The Differential: Medscape Med Students Blogs

The End

Ben Ferguson -- Unfortunately, I’ve got to stop writing for The Differential, and this will be my last post. As an aging grad student who still has half of medical school remaining, I’ve got other responsibilities to attend to (and no one wants to read about the exciting life of a researcher anyway).

Looking back, it’s been so much fun writing for this blog. I’ve been amazed by the amount of discussion some of my posts generated, undoubtedly not because of my chosen topics but because of your enthusiasm as readers. Undoubtedly, too, I imagine that some of you might be happy to see me going, as I’ve at times been called “annoying,” stuck-up, arrogant, “unmistakably egotistical,” “dead wrong,” racist, sexist, classist, discriminatory (not otherwise specified), bigoted, small-membered, hypersexual, ignorant, bellyaching, unthankful, “unprofessional,” offensive, “jaded,” narrow-minded, “stochastic,” AND overbearing, all within the past year. Whew. Those are some flowing emotions. The thing is, however nasty, most of them were well-intentioned and helped me to scrutinize and improve my own writing (except maybe the small-membered jab).

Like I said before, I’ve run out of stories to tell for now -- except for this last one.

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When I was four, I broke my leg. It happened after I had one of those slo-mo, running-across-a-field-of-tall-grass-toward-a-lost-lover scenes, except this one was with a dog. Couldn’t tell you why this dog and I were running toward each other with such gusto (or at all), or how it was that neither of us realized the need to 1) stop, and/or 2) change course, but we ended up colliding with each other and falling-down-going-boom.

You’d think that having two doctor-parents would increase the likelihood that I’d get some medical attention, wouldn’t you? Isn’t that the logical outcome, that I’d go to the hospital and maybe have some x-rays following lengthy complaints of intolerable leg pain?

No. You would be wrong.

As I remember it now, I walked miles (in reality, probably to the bathroom and back) all day (maybe a couple of times per day, actually) for about 6 weeks (likely the next morning) before ever seeing a doctor, and when I did eventually persuade them to take me in, the diagnosis was that my leg fell completely off (tibia frx). I did get a cool cast, though, and was for a few weeks the cool kid at school who endured a vicious and life-threatening attack by (accidental collision with) a rabid, blood-hungry doberman on the loose from the pound (the neighborhood golden retriever chasing a ball down the sidewalk).

There is no moral to this story, unless you’re four, in which case: Where applicable, tone down the massive hypochondria, lest your parents think you’re whining excessively about your leg being broken in an attention-getting fashion when, in fact, you’ve actually just broken your leg and would like to see a doctor. Also, stay away from rabid dobermans.

My First Time... Down There

Ben Ferguson -- This is my penultimate post for the unforeseeable future, as I have run out of stories and also must graduate at some point.

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Thursday, 6pm. Outpatient gyn clinic exam room. 10x10, maybe. Professional attire. Me, five female classmates, a female attending, a female resident, and... the patient, half naked.

It did not start well. “I’ve been at two other schools today, had about two dozen fingers up there so far, so be gentle, okay? I’m a little chafed by now, you know?”

No. As a matter of fact, I didn’t know.

The ladies in the room cringed. I cringed, too, out of a combination of imagination and extrapolation. She chuckled, intending to keep things on the light side rather than the morbid. I doubted any of us students had performed gynecological exams before med school, but I felt especially unprepared not having lived for more than two decades with a vagina of my own. All of the other students almost certainly had had multiple exams performed on them, so they at least had that going for them.

The resident instructed us on the various parts of the exam while the attending looked on: how to choose the appropriate speculum and how to manipulate it in practice, how to apply lubricant and how much to use (a lot), how to remove the speculum, that it’s important to warm up your hands, how much lubricant to use for your fingers (even more), where to expect to feel the ovaries, what to expect to feel, what to look for. The focus, though: what things to say (and how to say them), or, more aptly, what things not to say (or, worst-case scenario, how not to say them). For example, use proper anatomical terms rather than slang; always explain what you’re about to do to the patient using such terms before beginning; do not make off-color comments about sexual activity or really anything else that would cause any awkwardness (above and beyond what the both of us were already undoubtedly experiencing, of course). The list was long but seemed sensical enough.

