1. Realize that you’re not the only one. The reality is that most of us worry about the same kinds of things – such as whether others like us, are bored by others, or the kind of impression we’re making.
2. Try to uncover the roots of your anxiety. There may be a variety of reasons for…
colossalmass asked: Could you make a post about what a typical day for a med student is like? :)
I can only vouch for me, but here is what a typical weekday for me was last semester.
A test or quiz or presentation was always less than a week away, looming over my head.
I always fell asleep around midnight.
6:15am: Alarm goes off. 15 more minutes. Cuddle the Cute Boy and sleepily mumble nice things to each other (this is a crucial part of mornings for us).
6:30am: Alarm goes off. For real this time. Get up.
6:30am-7:30/45am: Maybe shower, eat breakfast, assemble materials needed for day, feed kittens, make small effort at not looking like a slob (makeup, some baubles, always pretty shoes if nothing else). Make coffee and leave. Try not to spill scalding hot coffee on myself as I drive to school. Usually I fail.
8am: arrive at school. Sit next to friend in same general area of mostly empty lecture hall.
8am-10am: Biochemistry lectures. Try to pay attention, but there is internet.
10am-12pm: Physiology lectures. Writing on paper notes in tremendously helpful, but sometimes there is internet. At some point text the Cute Boy or receive text from him with general ‘Have a good day, I love you, this thing happened.’ missive.
12pm: leave school. Maybe stay if there is a lecture with free food.
12:30pm: Eat lunch at home. Generally either leftovers, a peanut butter sandwich and some fruit, or a quesadilla if I’m feeling fancy. Debate taking a nap.
1pm-7pm: A mixture of studying, internet, cleaning, household chores, napping, snacking. Sometimes there are afternoon classes, boo hiss. Sometimes I study in a coffeeshop or at the library if I really need to make sure I don’t nap, but mostly at home. No set schedule. Roommate arrives home at 7pm and by then I am always up in my study cave upstairs. We discuss our day. She goes downstairs to make dinner because she is wonderful.
7:30pm-8pm: Eat delectable dinner that female life partner/roommate has concocted. I do dishes and go back upstairs.
8pm-10pm/11pm: Make evening arrangements with Cute Boy. Squeeze last little bit of studying out of myself.
10:30pm/11:30pm: crawl into bed with Cute Boy. Cuddle and talk and do grownup things… probably staying up longer than we should, but it’s ok because we miss each other.
So… yeah. That was my typical weekday. I definitely could have been more efficient with my studying if I’d had more discipline.
With obesity reaching epidemic levels in some parts of the world, scientists have only begun to understand why it is such a persistent condition. A study in the Journal of Biological Chemistry adds substantially to the story by reporting the discovery of a molecular chain of events in the brains of obese rats that undermined their ability to suppress appetite and to increase calorie burning.
It’s a vicious cycle, involving a breakdown in how brain cells process key proteins, that allows obesity to beget further obesity. But in a finding that might prove encouraging in the long term, the researchers at Brown University and Lifespan also found that they could intervene to break that cycle by fixing the core protein-processing problem.
Before the study, scientists knew that one mechanism in which obesity perpetuates itself was by causing resistance to leptin, a hormone that signals the brain about the status of fat in the body. But years ago senior author Eduardo A. Nillni, professor of medicine at Brown University and a researcher at Rhode Island Hospital, observed that after meals obese rats had a dearth of another key hormone — alpha-MSH — compared to rats of normal weight.
Alpha-MSH has two jobs in parts of the hypothalamus region of the brain. One is to suppress the activity of food-seeking brain cells. The second is to signal other brain cells to produce the hormone TRH, which prompts the thyroid gland to spur calorie burning activity in the body.
In the obese rats alpha-MSH was low, despite an abundance of leptin and despite normal levels of gene expression both for its biochemical precursor protein called pro-opiomelanocortin (POMC) and for a key enzyme called PC2 that processes POMC in brain cells. There had to be more to the story than just leptin, and it wasn’t a problem with expressing the needed genes.
