Basics Flashcards

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1
Q

Tell Me About Yourself?

A

NYU:
-I grew up in New York City near Washington Square Park because my mom is a professor at NYU. I think because of that I grew up on a college campus in a very academic environment where I was always encouraged to spend time reading and thinking. I was exposed at a very young age to chess and that was one of my favorite things to do growing up.
Chess:
I would always go to Washington Square Park and they have chess tables there so I would go and play with the incredibly good chess players and get beat by them every time. I still play chess today, although I took a large break so I am definitely not as good as I would like to be.
Movies
In terms of my other influences, my grandma was also a movie critic for the Wall Street Journal, so I was always around movies growing up and my grandma would show me a lot of her favorite movies from the 70’s, like Raging Bull.
Soccer:
I grew up playing soccer and squash all the time and I would always go from one to the other. I stopped playing soccer after freshman year of high school to focus on squash, but I love watching English premier league soccer and I am a die-hard Manchester United fan I have watched every game since I was 6 years old.
Dogs:
I also love listening to all kinds of music and I love dogs and have two at home, Posey and Pepper

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2
Q
  1. Why did you choose your undergraduate major?
A

I am fascinated by the puzzle of the brain. I was initially drawn to it because of my own experience, but I found it to be so much more than I expected. I was pretty amazed by how much more there is to find out about the brain and in how many ways we can study it. So, I was able to take classes on how the brain evolved, on how the brain communicates to produce function and how the brain develops. I am very interested in the link between the physical of the brain and producing thought and complex consciousness and that’s why one of my favorite classes at Middlebury.

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3
Q
  1. How have you tried to achieve breadth in your undergraduate curriculum?
A
  1. Class With Amy Morsman – Civil War
  2. Class With Consciousness – Adam Wager
    Yes – I think coming from a liberal arts school like Middlebury has allowed me to explore a ton of different disciplines. I really enjoyed exploring before I decided what I wanted to do. Even the approach to neuroscience was very multidisciplinary like I said you have to take one philosophy class, but you can also take classes in psychology and in neuroscience in many different areas. One downside of all of this breadth is that I wasn’t able to do as much as I wanted with data science in terms of gaining hard skills.
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4
Q
  1. How has your undergraduate research experience, if any, better prepared you for a medical career?
A
  1. Breadth of Research
    I think I have been able to do research in a variety of fields actually, including doing research in multiple ways using data science to solve medical and scientific questions. I really want to incorporate the data science approach into my future research.
  2. Research – Thomas De Raedt
    - Gave me a good understanding for how slow and difficult and messy scientific research can be.
    I worked in a lab at the Children’s Hospital of Philadelphia, which I really enjoyed, and it taught me a lot about how to approach and solve scientific questions. How fun and unpredictable but also tedious and frustrating it come up with hypotheses and test them yourself. It gave me a really good understanding of how slow but rewarding actual scientific advancement is. It is painful at times, but it is our best way of learning more about the world.
    - Gave me a good appreciation for the difficulty of applying drugs to different ailments.
    It gave me a really rich appreciation for the complexity of human biology and allowed me to engage in a hands-on way with complex biological processes. We were trying to find a new drug target for high grade glioma brain tumors and we were looking at a chart of 50 possible targets and each interacts with each other. Each person can have different interactions between these different segments.
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5
Q
  1. How have the jobs, volunteer opportunities, or extracurricular experiences that you have had better prepared you for the responsibilities of being a physician?
A
  1. Working with Dr. Gardner – Taught me how important communication and empathy is
    I unfortunately have not been able to get as much as experience as I wanted to in an actual clinical setting. But I was able to spend a whole summer at NYU with a physician seeing her handle these patients. I think this really taught me about how difficult it is, I think when I was being treated, I thought of these people as heroes and I stand by that, but I didn’t see how difficult it is behind the scenes. You’re constantly juggling different, it’s also difficult physically as you spend the whole day walking from center to center seeing patients, spending the whole day on your feet. I remember getting home and being like wow that was incredibly hard and my feet ached.
  2. One Life
    - Taught me a lot about medical advocacy actually
    - Explaining why a disorder is important, explaining funding disparities
    - Hearing directly from patients about what doctors could provide them and what they couldn’t like the financial hardship of a pediatric cancer diagnosis.
  3. Excited to see more about a vaccine clinic called Betances for underserved communities on the lower east side. Hands-on experience from that.
    - Helping people schedule appointments
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6
Q
  1. How do you envision using your medical education?
A
  1. Academic Medicine
    I am very interested in academic medicine so I really want to be doing research and learning more about my field as I go along. So, I want to see as many patients as I can but also be learning more about the specific topic and become an expert as I go along.
  2. Strong Interest in the Brain and Strong Interest in Children
    I am not sure exactly what I want to go into to be honest, but I am obviously very interested in the brain and I love working with children. I also, as I have mentioned, hold a strong interest in pursuing applications of artificial intelligence as applied to medicine so I want my research to have a big data aspect. I want to find ways to more effectively combine artificial intelligence with clinicians in a more symbiotic relationship where it helps clinicians be better at their jobs.
  3. Education
    -I’d also like to teach and do advocacy work on behalf of the patients that I treat.
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7
Q
  1. Favorite class?
A
1.	Consciousness
I loved consciousness class I took because it was so unlike a lot of the other science classes I took. Because we really don’t have a scientific way at the moment to investigate consciousness, I really enjoyed learning about the different theories and I found it to be super imaginative and exciting. I am very interested in the link between the physical of the brain and producing thought and complex consciousness and that’s why one of my favorite classes at Middlebury. 
I also really loved all of the data science classes I took obviously and I love how we would take random data sets from sports and movies and pop culture and generate insight and visualizations.
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8
Q
  1. What are your greatest strengths and weaknesses?
A

