Medical Thread

[BarakzaiAbdali]

I previously discussed how there are tracks for those that wanted to start out pursuing their career early. I mentioned how there are 6 year programs throughout the US that directly accept people into a two year bachelors degree course and supplement that with 4 years of medical schooling. These degree pathways are called BS/MD programs. However, there are a few other things that high schoolers can do if they decide they want to pursue medical schooling.

1. Take AP coursework. In the US, many schools offer advanced placement (AP) courses that allow you to get college credit. You should take as many of these courses as you can to A) be ahead of the curve when it comes to doing well later on, but also B) opening up space in your college schedule to pursue extra curricular research related work.

2. There are many programs locally at Universities that take in High School students and put them on lab work projects. Mayo Clinic, Cleveland Clinic, many Universities have summer programs that can be springboards for long term project work. Many people do not understand just how amazing an opportunity it is to get involved early on. There certainly is a whole lot of life lessons you glean from working in a some odd job as a high school student (in fact that was what I did for some of high school). However, when you start in on a research project at the high school level, people treasure mentoring you and the expectations generally are not that high. So when you actually end up producing good data/results, you stand out. As an example, my younger sister worked on a proteomics project (sort of like genomics except at the next level) with our local university and she started her work in high school. This allowed her to build her CV (Curriculum Vitae). The CV is the most important thing for a professional medical doctor to build. It is like a resume, but more detailed. I will post separately on the CV as it is a very important subject and deserves its own posting. You can usually find these projects and activities by searching out summer research opportunities. Other options are to find a cool lab online and actually try to contact a member of the team to join their work. Usually if you have some good hard coursework under your belt like an AP physics, AP chem, and AP bio course, you can really start out a preliminary CV/resume and note to them that you have some lab experience through your coursework. They understand, of course, that at the high school level you know nothing, but they still will want to take you on and teach you. Often times you have to get used to the fact that these positions may end up being volunteer style positions that become paid positions as you prove your worth. You can get officially registered at the university/hospital as a volunteer and specifically designate yourself as a research volunteer. Then, you can stack this experience onto your CV.

3. Get involved as a hospital volunteer. You can even do it through some organization like the Red Cross, that can look even better. Beyond this, also consider volunteering, during a summer, with an organization like habitat for humanity, or even in our own neck of the woods with an NGO in Afghanistan. I think the latter is the best option and will make you look fantastic for applying to some big name colleges.

4. Consider building your high school resume towards a strong BSMD program like Northwestern University. They appear to have the best around. See what sort of profile their students fit. More often than not it means getting solid SAT scores, solid SAT 2 scores, ACT scores, a strong GPA with advanced courses, and of course something that makes you stand out like the research I mentioned above or some impressive volunteer work abroad.

If there are any further questions, the floor is open.

[Dreamer]

wow I just saw this thread, I have a question but it's my cousin who is asking it.

After you get accepted in Med school how difficult do the studies get? is there any way to audit the course work?

depends on which country lol
its not hard... At least I didnt find the work load hard... the exams were solid... we got bombarded with Histology and in 1st year in our Viva we had 9/15 on histology and anatomy alone 2nd year it was 14/20 :S

[BarakzaiAbdali]

wow I just saw this thread, I have a question but it's my cousin who is asking it.

After you get accepted in Med school how difficult do the studies get? is there any way to audit the course work?

I think it it is a very tough road. I mean my average first and second year medical school schedules revolved around 8+ hour study days and 12-16 hour days on the weekends. That was of course, not counting the lectures if they were worth going to. There is no point in auditing those courses. You just have to get in to medical school and go through it all. The best way to prepare is to take some good college courses that may address the subject matter, like microbiology, pharmacology, pathology etc. Otherwise, it is not worth auditing a course unless it is physiology.

You have 2 basic science years that drill the information into your head and then you usually have 2 clinical years that drill clinical protocols and expose you to stuff that you just have to see and can really not learn only from text books. It becomes more practical the last 2 years. However it is a joy to see the knowledge you learned actually applied (and sometimes not pan out!).

