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.

Emergencies on airplanes

I've slowly been writing about my experiences over the summer and the following occurred on one of my flights. This post was originally written in response to a thread about helping in medical emergencies as a doctor and if such interventions make a difference in patient outcomes:

About half an hour into the flight they asked for a doctor, nurse, or anyone with medical experience. A little while later the plane took a hard left to divert for "an unexpected landing" as they called it.

(This was a foreign airline so most announcements were in a language I didn't understand with English translations lasting a fraction of the original announcement. So I only have a bare-bones understanding of what really occurred.)

Either no one was available to help or no one volunteered because the flight attendants were the only ones providing medical care to the passenger. I was asleep and awoke to the sudden turn and "unexpected landing" announcement, which scared the crap out of me because I thought we were going down, until I saw the oxygen tank attached to an unconscious dude being carried down the aisle.

All in all, I don't think a doctor or medical professional would've changed the outcome for the passenger since the guy was hooked up to an AED ("No shock advised" numerous times) and CPR was being performed with an hour still left to our emergency landing (we were over water). At that point, the flight attendants were doing all that could be done with the limited resources found aboard an airplane and more training on their end wouldn't have made a difference.

I'm applying to med school now thus I'm not a doctor but I've been in EMS for 6 years so I'm familiar with emergencies in weird places. I like to think I would've volunteered had I been awake and no one else had been available. But I don't know.

What's worse is that the guy didn't suddenly die. He had some sort of medical emergency that eventually led to cardiac arrest so maybe even my basic assessment could've helped him in some way. And had this happened on land, with the 30 minute lag between the first signs of medical trouble and cardiac arrest, he maybe would've made it.

But since we were airborne, there's really not much anyone could've done in that situation with such few supplies and such a long transit/landing time to higher level care.

In short, a plane over water is most definitely the worst place to have any kind of medical emergency.

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?

Being a bad doctor, or so they say

This is going to be a loaded post, so stay with me if you can. I've also seriously debated posting this thing at all, but I've felt this way enough times in the past eight years that it's a valid feeling and shouldn't be ignored. So here it goes.

Every close friend I have ever spoken with has said that I would be a bad doctor. If they had the choice, they wouldn't come see me. Normally, I don't care what people think, but in this case, when I'm already questioning my decisions, this doesn't help things.

I put on a tough exterior, and I pretend to be a hardass when talking about children and puppies so I can kind of see the point. A lot of the time when I describe my day, I sound mean, intolerant, and grumpy. But I do care about people, and I'm actually really awesome with people of all ages. I can relate to almost anyone from any background. I grew up going from the developed United States during the year to essentially third world Eastern Europe during my summers, so I know how to adapt and deal with all kinds of people.

I have empathy, or can at least fake it, even if I complain about the stupid decisions my EMS patients make. I feel like my friends only hear the bad part of my job and thus my judgmental side, and don't see my interactions with the people I see.

But their harsh words have been worrying me. I used to be pre-med in undergrad. Even though I was so over school then, I still put in 12+ hours a week at the ambulance company and loved every minute of it. But running 911 calls got old eventually. And that's what scared me away from medicine. EMS became a dreadful job and not something I looked forward to every day. It was still exciting, but I didn't get the kind of thrill I used to experience even 6 months earlier. So I quit the medical track and decided that I could be happy without the years of schooling and sleep-loss and stress that medicine required.

I'm not in it for the adrenaline rush. I genuinely love fixing people's problems. It fulfills me and is absolutely amazing. But I'm worried that medicine will not be worth it in the end. Maybe I can satisfy my need to make people happy by putting on a good event, for example, or something that doesn't require as much education and years of training. I don't know, and that scares me a lot.

I still get jealous of all the stories my med school friends tell me. It's not the gnarly things they describe that pique my interest, but rather their ability to do something to the human body that makes it work correctly again. But will that wear off once I realize that most things are actually routine?

I shadowed a hand surgeon a couple days ago and it was an experience. It seemed like a lot of his patients had the same thing going on in one way or another. There was lots of carpel tunnel and fractures and pins. All in all, though, it didn't seem like he was stumped all that much. There weren't any real "a-ha!" moments and it all just seemed like an office job that he had gotten good at after working there for so long. Except, he's not that old, considering he had finished his hand fellowship about a year earlier. But if it's something you're passionate about, then it's not routine. And as another young doc I've spoken with recently said, "When you're responsible for someone's life, it doesn't get boring." There you have it.

Maybe the answer is doing a normal specialty with trauma on the side, to get some unpredictable things once in a while. But if my EMS experience is any indication, even emergencies become routine. And routine is not what I want after a decade of stressing, studying, and busting my butt to become a doctor.

At this point, I honestly don't know. Should I really go into medicine?