Monday, April 8, 2019

FHSP Sponsors Trip to USD Sanford School of Medicine's Pre-Med Day

The front of the Lee building.
On Saturday, the University of South Dakota Sanford School of Medicine held their annual Pre-Med Day in the Andrew E. Lee Memorial Medicine and Science Building on their campus in Vermillion, SD. The Future Health Science Professionals sponsored the trip for members, covering the costs of travel and lodging for the weekend. We left Rapid City on Friday afternoon and arrived at our hotel in Vermillion around 11:00pm. After a hot breakfast, compliments of the hotel, we checked out and made our way over to the USD campus for the day's event.

The event began with a welcome from the USD Pre-Med Society officers and from the Dean of Medical Student Affairs, Dr. Dawn Bragg. Next came Dr. Pasquale Manzerra, who talked with us about the admissions process for USD SSoM and the strengths of the program. Did you know that USD SSoM won the 2017 AAMC Spencer Forman Award for Outstanding Community Service? They received this prestigious award for their community-based program with multiple campuses and clinical training sites throughout the state of South Dakota. Many of their faculty and staff have also won awards. Dr. Mark Garry was awarded the 2018 Arnold P. Gold Humanism Award and Dr. Gerald Yutrzenka was the 2018 recipient of the Exemplary Service Award from the AAMC Group on Student Affairs. We arrived early for registration on Saturday and were fortunate to get to meet Dr. Yutrzenka at Pre-Med Day before the event got started!

Dr. Manzerra discusses admissions at USD SSoM.

In 2018, the AAMC named USD SSoM as the top school in the nation for graduates practicing in a rural area and placed them in the 95th percentile for students entering into Family Medicine. Additionally, they rank in the 98th percentile for proportion of graduates who are American Indians or Alaska Natives.

We learned more about USD SSoM's Culture of Caring. Because of the small class sizes, students develop close relationships with each other and with the faculty and staff. There is a lot of respect for student input on the learning process, with students serving on various committees alongside faculty and staff, focus groups for institutional improvement, and anonymous suggestion boxes for helping improve courses and activities. The students interact in a collaborative environment rather than in a competitive one. There is a ton of support for students, including academic, personal, financial, and professional support services. There's even guidance for pregnancy and adoption during medical school to help students who are planning for a family during medical school.

DNA artwork on the floor of the Lee building.
They also have an integrated wellness program with the motto Well Students, Well Doctors, Well Patients, which focuses on helping students live balanced lives during their training and promotes self-care to combat student/physician burnout. Throughout the year, there are many wellness activities available, including student-led events, mentoring and advising, stress management, and resilience training. Each class elects wellness officers, who oversee budget and promote wellness for each of their representative classes, such as yoga, movie nights, aromatherapy demonstrations, wellness retreats, study-a-thons with snacks and massages, etc. It is important for students to have these kinds of activities and wonderful that USD promotes a culture of self-care and wellness among its students. Approximately 50% of medical student experience burnout, with 9% experiencing suicidal thoughts. High levels of stress can induce anxiety, leading to a range of mental health consequences. As one of the medical students would say to us that day, "Medical school is a jealous lover. It will take over your life and drain all of your time if you don't set boundaries."

Sanford School of Medicine places an emphasis on life-long learning and uses case-based, problem-based, and team-based learning strategies alongside simulation activities and hands-on experiences to prepare medical students to be outstanding physicians. They also feature longitudinal integrated clerkships as part of their curriculum and they have opportunities to tailor Pillar 3 of the program to your specialty interest. They are one of the best "bang for your buck" institutions, featuring low in-state tuition rates and a wide array of scholarships to help students finance their educations.

There were two Q&A panels during this year's Pre-Med Day. The first panel featured students in various stages of their training...spanning from a student who is in their first year to a student who just matched into a residency program. They shared many great insights with the attendees and gave advice to those interested in applying to USD's program. After a yummy lunch of tacos/nachos, several of the faculty members spoke to students about preparing for and being successful in medical school. Dr. Dan Bird summarized their advice best when he said, "Success is to be adaptable and to be receptive to change."

USD medical students answer pre-med questions.

There was also a session about how to pay for medical school presented by Carol Hemmingson, who works for the financial aid office. During that time, the health professions advisors from the various South Dakota schools met with Dr. Manzerra to talk more about admissions and preparing students for success in medical school.

Afterward, students and their advisors reconvened for a tour of the medical school, which included a trip to the simulation rooms, study rooms, classrooms, and, of course, the gross anatomy lab. Students were able to see where medical students work, study, relax, and socialize during their time in Vermillion. We were also able to get a better feel for the kinds of resources available to students and to ask lots of questions about life in a medical program.

