Medical School: A Non-Traditional Approach

Dismissed.

2010-12-20T13:10:00.000-08:00

No one ever said it was going to be easy.

I can't say I'm surprised. The writing was on the wall. The final and cumulative semester grades were just released a few minutes ago and not only am I not going to be able to progress to 3rd semester, I won't even have the chance to repeat 2nd. I was still studying up until the very end, hoping that I'd do well enough to repeat, but things haven't been looking good for at least the past 2 or 3 weeks.

Because of this (although I'm really bummed out) I'm not completely shocked. I wasn't anxiously awaiting for my grades because I knew it wasn't close. Also because of this, I've had a lot of time to think about what to do next. The way I see it I have 4 options that are attractive, all for different reasons, and a 5th option in which I have no interest:

Appeal the dismissal in hopes of being able to return to Ross. - From what I understand, I should be receiving an email shortly which formally informs me that I've been dismissed (and not just an email that contains numbers). That email will have instructions on how to go about the appeals process. I also understand that successfully appealing a dismissal and being re-admitted into Ross is very rare. I don't expect to be able to return to Ross, but I'll go through the steps anyway. The worst they can say it 'no'.
Inquire about admittance to AUC. - When I first applied to schools I only ever began the applications process for SGU and Ross. Since that time, knowing what I know now, (while giving advice to others) if I had to go to the applications process again, I'd apply to AUC as well. This option is also a long shot. I've already sent their admissions department an email, but they haven't replied yet. I plan on calling them in the next day or two just to ask some questions.
Apply to AUA, MUA, and SMU. - This option took a while to accept this as a viable option. If you go back through this blog, I've always said that Ross was the last option for me and if it didn't work out I'd have to figure out what I really wanted to do with my life -- and that I wouldn't be applying to other schools. This isn't just about reputation or anything like that. Being from California, the ability to practice in California is a big deal to me. I've always said that while traveling the country, practicing in any number of states for the next 5, 10, or 15 years was appealing, I always saw myself returning and settling down back in California. And if I graduate from any of these schools, practicing in California isn't an option. But things have changed... Some people give "the dream." People have their reasons. I'm not really judging, it's just that everyone's different and you don't really know what you're going to do until you're put into this situation. Life goes on and you have to make a choice. In the past 2-3 weeks I've decided pretty concretely that this isn't the end. In the end, I really do want to be a doctor. I'm going to be inquiring and applying to AUA, MUA, and SMU (in that order) in the next couple weeks. From everything I've heard, out of the options I've listed so far, this is the most realistic option. The first 2 are long shots. It's common knowledge that dismissed students from Ross (and SGU and AUC) are easily admitted into these other schools. I'm almost 100% positive that I'm going to be accepted to one of these schools if I choose to pursue it.
Give up medicine and start looking into international relief organizations. - Maybe I'm just not cut out to be a doctor. I believe I genuinely want to and I had the right attitude and drive for it and that I'm pursuing medicine for all the right reasons, but maybe I'm just not smart/studious enough and it's actually an impossible/unrealistic goal. After all, if just anyone could be a doctor, there would be a lot more doctors. I've lived on Dominica, on my own, for the past year. I've spent the entire year of 2010 on the island. I've also received so many thousands of dollars of loans and am in so many thousands of dollars in debt. And I've done all this with absolutely no promise of success. And I think when you (anyone) puts themselves in any situation where you have to take a leap of faith, without a safety net, in the face of absolute success or failure, you kind of learn things about yourself. Whether it be going to Ross in the pursuit of medicine or anything else in life, I think it's almost inevitable. I would guess that the majority of students at Ross think the same thing -- maybe not all -- but the majority. I've learned: (1) I absolutely don't get home sick, (2) the really do love learning medicine and the decision to pursue it was the right one, and (3) I enjoy traveling outside the US in order to work. In the past year I've done a relatively fair amount of inquiry into organizations like Doctors Without Borders. I've mentioned Doctors Without Borders in the past at least once or twice, but I didn't mention that I've already contacted some members and already had the chance to ask some preliminary questions. If I ever graduated, I had no doubt that joining one of those types of organizations for at least a couple years was one of my life goals. And those "couple of years" may have stretched out much farther, depending on the experience as a whole... But who says you have to help out as a doctor? If medicine really isn't for me who says you can't join one of those organizations anyway? They have all kinds of positions waiting to be filled.
Nursing. - This is option 5 (a.k.a. the non-option) and have zero interest in this possibility. And when I say this, this isn't coming from with an attitude of "looking from up on high as a doctor, looking down at all the nurses." Remember, I spent my first couple years out of high school, trying to figure out what I wanted to do. While I was doing this, I was completing nursing pre-requisites at my local community college. I've had plenty of time to see nursing from an academic stand point and a practical one (working inside hospitals) and it's just not something I want to do. That was 8 years ago. But even now, in the face of having to make another decision, that route has little appeal to me.

For all intents and purposes, my life at Ross is over. I would say that "as soon as it started, it was over." But I can't say that because after being there for an entire year, I had plenty of opportunity to succeed and I didn't. I can't say that because it "didn't just start." I received my acceptance letter 2 year ago. It was 2008 and I was 26 years old. I'm 28 now and life definitely goes on. I'm a little older (and a little wiser?) but I figure I'm still young enough to give it one more go at one of these other schools. And if that doesn't work out, maybe I'll be joining Doctors Without Borders or Red Cross or any other of these types of organizations a little sooner than expected (and without some fancy initials next to my name).

So there you have it. Unless I get approved for a miracle appeal, the Ross Experiment is over.

And I think I'll end this blog here. I've always said that this blog would either be a written record of success or failure at Ross. That written record ends today. For all potential Ross students looking for information, read this blog for my advice, but I warn you now to consider the source.

Which ever one of the options I listed above comes true, I'll continue to record everything on a new blog I set up here:

Failing Out of Medical School: A First Hand Account

Thanks to everyone who's been following along and leaving comments all these years, but it looks like it's time for something new whether I like it or not.

-Jonathan

Waving the white flag.

2010-11-23T07:25:00.000-08:00

So it's been a little over 2 weeks since the last time I posted anything and there have been a lot of comments left with a lot of people with many nice things to say.