Not ever having had to spread my legs to reveal my non-existent vagina to a gynecologist, it was much more difficult than I expected to place myself emotionally in the seat across from me. When you don’t have a vagina and have thus never had your vagina examined by a stranger, it’s incredibly hard to anticipate what will offend a patient and her vagina and what will be taken as a benign statement. Honestly, on paper, it really shouldn’t be that difficult, but when you’re nervous, and you’re of the opposite sex, and you’re examining someone’s genitals with seven female escorts scrutinizing you, and it’s a generally uncomfortable situation and would be even without the escorts, and literally the first interaction you have with this patient consists of inserting a clear plastic object with a mound of lube on top into her vagina -- well, that changes the game a bit.

I think I did okay, though. I was sweating profusely the entire time, which was both rather embarrassing and a bit cumbersome since my hands happened to be doing other assorted things at the time, but I managed not to get slapped by any party present (though I was insulted to hear that, despite having relatively large hands, my fingers weren’t quite long enough to perform a comfortable bimanual exam). The point of the exercise was not only to learn how to perform such an exam, but to learn how to perform such an exam while also conducting oneself professionally and to correct mistakes that one didn’t initially (or ever) realize one was making. And, despite my classmates’ aforementioned anatomy, we all made many, many mistakes, some of them repeated by every single one of us, giving me slight schadenfreude in that I wasn’t retarded in the absolute sense, just in the relative sense.

Then, it was over. I couldn’t tell you how to perform a gynecological exam today, nor would I want to do another before having a thorough refresher. But, the experience did teach me a little about how important it is to always watch what I’m saying to patients, how what we all say can often be misconstrued as offensive or off-putting, how ovaries are supposed to feel like walnuts and that I should just take their word for it if I can’t feel them, and how I should always use more lubricant than I ever thought necessary.

Don't Do That

Ben Ferguson -- Writing my previous post reminded me of two other “don’t” stories to share.

A good friend of mine -- let’s call him Jon -- was scrubbed in on an operation during his third-year surgery clerkship, working alongside a surgeon who is well-liked here but has a reputation of being rather intimidating among the medical students. Being a green medical student (yet certainly feeling lucky to have some hands-on responsibility in the first place), Jon was relegated to working the laparoscopic camera during something like a lung resection. The surgeon asked him to reposition the camera to get a better view of the surgical field, but he replied that he didn’t think he could maneuver at such an angle because if he were to try, he was afraid he might break one of the patient’s ribs.

The surgeon stopped what he was doing, put down his cautery probe, looked directly at Jon across the table, and cleared his throat.

“Don’t do that,” he said flatly, as if he were lecturing on the innervation of the puborectalis. Then he picked up his instruments and went back to what he was doing.

Jon said only a little urine came out.

A few weeks ago, I was having a chat about some trouble I was having with one of my projects and how I was going about troubleshooting it. (I’ve been troubleshooting for about a month now; accordingly, we’ve been having a lot of these conversations.)

I started cycling through my options: “Well, I could run my samples on a gel again, or I could resequence the construct, or I could redo the mutagenesis entirely, or I could digest with Ava1, or I could re-digest with Dpn1, or I could try a different polymerase, or I could increase the transformation volumes. OR, I could just shoot an email to [our collaborator] and ask him to send some of his -—”

“Don’t do that,” my PI said. “Stick with the other stuff and you’ll get it to work eventually.”

The thing is, I will get it to work eventually, but I wish I didn’t have to. I wish someone could just send me the final product so I can use it immediately in my experiments, but it doesn’t work like that most of the time. Or any time, really, unless you’re extremely lucky, have extremely generous collaborators, and/or have a PI with a fat, disposable wallet. These thwarting words weren’t very encouraging to hear, but it’s the right thing to hear in the end and it has taught me that the best solution isn’t always the easiest one or the one most readily bought or mooched. For rapidity of data, that may be true, but it doesn’t hold up when taking the broader goals of graduate work into consideration, not the least of which are learning how to master basic techniques and learning how to deal with them when they inexplicably fail.

How Not to Give a Presentation

Ben Ferguson -- I’m currently at a conference on worms (don’t ask), struggling to stay awake through 22(!) rapid-fire presentations each day. Some are average, some are really quite good, and some are just annoying and terrible.

