Pharmaceutical ads

So I wrote this short essay for a class recently.  It's on the effectiveness of a pharmaceutical ad for the antidepressant Pristiq:

       Pharmaceutical ads have been around as long as I can remember, which is the 90’s.  The reason is that in the 1980’s the FDA allowed drug manufacturers to begin advertising directly to consumers.  Prior to this, they were only allowed to advertise to healthcare professionals.  The drug ads we see on TV are called Direct-To-Consumer Pharmaceutical Advertising (DTCPA).  You should be familiar with these ads, as drug companies spend billions every year to advertise.  In fact, a study from 2004 showed that pharmaceutical companies spend twice as much on advertising as they do on research and development. [1]

        Since drug companies spend so much on advertising, these commercials are surely effective.  Two of the most important things in these commercials is the imagery and actors used.  We know that the information is obviously important, but more on that later.

The ad I would like to discuss (because it came up first on Google) is a commercial for Pristiq.  Pristiq is the brand name for the molecule called O-desmethylvenlafaxine.  It is an “antidepressant of the serotonin-norepinephrine reuptake inhibitor class developed and marketed by Wyeth (now part of Pfizer).” [2]

In the commercial, a lady is describing how depression affects her life, vaguely and with buzzwords of course.  She says that she has to “wind herself up” just to get going.  Meanwhile, the music is in the minor scale, and also depressing.  The lady looks and sounds unhappy, and so does the music.  You feel unhappy too now!  You can relate to the lady in the commercial, and are being affected as the advertisers intended.

Then, you are shown Pristiq.  Glorious glorious Pristiq!  It is even “proven to treat depression”. [3]  At the same time the scale the music is played in changes to major, more instruments are added, a nonspecific science looking clip showing neurotransmitter uptake is fed to your eyes.  And of course, our actress is now smiling.  She is happy, and you can be too!

The rest of the imagery in the commercial makes little sense to me.  The same lady is shown trying to sell some kind of vase to a couple?  Meanwhile we get to learn about all of the horrible, yes horrible side effects.  Such as the higher risk of suicide...  Anyway, the goal of the commercial is to get you to request this drug from your doctor if you experience symptoms of depression.  I find that the commercial is quite effective as it affects my moods with its imagery and audio cues.  The side effects dialogue, while important, is boring, and I obviously do not listen to it too intently.  Either way, if I was depressed, I would definitely be asking my doctor about Pristiq.

References

[1]  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2174966/

[2]  https://en.wikipedia.org/wiki/Pristiq

[3]  https://www.youtube.com/watch?v=uVNZ8ZBP5gY

Last Semester Before Med School

Figure 1:  American flag, because 'MURICA is the best.

I got my med school acceptance last Fall, and I have been in college since.  I'm in my fifth year, and I'm only taking 12 credits with a pass/fail course.  Three of the classes are in science and the fourth is a public speaking class.  (I really think public speaking is a totally sweet skill to have by the way.  Like most people I'm not too good at it, but I hope to get better!)

As of now there are only four weeks left until finals week, and everything is going pretty well.  I have a B or an A in all of my classes, and I only need two A's to have magna cum laude on my degree.  Other than that, I'm not too concerned with how strong I finish.  Three classes won't significantly affect my GPA.  Besides, I doubt the honors on my undergrad degree will matter a whole lot when I get the MD anyway.  I guess it could matter when applying to residencies though.

Other than that, I followed up with almost all of the medical schools that never got back to me, and I am currently looking for a place to live next year with other med students.  It's a pretty exciting time for me.  Five years ago I had brushed off the idea of medical school as unrealistic and far too difficult to get accepted to, but then I learned that not becoming a doctor would be a poorer alternative for me.  It has taken a lot of hard work, and a lot of time, but I'm about to start medical school.  I'm really happy that I got in, and I look forward to sharing my experiences in medical school and my future through this blog.  

Have a good day, and work hard!

References: Figure 1

How Much Does it Cost to Go to Med School? Answer: a $hit ton

Figure 1: The way Doge sees it.

tl;dr
You'll owe $409,239.01 after residency.  Paid off in ten years, you will have paid $565,144.12.

Let's assume that you have $50,000 in loans from undergrad, $12,500 for each year, at 6.8% interest. Because let's face it, your middle class family couldn't afford to pay for your college, but you were still too wealthy to get subsidized government loans.  We will also assume that you will defer to pay off any loans until you finish a four year residency.  Let's also assume that med school will cost $200,000 total at 6.8% interest, and again, you will defer to pay until after residency.

Table 1:  Loan amount at end of medical school.*  

(How student loans will own your ass.)

