor), which makes sense. By the time I took the MCAT I had taken eight practice tests, doing all sections for all of the practice tests, my reading comprehension score only varied by one point across all of the tests, while my other scores drastically improved as I studied.

    Speaking of which, we're now at the first of two Study Phases:
  • Preparation:

    To prepare for studying, I purchased the Kaplan MCAT Prep textbooks. They're available here, but I got mine off of Craigslist from a guy who had enrolled in (and completed) an official Kaplan prep course. During the Preparation phase, I read through each of the science books cover to cover. Because I was happy with my reading comprehension score, I didn't really do much studying out of that book. I also felt that I was a pretty good writer, so I just focused on covering the Chemistry (Inorganic and Organic), Physics, and Biology in the textbooks. As I read through, I made notecards using an app called Mental Case. It is available on Mac OS X, the iPod/iPhone, and the iPad.

    Before I go any further, I need to say this: I understand that not everyone has an iPad or iPhone. However, I can't even count the number of times that I've spoken with a current med student and heard them say one of two things. It's always either, "I really wish I had an iPad. Everyone who has one says they're incredibly useful." or "I love using my iPad to study. I can do everything on it - annotate our coursepacks, make notecards, store textbooks - EVERYTHING." I've heard variations on this last one from students from multiple schools. Apparently if you don't have an iPad, you'll wish you did. Whether you're comfortable with technology or not (most apps are developed to be incredibly intuitive and user-friendly) having an iPad allows you to be much more effective and productive. Apparently, making the most of your time is key when you're a med student, which means that the purchase of an iPad will most likely be a wise investment in your education.

    I can't state this enough: this app made it SO MUCH EASIER to study for the MCAT. As I went through the Kaplan books, I made notecards for everything from definitions and equations to practice questions and answers. Users are also given access to thousands of notecards made publicly available for FREE through Flashcard Exchange and Quizlet.com. They have categories for everything from Biochemistry to Medical Spanish to the USMLE - and it's all free! So if you get sick of making your own flashcards, chances are you'll be able to find fresh quizzing material pretty quickly.

    I am currently planning on writing a review of Mental Case, focusing specifically on how you can use it to study for the MCAT and med school in general. The OS X version is available for $20 through the App Store on your mac, and is just beautiful. Click here to find out more about the Mac version, here to find out more about the iPad version, and here to find out more about the iPhone/iPod Touch version.

    Let me just give you an idea of what Mental Case is like on the iPad. It's similar on the Mac and iPhone, just with slightly different layouts and features. You can store your notes in cases (folders) by topic, nesting them by sub-topic if you'd like. Here's an image of the main view of my Mental Case app after I downloaded some free notecards (Amino Acids, Biochem, USMLE) to show on here. Also shown are my leftover notecards from Analytical Chemistry from last semester:
    I tend to organize my cards by subject, then subtopic. For example, here are my cases for Analytical Chemistry:
    Notice, you see the cards in the background when a specific case is selected. This allows you to sort through the cards in a case, flicking with your finger to move from one card to the next, as shown below:
    If you tap on a specific card, it moves aside to show you the "back" of the card. This is really helpful when you're trying to find a specific picture, or if you're just idly flipping through and quizzing yourself. It's especially nice because it allows you to see the front and the back at the same time.
    Mental Case allows you to study a slideshow of the notecards in a selected case by pressing the Play button, then selecting your parameters. Though they're greyed out in the example below, you can add cases to a Lesson, allowing you to gather larger amounts together for strategic studying. I made Lessons of specific topics that I wanted to focus on when studying for the MCAT. I also do this when preparing for an exam. Mental Case keeps track of which notecards in the Lesson you've studied recently, cycling through them on a user-defined basis, e.g., intensely, daily, weekly, monthly, etc. Once you see a card (and get it right) when viewing a Lesson, you won't see it again until the next time it's scheduled to come up. In this case though, I just wanted to view the cards in that case for a quick, impromptu session:
    Mental Case then switches to a full-screen view showing you the content of the note. It shows you the controls for a couple seconds, fading them out once you begin. It allows you to tap certain areas of the screen to continue to the next card, go back to the last card or face, say that you got the card right (check mark), or say that you got the card wrong (x). You can tap these regions of the screen, or use the buttons at the bottom of the screen to do each command.
    One of the best features about Mental Case is that it remembers which cards you get right and which ones you get wrong. Just like a study partner putting the cards that you get wrong in one pile and the cards you get right in another pile, Mental Case will remember which ones you get wrong and give them to you more frequently. Basically, it keeps a tally in the background for each card, giving you +1 for each time you get a card right and -1 each time you get it wrong. Cards with more positive scores appear less frequently, and cards with more negative scores appear more frequently. Below is an example of the back of the above card for Serine. If I realized I got the card wrong, I would tap the lower left area of the card (or the red X at the bottom), and continue with the stack.
    Anyway, this is the absolute best way to study using an iPad, iPod, iPhone, or a Mac laptop. You can easily sync between all devices using Bluetooth or a WiFi connection. It's a piece of cake to share flashcards, too. You can email notes directly from the app, and can even share from one device to another to give cards to a friend. Putting photos (and audio too - you can record your voice reciting a pneumonic device and have that be the backside to a flashcard, for example) onto cards is easy and fast. The app allows you to crop and automatically rerenders photos to minimize file size.

