Thoughts on U.S. News University Rankings

Ahh yes, rankings are out for 2011 for undergraduate and graduate schools by US News. What do I think of these rankings? Fuck em. For the most part they're bullshit if you strictly use them to determine which university to attend.

After attending Washington University in St. Louis, which I believe was ranked in the top 10, and is now (gasp) ONLY number 13 in the country, I can fully attest to how much my education, experience, and current future outcome was affected by this drop in rankings: nada. For those of you matriculating to college next year, please do not go solely by rankings. All top 20 (and perhaps more) will provide you with essentially the same general opportunities. If you love a specific program due to specifics (location, people, overall feel, cost, a particular education path, etc), then fuck rankings and go based on what will make you happy for the next four years of your life.

Now I don't know as much about the college rankings as much as I do medical school ones (since I'm currently in the middle of hearing back from schools). As a student who has been fortunate as fuck, enough to be a accepted to a few top 20 schools, I can say that I will most certainly NOT be using these rankings to choose where I will matriculate in the fall. (Example: Well University of Pitt>Vanderbilt>Northwestern>Case Western, hm, I should definitely go to Pitt then because that extra tiny bump in the rankings will make me a better physician!).

First off, a primary factor that is used in these rankings is NIH funding and endowment (hence, Harvard Medical School will never be less than #1). You might ask, well, isn't that important since I wanna do some crazy ass research in medical school? Wouldn't HMS or Penn or Hopkins give me the best chance to help me find that next cure for Cancer or AIDS? Not really, as the difference in NIH funding for top 20-25 schools will not effect you as a medical school student. If you're really crazy about a specific type of research, look at the faculty and research opportunities specifically for what you wanna do. You might find that UVA might be better for what you're interested in than UCSF. And honestly, look at the rankings carefully, Mayo Medical School is #26 and Case Western is #22...wtf? They have the two best hospitals (along with Hopkins and Massachusetts General), how the balls are they so low when they will offer, arguably, the best clinical experience possible? Furthermore, Cornell is ranked #17 and Columbia is ranked #10...well, these two schools are super inflated as they share the same hospital (New York Presbyterian). In essence, the rankings will not make much of a difference for you as a future medical school student, and practically all top 20ish schools will give you the same opportunity to excel in your future.

So...what is important when deciding which medical school to attend?! Heres' my thoughts on some of this:

1) Impression of the students: By this, I don't mean based on your interview day, since you're gonna have a limited time talking to them, will be stressed, and they're gonna be professional and really nice and shit when talking to you. And even if you spend an extra day or so with your host and meet other classmates, it really doesn't matter, as everyone's class is different. When I say impression of students, I mean students in your class. How will this work? Second look weekend. I mean, honestly, make sure you can really enjoy the company of the 100-150 students for the next four years, or you're boned.

2)Curriculum and Early Patient Contact: Honestly, from what I've heard from almost everyone that I've talked to, you're gonna be learning most of medical shit yourself from the books, so I don't think curriculum (PBL vs. a lotta lecture) should make much of an impact. What I think is important is seeing whether a school is Pass/Fail or not (and true Pass/Fail, not that Honors/High Pass bullshit) for your basic science years. Also, early patient exposure? Unless you're talking about Duke's 2nd year rotations, fuck it...you're not gonna know anything to do any good as a 1st year when seeing patients.

3) The Shiny Facilities: You're a 3rd year student, it's snowing hard, you're cold and tired as it is past midnight. Oh, but at least you have a shiny new hospital you're walking by! Essentially, it doesn't matter what the hospital looks like.

4) The Third Year: Now this is the big one to pay attention to and really find out about for the schools you are considering. Essentially, you want to go to a university where you have a clear role in the wards and really get down and dirty, instead of simply shadowing physicians and walking around pretending like you're hot shit.

5) Board Scores: Ok, first of all, your scores on Step 1 are mostly based on YOU and how hard you work and time you put in to do well on this test. Yes, there are students at Harvard that get 220s and yes there are students at MUSC that get 250s. Don't let average board scores swing you too much. They are also not necessarily based on curriculum either. For example, Vanderbilt gives its students much more than the conventional 6 weeks off to study for them and they consistently have the best board scores in the nation--obviously so. Furthermore, you want to make sure that your school adequately teaches Pharmacology and Microbiology, as even top schools often neglect these courses and you don't wanna be stuck learning it for the first time for your boards.

