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Sharing my story, and redefining success

During my M1 year, I’ve learned an enormous amount about biology and medicine, but I think I’ve learned the most from my classmates. It’s been an unbelievable experience. The class is full of people who have done interesting things, work hard, and thoroughly enjoy both life and medicine. Everyday, I learn something from a classmate through a story, their advice, or observing their interactions with peers and patients.

The running community I’ve built in Ann Arbor, after the Dexter to Ann Arbor Half Marathon. This group helps me stay grounded and be successful, and includes some of my best friends. From left: Noah, Sam, Jake, Paige, Jonathon (me!), and Luc.

With this in mind, I thought it was time to share a story of my past experiences, so I signed up for the Leadership curriculum’s “Story Series: Stepping outside my comfort zone.” These events are my favorite thing the medical school does. It’s a “Moth-style” story slam where medical students tell a story to teach their classmates in an informal setting.

I spent some time reflecting on what I’d learned by being a member of the Northwestern Club Cross Country and Track Teams as an undergraduate and decided to share this story. I joined the team my sophomore year even though I’d never run competitively before. I quickly realized I was the slowest on the team. This was hard for me because I had never been so bad at something compared to my peers for such a long period of time. I wasn’t sure if I wanted to stay on the team, or if the team wanted me.

However, as time passed and I got to know everyone, the team became my community. In fact, I realized that the team transformed my time at Northwestern and gave me some of my best friends. This experience helped me redefine what success meant to me. It wasn’t about winning races or being good at something, it was about finding a community, making friends, and being happy.

I’ve brought this new definition of success to Michigan with me. I still run almost every day, but I’m not really trying to race anymore. Instead, I’ve used running to build a community in Ann Arbor. I’ve met most of my best friends through running – there’s a group of eight other medical students I go running with almost every day. We talk about medical school, life, and plans for the weekend. We use running to relax and take a break from our studies. Though I may not be running at the same level I was, there’s no way I can think about the community running has given me here and say that I haven’t been successful in running.

Stepping up on stage to share this story was a tough thing to do. It’s easy to share our successes, but much more difficult to be vulnerable in front of the whole class. However, because I learn so much from my classmates, I decided to share. For medical students, I feel this story is important. We’re at the bottom of the hierarchy in the hospital – and we don’t know very much. So finding ways to persevere when things aren’t going well and find success in whatever form will continue to be incredibly important for our education.

Remember when I was terrified to even be within 1 square mile of an OR?

TONS of things have happened since last I wrote, and I figure the easiest way to address them all (or at least the major stuff) is to do so in chronological order.

March: Neurosurgery. Neurosurgery was AWESOME. One of my primary goals in doing a neurosurgery elective was to determine whether or not I felt confident that was the field I wanted to pursue. Consider that goal thoroughly met. I was able to see a far wider variety of neurosurgical procedures than I’d previously been exposed to, and I enjoyed every single one of them. I was particularly worried that I wouldn’t like spine (especially since being able to even see anything as the med student involves both contorting oneself into extremely uncomfortable positions and a fair amount of luck). Turns out spinal surgery uses some of the coolest and most ingenious toys ever. Who came up with this stuff?! I often say that assembling furniture is like Legos for big kids; placing spine hardware is like those technical Lego kits (the ones with motors, lights, what have you) for big kids. I had a number of memorable conversations with several of the residents. They were wonderful about providing candid responses to questions, important things to consider about the field that aren’t necessarily obvious, and advice about how to set yourself up for success. The month also provided an opportunity for me to prove to myself that I could function on minimal sleep (though there’s, shall we say, room for improvement) and manage to keep myself together after witnessing some really tough situations. It was an all-around amazing experience.

