Diversity: cultural competency, communication, family?

[Prometheus123]

Should I talk about my cultural competency and family like this in my secondaries about diversity? Am I answering the question convincingly? @Goro has said that the goal of diversity is to write about what makes you cool, unique, different, not necessarily about your socioeconomic background. Thoughts? Here's an abbreviated version with the most important parts in bold:

"I may not look diverse, but I am exceptionally diverse in my experiences, perspectives, spiritual practices, communication skills, and cultural competencies. I lived and worked for a year each in India and Dubai. Since my wife of 4 years is Indian, I also married her family, language, and culture. Indeed, her parents and sister have been living with us for a month, and we spent every weekend together when we lived in Dubai....

For hours, I mediated between my father-in-law and the women of the family across cultural, linguistic, gender, and generational differences. I communicated with active listening, simple words in both languages, mirroring, body language, gestures, and empathy....My father-in-law said I made everyone feel understood....

[Sorry! Tell me to delete this and I will:] He let me buy some supplements for his metabolic syndrome and impulsivity. I gave him nutrients his medications deplete plus a dozen promising nutraceuticals with good evidence behind them indicated in the scientific literature to address pathogenic mechanisms underlying his conditions. I also taught him a breathing exercise to reduce stress, calling it pranayama yoga, the traditional name for it in his culture.

My diversity makes me different in a clinical setting too. While volunteering last week, a family member asked a nurse something in another language. The nurse was nonplussed, but I easily interpreted the woman’s body language correctly and lead her to the bathroom using universal gestures to communicate. I hope to take my service to diverse patients to the next level as a physician one day."

For reference, the NIH's definition of cultural competency is: Deliver[ing] services that are respectful of and responsive to the health beliefs, practices and cultural and linguistic needs of diverse patients."

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[gyngyn]

"I may not look diverse, but I am exceptionally diverse in my experiences, perspectives, spiritual practices, communication skills, and cultural competencies. I lived and worked for a year each in India and Dubai. Since my wife of 4 years is Indian, I also married her family, language, and culture. Indeed, her parents and sister have been living with us for a month, and we spent every weekend together when we lived in Dubai....

1. For hours, I mediated between my father-in-law and the women of the family across cultural, linguistic, gender, and generational differences. I communicated with active listening, simple words in both languages, mirroring, body language, gestures, and empathy....My father-in-law said I made everyone feel understood....

2. [Sorry! Tell me to delete this and I will:] He let me buy some supplements for his metabolic syndrome and impulsivity. I gave him nutrients his medications deplete plus a dozen promising nutraceuticals with good evidence behind them indicated in the scientific literature to address pathogenic mechanisms underlying his conditions. I also taught him a breathing exercise to reduce stress, calling it pranayama yoga, the traditional name for it in his culture.

3. My diversity makes me different in a clinical setting too. While volunteering last week, a family member asked a nurse something in another language. The nurse was nonplussed, but I easily interpreted the woman’s body language correctly and lead her to the bathroom using universal gestures to communicate. I hope to take my service to diverse patients to the next level as a physician one day."

1. ok
2. no!
3. no.

 

[deleted480308]

2 is a really bad idea, 3 is just a normal severity bad idea

1 is fine

 

[Prometheus123]

1. ok
2. no!
3. no.

OK, thank you!

1. I'll leave in 1.

2. I will delete 2. However, If my protocol successfully lowers his HbA1c, LDL, triglycerides, CRP, or ESR over the next two months, can I bring a letter from his doctor with the test results saying that my protocol correlated with an improvement in his biomarkers to interviews? Or is suggesting supplements just too ethically questionable to talk about? In my defense, I only ever suggest dietary supplements, which are food by definition. It's ethical for anyone to feed people, right? Also, I check for contraindications and possible side-effects (as you know, some foods have those), and I ask permission from the person's primary care physician first whenever possible.

3. I'm a little surprised about 3, but I'll delete it. Was it just too minor and insignificant to warrant inclusion?

 

[Prometheus123]

2 is a really bad idea, 3 is just a normal severity bad idea

1 is fine

Haha, I actually heard this in Ron Swanson's voice when I read it. Got it. Thank you!

 

[gyngyn]

1. OK, thank you! I'll leave in 1.

2. I will delete 2. However, If my protocol successfully lowers his HbA1c, LDL, triglycerides, CRP, or ESR over the next two months, can I bring a letter from his doctor with the test results saying that my protocol correlated with an improvement in his biomarkers to interviews? Or is suggesting supplements just too ethically questionable to talk about? In my defense, I only ever suggest dietary supplements, which are food by definition. It's ethical for anyone to feed people, right? Also, I check for contraindications and possible side-effects (as you know, some foods have those), and I ask permission from the person's primary care physician first whenever possible.

3. I'm a little surprised about 3, but I'll delete it. Was it just too minor and insignificant to warrant inclusion?

1. good
2. no
3. just no.

 

[deleted480308]

OK, thank you!

1. I'll leave in 1.

2. I will delete 2. However, If my protocol successfully lowers his HbA1c, LDL, triglycerides, CRP, or ESR over the next two months, can I bring a letter from his doctor with the test results saying that my protocol correlated with an improvement in his biomarkers to interviews? Or is suggesting supplements just too ethically questionable to talk about? In my defense, I only ever suggest dietary supplements, which are food by definition. It's ethical for anyone to feed people, right? Also, I check for contraindications and possible side-effects (as you know, some foods have those), and I ask permission from the person's primary care physician first whenever possible.

3. I'm a little surprised about 3, but I'll delete it. Was it just too minor and insignificant to warrant inclusion?

You aren't a doctor. If you ever want to get to be one, drop 2 and stop pretending that you are qualified to be curing disease with supplements and making "protocols"

Dangit...are you trolling? Because you might have just got me. I don't know if I'm annoyed or begrudgingly impressed

 

[Goro]

You aren't a doctor. If you ever want to get to be one, drop 2 and stop pretending that you are qualified to be curing disease with supplements and making "protocols"

Dangit...are you trolling? Because you might have just got me. I don't know if I'm annoyed or begrudgingly impressed

Sadly, Promy is 100% NOT trolling.

