Launching out !

Hi yall! I have been MIA, where do I begin, so much has happened? I took a solo five day road trip from NY to DC, afterwards Norfolk Virginia, and then Delaware. I saw the white house, the Martin Luther King, Jr. Memorial and above all else, I got the me time I needed.

The White House

MLKJ memorial

After that, I went to Jamaica, and I did an OBGYN Observership ( at a rural public hospital), in addition to that I attended the The American Congress of Obstetricians and Gynecologists conference (absolutely amazing-- learned so much and was inspired) bonded with family, ran three 5k's, one 2K and participated in a Boot-camp obstacle course. To say the least I have been busy. 

As you can see the drill sergeant wasn't letting up-- I needed help

I fell gracefully

oh was I happy to observe

ACOG certificate

right before my run

I just recently moved out of NY (now it’s just me in a new city all by myself). I was accepted and will be attending a well-known, program in which I will be taking medical graduate classes. However, they have a strict privacy and social media clause/rules. So I will share more, at the appropriate time.  Just know I am working on becoming a Physician.

This summer I will be running a MCAT Biology series overview. I will cover topics that I found particularly difficult when I studied and also review topic's friends of mine had difficulty with. Correspondingly, I will list study materials (books, videos, etc....) that I found above all useful and essential to me grasping the subjects.

Disclaimer: I am open to discussion, and In fact; I encourage it. I am in no way an expert, and so I am able to take criticism/feedback. I truly believe that the more we help each other; the more disadvantaged students, like me (those who possess the potential but for whatever reason are not able to show their academic abilities) will succeed. I believe that I became a better student when I learned how to self-diagnosis my own academic issues. I can relate, I talk the talk. 

So I hope many will join me and will find these post useful.

My Jamaican Observer-ship.

Disclaimer: For privacy and anonymity, the names and the location will remain unspecified. Please be mindful that I am a layperson, at the beginning of my journey. The terms, procedures and examinations are presented from my point of view. 

That's me to the far left!

The shift was 9:30am to 9:30am (24 hours— yes you read correctly). I was shadowing the senior OBGYN at a public hospital in rural Jamaica. The shift started on the Maternity ward and ended on the Maternity ward. However, I did not stay there. It was quite an unforgettable twenty-four hours, an adventure that led me to the Accident & Emergency (the emergency room), the genealogical ward and the operating theater (that also turns into a makeshift ICU when necessary). 

 The OBGYN I was shadowing started the shift by looking over the dockets (patient charts) on the maternity ward. Making note of those patients who were near delivery and/or were a high-risk pregnancy. Subsequently, the physician called those patients into an office to do an examination and write out a treatment plan. When the first patient came in, it became clear to me that the amenities, we Americans take for granted were not available to these patients. For instance, the patients in this rural public hospital were required to bring a towel (because there were no examination table paper rolls), their own hospital gown and a whole list of other things that a private hospital in Jamaica and/or the hospitals in the states would have readily provided. Nevertheless, despite scarce resources, the patients received applicable care. The physicians were extremely knowledgeable, caring and professional. 

During the ward rounds, the senior OBGYN explained the examination steps to me, why certain tests were needed and the recommended treatment plans. For instance, The physician examined the pregnant patient’s tummy to determining the baby’s position: applying slight pressure around the pelvic area to feel for the baby’s head, then each side in search of the baby’s back (a long hard mass); this was necessary for finding the fetal heartbeat. Next the physician attached two transducers one above the fetal heart and the other at the fundus (top of) the uterus to monitor the fetal heart rate and the activity of the uterine muscle. This information was recorded on a cardiotocograph (CTG). 

Later in the shift, I followed the physician into the delivery room. There I observed a woman experiencing contractions (screaming for relief—I am stunned at how miraculous the human body is and how resilient women have to be to give birth). The physician determined that the labor needed to be induced. So with a dilator stick/rod the physician broke the membrane; by rupturing the amniotic sac. This I was told will increase the intensity and frequency of contractions by the release of the hormone oxytocin. 