We all know the typical no-nos -- don’t talk too quickly, don’t put too many words on one slide, don’t read directly from your slides, don’t make the text too small to be legible, don’t be rigid but don’t move around too much either. So many don’ts.

Even if you didn’t think it was possible, I have more. It’s weird, but people always forget how to do the most basic things when they’re in front of a large audience. If you can help it, don’t do this either. Some pointers for your own future presentations:

• Don’t mistake the wireless slide changer for the laser pointer. If you absolutely must, at least recognize this within the first few slides, and try not to use the slide changer as the laser pointer for your entire presentation or until an annoyed audience member interrupts you to inform you that you are not, in fact, actually pointing to anything. Also, don’t make this mistake if several dozen others before you have also done it.

It’s always a bit uncomfortable watching someone point to the screen with a non-lasering piece of plastic while believing that they’re demonstrating exactly what they are referring to, and I’ve never quite figured out why this oblivion sometimes occurs and why it occurs for such a long time. I suspect it has something to do with extreme focus on the content of their presentation at the complete expense of attention to their surroundings (save, of course, for audience members shouting at them). Maybe there’s some mental image they’re creating in their head in lieu of an actual visual signal confirming a laser point showing up on the screen. Who knows.

• Don’t fumble around with the wireless slide changer when you don’t know how to operate it. (Expressed another way: When the slide changer does something you didn’t expect or want, don’t continue to press that button several dozen more times hoping it will eventually comply.) Also, don’t not know how to work the wireless slide changer in the first place. They’re all THE SAME: right moves the slide ahead one, and left does the opposite. Also, if it turns out that you are completely inept or have ignored this tip, and the computer from which you are presenting is within arm’s reach, you may just consider using the computer itself to change the slides.

• After you have the laser pointer vs. wireless slide changer thing down, don’t point to items of interest on your slides using gigantic, frantic circles as if you have just pushed a bolus of caffeine into your arm. This is especially true if you’re attempting to highlight single words on the screen, or a phosphate group, or part of a cell taking up the entire screen. Also, if you must make gigantic, frantic, caffeine-driven circles, try your best to at least keep them smaller than the screen itself; otherwise, it’s quite hard to determine what you’re pointing out.

• Don’t say “in conclusion,” or “in summary,” or “and finally, I’d like to end with...” more than six times per presentation, and don’t say these things at all if you plan to be talking for another 20 minutes. It really can drive your audience nuts. Instead, say “to conclude this portion of my presentation,” or “before I move onto something else, I’d like to summarize...”

• Don’t go too long over or under your alloted time, especially if there are people following you on the agenda or if you’re early in the day. It can really mess up the rest of the schedule, putting pressure on those presenting after you to cut theirs short in an attempt to comply with the preset agenda or stressing people out if they thought they had a bit more time to touch up their slides or get their wording right.

I’m realizing that my tone is really bordering on arrogant here, but I’ll be the first to admit that I’m completely and utterly fallible when it comes to presenting my own research. If anything, this is food for thought; most of us don’t think about these things before taking the stage, but given how our senses seem to unintentionally go by the wayside sometimes while presenting, maybe we should.

Guess I'll Go Eat Worms

Ben Ferguson -- I came across some old papers the other day in the bowels of my file cabinet and thought I’d share some excerpts.

Dear Mr. Ferguson:

      I have reviewed your application to [our school] for admission in 2004. I regret to inform you that we will not be able to grant you an interview. We have received a very large number of applicants (over 5,000) for 100 places in the first year class…

Mr. Ferguson,

      Admission to [our school] has become more competitive in recent years, particularly due to a continuing increase in the number of outstanding applicants. While we regret any disappointment you may feel with regard to your medical school plans, we are sorry to inform you that, after careful review, we will not be able to give your application further consideration…

Dear Mr [sic] Ferguson:

      The Comittee [sic] on Admissions of [our school] has carefully reveiwed [sic] your application to the 2004 entering class. Unfortunaetly [sic], we cannot grant you the admission at this time…

Dear Benjamin,

      The Admissions Committee has carefully reveiwed [sic] your application to [our school]. The Committee regrets to inform you that we are unable to offer you a place in the 2004 entering class…

Dear Benjamin:

      I am writing to share what I believe will be disappointing news. The Admissions Committee of [our school] has considered with care your application for admission. Unfortunately we are unable to offer you a place in our next entering class…