    It's hard to feel like I've said enough about this app and everything that it can do. I was constantly pulling this out to study here and there while preparing for the MCAT, and the best thing of all was that I didn't have to carry around a case of notecards, sorting through them to study a particular topic. One of my favorite features of the app is that all of the notecards are SEARCHABLE. That's right - no more sifting through two hundred cards for the one that shows the structure for molecular structure X. You just type the word you're looking for into the white oval-shaped search box at the top of the app, and it immediately shows all the cards containing that word. If there were a function that sealed the deal for me with this app, it was that. Any time I was wondering about something, I had the answer at my fingertips as quick as it took to type it in.

    As a quick aside, I'd like to mention the app entitled "MCAT Question a Day." It offers great practice questions, one for each day. If you have an Apple device, I highly recommend this app. It also allows you to go backward and practice questions from previous days. Plus, it's free!

    All right, back to my study model. Once you've reviewed your trouble subjects, gone back through the books, made your flashcards of facts, equations, molecular structures, and sample problems, it's time to start practicing.

  • Practice:

    I practiced by doing two different activities:

    1. Going through flashcards that I'd made on Mental Case, which included chemical reactions, physics problems, molecular structures, everything you can possibly think of that might be applied on the MCAT.

    2. Taking the purchased practice MCAT exams from AMCAS. I found this to be most effective by doing everything I could to replicate the settings for the actual MCAT. This meant that each Saturday for months leading up to the big day, I designated five hours for the test. I took my laptop to a quiet study room and took the timed test. The practice tests allow you to take them untimed, or to stop a section and continue it later on. For my tests, I kept the timing settings just like the would be in the actual MCAT. I usually finished in about 4-4.5 hours, depending on if I took the suggested breaks in between sections. At the end, I would review my areas of weakness, going over the problems I had gotten wrong and looking at the correct answers and help sections.

    When going over the practice MCAT exam results, I would make a list of the areas that I felt I needed to focus on in studying. If I didn't have any notecards that covered that topic, or if the ones I had didn't do a great job of covering the topic, I would look in the books or in the online flashcard databases for cards and practice problems that did a better job. Unfortunately I didn't have the material from when I actually took some of the General Physics and Inorganic Chemistry, but I made do.

    And that's my method for preparing for the MCAT, summed up into these steps:

    1. Take the free MCAT to assess your strengths and weaknesses.

    2. Go through the Kaplan MCAT prep books.

    3. Make flashcards of everything using whatever method works best for you - though I highly recommend Mental Case software.

    4. After studying everything hard, start taking one purchased AMCAS practice MCAT each week.

    5. Shore up the weak areas identified in the practice exams by further focusing and improving your study materials.

    By the time the MCAT arrives, your test scores should be at a level with which you're comfortable. In speaking with other people who have taken the MCAT and with my advisor, the score that most students get on the real MCAT is usually lower than their highest practice test score. This was the case with me as well, but I was still content enough with my final score that I didn't end up taking it a second time.

