Sophomores declaring concentrations

We've heard it's a particularly busy time among concentration advisors meeting with students regarding their concentration elections. Keep in mind that being "premed" should not be your primary reason for pursuing a particular concentration (in or among the sciences). With some planning, students are able to declare a concentration in any area they are most passionate about and still prepare themselves for medical or health professions school. Take this opportunity to develop depth in a field you truly love. Good luck with this hard decision!

Sophie is rooting for you...

An alum's perspective: Before joining a medical research lab…

A recent Harvard alum was generous enough to share with us her thoughts about medical research and what she hopes would be useful for current students to consider. Lee Ann and I think it's a wonderful piece. Here it is in its entirety. Many thanks to this very helpful alum!

Dear current, past, and future pre-meds,

There are many advantages to attending the world’s pre-eminent research university, including, unsurprisingly, the opportunity to conduct world-class research. Completing a research project can be an extraordinarily enriching part of your undergraduate experience, or it can become the bane of your existence, depending largely on what you get yourself into. The more you think about what you are looking for before you apply for positions, the more likely you are to find a good match. Whether you’ve just completed the intro life sciences course or you’re heading out into the real world with a masters in hand, I hope that considering the questions below will help you find the perfect research position for you.

Do you want to do clinical or basic research?

What you’ll be doing on a daily basis will vary from lab to lab, but there are some basic differences between clinical and basic research. Clinical research often involves a lot of time spent on the computer and on the phone, communicating with patients, updating excel files, etc. Depending on the study, you may get to do a fair bit of interacting with patients, which can be exciting. But if the idea of sitting at a desk all day isn’t something that appeals to you, you may want to consider another type of employment. Bench research, on the other hand, can range from maintaining mouse colonies, to running hundreds and hundreds of gels, to endless hours spent under a sterile hood. The bottom line—you should consider where and how exactly you want to spend your working hours.

How much time do you have?

You need to be realistic about how much time you have, both on a daily basis, and on a yearly one. If you’re still in school, how many hours a week can you work without jeopardizing your coursework? And how long are you planning to work in the lab? Generally speaking, the longer you can commit to a lab, the more likely you are going to be able to get substantive work done on a project. If you’re applying to work right after college, consider whether you can make a two-year commitment. Many labs consider one year too short a time for someone to substantially contribute to a project.

How much time will you spend doing lab management?

Some labs have managers who order all the supplies and dishwashers who wash all the beakers. Some don’t. You should find out how much of your time will be spent doing general lab maintenance and then figure out whether that suits you. Generally, the less experience you have, the more likely you are to be autoclaving reagents, at least initially. But don’t get discouraged. People often start working in research labs before they have the scientific background necessary to contribute much—you will pick up what you need to know by being in the lab.

How big is your lab?

There is a difference between working for a 25-person lab full of students and post-docs and working one on one with a professor. In a larger lab, you tend to have more of an opportunity to interact with other students and researchers. In a smaller lab, you may get to know your PI better, but may not have anyone your own age to talk to. Consider what kind of a work environment suits you. Do you need to be around a lot of people? Can you spend a whole day working alone?

How famous is your boss?

There are upsides and downsides to working at the biggest lab at HMS. On the one hand, you might get to be involved in well-funded, cutting-edge research. On the other, your boss may never know you exist. This is related to the previous point, but think about the kind of interaction that you are likely to have with your PI. Is he a new assistant professor who may not have a recognized name but who will invest a lot of time and energy in you? Or is she a Nobel-prize winning researcher who will speak to you twice a year? You can’t always know this at the outset, but try to get a sense of who your boss is, and whether you think you’ll be able to cultivate the kind of relationship with him or her that you need.

How much do you really like rats?

Many labs conduct research on animal models, be they rats, mice, monkeys or flies. The majority of this research involves “sacrificing” the animals. You should be honest with yourself about how you feel about killing living creatures. Are you okay with mice but not monkeys? Flies but not mice? There is no point in spending your days doing something you find distasteful.

And finally, how will you get paid?

Although education can be its own reward, you still need to eat. If you have graduated, and are applying to be a full-time research assistant, you will get a full-time salary, so you’re all set. If you’re working during school, however, it’s unlikely that your PI will offer you a salary. Some labs offer stipends to undergraduates, but many don’t. Your best bet is to apply for a research fellowship, scholarship, or award. Fellowships and scholarships, including those listed on the OCS website, are generally intended to offset the cost of living for students conducting research instead of working. Before you begin your project, you will need to submit an application including a project proposal, and often a recommendation letter from your PI. Remember to always give your PI as much time as possible to review drafts of project proposals and compose letters for you. Another way to get funding is to apply to awards after the research is done. Harvard offers some prizes for independent research in a variety of disciplines, especially if you are conducting research for your thesis. Although you can’t necessarily count on awards, they are a good way to reap financial reward from all your hard work.

Conducting research can be an amazingly rewarding experience. Hopefully these notes will help you figure out what kind of research might suit you best, and thus enable you to get the most out of your research experience.

Cheers,
an ’06 alum

Questions about time off

We've gotten several good questions about time off. For example:

Is it possible to take a year or two off after getting into medical school? As in, is it possible to apply to medical schools during junior/senior year, and possibly get into one or two, and then ask to defer years, once in? Or if you take time off, do you have to apply during that time off?

