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Hi! my name is Andy (like the guy, but not). Now normally I wouldn't consult an internet forum for advice but in the absence of regular avenues I thought I would consult my peers. I pormise this is not something along the lines of "My grades are poor cause my dog died." But lest I judge others!


Alright, here's the Reader's Digest version of the situation so far.


I was raised in a severely abusive household. You know, the kind with pavlovian fear-conditioning, neglect, poverty and sexual abuse. I was a pretty deviant kid and I'm certainly no stranger to therapy and all of its bells and whistles. I used drugs and drank and did all sorts of unruly garbage. My highschool grades were simply crap, 50-65% on average. Though I do believe I got an 90% in 'Lawn Class' as we called the smoking turf during class time.


I couldn't tell you why it happened or where it came from but in the middle of highschool my Academic-Stream science classes began to touch things that had me nosing around in the medical reference section of the library. Long, dramatic, free-willy-style story short, I found myself unable to shake a strong desire to persue a career as a physician.


My grade 12 year (the year of the double cohort in ON) I uprooted myself, switched schools and focused only on school. I made the admission requirements for U of A in Alberta with an 84%. The subsequent first year in Alberta went as wonderfully as could be hoped for,even with a sudden onset of CANCER! I still managed to come out on the good side of the bell-curve.


I transferred home and everything feel apart, details are negligible but suffice it to say if something bad could happen, it pretty much did. I should have withdrawn but I didnt. I'm a stubborn young lady. I had a nice two-year drowning session with booze and painful admission that I was not going to get what I wanted. So when I was suspended I didn't care and I went to Toronto to accept my fate as an overworked, underclass white female.


I spent 2 years in Toronto working as an Escort (Yes, an over-priced prostitute) passing my life way with jaded rich guys and their supplies of cocaine and whatever other pharmacy-candy you can think of. And for a long time I thought I had finally managed to stamp out that annoying, incessant little pain in the ass voice. "You want to be a doctor more than anything WTF are you doing!?". That voice.


I gave up on trying to ignore it and despite a realistic assessment of the circumstances I still decided to leave Toronto, go home, collect myself and clean up my toxic-waste body and get some sound, professional help. I got back into school and while I'm not having much of a problem pullng up my grads to ye olde U of A day-standards I am deeply concerned about a few things. I volunteer during my free time since I don't work (ADD grants me extra funding so working at McDonalds is not necessary) and that is going well. I've accepted that I can't seem to strangle the Wannabe Doctor in me but I can't seem to reason with it about the following:


1. Your a miscreant! An ex-Drug abuser and whore!

2. You ahve two years of vomit-worthy academics!

3. Who cares about your Volunteer work with the elderly and disabled children!? It matters not in the face of your pitiful personal track-record.

4. You have a psychiatric record!

5. You will be on Psychotropic drugs for the rest of your life! A doped-up Doctor flying on Amphetamines just doesn't seem good...

6. If you ever got to the interview process what in the name of God would you talk to them about? "Yessir, I have to tell you, I could certainly handle the stressors of medical school because, lets face it, there is no way its as bad or as stressful as growing up in an urban POW camp." I'm quite sure they're looking for things like 'Well I managed to complete my Varsity game even though I had a broken leg."


Wow, isn't it brutal that the Reader's Digest version is still uber long? I wish this wasn't my track record, but it is. The really twisted part...is that I actually have managed to delude myself into thinking "A reasonable person would see these 'disadvantages' as advantageous."


I'm 23, I'm currently continuing my B.Sc.(Hon). in a joint-major of Biology and Psychology. I would beautifully with people from the lower, unloved sectors of humanity and in the opperatunities of the past that I've had to work in a hospital environment I know I have a precious and agreeable bedside manner. My interest is Psychiatry.


Should I manage to one day negotiate myself into a white coat I'd be fiercely adamant about working with the kind of people to whom I am kin. I'm very aware that my interest in such a persuit has certain psychological reasons that I would assume are apparent to just about anyone, but to be honest if I did not end up in psychiatry I can honestly say I would happy and fullfilled working in any aspect of medicine. Medicine is the monkey on my back who I can't seem to catch long enough to put a captive bolt through its head.


So aside from the fact that I'd be perhaps the most undesirable of potential colleagues (I suppose I'm one of those 'weridos' that your all hoping interviews ill keep out of your medical school seats) does anyone have an opinion of the following:


1. I have an opperatunity to trasnfer to Nursing and complete a compressed program. If I know anything for 23 short years of life its that getting screwed is the norm, not the exception and having a plan B (and C and D, for that matter) is the only control you can choose to exert on your future.


I wouldn't be unhappy as a nurse and having taking some nursing content Im very comfortable with it and I excell at it.


I am quite certain that my path to medicine would be quite unorthodox and any commitee that would choose to take me would be rather different than what I expect them to be like. That considered I fully believe it will take more than one attempt to get to even the interview process.


I am content with these expected failures and Id like to be able to come away from an unsucessful attempt with peace to work in something I care for. When I am rejected Id like to do more than wait for the next round. I'd like to take time to get more expeirience, upgrade, etc. Whatever needs working on and I dont want to spend this time working in a lab somewhere or in grad school slicing up monkeys. I would rather spending it doing what I love; helping people who are sick.


However, as stated, the Monkey rules supreme and I don't want to anger it by making a mistake. I'm not sure if I should finish this bachelors (Im currently sitting at 2.5 years worth of work) and then perhaps go to nursing school (my GPA is irepairable and I wouldn't feel confident submitting this GPA to a commitee, even with a good MCAT ) or should I just cut my losses, salvage whats good and give myself a chance to sort of 'start-over'?


Ive only been considering nursing for last few years becuase as much as I love my course content....I don't love it enough to really enjoy the intensive study.


2. If you got this far, I applaud you. at least YOU don't have ADD :P . My other great concern which is just as unavoidable as my GPA is my history. I'm an honest person, blunt and to the point. They call me a 'straight-shooter' and I'd have to agree. I don't feel I should apologize for the things I did in Toronto and I don't feel that I would except anyone saying 'Oh well...you WERE abused, so thats why you have such a rocky life." because I dont beleive that either.


I made choices that were bad. I chose not to withdraw when I got Cancer. I chose not to withdraw when I got mentally ill. I chose not to withdraw when my sister fell Ill and I was the only one responsible enough to care for her. I chose not to appeal my suspension and to go to Toronto and to take prositution over social assistance when a job became unattainable.


