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Effect of Medical School Ranking on Competitive Specialty Aspirations

Ace Khalifa

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    Please don't judge my qualifications because you do not know me like that. And that's not what this post is about anyway. I'm not saying anywhere that I can't take negative criticism. What I am saying is that we should keep the posts here constructive and fun and NICE. and that is my plan for med school....to take negative criticism and teach people around me to be nice. you have to take people's feelings into account when you deal with people (or post on here). so i don't get why you folks are so quick to be soooo mean and negative. why not be supportive? constructive? why not bully? is there bullying in med school? is that what i should be getting ready for?
    This is NOT bullying. This is everyone giving you a reality check. You say you are able to handle negative criticism, but your posts say otherwise. And don't give me that "our generation is awesome because we're gonna change the world" crap. That's nothing but overly naive and idealistic GARBAGE that only further intensifies your already bloated arrogant narcissistic generation Y ego. @FriendlyFH is right. You do not belong in med school. You don't deserve to become a doctor, much less a dermatologist. And I certainly would never want you as my doctor or my colleague.
     
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    DermViser

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      i have to admit though. the slide in the millennial presentation about giving frequent feedback and being ENTHUSIATIC is true though! what's wrong with having that mentality? being NICE. why can't we be NICE in this forum? i just don't really understand how such future doctors could be so MEAN and gang up on a poor defenseless person who isn't really being mean at all.....
      And a lot of the millenial characteristics listed have led to VERY UNREALISTIC EXPECTATIONS and thus unhappiness:
      http://www.huffingtonpost.com/wait-but-why/generation-y-unhappy_b_3930620.html
       
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      deleted407021

        okay so are you trying to say that someone being a stereotypical millennial is not gonna have a good time matching/in med school? cause wouldn't the existence of this ppt confirm that the entire system is changing to reflect reality?
        No! He is saying that you can't be a wide eyed, naive and entitled child and expect to be treated well by the real world which many of us, admittedly, haven't had enough exposure to.

        What does the bolded even mean?
         
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        WillburCobb

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          I love reading about those studies, and studies in general. If I remember correctly, people who troll tend to have personality disorders in a way that's more so than people who respond to troll. People who give no craps to either are the least likely to have personality disorders.
          I'm not too up to date on the research those labs put out. I mainly stuck to my existential psych stuff. I know they had hells fun though!!!
           
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          DermViser

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            okay so are you trying to say that someone being a stereotypical millennial is not gonna have a good time matching/in med school? cause wouldn't the existence of this ppt confirm that the entire system is changing to reflect reality?
            The powerpoint was from the AAMC, and it was done bc there is a generational clash between attendings who are of one generation and millenials who are of another generation. Someone who is your stereotypical millenial will have difficulty in medical school in some respects, yes, esp. with certain resident/attending specialties who won't necessarily respect you or be as nice as you want them to. You can't crumble everytime that happens or give them a lecture to be nice to you.
             
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            DermViser

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              No! He is saying that you can't be a wide eyed, naive and entitled child and expect to be treated well by the real world which many of us, admittedly, haven't had enough exposure to.

              What does the bolded even mean?
              That the system is changing to cater to millenials - not even close to true.
               
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              prioritiesinline

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                The powerpoint was from the AAMC, and it was done bc there is a generational clash between attendings who are of one generation and millenials who are of another generation. Someone who is your stereotypical millenial will have difficulty in medical school in some respects, yes, esp. with certain resident/attending specialties who won't necessarily respect you or be as nice as you want them to. You can't crumble everytime that happens or give them a lecture to be nice to you.

                lol but you can report them/make it a big deal/teach a big lesson to everyone that being nice and embracing of others is a requirement for civilization.

                like if a resident acts aggressive or raises their voice at a student for no reason, isn't that considered inappropriate? can't you tell someone? i know this further makes me sound like a millennial, but what's wrong with having rules and making sure everyone is happy as opposed to only positions of power being happy.....? like i don't get the political side of it and why it even has to exist. we can acknowledge people's status and knowledge but it shouldn't mean we're inferior to them and they can slap us around emotionally if they want to. if you think about it, being a millennial isn't such a bad cause
                 
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                FFH

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                  I simply can't accept that this person is real and has been accepted to medical school. If this is the reality of med school admissions, it is seriously depressing. :(
                  I'm not sure OP is accepted though. In his first post he said he's very depressed because only 2 interviews and no mentioning of acceptance.
                   
