Details of a non-traditional medical school application

I'm a non-traditional medical school applicant ("non-trad" in med speak) in that I have spent some time in the real world between graduating from college and applying to medical school. It's been nearly 7 years at this point and I have done a wide variety of things in that time, some of them medicine-related but most of them not at all.

A commenter asked me to elaborate on my activities and what I put on my AMCAS, so here it goes. I don't particularly like lists so instead you get an abridged version of my adult life story, even though it may not seem very abridged. Everything I mention below is in one way or another presented in my primary application. So you're getting essentially what the adcoms got when they received my application, with some flowery commentary thrown in for good measure.

Bright College Years:
My major was in the natural sciences, so a lot of the requirements for my B.S. overlapped with those required for medical school. At the time, it was great to knock out both sets of requirements but in retrospect, I wish I had stayed far away from any BCPM classes during undergrad. I would've had a much easier time getting into medical school that way. But alas, I don't have a time machine so the past remains unchanged as much as I wish otherwise.

As a natural extension of my academic interest in medicine, I began getting involved clinically my freshman year. I volunteered as an EMT at a 911-only ambulance service a couple of towns away from my undergrad campus. Since I was never cleared to drive the ambulance, all of my hours were spent providing direct patient care. Over the course of the three years I spent in EMS, I acquired something like 1,700 hours of clinical community service. It was awesome and is one of the major reasons I am pursuing medicine as a career. I listed it as a meaningful activity and elaborated further on the previous statement.

Other extracurriculars included rugby, which I also listed as a most meaningful activity on my AMCAS, sailing, and Habitat for Humanity, which I had been involved with in high school and continued to work with in college.

Gap Year(s):
I went abroad after graduation and spent the next year and a half sailing the high seas, working in a café, playing rugby, moving to another country whose language I didn't speak, working for food and wine, all before finally coming back stateside to work at a summer camp. Again, this all went into my AMCAS application.

For those ~18 months, I did nothing that went anywhere near medicine. I simply had fun. I learned a lot about myself during that time and a lot of those experiences led me to apply to medical school, all of which I discussed in my personal statement.

I came back to the U.S. because my money ran out (working for food and wine doesn't go far with regard to savings) and because I was tired of living out of a suitcase. I wanted my own sofa and I couldn't have that with my nomadic lifestyle. This part was not in my application, for obvious reasons. I don't think I actually told med schools why I moved back. Only one interviewer has ever asked and I gave her a more eloquent and mature answer, one which didn't involve a sofa.

The Real World:
Unbeknownst to me, the town I moved to after the summer camp experience was a Mecca for the career I had planned to pursue at the time. I hadn't come around to medicine quite yet and was instead focused on working in the industry of my undergrad major.

I got a job in research full-time at the local university and have been here ever since. While the experiences I have had as a member of this research group have been incredible (see the trip to Alaska and other deployments to equally exotic locations), I have ultimately realized that this career is not for me and that I needed to find something else to do.

As soon as I began thinking about medical school again, I started volunteering at the hospital where I've been lucky enough to have direct contact with both patients and physicians. I also enrolled in pre-med classes at the same university I work at since I had to take or retake nearly all of the med school pre-requisites.

I have continued to be heavily involved in rugby as well as with Habitat for Humanity.

Lastly, I went on a medical mission trip with the U.S. Navy to Southeast Asia for a month about a year ago. I have a well-documented interest in international outreach so this wasn't simply a box-checking activity. Instead, it was the perfect combination of the things I'm passionate about: international missions, boats, and medicine. It opened my eyes to how international medicine is really done and somewhat changed what I had envisioned as my future career in medicine.

How all of this is perceived by adcoms (people that matter):
Like I've mentioned before, my application is either loved or hated by the powers that be. I have yet to get a neutral reaction to my experiences and journey to med school. One interviewer has grilled me on why now, how I know I won't quit again, and the like, while a pre-med advisor (Ms. D) simply doesn't like me for reasons I can't explain.

For the most part, though, interviewers were curious and excited to discuss the reasons behind my adventures and wanted to know why I finally came back to medicine after so many years pursuing vastly different things.

I don't think there are any "required" extracurriculars or activities for non-trads. I've known people who got in with very little recent volunteering or practically no research. However, it seems like you need to have one or the other, or a very valid reason for being light in those areas such as family, job, or other pressures. I happened to have both research and volunteering, although I didn't have any publications even though I worked for ~5 years as a research assistant, which I know hurt me at some schools.

