Saturday 31 December 2011

End of the year...

So, 2011 is finally drawing to a close. It's been a rather interesting year for me and so I feel compelled to join in with the corny reflective blog entries, and then I'll probably continue with the corniness and make some resolutions of some kind.

2011 didn't start off in any particularly exciting way - my then-bf's uncle died on New Year's Eve and so the first event of any significance in the New Year was a funeral. I suppose that did mean that things really could only improve!

My first placement after the holidays was in general practice. I hadn't really expected to enjoy it much but I had a fantastic time. The staff were all lovely and I've kept in touch with one of the nurses and one of the receptionists. I was also able to do an audit whilst I was there, which was probably pretty good for the CV/job applications. Plus, it was on one of my "favourite" (read "favourite thing to rant about") topics - MMR vaccine uptake.

The rest of the academic year went fairly well, if uneventfully. Fourth year was rather stressful in the sense that, GP aside, we were only on most blocks for a week at a time so by the time we'd worked out who and where everyone/thing on the ward was, it was time to move on. On top of that, as anyone silly enough to have read my blog will know, in June we had our final written exams. From about March time I spent most evenings and weekends studying. Rather sad, but it paid off when I passed. A little scary to know that the next written exams I take will probably be my membership exams - eek!

Over the summer I had two wonderful weeks away volunteering. I won't go into details as I've already blogged about them, but they were lovely experiences and even now, months later, I still smile when thinking about them. I very much hope that I can squeeze in at least one this year.

This academic year has been rather up and down. After something of a dull start (professional practise block - yawn!( I had a wonderful experience on my elective in New Zealand. As well as enjoying the travel and change of scenery, my placement was fantastic and only reinforced my absolute love of paediatrics. After getting back to the UK, my gastroenterology placement was slightly less to my liking. However, I do feel like I came on a lot in terms of my knowledge and clinical skills, so overall I'd say it was successful.

Uni aside, I have of course got my job for once I've graduated. Rather exciting and terrifying at the same time. I'm still waiting to find out the exact details of my contract but it's nice to know that, providing I pass my OSCEs in June, I will have a job to start. After 7 (!!!) years of studying I'm rather looking forward to joining the real world.

Ignoring a lot of trivial and banal things which really don't matter, I'd say overall 2011 has been a pretty successful year for me - I hope 2012 continues in a similar way!

Now, resolution time! These are largely unrelated to work so don't really belong in this blog, but I thought it would be good for me to write them down somewhere so that I felt accountable!

- Get fit again. This is a major one for me because I know when I'm fitter and exercising more regularly my mood, energy and sleep are all much better. I was going to the gym at least 3 times a week until exams started taking up too much time. Then with elective and a placement out of town I haven't really had the chance.
- Start eating properly again. This is another "again" as it's a good habit I'd managed to get into which has lapsed recently. Ideally I'd like to lose weight but my primary goal is to eat properly and stop using food as an emotional crutch.
- Sort out my finances. Rather dull but as I'm now in my 7th year of student life, I am rather skint. This isn't an immediate thing but I'm hoping that if I'm sensible now and start working (hopefully!) in August that by the end of the year I will at least have cleared my credit card and overdraft...
- Attempt to be more positive. This is something I say every year and I'm not very good at it (look what I did there, self deprecation in action!) so I'll have to keep on trying.

Right, those are my little aims for the next year. And to graduate and become a doctor of course!

Happy New Year everyone! xxx

Tuesday 20 December 2011

Merry Christmas!

Well, I've made it to the end of term.

I must say that this has been a very up and down semester for me. Whilst I've learned lots and been kept busy (definitely a good thing for me) I've found there have been periods where I've felt stressed and unstimulated in equal amounts. As mentioned in my previous post, the staffing on my ward wasn't amazing. This meant that on more than one occassion, I was the most senior medic present. Given that I'm not qualified and therefore can't prescribe drugs (or even simple fluids) or do most procedures unsupervised, it meant I felt rather useless. At one point I was asked to see a patient who could potentially been very sick when there was no doctor present. Whilst he turned out not to be too unstable, the situation could have been rather disaterous. I'm not entirely sure what the right thing to do in that situation is, but I decided that taking a quick history, doing a brief examination, sending off some bloods and then bleeping my consultant was the way forward. No idea what I'd have done if I'd arrived to find him unstable - probably just skipped the history and bleeped someone asap. Hopefully I don't find myself in that situation again until I'm at least able to do something reasonable about it.