It was probably the day of I made my last post or immediately after when I brought up a lot of the same concerns to some of the people around me in class. At the time, after a little arm wrestling, they convinced me to stick it out and see what happens. Two of them in particular brought up examples of other friends they had who had some amazing come-back stories where they dug themselves into a hole on the first 1 or 2 exams and just focused and got all the grades they needed.

The hole that I'm in is deeper than the hole their friends were in. Still, they had a convincing argument.

It's 2 weeks later and anything can happen on an exam, but it comes down to these questions:

Do I feel so much more prepared for Mini 3 than I did for Minis 1 & 2?
Do I feel like I own the material as much as I think I should have for those previous exams?
Do I feel leaps and bounds more in command of every learning objective for every lecture for every class? Because that's what it's going to take.

The answer is 'no' to all 3 questions. I mean, I don't want to give up. That's the last thing I want to do. But when everything wasn't looking good, I stuck around for 2 more weeks and it's time to make a decision:

I'm not attended or watching another single Biochemistry or Neuroscience lecture.
I'm not going to participate in the Mock Neuro Practical this Friday.
I'm not going to take the Neuro Practical next week.
And I'm not going to worry about either subject during finals week.

I've put a lot of thought into this and it just doesn't make sense to continue on this way. Say what you will about my chances of ever graduating at the end of it all, but as far as this semester is concerned and my ability to stay at Ross, it's the difference between being a heroic optimist and a stubborn failure. And it's becoming more and more clear to me which one of those paths I'm on every additional moment I refuse to change.

I'm not sad or mad or anything like that at this time. I might be a little frustrated, but that's not saying it correctly either. The truth is that I'm overwhelmingly disappointed in myself and it's completely my own doing.

It's time to focus solely on Anatomy, Histology, and Physiology and the practicals and finals that are coming up in the next few weeks.

EDIT: I just sent an email to the dean's office a few minutes ago with questions about attendance for exams and repeating (and it's a good thing I did). I already got a response and it turns out you're required to sit for all exams in all subjects you're registered for. The person who responded followed up by saying that I could just show up and bubble any letter if I choose to concentrate on other subjects.

Things are looking bad.

2010-11-07T17:38:00.000-08:00

To be perfectly honest, I'm doing really bad right now.

I posted that I did bad on the 1st Mini and was too embarrassed to share my grades this time around. I was actually hoping to do much better on the 2nd Mini and then just post it all, just so I had something to show for everything I'm trying to do here. I actually did slightly better on the 2nd Mini, but not nearly good enough. And again, (unfortunately) I'm in a familiar position.

There are 5 weeks of class left and it looks like I'm going to be fighting for the right to repeat 2nd semester.

I'm not going to post too many excuses right now, I'm just disappointed more than anything.

Considering my past track record, of course the legitimate questions of, "are you sure you have what it takes?" pops up. When you repeat you fall farther and farther into debt and who knows what will happen the semester after this one? Right now my response to that is that I'll keep on repeating and coming back until Ross tells me that I no longer can.

Hurricane Tomas, Video from Dominica

2010-10-31T13:44:00.000-07:00

A short video from last night, on campus:

Hurricane Tomas is moving through the Caribbean. It was a category 1 hurricane as it moved through the East Caribbean, but it wasn't a direct hit on Dominica and we only got tropical storm level winds.

Mass emails went out sporadically throughout the day, updating everyone on the status of the storm. But the funny thing is that until security guards actually would have done a sweep of the campus and told everyone to go home, stay indoors, and wait for further updates, nothing really changed in anyone's schedules. The power must have gone out and back up 5 times and there wasn't much else to do but keep on studying.

It's just another storm until it stops being just another storm.

Volcanes erupting on nearby islands and hurricanes just passing through like it's the most normal thing in the world... Interesting place to go to school.

Standardized Patient

2010-10-29T00:03:00.000-07:00

So this was actually kind of fun.

In 1st semester we made up imaginary interviews, based on imaginary patients. Yesterday, in pairs, this time we interviewed actual people acting as patients with imaginary problems. And of course, this is all leading to 3rd and 4th semesters when we'll start going out into the clinics, shadowing doctors, and taking a more active role with actual patients with actual problems.

What I initially wanted to do was to list all of the patient interview information as it was gathered, in the order that it was gathered and see how soon you could figure out a probable diagnosis for yourself. Unfortunately, I can't actually talk about the interview itself. Even though it was just an actor with imaginary signs & symptoms, the school was very clear that we all had to keep the information to ourselves. Instead I'll just keep it in vague terms.

Now the following will probably seem so basic to all the 3rd and 4th year students out there (as well as any current physicians), but the way an actual interview unfolds is really interesting. And I use the word 'unfold' intentionally in this case; based on the way it all the information comes together in the end as the details of a patient and their problems are slowly revealed.

Imagine the basic outline of any patient interview which includes the basic information (name, age, marital status, occupation), chief complaint, family history, past medical history, physical exam, and vitals (including height, weight, etc). The skeleton of the interview is nice but there really isn't anything to sink your teeth into until you get into the follow-up questions and scrape for more information in the review of systems. This is mostly because any single sign or symptom can be used in describing many different diseases and syndromes (which is actually the definition of a syndrome). But the point is that, at least from what I've seen, is that there's always that key bit of information that suddenly explains many of the problems the patient is having.

At first you're in the dark, gathering as much as you can. Next, you pick up on very unusual bits of information -- usually that have a very distinct onset within the patient's recent history -- that slowly raise flags. But even with those flags, the complete picture still isn't made clear. You kind of know there's something more, but you can't exactly put your finger on it. Although it's with these flags that direct your questioning and examining. And if you know the information you've learned in class and if you've asked the right questions during the interview, when that key piece of information shows its face, the light bulb goes off.

It's at that time when you revert strictly into lecture and your studies and your flashcards and lists. And you just go down the line of clinical presentations associated with that particular pathology. And if you're right, most (all?) the answers that come out of the patient's mouth after asking these very directed questions are exactly the answers you're expecting to hear -- but only if you're suspicion is correct.

Organization of Latin American Students (OLAS)

2010-10-16T11:34:00.000-07:00

I'm not Latin American, but you don't have to be anything to participate in any of the activities from any of the student groups.