 

[Prometheus123]

1. good
2. no
3. just no.

OK! Thank you for the reality check on 2.

You aren't a doctor. If you ever want to get to be one, drop 2 and stop pretending that you are qualified to be curing disease with supplements and making "protocols"

Dangit...are you trolling? Because you might have just got me. I don't know if I'm annoyed or begrudgingly impressed

Haha, no, not a troll, just someone who's read too many papers in the scientific literature about things that might help to not do anything when his family members are dying slowly around him.

 

[Lawpy]

Don't show off your medical/science knowledge in your essays. Use the essays to talk more about yourself, your values, your traits etc. And why you are interested in that school.

 

[Prometheus123]

Sadly, Promy is 100% NOT trolling.

What can I say, it's something I like about myself and I think is great evidence of my suitability for medical school. No one else sees it that way, which is fine. Just thought I'd try it again to see if I've found a way to say it so that people hear what I hear in it.

 

[deleted480308]

Haha, no, not a troll, just someone who's read too many papers in the scientific literature about things that might help to not do anything when his family members are dying slowly around him.

Don't pass that silliness off as loving your family haha

There is a big difference between, "hey dad, stop it with the ice cream, you have diabetes" and trying to brag to actual doctors that you create "protocols"

 

[Prometheus123]

Don't pass that silliness off as loving your family haha

There is a big difference between, "hey dad, stop it with the ice cream, you have diabetes" and trying to brag to actual doctors that you create "protocols"

Well, that sort of diet and lifestyle education/modeling/nagging that you mention is the bulk of what I do. I didn't mean to brag. I just used the word protocol because I suggested a bunch of supplements, not just one.

It may be silliness, but thinking about the cost of inaction really is what motivates me. Damage on these conditions builds up over a few years. It might be too late for me to do anything by the time I'm licensed. It might be too late already. You know?

 

[gyngyn]

Well, that sort of diet and lifestyle education/modeling/nagging that you mention is the bulk of what I do. I didn't mean to brag. I just used the word protocol because I suggested a bunch of supplements, not just one.

Supplements are helpful for deficiency....
Are your relatives deficient?

 

[blackroses]

What can I say, it's something I like about myself and I think is great evidence of my suitability for medical school. No one else sees it that way, which is fine. Just thought I'd try it again to see if I've found a way to say it so that people hear what I hear in it.

It's a personality flaw, and a pretty significant one at that. Probably not the sort of thing you want to advertise to admission committees.

 

[Lyoness]

The last one is hilarious


Sent from my iPhone using Tapatalk

 

[Prometheus123]

Supplements are helpful for deficiency....
Are your relatives deficient?

@gyngyn , thank you for your post. Good, reasonable, skeptical disbelief and questioning is something I'm happy to answer.

History: My father-in-law is a middle-aged man with full metabolic syndrome, including coronary artery disease with calcium deposits in his arterial plaques, type II diabetes, overweight, hypertension, dyslipidemia, intermittent nephropathy. History of myocardial infarction and has a stent. Risk factors include chronic stress, chronic exposure to high levels of toxic compounds, poor diet and sleep, circadian dysregulation, etc. For several years in Syria, he never drank water and only drank beer and soda, which he says coincided with the emergence of his metabolic syndrome, suggesting mitochondrial dysfunction via excess sugar and alcohol and fatty liver disease.

Deficiencies?: To your point, the fact that there's calcium in his plaques shows that he's functionally deficient in vitamin K2 I would argue, which takes calcium out of deposits and puts it back into bones. In addition, he's taking metformin, which depletes vitamin B12. I gave him both. K2 has less of an effect on coagulation than K1 (the form that's used for nosebleeds). Just to be safe though, I've discussed this possible interaction with my wife and sister-in-law, both of whom are physicians, and about the possibility that his aspirin dosage may need to be adjusted accordingly. I'm going to ask his PCP about this once they're back in Dubai. For now, wife and sister are monitoring BP, glucose, and mood daily for changes.

Q: Supplements are only useful for vitamin or mineral deficiencies, right?
A: It's a common misconception that very few supplements have ever been shown to be useful for anything other than overt deficiency diseases. Most institutions tell us that nothing is proven about such treatments, and that's true, but nothing is ever proven in science by definition. All we get are different degrees of probability. I'm not saying I have proof. I'm saying it's probable enough that they'll work to use them to help patients clinically today in some cases. If you look in the scientific literature, you will see this for yourself. Here is my opening gambit and a few of the many facts that spurred me to action with sources linked:

• Sulforaphane (sold as BroccoMax) prevents diabetic neuropathy, cardiomyopathy, and nephropathy via Nrf2 activation and NFKB inhibition. It reduces hepatic glucose production and improves glucose control in patients with type 2 diabetes. It may prevent cardiovascular disease in aging populations.
• NT Factor (bioidentical phospholipid membrane replacement therapy): This reverses acquired mitochondrial dysfunction, a core feature of diabetes II, CAD, nephropathy, etc. For an excellent clinical perspective on this fascinating and exciting treatment paradigm, I suggest Dr. Vasquez's (DO, professor of functional medicine) handy primer. It reduces fatigue, one of the most common presenting complaints, by about about 25%-40% in patients with a variety of conditions. It may assist regeneration of hepatocyte membranes and thereby help reduce non-alcoholic fatty liver disease. It increases sperm motility, and this was shown to be directly related to improved mitochondrial function.
• Curcumin: Curcumin Significantly Improves Obesity-Associated Inflammation and Diabetes in Mouse Models of Diabesity. It's healed renal lesions related to diabetes in rats. According to a study published by the American Diabetes Association: "After 9 months of treatment, 16.4% of subjects in the placebo group were diagnosed with T2DM, whereas none were diagnosed with T2DM in the curcumin-treated group. [This intervention] significantly lowered the number of prediabetic individuals who eventually developed T2DM. In addition, the curcumin treatment appeared to improve overall function of β-cells, with very minor adverse effects." It reduces LDL and VLDL-cholesterol.
• Lower serum P5P, a different form of Vitamin B6, is associated with more inflammation in the population. P5P supplementation reduces inflammation and oxidative stress via inhibition of the NLRP3 inflammasome and NFKB, key drivers of the pathogenesis of type II diabetes.
• Vinegar has been shown to improve insulin sensitivity in type II diabetics and increase satiety.
• Superoxide dismutase prevents diabetic cardiomyopathy by reducing oxidative stress. It "blunts diabetes-induced upregulation of NADPH oxidase and endoplasmic reticulum stress in a rat model of diabetic nephropathy." It prevents material embryonic diabetes.
• Milk thistle lowers blood sugar and lipids by stimulating PPARγ, which is also the mechanism of action of insulin-sensitizing thiazolidinediones with none of the side-effects of those drugs.
• I also really wanted to include BAIBA but wasn't able due to cost. Folks at Harvard have shown BAIBA increases burning of fats in the liver and causes white fat to grow new mitochondria and turn into Calorie-burning brown fat.