6) Match List: How the fuck do you even read these? For example, many of Northwestern graduates end up doing their residency at Northwestern. Does this mean these guys didn't get into their top choices, or does that mean that they like Northwestern so much that they decided to stay there? It's hard to tell (especially since such schools have amazing residency programs). Honestly, all top 20 schools will have connections to get you into any residency at any hospital you want as long as you're qualified.

All in all, I have looked into all of these when deciding on which medical school to attend next year, and therefore, will hopefully eventually choose the right one for me. Hopefully, this is helpful to future medical school applicants as well!

Thoughts on Losing Weight

So I was watching TV today, and realized how many commercials there are dedicated to new workout "machines" and different diets. It's all the rage right now. So many people have become obsessive about losing weight, getting into the best shape of their lives, and have that perfect body to not only impress others, but to feel good about themselves. However, along with this new craze, an ironic certainty is amidst: America is fat as fuck! In fact, the obesity rate for every single state in America is >20%, except for Colorado (who knew? you'd think the extra blubber would be useful for somewhere that cold).

So exactly what is going on here? Why are obesity rates continuously increasing although there has been a greater emphasis on eating healthy (with whole-grain this and low-fat that), and working out (p-90x, insanity, and cross-fit workouts)? One reason could be fast-food restaurants. As economic times are fairly harsh nowadays, a 99 cent meal looks oh-so appetizing, and it may be a higher priority to work extra hours rather than go to the gym.

However, another reason I think is that many of the diet plans that are out there are not effective (at least in the long run). So I thought, hm, let's try to dispel some of the misconceptions about some of these diets.

1) Low/No Carb Diets: Basically this entails eating a shit-load of protein and fat (preferably oils), and limiting carbs to less than 100 grams per day. This actually does do wonders for you the first couple of weeks. First off, you lose your glycogen as your body is depleted of carbs, and along with the glycogen, you lose the water associated with it, so essentially you will drop at least 5 lbs fairly quickly if you're new to this type of diet. However, a few things will happen after a couple of more weeks. Your metabolism will first of all, slow down, as you have to rely on less efficient means of gathering energy (fat AND protein). You will feel like absolute shit (especially if you go on a no-carb diet) and if you're working out, this will be detrimental to how hard you push yourself in the gym (especially if lifting weights). Finally, it can cause some catabolism of muscle protein, which is something you do not want. It's not worth losing weight if you're just gonna look like a smaller version of your fat self.

2) High Protein Diets: True, ingesting a lot of protein will boost your metabolism as it takes more energy to break-down protein, and it will cause a "thermogenic" effect. However, there is only a certain amount of protein your body can actually use to build new muscle (assuming you're working out), and all the extra protein calories will be converted to fat if you're at a surplus of calories. Not to mention, consuming protein more than 1.5 times your body weight could cause a lot of exertion for your kidneys.

3)Very Low Calorie Diets: And by this, I mean >500 calories under your maintenance level. Yes, you will lose fat, but you will also lose a significant amount of muscle on these crash diets as well. Furthermore, you'll be putting your body into "starvation mode" and your body will hold on to some of that "stubborn" fat as a defense mechanism (and for guys this means around the stomach and love handles). Essentially, you'll look fucking weird if you do this. Not to mention, your metabolism will slow down like hell, so if you come of this crash diet and start eating a few cookies/cakes for a couple days, you'll put on fat FAST.

4) Cookie Diet: Get the fuck out of here...this dude is barely a real doctor.

