Pre-Med Newsletter Issue 9 - Georgia College & State University

Premed Newsletter
A Service for Premedical Students
Georgia College & State University
Issue No. 9 25 August 2009
Dr. Ken Saladin, Professor of Biology and Premedical Advisor
Ken.Saladin@gcsu.edu, Ph. 478-445-0816, GCSU Box 81, Milledgeville, GA 31061
Reboot!
“What is a living human being? A collection of many body parts and
systems that interrelate in such an elegant and powerful way
that life is clearly more than the sum of its parts.
Perhaps this insight has its fullest power to a
person who has dissected a human body.”
—Albert Howard Carter III,
First Cut: A Season in the Human Anatomy Lab
Welcome back for another year of intellectual stimulation at GCSU—another year closer to
your goal. Those of you who were here last year know that this Premed Newsletter was initiated
last fall as a spinoff from my project, the Premedical Mentorship. While the mentorship itself is
limited to a small group of my top-GPA advisees, I wanted other premedical students,
regardless of major or advisor, to get some benefits from it as well. Hence this newsletter was
created as a means for wider dissemination of information and topics originating in the
mentorship. Last fall, I issued a flurry of eight editions of the newsletter, sometimes at intervals
of only a week or so, but then in the spring semester I had a much heavier teaching schedule
and didn’t get any newsletters out at all. So this is a reboot. I hope to get several of these
newsletters out this semester.
Meeting Announcements
The Premed Club will meet Wednesday, September 2, at 12:30 in Room 313 Herty. All
premeds are encouraged to attend and to get involved. The officers are considering the benefits
of making the Premed Club a formal registered student organization (RSO), as well as
discussing activities for this year. Your input will be helpful.
The Medical College of Georgia will be visiting GCSU on Wednesday, September 23,
12:30 to 1:30 in Room 249 Herty. Representatives from the medical school, dental school, and
allied health programs are coming to recruit applicants and answer your questions about
professional school.
Would You Like To Talk To a Medical Student About Med School?
Aaron Adams, a 2009 GCSU graduate, is now in the Mercer Medical School and has
generously offered to answer questions you may have about medical school. He invites current
GCSU premeds to write to him at adams_wa@med.mercer.edu. Please bear in mind how
incredibly pressed for time medical students typically are and don’t beseige him with excessive
or frivolous e-mails, but for judicious and substantive questions this is an excellent opportunity
to get some inside insights from one of our own who has “made it.”
This is very kind of you, Aaron, and a good example for other GCSU students who make it in
and are willing to extend a helping hand to those coming along behind. Thank you!
Gain Some, Lose Some—Members of the Premedical Mentorship

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We’ve lost one mentorship member this year, as Megan Culligan has transferred to Valdosta
State University in order to spend the year with her family before their planned move to
Chicago next year. We’ll miss Megan. Invitations were extended to, and accepted by, two new
members at the start of spring semester and one new member this semester—Dupe Babalola,
Christin Sams, and Jared White. Current members are therefore:
Dupe Babalola
Christie Hall
Krystal Meadows
Christin Sams
Catlyn Thigpen
Jared White
Jenny White
Melanie Wooten
Premed Club Tours “Bodies—The Exhibition”
Just to catch up with a little old news since I didn’t issue any newsletters spring semester:
Twenty-six Premed Club members and others traveled on February 28 to the Premier
Exhibition Center at Atlantic Station, Atlanta to see “Bodies—The Exhibition.” This is a
display of dissected human bodies preserved by the process of plastination. By freeze-drying an
organ or an entire body and replacing all the water with plastic resin (silicone, polyester, or
epoxy), this technique remarkably preserves the size, shape, color, and even microscopic
structure of the original tissues almost indefinitely. The results are dry, lightweight, lifelike
specimens that can be easily handled. Plastination is now used on a wide variety of biological
specimens, but none so dramatic or fascinating to the public as the human body.
[photo deleted because it made document too big to be e-mailable]
Plastinated arteries of the head, from Gunther von
Hagens, “Body Worlds”.
