Pre-Med

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A Day in the Life of a Pre-Med

By Tara Thacker '97                         August 8, 1995

Pre-Med Stress!! Have you ever wondered if "Pre-Med" was more than just a set of courses needed to get into Medical School? Does it really take over your life and become more than a classification, but a mindset? Then sit down and read this article that was the subject of research for an anthropology class about a common phenomenon that affects hundreds of students each year. All data were taken from Pre-Med and non-Pre-Med Dartmouth students.

What Makes a Pre-Med

I remember the first day of organic chemistry (orgo for short) last term. The professor wrote the question on the board "what is organic chemistry?" Under this, he drew an odd blob and named it a twinkie. The man was obviously having fun, changing chalk colors and telling how the scientists of the past would have never been able to figure out whether or not a twinkie was organic, as we've put so many chemicals into it! I happened to glance around and saw a student in the front, obviously a "pre-med," writing down word for word what the professor said, changing pen colors as he did.

I recall that I had simply rolled my eyes and dismissed the person from my mind as a pre-med. It was then that I stopped to think...I'm a pre-med. Why was I so easy to dismiss this person as a member of a certain group?

To non-pre-meds, and even to many pre-meds, "pre-med" stands for unnecessary stress, "analness," competition that goes beyond the normal limits- well into insanity, and a group of followers who jump on the band-wagon for all the wrong reasons. Indeed, the fact that the group is referred to as simply "pre-med" implies unity and conformity.

 ..."pre-med" stands for unnecessary stress, "analness", competition that goes beyond normal limits - well into insanity... From the moment one hears about pre-med classes, a certain stereotype is put forth.

I have come to the conclusion that the system actually fosters these characteristics. From the moment one hears about pre-med classes, a certain stereotype is put forth. One will always hear how that the classes are so hard, stressful, and how they will make your life miserable. This kind of publicity creates a mind set for the people going in - it is very hard not to stress out, when you feel that you should be stressing out. Such devices as "the curve" pit one student against the next, adding to the competitive atmosphere.

Pre-Med Society

As a group of people, pre-meds are actually diverse and different. They are accused of having many similar characteristics, and indeed at times seem to represent them. They are fiercely competitive, goal oriented, and deal with a lot of stress. There are always the strong ties of shared experiences, of lab and hard work, and the knowledge and stress related with medical school that holds them together, a common thread that brings together a diverse group with common interests. Yet on the individual level, most of this uniformity vanishes. All in all, they are a very diverse and fascinating group, and I hope that more work is done on them in the future.

 There are always the strong ties of shared experiences, of lab and hard work, and the knowledge and stress related with medical school that holds them together, a common thread that brings together a diverse group with common interests.

Though pre-meds are an extremely diverse group, they are still a part of a society that functions with its own symbols, characteristics and knowledge sets. All pre-meds know and understand pre-reqs, lab experiences (the word "sep funnel" causes a grimace to come to the faces of all post orgo pre-meds), scientific vocabulary, MCAT's, studying, and having to plan out their schedule by the end of their freshman year.

The Symbols Make the People

As a society, these people are subject to symbols that come to represent the group. The symbol that most people come to see as a representation of pre-meds is the "clicky pen." This pen is found in every pre-med class, and it is especially common in organic chemistry. The professor will change colors of chalk, and automatically a chorus of clicks will go off as people change colors of ink in their notes to match. The sound is rather annoying, and has come to represent pre-meds as a group. It often has negative connotations, tending to represent all the negative characteristics people think about the group. Why did so many of these people feel it was a must to have this pen?

The need that people feel for this pen stems from factors other than necessity. I have come the conclusion that, because it has come to represent pre-meds as a group, people often find themselves using the pen to associate themselves with the group-plus you get colorful notes!

Another symbol of pre-meds as a group is lab. Labs are scheduled for four hours, and the organic chemistry labs are six hours long. It is a long chunk of each week that becomes second nature to every pre-med. These labs become a shared experience that often come up in conversation; I have noticed that pre-meds (and science majors) will exchange lab horror stories as well as good experiences like old war veterans. To a non-pre-med, lab and "pre-medness" go hand in hand.

