May 16, 2020 · personal opinion medicine ·

Med School + Other Things

It's COVID-19 season, and I've finally decided to dedicate some time to write a personal blog post! The abundance of technical posts and guides on this blog is due to their ease of production. They're a lot more methodical and algorithmic to write, but here I am, using the right side of my brain! As a warning, parts of this post get a bit ranty.

As I sit in the confines of my room, due to COVID-19 lockdown measures, I started to think about the many changes in my life so far. Approximately one year ago, I graduated from the University of Toronto with a Bioinformatics and Computer Science (CS) degree. It was a pretty care-free time, and in the following months I did some part time work at the Vector Institute with Dr. Quaid Morris. This was one of the best labs I ever worked under (along with Dr. Suh's lab back in 2016!). The lab's focus was on using machine learning methods with biological data, which so happen to be my two favourite subjects. Machine learning was conducted very rigorously at Vector, and I remember feeling a bit out of place with my bioinformatics background, although that's the case with any interdisciplinary study. One key difference that I noticed about Quaid's lab, was the perceived lack of hierarchy. He would ask us to call him by his first name, Quaid, and would give respect and focus to all of us during meetings. The lab culture was great with everybody eager to teach/learn, and with many spontaneous whiteboarding sessions, sometimes even interrupting the lab presentations themselves. We had picnics, outings, and beer days. This sort of culture trickles down, with Quaid having brought some aspects from computer science culture. What surprised me was that yes, fiddling with biological data using computers is still considered a "scientific experiment", although it doesn't quite fit the archetypal wet-lab experiment.

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I think I really enjoyed Quaid's lab's culture, due to my less than ideal experiences in other labs. For example, in the summer of 2018, I worked at a strongly hierarchical and bureaucratic lab with over 60 employees, all under one head researcher. Unfortunately, the lab environment did not encourage learning and creativity, and people were generally there just to collect their paycheck. The conversations I tried to have with members during lunch rarely steered towards their research or science. As for the lab culture, I remember talking to the other lab members and hearing that they feared the head. Understandably, I was at the bottom of the pole, under 3 levels of hierarchy, first my post-doc supervisor, then the scientific head, then the head of the lab. Near the end of the term, my supervisor gave me a very unfair evaluation on my final paper due to personal issues. Getting the paper remarked felt like battling my way to Supreme Court. In the end, my grade ended up increasing by more than 20%.

Another lab I worked at made teams compete against each other to see how much data-entry they could accomplish. It was absolutely mind-numbing work, which involved copying down digits from a computer screen, going to another computer and typing them in, for 10 hours a week. Not only that, but we were regularly forced to vote on the worst performers within our team, causing a lot of backstabbing and mistrust. We were told that no team was allowed to have perfect evaluations. I left after only two semesters, frustrated by the overworked and toxic situation. Having talked to a quiet friend who had stayed at the lab, I learned that she had been chosen as the scapegoat of her team evaluations that year. This caused the head of the research lab to inform her that she would no longer be getting a strong reference letter for medical school. Many tears ensued, and she quit after her 2.5 year commitment at the lab. I've talked to three other members from that lab, and they confirm my experiences.

If you take even a cursory look, you can see a pattern emerging. Undergraduate biology research (usually) blows. I'm fairly certain that it's due to the glut of pre-med students who need to find research opportunities at whatever cost, to pad their autobiographical sketches for medical school (a standardized list of achievements). As long as they get to talk about their research activity "on paper", they don't care if they are pipetting liquid for 10 hours a week. At the data-entry lab, we had around 25 undergraduate students, and almost everyone was trying to get into medical school. The head of the lab dangled that reference letter over our heads, bestowing the prize to only the most efficient data entrists. Coming from a CS background, I am certain that the lab could have hired a programmer to replace all of us over the course of a few months, but of course, that didn't happen. If you said that this situation was partly our fault, caused by us pre-med students having no goddamn self-respect... I would have to agree.

I was elated to find out later that summer that I was accepted to the University of Manitoba (U of M) Medical School; I had managed to pass through the interview selection process as well as the gruelling Multiple Mini Interviews (MMI)! Interestingly, U of M doesn't actually factor in undergraduate research for the application process, which is alright since I did research for the fun of it anyway. And after what felt like a blink of eye, it was time to pack up and move back to my hometown, Winnipeg. I'm not going to lie, I miss many things in Toronto, such as my friends, the food, the downtown life, and the research opportunities. But now, it seems I've entered a new world, where life revolves around medicine, where the work is hard, but the patients are thankful and the interactions meaningful. I just need to study three more years before I start making $50k a year! Contrast that with my CS friends...

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On a more positive note, I'm enjoying a lot of aspects of medical school. We go surprisingly deep into the underlying causes of disease, and have clinical exposures and patient encounters that add some variety to the week. Unfortunately, my studying habits have barely changed since undergrad, meaning I still cram and gulp Red Bulls the night before exams. The exams never seem to stop: our class will have written 37 exams by the end of May.

What's crazy is that our whole class of 2023 uses Slack. It's as if I'm working at a tech startup! Some of the memes we make (on the #memes channel of course) are pretty funny, and it's interesting to see the different meme formats that manifest within every group/community. Here's a meme produced after we learned that our clinical skills exam was canceled (JVP stands for Jugular Venous Pressure).

To fully beat this meme into the ground, the doctor above is checking the wrong pulse (popliteal). Slack has been proving to be extremely useful, and much better than using a Facebook group. Using Facebook for whole group communication was downright hell; currently there are more than a dozen channels in Slack, but imagine having all those posts on one bloated feed! It took an executive decision from our class council to have a switchover day, and although some people complained, everybody seems to have converted. It's pretty awesome that we have such a large and active community, although personally I'm a fan of smaller, more tight-knit ones. My sister tells me that such a sense of community is not as pervasive at the University of Toronto Medical School, which has about two to three times the class size.

Overall, I'm looking forward to pursuing my goals as a family physician/hospitalist, which is attractive to me due to the work-life balance (code for I don't want to burnout). Family physicians are in demand in Canada, and play a crucial role as the point of first contact before being referred to other specialists. Working in the hospital also exposes you to more acute cases, which I am personally interested as well. As a first year student, I'm totally open to trying different specialities as they come my way, but at least it's something to focus my efforts towards.

Thank you for reading this wall of text!