Wednesday, August 6, 2008

Application Essay Advice for Pre-Meds

Because it's pre-med season in town, I will try to post some advice for applicants trying to get through it unscathed. My first topic is about the AMCAS essay.

My suggestions are:

1) Tell a story

2) Feel free to brag, but be descriptive and specific (Not "I worked closely with patients," but "I held so-and-so's hand when she tearfully told me that she was ready to enter the OR."

3) Avoid phrases like "The experience taught me..." and "It was rewarding because...." Just make those things implicitly clear through your writing.

4) Show, don't tell!

Savvy readers will note that all of the above snippets of advice are basically the same. But that is because pretty much all boring application essays make the same mistake.

Pretend you're trying to impress the hot girl in Italian class. Are you going to pick her up by listing all of your extra-curricular activities, or by just making her feel like she'd have fun going kayaking with you this weekend? In other words, show your personality, not your CV.

And now, for your final viewing pleasure, my AMCAS essay. (All of the names that appear in the essay are names of people I met that summer, but none refer to the actual child being described. I will readily admit that I'm a bit of a braggart in the essay, and I will trust my audience to assume that I don't usually try to come off like I have all my **** together (which I don't). I should also note that, although I did at the time want to do international medicine, I am no longer sure that that is the case):

Exiting the subway in the Brownsville section of Brooklyn to begin my first day as head of a camp infirmary, I conjured up childhood memories of my own camp's infirmary, where scraped knees earned Ninja Turtles band-aids, and sore throats were soothed by a good dose of ice pops. This reminiscence, however, was tempered by recollections of my previous summer as an EMT serving in an economically disadvantaged neighborhood in Israel. The realities of domestic violence, acute physical illness, and emotional dysfunction in a population of Ethiopian and Russian immigrants, Ultra-Orthodox Jews, and Israeli-Arabs had dispelled my naive notions of emergency medical care. Would my experience in East New York also bring unexpected challenges? These musings were cut short by my arrival at a dilapidated public school building on a graffiti-filled block, with throngs of boisterous children running around in Camp ******* T-shirts.

As the individual responsible for the physical well-being of the campers, I felt that my primary task was to secure a safe and healthful camp environment. Thus, after helping to organize game of "Simon Says" until all the counselors arrived, I found an unventilated storage closet to function as a medical office, brought in a fan, and, over time, decorated the space with the children's artwork. Ascertaining that there was only one working water fountain for over 100 campers, I coordinated with the counselors to supervise the ongoing refilling of the children's water bottles. After noticing that soap was absent from the bathrooms, and learning that the facilities staff were too budget-strapped or overloaded with work orders to replace them, I bought and allocated soap myself. Finally, I aimed to make the medical office a safe haven for the kids, often playing games or reading with my visitors.

I soon discovered that, while there were few medical emergencies in the camp, there were plenty of ethical, practical, and cultural challenges confronting me. What should I do if, before breakfast, a child says that she is starving because she did not eat dinner the night before? What was my role if a mother told me that she cannot bring her child to the doctor because she lacks health insurance? What of the child who is afraid because she says that her brother often beats her mother? How do I effectively empathize with a child who suffers from sickle-cell anemia? Many of these problems, such as violence, depressive moods, and general illnesses can be found in any community, rich or poor. However, some issues were disproportionately prevalent as this was an economically disadvantaged community.

When I encountered these complex issues, I often dealt with them by consulting with my supervisors and peers. The counselors were role models for me, as most of them were college students from the neighborhood, and brought a wisdom born of experience. At other times, I relied on my own judgment. As an oldest child in a family whose youngest brother is fifteen years my junior, I have had my share of dealing with interpersonal conflicts, scraped elbows, and negotiated truces. Thus, when it became clear to me that five-year old Bianca was manufacturing the illnesses that required her visiting me during reading session, I proactively offered that she read with me during that time-slot.

What impressed me most of all that summer was the incredible power of a caring community. Despite the difficult realities surrounding them, the children were ambitious, intelligent, friendly, and playful. Many would pass my makeshift office, and announce, somewhat inaccurately, "Hi nurse!" Tafari informed me whenever he won relay races, while Kyana always showed me new stickers, earned for good behavior. The parents were kind and supportive, as evidenced by their filling the auditorium on "performance day," as well as the generous home-cooked soul food that they brought.

This interface of medical practice and real-life ethical and practical challenges draws me to public health, international medicine, and perhaps, specifically epidemiology. I want to address issues such as the Ebola virus or the effects of unsanitized water, but also how to make health care economically efficient and sustainable, and to explore the relationship between doctors and the communities they serve. I hope to listen to patients talk about their lives, their assessment of their illness, and their collaborative thoughts on the healing process.

On the last day of camp, many campers came by my office to sign messages on my staff T-shirt. This included eleven-year old Najee, who, while recovering from a stomach ache, had related to me some difficult emotional issues that she was facing. I had developed a good relationship with her and encouraged her to visit the camp social worker. Najee's note to me summed up my goal for the summer and my future goal as a doctor- to develop a meaningful relationship with each patient: "Dear nurse," she wrote. "Thank you for letting me talk in your office and listening to me.”

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