Sunday, October 18, 2009

Things I Appreciate: Very good teachers

A very good teacher doesn’t have to work in academia: people don’t need degrees to teach. I’m going to focus my post on the learning that occurs inside of the classroom, however, for simplicity’s sake.

I have taken courses from two very good professors in college and one in medical school. From the experiences, I have found trends:

Going into the course, there are expectations, high ones. Building expectations requires myth-building, the established lore. When the name is dropped, people respond. A percentage will have negative things to say. But a general, resounding positive aura will prevail over the hours of work and anxiety that follow the class. Students feel overwhelmed by newfound naivety. But everyone else feels the same way, so it’s okay to an extent. And the professor is understanding and knows what the students are feeling: they’ve been there too; they keep on pushing. The expectations are real and are not fulfilled. A lot is learned, but there is always more. The learning continues after the class so that when nostalgia calls, the student thinks about how on point they would be if they sat down on the class today. That’s what a really good professor does.

Thursday, October 08, 2009

Things I Appreciate: Words

Medical school has brought an appreciation for words. For example, I can appreciate the word “appreciate.” The word is thrown around so much, almost making it cliché, yet it continues to carry import. Appreciate implies complexity, often an observation without the knowledge of mechanism. The word is a lame attempt to describe something that we can't, a limit. From one word a sentiment of what it is like to be human explodes. At the same time, medicine (and science and any other field) tries to collapse a myriad of descriptors into neat packages. Consider the words “septic shock.” The words provides parameters of different variables that paint a clear picture of Shit. Words like septic shock allow for effective communication, especially when presenting. Things get spicy, though, when words like appreciate and septic shock, that expand and condense coexist: appreciable septic shock: Oh-Shit.

The Things I Appreciate in Medical School Series

Stay tuned. In the hope of posting more consistently, I've created a theme. Let's see whether I can trick myself into writing on this blog.

Thursday, August 27, 2009

Katrina Redux

This is a long read, but worth considering. I'm still trying to digest it all.

Wednesday, July 08, 2009

Business and Medicine collide

And the results aren't so pretty. But to ignore the trends in medicine and the economics of being a physician is to be on the sidelines. We will all have to be active and informed participants in the arena of medicine and business in the future. Now's as good a time as ever to understand the issues.


(The Groopman/Hartzband piece is here. You need to be at university or other location that has an NEJM subscription to read it.)

Friday, July 03, 2009

brownian motion

I didn't know what to say when I was asked for advice during revisit weekend. I could've told the prospectives which books to buy, what lectures to skip or attend, how to approach PBL, or why you should selectively listen to your classmates and professors. While tiny nuggets of wisdom may have emerged from my mountainous rant, I decided that my advice was specific to my experiences and it wasn't fair to project my MS1 onto the listening. I couldn't provide an answer.

I cannot lie: I inundated Chuck C with a myriad of questions before I matriculated. Most were petty, some were practical, all were motivated by uncertainty. I didn't know what to expect then, and I don't know what to expect now. But I'm not worried. With time, a lot of questions have been addressed, as I have navigated my way through the first year of the MSTP. I tried to express this vague sentiment – intentionally omitting examples – to the revisit-ers. “Just go with the flow” was the gist of my answer. I imagined they were unsatisfied. At least I told them the truth.

I've been lazy

It's been a while since I last posted. I'll be honest: I've been lazy. I have a resolution, though, and that involves a series of posts, snapshots of moments or ideas that have rattled around my skull for some time. Let the regurgitation begin.

Thursday, June 25, 2009

MJ

In cased you missed it, Michael Jackson died today.

The UCLA Ronald Reagan Medical Center across the street from my lab was the epicenter, the place paramedics took the unconscious King of Pop, the place where there weaved around for several blocks countless sattelite-dish-toting news vans, and above which a handful of helicopters buzzed incessantly from about 2 pm until dusk.

What a surreal moment it was when I realized he had been taken in full cardiac arrest to the UCLA ED and that the place was about to be swarmed with people.

As I left at around 9 PM this evening, much of the commotion had died down. But the day will have a lasting impression on me. When I walked outside in the late afternoon for a break from my work, I saw a crowd of people gathering in front of the Med Plaza buildings (just south of the hospital). Amidst the honking cars, chatter of voices in all directions, cameras flashing, and newspeople primping themselves for their live reports, I heard a boombox begin, at first softly and then more loudly (and grainily), playing "Thriller." Putting all of the insanity of the moment aside, that to me seemed like the perfect tribute to the triumphant, troubled, and tragic life of MJ.

