To the west and back: UCLA

After I wrapped my interview day at WashU, I went to Lambert Airport and set off on a flight to LAX, with a stopover in Denver or Phoenix (can't remember which), to interview at the David Geffen School of Medicine at the University of California Los Angeles. I'd always wanted to visit UCLA.

It had been a long time since I visited LA, and frankly I have no recollection of the previous occasion except my family stopping over to see other family in the midst of a journey to Baja California. I was really looking forward to it; I had already dreamed up the possibility of experiencing California and West Coast living during medical school, an intriguing change after years of snowy New England.

I took a shuttle to Westwood, the neighborhood home to the UCLA campus. It was already pretty late, so I saw nothing except a host of strip malls, mid-size high rises, and lots of long roads and traffic lights. After getting off the bus, I followed my host's instructions to his apartment, where he and his roommate (both MS1s at UCLA) welcomed me with my first In 'N Out burger and plenty of descriptions of life at UCLA. Things I noticed: LA really is teeming with Asians; my hosts were very relaxed, laid-back, and friendly, hinting at the real difference in culture between here and, say, New York; In 'N Out burgers really are pretty good (great texture).

In what became a recurring theme during the interview season, I had really great hosts. My main student host took me the next morning to the front office get a separate key card for the apartment even though I was only staying for a couple of days, and his roommate graciously answered all my questions and outlined a good running path to take, as I had taken my sneakers and hoped to get a taste of Westwood by taking a jog. To put it succinctly, the run was smooth, sunny, and comfortable (as Southern California weather tends to be), with a decent amount of incline and the sights of arid hills in the distance. I could have gotten used to this.

Other things before the interview: I hung out in a coffee shop for a while; I ate at a sandwich shop my host's roommate recommended and was impressed (pretty sure it had avocado in it); I chatted with DM about my pending trip to Albuquerque right after LA.

Interview day: this was my second MMI. A little bit more on the MMI: schools like Stanford, UCLA, and NYU began adopting the MMI format in belief that performance on the MMI correlated better with performance later on than traditional interviews. Furthermore, the multiple stations in an MMI helps correct for any biases (such as those of the interviewer), while a traditional interview with just one person would depend heavily on the perception of that single interviewer. So, basically, there is some measure of rationale here.

The other interviewees and I (all of us just guys -- the only time this ever happened to me during the season) gathered in admissions office (a little bit difficult to find) and ate a bunch of fruit and muffins while waiting. A staff member then explained to us how the MMI would go down, how fortunate we were to be interviewing at UCLA and that that alone meant we must be at the top of the applicant pool, and how great life at UCLA and in the city of Los Angeles is. Honestly, not much else besides. No official presentation, no pamphlets. Very sparse compared to the other schools I had visited thus far, which generally gave out a folder with all kinds of details.

We were taken in a shuttle to another building on campus, given instructions by the admissions dean (who the staff member enthusiastically endorsed), and then... that's it! We did the MMI. I didn't enjoy it. In fact, it was a little worse than NYU. Questions that I remember, in my own words:

• If you have a car with a restricted parking permit but you are not disabled, is it ethical to use it to park in a restricted parking space? What if there is an emergency? What if there are no other cars around?
• A situation in which you are facing away from the interviewer and an assistant, and you are given a diagram for something they are to construct with your instructions. You cannot look at the interviewer and assistant. Afterward, the interviewer asks how the process went, how communication could have been improved, why this is relevant in medicine, etc. 
• The interviewer presents a video of homeless person and how he feels about his life in the city, which is later revealed to be an actor. The interviewer asks for your reaction. 
• You're doing some kind of survey of different households and you notice that one household is lacking in medical services (or something like that). What do you do?
• Someone has undergone a sex change and is now seeking additional surgical treatment for something cosmetic, but wants to retain confidentiality by not revealing certain critical body parts during the surgery. How would you accommodate the patient?
• Tests reveal that a patient has cancer (or some kind of terminal illness, I can't remember), but the patient's partner advises not telling the patient right away for fear of how the patient would react. Does the patient still have the right to know? How do you respond?
• One station has a computer with a prompt asking about your projected career in medicine and its underlying motivations. I basically ended up trying to sum up my personal statement as best I could, as quickly as I could. I stopped midway through a sentence, knowing that they had said they didn't expect any of us to finish writing anything too substantive. 
• Have you ever done anything wrong? If so, what?

At the end of the stations, they had each of us go back to our original first station to have a more traditional interview for about 20 minutes, similar to NYU's format. This was probably the worst part. I perceived my interviewer to be a very old, conservative guy who seemed deeply skeptical of my motivations in medicine and aspirations to global medicine. He also found it concerning that I hadn't chosen a specialty yet. I honestly felt like I was just a bit unlucky here. 

