doc w/ pen

a journalist becomes a doctor before your eyes

Month: March, 2014

The Difference a Day Can Make

One of my mom’s patient’s died during the night. Given that she works in hospice, this is neither out of the ordinary nor surprising. Death is a daily part of life for her. What makes this particular situation heart breaking is that the patient’s son and granddaughters – whom she hadn’t seen in years – were traveling from across the country to visit today. One day too late.

I don’t know the family situation, and it’s not my business to. What I do know is that I feel sadness for the patient who died without seeing her son and granddaughters again, and for the family, for missing her by only a day. But this day spelled the difference between life and death.

At the same time, this situation serves as a reminder, to care for and nurture the relationships that matter. Like it or not, that day comes for everyone. For you, for me, for the people we love. I don’t want it to make such a difference.

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For the Record …

Patient: What was my blood pressure at my last visit?

Doctor: That’s part of your medical record. I’d rather not say.

Sounds absurd, right? It is. And I’m guessing not many doctors have had that attitude. But prior to Congress passing the Health Insurance Portability and Accountability Act (HIPAA) in 1996, there was no federal law requiring health care practitioners to give you access to your own medical records or information. (Some states did have a law to that effect, though.) Now that access is guaranteed – even if you haven’t paid your bill – although practitioners are allowed to charge a “reasonable” amount for providing the information.

As more and more practitioners and facilities transition to electronic health records, some are piloting a new type of on-demand access: electronic patient portals. While they differ some in format or the extent of information available, the idea is that the portal is a secure, online repository of your medical information, from physician notes, to medication lists, to lab or test results, to upcoming visit schedules, and so on. These portals are often also interactive, allowing patients to schedule appointments, message their practitioners, and request medication refills.

Rush University Medical Center, which my internist is affiliated with, offers “MyChart,” its own patient portal system. There never seemed to be much reason to view it, though. After my recent run-in with the medical establishment, I decided to check it out, more for curiosity than anything.

Through the MyChart patient portal, I have access to a wealth of medical information, including these lab values.

It’s really pretty cool (at least for a curious pre-medical student such as myself; its efficacy for the general public is still a matter of debate; more on that later). For example, I was able to view all my labs from when I was in the ER, everything from my mono test (positive) to my strep culture (negative) to all of my CBC values. Upon opening up the CBC link, for example, two columns appear – both the standard ranges and my values.

OK, I’m no doctor (yet). So when I see values outside the normal range, or narrative values that make no sense to me, I have the tendency to become curious (at the least). For example, what the heck does “ATYP LYMPH / MODERATE” (at the very bottom of the screenshot) mean? Enter my good friend Google: this signifies that my immune system is actively fighting an infection. One Web site I found even specifically referenced infectious mononucleosis, explaining that mono produces a lymphocyte morphology with a dented cytoplasm, in addition to some other specific characteristics. So. I’ve got dented lymphocytes. Who knew?

So far, my use of MyChart has really been more for curiosity’s sake than anything, though. The true purpose of an electronic patient portal is to better patient outcomes, increase transparency in health care, improve coordination and continuity of care, enhance practitioner-patient communication, and foster a sense of ownership regarding one’s care (among other things). The question is: do patient portals live up to these goals?

To answer this particular query, I turned to another dear online friend, PubMed.* While my search on the subject is by no means exhaustive (or particularly scientific), here is a theme I found repeated:

We don’t know yet.

In fancier, more scientific language:

Evidence is mixed about the effect of portals on patient outcomes and satisfaction, although they may be more effective when used with case management. The effect of portals on utilization and efficiency is unclear, although patient race and ethcnicity, education level or literacy, and degree of comorbid conditions may influence use.

[Source: “Electronic Patient Portals: Evidence on Health Outcomes, Satisfaction, Efficiency, and Attitudes,” Annals of Internal Medicine, 2013]

Like I said.