...pre-meds devote their lives to helping others, should the path they take there be any different? There is one last thing that I would like to mention about the group - something that has troubled me very much both in my study of the group and in my own pre-med path, and that is this: pre-meds spend so much time on their classes, they often become so intent on doing well

that they focus on what they need; on how to do a problem not how to understand it or on how they must take the pre-med class for the grade but never stop to think about others. I have been told that this changes the feel of the class from an atmosphere for learning to one of competitiveness. That raises an interesting question: pre-meds devote their lives to helping others, should the path they take there be any different?

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The Medical School Application: A Student's Perspective

By Patsa Hungspreug '96                         October 27, 1995

What does applying to medical school entail? Is it as horrible as everyone makes it out to be? Patsa Hungspreugs '96 shares her experience of applying to med. school...

Challenging... and Thrilling

"Have you come to terms with your own mortality?" This difficult question was only one of twenty-four that I was asked during my standardized telephone interview for Mayo
"Mentally exhausting yet exciting" - a perfect phrase to describe the medical school application process. Medical School. After voicing my opinion on everything from the existence of pain to perfectionist personalities and then saying good-bye to my interviewer, I finally hung up the phone, mentally exhausted, yet strangely excited. Would I make it to the next step of the application process by being offered a live interview?

'Mentally exhausting yet exciting' - a perfect phrase to describe the medical school application process. The project is at first highly intimidating, with a seemingly endless list of things to do: the MCATs, the primary AMCAS application, each individual medical school's secondary application and interviews, not to mention the non-AMCAS medical school applications, pre-interview essays, and obtaining recommendations and a composite. All this while still trying to juggle classes, job and other activities. Just the thought of such a task is bound to invoke a level of procrastination in most students, while causing others to decide not to pursue medicine altogether, as a few of my friends have done.

While I must admit that I have done my share of procrastination throughout the application process, once I finally did get started, I found that it was (and is currently
still) a very rewarding experience. I have learned so much about myself and my strengths from the introspective essays I have written. Such a process has made me think what I really want to get out of medical school and a career in medicine and what I have to offer.

 I have learned so much about myself and my strengths from the introspective essays I have written.

And after all my efforts, I find it very fulfilling as I begin to get results. I become more and more excited as I hear from each school, whether it may be a card telling me that my application has been received or, even better, an invitation for an interview. The interviews themselves are the most thrilling, however. I have had a fantastic time so far meeting medical students of all ages, touring campuses that could possibly be the one at which I will spend my next four years, and of course, conversing with the interviewing physicians. Thus, though many people say that the medical school application process is highly stressful, I have found a great deal that has been enjoyable.

What About Taking a Year Off?

If you feel that you are not 100% certain about going to medical school, you might want to consider taking some time off before applying. Over the past few years, there has been an increasing number of students waiting a year or two before applying to medical school. Just this year, 114 alumni and 101 seniors have applied to medical school.

Most of the students who took this time off before going to medical school were happy about doing so and highly recommended it to any student with doubts about going to medical school. Some of these students said that once you are in medical school, you aren't left with any time for pursuits in fields other than medicine and for that reason, it is a good idea to take time off to do something that really interests you. Other students used this time to get more experience working in a research laboratory or in some kind of health related setting. Either way, taking the time off will provide the student with a more mature outlook on life that will be beneficial in medical school.

For the college senior who does not really know why she is going to medical school, it is a very good idea to take the time off to explore health professions, as well as different areas of interest.

The major question to answer now is as to whether medical schools look favorably upon the applicant who has taken some time off between graduating from college and applying to medical school. Unfortunately, there is no concrete answer to that question. Most medical schools do favor the college senior who is absolutely certain about going to medical school and who is ready to make the commitment. For the college senior who does not really know why she is going to medical school, it is a very good

idea to take the time off to explore health professions, as well as different areas of interest. This will help the student confirm her original decision of going to medical school and will therefore provide an application that shows a higher degree of certainty and dedication to the medical profession.

Be Prepared Before You Go

If taking time off sounds like a good idea to you, it is advisable to get recommendations from professors while you are still in school. These recommendations can be put on file and are kept at Dartmouth for ten years. The MCATS can also be taken while still in school since most medical schools accept test scores that were taken two to three years before entrance. This does, however, vary with some schools and it is best to look up these facts for a particular school.