Strengths: working with others, persistence/motivation, independence
Weaknesses: asking for help, can sometimes get way too absorbed into topics and find it hard to give them up.

  • I think one of my major strengths is getting along with people and communicating well. I think I am generally able to work with just about anyone and understanding that everyone has different ways of communicating and different ways of showing different emotions. I am very good at staying positive and encouraging people in reinforcing ways.
  • EX: One major example is working with my friend on this brain tumor project who’s bipolar and one of my best friends. So, he goes through major periods of being so excited about the project and about life in general and then would totally forget about it and not care at all. It’s challenging at times when I wanted to get something done and he just wasn’t in the right frame of mind, but I was able to very sensitive to that and to learn more about his needs.
  • I am very independent – I have always prided myself on that. I was the first one to walk to school alone in my grade and the first one to start taking the subway alone. I wrote my high school essay about how I would make myself a peanut butter and jelly sandwich every single day after school because I prided myself on not having to depend on my parents at all.
  • I am very persistent, sometimes too much so. I find it hard to let things go when I am doing academic assignments, but it drives me crazy when I can’t figure something out or something doesn’t feel right.
  • I think one of my biggest weaknesses has been I find it difficult to ask for help when I am struggling with something. I think this goes hand-in-hand with maybe putting too much pressure on myself at times to figure out problems. I have gone a long way with this and a lot of the times when I ask for help it used to feel more like admitting weakness or that I wasn’t good enough, but that’s a little childish frankly. I think my brain tumor (and I actually wrote my college essay about this) helped me in a way to ask for help more, but it’s still something I struggle with and I am trying to get better at.
  • Getting way too absorbed into specific activities.
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9
Q
  1. What travels have you taken and what exposure to other cultures have you had?
A
  1. Soccer Team and NYC
    My exposure to other cultures started at a very young age with my soccer team really. Living in New York allows me to meet people from everywhere, whether it’s having conversations with taxi drivers and getting to know them or eating food from places all over the world, I think it’s incredibly special. Something I cherish.
  2. Squash Travel
    I have been fortunate to travel a lot, I actually travelled a lot for squash when I was younger, so I played in the Italian Open twice, I played in the German Open, I played in the British Junior Open. I also did a trip to Asia where I was able to play. My grandma when I was younger loved to travel, so she was an NYU professor and she was allowed to travel each summer and teach in a different city. So, I went to London with her and to Paris and we would walk around everywhere and she somehow had more endurance than me even at her age when she was in her 70’s. Hopefully, I get to stay in London longer, but I have loved exploring the city and there’s something special about meeting new people and experiencing different places.
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10
Q
  1. Thinking of examples from your recent past, how would you assess your empathy and compassion?
A
  1. Empathy as deeper than sympathy
    I see empathy as deeper than sympathy which is just feeling bad for someone and it’s ant to have sympathy as well. But I see empathy as the ability to really put yourself in someone else’s shoes, to feel for them but also caring enough to understand why they might be feeling that way. What’s going on in their life? And doing anything you can to help and show you care and be there for them.
  2. Squash Practice
    An example would be on the squash team repeatedly having to deal with people coming late to practice or acting out or being a poor sport. The first thought cannot be this is unacceptable this person is terrible. It has to be – why are they acting this way? What’s going on in their personal life? How were they raised? How can I get through to them by speaking their language?
  3. This is Water
    Whenever I think about this question I always come back to David Foster Wallace gave a Kenyon university graduation speech called “This is Water” and he was talking about our default settings in life are always to think about yourself and how this affects ME and my frustration or tiredness, but it’s so important to be conscious of that default setting, and to give other people that same benefit of the doubt. So I think he gives the example of someone driving crazily and cutting you off and maybe they are rushing to the hospital or maybe the SUV-driver has had an accident in the past and this is the only way they can get up the courage to drive.
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11
Q
  1. As a pre-med , what skills have you learned to help manage your time and relieve stress?
A
  1. Planning ahead
    Yeah, it’s difficult frankly. I think coming to the conclusion that you don’t have to do everything every day and not to put too much pressure on myself was difficult at first. I would end the day having done a lot but not having finished the one thing and getting down on myself about it. One of the main things that I did at Middlebury that helped me was every Sunday night, I would stop doing work and spend 20 minutes writing my exact schedule and when I was going to do everything in advance. It’s weird to describe, but it just felt like a weight off my shoulders, I don’t have to constantly remember oh I have to do this then this then this, but what about this one task or errand. This allowed to relax because there was enough time in the week for me to get everything done, I just had to be efficient. So that was the activity that took the most stress away from me honestly. Working is the easy part, it’s the stress about getting things done in time with deadlines that is more difficult to deal with.
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12
Q
  1. If you could be granted three wishes for making the world/society/ your community a better place, what would they be and why (or, If you were given a million dollars to achieve three goals, what would you work on and why)?
A
  1. Wealth Disparities
    I am pretty passionate about income and wealth disparities, and it’s very stark in New York City. Our society is obviously set up in a way that allows wealthier people to continue to gain money through social connections, through privileges like being able to pay for better schooling and college, being able to invest money and get returns. This is also very intertwined with the racial wealth gap – 10x disparity (17,000 vs. 170,000). I would fund public education and enacting policies to lessen residential segregation.
  2. Tribalism
