Is this too controversial to say on AMCAS?

[epsilonprodigy]

One of my "most significant" activities is a medical aid trip to Haiti during the cholera epidemic. I'm a nurse, and part of the reason we were there was to teach the Haitian staff how to better care for patients. I know, I know... I thought it was iffy at first too... until I got there. I am talking about some scary ****. Problem is, I'm trying to talk about "teaching the staff in Haiti," what we were trying to teach, and why it wasn't just a bunch of self-righteous WASP-y B.S. I'm just worried it sounds condescending or arrogant. Here's a blurb from my "especially meaningful" blurb. Do you think it sounds offensive in any way?

The culture of the hospital we worked in was dictated by rules that couldn't be broken, and providers struggled to adapt when patients didn't conform to an expected trajectory. For example, the day before we arrived, a patient underwent surgery. The hospital staff extubated him 30 minutes after surgery, because that's what the protocol stated. He had not reached an appropriate level of consciousness to maintain his airway, however, and passed away. Another morning, we all crowded around the crib of an infant who, though playful the day before, was now limp and sickly gray. The staff nurse explained that he was to get Digoxin twice a day, but to save time, she had given both doses at once. Aware that we were from a different culture, and in many ways, a different world, we struggled to better enable our Haitian co-workers to care for their patients without making them feeling disrespected.

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[CodeBlu]

This sounds fine. It's not like you were overstepping your boundaries and doing something unethical.

 

[luli]

I don't think it sounds condescending. It's all in the approach-- you are aware of the potential for arrogance, which makes you more likely to be cautious.

What an amazing experience that must have been, btw! Thanks for sharing.

 

[rentedmule]

The culture of the hospital we worked in was dictated by rules that couldn’t be broken, and providers struggled to adapt when patients didn’t conform to an expected trajectory. For example, the day before we arrived, a patient underwent surgery. The hospital staff extubated him 30 minutes after surgery, because that’s what the protocol stated. He had not reached an appropriate level of consciousness to maintain his airway, however, and passed away. Another morning, we all crowded around the crib of an infant who, though playful the day before, was now limp and sickly gray. The staff nurse explained that he was to get Digoxin twice a day, but to save time, she had given both doses at once. Aware that we were from a different culture, and in many ways, a different world, we struggled to better enable our Haitian co-workers to care for their patients without making them feeling disrespected.

"Feel" would be the appropriate form here.

No, it does not sound condescending or offensive in any way. You're just describing/documenting what you observed and identifying some real issues.

 

[MrBird]

Might be a bit controversial

 

[LizzyM]

I don't see how it would be controversial. Quite eye-opening, for me. Quite the challenge for you. I think that this puts you squarely in the "I'd-like-to-meet-this-applicant" queue for an interview!

 

[deleted307836]

I agree; it doesn't sound controversial IMO and shows you had a very interesting experience.

This may be overly nit-picky but you may want to avoid the use of contractions on your application.

 

[CodeBlu]

I don't see how it would be controversial. Quite eye-opening, for me. Quite the challenge for you. I think that this puts you squarely in the "I'd-like-to-meet-this-applicant" queue for an interview!

This is a good sign. Hahaha.

 

[Soulstice]

I like it a lot. It sounds interesting.. like you're thinking about your foreign medical experience from a different perspective than "OMG I got to do super awesome illegal procedures" or "OMG I saw poverty and it was sad"..

 

[mmmdddd]

Am I the only one who thinks this is a very bad idea? I too am going to need to tone down some incredible stuff I did overseas as well as in this country for 5 reasons -