The charge nurse (which they call “Sister”) took over and was instructed by the physician to administer oxytocin and methergine, to further induce contraction and to minimize blood loss. I was so happy that I was allowed to stay in the room and observe the delivery. It didn’t take long before the nurse coached her to push. After a few pushes we saw the baby’s head (crowing point of delivery) and then there was this new life “bawling from here to mars” (crying very loudly). There was a part of me that wanted to cry for joy (I would never by the way—I know I must maintain professionalism all the way through) because of this little baby, so new to the world; It was nothing short of amazing. Following, another nurse cleaned the baby with virgin olive oil, weighed, measured and tested for sickle cell. 

Shortly after, the baby was given to another nurse, and the mother was instructed to push again so she could deliver the after-birth. Then the nurse made sure that both the placenta, and the membranes were complete. First by checking the umbilical cord (in search of 3 vessels at the cut end: two arteries and a vein). I was told by the nurses that if only one umbilical artery is present, the infant may have congenital abnormalities. Secondly, the umbilical cord is held up, so the membranes can hang down and be examined for completeness. This is to make sure that the entire placenta was expelled.  

After an hour or so passed, the senior OBGYN I was shadowing was called into the operating theater. The patient presented with right ruptured tubal pregnancy (ectopic pregnancy) and was hemorrhaging. This was an emergency. We quickly made our way to the operating changing quarters. I was told from the A&E physician intern that in a matter of hours, the patient’s hemoglobin went from 7.7 to 4 g/dL (hemoglobin levels below 11g/dL is determined anemic). 

Following we went to the scrub room were the circulating nurse assisted us with putting on the sterile protective equipment and then “scrubbed in." I was instructed that I could witness the surgery from a distance inside of the operating theater (oh boy was I excited). I watched as the senior OBGYN prepared the surgical site for the prevention of infection. Then before you know it the nurse was passing instruments, and the physician was making a midline abdominopelvic incision, and the surgery was underway. There was so much blood, I heard the anesthesiologist call for blood to replace the loss. The senior physician was calm and confident; just amazing. As the physician excised the ruptured fallopian tube, a large cyst was discovered. Another physician called the theater to check the blood loss; I heard the nurse anesthetist say the total loss was three liters. Before starting the shift I was hoping for excitement, and boy did I get it. 

Many hours after the cyst was ruptured, excised and sutured it was time to close up. I observed that the closure occurred in layers: first the peritoneum, then the deep fascia, followed by the muscle, then superficial fascia, then subcutaneous tissue ( after the physician used an instrument called a diathermy to produce localized heat which initiates coagulation) and lastly the Skin. 


To mince words I will conclude by saying the patient survived. Following the surgery, I was also able to witness another birth, and the A&E patient intake procedures. Overall it was an amazing experience that re-solidified my desire to be a doctor. 

I want to say , thank you to those who made this possible. You know who you are. God blessed me tremendously by introducing me to you.

News Update !

 

As my readers know I applied to medical school despite not having competitive stats, I decided to roll the dice and let the chips fall where they may. This was a gamble (a very expensive and time consuming gamble). Ideally, one should apply with their best foot forward. As late as it is, in the application cycle, I am still under review at three medical schools. Having been rejected by a great majority of the schools I applied to, I am not optimistic (but I do know - all I need is one yes) instead, I am realistic. If I don’t get in the front door (the traditional route) I'll get in the back door. 

I applied to several special master programs- as a way of casting my net wide and increasing my chances of medical school matriculation. Check out my post: Post bacc programs for underrepresented minorities for an exhaustive list. These graduate programs allow you to get a master's degree in a hard science and provide medical schools' admission committee with an insurance that you can stand the academic rigour. Furthermore, as a plan B some of these master programs allow you to take additional course-work to turn your science degree into a professional degree—one that will allow you to enter the work force competitively. 

Mean while back at the ranch (I have always wanted to use that statement-lol don't mind me) the national vice-chair of the Student National Medical Association (SNMA) publication committee reached out to me, to write an article that would be published in the April 2015 MAPS (Minority association of premedical students) minutes. (who'd have thunk it— my story is being used to help others). 