After the MMI, we were invited by the dean to give our own comments and criticisms of the different stations. I offered that the computer station was biased against those who simply didn't have the same typing ability as others. We then had a tour, which honestly was probably the best part of the day. It wasn't so much the tour itself, but rather, the two student tour guides, who were highly enthusiastic and friendly -- very different from the overall lack of presentation from the admissions office. We ended with a chat with Dr. Iljie Fitzgerald, the new Assistant Dean for Student Affairs who made it clear that she would work with students individually to direct them in whatever way they wish, whether it be additional support from the school or a connection to a suitable research opportunity. And John, one of the tour guides, offered his own feedback on the school, that he felt the school starts "cold," that it could do a better job selling itself to prospective students on interview day. Spot on. I was particularly appreciative when he offered his phone number and email for anyone to just reach out in case they wanted to chat, especially in the heat of the interview season and the feeling that the process was unfair. "I don't know how that guy got in, especially when I know for a fact that he just smokes weed all day." Hilarious. I had a good number of invites at this point, but I still made a point to reach out to him by email afterward and thank him for his empathy. 

The day ended pretty quickly in the early afternoon, and my flight wasn't till late at night, so I had a good amount of time to kill. Another interviewee wasn't flying out till the next day, and he happened to have a car rental, so we decided to drive together to see the beach. I liked him: a refugee (along with his family) from Afghanistan, had had a difficult time growing up in upstate New York, was currently getting a Masters in something related to biomechanics, and applied to UCLA almost on a whim (just seemed like a good school in the west to apply to, he said). And we had a good time eating Mexi-Cali food and enjoying the weather: 

A seal -- there's a video I might upload later

He graciously drove me back to campus, and as I had already said goodbye to my host before the interview, I just took off for the airport. I had mixed feelings about UCLA, but overall I felt like I could come here. (Especially with the David Geffen full scholarship a possibility...) But at the time, I wasn't really counting on admission, and of course, now that it's July, I won't be attending. But alas -- till next time, LA!

To the west and back: WashU in St. Louis

Shortly after my interview at Columbia (for point of reference, that was November 12th), I spent the weekend recuperating and at the same time preparing for a nearly two week trip to the west coast and back to interview at Washington University in St. Louis, UCLA, and the University of Chicago, with a break in Albuquerque between UCLA and UChicago to chill with DM.

I arrived in St. Louis, Missouri, the Sunday immediately after my interview at Columbia. Lambert St. Louis Airport, for the record, is quite small. I took the train heading downtown, stopped at Central West End, and climbed the steps leading up to WashU's campus.

It was... quaint. I failed to take pictures, but it was a nice looking campus. Plenty of tall buildings. Clean. Quiet.

I went to Olin Hall, a dormitory for first year students that the school offered for interviewees for the night. After being kindly oriented by the front desk staff, I settled into my room, relaxed for a little bit, and then went to go have a lunch. I remember that it wasn't a far walk to the college town-ish part of St. Louis, and that I had a nice, "Modern American" type meal. I also got myself a fro-yo. All solid, but nothing that stands out in memory.

I then decided to head downtown. I'll be honest: I thought that the chances I'd end up here for the long term were quite low to start with, so I decided to see St. Louis while I had the chance. I took the train for the stop at the Gateway Arch, probably St. Louis's most distinctive architectural feature. I purchased a ticket to enter the Gateway Arch and go to the top. Everything was in walking distance.

And here's what I saw:

Inside City Hall, where you can get tickets to the Gateway Arch and read a little bit about St. Louis's history:

Leading up to the Gateway Arch:

View at the top:

At the back, a view of the Mississippi River:

I spent maybe an hour at the Arch, making small chat with other visitors (generally from the Midwest) and taking in the history of the Arch and the views. And then I decided that I was good, and left.

One last view of City Hall and the Arch before taking the train back:

Once I settled back into Olin, I decided to go for a run in Forest Park around sunset. It was too dark to take any pictures, but I do remember that it was a really nice park. Large, spacious, not too crowded, surrounded by suburban type homes and apartment buildings. Some people playing recreational sports in patches here and there. A brightly colored museum nearby. 

A small city, a nice park, quiet living. My glimpse into St. Louis living.

After I showered off the sweat from my run (in dormitory style bathrooms... not something I miss from Ellicott Hall at UMD), I went to a pizza get-together put on by the med students for interviewees. There were a lot of people and a lot of pizza. I enjoyed a few bites, chatted a little bit with some other interviewees and med students. The interviewees were all quite young, nice. Sadly I can't recall anything more distinctive about them. The medical students were happy to chat, but the one thing I remember is asking a student why she chose WashU. "Well, it was the best school I got into," she said, with a shrug. I smiled and nodded, but frankly, I felt less than inspired. 