The reason we don’t yet know how beneficial patient portals are is that they are relatively new, which means studies on them lack the longitudinality, detail, and context necessary to make convincing conclusions. The review article quoted above mentioned that in the studies they looked at, patient attitudes regarding the portals are “generally positive.” On the other hand, it seemed that not all patients had equal access to or understanding of the information available: “… more widespread use may require efforts to overcome racial, ethnic, and literacy barriers.” In other words, it becomes a health literacy issue, one complicated by the involvement of technology.

The review article’s bottom line:

Portals represent a new technology with benefits that are still unclear. Better understanding requires studies that include details about context, implementation factors, and cost.

That said, there is anecdotal evidence that patient portals are a positive development. Another article in the Annals of Internal Medicine, from 2012, looked at a group of 105 primary care doctors who provided electronic links of their visit notes to some 13,564 patients across three different practice sites. The self-identified goal of the study was to “evaluate the effect on doctors and patients of giving patient access to notes over secure Internet portals.”

The overarching result of the study:

At the end of the experimental period, 99% of patients wanted open notes to continue and no doctor elected to stop.

[Source: “Inviting Patients to Read Their Doctors’ Notes: A Quasi-Experimental Study and a Look Ahead,” Annals of Internal Medicine, 2012]

More detailed statistical findings, summarized below, were quite interesting as well (statistical ranges are given to represent the differences between practice sites).

Of the 5,391 patients who opened at least 1 note and completed a postintervention survey:

  • 77% to 87% across the three sites reported that the open notes helped them feel more in control of their care
  • 60% to 78% of those taking medications reported increased medication adherence
  • 26% to 36% had privacy concerns
  • 1% to 8% reported that the notes caused confusion, worry, or offense
  • 20% to 42% reported sharing the notes with others

After the intervention, the physicians were surveyed as well:

  • 0% to 5% reported longer visits
  • 0% to 8% reported more time addressing patients’ questions outside of visits
  • 3% to 36% of doctors reported changing documentation content
  • 0% to 21% reported taking more time writing notes

This anecdotal study has both strengths and weaknesses. A strength, and something I appreciate as a future physician, is that the authors did survey the doctors as well – important because anytime you introduce something new like this, you need the doctors on board to make it work. Making conclusions from this study, though, is dicey. The authors acknowledge this upfront with a “Limitations” section at the top of the paper: Only three geographic areas were studied. Most patients were already experienced in using such portals. Both doctors and patients choosing to participate and complete the final survey “may tend to offer favorable feedback.” The end survey response rate was low (41%).

Still, the results are something to think about. If, somehow, we could develop strategies for overcoming the racial, ethnic, and literacy barriers (as cited by the first review article), then maybe we could see more of these positive results across the general population.

Or … maybe not. But if it might help people take ownership of their health, I think it’s worth a try.

 

 

* In case you’re not familir with PubMed, it is basically a ginormous collection of scientific and medical journal articles online, curated by the US National Library of Medicine and the National Institues of Health. Some of them are free; others are available for purchase on the specific journal’s Web site. Being a Northwestern University employee, though, I have access to most of the articles at no charge. Gotta love connections.

From Abscess, to Aspiration, to Ambulance: An ER Adventure

At least the IV stick didn’t leave a bruise on my arm.

That was one of my first thoughts upon waking up Monday morning of this week. Not a typical waking-up thought, but understandable given what I had experienced Saturday and Sunday. I’d had a health care adventure, all of it quite accidentally. The 18-gauge needle down my throat and ambulance ride (among other things) were never supposed to happen. But they did …

It all started around 4 p.m. Saturday afternoon with a trip to urgent care for something seemingly simple – a sore throat. I figured it for strep. Along with the pain, though, I had developed some difficulty swallowing, problems breathing at night, and a slightly muffled voice. The urgent care physician took one look at my bulging left tonsil and told me I needed to go to the ER immediately. “You don’t have strep,” he said. “You have a peritonsillar abscess.”

Peri-what?

