You Didn't Get into Medical School, Now What?

Nationally, only about 45% of medical school applicants get accepted to med school the first time they apply. This means that the majority of people who matriculate into medical schools have applied more than once. More and more applicants are applying after a "gap year." A gap year is the years(s) between college graduation and medical school matriculation.

We are frequently approached by people who want to go to medical school, but did not get in the first or second time around. Typical questions that we get asked are: should I just give up? Should I study study study for the MCAT and take it again? Should I get a Master's while trying to study for the MCAT? Should I do research while studying for the MCAT? Should I gain some life experience? Should I start working and make money? Should I take some more undergraduate courses to strengthen my GPA?

Well, there is no ONE right answer, but I do think that some answers are better than others. Here are some things to think about and to consider doing if you don't get into medical school the first time around.

1. Do you really want to be a doctor?

This may seem like a dumb question, but I promise you it's not. It's something you really need to give some serious thought. Don't just look deep within yourself for an answer, do your research. Ask the doctors you know about the joy and fulfillment they experience at work. Would they do it all over again if given the opportunity? What are some of the rewarding parts of their job? What are the not so rewarding parts? Shadow as many doctors in as many settings as you can. Really try to soak up what it's like to be an actual doctor and think about if that is compatible with what you want out of life. Yes, doctors make good money once they complete training, but typically they work 60 hours a week on average (varies widely from specialty to specialty) and at times have to be "on call." Are you about that life?

To find a doctor to shadow, start by asking your own doctor or any doctors that you or your family/friends know if you can shadow them. You can also ask professors or pre-med advisors if they know of any doctors that have had students shadow them in the past. Additionally, you can contact the volunteer office at your local hospital to inquire about shadowing opportunities.

I shadowed my pediatrician in high school and my younger siblings' pediatrician when I was in college. I saw the Mercedes Benz my preceptor was driving, I heard about the fancy parties he and his wife attended on South Beach with people like Nelly, but I also saw the amount of paperwork he completed and the large number of patients he saw each day. Ultimately, it was the difference he made in the lives of the children he cared for both medically and socially that had the largest impact on me. This opportunity also gave me one more experience to write about on my ERAS application and speak about during my applicant interview.

*Hint: Be weary of people who give you extreme answers. Try to take advice from people who live balanced lives and give balanced answers - people who tell you the good and the bad. 

2. Why didn't you get into medical school?

You have to be honest with yourself in order to answer this question and succeed the next time around. Did you apply to enough programs? Did you make the right grades? Do you have the extra-curricular activities and life experience medical schools are looking for? Did you interview well? Did you score high enough on the MCAT? These are just some of the things to consider. I can tell you that even if you are deficient in any one of these areas there IS STILL HOPE.

The MCAT can be a HUGE hurdle for many applicants. Consider a prep course like the Princeton Review, get into a study group and start studying early and often. If you don't have $$ for the prep course consider applying to summer programs that offer it for free through certain medical schools. I attended a free Princeton Review Course at my alma mater, University of Miami. Click here for more information.

3. What do I do now?

• You can always apply to more programs. If you need financial assistance to apply to more programs or to pay for the MCAT click here.
• You may have to go outside of your comfort zone to other parts of the country, but it is well worth it. Being raised in Florida, I was in complete denial about moving to Ohio for med school. In fact, I was partying in Miami without a care in the world 2 days before flying out to attend medical school in Ohio. However, leaving my comfort zone at that time was the best decision I could have made. I grew up. I was away from distraction so I could study, I went to a reputable school that future employers will recognize, I got closer to God, I traveled to different countries for medical missions and I made long lasting relationships. Weathering the cold winters was well worth it. Again, don't be afraid to get out of your comfort zone.
• Also consider D.O. programs if you have not in the past.
• Some people apply to U.S. Caribbean medical schools and end up doing very well in their careers. From what we have heard and seen, the upside to going to a Caribbean medical school is that you get to go to school in a tropical climate and they typically enroll year round. The downside is it can be very expensive and there is a stigma attached to them. Whether you decide to go to medical school in the states or in the Caribbean, make sure you know the board pass rates for the school. This will give you an idea about whether or not the students are being well prepared academically.
• I think the BEST option for someone who is looking to strengthen their application is to use the gap year by enrolling in a post-baccalaureate program with DIRECT LINKAGE into a medical school. Some of them are expensive and they don't guarantee acceptance into medical school- don't do those! Apply to programs that offer conditional acceptance upon successful completion of the program. The programs usually consist of science courses and MCAT prep. For more information on post-bac programs click here.

If you decide that being a doctor is for you, don't give up. Keep going and do whatever it takes. Don't waste time, it takes enough time to become a doctor already ;-). So do what is necessary now. Even if that means getting out of your comfort zone or spending a year in a post-bac program that will prepare you for med school. Trust me, the time will fly by and you'll be better for it.