Dear Mr [sic] Ferguson,

      The Committee on Admissions of [our school] has completed its review of your application. It is with great regret that I inform you that we will be unable to offer you an interview. This is a disappointment, as much for those who are responsible for the decision as it may be for you, the candidate who is turned away…

Dear Applicant:

      We will not be considering your application for the Entering Class of 2003 [SIC!] any further. You have our best wishes for continued success in all your educational pursuits…

A few thoughts, four years passed:

1. All in all, there were 15 of them, alongside two acceptances, two waitlists, and one *RANKED ALTERNATE* [emphasis theirs]. Following my submission of the primary application in early October, they came in droves between December 19 and April 1, most as the point of first written contact from them to me. There is nothing quite like waiting more than six months for some schools to confirm they’ve received your primary application by sending you a letter rejecting your primary application. Going through this odyssey makes you realize unexpectedly that schools that pay attention to you during the application process might also pay attention to you while you’re a student there, and so it becomes more important than most people expect.

2. Having typos -- and mentions of blatantly incorrect application years -- in rejection letters really seems classless to me, especially when you consider that identical letters probably go out to >85% of the people who apply to any given school.

3. Save for changing a few words here and there, these letters are all exactly the same. They feature regret, remorse, careful and thorough consideration, best wishes offered, and, ultimately, unsuccessful attempts at making you feel like something of a winner while simultaneously smashing your dreams and explicitly telling you you’re not good enough for their school. Some were a full page long and some not even a full paragraph, but does it ever really matter to you, as an applicant, how complex and intense an admissions committee ordeal is?

4. Try to check your mail as often as possible while applying. It may drive you nuts -- you’ll already have been nuts anyway -- but this way you reduce the risk of receiving more than a few rejections all on the same day, which can really get you down.

5. The day you get your first acceptance and the day you get into your dream school will be some of the best days of your life. Go have some champagne, but be careful -- they may both be on the same day, the greatest day of your life.

All Because of a Cat

Ben Ferguson -- My fiancee and I had this cat once, probably the coolest cat I or she or anyone else who visited us had ever seen. He was so hairy, so cuddly, and so strangely human, as if he could communicate with us and understand what we were feeling (with the slight exception of all those nights from 2-5am when he just would not shut up). Ringo was surely one of the greatest pets ever.

He often slept so soundly that practically no amount of rousing or kitty versions of sternal rubs would wake him. Lucky for us, this allowed for at least a few minutes of unobstructed access to his gloriously soft paws, of lifting his feet up and letting them fall to the ground, and, thankfully, of freedom from the extreme heat he generated while sitting on your lap.

Then one day I came home and he was dead. He looked asleep, but no amount of shaking or sternal rubs could wake him. It was probably one of the worst days my fiancee or I have ever had, but it also has had lingering effects.

It set into place an emotional connection I’ve developed between deep sleep and death, so much so that I cannot look away from someone or something who’s asleep until they’ve moved, until I know for sure that they’ve not also died. Several mornings a week now, I have a brief, intense fear that my fiancee has died in her sleep while I go to kiss her goodbye. My dog often has bouts of apnea while he sleeps, and if I come upon him during one of them, I think that surely he’s dead. I do this with homeless people sleeping in the park, fellow bus riders who’ve dozed off, and our other cat, too.

I’ve never been happier than I am these days to see the smallest of movements in someone’s chest, but I’m really hoping this goes away before it has a chance to haunt my life on the wards like it is now in the lab.

The Constant Battle

Ben Ferguson -- It’s the most frustrating thing, really, to be in this position, to see it from their side for once. It’s a perspective they don’t explicitly offer in medical school within the bowels of biochemistry or pathophysiology or even the social context of medicine. I’ve had a few personal health issues come up recently -- not too serious, but serious enough that it definitely would have been mind-easing to have been seen by someone -- but because I’m poor, because I’d rather, if I must, spend large amounts of what money I do have on other things, and because my school’s insurance policy and inevitable red tape are so unbearable as to be less convenient to deal with than limping around all day, I’ve decided to largely opt for watchful waiting for pretty much everything that’s wrong with me.

And that is not good. That can never be a good thing.