Nillni and his co-authors, including lead authors Isin Cakir and Nicole Cyr, conducted the new study to find out where the alpha-MSH deficit was coming from. Nillni said he suspected that the problem might lie in the brain cells’ mechanism for processing the POMC protein to make alpha-MSH.
Protein processing problems
To do their work, the team fed some rats a high-calorie diet and fed others a normal diet for 12 weeks. The overfed rats developed the condition of “diet-induced obesity.” The team then studied the hormone levels and brain cell physiology of the rats. They also tested their findings by experimenting with the biochemistry of key individual cells on the lab bench.
They found that in the obese rats, a key “machine” in the brain cells’ assembly line of protein-making, called the endoplasmic reticulum (ER), becomes stressed and overwhelmed. The overloaded ER apparently fumbles the proper handling of PC2, perhaps discarding it because it can’t be folded up properly. The PC2 levels they measured in obese rats, for example, were 53 percent lower than in normal rats. Alpha-MSH peptides were also barely more than half as abundant in obese rats as they were in healthy rats.
“In our study we showed that what actually prevents the production of more alpha-MSH peptide is that ER stress was decreasing the biosynthesis of POMC by affecting one key enzyme that is essential for the formation of alpha-MSH,” Nillni said. “This is so novel. Nobody ever looked at that.”
Novel as it was, the story — a stressed ER mishandles PC2, which leaves POMC unfolded, which impedes alpha-MSH production — needed experimental confirmation.
The team provided that confirmation in several ways: In obese rats they measured elevated levels of known markers of ER stress. They also purposely induced ER stress in cells using pharmacological agents and saw that both PC2 and Alpha-MSH levels dropped.
Next they conducted an experiment to see if fixing ER stress would improve alpha-MSH production. They treated lean and obese rats for two days with a chemical called TUDCA, which is known to alleviate ER stress. If ER stress is responsible for alpha-MSH production problems, the researchers would see alpha-MSH recover in obese rats treated with TUDCA. Sure enough, while TUDCA didn’t increase alpha-MSH production in normal rats, it increased it markedly in the obese rats.
Similarly on the benchtop they took mouse neurons that produce PC2 and POMC and pretreated some with a similar chemical called PBA that prevents ER stress. They left others untreated. Then they induced ER stress in all the cells. Under that ER stress, those that had been pretreated with PBA produced about twice as much PC2 as those that had not.
Nillni cautioned that although his team found ways to restore PC2 and alpha-MSH by treating ER stress in living rats and individual cells, the agents used in the study are not readily applicable as medicines for treating obesity in humans. There could well be unknown and unwanted side effects, for example, and TUDCA is not approved for human use by the U.S. Food and Drug Administration.
But by laying out the exact mechanism responsible for why the brains of the obese rats failed to curb appetite or spur greater calorie burning, Nillni said, the study points drug makers to several opportunities where they can intervene to break this new, vicious cycle that helps obesity to perpetuate itself.
“Understanding the central control of energy-regulating neuropeptides during diet-induced obesity is important for the identification of therapeutic targets to prevent and or mitigate obesity pathology,” the authors wrote.
slo-med-love asked: Hi, congrats on finishing the first year! I was wondering: when does a school year start at where you're from? Because I'm the first year med student as well but we won't be finished until the end of June.
In the fall semester we start in the first couple weeks of August (this year it’s like August 3rd or some ridiculousness like that) and go to the middle of December. In the spring semester we start right at the beginning of January (January 2nd this year, thus killing all my plans to go NYE crazy in Chicago) and go till the beginning of May. Second years get out at the end of April so they can have as much time as possible to focus on Step 1 studying.
Third and fourth year… do not abide by the normal rules. Pretty sure that business is basically continuous after Step 1.
End of June, huh? Stay strong. I believe in you.
xoxo0000 asked: So I am aiming for the Ivy Leagues, I have a B- in calculus part 2, everything else is A-, A, or A+ in my freshman year. SHOULD I FREAK OUT?!!! I'M FREAKING OUT?!!! I wouldn't be if I was going for mid level med schools but Ivy Leagues?!!!
