PMY 228 : Maintaining Confidence Through the Grueling App Process

Session 228

Today, I will be talking with Mariah whom I've worked with through the application process and helped her gain an acceptance to medical school but her biggest struggle was her self-doubt. Find out how much this has affected her and and how you can also overcome self-doubt as she did along her journey.

Mariah has spent years on the Hill helping lobby for those without a voice. She has always wanted to become a physician but the discouragement she got through the years has just instilled fear in her. She just drew further and further away from the thought of getting into medical school until that one particular clinic visit that finally led her to listen to her own voice this time.

First off, I would like to welcome Cram Fighter as the newest sponsor of The Premed Years Podcast. We talked about this back in Episode 195 when we had the founder of Cram Fighter, Amit Mathew, talk about it on the show. Cram Fighter helps you create the perfect study for you in just minutes.

Let’s go back to my conversation with Mariah.

[01:55] Gender-Defined Roles

Mariah has known he she was going to be in healthcare ever since she was a kid seeing her grandmother who was a nurse and growing up to a family of healthcare professionals (phlebotomists and nurses). Although for a while, she initially thought women couldn't be doctors since all the nurses she knew were women and all the doctors she knew were men. She thought it was the default based on what she saw growing up. One day, during a follow-up doctor's visit with her grandmother, she finally met a woman whom she never expected to be the doctor although she had a lot of doctors as she dealt with asthma, allergies, and eczema as a kid.

[05:01] Doctors as Decision-Makers

She was initially interested in becoming a nurse but she likes the idea of the physician as a team leader and the decision-maker who's able to determine the treatment and it's something that just appealed to her.

After finishing undergrad and having spent a great time of her career working with physicians, she has been exposed to public health and policy issues such as the implementation of the Affordable Care Act and physicians coming to the Capitol Hill and testifying on any range of issues. The expertise exhibited by these physicians was just appealing to her.

When she was younger, she just assumed that healthcare has always been the path for her considering her family background but when she knew that should could actually be successful in it was around her middle school when as a seventh grader, she took eighth grade math and science classes. They also had career programs and had taken some of the aptitude tests that assessed what they might be good at.

[08:18] Resources and Mentors

During middle school, she had a teacher who became her mentor and it was through a 21st Century Grant program that her teacher established an after-school mentoring program consisting of middle school girls designed to help transition students from middle school into high school by providing them with skills to work with different pressures especially in their area where there is often really defined gender roles. From there, Mariah started to explore and got the support and encouragement to pursue medicine. Additionally, she looked online about how to become a physician and also looked at her study skills.

When she got into high school,  she participated in a pre-health school club where she had the chance to shadow a cardiologist and spend an entire day at a cardiac cath lab. Then she realized that if you want to hyper-specialize, it takes even more than twelve years and you have to do things like fellowships. So she started to ask questions to get all the idea of what it would take knowing that she was going to try to go outside of the state for college, a decision she made on her eighth grade.

[13:26] The Premed Route: Taking Too Much on Your Plate

Mariah sure did encounter people doubting her ability to do it and telling her negative comments. Although these were thrown at her indirectly, there were definitely voices that tried to instill fear in her.  Even her grandmother who was very supportive of her also tried to steer her towards being a nurse anesthetist considering that she was engaged at that time and her grandmother wanted some grandchildren from her thinking it was the quicker way for her to practice in a relatively lower stressed environment.

Set on being a physician, Mariah took the premed route majoring in Biology with a Chemistry minor. She took all the prereqs for med school and graduated with honors. With strong interest in medicine, that was her goal in college. Mariah further recalls also getting some C's. In fact, the advice they got from the pre-professional office was that C's get degrees but not MD's.

After her sophomore year, she got really discouraged when she started questioning her aptitude and thought she had ruined her academic chances of being accepted to medical school. She accounted poor time management for her struggles, specifically getting two C's in General Chemistry and Calculus 2 classes during freshmen year which she took simultaneously which she shouldn’t have taken looking in hindsight. She was also in a marching band which she described as an incredible commitment. She practically jumped into the deep end without realizing what she got into. It was during the second semester of her sophomore year that she got a C in Microbiology, an upper level bio class, that suggested med school wouldn't be an option.

