Bio Products Opportunity

For many pre-medical students, Organic Chemistry represents a monumental hurdle that must be crossed painfully. This need not be the case if you can change your “thinking” about organic Chemistry. I will be the first person to say with great conviction that I was not a “carbon-friendly” chemistry major but I had a passionate love of the subject matter of chemistry and organic chemistry was but one more course that added to my knowledge of the subject matter that I loved. I ended up performing very well in Organic chemistry even though it wasn’t my favorite course in chemistry.

Organic Chemistry is the chemistry of carbon-containing compounds. It is not the basis of Biochemistry, though both chemical disciplines share carbon as a component for many of the compounds that are studied within each discipline. O-Chem is centered around carbon and the special characteristics of carbon-containing compound families while B-Chem generally looks as structure, function and characteristic reactivity of macromolecules that contain carbon. This is why I could happily study B-Chem in graduate school and not be a particularly “carbon-friendly” chemist.

O-Chem starts out with the special atomic characteristics of carbon that are responsible for it’s bonding and reactivity. There are plenty of explanations of reaction mechanisms that must be mastered and absorbed as these basic reaction mechanisms will present themselves repeatedly as you move through the course. Rather than look at them as abstract and in isolation, learn them and be able to recognize them as a recurring theme as new carbon-containing families are presented. In short, you should be able to look at the way electrons behave in the various mechanistic schemes and apply that knowledge to new reactions as you encounter them.

O-Chem has a specific vocabulary that includes terms like nucleophile, electrophile, substitution, replacement, degradation etc. It is a very good idea to keep a list of the new terms as you encounter them and make sure that you understand them within the context of your o-chem study. One of my techniques was to take class notes on the left side of my spiral notebook. The right side was reserved for adding notes from my textbook and for working problems. I also kept a running tally of terms by leaving the last ten pages of my spiral notebook clear and using those for listing new terms and their definitions. I would circle in red, the new terms that I had defined in my notebook glossary as they were mentioned in my notes.

O-Chem requires daily study while you are taking the course. You need to review the previous lectures and notes, preview the next lecture and study the current lecture notes within the context of how they fit with the assigned reading and problems. Always look at an o-chem problem by making a note of the concept that the problem will be illustrating. Every o-chem problem or synthetic scheme has a concept behind it. Make a practice of noting these as you work the problems and studying the concepts as you work the problems.

O-chem also builds upon previous principles. For example, as you are introduced to the simple alkane family of compounds, the characteristics of this family should be compared and contrasted to the alkenes, alkynes, aromatics and other families as they are introduced. Make yourself get into the habit of reviewing summaries and characteristics of each old family as new families are introduced. This will greatly help you with synthetic schemes and problem-solving.

Before you go to lab, you should sit down with your lab book, write out a simple outline of each experiment with a listing of the steps that you will be doing. You should do any pre-lab exercises and review any topics in your text as they relate to your experiment. Many organic labs require that you answer post lab exercises, write up a report and submit these for grade. Look over your post experiment questions before you begin the lab so that you can be sure that you have obtained the proper observations that will enable you to answer these questions easily.

If you are required to keep a laboratory notebook, make sure that you include the following:

• The purpose of the experiment
• The experimental procedure
• Your data (tabular form is a good way to present this
• An explanation of your data that includes possible errors
• Any spectra (NMR, GC, Mass Spect that you obtained
• A summary of your observations

Don’t record data on little scraps of paper! Those little paper scraps can get lost and your grade will suffer. Get used to preparing for each experiment and recording your data directly into your laboratory notebook. I used to take photos of my experiments as I went along and pasted these directly into my laboratory notebook so that my instructor knew exactly what my reaction setup looked like as I progressed through an experiment. I also pasted my NMR spectra and GC results directly into my lab notebook with annotations and directions to my conclusions about their appearance.

As you encounter a new family of compounds, look at their reactions and usefulness in synthetic schemes. Again, you may want to keep a running list of characteristic reactions of each family as they are presented. With each lecture, link to the previous lecture and study a whole weeks worth of material and data on the weekend.

O-chem is a preview and practice course for many of the courses in medical school. The manner in which you approach your o-chem will be good practice for medical biochemistry, pharmacology, microbiology and pathology. These medical school courses build heavily on their introductory concepts just as o-chem builds upon the concepts that are presented at the beginning of the course. Like o-chem, these courses require daily mastery and will increase your vocabulary exponentially.

What you cannot do with o-chem or any other pre-med course is decide mentally that you cannot master this course or that it’s a “weed out” course in which the professor is out to “destroy your career”. No professor has the time or energy to care about working to destroy any particular student. While there are good professors and poor professors, the material to be mastered in o-chem or any other subject, does not change. Don’t let your feelings about a particular professor distract you from the business of learning.