Ive made bad choices and Ive also made very good ones. I learn from my mistakes and I have become a humble person in my adulthood. As much as this history is truely undesirable...I don't see it as something that is bad in its end product, especially for a prospective physician.


My God Andy! How can you say this? What doctor do you know who used to snort coke off the bare buns of other women? You could never be a desirable physician as your whole life has been unbecoming for such a station!


Yeah, ok, I get that. But I also digress. Any person from my genre of people such as the mentally ill, the destitute, the abused, used, beaten and uncared for will unanimously agree that they don't like their doctors because they don't undertand them. No patient wants to feel like a filth when they go for help. No girl with slashed up arms wants to be looked at like doctors so frequently look at them. etc etc etc. the list goes on.


My empathy is not special or unique, but I do strongly believe that my understanding of such people and such circumstances is far superior to that of many of you who will successfully gain entrance and find yourself sitting before such patients. Many will respect such patients because they have to, and beucase they are good people who really don't want to acknowledge thier disgust or disturbance.


I respect such people because I came from that and I'm not shocked or disturbed by what I see or hear and my primary conern in such situations is always their best interest. I value such people beucase those are the kind of people that have populated my life and that being said, dont misunderstand me, I have the same respect and care for people who are not from that cesspool section of Ontarian society.


So in finality (Thank God it DOES end. :D ) I have a bad history. Im the last person anyone would expect to really, really even want to be a physician. But I'm smart, competant and I am fiercely capable. I want to be able to call myself a Physician and I want the opperatunity to care for people. I'm not overly enticed by the money or the sociel prestige. I was a hooker for christsake things like social prowess are not concerns for me.


I want very much to be a doctor, and I am quite willing do what I can to further my chances. But should I be able to account for the variable I can control (GPA, MCAT, Volunteer time, References, etc.) what would ones advice be on accounting for those independant variabels (Drug Use Hx, Abuse, Psychiatric record, etc.) and would be taking a step into Nursing be considered higher in cons than pros?


I seek some honest advice or opinions. I value what you have to say from angle that you say it. So if you read this and you have something to point out or add or critique, please do. I would be fascinated to review such replies.



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I think that if you are mature and aware of your own specific situation, and feel you are now ready to pursue your goal - I say go for it.


Now here are some side-points related to your situation.


Empathy is important, but so is professionalism (of which being empathetic is a part of anyway) and being consistent and reliable. The reason why people with a severely tarnished life-record (history of cheating in school, charged with a serious crime involving the harm of another person, having severe psychiatric disorders, prostitute, gangster, drug dealer, etc) - though you are right in saying that it is easier to understand the underclass when you have been there yourself - is that there is a high risk of past behavior reoccuring again in the future. Why do you think that a convicted pedophile, even after having gone through therapy, served their time, is reported by experts to be "clean", will NEVER EVER get a job, paid or volunteer, working with children?


It's very difficult to say who will do what when, and I suppose it's not fair to those looking for a second chance - but when you are entering a field where you have to work with people at their most vulnerable and concerning an aspect of being human that society pretty much deems to be the most sacred (ie. their health), the profession has decided it is better to be safe than sorry.


Point is: If you can get the grades, scores, and ECs to do this, and you want to do it - go for it. But not before you have seriously given some seriuos introspection to yourself and character - because medicine is stressful (you also cannot predict what life problems will come your way into your 30s, 40s, 50s), and as a healthcare professional, you can't turn to drugs or alcohol as a means of coping with life problems.

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Wow! That's a fantastic story. My advice must be taken for what it is, very limited with respect to experience. In most cases on this forum people ask about how to deal with a random bad grade or the fact that they don't have any medical related experience etc. I personal didn't go to medical school the "traditional" way, however in comparison my life has been rather "traditional."


I could only get accepted at my local school, my undergraduate grades were horrible and not for any reason other than I hadn't grown up yet and was not mature enough. I tried 3 times to apply to med school before I was accepted.


I think a backup plan is a good idea, that being said I don't think you should give up on your dreams, you are still very young and have lots of time to work towards medicine. I'm in first year this year and I am 27 and although I am among the oldest in my class I'm definitely not the oldest, I think that person is 38 years old.


I think nursing is a good way for you to get even more medical experience and will be a great for you to make some money if there is any down time between the end of undergrad and the beginning of med school. Having never gone to nursing school I can tell you anything about, but I definitely don't see any cons to nursing school unless it is something that you are just REALLY not interested in. It definitely won't hurt your med school application and it may even help.


The other part of your application will be the essay/supplemental section. I think being honest is a good thing, however, professionalism is a really big thing in med school at least it is at Dalhousie. I think you need to make sure you write your story in a way that makes everyone see how your experience can only enhance your future as a doctor but make sure that you sound professional at the same time. I think it would be very wise to talk to someone in med school admissions at the particular school(s) that you would like to apply to get there opinion of how this will effect the outcome of your application.


I also think that you're selling yourself short. I haven't done anything related to psychiatry yet so I don't know if this is because of your past or not, but taking responsibility for yourself only goes so far. It's great that you are taking responsibility but at the same time you need to cut yourself some slack. You were young and had many things happen to you and around you that most people would never see in a lifetime. Making appropriate decisions under these circumstances is almost impossible. Chalking everything up to bad decisions is unfair. Especially where mental illness is involved. If you are ill in that way how can anyone expect you to make appropriate, mature, forward thinking decisions? I certainly wouldn't! Even privileged children/young adults (and I consider myself to be/ to have been one) have difficulties making decisions about their futures at an early age. If people never made mistakes we wouldn't learn very much. This all being said I'm not saying you should just start making crazy excuses and told eliminate any responsibility from yourself.


I hope some of this helps and if you would like any other advice please feel free to message me and I can try to help.



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Wow. Thanks guys. I expected more "Oh boy...transference case in the making." lol.


xylem29 you point out one of the exact concerns I have, especially in regards to how a doctor would feel about someone with my track-record wanting their job. I get this alot. The thing about "well you might turn back to drugs and alcohol..." has been an interesting speed bump to deal with. I can't ask people to take a different view point on something we know to be true. Previous offenders are likely to offend again.


I am honest with people about my past, especially as it pertains to things like this because I know they are a concern and I feel that my history of exposure to such things is, in fact, their business. So I do understand the concern.