Peritonsillar abscess: a bacterial infection of the head and neck that can progress into what is basically a collection of pus that forms next to the tonsil. Severe cases can lead to a muffled voice (check), difficulty swallowing (check), problems breathing (check), and eventually complete airway obstruction (yikes!). Hence the need to go to the ER.

So head to the ER I did, at Rush Oak Park Hospital, which is just blocks from my house. The nurse practitioner (NP) who saw me agreed with the urgent care doctor’s diagnosis, and said she would attempt to aspirate the abscess. In other words: poke a hole in it with a big needle and suck out some of the pus with a syringe.

Gulp.

She and the nurse took me back to the ear/nose/throat (ENT) room, sat me in what looked like a dental chair, and prepared their instruments. As the NP was unwrapping the syringe and needle, my eyes widened.

“What gauge needle is that?” I asked. “Is that a 16?” I would know, having seen the gamut of sizes during my mouse work in the research lab at Northwestern.

She smiled wanly. “An 18,” she said. “I didn’t want you to see it because I thought it would make you nervous.”

For those of you unfamiliar with needle gauges, the smaller the number, the bigger the needle. When it’s about to be shoved down your throat and into your tonsil, an 18 gauge looks like a silver coffee stirrer with a pointy end. Lovely.

Not wanting to decrease my gag reflex, the NP didn’t anesthetize my throat at all, just swabbed the spot where she was going to aspirate with a bit of betadine (a solution to prevent infection). As her hand, and the syringe, neared my mouth, I closed my eyes. And then … owwwwww. When I opened my eyes again, I looked at the syringe. Empty.

After the nurse had suctioned my mouth, I asked: “Did you get anything?”

“Just a few drops of blood,” the NP said. “I’m going to try again.”

Hooray.

The second time was just as painful, with no better results.

After more suctioning and rinsing my mouth with peroxide (“Don’t swallow this!” the nurse said), I asked what was next.

“On to Plan B,” the NP said.

“What’s that?” I was understandably nervous, given Plan A.

“I haven’t figured that out yet,” she replied.

So back to my corner in the ER, where I was given IV antibiotics, steroids, and some painkillers. Shortly after that, I got a head/neck CT scan to see whether the abscess had infiltrated other tissues. It had not, thankfully.

Eventually, the NP came back. “I talked to the ER doctor, and he said you need to be transferred to Rush downtown [an affiliated, and much bigger hospital] to see ENT,” she said. “We’re calling an ambulance.”

By now, it was about 10 p.m. I was exhausted and in pain. Not to mention hungry. I hadn’t eaten since lunch. My plan had been to eat dinner after my trip to urgent care, but that went out the window. At this point, though, because they didn’t know what ENT would want to do, which was a comforting thought, I was NPO (nil per os, Latin for nothing through the mouth, aka no food or fluids).

After what seemed like ages (more like an hour), the ambulance came. One thing about an ambulance ride is that you feel every single pothole in your bones. And there are a lot of them on I-290 heading toward Chicago.

Rush University Medical Center in the city, nearly brand new, is impressive. I had my own room (with lots of bells and whistles) and a real hospital bed (exciting after having been on something resembling a padded cot for several hours). My nurse quickly hooked me up to a monitor and gave me more antibiotics and pain meds. Oh yes, and drew more blood.

At this point it was after midnight Sunday, and I had been up since before 5 a.m. Saturday. But the ER is not exactly a good place to sleep, with alarms constantly going off, people chattering, and an IV sticking in my arm. Not to mention a painfully swollen throat. As I drifted in and out of semi-consciousness, various people came in and out of my room to check on me. My nurse. The ER doc (who took one look at my throat and said: “Yep, that’s a peritonsillar abscess”). A fourth year medical student (at 3 a.m.) who had never seen a peritonsillar abscess before. Yep. Glad to be of educational service.

I had been told ENT would come around 7 a.m. Which came and went. It was 8, then 9, then 10. Finally, two residents came. One of them did all the talking. He basically said there was good and bad news. The good news: “You don’t have a peritonsillar abscess.” The bad news: “You have mono.”