The Organization of Latin American Students (OLAS) was looking for volunteers for their health fair, I signed up, and the health fair was this morning:

The health fairs are actually really common events among different clubs. When people show up they are basically shuttled from station to station, with different tests performed at each:

Blood Pressure
Blood Glucose
BMI
Eye Exam
Breast Exam

I was on the Eye Exam station, which was probably one of the easier stations.

It's also important to remember that many (most?) of the Dominicans never have regular check ups of any kind at any health care facility. So the health fairs organized by the student groups always get random foot traffic by people curious so see how they're doing.

It's been 2 weeks since Mini 1 and I already feel like I'm lagging behind a little when it comes to study. But I did this because it's a 2nd semester requirement to attended one of these non-profit events (which involves a short paper and presentation). And I figure it's always important to get these official experiences on your Dean's Letter by the time you graduate.

In the end, there were only a couple things I would note:

It's interesting to see how tight lipped some people are.
It's interesting to see how much some people are willing to share.
For me, the most important thing I remembered to say after any of my questions or pieces of advice was to remind them that I wasn't a doctor and if they're really concerned about something, they should see their (real) doctor.

Anatomy of the Head and Neck

2010-10-15T18:22:00.000-07:00

I'm a little bummed out because I thought I did better. At this point, I suppose I shouldn't be surprised by this because it's been a constant theme of mine ever since 1st semester.

Jonathan's 2nd Semester Anatomy Practical #1 Score:

Anatomy Practical Score = 28/40 = 70%

I'm not going to complain too much right now, but I am going to calmly vent, just a little.

A 70% is still a 70% and all everyone really wants to do is pass. I'm sure there's at least a couple people who didn't. Right now I'm just really curious to see which questions I got wrong, but at Ross, they don't give back exams so I guess I'll never know. It's just that out of the 40 questions I was almost sure I didn't get more than 8 wrong. That would've given me an A, but I'll have to settle for a B.

Not bad, but not great.

I've come to the conclusion that if were in a scary movie for teens, I'd be the first to die. I keep happily opening my door when I hear strange scratching sounds, late at night.

2010-10-14T00:59:00.000-07:00

This time armed with a pair of scissors instead of a big ass kitchen knife, strange sounds go bump in the night once more. First, I turn off the lights and look for silhouette the shape of a human. Next, I use my camera to try and get a better angle through the bars on my window:

(You might have to turn the volume up to hear the constant scratching.)

Nothing.

Next, I stuff half of the scissors in my pocket and get the broom.

As always, only in Dominica.

(And no, this wasn't the first time something like this has ever happened.)

Anatomy Dissection Videos on Your iPod and iPhone

2010-10-13T21:52:00.000-07:00

I'm going to preemptively put myself on the spot and go ahead and say that I think I did pretty good in today's Anatomy Practical, covering head & neck.

Note that we didn't get the score back yet and also note that from Mini 1, anatomy was the single class I did well in, but walking out of the anatomy lab, this was probably the first time I felt like well on a practical. We should be getting the scores back either tomorrow or Friday. They're usually pretty good about getting practical scores back quickly.

(This is going to be a long winded post for something really simple, so bear with me.)

I writing now because I wanted to share one of the things I've been doing differently this semester for anatomy that I think helped a lot:

So if you remember the list of supplies I brought with me back to the island over this last, recent break, my iPod was one of those supplies. I've never owned an iPod. It's just one of those pieces of technology that I never bothered with for some reason. But out on the island with a somewhat weird schedule and lots of time to walk around I thought it would be useful.

I'm now subscribed to about 30 podcasts, mostly about TV shows, sports, and video games. I love things like director and producer commentaries for shows, I'm a huge baseball fan, and I grew up on video games. (I haven't really played a video game for more than an hour or two at a time in the past 5-6 years, but I still keep up with the scene for some reason. It's endlessly entertaining for me.)

Anyway;

At Ross, all students get access to a huge amounts of electronic resources on day 1. These resources include Power Points for all lectures, practice questions, and anything else any particular professor decides to upload to the server. The good professors put more information than you know what to do with. For anatomy lab, one of the resources we all have access to are dissection videos for all labs.

"I have an idea" said the struggling medical student, "why don't you put all those videos on your iPod and make use of all time time you're walking back-and-forth to campus, while you're on the bus, and when you're on the toilet.

(Yes, I said on the toilet.)

It's amazing how much time you waste... on the toilet.

The problem was that most of the videos were in a format that wasn't supported by Apple's iPod (mpeg-4.video files in 960x540 resolution). After a little searching I found something simple, easy, and free to downgrade all the videos into something usable:

Videora iPod Converter

There may be better ones out there. This was literally the first one I could find. It took me about an hour to convert all the anatomy files, but it worked. And then there are always other hand-me-down videos that other students pass around. Those got converted and put on my iPod too. I just wish Apple made iPod Nanos with more than 16MB of storage. Between the podcasts and anatomy videos I only have about 4-5MB of space left.

In short, if I could go back and start from day 1 of semester 1, I would:

Buy an iPod
Convert all the Dissection Videos to be more iPod friendly.
Upload them all ASAP.

Like I said, it's so simple, sometimes I wonder why it takes me so long to think straight. But I do think it helped me a lot this time around. I guess we'll find out how much if helped (if any at all) when the scores are finally released.

Okay, this is sounding scary. Neurology is actualy what I think I'm interested in. So my question is, Why's it so hard?

2010-10-06T10:11:00.000-07:00

Stranded writes in response to this and this:

Okay, this is sounding scary. Neurology is actualy what I think I'm interested in. So my question is, Why's it so hard? Looking at the Youtube video, I get the sense that the subject can be like trying to visualize a subway system, including the various destinations of all the passengers at different times of day. Is it hard just because of the intricacy and all the terminology?

Hi Stranded,

Well again, I have to point out that the class average was 77. (And the averages for all the exams seem to be around the 70's.) So if you look at it that way it's not impossibly hard, it's just who really sucks.

For the practical itself, I'm not sure how other schools work, but this was the first test that we actually had to write in the answers instead of it being multiple choice. (I've actually heard of both styles from other tests, like anatomy practicals, etc.)

And as with almost everything else in med school, it's not really the material that's your biggest threat, it's the fact that you just don't have enough time to study. I'm sure there are other people out here to did just as bad (if not worse) than I did and I'm equally sure that every single one of us could have gotten A's or B's if we had unlimited time for study.