Let me add a little to this admission of past usage.


My adventures with alcohol were no more pathological than a binge-drinker college student pulling down C's. When I drank I drank to get drunk and to have fun. Drinking has never been a coping mechanism for me. Plainly...I don't much care for it.


If asked an honest question such as "Do you think you run a risk of excessive alcohol usage in the future?" I would say with confidence, No. I'm honest with myself and I know what my tendencies are and if I don't find it agreeable I don't opt for it. I don't particularly find alcohol agreeable.


If asked about drugs I'd probably want to know which drugs we're talking about but I would answer that honestly as well. My drugs of choice have been Heroine and Cocaine. Two of the big heavy-hitters. While I'm pretty sure I called myself an ex drug-addict in my OP this is a bad habit. I'm quite used to professional and laymen alike hearing DRUGS and adding addict that I've picked up the presumptive habit myself.


I did alot of drugs. This is no secret and while have no intention of wearing a button my sweater that says "I survived Drug Addiction; adore me." I presume that such a history is something a school would want to know.


That being said if I am so bold as to say "Yes. I agree there is a high risk. But I also contend that I was never 'addicted' and also propose that after over a decade of living with myself and my various 'issues' and tendencies...I know what I exert proper control over, and i know what I dont. Thus, I have spent a great deal of my young life putting supports and fail-safes into place so that should I ever approach that dark place where my judgement is flawed ever again, well...I have professionals in place whose job is to help me see it before it happens."


I would never be so foolish to say "Nope. No way. I will never do drugs illegally again." Because I too believe that the past has some indication of my future tendencies. What I can do is make sure that I do everythin in my power to plan ahead and to create a support system that greatly increases my odds of avoiding an unfortunate return such inappropriate behaviours.


For me, that means that I see a Psychiatrist at least every other month, more if I am expeiriencing elevated stress and having issues coping to the best of my abilities. I put my psychiatrist in charge of my medication and I'm fully honest with him about how and when I use it. Really the only things he gives me that are a little 'sketchy' I suppose are Adderall and Lorazepam. I'm aware of how my drugs affect me and I'm aware that they are highly abused. Have I abused them? Yes of course I have. I've been filling lorazepam perscriptions since I was thirteen. Do I still abuse them? No. I rarely fill the script and when I do I use it so infrequently that i often lose the bottle.


Adderall is amphetamines. Speed. It affects me quite surely. It's a stimulant and its quite potent (at least it feels that way, geez).


So here is my own reasoning regarding my drug use and how that relates to suitability for medicine. Yes, I am at risk to abuse. Yes, I am well versed in creating the required support network to avoid such a happening. Should you be concerned about what I may be ingesting while dealing with the astronomical stress of medical school? Yes. You would be foolish not to. But you should also be willing to accept the possibility that this is not happening.


I'm clean, I don't own, buy, trade or use illegal substances. In the many opperatunities since returning to the normal world that I've had to indulge in old habits I have not partaken. But there is nothing anecdotal I could say that would alleviate anyone's concern about this. Once you've admitted to drug use it is with you forever. And yes we could liken it to pedophilia - however uncomfortable such a likening may be - and some will choose to see this aspect of my record as having a similar magnitude as pedophilia or any other such horrid thing. Others will see it more as I do; Something I used to do but don't do now. I can't do anything about those people that care to see me as a monster. All I can do is take the steps available to me to ensure it doesnt happen again.


You suggest I should take a deep look at myself and my character and you point out that Medical School is stressful. Well...instrospection is something I am well versed in and I know myself quite well. I am not looking for a 'second chance' as I dont feel this is about chances. I'm not sorry for my life, and I'm not sorry to anyone for it.


Medical School is stressful. This is fact. I have been through much, much worse. This is also fact. And while a keen individual might pop up at this and point out that I didn't fair too well in those much, much worse times...I also have to point out that academic and professional pressure is a far cry in severity from being raised with a proverbial gun to my head. On the scary-meter projects and exams just don't chalk up to "no meals for a week".


I dont expect Medical School to be anything but a demanding challenge. But then again, nothing has been anything less than that. My risk for trouble might go up...but Ive gotten alot better at accounting for such desparities and making sure that the frequent bumps and backlashs from the circumstances to which Ive either put myself in or found myself in, don't smash my delicate glass tower.


Doc2B, I take responsibility for myself and what I am because no one else is going to. Nor do I think I'd be inclinded to allow such a thing. Even if some aspect of responsibility could be reasonable allotted to them. But that's just me.


Professionalism...thats the thing. I have the grades, the MCAT is covered, I have the 'extra-carriculars' like volunteering and employment experieince. No, I don't put 'Escort' on my resume:eek: . My concerns are the rough spat after first year (I don't really care that my sister was sick or I was sick or the sky fell, bad grades are bad grades) and the stigma that will inevitably become apparent when I'm asked a question that I answer honestly.


How does one talk about how such a past (since highschool) could be seen as something beneficial, rather than wholly aversive? If I say anything then I have to point out the childhood thing. Thats more stigma. It just keeps stacking on itself and I just can't lie about it.


Further more, I wonder if its really responsible at all for me to persue medicine. If I get in and I finish school and I practice...well...is this sort of like giving a pedophile reign over the daycare?

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My empathy is not special or unique, but I do strongly believe that my understanding of such people and such circumstances is far superior to that of many of you who will successfully gain entrance and find yourself sitting before such patients. Many will respect such patients because they have to, and beucase they are good people who really don't want to acknowledge thier disgust or disturbance.




thanks for sharing your story. i agree with other poster, you are quite young (which suprised me, given your life experiences to date) and you have opportunities ahead of you. i would offer caution re the above quote; doctors need to sit in front of a whole range of people who bring diverse experience to the dyad. so do nurses ( i have 3 more weeks of course work!) before i worked on OBS i wondered how could i help a woman to give birth/breast feed, if i had never done that myself? could i offer anything of value? would i be seen as a 'fraud'?. but then i had no trouble helping stroke survivors, or schizophrenic patients, or babies with Down's syndrome. i have never personally experienced these conditions, but i have a sincere desire to be of service in health care, and so my work makes a difference (at least, i like to think so) i think you would certainly bring alot to the MD/Pt relationship, esp in the care of marginalized persons, but it would be wise to let go of any judgment of your fellow colleagues, and any assumptions of where they are at without really knowing their story.


as i am almost a 'real' nurse, i could tell you about my experience with nursing school, but i am far from having the wisdom of a seasoned professional. i myself got my grades up in this second degree, and i think it is a good choice for pre-med. and, it is a good choice in general if you want to help people; you will never lack for work. you could even specialize in Psychiatry.


good luck to you.