a) If there is a local from that region, the person might take needless offense
b) It would make me sound boastful, even to White Americans
c) Any non-American, even a European, would interpret this as the American thrusting his culture, values, practices, opinions on some other culture, however good it may be. Minority adcoms are also likely to think this way
d) In mock interviews, most people on the panel liked the idea but the one that didn't like it was vehemently against it. There is no point strongly antagonizing one adcom because the other adcoms may not stand up for me but this one adcom will be sure he doesn't want me.
e) There will be credibility problems. In your case, you say "the hospital staff extubated him 30 minutes after surgery, because that's what the protocol stated" and the patient passed away. Then someone will think, whatever happened to the learning curve, if patient after patient died from this, how is it that no one got wiser and stopped extubating right after surgery? The inference: this interviewee is just making things up. In my case, when I was shadowing, an oncologist from Iowa had a colleague from Haiti who was superb and after hearing my experience, she told me, "You know Haitian doctors are extremely skilled and talented. Many of them are educated in England. Are you sure something like this happened?" So she doubted my word - just because she had a colleague from Haiti who she was in awe of. There is considerable literature - google it - on extreme evaluations of minorities. If someone has positive experience, they sway to one extreme. Such people won't believe you. Of course, if someone has negative experience, they sway to another extreme.

To the OP: just nursing experience in Haiti is marvelous enough, so why do you want to mess with fragile egos? Anyway, this is just my opinion and something I plan to do, so feel free to disregard it.

 

[vin5cent0]

I don't see anything wrong with it. If anything, it's just interesting.

 

[gettheleadout]

Am I the only one who thinks this is a very bad idea? I too am going to need to tone down some incredible stuff I did overseas as well as in this country for 5 reasons -

a) If there is a local from that region, the person might take needless offense
b) It would make me sound boastful, even to White Americans
c) Any non-American, even a European, would interpret this as the American thrusting his culture, values, practices, opinions on some other culture, however good it may be. Minority adcoms are also likely to think this way
d) In mock interviews, most people on the panel liked the idea but the one that didn't like it was vehemently against it. There is no point strongly antagonizing one adcom because the other adcoms may not stand up for me but this one adcom will be sure he doesn't want me.
e) There will be credibility problems. In your case, you say "the hospital staff extubated him 30 minutes after surgery, because that’s what the protocol stated" and the patient passed away. Then someone will think, whatever happened to the learning curve, if patient after patient died from this, how is it that no one got wiser and stopped extubating right after surgery? The inference: this interviewee is just making things up. In my case, when I was shadowing, an oncologist from Iowa had a colleague from Haiti who was superb and after hearing my experience, she told me, "You know Haitian doctors are extremely skilled and talented. Many of them are educated in England. Are you sure something like this happened?" So she doubted my word - just because she had a colleague from Haiti who she was in awe of. There is considerable literature - google it - on extreme evaluations of minorities. If someone has positive experience, they sway to one extreme. Such people won't believe you. Of course, if someone has negative experience, they sway to another extreme.

To the OP: just nursing experience in Haiti is marvelous enough, so why do you want to mess with fragile egos? Anyway, this is just my opinion and something I plan to do, so feel free to disregard it.

I think you're being a bit paranoid...

 

[Nymphicus]

Honestly I think the excerpt you posted is really good and actually would want to read the rest of your essay. It stands out in a good way!

Aaaand...you have your ethical dilemma secondary all lined up lol

 

[mmmdddd]

I think you're being a bit paranoid...

Well, my experience with an oncologist led me to question about a year ago what the OP is currently questioning. If I am being paranoid, why should the oncologist respond as she did?

 

[mmmdddd]

An idea for the OP: you may want to mention this only at the top schools (who're used to terrific candidates) but not at the mid-tier or lower-tier schools (who may be used to more run-of-the-mill candidates)? This is just a thought.

 

[music2doc]

OP, I think your approach is great. I actually started w/ the thought of "this is going to be arrogant" b/c you sort of primed your audience that way (w the commentary at the beginning) but I still found it very effective and nonoffensive.

Am I the only one who thinks this is a very bad idea? I too am going to need to tone down some incredible stuff I did overseas as well as in this country for 5 reasons -