I felt like 2 years of my life (first two years of medical schooling) were really spent living in the library. The laboratories and dissections can also be very demanding and consume time. The clinical ward months are very structured here and you are expected to act like a minature intern physician. You are there for long hours and usually you are performing a lot of scut work alongside trying to prepare for shelf exams. You pick up, on average 5 patients that are all yours and that you are expected to make decisions for (someone is always watching over you of course). You are simultaneously preparing for the USMLE exams. I think that is what makes the curriculum challenging… its not the individual components that are hard… it’s the things all be staggered together like that. The average foreign grad studies for the Steps ~ 6 months. The American grad has about 6 weeks, if that. The joke about Step 1 was: “2 months” and Step 2: “2 weeks and 2 number pencils.” The ICU clinical ward months are very demanding but very rewarding. As a medical student the expectations are less, but you still are there long hours.

Some of how hard it is depends on what you want to do. If you want to be an ophthalmologist, radiologist, orthopedic surgeon, or dermatologist you have to bust your butt and stand out. Just getting through does not suffice. If you want to settle for something less then you can try for mediocrity. If you want to go to a solid general surgery or internal medicine residency, you have to work hard and get Alpha Omega Alpha status (top percentages of the class).

[Mayana]

The one thing that bothers me the most probably is how time consuming it is. In Germany, it only takes 6 years for a student to become a physician. Here in the US, it takes up to 12 years, you will spend your entire twenties in lecture halls, libraries and labs. Not that I mind that, but I sometimes wish the hassle wasn't be that big. =/

[Michin Khel]

In pakistan it takes 5 years study and 1 year house job.

Medical study is not so easy like other fields so 5 or 6 years are appropiate to become a docter.

[BarakzaiAbdali]

Dear BarakzaiAbdali how did dreamer become a doctor at age 23? Why is it that we Americans have to study for 10 years to become a doctor(including undergrad)while Pakis and Britishers only study 4 years?

I have seriously considered changing my major to premed due to your amazing advice.

Dear Wrorre,

That is not the case. If you read my prior threads wrorre, you will see that it generally balances out. They become doctors officially with an MD or an MBBS, but they are not attending physicians. For example, your family doctor is an attending physician, which means he is all done with both medical school and training. Your cardiologist in the US is also all done with medical school and training etc if he has his own office. However, the young people that work on your family members inside the hospital are trainees. They are resident and fellowship level physicians.

Furthermore, the standard of certification in the US means that to become a cardiologist you must do a fellowship. However, in Pakistan the the country has not yet standardized things. They do a residency equivalent period called house job. Thereafter, an extra year or two as an apprentice earns you the chance to call yourself a "heart doctor." They may be capable, but you certainly cannot call all of them standardized to have trained to the level of an American specialist or subspecialist; at least in Pakistan. By the time they come here and finish getting into residency (they usually spend about 1 or 2 years trying to just get in) and then try to apply to fellowship (they have a harder time landing competitive ones) they reach the same age as the American graduate.

The British system is far more elegant and standardized than the Pakistani one of course and they produce top notch physicians. However, you are not an attending physician until more years of training and subsequent specialization.

So the bottom line is that where the American adds usually 2 years to his bachelors level studies, he has less gap years to the end goal. This ends up balancing the three groups out where all three end up being attending physicians around the same age. Simply having the degree and not being an attending means little in the world of medicine... you cannot practice and be licensed.

[BarakzaiAbdali]

The one thing that bothers me the most probably is how time consuming it is. In Germany, it only takes 6 years for a student to become a physician. Here in the US, it takes up to 12 years, you will spend your entire twenties in lecture halls, libraries and labs. Not that I mind that, but I sometimes wish the hassle wasn't be that big. =/

See my above answer to Shlombay Wrorre's question. Once again, its about where one practices and where one sees the most economic benefit. The German may get his MBBS/MD degree in a shorter period of time, but the residency and fellowship portions and the requirements therein end up placing him at the nearly the same finishing point as the US student. Moreover, the Germans have it a little tougher than the British on easily making their way into the system here which also adds time if they want to make it into an American residency.

[BarakzaiAbdali]

Dear BarakzaiAbdali how did dreamer become a doctor at age 23? Why is it that we Americans have to study for 10 years to become a doctor(including undergrad)while Pakis and Britishers only study 4 years?

I have seriously considered changing my major to premed due to your amazing advice.