Learning to tune out your fellow classmates i.e. those who whine, complain and otherwise attempt to distract you, is another good characteristic to develop. Some immature folks are going to brag that they “never study and get As” or that “the professor doesn’t give As” or my personal favorite, “you can’t possibly earn an A because you are not that smart”. Don’t buy into any of this stuff. Look at the course syllabus as soon as you get it. Look at the requirements for each grade and decide that you will meet them. At the first sign of trouble, get some help.

Check out the O-Chem help site at Frostburg State University. This site is under construction but can be an excellent adjunct to any o-chem coursework. Use the site as a tool not as a substitute for attending class and working your assigned problems. The URL for the site is: http://www.chemhelper.com/ This site requires registration but has a message board, discussion forums and plenty of resources for any o-chem student. In addition to this site, there are likely others too including possibly one at your school so utilize them as you need them.

Don’t underestimate the value of attending recitation sections and tutorial sessions. These sections/sessions are great opportunities to get your questions answered or reinforcement of your knowledge of the material as you learn it. Don’t skip these sessions and don’t skip class. Utilize the office hours of your professor and make an appointment for a consultation at the first sign of trouble. Don’t wait until a couple of days before the exam to seek help.

Keep up with your homework and studies. Again, I cannot overemphasize the importance of keeping up and not getting behind. Few people fail or do poorly in o-chem because they cannot understand the material. Most people struggle because they get behind and cannot catch up. Don’t get behind and don’t skip class. If possible, get ahead of the class and stay ahead. If something comes up that takes time away from your daily study, take care of it quickly and get back on track. If you are taking o-chem during the summer, skipping even one day of study can be a “deathblow” to your total course performance.

Finally, get a copy of the Biological Science Topics for the MCAT(o-chem starts on page 12 of this document) and make sure that you are systematically checking the topics off from both your General Biology and o-chem course as you go along. This document can be downloaded at : http://www.aamc.org/students/mcat/preparing/start.htm Go to the Tests Sections and download the topic lists (pdf documents) for Biological Sciences, Physical Sciences and Verbal Reasoning. These three documents can help to keep you on track as you move through all of your pre-med coursework.

After the heady experience of orientation, it’s time to get to the business of medical school. The classes will start, syllabi will be handed out and lectures will be available for download. It’s time to “Go Live” and get off to a strong start. At this point, you should have your living arrangements settled (at least for the first semester) and you should have a pretty fair idea of how your class time will be utilized during the first semester. Now, you have to get into some kind of a routine.

As I have mentioned in other posts, you need to be thoroughly prepared for each class before you enter the classroom. The volume of material will not allow you to sit in lecture cold. This preparation means having your text/syllabus reading done before you hear the lecture. In addition, you need to have thoroughly mastered the previous lecture’s material before you move into the current lecture’s material. Gone are the days of sitting down on the weekend and learning the previous week’s work. Studying and learning are daily “friends” once you reach medical school.

You are going to hear differing opinions on class attendance. Some schools have mandatory attendance while others don’t care except for the occasional mandatory session. If you have signed up for a problem-based learning curriculum, you are going to be subject to mandatory attendance. In general, if class attendance is optional, attend class until you find that you are more adept at mastery of the material on your own or when you feel that your learning is being slowed by the lecture.

When students are sitting in lecture, they are listening to the lecture material being presented in an aural manner. Their isn’t much mental processing of the material unless you have a base to which your are mentally linking as the lecturer presents the material. Most of the “learning” of the lecture material will take place when you go home and review the lecture presentation.

Some students will sit in lecture and “personalize” the material as the lecturer presents. This is generally a distraction and leads to those “sometimes annoying” classroom debates between one student and the lecturer. When I was a freshman medical student, these debates would generally occur during out psychiatry lectures when the professor would present a controversial theory or treatment. There was always one or two students who felt the need to be the “moral pulse” of the class. The rest of us learned to tune out and tune back in once the lecturer got back on track. Most experienced lecturers are adept at redirecting but occasionally, these interludes could go on for several minutes leaving me time to pour a fresh cup of coffee (or water) or take a breather.

For many students, taking notes seems to be oppressive. Don’t fall into this category. There are very few notes that must be taken for the most part. Don’t fall into the trap of thinking that you need to take down every work that comes out of a lecturer’s mouth. When this happens, you become more clerical than engaged in information acquisition. You need only write a word here or there as most lecturers will have downloadable handouts/slides. Once you reach the point of figuring out how the lecturer approaches the subject matter, you can take a word here and there to direct your learning later on.