    Hopefully that helps you out if you were feeling daunted by the seemingly insurmountable task that is preparing for the MCAT. There's a light at the end of the tunnel; just take things piece by piece and you'll get there! Feel free to contact me with any questions you might have, or simply comment below if you just have something to say!
  • Wednesday, January 11, 2012

    Super-Intelligent Kestrels and the Colors of Tiny Things

    In my Biochem book, we're always seeing pictures of really tiny things (like the chylomicron being observed above by the below-mentioned super-intelligent Kestrel) that are always shown in a myriad of colors, presumably so as to better hold our attention. This morning as I was studying lipid catabolism, an errant thought popped into my head, thoroughly distracting me and resulting in the blog post you're now reading. What I thought was, I wonder what color triacylglycerols actually are? Then I thought about it conceptually and realized that even if we had a good enough microscope, we probably wouldn't be able to see them in visible light. This is not a very interesting answer; however, the explanation (and subsequent ponderings) ARE interesting.

    You see, a single carbon-carbon bond in most molecules averages around 1.5 angstroms in length, where 1 angstrom = 1x10^-10 meters. So, for triacylglycerol palmitic acid (16-C, saturated) side chains (plus let's say 3 angstroms of added length for the glycerol C-O-C bond) we'd have a total maximum length (assuming the molecules are completely stretched out, i.e., all bond angles = 180 degrees) of only 19 angstroms, or 1.9 nanometers.

    Given that the visible portion of the electromagnetic spectrum only extends down to wavelengths of about 350nm, this size as a photon wavelength would lie solidly in the ultraviolet portion of the spectrum. In other words, an individual triacylglyceride molecule would probably be invisible to the naked human eye even if we had a visible microscope capable of such precise focusing because the molecule would be too small of an object to reflect a photon of visible light.

    That is, unless we genetically engineered some super-intelligent species of bird (many of which, like the above Kestrel, can see UV light), provided it with a unique linguistic diction capable of identifying ranges of the UV spectrum as specific colors, sat it down in front of a futuristic (specially designed with avian ergonomics in mind) ultra-violet spectrum microscope pointed at some tracylglyceride molecules, then asked it to tell us what it saw.

    That would be a cool experiment. I'd put my name on that paper.

    Tuesday, January 10, 2012

    The Application Process, Interview Selection, and Self-Perception

    The process of applying to medical school is like a ride on the most dynamic emotional roller coaster imaginable. None of the rejections are easy for a med school applicant to handle, and I am no different. Most applicants are smart and competitive enough that they probably haven't had to deal with much rejection from schools, jobs, or anything else. However, having dealt with a few rejections prior to this, I can tell you that it doesn't make it a whole lot easier to have a med school tell you you're unwanted.

    Now that I've been through a couple interviews and have been accepted to a school, it's much easier to get a letter of rejection and have it not affect me so much on an emotional level. It's in no way easy, as it always feels somewhat like a slap in the face. No matter how kindly they word their rejection, it's still a rejection. Granted, not all schools try to be nice about it. One school just put it blatantly, saying something along the lines of, "After our review of your application and qualifications, we have determined that you are not a competitive applicant."

    However, sometimes when schools try to be nice, it just gets confusing. For example, when they try to explain it away by saying that "this year's was an exceptionally competitive applicant pool" or that "our standard minimum requirements for an interview include a 3.0 science GPA and 27 MCAT score, as well as volunteer/community involvement and clinical experience." I don't like sharing my statistics, but I will say that my numbers are significantly higher than both of those minima, I have something like 2200+ hours of volunteer experience over the past nine years, 2.5 years of nuclear physics research experience with multiple publications, and more than 200 other hours of clinical volunteer and shadowing experience in a hospital emergency department environment. I've served as a tutor and teacher in a wide variety of environments, been on multiple international missions trips, and worked with dozens of different cultural groups in my career in human resources while going back to school for the premed course requirements.

    So when I get generic explanations that tell me I'm not a competitive applicant or didn't meet their standards, I start to wonder. Did they mix up my file with someone else's? Did they read my file at all? Usually, I tend toward disbelief and end up chalking things up to a difference in fit or perception that resulted in them sending me a generic rejection letter. Maybe my reviewer didn't like an essay, or maybe they had so many qualified applicants that the decision-making process for awarding interviews turned into a large-scale game of darts. I can just picture it now - in a huge gymnasium with each applicant's file stuck to the wall, the Dean of Admissions grabs twenty-five darts and lets them fly; whoever's application ends up getting a dart gets an invitation to interview. Who knows?