I agreed to write the article entry because this opportunity will allow me to help pre-meds through a different outlet and  it will  hopefully increase my blog reader-ship. Below I attached an excerpt of the article, that can be checked out at: http://jsnma.org/category/premed/ when it becomes available 

 "… Success, for some, a small few is a straight line. For most, success is an ever-changing squiggly line, which plateaus at its finale. For me, success is the latter. I am twenty-five and some might say, “If you didn't accomplish your dreams by now, then you should change them give up.” That thought is probably shared by many people who believe that it is a harsh reality. A concept rooted in, the miss understanding of the difference between practicality and cynicism. 

Cynicism is catching and crippling. It clouds your ability to see things as they are. Cynics (a.k.a haters and naysayers—Jamaican’s call bad mind people) rely on past’s disappointments; to guide future endeavors instead of using past’s failures as feedback. 

This is a  fine line between pragmatism and cynicism; the difference between an unattainable dream and a realistic goal. That is the ability to thoroughly self-reflect and progress…”   

It's no use crying over spilled milk

I have been reluctant to post; I wanted to have a fascinating story to share before I did. Oh how I wish I had a medical school acceptance to discuss at this point. A post that would allow you (my reader) to see the fruits of my labor (in a sense of course— fully aware that medical school is its own beast).  Instead, however, this post is about how I have moved past my rejections. By what method I have turned my sadness into an opportunity to grow and learn (better yet how I can fix the errors in my medical school application).

When I reflect on why I started this blog, I am reminded and encouraged to post despite my apprehensions. Sharing my story means also sharing those things that may not put me in the best light, those things that show me in my most human form. Obstacles and disappointments can be understood and related by all. If I only discuss my achievements, then I would be doing a disservice to my reader. I would be "painting" a story instead of telling my story. Let’s face it a good or better yet a great story is one that is not predictable. 

So here it goes: I have been rejected by a considerable majority of the medical schools I have applied to. I have also received a rejection from a post bacc program, one that gave me the sense I was a shoe in. Considering I was in constant communication with them, this gave me a false sense of security. That rejection had felt the worst of them all—I was at my lowest. That rejection dampened myself-esteem. However, I keep calm and carry on. This non trad is doing what she does best; brushing her shoulders off and wiping away her tears.

As the saying goes "there is no need to cry over spilt milk," after all that does not solve the problem and having to one day be a physician (where my job will be problem solving daily) I need to learn how to roll with the punches and solve the problems that life presents. So with self-reflection I decided to fix what I could about my application that being, my MCAT score. So this time I am keeping what worked last time and changing what didn't this time. 

 I have started studying with someone (unlike last time— I studied solo) I met on student doctor network (a forum devoted to all things' medical school related) that was in my area that had taken the MCAT before (like me) and was looking for a study partner. So far, she has been a blessing in more ways than one. I cannot stress this enough, being around like-minded people is essential for success. I have also started exercising, which has worked wonders for my stamina and mood (those little endorphins I tell you, pack a mean punch), Last but not least I have started getting back into cooking — because fast food is my biggest enemy.

Overall things are looking up, and I am not giving up anytime soon. Neither should you.

Growth Through Appreciation

As the end of the year approaches, I'm looking back on 2014 and I am counting my blessings. This has been such a transitional year for me. In 2014 I turned 25, I graduated from college, and I started a new job. With this being said, I have much to be thankful for. The holidays are a time of atonement (regardless of your religious views), a time of family, and a time of thanks giving.

I went to church last week and the lesson I learned was growth through appreciation, this has prompted this blog post. With out getting too metaphysical, I will explain the take home message. The pastor said that we should not only be appreciative of the opportunities, the goods and services provided, but also be appreciative of the obstacles and challenges. For they facilitate growth and understanding the most. Its the obstacles and challenges that mold a persons character.

2014 was also the year I started blogging about my premed journey. I started this blog to be educational and informative.... But it has turned into so much more. Accepted.com runs an interview series with med school applicants and they loved my blog so much  they wanted to feature it. You can check it out here: http://blog.accepted.com/2014/12/15/meet-toni-an-optimistic-realistic-pre-med-with-a-solid-plan-b/ This opportunity will allow my blog to have a broader reach.

In the beginning of the year I  started a self love journey. I got the idea from Andrea Lewis a fellow blogger (http://missandrealewis.com ).

