Research Gap Year or Straight into Med

Recently, I’ve hit a cross-road. This is my dilemma/confusion. Should I apply for Medical School this year and potential enter next year September – so I’ll be starting medical school straight after I graduate with my first degree (completed in 3 years) OR should I apply for medical school next year, and have a whole year off to do a paid-research internship/job to help pay for medical school tuition and living expenses?

1941473_orig

Source: Google Images

(http://crossroads2recovery.org/uploads/3/4/8/2/34829116/1941473_orig.jpg)

Proverbs 3:5 ‘Trust in the LORD with all your heart, AND lean not on your own understanding; In all your ways acknowledge Him, And He shall direct your paths’      

Psalm 37:5 ‘Commit your way to the LORD, Trust also in Him, And He shall bring it to pass’

Matthew 6:33 “But seek first the kingdom of God and His righteousness, and all these things shall be added to you”.

So here’s the deal. I would love to enter medical school straight off graduation, just because of that feeling of finally making it and not having to continuously doubt about the ‘will i get in, or not get in’ scenario. To know that I’ve finally arrived, and working towards something I am so deeply passionate about and as cliché as it might sound, something (medicine) I cannot imagine myself not doing – I  literally can’t think of anything else that would bring joy of knowing you have had a positive impact on someone’s life. To be a doctor is a privilege. You are given the opportunity to help those in dire need and provide care for the unfortunate. YES. I would love to enter straight in.

On the other hand, as a UK-resident, graduate-entry medicine is considered a post-graduate degree. Due to this complete funding from the government is not given and you are required to pay some fees. From my research; the grad-route is a four year course for students with an undergraduate degree in the experimental sciences (first degree requirement is subject to the school you apply to). The first of the four year course must be self-funded (* £3,465) with the rest of the tuition fee to be paid either by a tuition fee loan, bursary, or scholarship. For years 2-4, students from England and Wales are able to apply for NHS funding to help fund tuition fees – paying £3,465 first. The rest of the tuition fees can be paid through a tuition fees loan, NHS bursary (up to 4,491), NHS grant, and university bursary. So you’re basically covered for years 2-4. Maintenance loan for living costs can be applied for from years 1-4.

Summary – you have to self-fund the first year of graduate-entry medicine of (£3,465) and tuition fee loan can be applied for the remaining fee. A bursary or scholarship can aid in the remainder fee. For years 2-4, the NHS will pay the first £3,465 and remainder can be paid by a tuition fee loan (that you are not eligible to apply for), bursary, grant, etc.

Aside from the tuition fees (total £9,250 each year) there are living expenses to pay for. Yes, the NHS bursary, university bursary, grants, and maintenance loan can provide the helping hand, but as I would like to apply to a majority of London-based medical schools – living in London is pretty expensive. I am considering living outside London too. I guess if you think about it, the funding isn’t so bad only if you’re eligible for the bursaries, grants, loans – and you could always get a scholarship. But I feel like, taking the year out to work does not only provide the financial need but would help me to develop the work ethic and discipline I need for medicine. Additionally, taking a year out to potentially do research does make me more of a competitive applicant. Applying to grad-route entry is REALLY COMPETITIVE. The number of places range from 20-177, with the majority being in the 20 and 30s and you could imagine the number of applicants applying each year (i.e >200).

Medicine is demanding. And after reading numerous blogs of people’s medical experiences, and hearing from medical students – you don’t necessarily need to be crazy intelligent or a ‘genius’ but capable of reading VOLUMES of notes/lectures and keeping on top of things (correct me if I’m wrong) and that requires discipline.

Plus, taking a year out isn’t really a big deal. US citizens’ first degree is *4 years – UK is 3/4 years. Theoretically, I would be the same age entering med school as an American if I took a year out.

Plan A: Get into Medicine

Plan B: Gap year with research

It’s never a bad thing to look ahead and plan for the alternatives. Don’t put all your eggs in one basket – so you don’t set yourself up for disappointment.