She thought that since she could juggle much in highschool, then she would also be able to juggle all in college. Apparently, it was a mistake on her part to take too much things on her plate.

[20:50] Perpetuating the Stereotype of a Perfect Student

Moreover, her advisor discouraged her to get into med school and it was pretty much the same advice that her peers got. It was clearly perpetuating this stereotype of a perfect student to be a physician. And that only students getting straight A's are going to medical school while those getting C's are discouraged by advisors.

[22:40] Work at the Capitol Hill

After she graduated, Mariah started a joint program between her alma mater, Howard University and Kaiser Family Foundation called the Barbara Jordan Health Policy Scholars Program, where she served as a Health Policy Scholar in the office of a member of Congress. Her office was actually the first African-American position elected to Congress (who was also a woman). So she spent the summer there working on the Energy and Commerce, a health sub-committee which was the primary committee responsible for overseeing the implementation of the Affordable Care Act just a few months after it was passed in 2010.

She again went to another member of the Congress' office and started as a staff assistant where she soon rose through the ranks as a legislative staffer. She worked broadly on health policy and was able to pursue her interest in health disparity and advocating for funding for public health programs that address health disparities specifically focusing on the minorities. So Mariah led the member's portfolio for the Labor Health and Human Services subcommittee on the House Appropriations Committee as well as her work on the Budget Committee.

All this opened her eyes to two things. First, is on the authorizing side as to how laws are passed, how they're being debated, the process by which different things are attached to pieces of legislation, and why they may pass or fail. Second, is the appropriation and budgeting side of things, being able to look at how funding decisions are actually made and be able to influence them as well. They got to forcefully weigh in how federal dollars were directed to the federal government.

This was her job for four years and from there, she went to a non-profit public health organization, working with the HIV and AIDS directors at state and territorial health departments, and soon expanding to work with CVC-funded local jurisdictions. They also work with the viral hepatitis prevention coordinators and state health departments. Mariah worked on the policy and legislative affairs in the hepatitis teams, working to provide technical assistance for implementing grants from the CVC’s specific to hepatitis prevention, and facilitating these through various ways. Basically, they identify other opportunities to leverage programming within health departments and other governmental agencies to be able to implement policies and programming that will help prevent hepatitis but also serve the communities that are most disproportionately impacted by hepatitis. What Mariah likes about this is being able to advocate for funding of viral hepatitis division as well as being able to continue work on health disparities within hepatitis.

As much as this is an exciting work, she also finds it frustrating in terms of how our government is currently structured and is functioning or not functioning. The process has to work in order to be able to direct funding where it needs to go. Unfortunately, over the years, the system has been barreling from shutdown to shutdown, operating on continuing resolutions that don't allow Congress to take a look at individual programs and determine what should be funded and not, and to really be intentional about how money is appropriated across the federal government overall which greatly impacts the people on the ground (labor programs, education programs which impact the whole health of an individual.

[28:44] About Cram Fighter

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[30:45] Taking Another Shot at Medicine

Mariah did a side visit in San Francisco for the annual The Liver Meeting, a conference attended by liver doctors where they did a visit at an urban health clinic managed by the San Francisco Department of Public Health. She then saw a primary care physician treating people with hepatitis who are also infected with HIV, diabetes, and other co-morbidities. These people were either unstably housed or homeless and they were practically complex cases. During the visit, the physician gave them a tour of the facility and she got the opportunity to meet two of the patients being treated. The physician talked about how she worked with them daily and weekly to really get them to a place where they were ready for treatment and where the State Medicaid would actually pay for treatment. Once they had success on the hepatitis medications, they then got motivated to get their HIV viral loads maintained and eventually suppressed and just do what they could to improve their other health issues.

It was one of those times where she just saw up close and personal, right in a health clinic, all of these things she was interested in and all the reasons why she wanted to go to medical school in the first place, and all of the policies she has been advocating for on a federal level, really come into sharp focus. Mariah left the clinic feeling so motivated. Patient treatment was something that never really left her mind but it was something she thought was just not possible. Her side visit experience was just all she could think about. Within a week since she got back to DC, she had already registered for the MCAT and started looking for support from people who were in similar situation as hers and stumbled upon The OldPreMeds Podcast.