We as humans tend to be so hard on ourselves, without looking at the silver linings (this is said from personal experience). I realize that I needed to work on counting my blessings and treating myself better and that's how  this self love journey began. It entails taking some time once a month (on avg) to list my blessings. (I provided some below)

I am healthy - working in allied health care for 6 years I have witnessed and empathize with many sick patients which allows me to be grateful

Having a great relationship with my parents - working at st Marys Hospital for children I saw many children without parents.

Being more in touch with who I am-  is a blessing because I now know exactly what I need to succeed physically, mentally and socially.

This will be my last post in 2014. I want to thank you all for reading. See you all next year !

An underrepresented minority’s perspective on Affirmative action

 I have a few provisos that I would like to put forth before I delve in.

1.       This is my opinion and I will try my best to be comprehensive, play devil’s advocate and encourage discussion. In this “PC” world we live in, people are afraid to state their opinion. 

                    "Those who stand for nothing fall for anything." - Alexander Hamilton

2.       As an educated person, I am open-minded, I appeal to reason and my opinions are not fixed. I love and encourage healthy debate. Learning and becoming more informed helps with dealing with diversity. 

3.       The definition of URM that I am using is that of the AAMC: "Underrepresented in medicine means those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population."

4.       I want to discuss what happens to typical URM, the obstacles that lead to lower college retention which eventually leads to lower medical school admission.

5.       I will ask questions, some will be answered with quotes and others indirectly with my own opinion.

6.       I will NOT discuss the controversial topic of white privilege, but I will refer you to this website. http://occupywallstreet.net/story/explaining-white-privilege-broke-white-person 

7.       Last but not least. My views are a lay interpretation of my surroundings, current events and my experiences (I am aware there are many sides to every story).  Embracing social diversity is necessary to promote a variety of perspectives and an exchange of ideas.

Please note:  “When babies are born, they are unaware of racial difference and attach no intrinsic value to skin color. We know that they begin to notice racial differences and their effects between the ages of two and four. Throughout their childhood, they are bombarded with stereotypes, misinformation and lies about race.”- Paul Kivel http://www.paulkivel.com/component/jdownloads/finish/1/103/0?Itemid=31

Why are there less minorities compared to “other groups” entering medical school?

AMSA’s study reveals:

“… factors contributing to the lack of progress in minority enrollment has been the inability of elementary and high school systems attended by minorities to adequately prepare students for college level science and provide role models in the medical profession to students. In addition, financial barriers exist for minority students pursuing college and graduate studies.”

http://www.amsa.org/AMSA/Libraries/Committee_Docs/study_meded.sflb.ashx

According to Daphne W. Ntiri’s “Access to Higher Education for Nontraditional Students and Minorities in a Technology-Focused Society” :

 “…One of the realities confronting the United States is that a major proportion of racial and ethnic minority students in this country have unequal access to higher education…”

http://uex.sagepub.com/content/36/1/129.abstract

What can be done to increase the numbers (what are the numbers)?

US Census Bureau:

“…In 2000, minorities comprised approximately 30% of the population of the United States (US Census Bureau). By 2050, it is projected that the minority population will represent approximately 50% of the total U. S. population, meaning ethnically and racially diverse people may no longer be a numerical minority…”

http://www.asha.org/practice/multicultural/recruit/litreview.htm

According to the Council on Graduate Medical Education (COGME):

“…increasing the number of URM students who successfully advance through the elementary, secondary, and postsecondary academic pipeline is the first step to enlarge the potential number of these students eligible to enter medical school.”

http://www.hrsa.gov/advisorycommittees/bhpradvisory/cogme/Reports/seventeenthrpt.pdf

My answer: Meet URM students in the middle (middle school that is) provide them with enrichment opportunities that allow them to see past their environment. This past summer (2014) I had the opportunity to work as a Teacher assistant for STEP a science-focused, college-preparatory program a part of a National Early College Initiative that helps prepare low income, underrepresented youth to transition from high school to college. As a Teaching assistant, I worked with a high school Biology and middle school general science teacher in a laboratory. In this capacity, I guided students with apparatus set up, data collection and lab report writing. What stood out to me the most, is the difference in attitude between the middle school students and the high-school students. The Middle school students were eager to learn, apply brute force, examine and ask questions. The high-school students didn’t share the same enthusiasm. This lead me to believe that the earlier the intervention the better the outcome ( i.e. higher college acceptance rates among minorities) 

Is affirmative action still necessary? (and for those who have benefited from affirmative action does it mean you were not qualified)?