I’ve never been in a position like this, but it really makes you empathize with patients you see on the wards who, at first glance, frustrate the hell out of you for seemingly having chosen to let their diseases go for as long as some of them have. My medical school happens to be in a pretty bad, pretty indigent part of town, which is bittersweet for us medical students. Sweet in that our clinical training is diverse, detailed, and not in any way cookie-cutter. Very bitter, though, in that such benefits come entirely at the expense of patients’ health. A huge reason our clinical training happens to be so good and varied is a direct result of the indigence of the surrounding population, simply because few around here can afford to pay for any of the procedures and medical attention they absolutely need, and so they make a difficult, conscious choice to opt out of medical care until it literally becomes a question of life or death.

While I’m not quite at that stage, I’ve caught a glimpse of this in my current scenario. It’s simply not worth it to me to spend several hundred -- if not several thousand -- dollars for referrals and physical exams and the briefest, most disengaged clinic appointment and imaging leading to a potential diagnosis of something I’m pretty sure I can diagnose myself, and something that would only present me with opportunities to spend even more money on treating the problem down the road, which itself may or may not be self-limited or all that detrimental to my overall health status in the end. It’s made me realize that patients I see -- patients everyone probably sees -- make value judgments like these all the time. Every time an appointment is made, you can be sure there was an internal conflict over whether the illness itself or the cost of attending to the illness would be more deleterious to their landlord’s quality of life.

Sometimes, things are just too expensive to fix, and so you live with them as long as you can.

What To Look for in a Medical School

Ben Ferguson -- What to look for in a medical school, in this order:

1. Location, location, location! I’ve mentioned this before, but it’s well worth passing on again: You will be spending four (or more) years at whichever school you choose to attend, and you should be sure that you can handle living there for that long. An amazing location won’t add all that much above and beyond a solid school, but a poor location can and will drive you crazy and distract you from your work as a medical student.

2. The grading system. This, to me, is by far the most important academic feature of a school. I cannot put into words how beneficial the pass/fail system used at my own school has been in every single aspect of my daily life as a medical student. Schools’ grading systems were not something I closely looked into while applying, but in retrospect, a pass/fail grading system should have been at the top of my list of requirements for a given school. I’ve clearly not attended a medical school that employs letter grades, so it’s tough from a personal experience standpoint to directly compare them, but based on stories I’ve heard from friends and colleagues at such schools, let’s just say I do not envy them in the least.

3. Happiness. When you visit a school, take a pulse of the emotional well-being of its students. Do they seem happy? Do they seem suicidal? Do they seem to get along with each other? Does anyone smile or laugh or crack jokes? Are there people studying together, or is every table you come across occupied by a single wallflower with his or her nose buried in a book? Try mentally inserting yourself into the school’s environment and see what happens. See how it makes you feel right then and there. See how it makes you feel one hour after leaving, and the next day, and the next week. Sometimes gut feelings can be great decision points, and this area is based almost entirely on your gut. A school’s social environment is almost as important as #1 up there, although at most schools, the classes are big enough that you can find friends and like-minded people practically without trying.

4. A great supporting cast. How nice has a school’s administrative staff been to you throughout your application process? That is indicative of how they’ll likely be when you’re a student there, and the quality and helpfulness of the administrative staff can most definitely make or break your quality of life as a medical student. Some schools can make you feel like a rock star all of the time, and some can make you feel totally alone. Don’t disregard this one.

5. Financial support and knowledge. Medical school is stressful enough on its own without having to worry about money. Throw financial issues into the mix, and you can get mighty distracted. A school that gives a lot of money to its students is one that has a supportive and active alumni and community and one that clearly finds it important that its medical students are able to focus on learning medicine. A school that has staff who know what they’re doing and can explain to you in clear terms what you need to sign/pay/do/read is absolutely priceless (especially if you score a full ride!).

6. Everything else. Student mentorship, shadowing and research opportunities, enthusiasm of faculty in working with students, daily routines, curriculum formats, number and breadth of extracurricular groups and intramural sports teams (if that’s your thing), format of patient records in the teaching hospital(s), and even match lists (so long as you have some idea of what fields interest you) go here at the end. They are all important factors to consider, but to me, they pale in comparison to those above. They are extremely flexible and largely dependent on how you thrive upon, or cope with, them, and they should not make or break your decision in general.