Despite my stressful experiences, there were plenty of good things about this block. I've got far more confident doing and interpreting bloods and ECGs, and I've been able to do an ascitic tap and insert a paracentesis drain. It comes very naturally to me to be negative about things, and in particular myself and my abilities, however if I'm honest I probably did quite well. All the consultants I worked with were very complimentary about me and said I'd make a good junior, which was nice to hear. One of the registrars even said I shouldn't go into paeds (as is the plan) because they wanted me in medicine. He was probably just being nice, but it was still good to hear something positive.

Continuing on a positive note (it really doesn't come easy to me, but I'm trying!), I've won a prize! I'm not actually sure what it means, but it's a student prize from the Royal College of Paediatrics & Child Health. I was nominated by a consultant I've done a bit of work with, which was nice. I'm fairly sure he only nominated me because I've annoyed him enough for him to remember my name, but none the less it was nice to get some recognition that I'm not totally rubbish. I'm getting to go to their annual conference in May, which will hopefully be really interesting as well as a good networking opportunity. I have submitted a paper to present there too, and I'll find out in January whether that's been accepted.

Well, it's now the holidays and a few days in I'm getting medicine withdrawal symptoms - so if any of you need any help researching/writing anything or want a student to analyse some data for you - get in touch!

Have a lovely Christmas everyone xxx

Thursday 24 November 2011

The more you put in, the more you get out...

...or at least that's what we're told about our placements this year. In reality, it seems that what you get out of your placement is down to how lucky you are with your consultants and registrars. I must say before I sound like I'm complaining that everyone on my placement has been really friendly and welcoming, which has been lovely. Unfortunately, I think I was spoiled by being paired with a really confident and encouraging reg in my first fortnight and now I'm not working with her (she's doing stints on AMAU, night shifts etc) I feel like things are a little bit dull. I think it's partly because we've also been very understaffed recently, and of course it's much quicker and easier to just do something than to supervise your medical student through it. I've just felt like recently I haven't had any opportunities to think. I actually look forward to consultant ward rounds because I know I'll get a grilling and will have to think a bit and most likely learn something too. I accidentally started a bit of a debate on Twitter at the weekend when I said this placement was making me not look forward to my FY jobs. 140 characters is pretty limited, so sometimes getting your point across is difficult. I think that what I was (admittedly rather inarticulately) trying to say was that there doesn't seem to be much opportunity to actually use your brain as a fifth year and I'm worried next year will be similar. Hopefully it's just a bad time on the ward with staffing etc and this isn't reflective of what my jobs will be like... Sorry for the rant there!

Thursday 3 November 2011

I'm A Terrible Blogger!

v note with some shock that it's been 3 months since my last update. Time has flown by pretty quickly and I'm now over 25% of the way through my final year in student-ville. I've been pretty busy so here's a brief update:

- I got back from my elective 2 weeks ago. A couple of months in New Zealand flew by ridiculously quickly. I had a fantastic time there, the people are super friendly, the country is beautiful and I learned loads on my hospital placement. I was based in paediatrics and got loads of hands on experience, including sticking venflons in neonates - something decidedly easier than I'd expected it to be. I'm seriously considering moving out there for specialist training. There were quite a lot of British registrars at the hospital and it's apparently pretty easy to get jobs.

- I have a job!! On 15th September I unfortunately didn't get offered a job in the first offers round, but was placed on the waiting list by two deaneries. However a couple of days later I got an offer for an acamic medical job. After briefly considering what to do, I decided to accept. I've already spoken to one of the consultants I've worked a lot with and he said he's happy for me to do the academic part of my job in paeds, so I'm super happy.

- At the moment I'm on placement in gastroenterology ward. I'm actually really enjoying it and it's been really good for showing me what I know and what I still need to learn. I've also got to do a few practical procedures; last week I got to put in a paracentesis drain which was pretty cool. However, what scares me about this placement is that the first two weeks have already flown by and there are only 6 before the Chr!stm@s holidays, when I'll technically be half was through the year. Terrifying.

Anyway, those are the major updates. I shall attempt to blog more regularly from now on, although no doubt my posts will be more medicine and less job related now the AFP is secured.

xxx

Tuesday 30 August 2011

Somewhat Overdue...