Inside of the main lobby of the Lee building. 

The drive back to Rapid City was full of great conversation about the things we experienced during Pre-Med Day. Overall, this was an excellent event that was well-worth the drive across the state. Next year's Pre-Med Day will again be sponsored by the Future Health Science Professionals, so if you are considering applying to USD's Sanford School of Medicine, consider joining FHSP (if you aren't already a member) and traveling with us to Vermillion for a day full of information, resources, and forums for discussion!
Hope to see you next year!

Thursday, March 7, 2019

Advice from an Alumnus: Meet Levi Franz!

SD Mines has a reputation for excellence that reverberates through our students long after they leave campus with their degrees in hand. Today, we are featuring on of our alumni, Levi Franz, who earned his degree in applied biological sciences in 2014. He was in the first class of students to graduate with an ABS degree from SDSM&T and is now pursuing a degree in medicine from the University of South Dakota Sanford School of Medicine. We caught up with Levi to ask him about his pre-health journey at SD Mines and how it helped him prepare for a career in health care.

Hey, Levi! Where are you and what are you doing as an SD Mines graduate? 
I am currently a 3rd year medical student at Sanford School of Medicine, which means that I am currently doing my clinical rotations with Physicians throughout Rapid City. 

What kind of shadowing did you do and what did you learn from those experiences?
I actually did very little actual shadowing before applying to medical school. However, I did work as a tech in the ER. This is a unique position at the hospital which generally requires an EMT, and allows you to work closely with many different Doctors. During my time in the ER, I had the opportunity to assist with Central lines, Spinal taps and many other procedures. I also got to know the physicians, and became friends with them outside of work. This proved very valuable once I was applying for medical school and needed to get letters of recommendation.

Did you do any research while at SD Mines?
I did research during my undergrad at SDSMT with Doctor Sinden, and I have been working on a research project focusing on SIDS that I developed myself. Research is a very important aspect of any career of medicine even if you don’t particularly enjoy it. I avoided research during my undergrad and regretted it, as I had a great deal to learn once I was in Medical School.  

What kinds of volunteering do you do?
While I was completing my undergrad degree, I volunteered as a part of the Pennington and Custer County Search and rescue teams, I was also a YoungLife leader in Rapid city. Since starting medical school, I have volunteered as a member of a student run clinic in Sioux Falls that serves disadvantaged populations. I also spent a week volunteering as a leader at Camp Wapyapi which is a camp that serves Cancer patients and their families in Colorado. This was a great experience that any prospective medical student can do; it’s a great experience and looks great on applications (Link to application:

How did you prepare for the MCAT or other entrance exam?
I was working as a Wilderness Park Ranger in Washington State while I was preparing for the MCAT. This was a great experience, as I did not have many other distractions, and could focus entirely on studying. After I reviewed my weaknesses, the most valuable thing that I did was practice MCAT questions. I would do a full length test on Saturday, take 2-3 days off, and then review the tests for a few hours in the evening over the next 10 days, then repeat the process over the next two weeks. I did this for 2 months, and was very happy with my score.

What do you do when you aren’t studying?
The First two years of Medical School I usually studied from 8:30-4 and then 6:30-10. While this doesn’t allow a lot of time to do much else, everyone else in your class is going through the exact same thing, so I was able to get to know lots of interesting people and make great friendships. Your life in medical school is what you make it; I would run, bike, play soccer or frisbee, or climb every day, and to be honest really enjoyed my first two years of medical school.

What techniques do you use to manage your time and stress levels?
Organization is something that I struggle with, fortunately every week in medical school is basically the same, with some small changes here and there, so once you get a routine, its very easy to manage your time and get everything done that you need. I found that I could waste hours on my phone, so most of my time management focused on limiting this through apps, or leaving my phone somewhere I couldn’t check it every few minutes.

Exercise is how I managed my stress. I would work out everyday regardless of what was going on, because if I didn’t I would sleep poorly and lose my concentration. 

What advice do you have for pre-health students who are struggling?
Work hard, don’t focus on your grades and consider all your options. It wasn’t until my Senior year of college that I stopped finding my identity in my grades and I definitely saw them improve after I made this mental change, as did my mental health. There’s so much more to life than grades and your profession. If you’ve work hard and your grades still aren’t great, relax and consider all your options. DO schools offer a less competitive option for becoming a physician, and DOs operate in the exact same capacity as MDs. Pre med Masters programs are also a great option that can make up for a poor GPA and prepare you for medical school in a way that few other things can. 

