Month: January 2014

Dear applicant, what are your strengths?

This is one question, I am pretty sure will come after ” Why Medicine?” in all med school interviews. Rightly so, for in the short span of 20-30 minutes, this is one question which helps the interviewer in figuring out what you think about yourself, not that it matters too much for they already know what they think about you but yeah, it tells them what you think you are worth.

So, 2 minutes and 17 years of life. How do you sum up what you think brought you so far? What would you say to this? Would you give the same answer every other applicant gives, would you say that you are competent, caring and calm with an inherent prowess for holding the scalpel. Trying to sound unique is even harder than being unique.
I have compiled a list of adjectives which I think can and should be used to answer this question and others of the same vein:-

1. Compassionate- a pretty strong attribute to have considering that medicine thrives on human to human contact. This may sound like a pretty clichéd term to use but I believe that the world can never have enough of compassionate people.

2. Perseverant- In the race to medical school finish line, I think this is one trait that gives one an edge. What is it like to be perseverant?Is it the tendency to not give up and persist against all odds. For me, the confidence to apply to a UK medical school among loads of home applicants and the ability to fight for the small number of seats offered to international applicants is in itself an example of perseverance. Maybe not the best example to give in an interview but the perfect one for a ranting blog.

3. Practicality- The virtue of being clear enough to separate logic from emotions and feelings from reality. How important would this trait be in a situation where the plug is to be pulled on a chronically ill patient or when the rationing of resources needs an objective mind.

4. Emotional- Although in striking contrast to #3, this would be of ample use in the world of medicine, a world where objectivity is fast replacing the humanitarian touch of mankind.

5.Enthusiastic- Yes, maybe all the 15 applicants for the interview are enthusiastic, but then can the university ever accept an applicant, who has the lack of zeal? Yes, you have an important lecture at 6 in the morning, who do you think will attend it, the enthusiastic applicant or the one with the clear lack of it.

6.Initiative- It takes a hell lot of initiative to make a blog on topics related to the journey of a novice through the webs of healthcare. I did it because I wanted to. Most importantly, I know it took you a whole lot of initiative to read this post, but you did it because you wanted to. See, when we can devote so much time and energy onto a mere blog, what would we do as doctors?

7. Ethical- I am tremendously impressed by the scope of medical ethics. I treat it as an amalgamation of science and art. I try to stay well versed with the Abortion act, the ideals of Jehovah’s Witnesses, the ethics of eugenics and stem cell therapy but for you it might just be the morality of everyday life. It does not matter, what does however is the fact that it plays a crucial role in our dealing with people.

8. Scientific- Medicine at first look ,looks like a boring collection of facts, journals and theories applied to ailing people. Trust me, no matter what they tell you, it is just that. The importance of having a scientific bent of mind can never be underestimated.

9. Effective communication skills- The ability to navigate through the maze of questions posed in an interview, this itself requires immense communication skills. I would like to include- effective speaking, listening and writing as a subset of this trait.

10. Independence- No man/woman can function alone, but as a healthcare professional, you may have to. The gist of this trait is that by this I would like to emphasize upon the self-reliant nature of mine.

These are 10 traits, I can think of at the moment. There are numerous other adjectives which could successfully be used to elaborate on oneself. The more the merrier……….

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UKCAT: the worst cat ever….

Yes, I am a wannabe medic, I fantasize about the white coats and the stethoscope! This is the “Dreamy Phase” of my life, the time when you see everything in rose tinted shades. And even a rectal examination seems like a major call of duty.

I have loved Grey’s Anatomy from day one, and even though the show is miles away from reality, I love the hospital setting that they show.

What I cannot believe however is that McDreamy or for that matter Dark and Twisty Meredith have ever given the UKCAT! ( I bet one cannot have such good hair, while doing the quantitative reasoning test.)
P.S: I am referring to mortal humans like me, no offense to you awesome people!
So yes, UKCAT has screwed up my brain enormously!!!!

1. After struggling with the aptitude test for like 3 months, my test was scheduled for the 1st of September, and needless to say I was not looking forward to it. In retrospect however, I don’t think I should have worried so much. But then Hindsight is a beautiful thing.