All I know is, I want God’s perfect will/plan to be executed in life. If I am  to enter med school straight off, or take a gap year then let it be so. He will take care of our needs If we put His kingdom first above all things. I know he will direct my path, because He is NOT a God of confusion. He is a faithful God. All I know is my case is in God’s hands – regardless the funding or competitive obstacles placed before me.

1 Thessalonians5:24 He who calls you is faithful, who also will do it.

Sources: https://www.nottingham.ac.uk/studentservices/support/financialsupport/studentfunding/fundingforgemstudents.aspx

http://www.ox.ac.uk/admissions/undergraduate/fees-and-funding/oxford-support/funding-for-medical-students

Check out this site for more detail:

https://www.healthcareers.nhs.uk/i-am/considering-or-university/financial-support-university/financial-support-medical-and-dental

  • Make sure to do your research before APPLYING!

Stay blessed,

-D x

1 Thessalonians5:24 He who calls you is faithful, who also will do it.

 

First few weeks

My first week was challenging. First lecture of 2017, I was unable to attend (tube strike) and as I live quite a bit away from university the trek down would have taken longer than the lecture (1 hour), but luckily I got my hands on recordings of the lecture and should be able to catch up just fine. Tuesday. I missed 3 hours of a lecture. I’m seriously painting myself as a ‘horrible’ student. I’m not, there were just some unforeseeable circumstances that prevented me from going but LUCIKLY, the lecture was Q-reviewed and I am now watching the lecture back and making notes. Next lecture, I made it in. Basic Immunology. I absolutely loved it, I was able to follow the lecturer throughout and understand the basic concepts, it was more of a consolidating  lecture as he spoke about the primary lymphoid tissue, secondary lymphoid tissue, T cells and B cells, bone marrow, thymus, lymphocyte development, the usual you would expect of a first lecture that ‘eases’ you in. And lastly clinical microbiology.

Monday – Biochemistry

Tuesday – Pharmacology

Wednesday – Immunology

Thursday – Clinical Microbiology

+ Labs, Workshops, and Case study (essay/MCQ)

Biochemistry:

First lecture was about Glutamate Dehydrogenase (GDH) activity and regulation. Glutamate Dehydrogenase is an enzyme that partakes in amino acid degradation, a metabolic process that mainly takes place in the liver; although GDH is highly expressed in the brain, pancreas, and kidney. GDH catalyses the conversion of an amino acid into a a-ketoacid (deamination) as well as the conversion of an a-ketoacid back to an amino acid (amination). This is a reversible transamination reaction; whereby GDH – a transaminase enzyme acts to remove the a-amino group from a-amino acid (i.e. glutamate) to form a-ketoacid. GDH deamination is an anaplerotic reaction as an intermediate (a-ketoacid) formed can be used in the Krebs, TCA cycle to provide energy. Anaplerotic reactions are carried out when energy is low and there is no requirement for growth and metabolic top-up.

Pharmacology:

What is the difference between pharmacokinetics and pharmacodynamics?

Pharmacokinetics – the effect the body has on the drug (i.e. the breakdown of drugs by the liver). Defined as the measurement of changes in drug concentration, with time in different locations of the body – what the body does to the drug

Pharmacodynamics – the effect of the drug on the body. This would include events brought about by interactions of the drug with its receptor/primary site of action. It is the relationship between drug concentration at the site of action and resulting effect – what the drug does to the body.

Terminology to know: pharmacodynamics, pharmacokinetics, agonist, antagonist, occupancy, affinity, efficacy, and potency.

Immunology:

Toll-like receptors; TLR are activated by a number of different pathogen associated molecular patterns (PAMPS). PAMPs are characteristic components of the pathogen found at either one or more stages of infection, but absent in the vertebrae cell (i.e. the flagellum found on bacterial cells). This allows differentiation between self and non-self components. TLRs are found on the surface of mammalian cells and act to recognise components of the pathogen; bacterial/virus/fungi in order to alert the immune system. There are 10 expressed TLR gene in humans (so 10 TLRs present, what are they?)

PAMPs that can be detected (examples):

  • Lipoproteins
  • CpG DNA
  • Flagella
  • Double-stranded viral DNA
  • Lipopolysaccharide (gram-negative)

Clinical Microbiology:

Don’t judge me, I’m yet to start on clinical microbiology.