The kegs to get good grades in medical school (regardless of subject):

Self-Motivation
Routine
Time Management

Then again, if that's all it takes and I just said it out loud, that speaks volumes about me. That means these really aren't the keys to success and I stand as living proof or... it means that I haven't been sticking to one or more of those 3 simple tips and am slowly self-destructing as I speak.

Hm...

(The truth is that the tips above are the same tips I kept hearing when I was asking questions of everyone and anyone I could get my hands on. These are also the same tips that I'm pretty sure I have been sticking to since I arrived at Ross. I'm now under the impression that the "keys to success" in med school aren't nearly as simple as everyone always made it out to be. I think I scratched the surface in one of my old posts, but I don't think I ever found the solution to the problem.)

Axiom Neuro - 3D Neuroanatomy and Neurology

2010-10-05T17:41:00.000-07:00

After a little thinking, I've decided to post my Mini 1 grades -- just not yet. Give me a couple days so I can let it settle in and marinate. Except for the B in Anatomy, it's probably the worst exam I've ever taken since I arrived here at Ross. For now, let's just look at my terrible Neuro Practical score:

Jonathan's Neuroscience Practical #1 Score:

Neuroscience = 29/50 = 58%
(Yes, my Neuro score for Mini 1 is worse.)

The class average was 77%, the class highs were 98%'s, and as of right now, I'm way below the curve.

But enough of that -- I'll have plenty of time to sulk over that later -- for now, we focus on today. And today we had 8 hours of lecture and 4 of those hours were on Neuro. And in one of the lectures the professor played this video:

I thought it was amazing. I also though of how useful it would have been if I had access to it earlier to learn the Corticospinal Tract for Mini 1. (Gee, thanks.) It wasn't played by the same professor who originally lectured about the Corticospinal Tract, but still.

Reviewing the lectures, I followed the link to YouTube and played it again, hunting for more videos. It turns out that this video was just one of many demo videos for a program called Axiom Neuro by Brainwashed Software.

It also turns out that it isn't just a series of videos, but an interactive program that details cranial nerves, tracts, and clinical presentations through a "virtual patient." And of course, it isn't free and costs $60.

I bought it. I'm desperate.

I've been playing around with it for about 30 minutes and I'm liking it so far. It's one of those things I wish I had at the beginning of the semester. I hope it's going to help me for Mini 2 & 3, I think it's going to help on the final, and I'm betting this this is going to be amazing to use to study for the Step.

I think it's great but you can decide if it's sixty-dollars-great for yourself.

(I figure that saving $60 does me no good if I don't graduate.)

***Note: I know what you're thinking, but when you buy it they send you a key code via email. And the programs requires a you to input the key to load it up. They also state that they monitor if any key is being used on more than one computer at a time.

...And besides, I just want to learn Neuro.

Wow, that was horrible.

2010-10-04T14:00:00.000-07:00

The mini was this morning and the raw scores are already out. I knew it was going to be rough, but this is one of the worst mini's I've ever taken. Let's just say my highest score was 74% for Anatomy and... I'm almost too embarrassed to say the rest. (I might reveal the actual scores when the official scores come out in a day or two and I might not.)

If you recall from last semester, I was struggling to break 60% on the minis for anatomy the entire time. This time I got that 70%+ that I always want from every subject. But the thing is, I don't think it's because I knew the material any better or worse than the other times. I think the questions were just that much easier...

--Which brings me to my complaint about the entire test in general: The difficulty of questioning from subject to subject was all over the place. It kind of feels like you're at the mercy of the question makers.

Either way, there's nothing I can do about it now. The good news is that was only the first mini and there's a lot of the semester to go. I tried a lot of things this time and I can only really point to 2 of those things that really worked while the rest kinda-sorta worked, but I'm going to have to adjust it a little. I'll talk about this more when the official scores are released.

One last thing: Neuroscience is going to be a problem.

We haven't gotten back the score from the Practical yet, but judging from the neuro section on the mini, it's not going to be pretty. Out of all the classes, I think this one is going to come down to the bitter end.

Taking the Day Off

2010-10-01T13:30:00.000-07:00

I just have one question for you:

If there is a lesion on the spinothalamic tract at the level of the caudal medulla in a patient who has already been initially diagnosed with Brown-Sequard Syndrome by a brand new neuro resident on his first set of rounds that evening, how sleepy are you?

(Think about it.)

* * *

The 1st Neuroscience Practical was this morning and... it was a lot harder than the Mock Practical hosted by the Neuroscience Society that was held Wednesday night. I don't think it would a stretch to say that it was twice as hard.

The Practical was 50 questions total and it wasn't multiple choice, unlike every other exam. I left 3 answers blank so that's 6% gone right there. There were probably a couple that I guessed on, so that's a few more points down the toilet. And if you figure in the fact that I'm not perfect (which has been well documented on this blog), at best I'm hoping for a 70%-ish. But you never know, it could be a disaster.

Mini 1 is on Monday.

I intentionally left all my notes and flashcards in my locker on campus and I'm taking the day off. I'll probably watch a couple dissection videos and review a couple power points, but that's it.

The plan is the rest today, start early tomorrow, do it again on Sunday, and take the test on Monday. After that, it doesn't stop. There's a full 8 hours of lecture on Tuesday, ready to build up for Mini 2, 4 weeks from now.

I think I'll watch Dexter, Stargate Universe, and House. I don't watch Scrubs or Gray's Anatomy, but House is awesome. I'm going to buy some groceries, clean my apartment, and pay my rent. Finally, I'm to watch the Giants destroy the Padres tonight.

And maybe -- just maybe -- I'll get more than 4 or 5 hours of sleep tonight.

(Buster Posey for Rookie of the Year.)

(Go Giants.)

Are there a lot of beggars in Dominica or is it just a few people who consistently ask for money?

2010-09-30T16:43:00.000-07:00

William Kennedy writes in response to this and this:

Are there a lot of beggars in Dominica or is it just a few people who consistently ask for money?

It depends what you mean by "a lot."

In general there are just a few people that constantly ask for money. Just to put it in perspective; in the 9 months I've been on the island I've been asked for money from roughly 6-8 different people. This is including Bob, who begged me for money roughly twice a week, every week last semester. The man is persistent. (He's a pro.)

