Interview questions; come up with a personal story and stats (if necessary); unique examples
What kind of experiences have you had working with sick people? Have these experiences taught you anything that you didn't know beforehand?
TALK TO MOM ABOUT PALLIATIVE CARE
People in the medical field that I would like to meet
Marci Bowers: an American gynecologist and surgeon who specializes in gender confirmation surgeries. Bowers is viewed as an innovator in gender confirmation surgery, and—as the first out trans woman to perform such surgeries—a pioneer.[2][6][7][8] Bowers has been referred to as the "rock star" of transgender surgery. Marci Bowers was known as Mark Bowers in her university years. Bowers later went on to study under Dr. Stanley Biber (1923-2006), a surgeon who performed more than 4000 sex reassignment surgeries, and who is credited for earning Trinidad the moniker "Sex Change Capital of the World.. Bowers is often asked about sex reassignment surgery for minors.[16] She has been critical of prohibitions against this in the WPATH Standards of Care. She has stated, "I believe the surgery should be responsibly performed for the proper, carefully screened candidates, not at age 18, but at age 16 or 17, while still under the caring environment of home, allowing some social transition still in high school. It is the only morally responsible approach to this problem. We have already made that change in our standards here, and I will live to see that change be made globally as well."... Bowers also offers restorative procedures for victims of female genital mutilation (FGM), whom she does not charge for surgery... Not all of Trinidad's residents were happy with the town's title of "Sex Change Capital". In 2005, Terry Keith, a pastor for the All Nations Fellowship church, told The Pueblo Chieftain, "Our reputation as sex-change capital of the world has brought shame and reproach on the community."[11] That same year, two pastors circulated a petition for the closure of the clinic. They cited a Johns Hopkins University study that they claimed was proof that gender confirmation surgeries were an ineffective treatment for gender dysphoria.[25] The petition was rejected.[11] Bowers said that the church misrepresented the study data: "If you look at the actual study itself, the satisfaction rates and happiness rates after [surgeries] were overwhelmingly positive, their interpretation of the study was that the respondents—the patients themselves—couldn't possibly be accurate about what they were feeling, because they were crazy in the first place. There's been nothing like it since—and it's very important to point out that it's from 1972...Bowers herself completed gender reassignment surgery in 1998.[11] She married eleven years prior to her surgery, and remains married to her female spouse.[11][23] They have three children together, Pauline W. Chen (born 1964),[1] is a Taiwanese American surgeon, author, and New York Times columnist. She is known for her 2007 book Final Exam: A Surgeon's Reflections on Mortality[2] as well as her online column "Doctor and Patient"...She was appointed faculty at UCLA, specializing in liver and kidney transplants and the treatment of cancer.... Through her practice as a transplant surgeon and her experiences of dealing with terminally ill patients, Dr. Chen came to understand that, commonly, doctors consider a patient's death as a sign of imperfect care and thus a personal failure. And doctors hate to fail. Doctors strive to combat their patients' sicknesses, but if the battle starts to become a losing one then doctors do not prepare their patients for inevitable death. Instead, the battle for life and denial of death continues with the frequent result that many patients die in a hospitals Intensive Care Unit while under-going painful treatment rather than at home with pain-management and in peace. Dr. Chen wants to change this practice... WANT TO MEET HER ESPECIALLY BC HER VEIWS ON END OF LIFE CARE
What do you do for fun?
"if you're bored than you're boring" quote
How have you tried to achieve breadth in your undergraduate curriculum?
-NYU does a really great job at making sure that its students are well rounded (Liberal studies = 3 philosophy courses, 3 art history classes); -That coupled with GPH major (Have to get to advanced level of language, ie spanish) and pre-med requirements exposed me to a wide variety of classes -Additionally, NYU offered Speaking Freely classes (French) -Now I go to Hicksville library; take online classes (Spanish for med; also arabic = self teaching and doing the online penpal thing?)
Highschool experiences
-National honors society -alternative -> preppy
NYU interview
-SART hotline in Metropolitan Hospital (50/50 men and women since my time there... LOOK UP) -Adam rippon = gay ice skater olympian
Stories about my sister
-had a dog lady, after lady and the tramp -pulled on her collar -went to dog trainer (sister was 13) -he told my mom, when my sister was 15 to come back and she had a job with him -now 26 and still working there
If you are not a minority, how might you best meet the needs of a multiethnic, multicultural patient population?