[34:30]  Taking the MCAT and Spreading Herself Thinly

As to why registering for the MCAT was her first step and not going to an advisor, she just didn't want to be discouraged anymore as she didn't feel like she was getting good guidance. Also, she wanted to put her feet to the fire and hold herself accountable and she just didn't want another out. This was something she wanted to do as she already had the prereqs and a strong undergrad GPA.

Mariah recalled how nerve-racking the experience that she didn't even tell her husband who has always known she wanted to go to med school. She was plain nervous and was just afraid of failing and so she just wasn't sure if she wanted anyone to know if she did fail.

Mariah says it was just hard to maintain confidence. Having been discouraged and been in such state for so long, there were just nights where she just didn't think it was possible for her. Another factor is the fact that she has a job. Although it gave her a good work-life balance, still at times it could be demanding considering she still had to do some travels and prepare for conferences and presentations on top of her daily routine. In short, she was just spreading herself pretty thinly. Being alert and staying awake to study for the MCAT was really difficult for her.

She did not get the score she wanted and having a full time job did have a huge impact on her MCAT score. Ih she would have done things differently, she would have just talked with her husband about quitting her job and dedicate her full time studying for the MCAT.

Mariah has learned her lesson and is now planning to devote herself fully to studying now that she got acceptance to medical school.

[44:05] Crafting the Perfect Story

Mariah typically had a lot of stories she wanted to cram into her personal statement but she crafted it in a way that only featured some of the highlights and really hit on those to tell the story of how she had come to the decision and why medicine was so important to her.

During her actual interview, her grades and the MCAT didn't even come up a single time. On her first interview, the interviewer was more interested in knowing why medicine and how she came to this decision and some general questions. On the second interview, they were interested in her story, her work in policy and Congress, and her thoughts on ACA and the issue around drug pricing. Her numbers passed muster enough for them to invite her and once she was there, they were just really interested in her. It was because she spent much time crafting her story and getting really comfortable talking about herself which took a lot of work and practice for her.

Mariah applied to a lot of schools and got rejected from them so there are schools that cared a lot about her numbers and the fact she finished her prereqs almost ten years prior. But she ended up at a place that truly values her experiences and what she had to bring to the incoming class.

[48:45] The Waiting Game and Overcoming Self-Doubt

The second hardest part in the application process for her was to wait and being the type of person who can be cerebral and tends to overthink a lot, Mariah just rehashed both interviews in her head over and over again. What made her feel even less confident was the way the school would rank everyone and if you fall within your score at the very top of the list where they can make a solid assumption that after everyone is ranked, you'd still be accepted, they'd then go ahead and accept you and then reject people at the lower end of the ranking. Everyone else will not be decided upon until March and this was what happened to her. She was happy though it was not a rejection. Still, she kept rehashing the interviews more and more and the less and less confident she became.

Mariah has always had a worrisome personality since she was a kid and she intends to work with a counseling office to connect as soon she gets to the campus as her way of overcoming self-doubt.

[55:20] Final Words of Wisdom

Mariah wants students who may also be dealing with self-doubt to know that if you know this is what you want to do and medicine is what you wake up in the morning thinking about and constantly in your mind, don't allow anyone to discourage you.Just make a commitment and really put your best foot forward and pursue it.

For nontraditional students who may have a lot on their plate, just take a step back and just look at what commitments you have and ask yourself, how is this contributing to you getting into medical school? How can you talk about this experience in a way that you can connect it back to your ultimate goal of getting into medical school?

Links:

Cram Fighter (Use the Code: PREMED25 to get 25% off any regular-priced plan until May 7, 2017.)

The Premed Years Podcast 195: How Cram Fighter is Changing the Way You Study for the MCAT

Affordable Care Act

21st Century Grant program

Barbara Jordan Health Policy Scholars Program

The Liver Meeting

The OldPreMeds Podcast

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