This can be a sensitive topic. If you want to talk more about it. Leave a comment below or email us at ohemaasaj@gmail.com. We are always willing to answer your questions!

Love,
Ohemaa Mina

PS for info on how to survive pre-med refer to our post here.

Losing One of Us

 On January 20 Stephen Pasceri walked into Brigham and Women's Hospital in Boston, Massachusetts and shot and killed cardiac surgeon Dr. Michael Davidson before turning the gun on himself. Pasceri's mother was a former patient of Davidson's and passed away last November.  Marguerite Joly, sister to the gunman told the Boston Herald "I think it comes down to the fact that my brother thought it was the doctor's fault that my mother died." It is believed that Pasceri believed a drug therapy given to his mother by Davidson was the cause of her fatality.

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The untimely death of Dr. Davidson brings to light the growing concern of personal safety for medical providers. Attacks by patients are truly a physician nightmare and last week's event is just one of a string of attacks against physicians in the past few years. For example, in 1999 a psychiatrist at Massachusetts General Hospital was stabbed by a patient during a therapy session before the patient was shot dead by a security guard.

Why are physicians suffering in the hands of those we have dedicated our lives to serving? I believe it comes down to perception. Point blank, many in the public think we are God. (We are far from it!). If things go wrong or not as anticipated the assumption is the doctor made a mistake. However often times the person being treated is either very sick or has a condition not amenable to treatment. Unfortunately you cannot save everyone, in spite of your best efforts.  I like to think that God uses physicians to carry out His work here on Earth and ultimately what happens to patients is His decision.  Yes, there are times when malpractice is the cause of unnecessary fatality or increased morbidity, but I don't think that warrants the death of the person who made the mistake.


Working in a high crime area, I have always been nervous about being caught in the middle of the various shootings and incidents that occur outside the hospital.  Never would I have imagined that I now need to be concerned with what happens inside the building. Hospitals and medical centers are supposed to be places of healing, not causes for anxiety and fear for your life. So what do we do now? Do we increase security at hospitals and implement hospital wide metal detectors? Should we evoke the idea of physician right to bear arms in the work place? Or do we just stand and pray that we never encounter a patient or patient acquaintance who wants to take matters into their own hands? I honestly don't know what the answer is.I do believe education should be given to medical staff on how to deal with aggressive and potentially dangerous patients.

I do feel an open discussion needs to be had on changing the public perception of physicians and health care providers. There needs to also be a dialogue on how to extensively explain to patients and family members the extent of someones illness and realistic expectations. Understanding the depth of an illness may help people realize that sometimes no matter how hard a physician may work, the outcome may not be a positive one.

Despite the tragedy at Brigham and Women's Hospital and others in the past, I still believe in the purity of human nature. I'm thankful for the opportunity to help others and believe the majority of people are grateful for the work physicians do.   We at OhemaasMD send our condolences to Dr. Davidson's family and Brigham and Women's Hospital who lost a hard working surgeon, mentor and teacher. Interventional cardiologist Dr. Andrew Eisenhauer said "You should all be assured that Michael Davidson was one of the kindest and best physicians and men that ever walked on this earth,". May his legacy live on through his wife, children, and all the patients who benefited from his work.

Natural Cold Remedies

On our previous post we discussed the most common ingredients found in popular cold and cough medications.  For those interested in alternative methods here's a list of home remedies that may improve symptoms including sore throat, runny nose, nasal congestion, sneeze, and cough:

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GARLIC

• Garlic is an anti inflammatory agent which is also has antifungal, antibacterial, and antiviral properties. 

• Garlic can help lower blood pressure so caution should be taken by people taking medication to lower blood pressure

• Garlic cloves can be added to  food or chewed raw

•  Cloves can also be boiled in hot water and drank with honey

MENTHOL

• Menthol salves (ie Vicks VaporRub) can help with nasal congestion when placed under the nose or on the chest

• Soothing ointments like camphor and eucalyptus can aid in numbing the skin around the nose which may be raw and painful from constant rubbing with tissue

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HONEY

• Honey helps soothe an irritated sore throat and can be added to teas and hot fluids or taken raw

WATER and other CLEAR FLUIDS

• Water, lemon tea/water all help loosen nasal and throat congestion helping removal of mucus.

• Constantly drinking clear fluids (while avoiding alcohol, soda, and coffee) will also help with congestion and dehydration.

 SALT WATER

• Salt water gargles can temporarily relieve a sore throat

• Mix 1/4 to 1/2 teaspoon of iodide free salt with an 8 oz glass of water and gargle for 10 seconds before spitting out.