Goodbye, Michael.

Monday, June 22, 2009

Checklists

Here's another piece I meant to post a long time ago. Dr. Atul Gawande discusses the value of checklists in the medical setting. No, not just the checklists interns and residents make for overnights on-call. We're talking institutional checklists, from janitors' to nurses' to physicians' tasks.

Yikes!

And the radiation oncologist behind nearly 100 botched procedures at a Philadelphia VA hospital was/is an MD/PhD on the faculty at UPenn.

There are numerous troubling aspects to this story, poor regulatory oversight within and outside the institution and a fundamental lack of peer review.

An overdue post on the occasion of the start of PhD training, year two

As I start my second year of Ph.D. training and fourth year in the MSTP, I thought it was high time to reflect on the current State of Things. A testament to the busy nature of my research, I started this post on 6/10/09 and just today am revisiting it.

The past year has been filled with what seemed like highs and lows at the time, but reflecting on it now it all seems like low peaks and shallow valleys. In short, it hasn't been all that crazy. And yet I have covered much ground -- I've been all over the place. So I'll cover the past year in numbered form, as briefly as possible.

1. Coursework: as of this moment, I have completed all required courses in Molecular, Cellular, and Integrative Physiology. What's left now are qualifying exam(s) [I have submitted my written qualifying exam, no word yet if I passed...I'm shooting to do orals by the end of the fall quarter], publish, thesis, defend, submit. To have time solely dedicated to research is a huge bonus. But the coursework of the past year has been a valuable part of my training.

Incidentally, the Powers-That-Be have decided that the didactic elements of the two core courses I took (Biochemistry and Cell Biology, Fall and Winter, respectively) this year are the least productive aspects of said courses, and the emphasis is shifting to a more problem-based learning (PBL) format in the future. I think this is a big mistake. Sitting in lectures five days a week covering a large array of biological science research was hugely important in helping me think about my research. Just because it's boring as hell does not mean it isn't (or wasn't) time well spent.

2. Research Progress: one year ago, almost to the day, I began setting up my own patch clamp rig in lab. Since then, I have learned a boatload about electrophysiology, data analysis, cell culturing, radioactivity handling and experimentation, electronics, handyman problem solving, and a little bit of molecular biology. My project appears to be well underway, and my PI remains confident I will finish the PhD by the end of my third year of graduate training. Things are progressing nicely.

What's more, I have made some important realizations about what it means to do research. A recent conversation with a cousin clarified what I mean by this: research can be either boring as shit or deeply meditative. And often times, it's a blend of the two. This is probably the case because research, when stripped of the flowery explanations, is really just making big observations and repeating experiments enough times to convince yourself and the world that results have physical significance. This may explain why I've logged hundreds of hours of patch clamping, performed tons of radioactive uptake experiments, and many of these experiments were the second, third, fourth, or even tenth repeats of earlier experiment.

So it can get really monotonous. But somehow, when things are working, it all seems OK - it's for a purpose. And even when nothing works, it's also OK, largely because outside intellectual joys [clinical activities, cooking, music, exercising, romance, et cetera] occupy more of my time. Something has to get you through the difficult and discouraging times.

And finally, I think the most important lesson from the research part of my training comes out of [Los Angeles Lakers'] coach Phil Jackson's playbook: nothing too high, nothing too low. No matter how exciting the experimental result or promising the progress, there's no good reason to be manic, euphoric, or irrationally dazed with excitement. And there certainly is no good reason to slip into a melancholic stupor if a project isn't working. It all requires disciplined moderation.

3. Clinical work: I have been less and less to the ICU to take nights/overnights of call. This is a function of many more side projects in lab, and yet I plan in the next month or two to make it in for an evening. That I am in this predicament is as much a testament to research consuming my time as it is evidence of the fact that I value my social life. The clinical skills will be there, even if I take call much less frequently than I used to. Plus I'm waiting for my colleagues who will be doing 4th year sub-I's in the ICU, figuring I can be less of a burden to the residents/interns if I'm bothering a med student.

4. Socially: it's all good. Doing a PhD is definitely a full-time job, but somehow all of the quiet (and monotonous) moments make the requirement for super-charged social interactions less than it used to be. I'm at peace with it all, even if my social life is laden with challenges, successes, failures, and everything in between, just as much now as it was before I started the PhD.