Gunther von Hagens, the inventor of plastination, creates a similar show, “Body Worlds,”
that tours major cities of the world. It is currently showing in San Diego, Buffalo, London,
Berlin, Augsburg, and Haifa. “Bodies—The Exhibition” originates from China and is still
showing in Atlanta, as well as Bloomington MN; Ledyard CT; Las Vegas; New York; and
beyond our borders in Quebec City, Cologne, and Brno.
The specimens I found most striking and memorable were a uterus with the largest fibroids
I’ve ever seen, and various specimens that reveal the tremendous density of blood vessels in the
tissues, far beyond, of course, the named vessels we teach in anatomy. The image above, a good
example of this, is from the catalog of the von Hagens exhibition.
What struck me less favorably about “Bodies—The Exhibition,” however, is that it seemed
to be put together somewhat carelessly. The dissections weren’t as clean (they were a bit more
ragged in several places) than I’ve seen elsewhere. Half of one exhibit room, and isolated
display cases in some of the other rooms, were without electrical power, leaving specimens in
the dark and barely visible; I was tempted to ask for a refund of a commensurate percentage of
my admission price. I also found about a dozen anatomical features misidentified—misnamed
muscles, labels in the wrong place, and so forth. In short, I was not entirely impressed with the
professionalism of the exhibition. It looked like a cheaper, more hastily created imitation of the
von Hagens exhibit, slapped together to capitalize on the craze. The long lines of people
waiting to get in at $26 a pop, day after day, month after month, certainly attests to the money
to be made from the exhibition of human bodies.
But despite its flaws, “Bodies—The Exhibition” is fascinating nonetheless, and for those
who have never seen cadaver dissections or plastinated specimens, I recommend a visit while
it’s still in Atlanta. It will deepen your sense of awe toward the human body. It is scheduled to
run through January 3. Adult tickets are $25.92. For further information, go here:

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http://www.atlanticstation.com/bodies-the-exhibition.php
For interesting information about these exhibits, including controversy and ethical
questions over how the Chinese bodies were obtained, see also the Wikipedia articles: “Bodies
the Exhibition” and “Body Worlds”.
Thanks especially to Krystal Meadows for coordinating the Premed Club trip.
In the Mentorship—Spring 2009
Since I didn’t issue any newsletters last spring, let me tell you some of the highlights of that
semester’s Premed Mentorship.
The mentorship always involves the reading and discussion of one book each semester. Fall
semester we read Albert Carter’s First Cut, about the lives of first-year medical students at
Emory University, especially their experience and evolving attitudes toward the human
cadavers in gross anatomy. Spring semester we read Jerome Groopman’s How Doctors Think,
about doctor-patient relationships and communication, and on the cognitive processes (and
errors) of diagnostic medicine. (See the next article regarding this semester’s reading.) We also
had a pizza and movie party at my home to watch Michael Moore’s film, “Sicko,” setting a
stage for this year’s discussion of health-care policy and reform.
The Groopman book, among other sources, often led us to tangential but fruitful
discussions of many topics. Among other things spring semester, we looked at (sometimes with
PowerPoint slideshows) the history of surgical anesthesia, the medical art of Rembrandt,
arthroscopic knee surgery, Stryker saws, trepanation, cremation, ectopic (tubal and abdominal)
pregnancy, and communicating more professionally even in casual conversation and e-mails.
In looking at the American health-care system, its advantages, and its problems, we are also
comparing health care in other countries. Dr. Kwan Christenson gave a slide presentation on
health care in Thailand, where she earned her M.D. and practiced medicine before moving to
the United States. Dupe Babalola gave a fascinating presentation on the terrible violence
against suspected “witch children” in her country, Nigeria (for films on this, direct the Google
Videos search engine to “Witch Children Nigeria”). I showed slides from my observations of
public health in the Dominican Republic in the late 1970s. In Maymester, Megan Culligan
and Melanie Wooten went with me to Ecuador, where we visited a hospital in the town of
Puerto Ayora in the Galápagos Islands. We were very fortunate to get a good interview with the
hospital director (with Megan serving as our translator) and a tour of the hospital.