So what is the best way to lose weight AND be healthy AND look/feel better? Here are some of my tips:

1) Exercise regularly: This means cardio AND weight-training 3-6 days a week. And don't over-train either--I would say an hour and a half is more than enough. Also, change up your exercise a bit every few weeks as to not reach a plateau by either increasing intensity or time.
2) Avoid simple carbs unless post/pre-workout: Simple carbs cause huge insulin rushes, which will take away from fat-burning, so try eating mostly, if not completely, whole-grain carbohydrates. The exception, however, are fruits and milk, as fructose and lactose are not broken down as easily, and of course, have health benefits.
3) Calorie Counting: If you're trying to lose weight, aim for 200-500 calories below your maintenance calories per day. Also, you can have a "cheat" day per week to get your cravings out of the way as well as keep your metabolism high.
4) Avoid saturated fats: Cut down on the butter, and instead go higher on the oils (flax seed, sesame seed, and fish oil are the way to go). Remember, you NEED fats to lose fat, as it trains your body to not only use fat as fuel, but is also necessary for hormones.
5) Eat more meals: Smaller and more frequent meals (like once every 3-4 hours) will really boost your metabolism while keeping you energized throughout the day.
6) Sleep more: yes, sleep is crucial for your body to burn fat. The more sleep, the more growth hormone you will release, and not to mention, you'll have better workouts.
7) Don't Stress: Stress causes hormone inbalances which hinder fat burning and the release of testosterone/growth hormone.
8) Get Enough Protein: Eat eggs, whey protein, chicken and other lean meats. Eat about 1-1.5 grams per lb of body weight while keeping your calories low to avoid losing a significant amount of muscle mass.

Anyways, that's my thoughts on losing weight. Most importantly, remember, you gotta stick to this shit no matter how much it sucks and burns, because fat won't melt off instantaneously. In fact, it'll probably take at least four weeks to see any significant noticeable changes in the mirror. Anyways, good luck on your fat loss pudgy motherfuckers! Now get outta here before I strip some bacon of your back...

Thoughts on the NBA

So today I was watching a couple of NBA games on ESPN--Heat vs. Spurs and Bulls vs. Magic, in which the Bulls won, and the Spurs will most likely beat (READ: demolish)the Heat. Why is this interesting? Well, the balance of power now in the Eastern Conference is gonna shift, as the Bulls will have the same record as the Heat (who will have lost 3 in a row). These games got me thinking about the NBA and my thoughts on the current season:

The Heat's Big 3: As much as I love to see teams with a shitload of all-star power ('04 Lakers, the current Celtics, etc), I really dislike this team. Why? Well, there are a few reasons: 1) I love Dwayne Wade, and I think that adding Lebron James kinda takes away from some of his star-power, and the focus really shifted from him to Lebron. I mean, honestly, most people think of LBJ now when they think of the Heat, and that just kinda annoys me. I mean, this is DWade's team; he's been there his whole career and got them a Championship with one of the greatest final performances of all time, and 2) a complete waste of an opportunity for Lebron to be one of the top 5 basketball players in the history of the NBA. Why? Well if he wins now, the credit will be shared by, if not mostly given, to Dwyane Wade. Also, Lebron's stats have significantly gone down; I don't think he'll be putting up the 30,8,8 stats he was posting up before, and nor will he be always the one taking the last shot. I do feel that Lebron James talent-wise is the best player currently in the NBA (and has been the last couple of years--sorry Kobe!), and for him to walk out from the Cavs (who btw had the best record in the league 2 years in a row), was extremely detrimental to him and his future career. I mean, come on, he went from the most loved player in the NBA to the most hated--and we are all witnesses.

MVP?: Wow, for once, I'm not completely certain who the MVP should go to, like at all. Kobe? I think the Lakers underachieved (for their standards) this year, so I don't think so, and plus, Kobe is kind of at a decline right now in his career (unfortunately). Lebron or DWade? Heat haven't exactly performed to expectations, so no. Kevin Garnett or Tim Duncan? Eh, too old and his stats aren't that impressive this year. Dirk? Already got one before so no. That really only leaves two players, Kevin Durant and Derek Rose, who have both played extremely well this season and both their teams have performed really well. Actually, I think I might give the edge to Rose because the Bulls have beaten some great teams this year (Spurs, Heat, Magic, Celtics), and may finish off as #2 in the East--who woulda guessed?!

