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: https://www.campwapiyapi.org/how-to-help/volunteer-at-camp/)

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. 

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:

• AAMC: Preparing for Committee Letter Process
• Committee Letter FAQs
• More FAQs about Committee Letters

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!