    If I had to choose another it would probably ending the rampant tribalism and inability to think logically that afflicts us. It’s fueled by rampant spread of disinformation so that might be where I start in terms of holding social media companies responsible somehow for false information on their platforms. It’s mind-numbing where we have come where we struggle to agree on anything. The whole pandemic response was marked by both incompetence but also just both sides took positions and the anti-mask movement because tribal. If we can’t come together and be reasonable during times of disaster then it’s not a very hopeful future.
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13
Q
  1. What do you do for fun?
A
  1. Athletics
    I love playing squash and soccer. Obviously, I have played squash for a while and I love it and it’s great way to keep active. And I love playing soccer as well with my friends. I used to play in the Spring at Middlebury and I was planning on joining an adult league in New York City before the pandemic and I definitely will when it’s over.
  2. Music + App / Movies + Grandma
    I love listening to music and watching movies – my grandma was actually a film critic and she would always come over and watch movies with us and she was very opinionated so she would always tell us when the movie sucked or when it was the best movie she had ever seen.
    Favorite artists: Thundercat, Steve Lacy.
    Really enjoy jazz – I just watched a Miles Davis documentary and I really love Kamasi Washington and Herbie Hancock.
    Favorite Movies:
    Documentary: Searching for Sugarman
    Movies: Hunt for the Wilderpeople, Do the Right Thing, The Lives of Others
    Animated: Kung Fu Panda
  3. Spending time with my dogs
    -Posey – 6 months old we got her last summer as a yellow lab
    -Pepper – 11.5 so she’s been with us for a while and they have a funny and cute relationship and I love spending time with them.
  4. Ceramics
    I really liked doing ceramics in high school and did some in college as well. One of my best friends from high school actually just opened up his own pottery store so I have been going over there and working a little bit.
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14
Q
  1. What is “success” in your opinion? After 20 years as a physician, what kind of “success” would you hope to have achieved? Please explain
A
  1. Having goals as a professional is important
    I think one main reason I have seen doctors give for physician burnout is that the actual process of getting to be a doctor is obviously very difficult that it feels like the end goal for some. And then you get there and feel like “what now?” So, it’s a good question and it’s really important to me that I have goals for myself as a physician so that I not only become and physician but I become a good one and set high standards for myself.
  2. Connecting with patients/Keep improving and finding ways to make myself a better doctor
    Specifically, for me, I really want to become an expert in connecting with patients, allowing them to feel comfortable and I at the end of that period, I would like to have a lot of patients who I stay in touch with and have some sort of personal connection with. One of my main goals is also on the research side where I want to find ways to do research to help doctors become better at their jobs and to better predict and manage diseases. One thing I really do not want is to feel static or like my job is the same every day.
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15
Q
  1. What qualities do you look for in a physician? Can you provide an example of a physician who embodies any of these ideals? How do they do this?
A
  1. Kindness and Empathy and Warmth
    I think that people often focus too much on the scientific knowledge of doctors, which is obviously crucial. But, given enough time, a lot of people can learn the knowledge and memorize information.
    Kindness, empathy, comfort.
  2. Dr. Allen
    Dr. Allen – is an incredible example of this. Every single time I went into his office, I knew it would be at least an hour and I was always late in getting to see him. But he would ask me how my day was – was I dating – how was my squash game – how was my family? It would be 20 minutes before we even talked about how I was feeling physically and my condition. And it’s important here because it helped to diffuse the tension and nervousness of me seeing my next scan. He recently retired but was in his job for 50 years.
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16
Q
  1. What kind of experiences have you had working with sick people? Have these experiences taught you anything that you didn’t know beforehand?
A
  1. Both ends of the spectrum – old people
    I also took care of my grandma a lot when she was sick this past year, which was a challenge with COVID, but she had cancer three times and the last time it was ovarian cancer. What really struck me was the psychological complexity behind her case. No illness is the same and our perceptions of our illness is so subjective. She lost her husband about 5 years ago and she felt so alone especially with covid. She had severe anxiety and depression but refused to get medicated because she saw it as a weakness and instead would drink half a bottle of wine every single night to go to sleep and tell her doctors that she doesn’t drink. She knew she was dying and was scared and so I saw firsthand how she copes with being sick and obviously I didn’t treat her, but it taught me so much about how painful and how difficult different illness burdens can be because of underlying conditions. And then towards the end she stopped recognizing me and that was painful.
  2. Children
    Yes so the main experience I have had for working with a sick person (I guess I’ve also been one) was a sick children at NYU. I worked with a lot of sick children at NYU and for the younger children it’s often more about communicating with the parents. Where it’s kindof the opposite end of the spectrum where it’s really difficult to know how much to tell a young child and it sortof depends on the parents, some wouldn’t tell them anything and others would be much more straightforward.
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17
Q
  1. Do you have any family members or role models who are physicians?
A
  1. Michael Fisher
    Funnily enough, my uncle is a pediatric neuro-oncologist at CHOP and he specializes in the same exact type of brain tumor that I had. So, when I first got diagnosed he came and lived with us for a few weeks and helped me recover. He helped me find the right doctors at NYU in the first place.
  2. Dr. Allen and Gardner
    I also really look up to Dr. Allen and Dr. Gardner, who are amazing.
  3. Eric Topol
    And, in terms of people I don’t know that well, I really look up to Eric Topol because of his engagement with the application of artificial intelligence.
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18
Q
  1. What family members, friends, or other individuals have been influential in your decision to pursue a medical career?
A
  1. Michael Fisher – works in same field as my tumor. Sharon Gardner, Jeff Allen had a large impact.
  2. Wouldn’t say anyone in my direct family had a huge impact besides being very supportive of my choices.
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19
Q
  1. If you could invite four people from the past to dinner, who would they be, and why would you invite them? What would you talk about?
A