-that thing where there is better patient service when patient-doctor identities concordant -LOOK UP STUDIES ON THIS -come up with own story
If you could invite four people from the past to dinner, who would they be, and why would you invite them? What would you talk about?
A woman in STEM? (Curie, mcclintock) Peter Singer (Look up more about him)
Opioids
ATHealth and Human Services (HHS) = in 2016: 11.5 ppl misused opioids, ~42,000 deaths from opioid misuse; $504 billion in economic costs
Why I don't want to be an MD-PhD
After graduation, MD-PhD students usually work as researchers or as faculty members at medical schools and universities.
If you are a woman, how has your gender impacted your decision to pursue a medical career?
Are you woman enough for science pamphlet -talk about my mom's experience (won't be a doctor b/c she's a woman, she's italian, and she's catholic)
What excites you about medicine in general?
Blending of science and caring for others -science = our bodies' ability to health themselves;; complex inner workings and synergy between different systems in our body (i.e. camila's work = young pregnancies can have preventative effect against breast cancer, potentially bc of immune system; BUT late pregnancies (i.e. 35+?) = bad, potentially b/c changes such as rapid breast tissue growth are not as easily regulated in older people)
Public health policy
Books read: The Spirit Catches you and you fall down; Anne Fadiman (Hmong girl, Lia Lee, who was diagnosed with a severe form of epilepsy named Lennox-Gastaut Syndrome and the culture conflict that obstructs her treatment. Through miscommunications about medical dosages and parental refusal to give certain medicines due to mistrust, misunderstandings, and behavioral side effects, and the inability of the doctors to develop more empathy with the traditional Hmong lifestyle or try to learn more about the Hmong culture, Lia's condition worsens. The dichotomy between the Hmong's perceived spiritual factors and the Americans' perceived scientific factors comprises the overall theme of the book. Fresh Fruit, Broken Bodies Seth Holmes. provides an intimate examination of the everyday lives and suffering of Mexican migrants in our contemporary food system. An anthropologist and MD in the mold of Paul Farmer and Didier Fassin, Holmes shows how market forces, anti-immigrant sentiment, and racism undermine health and health care. Holmes's material is visceral and powerful. He trekked with his companions illegally through the desert into Arizona and was jailed with them before they were deported. He lived with indigenous families in the mountains of Oaxaca and in farm labor camps in the U.S., planted and harvested corn, picked strawberries, and accompanied sick workers to clinics and hospitals. This "embodied anthropology" deepens our theoretical understanding of the ways in which social inequalities and suffering come to be perceived as normal and natural in society and in health care. A Civil Action is a non-fiction book by Jonathan Harr about a water contamination case in Woburn, Massachusetts, in the 1980s...After finding that her child is diagnosed with leukemia, Anne Anderson notices a high incidence of leukemia, a relatively rare disease, in her city. Eventually she gathers other families and seeks a lawyer, Jan Schlichtmann, to consider their options....Schlichtmann finds evidence suggesting trichloroethylene (TCE) contamination of the town's water supply by Riley Tannery, a subsidiary of Beatrice Foods; a chemical company, W. R. Grace; and another company named Unifirst....In 1988, Schlichtmann attempts to reraise the case against Beatrice, but the judge dismisses the case, citing testimony from Beatrice's soil chemist. However, due to the lawsuits brought forward by the Environmental Protection Agency, W.R. Grace and Beatrice Foods are eventually forced to pay for the largest chemical cleanup in the history of the Northeastern United States at that time, which cost about $68 million.
Can you think of any examples in our society when healthcare is a right? When is it a privilege? When is it not clear?
Emergency care plastic surgery reconstructive surgery -come up with more unique examples?
Order of the classes I took
Freshman Fall: -Calc I -Writing I -CFI -SFI Freshamn Spring: -Gen Chem I -Writing II -CFII -SFII Sophomore Fall: -Bio I -Gen Chem II -CFIII -Epidemiology Sophomore Spring: -Bio II -Orgo I -SFIII -Environmental Health Junior Fall: -MCBI -Genetics -Physics I -Spanish: Advanced Grammar and Comp Spring Fall: -Physics II -Orgo II -Health and Society in a Global Setting -Intro to Psych Senior Fall: -Biochem I -ATB Genetics -Biostats -Internship w/ SEEDLab Senior Spring: -MCB II -ATB Biological Chemistry -Behavioral Risk Taking in the... -Health Policy
What travels have you taken and what exposure to other cultures have you had?