As always, the mentorship places an emphasis on peer-evaluation and MCAT preparation,
and we had several spring semester writing exercises—practice AMCAS admission essays and
impromptu MCAT-style essays. Anonymous copies of the essays are distributed to everyone in
the group, with everyone providing anonymous, candid critiques of each the other members’
writing. Mentees have said they find this very helpful, not only for the constructive criticism
received from their peers, but also because in evaluating someone else’s writing, they become
more aware of ways in which their own writing could have been better. As I read their latest
essays, I felt there had been a lot of improvement since our first efforts fall semester. These
students are writing much more sharply focused, tightly organized, effective MCAT essays than
they did at first, and they are drawing ever closer to having an excellent admission essay ready
by the time they file their AMCAS applications—which, for most, comes at the end of this year
of mentoring. Dr. Rosalie Richards says she hopes to extend MCAT essay practice to other
premedical students, and we expect to meet soon to exchange some essay topics for that
purpose. This might be a very beneficial activity for the Premed Club this year.
We’ve also had practice Verbal Reasoning and Life Science MCAT exams. Students have
found these to be sobering experiences—showing just how unready we are for the real MCAT

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as yet, and giving mentees some feeling for the nature of the MCATs. This year, as more
students in the group take organic chemistry and physics, we expect to have more complete
practice MCATs including at least one full-length practice exam.
In the Mentorship—Fall 2009
We’ve had just one meeting so far this semester (August 20), so there’s relatively little to report
as yet. Each member described the clinical experiences she or he had over the summer. I was
very impressed! These were very enriching experiences, not only in patient contact in clinical
settings but also in networking—building relationships with medical professionals who may be
good sources of recommendation letters to medical school later. These students are doing
exactly what is needed to strengthen their likelihood of medical school admission, and to
explore and reaffirm the sincerity of their interest in the medical profession. I found it
particularly impressive that several or most of the mentees earned such a level of trust by their
physician-mentors that they were allowed to perform some hands-on clinical procedures with
patients and not merely stand around watching other people do things.
We’ll place increasing emphasis on MCAT preparation this year, since seven of the eight
members are now juniors and will be taking the MCAT sometime in 2010. We discussed MCAT
preparation strategies including the pros and cons of the Kaplan MCAT course. Krystal
obtained some information on the Kaplan course that I’m sure she will happily pass on to the
Premed Club.
Our reading this semester is Understanding Health Policy by Thomas Bodenheimer and
Kevin Grumbach. This is a slim textbook for medical, nursing, P.A., and other health-science
students that covers issues of accessibility, affordability, and administration of U.S. health care,
health insurance, Medicare/Medicaid, and related matters. Thus, our reading over the first three
semesters of mentorship is progressing from the medical student to the individual physician and
now to the broader issues of the whole U.S. health-care system. Previous recruiters from
Mercer and MCG have said that they like to see applicants show some familiarity with the
national health-care system. This reading, a study of the Obama Administration’s health-care
reform plan, and attention to the news revolving around the Obama plan should give these
students a pretty good insight to take with them into their admission interviews, in case the
subject comes up there.
Our study of health care in other countries is soon to be further widened by a presentation
from my new premedical advisee, Ahmed al-Bayati, who comes to GCSU from Iraq and
whose parents both practice medicine in Baghdad. In my first meeting with Ahmed, I was
particularly impressed with his account of the extreme difficulty and danger facing physicians
in Iraq at this time. I’m pleased that he has accepted my invitation to tell his story to the
mentorship.
What Would Osler Do?—Recommended Reading
Probably anyone with Emergency Room experience has encountered “frequent fliers,” patients
who may or may not have personal physicians or health insurance, and who come in time after
time for various complaints. Some are homeless, mentally ill, have substance abuse problems,
and may be combative or abusive toward E.R. staff. Dealing effectively and compassionately
with such patients may be among a health-care worker’s greatest communication challenges. In
the mentorship, we’re reading an article about this from one of this summer’s issues of the New
England Journal of Medicine—Michael Kahn, “What would Osler do?” NEJM 361:442–443
(30 July 2009). Kahn describes an exercise that he calls “Difficult Patient Rounds” for thirdyear
medical students on their clerkship rotations. He shows that compassionate
communication even with the most difficult and least likeable patients can open the door to a

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more effective physician–patient therapeutic relationship. Interested premeds may get a copy of
this article from my office (236 Herty).