There are several others, but you get the idea. I haven't even mentioned any of the more behavioral lifestyle interventions I tried to model and educate the whole family about.

If we want to beat the pandemic of chronic diseases, we have to think outside the box. We have to attack from every angle that is safe, effective, and affordable, using every tool in the toolbox that works. We have to look to the scientific community to find the future of medicine. One treatment alone will never be enough to take down a disease like TII diabetes, but maybe with enough treatments that work in concert--with multi-component, personalized protocols--we can slow the progression. Maybe one day we will turn the tide in favor of homeostasis and vitality enough to start reversing these diseases too. I don't know if we'll ever get there, but I'm going to spend the rest of my life trying as a physician. Please forgive my boldness and verbosity.

 

[catlady87]

I'm just a premed (though an older one), also applying to med schools this year.

I think you have had lots of interesting life experiences, and probably would add some diversity and color to a med school class. But, when you talk about your experiences, you have a tendency to really aggrandize relatively simple gestures and interactions, and unfortunately I think it comes off as arrogance coupled with a lack of self-awareness. If I had any advice to give you, it would be keep things simple and really resist the urge to make your (interesting, but not so exotic) experiences sound grandiose. Even the paragraph about the discussion with your in-laws sounds over the top to me.

I'm very excited to (hopefully) go to medical school myself, but I figure the first years are going to be all about realizing how little I knew about how the body worked up until now and how much I have to learn. In that context, I think it's a faux pas to discuss designing "protocols" for your father-in-law and talking about how you are "treating" his metabolic disorder, particularly in an essay that will be read by practicing physicians, who probably have a thing or two to teach you. If I were you, I'd be a bit more humble and talk about your interest in certain areas of medicine and how you look forward to exploring those more in medical school.

 

[deleted480308]

@gyngyn , thank you for your post. Good, reasonable, skeptical disbelief and questioning is something I'm happy to answer.

History: My father-in-law is a middle-aged man with full metabolic syndrome, including coronary artery disease with calcium deposits in his arterial plaques, type II diabetes, overweight, hypertension, dyslipidemia, intermittent nephropathy. History of myocardial infarction and has a stent. Risk factors include chronic stress, chronic exposure to high levels of toxic compounds, poor diet and sleep, circadian dysregulation, etc. For several years in Syria, he never drank water and only drank beer and soda, which he says coincided with the emergence of his metabolic syndrome, suggesting mitochondrial dysfunction via excess sugar and alcohol and fatty liver disease.

Deficiencies?: To your point, the fact that there's calcium in his plaques shows that he's functionally deficient in vitamin K2 I would argue, which takes calcium out of deposits and puts it back into bones. In addition, he's taking metformin, which depletes vitamin B12. I gave him both. K2 has less of an effect on coagulation than K1 (the form that's used for nosebleeds). Just to be safe though, I've discussed this possible interaction with my wife and sister-in-law, both of whom are physicians, and about the possibility that his aspirin dosage may need to be adjusted accordingly. I'm going to ask his PCP about this once they're back in Dubai. For now, wife and sister are monitoring BP, glucose, and mood daily for changes.

Q: Supplements are only useful for vitamin or mineral deficiencies, right?
A: It's a common misconception that very few supplements have ever been shown to be useful for anything other than overt deficiency diseases. Most institutions tell us that nothing is proven about such treatments, and that's true, but nothing is ever proven in science by definition. All we get are different degrees of probability. I'm not saying I have proof. I'm saying it's probable enough that they'll work to use them to help patients clinically today in some cases. If you look in the scientific literature, you will see this for yourself. Here is my opening gambit and a few of the many facts that spurred me to action with sources linked:

• Sulforaphane (sold as BroccoMax) prevents diabetic neuropathy, cardiomyopathy, and nephropathy via Nrf2 activation and NFKB inhibition. It reduces hepatic glucose production and improves glucose control in patients with type 2 diabetes. It may prevent cardiovascular disease in aging populations.
• NT Factor (bioidentical phospholipid membrane replacement therapy): This reverses acquired mitochondrial dysfunction, a core feature of diabetes II, CAD, nephropathy, etc. For an excellent clinical perspective on this fascinating and exciting treatment paradigm, I suggest Dr. Vasquez's (DO, professor of functional medicine) handy primer. It reduces fatigue, one of the most common presenting complaints, by about about 25%-40% in patients with a variety of conditions. It may assist regeneration of hepatocyte membranes and thereby help reduce non-alcoholic fatty liver disease. It increases sperm motility, and this was shown to be directly related to improved mitochondrial function.
• Curcumin: Curcumin Significantly Improves Obesity-Associated Inflammation and Diabetes in Mouse Models of Diabesity. It's healed renal lesions related to diabetes in rats. According to a study published by the American Diabetes Association: "After 9 months of treatment, 16.4% of subjects in the placebo group were diagnosed with T2DM, whereas none were diagnosed with T2DM in the curcumin-treated group. [This intervention] significantly lowered the number of prediabetic individuals who eventually developed T2DM. In addition, the curcumin treatment appeared to improve overall function of β-cells, with very minor adverse effects." It reduces LDL and VLDL-cholesterol.
• Lower serum P5P, a different form of Vitamin B6, is associated with more inflammation in the population. P5P supplementation reduces inflammation and oxidative stress via inhibition of the NLRP3 inflammasome and NFKB, key drivers of the pathogenesis of type II diabetes.
• Vinegar has been shown to improve insulin sensitivity in type II diabetics and increase satiety.
• Superoxide dismutase prevents diabetic cardiomyopathy by reducing oxidative stress. It "blunts diabetes-induced upregulation of NADPH oxidase and endoplasmic reticulum stress in a rat model of diabetic nephropathy." It prevents material embryonic diabetes.
• Milk thistle lowers blood sugar and lipids by stimulating PPARγ, which is also the mechanism of action of insulin-sensitizing thiazolidinediones with none of the side-effects of those drugs.
• I also really wanted to include BAIBA but wasn't able due to cost. Folks at Harvard have shown BAIBA increases burning of fats in the liver and causes white fat to grow new mitochondria and turn into Calorie-burning brown fat.