Seriously?

They gleaned this from the CT scan I’d had done at Rush Oak Park, my bloodwork, and then finally their physical exam.

After relaying their news, the residents left to confer with their attending. They all returned a bit later. The attending physician repeated the diagnosis and gave his treatment instructions. For at least a month: no alcohol, no strenuous exercise, at least 8 hours of sleep a night. And basically, no stress. Yeah, right.

“Just from meeting you, I can tell you’re the kind of person who needs to be told to take it easy,” the attending said. “If you don’t rest now, this will return with a vengeance, and you will be on your butt for two months.”

I certainly don’t want that. So I’m taking a week off work, at the doctor’s suggestion, sleeping a lot, and trying to avoid stress. Which is a challenge when you’re in the midst of medical school applications. But I’m doing my best.

While I wouldn’t exactly recommend this adventure to other doctors-to-be, it was very much a learning experience.

For one thing, nurses can make or break a hospital stay. I was fortunate enough to have three fantastic ones throughout this ordeal: Amelia, Carma, and Laura. All three were helpful, kind, compassionate, and responsive, both in big and little things. Doing an IV stick that didn’t leave a bruise. Bringing me a warm blanket. Ordering me breakfast even while I was still NPO, in anticipation of ENT allowing me to eat after their examination (which they did). I felt like a person, not merely a bar-coded patient.

Another thing that struck me was that everyone (up until ENT came) thought I had a peritonsillar abscess: multiple doctors, nurse practitioners, and nurses. This got me thinking about how easy it can be to misdiagnose something – how two different issues, in my case a peritonsillar abscess and mono, can have very similar symptoms and pathologies.

In other words: It takes everyone working together as a team to make the medical magic happen.

One of my first thoughts as I woke up Tuesday, thinking back on all that happened this past weekend:

At least I have fantastic insurance.

Interview #6: University of Illinois at Urbana-Champaign (MD/PhD)

Since early October of 2013, I have had six medical school interviews. I will write a post about each one. Note: a version of this content was originally posted on OldPreMeds.org.

 

UIUC_logoInterview #6: University of Illinois at Urbana-Champaign, MD/PhD (3/8/2014)
Status: Withdrew

Given that this was my second MD/PhD interview (the first being at University of Illinois at Chicago), I more or less knew what to expect – LOTS of interview sessions with researchers, and LOTS of questions about my research. Also: Why both degees? And less of an emphasis about the clinical side of things. This pretty much held true at UIUC as well.

A little about this program – it’s different than most MD/PhD programs. Most of them have you do 2 years of med school (the basic sciences), then grad school, then the 2 years of clinicals. UIUC’s program involves all of grad school first, THEN all of med school. This means that you immediately apply to a specific graduate school program. In my case, since I am interested in diabetes/metabolism, it is the Division of Nutritional Sciences (DNS).

First thing in the morning, I had a 30-minute panel interview with both MD and PhD people. Given that this was my sixth med school interview, that wasn’t such a big deal. The rest of the day was (mostly) DNS interviews. I met with five researchers, plus the assistant director of the program, as well as had lunch with DNS students and later dinner at the DNS director’s house. (There had also been a social event with DNS students the previous night.) These MD/PhD interviews are INTENSE, to say the least!

I was very impressed with the administrators of the MD/PhD program – they truly seem to care about their students, and to support them in every way possible. The DNS folks were also quite wonderful. The PIs I talked with are doing some incredible work, and the administrators (like on the MD/PhD side) seemed very supportive and helpful.

One drawback on the MD side, though, is that Champaign-Urbana is a college community (population ~180,000), so the clinical opportunities aren’t the same as they would be in Chicago, for example. A downside on the PhD side is that you have to commit to a PI immediately (rather than do multiple lab rotations, as is done at many institutions).

