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Psychiatry Personal Statement #5

A feeling of heat, tingling, and terror struck, and then there was nothing. Later, shapes, colors, and movement emerged but there was no sound. Then meaningless noise began to pierce through, with a human voice holding no more significance than a car horn. After another minute, sounds began to coalesce, voices and words could be sorted out but their meaning remained just out of reach. Finally, I started to comprehend the world around me again. I would remain confused, unable to speak, and physically uncoordinated for a while still. Shame, embarrassment, and anxiety at how the people around me would respond lasted far longer. Until my senior year of college, I had refractory epilepsy in clusters every three weeks or so. For twelve years. How could I help being fascinated with the human mind?

After college, I worked in psychiatry research for four years as I wavered between medical and graduate school. In the end, medicine won because I craved more human interaction and a broader education. Neurology at first seemed like a natural field for me to go into- I would be able to work with patients whose condition I had experienced myself. However, more exposure to neurology and psychiatry made me realize that psychiatry focuses more on the aspects of the mind that interest me most- high level cognitive dysfunction rather than global aphasia, conversion disorders rather than paralysis. Primary care also appeals to me because of the continuity of care and because it is “whole person” medicine. Psychiatry will allow me to have long-term relationships with my patients and it necessarily incorporates the biological, social, and psychological factors contributing to illness.

Another reason that psychiatry appeals to me is that I am interested in working with underserved populations and in cross-cultural communication. I have traveled extensively and I grew up in a struggling family surrounded by families that were far worse off than mine. Primary care is obviously necessary in these communities but there is also great need for psychiatrists, because mentally ill patients are likely to have lower socio-economic status and because the stress of living poor makes people more likely to be mentally ill. Through my school’s Primary Care Track, I have worked for two years in the adolescent clinic that serves a disadvantaged population and as a National Health Service Corps scholar, my first job will be in an underserved area. I am a returned Peace Corps volunteer (Morocco) and have worked with the Crow, Blackfeet, Haida, and Tlingit tribes at home. I enjoy learning new languages and appreciate the degree of communication that can occur without a common tongue. Immersion in a new culture exposes the underlying rules and assumptions of familiar society- it forces both exploration and introspection. While any field of medicine requires some awareness of patients’ background and social habits, psychiatry is the only field that actively examines these areas.

My experience in clinical rotations reinforced my decision to pursue psychiatry. My favorite patient on the service was X, a 26-year old woman with mental retardation, congenital deafness, and schizophrenia. When we first met, she was standing in front of the nurses’ station making loud, unintelligible noises deep in her throat; a two-month-old’s cooing sounds more like speech. Her life had been chaotic from the start, but she had still managed to learn language and read lips. Before her interpreter arrived, she sat in front of the team, listened to our questions and tried to give complex answers, complete with changing emphasis in her voice, facial expressions, and gestures. Despite the severity of her disabilities, she showed an amazing will to communicate and be social. Mental illness is sad, frightening, and mysterious to most people, but it is beautiful to see hope and determination in patients like X.

For my psychiatry training, I am seeking a program that includes a balance of biological psychiatry and psychotherapy training. Because I will practice in an underserved community, I would like a program in an ethnically diverse urban setting that has strong community outreach. I have enjoyed my time in the adolescent clinic and am considering a child and adolescent fellowship. I would also like a program that has a strong didactics and encourages resident research. After a long and winding educational path, I am excited to be entering a career of aid and inquiry.


Psychiatry Personal Statement #5

 

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The United States Medical Licensing Examination (USMLE) is a three-step examination for medical licensure in the United States. The Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME) sponsors USMLE.
The Three Steps of the USMLE
Step 1 tests the important concepts of basic sciences basic to the practice of medicine. It also places special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of the sciences that provide a foundation for the safe and competent practice of medicine. It also tests the scientific principles required for maintenance of competence through lifelong learning.
Step 2 CK tests the medical knowledge, skills, and understanding of clinical science essential for the provision of patient care under supervision. It also includes emphasis on health promotion and disease prevention. Step 2 CK ensures that due attention is devoted to principles of clinical sciences and basic patient-centered skills.
Step 2 CS tests your capacity to practice and provide good medical service in real-life situations. It also tests your communication skills.
Step 3 tests your medical knowledge and understanding of biomedical and clinical science essential for the unsupervised practice of medicine. Step 3 provides a final assessment of physicians assuming independent responsibility for delivering general medical care.

 

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