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                  deleted407021

                    lol but you can report them/make it a big deal/teach a big lesson to everyone that being nice and embracing of others is a requirement for civilization.
                    You have a poor understanding of social dynamics between animals in high stress environments. There is a huge difference between someone being short with someone in an ER and someone being short with someone at a farmer's market. One person is responding appropriately, given the environment, where as the other is being a jerk, behaving inappropriately.

                    Also, generalizing from an online forum to "civilization" is silly.
                     
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                    DermViser

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                      lol but you can report them/make it a big deal/teach a big lesson to everyone that being nice and embracing of others is a requirement for civilization.
                      Report your resident/attending to your medical school administration (i.e. your Dean of Student Affairs) and let me know what happens both on and off the clerkship. Hint: It won't end up the way you think it does.
                       
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                      prioritiesinline

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                        Report your resident/attending to your medical school administration (i.e. your Dean of Student Affairs) and let me know what happens both on and off the clerkship. Hint: It won't end up the way you think it does.

                        why not? what would happen? see....THIS is actually useful information to know and HELPFUL for me to not so that i don't even think about doing something like this bc its for some reason not allowed through an unwritten constitution? this is the kind of constructive advice i need.

                        but seriously...what would happen? on and off?
                         

                        WillburCobb

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                          How fun! I'd love to know more about it. I've been into existentialism and into psych since when i was a teen! This is the first time I realize the two have a scientific connection.
                          PM me and I can fill you in... almost went to grad school for social Psych over med school FWIW.
                           

                          DermViser

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                            like if a resident acts aggressive or raises their voice at a student for no reason, isn't that considered inappropriate? can't you tell someone? i know this further makes me sound like a millennial, but what's wrong with having rules and making sure everyone is happy as opposed to only positions of power being happy.....? like i don't get the political side of it and why it even has to exist. we can acknowledge people's status and knowledge but it shouldn't mean we're inferior to them and they can slap us around emotionally if they want to. if you think about it, being a millennial isn't such a bad cause
                            A resident is for all intents and purposes an indentured servant. They are, on average, paid about 40K - 50K, working about 80 hr. work weeks, on average, and on call, seeing and working up patients. They are being trained and educated as well as having a service function. You would be a student with no actual real responsibility and accountability in terms of making sure clinical tasks are completed.

                            There are always rules, that doesn't mean they are always followed to the letter. Your feelings can not saved every moment of the day. In other words, your resident's/attending's worlds don't revolve around you, as much as you might like them to. A lot of medicine is hierarchy based -- esp. in Surgery and the surgical subspecialties.
                             
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                            lol but you can report them/make it a big deal/teach a big lesson to everyone that being nice and embracing of others is a requirement for civilization.

                            like if a resident acts aggressive or raises their voice at a student for no reason, isn't that considered inappropriate? can't you tell someone? i know this further makes me sound like a millennial, but what's wrong with having rules and making sure everyone is happy as opposed to only positions of power being happy.....? like i don't get the political side of it and why it even has to exist. we can acknowledge people's status and knowledge but it shouldn't mean we're inferior to them and they can slap us around emotionally if they want to. if you think about it, being a millennial isn't such a bad cause

                            You assume that people in positions of power are happy when they yell? This isn't about you or them, OP. It's about your patients, about getting things done. Sometimes, In order to teach, people have to learn the hard way.

                            High stress environments don't depend on being sweet. Everyone deals with stress differently, and sometimes, to get things done for the sake of your patients and hospital efficiency, you suck it up and do your job.

                            Sure, some people are a******s. You won't change that. You can control how YOU react towards others, but you also have to understand that not everybody has had identical life experiences to you. That's the name of the game.
                             
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                            deleted407021

                              why not? what would happen? see....THIS is actually useful information to know and HELPFUL for me to not so that i don't even think about doing something like this bc its for some reason not allowed through an unwritten constitution? this is the kind of constructive advice i need.

                              but seriously...what would happen? on and off?
                              It's a social convention within the framework of the professional and academic relationship between attending, resident, med student, etc. Dang, it's not that difficult to deduce that some things are just the way they are because that's how the social structure worked out.