And why am I bringing up Bob again?

Because he struck again today, of course.

These past few weeks leading up to the mini I've been spending more and more time on campus. Almost every day these days I walk to campus in the morning and take the shuttle home late at night/early the next morning. I bring this up because most of the time Bob strikes in the afternoons or around dusk.

In summary: Lately, the only times I've ever been at my apartment have been the hours I've been sleeping. This means the time that I've spent walking back and forth to my apartment has been cut in half. And in the time that I'm out of my apartment, the majority of that time is almost exclusively on campus.

...And yet Bob always finds a way.

So it's like this;

Me and the rest of the entire 2nd semester is going to be studying all night long for tomorrow's first Neuroscience Practical exam. I'm hungry, the sun is setting, and the last of the food shacks are going to close soon. The Shacks are located in and around the main side-entrance to campus. It's basically an extension of the campus, but it's outside of the gate, so it's a public area. I go to buy some pizza, but I only have a $50 on me. Many times the people at the Shacks hate getting large bills because it's a hassle to get more change if they run out. I get my 2 slices of pizza for $7 each and wait for my change.

"Bro."

"Hey, bro."

("You've got to be kidding me...")

Bob's back.

Long story short; I have 2 slices of pizza in one hand, he just saw me stuff a 20 dollar bill, a 10 dollar bill, and a 5 dollar bill in my pocket, and he's asking for money to buy some food. I give him the single dollar in my other hand, watch the look of disappointment on his face as he was hoping to get more and I just turn and leave.

I know what you're thinking: Didn't you say that you weren't going to give him a dime this semester? That would've been the case, but the conversation went something like this:

"I've already given you a lot." I say out loud what we both know is true.

"I know, man. I know. But this is the last time. I promise." He says.

"The last time?" I prod him again and fish for him to repeat what he just said.

"The last time." He affirms.

Those were the magic words for me because what happens next now becomes very simple:

Plan A: Throw the phrase, "This is the last time" back in his face the next time he asks me for anything.
And if that fails...
Plan B: Swear the shit out of him and see what he does next.

And why do I keep talking about Bob? Because I want you to understand my frustration. There's too much on the line here for me that will literally effect the rest of my life and there is so much more here to worry about than to have to think about habitual beggars, begging me for money I don't have. I talk about it now because it's relevant to what it's like to be out here studying at Ross. All Bob see's are the tens-of-thousands of East Caribbean Dollars each of the students has on them or in their bank accounts. The irony of it all is the fact that whenever I've said, "I don't have anything" to him in the past, I wasn't lying. Every cent I have on me and every dollar to my name is borrowed from the U.S. government. I have nothing to my name and here this guy comes along asking and begging and pleading for me for money that isn't mine. If you think about it, he has more money than I do.

And the saddest thing about it is that when he finally fucks off, he's just going to continue on with all of the other students he's been begging and then continue on to beg future students as they rotate through the island.

(To be continued, I'm sure...)

Why are you $125,000 in debt after only 3 semesters?

2010-09-28T06:21:00.000-07:00

Paul writes:

Why are you $125,000 in debt after only 3 semesters? I assume some of that is undergrad right? How much in loans is required to fully finance Ross U. per semester (including rent, food, etc)?

Hi Paul,

You're right, it's ballooned to $125,000 because of my existing debt from undergrad.

When first starting at Ross I don't think anyone really knows how much to borrow. Most people apply for the full recommended amount, according to the Ross default recommendations. That recommendation turns out to be roughly $25,000 per semester.

Tuition per semester is roughly $15,000.
Round trip plane tickets vary, depending where you're coming from. It turns out to be $1,300 for me, from San Francisco.
My rent is $650/mo ($2,600 per semester). I use air conditioning all the time and I spend about $250 on electricity. I think I really don't spend as much as a lot of other students when it comes to creature comforts and food.
At the end of each of my 2 previous semester I had about $5,000 left over. So that means I've only been spending $1000 on food for 4 months. (Remember that the exchange rate is 1 US Dollar for 2.67 East Caribbean Dollars.)

After my first 2 semester I had $10,000 left over from loans, but I went ahead and borrowed the full $25,000 again, this 3rd semester. I'd rather have more than less.

I'm also keeping in mind that on my next break I'm going to have to buy a full set of professional dress clothes, which I'm going to pay for in full from my loan money.

If I keep building up my leftover cash, I'm going to start borrowing less and less.

Weekend Confirmed

2010-09-26T18:40:00.000-07:00

The Long Version:

It's Sunday night, the first Neuroscience Practical is in 5 days (on Friday) and Mini 1 of 2nd semester is in 8 days (next Monday).

I've talked about some of the things I've been doing this semester that I wasn't doing last semester, but I've adopted something else recently.

My normal, self-imposed schedule keeps me on campus from 7:00am to 5:30pm. There's some breaks in between, like for lunch or anything else I need to get done, but for the most part, my butt's in the chair. When I get home I usually try to get at least 1 or 2 other things done before I go to sleep.

This past weekend I've been on campus from 7:00am-11:00pm on Friday, 7:30am-1:00am on Saturday, and 7:30am-5:30pm today on Sunday, and I think I'm going to continue doing this from now on. Right now it's Sunday night. I'm trying to do as little as possible and I'm going to sleep early just so I can do it all again starting on Monday, getting ready for the first set of exams.

It's kind of nice in and around campus on the weekends because there are a lot fewer people there. The study areas are quieter and the lines for the vendors (the ones that are open) are all short. Plus, there's always at least a couple people not doing anything (or studying all day) and are free to do dinner (or whatever else).

(I'm probably going not going to stick to this weekend schedule on the first weekend after each Mini. There just isn't as much to study after only 1 week of lectures and plus... sometimes you need a break.)

The Short Version:

Padres lose, Giants win, Braves lose, Dexter season 5 premiere is tonight, and I just studied for 44 hours in the past 3 days. It's not so bad, yeah? Oh yeah, and I'm $125,000 in debt. That too.

If you didn't know this about me before, MLB.tv keeps me sane at night. A 1 year subscription for $100 is the best $100 I've spent here on the island. Surprisingly, I actually do have interests other than medicine.