My advice to other non-traditional applicants is to first and foremost focus on your grades and MCAT. Those are the most important things in your application. Then, do clinical volunteering/work and shadowing, and maybe get some research in if that's your thing. Primarily, you need to show that you can handle the academic workload. Secondly, you need to be able to show that you know what you're getting yourself into and having those activities on your application will go far in convincing adcoms that you're making an educated decision to pursue medicine.

Generally, activities of non-trads are not more heavily scrutinized per se but rather the reasons behind those decisions are questioned more intensely. It's a lot harder to quit another career to pursue medicine than it is to apply to med school as a junior in college so adcoms want to know why, why, why. In your applications, but more importantly in your interviews, make sure you can convincingly communicate why you switched to medicine and have some evidence/stories to back that up.

Be prepared to discuss any deficiencies you may have in your application, even if the reason that your undergrad grades sucked was because you were young and stupid. Own up to your mistakes and let interviewers know that you've learned from them and that you're better for it.

I'm not an expert on medical school admissions for traditional or non-traditional students by any means. After-all, I've been placed on 5 waitlists and only accepted to one school after applying twice. So take everything I say with a grain of salt.

However, the above "advice" is based on a lot of research on the subject both from SDN (there really is some good stuff there if you wade through the bullshit) and from talking with a lot of people. I haven't always heeded my own advice but now I know better and hope that this helps you, dear commenter.

If you have any other questions, don't hesitate to write below and I'll try to elaborate further.

Shadowing in the OR

This week I shadowed an orthopedic surgeon in the operating room and watched him do two cases. At first, I was a bit grossed out by seeing the surgical fellow pull on stuff inside the dude's knee, mostly because I was imagining how much it would hurt to have my tendons stretched like that. But then I remembered the patient had a nerve block, was under general anesthesia, and was prescribed some serious pain killers for recovery, and the feeling of empathetic pain went away.

For the first procedure, I had some decent questions to ask the surgeon because I have a bit of background with that injury and knew generally what to ask. So it wasn't so awkward. But the second procedure consisted of me standing quietly in the corner not saying a word, until the surgeon mentioned he had lived in Italy and I inquired where because I, too, had lived in Italy recently. Other than that, I kept my mouth shut, which is not the way to go apparently.

My interactions didn't get any better after that, and instead I managed to communicate the fact that my undergrad GPA was crap and that I don't like evening classes, which resulted in the surgeon chuckling a bit under his breath. Oops. Way to make a good impression. Not! I should just learn to keep my mouth shut.

One of the biggest issues I had with shadowing was not knowing when it was ok to ask questions. The surgeon also had a fellow doing most of the work so he was teaching a fair amount of the time, and I didn't want to interrupt that. He was also doing a lot of shop talk with the biomedical sales reps so that didn't seem like a good time to interject with a question. But there was also a lot of silence, so I can't use all that as an excuse.

My other problems included not being prepared for the second procedure, and being too afraid to ask "stupid" questions. The thing is, as a pre-med, I'm not expected to know anything so unless I'm asking things like "What the heck is a shoulder?", my questions most likely aren't perceived as idiotic.

I'm generally a very curious person, so why do I have such difficulty being around doctors? Why am I so quiet and insecure about medicine? These are the questions to answer.

And since this was supposed to be a learning opportunity, here are some lessons learned:

1. Being prepared is always a good thing.
   I should have looked up the second procedure before I observed one because then maybe I could've asked some decently intelligent questions.
2. I don't have to come off as awesome all the time.
   I need to stop being afraid to ask seemingly stupid questions. Usually, they're not stupid and I have a right not to know the answer.
3. Better to keep your mouth shut and be thought a fool than to open it and remove all doubt.
   I need to learn to paint myself in the best possible light and stay away from the self-deprecating talk. I shouldn't lay out my flaws for everyone to see.
4. Doctors usually like teaching.
   This especially applies to those at teaching hospitals and those who take on fellows, so I should not be too intimidated to ask questions. They are most likely more than happy to answer them. At least that has been my experience with all the doctors I've encountered. They've been pretty awesome.

I may ask to shadow this same surgeon again over the summer to see a joint replacement. The two procedures I had yesterday were mostly arthroscopic so replacements would be a nice change. And it would give me a shot at redemption.

Mostly, I want a re-do because if I get into the local medical school, I will most likely be asking to do research with this surgeon. So I need to make a better impression of preparedness than I did this time.

Oh, I almost forgot to add...I posted a thread about this to SDN and this was one of the replies:

Physicians will know that a college student won't know much medicine/surgery, so don't be afraid to ask basic questions. It would be strange to NOT ask questions at your stage.