Let’s look at the famous case of Fisher vs. University of Texas. The back story is Abigail Fisher, a white female who had a GPA of 3.59 and score of 1180 out of 1600 on the SAT was denied admission to the University of Texas at Austin in 2008. She alleged the University had reversibly discriminated against her based on race and was in violation of the Fourteenth Amendment. She argued that minority students with fewer impressive credentials than hers had been admitted.

“…The University of Texas at Austin considers race as one of various factors in its undergraduate admissions process. The University, which is committed to increasing racial minority enrollment, adopted its current program after this Court decided Grutter v. Bollinger…” excerpt from - http://www.law.cornell.edu/supct/pdf/11-345.pdf

The Fisher vs. University of Texas results: In a 2-1 decision, the Fifth Circuit found in favor of the school in its decision to use race as a part of a holistic admissions approach to achieve diversity.

*Side note: Grutter vs. Bollinger similar story: In 1997, Barbara Grutter, a white female resident of Michigan, had a 3.8 undergraduate GPA and a 161 LSAT score was denied admission to the University of Michigan Law School. The Law School admits that it uses race as a factor in making admissions decisions. The Supreme Court ruled that the use of affirmative action in school admission is constitutional if it treats race as one factor among many.

My answer: I wanted to start this discussion by looking at those two cases because I wanted to frame the argument while considering all sides. I felt giving examples would put this argument in perspective. Should grades be the only factor that’s considered in admission? And for those that will quickly Jump and say yes, I urge you to consider the factors that lead to higher grades—do only the smartest people get good grades, and if you get lower grades does that mean you are intellectually inept? Let’s look at why the majority on average (considered from the largest context) get higher grades. Many will say better preparation, better role models, superior socioeconomic status...etc. I personally believe that greater work effort and cultural approach, not innate cognitive ability is the reason for the higher grades and if that is the case (which I highly suspect). Grades CANNOT BE THE ONLY FACTOR considered for admission

I believe that looking holistically at each applicant is a far better admission criterion than looking at grades alone. Since there are numerous factors that lead to high grades all of which may or may not depend on academic ability. Please note affirmative action may get someone to the door but THAT is its extent.   

Appreciating your journey… filling out “secondaries”

I decided to write this post  in response to a FB status that I read recently that said “We've been fooled into think(ing) our little accomplishments mean something until we reach the real world and none of that sh&$ matters”.

I immediately responded with: “Your accomplishments mean something! You can't measure ur (your) success by looking at others. You (you’re) always gonna (going) to find someone smarter, richer and more attractive. (remember that(‘s) goes vice versa- there's those that haven't even graduated)”

For some reason I went to bed with this post on my mind. I thought to myself could this be true. Do my accomplishments “really” matter? This led me to think about my dreams of becoming a physician. I then began to reflect on the questions medical schools asked me on my secondary applications. They asked for example: tell us one thing about yourself that would help the admissions committee determine if you should be admitted to our program,  discuss a time when you stepped out of your comfort zone, and describe a personally rewarding experience.  

I asked myself what all these questions have in common.

I realized they all wanted answers that SHOW not just tell. In order to show why you are deserving of a seat, you must reflect.  For you to reflect you must have accomplishments worth the reflection. In other words every experience/accomplishment makes you into the person you are. In order to differentiate yourself from another candidate you have to be proud of what you have accomplished and realize that not only the big accomplishments like graduating from college or overcoming an extreme academic difficulty matter.  Any time you stand up for social injustice, encourage your peers and underclassman, anytime you learned from a mistake and put yourself in others’ shoes:  you accomplish something that “really” matters in the “real world”. It is crucially important to not compare yourself to others “You (you’re) always gonna (going) to find someone smarter, richer and more attractive”.