April: Pathology. The fact that I was able to line up my neurosurgery and pathology electives back-to-back ended up working out perfectly. Pathology is what I initially envisioned myself most likely doing when I was first starting medical school. It’s, um… slightly different than neurosurgery. Just a smidge. Being able to transition directly from one to the other served to emphasize this difference and further bolstered my certainty that neurosurgery and I are in luuuuurve. That’s not to say that I didn’t enjoy pathology: quite the contrary! I got to see some really cool stuff and was pleasantly surprised at how often important foundational concepts came up in the midst of specialized pathology-specific knowledge. I was able to try my hand at following surgical specimens through the process of initial receipt from the OR, “grossing” (basically looking at and describing the tissue with the naked eye), and then examining slides of the tissue under the microscope. I also got to participate in autopsies, which was wild after having only seen the majority of the anatomy in preserved specimens in the anatomy lab. Spoiler: it looks different. Despite the fact that I’m now convinced that pathology is not where I’ll end up, I had a fabulous time and don’t doubt that my experience will serve me well in the future.

May: Step 2 Study Stupor. Not much excitement here. I dedicated the month to preparing to take both parts of Step 2: CK, or Clinical Knowledge, and CS, or Clinical Skills. CK is the standard multiple-choice, computer-based test. It’s essentially the same as Step 1, but with a more clinical focus. Lots of “what’s the next best step in management” questions. Still lots of anguish. CS is a series of encounters with standardized patients (actors who pretend to be patients) and a patient note following each encounter. It’s only offered in five places in the country and thus often necessitates a road trip. We’re fortunate enough to have a test center in Chicago, which is only about a 4-hour drive. I’m currently in the gut-wrenching waiting period that inevitably follows any of these exams until you find out how you did. I’m trying to pretend that it doesn’t matter. It’s not working.

June: RESEARCH YEAR!!! I officially started working in the lab this week after driving back from Chicago. Thus far, my time has mostly been spent getting situated: reading up on techniques I’ll be using, finishing up with required training to be a fully-fledged lab member, and becoming familiar with the work that everyone is doing. I won’t say any more on this now as this entry is already quite long, but I’ll leave you with the following proof of how hardcore my lab is:

We’re kind of a big deal.

The Long and Winding Road

Each time I participate in the UMMS interview day, my own interview day seems farther and farther away (and I’m usually quite thankful not to be wearing a suit). Well, the time for dusting off the suit is coming soon. In medical schools across the country, preparation for the upcoming residency application season is beginning. Students are attempting to craft personal statements (which, like when applying for medical school, is a task that sounds much easier in theory than it is in practice), updating their CVs, and asking for letters of recommendation.

In terms of letters, the residency application has an additional kind: the Medical Student Performance Evaluation (MSPE) or, more colloquially, the Dean’s Letter. Written by one of the medical school deans, the MSPE gives a summative evaluation of your performance in medical school, including comments from third-year clerkship evaluations, as well as notable characteristics that are evidenced by extracurricular and co-curricular involvement.

In order to create these letters for each graduating student, the deans meet with students individually to discuss their content and for us to give input. For example, at my MSPE meeting last week, we decided to include my love of learning languages as a notable characteristic (I’m fluent in French, but am working to improve both my general/medical Spanish and Mandarin Chinese).

The other aspect of the application process that bears mention at this point would be narrowing down the residency programs to which I will be applying. I will be pursuing a residency in family medicine, which means there are over 500 programs to which I could apply. That number is slightly overwhelming to say the least.

I spent several weeks (at least) freaking out over how I could possibly narrow down to 20-ish programs and soliciting advice from everyone I knew who has already been through the process. The principal answer: start by defining your geographic preferences then decide what program characteristics are important to you (for family medicine, common factors are the strength of OB training and desired population characteristics, such as focus on the underserved). Several people steered me to the AAFP (American Academy of Family Physicians) website, which has a search engine of available residency programs that easily delineates these characteristics.

Prepping my application has a long way to go, but baby steps. In the meantime, I’ve enjoyed being an M4, including my vacation time last month. I was able to go to London with my family and we had an amazing time.

This sign made me laugh. I was on the upper deck of a tour bus and was going to try to get a clear shot but the bus went up on a curb and I had to abort that mission or I would have dropped my phone on the pavement (not sidewalk, our tour guide said that was too descriptive for the Brits). “Changing priorities, 50 yds ahead” indeed.