Mom stressed traveling, we lived in a small town and she wanted us to be exposed to diversity -peru, bolivia, australia, western europe, ghana, kenya -future = china! :)
nalaxone/narcan
Naloxone, sold under the brandname Narcan among others, is a medication used to block the effects of opioids, especially in overdose.[1] Naloxone may be combined within the same pill as an opioid to decrease the risk of misuse.[1] When given intravenously, naloxone works within two minutes, and when injected into a muscle, it works within five minutes;[1] it may also be sprayed into the nose.[3] The effects of naloxone last about half an hour to an hour.[4] Multiple doses may be required, as the duration of action of most opioids is greater than that of naloxone
What do you believe to be some of the most pressing health issues today? Why?
Obesity opioids health insurance
fentanyl
On the left is a lethal dose of heroin, equivalent to about 30 milligrams; on the right is a 3-milligram dose of fentanyl, enough to kill an average-sized adult male. Drugs users generally don't know when their heroin is laced with fentanyl, so when they inject their usual quantity of heroin, they can inadvertently take a deadly dose of the substance. In addition, while dealers try to include fentanyl to improve potency, their measuring equipment usually isn't fine-tuned enough to ensure they stay below the levels that could cause users to overdose. Plus, the fentanyl sold on the street is almost always made in a clandestine lab; it is less pure than the pharmaceutical version and thus its effect on the body can be more unpredictable. The difference in strength between heroin and fentanyl arises from differences in their chemical structures. The chemicals in both bind to the mu opioid receptor in the brain. But fentanyl gets there faster than morphine — the almost-instantaneous byproduct when the body breaks down heroin — because it more easily passes through the fat that is plentiful in the brain. Fentanyl also hugs the receptor so tightly that a tiny amount is enough to start the molecular chain of events that instigates opioids' effects on the body.
Things to bring to interview
Pen, paper Put together a portfolio for interview?!! -Many interviewing candidates like to bring notebooks and portfolios with them featuring papers they have published, photographs of creative work or an updated resume. You may need to check each school that invites you about its preferences in relation to bringing supplemental materials to the interview.
What is "success" in your opinion? After 20 years as a physician, what kind of "success" would you hope to have achieved? Please explain
Right now in my life I think my biggest success is in DIAS, creating this outlet thru which URM scientists can .... In 20 years it will probably a similar success. Creating an infrastructural(?) change that can have a lasting effect (based on my patients' needs) i.e. HealthLeads Article about NYTimes drug users getting heart infection, get surgery but don't get any drug rehab; https://www.nytimes.com/2018/04/29/health/drugs-opioids-addiction-heart-endocarditis.html
Why did you choose your undergraduate major?
STAR -I found out about Publich Health late in my Freshman year. Was one of the children with grand ideals of changing the world. With Public Health this actually seemed like this could come true. -Heard about it in SOPHOMORE year, but wasn't sure. -STAR: I remember I was sitting in Environmental Health (NOT THE 1st PH course I took!) and a speaker came in to talk to us about PH interventions that he had implemented to lower the rate of traffic accidents. Thought it was going to be boring, common sense interventions but the way he explained how they went about thinking about traffic interventions was what convinced me to pursue PH. He talked about interventions that were INTEGRATED into everyday life. Simple/subtle as adding a countdown to the pedestrian walk signs
As a pre-med, what skills have you learned to help manage your time and relieve stress?
Scheduling things out!!! And then sticking to the schedule (and making sure the schedule is realistic) -work hard during times when I have blocked out to work; relax when not -friends :) -hobbies: skateboarding, rock climbing, volleyball?, sailing? -get stressed/unhappy when I'm not pushing myself (i.e. spend whole day watching TV = end up unhappy/feel unproductive)
What are your greatest strengths
Strengths = -compassion = -work well under stress -self motivated? -persistance = starting DIAS, didn't expect the pushback we got (thought it was going to be quite smooth) but VP of HR (and from my own boss, the whole staying with WiSE) = lots of push back.... continued despite this, got boss on our side, support from other scientists
Insurance vs uninsured mortality risk
The study also found that uninsured, working Americans have an approximately 40% higher mortality risk compared to privately insured working Americans (2009, harvard) Steffie Woolhandler, study co-author, professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance, noted: "Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives." "The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance," remarked David Himmelstein, study co-author, associate professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance. "Even this grim figure is an underestimate — now one dies every 12 minutes."
fun fact: using apps to increase medical prescription adherence
The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy. Although these medications are effective in combating disease, their full benefits are often not realized because approximately 50% of patients do not take their medications as prescribed. -Mayo Clinic study "the use of more than three medications by the same patient (also known as polypharmacy) is a major barrier to adherence."