If you are a participant in a problem-based learning curriculum, you will have to become adept at linking medical concepts. I can tell you that by the time your first two years are done, you will become nauseated at the mention of the words “learning issues” and “learning goals”. While problem-based learning (PBL) is admirable, sometimes one or two group members - usually the loudest and less shy - can dominate conversations or delay progression. At this point, an excellent facilitator (another word that will bring on nausea) will intervene but sometimes the group dynamics can get in the way of obtaining the information that you just need to learn.

Other things to think about are time-management in general. Yes, there are only 24 hours in the day and you will need to sleep at some point. I did find that after a couple of weeks, I could actually study when I was tired and that more coffee was not necessarily going to keep me awake. Having and keeping a fairly detailed daily schedule that included timing for the necessities of life (sleeping, eating etc) was helpful but there are going to be some days when the schedule is going “out the window” and your time will be spent in less productive ways. (You want to try not to have too many of these types of days). When this happens, forgive yourself, forgive the person (s) who wasted your time and get back on track as soon as possible.

Getting enough sleep is going to become something of an experimental journey for you. Resist the urge to listen to people who say that they “go for days on 1 hour of sleep” or the people who say “if you are sleeping 8 hours a night, you are not studying enough”. Both of these are extremes and you will find that some the amount of sleep you “need” is just that, the amount that you “need”.

If you are drowsy most of the daylight hours, you are probably not getting enough quality sleep. If you are drowsy when the lecture hall is too warm and dark and the professor’s voice is monotone, you are normal. If your sleep quality is not good, be sure that you are getting enough “de-stressing” (physical exercise is good for this) or getting enough rest (being overtired can disrupt your study efficiency).

If your sleep pattern is disrupted, try some good sleep hygiene such as getting in bed at the same time every night. Don’t try to read or study in bed (keep the bedroom for sleeping and recreation). Don’t have a television in the bedroom (Ok, but un-plug it). Avoid coffee, tea and high caffeine “energy drinks” within four hours of bedtime. Avoid exercising before bedtime as it can disrupt your sleeping patterns as do naps of more than 45-minutes in the afternoon.
Be sure that your bedroom does not contain molds and too much dust. If you have allergies, these things will decrease your sleep efficiency and disrupt your sleeping patterns. Clean and dust your bedroom on a regular basis. If possible, wash your pillows monthly too.

Finally, forgive yourself if you find that your don’t have everything together perfectly for the first set of exams. Adjusting up or down is part of the adjustment phase of medical school. You are definitely going to find that some subjects will demand more of your time and some will demand less. In the beginning, keep up with everything but generally give the time where it is demanded most.

Don’t try to “explain” your schedule or study needs to anyone. Every medical student is different. If you can get through the semester, get the material mastered and get some stress relief on a regular basis, then you have gotten off to a strong start. Your family is not going to understand the pressure of your daily routine so don’t expect this understanding. Your classmates will understand and your professors (to a certain degree) will understand but searching for “understanding” is largely counterproductive outside of medical school.

Start strong and finish strong but in the first few weeks, just get the start under your belt. Largely the study skills that you have brought with you from undergraduate/graduate school will work in medical school. Do realize that you are human and will make mistakes. At the beginning, there are no fatal mistakes so use this time to “ratchet up” or “ratchet back” until your reach your optimum.

The best words of advice that I received as I started medical school were “you create your own success and you create your own luck”. Don’t overanalyze and above all, don’t be afraid of the task that is in front of you. You will adjust and you will have some successes. Overall, you just have to be willing to make adjustments daily and adapt.

Many people have asked me, “What was medical school actually like?” “What was you day-to-day schedule?”. I will attempt to describe my first day in medical school from the time I woke up to the time I fell asleep in this essay.

I woke up at my usual time of 4:30AM. I was raised on a farm and getting up early is as much a part of my life as brushing my teeth every morning and evening. I am fortunate that I actually have always had less of a sleep schedule than most of my buddies and thus, I generally awaken around 4:30AM without the need of an alarm clock. I also roll out of bed and hit the shower while my single cup of “Joe” is brewing.

Over coffee, I usually catch up with the newspaper (online) and then I headed out the door for my walk to the subway station. This walk generally took about 20-minutes and was a built-in source of exercise for me for the first couple of weeks of medical school. My coursework on the first day consisted of Introduction to the Practice of Medicine Class at 8:AM- 10AM, Psychiatry at 10AM to noon. Lunch was from 12 noon to 1PM. Afternoon was Gross Anatomy Lecture from 1PM-3PM and Gross Anatomy Lab from 3PM to 5pm.