That was my first week. It’s been a month now. I have been struggling a bit, trying to adjust to the added workload from Sem B has been quite challenging. The detail of information you’re required to know is in fact more, and there is more to know. I know Medicine is x100 worse and the lectures they get in a day is probably a week’s worth of mine (slight exaggeration but could be true). So I have no excuse, I really need to step up and catch up with my notes; hence I am patiently waiting for reading week.

I’ve started reading: The Power of Habit by Charles Duhigg

Just to gain the concept of making good habits and changing bad ones.

I’d really like to make a habit of waking up early in the morning and dwelling in the presence of God before going to university and getting by through the day. I would like to make a habit of being more consistent with my studies despite the long commutes, to be consistent with the gym, as well as this blog. The book I’m reading is not going to suddenly form new habits for me, I’d much prefer the needed insight on what to do to make changes. It won’t be instant – but it’s a step in the right direction. In all honesty, I know my helper is God. And through Christ who strengthens me, I can do anything. My God will help me form the right habits, and see me through the plan and purpose he has for me.

1 Thessalonians 5:24 He who calls you is faithful; he will surely do it (ESV)

-D x

Stay blessed

2 Peter 1:5-8 For this very reason, make every effort to supplement your faith with virtue, and virtue with knowledge, and knowledge with self-control, and self-control with steadfastness, and steadfastness with godliness, and godliness with brotherly affection, and brotherly affection with love. 8For if these qualities are yours and are increasing, they keep you from being ineffective or unfruitful in the knowledge of our Lord Jesus Christ. (ESV)

 

Guys I hosted the ‘Doctor’s Panel Talk’

I spoke, I introduced Surgeons that are experts in their fields,  and I ran the talk/event. It was crazy, I’ve  never felt so nervous in my life. God opened a door for me, an opportunity for me and I took it. It wasn’t  smooth sailing, I stumbled on my words with some occasionally stuttering and I couldn’t even pronounce ‘ALLERGIC’. After numerous attempts I finally got it and the audience laughed.  I cracked a smile, maybe they were just trying to ease the tension. I got into the flow of things as I read the credentials of some the surgeons, each of them helplessly smiling to encourage me the more. Two of them weren’t able to attend, due to unforeseeable circumstances , and that was perfectly fine as we  overran with the 5 surgeons we had.

I can see I am pushing/putting myself out there. If you would have asked me to host anything close to an event such as the talk a year ago, I would kindly decline because I saw myself as the shy and quite type. But in the years to come, I want to be more confident in myself and my abilities. So in order to do so, I have to take on opportunities that come my way and not let fear and self doubt take it’s toll.

After introducing the surgeons with my partner, each surgeon took to the stage and spoke about their subspecialty. It had to be the best talk I’d ever attended in years. Each speaker so interesting and passionate about their speciality, granting as invaluable knowledge we’ll need and use as I was sure to have seen students jotting down notes. I think I was far too excited to listen at times, but when I did catch up with their talks, I was in awe. Do I want to be a surgeon? Well they sold it to me. The talk surely inspired and motivated students. One of the speakers actually completed a bachelors, masters, and PHD before embarking on Medicine knowing the medical career was all he could picture himself having. He is now a consultant Neurosurgeon. Graduate students studying a mere  bachelors, such as I,  would have definitely been encouraged as the time and journey it takes to get there accounts for nothing once you’ve achieved it. Have faith, because all things are truly possible for those who believe. As a Christian, the ‘faith’ mentality has truly helped me and It’s something I am still working on.

The subspecialties spoken about included: Ophthalmology, General Surgery, Plastic Surgery, Neurosurgery, and Gynaecology and Oncology.

Here are a few pictures from the evening:

dsc02897dsc02879dsc03903DSC03891.jpgDSC02848.jpg

Christmas break is going well. First week was totally relaxation time. Did I deserve it? I don’t think so. I’ve got a lot of lectures from Semester A to catch up on, or It’ll haunt me in Semester B. So now I’ve got approximately 2 weeks to finish ALL LECTURES NOTES on about 4 modules. Not too bad.