Undergrad:		Initial Loan @ 6.8%	Loan Amount by Residency	Accrued Interest	Months Deffered
	Semester 1	$6,250.00	$14,101.60	$7,851.60	144
	Semester 2	$6,250.00	$13,786.30	$7,536.30	140
	Semester 3	$6,250.00	$13,176.96	$6,926.96	132
	Semester 4	$6,250.00	$12,882.47	$6,632.47	128
	Semester 5	$6,250.00	$12,313.08	$6,063.08	120
	Semester 6	$6,250.00	$12,037.89	$5,787.89	116
	Semester 7	$6,250.00	$11,505.83	$5,255.83	108
	Semester 8	$6,250.00	$11,248.69	$4,998.69	104
	Undergrad Totals	Original Principal	Loan Amount by Residency	Accrued Interest
		$50,000.00	$101,052.82	$51,052.82
Med School:		Initial Loan @ 6.8%	Loan Amount by Residency	Accrued Interest	Months Deffered
	Semester 1	$25,000.00	$43,006.03	$18,006.03	96
	Semester 2	$25,000.00	$42,044.88	$17,044.88	92
	Semester 3	$25,000.00	$40,186.54	$15,186.54	84
	Semester 4	$25,000.00	$39,288.41	$14,288.41	80
	Semester 5	$25,000.00	$37,551.91	$12,551.91	72
	Semester 6	$25,000.00	$36,712.65	$11,712.65	68
	Semester 7	$25,000.00	$35,090.00	$10,090.00	60
	Semester 8	$25,000.00	$34,305.77	$9,305.77	56
	Med School Totals	Original Principal	Loan Amount by Residency	Accrued Interest
		$200,000.00	$308,186.19	$108,186.19
Total Debt at start of Residency:	$409,239.01

Okay, so that is a shit ton.  Let's see how much it will cost me in the end if I repay it in 10 years.

Table 2: **What you will have paid 10 
years after residency

Loan Balance:	$409,239.01
Loan Interest Rate:	6.8%
Loan Term:	10 years
Monthly Loan Payment:	$4,709.54
Number of Payments:	120
Cumulative Payments:	$565,144.12
Total Interest Paid:	$155,905.11

First off, none of these assumptions include the cost of living expenses. They only include the cost of the actual schooling.  Also, we aren't taking into account increasing tuition each year (which you just know will happen).  Another thing, the interest rate is unlikely to be 6.8% for all of your loans.  This is just an exercise to get an idea of the cost of becoming a doctor.  It will probably be quite a bit different from here, give or take $50,000-$100,000 or something.

*Loan amounts calculated here.
**Total paid calculated here.

You're Going to Get Rejected...A Lot

Figure 1: Your med school application. (Source 1)

My Application Stats

cGPA: 3.82
sGPA: 3.52
MCAT: 34 (12B 12P 10V)

Schools applied to: 18
Interview invites: 6
Interviews attended: 4
Acceptances: 2
Waitlists: 2
Rejections: 12

That's Not Very Encouraging...

First off, you can get into medical school, it's not impossible.  Now, I am extremely grateful to have gotten into medical school, but holy hell it is difficult.  But you guys all knew that from browsing the SDN forums (Don't listen to everything those forum users say).  I mean seriously SDN, not everyone that gets into med school will have a 36+ MCAT and 3.9 GPA.  Still, just look at this USNews article on the most applied to medical schools in the USA.

http://www.usnews.com/education/best-graduate-schools/the-short-list-grad-school/articles/2013/04/23/10-med-schools-that-receive-the-most-applications

The ten schools in that list received over 8,000 applications, with the top school getting 14,700 in 012-2013.  Most med schools have 120-250 spots, but even 8,000/250 is 32 people competing for one seat.  Just getting the interview invite means you're doing pretty good so far.

So, how did my application process go?  Well, I already gave you the numbers, so here's the timeline.  I applied and finished all of my secondaries by late July, early August.  I applied to all of the schools in my state, and many in neighboring states.  I got interview invitations here and there for each month from September to February.  After I received an acceptance in November, I cancelled a couple of interviews.  During all of this I received a few rejections and holds (which are basically rejections).  The rest silently rejected me (without even an email!).

Advise for You

First off, YOU CAN DO IT!  I know you can get into at least one medical school.  Yea yea yea, I know what I titled this post, but trust me!  If you have decent stats, ~30 MCAT ~3.6 GPA, you will eventually get in.