a) If there is a local from that region, the person might take needless offense
b) It would make me sound boastful, even to White Americans
c) Any non-American, even a European, would interpret this as the American thrusting his culture, values, practices, opinions on some other culture, however good it may be. Minority adcoms are also likely to think this way
d) In mock interviews, most people on the panel liked the idea but the one that didn't like it was vehemently against it. There is no point strongly antagonizing one adcom because the other adcoms may not stand up for me but this one adcom will be sure he doesn't want me.
e) There will be credibility problems. In your case, you say "the hospital staff extubated him 30 minutes after surgery, because that's what the protocol stated" and the patient passed away. Then someone will think, whatever happened to the learning curve, if patient after patient died from this, how is it that no one got wiser and stopped extubating right after surgery? The inference: this interviewee is just making things up. In my case, when I was shadowing, an oncologist from Iowa had a colleague from Haiti who was superb and after hearing my experience, she told me, "You know Haitian doctors are extremely skilled and talented. Many of them are educated in England. Are you sure something like this happened?" So she doubted my word - just because she had a colleague from Haiti who she was in awe of. There is considerable literature - google it - on extreme evaluations of minorities. If someone has positive experience, they sway to one extreme. Such people won't believe you. Of course, if someone has negative experience, they sway to another extreme.

To the OP: just nursing experience in Haiti is marvelous enough, so why do you want to mess with fragile egos? Anyway, this is just my opinion and something I plan to do, so feel free to disregard it.

Honestly, I think you're being a little overly cautious/paranoid/hypersensitive.

 

[mmmdddd]

Another thing I gather from Psychology literature that I read over a year ago is that a decision on whether to select you or not select you is made in the first few seconds of seeing you (less than 30 seconds for sure, the literature said). And the rest of the interview the person is merely seeking confirmatory evidence to confirm his/her views. So apparently, we're at an advantage if we end the interview as soon as possible - make the interview as brief as we can.

If we interject any fantastic stories, there is a tendency by an interviewer to reassess initial evaluations.

Because such fantastic events raise eyebrows, at least in my case. But my case is different - I have not only OP-like experiences in Haiti in medicine, but also some incredible experiences outside of the field of medicine. For example, I have been around wild gorillas with no protection of any sort. I have touched wild gorillas (who are totally peaceful and harmless - if mankind had evolved from gorillas rather than chimpanzees, we would not see any wars). I have also been, for many times over a year, within a few feet of a pride of wild lions in Africa with no protection on me (just a walking stick and a bottle of water). Now such events are non-confirmable by interviewers, so I could have a credibility problem. A good way to test such a hypothesis is to narrate them to some drunks at a bar. They've told me outright that I am lying about gorillas and lions, so I am not going to chance it with an interviewer. The OP may be of a different gender and personality than me, so he'she may not have the credibility problem I have.

 

[gettheleadout]

Well, my experience with an oncologist led me to question about a year ago what the OP is currently questioning. If I am being paranoid, why should the oncologist respond as she did?

Because she was a single, individual person? Why should her views represent those of medical professionals and administrators in general? The first couple points you made make big assumptions, by the way.

 

[rhcarolina]

A good way to test such a hypothesis is to narrate them to some drunks at a bar.

That sounds like a great way to practice med school interviews!

Not.

 

[senorsquishie]

OP, I think this is great addition to your application!

 

[The right Path]

The OP's excerpt is fine. It's more likely that any native Haitian (or someone who is friends with one) are very familiar with the problems in healthcare delivery in Haiti and would be glad to meet with an interviewee that shares an interest in global health. The excerpt does not say that Haitian doctors are not skilled nor talented, but that there are people suffering as a result of system-based problems (i.e. prescribing the same protocol to all patients whether appropriate or not). The bigger picture is lack of consistency in access to resources and education for all healthcare providers. FWIW, I think it's a good topic.

Is it remotely possible that there's an adcom member that would take offense? Sure. You can also find people out there that are offended by the moon. It shouldn't stop you from presenting your interests that define "Why medicine?" for you. Otherwise, I think the more real risk (IMO) is getting lost in a sea of generic "Derrr, I wanna help peepul" pre-meds.

 

[JESSFALLING]

It seems great, esp. because you had prior training as a nurse and you didn't go beyond your level of training. People cross the invisible, 'ethics' line when they start offering health care services without the prerequisite training. Perhaps you can place a bit more emphasis on the organization you were working with if you're still concerned. Awesome experience, congrats!

 

[HatWobble]

Only problem I notice is that digoxin should not be capitalized, as it is a generic name.

 

[epsilonprodigy]

Thanks to all who responded! Thanks for spotting the grammatical/spelling errors too, LOL. This was the rough seedlings of my ramblings typed over a latte at Barnes and Noble.

