Undergraduate / 'waiting for the shuttle bus in NUS' NUS graduate medical school-Why Duke-NUS? [3]

Prompt
"What advantage do you think an M.D. degree from Duke-NUS will give you?"

Feel free to give any comments or critics. THanks in advance! Really enjoyed interacting with the people here. You are all very warm and helpful!

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I first heard of Duke-NUS in 2006, when I was waiting for the shuttle bus in NUS and browsing through the notice board at the bus stop. An A4-sized poster grabbed my attention - Singapore is going to have a graduate medical school, and it's called Duke-NUS graduate medical school. At that moment I knew nothing about Duke, besides it being a top university in America and in the world, but this glimpse woke up a dream of mine, the dream of becoming a medical doctor. Somehow I was not able to study medicine at undergraduate level. When I almost had to give up this dream, I saw the poster of Duke-NUS, and was telling myself: "Maybe this is a second chance for me."

But Duke-NUS is not merely a second chance.

As I explored its official website, looking through its brochures, attending webinars and going to campus tours, I started to realize that Duke-NUS should be my "first choice".

I was very impressed by the innovative Team-Based Learning model which focuses on problem solving, collaboration and application. As a teacher, I understand how important it is for students to be able to work in teams to solve problems and apply their knowledge into real life situations. In fact I use these strategies in my classroom as well! I think this approach will not only facilitate the learning process but also equip future physicians with the necessary "soft skills" such as good communication and team-working.

Being able to start clinical practice as early as in year 2 is another advantage that Duke-NUS has to offer. Based on the solid curriculum of the world-renowned Duke University School of Medicine, students will cover basic science in one year's time and start clinical rotations in their second year. This means that students can apply what they have learned in year 1 immediately into real clinical situations, which makes more sense and is likely to be more effective. I remember my friend who was studying medicine complaining to me about she had forgotten everything she learned when she started her clinical rotation only in the last year of curriculum. Ultimately the purpose of studying medicine is all about applying our knowledge and skills into clinical practice so it is definitely an advantage to be able to start earlier. Starting earlier also allow us to gain more experience in clinical practice and make us more competent as doctors.

Another advantage of Duke-NUS's program is the focus on research. Being one of the top research universities, one whole year of its curriculum is fully devoted to independent research. As research is an intrinsic part of medicine, having the opportunity to be able to work with world class scientists to conduct research in an area in greater depth will surely benefit every prospective physician in both his clinical practice as well as future research, especially for those without much research experience prior entering Duke-NUS. Since I am interested in the MD/PhD program, I also see this one year research as a great chance to prepare me for the subsequent PhD component which involves more highly intensive research.

Being a collaboration between Duke and NUS, I think Duke-NUS has the strengths of both universities, and on a wider scale, the strengths of both American and Asian education systems. With students coming from many different countries, cultures and backgrounds, it provides a good platform for the students to respect and learn from each other, which in my opinion, is an important attribute of a doctor in today's globalized world. I stayed on campus throughout my four years in NUS, during which I met people from a diverse range of cultures. Besides learning to respect others from different backgrounds, I also developed independence and responsibility. I think Duke-NUS's campus life will strengthen me in this aspect even further.

As a whole, Duke-NUS strikes me as a school that has academic intensity, strong focus on research, diverse student culture, and a commitment to service. I see Duke-NUS not solely as a step towards becoming a doctor, but also as a journey to better myself, feed my intellectual curiosity, be surrounded and inspired by outstanding students and teachers, and hopefully, become someone who can make a positive impact on the medical field. Since the first day I heard of Duke-NUS, it has been a place that I look forward to going to. Although it took me many years to fulfil my other obligations before I can apply for it, I am glad that I am now taking this step further towards my dream. I look forward to the day when I can walk into the school building and whisper to myself: "I finally come here, to this place I want to feel proud of, to this place I want to call home."

Graduate / Duke-NUS graduate medical school "Moral and ethical dilemma" [3]

Prompt
"MD Essay 4: Moral and Ethical Dilemma
What is the most significant moral or ethical dilemma that you have faced in your life thus far, excluding academic dishonesty? Describe how you dealt with and potentially resolved it, including personal and societal beliefs, ethical/ philosophical principles, resources, individuals, etc. How did this dilemma and its resolution change your life? What impact will this have on your future as a healthcare provider?" (no word limit given, hence the length...Please advice on how to cut the length)

All suggestions, corrections, critics are welcome! Thanks in advance.