I had my interview the following day. The other interviewees and I met up in some library-type room for probably the best breakfast I had had thus far (and which would continue to stand out throughout the interview season), with sausages, eggs, tomatoes, quinoa, other things I don't remember except that I liked it and felt full. Staff gave us instructions and then guided us into another room to hear a presentation about the curriculum and student life. 

All well and good. We then went to the rooms on our instruction sheets for our interviews, in a variety of places. I only had one interview, with the admissions dean herself, Dr. Valerie Ratts, and it was quite early in the day. The interview went... okay. She remarked on my record when I came in, and then asked me what I would come to find to be standard questions, like "Have you considered the ramifications of going into medicine?" and "What kind of work are you doing in South Africa?" Somewhat similar to my interview with Dr. Landry at Columbia, but just a little different in tone. She was friendly but direct, and she made every effort to sell WashU. She even made what might have been swiping gestures at programs like Columbia's three year PhD-to-MD program, saying "medicine is a big commitment... you can't study it in three years." And when I asked about the typical patient population at Barnes-Jewish (WashU's main teaching hospital) and the lifestyle of St. Louis, she said it was essentially like Baltimore but without the Bay, and that the patient population is arguably more diverse than some larger cities, since Barnes-Jewish provided catchment for not just St. Louis residents but also for those living in the surrounding suburban and rural areas. 

After the interview, I waited at a nearby cafe in the building with some other interviewees, listening to bits and pieces of gossip about the interview season. One guy found UCLA "underwhelming," and another guy said he had either already gotten into Baylor or had an interview lined up, and was just hoping for that really. People seemed at least modestly impressed by WashU, but I don't remember meeting anyone dying to get in. Just my personal sample.

I enjoyed the tour and appreciated the tour guide's friendliness and general knowledge of the school (an MS4 looking to specialize in radiation oncology, if I remember correctly), though really, at this point, I was becoming more and more convinced that all med school tours were pretty much the same. The financial aid info session was helpful and there was mention of merit scholarships, to be distributed in however way the committee saw fit. I enjoyed the lunch -- the food was pretty good, buffet style, and the students who came to eat with us with all warm and polite. I'll be honest again: I was kind of zoning out for a lot of it and have no good recollection of the questions that my interviewees asked and the answers they received.

The day ended with Dr. Ratts coming to say goodbye, asking us to fill out surveys for the admissions office, and giving us a cookie. It was a good cookie. And overall, I enjoyed my time at WashU. Everyone I had met seemed to all be "good cookies," as TL would say. 

But as I left on the train to the airport, watching the landscape of St. Louis and Missouri, I knew from the start and knew now that the odds were extremely low that I would end up here. A great school that lived up to its reputation, but did not really win me over. 

I got on a flight to LAX.

Columbia P&S

Ah, Columbia!

Riding with my Uber driver to Washington Heights, I think that's when it was beginning to really strike me just how GIGANTIC New York really is. I had been to NYC before and seen some of the sights -- Empire State, Statue of Liberty, the Met, a Broadway show -- but I think now that I have a bit more context, having lived in Boston for five years and seen more of the world up close, I was able to really appreciate how unmatched NYC is in the US in its sheer density of tall buildings, people, shops, etc. And this was without even leaving Manhattan.

I arrived and strolled into the tower that matched the address my host, NS, gave me. She instructed me to just come up to her floor (it was a tall floor in a tall building -- can't remember the number though) and knocked and was let in by a roommate, and found a life-size cut-out of Benedict Cumberbatch as Sherlock Holmes standing right before me. Amazing. And set the tone for how my stay with NS went. (Really wish I had taken a picture of that cut-out now.)

NS was really great. Went through the whole she-bang of trading life stories, why medicine, etc. She graduated college at some ridiculously young age -- 16, I think? -- and applied to MD/PhD programs, but was told she was, well, 16. (Maybe it was 17.) Anyway, she decided to do a joint PhD program with the NIH and Oxford, and split her time between England and Bethesda. But she knew she wanted to do the MD as well: "I think medicine is just really cool." She applied to Columbia, ended up being sorted into an interview for the three year PhD-to-MD program; the program basically admits those with PhDs into an accelerated three year MD program, intending to support those who wish to do biomedical research but supplement their training with formal clinical training.

We kept talking and I met some of her roommates as well, and ended up hanging out with them as NS went off to get a haircut at 9 or 9:30 pm or so. (Ah, the city that never sleeps.) We walked to the other tower (there are twin buildings) to join some other P&S students to watch the Republican presidential debate. The debate of course was just sad, but it was interesting to get to interact with more current students. I appreciated the diversity of interests of the students -- one spoke to me about opportunities to get involved in theater and the arts -- and they all definitely had a sharply liberal, political bent (at least the ones I met). I remembered that NS told me earlier that what distinguishes P&S students from other med students is that they're "plugged in"; I suppose that by this she meant that they're engaged, they get involved, and they're proactive in the Columbia community.