All of our lectures were in 50-minute blocks with 10 minutes of break in between each lecture. This allowed us to get a drink, walk around and prepare for the incoming lecturer. It also allowed the media person to set up in between the lectures as our lectures were available for download and all PowerPoints were down-loadable from out seats. Most of us took notes on the Powerpoint slide sheets or just listened in class.

Our syllabi had been handed out during orientation so that we knew the objectives and content with each lecturer. We also knew which textbook readings were to be covered. My Introduction to the Practice of Medicine course had a syllabus that contained an outline of the lecture. There was no text reading for this opening lecture that included the duties of a physician, how to fill out a death certificate and how to gather and interpret vital statistics for a locale such as birth rates, death rates and rates of disease.

With all of my syllabi and text books, I would remove the covers, take the books to Kinko’s and have the bindings removed. I would then have three-holes punched and I would place these sheets in large 3-ring binders. I had a binder for each course. In the evening before each course, I would remove the syllabus sheets for that course, remove any textbook pages that I thought I might need and place them in a small 3-ring notebook along with sheets of lined notebook paper (for taking notes). This was the notebook that I brought with me to school. I would have the subject matter divided by separators so that I had all of my information with me for the day.

I would download my PowerPoint slides and place copies of these in my subject notebook when I got back home for the day. My lecture notes (or copies of note service) would also go into each subject note book. My textbook pages would go back into that textbook three-ring binder.

On my first day, I took notes and placed them in my Introduction to the Practice of Medicine binder when I arrived home at the end of the day. For psychiatry, again, the lecturer had no slides but discussed Erickson’s stages of development and Piaget. I took notes but knew that detailed explanations of these subjects were in my textbook.

For Gross Anatomy, I had the text pages with me and made notes in the margins of the material presented by the lecturer. I also made a few notes on photocopies of my Netter plates for use in our lab. During Gross Anatomy lab, I had my list of structures that I had made from scanning the dissector. I had also reviewed the relevant plates in my Netter atlas and had made photocopies of these plates. My photocopies were stapled to my list of structures.

In our first Gross anatomy lab, we studied the bones of the vertebral system and skeletal structures. We were also given instruction in how to work with the diener to keep our cadavers in good condition for the entire semester. We were also introduced to our cadavers and our tank groups (each was six people).

After lab was over, I took the subway back home (45-minutes) and walked from the subway station to my house. I then took an hour, made dinner, ate and begin to study and review the material from the first day’s lecturers. As I studied, I made notes an questions in the margins of my books, syllabi and note sheets. Since most of my notes were typed, I printed these out and placed them in my subject binders. I also studied and memorized the relevant bone structures using my bone box that was issued to me during the first day of Gross Anatomy laboratory.

My next task was to preview the notes for the next day’s subjects and do any readings/problems that had been assigned. After my previewing, my textbook pages, relevant notes and syllabi pages were placed in my daily notebook which went into my backpack. My next days courses were Biochemistry, Microbiology and Microbiology lab.

My day ended about 11 PM and I hit the bed because I knew that my next day would be starting at 4:30 AM. Since Tuesdays and Thursdays were shorter days (class started at 8AM but ended at 4PM) I actually had an extra hour on these days. We also had a Microbiology Discussion session on Tuesdays and a Biochemistry Case Discussion session on Thursdays where we would discuss clinical cases from the standpoint of these subjects. Our instructors would bring a case, present it and then we would discuss these cases in detail from the standpoint of the basic science involved.

When we started to actually dissect the cadavers, my Mondays, Wednesdays and Fridays included 2-3 hours of dissection in the evening after class was done. I would get some dinner at school and then get into the dissection laboratory to study and complete dissections. The extra dissection/study moved my bedtime back to after midnight on these nights.

I also studied in the dissection laboratory and with my study group on Saturdays. We would have an early breakfast (at one of the nearby churches to help them raise funds) and then study and quiz each other until noon. We would then study and quiz each other in the Gross Anatomy lab after lunch and generally until 3 or 4pm. After that, we would do another group session in Biochemistry and Micro and then head home around 8pm.

Sunday’s were generally my day of rest. I would spend a couple hours in the evening putting together my materials for my Monday classes but most of my studies would be completed in the time that I had put in Monday through Saturday.

If this amount of study time seems extreme, it was extreme in some ways. I would not stop until I felt I had mastered the material. I also made the crucial mistake of neglecting my physical conditioning in favor of my studies when I should have incorporated my studies into my physical conditioning routine. I ended up gaining a considerable amount of weight but my grades were excellent. At this point in my life, I know that I have to strike a balance and now I am in excellent physical condition with no neglect to my academics/reading.

Medical school was all about balancing my studies with my life. I learned to multi-task and I learned how to focus on getting things mastered and completed. I also learned the value of discipline. My schedule didn’t allow much “downtime” but the “downtime” that I had was utilized to an ultimate degree.