Welcome to M4

It’s June apparently. The past three months have passed in a flash. It was still March the last time I wrote, and a lot has happened since then, including sub-internships, the last ever board exam that I had to take in medical school, and the arrival of some very spring-like weather. I can also officially say I’m an M4. Congratulations to this year’s graduates who have officially been MDs for a couple weeks now!

Furry study buddy

The beginning of April brought the beginning of my pediatrics sub-internship. The sub-internship is one of the much-anticipated rotations of 4th year. It’s a chance for us to act as interns, or first-year residents. We’re the first contact for our patients, and we have a significant role in their care. It’s a chance to stretch and enhance our clinical reasoning skills with much more responsibility than we ever experienced as M3s. As frightening as it initially was to get pages about patients (wait, is that my pager?), it eventually became part of the normal day. It was nice to be given a great deal of autonomy but to also know that there were multiple people checking everything I did. The team was also great and really treated me like one of the interns. For the first time, I truly felt as though I could call the patients that I cared for mine. It was overall an amazing experience.

May brought a very different kind of experience. I was able to take a quick trip to Chicago to see Hamilton and spend a weekend in Traverse City to attend a friend’s wedding. Then, I took most of the rest of the month to study for Step 2 CK, the last part of our national licensing exam that I had to take while in medical school. I have to admit that I had a difficult time transitioning back to hours of studying after spending most of the past year on the wards. I found myself longing to be back on the floors among patients. However, boards are a necessary evil, and that is that. Luckily, several of my best med school friends were also studying at the same time, and they were an incredible support system for the rough days. I also enjoyed studying with them because they kept me motivated, and we could help each other out with areas of struggle (this was especially helpful since we’re all interested in different fields and definitely have different strengths). The test itself involves a 9-hour day, so I left exhausted that evening. When we were done, we took a nice trip to the sandy Lake Michigan beaches and just enjoyed life for a bit—a much-needed mental break before our next rotation.

Step 2 studying is so much better than Step 1 studying!

Now, it’s June, and I’m back on the wards (yay!). I’m on my ICU rotation. I’m in my first week, and the learning curve is very steep (learning new terminology and seeing things that we’ve never seen before can be overwhelming). However, I am really enjoying the medicine. The patients are very complex and very sick, which can be difficult to deal with; at the same time, our goal is to give them the best chance at returning to as close to their normal lives as possible. I’m excited to see what the rest of the month brings.

In the meantime, I’m enjoying the nice weather and trying to spend as much time as possible outside. I spent last weekend out in the sun at a track meet (one part of my pre-med school life that I miss a lot). I’m also hoping that I’ll be able to make it to Top of the Park this year (Ann Arbor’s month-long summer festival including music, outdoor movies, and yoga to name a few of my favorite events).

As always, thanks for reading. Until next time, go out and enjoy something that makes you happy (preferably outside because the weather is perfect).

Loving our day at Lake Michigan!

Running for my life in medical school

It’s shortly after 6 a.m. on a Tuesday morning, and I’m lacing up my shoes to go for my usual morning run. As I turn from Maiden Lane onto Fuller Road at the hospital, my pace quickens as I go down a small hill and over the Huron River bridge. Several hundred meters later, I climb a gentle incline, passing the VA hospital on my right. Just as I clear the VA, I accelerate down another drop-off. After a small bend in the road, the path drifts away from Fuller Road as the dense forest that had been hugging this route gives way to an open field of long grass. This is a place where I’ve seen countless rabbits, baby deer, and even a Gandalfian goose who fearlessly stood its ground in the center of the path as I approached, as if to say, “You shall not pass!” As I look into the horizon, the sun is beginning to peek out above the tree line. This is one of my favorite places to run: The natural beauty at this moment gives me reason to pause and reflect on how fortunate I am to be at the University of Michigan and experience this sight most mornings.