    Regardless, when I receive rejections, I do my best to not take it personally. That's my best advice to others who might be reading this as they prepare for the application process, or perhaps are going through it with me. Try not to take things personally. It does no one any good, least of all you. You will most likely get rejected by way more schools than you initially anticipate. It's very possible that schools which you considered to be shoe-ins will be some of the first to reject you. That definitely happened to me; some of the schools which I statistically (based on average MCAT scores and GPA) considered "backup schools" didn't even request a secondary application! The most important thing is to keep your head up and remain confident, anticipating that perfect-fit school and the career to which it will lead you.

    Sunday, January 8, 2012

    Electronic Textbooks

    Just got done hanging the above shelf and helping my wife get all of her textbooks on her computer and iPad for this semester. It was cheaper than getting the paper versions used, and we are able to download all the books so she can access them offline. The iPad / Mac (also available for Windows! bahahaaaa) app is called VitalSource Bookshelf, and I'm very impressed with how well it works. If you're looking to get your books on your iPad or lappy, that (or Inkling, just on iPad, as it has really impressed me with its presentation format of books if not the volume of available books - though that IS growing) is my highest recommendation.

    My Biochem book for this semester is the same as last semester. I got it as a rental through CourseSmart, which I don't recommend. The download process was a serious hassle, and they don't allow you to purchase the book. Plus, their prices are way higher than most other people's. However, they had the book, and I didn't know about VitalSource at the beginning of last semester...

    So there you have it - both my wife and I will be going paperless with our books this semester. One book for me, six normally fat Nursing textbooks for her, all weightless and tiny inside our technology. Easier on the back and wallet = a nice big Win - Win situation for both of us!

    Saturday, January 7, 2012

    Notes Plus - Handwriting App for the iPad

    Note: if you don't have an iPad (and won't be getting one any time soon), you probably won't care about this entry, as I'll be reviewing the Adonit Jot Pro and Notes Plus v3.0 - writing tool and app, respectively, for the iPad.
    For several semesters, I have been using a variety of notetaking apps on my iPad 2, the best of which I consider to be Notes Plus. The newest version is 3.0, and simply put, it's phenomenal. It combines everything you could hope for (with the temporary exception of Dropbox synchronization, which is said to be coming soon in version 3.0.1) in a digital handwriting application.

    My main reason for having an iPad is how nice it will be for medical school, where everyone says you're bombarded with material in the form of presentations, coursepacks, pdf articles and more. All of those can be stored, viewed, edited and annotated on the iPad. The newest version of Notes Plus is the best app I've used (and I've tried all the mainstream ones) for taking notes and annotating PDFs on the iPad. Before I review a few of my favorite features of the app, I'd like to note that I use a Jot Pro by the company called adonit, pictured below:
    The adonit Jot Pro has a plastic disc rotating on a stainless steel ball as its tip. This allows it to interact with capacitative touch screens like that of the iPad without sacrificing range of motion or precision, as you can see through the plastic to more precisely place it when writing or drawing. The overall size of the Jot Pro is also more comparable to a real pen. It's a bit pricey, but well worth it and definitely what I would recommend if you're looking for a pen tool.
    Now, on to the review of my favorite features of Notes Plus:

    1. The layout.

    Below, I took a screenshot of the portrait layout of Notes Plus, imported the screenshot, and annotated it in Notes Plus to show the features and tools available. The layout is simple and intuitive, easily customizable.
    2. Customization

    All of the tools and pen styles can be customized to be whatever the user wants, allowing each person to choose exactly what they want and where they want it. You simply press and hold on the tool or pen style, then slide to select the tool that you want to have in that space.
    The variability of Notes Plus leaves nothing to be desired in terms of pen tip styles and font options.
    3. The Browser Panel

    The Browser Panel is probably (for me) the most useful addition to the Notes Plus user interface. Accessed by sliding the center panel to the right, it allows the user to grab any image simply by pressing and holding on the image, then "tossing" the image over to the notebook they're currently working in. The image smoothly shoots over for placement on the page. Images can then be duplicated via copy & paste, rotated, and resized.
    If what you want to include in your notes isn't a picture, you can take a snapshot of a portion of the browser, then insert it as an image in your notes.
    Once you're done getting content from the browser, simply slide the center bar back to the left and keep taking notes.
    4. The Close-Up Box