It becomes easy to procrastinate in medical school because the days are long and the material seems voluminous. I fought procrastination by asking myself, “Why are you avoiding getting on with this task?”. Since I never had a good answer for this question, I just broke the task into smaller tasks and checked them off until they were done.

As I have said in other posts on this blog, the telly went by the wayside. I would spend a bit of time on Sunday scanning the log for shows that might be of interest. I would program my recorder for the shows of interest and watch them the next Sunday if I felt like a bit of relaxation. In most cases, my relaxation became hanging out with my classmates and the telly wasn’t much entertainment. I still tape shows that I love or documentaries that might be of interest to my students as I am teaching more these days.

Other things that tended to waste my time in medical school were phone conversations. I seldom use my telephone more than 5 minutes per week and tend to use e-mail communication more. I also pick and choose the meetings that I attend. Many times, academic committee meetings can be a total waste of time and energy and thus, I pick and choose whenever possible. If something is mandatory, the organizers generally will time the meetings around the schedules of those folks who are attending.

One of my medicine professors encouraged us to read the case reports in the New England Journal of Medicine every week from the first day of medical school. He said that we might not understand all of the aspects of each case but that this habit would prove invaluable as we moved through the curriculum. He was totally “on the money” with this one. I can’t tell you how studying and reading these cases helped me on all steps of USMLE and in residency too.

Medicine requires that you read and keep up with the journals of your discipline. I strive to read selected articles in New England Journal of Medicine, Journal of American Medical Association weekly. I also read American Surgeon and Archives of Surgery regularly along with Nature Medicine (excellent articles to be found in this journal). I keep a computer log of the articles that I have read and their sources. This keeps me current with the literature as much as possible.

For many pre-medical students, summer courses look like a great way to get ahead of the curve and fast-track through your introductory sciences, math or general educational requirements. For some medical students, summer coursework is an opportunity to shore up deficiencies or remediate coursework from the previous year before academic progress is granted. In both the case of the undergraduate and the medical student, there are characteristics of summer coursework that need to kept in mind.

Summer courses at any level go very fast. There simply are not enough weeks during the summer months to allow the same pace as regular-term coursework. Keeping this in mind, prepare to work faster and longer to master the same amount of material as a regular-term course. In the case of repeating a medical course -or remediation of previous course work-you are expected to be able to move through the material faster because this is the second time you will have covered this material. In the case of an undergraduate course, the summer student has to be dedicated and disciplined during a time when many of your friends are enjoying a much needed vacation.

My rules for mastery of coursework apply for summer coursework but let’s call the rules “course mastery on steroids” because you have to devote more time and cover more material at each sitting. There is little time to allow the material to “digest” before you move onto another topic or lecture. To this end, your previewing and reviewing become more focused in addition, the student has to be more adept at moving through the material at a more rapid pace. If mastery of concepts comes slowly, summer school is not a very good idea.

In the case of the remediating medical student, this being the second time through gives you an added advantage in the sense that you already have good insight into what you need to master. Each time the material is presented, you will gain new insight. This doesn’t mean that doing a summer medical school class is going to be wonderful and a “cake walk” but it does mean that you will likely know your remediated material in great depth for your board exams. This is not a bad trade-off for missing your vacation time and staying with the rest of your medical school class.

I never recommend that pre-medical students take pre-med coursework during a summer session. Summer courses move so rapidly that there often is not enough time for good integration and mastery of the concepts in sufficient depth for application on the Medical College Admissions Test (MCAT). Good summer courses are English courses, History courses, physical education coursework and math coursework. By taking these types of courses during the summer, a pre-medical student can get pre-medical course pre-recs out of the way or get degree requirements out of way allowing more time for concentration of major subjects.

Other great summer coursework for pre-medical students are “immersion” type courses such as marine biology (on a ship at sea), summer semester in Europe or South America, or summer research. Being able to devote your attention to one subject in total immersion can greatly enrich your college experience. Many undergraduate institutions offer immersion language coursework over a summer or opportunities to work with world-class researchers during a summer session.

Summer Course Study Strategies
As soon as you receive your course syllabus, reading/lecture schedule, sit down and plot your study schedule. You need to figure out how much time you will have to devote to study in order to cover the material. A good rule of thumb is two hours of study time for every hour of lecture time (same as for regular session). Since summer lecture are often longer (or take place five times a week instead of two or three), you have to block out your study time without exception.

Be sure that you have a strong and organized approach to mastery of your material. Having a buddy in the same class to study and work with becomes invaluable especially when you quiz each other and explain concepts to each other. It is also a good idea to meet with your instructor on a regular basis to be sure of your understanding of your coursework. Since summer courses go so fast, you do now want to “dig into a hole” that you are constantly attempting to pull out of. Chances are not good for pulling up, if you get into trouble on a test.