Why NOT Physician's assistant?
Think it is a GREAT career option, and am excited that it is gaining more traction within the US. HOWEVER, my goal truly is to become a LEADER in whatever field I enter. To have the latitude to address the roots of the problems that I encounter in my field. My goals are not to graduate from medical school/higher education and work a 9 to 5. I really want to become an integral part of the leadership and I think that the skills that I will be taught in Medical school (vs PA and Nursing) will help foster/advance these goals
Why I want to become a doctor
Took me a while to find medicine INITIALLY: Mother always instilled in us how lucky we were to LEAD THE LIFESTYLE WE DID. -impressed upon us importance of giving back (AND being happy); 2 most determinative factors for me in deciding what to do -went into college, no idea what to do -stumbled around looking at majors; didn't want to stick with what i felt "safe" with (i.e. medicine) -STAR = stressful nights tossing around in bed trying to figure out what I wanted to do;; -passionate about social issues and getting involved in them BUT interested/good at in biology/sciences/genetics -Healthleads = shows me how you can combine both NOW: -Have fallen even more in love with it because, in my opinion, the field allows doctors to integrate EVERYTHING. From basic knowledge to life experiences to hobbies. Medicine values every background experience we have and encourages people who love learning everything for the sake of learning. So we are encouraged to be the master of our trade AS WELL AS a jack of the rest because that peripheral knowledge can be what allows us to more fully connect and empathize with our patients. Very few careers where this happens (i.e. in science, your hobbies could influence your ways of thinking but really your knowledge on your field is what matters. In medicine, my hobby of rock climing can help me connect with a patient or ...) -Glad i had this wandering path. glad that my mother compelled us to try other paths (sister is a dog trainer); made me SURE this is what I wanted to do. -healthleads cemented it
How has your undergraduate research experience, if any, better prepared you for a medical career?
Undergraduate: -Switzerland: Worked on melanoma vs moles; first exposure to cancer research (i.e. oncogenes and tumor suppressors) = very educational -Did both wet lab work and clinical analysis so got a glimpse at both facets of medical research -Where I started learning about pharmaceuticals/drug making process and trials -MORE, why is it significant?!??!! Sheltzer lab -Most impactful -everything that I learned in the Switzerland lab but intensified -professionalism: working 10hrs a day = you must really love what you do -the ADMINISTRATIVE side of things, I think as a premed student, the admin/paperwork part of the job gets overlooked. I was in charge of coordinating a lot of the admin stuff for people in lab so if anything went wrong I was usually the first point of contact. We kept very precise records of everything (or I at least tried to). IMPORTANT IN MEDICINE AS WELL!!!! -critical thinking: a) about scientific papers; b) troubleshooting things in lab (i.e. when machines were broken, it was usually up to me to fix them) -MORE: expand on both of these
What qualities do you look for in a physician? Can you provide an example of a physician who embodies any of these ideals? How do they do this?
Understanding, no judgement (empathy), MORE PCP
How do you envision using your medical education?