                              I'm starting to see why some med schools might be adopting upper div. psych courses as pre-requisites. Jeez.
                               
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                              DermViser

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                                i dont "want" a top 20. since my OP all I've been asking is if it MATTERS or if i should be worried or do anything about it. i said that i would be happy at the schools i have already....many times.
                                You were initially ready to give up your acceptances and try again for a Top 20 medical school.
                                 
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                                prioritiesinline

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                                  A resident is for all intents and purposes an indentured servant. They are, on average, paid about 40K - 50K, working about 80 hr. work weeks, on average, and on call, seeing and working up patients. They are being trained and educated as well as having a service function. You would be a student with no actual real responsibility and accountability in terms of making sure clinical tasks are completed.

                                  There are always rules, that doesn't mean they are always followed to the letter. Your feelings can not saved every moment of the day. In other words, your resident's/attending's worlds don't revolve around you, as much as you might like them to. A lot of medicine is hierarchy based -- esp. in Surgery and the surgical subspecialties.

                                  Does what you just mentioned apply more to derm than other specialties?
                                   
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                                  DermViser

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                                    Does what you just mentioned apply more to derm than other specialties?
                                    +pissed++pissed++pissed++pissed+

                                    I was referring to the required MS-3 clerkships you will rotate thru and be evaluated and graded on: General Surgery, OB-Gyn, Internal Medicine, Pediatrics, Psychiatry, Family Medicine, and Neurology. They will all have some form of hierarchy. Individual interactions with residents in each specialty will vary, which you may either like or dislike.

                                    Derm has hierarchy as well bc you're checking out as a resident to an attending.
                                     
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                                    Aerus

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                                      OP, here's what you do if you want to be happy:

                                      1) Accept the fact that you probably won't match into dermatology.
                                      2) Work your ass off and go as far as you can.
                                      3) If you match into derm, great! If you don't, you were expecting this.
                                       
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                                      I'll just leave this right mmhere.

                                      turpentine.jpg
                                       

                                      prioritiesinline

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                                        hi everyone....i wanna say toodle-oo for the night. it's getting late and i definitely need to be up tomorrow to have a fruitful, productive Tuesday :)

                                        thanks to those who responded with constructive criticism and did so in rational ways to help my understanding of the process/dynamics. the discussion about social dynamics in medicine is getting particularly interesting and helping me (and others) learn more about a new topic.

                                        to those that were disrespectful and unsupportive, i sincerely hope that you will find a way to be kinder to your patients and people around you. please.


                                        good night everyone. mwaaaaaaaa :kiss:
                                         

                                        DermViser

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                                          OP, here's what you do if you want to be happy:

                                          1) Accept the fact that you probably won't match into dermatology.
                                          2) Work your ass off and go as far as you can.
                                          3) If you match into derm, great! If you don't, you were expecting this.
                                          Or do as I said, and become a PA or an NP and practice derm as a residency is not required in those professions to practice in the specialties they do.
                                           

                                          DermViser

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                                            All those long nights in the DICU, running codes on giant moles...burnout fuel man.

                                            jk DV.
                                            I can just imagine during a code situation when the intern is concentrating on reviving the patient, that she would be hurt when he's very brisk in his language and demeanor towards her, and he says for her to hand him something and she says, "Now ask nicely!" or like this:
                                            0f22ee8dfade8486ae6a298a9fe96e4e.jpg
                                             
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                                            prioritiesinline

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                                              I'm peacing for the night, but before i go. i can't really get the idea of np or pa to sit well with me. i did in fact shadow a PA once in hs and once in college. didnt really like that they had a doctor validating their job. the political side of it was annoying. i want to be independent and so at that point i would be more happy being an IM doc than a NP or PA even if the later options were in a derm setting. i wouldn't ever be able to look at the derm i worked for an feel happy bc it would be a constant reminder of what i didnt try to accomplish.