I think I'm going to just go for it. The main reason I am/was nervous about saying such a thing is because one of the schools I'm applying to is Howard, and I'm white Given that some adcom members might not be too wild about non-URM's at their school anyway, I don't want to confirm their expectations/sterotypes, ya know?

It WAS an amazing experience, in so many ways. Honestly, though, I reached the conclusion that I just. don't. understand. their thinking. mdddd- or whatever his name was, raised a good point about sounding like we were trying to impose our culture... and this is precisely what I was worried about. But honestly, I have no problem saying that just because something is a "facet of a culture" doesn't make it right. Language, marriage practices, religion....these are all things we should respect and leave along, but a "component of culture" that KILLS people?! I honestly have no friggin clue why they don't notice patterns like "gee, when we extubate people who are out cold, they have this tendency to die!" I can't imagine that poor man was the first to suffer that fate. Really, really fascinating experience. It was REALLY hard for a surgical personality like me to sit and watch a nurse beat the crap out of a patient's cariina while suctioning and not say "for God's sake! Will you just let me do it!?" and instead just make some gentle suggestions about "what might be 'easier'," etc.

Do you guys really think adcoms try to call BS on unusual experiences? I mean I have proof (references, etc.) but that could kinda be a death sentence if they simply say "yeah right!" and chuck your app.

 

[OBK]

Thanks to all who responded! Thanks for spotting the grammatical/spelling errors too, LOL. This was the rough seedlings of my ramblings typed over a latte at Barnes and Noble.

I think I'm going to just go for it. The main reason I am/was nervous about saying such a thing is because one of the schools I'm applying to is Howard, and I'm white Given that some adcom members might not be too wild about non-URM's at their school anyway, I don't want to confirm their expectations/sterotypes, ya know?

It WAS an amazing experience, in so many ways. Honestly, though, I reached the conclusion that I just. don't. understand. their thinking. mdddd- or whatever his name was, raised a good point about sounding like we were trying to impose our culture... and this is precisely what I was worried about. But honestly, I have no problem saying that just because something is a "facet of a culture" doesn't make it right. Language, marriage practices, religion....these are all things we should respect and leave along, but a "component of culture" that KILLS people?! I honestly have no friggin clue why they don't notice patterns like "gee, when we extubate people who are out cold, they have this tendency to die!" I can't imagine that poor man was the first to suffer that fate. Really, really fascinating experience. It was REALLY hard for a surgical personality like me to sit and watch a nurse beat the crap out of a patient's cariina while suctioning and not say "for God's sake! Will you just let me do it!?" and instead just make some gentle suggestions about "what might be 'easier'," etc.

Do you guys really think adcoms try to call BS on unusual experiences? I mean I have proof (references, etc.) but that could kinda be a death sentence if they simply say "yeah right!" and chuck your app.

i have been to haiti more than once and the validity of what i wrote about was never brought into question. while there were tons of medically interesting things that i was involved in down there, the differences in culture, care, expectations, opportunities etc. were most revealing for me. everyone i spoke to about it seemed to display a genuine interest and curiosity. certainly no one ever insinuated i made any of it up

good luck

 

[The right Path]

As far as culture and minority group's healthcare. It is well known that this group is particularly vulnerable to problems with access as well as less quality care. Perhaps this is a facet of concern of yours that a school that champions URM students would actually like to see.

In your excerpt, you're not disturbed by aspects of their culture, but rather the disparity in the quality of care provided. After all you weren't on a proselytizing mission (er, were you?) For good measure, if it's genuine you may consider including aspects of the culture that you were particularly delighted to experience. Perhaps the strength of family bonds as demonstrated by multiple generations caring for each other?

And as I've tried to say before, the less than quality practice of medicine as you've observed is more of an issue of resources/education rather than culture. After all, you're not slamming their traditional folk remedies/healers. If you're concerned about appearing ethnocentric, perhaps you can include experiences in which you observed successful partnership of modern and traditional therapies.

Focusing on that kind of stuff is much better than discussing this experience in light of "helping those poor wretches" (really how patronizing is that) or "I got to see a lot of weird, kewl dizeeses and perform a lobotomy!"