There are several others, but you get the idea. I haven't even mentioned any of the more behavioral lifestyle interventions I tried to model and educate the whole family about.

If we want to beat the pandemic of chronic diseases, we have to think outside the box. We have to attack from every angle that is safe, effective, and affordable, using every tool in the toolbox that works. We have to look to the scientific community to find the future of medicine. One treatment alone will never be enough to take down a disease like TII diabetes, but maybe with enough treatments that work in concert--with multi-component, personalized protocols--we can slow the progression. Maybe one day we will turn the tide in favor of homeostasis and vitality enough to start reversing these diseases too. I don't know if we'll ever get there, but I'm going to spend the rest of my life trying as a physician. Please forgive my boldness and verbosity.

You're going to think I'm picking on you but I'm trying to help.....I'd advise you don't go anywhere near this stuff on the interview trail

 

[UBLI-EINSTEIN]

You're going to think I'm picking on you but I'm trying to help.....I'd advise you don't go anywhere near this stuff on the interview trail

I gave up reading his passages. I think he might just not stop talking about all these things.

 

[cactusman]

You're going to think I'm picking on you but I'm trying to help.....I'd advise you don't go anywhere near this stuff on the interview trail

This is maybe what I'm most concerned about for you, OP. You keep trying to show off in essays that you can suggest supplements or turn off lights after reading a lot of papers, and then you say that you thought it might have been a bit off but you thought it was worth one more attempt at showing off your scientific knowledge.

If you get an interview, and you go in and think to yourself "this is a risky answer but I think it might pay off" DON'T USE THAT ANSWER. You don't seem to be great at calculated risks in your application, and if you say something that sounds crazy you can't pull out a bunch of citations. You can't get a note from your family member's doctor. STOP trying to do that. Your application is already imperfect in other ways, stop flinging bad essay ideas (and potentially bad interview answers) at it.

Just think, "would @Goro express exasperation if I hopped on SDN and suggested this?" And if the answer is yes, then don't answer the question that way.

 

[Prometheus123]

You're going to think I'm picking on you but I'm trying to help.....I'd advise you don't go anywhere near this stuff on the interview trail

Not at all, I appreciate the feedback and I will not mention it in interviews.

I'm just a premed (though an older one), also applying to med schools this year.

I think you have had lots of interesting life experiences, and probably would add some diversity and color to a med school class. But, when you talk about your experiences, you have a tendency to really aggrandize relatively simple gestures and interactions, and unfortunately I think it comes off as arrogance coupled with a lack of self-awareness. If I had any advice to give you, it would be keep things simple and really resist the urge to make your (interesting, but not so exotic) experiences sound grandiose. Even the paragraph about the discussion with your in-laws sounds over the top to me.

I'm very excited to (hopefully) go to medical school myself, but I figure the first years are going to be all about realizing how little I knew about how the body worked up until now and how much I have to learn. In that context, I think it's a faux pas to discuss designing "protocols" for your father-in-law and talking about how you are "treating" his metabolic disorder, particularly in an essay that will be read by practicing physicians, who probably have a thing or two to teach you. If I were you, I'd be a bit more humble and talk about your interest in certain areas of medicine and how you look forward to exploring those more in medical school.

Fair enough, I can see I have that tendency in my writing. In my defense though, the story with my father-in-law was actually more over the top than what I wrote if anything. Very strange (but gratifying) experience.

I also feel like what I know is dwarfed by what I don't know. Sometimes I feel in awe of how much I need to learn still. That feeling is the main reason I want to go to medical school. But does that mean we know nothing? Does that mean we have to do nothing until it's too late? Also, none of this coming from me. It's coming from the world's leading researchers on these topics.

 

[Prometheus123]

This is maybe what I'm most concerned about for you, OP. You keep trying to show off in essays that you can suggest supplements or turn off lights after reading a lot of papers, and then you say that you thought it might have been a bit off but you thought it was worth one more attempt at showing off your scientific knowledge.

If you get an interview, and you go in and think to yourself "this is a risky answer but I think it might pay off" DON'T USE THAT ANSWER. You don't seem to be great at calculated risks in your application, and if you say something that sounds crazy you can't pull out a bunch of citations. You can't get a note from your family member's doctor. STOP trying to do that. Your application is already imperfect in other ways, stop flinging bad essay ideas (and potentially bad interview answers) at it.

Just think, "would @Goro express exasperation if I hopped on SDN and suggested this?" And if the answer is yes, then don't answer the question that way.

I'm not trying to show off. That's not my motivation. I'm trying to show that I'm not BSing when I talk about supplements that are indicated for specific conditions in the scientific literature. My main motivation for bringing it up, I guess, is that I feel strongly that it speaks to my suitability for medical school and to be a physician.