♦ Fritz Haber
-I have been interested in him ever since I listened to a RadioLab episode. Ethical questions. He I think was Jewish in Germany but worked as a scientist and came up with the chemical weapon chlorine gas that was used during WWI and was used on to kill Jewish people during the Holocaust. Haber–Bosch process, a method used in industry to synthesize ammonia from nitrogen gas and hydrogen gas.

Michael Lewis
-Undoing project

Confirmation bias – physicians thinking that their procedure has worked even though there’s no evidence.
Availability Bias – you think shark attack more likely
Really informed my view of the world and my ability to understand that I am not perfect.

♦ Rodriguez
Searching for Sugarman. Beautiful story of serendipity

♦ Eric Topol
- Role model for me in ways to connect artificial intelligence and healthcare. I saw him speak at the UCL AI in healthcare series and he was the main speaker and I am so impressed with him.

Other:

♦ Steven Pinker
-I really admire him and I have read many of his books, like Language instinct arguing that language is innate.

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20
Q
  1. Does your academic record reflect any major challenges? If so, what are they and why did they occur?
A

Sophomore spring was my greatest challenge because of the insane work of Grilleme. Taking organic chemistry and would have to deliver food the night before exams. One night I had to deliver until 2AM. Terrible website I would always be taking calls from people.