I guess I was the strange kid in the corner then. Oops.

The good part was that I was fairly animated outside of the operating room, except by that point, I had verbal diarrhea. Here I go with the self-deprecation again. It's a vicious cycle, I tell ya!

Shadowing, Version 2.0

I'd been debating asking my knee surgeon if I could shadow him, because I already have shadowing history with a specialist (my hand guy from this summer), so it'd be kind of redundant with regards to my medical school app. I'm all for jumping through hoops to get into school but I'd like to minimize them because I don't have that much time between school, work, and now, MCAT studying. So if I'm going to shadow somebody out of necessity, it's either going to be a family practitioner or the pulmonologist.

But then I realized that not all of this is about off checking boxes and I'm truly interested in orthopedics, so why not? The hand guy shadowing was limited to his clinic and not the OR, so I figured I'd give the knee surgeon a shot and see what happens with this dude. If I decided I didn't want to do it after inquiring, then I could always not follow up and let it be. But this was my only chance to ask him in person, so I might as well take the opportunity while it presented itself.

So I mentioned to the PA that I wanted to speak to the doctor about shadowing him during my post-op visit, and as she was taking out my stitches she asked, "You mean the OR or the clinic?" I did the Barbara Walters "Wait, what?" face, because I couldn't believe my ears! Heck yeah, I want to shadow him in the OR!!!

Suddenly my meh-I-don't-feel-like-shadowing-an-orthopedist-again feelings went out the window. The PA talked to the office manager, who totally agreed, and the doc seemed very enthusiastic about it when I saw him at the end of my visit so I'm super stoked.

This whole surgery has been one heck of a good decision!

My first shadowing experience

You would think that at this stage of the application process -- having finished my pre-reqs, preparing for the MCAT, writing my personal statement, and choosing possible med schools -- I would have already checked off the "Shadowing" box on my "Preparing for Medical School" Checklist. But no, I've been slacking on this end.

I thought that with my extensive EMS experience as well as doing idiotic things that required me to see many doctors for random things over the years (the most recent visit was for an extreme slip 'n' slide injury), I had a pretty good grasp of what medicine was all about and standing in the corner cluelessly following a doc around would be boring and lame.

But I wisened up, swallowed my pride, and decided this was a fairly easy hoop to jump through and I should give it a chance. And so I started with a specialty I'm very seriously considering: hand surgery. It didn't hurt that I was seeing my hand surgeon quite regularly at the time and he had a student shadowing him during my first visit. So I asked, and he accepted. Easy as pie.

In short, it was a very interesting experience. Surprisingly, I learned a lot about hands and elbows, but it wasn't anything I couldn't have read in a book on my own (only because my education during that day was so superficial, and not because orthopedic surgery is easy). I know I wasn't there to learn about hand surgery enough to be able to perform it next week, and this wasn't part of my medical education. So instead, I tried to focus on the clinic aspects of my doctor's day, as in how his day was structured, how he worked with others around him, and all that jazz. And that was pretty informative.

The following interaction kind of worried me and made me question my decision to go to medical school (again):

He had a perplexing case one day where he just couldn't figure out what was wrong with this man who had had wrist pain for a few years now. His MRI came back negative, and the doc even said to his colleague that he didn't expect that to be normal. He was thoroughly confused after yet another physical examination. So what does he do? He uses the medical equivalent of Google! It was so interesting to see how he tries to understand cases that just stump him, and that he's clearly still learning.

I asked him if he often gets these kinds of cases where he just doesn't know what's going on and he replied that they're few and far between.

That response somewhat concerned me because my biggest worry about going through with this medical thing (as it was when I considered it back in undergrad) is that I'll get bored with my specialty and I will have wasted all these years of education for nothing. I mean, if I'm going to be bored with my job regardless, I may as well choose one that doesn't require so much sacrifice, stress, etc.

My doctor's day could be summarized as seeing a bunch of patients, approximately one every 10-15 minutes, a lot presenting with similar diagnoses. It just seemed routine, with the exception of the case mentioned above. But since those don't come up that often, it seems like his day-to-day life is pretty routine.

But I guess that's where the passion for your work comes into play. If you love it, then it's not routine to you. I thought I loved EMS (and still kind of do) but even emergency situations got boring in that we did the same thing for each patient: figure out what's wrong in the same manner, have a plan to keep them alive, and drive like crazy if it was particularly bad.