I do have a bit of a blind spot for this specific subject because, as I mentioned, I feel very uncomfortable with waiting around for my family members to die slowly of chronic diseases when I know about additional things that might help them. Personally, I think my drive is a clear sign I'd make a good doctor. But, like I said, everyone but me only sees the problematic aspects of this, not the potential, and that's fine. I suspect the disbelief that what I'm saying is real is too strong for people to get past. I accept that. I won't mention it officially ever. I hope you'll forgive me for using SDN as a sounding-board like this.

 

[Prometheus123]

Maybe the main reason I want to attend medical school ASAP is that I feel so woefully incomplete as a person. I feel like I'm not good enough yet to do what I need to do, and it's high time that I got the education and training I need to proceed. I need to learn from clinicians one on one how to treat people, not just through reading their papers and shadowing. I need to learn about all the body's systems thoroughly. I need physio, patho, and pharma. I need to master the USMLE Step 1 curriculum like my wife is doing. I need that knowledge. As excited as I am about my diet and lifestyle suggestions for my father-in-law, I spend a lot of time worrying about what if I missed some medication interaction, allergen, or other contraindication because I don't know enough. I had supervision with this from multiple physicians, but it's still on me. I need to learn more. Above all, I need to learn from physician's clinical experience more. I believe in and need the clinical wisdom and intuition of experienced physicians. I need to apprentice to a bunch of doctors basically. In other words, I need to go to medical school.

 

[Prometheus123]

I'm just a premed (though an older one), also applying to med schools this year.

I think you have had lots of interesting life experiences, and probably would add some diversity and color to a med school class. But, when you talk about your experiences, you have a tendency to really aggrandize relatively simple gestures and interactions, and unfortunately I think it comes off as arrogance coupled with a lack of self-awareness. If I had any advice to give you, it would be keep things simple and really resist the urge to make your (interesting, but not so exotic) experiences sound grandiose. Even the paragraph about the discussion with your in-laws sounds over the top to me.

I'm very excited to (hopefully) go to medical school myself, but I figure the first years are going to be all about realizing how little I knew about how the body worked up until now and how much I have to learn. In that context, I think it's a faux pas to discuss designing "protocols" for your father-in-law and talking about how you are "treating" his metabolic disorder, particularly in an essay that will be read by practicing physicians, who probably have a thing or two to teach you. If I were you, I'd be a bit more humble and talk about your interest in certain areas of medicine and how you look forward to exploring those more in medical school.

In case you're interested, here's the full version of the in-laws paragraph. Maybe it will make more sense without half the sentences taken out. The new material starts in bold.

"I may not look diverse, but I am exceptionally diverse in my experiences, spiritual practices, cultural competencies, communication skills, and perspectives. I lived and worked for a year each in India and Dubai. Since my wife of 4 years is Indian, I also married her family, language, and culture. Indeed, her parents and sister have been living with us for a month, and we spent every weekend together when we lived in Dubai. I love her family as my own. Most of the time, we accommodate each other’s cultural differences and enjoy being together. But on our anniversary, her father said she was dressed like a call girl even though she was the most conservatively dressed woman in the restaurant (it’s a long story).

I insisted we talk about it when everyone was calmer the next morning. My sister-in-law said it’s pointless, Dad is just crazy, it will probably make things worse. But my wife asked me to try, so I prepared and initiated. For hours, I mediated between my father-in-law and the women of the family across cultural, linguistic, gender, and generational differences. I communicated with active listening, simple words in both languages, mirroring, body language, gestures, and empathy. Following my model, they listened to each other. I helped them identify problems and create win-win solutions. They wished they could talk like this normally. I pointed out they could. My father-in-law said I made everyone feel understood and he was happy to have someone like that in the family."

There are a lot of other details about that incident and the context in which it occurred that are actually more over the top that I've not included for privacy and space.

By the way, this fight started on August 4th, which was also our 4th wedding anniversary, and the day I got AMCAS verified and my state school sent me their secondary. I also got an email that day I had been expecting for months now regarding my campaign to remove dangerous trans fats from our patients food from the Director of Food Services at my hospital.

 

[wizzed101]

""I may not look diverse, but I am exceptionally diverse in my experiences, spiritual practices, cultural competencies, communication skills, and perspectives. I lived and worked for a year each in India and Dubai. Since my wife of 4 years is Indian, I also married her family, language, and culture. Indeed, her parents and sister have been living with us for a month, and we spent every weekend together when we lived in Dubai. I love her family as my own. Most of the time, we accommodate each other’s cultural differences and enjoy being together. But on our anniversary, her father said she was dressed like a call girl even though she was the most conservatively dressed woman in the restaurant "
---->
"On our anniversary, my father-in-law told my wife that she was dressed like a call girl."
The rest added nothing. Just saying.

Actually, I think I've just improved your paragraph, like a lot.

 

[Prometheus123]

""I may not look diverse, but I am exceptionally diverse in my experiences, spiritual practices, cultural competencies, communication skills, and perspectives. I lived and worked for a year each in India and Dubai. Since my wife of 4 years is Indian, I also married her family, language, and culture. Indeed, her parents and sister have been living with us for a month, and we spent every weekend together when we lived in Dubai. I love her family as my own. Most of the time, we accommodate each other’s cultural differences and enjoy being together. But on our anniversary, her father said she was dressed like a call girl even though she was the most conservatively dressed woman in the restaurant "
---->
"On our anniversary, my father-in-law told my wife that she was dressed like a call girl."
The rest added nothing. Just saying.

Actually, I think I've just improved your paragraph, like a lot.

The rest is preamble to the point, isn't it?

 

[wizzed101]

What point? The only thing interesting in that paragraph was the last sentence. I garnered no information from the rest that could've helped clarifying or made the sentence more interesting.

 

[Prometheus123]

What point? The only thing interesting in that paragraph was the last sentence. I garnered no information from the rest that could've helped clarifying or made the sentence more interesting.

The point being the second paragraph, the meditation. I see your point that that's really the only sentence that's really necessary in the first paragraph. It's mentioned elsewhere in my app that I lived in India and Dubai and and yada yada. The fact that I'm unusually spiritually diverse is true, but I never discuss it in this.

I'll think about what to fill the rest of the space with.