Note: I have many thoughts as to why it takes me so long to study, but I really don't want to say any of it out loud until the first Mini is over. Many other students (including all of the other people who are in the classrooms with me on the weekends) probably study as many hours as I do. But there are many other students who study much, much less and are already in 3rd and 4th semester. But only when they send out the official scores for Mini 1 will I know if what I'm doing is actually working or not. It will do little good to self-analyze right now.

The Beggars of Dominica are Back

2010-09-24T07:40:00.000-07:00

I should probably say that I'm back and the beggars never left.

I was wondering how long it would take before he showed his face again. I try to keep this blog semi-professional. Sometimes I post official updates about my academic status, sometimes it begins to sound a lot more like a "dear diary", other times I may get a little more philosophical (based on wild, baseless assumptions), and yet other times I can be as negative as I want to be. It's my blog after all.

It took exactly 17 days since I landed back on Dominica for the beggars to start showing their faces again. Actually, it was probably more like 2 weeks before I saw one of them begging a female student who was walking in the opposite direction (to campus) as I was walking home. It was 17 days until the same guy started interrupting my daily routine. You know and love him as Bob, from my previous post, at the end of last semester.

If you look busy, if you have headphones on, if you're sweating and just want to get to your destination so you can cool off, it doesn't matter. Bob will hunt you down, get right in your path, and begin with the "hey bro" and "welcome back bro" and "can you help me out bro" and "I just want to buy some chicken and I'm 1 dollar short."

Three days ago I just brushed him off, but this time he came up with a new trick:

You probably don't know the general layout of the campus of Ross University, but one of the main entrances has a bunch of food vendors called "The Shacks." Occasionally you can see Bob hanging out here, probably either asking for more money or maybe spending some of his hard earned money (that he got from even more students).

So yesterday I spot Bob as I'm walking off campus, back to my apartment. It's a walk that takes roughly 12-15 minutes. He spots me to, but it's a busy place, I just keep walking. Good, right?

12-15 minutes later, when I'm about to turn off the main road, with my apartment 3 houses away, there he is again!

(Magic?)

Or maybe... he spotted me at the Shacks (and figured I didn't see him), hitched a ride with someone he knew, and waited for me to come to him while thinking up some bullshit story of why he needs more money once again.

"Hey bro."

(I take off one of my headphones.)

"blah blah blah, I just need a dollar or two."

"No, sorry."

"You don't have any money?"

"Nope."

(I put my head phones on again and keep walking. I think he keeps talking, but I don't really care.)

I'm obviously lying to his face and he knows it. But I'm sure he has other students that he regularly bugs for other sources of income. He's not going to get a dime off me this semester. I wonder what other tricks he has up his sleeve?

Dominica might be a beautiful place, but Bob always seems to bring the surroundings back down to Earth.

(To be continued...)

Studying Clinical Biochemistry

2010-09-19T07:59:00.000-07:00

Here are a couple biochemistry books that I bought last semester that I'm finally putting to use and finding really helpful this semester:

I've already mentioned BRS Biochemistry a couple times on this blog, but here are a couple more books. And I really haven't cracked my BRS open this semester and I don't plan on doing so until the weekend before Mini 1 when I'm reviewing all the material. In its place, the books that I've been using so far have been Principles of Medical Biochemistry and Biochemistry and Genetics: Pretest Self-Assessment and Review.

Principles of Medical Biochemistry - For me biochemistry as always been a dense subject. This book is even more dense, but it gets to the point and really makes clear the concepts that are covered in lecture. DO NOT pre-read the book the night before lecture. I've found the most use out of it when I go back over the different pathways and mechanisms the night after class. (It also helps with the fact that the author of the book, Dr. Meisenberg, is the Department Chair of Biochemistry here at Ross. When he doesn't give a particular lecture, one of the the other biochemistry faculty is referencing the book.)
Biochemistry and Genetics: Pretest Self-Assessment and Review - Another source for MCQs; not much else to say. Wherever you go for your question banks, a lot of the times some of the material is beyond the scope of what you're covering in a particular class. In this book, I'd say that maybe a little over 50% of the questions in here are relevant to the biochemistry material taught here at Ross. The questions that aren't relevant sometimes reference other, lesser uses of the body for a particular vitamin, for example. (Some of that material may have to be learned on my own when studying for Step 1, but for now it those questions do me no good.)

If I used these books more often last semester maybe I wouldn't have struggled so much with the material. That's what I'm hoping will make the difference this time, anyway.

I always talk about making adjustments and "breaking the pattern" when something isn't working. When something isn't working, I figure you either need to put twice as much effort in what you're currently doing (to get over the hump) and try a different approach (if there is no hump and you're just doing it wrong).

I was definitely doing it wrong last semester and this is my adjustment this time for round 2.

"As someone thinking about going to medical school, any insight into the daily routines is welcome."

2010-09-15T19:29:00.000-07:00

Stranded writes:

As someone thinking about going to medical school, any insight into the daily routines is welcome. I don't know how you find time to blog, with all the other stuff you have to do. And is that a Bible on top of that stack of books?

"As someone thinking about going to medical school, any insight into the daily routines is welcome."

I've posted my daily schedule here a couple of times in the past, but I haven't done it this semester, so I guess it won't be too redundant to do it again:

6:00am - Wake up. (w/ alarm clock)
7:00am - Get to campus.
8:00am - Lecture Begins
12:00noon - Lunch
1:00pm - Either Lecture (Again) or Anatomy Lab
3:00 or 4:00 or 5:00 - Lecture / Lab Ends
6:00pm - Home. Relax. Cook. Eat. Shower.
8:00pm - Attempt to Preview the next day's lectures / Make Flash Cards / Watch Anatomy Dissection Videos
11:00pm - Sleep.

-When I get to class at 7:00 I'm usually printing out slides.
-Sometimes I get lazy. I'm not a robot.
-If I stick to the above schedule I feel great at the end of the day and I feel like I'm on top of things. If I don't, it's time for Heinekens and Red Bulls the next day.
-In other words, when I wake up in the morning, this schedule is the goal. I actively think about accomplishing this when I wake up.
-Sometimes there are random other things to do, like simulation labs, PBL, etc.

"I don't know how you find time to blog, with all the other stuff you have to do."

I blog (and I've stuck with it for over 3 years now) for 2 reasons:

This is one of the things I do when I don't feel like thinking. This is kind of break time for me.
I enjoy writing. It's one of those things that I've always done.