The admissions process to this program is three pronged. You have to be accepted to the MD/PhD program, to the graduate school program, and to the College of Medicine (which is separate from the MD/PhD program). UIUC and UIC are in the same state university system, and I was accepted at UIC, so the College of Medicine acceptance part is taken care of for me. The other two groups are making their decisions very soon, so I won’t have to wait long to know the outcome.

Interview #5: Cornell (MD)

Since early October of 2013, I have had six medical school interviews. I will write a post about each one. Note: a version of this content was originally posted on OldPreMeds.org.

Interview #5: Weill Cornell Medical College (2/26/2014)
Status: Accepted (off the wait list)

To my understanding, Cornell chooses its incoming class in March. Which is now. So even though I interviewed very late (the last interview session as a matter of fact), I’m not in a terrible place.

Which is good. Because I very much liked it there.

My interview day was … interesting. And simultaneously wonderful.

I have a (presumed) stress fracture in my foot, and my doctor told me that if I was going to be traveling, I had to be on crutches. This made everything more difficult, as many of you know. Having never been on crutches, I was quickly made aware of this reality. From the airport, to my hotel, to Cornell, I had to ask numerous people (strangers) for help. Being an independent woman, and rather self-sufficient, this was very hard for me. And certainly gave me some empathy for people who deal with a physical disability on a regular basis.

I was blown away by the helpfulness of my fellow interviewees, my interviewers, the Cornell students I met, and especially the admissions staff. From stowing my luggage, to getting a bottle of water, to slowing down while walking, to hailing a taxi, people could not have been more kind.

So there was that. Then there was the interview experience itself.

My tour was led by not one but TWO non-trads. Totally coincidental, but that plus the fact that one of their classmates, an MS1 now, started at age 53, and I am totally impressed with the diversity of age range and life experiences at Cornell. There were opening remarks with one of the deans, lunch with students, and the aforementioned tour, as well as two 30-minute interview sessions. My first session was with an MD. We talked some about my secondary application essays (which included one on my divorce – a touchy subject for some perhaps, but one I am fine discussing). So word to the wise: if you don’t want to talk about it, DON’T write about it. We also talked about a program he is involved in, Music in Medicine, which is a privately funded program aimed at encouraging medical students to stay involved in music (instrumental, vocal, whatever). Given that I have played the piano since I was 8, I was intrigued by that for sure. They also have a writing group (I sort of like writing, as you might have figured out). My second interview was with a 4th year med student who, while in medical school, had managed to publish in peer-reviewed journals, write a book, and then take a year off to work on the Dr. Oz show. His take-home message was that if you want to accomplish something – from research to going abroad to whatever else – Cornell will help you make it happen, or at least put you in touch with the right people.

Another thing I like about the school is that nearly all medical students go abroad for a clinical, either to an established program, or to one of their making. Cornell is also piloting a new 18-month curriculum (as done at NYU, for example) that would allow for more flexibility in clinicals and other activities (such as going abroad). And who can beat subsidized housing in Manhattan, across the street from your classes?

Interview #4: University of Colorado (MD)

Since early October of 2013, I have had six medical school interviews. I will write a post about each one. Note: a version of this content was originally posted on OldPreMeds.org.

Interview #4:  University of Colorado (1/17/2014)
Status: Accepted

Colorado is like a second home to me. I was actually born there (in rural Colorado, near Pueblo). My dad’s whole family lives there. As a kid, we visited my relatives about once a year. I also have family ties to the University of Colorado (CU) – my dad went to medical school there, and my mom got her MSN there. One of my current PIs at Northwestern also went to CU for her MD/PhD.

But there is hearing about a school, and then there is actually seeing the school yourself. CU, which is now in Aurora at the Anschutz Medical Campus (just outside of Denver) on a nearly brand new campus, is a gorgeous school. The anatomy lab even has windows, which I’ve been told is a huge plus. There are multiple hospitals on the campus, and because CU is the only major medical center in the area, I was told a lot of interesting cases are brought (often flown) in. As a future physician-scientist, I also like that the school places a high value on research, offering a specific “track” in research (as well as other subjects).