 

[Lifeblood_20]

In case you're interested, here's the full version of the in-laws paragraph. Maybe it will make more sense without half the sentences taken out. The new material starts in bold.

"I may not look diverse, but I am exceptionally diverse in my experiences, spiritual practices, cultural competencies, communication skills, and perspectives. I lived and worked for a year each in India and Dubai. Since my wife of 4 years is Indian, I also married her family, language, and culture. Indeed, her parents and sister have been living with us for a month, and we spent every weekend together when we lived in Dubai. I love her family as my own. Most of the time, we accommodate each other’s cultural differences and enjoy being together. But on our anniversary, her father said she was dressed like a call girl even though she was the most conservatively dressed woman in the restaurant (it’s a long story).

I insisted we talk about it when everyone was calmer the next morning. My sister-in-law said it’s pointless, Dad is just crazy, it will probably make things worse. But my wife asked me to try, so I prepared and initiated. For hours, I mediated between my father-in-law and the women of the family across cultural, linguistic, gender, and generational differences. I communicated with active listening, simple words in both languages, mirroring, body language, gestures, and empathy. Following my model, they listened to each other. I helped them identify problems and create win-win solutions. They wished they could talk like this normally. I pointed out they could. My father-in-law said I made everyone feel understood and he was happy to have someone like that in the family."

There are a lot of other details about that incident and the context in which it occurred that are actually more over the top that I've not included for privacy and space.

By the way, this fight started on August 4th, which was also our 4th wedding anniversary, and the day I got AMCAS verified and my state school sent me their secondary. I also got an email that day I had been expecting for months now regarding my campaign to remove dangerous trans fats from our patients food from the Director of Food Services at my hospital.

Just my $0.02. You have a habit of writing "...something, something, something, and something." That's telling not showing. The "somethings" are completely unmemorable. Don't just summarize. You don't have to mention a ton of things without ever coming back to them. You just need to talk about a few things and back every one of them up.

 

[Saifa]

I'm trying to show that I'm not BSing when I talk about supplements that are indicated for specific conditions in the scientific literature.

I suspect the disbelief that what I'm saying is real is too strong for people to get past. I accept that. I won't mention it officially ever. I hope you'll forgive me for using SDN as a sounding-board like this.

Dude you can't have this indignant attitude if you want to go into interviews and succeed. No one is giving you backlash because of "disbelief that what you're saying is real." It IS bs. You literally don't have the legal authority or educational precedent to be doling out this sort of advice to people. Nothing about what you suggested is "real."

"I want to go to med school because my dad presented signs of cholecystitis but I just didn't have the know-how to complete the cystectomy and had to send him to the hospital halfway through the operation."

My greatest challenge will be balancing my duty to my family and my career. My wife is 33, so to avoid congenital birth defects we have to have our first child by 2019 at the latest.

Maybe take a step back and wonder how people will think about the things you say before saying them.

 

[wizzed101]

The point being the second paragraph, the meditation. I see your point that that's really the only sentence that's really necessary in the first paragraph. It's mentioned elsewhere in my app that I lived in India and Dubai and and yada yada. The fact that I'm unusually spiritually diverse is true, but I never discuss it in this.

I'll think about what to fill the rest of the space with.

About the 2nd paragraph...
You've just used the man who publicly humiliated your wife on your wedding anniversary as a voucher for your ability to mend differences....

 

[Goro]

Maybe the main reason I want to attend medical school ASAP is that I feel so woefully incomplete as a person. I feel like I'm not good enough yet to do what I need to do, and it's high time that I got the education and training I need to proceed. I need to learn from clinicians one on one how to treat people, not just through reading their papers and shadowing. I need to learn about all the body's systems thoroughly. I need physio, patho, and pharma. I need to master the USMLE Step 1 curriculum like my wife is doing. I need that knowledge. As excited as I am about my diet and lifestyle suggestions for my father-in-law, I spend a lot of time worrying about what if I missed some medication interaction, allergen, or other contraindication because I don't know enough. I had supervision with this from multiple physicians, but it's still on me. I need to learn more. Above all, I need to learn from physician's clinical experience more. I believe in and need the clinical wisdom and intuition of experienced physicians. I need to apprentice to a bunch of doctors basically. In other words, I need to go to medical school.

You don't "need" anything. The bolded is a terrible reason for wanting to go to med school. People who wrap all their self-image and being into getting accepted often end up absolutely miserable.

A seat in medical school and a career in Medicine is a privilege, not a means to affirm someone's self-worth, or worse, a tool so they continue to play Doctor.

I am STILL very worried about your chances, Promy. I see reject material. You've been warned.

 

[getdown]

Hey buddy. I know you're probably well intentioned and very eager to get into medical school but there's a difference between bragging and "bragging".

The first kind is where you just can't wait to let people know how amazing you are and that's just simply off-putting. Your posts have been kind of on this side of the douchy isle. Again, probably because you're over-eager or truly have a passion for it but it's just coming off all wrong. You need to convey yourself better without coming off as an annoying person. Saying things like "I read scientific papers therefore I can make protocols" or "I feel incomplete as a person thus I need to get into med school" just reinforces that.

 

[gyngyn]

@gyngyn , thank you for your post. Good, reasonable, skeptical disbelief and questioning is something I'm happy to answer.

History: My father-in-law is a middle-aged man with full metabolic syndrome, including coronary artery disease with calcium deposits in his arterial plaques, type II diabetes, overweight, hypertension, dyslipidemia, intermittent nephropathy. History of myocardial infarction and has a stent. Risk factors include chronic stress, chronic exposure to high levels of toxic compounds, poor diet and sleep, circadian dysregulation, etc. For several years in Syria, he never drank water and only drank beer and soda, which he says coincided with the emergence of his metabolic syndrome, suggesting mitochondrial dysfunction via excess sugar and alcohol and fatty liver disease.