Sunday, June 07, 2009

Night with the guys, circa 2006

Last night, Jeff, Kevin, John, and I returned to our old stomping ground of Westwood village. We even had liters at "Maloneys." (It's now apparently "Ohara's") That was how authentic we went for it. In three short years, a lot has happened. Half way through medical school, entrenched in research, and John has a ring on his finger. In some ways it seems like just yesterday that we were entering the program, unaware of what med school was going to bring. In other ways, it seems like an eternity.

In any event, congratulations John (and Tiff)! How far you've come. How far we've all come.

(How far we have to go...)

Sunday, May 03, 2009

NYC rabble rabble

I'm in New York city this weekend.  I applied to several MSTPs out here during the application process but never went to the interviews.

Not that I would have gone here, but it's still worth considering if you can't decide where to apply.

Monday, April 20, 2009

A perfect shade of blue

The sky is a perfect shade of blue, and it is 85 degrees out. I’m sitting here, dressed-down in my tank-top and boxers, wanting to bike westward to smell sunscreen. I have finals tomorrow, so I’ll stay seated for now. My bike is waiting, and I probably would go, but I already went to Coachella on Saturday. I should spend some time studying, I guess.

Friday, April 10, 2009

Good Friday, Stem Cells

I've been trying to come up with a coherent argument about stem cells for a long time. This is probably neither coherent or much of an argument for that matter, but I think it does address two fundamental issues surrounding the lay public's and the scientific community's approach to the issue of stem cells.

Writing this on Good Friday, as a lifelong Christian (raised in the Episcopal Church), my mind has been swirly all day with thoughts of faith, death and dying, responsibility and guilt, betrayal, sacrifice, and sorrow. And whether by accident or by desire, I began thinking about stem cells.

The issue of stem cell research has created a cycle of never-ending morality wars, pitted on one side are the fanatical religious, right-to-life, anti-abortion folks. On the other side are the folks yelling and screaming about how preventing stem cell research is like murdering their sick selves (or friends). Neither side has done much of a good job at convincing moderate people to tilt to the extreme. While it looks like the public is generally open to the idea of government-sponsored stem cell research using discarded embryos originally meant for IVF, they aren't picketing the streets (or using the issue as a deciding factor in elections, with some notable exceptions) in favor of one side or the other. But, as it is with so many other issues, the fringe groups are shaping the public discourse on the issue. They tell us that people either, "support lifesaving research" or "don't believe in murdering embryos that have a chance at life." People talk about stem cell research at parties, and they usually feel each other out (make sure they're on the same side of the issue), and then have a glorious time patting each other on the back for supporting the "most logical and just viewpoint." Even scientists find themselves reduced to conversations in which it is acknowledged that the "Bush administration's and christiantist movement's war against stem cell research has now ended," and that basically is the end of the discussion.

So, the implications of moral wars is that they prevent people from delving deeper into stem cells in a discussion. On a societal level, this makes stem cells an easy wedge issue when we consider health, human disease, health care of the future, and deep dilemmas in medicine. Obviously, people find it much easier to have an opinion on stem cells than they do with regards to the care of the elderly, palliative care, genetic discrimination, or the ethics governing clinical trials of life-saving medicines. How many people get into discussions about the moral and ethical issues of marketing and prescribing anti-cancer chemotherapeutics in only the interest of extending a person's life by several months? How many families are able to candidly talk about their decision to support an elderly relative in making the decision to initiate comfort care measures? Have you ever considered how and whether you would decide to undergo genetic testing? Not that these questions aren't brought up, but my point is that perhaps because they (thankfully) have not become easily-packaged wedge issues, they haven't been picked up by the fringe radicals. (Yes, I know, Terri Schaivo was an exception to this. But while her case was picked up and widely debated in the mainstream media, I don't think anyone really resolved how they felt about the issue, just that it shouldn't have become the circus it did. Maybe this is because I still have a challenging time about thinking about the Terri Schaivo case in the abstract, even if I know exactly what I would do...). In any case, we don't engage in the issue nearly enough. Worst of all, many of the people willing to talk about it boil it down to a one liner such as, "Well they just starved Terri Schaivo to death!" or "How dare those smug conservatives prevent a fair and appropriate withdrawal from care, interfering with the family's privacy like that!" The conflicted persons (and the families who are nevertheless forced to make difficult decisions) fall silent, they can't generate a soundbite in the allotted time on "Larry King Live."

