I reflect often on my good luck in life. A big struggle arose when daughter Amber, who aspired to get into medical school was not accepted two years running despite excellent grades, great MCAT’s, and an upbringing that found her more knowledgeable than most about what being a doctor actually meant. I think I believed my luck would be passed through to her. I did not have all her advantages and did get in, albeit as an “alternate.” I did not make the first draft of entering students in 1974 and knowing that most applicants were at least on paper, good candidates, I took it then as now as something of a lottery. And I had good luck.
Of interest, the odds of getting into medical school in 1974 was 35.5% ie roughly one in three found a spot. Being an alternate does not look so bad with that lens. Also of interest, in 2022, the rate was 43.7% despite the fact that the number of school positions has not kept up with population growth.
I am growing out of date with modern doctoring—the precedents and complexity of care add to the realistic problem of, “if you don’t use it, you use it.” That has always been the case for me. Looking at my grandchildren and their peers, it is an alien world, contemplating the work of a high school and college student who aspires to enter medical school. I believe the hard work is foundational and plenty of people (again, Amber) who demonstrate that do not get in. I think that given the sheer numbers of slots vs number of applicants, there is the case for serendipity and luck to influence the selection committee’s choice especially when you add the now required “extras” ie the things that make you a good candidate besides a 4.9 GPA.…
Amber believes that she did not interview well. She was brutally honest: when asked, “Where do you see yourself in ten years?” Her reply, “I will be working part time and raising a child” was not what the interviewer wanted to hear. They wanted commitment, not honesty. I was floored that one of the interviewers asked her casually, two years running, “OK, you are Hiliary and you can make a difference, what is your plan for healthcare.?” What a question to ask a recent college grad—and once more, what a loaded question: Hillary, by first name, is he a fan or not? If I am not honest, what does he want to hear? Do I have a clue what Hillary or I think should be the over-arching plan for healthcare?
I struggle with the question now despite the fact that I worked for a health care system that prided itself on, “transforming healthcare……”
I lucked out when I got the 1974 version of that question: “What do you think of socialized medicine.” My response, on the fly? “Well, I was raised on socialized medicine and it worked out pretty well for me.” Now that got someone’s attention! When asked what circumstances did I grow up in that led to that answer, I responded, “I was raised in a military family and if the Naval Medical Corps is not socialized medicine, I don’t know what is….” I think I got a good mark on that one.
Before that question, there was the process of applying. Years later, when showing Amber a range of college options after High School, we went to my alma mater at Santa Cruz. As she got the tour with peers, I ambled along the paths under redwood trees and paused for the doe and her fawn as I neared the registrar’s office. I asked about out of state tuition and identified myself as an alumnus. When asked what I did for a living, I let them know I was a doctor. The office went silent. “You graduated in 1974 and got into medical school?” I was a bit surprised by this response as I have known plenty of Santa Cruz alumni to have become doctors. I was and am proud of the academic credentials that are UCSC as well as the quality of the doctors who started there.
But I know why the question was asked. UCSC in 1974 was a Pass-Fail school and so when applying to medical schools, I had no GPA to advertise. I did have MCAT scores and GRE scores that told them I was smart and knew how to study. It remained a barrier and as a consequence, four of the six schools I applied to, the smaller of the group all sent rejection letters when the checks were in the mail to set up interviews. Applications cost $50-$100 dollars back then (that is 1974 dollars--a month's rent was about $100). I applied to six schools on an austerity plan. I did get interviews at the two largest schools I applied to: USC and UCLA. I believe they had selection committees that could take some time to read my class by class transcripts which notably, glowed but would have been hard to render into a simple grade. I had petitioned to take Biochemistry for a grade and received a B plus but if you read the transcripts, you would have thought I was ready to be accepted into a graduate program.
My interviews were mixed. I knew USC was a lost cause when a fervent resident asked me what the difference between a generalist and a Family Practitioner was, and I responded, “well, functionality they are equivalent.” I had not done my homework on the new world of advocating for a specialty focused on family medicine. The UCLA interview would be where serendipity worked for me.
As a third year undergraduate, I developed an interest in neurobiology and had worked in a world class researcher’s lab at Santa Cruz. My interview was at the Brain Institute and was conducted by a researcher there who worked with crustacean nervous systems, just as at Santa Cruz. That was luck. My knowledge with respect to his research made me interesting. He had a Latin name and his accent told me English was a second language. I asked about his background and it turned out he grew up in Uruguay. I proceeded to tell him of my life in Rio as a child. He liked me. That was nice, but he was not an MD and it was unclear what his recommendation would do for me. I did not get an acceptance to UCLA by the time I graduated from college.
I made a psychological adjustment that June and felt just fine about it. My world was opening up. My old girlfriend had decided to travel through Europe that summer after graduation and I never got a passport. I bunked in Felton, a small town in the redwoods East of Santa Cruz and worked on my neurobiology thesis—sort of—slowly—as I was infatuated with a very interesting woman who would become quite the biochemist. The summer romance blossomed and I welcomed the notion of finding a job, enjoying a college community, and essentially having a year off. I would need money though……and I would apply to medical school the next year.
I applied for jobs. The most likely prospect was working for Animal Services as a county employee. My main job was likely to be euthanizing animals. I had some experience with this in the lab and had hardened myself to it but………could I really do that for a living? The job interview awaited when I called my high school friend, Bruce, to see how things were doing in my home town. He was pleased to hear from me and this was conveyed with some urgency. My mother was on vacation, Bruce was watching over her home (my permanent address), and I had a letter from UCLA that had come that week and until my call, he had no idea where I was. He opened the letter and it was my acceptance letter to UCLA class of 1978. I had four days to get my $100 deposit in to confirm a place in the class.
I needed a little moment to process but there was really no question. I wrote the check and mailed it that day. Now I had to celebrate and readjust my projected upcoming months, not to mention years.
Like most doctors, I entered medical school not really having a clue what it was going to be like, being a doctor. What was clear in the first two years of academic study was that the first draft students were uniformly crisper and quicker than I was. I struggled with the feedback of getting grades for the first time since High School (except for the B plus, of course, in biochemistry). I became comfortable with being in the middle of the pack academically. On the other hand, one the clinical years came, my life changed. I did like medical work with patients and my future began to look like a mission. And in the end game, my last year and half of that work, I met and married Kernie. She changed my life!
And that made getting into medical school a blessing indeed.
I do wrestle with the question, “what if you had not gotten in?” I am happy to say, I will never know. I am pretty sure I would not have found a career working in the Santa Cruz Animal Control office.
Of interest, while playing tennis one weekend my second year at UCLA, I spied the Uruguayan researcher playing on the court next to me. I had interviewed in a suit with a mustache and relatively short hair; I now had my RAM beard and longish hair. As I was packing up at the end of the sets, he came over, addressed me by name, and asked how I was doing in my second year. While I marveled at his memory, I also can’t thank him enough for seeing something in me to be so memorable. He changed the course and opportunities in my life.
Comments