The best application advice I was given is to apply early, and to many schools.  You have to apply early, because these schools will get inundated with applicants.  Getting reviewed first doesn't mean you'll receive a response first, but it doesn't hurt.  The longer you wait to apply, the sooner interview spots and class seats will begin to get filled.

Why should you apply to a lot of schools?  Well, look at my stats.  I got rejected by 12 places!  My numbers were in their ranges, and most weren't public out of state schools.  Admittedly, some of my secondary essays probably sucked since I wrote ones for 18 schools.  Still, you cannot predict how the application process will go, and your best option is to hedge your bets.  A surgeon I know got into UPenn (Ivy League), but was rejected from Jefferson when he was applying.  Yeah, that makes no sense, and neither will most of your application process.

To close, the general rate of acceptance I have heard is 1 for every 3 interviews.  My experience kind of matched up with that.  I wish you the best of luck when you apply, and follow my advice to increase your chances.  Good luck!

References

1. https://commons.wikimedia.org/wiki/File:Rejected.jpg From Wikimedia commons under the creative commons license.

MCAT Strategy: One and Done

Figure 1: Jellyfish at the Baltimore Aquarium.  (*Pic unrelated)

tl;dr
Study some early on ~6 months before the exam.  Build up slowly, but exponentially, taking a diagnostic practice test early on, then one test a month.  The month before the exam, one practice test a week.  Two weeks before, one practice test every other day.  By this time you should be hitting 30's every time. You should be doing over 7-8 hours a day of actual studying the during the 6 weeks right before the exam.

You only want to take the MCAT once, and never again.  It is stressful, expensive, and a large time commitment to study for.  Fortunately for me, my strategy worked out okay.

I didn't think I would do well on the MCAT, but thankfully I got a 34 (12P 12B 10V).  This is simply a timeline of how my studying went down, materials I used, and how my strategy might work for you.

Timeline:

Winter before MCAT:

First, I bought some used copies of the Kaplan MCAT prep books.  (Not the ones you get at Barnes and Noble's.  I'm talking about the ones that come with their preparatory course.  Ebay has them.)

I began my review over winter break, and I started with the physics book since that's my strength.  While going through it, I began chemistry so that I wouldn't get bored with physics.  The spring semester started, and I cut back on how much I was studying.  By this time, I had finished Physics, and most of Chemistry.

Early Spring Semester:

This is when I realized that the textbooks alone, and AAMC's practice tests would not be enough. I enrolled in Kaplan's online access course thing for the MCAT.  I chose the online access because I wanted access to practice exams and questions.  A course instructor would only slow me down to the pace of other students, but you want to move faster than other students.

I scheduled my exam for late May, and I took a practice test.  I got a 24.

Mid Spring Semester:

Now, I dove into the biology review text, and at the same time I went back and studied physics and chemistry again.  I took a practice exam once a month during the semester.  I also went along with Kaplan's study schedule on the course thing I bought.

End of Spring Semester:

This is when things got serious.  My practice tests had reached upper 20's, so I needed to kick it into high gear.  School ended in early April for me, and so I had a little over 6 weeks to get good at science.  I finished the biology book in a few days, and started Ochem.  Funny thing about Ochem though, it's only about 25% of the life sciences section.  So I only studied about 3/4ths of the book because screw Ochem.

Before the Exam:

I studied every single day like a madman.  I had at least one day a week of relaxing though.  (Don't burn yourself out, but push your limits!)
Literally over 8 hours a day at this point.  There was a 2 day stretch where I did not go outside, and the weather was mid 70's.  It sucked.
I took a final practice test two days before the exam; 36.  The day before the exam I relaxed.

Protips:

Emulate test conditions as closely as possible.  That is, take the practice test on the computer, with earplugs, the same time limits, and the same amount of scratch paper.  (Google these things, I don't remember them =P)
Don't eat anything too exotic that might upset your stomach before the real test day.
Know how to get to the test site.  You DO NOT want to be lost the morning of the exam.  You'll be stressed enough as it is.
Bring some light snacks for during your test breaks.

Will this work for me?

I don't know.  All I know is that you have to do your best, realize it's not enough, and do better.  Here is the quote I had in the back of my head as I studied:

"Nothing in this world can take the place of persistence. Talent will not: nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not: the world is full of educated derelicts. Persistence and determination alone are omnipotent."

-Calvin Coolidge

------------------------------------------------------------------------------------------------------------
For more info on the MCAT, and how it is changing in 2015, check out the AAMC's official MCAT website:
https://www.aamc.org/students/applying/mcat/

------------------------------------------------------------------------------------------------------------

Next time: How many schools I applied to; the acceptances; and the many many rejections, holds, and wait lists.