Because of the heavy concentration and course time commitment, working will be very difficult with summer courses. Unless you are taking a physical education course or a performance course with minimal prep time, working will be very hard. The effort that it will take to keep up with your course materials will generally rule out employment except for either a Saturday or Sunday on the weekend (but likely not both). If you need money, opt not to register for a summer course unless you have a job that permits long hours of down-time regularly. Even then, attempting to work and do a summer course will be very difficult.

If your family (or you) have an elaborate vacation planned, do not expect that you will be able to “miss a couple of days” of your summer course. You should have enough time for a weekend at the beach or to take a short trip but missing a day of summer work is equivalent to missing a week of regular session work. Again, opt not to take a summer course if you NEED your vacation time. Taking the time off is a better use of your summer instead of attempting to take a summer course and doing poorly because you had to go on vacation. If summer school is your plan, it IS your vacation.

In this short essay, I am going to tell you something that I didn’t do that I should have done. It’s called “Learning by Experience”. When I started graduate school, I vowed to get myself into good physical condition. I had a few extra pounds but nothing that was morbid obesity just about ten extra pounds. I had been a middle distance runner (10K) off and on with my best mile time being 6:25 and my best 10K time being 40 minutes but working in the chemistry lab and getting ready for graduate school had eroded most of my base-line mileage. I saw the pounds creeping on and I decided to “stem the tide” right then and there.

I joined a gym where loads of guys from the U.S. Navy JAG office worked out. Soon I was grunting and sweating with the boys. Those extra ten pounds quickly melted off and I would run 4 to 5 miles daily. My flexibility increased and my brain loved the extra perfusion of oxygen from those daily runs either outside on the bike paths or inside on a treadmill. My workout partners, all JAG guys, introduced me to weight training. Soon I was benching 125lbs and leg pressing 400lbs.

I loved swaggering into the gym in my baggy gym pants and muscle shirt. I would hop on the stationary bicycle for a 6-minute warm up. After a few stretches, I would start my circuit working legs first then arms and finishing up with abs. I wore a red scarf on my head and definitely sweat as much as the guys. When I reached 80lbs on the bench press, I earned a spotter. Nothing gave me more satisfaction then when the guys and I would take turns on the chin-up bar. (No other women came near the bar). My biceps and triceps bulged. I would put 400 lbs on the leg press and just work away with some nice hamstring stretches in between.

After my weight-lifting, I would take a soak in the Jacuzzi and then a dip in the pool. I am not much of a lap swimmer but swimming a few laps would bring my body temperature down and would keep my back stretched out nicely. My entire gym routine took about 2 hours from start to finish. I would get a protein shake in the juice bar and head back to my lab feeling powerful and refreshed.

The best thing about being in such great shape was that the discipline of working out carried over into all aspects of my life. I slept better at night with no stiffness in the morning. I easily ran flights of steps and could carry heavy loads with no problem. My clothes fit great. I had a solid study plan that had gotten me a 4.0 in my graduate studies. While I ran, I thought of new experiments and analyzed my data in my mind. Though my diet was not bad (I am not much of a junk food eater), when I was working out, it was excellent. I ate plenty of fresh vegetables, fruits and little meat.

With all of my energy, I was able to awaken in the morning, run a couple of miles with the Marines from the barracks down the street, and then bike 6 miles to school in the dawn. I would check my experiments and review my lectures for the day. I would then shower (I really sweat when I bike); change into my suit and lab coat, and then do my morning lectures. During lunch, I would hit the gym. After lunch, I would study and prepare more experiments or go to meetings. This was the routine of an assistant professor.

When I decided to attempt medical school, I knew that I needed to take the Medical College Admissions Test (MCAT). I had far more coursework between a double major in biology and chemistry with double minors in physics and math. My graduate work was in Biochemistry and Molecular Biology so those subjects were well covered. I knew that I needed to brush up on my verbal reasoning skills so I bought a review book and worked some problems daily. I also worked on my Physics too since it had been five years since I had taken General Physics. I was solid on the Quantum Mechanics but Classical Mechanics and Optics needed review.

My graduate comprehensive exams were also looming that summer too. We would be examined over the course of two days with eight hours of testing on both days. I studied for my comprehensives and studied for the MCAT at the same time. This turned out to be a great strategy. I simply made a review schedule topic by topic and checked off as I reviewed each concept. As a poor graduate student, I couldn’t afford a prep course so I purchased ($35) a huge review book called Flowers and Silver. It was money well spent.