Want to place a strong emphasis on Public Health education; Institute stuff like healthleads at any hospital that i'm working at (or get involved in any similar program if there is one already) -Go to underserved areas w/in US orrr go abroad to developing countries (but if I do this, would want to get more involved than just drs w/o borders, would want to find a place and settle down there permanently (i.e. 5+ years) to really affect change and not just do a quick fix)
Questions for the interviewer
What is the school's culture like? Describe the clinical experiences — when do they begin and what kind of patients do we serve? Is there research funding available? WHat is the match rate w/ residencies?(??) Does the school use emerging technology?(???Look up emerging technology examples...) What is your policy on participating in outside activities of organizations such as .....? https://students-residents.aamc.org/applying-medical-school/article/selecting-medical-school-35-questions-i-wish-i-had/ Prepare a few questions for the interviewer, but don't ask about strengths and weaknesses of a program - be more creative. sk about the location in proximity to other communities or major cities, the arts and culture, parks and recreation, and other attractions. Be sure to read the information about the school on their web site, so that you don't ask questions about something for which information is readily available. Be creative in your questioning. A few examples might include: 1) "If I were to ask the students in your first-year medical school class what they would like to change, what areas do you think they would emphasize?" 2) "How do you see the cost of a medical education affecting the students here?" 3) "What do faculty members feel is the most unique aspect of this medical school, such that they would encourage their sons or daughters to attend?" What qualities do you think are most important for someone to excel in this position? Address any qualities that they mention that you haven't demonstrated during the interview THINK UP RESPONSE TO THEIR ANSWER!!! What are the most important priorities for this Medical school right now What do you personally like most about working for this company Can you tell me more about a typical day on the job https://aamc-orange.global.ssl.fastly.net/production/media/filer_public/6a/42/6a42262e-a76f-47df-b706-64489b654ff4/15-001a_msar_2016_worksheets_fillable_final81.pdf
Tell me about yourself
Who you are -I graduated from NYU a year and a half ago before becoming a technician at the Sheltzer Lab where I investigated the role of aneuploidy, or chromosomal imbalances, in cancer. -I first knew I wanted to pursue medicine when I .... Why you're qualified (find a segueway) Why you're here -I've always compelled to pursue a career focused on compassion, serving others, and challenging myself.
If you could be granted three wishes for making the world/society/ your community a better place, what would they be and why (or, If you were given a million dollars to achieve three goals, what would you work on and why)?
Wishes Improve education system (logic/fact based, idk, fix history classes?)... Make everyone more empathetic/patient (people get caught up in their own issues) Million dollars Improve education system (logic/fact based, idk, fix history classes?)..
Health care in the US
https://en.wikipedia.org/wiki/Health_care_in_the_United_States
If you want to help people, why not social work?
look up effective altruism (?) or something like that http://effective-altruism.com/ea/eg/effective_altruism_and_utilitarianism/
People in white house
secretary of state = rex tillerson chief of staff = john f kelly (Used to be reince priebus) Attorny general = jeff sessions
How have the jobs, volunteer opportunities, or extracurricular experiences that you have had better prepared you for the responsibilities of being a physician?
sheltzer lab = professionalism; also kinda being a leader (Jason usually tells me to tell the lab to do things, i.e. organize, etc; is v. busy and relies on me to take care of certain things in his stead) Volunteer = metropolitan hospital = insight into what its like to be a doctor DIAS = being a leader
Thinking of examples from your recent past, how would you assess your empathy and compassion?
suicide guy (x2) THINK OF MORE EXAMPLES;; harder now that I'm in LI working everyday... basically drive to work and then home trying to be nice day to day; keep a booklet of 1 nice thing I did for somebody a day drawing anand out, was really quiet and not part of lab community, started talking to him more/made sure to invite him to all of our outings -trying to make our lab more of a community -also DIAS -practicing patience w/ everybody; being an understanding and compassionate ear to any of my co-workers; when there is a conflict, I try to be the one to diffuse; if someone is being mean, come to the other person's defense (i.e. within DIAS = tensions, lots of conflicting opinions
What are your greatest weaknesses?
weaknesses = -I think in the past years I have found that my greatest weaknesses were: -finding my voice (i.e. in lab meetings = don't speak up when I know the answer; even in classes in college I would need to be comfortable with the teacher and all of the students to speak);; realized how it can hurt others' perception of me as not thinking about the questions being posed (include this?); How i'm trying to fix it = push myself to say at least one constructive thing (or ask one question) during lab meetings -Telling others to do things (i.e. in DIAS = It's hard for me to delegate responsibility, especially bc everyone is older than me and Post-docs/PhDs);; how i'm trying to fix it = ask "who would be willing to do this" and then be comfortable waiting longer for someone to volunteer; or asking someone pointedly to do something if it was their idea (i.e. ___, would you like to take the lead on this) -workaholic = in science you can make your own hours and there's always something else to do....sometimes my boss gives me things to do that don't necessarily have a deadline but I feel the need to stay late and get them started... always another experiment that could be set up; how i'm trying to fix it = set hours for myself (8-6pm)