2. What’s different! I have given so many exams now, all through my life,its been just one exam after another then why is the UKCAT such a pain in the ass???

3. ZAP, Your Results are here-Okay, I agree that the wait for results is frustrating….
After the exams- confidence level is on a peak
3 days after the exam- I have the firm belief that I can make it through without sinking.
week after the exams-I start preparing for the retest.

so, getting the results immediately after the test is good in that way but what do you tell people waiting right outside your test centre? There is no freaking way you can hide the ominous fact!

4. If you care- I had been preparing using the following material:-
a. 600 UKCAT book (pretty difficult)
b. Kaplan UKCAT online course.
c. Emedica
d. AceMedicine (one of the worst packages I purchased)

In a nut shell, I had spent a lot of my daddy’s “hard earned” money on this test and all this after I read on the official UKCAT Site that “you can absolutely not prepare for this test”!

So more the money spent, more the “great expectations”,more the sleepless nights ( or in my case more drowsy days)

5. Abstract Reasoning- I somehow had begun to understand it, days before the test (Some miracle that was, for at the very beginning I was failing dramatically at it) Every time I saw a pattern would I start counting- no of sides,no of intersections, colours,shapes etc

6. THE SITUATIONAL JUDGEMENTAL TEST- this was the major issue. I think I am probably the only person who had a problem with this. It came as a major shock cos I am a pretty ethical person (or so I like to believe)but yet I screw up about one third of the questions.

Actually in real life, stuff is either good or bad, it can screw you or inflate you,but in UKCAT it is :-
a. Very Appropriate
b. Appropriate but not ideal
c. Inappropriate but not awful
d Very inappropriate.

7. Freaking Forums- To top it all, I had been stalking TSR,New media medicine and all other student forums I could find and wherever I went, I found awesome-blossom people who had an average of 700 or above, and boy was I pissed?

I always wish well for the fellow contenders, its just that I could not understand why they all wanted to apply in 2013???

8. Timing is always the crucial factor- The average time for one question in the test is about 30-35 seconds and this has been one of the most damned things about it. Initially, I used to read the question in 60 seconds and now I do the question in about 35-40 seconds, its still not perfect but hey! even UKCAT is not perfect… so do not judge me!

9. Get it done with- Despite all this I decided to go ahead with the test in September itself, even though I had initially decided on the 1st of October, some of the notable reasons are:-

a. I had been working on it long enough, and I was starting to feel a teeny bit bored!!!

b. With the scores in hand, I could then decide the universities I wanted to apply to, find out the ones which would not trouble me too much.

c. Prepare the final draft for the personal statement, prepare for the BMAT.

UKCAT in a nutshell, would be a test of how well, you could persevere in the face of adversities and more so when pressed for time. I still remember how 20 minutes into the test, I felt that I had ruined all my chances of getting a place but then what was important was to cast all the negativity aside and try to grab as much of what was left. Surprisingly, my score came above 750, which by 2013 standards was pretty good. I still don’t know if I will going to a med school this year, but what I definitely know is that I somehow aced the UKCAT, maybe not the worst cat ever……

I love you…..

I love you without rhyme without reason,

sometimes against time,

sometimes against season

oft alone yet never alone,

Sometimes with dusk,

sometimes with dawn

part a trepid, part a fawn,

I love you against rhyme against reason.

Against joy against harm,

sometimes too cold

sometimes warm

Oft alone yet never alone

sometimes like a bird soaring high,

sometimes like a sigh

I love you against rhyme against reason

Sometimes too far,

sometimes nigh,

Sometimes a devil, sometimes too shy

I love you against rhyme against reason

Against souls,against life

against all wrath,against all strife

Against all miseries,

against all hope

Against all troubles

against all dope

Oft alone,yet never alone

I love you for rhyme for reason…….

Oxbridge: what the winky spider did there and more…….