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GINGER

• A known expectorant and anti inflammatory, ginger is an excellent cure for the common cold
• Ginger can be added to teas, drank with boiled water, or chewed raw

MOIST AIR

• Cold viruses thrive in dry air, one of the reasons why they are more common in the winter

• Humidifiers, hot showers, and inhaled steam (by covering your face over a pot of boiling water) can all help with congestion 

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CHICKEN SOUP

• Everyone's favorite cold remedy, chicken soup contains anti inflammatory properties, with the clear broth helping to prevent dehydration.

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REST

• Resting will allow your body's immune system to fight off the infection rather than working on operating several body systems at the same time (muscular, neurological, endocrine,etc)

Why aren't Vitamin C and Zinc on the list?

• Several studies on Vitamin C have shown that contrary to popular belief, it is not effective in the prevention or reduction in severity of the common cold.

• Zinc was once thought to decrease the duration of a cold howeever research has shown that there may be no acte beenfit of taking zinc to improve symptoms of a cold
• The FDA recently released a warning against zinc containing nasal sprays due to cases of permanent loss of sense (anosmia) after use.

More remedies can be found at Mayo Clinic

What are some of your favorite remedies?

The Common Cold

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It's that time of the year again, the winter season has brought along what everyone dreads; the common cold.

"The cold", also known as a head or chest cold is most often caused by one of over 400 viruses, rhinovirus and adenovirus being the most common. Symptoms include low grade fever, cough, sneezing, nasal congestion, itchy/sore throat, and general fatigue and malaise. Transmission is through direct contact with air droplets containing a virus or objects (like door handles) with virus particles on them which you touch and invariable transmit to your mucus membranes (mouth, nose) by touching them.

Since the common cold is caused by a virus there is no "quick fix" such as an antibiotic which will cure the infection. Symptoms occur due to the immune response to the virus, more so than the virus' actual destruction of cells and tissues. The average course lasts about 7-10 days and can extend up to 21 days.

The #1 way to prevent getting a cold is to WASH YOUR HANDS. Washing hands after using the restroom or when hands are soiled, after contact with a sick person, and when coming home will decrease your chance of receiving and transmitting viruses. If soap and water are unavailable, hand sanitizer is your next best option.

There are now several over the counter medications which can aid the process of recovery. Discussed below are the most common ingredients found in several cough and cold medications in stores today:


DEXTROMETHORPHAN

 An antitussive (cough suppressant), dextromethorphan is the major ingredient in the majority of cough medications helping to lessen the severity of a cough. Drowsiness is a common side effect so caution should be used when taking this medication and handling automobiles or machinery.
Dur to its ability to create a hallucinogen/"high" effect when taken in large doses, many medications with dextromethorphan (especially cough syrups) now must be bought directly from the pharmacist and with ID.

GUAIFENESIN

An expectorant, guaifenesin thins and loosens mucus in respiratory passages likes the nose and throat.This allows you to cough out the mucus in an attempt to breath easier and also suppress cough.
The most common side effect is nausea and vomiting, especially when taken without food.

ACETAMINOPHEN

The active ingredient in Tylenol (also known as paracetamol), acetaminophen is primarily a fever reducer and pain reliever. 
Generally deemed a safe drug, speak with a physician prior to taking if you have liver disease or have had an allergic reaction to acetaminophen in the past.
In the setting of possible overdose, head to your nearest emergency department as soon as possible.

PHENYLEPHRINE 

Found in both cold medicines and nasal sprays phenylephrine is a nasal decongestant used to help make breathing easier.
Side effects include increase in blood pressure, headache, rebound worsening of symptoms, and feelings of excitation and restlessness.

DIPHENHYDRAMINE

A potent anti histamine, dipenhydramine is used to combat symptoms such as itchy, red eyes, sneezing, itchy/sore throat and a runny nose either from the common cold or allergies.
Diphenhydramine's most common side effect is drowsiness, and is commonly used off label for insomina (difficulty sleeping).

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Since the majority of cough and cold medications contain these 5 ingredients they may all potentially help decrease symptoms.  Viruses usually have to run their course before you will notice any improvement so do not be discouraged if you feel the medicine is "not working". Rest, drinking lots of fluids, and avoiding other sick individuals will help you get better in no time.

Cough and cold medication should not be given to children under the age of 4 unless directed by a physician. If you are pregnant speak with your Ob/GYN or primary care physician prior to taking any medication.

If you or someone you know may have overdosed on cough syrup, or any cold or flu mediation, call the Poison Help Line immediately at 1-800-222-1222 or go to your nearest emergency room.

If cold symptoms persist after 21 days with worsening cough, fever, and difficulty breathing you should be seen by a health care professional as colds can sometimes progress to pneumonia or bacterial sinusitis.

Stay tuned for the next post where we discuss natural remedies for the common cold!