Ok. Step one: stop freaking out.
Aiming for Ivy Leagues? Fuck yeah! Mega fistbump!
OK, so I would probably see if you can talk to a representative from the school(s) you are looking at- ask them what they weight in admissions. Maybe GPA is not as important as MCAT or interview or any of the other 16 factors in an application.
Honestly, in my unprofessional opinion, I feel like a B in Calc 2 (which most schools don’t even require as far as I know) in your freshmen year- especially if you have that Ivy League level MCAT score and all the research/volunteer work/you are a real person/etc- is no big deal. But what I do I know.
Also check out THIS nifty website out- all the US medical schools, their average GPA and MCAT score, and deadlines for submission (also be super sure to check your school’s admissions website, this info might be on there in a more updated form). You’d be surprised at some of the Ivy League stats- but remember, these are averages.
And, just kick ass the rest of your undergrad career! Those schools are massively competitive, so do whatever you can to make sure you stand out from the pack.
So I’ve noticed on my blog and most of the other medblrs I follow that there have been a metric crapton (units= kg/crapⁿ, n=number of craps) of asks from concerned pre-meds about their grades. It’s the end of the year. You’re getting your grades. Activate freakout mode.
I understand your concern you guys, I really do. I remember what it was like, and, back in my day, (like before 2010) there was only SDN to turn to for questions such as these. It was a dark, dark time.
But, I’ve got to unleash a little tough love on you all because y’all are going to drive me, everyone else, and yourselves flipping crazy.
Ok. So. If you are:
+ in high school or below
+ anything less than a junior in undergrad
Calm. The. Fuck. Down.
Getting a B or even a C or getting a several B’s is not the end of the world. Your hopes of getting into medical school are not crushed forever. This does not mean that you are dumb or won’t make a fantastic doctor.
Here is a brief list of things I got a B in: Intro to biology (by one stinkin point), Organic Chem II, Physics I, Physics II, Physiology. I got a C in Ochem I. Ask any other medblr, I promise, and you will hear similar tales involving some B’s and some C’s.
Obviously, I am not saying “Oh, get B’s, whatever.” You should try as hard as you fucking can. But, sometimes things happen. Maybe there was a family or personal crisis or a host of other very legitimate reasons that you didn’t do as well as you hoped in the class. That’s ok. A B is not ideal, but it’s also not necessarily the end of the world and your hopes and dreams.
You (and your application) are more than your GPA.
Say it aloud with me:
You (and your application) are more than your GPA.
Medical school admission committees are going to look at your whole kajillion page application: your MCAT, your letters of recommendation, your volunteer/work experience, your extracurriculars, your personal statement (for the love of holy french fries do not put the words ‘I want to help people’ in there- of course you do, that is why most people become doctors- say it another way.).
No one is going to say, “Shucks about Suzy Q Pre-Med; she has such an awesome MCAT score, and loads of volunteer work that you can tell she really cares about, and she’s been in the hospital environment, and she plays tennis, and loves to paint birdhouses… but those two B’s from her freshmen year are really just killing her application.” (Disclaimer: Does not apply to ultra competitive/Ivy-League type places, sorry, those B’s might matter there)
OK, so maybe you aren’t in high school or just wrapping up your first year of college. Maybe you are a junior and you only need 24 more credits to graduate and your GPA isn’t super.
You don’t get to despair either, sorry.
Here is my advice to you:
+ kick ass in your remaining classes, retake any relevant pre-reqs that you got low grades in if possible
+ kick ass on the MCAT. Not to put any pressure on you, but yeah.
+ you should have already had some volunteer/research/work experience by now. Beef that up.
+ explain any weak spots in your transcript on your AMCAS application- there is a spot for that, and it does get read.
+ wait and see
If you get in, HOORAY!! If you don’t, call your choice schools and ask why. That’s totally ok, no one keeps a record of people who call and ask questions I promise. Was it your GPA? Your MCAT score? Your interview?