I apologise for not going into much detail of the event, this post is sort of a small update.

Hope you’re all enjoying your Christmas break!

Happy Holidays

-D x

John 5:38 ‘But you do not have His word abiding in you, because whom He sent, Him you do not believe.’

Doctor’s Talk

Hey guys! It’s been a minute.

This week by far has been the most intense since returning. The week started with two tests, a physiology MCQ followed by a human molecular biology test (more IT based test on genomic data and how to use the genome browser overall. Here’s the site we used: https://genome.ucsc.edu/). With a slight interlude,  I had to prep for a PBL session by researching objectives that correlated with the patient case study provided. We’ll then have to write a 2,000 word essay on the study. The case study is of a patient X. X has a ‘supposed ovarian cancer’ as blood tests showed high levels of CA-125 levels (protein/tumour maker produced particularly by ovarian cancerous cells). As CA-125 is produced and released into the blood, a CA-125 test can be administered. High levels of CA-125 is usually an indication of the cancer, however the test is non-specific as other conditions of the genital system: fibroids, endometriosis, pelvic inflammatory disease, and pregnancy can result in an increase in CA-125 levels in the blood. Other tests that can be carried out to solidify the diagnosis include; an MRI scan, CT scan, Ultrasound, chest X-ray, laparoscopy, and an abdominal fluid aspiration – where a very thin needle is inserted into the abdomen and a fluid sample is taken. The fluid sample obtained is then tested for the presence of cancerous cells.

Ovarian adenocarcinoma: cancer that arises at the ovary or ovaries causing the production of cancerous cells able to spread and invade other organs.

Treatment proposed for patient X included;  Bilateral salpingo-oophorectomy, Total abdominal hysterectomy, and Omentectomy.

Bilateral salpingo-oophorectomy – removal of ovary and fallopian tube. This can be unilateral (one ovary and tube) or bilateral (both ovaries and both tubes).

Total abdominal hysterectomy – removal of the uterus (womb) via an incision made in the lower abdomen. A partial hysterectomy can also be performed. This is where only the uterus is removed, but the cervix is kept intact. Total abdominal hysterectomy removes both uterus and cervix.

Omentectomy – removal of part of the omentum or all of the omentum. The omentum is the fold of peritoneum that connects the stomach to all other abdominal organs. It is a large fatty ‘sheet’ that overlies the abdominal organs, and functions to nourish the organs.

 

A mass from Patient’s X ovary is taken and sent to histopathology’s. The pathology report revealed the mass to be a malignant tumour and the above surgeries mentioned were to be carried out. After the surgery the patient is referred to the oncology department and placed under chemotherapy treatment.

The objectives given required us to explain treatments associated with ovarian cancer, prognosis of the patient,  the genetic basis of cancer and so forth. I find this ‘Case Approach’ module to be simply intriguing. In fact, It’s sort of a step up to the conventional analyse results and tell me why your results are so in terms of the biological aspects but to look forward to how cases may be approached in medical school. Our particular course does have in mind that many of the undergraduates aspire to go on to medical school, thus, the modules are tailored just for that – to build a foundation. During the PBL session we discussed points we should address in the essay and answered the objectives briefly. At the end of the tutorial, I had to rush of to volunteer – can’t go into much details here but I ended up returning home around 7pm and just crashed – watched a bit of The Apprentice of course. Next day, I had to complete a lab report in basically a night because of all the prior assignments set for completion at the beginning of the week. Stress. I managed to finish the report and handed it in just in time before the deadline. God is faithful. It’s been a busy week – and It’s not ended yet, It’s Friday and I’ve got a 3 hour lab session + 4 hours of lectures. All in all, I’ve already conquered this week.

I remember telling you of my position in the Biomedic’s Society – Academic Officer. So I’m required to plan and execute academic events that support the ethos of the society. An idea of mine was to have a panel of doctors to inform us about what their sub-speciality entails- what a day in the hospital really looks like  and  subject areas most grad-entry medicine students would love to know about: their career path, their current views on the NHS , interview and application tips, why medicine? etc. By God’s grace, I’ve managed to get consultants in the following fields: Neurosurgery, Cardiothoracic surgery, General surgery, Ophthalmology, Paediatric Gastroenterology, Gynaecology and Oncology, and Plastic surgery. Neat right? I’m seriously dead excited to meet these consultants and bottom line gain invaluable knowledge about their subspecialties.