Deficiencies?: To your point, the fact that there's calcium in his plaques shows that he's functionally deficient in vitamin K2 I would argue, which takes calcium out of deposits and puts it back into bones. In addition, he's taking metformin, which depletes vitamin B12. I gave him both. K2 has less of an effect on coagulation than K1 (the form that's used for nosebleeds). Just to be safe though, I've discussed this possible interaction with my wife and sister-in-law, both of whom are physicians, and about the possibility that his aspirin dosage may need to be adjusted accordingly. I'm going to ask his PCP about this once they're back in Dubai. For now, wife and sister are monitoring BP, glucose, and mood daily for changes.

Q: Supplements are only useful for vitamin or mineral deficiencies, right?
A: It's a common misconception that very few supplements have ever been shown to be useful for anything other than overt deficiency diseases. Most institutions tell us that nothing is proven about such treatments, and that's true, but nothing is ever proven in science by definition. All we get are different degrees of probability. I'm not saying I have proof. I'm saying it's probable enough that they'll work to use them to help patients clinically today in some cases. If you look in the scientific literature, you will see this for yourself. Here is my opening gambit and a few of the many facts that spurred me to action with sources linked:

• Sulforaphane (sold as BroccoMax) prevents diabetic neuropathy, cardiomyopathy, and nephropathy via Nrf2 activation and NFKB inhibition. It reduces hepatic glucose production and improves glucose control in patients with type 2 diabetes. It may prevent cardiovascular disease in aging populations.
• NT Factor (bioidentical phospholipid membrane replacement therapy): This reverses acquired mitochondrial dysfunction, a core feature of diabetes II, CAD, nephropathy, etc. For an excellent clinical perspective on this fascinating and exciting treatment paradigm, I suggest Dr. Vasquez's (DO, professor of functional medicine) handy primer. It reduces fatigue, one of the most common presenting complaints, by about about 25%-40% in patients with a variety of conditions. It may assist regeneration of hepatocyte membranes and thereby help reduce non-alcoholic fatty liver disease. It increases sperm motility, and this was shown to be directly related to improved mitochondrial function.
• Curcumin: Curcumin Significantly Improves Obesity-Associated Inflammation and Diabetes in Mouse Models of Diabesity. It's healed renal lesions related to diabetes in rats. According to a study published by the American Diabetes Association: "After 9 months of treatment, 16.4% of subjects in the placebo group were diagnosed with T2DM, whereas none were diagnosed with T2DM in the curcumin-treated group. [This intervention] significantly lowered the number of prediabetic individuals who eventually developed T2DM. In addition, the curcumin treatment appeared to improve overall function of β-cells, with very minor adverse effects." It reduces LDL and VLDL-cholesterol.
• Lower serum P5P, a different form of Vitamin B6, is associated with more inflammation in the population. P5P supplementation reduces inflammation and oxidative stress via inhibition of the NLRP3 inflammasome and NFKB, key drivers of the pathogenesis of type II diabetes.
• Vinegar has been shown to improve insulin sensitivity in type II diabetics and increase satiety.
• Superoxide dismutase prevents diabetic cardiomyopathy by reducing oxidative stress. It "blunts diabetes-induced upregulation of NADPH oxidase and endoplasmic reticulum stress in a rat model of diabetic nephropathy." It prevents material embryonic diabetes.
• Milk thistle lowers blood sugar and lipids by stimulating PPARγ, which is also the mechanism of action of insulin-sensitizing thiazolidinediones with none of the side-effects of those drugs.
• I also really wanted to include BAIBA but wasn't able due to cost. Folks at Harvard have shown BAIBA increases burning of fats in the liver and causes white fat to grow new mitochondria and turn into Calorie-burning brown fat.

There are several others, but you get the idea. I haven't even mentioned any of the more behavioral lifestyle interventions I tried to model and educate the whole family about.

If we want to beat the pandemic of chronic diseases, we have to think outside the box. We have to attack from every angle that is safe, effective, and affordable, using every tool in the toolbox that works. We have to look to the scientific community to find the future of medicine. One treatment alone will never be enough to take down a disease like TII diabetes, but maybe with enough treatments that work in concert--with multi-component, personalized protocols--we can slow the progression. Maybe one day we will turn the tide in favor of homeostasis and vitality enough to start reversing these diseases too. I don't know if we'll ever get there, but I'm going to spend the rest of my life trying as a physician. Please forgive my boldness and verbosity.

Until we have evidence that an intervention is better than placebo, all we have are theories. Even with evidence, the results may be quite different in different populations or different states of disease or stages of life.
These are all interesting, but none of them constitute an indication for intervention.
If you want to put more vinegar in your diet or increase a spice, go for it.
If you are employing (a small amount of) condiments as a placebo, no problem.
Generating a list like this makes you seem a lot more like a patient than a physician, though.

 

[Prometheus123]

About the 2nd paragraph...
You've just used the man who publicly humiliated your wife on your wedding anniversary as a voucher for your ability to mend differences....

Interesting point. My father-in-law is 99% a great guy. He's deeply loving in his own way, he's a good man, he's worked ridiculously hard his whole life to make it as an Indian immigrant to the Middle East to build a better life for his family. Because of his hard-work and sacrifices, both his daughters were able to go to medical school and become doctors, and that's huge. I just lived with him for over a month, again, and I can honestly say I love that man, that I enjoy talking to him and spending time with him, and that he's a good man. He's incredibly intelligent, skillful, resourceful, and resilient too. Sometimes he drives me crazy, but that's just part of the human condition, right?

That being said, he grew up in a very different culture than ours, one that was similar in many ways to the culture that our grandparents' generation grew up in, i.e. pre-WWII America. You can't judge him for being a product of his time and place in terms of his attitudes towards women, division of labor in a family, gay people, love marriages, acceptable child-rearing practices, marital power dynamics, etc. Sometimes it's hard not to, but you have to understand, by the standards of the culture in which he grew up, he's relatively extremely progressive and open-minded.

And he's made a lot of additional progress I think by being in the US and getting to know some gay people, getting to see a guy like me cook dinner and clean up in the kitchen, watching how affectionate and respectful I am towards my wife, etc. Should we judge our grandfathers in the US for having attitudes and thought-patterns that contemporary US society has evolved beyond? In this analogous situation, I focused on being compassionate and gently nudging him to improve. And based on behavior changes I observed in him before they left here, I think that approach may have helped a little. We'll see if the old ways slip back now that he and I are no longer living together, but I'm hopeful the changes will be sustained.