What not to look for in a medical school:

1. Board Scores. I’m probably going to get reamed by some for saying it, but this really shouldn’t be taken into account when you’re deciding between schools. There are so many confounding factors that go into a school’s average board performance, and overall it’s a poor judge of academic quality in my opinion. If you’re a genius, you’re probably going to do very well on the boards no matter what school you attend, and a few extra points in a school’s average board score doesn't come anywhere close to making up for other shortcomings it may have. If you’re not so good at standardized exams, there are far better ways of determining what sort of professional success you’re going to have other than a given school’s average board score, and going to a school with very high reputed average board scores doesn’t in any way guarantee you a very high board score.

2. US News ranking. Seriously? It’s a magazine just trying to sell issues like everybody else. In 20 years, none of your patients are going to come to your clinic on the basis of your medical school’s #11 ranking in the April 2004 issue of US News and World Report. They are going to come to your clinic because you have a medical degree, you are an expert in your specialty, you are comforting, and you don’t kill your patients. If you are lacking any of these things, a poor US News showing from 20 years prior is the least of your worries.

3. Hottest potential suitors/faculty/patient population. You don’t even have time for that anyway. Professionalism, people.

4. How many derm/plastics/rad-onc residencies the Class of 2006 matched into. These numbers tend to vary widely from year to year and are largely based on whether anyone was even interested on an individual level in these fields in a given year. If you think this is an important thing to look at, you need to reconsider your priorities.

On Graduate School and the Practice of Science

Ben Ferguson -- Graduate school seems to be fascinating to people who are not in graduate school. More fascinating, say, than the IT industry is to people who are not in the IT industry, or the janitorial profession to people who are not janitors, or even the medical profession to people who are not medical professionals. I say this not because I enjoy exaggerating my chosen profession’s level of interestingness, but because I always seem to get the same questions about it in passing conversations and with people I’m meeting for the first time. The most common seem to be, in this order: 1. “When will you be done?” 2. “What do you … actually do?” often followed up with “Huh?” and/or blank stares; and 3. “What on Earth is wrong with you?”

Honestly, it’s tough, for me at least, to answer these questions over and over and over again without boring my counterpart (or myself) into a deep sleep, and I think one reason that many of these questions even come up is because people have a general lack of understanding of what grad school is and what grad students do with all of their time. To be sure, almost the whole of graduate school, as I have said before, is transferring liquids between their receptacles and occasionally analyzing those liquids in different ways. Much of the rest is reading about other scientists’ experiences with their own successful liquid transfers, trying not to fall asleep, and trying not to fall asleep while reading about other scientists’ experiences with liquid transfers. Despite all indications to the contrary, the reading part has some utility.

Today, in a seminar class I’m taking, I realized that the practice of science -- graduate school included -- really is a lot different from most professions in a number of ways. Perhaps the biggest fundamental difference is that, in science, one is expected to know a number of different things -- pathways, techniques, etc. -- that rarely ever come up in one’s specific focus or area of expertise. For example, in this seminar class, we students discuss assigned papers by going through the figures and explaining them as if we have some clue about what the researchers did to generate the data within. None of us have ever actually done experiments analyzing facial phenotypes in embryonic knockouts, and none of us probably ever will in the course of our career, but we’re still loosely familiar with the concepts and rationale underlying the experiment (and even more loosely familiar with how to interpret the data). None of us have ever done wound healing assays, or mass spectrometry, or protein crystallization, or in vivo metastasis modeling, but we are expected to know what they’re all about. Through reading about them and about how others design and interpret experiments, we, then, are expected to be able to add these options to our own arsenals in case such techniques present themselves as useful methods for answering unique questions that come up in our future work.

For the most part, medicine isn’t like that. IT work isn’t like that. Janitorial work isn’t like that, and most other jobs aren’t like that. In most other fields, including medicine, you are trained broadly but then focus on a specific aspect, however large or small, of that field.

In medicine, you practice surgery, or dermatology, or pathology. Yes, in the course of your training, you’ve seen psychiatry and you might have even placed a central line or two. No radiologist though, for example, would be expected to perform trauma surgery at the drop of a hat (or even after a short amount of training), nor would any orthopedic surgeon be expected to treat schizophrenia. Reading about it in papers certainly wouldn’t cut it for these things. (This is why we specialize in the first place, no?)