Know what I'm sayin'?

And I doubt BS is going to be called on this experience. Particularly by those who have served on medical missions in poverty stricken areas that have been further devastated by disaster.

 

[Application Doc]

OP, I think what you've written is terrific. It demonstrates that you're interesting, observant, and articulate (enough to get you many interviews), and the rare interviewer who finds it inappropriate will likely engage you about your experiences. Perfect interview fodder!

 

[epsilonprodigy]

Thanks everyone! Great feedback. As far as the contractions go... this has been a trick I've been using to squeeze through the character limit. I tend to have a fairly informal way of speaking (grammatically correct, but I definitely use contractions in speech.) Is this a no-no?

Also, what do you guys think of using commonly-understood acronyms, particularly medical ones such as ICU, ECMO, etc.? (off topic, much?)

 

[epsilonprodigy]

Edit: yikes! good point guys.

 

[epsilonprodigy]

bump

 

[Myuu]

I would suggest that you not post the full content of any text you're putting on your application on the internet.

 

[user003]

You had a wonderful experience and you're sharing that with the medical community. Whether it is insulting or controversial is not important (it's not by the way). You were part of a group that donated your time and effort to help another people outside your community. It was not you personally shoving your beliefs on someone.

Great job!

 

[paul411]

I would suggest that you not post the full content of any text you're putting on your application on the internet.

Yeah, at least wait until you're done with the application cycle to post this stuff on the interwebz. If you want help with editing, try PM'img "trustworthy" members (however one goes about determining that).

 

[isoquin]

I think sharing the experience is fine. If someone on the admissions committee is from that region, they're here now for a reason. I don't get a sense of disrespect or condescension, just cultural differences and the hardships of global health, which is a great topic on which to write.

However, there is always room for improvement, so I offer the following nitpicky recommendations to make the theme even better. I agree with CityLights in that formal letters generally should not include contractions. Well established medical acronyms are fine. If a lay person knows it (ICU, OR), it's good to use. You may want to rewrite some of the prose to be a bit more fluent and story like instead of static chronological. It currently reads along the lines of "first this happened. then this. then we did this. then we observed this." Put into paraphrased context: "we went to a baby's crib, but yesterday he was good, but now he's bad, but at some point he was prescribed X, but he was given it in Y way." I'd rather read it from your perspective with explicit emotion. Something like "I was [insert emotion] to see a previously healthy baby that I had played with the day before to be in a toxic state. To my [insert emotion], I ascertained that the baby was given a double dose of digoxin by the nursing staff because they believed it would save time." It says the exact same thing, but does so through your eyes with your emotion. Just a suggestion.

 

[LizzyM]

I think sharing the experience is fine. If someone on the admissions committee is from that region, they're here now for a reason. I don't get a sense of disrespect or condescension, just cultural differences and the hardships of global health, which is a great topic on which to write.

However, there is always room for improvement, so I offer the following nitpicky recommendations to make the theme even better. I agree with CityLights in that formal letters generally should not include contractions. Well established medical acronyms are fine. If a lay person knows it (ICU, OR), it's good to use. You may want to rewrite some of the prose to be a bit more fluent and story like instead of static chronological. It currently reads along the lines of "first this happened. then this. then we did this. then we observed this." Put into paraphrased context: "we went to a baby's crib, but yesterday he was good, but now he's bad, but at some point he was prescribed X, but he was given it in Y way." I'd rather read it from your perspective with explicit emotion. Something like "I was [insert emotion] to see a previously healthy baby that I had played with the day before to be in a toxic state. To my [insert emotion], I ascertained that the baby was given a double dose of digoxin by the nursing staff because they believed it would save time." It says the exact same thing, but does so through your eyes with your emotion. Just a suggestion.

I disagree. I think that the original reads fine and the contractions are natural and conversational and quite appropriate.

 

[da8s0859q]

OP, do it. If you keep trying to polish that or listen to all the people who are thinking of all the ways it could "go wrong" because they see med school admissions game as akin to walking on eggshells, you're going to polish the personality and a lot of the value right out of your writing.

You have an interesting story to tell and are giving your future interviewer some great interview fodder. Leave it alone.