This is all just the tip of the iceberg. There is much more information, including binders of post-graduate internships, at the Career Services Office. There are also group advising sessions for the medical school application process every Thursday morning and afternoon at the Graduate Advising Office. For more information, be sure to stop by the Career Services Office on the third floor of Collis!

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To Pre-Med or Not to Pre-Med

By Simone Swink '98                         February 8, 1998

"What are you going to be when you grow up?"

"I don't know."

And I don't. I may even, heaven forbid, graduate and not have a job. It's difficult to remember that in the great scheme of things, it just doesn't matter when June rolls around if you are an unemployed [insert your major here] major. If you plan on attending a professional school, the soul-searching often begins much sooner than June 14. For women with science majors, the question of "to pre-med or not to pre-med" frequently arises during their Dartmouth careers.

The women I talked with are majoring in everything from psychology to genetics. All of them have questioned whether or not medical school is the right path for them. Shannon Jarosh '98 is going straight to medical school while Colleen O'Connor '98 and Nita Farahany '98 are taking a year or two off before entering medical school. Wendy Simon '98, on the other hand, does not intend on going to medical school at all.

"Swimming Kept me Steady"

Wendy Simon '98 always wanted to be a chemistry major. After a chemistry class in high school, she felt drawn to the subject. While many chemistry majors are on the pre-med track, Wendy has bypassed it planning instead to work in the lab of a pharmaceutical company or teach high school chemistry in a private school. As a veteran swimmer who currently captains the Dartmouth women's team, she is a strong believer in fair competition. "While swimming can get very competitive, you can't sabotage someone's lab like I've heard stories about people doing in med school."

Wendy's path toward a pharmaceutical track or teaching track are not well-worn through Career Services. She commented that most jobs she has applied for are ones she has found on her own. Like the other women interviewed, she has had some angst about what to do after June, but she commented that swimming has kept her steady. No matter where she's working, she plans to coach a swim team and keep chlorine a part of her life.

Looking at the Possibilities

Shannon Jarosh '98 on the other hand anticipates on going directly to medical school. She commented, "I have always wanted to be a doctor, ever since I was 18 months old, and learned to say the word "pediatrician", or so the story goes." Shannon had planned to major in biology, but her Psychology 1 course during sophomore fall inspired her to also consider psychology as a major. To capitalize on both her scientific interests, she decided to double major.

Though she said "pediatrician" at 18 months, the road to mailing her medical school applications was not easy. During junior year, she started questioning her goal of becoming a physician. Unlike Wendy, the med school atmosphere did not bother Shannon, but rather the idea of

"I realized at one point that there were a lot of things I could do, and that was a new realization."
putting off starting a family daunted her. "I realized at one point that there were a lot of other things I could do, and that was a new realization." So she investigated other options and was intrigued by other scientifically-related fields, particularly genetic counseling. In the end, the goal of becoming a doctor was too important to let go, but taking the time to examine the decision has made her more confident of it. "Letting the romantic notions go" and pondering if she could fulfill her personal and professional goals was agonizing. But she is more certain than before that she wants to be a doctor and she's still saying "pediatrician," just with more certainty.

Taking Some Time

Unlike Shannon, Nita Farahany and Colleen O'Connor are not going directly to medical school. Taking a year off to relax from the studying grind entices them, but they both plan to apply this coming fall. Like Shannon, Colleen was attracted to psychology because she is fascinated by the brain. In particular, Colleen is interested in studying childhood learning disorders. Capitalizing on her interest, she worked with autistic children last summer. She contrasted that experience with her research internship at DHMC last winter where she studied the carbon dioxide receptors in rats. Her experience there made her realize that she much preferred working with people than rats.

Her genetics major has proved invaluable in interviews since much of her coursework has required more problem-solving than other aspects of biology do.