                                              Or do as I said, and become a PA or an NP and practice derm as a residency is not required in those professions to practice in the specialties they do.
                                               
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                                              deleted407021

                                                OP, it's not as if physicians don't answer to any kind of authority. Most have bosses (some of which aren't even doctors) and are often in highly politically charged environments. Sure, doctors can start their own practices and be more or less independent, but that comes with enormous challenges and liability as well which probably - based upon my shadowing experiences - often detract from a sense of independence.
                                                 
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                                                DermViser

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                                                  I'm peacing for the night, but before i go. i can't really get the idea of np or pa to sit well with me. i did in fact shadow a PA once in hs and once in college. didnt really like that they had a doctor validating their job. the political side of it was annoying. i want to be independent and so at that point i would be more happy being an IM doc than a NP or PA even if the later options were in a derm setting. i wouldn't ever be able to look at the derm i worked for an feel happy bc it would be a constant reminder of what i didnt try to accomplish.
                                                  A physician signs off on charts long after the patient encounter with the NP/PA is over. The NP/PA has seen the patient, written Rxs and the patient has gone home. If you truly wanted to do Derm, it wouldn't matter to you whether it's PA or NP (the latter practicing independently, just like physicians, as well).

                                                  If you go to the Derm forum, there are many stellar unmatched Derm applicants who if given the chance to backtrack would be perfectly happy doing Derm as a PA, bc they truly enjoy Derm as a specialty that much. You've been given advice on that - and have chose to disregard it, which is your perogative. Based on what you have said here, thank you for confirming then that it is more of an ego issue for you than anything else. You have a lot of growing up and maturing to do.
                                                   
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                                                  DermViser

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                                                    OP, it's not as if physicians don't answer to any kind of authority. Most have bosses (some of which aren't even doctors) and are often in highly politically charged environments. Sure, doctors can start their own practices and be more or less independent, but that comes with enormous challenges and liability, as well which probably - based upon my shadowing experiences - often detract from a sense of independence.
                                                    A private practice is also completely on you as well in terms of liability and capital - whether it succeeds or fails. You're still accountable to a practice manager who runs your private practice to make sure your practice doesn't go under.
                                                     
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                                                    Ace Khalifa

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                                                      The future of medicine (and the world) is doomed if there are so many egotistical stubborn delusional thin-skinned gen Y fools like OP running around. OP can't take negative criticism? Weak. OP can't take advice from a seasoned Derm resident who doesn't bull**** and tells it how it is? Dumb. OP can't defer to authority and thinks the world revolves around her? Selfish and entitled. It's people like OP who give gen Y'ers a bad name.
                                                       
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                                                      prioritiesinline

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                                                        A physician signs off on charts long after the patient encounter with the NP/PA is over. The NP/PA has seen the patient, written Rxs and the patient has gone home. If you truly wanted to do Derm, it wouldn't matter to you whether it's PA or NP (the latter practicing independently, just like physicians, as well).

                                                        If you go to the Derm forum, there are many stellar unmatched Derm applicants who if given the chance to backtrack would be perfectly happy doing Derm as a PA, bc they truly enjoy Derm as a specialty that much. You've been given advice on that - and have chose to disregard it, which is your perogative. Based on what you have said here, thank you for confirming then that it is more of an ego issue for you than anything else. You have a lot of growing up and maturing to do.


                                                        you keep advocating for PA/NP. why didn't YOU do derm as PA/NP?
                                                         

                                                        DermViser

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                                                          you keep advocating for PA/NP. why didn't YOU do derm as PA/NP?
                                                          Is that an actual question? I didn't go into medical school (the way you are), as an MS-1 saying that 1 specialty and only 1 specialty in all of medicine will make me happy (or "glowing", whatever). Part of medical school is ruling specialties in and out, which you don't wish to partake in (or are doing so very reluctantly). In this thread tons of people have tried to nicely and patiently explain this stark reality to you, but it seems like you don't wish to listen.

                                                          I would have said the same if you said ENT, Ophtho, Radiology, or Rad Onc. Since you are thoroughly convinced that Derm is the only field for you that you would be glowing in, then you should enter the profession where the filter/bottleneck doesn't get even tighter than it already is to reach that destination.
                                                           
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                                                            OP, it's not as if physicians don't answer to any kind of authority. Most have bosses (some of which aren't even doctors) and are often in highly politically charged environments. Sure, doctors can start their own practices and be more or less independent, but that comes with enormous challenges and liability as well which probably - based upon my shadowing experiences - often detract from a sense of independence.
                                                            I'd rather deal with liability than a non-physician trying to tell me what I can and can't do.
                                                             
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                                                            DermViser

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                                                              Because his goal was to be a physician, rather than become a dermatologist.