After completing my comprehensives in June and getting my AMCAS application done, I knew I had one month to prepare for the August MCAT. I had stuck to my study schedule and my workout schedule. The funny thing was that none of my graduate school colleagues, except my best friend, knew that I was even interested in medical school. My best friend in graduate school was a neurosurgery resident who was working on his Ph.D. We had been study partners for the comprehensive exams.

On the morning of the MCAT, I hopped on my bicycle and rode the 6 miles to my testing center. It was great rolling off the hills at top speed and feeling the early morning wind in my face. My legs were strong and I imagined myself “smashing” that exam as I pumped up and down the street. I stopped into my favorite coffee shop for a morning cup of fresh “joe” and a high-five from the shop’s owner (a little Korean lady who always offered me encouragement).

I stood in line, dressed in my bike shorts and muscle shirt with my helmet and gloves. I stretched some but other than that, I was pretty relaxed. I could feel the tension all around me. As I got to the test room, I hoped for a seat next to the window because outside, there was a beautiful pink blossomed tree. I knew that I would be able to look up and out the window for a little mental break if the test was too much. My prayers were answered as I took my seat next to the window.

I moved through the Verbal Reasoning. My strategy was to do the passages that I found least interesting first and the things I loved last. I paced myself reading the questions first and marking the answers as I read through the passages. I paid close attention to punctuation, tone and critiqued in the margins of the test booklet. Soon this portion of the test was behind me. About ten minutes into the test, three young men, arose from their seats and left the test center. Was I missing something? The entire test went fine for me with my being able to figure out the “hook” behind each question. It was more like a game than anything else.

At the end of the test, I rode to my lab, checked my experiments and said a “thank-you” to God for giving me a nice day to ride and a clear head. From then on, I was stayed in great shape and kept working out clear up until the last day of medical school orientation. When classes started, I started studying and eating. My study group would feast on Nacho Cheese Doritos as we quizzed each other. By the end of first year, I had gained 30 pounds. My teaching over the summer and second year packed on another 20. By the end of medical school, I had gained 65+pounds and carried that weight around until my third year of residency.

After three years of standing and huffing up stairs, I vowed to get the weight off. I didn’t have two hours to work out daily but I made time for an hour workout even if I lost sleep. On my call days, I would walk the steps. Soon I had a good aerobic base but I am still working on getting my weight lifting back up to my level before. Even today, I work out at least four to five times weekly doing something. My gym opens at 5:00AM so I can get an hour in on the elliptical trainer if necessary.

In short, in medical school, I let my fitness level drop and endangered my health. I am fortunate to be able to get back to my previous level of fitness though the weight is not coming off as fast as I would like. I know that I won’t lose as much weight until I can get my running base back and I won’t pound my knees until I have lost another 20 pounds. That day is coming though.

In short, get a good fitness plan today, if you don’t already have one. It can be as simple as a 30-minute walk after dinner. Keep yourself in good physical condition and take an hour for yourself because you deserve that time. Physical exercise drops your stress level and makes everything in your life hum. I am having some “zone days” now that my physical condition is getting better and better. Having a good physical conditioning strategy is as important to your studies as your textbooks. Get moving.

Today is my Birthday!!

First of all, today’s my birthday and I have the day completely off. I have been basking in the warm sunshine (by the pool) and thinking about this post.

 Study Skills

Learning Style
One of the most useful things that I did was figure out my learning style. I am a very visual learner. I love to color-code information and I never go anywhere without my different colored highlighters and multi-colored pens. When I am studying, I use my highlighters to circle information, rather than highlighting words. Each color has a particular significance such as blue represents the main headings, pink represents the words that must be defined and all important concepts are circled in yellow. Green is my check-off color as I check off things as I study. This lets me know what I have accomplished. Visual learners like to sit in the front of the classroom for less distractions. During my first and second year of medical school, I sat on the end of the third row so that I could see. I was not a front-row person (too easy to get covered in saliva) and I would only sit in the back if I was doing something else (like reviewing another subject because I wasn’t particularly interested in this lecture).

As many folks are heading for summer school, medical school or just taking a much-needed break, I thought it would be a good time for me to review some study skills that helped me excel in undergraduate, graduate and medical school. I am planning to present my “Study Skills” in more than one part and as an ongoing series. One of the first things that needs to be done is an assessment of the skills that every student needs in today’s world. Along those lines are :

• Excellent reading and reading comprehension skills
• Computer skills
• Excellent writing skills
• Good math skills

The above components are the essence of doing well in your coursework and laying a strong foundation that will enable you to do well on the Medical College Admissions Test (MCAT). If you find that you are weak in one of these areas, use the summer to work on your weakness and convert it into a strength. All of the above skills can be mastered with practice.