An interesting story: NS also told me of how NewYork-Presbyterian, Columbia's main teaching hospital (which it shares with Cornell), had tried to abolish the Center for Family Medicine. Apparently the student body and many faculty were shocked and protested, speaking to how "plugged in" P&S students are but also reflecting the attitudes of some of the faculty and administration on primary care in general. I appreciated what NS said about the student response, but did see that P&S really did seem geared towards specialization.

I actually scheduled my interview for Thursday (and my NYU interview was Tuesday), so I relaxed a bit the day before strolling around Washington Heights, getting a feel for the community, hanging out in cafes and lecture halls to do some work and kill time. In the middle of the afternoon, I received an email from the University of Maryland School of Medicine -- finally. Application on "hold." I was amused. I had the security of several other interviews already, so I wasn't too worried.

When night arrived, NS texted me asking if I wanted to come to the Global Health Lecture Series and then come rock climbing at a gym in Queen with her. Obviously, if you know me, the answer to both is YES. I had a fabulous time. The lecture on obesity gave me a handle on what the Columbia community was like... and let me meet some admissions committee faculty members. I focused on not screwing anything up.

The rock climbing adventure with NS was just that -- quite an adventure. Not only do I generally enjoy physical activities, but I actually met a random NYC stranger who happened to be a Columbia alum (undergraduate, not med) and was now doing documentary filmmaking on the American Civil War (if I remember correctly). We got a good conversation going and ended up leaving together with NS on the subway, where NS ran into other people she knew and we all ran into other strangers who struck up conversations. I'm not sure if that's what a typical trip through NYC on the subway is like, but I was certainly impressed with urban life that night.

NS graciously lent me a super tech towel (very small, but dries quickly or just absorbs tons of liquid) and I woke up early along with her to head out. We parted ways, she to do some shadowing and I to the interview.

The interview day was fairly similar to the set ups at UVa and NYU. The other interviewees and I sat in a semi-circle in a small waiting room, chattered for a bit, then heard instructions from admissions staff. Columbia's system is nice and simple: a single interview. That's it. Though the admissions chair, Dr. Stephen Nicholas (who I shook hands with the night before at the global health lecture), does spend some time talking about his journey to Columbia in very aspirational terms, why he feels it's such a "special place," and then asks each of us in turn to talk about something that "gives us joy." I didn't have a great answer for this; I talked about the feast I tried to cook up for my South African colleagues (with strawberry cobbler and other American plates) and my thrill-seeking ways that made me aspire to bungee jump off the bridge at Victoria Falls after I finish my job. I wished I had kept the story shorter and more concise, but I doubt it mattered too much.

I interviewed with Dr. Donald Landry, chair of medicine. After waiting for 15 minutes with his secretaries outside his office, he ushered me in and just went straight to it. It felt like NY -- very direct, straightforward, to the point. We talked about my PhD project, why medicine, why I sought the clinical experience, personal family stories around illness, such as those of my grandfather and my own head accident. We also talked about Paul Farmer -- and I loosened myself to my most liberal self, and somehow ended up proselytizing my belief in health as a human right, how I felt everyone around the world deserves the type of care you would receive at MGH, Johns Hopkins, NewYork-Presbyterian... I wasn't really thinking when I said this. I just said what I felt. And in that, I felt like I had at least portrayed my truest self, though I knew what I was saying might or might not be well received. I couldn't really tell from Dr. Landry's expression. His lips were turned up very slightly and looked mildly impressed, perhaps with my boundless, idealistic naivete.

At the end, he gave me his card to send him some of the work I was doing for Bertha, specifically the short documentary films, and bid me farewell. Oh, and in closing he did congratulate me on a "spectacular" record and that I was very well qualified to begin training in medicine. And after I asked, he also said that the three year PhD-to-MD program (NS's program) was not quite right for me, given my career aspirations.

The only thing left for me was the tour. It was the usual -- a couple of students took us around the various parts of the P&S campus, let us glimpse Bard Hall (the dormitory where most first year students live -- let's just say it felt like college again), and took us around NewYork-Presbyterian. I was most impressed by the view:

There really is something about the vast expanse of the NYC skyline. I suppose I had my urbanite tastes affirmed.

And... that was it! I left feeling good about the interview, and waited around in a coffee shop somewhere by the bus stop for a while. At the time, I was highly impressed by P&S. NS was a great host, Dr. Nicholas did a good job making us really believe that P&S was amazing, and I wasn't really sure what Dr. Landry thought of me, but if I had to guess, I would have been willing to guess that I made a positive impression. I mean, he did say I had a "spectacular" record, and he also happened to be a PhD in Cambridge (Harvard Chemistry) who ended up going to medical school, much like myself. On the bus ride back to DC, I had high hopes!

Next episode: my first foray to the midwest at WashU in St. Louis!