So Who Was Osler?
Perhaps Kahn’s title has led you to wonder who Osler was and why Kahn invoked Osler’s
name. Osler is a name that any literate medical student should know, and any premed would be
at some advantage to know—perhaps on a level with a history student knowing well the names
of Jefferson and Madison.
[Osler portrait deleted]
Sir William Osler (1849–1919) was in many respects a key founder of modern American medical
education. Born in Ontario, Osler first aspired to enter the Anglican ministry, but in college he
found medicine more interesting. Trained in Toronto and Europe, he returned to a professorship at
McGill University in Montreal; then became Chair of Clinical Medicine at the University of
Pennsylvania; and finally held appointments both at Oxford University in England and as the first
chief of staff at Johns Hopkins Hospital in Baltimore and one of the first professors of medicine
at Johns Hopkins University.
Osler invented the concept of medical residency, which then meant that young M.D.s lived in
the hospital, leading an almost monastic life isolated from the outside world, for as long as seven
or eight years. He also was the founder of clinical clerkships—training advanced medical students
through rounds in the patient wards. Osler insisted that medical students and residents learn not
merely from books, but from hands-on compassionate care of and communication with patients.
He insisted that medical students get bedside experience early in their training, and placed greater
emphasis on this than on didactic sessions in the lecture hall. By their third year, Osler had
medical students taking patient histories and performing physical examinations and lab tests.
Osler had a well-known sense of humor and prankster spirit that sometimes led to his being
taken the wrong way. Arguing that the most important, vitalizing work in the world is done by
people from 25 to 40 years old, he quipped “It’s all downhill from there” and satirically
envisioned a college in which professors retired at the age of 67 and were “peacefully
extinguished” with chloroform a year later. The popular press took him a little too seriously and
with undue alarm at his whimsical suggestion of euthanizing elderly medical professors. Osler
died at 70 in the Spanish influenza epidemic of 1919.
Students hoping for a medical school admissions interview could do worse than having a
little awareness of medical history, especially such luminaries as Sir William Osler. One can do
no better in capturing Osler’s spirit and teaching philosophy than to offer a few aphoristic quotes
from him:

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I desire no other epitaph…than the statement that I taught
medical students in the wards, as I regard this as by far the
most useful and important work I have been called upon to
do.
He who studies medicine without books sails an uncharted
sea, but he who studies medicine without patients does not
go to sea at all.
If you listen carefully to the patient they will tell you the
diagnosis.
Source: Wikipedia, “William Osler”
The Hippocratic Oath
Graduating medical students traditionally swear an oath of professional ethics just before the
M.D. degree is conferred upon them. One popular misconception is that they swear the
Hippocratic Oath. Another is that the oath begins with or contains the maxim “First, do no
harm” (primum non nocere, more literally translated “First, not to harm”). Neither is true.
Primum non nocere has been authoritatively traced only as far back as the 1600s, and is
primarily a maxim for emergency medical care—apprising the physician that it is sometimes
better to do nothing than to undertake a procedure that could do more harm than good.
The Hippocratic Oath is commonly thought to have been written or spoken by Hippocrates
(ca. 460–370 BCE), the father of western medicine, or by one of his students expressing his
teacher’s ideals. Although of historic interest, it would seem rather archaic, irrelevant, even
bizarre, for medical students today to recite the classic oath. Many Christian, Muslim, and
Jewish physicians today even regard it as blasphemous in its invocation of the pagan deities. In
one of several English translations from the Greek, 1 the classic oath reads:
I swear by Apollo the Physician and Asclepius and Hygieia and
Panaceia and all the gods and goddesses, making them my witnesses,
that I will fulfill according to my ability and judgment this oath and this
covenant:
To hold him who has taught me this art as equal to my parents and to
live my life in partnership with him, and if he is in need of money to
give him a share of mine, and to regard his offspring as equal to my
brothers in male lineage and to teach them this art - if they desire to
learn it - without fee and covenant; to give a share of precepts and
oral instruction and all the other learning to my sons and to the sons
of him who has instructed me and to pupils who have signed the
covenant and have taken an oath according to the medical law, but no
one else.