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Further more, I wonder if its really responsible at all for me to persue medicine. If I get in and I finish school and I practice...well...is this sort of like giving a pedophile reign over the daycare?


Well I didn't mean to use it as a legitimate comparsion - just to make a point about "future risk" and the point of view that the profession is coming from. With your case however, you have the answer to this question, and it seems like you know the answer ;)


Now, let's get on with the ethical dilemma here. You say that you are not sorry at all about the decisions you have made - now, when it came to choosing b/w


1) Social Assistance

2) Escort


You chose Escort. Now, I have a friend who was on SA and so I do know of how bare this assistance really is. Essentially, after you are covered for housing, you are given ~$211 per month for whatever you want, most people choose food. With the basic necessisty of a landline - you're really left with $180 per month for food, and other basic things like soap, shampoo, etc. You are really pushed to live as cheap as possible - not everyone can do it. My friend was driven to the psych ward. It's tough, I know.


Now, Escort is illegal BUT how humane is SA? Sometimes, re: laws, depending on one's view - there is a grey area, most cited example is stealing in order to save someone's life. I can understand how one could choose being an escort over being on SA.


Here's the thing - as tough as SA is, it can be done. There are people who are getting through it and this includes immigrant families who can't even navigate our system well and who can speak little english.


So the question is: When faced with an ethical dilemma in the future as a physician, what will you choose: what you think is best (morally, etc) or what is written as law (according to the standards of practice, code of ethics, acts and regulations governing the practice of medicine)?


According to the profession, you always put patients above yourself and your views, while on the job, are trumped by your duty as a professional health-care provider. You'd have to follow the code of ethics, even if it means you will be doing something that you personally feel is wrong.


Ok, let the discussion start - good practice for interviews :)

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to Ocean, you caught me there. I do have a rather unfair and biased view of healthcare professionals and that is something I am trying very hard to resolve. My own expeirience as a patient in times past has given me a leniency towards mitrust and negative assumption.


As a nurse or a doctor I really am concerned about making sure I really solidify in myself that I'm not the patient anymore, at least not in that role. And while my patient-self may always be a little less than trusting, thats not a view that can carry over to being on the other side of the glass, so to speak.


Its sometihng I'm aware of and I am working on it. But its certainly one of my more subconscious bad habits. It wont serve me or my patients or anyoen around me by lending myself to such views. And I really do not think an interviewer would be very impressed by a statement like "Oh, you know doctors..." That doesn't quite mesh. :o


Ah Xylem! That is a good question. I like it. First I have to point out though that Prostitution is not illegal in Ontario, solicitation is. Its a fine line, but it is there. But let us assume prostitution in itself is unethical for one reason or another.


I made my choice for whatever reasons seemed valid at the time and yes, I am not sorry for them. I could say I am sorry to myself for having a poorly formed idea of what it would really be like and what the long-term costs would be, but the desicion itself...no, I'm not sorry and I'm not ashamed. I'm ashamed of all the wedding bands on the hands of men who employed me, but that my own personal guilt that I've always carried during and after my time in the 'underground'.


SA is...sadly very tight. In my time at the bottom (or perhaps slightly above, I wasn't homeless or hungry after all) I came to lose my prejudice agaisnt the assistance users. Oddly enough, being raised on it I was still prejudiced against it. But it didn't take long to get over it and realize that my issues were personal and had nothing to do with these people or their circumstances.


SA can certainly drive people off the deep end. Well...I shouldn't say it actually cuases this, but it certain helps the process of deterioration. I have been in psychiatric wards throughout my teeny tiny little life and once I crossed the 18-year-old gate I became well aquainted with the SA and the Ill.


Now your example that you used to pose your question was somewhat based on the misconception that prostitution is illegal (maybe it is in some parts of Canada. I didn't care to check when I was finding out my rights). So for the intents of this discussion let us say that your assumption was correct and that prostitution is illegal.


So if this is the case then hypothetical two options are presented, both of them undesirable. SA is legal, safe, consistant etc. But its meager and the expeirience of going through the system is perceived by myself to be traumatic in its own right. Prostitution is illegal, not safe, inconsistant etc. and is definately going to be traumatic.


Now I wasn't aware of what the monetary assistance was through SA when I opted not to persue it, so its fairly safe to say that the money amount at hand was not particularly pertinent.


So if the popular consensus would be that SA is the ethical choice and Prostitution was the unethical choice then I have a large dot on my record that says I chose the unethical choice.


One could also say that I chose the 'easier' of the choices. I agree, many people make SA work and they do an exemplary job. And while I don't want to generalize and speak as if I am valid enough to represent the voices of any other sex-workers I would have to say that for me, my conclusion is that prostitution was easier.


SA may be questionable in its humanity but I think it fairly reasonable, at least in my case, to say that being a single, semi-educated female SA would not have been a bad choice. I would have dealt with some unpleasentness and Im sure it would ahve presented residual issues of its own...but I don't think I would being with the onslaught of issues that I'm dealing with right now, in working my way back into academic and regular society. Being worried about making ends meet versus being subjected to 'flashbacks' when standing in line and catching a whiff of a familiar clients calogne...well...cologne might not sound like much but now I have to say SA might have been a wiser choice, if not a more ethical choice.


(This could further be complicated if I had a child...)


So at some point in my adult life I chose to be unethical, now I am asking to be put into a station where ethics play a large role in establishing the trust inherant in said station.


Now, I think I have a decent understand of the Doc/pt. Relationship and the fact that in such a profession there are various, definable 'roles'. Whiel the subject matter is less lewd, this is not unlike the 'role' of an enticing, intelligent, ukrainian female whom <insert John here> is lucky to have picked up. That too is a role. I can't give a colorful verson of the role of physician because I've never been one, but my assumptions will have to be enough.


Roles define - for me - what is expected of me. They define as a sort of 'alter-ego' that is grown from me, but is not my own personal property or entity to take ownership of. Who I am in my pajamas in my room mashing buttons on World of Warcraft after a six hour study-haul is not the same person who put on heels and make up and barely any clothes. Perhaps 'person' is too definitive of a word...let me say then if the state that I could be found in while in my PJ's is me as I am naturally in my own self-created role, then the me that is experienced while fitting into the role of prostitute is a facet of the PJ's me, but is molded by role that was not created by me.