21
Q
  1. What excites you about medicine in general?
A
  1. Constant state of flux – way I am treating patients at start is different from beginning. ANY CONTRIBUTION. I MAKE DIRECTLY GOES TO SOMEONE TO HELP.
    The way I am treating patients at the start of my career is going to be completely different than at the end of my career. It really excites me that the field is not static, things are always changing and because of that, there is a real opportunity to improve and innovate within the field. The opportunity to actually make a contribution to the field and improve a field. Any contribution I make to the field, actually makes a difference in someone’s life is the most exciting to me. My individual effort is put doing something I really like and all of the work is directly going to make a real difference in someone’s life.
  2. Problem solving and puzzles of diagnosis and like being challenged.
    - Love Chess and board games
    - The puzzles and problem-solving – I always have loved mental challenges, which is why I play so much chess and I love doing difficult riddles and puzzles.
22
Q
  1. What do you know about the current trends in our nation’s healthcare system?
A
  1. Rising Cost of Healthcare
    Rising cost of Health Care and the large inequities in the system that come with it – somewhere close to 4 trillion dollars. I read one paper that showed that up to 30% of people either don’t seek treatment or delay treatment until it’s absolutely necessary to do, which makes any condition harder to treat. So, it’s preventing people from getting the care they need. Prices for medical care grow way fast than inflation and the higher spending hasn’t generally correlated with better outcomes with our life expectancy and infant and maternal mortality rates lagging behind. We’re almost double the next country when it comes to healthcare cost as a percentage of GDP.
  2. Physician-Patient Relationship and Empathy Deterioating
    The physician patient relationship is a big one. Most of the time for appointments is spent just entering information into a computer. One of many reasons for the high rates of physician burnout. The lack of time and ability to really know a patient is also a major reason for the overordering of tests. Of the 80 million CAT scans 30-50% are unnecessary, there were 12 million missed diagnoses a year. 1/3 of all medical procedures are unnecessary. US is the worst offender in studies that have looked at wasteful procedures in all countries. The average appointment lasts 7 minutes and 12 for new patients.
  3. Lack of Technology
    Drawbacks with digital implementation. Way behind in technology. You can use a debit card to pay for something like anywhere in the world, but you can’t send an electronic health record across the street to a different institution.
23
Q
  1. What do you believe to be some of the most pressing health issues today? Why?
A
  1. Science Denial – for COVID, like if we can do all of the science and then present it to the public and then the public doesn’t believe it or doesn’t trust it, then there’s almost no point. You are losing the benefits of doing the research in the first place if the very people it’s meant to benefit don’t buy it. Anti-vaccine sentiments.
  2. Big looming health crisis is antibiotic resistance, where it’s only a matter of time before bacteria become antibiotic resistant to anything we can throw at it evolves to become resistant. It’s almost like a race because we also use so many antibiotics for live-stock, 80% of all antibiotics used on live stock.
24
Q
  1. What do you feel are the negative or restrictive aspects of medicine from a professional standpoint?
A

Things that take you away from your main job of treating patients

  1. Administrative Overburdening
    - As from Deep Medicine, more than half of the time doctors spend on administrative tasks. Constantly have to enter data. I want to try to find a way to end that and allow doctors to practice with empathy. This leads me to a lack of time to consider things. Danny Kahneman Thinking Fast and Slow talks about System 1 and System 2 thinking, where system 1 is immediate, reflexive thinking and system 2 is slow, reflective thinking that is more aware of your own biases and inclinations. If doctors don’t have time to consider the problem and think it through, diagnoses are going to be more reflexive and full of mistakes, like over-prescribing certain procedures and scans and medications.
  2. Dealing with Insurance Companies
    - Another source of paperwork and time that takes you away from patients.
  3. Too many patients
25
Q
  1. If you had to choose between clinical and academic medicine as a profession, which would you pick? What do you feel you might lose by being forced to choose?
A

Academic medicine.
1. Obsessed with learning and exploring my field
I think I am somewhat obsessed with learning new information all the time. I want to learn new information through medicine and research and constantly be reflecting and learning about my craft. I want a varied environment where I am treating patients, but I am also doing research and constantly learning about how to treat them and how to do my job itself better.
Might lose a little bit of patient time, but worth it to become more well-rounded overall.

26
Q
  1. What do you feel are the social responsibilities of a physician?
A
  1. Educational Responsibility:
    Help educate their patients and the public about medicine and health. Empowering them to make the right decisions that lead to less disease like promoting vaccinations, promoting healthy habits like eating and exercise. They should be heavily involved in health messaging and in helping to guide health policy in the right directions. Countering anti-vaccine sentiments.
  2. Advocate Responsibility:
    Responsibility to speak out politically against inequities in the healthcare system, about things you see in the clinic.
    That’s the only way physicians can be true patients advocates is to advocate for their patient’s in all ways and speak about of the social determinants of health.
  3. Responsibility for their Clinics:
    Responsibility to create a safe, accessible health-care experience that enhances the well-being of the whole community. To make people feel comfortable when they access the resources, when they enter your office.
27
Q
  1. What do you consider an important/the most important social problem facing the United States today and why?
A

Tribalism, inequality.