I had the patient contact, the team environment, the use of medical knowledge (to a certain extent), and the need to use that knowledge to make critical decisions. But it still wasn't enough. As someone mentioned on a forum I was reading, maybe I was bored with EMS because it wasn't intellectually stimulating. Maybe that's the last thread that was missing. But if I pursue medicine in the hopes that being a physician will fill that gap and it doesn't, I will have wasted a lot of years and a lot of money being unhappy. And that's scary.

As you can tell, I'm starting to question this decision in the same way I was questioning it six years ago. Then I quit medicine and tried to find happiness and fulfillment elsewhere, to no avail. What do I do this time around?

Update on my previous concerns

I'm currently sitting at the hospital, post hand appointment, killing some time before I have to catch the bus to the airport. My doctor's appointment went extremely well. The doc said that everything looks great on the MRI and so I have a really bad sprain.

He also mentioned that there's been some research with cadavers where they essentially throw arms at things to injure them the way I did (rotation of the wrist with the application of a large amount of force) and see what happens to the soft tissue. And my symptoms are identical to what they've found in the cadavers, which makes my injury super interesting to him. I then mumbled something stupid about it and we moved on.

My silence and lack of further questioning on this matter, though, may come in handy because it can be something I ask about WHEN I SHADOW HIM!!! Yup, you read that correctly. I asked the doc if I could shadow him sometime and he said he doesn't have a problem with it, but I would have to check with the hospital. We chatted and decided on me shadowing at his clinic in my laid-back town. He definitely said just the clinic, so I may have to edge my way into getting in on a surgery or two. We'll see about that. I'm really excited since hand surgery has intrigued me since I was in high school, and this seems like the perfect opportunity to see what it's really like.

As for the organic chem final. I got 100% on it. No biggie. All that stress for nothing.

Today has been awesome. Now I just need some sleep.

In denial

Summer session will end tomorrow. I have one more final to get through in the morning, and then I'm on my way to catch a flight to California for a much-needed vacation. But for some reason, I can't force myself to study. All week I've been in denial about this final and the one I had yesterday. I know I don't have everything memorized or learned as well as I'd like to. I definitely need to put in a lot more time than I have all week. And simply getting an A in the class is not going to be enough. I'm getting a letter of recommendation from this professor and he puts our rank in there. And I need glowing recommendations to have any hope of getting into medical school. Right now, I'm at the very, very top of the class, and I'd hate for my laziness to be the only thing that'll bring me down.

Yet, I still seem distracted. I'm too excited about this California trip and I'm also kind of stressing about my doctor's appointment tomorrow. You see, about six weeks ago I hurt my wrist pretty badly. I eventually went to see a hand specialist and he said it's probably just a really bad sprain based on the x-rays and the places my wrist was hurting. Ever since the injury, I've been going back and forth between thinking that's it's nothing and will heal slowly, and thoughts of something being torn and needing surgery.

I've scoured the internet, but there's really nothing on there that's helpful. I got an MRI yesterday and I'm going to see my guy again tomorrow to hear the results. At this point, I'm pretty convinced that it's just a sprain since it hasn't been hurting much since the MRI (and by that I mean, at all). And that's what makes me think all this pain is in my head. Like, when I convince myself I tore a ligament or cartilage, my wrist throbs all day. But when I think that it's all healed, I can function for the most part without my splint. I'm mostly concerned that I cried wolf, and got an MRI for no reason, and the hand surgeon was right a month ago when he said it's just a sprain, a bad one, but just a sprain nonetheless. I hate being "that girl" that insists on more imaging than is necessary. I just want this darn thing back to normal!

So yeah, those last two paragraphs are what has been going through my head on repeat all week instead of organic chemistry. And that's not good, since I am capable of doing really well on this final, if only I put some more hours into it today.

Oh, and this wrist injury has seriously made me consider going into ortho as a specialty. I've seen enough orthopedic surgeons in my lifetime that it's always been in the back of my mind, but hand surgery has always stuck out as one of the more interesting aspects of the specialty. Depending on how my appointment goes tomorrow (if it's my last one or if I have another follow-up), I think I'm going to ask my doctor if I can shadow him. The worst that can happen is he'll decline, and considering he had someone shadowing him during my first visit, I think he may be ok with it. Granted, that was a medical student and he may not have time for a lowly pre-med, but it really doesn't hurt to ask.

Lastly, here is a video of how I hurt my wrist. I'm the one coming down the middle screaming "Coming through!" While going down a slip-n-slide down a ski slope at full speed at a Tough Mudder event, I got my fingers caught in the tarp while my body kept going. Massive pain ensued.