I am tempted to propose that the role of Doctor is much like any acting role. There is a script which outlines, in detail, the expect production. Now a creative actior may be able to make use of some 'wiggle' room to improvise based on his own assessments or personality traits. But essential his behaviour will be dictated by the role has accepted and it will be governed by how closely he matched the script.


So I will make more assumptions here ( they never end, do they?) and assume that if I were given the privledge of practicing medicine then I have taken great pains to ensure that I fit into this role as best as possible and I have studied my script and the various levels of 'wiggle' room avialable to me. So we can assume that this hypothetical, future me is fully aware of the expectations of such a role and is in sound mind to take responsibility of them.


The role of physician is one that while I would certainly like to devlop my own improvisation of it, is a role that is well defined. Characteristics and practices and tendencies that are beneficial to ones efficacy as a physician are well documented and avaialble. This is a role that - in theory - has very little guess-work to it. So being able to acknowledge what my option are should be fairly easy (again, in theory). Outside of any emotional cross-over or personal bias the options are available to me in a substantiated and reliable manner.


Now, when I faced the desicion between choosing SA or Prostitution I was again confronted with prospective roles. I chose postitution, the unethical choice. Now when confronted with a similar situation I forsee myself assuming the role of physician. I have already established that I believe the options available to a physician are well laid-out and available for my consultation so outside of extraneous variables I would have to say that I would consult the options that were accepted by my role at that time. I should think that such an option would be ethical.


I may be a Doctor one day, and I may have a great deal of expertise and talent or what have you, but I am still JUST a Doctor, I am not the Law, I am not the patient, I am not the administration that governs me...and by taking this role I did agree to base my desicions around my knowledge, experieince and ultimately...the Law.


Whats an example of a prospective situation like this that I could find myself? Well...ok, here's one thats actually come up as a topic of conversation between myself and my friends from the Hooker Days. Since Psychiatry seems to be my 'bag' I'll use soemthing from that ball park.


The adminsitration of amphetamines for treatment in psychiatric cases besides ADHD and lets say, maybe, well-documented treatment-resistant depression. Lets have this for the overhead topic in the posed scenario.


Let's assume I'm a doctor now and I know my bit, but I'm also going to include the extraneous variables that were previously deducted from the discussion.


Let's say I'm presented with a fictional patient. 21-year-old, caucasian female, mother of one (F) who is referred with a diagnosis of depression and anxiety. Upon interview its revealed that she was raised by a single mother who had an alcohol-comsuption issue. Pt. also is not in possession of a high school diploma. Pt. collects disability support as her primary source of income but supplements this income with modeling and fetish work in the local club and fetish scene.


My personal opinion of this Pt. is something along the lines. "Oh Damn...thats a bleak existence at first glance." Now in my case I'll probably identify on some level and I'll likely be predisposed to view her as familiar and 'kin-like' to me because she could be any one of the girls I came to care about when I did my time.



Lets further assume that I don't experience my own bout of transference and project people of my past onto this Pt. Let's assume I got that covered and while the similarity is perosnally noted, its not going to play a role in influencing my assessment or subsequent desicions.


After reviewing the history and the concerns of the Pt. we turn to a look at her current prescribed drug situation. Sertraline @ 200mg and Wellbutrin XL @ 150mg have not yielded much success. Pt. complains of a lack of energy, a great conecern for her difficulties operating as a mother and feels that while she does greatly desire to leave her Disability and Supplementary Job behind, she just doesn't have 'enough of herself' to do what she would need to do.


Now, this is all fine and dandy, but me, myself, this person with their unique SIN number is looking at this patient whith perscription pad on my lap and I now need to think about what I'd like to do. For a moment Doctor Me and Me-Me might conflict.


Me-Me recalls her days in the 'underworld' where popping dexedrine in the morning was how you got through the day. Dex was how you managed your life, your strife and all the Johns in between. Or at least, thats the old saying. I myself take Adderall for ADD and find it to be particularly helpful in all matters of mental health and productivity, so I'm already biased as a user.


As a Doctor in this position I have the power to consult with and acknowledge either Me-Me or Doctor-Me and come to some sort of confident conclusion that I will feel is likely to increase some level improvement for the patient and is going to be a sound desicion in the context of asking this young lady to put a substance into her body everyday because I said so.


My concern in this situation is patient. Or at least, let's say thats what I believe. I believe at this hypothetical time that I can help this young women with a simple adjustment of medication. I believe that I can alleviate some of her suffering through manipulating her physiology. My intentions are good but I am in a situation in which I can pave nice, long, road into hell, all with good intentions.


Doctor-Me would consult the literature. Doctor-Me would think of adjsutments in dosage, particular formula, etc. Doctor- Me might even actually whip out a compendium to check her options and discuss them with the Pt.


This is assuming I dont tinker with the diagnosis and I leave it at just Depression (not recurret or considered to be treatment-resisitant just yet) .


I'm not going to try and give an example of what I may or may not decide becuase I'm not a physician and I really can't say why I might look at in particulars. But for sake of argument (and this will have assumptive traits assigned to it as well) that Doctor-Me decides maybe Sertraline has not lived up to the time its been given to work and that tinkering with its dose is not desirable. So Doctor-Me wants to think about switching it out for whatever seems to be very effective lately. (let's assume Sertraline is my favoured SSRI in the first-place). Let's say Effexor is what I opt for. (This may or may not have any clinical plausability. lol. I apologize if my pharmacology is off.)


So in this exmaple Effexor is determined by me to be a suitable SSRI that is quite effective and one that I think may have better success with the patient. I don't decide to do anything with Wellbutrin because I would rather switch out one at a time rather than reassemble the whole cock tail.


My desicion is Effexor at whatever dose and while I hope this will be effective I am also of the opinion for various reasons not pertaining to Me-Me that whatever improvement is exhibited, if any, will be marginal and perhaps ongoing psychotherapy is our best bet.


Let's assume thats the ethical desicion; Marginal improvement, if any.


Me-Me looks at this situation and says "Hot-damn, I need not the CPS I have great anecdotal knowledge of how successful amphetamines are!" As a doctor I may be aware of certain uses outside of ADD and treatment-reisistant depression, but we'll assume they don't apply.