Monday, March 4, 2019

Pre-Health Prep Series: What is a Committee Letter?

When applying for professional schools, admissions committees need more than your GPA and entrance exam scores to know whether or not you would be a good addition to their program. As you likely already know, these schools are going to ask you to provide contact information for people who can tell them more about you and your abilities. The people that are asked about you are often called references, but you may also hear them referred to as "letter-writers" (implying that they are willing to write you a letter of recommendation), "recommenders", or "evaluators". Admissions committees rely on these folks to help them understand what kind of student you are, how you handle difficult situations, your level of motivation, your competencies and strengths, and a whole host of other attributes. For this reason, you should chose your recommenders wisely, selecting those who know you well and are able to sing your praises authentically to a group of strangers.

Typically, you select 3-5 individuals who you think would be able to represent you well and then you ask those individuals whether or not they would be willing to write you a positive letter of recommendation. Then, you enter their contact information into your application and maybe check in with your letter-writers as you get closer to deadlines to make sure they have given programs whatever they have been asked to provide (usually a letter of recommendation, but some programs will ask them to fill out an evaluation form instead of or in addition to providing a formal letter). This is the most common mechanism for references and is often known as the individual letter/evaluation.

There are also other forms of recommendations that can be submitted to professional programs. The letter packet is a collection of individual letters that can be collected and sent from a coordinator (such as your neighborhood friendly Pre-Health Pathways Advisor) on behalf of everyone who writes a letter. This sometimes counts as a single letter submission, which can be a good way of strengthening an application when appropriate.

The most powerful form of recommendation is also the least well-known mechanism among pre-health students: The Committee Letter. A committee letter is a recommendation letter submitted to a professional program on behalf of a committee of professors representing a collective, academic perspective regarding the applicant. These letters offer evaluations of your performance as a student and can highlight your competencies and professional growth. They help admissions officers learn more about you as an applicant by providing further context for your professional narrative.

Committee letters can strengthen your application by:

  • Giving the committee a holistic view of you as an applicant
  • Providing context for extenuating circumstances or challenges
  • Outlining your overall preparation and motivation for going into health care
  • Advocating for your admission

Committee letters are written by faculty members who can speak to your strengths and potential for succeeding in a professional program. These letters often carry more weight than individual letters because, to some extent, they represent an institution's evaluation of you rather than a single person's perception of you. When selecting people to serve on a committee that can write you a letter, consider how well the potential committee member knows you and whether or not that person can speak to your professional growth and development as a student.

Ask yourself:
  • How well does this person know me?
  • Will this person talk about me in a positive and professional way?
  • Does this person have enough evidence to demonstrate that I would be a good fit for the program where I am applying?
  • If I were this person, would I feel like I could write a good letter on their behalf?
  • If I get an interview and this person’s name comes up, how would I explain our professional relationship?

Here's a few tips about when to ask:
  •  Don’t ask if:
    • The professor only had you for one class.
    • The professor hasn’t had you in a class recently.
    • The professor doesn’t remember your name.
    • You never spoke to the professor when taking their class(es).
    • You have had negative interactions with the professor.
  •  Do ask if:
    • You took multiple classes with the professor.
    • You took the professor’s class within the last academic year.
    • The professor recognizes you when you see each other outside of class.
    • You spoke often with the professor when taking their class(es).
    • You have worked with the professor on a research project.
    • You have had positive interactions with the professor.

Though not always a requirement for entry into a professional program, many institutions highly recommend or strongly prefer to have a committee letter provided for the applicant if the applicant's institution offers the service of providing a committee letter. Ask your pre-health advisor if a committee letter is right for you!

Here at SD Mines, we offer this service through our Pre-Health Pathways office within the Student Success Center. If you are interested in learning more or would like to know the protocol for requesting a committee letter, contact Dr. J.

For more information about committee letters, check out these resources:

Friday, March 1, 2019

Closed Case Friday: The Woman with Sudden & Referred Pain

Earlier this week, we gave you a hypothetical patient with the following case:

This week's hypothetical patient is a 25-year-old female who is admitted to the ER with sharp abdominal pains, vomiting, dizziness, nausea, and weakness. Her boyfriend, who brought her into the ER, states that her pain began suddenly and that she said she felt as if she were going to faint all the way to the hospital. Because she was stable upon arrival, a physical examination was done. When asked if she could be pregnant, she stated that she could not be as she has an IUD, but did acknowledge that the couple were sexually active. She also stated that she had missed her last period, but assumed it was because she had recently started training for a 5K and was trying to quit smoking. The patient's vital signs were normal. The patient was experiencing diffuse abdominal tenderness. During the exam, the patient began to bleed vaginally and started feeling pain in her shoulder that radiated up to her neck. She was immediately given a FAST (focused assessment with sonography in trauma) exam. An OB/Gyn was called in for an emergency surgical consultation.