Greetings from Kuala Lumpur! I'm currently here for a couple of days en route to my elective placement in New Zealand. Staying in a rather basic (but clean!) hostel, exploring a new city and chilling out so that hopefully by the time I arrive in Hawke's Bay on Friday morning I'll be nicely rested and relaxed :)

The lack of updating recently has been due, in no small part, to me deperately trying to get organised for my elective. However, I also had my last week of work at my job (summarising medical records in a GP surgery - just can't commit a reasonable amount of time to it this year), 2 weeks of uni and an interview for the Scottish AFP. I'm hoping that justifies my silence in the blogosphere!

Having got back from my Sense holiday, I had 2 days at my parents' house before returning back to my uni flat and working for the final week of my summer break. It was quite odd finishing as I've been there over 18 months and actually really enjoyed it. I would happily keep it up, particularly as the money would be handy, but with elective, placements, finding an FY post etc I just don't think it's realistic to pretend I can hold do a job. Once I was done with work, I had 2 weeks of (pretty dull) classes on professionalism, communication skills, careers and all the other dull stuff you have to do at medical school aside from the actual medicine. It does feel quite strange knowing that, after all this time, I'm actually in my final year of medical school and if all goes well I'll be a doctor in less than a year...

As I mentioned before, I had an interview for the Scottish academic foundation programme on Thursday. It was a really difficult interview to prepare for as I genuinely had absolutely no idea what to expect. The interview was in 2 parts, a 10 minute interview with 2 clinicians (in my case a GP and a liaison psychiatrist) on clinical issues and a further 10 minutes with 4 academics on the more academic side of things. The clinical stuff was ok, largely about communication, professionalism, good qualities for a dr to have etc - really quite similar to the kind of things they were asking when I applied to med school, but looking for more specifics as I actually know some medicine now! I did screw up a bit when they asked how I'd treat an insulin overdose because we've never been formally taught that so I didn't have an answer to hand the way I would if they'd asked about, say, DKA or acute asthma or paracetamol overdose, but I'm hoping that I managed to come to the right conclusions eventually, and if not, the fact that I said "call for senior help" will give me some credit! The academic part was really difficult as it's a bit strange trying to talk to 4 people at once, but the questions themselves were easy enough to answer and the panel all seemed really nice. I hear either way on September 15th so just got to keep my fingers crossed until then - although it's not the end of the world if I don't get it, it would be nice.

Right, it's 11.30pm here and I'm hoping to fit in a decent amount of sightseeing tomorrow as it's my last day here, so I'm going to sign off and head to bed.

Hope everyone's keeping well and I'll update about New Zealand once I get there :) xxx

Sunday 7 August 2011

Makes Sense!

Yesterday I got back from a week's volunteering with Sense (http://www.sense.org.uk/), who are the UK's national deafblind charity. A group of volunteers took 5 young boys with multisensory impairment (as well as other needs/difficulties) away to the Cotswalds for a week, where we swam, ice skated, go-karted, ate, drank, laughed and generally had a fantastic time. This was my third holiday with Sense (those of you who also read my OTW-related posts may have gathered that I'm a bit of a volunteering addict), although my first with children as I'd previously worked with adults. I cannot describe adequately what a special experience this kind of work is. It is, however, rather tiring, thus I have spent most of the time since I got home sleeping. This got me thinking - I am exhausted after just a week. How on earth do parents/carers who look after these kids full time manage? I have the utmost respect for anyone who looks after someone with these kind of complex needs.

After such a good week, I'm feeling pretty positive. This is in no small part due to the fact that on Monday, I received an email inviting me to interview for an AFP at the end of the month. There are two short interviews, one regarding clinical issues and the other on academic/portfolio issues. I am absolutely terrified as I have no idea what to expect. I'm going to make sure I've read over my application and know everything there is to know about anything I've mentioned. The last time I had any kind of serious interview was when I applied to medical school so I feel a bit out of practise... Any tips greatfully received!