"Hey, her cocktail is actually oddly similiar to my own! If I just added some 30mg of adderall we'd be twins." Let's say I dont do that exactly but I do decide that using a 20mg administration of 8-hour Dexedrine is going to be effective and I'd like to leave her current drugs alone and add this one.


I base this desicion off of personal experieince and the reports of people with home I am connected to outside of my professional roll. I base this desicion on what I feel is consistant results; Speed will make your feel better.


Now because the typical conditions that are known to me at this time for the appropriate administration of Dexedrine do not include her diagnoses I can't perscribe this without fudging a few things. It's not too hard for Me-Me to choke the information needed to falsify the Pt's documentation to place her in the status of 'Treatment-Resisitant Depression" from Doctor-Me who does not wish to cooperate.


So in this option I will I have violated several expectations that are set in place for my role as a physician, let alone a psychiatrist. I don't consult the literature. I don't consider alternative options. I don't look at how successful or unsuccessful her current medications are because I've blinsighted myself with the wish to prescribe Amphetamines. My scientific deductions are made on sloppy, unverifiable information obtained through the most subject POV; me- me. I blatantly allowed for some level of transference to occur by seeing her as me and then subsequently changing her papers to resemble my own diagnosis. This list could go on, I am sure.


Let's assume this is the unethical desicion; Almost garunteed improvement and alleviation of primary symptoms.




Now Xylem, you asked

"So the question is: When faced with an ethical dilemma in the future as a physician, what will you choose: what you think is best (morally, etc) or what is written as law (according to the standards of practice, code of ethics, acts and regulations governing the practice of medicine)?


According to the profession, you always put patients above yourself and your views, while on the job, are trumped by your duty as a professional health-care provider. You'd have to follow the code of ethics, even if it means you will be doing something that you personally feel is wrong."


In this situation proposed above I feel that providing the Pt. with the msot relief possible is a morally-permissable action. If I were to still wish to opt for the Dexedrine perscription after cleaning up my assessment to code, then I would still feel that prescribing Dexedrine to this Pt. was a morally-permissable action. I have convictions determiend by my own experiences and beliefs that tell me her best option for quick alleviation and return to productivity is Amphetamines.


So in extension it would plausable to presume that I feel it is somewhat morally-apprehensible to deny her this treatment when I feel that even though use in this case is not located in the literature, it would still be safe enough to do off-label. My personal feelings on this matter are that I will not be give her the best help available by not making this medication available to her.


However, in this sitaution, I am a physician and I am versed in the code of my practice and profession. I am very familiy with my prescribing privledges and what my boundaries are. I am aware and in admission that the prescription of amphetamines would not be considered an acceptable course of therapy if I were to present my case to at least three other Physicians who had no bias in my favour.


If I choose to select a therapy option that is documented to be acceptable for the treatment of her current diagnosis in the context by which it appears, I am actively choosing to do something that is morally-apprehnsibile to my Me-Me, personal self. But if I chose to select a therapy option from this group of options that I can confidently say all three of these scrutinizing physicions mentioned above, would approve of then I am acting agianst my own morals and acting in favor of the morals laid out for me by my betters, my peers and those that came before me.


Well if I was in the business of practicing medicine without a license and I was doing psychiatry out of the back of the van, then sure, I'd probably do the unethical thing. But thats not the case in this example. I'm a physician and what is expected of me is independant of what I expect of myself (At least in this respect.) My moral discomfort is secondary to following the practice guidelines that have been set in place for me to follow.


So, after my long-winded novel I can conclude with a quick summary you wish had been at the top; I'd do what was expected of my station, regardless of my personal opinion.


I promise I'm not this ridiculously excessive when in an a verbal exchange, writing just seems to lend itself to thoroughness. And yes...I still don't spell-check. :D

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According to the profession, you always put patients above yourself and your views, while on the job, are trumped by your duty as a professional health-care provider. You'd have to follow the code of ethics, even if it means you will be doing something that you personally feel is wrong.


This is off topic, but I don't really agree with that statement. Physicians should put patients above themselves, but that doesn't equate to the idea that they should do things that they consider morally wrong. Codes of ethics aren't infallible, and sheltering in authority's guidelines without thinking has led doctors to become involved in serious atrocities quite a few times. An internal moral compass is a pretty important thing to attend to. That said, if a personal opinion differs from a well though-out collective one, obviously the individual needs to consider whether their reasoning makes sense and is defensible. And I will step off my soapbox now. :P


To the OP, best of luck - there's no doubt that your experiences will have given you enormous depth that many students don't have, and that's incredibly valuable. If you can convince yourself that you're stable enough to be ready for medicine, my guess is that you can probably convince admissions committees too. :)

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I think you should look into the admissions requirements/processes of the schools you are interested in.


I don't think you should concern yourself with a bad period after 1st year. It might require some explanation depending on the school, that you can touch upon in your application essay. Some schools only really consider your last 2 years or your best 2 years so 1 bad year or even 3 or 4 bad years don't really matter that much.


I chalked my very mediocre grades in 1st and 2nd year and my horrible grades in 1st semester of 3rd year to immaturity. I failed a course in first semester of 3rd year and I got 3 Ds that semester as well along with a B. Obviously, those marks are no where near what is required for medical school admission. I wasn't sick nor were any members of my family. I made some bad course choices and had some bad study habits at the time. I learned my lesson and finished another 2.5 years (5 year undergrad in total) and did OK but still not spectacular. I then did a course-based graduate degree which is when I finally learned how to study. I did very well in that 2 year program and I was finally accepted to Dal after my 3rd application. I re-wrote my MCAT at that point which is also probably one factor as to why I wasn't accepted the first 2 times I applied.


Anyway, you can't change the past so you can't wipe your academic or life record clean. Most schools aren't expecting people to have awesome grades for their entire undergraduate program.


Good luck!

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Well I actually read your very long posts, whew my brain hurts. I say you are young, you have time on your side. If you can show that you were able to pull yourself up by your own bootstraps from your abusive childhood and morally questionable young adulthood then I would see that as an asset rather than a liability on your application. Unfortunately you will likely encounter some closed-minded types that won't be able to forgive you for your past but I think that you will be able to get in. You will just have to count on the luck of the draw.