28
Q
  1. How do you think national health insurance affects physicians, patients, and society?
A

Affordable Care Act – might be repealed by the supreme court.
Prior to affordable care, if you were sick insurance companies didn’t have to take you. Beneficial to only take healthy people bc its cheaper.
Lifetime limits of care and then insurance ends
ACA mandates 10 essential health benefits – including preventative care, hospital stays, drugs. Ambulances and forces
Put rules private insurance companies and allows them to remain the main way.
Forces insurance companies to insure people with pre-existing conditions but also forces healthy people to get insurance.
Medicaid – for poor people. Medicare – for old people (65+)

Affects people and gives them healthcare – it’s not perfect, there are still almost 20 million unemployed people, but hopefully more patients feel able to get the medical care they need.
Society – you want a society with less inequity with people who don’t make a lot of money can get the care they need.

I think if you were starting a program from scratch, a single-payer system would probably be ideal. It provides a lot less of the inequities we see with different health care insurance quality based on income. Some people can only get medicare. You just pay more taxes and people get their services covered by the government. It does feel really difficult to implement and there are lots of countries that have mixed the public and private option efficiently, including the Netherlands and Germany but they have more regulated markets.

29
Q
  1. In what manner and to what degree do you stay in touch with current events?
A

I actually stay in touch with current events a lot. I try to read the New York Times a lot of morning, or at least skim it as much as I can. I think that’s where my dad has actually had a major influence on me in that regard because for as long as I have been alive, he wakes up every single morning at 530 and reads the entire New York Times and WSJ cover to cover. A major source of news is that I actually have a twitter account which is the only social media I use regularly where I follow tons of doctors and scientists as well as political reporters, op-ed writers and I from there get a pretty rich source of new scientific articles and updates on COVID, as well as long form journalism in places like the New Yorker.
Partisan Politics.

30
Q
  1. What books, films, or other media come to mind as having been particularly important to your sciences/non-sciences education?
A

Deep Medicine Eric Topol – I am reading right now has been crucial to me honestly. It details the ways in which medicine fails, as well as the amazing things that it does. I think when people talk about artificial intelligence, it’s super hyped up and we talk about it as this cure-all for all problems and it’s gonna take away doctor’s jobs because it can do everything personally but that’s not true at all. He talks a lot about how AI can be paired with physicians to make them better at their jobs. So, he talks about how most of medical appointments are spent just entering information and perhaps if we recorded and then used natural language processing we could do a much better job and doctors would be freed up with their time to spend more time with patients and to learn more about them and to show more empathy.
The Undoing Project Michael Lewis – Daniel Kahneman and Amos Tversky about two Israeli psychologists who team up and basically find out a bunch of cognitive biases that cause people to make poor decisions. I think it appealed to me obviously since I have a neuroscience background but also because these ways that we think apply to every field and every person. They are completely pervasive – the availability heuristic where if something’s more available in your mind and easier to picture, you think it tends to happen more often, like vending machines and shark attacks for example. This could apply to medicine with bias in diagnoses, over-diagnosing the prevalence of a specific disease for example.
Moonwalking with Einstein – Memory palaces, so you place objects into your memory and retrace them. I wrote a sample grant proposal investigating the differential role of the hippocampus, which is the part of the brain for memory, in spatial memory.
Soccernomics/Moneyball – taught me about cognitive biases in sports and how to avoid them.
The Righteous Mind/Coddling of the American Mind – Jonathan Haidt

Searching for Sugarman.
About a singer named Rodriguez who works as a construction worker in Detroit he plays gigs at a local bar and gets discovered by a local record label. They put out an album and only a few copies are sold. The rest of the copies get sent different places and he thinks he’s missed his chance. Meanwhile, in South Africa, he’s become a hero and his album is incredibly popular – there’s this legend about him burning himself on stage or something, but meanwhile he just works as a construction worker in Detroit. For me, that was an amazing lesson in coincidence and I listened to that album all throughout my hospital stay.

Lives of Others, Shawshank Redemption, Do the Right Thing, Hunt for the Wilderpeople

31
Q
  1. Can you think of any examples in our society when healthcare is a right? When is it a privilege? When is it not clear?
A

Healthcare is generally always a right when it comes to procedures that improve the health of an individual. Unfortunately, we still have a ton of uninsured people and vast inequities in the healthcare system. About 30 million people are uninsured still. Insurance companies prior to affordable care act could just say no you’re too sick we don’t want you because we don’t want to pay because you have a pre-existing condition.

I think it’s a bit easier to take cosmetic or plastic surgeries as elective. It becomes a little more difficult if you start thinking of cosmetic procedures as perhaps improving the mental health of an individual or their own self-perception, but generally this is a privilege to me.