Today, we reveal that our hypothetical patient was diagnosed as having: 

Ectopic Pregnancy with Fallopian Tube Burst 

This patient had many of the classic symptoms of ectopic pregnancy, including abdominal pain, weakness, dizziness, nausea, and vomiting. She also had many of the risk factors, such as smoking, a missed period, and an IUD. Becoming pregnant while having an IUD is rare, but those who do become pregnant while having an IUD are more likely for the pregnancy to be ectopic. A tubal ligation also increases the risk of ectopic pregnancy if a woman becomes pregnant following this procedure. Smoking can also increase the risk of ectopic pregnancy. In this case, the patient's Fallopian tube burst, causing the vaginal bleeding. The internal pooling of blood following the bursting of a Fallopian tube can occur near the diaphragm and irritate nerves that run into the shoulder and neck, which can lead to the referred pain that this patient experienced. The FAST exam likely showed the damaged Fallopian tube and internal bleeding, which led to calling in an OB/Gyn for a surgical consultation. The classic triad for the clinical presentation of ectopic pregnancy is abdominal pain, vaginal bleeding, and a missed menstrual period. This typically presents 6-8 weeks after the last normal menstrual period. Rupture of the Fallopian tubes may be suggested by severe abdominal pain, nausea, vomiting, lightheadedness, referred pain (to the shoulder, neck, or rectum), and/or abnormalities in the vital signs, including hypotension, tachycardia, or shock. Early diagnosis of ectopic pregnancy can often be managed with medicine if there is no damage to the Fallopian tube. This is typically done using an injection of methotrexate (Trexall), which stops the cells from growing and allows the body to absorb the pregnancy. In cases where this medication doesn't work, or a woman has severe symptoms, such as a ruptured Fallopian tube, surgery is the only option. Surgeons prefer doing laproscopic surgery when possible, but in our patient's case, a larger incision would likely be necessary as her Fallopian tube might have to be removed. After surgery, the patient's hCG levels will be closely monitored to make sure that the pregnancy was properly removed.

Thanks for joining us for this week's Mystery Case and we hope to see you next week!

Thursday, February 28, 2019

Pre-Health Prep Series: Pre-Professional Competencies for Medical School

Like many professional programs in healthcare, medical schools are looking for more than applicants with high grades, stellar entrance exam scores, and a collection of coursework that has provided them with a broad educational background. These programs are also wanting to accept applicants that they know will be able to balance the rigors of medical school with serving their communities and future patients. They want life-long learners and problem-solvers who are compassionate, empathetic, and devoted to being good colleagues and great practitioners.

The Association of American Medical Colleges (AAMC) as designated 15 core competencies that all applicants entering medical programs should have. This list of competencies was developed after reviewing the medical education and employment literature extensively and seeking input from numerous advisory panels and medical professionals.

While each medical program has their own review process for evaluating and selecting applicants, most programs use a flexible system, known as holistic review, to help admissions committees balance the experiences, attributes, and academic metrics of the applicants that they are considering for entrance into their programs. (We will likely talk more about the holistic review process in a future blogpost, but if you are interested, you can read more on the subject by going here.) The AAMC's 15 Core Competencies for Entering Medical Students has been used by many medical schools to help them articulate what they are looking for in applicants.

This list isn't intended to be used as a checklist for getting into medical school. Many applicants simply will not have mastered all 15 competencies by the time they apply to medical school and that is perfectly okay and normal. Instead, this list provides a framework to consider and to use as you communicate your experiences during the application process (and on interviews) to demonstrate your readiness for a professional program.