"And is that a Bible on top of that stack of books?"

It's funny that you say that because it might as well be. It's the same medical dictionary that I've been keeping with me since last semester. And yes, I've been keeping us with that same Dictionary Trick this semester. (Except this semester I'm using a different highlighter color and it's interesting to see all of the words that I don't know that I should know. And also, I think it works. I can usually look at any of the words and put them into context of where it was introduced in my medical education first.)

Hope that helps.

Red Bull, Heineken, and Ross University

2010-09-09T18:30:00.000-07:00

The first week of 2nd is over and now we get a 3 day weekend.

1st semester vs. 2nd semester, you ask?

Think about it this way: Last semester we basically had lecture from 8:00am-12:00 everyday, Anatomy lab from 1:00/2:00pm - 5:00pm on Tuesdays and Thursdays, and PBL from 3:00pm - 5:00pm on Fridays. There were always exceptions for extra lectures in the afternoons and maybe every once in a while we'd start morning lecture at 9:00am, but that was the basic schedule for 1st semester.

This semester is basically the same, but instead of 4 hours of lecture on non-lab days, we have either 6, 7, or 8 hours. I was looking at the schedule and a lot of days, lecture runs from 8:00am - 12:00 and begins again from 1:00pm - 5:00pm. And remember, every extra hour of lecture for the week is really 2+ hours of the week lost. You lose 1 hour for that lecture and 1+ additional hours studying for that extra hour.

After 4 days, I feel pretty good. It's still easy to wake up and paying attention in class isn't a problem. But that'll change at around week 8-10. That's when it'll be a struggle to get up and it's when I'll start downing Red Bulls during the day and Heinekens at night just to stay sane. So far it's just been Diet Coke and water.

That's all of my non-electronic 1st semester material. It felt like a lot more. And I can't lie, while I kind of have a handle of this semester's material (?), because of how poorly I ended last semester, the looming comprehensive finals at the end of this semester has me a little nervous. Sure, I start off this semester with a clean slate, but when week 15 rolls around, this time it's going to be a true "finals week" instead of just a "finals day." It's going to be exam after exam after exam on all of 1st and 2nd semesters of anatomy, biochemistry, histology, and physiology (in addition to neuroscience).

You can kind of tell from this pic, but I tried to stay organized. "Staying organized" from day 1 of semester 1 was a piece of advice I got from upperclassman. And the big reason for it is the 2nd semester comprehensive finals.

And finally for no apparent reason, except to wipe my hands of 1st semester once and for all, here's a short video (21 sec) of my bus out of Dominica. This was when I still thought I wasn't coming back:

Moral of Today's Story: When/If I ever graduate, I need a T-shirt that says, "Red Bull and Heineken got me through medical school."

Pulled a brain out of a cadaver today. Don't ask me about Ross University pass rates.

2010-09-06T20:39:00.000-07:00

1st day of 2nd and we're yanking brains out of cadavers. Feels like ages since I've had new material.

I just want to throw some numbers out there just to prove to you all how much you shouldn't listen to every word that comes out of my mouth.

I've said that out of the ~500 January 2010 1st semester students, ~200 students either failed out or chose not to come back. This is kind of the ratio that I've been working with when it comes to pass rates. And now from what I've heard, out of the ~270 May 2010 1st semester students, only ~30 students either failed out or chose not to come back.

And when you add on the people repeating 2nd semester and compare classes sizes (judging from the Anatomy Lab table assignments document), the current 2nd semester class (283) is bigger than the current 1st semester class (274).

Of course it all doesn't really matter.

But a lot of people like the numbers.

I like numbers sometimes, but there's too much work to be done to focus on things that don't matter. You pass/fail individually after all.

I miss airport food already.

2010-09-04T14:38:00.000-07:00

Here we go again.

I just touched back down on the island, getting ready for 2nd semester, starting on Monday.

Step 1: Throw out all old food.
Step 2: Clean Sink
Step 3: Buy Groceries
Step 4: Pre-read lecture notes for Monday.

(Yes, there are maggots and at least 1 cockroach. I'm betting he has friends.)

It's pretty simple: Start strong and don't get left behind. Judging from how poorly I closed out last semester, I can't count on the MS1 comprehensive finals at the end of the semester to boost my grades up. I figure if I'm not ahead after Mini 3, I'm dead. I don't think I can dodge another bullet.

Also, keep in mind that at Ross you're only allowed to repeat 2 semesters and they can't be the same semester. I've already used up one of my get-out-of-jail-free cards so I'm already walking a thin line.

I took a peak at the 1st week of the 2nd semester schedule and there's a ton of Neuroscience.

Here we go.

Full Tuition Waiver for January 2011?

2010-09-01T23:25:00.000-07:00

I got the strangest email from Ross on Tuesday. I wrote out a long-winded "dear diary" about it, but I deleted it all instead. I'll just give the short and sweet version:

Ross University offer "a select few students" the option of voluntarily skipping September 2010 semester. They would then return and continue their studies in January 2011.
All students who choose to do this would have their entire January 2011 tuition fee of $15,000+ completely waived.
They are doing this to even out the infrastructure versus student population ratio.
Also note that as of September 2010, the entire Ross University curriculum is being altered into a "Systems Based" curriculum. I'm assuming this is one of the main reasons why they have to now shuffle students around. (In effect, if you skip the 2nd semester September 2010 class, you'll be resuming your studies in January 2010, now in-sync with the Systems Based class.)
This offer was emailed to me Tuesday morning and had a deadline of Wednesday 12:00noon PST.
They were basically handing me $15,000+, if only I would say 'yes.'
I thought about it, let the deadline pass, and politely said 'no thanks.'
I'm sure many students took them up on their offer.

It's so tempting, but I couldn't do it. I don't talk about this too much, but I'm already in unbelievable amounts of debt as it is. Like I said in some of my posts in early January 2010, I've passed "the point of no return" long, long ago. In some ways I feel like if I lose any momentum I'm never going to make it. It's also hard to imagine that it was almost 2 years ago where I received my acceptance email from Ross and after delay after delay (after repeated semester), I'm still only going to be in my 2nd semester when that 2 year anniversary rolls around. And as much as Ross emphasized how much they "do no anticipate student difficulty in transitioning" into the new curriculum, you know there are going to be problems.