Hope all the students reading have had exam success and are enjoying the summer and all junior docs are settling into their new jobs :) x

Wednesday 27 July 2011

The Waiting Game

Today is, according to their website, the day when the one of the AFPs I applied to are due to finish shortlisting of applications - which means that by the end of today, someone, somewhere, knows whether or not my application form was good enough to convince someone to interview me. I'm not entirely convinced it will be; of the three forms I filled in, I felt I made the best job of the other one, and I didn't get an interview there. That said, I don't know how much emphasis each deanery put on different components of the application. Unlike a lot of applicants, I don't have a single publication yet. I have got something which has been approved and is currently with the editors, but that doesn't count for much. I am hoping that my BSc, having some lab experience and the audit I did during my GP placement will go some way to compensating for that, but we'll just have to see. I hope I hear soon one way or another - I can cope with disappointment but the not knowing is frustrating!

Monday 11 July 2011

You Win Some, You Lose Some

As mentioned in my last post, I've just spent a week volunteering with Over The Wall and had an absolutely fantastic time. This was my fourth holiday with them and it was every bit as fantastic as the previous three I've done. One of the great things about OTW, aside from meeting a lot of inspirational young people and having a brilliant time, is when the other volunteers write you "warm fuzzies"; these are basically just little notes to say hi and comment on anything they think you did well or which stood out over the week. Anyway, after reading mine (and getting out old ones from previous camps), it occurred to me that I'm perceived in a totally different way at camp to how I'm perceived in "the real world". I can think of two possible explanations for this. Either I'm a completely different person for one week of the year, which seems unlikely, or I actually have no idea how I'm normally perceived and just make it up. This seems somewhat unrelated to this blog, which is supposedly about my academic endeavours, however it just made me realise having such a negative view of myself was probably not going to help my career prospects. So I shall now attempt to be a more positive person!

Moving on to more relevant stuff, on Wednesday I got an email to say my one of my AFP applications had been unsuccessful. I was pretty disappointed, as having read over their criteria, I have all of the "essential" and some of the "desirable" qualities and thought I might manage to get an interview. However, it's a hugely competitive and popular programme and I know that there are a lot of applicants with far more research experience, publications etc than I have. I'll just have to hope I have better news from one of the other two!
On a much more positive note - I passed my exams! Hugely relieved, especially about the OSCE as there were so many things I realised I'd forgotten to do/say as soon as I got out of each station. This means I'm officially a final year, which is a little bit scary but very exciting :)

Hope everyone waiting on exam results has good news soon xxx

Tuesday 28 June 2011

OSCE and Freedom!

So today was the dreaded OSCE. I've always suffered horrendously with exam nerves, and although in recent years I've managed to get a hold of myself during written exams, I really struggle to hold things together during OSCEs. For some reason, every examination, history or procedure that I've done numerous times in the preceeding months leaves my memory and I feel like I enter every station completely clueless. This year in particular, things were not helped by the revision day put on for us at uni, where I was not-so-politely told, after one particularly disasterous station, that I was under no circumstances to go anywhere near a sick patient as I was basically completely incompetent... Cue an evening of tears, sickness and panicky phone calls to medical friends. Utter nightmare. However, once that was done I decided to focus on "practise, practise, practise" - the only way to really get through a clinical exam. I spent Friday and Saturday reading MacLeod's Clinical Examination and my Ask Doctor Clarke books cover to cover, then Sunday and Monday both involved practising with friends.

This morning I have to admit I felt rather unwell (ie like I could well vomit on the first patient I saw...), but having seen most of my year group feeling the same way, I realised things could've been much worse. The exam itself was rather hard to judge. I was lucky in that my first 3 stations were all written, as I find the written bits much easier and less panic-inducing, so that meant I started on a reasonably positive note. Aside from forgetting to take the respiratory rate of the patient in the "examine this gentleman's respiratory system" station (schoolboy error!), I can't think of any epic disasters. There were more communication/history stations than I'd imagined, which I think was a good thing, and no limb neurology or musculoskeletal exams - a definite bonus as they're my two weakest areas. All in all, I suppose it went "ok", not amazing, not terrible. I didn't cry when I came out of the exam (unlike quite a few people, and indeed me myself last year) and don't think I had any complete blanks. So I'm just going to try and forget about it until results come out a week on Friday.

This evening I'm going for dinner with some of the people from my ward group, which should be a nice way to mark the end of the year, and then we'll meet up with the rest of our class for some drinking, dancing and general debauchery! We have some lecture thing at uni tomorrow about registering with the GMC, and I suspect I may not be alone in attending with a bit of a headache (or possibly still drunk!); having to be in at 9.30am the day after exams isn't ideal but I'm sure I'll survive.