I will apply dietetic measures for the benefit of the sick according to
my ability and judgment; I will keep them from harm and injustice.
I will neither give a deadly drug to anybody who asks for it, nor will I
make a suggestion to this effect. Similarly I will not give to a woman
an abortive remedy. In purity and holiness I will guard my life and my
art.
I will not use the knife, not even on sufferers from stone, but will
withdraw in favor of such men as are engaged in this work.

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Whatever houses I may visit, I will come for the benefit of the sick,
remaining free of all intentional injustice, of all mischief and in
particular of sexual relations with both female and male persons, be
they free or slaves.
What I may see or hear in the course of the treatment or even outside
of the treatment in regard to the life of men, which on no account one
must spread abroad, I will keep to myself, holding such things
shameful to be spoken about.
If I fulfil this oath and do not violate it, may it be granted to me to
enjoy life and art, being honored with fame among all men for all time
to come; if I transgress it and swear falsely, may the opposite of all
this be my lot.
Among other outmoded provisions in the classic oath, paragraph 2 is a reference to the ancient
method of medical education, through mentoring. Paragraph 5 (“I will not use the knife…”)
alludes to the fact that ancient physicians considered surgery beneath their dignity, properly left
to lower-ranking “barber-surgeons.” “Stone” refers to kidney stones and their surgical removal
from the bladder.
However outmoded the exact words and provisions of the Hippocratic Oath may be today,
some of its precepts are not without merit. Moreover, it remains an admirable practice for all
time for soon-to-be-physicians to swear by a code of ethics and to regularly think about it in
relation to their professional practices. So most medical students in the U.S. do take an oath
before receiving the degree, but the oath varies from school to school. One of the most widely
used today is this one, now 45 years old, written by Dr. Louis Lasagna, Academic Dean of the
Tufts University School of Medicine. 2
I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in
whose steps I walk, and gladly share such knowledge as is mine with
those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are
required, avoiding those twin traps of overtreatment and therapeutic
nihilism.
I will remember that there is art to medicine as well as science, and
that warmth, sympathy, and understanding may outweigh the
surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my
colleagues when the skills of another are needed for a patient's
recovery.
I will respect the privacy of my patients, for their problems are not
disclosed to me that the world may know. Most especially must I tread
with care in matters of life and death. If it is given me to save a life,
all thanks. But it may also be within my power to take a life; this
awesome responsibility must be faced with great humbleness and
awareness of my own frailty. Above all, I must not play at God.

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I will remember that I do not treat a fever chart, a cancerous growth,
but a sick human being, whose illness may affect the person's family
and economic stability. My responsibility includes these related
problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to
cure.
I will remember that I remain a member of society, with special
obligations to all my fellow human beings, those sound of mind and
body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I
live and remembered with affection thereafter. May I always act so as
to preserve the finest traditions of my calling and may I long
experience the joy of healing those who seek my help.
1
Ludwig Edelstein, 1943. The Hippocratic Oath: Text, Translation, and Interpretation. Baltimore: Johns
Hopkins Press.
2
http://www.pbs.org/wgbh/nova/doctors/oath_modern.html
I Want to Be a Doctor Because…
Perhaps you plan to write on that point in your AMCAS essay. You might be asked to explain
your motive in an admission interview. Have you been thinking about what to say?
Next to “because I want to make buckets of money,” perhaps one of the most banal and
counterproductive things you could say is “because I want to help people.” An admissions
committee member reading your AMCAS essay might just roll her eyes and toss your paper
aside into the “another one of those” pile. An interviewer might well respond, “If you want to
help people, why not become a plumber?” In short, you need to have something more
substantive, more original, and less trite to say for yourself. As you can well imagine,
admissions committee members have read hundreds, if not thousands of essays and seen
countless clichés. How do you avoid writing in tedious clichés when, in fact, your motivation
probably is much the same as the motivation of thousands of applicants preceding you? Here’s
a source of useful advice:
http://www.bestpremed.com//essayedge/lesson2.htm#article
Alternative Careers in Medicine—Anesthesiologist Assistant
Interested in a health-care career? Hoping for a comfortable income? Apprehensive about the
long years and steep debt entailed in going through medical school and residency, or the long
hours a physician is away from his or her family and home? Here’s an option you might want to
consider—two years of education beyond your bachelor’s degree and you could be an
anesthesiologist assistant, where starting salaries as of 2006 ranged from $95,000 to $120,000,
and high-end salaries for those with experience were $160,000 to $180,000. 1
An anesthesiologist assistant (AA) is a physician assistant (PA) specializing in anesthesia.