While she prepares for medical school, Colleen plans to work as a physician's assistant or teach for a year before starting work on her M.D. Nita Farahany is also taking a year off before medical school. Like Colleen and Shannon, she's wanted to be a doctor since she was a kid. Unlike Colleen, Nita has chosen the corporate route and has actively pursued openings in healthcare consulting. Her genetics major has proved invaluable in interviews since

much of her coursework has required more problem-solving than other aspects of biology do. She sees her training in healthcare consulting as another step to eventually making her a better physician. Nita anticipates that her training will prepare her to deal with the changing structure of tomorrow's healthcare industry.

The above profiles are just a sampling of what different women are doing with their majors. I tilted the focus toward the pre-med debate since it consumes so many people's thoughts. In weeks to come, articles will focus on women thriving in the so-called "hard sciences" such as physics and engineering. But the decisions, angst, and strategies of the above women may provide you with some inspiration to do some of your own soul-searching about your current path. And perhaps you will find yourself taking some turns you never expected, even if your first word as a kid was "pediatrician."

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Out of the Laboratory and Into the Community:
MD/PhD Candidate Grace Migaki Educates on Endometriosis

By Anne H Loomis '99                         May 2 1999

Research Coupled with Outreach

Grace Migaki is a woman with a cause. Migaki, an M.D./Ph.D. student at Dartmouth Medical School, not only does research on the fundamental immunology of the female reproductive tract, but she also works to educate the public about a common, yet often overlooked disease: endometriosis.

"Endometriosis is a disease where the tissue that normally lines your uterus, called the endometrium, is actually found growing in places other than your uterus," says Migaki. "Like the endometrium, it bleeds periodically and this leads to a massive influx of leukocytes, which are your immune cells, and this leads to inflammation and scar tissue formation, chronic pain and infertility, and a lot of other problems that can plague a patient."

Because of the nature of the disease -- one of its hallmark symptoms is having a bad period -- and the fact that it affects predominantly the female population, endometriosis "just kind of gets slipped under the carpet." But it is very common, affecting approximately 10% of menstruating women. That's 5.5 million women in the U.S. and Canada

The fact that it affects predominantly the female population, endometriosis "just kind of gets slipped under the carpet."
alone. "It's more common than breast cancer, multiple sclerosis, Alzheimer's, inflammatory bowel disease," says Migaki. "It's more common than all of those combined."

Patients Educating Their Physicians

Migaki became involved with the Endometriosis Association seven years ago, and has been working to educate the public about endometriosis ever since. She has started a letter-writing campaign, founded an online endometriosis support group on America Online, and has undertaken a number of other public awareness activities. "I want the patients to go out and educate their physicians, and I want the patients to educate the public," says Migaki. "And it's an interesting turnabout to have the patients educating their physicians, because this is one of those diseases when often the woman will know far more about her disease and her body and her symptoms than the physician will ever know."

... this is one of those diseases when often the woman will know far more about her disease and her body and her symptoms than the physician will ever know."

Part of Migaki's motivation to practice medicine and educate the public comes out of her personal awareness of endometriosis. "My experiences with doctors have been both good and bad. I know how bad the bad experiences are and how good the good experiences are, and I really want to be someone who can make the good experiences even better. It's the most demeaning experience to go in to someone for help, feeling poorly to begin with, and then

to be told that there's nothing wrong with you, that you're just stressed out, or it's just P.M.S., and not be taken seriously. And it's dangerous, too, because like I said, endometriosis can lead to a lot of problems like chronic pain, fatigue, miscarriage, and infertility if you don't catch it in time."

Among her local public awareness activities, Migaki plans on giving a series of lectures at Dartmouth. "I'll be giving five lectures to the undergraduate community in the dorm clusters, and at each one of those lectures there'll be a free raffle. It's to target young people because it's one thing to educate physicians and scientists, but it makes no difference if a woman grows up and never knows that she should go to the doctor in the first place because this is something that's abnormal. It's not normal for you to be throwing up during your period. It's not normal for you to be experiencing all this pain. It's not normal to not be able to carry on your normal, everyday activities during your period or during ovulation or during the week immediately preceding your period. It's normal maybe to have a temper tantrum or two, but it's not normal to have incapacitating pain that interferes with your life."