Dear Wrorre,

I am touched that you take my advice so much to heart. Remember though, it is not necessary to change your degree.... you can always stay in your degree and just finish the requirements. In fact, if it is a good degree that is better than just simply switching to a common degree like chemistry, biology, etc. Coming out Columbia, you will be able to go to any medical school in the nation if you do the right moves.

You are a computer engineering major right?

[Mayana]

There is a really interesting podcast in the iTunes store called The Pre-Med Podcast.. It covers many different and interesting topics that concern the aspiring Pre-Med student. Check it out, people! =D

[Laila]

Laila, Its absolutely a great idea for both your personal ambition of applying and for spiritual reasons. First of all, do it for learning and for helping people out and God will put barakah in it. Make that your niyaat and you will prosper either way. It will also give you a personal goal and ambition to work toward. Then, when you get in, what you will seek to achieve will be for the selfless benefit of others, especially the most downtrodden of our people. You will gain fuel to work through the ensuing tough years of training with the inspiration that you are doing this for the benefit of the world and not for personal gain.

I have always, always wanted to contribute in any way possible towards Afghanistan. That has always been my dream. What better way to actually interact with its people and help them in need. And Afghanistan, of course we all know, needs potential and ambitious people, of their own people, to help them.

In regard to the practical aspect and implications of your work, it gives you some good stuff to write about in your personal statement. Get some good pictures while you are there. For my interviews, I had a portfolio I had put together with my research work and I supplemented that with some articles in the news about the work I was conducting using tribal connections to build links between Afghan and American Universities back in the earlier part of the last decade.

That is definitely a good idea. I never thought of making some sort of portfolio for my interviews.

You have to look at your interview and application like a business portfolio in a way. When you approach it with this unique mindset and prepare the way a politician or a business man or a lawyer does his brief you can blow them out of the water. Remember, you want to put interesting things like this on your AMCAS application and also reflect on it in your personal statement. Then you control the terrain of the interview because they will want to discuss this with you. You pull them onto your ground and seize the initiative in the interview. What is more to your benefit is that you provide a view to the Americans from the perspective of an Afghan girl. We can talk more about this if you would like.

When it comes to that time, i will definitely come to you for more advice. If you dont mind, may i have your email via private message?

Look at the application and the interview like a battle that you want to control the tempo of. Eventually you develop a stump speech in a way. More often than not they are blown away.
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I was telling my wife to do the same thing recently when she was in Pashtunkhwa. She is planning on applying to professional schooling. I sent her to the camps on the border and she also visited some of the Khybar run clinics in the Wana area. It was an amazing experience and she has a lot to talk about now. She saw some appalling oncological (cancer) cases and played a good part in the team effort a local NGO was putting in to couple American/European trained doctors to help those local grads care for the tribal Pashtoons.

Also Laila, if that OB.Gyn in Afghanistan has American accreditation then consider getting a recommendation from them, especially if they have academic affiliations. Try to define a role there for yourself and be actively involved.

I do not think that lady has US accreditation. She herself studied alongside with my father at Nangarhar Medical University. But hey, i think a personal recommendation shall still be valid, right?

I will post more later after work. Back to the grind. Tell me if this was helpful. If you have specific questions on what I wrote above then write back. I will post mroe after work to answer the other questions.

Very helpful doctor sahib I will post more concerns and/or questions when needed.

[Dreamer]

Dear BarakzaiAbdali how did dreamer become a doctor at age 23? Why is it that we Americans have to study for 10 years to become a doctor(including undergrad)while Pakis and Britishers only study 4 years?

I have seriously considered changing my major to premed due to your amazing advice.

our system is different
basically its this
Medical School- 5 YEARS of which 2 are pre-clinical and then 3 are clinical
mines was an integrated model so in year 1 we studied physiology of all systems alongside anatomy, pharma, histology etc... this was called Systems in Health
year 2 was same but called Systems in disease so focussed more on pathophysiology
year 3 was cardiorespiratory and endocrine clinical year as well as clinical theraputics and ethics
year 4 were all the specialities so obs and gynae, psychiatry, neurology etc
year 5 was elderly care medicine
take exams at end of 5 years- pass and get MBBS now your a Dr

you then do FY1 or Housejob (4 months medicine and 4 months surgical attachment as well as another 4 months in any speciality)
your now an SHO and you specialise
do SHO for three years take your membership exams of the chosen speciality
so MRCP, MRCGP, MRCPysch, MRCOand G MRCS etc
upon completion of the SHO years and providing youve passed the relevent exams (different specialities allow diff time frames for when you can take the exams) you become an SPR or specialist registra of the chosen field... this lasts about 5 years and is the same as the atteneding physcian but your still under a consultant... after the 5 years you take exist exams and get you CCT and now your a consultant...
our system is longer allowing for more training but upon MBBS your a Dr and you get paid so
Ive passed the USMLE step 1 and it wasnt that hard... dont know what all the fuss was about

