A few things matter a lot with your profile:
1) Why do you want to do medicine?
2) What have you done to immerse yourself in the clinical workplace (that is not related to your research)?
3) Can you be humble around other physicians and professors who also have Ph.D.'s?
4) Where does your spouse want to be? What are your plans for your family and preferences with proximity with your family and in-laws?
1. Big question. I'll keep my answer shorter so as to not drone on. Essentially 4 components:
1a: The unique, patient-forward training environment at the NIH. Most of my post-undergraduate career has been spent at NIH. Did a 2 year stint at NCI and then I will have been at the clinical center for ~3 years by the time I defend. It isn't just spent in a lab - you interact with patients on the daily despite not working in a patient facing role. You see them and their family members sitting in the atrium having a coffee, waiting in line at the pharmacy or sitting in the phlebotomy suite. You see the seriously ill being pushed through the corridors of the hospital to and from procedure rooms and the in-patient wards. All of these experiences humanize the research work we are doing, and ground you in the fact that research isn't just abstract - these are real people needing real help. It is a true motivation.
1b: My own research experiences have all been related to human health and finding answers for the sick. In undergrad I worked on research relating to how tattoo inks can cause illness in humans; then I worked on the transfer of chemotherapies into the breast milk of recently post-partum women and the risk it may pose their newborns; then I went to NCI where I played a role in phase I studies evaluating safety, tolerability, and sometimes efficacy of novel agents in various cancer populations, or evaluating an already approved drug in a new patient population; then finally, my graduate study leveraging all of this experience to directly write clinical pharmacology sections of protocols, analyze, and make conclusions regarding the clinical pharmcology of agents being used in patient populations. Again, it is not lost on me that the human aspect is what makes this work important.
1c:
The human aspect. I will have around 1100 clinical volunteer hours at a large academic hospital by the time I defend in the spring. Throughout these 3 years of volunteerism I have made so many connections with the ill and their families. That human experience, sharing a connection with someone, is so strong. In a setting like a hospital, talking to young cancer patients or the elderly who have fallen and are bruised -- it's always the same feeling for me: research isn't enough. I feel called to be there for these people, sit with them by their bedside, chat with them about the daily monotony of life even just to remove their mind from the situation they find themselves in. To be able to practice medicine -- to study disease, how to treat it, and include my prior research training in my career to work towards the development of new and better treatments for diseases, give patients hope and health -- would be such an incredible privilege and honor. In my opinion, we live in a golden age of medicine -- look at the daraxonrasib data that came out a few months ago. Hope for pancreatic cancer patients. Providing for patients, caring for them, working through everything with their family and giving everybody hope is the best use of my time I can imagine.
1d:
My personal connection with illness. I find myself pretty lucky that, despite going on 30, my parents are both in good health and all of my gradparents lived into their 90s. In my family, health has not been a major concern (thank god). But that doesn't mean I have no experience in dealing with illness. For some reason a startling number of my friends have had some sort of cancer over the last 8 years. One of my closest friends from college is currently battling brain cancer after being diagnosed a few months ago. Another girl from high school who I'm less close with (family friend though) is also battling brain cancer, and a good friend of my sisters is battling Ewing's sarcoma. Talking to my friends going through these things has provided insight into patient life that volunteerism cannot. Of course, as a volunteer you need to be professional and talking to a stranger a patient and family only wants to say so much. My friends however have been more than open about their struggles. The traveling to cancer centers, radiation, chemo, the uncertainty, the fatigue, the unexpectedness of it all. It's terrible. All of it invokes a greater empathy and understanding of patients, their family, and their struggles. Still, it only drives me more to pursue this path.
2. For the last 3 years I have been a volunteer at another hospital, not NIH CC. This is where my ~1000h of clinical volunteering come from. Not in any way related to my research or NIH.
3. I don't think I'm typically an arrogant person, and I'm self aware enough to watch what I say so as to not be perceived as arrogant.
4. Great question. My spouse is from the South, I am from upstate New York. the mid-atlantic area is a great middle ground for us, so Hopkins, GWU, Georgetown would be the 3 schools I'd be most likely to attend if I was accepted. After that, probably UNC/Duke or up in Philly though my wife hates the cold so our fingers are going to be crossed I am accepted somewhere south of the Mason-Dixon line.