A second phenomenon, which is very much linked to the morality wars, is one of inflated and conflated expectations of who, what, where, how, and why stems cells are. In general, the public and scientists (correctly) believe stem cells to be the starting point of organismal life -- they contain all of the genetic information, cellular machinery, and, in response to external and internal cues, they can give rise to fully developed and genetically identical tissue. It has thus been thought that stem cells have the potential for giving rise to the regrowth and re-engineering of tissue in an ex-situ fashion. Unfortunately, this is a sad over-simplification of what and where stem cells (and our knowledge of them) are in the scientific arena at present. Perhaps this is in part due to the fact that both of the fringes (pro and con) can easily justify their points of view using the simplification. For example, the right-to-life folks argue that adult stem cells can easily be used, and will "do the same trick" as those stem cells derived from the blastocyst of discarded IVF embryos. And the pro-stem cell community states that adult stem cells likely won't answer every question and may lack certain key elements that embryonic stem cells would otherwise contain.

Here's the problem I have: this prevents us from truly understanding what stem cell research is, what it should seek to do moving forward, and it denies us the chance to come up with reasonable expectations about what might happen with future stem cell-directed therapeutics. We're so focused on stem cells as a means to an end: a tool for replacing lost or damaged tissue, implanting new (genetically reprogrammed tissue), or as a way to circumvent the need to undergo transplants. I think to focus so broadly on those goals is a huge mistake. We think simply about what we can make, what we can surgically place or inject into a person, and what we may be able to engineer in the laboratory. How often have people spoken instead of stem cell research as a way to unlock secretes about how organs regenerate in situ? (Or, how organs have the intrinsic ability, given the correct internal and external cues, to respond to injury with regeneration instead of with chronic fibrotic and inflammatory processes?) In other words, aren't stem cells important because they offer an opportunity to unlock the internal and external cues that govern tissue genesis and regeneration? Making new organs can come later, or not. But better understanding how to manipulate what we have (rather than what we might transplant) is a more realistic, down-to-earth expectation I have from stem cell research. Maybe it doesn't sound as sexy. But maybe it's more practical.

Perhaps we should start really thinking about the implications of these issues, and stop bickering about abortions and embryo-killing.

Friday, March 27, 2009

The Curse of the Match List

It's 1645hrs on a Friday afternoon in late March. If I'm writing a post, it means either a) there isn't enough lab work for me today, b) I'm avoiding my lab work, c) both, or d) happy hour is nigh. Maybe some combination of all the above.

I recently finished all the rigorous lecture-based coursework for the graduate phase of my training. All that is left is to tweak my project to get an impressive enough quantity of data, do some tutorials with individual faculty members, take some more seminars, do qualifying exams (both written and oral). So, there's a ton more to do.

But something about this time of year always makes me feel so optimistic and forward looking. That something is the match list. In three pages, I can browse the future hospital, program, and specialty of every graduating senior in the medical school class. It looks, without question, quite impressive. And this year, I'm looking at names of people I know, people with whom I attended parties, with whom I compared notes about how to study for exams and how to make it through difficult stretches with research. Granted, nothing can prepare me for the match list next year, in which my first and second year colleagues will be the beneficiaries of The Match.

The problem I have with scrupulously looking over The List is that it allows for a thought experiment that eerily reminded me of what I did when finding out about my older friends and their successes in applying to medical school. Mulling over the final product of the labor of others takes time, but worse, it's like Facebook stalking someone [1]. You sum up a person based on a nifty quotation, a photograph, a really impressive status, or any number of other inane metrics. With The Match, one does the same kind of simplification/idealization. It's toxic. It allows me to say, "Well, because I have a similar board score to Mildred, or better research credentials than Jose, or more impressive clinical skills than Felipe, I surely can get into otolaryngology at UCLA as well!"

Perhaps the internal dialogue above is most indicative with the problem many of us (especially yours truly) have when we look at the achievements of others. We can't but help project onto/into/through ourselves. To do so with The Match not only makes a decision based on years of work and on many challenging moments of reflection seem boiled down to a single line on a PDF accessed securely through the medstudent website. It shouldn't be. So I guess my concluding emotion on The Match for MSTPs graduating this year is, "Well done, guys. Looks like you matched to impressive programs." And for at least one student, I know he matched to the specialty and institution of his choice. That's something worth celebrating.




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1. Yes I've facebook stalked before. Not something I'm proud of, but at least I'm willing to admit it. I could probably write a small opus about the feelings I've had during (and with regards to) FB stalking.

Sunday, March 15, 2009

Sit on top of the mountain...

