It’s been at least 4 years since I’ve dyed my hair; somehow I’ve always had good excuses for why I couldn’t. “Graduation’s coming up,” I would think to myself, “I’d hate to look back and be upset about my grad photos†”. Or, recently, “I really can’t go walking around the wards with blue highlights, now can I? Whatever would my patients think?”

So, I promised myself that once all my interviews were over, I’d stop by walgreens, grab some hair dye, and shake things up a bit. I’m going to be in the anatomy lab for the next month anyway, so if I look like an idiot at least I won’t do so rounding on patients.

As I type, the ammoniac fumes are wafting from my new, red-dyed hair. Kickass! You know, they always say redheads have more fun :)

† of course, I was a solid 10 pounds heavier at graduation than I am now, which is just as permanent…

After my interview I head back to the hotel, change into more comfortable clothes, and take a stroll around town. Street jazz bands play while the warm breeze gently caresses the city. People take it slow down here in the South. Today during the interview a woman stopped our group, “Y’all should know I’m the survivor of a pul-mow-nary em-bow-luss. Thanks to God Almighty and to y’all wonderful doctors, I’m still here today to speak with you. God bless”. And she continued upon her way, a smile on her face.

An Irish pub with cheap Guinness beckons, and I sit at the bar with a few NASCAR fans. One offers me some chicken tenders, which I politely decline. Eventually the conversation turns round to jobs. The guy next to me, Budweiser in hand, with a flannel shirt and a trucker hat, speaks up.

“So, buddy. What brings you all the way out here from the southwest?”

Slowly, drinking my beer, I reply. “ER residency, actually. Your hospital out here is one of the best in the nation.”

“Now, that’s a job I can respect. Me, I roof houses.” He pauses, catching a quick glance at the cars flying around the track. “You seen people die? And there ain’t nothin’ you can do about it?”

“Yep,” I reply, “it can be pretty rough.”

“So what makes it worthwhile? I think I’d up and quit the first time someone died on me.”

I pause. This is the most honest question I’ve gotten on the interview trail, and it isn’t from an attending, a resident, or a program director.

“I suppose,” I slowly say, “I suppose it’s when you can help people that makes it all worthwhile. When you can look someone in the eye and tell them they’ll be ok.”

He smiles quietly, as though I said just what he expected to hear from a doctor in the making. I smile too. We clink glasses and toast, then sit back and watch the cars race around the track in comfortable silence. This is a good place for me.

The matching of US medical seniors into residencies is a terrifying, nail-biting, potentially stress-ulcer-inducing process. It involves traveling the country, renting Toyota Yaris after Toyota Yaris†, checking in to endless hotels, plastering smiles upon faces for hours at a time, and trying to be insufferably impressive – even though you occasionally suspect, somewhere deep inside, that you aren’t. This process occurs for roughly 3 months.

The reason The Match is so overwhelmingly nervewracking is that it represents one of those few branch points in our lives where what we do will define us. It’s like a Choose-Your-Own-Adventure where To go through the door, turn to page 52 and To stay in this room for now, turn to page 87 are very real indeed.

I do my last interview tomorrow, and once completed, I need to decide how to rank the 10 programs I visited. Who do I rank higher; the hyper-competitive hospital in the trauma capital of the northeast, or the super-friendly residency in the midwest? The laid back academic powerhouse of SoCal, or the community hospital in the Deep South? The political hub in the Capitol, or the critical care experts in the city ‘o cheesesteaks?

In each of these futures I see a slightly different Dr. Zac emerging, quietly nudged and shaped by the subtle strengths and weaknesses of each program. Some graduating medical students know exactly what they want; a particular city, a school with a Name, a specific faculty mentor. I don’t have that sort of singular drive.

Instead, each of these schools represents potential in me as yet untapped. It is at once exhilarating and deeply unsettling. I know there cannot be a wrong choice here; the field of Emergency Medicine is blessed with incredible faculty and residents across the nation. At the same time I’m acutely aware of the significance of how I rank these schools.

1… 2… 3…

† I mean, these must be incredibly cheap, shoddy cars, because every time I’ve rented, I’ve gotten one of these. But hey, they’ve done the job!

Here’s a transcript of the note I’m about to leave on the door of the condo across the way:

If you’re the person who got my car towed last night, I apologize for parking in your “reserved” space. I didn’t realize it was reserved until I woke up this morning and saw that my car was gone, and then noticed the faded “reserved” lettering I must have missed late last night.

Just so you know, it cost me $127 to catch a cab and pay to get the car out of the impound. A simple note on the windshield would have sufficed, I think. Either that or a polite phone call to the out-of-state number so prominently displayed on the “Overnight Guest Parking” permit in the dashboard. I know it must have been difficult for you to find parking in the sea of empty spaces in this lot, and for that I am truly sorry.

Just so you know, I’m a medical student out here interviewing for residency as an ER physician, and I almost missed my interview with Johns Hopkins because instead of driving to Baltimore, I was catching a cab to CJ’s Towing Co. Luckily for me, CJ’s is very professional and quick. Wish me luck on my interview!

Sincerely, Zac.

P.S. if you had nothing to do with the towing of my car, please disregard this note.

By the way, loyal readers, I apologize for the dearth of posts lately. I haven’t been on rotations for 2 months so I’ve got no new stories trying to burn their way out of my brain. I can promise things will pick up soon-ish!