Then, fix it. If it’s your GPA, consider getting a Master’s in something health-related to beef that up. Apply again. There are several people in my class who applied two or three times before they got in. Because if it’s your life dream to be a doctor and you can’t imagine doing anything else with yourself, don’t let anything stop you.
ERmedicine enters, quite dramatically.
From the perspective of a pre-med and someone who has been in all of your anxiety ridden shoes, I can 100% relate to your worries. I don’t have an amazing GPA and I had a lot of anxiety about medical school. BUT, there comes a point where you’re worrying too much. I’ve been there. Before finding the medblr community, I was stuck reading SDN, which as we all know MAKES EVERYTHING WORSE AND YOU SHOULD NEVER EVER SEEK ADVICE ON THAT WEBSITE UNLESS YOU WANT TO MAKE THINGS WORSE.
I’m also going to pull the example of someone I know who had a 3.7 science and a 3.8 cumulative, did well on the MCAT, AND still didn’t get into medical school. Why? Because they were nothing but their GPA. Your GPA is like a pie crust. It holds everything together, and it’s important, but it’s nothing without the filling (which is YOU). You can have an okay tasting pie crust and still have an amazing apple pie. Without any pie filling all you have some bland ass bread.
But y’all just need to slow down. The more you worry, the more you’ll put yourself in a bad situation. If you’re a freshman- hell, even a sophomore- you have room to improve. Don’t let grades stop you from pursing medicine if it’s what you’re serious about. There are so many ways to improve your application as AspDocs mentioned earlier. It’s the road I chose when I realized I was lacking in the grades department. I have a wonderful job that gives me a such an amazing experience and it honestly showed me that if you’re determined to get into medical school and you take the right steps, you will eventually get in. And even though I’m not applying this cycle, I’m not worried one bit. (Yes I’ve had worries about applying, but not about getting in). I’m determined to get in and I know it’s what I want to do with my life, and I’m not going to roll over on my goals because of my GPA. I have so many options available to me and they’re all going to get me into medical school.
In most cases, your GPA is not going to permanently bar you from getting into medical school (I put this disclaimer here because if you’ve failed every single pre-req then maybe this isn’t the right field for you, and there’s no shame in that).
Here’s some statistics for you (it’s time for a come to Jesus circle, y’all):
+ The average age of medical students at matriculation: 24
+ The average age at undergraduate graduation: 22
In case you forgot how to math, that’s a two year difference. Not everyone gets into medical school their first time. No one is going to think less of you as a physician because you applied more than once to medical school. Your title isn’t going to be “Dr. Paul M.D./D.O (Applied more than once to medical school)”. No one is going to care.
You really just need to calm your tits. No other way to say it. Your B(s) in freshman year aren’t going to kill your chances of medical school. Your C in Ochem isn’t going to make your application look bad. AND FOR THE LAST TIME SUMMER COURSES DON’T MAKE YOU LOOK BAD YOU SHOULD TRY TAKING AN ENTIRE SEMESTER OF OCHEM IN A 5 WEEK PERIOD AND THEN EXPLAIN HOW IT’S GOING TO LOOK BAD.
Just chill out, and, instead of spending all of your energy worrying, spend it actually changing the situation you’re in.
And really… don’t forget to have some fun (no I don’t mean go one a crazy week long crack/cocaine binge). Actually realize what it’s like to be in college. Plan out some free time and learn to relax. You’re going to kill yourself if you spend all of your time pent up in your dorm studying and not enjoying your college experience.
Approach your studies with a positive attitude
Arrange your schedule to eliminate distractions
Select a reasonable chunk of material to study
Survey the headings, graphics, pre- and post questions to get an overview
LOOK LOOKIE YOU GUYS SUMMER IS HERE THE SHANDY IS AT THE GROCERY STORE.
I also made something badass for dinner:
- one onion, diced and sauteed in olive oil
- two chopped up tomatoes
- copious amounts of goat cheese
- two pacakages of croissant dough.