Her Advise to Pre-Meds: Go Out and See the World

Through her outreach effort to educate others, Migaki is taking her research a step further: out of the laboratory and into the community. And, knowing the importance of community-involvement, she stresses it in her advice to potential med-school students. "My advice [to undergraduates] would be to take a couple years off and

"My advice [to undergraduates] would be to take a couple years off and see the world. Find out what your true passions are."
see the world. Find out what your true passions are. Even if you did research as an undergraduate, do you really know what it's like to do it full time? Do you really know what it's like to have to get up in the morning and go in at eight and do this stuff? Is that really what you want? Or if you really think you want to be a doctor, why don't you go out and work in the health field for a little while. Why don't you go interact with patients? What if you get to medical school and find out you don't like sick people?" She smiles. "I can't tell you how much of a difference that made in my interviews."

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Did You Know...? Lights, Camera, Action!

By Chris Wilson                         April 1, 2002

The following is another installment of "Did You Know...?" by WISP's Chris Wilson. Below, Chris discusses the amazing advances in cancer diagnosis being made in Professor Mary-Ann Mycek's physics lab. Chris notes the cooperation that has gone into this interdisciplinary project. Read on to find out more about this fascinating field.

What if a physician could scan the human body with a light wand similar to a laser pointer and the computer it was connected to could distinguish a healthy cell from a cancerous cell? Or maybe it could determine that the cell is exhibiting characteristics that suggest that it will turn cancerous, and therefore should receive a different treatment. Imagine a diagnostic tool that would be safer than x-rays; patients would be able to sit comfortably in their doctor's office during this procedure, and not be subject to long delays, trapped inside the small confined space of the magnetic resonance imaging (MRI) machine. There would be no invasive tissue removal for biopsy. The results would be almost instantaneous.

Dr. Mary-Ann Mycek has been envisioning just such an instrument in her Physics Department laboratory in Wilder, and is well on her way to bringing her vision into reality. Fluorescence spectroscopy is the technique involved. The

Fluorescence spectroscopy is the technique involved. The general premise is that when ultraviolet (UV) light is shone onto tissue, the tissue will "fluoresce" or basically glow (think Halloween light stick). The color, intensity and duration of the glow are signatures of different cells and their metabolisms. Normal cells reflect UV light in very different ways than cancerous cells.
general premise is that when ultraviolet (UV) light is shone onto tissue, the tissue will "fluoresce" or basically glow (think Halloween light stick). The color, intensity and duration of the glow are signatures of different cells and their metabolisms. Normal cells reflect UV light in very different ways than cancerous cells.

The UV light is directed at the patient from a laser source through fiber optic cables. LASER is really an acronym for Light Amplification by Stimulated Emission of Radiation.
This cutting-edge biomedical instrument is the epitome of collaborative effort, from the physics of laser beams and fluorescence, to the biology and chemistry of cells and their metabolisms, to the engineering of the hardware, and the computer programming that links all the pieces together. A laser beam is an extremely narrow beam of intense light of the same wavelength and phase, and therefore very uniform, controllable and predictable. Ordinary light is a mixture of different frequencies of light moving in various directions; it is therefore not uniform. A prototype of the clinical biomedical diagnostic tool is currently up and running in Dr. Mycek's lab. A laptop computer sits on the top of a rack on wheels, with lasers, lenses and fiber optic cables on the shelf below. The fiber optic cable carries the UV laser beam out to the patient and retrieves the incoming light fluoresced from the tissue, as the fluorescence happens very quickly. The lenses diffract or split the fluoresced light into its various parts, or wavelengths. By looking at the quantities of the different
parts of the fluoresced light, a spectrum (or graph of the amounts of each of the various wavelengths) can be created that can be analyzed to determine things like how much of a particular chemical is in the sample.

The data and subsequent spectrum is analyzed using computer programs written by Dr. Mycek and her staff. The spectrum and its implications are then displayed on the screen of the laptop for the physician to analyze. The computer program that acts as the interface between the physician and the hardware was written by people in the Computer Science department to make the equipment more "user-friendly" for physicians in the field. This cutting-edge biomedical instrument is the epitome of collaborative effort, from the physics of laser beams and fluorescence, to the biology and chemistry of cells and their metabolisms, to the engineering of the hardware, and the computer programming that links all the pieces together. Together, it seems all things truly are possible.

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