On Friday I'm going away for a week to volunteer for Over The Wall (http://www.otw.org.uk/), an amazing charity who run holidays for children affected by serious illnesses. It'll be the fourth time I've volunteered with them and I cannot wait! It's usually a completely crazy week involving lots of facepaint, nail varnish, singing, dancing, food challenges and general silliness :) So I may not update until I'm back, by which time I should have my results - eek.

Good luck to anyone still doing exams, and those who are finished enjoy your new-found freedom! xxx

Wednesday 22 June 2011

Exams Pt II

Written exams are now done! It feels incredibly odd to know that if I've passed, I won't sit another written exam until I do my membership papers.

There was another MEQ this morning, which was probably on a par with Monday's paper in terms of difficulty/weirdness. There were good psych and paeds questions, and a decent obstetric one too, which I'm happy about. There was a pretty tricky one on burns management, which everyone seemed to have found difficult, but the rest was fine. Once again I was first to leave, which made me a bit paranoid that I'd misinterpreted something that was actually more difficult/time consuming than I'd thought, but I think overall it went reasonably well (although the invigilator did say they were going to make me a more difficult paper so I took longer next time..).

This afternoon was the SBA (single best answer) paper, which is well known for being incredibly difficult because for a lot of the questions, there will be two answers which are correct, but you have to chose the one that's "most" correct. The majority were relatively obvious though, or at least possible to work out using first principles. Funnily enough after a Twitter debate last night (I'm @the_learnaholic) on the relevance of hypoxic drive, a question about an acute exacerbation of COPD came up. I left this exam first too, which makes me think that I read abnormally quickly! I was home and in the bath before the exam was even over...

Well, only the OSCE on Tuesday left to study for. There'a revision day at uni tomorrow which I'm hoping will be useful, as I'm never too sure how to prepare for OSCEs. I also went on the Ask Doctor Clarke revision courses earlier this year, which should prove useful.

Hope everyone else with exams is getting through without too much stress! xxx

Monday 20 June 2011

Exams Pt I

I had my first two exams today; I have two more on Wednesday and then an OSCE next Tuesday.

This set of exams are a little odd, as they're my "finals" in the sense that I'll only have an OSCE to do next year, no written papers. It feels strange calling them finals when I still have another year at uni, but we keep being told that next year is all about the practical stuff so our knowledge now should be all we need to get through - scary thought!

Anyway, after a near nervous breakdown last night (asking friends to test you less than 12 hours before an exam is never a good idea, especially if they test you on things you've honestly never heard of in your life!) and about 8 hours sleep all weekend, I managed to get through.

This morning was the MEQ (modified essay questions), where there were 9 scenarios with associated short answer questions. A slightly odd mix of topics came up. There was no paediatrics or psychiatry, which is a little annoying as they're probably my best subjects. Cancer came up 3 times (suppose it is common and important) and there was a scenario which was largely about audiology... Bizarre! I was the first person to leave, which often happens in exams as I'm a really fast reader. I'm not sure how anyone spent 2 and a half hours on it, but I definitely answered everything! Anyway, having chatted to other people it seems like we all wrote vaguely similar things, so either I've done ok or the majority of the year have failed. Fingers crossed for the former! We have a second MEQ on Wednesday so if paeds and psych don't appear at some point in that I will be annoyed.

This afternoon was the EMQ (extended matching questions), which is a slightly bizarre format which is similar to multiple choice, but there are 5 questions relating to each set of possible answers. The range of subjects was a bit better (very glad I spent ages on developmental milestones) and there were only a couple where I was really unsure. Again I finished stupidly early, was second to leave (after the guy who left second in the morning - I guess we're both just quick!). I think I'm one of those people who feels the need to change things if I sit there too long, so after checking my answers 4 or 5 times, I have to go before I start changing all my correct answers to wrong ones!

I have written down a list of topics which came up, should anyone be interested.

I'm going to head off and try for a decent sleep tonight, then will spend tomorrow going over the things which weren't in today's exam as they're likely to appear on Wednesday.