I say this not implying incompetence; but they're about to overhaul an entire medical school program, in addition to you being shuttled from one curriculum to another. We call the September 2010 incoming class the "guinea pig class." And I don't envy them one bit. (And then watch as their program works beautifully and 100% of their class passes and becomes excellent doctors because of the new system, leaving us all in the dust. Just saying.)

At this point, I feel like I actually have a handle on the pre-clinical years as a whole, from a macro point of view. There are hand-me-down notes that have been passed down for years and years and some people credit them for passing their classes, passing the Step, and graduating.

Maybe I'm a fool for turning it down.

2nd Semester Books & Supplies

2010-08-31T17:35:00.000-07:00

After asking around a little, here are the only extra books I'm bringing with me back to the island:

Remember, 2nd semester is basically 1st semester all over again, but with an additional class (Neuroanatomy). So I don't really need too many more books. Some people swore by these books so I got them all. I guess this means I could have bought BRS Physiology for 1st semester but... I don't think I would've read it.

Other supplies:

I've never owned an iPod before and there are bunch of audio files that I found that I'll be listening to constantly.
I like studying in the classrooms (instead of the home, the library, or other designated study areas). The noise usually isn't a problem for me, but I got some noise canceling headphones anyway.
I had a cheapy blood pressure cuff that I had since my community college days, but it was really terrible. Even though we don't really get into the diagnostic part of the program until 3rd and 4th semester, there are still a bunch of hands-on opportunities through a lot of the different clubs on campus.
There are all kinds of stories of people's laptops crapping out on them. I probably didn't need a terrabyte of hard drive, but I got it anyway.

I also bought more binders, high lighters, and about 1500 index cards.

My flight leaves on Friday and the first day of class is on Monday.

Holy shit. I passed.

2010-08-24T01:11:00.000-07:00

You know, I swear on this blog occasionally. Sometimes it's just how I talk, other times it's to emphasize a thought or emotion, and many times it's probably unnecessary. But in this case, I think the title of this post is appropriate. Holy shit. Let me walk you through what I've been going through in the past 3 weeks just so you really understand how close this was. I'll also finally post the Mini 3 scores that I was too embarrassed to share:

My 1st Semester Grades Excluding Mini 3 and the Final:

Cumulative Anatomy Grade = 63.50%
Cumulative Biochemistry Grade = 65.28%
Cumulative Histology Grade = 74.60%
Cumulative Physiology Grade = 81.71%
Cumulative DPS Grade = 71.62%

I was feeling pretty good this point. Not too bad and it was all manageable. But now let's take a look at what happened from there:

My 1st Semester Mini 3 Scores:

Anatomy = 47.37%
Biochemistry = 58.06%
Histology = 57.89%
Physiology = 52.50%
DPS = 73.47%

Like I said earlier, every single one of my cumulative grades dropped. Mini 3 also counted for 40% of the cumulative physiology grade. Physiology was supposed to be one of my "safe" subjects. And all of a sudden it went from an A to a C and was falling into that danger zone along with anatomy and biochemistry. Histology and DPS were the only two subjects that I was comfortable with going into the final.

My 1st Semester Grades Excluding the Final:

Cumulative Anatomy Grade = 60.48%
Cumulative Biochemistry Grade = 63.22%
Cumulative Histology Grade = 71.47%
Cumulative Physiology Grade = 66.13%
Cumulative DPS Grade = 73.47%

I wish I had kept the Minimum Passing Scores (MPS) from last semester, but I didn't. From memory all of the MPSs fell between 58 - 62, but I didn't know for sure. This would mean that I needed a 70% for anatomy and anything about a 63% for biochemistry. This semester I've never gotten either of those grades for those subjects on any Mini exam. (I did reasonably well on the anatomy practicals and my biochemistry grades on the 3 Minis were 62.22, 60.00, and 58.06, respectively. Anatomy felt out of reach and biochemistry was on a downward trend.)

My 1st Semester Final Scores:

Anatomy = 68%
Biochemistry = 48%
Histology = 48%
Physiology = 48%
DPS = 50%

My 1st Semester Cumulative Grades:

Cumulative Anatomy Grade = 62%
Cumulative Biochemistry Grade = 59%
Cumulative Histology Grade = 67%
Cumulative Physiology Grade = 62%
Cumulative DPS Grade = 68%

Terrible, yeah? But wait a second, let's take a look at the MPS for this semester:

1st Semester Minimum Passing Scores:

Anatomy = 61%
Biochemistry = 59%
Histology = 61%
Physiology = 61%
DPS = 61%

I passed. I barely (barely) passed, but I passed. If I got a single additional anatomy or biochemistry question wrong on any of the Minis or on the final, I would have failed. If the biochemistry MPS was 1% higher I would have failed. If I wasn't doing as well it either histology or physiology before Mini 3, I would have failed. If my PBL group wasn't awesome and if we didn't get a 99.5% for the semester -- translating into an additional 4.48% for each subject -- I would have failed.

There a couple things to note here. The first is that I passed. The second thing to note is that I'm a straight C student. Even histology and DPS dipped down into the C range. I know a lot of people ask me questions here on this blog, but put my advice into perspective. Until I can prove otherwise in any of the following semesters, I'm going to be a straight C student. Until I can prove otherwise, this is part of my identity and it's not pretty.

The third and most important thing to note is that this can't happen again. I started off strong and was doing reasonably well the entire semester and it all fell apart on Mini 3 and the Final. I just spent the last 17 hours traveling from my apartment on Dominica to my parent's house in California (taking 3 flights from Dominica to San Juan to Miami to San Francisco) and you can imagine I had a lot of time to think about what I was going to write about in my letter of appeal to the school to reconsider my dismissal. I was going to tell the truth. The truth is that I think I have what it takes and I know how to succeed at Ross, but in order to pass I need to keep up my study habits and discipline for the full 15 weeks of class instead of just the first 12.

I'll have more thoughts on what to do for 2nd semester later. For now I'll just take it as a sign that it wasn't a mistake that I was accepted into Ross in the first place and I'll reset and regroup for 2nd semester later.

This was way too close and I can't go through this every single semester or I'm going to lose my mind. I have to do much better next semester because from everything I've heard, 1st semester was the easy part.