When does a medical applicant apply to Oxbridge? Is it when confidence overcomes reality and  when you really think for a moment that you are the chosen one who can study for 6 years in the Hogwarts like atmosphere of Oxbridge. Nah, I applied because I was out of choices and I also did not want to regret on my deathbed that I could have studied at Oxbridge, and found the cure for the disease that brought me to the deathbed in the first place. After all what did I have to lose? On the contrary, lets sum up the motivation I had for applying to Oxbridge.

1. I have spent half of my childhood, wearing capes and scaring off make-believe dementors, muttering J.K Rowling created magic spells and believing that Hogwarts would be where my muggle parents would send me to become a full blown witch. And, when you have a look at Oxford/Cambridge, you can for a moment actually feel the magic in it. This was one half of the reason why I chose it.

 P.s Truth be told, I only got to know later on that Harry Potter was actually shot in Durham, Damn the heartbreak!

2. Winning the Nobel Prize- I have actually seen myself winning the nobel prize for medicine, and Oxbridge seemed to be the right place for kick starting my career, the league tables all played a crucial role, why are they so biased towards Oxbridge people? Always first or second……

3. If you submit the UCAS application in November like I did, you are looking forward to almost 5 months of waiting and interviewing before the results. Oxbridge comprises the only university to interview you in December and send results out in January, for gap year people like me, this keeps you busy for atleast 2 months.

4. BMAT- I did the blunder of looking at section 2 of the BMAT and feeling that it was a piece of cake, after the UKCAT, the prospect of having a pen and paper test with no timers running in the background seemed a bliss. But then came Section 1, which fucked my brain immensely.

5. To think that I could actually study at Oxbridge, brought a kind of respect for me from my family. For a person experiencing that kind of reverence for the first time, the mere probability of getting an offer seems something to leap for.

6. Being an international applicant, my choices were pretty limited. Some places did not find my qualification acceptable, for the others I did not find theirs acceptable…….

6 points are enough, aren’t they? well they were for me then and I spent almost a month waiting for the BMAT results and then an interview call. My BMAT score was definitely above average and section 2 and 3 were real good. More about my Bmat experience later on but I think for now it suffices to say that I was called for an interview. Now let me emphasize how hard it is for international applicants to get even an interview invite. Whilst packing for my trip to Oxbridge, I often felt that since I had crossed the first difficult part to interview, I was definitely going to get an offer. Screw modesty, I really think I had good enough communication skills. Aah, the investments I did for the interview, shining black suits, a new haircut, expensive spa treatment to get that Grey’s Anatomy glow on my face and air tickets ( beware around Christmas, tickets are harder to find than Santa himself and costlier than all the gifts in his bag) .

Hmm, in retrospect the interview went really good, the kind where you come out feeling really high and happy. But then there is the gut-wrenching wait through Christmas New year and a week after that before you hear from them. Now this was the moment, I had been waiting for all my life (atleast all my medical aspiration life), imagine a young person, fresh out of school, back from Oxbridge, with the memory of a good enough interview and looking forward to classes in September. Yup, you imagined that right, now imagine a dejected applicant, heartbroken and unable to believe on humanity. Yes, that was me after the results, I had been rejected.

 Really all that waiting had reached a saturation point, I wouldn’t say that it did not feel bad, cos it did and more so because I could not for a moment figure out what had gone wrong. Well, truth be told I cannot figure out even now…..

So, how was life after the results? It was slow, like a long drawn drama and with no other med school interviews at the moment, the dejection lingered on for quite some time. And then I got an invite from another med school in London, that felt good, but what Oxbridge did for me was that it kind of stole the area of my brain which told me that I was really good at doing interviews. All through school and beyond, I don’t remember even thinking about my communication skills but now freshly rejected from Oxbridge, there was this dread of not being good enough……

So I still have an interview to give next month, this is going to be my ever first encounter with an interviewer after Oxbridge and like a heartbroken person, I sometimes have the feeling that I might not be too good at the game, but as my mother rightly says I need to just hang in there……..