Good luck to anyone else with exams at the moment xxx

Tuesday 14 June 2011

No Going Back

After a lot of stress and panic over my application forms yesterday, I asked my consultant friend to have a look over them for me. I always feel slightly guilty asking for help with this sort of thing, but I suspect most people will have someone look over their forms, so surely it's not giving me an unfair advantage... After constructively ripping my answers to shreds (in a nice way, but still...), he did help me make them sound considerably more confident and professional. So, slept on it last night, had one final read this morning and sent them in! Eek! I'm convinced I've left some glaring errors on there somewhere so I'm not looking at them again unless I get an interview and need to remind myself what I wrote!

Sunday 12 June 2011

Cold Feet

Well, I've filled in all 3 of my regional AFP application forms. I've read, them, re-read them, had my Mum (!!) check them... I really don't know that there's anything else I can do - and yet I don't dare to send them in - my first deadline is 20th so I have a week or so to calm my nerves, but I don't know why I can't just hit send... I'm currently debating asking some doctory friends to have a look over them, but I think I'm just trying to delay the inevitable! I need to get a grip!!!

Wednesday 1 June 2011

It's Started!

So today I registered with the foundation programme website and submitted my general application form - that was just a basic one where I listed my personal details, qualifications, referees and where I wanted to apply. I found it a bit odd only being allowed to apply for 3 schools, but then some of the foundation schools cover fairly big areas (Scotland is one school, despite there being 4 and a half medical schools and 4 postgraduate deaneries there). The first of my school-specific applications could be sent in on the 6th, which is rather a scary thought and it only gives me a couple of days to perfect my responses to deliberately difficult and vague questions with stupidly short word limits. That said, the forms for 2 of the 3 schools I'm applying for have been available for a while, so I have been working on them. The third is and online only form which isn't yet available, although they have published the questions which will be asked so I can prep them too. It's all starting to feel a bit too real now that I've officially enrolled in this round of applications though - eek!

Monday 23 May 2011

Busy Bee!

Why is it that weekends seem to go by so quickly?! I had so many things I wanted to get done, but am nowhere near through them. My list looks a little bit like this:

1) Finish neurology revision and start on gp stuff
2) Work on application forms for academic foundation programme
3) Complete pre-elective reading, write up findings and send to host supervisor
4) Work on systematic review for home supervisor
5) Clean kitchen and bathroom
6) Do food shop

So basically this weekend I've successfully cleaned my flat, and bought some food. Useful, but not exactly the top priorities, were they?! I have done some neurology (and covered a bit more in clinic this morning), but I really ought to have finished it by now. I've added nothing recently to my AFP forms - I'm struggling to answer questions such as "explain how your SSM or elective demonstrates your suitability to an academic post" - argh! I did do a little bit of my pre-elective work, but ideally I would have finished it. My host supervisor is very relaxed so there's no pressure, but it'd be nice to have out of the way. The systematic review has been largely ignored, but I'm less concerned about that as there's not a lot I can do until I receive other people's information.

I probably spent too much time catching up on Grey's Anatomy - what a tear-jerking season finale! I actually cried more than I did at the end of season 6, which I didn't think possible! Anyway, it's now finished, so I suppose that's one less thing to distract me this week.

Better get back to the books...

Friday 20 May 2011

Not Another Medic's Blog...

I've been thinking for quite a while about starting a blog. I had one as a teenager, where I whined about how unfair my life was and how nobody could possibly understand me, but I like to pretend that I'm slightly more interesting now.

To put the rest of my gibbering in context, here's the compulsory "about me" entry.

I always wanted to be a doctor, but I messed up my A levels* so ended up studying Biomedical Sciences. I really enjoyed it, particularly the last 18 months. I did contemplate applying for a PhD and going into academia, but for some (not entirely clear) reason, I decided to apply to medical school once again. Luckily for me, my initial BSc covered lots of anatomy, physiology etc and I was able to go straight into second year at the same uni where I'd done my degree. This does mean that by the time I graduate next summer, I'll have been in this city for 7 years, so I'm rather hoping to get my foundation jobs somewhere else.

Despite having spent a silly percentage of my life in formal education (rough guestimate ~80%), I feel like I want to spend more time doing research and learning things, which is why I've decided to apply for an academic foundation programme. The application window opens shortly, and nicely coincides with my exams, so no doubt my next few entries will be somewhat stressy - apologies in advance!

Bye for now xxx

*Didn't strictly mess up, just didn't do as well as I needed to get into medical school