Finals Match-up: Now in all honesty, what I would really love to see in the next few weeks is for the Lakers (my favorite team) to pick it up, get that #2 spot in the West, and go back to the finals. Come on, it's Phil's last year, and what better to finish his impeccable career with a fourth 3-peat--not to mention Kobe tying MJ with 6 rings. But right now, the Spurs are definitely better than them--hopefully that changes soon. Also, I would love to see either Miami or the Knicks go to the Finals (ok, Knicks is probably gonna happen, but NY vs. LA, Madison Square Garden vs. Staple Center matchup would be unbelievable. In the former case, you have insane star power--Dwade, Lebron, Bosh, Kobe, and Pau all on the same court for a championship--the defending champs vs. the preseason favorite? How sick would that shit be.

Thoughts on Affirmative Action--Bottoms Up!

So I’m currently in the middle of hearing back from medical schools (in fact, I hear back from a couple in the next week or so), and while browsing through student doctor network (yes, I use sdn, and go fuck yourself if you laugh at that because that shit is helpful), I keep running into similar posts all addressing “why does race matter in admissions?” That got me thinking about the role of race in medicine and affirmative action in general, so I thought I’d spill some thoughts.

In terms of medical school admissions, yes, it is true that underrepresented minorities (African Americans, Hispanics, and Native Americans) accepted into medical schools (let alone the likes of Harvard) have lower numbers than non underrepresented minorities. I mean just compare these charts: https://www.aamc.org/download/157594/data/table25-b-mcatgpa-grid-black-0810.pdf.pdf and https://www.aamc.org/download/157450/data/table24-mcatgpagridall2008-10.pdf.pdf

So, yes, I think it’s pointless to argue that there is equal treatment when it comes to the application process. But, now, the question arises: should affirmative action hold place in medical school admissions? Being an Indian American male (basically the shittiest possible scenario for a med school applicant), I was at first skeptical of this notion, but then I thought about it and have to agree that yes, in fact, it should, and here’s why:

1) Race does matter to many patients. Many minority patients do feel more comfortable and have a better connection with a physician of the same ethnicity as they do (whether it be due to cultural values or simply because they feel that the physician can empathize with them a lot better). Like damn, I’d be more comfortable with an Indian physician--especially an Indian physician that grew up in the states. I feel like he’d understand my problems much better (not just biological, but also social and mental, as healthcare should try to alleviate problems of mind, body, and soul). And yes, there are a shit-ton of black and hispanic patients, and not a shit-ton of black and hispanic physicians--maybe we should get on that....

2) Pictures motivate. Think about all those flyers you got when applying to college for a lot of those top ivy league-ish schools. You have the few white kids, the asian kids, and then black and hispanic kids all happy and smiling together like they’re all one big family. The truth is, whether or not that shit actually happens in college (some colleges are mad segregated), the black kid who gets that flyer from Harvard is gonna think, “hmm I see another black kid that’s at Harvard, maybe I can get in too?” In essence, it’s a way of motivating URM’s to strive for higher education. Think about how many black kids think they have a chance of being president after Obama won?

3) There are simply less of them. If you have a smaller number of applicants that must be distributed across a number of schools, then you simply will have a few students at top universities who numerically are less than the average accepted student. And honestly, only about 10-20% of a student body is composed of URM’s, so if anyone’s “stealing” your seat, it’s non URM’s that take multiple years off to do amazing shit and really beef up their resume.

4) An argument is often made that affirmative action should be based on those applicants who have been socio-economically disadvantaged, and I whole-heartedly agree. However, it is also true that being a URM and being economically disadvantaged is correlated, and many of them actually are. And even if they aren’t economically, many URM families for the most part have been disadvantaged socially at some point in the past (for example, first generation college students are often URM’s).

5) Diversity is important. Honestly, I don't wanna go to a school (let alone the most important school in my educational saga) with only one or two types of ethnicities and cultural backgrounds--been there, done that in high school, and that shit was wack. Having this type of diversity makes one learn about not only different cultures and viewpoints on different matters, but also allows you to learn more about yourself and your own viewpoints. Also, it allows you to relate to a wider variety of people.

Is it a perfect system? Absolutely not, and it does get abused often every year. However, I do think that it is a step in the right direction to “fairness.”

I think Chris Rock says it the best here: http://www.guavaleaf.com/video/4666/Chris-Rock--Never-Scared-Affirmative-Action He accurately says, "I don't think I should get accepted to a school over a white person if I get a lower mark on a test. But if there's a tie? Fuck him! Shit, you had a 400-year head start, motherfucker!"