So, would I apply to Oxbridge again if given a chance? Yes, definitely, because like everything else in life, even in loss this has taught me an important lesson. The lesson of patience and perseverance. Yeah, maybe next time I will  talk to my parents and make sure that they understand that getting an interview is not what gets you an offer, there are a number of other things which matter. Maybe, I will rejoice in the fact that I had an interview and feel blessed that I could atleast go so far.

So now finally, the post rejection take on my reasons for choosing Oxbridge

1. Hogwarts is just fictitious and like I said Durham was where it was all shot and afterall Harry Potter is so old school!!!

2. Winning a Nobel Prize does not mean that you have to be an Oxbridge graduate. It just means you are really good at what you do no matter where you come from.

3. November, December, January, February. Days are meant to fly and they shall. Trust me for I have experience, one does not need Oxbridge to while away time.

4. UKCAT has really been kind to me. I somehow came in the top 10% of UKCAT scores. BMAT take that!!!!

5. League tables- I am going to start my very own Winky Spider University ranking table and no guesses where Oxbridge is going to figure

Aah, that was my Oxbridge journey, loved and cherished……

How UCAS medical school application is turning out to be a life changing experience for me…

Medical School applications in UK are submitted via the UCAS portal. For all Harry Potter fans, UCAS is like your very own Hedwig, bringing messages to and from universities. When I decided to apply, it took me almost 2 months of preparation to finally muster enough courage to click “SUBMIT”. In the short spread of a few pages, UCAS gets you to fill in your complete life story, not only so far but also what you anticipate in the coming years.

For me the entire process of filling in the Personal Statement, getting a reference, submitting your grades and finally choosing med schools to apply turned out to be far more time-consuming than I had thought.
After almost a month when the time came to cross-check the application before hitting send, I had reviewed every column almost 10 times. Trying to make each and everything speak volumes. Trying to look like the perfect candidate for their school. Trying to become the “Chosen one”. Aah! I can even remember trying to fit in “Meredith Grey” in my name to sound like a real pro.

UCAS like so many things in life, will not tell you if clicking send is worth it. It will have the same boring color no matter how good or bad your application is. The one thing/person/organization in your application journey that/who will not judge you on your lack of academic prowess/internship work and your grammatical errors. The only thing it indicates is “Keep calm and watch”

And then you click send. The application is bundled off, 4 universities (plus 1 insurance one) send you acknowledgement letters. The first step which you receive so happily! I still remember getting the letters and looking forward to my offers. The letters are so warm and exuberant, that you would almost want to go and buy stuff for it. But trust me, 5 months later, when you are still waiting for a reply from them (even a season’s greeting) that letter will drive you nuts. You will look at it and scream “Hypocrites”. And that is when you will realize the value of UCAS. The Stability of the portal, which has not changed over the past 5 months. You learn to respect it for its never-changing nature.

Right so now, 5 months and 15 days on, you spend every moment of your life checking Uni1’s portal, Uni2’s portal,Uni3’s portal, Uni4’s Portal and finally you come onto UCAS. The one stop for your university needs. The integrating factor in your application. The one thing that joins you to so many other buffoons who have applied to med school. Your love, Your UCAS.

And then suddenly UCAS speaks up,sends a notification “Your application is in premature labor” and like a harried father you rush to the portal, and there right in front is the outcome of the entire process, its either a REJECTION or an ACCEPTANCE, but trust me most of the time, the gestation period of your application seems so long that you heave a sigh of relief even if it is a rejection. See, this is how UCAS lessens your grief, by making it so stretched that you cry with joy when the process finishes.

Okay, at the moment I have an offer for Biomedical Sciences from a world class uni in London, but like so many applicants I would give anything to replace it with an offer of place for medicine from maybe a lesser known University, such is the desperation to be a medic. But through all this what has become really close is UCAS, we have even come to nickname terms, he has given me a 10 digit Personal Id number and I call him “%^%#$#” but nevertheless, he has taught me how life is a collection of decision letters, some rejections and some acceptances but most importantly it is the desire and the patience to wait for another golden day……

LOVE YOU UCAS, NOW GIVE ME AN OFFER ALREADY!!!