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IMO your past issues will not likely work against you. Your main problem: your GPA is a total variable. All you know is that you didnt really try that much academically and didnt do well. I have a feeling a lot of people like that think "if I tried I could get a sky high gpa", when in reality, a lot of them cant.


Take a year or 2 of undergrad, and actually try, without letting other issues get in the way. If you can pull a 3.7+, you have a shot.

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Andy I have a few thoughts, take them or leave them.


Your story is indeed unique and has caused me to reflect on my life. I will not tell you that I understand fully what your life has been like, but without giving details I can say that I connect with some of the darker moments of your life. Please do not disregard my comments because of any thought that I am a typical premed applicant.


You may, as I do, look at yourself today and marvel at how different you are compared to just a few years ago. As I have surrounded myself with positive people and positive activities, who I am has changed. Old ways of thinking have disappeared, emotional responses have matured, relationships are healthier, and habits (though stubborn) have slowly subsided. Good choices, caring support, and time, time, time has allowed me to distance myself from who I was. I did not force it, it just happened. Count yourself lucky and blessed that you are where you are now in your life.


That is not to say that you were not a great person even in your darkest hours. However, I know that when I look back (rarely helpful) many of my choices still hurt today. Letting go of the past is essential to happiness.


Your original post seemed to be a feeler for advice about the medical education process. You want to know what some of us think about you being a doctor. You want to bounce ideas off us about what adcoms, colleagues, and patients will make of you. You specifically asked whether pursuing medical education is prudent for someone with your "track record." These are crucial questions and asking them shows you are pursuing a dream. I want to share my thoughts on these questions.


First of all, do not put pressure on yourself. It is bad practice to listen to the voice that tells us either we will achieve our goals and dreams or be a complete failure. Trying to redeem your own life through success as a doctor will only cause you to dwell on negative feelings of the past that you desire to overcome. This journey can NOT be about making up for wasted years. I do not imply that you are doing this. I only say it because it is good for me to reflect on my motives for everything I do. This ensures that my pride or desire to recompense what I wasted is not fueling my desire to become a physician.


The idea that we must reach for the top is garbage. You may think that you and I owe it to ourselves because we put off our dreams for so long. This sets us up for failure. Not because you or I will fail at becoming doctors and realize our past choices really DID screw us. It sets us up for failure because it makes us dwell in the past. Again, we must let go of the past to let happiness happen.


The past is irrelevant. I mean to you, to me, to colleagues, and to patients. A patient who presents problems that you have experienced first hand will not care that you had the same problem x number of years ago. They will want to get better. No colleague will give two hoots that you used to be an escort. No colleague should even know that you used to be an escort, unless you disclosed it for a personal or professional reason in confidentiality. (I cannot fathom a circumstance where this would be necessary).


The past is also irrelevant to adcoms. They need only know three areas of yourself. First, what has made you the person you are today? Your poor choices have NOT made you who you are today, your good choices have. Second, they want to know why do you want to be a doctor? I will not speculate your motivation for being a doctor. These things are hard to fully express. I am satisfied that your motives are good enough for you (again, as long as it is not the self redemption thing, which I think you understand). Finally, adcoms want to know how you behave. How you behave TODAY. This is done primarily through MMI interviews. How you solve problems on interview day will give adcoms an idea of how you will solve problems in school and in clinical situations.


I would be remiss if I did not address the fact that, yes, most schools want to know your "track record." But they are only interested in what was meaningful to you so make sure you define yourself by your good choices. The only time your hands are tied would be a previous criminal offense or other information that you are required to divulge that does not look great. These details must be divulged and essentially ignored by you since you cannot change them. If and when adcoms see this kind of thing they will either ignore it, ask you about it, or trash your application. In the latter case you can do nothing so you might as well not worry about it, and if they ask you about it you get your chance to show them who you are.


Another important thing I wanted to discuss with you when I read your post is "FIT." A professor of mine who is a medical doctor gave me some sage advice. He told me that I needed to "be the right fit for medicine", and that "medicine needed to be the right fit for me." These two may seem like the same thing, but are drastically different.


I am well suited for medicine. I love, and excel at science. I think logically. I am rock solid in emergency situations. I care about people who are suffering and I want to heal. You may share some of these, and likely have a whole host of characteristics that would make you an excellent physician. You see this in yourself. You see yourself in ten years as a practicing medical doctor. You can actually visualize it. You belong there, and you are excellent at what you do. You are a good fit for medicine.


This fit, however, is not as important as another fit. Medicine involves grueling hours, pressure on you, strain on relationships, low pay for time, threats, legal issues, overhead, paperwork, and travel. It also brings, perks, sex appeal, job security, respect, prestige, influence, and a great deal of power. Are these things that you want? Can you handle the power that comes with being an MD? Do you WANT to handle the power that comes a with being an MD? Medicine is a lifestyle and culture. It is adaptable, but some things just come with the territory. Medicine must fit with your way of life or you will not be happy.


This is not to talk you out of being a doctor or scare you. I have no reason to try to convince you that you should not be a doctor. I am not trying to "burst any bubble" or "bring you back to earth" (sorry for those consecutive cliches) Just some things that have been passed on to me by an influential doc in my life that I continue to ponder.


You may notice that some of my paragraphs are centered on happiness. This brings me to my final point. We all need to put our activities in context. Why do I study for my exercise physiology final next week? Because I want to get a good grade. Why? So I can get into a good medical school. Why? So I can become a doctor. Why? So I can save some lives and get paid for it. Why? Because I just think it is cool to save peoples lives and I want to make money for my family to survive. Why? Because I love my family and they bring me joy. . The context of why we do things must add up to a supremely satisfying point or we will be frustrated.


Joy is the most important thing in this life. I deserve it. You deserve it. Everyone deserves it. Few actually find it because they are working so hard to achieve their goals. One of the happiest people I know is dirt poor, has six kids, and drives a bus for a living. He never thought "boy I hope I drive a bus someday. That will make me happy!" He is happy because he has decided to enjoy his life.


Consider the words of Victor Frankl, a psychiatrist who learned some of his most important lessons as a prisoner in a Nazi death camp during WWII.

"Again and again I admonish my students both in Europe and in America: Don't aim at success-the more you aim at it and make it a target, the more you are going to miss it. For success, like happiness, cannot be pursued: it must ensue, and it only does so as the unintended side-effect of one's personal dedication to a cause greater than oneself. Happiness must happen, and the same holds for success: you have to let it happen by not caring about it. I want you to listen to what your conscience commands you to do and go on to carry it out to the best of your knowledge. Then you will live to see that in the long run-in the long run, I say!-success will follow you precisely because you had forgotten to think of it."