My favorite part of running eastward in the morning

I would not be able to tell my Michigan story without talking about running as it has been a focal part of my medical school experience. Running not only affords me the opportunity to break out of the library and spend some time in nature, relieving stress and reminding me of the many wonderful parts of life, but has also helped me form close bonds with many of my classmates.

First stop when (from left) Jonathon, myself, Jake, and Paige ran from Ann Arbor to Dexter: A pitstop at Dexter Cider Mill for donuts and cider. Next stop: Jake’s parents’ house for a homemade breakfast of pancakes, eggs, and sausage. Big thanks to Jake’s Mom for her hospitality—and the ride back to Ann Arbor

There is something special about two people running side-by-side, looking off into the distance while talking about any topic under the sun—or simply enjoying each other’s company. I think back to conversations with Michael, another M1, about Huntington’s disease or something completely unrelated to school such as blood doping in professional sports. While running with Chrissy, who serves on the UM Student-Run Free Clinic (UMSRFC) leadership team, I got to hear the story of how she met her fiancé Justin, a great guy who has been ‘adopted’ into the medical school family—along with many other significant others. Carolina, another member of the UMSRFC leadership team, and I, on the other hand, merely basked in an idyllic spring morning, with the crisp air, singing birds, bright sun, and cloudless sky as we ran through Argo Park. Moments like these give so much meaning to my medical school experience.

There are lots more people in the M1 class who run! Here are some classmates post-color run (From left: Carol, Sarah, Dema, Christina, Laura)

While all well and good, I think it is appropriate at this point to bring up the elephant in the room: the long, cold Michigan winters, presumably the archenemy of outdoor running. But with a little planning and the appropriate gear, running outside in Ann Arbor in February can be an almost magical experience. There is nothing like the soft “crunch, crunch” of footsteps on fresh snow piercing the silence of a still winter morning. Or the way light rays from a headlamp bounce off falling flurries, giving the illusion that one is running in the middle of a life-sized snow globe. Yes, I dare say winter runs were a positive surprise for this Houston transplant.

Water-resistant trail running shoes and a headlamp: Key running accessories for the dark, snowy Ann Arbor winters

And now, 30 minutes after I first saw the sun peeking over the treetops, I come to a stop on my driveway. It’s 7:00, and I have just enough time to eat breakfast, shower, and get ready for a full Tuesday including lecture, infectious diseases lab, and Doctoring. But thanks to my morning workout, I’m ready to hit the ground running.

Decided on a specialty and made a website.

So, I’m a 4th year medical student. For the longest time in medical school, I thought I was going into Family Medicine. Third year changed that. You’re just exposed to so much. I realized I liked becoming the specialist, working with my hands, having both longitudinal and case-based relationships, and working in an outpatient setting. After exploring several fields, I realized that Ophthalmology was a perfect fit. I love so much about the field, and am working to get involved in a variety of projects at Kellogg Eye Center leading up to applying this fall.

The project that I’d like to share with you brings my premedical experience into my new career. In my former life, I would build websites, do public relations, and practice brand marketing for a number of nonprofits and businesses. In my present experience, I realized that it was difficult to discover which ophthalmology resources in terms of books, videos, podcasts, and match information are most recommended. At first, I surveyed recently-matched medical students and residents just to answer my own curiosity. Then, I decided to publish the results.

The final product — although by its very nature, a work in progress — is Pre-Ophtho.com. It is an ophthalmology resource for medical students that contains “near-peer” recommendations. Near-peer is a concept that I’ve really appreciated here at Michigan. It means learning from people who have recently experienced what you are about to experience, so preclinical medical students ask clinical medical students how to study for sequences, boards, exams and get access to study guides, for example. Clinical trunk students can ask branch students about which electives are interesting, and so forth. My website continues that tradition, presenting the resources that recently-matched students and residents suggest to clinical medical students interested in Ophthalmology.

I’m happy that I’ve been able to combine medicine, marketing and web development together for this project. Going forward, the plan is for Michigan’s Ophthalmology Student Interest Group to update the site each year with new podcasts, videos and other recommendations.

Good luck to you in your medical adventures — and don’t forget to ask near-peers for advice.