                                                              (just a guess)
                                                              Correct. Specialty selection happens later and evolves - everyone knows this. No one comes into medical school saying I will only be happy in medicine if get to do PM&R, bc you will be learning TONS of **** that isn't PM&R related.
                                                               
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                                                              DermViser

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                                                                I'd rather deal with liability than a non-physician trying to tell me what I can and can't do. I will NEVER be an employee.
                                                                If you work for a hospital, you are an employee. If you don't want that then you select a specialty that has a good private practice model and/or is an outpatient specialty: Psych, PM&R, Derm, Ophtho, Pain medicine fellowship, etc.
                                                                 
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                                                                DermViser

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                                                                  The future of medicine (and the world) is doomed if there are so many egotistical stubborn delusional thin-skinned gen Y fools like OP running around. OP can't take negative criticism? Weak. OP can't take advice from a seasoned Derm resident who doesn't bull**** and tells it how it is? Dumb. OP can't defer to authority and thinks the world revolves around her? Selfish and entitled. It's people like OP who give gen Y'ers a bad name.
                                                                  I was just going to say, forget medicine. All of humanity is doomed.
                                                                   
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                                                                  DermViser

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                                                                    This is NOT bullying. This is everyone giving you a reality check. You say you are able to handle negative criticism, but your posts say otherwise. And don't give me that "our generation is awesome because we're gonna change the world" crap. That's nothing but overly naive and idealistic GARBAGE that only further intensifies your already bloated arrogant narcissistic generation Y ego. @FriendlyFH is right. You do not belong in med school. You don't deserve to become a doctor, much less a dermatologist. And I certainly would never want you as my doctor or my colleague. Grow some balls and grow up before you try talking to me again with that worthless fake-ass gen Y bull****.
                                                                    I swear medical school admissions really needs to be revamped and have better effective filters bc MCAT and GPA alone just aren't cutting it. I seriously can't believe someone who if I read correctly, has only done a total of 80 hours of medicine/health shadowing, is surprised they didn't get an interview at a Top 20 medical school.
                                                                     
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                                                                    prioritiesinline

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                                                                      I swear medical school admissions really needs to be revamped and have better effective filters bc MCAT and GPA alone just aren't cutting it. I seriously can't believe someone who if I read correctly, has only done a total of 80 hours of medicine/health shadowing, is surprised they didn't get an interview at a Top 20 medical school.
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                                                                      DermViser

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                                                                        They do a bad job of advertising how much clinical experience is actually required for getting in. I didnt have much bc i had a friend with similar stats who had zero* clinical exp get into a top 5 med school. The reason i didnt do much more is bc i felt that i wasnt really contributing during the experience bc of the nature of volunteering/shadowing. So i spent the rest of my EC volunteering at a homeless shelter which isnt clinical but i guess still shows caring. Id still do volunteering like this as a derm in the future, but it would be more difficult time wise as an IM or other specialty. I really am a nice person. If i wasn't nice, how could i slip through an interview? I'm nice i just think people on here take things too literally
                                                                        Medical schools don't have to "advertise", esp. those in the top tier. Was your friend a URM? That may have been why she didn't need as many hours. These aren't your local pawn shops that have to advertise on tv. Clinical experience hours isn't a requirement that you check off after which a certain number, guarantees you a spot in that upcoming med school's class. There is a reason there is a holistic review process in place in which different puzzle pieces are put together to give the admissions committee a good idea about you. Volunteering at a homeless shelter, while will show to adcoms what a "caring" person you are, won't have the benefit of showing that medicine is right for you. Medicine isn't the only profession that is caring.

                                                                        You're not supposed to be "contributing" - those experiences are to see whether you can handle mentally and physically with being in a medical setting in a hospital -- i.e. not passing out when you see blood, not vomiting when you see a code happening, ok with seeing death, etc. If you're having panic attacks when you're seeing daily things that happen in a hospital, that's a major red flag.

                                                                        There are tons of people who slip thru a one day interview. It's not foolproof. I don't think you're not nice. You're very naive and wet behind the ears in terms of real life experience and the realities of medical school and the match.
                                                                         
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