I helped host a beer hour on Friday afternoon in my department. It was the usual host of suspects: faculty, grad students, post-docs, lots of beer and pizza, and inhibitions dissolved.

I'll keep this brief, for once.

I can't help but think, as an MD/PhD student, people think of me in a vastly different way than they do about graduate students. I'm not sure why, exactly, but:

1. They think we're really crazy. No, really crazy, obsessed, ambitious, etc.
2. They say things like, "When you're done with getting both degrees, you'll need to sit on a mountain top for a year and smoke lots of pot."

I couldn't "take a year off" (what does "taking a year off" mean anyway?).


How about just a weekend?


P.S. Really working hard in grad school is similar to studying for boards. Research can easily become your life. And according to people who do science PhDs, it almost should become your life. Just saying.

Monday, February 02, 2009

Just a heads up

For anyone coming to UCLA for an interview, if you're arriving from LAX and plan on taking the Westwood FlyAway bus, be aware that the fare is now $5.00 (exact change required) and the hours are 6am - 11 pm (this used to run until 1 am). I realized this during a rather unfortunate hour of waiting at LAX last night that ended in a $40.00 cab ride home. For more information, here is the LAX flyaway bus website. Click on "Westwood." Of course, you can always send us questions at mstpla at gmail dot com.

Saturday, January 24, 2009

Learning and trying not to forget

I can't help but think I took the red pill when I decided to enter the MSTP at UCLA. I had no idea what I would find, but I knew it would be too much to grasp at first. Or ever. And yet, two years and seven months into it, I'm starting to see the beauty of this journey all over again.

One might imagine that I'm about to launch into an (albeit weak) attempt at philosophizing [1] about the experience that is MSTP at UCLA. I am not. I just want to share some of my sentiments, now that I feel firmly entrenched in the PhD phase of my training. And I want to say that, while I do not endorse any one way at how to go about this, I will invariably focus on issues as they pertain to my roadmap. But others (Jeff, Anthony, et al) have much different roadmaps in mind, and I think they are finding similar satisfaction [2].

Which is to say the following: I do an overnight of call [3] in the Fourth Floor East Medical Intensive Care Unit (MICU) in the Ronald Reagan UCLA Medical Center (RRUCLAMC). I've watched numerous central and radial arterial lines get placed, I've seen a couple patients die, I've attempted (and failed) to draw an arterial blood gas, I've watched (and sort of helped with) endotracheal intubations, I've run when the words "Code blue team, code blue team," go up over the loudspeaker in the middle of the night. I've seen the spectacle of a patient being cardioverted during and acute atrial fibrillation episode, I've sat in on family meetings for parents whose grown children are dying, I've seen the same patients, in the units for months at a time, while pressors, ventilators, oxygen, blood, blood products, plasma, dialysis, fluids, antibiotics, keeping them alive for weeks and months longer than seems even possible [4]. In short, I've obtained a crash course into one of the most exciting and indeed "critical" areas of inpatient medicine, the ICU.

I started doing this unofficial-ICU-call-longitunal rotation in November, and I have since been in the unit, usually on a Friday night into saturday midday, every other week. I generally will arrive at campus on Friday morning at 7-7:30 a.m., do work in the lab until late afternoon/early evening, and then a call night begins [5]. I began this work when my class schedule prevented me from continuing my once-a-week clinical exposure. Logistically, the MICU call was the only way to continue some clinical exposure.

There's another reason, too. If you recall [6], I had become frustrated with some of what I had learned about scientific research. Basic science, it seemed, suffered from the same failings that evidence-based medicine (EBM) does, or of empirical and non-data-driven clinical care. And I was asking myself a series of questions about what I had gotten myself into [7]: Why was I doing this? Am I forgetting everything I learned in the first two years of medical school? What am I really trying to do?

