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The Struggle

“Get my MD? Pshaww, that’s a piece of cake!” – said nobody. Ever. Why is it so difficult to get into Medical school? First let me explain the actual struggle, and then why it exists. Starting in High School you are expected to condition yourself to fit the standards of colleges. You are expected to excel in math and science, and take ALL of the APs. Like, even AP Nail Art. (Ok that might not exist, and was also a bit of an overstatement, but you have to take as many APs as you can to show that you are intelligent.) Regardless of the fact that doing well in school does not equal intelligence. What about school related activities? You should probably be super involved in around 5 clubs which need to be diverse, but you also need to join any and all clubs medicine-related. You have to show an interest in medicine, not just have one. Outside of High School you are expected to volunteer at a hospital or other medical related facility, and this all on top of some other volunteer work, because you need to show diversity. Don’t forget internships and shadowship (a word I have made up for the purposes of this article, meaning a shadowing of sorts) either! If you can intern at a biology lab then you can have both a new impressive college reference, and show you love science. Getting a shadowship is kind of hard and annoying. If you don’t have any familial/personal ties with a doctor its ten times worse than just hard and annoying. A favorite thing for doctors to do is say “Hi Ashley, I am sorry to say that we are unable to have you shadow the surgeons at this time. The Hippa rules are extremely harsh. Please feel free to contact us once you are in medical school. Good Luck to you and keep that enthusiasm!” That was a direct quote I have in my inbox. When I got it I cried because I was so frustrated. Grrrr. It still bothers me now. That response is total bull, because if that really was the case then there would be no shadowing in the medical field at all. What that response really means is, “I’m too lazy/don’t feel like having some snot nosed brat follow me around in my place of work.” Earlier I referenced a term used in two quotes that you may not be familiar with, “The Hippa rules.” This is referring to the Hippocratic rules. You may have heard of the Hippocratic oath, where a doctor swears to preserve and respect all human life (with the exception of abortions in the U.S.). The part of the Hippocratic rules that is the bane of my existence is Doctor-Patient confidentiality, but even that can be circumvented with the right waivers. In fact I am one of those lucky people with a family connection, and have a shadowship lined up with one of my Mom’s doctor friends. Why do you need shadowing experience, anyways? It’s because you need to prove that you can go out and make connections (thanks, Mom!) and are expected to have some knowledge of what it’s actually like to be a doctor.

I want to back up a step and talk about the decision to become a doctor. Last year was when I had my epiphany to be a doctor. As a kid I was told that you had to be intelligent to be a doctor, and as a kid I was not intelligent. I had written off the pursuit of an MD as way above me before I had even figured out what I wanted to do. I originally wanted to go into Psychology (which I can barely spell), because it was an opportune way to help people who really needed it. I thought about it and realized that it would wear me away to sit and hear about people suffering emotionally day in and day out. I knew I wouldn’t be happy if I had the knowledge of so many others who were suffering with only words to slowly assuage the pain, so I didn’t want to be a Psychologist. I wanted to be an Anthropologist. I may have been binge watching too much “Bones,” but it’s such a supercoolawesome job. (Yet another word I’ve thus invented). I loved the aspect of working with past artifacts and skeletons, and using biology, history, and some chemistry to place something in its time period. It’s a very interdisciplinary job. It also helped that social studies was, and still is my strongest subject. But soon after I realized that there isn’t much of a need for Anthropologists. Even more importantly there is no aspect of helping others in Anthropology. So I felt hopeless and listless for a while until someone said to me “Why don’t you become a doctor?” and I just said “Lulz because I’m too stupid for that.” Then I realized that I’m not too stupid, and that I really do want to be a doctor. The problem with this story is that if you want to be a doctor you are expected to know your aspiration as soon as you pop out of the womb. Another exaggeration maybe, but I’ve heard admissions officers say “We want the kids who knew they wanted to be a doctor their whole life, the kids that grew up playing doctor with their friend.” Jokes on you admissions officer because I never had any friends. What colleges are searching for is someone who is committed to becoming a doctor- they just judge it by time instead of passion. To be fair there really is no way to measure passion, but I also just flat out lie when important people ask me how long I’ve wanted to be a doctor. If I say a year nobody will take me seriously.

On to another difficult task to becoming a doctor, let’s talk about tests. Pretty much everyone takes an SAT/ACT, and one or two subject SATs. If you’re going into medicine you need to take three: Biology M (because nobody cares about ecology), Chemistry, and Math II (because nobody cares about Math I) and need to do well, it’s not just good enough to do them. This is on top of getting 4s and 5s on your APs.