32
Q
  1. Are you aware of any current controversies in the area of medical ethics? List and discuss some of these.
A
Four pillars:
Beneficence – helping patients
Non-maleficence – not hurting patients
Justice – fairness for society
Autonomy – patient choice

Euthanasia - below
Abortion – I do believe it’s a women’s right to choose but I respect people who actually have strong opinions about wanting the child to be born and they’re right that a child would be born if it wasn’t aborted, so it’s not exactly an easy issue. I just think on such a difficult issue, it should be up to the person to decide and it’s difficult enough for the person to decide.
CrispR – Whether it’s able to genetically alter a baby’s life. Really problematic, like anything in our scoeity richer people will have more access to create designer babies. We are a long way away from that, but I think for now, let’s just focus on curing potentially fatal or life-altering monogenic diseases and then go from there.
Use of AI and Racial Biases – if we are going to use the tools. The thing is that artificial intelligence isn’t racist, we are. AI is only as good as the data we give it, so if we are trying to create an algorithm that assess risk score and warns people to get tested in certain scenarios and doctors tend to systematically under-rate the risk scores of black or latino patients, then it’s not going to work.

33
Q
  1. Have you personally encountered any moral dilemmas to date? Of what nature?
A

A big one academically was getting requests to cheat by passing down resources from a class that I was in to the next year. I think that’s pretty common. I was super uncomfortable with it and I ended up kindof deflecting but offering help in any way that I possibly could without giving materials or sending help or links that might be useful for their learning.

• What do you think of affirmative action?
I fully support affirmative action – I think that ideally it wouldn’t have to exist in a world where everyone started with at least somewhat similar opportunity. But that’s not the reality and the reality is that many students, disproportionately those of color, have had more difficult roads to college or to medical school than others or less access to resources, less time to study for exams, fewer social connections and less social capital to rely on. So all of that stuff needs to be taken into account before you just look at raw numbers and raw information of an application.

34
Q
  1. What’s your greatest fear about this opportunity?
A

Shaky hands – I don’t have great fine motor skills, so I think I might struggle with some of the initial stuff. I feel like I probably couldn’t be a surgeon.

35
Q
  1. How do you feel about euthanasia or medically assisted suicide?
A
  1. Support – could imagine wanting it for myself WITH CONDITIONS
    I support it being legal because I could imagine situations where I would want it for myself. Legal in 9 states including Vermont. As long as someone has a terminal diagnosis that is expected to die pretty soon with no chance of improvement and isn’t clearly mentally impaired and clearly expresses a desire to end their life early I think we can respect those wishes if they’re in so much pain. Even though this breaks one of the pillars of medical ethics which is non-maleficence.
36
Q
  1. What different feelings and issues might you experience with a terminally ill patient, as opposed to other patients?
A

I experienced this in a major way this year when my grandma had terminal cancer. We and she knew she only had a few months to live. I think it depends a lot on the patient, so some patients may want to reflect a lot on the meaning of their life, whether it’s their career or their friends or their grandchildren or their experiences. So, my grandma would talk a lot about how full a life she lived. But for other patients, they may want to not think about it quite as much and talk about other stuff and you need to respect that. So, it’s about really managing each patient individually and really listening to them.

37
Q
  1. How would you feel about treating a patient who has tested positive for HIV?
A

I would feel good and take precautions and do the best that I can. I know the dangers of being a doctor and it’s part of the job to give anyone who needs it care no matter what.

38
Q
  1. What are some of the ethical issues that our society considers in regard to teenage pregnancy?
A

Ethical concern would be that it’s rare that someone so young has the time and the responsibility. IF your brain doesn’t even fully develop until your 20’s. More likely to have complications like maternal and developmental problems for the child. I think that’s fine in certain cases and some people are ready and it’s especially useful to have family that can help in that case. But in other cases, it’s irresponsible and I also think that better access and education to sex education and contraceptives would help here.