Make a square with the croissants (2 together), drizzle olive oil, layer of onions, layer of cheese, layer of tomatoes, salt pepper and basil, another layer of croissant dough. Makes 4 pockets/squares of delicious. Tap together to seal.
Bake at 375 for 15-18 minutes.
I do not like nature. I am a city girl to the core.
I get sunburned if I think about the daystar (thanks, Swedish ancestors, you jerks), bugs sense my presence and tell all their friends and family than an all you can eat buffet has rolled into the neighborhood, and plants turn me into a pathetic itchy, sneezy, coughing, runny nosed ball of sadness.
However. The Cute Boy, whom I adore more than pretty much everything, loves the outdoors.
And, when we first met in November, I went on a overnight camping trip that was mostly successful- and now he has all these great dreams of us camping and swinging on rope swings into creeks and eating hot dogs by the campfire and cuddling under the stars. I realize the first trip was a smashing success because everything that I am allergic to or bites me was dead and it was cold enough that I was covered up by clothing so the sun’s rays couldn’t get me.
But, because part of loving someone is sometimes making compromises for them, I am going to attempt to do this nature thing this summer. It would make him so happy.
To ease myself into it, a friend from school and I went on a hike in a local park this morning. After our hike we were going to picnic and eat sandwiches and drink beer. It was going to be swell and marvelous.
Guess what happened?
First we got lost and then a torrential downpour hit us.
Conclusion: Nature hates me.
F-bombs are like salt and pepper. You need to sprinkle them in every now and then to add flavor.
I teach my residents all sorts of important things on rounds (via baffledinbrooklyn)
The f word is one of my favorite words. I prefer to use it like punctuation, just so people know where commas and exclamation points would go.
Recently, your mother and I were searching for an answer on Google. Halfway through entering the question, Google returned a list of the most popular searches in the world. Perched at the top of the list was “How to keep him interested.”
It startled me. I scanned several of the countless articles about how to be sexy and sexual, when to bring him a beer versus a sandwich, and the ways to make him feel smart and superior.
And I got angry.
Little One, it is not, has never been, and never will be your job to “keep him interested.”
Little One, your only task is to know deeply in your soul—in that unshakeable place that isn’t rattled by rejection and loss and ego—that you are worthy of interest. (If you can remember that everyone else is worthy of interest also, the battle of your life will be mostly won. But that is a letter for another day.)
If you can trust your worth in this way, you will be attractive in the most important sense of the word: you will attract a boy who is both capable of interest and who wants to spend his one life investing all of his interest in you.
Little One, I want to tell you about the boy who doesn’t need to be kept interested, because he knows you are interesting:
I don’t care if he puts his elbows on the dinner table—as long as he puts his eyes on the way your nose scrunches when you smile. And then can’t stop looking.
I don’t care if he can’t play a bit of golf with me—as long as he can play with the children you give him and revel in all the glorious and frustrating ways they are just like you.
I don’t care if he doesn’t follow his wallet—as long as he follows his heart and it always leads him back to you.
I don’t care if he is strong—as long as he gives you the space to exercise the strength that is in your heart.
I couldn’t care less how he votes—as long as he wakes up every morning and daily elects you to a place of honor in your home and a place of reverence in his heart.
I don’t care about the color of his skin—as long as he paints the canvas of your lives with brushstrokes of patience, and sacrifice, and vulnerability, and tenderness.
I don’t care if he was raised in this religion or that religion or no religion—as long as he was raised to value the sacred and to know every moment of life, and every moment of life with you, is deeply sacred.
In the end, Little One, if you stumble across a man like that and he and I have nothing else in common, we will have the most important thing in common:
Because in the end, Little One, the only thing you should have to do to “keep him interested” is to be you.
Your eternally interested guy,
My Dad has said almost these exact same things to me and my little sister since we were very small.
It’s so easy to forget in the sea of modern culture that is constantly thrown at me from grocery story checkout line magazine racks and internet ads and TV shows and mindless pop song lyrics.
Ladies (and gentlemen): Read this. Take it to heart.