    The close-up box is probably one of the very best features, separating Notes Plus from the rest in simple ease of functionality. Its lack was always the first thing that bothered me about other handwriting apps; it's the most natural way that I've found to clearly write whole paragraphs on the iPad. Obviously, the close-up box is much smaller than the whole line, since it's pretty much a zoomed-in view. As you write from right to left, you will approach the right side of the close-up box long before you reach the end of the line. When this happens (and when you actually reach the end of the line) a grey box appears in the left-hand area of the close-up box, as shown below.
    That grey area acts as a sort of transportation window, moving your writing point either further along the current line of writing, or directly to the following line on the paper. The result is a seamless experience that makes the creation of paragraphs effortless. If you happen to notice a mistake earlier in your writing, you can simply grab the dotted grey box that shows your writing area and move it to the appropriate portion of the paragraph. Notes Plus also supports the ability to zoom in and write/draw directly on the text without using the close-up box. I use this option extensively when drawing chemical molecules and annotating figures, but not as much when I'm just taking notes.
    5. Moving & Manipulating Written Text

    I don't know why this isn't something that all handwriting apps can do, but so far Notes Plus is the only one where you can select and move groups of text after you've written them. After selecting a group of text, an arrow appears that you select to access options for what to do with the selected text.
    a. The first two options, Draw stroke instead and Draw shape instead are useful for interconverting between drawn shapes and vectorized shapes. That's right - Notes Plus can create smooth, perfectly-proportioned shapes.

    b. You can also Group your selection to make it easier to move or keep track of. This option is handy for when you want to keep shapes, written text, and typed text together.

    c. One of the most advanced options is the Convert to Text feature. Sadly, it's only available as an in-app purchase for $1.99, but apparently the developers are taking a hit even at that price, as the handwriting recognition engine license is leased on a per-user basis and actually costs more than that. Regardless, the feature is great. It recognizes handwritten text and converts it to typed text with incredible accuracy. The resulting text is then searchable, allowing you to search a notebook for a specific word or phrase without having to sort through the pages manually.

    d. You can also Copy or Delete your selection. The Send to Back option is very useful when trying to arrange a figure or photo behind some written text. Selecting or editing an image will bring it to the foreground, so a handy option for sending something to the back layer is a good thing to have.
    6. Flexibility in Tools

    The tools and flexibility offered by Notes Plus are great. Not only can you directly import PDF files from your email or a web browser for annotation (done by selecting Notes Plus from the "Open In..." option), you can also save PDFs directly to Google Docs. While at the time of this writing Drop Box synchronization and exporting is not an option, it will soon be enabled in Notes Plus v3.0.1. See the below screenshot for the options available in the Tools menu.
    The ability to change the page settings is particularly useful. This allows the user to create gigantic pages - very useful in creating flow charts and poster-sized documents to view later on a larger screen or print on poster paper.
    7. Recording Audio

    I can't tell you how many times I've wanted to hear what the professor said when going back through a confusing part of my notes after a lecture. With Notes Plus, it's easy. You simply tap the microphone icon on the center bar. It will glow red when actively recording, as shown below.
    You can play recordings back while maximizing your view of the notes by sliding the playback controls from beneath the microphone icon.
    To organize and manage your recordings, just go to the Audio section of the Notebooks menu:
    8. Textbook Organization

    The organization of notes in Notes Plus is simple. You have Folders, Notebooks, and Pages. Folders contain Notebooks, and Notebooks contain Pages, just like in real life. Unlike real life, Notes Plus allows users to move or copy whole pages or even entire notebooks from one place to another. Below is how I currently have my documents organized - one folder for this Spring semester, a template (read-only) notebook to be copied for future classes (all the pages are a custom size), and a scratch-pad notebook for miscellaneous doodlings.
    Within the Spring 2012 folder, you see my two notebooks:
    Within a notebook, you can see a preview of each page. Notes Plus also allows users to give each individual page a name, which is then searchable within the notebook. Simply drag the list of pages down to access the search field.
    While this in no way covers even half of the features and functionality offered by Notes Plus, it at least gives you a feel for what you can expect from the app before purchasing it yourself. Unless something better comes along (doubtful) I plan on using it throughout medical school and possibly (probably) beyond. Hopefully you've found this useful; feel free to leave any comments or questions that you might have.