The list of core competencies is as follows (taken directly from AAMC):

Pre-Professional Competencies

  • Service Orientation: Demonstrates a desire to help others and sensitivity to others’ needs and feelings; demonstrates a desire to alleviate others’ distress; recognizes and acts on his/her responsibilities to society; locally, nationally, and globally.
  • Social Skills: Demonstrates an awareness of others’ needs, goals, feelings, and the ways that social and behavioral cues affect peoples’ interactions and behaviors; adjusts behaviors appropriately in response to these cues; treats others with respect.
  • Cultural Competence: Demonstrates knowledge of socio-cultural factors that affect interactions and behaviors; shows an appreciation and respect for multiple dimensions of diversity; recognizes and acts on the obligation to inform one’s own judgment; engages diverse and competing perspectives as a resource for learning, citizenship, and work; recognizes and appropriately addresses bias in themselves and others; interacts effectively with people from diverse backgrounds.
  • Teamwork: Works collaboratively with others to achieve shared goals; shares information and knowledge with others and provides feedback; puts team goals ahead of individual goals.
  • Oral Communication: Effectively conveys information to others using spoken words and sentences; listens effectively; recognizes potential communication barriers and adjusts approach or clarifies information as needed.
  • Ethical Responsibility to Self and Others: Behaves in an honest and ethical manner; cultivates personal and academic integrity; adheres to ethical principles and follows rules and procedures; resists peer pressure to engage in unethical behavior and encourages others to behave in honest and ethical ways; develops and demonstrates ethical and moral reasoning.
  • Reliability and Dependability: Consistently fulfills obligations in a timely and satisfactory manner; takes responsibility for personal actions and performance.
  • Resilience and Adaptability: Demonstrates tolerance of stressful or changing environments or situations and adapts effectively to them; is persistent, even under difficult situations; recovers from setbacks.
  • Capacity for Improvement: Sets goals for continuous improvement and for learning new concepts and skills; engages in reflective practice for improvement; solicits and responds appropriately to feedback.

Thinking and Reasoning Competencies

  • Critical Thinking: Uses logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
  • Quantitative Reasoning: Applies quantitative reasoning and appropriate mathematics to describe or explain phenomena in the natural world.
  • Scientific Inquiry: Applies knowledge of the scientific process to integrate and synthesize information, solve problems and formulate research questions and hypotheses; is facile in the language of the sciences and uses it to participate in the discourse of science and explain how scientific knowledge is discovered and validated.
  • Written Communication: Effectively conveys information to others using written words and sentences.

Science Competencies

  • Living Systems: Applies knowledge and skill in the natural sciences to solve problems related to molecular and macro systems including biomolecules, molecules, cells, and organs.
  • Human Behavior: Applies knowledge of the self, others, and social systems to solve problems related to the psychological, socio-cultural, and biological factors that influence health and well-being.

As an applicant, you should be thinking about which of these competencies you have mastered and which of these competencies could use a little work. For areas where you aren't as strong, you should be taking the initiative to seek out professional development and personal growth opportunities that can help you hone these skills. Successful applicants are able to demonstrate that they are competent in each of these defined areas by using examples in their personal essays and in their responses during interviews. To help you self-reflect and strengthen your competencies, the AAMC has created an Anatomy of an Applicant workbook, which you can access for free by going here

Wednesday, February 27, 2019

WPC Week 8 Winner: Danielle Theis!

Every Wednesday, the Student Success Center holds a
Weekly Physiology Challenge (WPC).

This week's winner is: 
Danielle Theis!

Congratulations on winning this week's WPC!

This challenge series will be held weekly throughout the semester to give students a chance to showcase their knowledge for a chance to win a free t-shirt!

Monday, February 25, 2019

Mystery Case Monday: The Woman with Sudden & Referred Pain

Welcome back to Mystery Case Monday! We will be posting a hypothetical case every week to get our pre-health students thinking about various clinical issues and the anatomical/physiological causes that underlie them. Join us in the comments section to share your insights and tentative diagnoses, then check back on Friday to read about the diagnosis and recommended treatments of these cases.

This week's hypothetical patient is a 25-year-old female who is admitted to the ER with sharp abdominal pains, vomiting, dizziness, nausea, and weakness. Her boyfriend, who brought her into the ER, states that her pain began suddenly and that she said she felt as if she were going to faint all the way to the hospital. Because she was stable upon arrival, a physical examination was done. When asked if she could be pregnant, she stated that she could not be as she has an IUD, but did acknowledge that the couple were sexually active. She also stated that she had missed her last period, but assumed it was because she had recently started training for a 5K and was trying to quit smoking. The patient's vital signs were normal. The patient was experiencing diffuse abdominal tenderness. During the exam, the patient began to bleed vaginally and started feeling pain in her shoulder that radiated up to her neck. She was immediately given a FAST (focused assessment with sonography in trauma) exam. An OB/Gyn was called in for an emergency surgical consultation.

Thought Questions:

What is the most likely diagnosis for this patient?

What are the risk factors for this condition?

What caused the patient's shoulder to begin hurting?

Leave your comments below and check back on Friday to see how our hypothetical patient was diagnosed!