I stayed the night before my interview with a student, who was a great host. For those of you on the pre-med journey, I very much recommend doing this if you can. She told me things about the school and the area I never would have heard otherwise.

As for the interview day itself, it was very relaxed. I had two 30-minute sessions, one with a retired MD, one with a JD. The JD asked me several thought-provoking ethical/hypothetical questions, but not onerous ones. I felt confident in my answers, and that I displayed a mature, well-thought-out response as opposed to a surface one. The MD interview was more laid back. He told me about his career (which spanned pediatrics and aerospace medicine … wow, just wow), and I told him about mine, past, present, and future. The associate dean of students also talked in between interview sessions. Turns out that he works part time as a family medicine physician in the same rural town where I was born, and where my dad worked in FP … such a strange coincidence. A clinical researcher (a non-trad, a former engineer) talked about some amazing work she is doing in obesity. There was also, of course, the obligatory financial aid presentation (those are always fun).

I really enjoyed my interview day, and the school in general.

I wound up staying with my cousin, who lives a few minutes from the medical school campus over the long Martin Luther King holiday weekend. I even got to go up to Rocky Mountain National Park on Sunday. Good times all around.

And a little more than three weeks later, my second acceptance!

Choices, choices, choices …

Interview #3: University of Illinois – Chicago (MSTP – MD/PhD)

Since early October of 2013, I have had six medical school interviews. I will write a post about each one. Note: a version of this content was originally posted on OldPreMeds.org.

Interview #3: University of Illinois – Chicago, MSTP (11/4/2013)
Status: Rejected

In November, I had my first MD/PhD interview, also at UIC. (UIC’s program is more specifically an MSTP – Medical Scientist Training Program – which is funded by the NIH.) I have had quite a bit of exposure to this program already, having attended its research seminars, met some of the students, etc. I think I have gotten a good sense of the program. I can see myself fitting in there.

I experienced a great deal of uncertainty, though, leading up to the interview. There were 12 interviewees; we received information about each other prior to interview day. When I saw people’s accomplishments – mainly, research experience – I felt out of place. (Not to mention that half of the applicants were biochem majors, one quarter engineering, one quarter biology … and then … me … journalism.) I realized that no matter how much preparation I did, I couldn’t compete with these other students in terms of scientific exposure or knowledge. That was impossible. What I could do, though, was talk about what other types of experience/skills I would bring to the program, and hope that resonated.

Unfortunately, I don’t feel like I had much of an opportunity to do that (or I didn’t seize it) during some of the interview sessions. And there were eight, yes, EIGHT, interview sessions total: three two-on-one sessions with adcoms, four sessions with faculty members of my choosing, and a session with the director of the program. I did talk about it with the program director, and he seemed very receptive to my being a non-trad, and told me that my enthusiasm shone through. I hope that counts for something.

Honestly, I don’t know how the interview went, overall. Some of the adcoms really seemed to appreciate and understand my story and path. Others were impossible to read. They interview people through February, so I may not hear until then, or even later. So I wait.

As of March 10, 2014: I still have yet to hear from the UIC MSTP, although I was told they wouldn’t even start extending offers until after the last interview date (in February). So I’m still hopeful.

Interview #2: University of Illinois – Chicago (MD)

Since early October of 2013, I have had six medical school interviews. I will write a post about each one. Note: a version of this content was originally posted on OldPreMeds.org.

Interview #2: University of Illinois – Chicago (10/16/2013)
Status: Accepted

Having worked at University of Illinois – Chicago (UIC) off and on for three years as a research assistant, I’m quite familiar with the campus, the medical school admission offices, where to park, etc. So that definitely took a lot of the uncertainty out of the day.

Another funny experience – I ran into an applicant who was at my IUSM interview. Which might have not been so strange except that he is not from the Midwest – he’s from Connecticut. Strange coincidence. It was nice, though, to see a familiar face.