    Thursday, January 5, 2012

    Last Week of Break / Sick

    On Tuesday afternoon I was at work, doing my regular thing, tapping away at my desk. I should have known something was up, as I'd been having quite a bit of... How should I say it in the most politically correct way? Ahh, whatever, I'm going to be a doctor someday, and this is the blog of a future doctor, so I'll just say it. I was having a lot of diarrhea that day. About six bouts by the time 1:00pm came around. Anyway, at about 4:00pm, my stomach gives a little rumble. A gurgle, you might say. One of those greasy little queasy turns that usually come when you've eaten something you shouldn't have. My face flushes, and a little voice whispers, "Hey, you! You know what I think? I think you might, just might be about to throw up."

    I immediately berate that mental voice with an appropriately mental scoffing. Pah! That's absurd. I do not throw up! Why, it has been years since I've last thrown up! Besides, it would be far too ironic, as just this past Christmas break I was laughing proudly with my wife and mom about how long it has been since I've thrown up. Ridiculous!"

    About thirty seconds later I threw up. Just a couple of mouth/nosefuls, but throwing up nonetheless. I told you so. Stupid little voice.

    Miraculously, no one was in the bathroom at work as my body did what it needed to. I don't know why, but I really don't want strangers to see me throw up. Why? Who knows, but I bet it's the same for most people. For some reason or another, it's embarrassing to throw up in front of others.

    Ahh, I thought. That feels much better. And I meant it. I figured if that's all I had in me, I was all set. I went back to my office, took a couple sips of water, and got back to work.

    About forty-five minutes later, that familiar rumbling and skin-flushing came back with a vengeance, and I pretty much sprinted back to the bathroom. I proceeded to watch as my stomach pumped all of that morning's Captain Crunch, coffee, and about half a work-day's worth of water into the public toilet. It was terrible. I remembered what it was like to throw up, and it was never as bad as that.

    To top things off, this time there was someone in the bathroom when I started. By the time I was done, he had left without saying anything. I could take this one of two ways. One: he didn't care one bit how I was doing. Two: he knows that it's embarrassing to vomit in front of other people. I choose to believe the latter, even though I know that it is less likely, because I think he's a pretty nice guy. I was very glad to have no one to confront when I was finished. I held out for about another hour, then went home a bit early.

    On Wednesday morning, my wife found that she didn't know how to behave when I threw up at home. She assumed that I would not want her around during the act. Whenever I got sick growing up, one of my parents would always be there to offer comfort and support until I was feeling better. For some reason, this is still a comfort, provided that I know the person well. I didn't anticipate needing or wanting that from my wife, but now we both know that I appreciate her presence, even during such an embarrassing event such as this.

    After learning that I still couldn't keep anything down, I called in sick and had my wife drive me to the doctor. It was extra interesting this time around, as I hadn't been to see a doctor (or any health care professional, in this case a nurse practitioner) since my wife began her training to be a nurse, nor since I made the decision to become a doctor. I paid more attention to everything, from the blood pressure reading to when she listened to my chest with a stethoscope, to taking my pulse. She did a great job and was very professional.

    In the end, I was given an injection of Phenergan (generically: promethazine) in the "hip." FYI: when a health care professional says they are going to give you an injection in your "hip," they mean your butt. Also, they are most likely doing it there because the needle is extra big. At least, that's the way it felt with this injection. I have a high pain tolerance, but this puppy hurt. Way more than any other shot I've had. It felt like the needle expanded to open up a golfball-sized hole in my flesh after she'd stuck it in. Then the hole began to burn like an ice-cold inferno. Right now, more than 24 hours later, it STILL feels like a grown man just punched me as hard as he could in my right "hip." Very, very sore. Riding my bike to work today was not the most fun I've had all week...

    And that is the story of the past few days. Lots of excitement, headaches, dehydration, and sleep. That's right - I slept twelve hours Tuesday night, four hours Wednesday afternoon, and twelve hours Wednesday night. Very nice.

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