 

[blackroses]

Ethical relativism has to be one of the worst ideas humans have ever developed.

 

[Prometheus123]

You don't "need" anything. The bolded is a terrible reason for wanting to go to med school. People who wrap all their self-image and being into getting accepted often end up absolutely miserable.

A seat in medical school and a career in Medicine is a privilege, not a means to affirm someone's self-worth, or worse, a tool so they continue to play Doctor.

I am STILL very worried about your chances, Promy. I see reject material. You've been warned.

Perhaps a poor choice of words on my part. My self-image has nothing to do with getting accepted. I base my sense of self-worth on my character, whether I'm acting with compassion towards other people, and whether or not I'm diligently working towards fulfilling the dharma, duty, and purpose I have chosen for my life. What I meant is that I need that knowledge, training and experience in order to fulfill my dharma. Without it, I am missing essential tools in my toolbox.

It is a privilege. If I don't get accepted this cycle, I will simply work to become worthy enough until I eventually get accepted or die, whichever comes first. As a lover of Stoic philosophy, I only judge myself and hold myself accountable for my own character and behavior, not for things that are out of my control. And I have made it my character to always keep trying.

 

[Prometheus123]

Ethical relativism has to be one of the worst ideas humans have ever developed.

Maybe, but harsh judgment doesn't result in any improvement. Compassion and education can actually improve the problem, not just condemn it.

 

[Prometheus123]

Hey buddy. I know you're probably well intentioned and very eager to get into medical school but there's a difference between bragging and "bragging".

The first kind is where you just can't wait to let people know how amazing you are and that's just simply off-putting. Your posts have been kind of on this side of the douchy isle. Again, probably because you're over-eager or truly have a passion for it but it's just coming off all wrong. You need to convey yourself better without coming off as an annoying person. Saying things like "I read scientific papers therefore I can make protocols" or "I feel incomplete as a person thus I need to get into med school" just reinforces that.

Sorry. Thanks for the feedback! I'll work on that.

 

[Prometheus123]

Until we have evidence that an intervention is better than placebo, all we have are theories. Even with evidence, the results may be quite different in different populations or different states of disease or stages of life.
These are all interesting, but none of them constitute an indication for intervention.
If you want to put more vinegar in your diet or increase a spice, go for it.
If you are employing (a small amount of) condiments as a placebo, no problem.
Generating a list like this makes you seem a lot more like a patient than a physician, though.

I'm going to defer to your wisdom on this one, @gyngyn . I will keep it to myself until after I'm educated and licensed. Thank you for the feedback!

 

[lpp06]

Observations:

1) the "diversity" essay also serves the purpose of showing an adcom what you will bring to your incoming class. Imagine you handed this essay to a potential classmate and what their reaction would be.

2) make sure an adcom would be excited to TEACH you. Don't give them the impression that you know everything by dropping terminology left and right

 

[BtmoreRavens18]

After reading a lot of your posts, your PS and other parts of your app I have become invested in your success, so I am going to give this a go...

You love reading scientific literature, so think about it this way: You have been replicating the same experiment over and over. Your goal is to get accepted to medical school. You have been using the same method; trying to demonstrate your medical knowledge and prowess in your essays in order to demonstrate you are suited for a career in medicine. You are at an N of 10 at this point and every experiment has come up negative. To summarize the feedback you have been getting, the way you are presenting yourself in your essays makes you seem like a know it all with a tendency to exaggerate their own importance, these are not attractive qualities in a candidate. This is not a criticism of you as a person, you seem like a very caring and enthusiastic guy BUT without question, this is how your stories make you seem. Everyone on here, including people who are really in the know, has come to the same conclusion.

This leaves you with two options. 1. Continue to tell the same stories and and come across as arrogant and lacking in self awareness. You keep reiterating that you mean the stories to come off differently, but the truth is, you are not painting the picture you want to be. You have tried enough times now and keep coming up with the same result. I repeat: If you tell these stories in your essays there will be Adcoms who question your character. 2. To drop this approach entirely. Write about something completely different. talk about your family, talk about your experiences living in other countries, but do so without mentioning anything medially or scientifically related. Please, please, please consider going with the second option. I understand what your intentions are, but take a step back and realize that these stories are not working for you.

 

[Prometheus123]

After reading a lot of your posts, your PS and other parts of your app I have become invested in your success, so I am going to give this a go...

You love reading scientific literature, so think about it this way: You have been replicating the same experiment over and over. Your goal is to get accepted to medical school. You have been using the same method; trying to demonstrate your medical knowledge and prowess in your essays in order to demonstrate you are suited for a career in medicine. You are at an N of 10 at this point and every experiment has come up negative. To summarize the feedback you have been getting, the way you are presenting yourself in your essays makes you seem like a know it all with a tendency to exaggerate their own importance, these are not attractive qualities in a candidate. This is not a criticism of you as a person, you seem like a very caring and enthusiastic guy BUT without question, this is how your stories make you seem. Everyone on here, including people who are really in the know, has come to the same conclusion.

This leaves you with two options. 1. Continue to tell the same stories and and come across as arrogant and lacking in self awareness. You keep reiterating that you mean the stories to come off differently, but the truth is, you are not painting the picture you want to be. You have tried enough times now and keep coming up with the same result. I repeat: If you tell these stories in your essays there will be Adcoms who question your character. 2. To drop this approach entirely. Write about something completely different. talk about your family, talk about your experiences living in other countries, but do so without mentioning anything medially or scientifically related. Please, please, please consider going with the second option. I understand what your intentions are, but take a step back and realize that these stories are not working for you.

I accept this, absolutely. I completely removed that part from my diversity essay, and it hasn't come up in any of my other secondaries. Just good old-fashioned life stories about grit, compassion, and self-improvement. I will avoid it in the future. Thanks for the feedback.