In science, though, most everyone knows what siRNA does. Everyone knows what a Western blot is and how to interpret its information. Everyone has at least heard of flow cytometry, C. elegans, confocal microscopy, G proteins, and knockout mice, and would be able to become relative experts in these methods and topics within a couple of days (say, for the purposes of writing a last-minute grant). (Perhaps that’s why science, at its most basic level, is easier than medicine. Literally anyone can learn it and then go do it.) In order to be a successful scientist, you absolutely must have at once this breadth of loose knowledge alongside your hardcore, focused obsessions, or else you risk not knowing at all what others are talking about. You must also be able to interpret these data and methods and experimental rationales in the context of your own work, or else you risk not taking full advantage of what’s available to you as an experimentalist. There are only so many proteins to assay using Western blotting (and only so many conditions under which to collect the proteins), and it’s important for any scientist to stay up to date with information not only in one’s own field, but -- dare I say -- in all of science.

Medicine? IT? Janitors? Important for those too, yes, but not so much.

Discrimination in Science and Medicine

Ben Ferguson -- As a disclaimer, I debated for a long time about whether to even write this post. To be sure, it’s a controversial issue. I’m presenting one side of the story as someone who’s been more affected by this environment than I’d guess anyone who originally meant well in instituting such opportunities ever intended. The opportunities are enormously useful for their beneficiaries, and in general they have revolutionized the societal makeup of those practicing science and medicine. It’s a good thing, a very good thing, but in my opinion, it shouldn’t exclusively employ exclusivity as the means to its end. I’m not looking for sympathy; I’m not looking to complain; I’m merely describing a slightly disturbing trend I’ve noticed that has emerged as a byproduct of the current system.

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Here are two sets of criteria for applying for travel grants and awards from the three most recent conferences I’ve looked into attending:

“The conference will award two (2) travel grants to graduate students/postdoctoral fellows who are underrepresented minorities/women and one (1) travel grant awarded to a junior faculty at the level of instructor or assistant professor within the first three (3) years of their initial appointment, also an underrepresented minority/woman.”

“Every year, approximately ten diversity travel awards are given out to conference attendees. We strongly encourage students to apply for this $500 award that covers registration and travel expenses. Consideration is given consistent with the NIH guidelines for minority recruitment.”

(For the record, the other conference, upon my inquiry as to whether travel grants are available to graduate students, said, “We don’t have any.” Blatant discrimination against graduate students, I tell you.)

In all seriousness, as a white male in both science and medicine, this is one of the most frustrating things I have come across, and I come across it pretty much all of the time, or at least any time I’m looking into such things. (For what it’s worth, my dad’s a doctor, so clearly that’s how I got to where I am today, right? Certainly, then, you wouldn’t want me to be participating in these programs and attending these conferences...I’m much too privileged for these sorts of thing after all. As a matter of fact, I pay cash for all associated travel costs -- that is, if my daddy doesn’t for me.)

In college, in order to gain more research experience, make some money, and boost my then-developing (and crappy) application to medical school, I looked into a lot of summer research programs in my college’s town and also all over the country. What did I find? Dozens of opportunities, great, fantastic opportunities, all for minority and women, and minority women, students. Some of them wouldn’t even accept applications from non-minorities or men. Most of them strongly suggested that white males needn’t even bother applying, some practically coming right out and saying as much. It was, in a word, frustrating.

And it’s been the same story ever since. I’m now reminded of my “struggles” with my recent interest in attending these conferences using their support, which -- I can take a hint -- doesn’t exist for people that happen to have white-skinned penises.

Google “summer research program.” I dare you. Programs that don’t at least make a passing mention to race or gender or some other measure of underrepresentedness in their small print are few and far between.

Come on, society. We’re all graduate and professional students here, and those that are not are aspiring to be in such a position. We’ve all “made it” to a certain extent, and it’s equally up to us as individuals how far we can take our successes and turn them into lifelong careers. Do we really need to continue to exclude people who are “privileged” based on the color of their skin? We’re all making the same paltry stipends; we’re all dead tired and doing -- for lack of a better word -- bitchwork; we’re all throwing ourselves into our projects, much of the time only to experience failure after failure; and -- we’re all the same, pursuing the same things.

All I want to be able to fricking do is fricking apply to get some fricking funds to attend a fricking conference, people.