I don't have answers to those quasi-philosophical questions, but the beauty of the last several months is that I don't even need answers to them. The ICU work, as infrequent (Q2wks) and humbling as it is (I really don't know shit [8]), has filled a small void. Somehow, since this has started, my research has flowed a little more nicely -- maybe because I take advantage of the time I am in lab, or maybe because I get a twice-a-month dose of why I am doing all of this. This isn't just the "I want to help people" sentiment. Certainly, when you watch young and old patients alike fading away from devastating illnesses, you can't help but feel some sense of sadness, sympathy, or frustration. But there's also this sense that, both at a very basic level (mechanisms, molecules and targets, animal models) and from the clinical perspective (drugs, monitoring schemes, preventitive measures) there are astounding amounts of work to be done by physicians, scientists, and physician-scientists. And this is not just for the new sexy cancer drugs, not just for the new stenting procedure for cardiac or neuro patients. I'm talking about really understanding the effects of endotoxin (LPS)-mediated septic shock. I'm talking about further nailing down what causes and how to treat Adult Respiratory Distress Syndrome (ARDS). Medicine spends a lot of time - in the hospital, the ICU - well documenting and observing these phenomena via critically low blood pressures, decreased oxygen saturation, multi-organ failure, positive disseminated intravascular coagulation (DIC) laboratory values, the list goes on. Physicians spend sleepless nights managing these patients. Researchers, who see around the corner to translational medicine, want to challenge assumptions that are in the textbooks and clinical references with fresh new experiments.

Not to belabor a point, but both medicine and research have much to contribute. I think that's cool, and I still want in [9].

Several final points:
Ultimately, the great challenges of medicine are not unlike the great challenges of our economy. We are still trying to figure out what causes disease, and yet we are treating diseases nonetheless. It's sort of like going with a one trillion dollar bailout to a problem without knowing exactly what caused the crisis in the first place and thus without quite knowing what to fix. Said Warren Buffett:

The answer is nobody knows. The economists don’t know. All you know is you throw everything at it and whether it’s more effective if you’re fighting a fire to be concentrating the water flow on this part or that part. You’re going to use every weapon you have in fighting it. And people, they do not know exactly what the effects are. Economists like to talk about it, but in the end they’ve been very, very wrong and most of them in recent years on this. We don’t know the perfect answers on it.

Replace "economists" with "physicians" or "scientists" or both. Needless to say, the quotation is more than applicable to how we approach numerous diseases. Our information is incomplete, our assumptions have been (and will continue to be) proven wrong. But you must keep flowing the water. Our basic sense of humanity requires it.

And so, more than ever, the MD/PhD path is for me. The rest is a mystery.



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1. The difference between philosophizing and sharing sentiments is sort of like the difference between using data to generate an exciting new model for some physiologic process (say a pictogram of vesicle fusion) versus simply sharing some exciting data. I would argue that here, and in most writings on this blog, we're simply trying to present our data, our observations, de novo, roughly as they happen and our thoughts about them (the data, observations) crystallize a bit. I doubt there's an MD/PhD or MSTP graduate out there who could package the experience into a philosophical model.

2. It doesn't matter what position you do it in, just that you're doing it...at least that's what she said.

3. This is a misnomer in my case. Medical students don't get "called." Case-in-point: two "calls" ago, the resident and intern with whom I was taking the overnight received a page from the Emergency Department for a patient w/ Diabetic Ketoacidosis needing to be admitted to the ICU. The resident claims she tried to wake me up by knocking on my door. "But you had my pager and cell phone number." But she didn't call. A weak knock, a med student doesn't respond, and it's just as well -- I get an extra hour of sleep, and it took the resident and intern no longer than thirty minutes to work the patient up and admit her to the unit. It probably would have taken twice as long if I was "helping." Which is also to say the following: medical students generally don't contribute much, especially if they aren't part of the ongoing care of patients (i.e. are on a rotation or a sub-internship, where they actually contribute little tasks to the medical team). Coming in for a night of call as a (quite inexperienced) medical student generally doesn't result in much help to anyone, except himself. It's this strange feeling of importance (white coat, "helping" make medical decisions) while being utterly inconsequential.

4. Or humane. Or natural. Or fair.

5. Sometimes a resident's page indicates a new admission, and at 4:30 pm I'm rushing out of lab to the ED, in scrubs and a white coat and feeling unsure of my uniform and skill set.

6. Go back to some previous posts, most recently one containing the sentence, "Yawn," or the phrase, "selling out but for less money," and you'll get the idea.

7. Admittedly, the risk of becoming overtly philosophical is highest at this point of the post.

8. If you really want, recall that I wrote these same words in a post during the first week of first year of medical school.

9. That's why I joined an MSTP. In some ways, this post feels like I'm re-writing my personal statement explaining why I want to join a medical scientist training program.

Friday, January 23, 2009

Applicant/prospective OPEN THREAD

In lieu of some posts that are brewing in my head (ICU post, research progress post, other details about the "pretentious" MSTP life), this post is an open thread for applicants and other individuals interested in MSTPs, either at UCLA or in general. So feel free to post away, and we'll offer our thoughts when/if relevant.