Every so often I dig into my treasure trove of things I need to write about. I actually wrote this draft 4 years ago, fresh into medical school, and finally decided that it’s high time to help some bloodthirsty sycophants ingratiating suckups eager young premeds out.  And so, without further ado, I present…

How to get into medical school… advice from someone who’s done it.

Medical school is tough to get into – everyone knows that.  One of the reason it’s tough is that many people simply don’t apply smart.  They get mediocre grades in college, bomb their MCAT because they stayed up all night cramming for it, don’t have anything interesting on their CV because they were too busy studying, and get a recommendation from a prof who teaches Intro Bio to 650 students.  Sound familiar?

Lets start with the basics.  These are the things you would hear from your premed advisor, if you had one.  Not just because “that’s the way it’s done”, but because each thing I’m about to talk about has a very specific purpose.  There are huge books on this subject, but frankly, all you really need to know is crammed on this one page.

For the sake of argument, I’ll be your admissions committee member for the next few minutes.

Volunteer experience

You need to do volunteer work. You need to do volunteer work. You need to do volunteer work. If you do not do volunteer work, you will never get into medical school. Ever. Don’t do “volunteer work” with your doctor father at his plush plastic surgery practice. Dole out food at a soup kitchen somewhere and moonlight at a retirement home with batty old ladies. Or, even better, find a scribe position – this is what I did, and it puts you FRONT LINES with patient care.  I firmly believe this is why I got into medical school.

Why are you doing this?  Because it gives your application weight – you’ve dabbled in the morass that is modern medicine, and you still know you’re interested.  Perhaps more importantly, it tells me that there’s a shred of human decency in you.  A caveat to the “need to do volunteer work” rule: it doesn’t have to be volunteer if you find something else medical-ish (want to be a pathologist?  Work for the county coroner.  Emergency minded?  EMS/paramedic is always a great route.  Cardiology?  Do research with the local university).

Seriously.  It cannot be emphasized enough how important experience is.  The average age of matriculating medical students is 24.  That means that MOST med students took time off, and MOST of them will have some sort of experience with the medical field.  If you don’t, I will wonder why on earth you’re applying, and how you know you aren’t going to lose interest.  Because people do.  And then they become washed-up asshole surgeons, only in it for the money.  I’m not kidding.

Groovy personal statement

Aside from volunteer work (actions speak louder than words!) this is the most important thing you’ve got. Write your personal statement about something you find interesting, and read it like a bored admissions member. You need to be so convincing that I – as your admissions liason – cannot bear to live with myself if I do not accept you. I need to think to myself “Hey, this girl really sounds really interesting, and seems like she’s got a good head on her shoulders.  Plus, that anecdote about helping grandma find her dentures… oh man.  Rolling on the floor with that one.”

Along those lines, don’t lie. Don’t pretend like you found deeper meaning in emptying bedpans. I know you didn’t. You know you didn’t. When you write your whole personal statement about how awesome it was when ol’ rheumy-eyed Agnes shat all over you while you were helping her to the toilet, I will roll my eyes, say “bullshit”, and mentally cross you off my list.  I’ll also make fun of you when the committee meets.  And the last thing you want is the admissions committee laughing at you.

Along these lines, remember one thing above all.  You are not applying to a faceless institution.  There is a person on the other end of that electronic application, and that person is me.  If your personal statement is boring, I will not care if you get in.  Your personal statement is the one part of this application that you have generated yourself.  It is your voice.  It is the explanation of WHY you are forcing me to spend 30 minutes reviewing a file with your name on it.

Good Grades

Here’s where we start getting into the murky stuff.  If you can get all A’s, great.  Assuming that you didn’t (I didn’t!), know that I care because good grades show that you can work within a system. Getting A’s and B’s means that you can handle whatever workload has been thrown at you in college. You can be the nicest person in the world, but if you aren’t able to pass Anatomy, you can’t graduate.  At my med school we took 6 years worth of graduate-level coursework crammed into 2. This is why you need to be able to pass in college.

Good MCATs

I don’t mean that you need to get a 42. Don’t go getting 12′s and assume you’ll get in, though. The beauty of the MCAT is that it’s a standardized test.  It’s an objective way for me to tell how well your grade-inflated school (Harvard, I’m looking straight at you) has prepared you.  Get a 45 and theoretically you can handle medical coursework. Your classmates will make fun of you for being a nerd, though.  It’s a tradeoff.

Good recommendations

This is the least important thing you will submit. When I write you a rec, it will say “Premed undergrad blah blah blah has worked in my lab for blah blah blah and is a good student blah blah blah I like him blah blah blah“. Everyone has nice recs. Yours don’t mean anything special. Oh, and don’t submit 10 letters. I will be required to read them all and will get PISSED at you.

How To Get Into Med School: The Conclusion

My parting words of wisdom are about the application itself.  I know it’s hard to do, but always keep in mind your audience.  I try to do that every time I write something.  In your case, your audience is me.  You are trying to befriend me through the pages of your application, and convince me that you:

a) want to go to medical school
b) are smart enough to go to medical school
c) will be a doctor that I will want to work with – and can trust
d) are not going to lock yourself in the library and live next to Frankie the homeless guy for the next 4 years

You get one shot.  Make sure everything fits together – if you mention you like to prepare sushi, put it in the personal statement.  ”When I’m not at the hospital, I come home and make sushi for my friends”.   Really?  Well that’s pretty cool.  Sounds like you’d fit right in.