39
Q
  1. If you are not a minority, how might you best meet the needs of a multiethnic, multicultural patient population?
A
  1. I am lucky enough to have some amount of training already
    I am lucky enough to have grown up in a place where there is immense cultural diversity and I have learned and benefitted from that. I mentioned my soccer team already as an example because that’s the most obvious one, but I was one of only one or two people on that soccer team with American born parents. I have had the privilege of having very ethnically and racially diverse friend groups, and I have been able to help out with underserved communities while helping out at the Hudson Guild and at StreetSquash, which I have spent a lot of time at.
  2. Acknowledgement that cultural competency is built over time
    That being said, I think it’s important for me to acknowledge that I don’t know everything about every culture and cultural competence is a skill that can be built and improved over time. I don’t pretend to and that’s why being willing to listen to people being respectful of them and everyone can constantly be improving their cultural competence and understanding. And it’s most important to realize that some groups may have (earned and understandable) distrust, that may cause them to avoid the medical industry as a whole until it’s a last resort and I need to do my best to understand and accept that and do the best I can to reach a place of trust and understanding.
40
Q
  1. To what extent do you feel that you owe a debt to your fellow man? To what extent do you owe a debt to those less fortunate than yourself? Please explain.
A
  1. Squash A Good Example
    I 100% owe a debt to those less fortunate to me. One example of this is that I was able to start playing squash in the first place. While I didn’t know how inaccesible a sport squash was when I first started playing it when I was 5. I couldn’t have chosen to different sports to play growing up, with soccer where all you need is a ball and it’s so readily accessible, compared to squash which is so much more difficult to ostart. I actually started playing a public affordable club, but it got bought out by equinox and they tore down the squash courts, and that’s happened all over and the most common places to play are the Harvard, Princeton and yale clubs.
  2. Goal to Make it More accessible – I enjoyed and profited from sport, so have a responsibility to make it more accessible.
    One of my ultimate goals in life is to find more ways to make squash and other sports like that more accessible. My dad actually recently started a non-profit squash club in Manhattan that offers tiered memberships and free memberships based on income level to make it affordable to all. I helped combine that club with an squash program for young kids at the Hudson Guild in High school. I want to continue that and continue to contribute. Things like that, where there is such a blatant disparity in access to a sport is something that needs to change.
41
Q
  1. What special qualities do you feel you possess that set you apart from other medical school candidates? What makes you unique or different as a medical school candidate?
A

I think I come at it from a slightly different perspective having been trained in data science and statistics and being incredibly interested in neuroscience and cognitive biases, I think I can bring a lot in terms of using these concepts to make myself a more effective doctor.

42
Q
  1. What kind of medical schools are you applying to, and why?
A

NA.

43
Q
  1. Pick any specific medical school to which you are applying, and tell the interviewer about it. What makes this school particularly desirable to you?
A

NA

44
Q
  1. What general and specific skills would you hope an ideal medical school experience would give you? How might your ideal school achieve that result?
A

I would really like to be trained in dealing with patients as much as possible. I think every medical school pretty much will teach me about the basic knowledge required for medicine, but one of the main challenges is making sure I become an effective communicator. That’s the most challenging part, so I would prefer a very in-person, hands-on experience to learn to combine the information aspect with the patient aspect. The information means nothing if you can’t explain it to the patient in a clear and digestible way.

45
Q

Why did you decide to choose medicine and not some other field where you can help others, such as nursing, physical therapy, pharmacology, psychology, education, or social work?

A

I think that would be great, but medicine is so immediate and scientific. I love the challenge and the breadth of medicine, where a patient can come in with any number of infinite symptoms and you have to decipher the problem and choose the solution. It means every day is completely different with a completely different set of issues and puzzles to decipher.

46
Q
  1. Discuss your decision to pursue medicine. When did you decide to become an MD, and why?
    1.
A

Brain Tumor In High School
So, it started as I was saying when I had a brain tumor in high school. I was pretty scared, I barely even knew what that was, was I going to be okay? It was scary. And they were so patient and kind and took the time to explain everything to me and to comfort me. I really idolized them and the idea of spending your life dedicated to helping sick children to feel better physically but also emotionally was so admirable to me. Wow, I really want to do this when I’m older. They made it look so simple and easy.
2. Finding Out the Real Story
I went back to spend the summer with them my freshman year and I was like this was not what I was expecting at all. It was so much harder and more draining – it was emotionally difficult to be dealing with all of these children, it was mentally difficult trying to keep all the information on each patient straight, it was physically difficult walking to the ICU and to different patient locations all day. It’s kind of like when you see the end product of like Lebron James and you’re like wow that’s so amazing and it looks so easy but you don’t see the behind the scenes of how difficult it actually is to make it look so easy.
3. Why I liked it
It was different than I was expecting and also much more exciting in a lot of ways – it was never static, it was chaotic and you were always learning new things, which really appeals to me.

  • I love to learn and I am excited about a job where nothing is simple, you never know what is going to be thrown at you. Being in a job where I can communicate and empathize and build connections with and help people is important to me.
  • Puzzles of medicine really excited me. I remember going home and telling my parents how excited I was.
47
Q
  1. What will you do if you are not accepted to medical school this year? Have you an alternative career plan?
A
  1. Apply again – work on areas of application that aren’t good enough
  2. Work on projects, especially in data science in the meantime.
    I will apply again, and take feedback and try to improve aspects of my application that didn’t work because I am really set on patient interaction being a central part of what I do. If I literally was prevented from being a doctor for the rest of my life, I would set my focus on using my data science background and providing improvements in health care. I think I would continue practicing my health data science skills and work on projects because I love that.
48
Q
  1. What are the strengths and weakness of AI in medicine?
A

Additional For Me:

Why is AI helpful for medicine?