AAs work under the supervision of anesthesiologists, usually in medical centers and pain
clinics. The duties of an AA are identical to those of a nurse–anesthetist. Prior to surgery, the
AA obtains the patient’s medical history and other relevant information, and performs such

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preparations as insertion of arterial and venous catheters. During surgery, the AA monitors and
adjusts the anesthetic, I.V. fluids, and cardiac and other drugs; monitors peripheral nerve
blockades; manages the patient’s airway; and performs cardiopulmonary resuscitation if
needed. After surgery, the AA provides recovery room care. An AA is not to be confused with
an anesthesia technician, who assists anesthesiologists, nurse–anesthetists, and AAs with the
equipment, supplies, and patient care.
To become an AA, one must earn a bachelor’s degree that includes the same prerequisites
as for medical school, then take a 24- to 28-month postgraduate AA course of study and pass a
certification exam. Currently there are five AA programs in the United States, two of which are
in Georgia: Emory University (Atlanta), South University (Savannah), Nova Southeastern
University (Davie, FL), Case Western Reserve University (Cleveland, OH), and the University
of Missouri (Kansas City). The American Academy of Anesthesiologist Assistants 2 lists the web
sites for those five programs and provides further information on AA careers.
1
American Medical Association Health Care Careers Directory, 2008–2009, www.ama-assn.org/
amal/pub/upload/mm/40/aa0809.pdf
2
www.anesthetist.org (“Facts about AAs” and “Education” links)
Back Issues
If you are new to the Premed Newsletter, you might be interested in some topics covered in last
year’s issues. Back issues are available upon request to me at ken.saladin@gcsu.edu.
Issue 1 (8/22/08)—Introduction to Premed Mentorship; introduction to the book First Cut–A Season in
the Human Anatomy Lab; the dropoff in premed numbers from freshman to junior year; Georgia’s doctor
shortage.
Issue 2 (8/29/08)—The medical art of Frank Netter; the Doris Moody biology honors scholarship;
admission statistics of Georgia’s medical schools; an online calculator for evaluating your own chances
at any U.S. medical school based on GPA, MCATs, and place of residence; the U.S. Medical Licensing
Examination; advice on whether to consider attending a Caribbean or Mexican medical college.
Issue 3 (9/5/08)—Report of activities in the mentorship; trends in female enrollment in medical school;
the medical history behind barber pole stripes; electives for premed biology majors; the ridiculous life of
a big-chain retail pharmacist; ratings of five offshore medical schools.
Issue 4 (9/12/08)—Report from the mentorship; the nature of the MCAT essays; the path to a career in
medicine—steps from high school to private practitioner.
Issue 5 (9/25/08)—Financing medical school–the Army Reserve Medical Corps; William Harvey,
pioneer physician–physiologist; scholarships for biomedical graduate study; an online source of medical
school advice and information.
Issue 6 (10/3/08)—Senior capstone opportunities in biology; report from the mentorship; a very short
(but funny) medical dictionary.
Issue 7 (10/15/08)—Updated admission statistics for Georgia’s medical schools; medical school letters
of recommendation; popular minors for premeds; alternative careers with a degree in biology; career
information in radiologic technology; the cycle of 4000-level biology course offerings; an impractical
guide to scientific units of measurement.
Issue 8 (11/07/08)—Mercer University visit to GCSU–advice on admissions; report from the
mentorship; links to autopsy videos; a certain cell phone myth; alternative spring break for premeds;
MCG’s “Resurrection Man” and medical grave-robbing in Georgia; expressing oneself professionally;
ethnic, gender, and other data on Georgia’s 2006–07 matriculating medical class; advice on medical
school admission interviews; study tips in undergraduate biomedical classes.