P.s: I have not received any commissions from the UCAS people, trust me they do not even pick up their phone calls…..

The clash of wills and thoughts

The first time I heard about Advance directives and living wills was when I was trying to cram my mind with sophisticated terms related to Bioethics, which I could flaunt in my med school interview. As the member of a yet to develop “third world” country, the very idea of directing the physician to stop efforts and letting go, was strange if not repulsive to me. I am a part of a community that strives to stay as far away from the medical community as possible. We endeavour to make sure that we maintain good relations with atleast one physician, so that in our time of need, he/she might go the extra mile and drag our soul down from the journey towards the heavens. Not once, had I thought of the idea of “dying with dignity”.

One argument that was put forth was that often at the very end of life, one is deemed to live as a vegetable due to the artificial ventilators which pump air unnecessarily in the system and keep the dead from dying. Wasn’t dying better than living as a vegetable? One with no ability to decide, no control over life and a mere financial burden to the economy was better off gone.
This argument had deeper implications, I could immediately think of three situations:-

a. A brain dead Mr.X- with no prospect of recovery, he could stay in the vegetative state for decades thanks to artificial means of prolonging life, but medically all treatment was futile. It was just a matter of switching off the plug and pronouncing the time of death.

b. An old lady around 80, who has an advance directive, which asks her physician to stop efforts of bringing her back as she would not like to live a life hooked to the “infernal” machines.

c. A young girl, comatose after an automobile accident, the decision makers in her case, her parents, aren’t able to reach a decision. The father feels that the girl is better off gone and the mother would like to wait for a miracle and believes that her daughter is going to wake up in another moment.

The first case here is that of “MEDICAL FUTILITY”. The healthcare team believes that no effort in the case of Mr.X is going to be successful and they have the power of switching off the plug and rationing the resources which would be better off used on someone else. A simple case as long as Mr.X isn’t your father, brother or husband. What would you do if your doctor suddenly tells you that your relative will no longer be treated as all resources used upon him are not bringing the success, they had hoped for. How come they get to decide, when your family becomes a lost cause. In case you fret and feel that the doctors aren’t acting in your best interest, they are most likely going to give you a day or so to calm your senses and then broach the question of withdrawing support. Ultimately, the power to let go must be mustered by the patient’s family.

The third case, would be an example of surrogate decision making, well the doctors ask the parents, what they would like to do with their daughter, she has minimal brain activity and is being fed by a nasogastric tube, how does the parent decide to let go? how do they decide if her quality of life now is better off or worse than what it would be if she were dead. The father has concerns, financial, social and physical. How much longer can he wait by her bedside waiting for her to stir? These concerns do actually figure in the mind of the person who is actually paying for the medical procedures. The mother feels that the treatment ain’t futile, she has shown minimal brain activity after all, it is only a matter of time before she becomes her cheery self again…..
What I wonder is how the doctor would maintain a neutral demeanour, he has just switched the plug off for Mr.X and here he is again asking about another vegetative patient, hasn’t this become routine for him? the job of rationing resources for better off cases and relieving the hospital of patients who are on the path of becoming futile cases. wouldn’t it indicate that medicine is actually only those who have potential for recovery, after a long day in the clinic, would a surgeon with the option of pulling the plug and going home spend another minute on the complex patient in front of him?

The second case, concerns advance directives. On the one hand, the old lady could be saved by charging the paddles and doing heroic medical procedures and here she is demanding to be “let go” on the basis of her hatred for the machines which have the potential of saving her life.
As a physician, wouldn’t this seem ironical that on the one hand there are patients who would like to be saved but are not responding to heroic measures and on the other hand they cannot save one who could be saved?

Indeed, she is doing a favour to the society by freeing resources which would be used upon her and her bed in the ICU can now be given to the emergency case waiting in the hallway but what this shows is the undermining of the principles of medicine, as a science and highlighting the role of philosophy in clinical practice….

Well bioethics, is indeed a complex area of knowledge, the more science develops the more the extent of conflicting situations but what I am pretty sure of is that my advance directive is only going to say

“Save me No matter what”………