Good question. It may seem that it is better to apply, have your acceptance in your pocket, and then take a year break. However, it is a bit more complicated than that:

1. Not all medical schools will let you defer.
   
   
2. Those medical schools that do grant deferrals may only do so for very specific reasons, such as winning a competitive fellowship like the Rhodes. For example, one of our students who had been accepted to a New York medical school asked for a deferral so that he could work in an AIDS clinic in San Francisco for a year after college graduation. The medical school denied him the deferral. Part of the reason admissions deans may not want to grant you a deferral is that they are admitting a whole class. Granting deferrals means they no longer have the balance they were trying to achieve with the incoming class.
   
   
3. In general, when you are granted a deferral, you are promising that you will attend that school after a year and that you will not apply to other medical schools. If you change your mind about the school where you were accepted, you can of course apply somewhere else. However, you will have to give up your acceptance, which is a hard thing to do!
   
   
4. Medical schools know whether you have applied to medical schools in the past. So, say you were accepted to Happy U Med School, were granted a deferral for a year, and then changed your mind and decided to apply to Very Important Place Med School. VIP Med School will know that you were accepted elsewhere and will not look favorably on your application.
   
   
5. Finally (sorry this is getting so lengthy!), you will most likely be a stronger applicant if you apply after your senior year. You will have one more year of experiences, courses, recommenders, etc.

Jeff and I are happy to talk to you individually to discuss your unique circumstances. As always, feel free to call OCS Reception at 495 2595 (press "0") to set up a time to meet with one of us and/or to find out about our walk-in schedule for the week.

Who's right?

One of the most challenging things about being premed at Harvard is that there's lots of advice available -- but it is often contradictory and confusing. I met recently with a student who said she was feeling overwhelmed by all the advice she was getting from her family, her premed tutor, her lab supervisor, her roommate, and her concentration advisor. Each one told her something different about how to improve her application for medical school. She burst out "I don't know who to believe!"

I've noticed this too when a student asks too many people for feedback on her essay for med school. The student's voice is often lost because she has incorporated so many suggestions from too many people.

I once spoke with an MD/PhD admissions dean about dealing with conflicting opinions at Harvard: He said, "Yes - that's Harvard for you. Often wrong, never uncertain!"

When someone is giving you advice about being premed, remember to consider where they are coming from. If you are passionate about community service and hoping to pursue clinical medicine, then advice from that MD/PhD who insists you should work in a basic science research lab may not fit you.

We all have particular perspectives and biases (including Jeff and me!) and your challenge is to figure out what makes the most sense for you.

The Space Between

The majority of Harvard applicants to medical school last year were alumni rather than seniors. This means that a lot of premeds are opting to take one or more 'gap years' before entering med school. There are rarely bad reasons for taking time off particularly if you're not sure medicine is the right thing.

So how to explore the issues and options around time off? I highly recommend perusing our alumni evaluations of Harvard medical students to get a sense of what Harvard folks have done and why they did it. Previous years' evals (a lot more than online) are in paper form in the OCS library. Another wonderful resource is Cornell's premed advising website. Their general info about time off is good but their premed alumni profiles are incredibly useful, personal narratives about the why, what, and how of time off.

These years in between go by many names: gap years, time off, slide years, post-grad years, in-between time, or living life (the last one's mine). The truth is that many alumni come to medicine as part of a career change so perhaps describing these as 'gap years' is probably not appropriate. Whatever the name, it's worth considering.

Quiet times at OCS

It's the strangest thing. For a couple weeks now, things have been extremely quite on the 3rd floor of OCS. Lee Ann and I find ourselves wondering where all the premeds have gone (let's just say, we don't often wonder this). We suspect everyone is plugging away at midterms and p-sets. But if there are questions or concerns simmering beneath the surface, please feel free to email us or post it via the comment feature below. (They can be posted anonymously, by the way.) Hope everyone's doing well!

The Business of Medicine

I've gotten quite a few questions recently about how interests and experiences in business are viewed by medical schools. More specifically, students are wondering whether a summer internship or full-time job after college may harm, even doom, one's chances to pursue medicine later.

I do think this is a bit tricky. That is, there may exist a bit of an industry stimga in medicine against business. Business and profit-driven enterprises in general are viewed by some in the medical field as being in conflict with the end goals of medicine. (See: problems with the healthcare system.) But while that sentiment may exist, does it also among medical school admission committees?

My short answer would be probably "not exactly." Regardless of an applicant's background, that applicant will need to show admission committees that they are genuinely interested in patient care, that they have explored and reality-tested their interests in medicine, that they truly understand how their background, interests, and abilities fit with the field. It's true that someone applying to medical school with investment banking experience probably has a more persuasive argument to make than someone doing work at a health clinic abroad. But that argument will need to be made all the same.

There are many students in medical school now who have come from finance or other business backgrounds. I assume that many of them had compelling reasons for doing business and also compelling reasons in deciding that their interests and abilities were in the end better suited for medicine. Having good reasons for doing something is more important than the thing itself, I'd say. Or, another way to put it, the particulars don't matter so long as the overall story makes good logical sense. I also assume that these successful applicants were able to maintain some connection to the medical field even while doing business.

The main thing to know is that it is fine to be pulled in multiple directions. Having other interests besides medicine does not erode one's perceived interest in medicine. Think about it from an admission committee's standpoint: If you were genuinely interested in trying out another career path, did so, but then came back to medicine, that says a lot. The ultimate decision to do medicine then is not just theoretical but firmly grounded in experience. And what's better than to be able to draw from this kind of perspective before committing oneself to a very demanding career.