Reading and Reading Comprehension

One of the best ways to increase your reading skills is to just read. Start with materials that you enjoy and move into your course materials. If you have the time, read some short fictions authors like Hemingway, Baldwin and Oates. As you are reading their stories, note carefully how their works are organized, how they set the tone of the work and how they use language to convey their thoughts to you, the reader.

Other short materials that you can look into are the editorials in your newspaper. These editorials are generally about the length of the writing sample that you will create on the MCAT. They usually follow the outline of Introduction and thesis, evidence, evidence and conclusion. Look at the paragraph structure underline the thesis statement and circle their evidence. Are their conclusions logical? Did they have a strong argument? Did they include a counter-argument? If you do not subscribe to a local newspaper, most large-city newspapers now publish on-line. Some of the best writing and editorials can be found in The Washington Post, The New York Times and The Richmond Times-Dispatch.

Another benefit of becoming a good reader is that good readers are almost inevitably good writers. As you read and become adept at critical analysis of your readings, you will likely become more skilled as a writer. Try reading an editorial and writing your version of a counter-argument to the editorial. It doesn’t matter if you agree or disagree with the editorial, just learn how to formulate a counter-argument. This task will also helps with getting used to using good grammar, sentence construction and word usage. By taking some time during the summer months (or a hour on the weekend) and practicing your reading and writing skills, you can greatly help yourself when it comes to writing your personal statement for you medical school education.

Another useful reading comprehension skill is learning to read and utilize your textbooks. Many courses such as General Biology, General Chemistry, Organic Chemistry and General Physics have excellent texts that are good adjuncts to your class lectures if you utilize them properly. At the beginning of every semester, you should be handed a course syllabus that contains your assigned readings, a lecture schedule and how you will be evaluated. Making sure that all assigned text readings are done BEFORE lecture can greatly increase your understanding of concepts.

The first task in evaluating a text book is to look at the overall organization of the book. Who is the author(s)? Where are they located? There is usually an “About the author” essay at the beginning (or end) of the book. Look at the table of contents and see how the material will be presented. Finally, look at each chapter and see if there are chapter summaries, key word summaries, concept summaries, questions and problems. Is there a glossary? Look at any appendices (often problem answers can be found here). Compare the table of contents with your course syllabus. This usually gives an excellent indication of how closely your professor will follow the assigned text. Finally, if there is a “study guide” for your textbook, purchase it. Study guides can help keep your mastery of the material on track. Also be aware that many textbooks have on-line study materials and extras. Be sure to take advantage of these materials whether they are assigned or not.

Computer Skills

In 2007, no college student can afford to say, “I don’t know anything about computers!” because the computer is as necessary to your college career as pen and notebook. If your computer skills are rusty, rudimentary or weak, go to your schools computer lab and take any free courses or just ask one of the assistants to get you started. Learn to use word processing software and presentation software. Add the use of data entry software after you have mastered word processing and presentation. Most colleges have courses and companies like Microsoft have free on-line tutorials.

If you don’t own a personal computer, head for the public library or your school’s computer lab. Purchase a portable “thumb” or “jump” drive to keep your documents handy. These drives can be purchased for less than $10 (512 MB) and can be worn around your neck or attached to your school ID card. You can use your jump drive to work on documents at home and at school. Just be sure to save your work on both drives.

Excellent Writing Skills

You should be sure that you have taken both English Composition and a literature course. You need to be very facile with both composition and critical reading. I have outlined some practice skills but your English coursework has to be in place in addition to practice. If your college English department offers a Critical Reading course, take it and do well. Often History and Philosophy Departments will have excellent critical thinking courses. These courses generally have research and writing assignments which should be taken into consideration as you are preparing your course schedules. Beware of taking a semester of heavy lab sciences coupled with heavy writing coursework.

Excellent Math Skills

If you didn’t study math in secondary school, most colleges will have remedial math courses for entering students. Take these courses and master mathematics. If you test beyond the remedial courses, the start with the math course that you testing indicates. Be sure to master mathematics as it is your main tool for mastery of General Chemistry and General Physics. Don’t “talk” yourself out of doing well in these courses by saying, “I am no good at math” because pre-medical studies will not allow you the luxury of being “no good” at anything. Just as I have to master the skills necessary to do surgery, you have to master the skills necessary to learn math and use it as a tool. Just because you are not working calculus problems in medical school, does not mean that you can afford not to learn calculus. It’s a great discipline and tool that enables you to master General Physics.

This is the end of the first edition of Study Skills. No matter where you are in your college or medical school career, you can utilize some of the things that I have outlined. You can decide today, that you are going to acquire the skills that you need to excel in your coursework.