Here’s what our flyer looks like:

 

doctors-talk

I have removed the names of the doctors for confidentiality reasons

We are hoping for a great turn out. Thus far, our promotion hasn’t really been on point but I’m hoping to kick start it  and just go ham on it. It’s because most of the society committee members being 2nd and 3rd years, they’ve had a busy week with tests and in course assessments, so it couldn’t really be helped. We’ve got a few weeks to make a change. At the moment, I’m trying to push for the event to be free just so more people would be encouraged to come. Hopefully I’ll be able to pitch a good case at the meeting on Monday.

My Cell Biology & Developmental Genetics module lectures take place on Fridays. We had an hour lecture in the morning, followed by an afternoon lecture. Thankfully, we’ve moved on from the developmental aspects of the module into lectures that focuses in on the cell biology aspects. Interestingly, the lecturer said that although the lecture isn’t based on cancer she’ll linking biology of cells to cancer- how things go wrong in the cells that result in cancer development. This is what I found to be most intriguing. The first lecture addressed the definition of a growth factor, modes of communication, and signalling pathways within the cell and many other subtopics.

 

picture

Lovely

It’s a new week. I have an essay to plan and write, I have 2 lab reports to finish, society work, and a full day of volunteering.

The joy of the Lord is my strength! I can do anything through Christ who strengthens me.

How has your week been?

Stay blessed

-D x

Psalm 28:7 ‘The Lord is my strength and my shield; My heart trusted in Him, and I am helped. Therefore my heart greatly rejoices, And with my song I will praise Him.’

Philippians 4:13 ‘I can do all things through Christ who strengths me.’

Nehemiah 8:10 ‘Then he said to them, “Go your way, eat the fat, drink the sweet, and send portions to those for whom nothing is prepared; for this day is holy to our Lord. Do not sorrow, for the joy of the Lord is your strength.”

UKCAT & GAMSAT

UKCAT – UK Clinical Aptitude Test is a 2 hour computerised test. It consists of five sections;

  • Verbal Reasoning
  • Decision Making
  • Quantitative Reasoning
  • Abstract Reasoning
  • Situational Judgement

Unlike the BMAT, the UKCAT does not test you on any science curricular but focuses on cognitive competence required in the medical profession. UKCAT in my opinion should be easier than the BMAT, however having done the BMAT previously and revised for the UKCAT, I much prefer the BMAT because one of it’s section questions you on your knowledge whilst UKCAT questions for the most part test you on how you think and make judgements. Although both forms of tests assess your critical thinking. There are more undergraduate universities that require the UKCAT for medicine than there are graduate.

Verbal Reasoning

The core objective of this subtest is to examine your ability to  gather information from the passage presented and draw out specific conclusions from the text. From this section, there are 11 passages presented. For each passage there are 4 questions asked. This can be in the forms; True/False/Can’t Tell or Free text. The time allowed for this section is 22 minutes. According to the UKCAT website, the reason for this section is that doctors and dentists must acquire verbal reasoning skills that can be used to understand complex concepts which can then be relayed to patients in a straightforward and clear manner. They should also be able to apply new medical findings to their practice as well as review it’s validity. Fair enough. Here’s an example;

..............2

Decision Making

Decision making is a new subtest as of 2016. It has replaced ‘Decision Analysis’. The main difference between them is the format of the question asked. In decision analysis a code is given, you are then asked a number of questions using the code, using logic and decision analysis the code can be translated into a sentence but you have to select the best translated sentence out of a number of competent answers. On the other hand, for the decision making subtest you are given text/charts/tables/graphs/diagrams accompanied with information. You are required to asses how valid the suggested answers are and hence select the most valid answer or place ‘yes’ or ‘no’ responses to each of the 5 statements given. There are 29 items given and 32 minutes allowed. Performance in this section is not counted into your overall UKCAT score neither is it sent to your medical school of choice. However, you are encouraged to take the subtest seriously as it contributes to evaluation of the subtest and selection process for future medical and dental students. There are 4 components to this section; deductive reasoning – where you deduce which of the conclusive statements is reflective of the opening statement, evaluating arguments – a text or question is provided and the best argument is chosen, statistical reasoning – conclusions are made based on data provided, and lastly figural reasoning – conclusions made are based on sequences presented.