[BarakzaiAbdali]

our system is different
basically its this
Medical School- 5 YEARS of which 2 are pre-clinical and then 3 are clinical
mines was an integrated model so in year 1 we studied physiology of all systems alongside anatomy, pharma, histology etc... this was called Systems in Health
year 2 was same but called Systems in disease so focussed more on pathophysiology
year 3 was cardiorespiratory and endocrine clinical year as well as clinical theraputics and ethics
year 4 were all the specialities so obs and gynae, psychiatry, neurology etc
year 5 was elderly care medicine
take exams at end of 5 years- pass and get MBBS now your a Dr

you then do FY1 or Housejob (4 months medicine and 4 months surgical attachment as well as another 4 months in any speciality)
your now an SHO and you specialise
do SHO for three years take your membership exams of the chosen speciality
so MRCP, MRCGP, MRCPysch, MRCOand G MRCS etc
upon completion of the SHO years and providing youve passed the relevent exams (different specialities allow diff time frames for when you can take the exams) you become an SPR or specialist registra of the chosen field... this lasts about 5 years and is the same as the atteneding physcian but your still under a consultant... after the 5 years you take exist exams and get you CCT and now your a consultant...
our system is longer allowing for more training but upon MBBS your a Dr and you get paid so
Ive passed the USMLE step 1 and it wasnt that hard... dont know what all the fuss was about

Salaam Dreamer,

Here, consultants = attendings.

I am getting worried that the message is getting lost here because the Americans have accepted the unsubstantiated claim that this system here ends up churning out physicians that are all older than their colleagues abroad or their colleagues that studied abroad and came back. I want to clarify that this simply is not true when we crunch the numbers.

I was clarifying for the viewers that pretty much anywhere you go, it is a nearly equal committment once you factor in the various additional training years that are at times country dependent. Moreover, I was clarifying that if one views the US system attending level as the endpoint (that is, if one wants to come back but go through other systems to become an attending) then you still end up having to jump through hoops that land you at about an equal age as your colleagues that never left states.

As I said in the discussion regarding MD versus PhD, I think that the time committment is worth it because in general the stacking of postdoctoral periods in a PhD route ends up resulting in your success end-point being about the same and possibly later than the MD route. See the links I sent Admin Khan in those posts a few pages earlier on this thread. In his personal endeavors he has seen folks reach that end point early. Once again though, I am advocate of doing what you love to do as opposed to for purely economic motives. However, if the discussion comes up we should at least look at the facts of the matter.

The issue is that the Americans on here should not walk away confused thinking that they are locked into years of training that they could avoid by cutting corners going elsewhere.

Regarding being paid once one recieved the MD/MBBS, that also happens here. A PGY1 resident is also paid $~60,000/year. The clarificationis is that that your consultants are equal to our attendings in terms of how we view the rank and file.

Guys, nearly any field except the trade fields like engineering, requires additional training and input time. For example, a lawyer does get through law school, on average in 3 years, but he also has to do his clerkships with the courts. The day he gets the JD degree (law degree) is not the day he automatically becomes a lawyer capable of taking on supreme court level cases. 99% of those guys have to do those clerkships.

The MBA route at a good school requires showing a few years of experience in the work force and then applying.

Certainly, the last two routes do not extend as far as the training Dreamer and I have to undergo, but they also offer a larger degree of unstability in terms of job placement/salary etc. Of course, if you have a passion, these things should not be your primary motivators. Your passion in the field will propel you toward success.