It does not matter if you or I become doctors. Just because we are well suited for medicine does not mean we owe it to ourselves to pursue it, or that we will be happy doing it. My bus driver friend has all the makings of a great therapist, but he is not disappointed that he did not pursue it. The only way we will make a mark on the universe, the only way our lives will matter in the end, is if we follow our conscience.


I think you can be a doctor, bus driver, hiker, painter, mom, farmer, or anything. Plan your future only so that you will enjoy every single moment of the present. You deserve to enjoy the rest of your life. Screw your "track record," it is being rewritten as you read this.

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Thanks for all the replies guys.


My grades during my 'icky period' are being assessed for deletion in January. The Ex-Chair of my department has recommended removing six credits from my transcript.


So I'll have to do those courses over, and my schedule will be strange with 400-level courses and 200-levels courses all over the place, but thats fine with me. Might be nice to give it another shot on firmer ground.


I know aobut the GPA thing, one person's optimal performance may or may not be enough, regardless. But I have performed acceptably at optimal-levels before, so I don't think it particularly unreasonable to expect A's from myself, even if they are A-'s on average. It's just a big challenge because I'm asking myself to be top of game...and well...thats not always easy.


But here goes anyhow...

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i breezed through this last post, obviously. have you thought about a psychology PhD? and/or writing a book about your life to date? i am sure many people would find meaning from it.



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your story is amazing...

thank you for that


i wish i could add something to your story to help you, but in all honesty, i have nothing.


have you thought about going abroad for medicine perhaps?


if you do well on the mcat, you may have a chance in the US (they love stories like yours... or at least they'll give it a shot - very holistic approach to the admission process), Australia (gpa just has to meet a cutoff and then means nothing) or Ireland (don't know much, but admission process seems reasonable)



anyway, good luck!

you'll make an amazing doctor one day

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i breezed through this last post, obviously. have you thought about a psychology PhD? and/or writing a book about your life to date? i am sure many people would find meaning from it.




writing a book is a fun way to fill in the time gap.

i do that secretly, i dont tell nobody, but well.

that is a fine suggestion, it could inspire other people.

i never thought of that. i always thought my life was meaningless.

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Guest soaring_eagle

Dear AndyAnderson, if you need a shoulder, there are people on these forums who will be here to support you. Unfortunately not everybody is fortunate to have strong support systems already in their lives.

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Remember gaining medical school admission is not a competition where the grand prize is waiting to be claimed, but rather it is a match to be made. You can have the most glorious accomplishment or have undergo enormous personal difficulties, in the end the assessment of whether you will gain admission or not is dependent on whether you are suited for the profession and whether the profession is the best match for you.


In a profession where every decision you make can have the utmost significance on patient's lives, you really need to demonstrate that you possess the ability to make sound judgement at the most stressful and difficult times. It will take a lot for you to convince the adcom that you are a new person now, and those "wrong choices" you made are just stops along the road of life that helped you to define your destiny. To the adcom, we are defined by our past, because that's all the information they have about us. How to use our past experiences and struggle to demonstrate our qualities that will fit a sacred profession is what they are looking for.


I believe your personal experience brings a new dimension to the medical class that is already overcrowded with high-GPA, high-MCAT, stockup their CV with EC just for the sake of it students. Medical education is not just about facts and what's written in text books, but also what you can learn for others in life, because in the end, you will be dealing with patients from all corners of society. I wish the adcom can look beyond simple numbers and facts and possess the open mind to meet you in person. I know I would.

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Um, amazing story...have you been tested? I am not sure but I think a criminal record check and HIV test may be on the horizon or here now for medical school admission. I would recommend the test though, being positive and being a doctor would have the CPSO regulating your practice to low risk medical activities, whether right or not.

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I have been tested actually. I'm clean, so is my record which has also been checked recently.


I want to thank you for all your time and attention, as well your encouragements and criticisms. I was really worried about this when I wrote it, and I was feeling very alien in my environment. A public forum is probably not the greatest place to spill one's cerebral contents, but I appreciate being afforded to do so, even I'm now 'face-palming' myself about it now. :o


I successfully completed my Fall semester. I found that I enjoyed the culminating term work the most and that discussing issues from various paradigms - be they scientific or not - is fascinating to me. I feel much more comfortable now, much less like a prostitute and more like a student.


I think now that wherever I end up, my past will come up. It may or may not be something that works against me. It could very well work in my favour. What I think is really important now that I wasn't thinking about at all in the Fall Semester, is that I am the most concerned about my past. My past is important. But it is most important to my own personal well-being and my relationship with myself. This is something I will explore with a supportive professional.


I feel much less disoriented now. I don't feel so alien to my environment. I am still concerned about the things that keep me up at night, but I am also finding that those things are becoming less and less of a priority. I'm becoming much less preoccupied with what can cast me in negative light and far more concerned with what can cast me in a positive light.


I'm enjoying my undergraduate work again and resuming some of my older academic ambitions with some enthusiastic peers. Right now I'm less concerned with what a possible panel of judges might think about me in the future, and more concerned with course work, my extra-curricular's, and my social life.


I think it's possible that my past and all aberrant highlights, can really only hurt me in the future if it keeps me from distinguishing myself in constructive and more conventional ways. I don't think I need to stand out because of whats strange, or aversive about me when I can stand out because of what I choose to do beyond those things.


All that being said I'd love to delete all this to soothe my embarrassment, but whatever, **** happens. I'm sure I'll make an ass out of myself again sometime soon. At least if I'm making an ass out of myself, someone else can feel better about what they're embarrassed about.


"Man, I would feel like a total R-Tard, but dude, at least I'm not as wonky-sauce as that chick!":eek:


Works for me! I seem to recall something about laugher...and medicine...


Cheers and my you all be successful in your own eyes and the eyes of those who depend on you,



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As far as I am concerned nobody is perfect. Doctors included. We are all human and do stuff we are not proud of...


You have dealt with a lot of stuff, which I think will only help you. You are a strong person, and know now more than ever that this is what you want.


I think you are going to make a wonderful Doctor someday (and an amazing psychiatrist if that's what you want to specialize in).


Good luck! :)

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