The UIC interview day lasted from 9 a.m. to 2 p.m., and included three, half-hour, one-on-one interview sessions (with an MD, a PhD, and an MS4). There was also a tour, an admissions office presentation, and lunch (Chicago-style deep dish pizza, of course). This was a (mostly) “blind” interview, meaning that the interviewers had read only our personal statements, but had not seen grades, extracurricular activities, and so on. I asked the rationale for this, and was told that the idea is to give them the opportunity to make their decision solely based on your interview, rather than have a pre-determined idea about what kind of candidate you are prior to the interview. I can see pros and cons for both types of interviews, and now have had both. At UIC, I was a practically blank slate to these people. That made for some interesting conversations, but also put pressure on me to make sure I brought up some of the highlights of what I have done.

The interviewers’ styles were extremely different. The first (with the MD) was both off the cuff and spontaneous, while at the same time extremely professional. The MS4 created a more relaxed and casual atmosphere. While we talked about serious medicine/medical school topics, he also wanted to know my hobbies, music tastes, etc. The PhD asked more traditional questions, which was fine and I was (mostly) prepared for.

The campus tour was mostly old hat to me, although we got to see the cadaver lab, which was new to me – very cool. I had never seen a cadaver before, and wasn’t sure what to expect. It was fascinating, and got me excited to dig into Gross Anatomy this coming fall.

After the interview was over, I felt that it had gone well. And about two weeks later, I had proof of that in my hands – in the form of a letter stating that I had been accepted to the UIC class of 2018! No matter what happens the rest of the application season, I’m going to be a doctor. Holy shit.

Interview #1: Indiana University (MD)

Since early October of 2013, I have had six medical school interviews. I will write a post about each one. Note: a version of this content was originally posted on OldPreMeds.org.

Interview #1: Indiana University (10/2/2013)
Status: Rejected

My first medical school interview was at Indiana University School of Medicine (this was an MD program interview). IUSM has 9 campuses across the state, and I interviewed in Muncie, which is about 4.5 hours from where I live in the Chicago suburbs.

Funny story before I get to the interview part – Because Muncie is several hours away, the night before my interview I stayed at the Ball State University student union hotel, which is very close to the IUSM medical facilities. When I was checking in, the hotel clerk saw I was from Chicago and asked what brought me to Muncie.

“I have a medical school interview tomorrow!” I told her.

“Oh, you want to teach there?” she asked.

Ha. I’d heard of non-traditional pre-medical students being mistaken for faculty, but this is the first time it had happened to me. At least I look mature, right?

In spite of the fact that I’ve been on countless job interviews, and as a journalist have interviewed countless people (and thus am familiar with the interview process), I’ll admit – I was a tad nervous going in to the interview. I just wasn’t sure what to expect. The staff at Muncie though, as well as the faculty, were quite warm and welcoming and that helped put me at ease.

All of us interviewees were together in a conference room while we waited for our interviews, watched a financial aid presentation, etc. I was (by several years) the oldest in the room, which I had pretty much expected. The thing that did shock me was that one young woman brought her father. Yes, into the conference room. Where we were all waiting. Talk about awkward. Now, I get that they drove from several states away and probably had to check out of their hotel, but he could have gone to a restaurant, one of the university lounges, etc. Bringing your dad just doesn’t seem to send the right message, in my opinion. It seems inappropriate, like you’re not grown up yet.

After a brief tour, I had my interview. The moment I walked into the interview room and shook hands with the interviewers, my nerves disappeared. I felt in my element, in a way. Two people interviewed me, an MD and a PhD. It was very conversational and comfortable. There were some difficult questions, but I think I handled them well. The interview lasted about an hour, and then I was headed back to Chicago.

As of March 10, 2014 (more than five months after my interview), I still haven’t heard from IUSM. I’m thinking that’s not a good sign. While disappointing, it’s not the end of the world because my next interview, just two weeks after Indiana, went much better …