Regarding engineering... once again, it is a hand on trade field that opens up many doors and can be immediatly applicable. However, the days of the American BSE level civil engineer going directly out there and capturing a high level post are no longer here. This now requires climbing through the ranks and achieving a master level degree at some juncture or possibly an MBA. Still, it happens everyday and as I echo my statements above, do the degree for the love of it and doors will open for you.

About the pathway here in the US, to clarify:

High school ---> College (4 years) --> Medical school (4 years) and then you get an MD --> residency (variable time length but you are paid) (you are called a resident physician and hold a rank called a PGY1,2,3... etc which means Post Graduate Year--> fellowship (usually 2-3 years) --> Attending (equivalent of consultant) or the top Dog of the chain

Alternatively, if one does not want to do a fellowship the pathway goes:

High school ---> College (4 years) --> Medical school (4 years) and then you get an MD --> residency (variable time length but you are paid) (you are called a resident physician and hold a rank called a PGY1,2,3... etc which means Post Graduate Year: generally medicine residency --> Attending (equivalent of consultant) of the top Dog of the chain

The residency time lengths are usually as follows:
Internal Medicine (this leads to cardiology, endocrinology, pulmonology, etc): 3 years
General Surgery: 5 years
Immediate specialized pathways like dermatology, opthalmology, orthopedic surgery are about 4-5 years.

So I think I have shown here reasonably well I hope that anywhere or anyway you go, to get that end point, where you are an independent doctor, takes nearly an equivalency of years in all the systems.

My hope is that this shows the Americans that you need to take advantage of your citizenship and not throw away a barakah God gives you if you can apply here. You are not going to be at an age disadvantage or have to undergo lengthened training.

PS. Dreamer, I keep trying to accept the friend add list message you sent but for some reason it doesnt process. Ill see what is going on with it later.

[BarakzaiAbdali]

I have always, always wanted to contribute in any way possible towards Afghanistan. That has always been my dream. What better way to actually interact with its people and help them in need. And Afghanistan, of course we all know, needs potential and ambitious people, of their own people, to help them.


That is definitely a good idea. I never thought of making some sort of portfolio for my interviews.


When it comes to that time, i will definitely come to you for more advice. If you dont mind, may i have your email via private message?



I do not think that lady has US accreditation. She herself studied alongside with my father at Nangarhar Medical University. But hey, i think a personal recommendation shall still be valid, right?


Very helpful doctor sahib I will post more concerns and/or questions when needed.

I will create an alternate email address as the past few rotations have been relatively light for me and things are likely to pick up per upcoming subspeciality fellowship interviews. I am interested in further subspecializing in congestive heart failure. That way you guys can reach me at that address and I can answer via iphone etc.

[BarakzaiAbdali]

Salamoona,
I have about a year left to finish my masters degree in Math at NYU. I was wondering if there is joint program to become a doctor shortly after.

Regards,
Aseerullah.

Salamoona Wrorre,

The essential thing is to take a look at the prerequisites that Admin Khan and I spoke about in a few exchanges a few pages back in this thread. Tell me if there are any issues finding this. You also generally need to take the MCAT. See if there are any biomathematics projects that are ongoing at NYU. If like some mathematic departments that overlap with engineering schools, you are trained in mathematica, matlab, LabView etc, that may also serve you when working with such groups. So once again, see what prereqs you would need to satisfy and which ones you have credits for, second hit the MCAT hard, third get involved in the way I said earlier. Your masters degree already is an added plus. Your pitch to any programs should be that you want to utilize your mathematics/engineering background in the realm of academic medicine and that is your skill you bring to the table. Note that you have an interest in outcomes research which requires statistical skills (we doctors get little bouts of that here and there but many still have a hard time understanding the simple concepts of t-tests, COX hazard models, sample size and its relationship to power, number needed to treat and its cogency when conducting studies. The fact that you are a mathematician and can visualize and derive these concepts gives you that niche to exploit. Then you can join me and do all of the statistics for my stem cell therapy work

However, at the end of the day, if you get your MD, you are not married or obligated to follow me into academia. Private practice and pure clinical practice remain open to you as options. Its just that this is your key selling point and what you bring to the table.

[Dreamer]

Brakzai bro, your forgetting one thing... in the UK those of us who choose to go into family medicine can be independently practising by the time we are 28 years old... I dont think you can do that in the States this is because it is of all the specialities the one that requires the least post grad training yet pays the most!