To sum it up, you need to be fully committed to something that you might not even succeed in, while you are in High School. Then you go to college. You need to find a college that will challenge you, but will also allow you to breathe. Medical schools only want the best, so you have to go someplace where you will be the best, but it can’t be too easy. Oh, and by the way, all of those high school requirements? They’re just to get into Pre-Med. Pre-Med is this silly program for undergraduates that has a set of mandatory classes (and hopefully some advising) that is supposed to help you with your MCATs. The classes are mainly in the science and math fields, with English and history mixed in. Pre-Med is hard to get into, and it does not guarantee you get into Medical School. What it does guarantee is that you are going to spend four years of your life enrolled in a demanding course, and you will not get a degree at the end. Pre-Med does not give you anything at the end other than maybe a ballpoint pen that says you completed Pre-Med. If you don’t get into a medical school you will have wasted 4 years of your life and only have a set of skills useful had you gotten in to Medical School. So Pre-Med is kind of useless except for the fact that you may get a higher MCAT score for taking it. If you don’t know what an MCAT is… (I honestly don’t know how anyone wouldn’t know what the MCAT is but…) I’ll briefly explain it. The MCAT is the college version of the SAT. The Medical College version. The MCAT is a standardized test that assesses your critical thinking along with your knowledge of health-related sciences. Can you think on your feet like a doctor? Have you learned enough biology to understand this? Are you more informed than the other people taking this test? These are the questions that the MCAT answers. Just like SATs, your grade on the MCATs determines what level school, if any, you can get into. Unlike the SATs you will not find any medical school that does not require MCATs. Also the SAT is weighed in conjunction with your GPA while for Medical School it’s more like if you do poorly on the MCATs you will not get in, even if you have 100s in every class. On the flip side if you do exceptionally well of the MCATs any B-minuses may be forgiven. So basically the MCATs are the end all be all for getting into Medical School.

Now we move on to an actual medical school, where you finally learn to become a doctor. Hopefully you did well on the MCATs and have been accepted to multiple colleges. Chances are that you haven’t been accepted into multiple, because over the past decade applications to medical school have increased while actual spots in medical schools have not. In 2000 the acceptance rate to medical school was 49%, so you used to have a half and half chance to get into medical school. In 2011 the acceptance rate dropped to a little less than 43%, and it keeps dropping. It’s hard to become a doctor when there is physically no space for you. Why is there very little expansion of medical schooling? Well, if you go by John Green’s theory then it’s because of profit control. Doctors in the U.S. are paid twice the salary of doctors in Sweden. The country closest to U.S. is the UK that has an average salary for doctors between 35 and 40 thousand dollars less. It’s simple supply and demand. If you have fewer doctors then there is a greater need for them and a higher price to pay. Now whether you think this is the case or it is that medical schools will be less profitable if there is not such a high demand is your decision, but either way people are suffering because they cannot get the health care they need without the health care professionals. If you think you can get out of the American medical game by going to med school somewhere out of the Country, you’re wrong. If you want to practice medicine in America then you have to go to an American medical school. I have a friend from Egypt whose mother spent years of hard work becoming a doctor there. She can’t practice medicine here, and was told that if she wanted to she had to go through and American medical school. But let’s be optimistic: I want to beat the odds and get into multiple medical schools and I need to pick the most impressive school with good programs in the field I want that can also make me connections. Therefore I need to weed out colleges that won’t help me advance myself. The ultimate aspect is so that I can get a job easier. If you go into a practice coming from “Middle of Nowhere Medical School” then you are less likely to get a job than the other person being interviewed from “Well Known and Highly Renowned University.” If you complete Med School then you have to go to anywhere between 2 and 8 years of residency/special training. It’s like the shadowship except now you actually do stuff instead of just watching. If you only have a 2-year residency then you are now 28 and a Doctor. You can finally have your first job as a doctor, if you find one. I am going to have 7 years of specialty training, so by the time I can have the job I want in the medical field I am going to be 33. I will have given a decade and a half to my pursuit of becoming a doctor.

After becoming a Doctor I want to open up my own practice, because for once I want to be the one making decisions. For a decade and a half my future will count on the decisions of others. It’s harder for women to commit to being a doctor because you have to put off having children and starting a life for 8 years minimum. If I want kids then I will be 35 by the time it is appropriate for me to have them. It’s also difficult to be independent, because you will have 8 years of school debt hanging over you, but for me it’s worth it. I want to take my skills and help others. I want to travel to third world countries and bring help to those who would otherwise never have it. For me it’s less of a question of how dedicated I am, and more of a question of “when can I start?”