Quantitative Reasoning

GCSE maths knowledge and problem solving skills are needed for this section. There are 9 scenarios each with 4 questions hence the total number of questions asked is 36. The time allowed for this section is 25 minutes. In relation to clinical practice, this subtest is required as a doctor is constantly presented with data such as  patients’ charts or drug calculations that have to be made in accordance to the patients weight, height, age etc. An online-screen calculator is provided however it is advised to carry out simple arithmetic calculations in your head to save time.

 

nnn

On-Screen Calculator

Abstract Reasoning

Absolutely hate this section – I see no point in this one. In this section you are required to determine the correct set of shapes amongst incorrect sets posed to be distracting. There are 55 items/questions with each question associated with sets of shapes. You are given a total time of 14 minutes. Out of the 55 questions asked, there are 4 core types that can be identified. For the first type you are given two sets – Set A and Set B within each set there are 5 boxes each with a number of shapes that may differ in terms of colour, pattern, and shape. You would then have to choose if the test shape asked in the question belonged to Set A, Set B, or neither. The second type you are presented with a series of boxes each with a number of shape that may follow a particular pattern. You are then required to choose the next box consisting of shapes that follows next in the sequence. For the third, you are given a statement that relates to two sets of shapes – where are change in one set causes a change in the next set, thus using the same principle, a set is given and you must apply the same change in order to determine what the new set would look like. The new set is then chosen from 4 options given. The last type requires you to identify which set of the 4 options given belongs to Set A or Set B. Here are the examples given for each type from the UKCAT website;

Situational Judgement

This section is used to test your perception on issues you may come across in everyday life or in a medical setting and how you would approach it. There are two forms of questions asked. First being able to determine how appreciate a response is relating to the scenario given. This could be; ‘very appropriate, appropriate but not ideal, inappropriate but not awful, and very inappropriate’. The second format questions you on how important an action is in relation to the scenario given. So you’ve got a scenario, a statement is made – which states response to the scenario. You will have to judge how important that response is to the scenario, is it ‘very important, important, of minor importance, or not at all important’ and so forth. This sections asses your judgement solely and hence does not require prior medical knowledge. There are 20 scenarios given and for each scenario 2-5 questions. Thus you have a total of 69 questions in this section and a total time of 27 minutes. Sweet.

In terms of scoring, raw scores are converted to scale scores that range from 300-900 for each subtest. The total scale score is then calculated by adding the scale scores for all subtests which can now range from 900-2700 opposed to 1200-3600 as there are now 4 subtest that contribute to the total instead of 5 as of 2016. Details are given on the UKCAT website on how to compare scores obtained to those used by the University. The situational judgment section is scored differently, where full marks are awarded when the correct response is chosen and partial marks are given when the response chosen is close to the correct response. The scores given are expressed in bands. From band 1 to band 4 with band 1 being the highest and 4 being the lowest. Here’s an explanation of the bands again from UKCAT;

oooooooooooooooooooooo

I think that’s about it. I know a lot you would know the UKCAT format but I just wanted to give a quick outline of the test as I have plenty of spare time. I got all this information from the UKCAT website as well as the Medic Portal – which is an extremely useful site where you can find all you need to know about the UKCAT,BMAT, and GAMSAT. They also have questions banks and courses as well as personal statement advice, reading list etc. I’m finding it really useful so check it out. Other sites that I’ve used for revision in the past is Medify – more question banks and Ace Medicine .Kaplan looks good too.

If I come across anymore useful websites I’ll make sure to list them here.

GAMSAT next.

-D x

James 2:26 ‘For as the body without the spirit is dead, so faith without works is dead also.’