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During my four years of being a teacher, one question that I frequently ask myself is "should I do this as a good teacher?" I ask this question not to be regarded as a good teacher by my students or colleagues or superiors; I ask this question because as a teacher, I want to make sure that everything I do is worthy of my students' trust. Most of the times I can get the answer easily because many things we do are easily justifiable as being good or not good for students. However, there was once that I could not answer this question to myself.

Every end of semester, I need to give conduct grades to my students for their behaviour in school over the semester. It is a very routine task and we have a few indicators which help us easily identify what grade should be given to a particular student. The indicators include general behaviour, punctuality, attitude and a few others. One ordinary afternoon near the end of a semester, the school counsellor came to me and asked me about the "fair" grade that I gave to a student. "Oh yes, he was late for twelve times this semester - absolutely a 'fair' grade." I answered. "But he is on financial assistance which requires him to obtain at least a 'good' grade to continue receiving the money to pay for his school fees!" The counsellor told me. She was right, but whether a student is under financial aid or not should not affect our decision on the conduct grades. I looked at her for a few seconds before she start talking again in a lowered voice:" I suggest that you just go and change it to a 'good'. It will make things much easier and he won't lose the financial aid."

After she left, I took out my file and checked through that student's record again. He was indeed twelve times late for school. Every time he gave the same reason of waking up late. In fact I have spoken to the parents about this issue but the parents woke up even later than him. I gave him an alarm clock and asked him to set two alarms. I had also asked several of his friends to take turns to call him in the morning but he often refused to answer the call. His house is not too far away from the school, so it was very clear that the problem is his attitude - he did not take it seriously and make the effort to come to school on time. However, if I give him a "fair", he would lose his financial aid for one whole semester or even longer (if he fails to regain a "good" grade in next semester). How is the family going to pay for his school fees? There were three children in his family but only his father was working. It would be a hard time for the family without the financial aid. Am I being too harsh to him? Aren't teachers supposed to be compassionate? Will the family complain to school management that I am not a caring teacher? Probably such things had happen before and what the counsellor suggested to me was the usual solution which seemed to be good for everyone. On the other hand, what if I change the "fair" to a "good"? Should I feel happy because I saved his financial aid? I might be happy for his family because they don't have to worry about the school fees, but other than that, I would have a lot of worries. First of all, I don't think a responsible teacher should give a student a "good" grade which he does not deserve. If I can freely change the grade, the whole grading system will lose its meaning and I am not being fair to other students who put in their effort in behaving well in school. Secondly, by giving him a "good" and letting him to continue receiving financial aid, I fear that he will take many things for granted. The purpose of financial aid is to encourage students from low-income families to behave well and work hard so that they can be rewarded in such a way. If this student gets the financial aid despites his unsatisfactory behaviour, he would think that the financial aid is a right with no obligation. It is very likely that he will continue to come to school late frequently in the subsequent semesters and years without realizing the importance of being punctual. In either ways, there is going to be further problems that are difficult to solve.

I thought about it over and over again for many days until the deadline of submission. On the webpage of students conduct grades, I clicked his, deleted the fair, and typed in g-o-o-d.

Then I clicked "cancel".

In his report card, his conduct was "fair".

I had a long talk with him. I explained to him why I gave him this grade and that he would lose his financial aid next semester. I told him that he must learn to be punctual in next semester so that he can get at least a "good" to regain his financial aid. I gave him another alarm clock and asked him to work out a plan to wake up on time starting from one week before next semester starts. I also gave him a name card of the manager of a nearby fast food restaurant, who will offer him a part-time job during the holidays. With this job, he should be able to earn enough money to pay for his school fees next semester. I told him that it is ok if he hates me, as long as he can learn from his past mistakes and become more responsible for his own behaviour, it's worth it. After all, I did not change it in the end because I wanted to be responsible for him, for other students, and for myself. I did not want him to take things for granted and I wanted him to face the consequence of his own behaviour this time. Without the financial aid, there are still other ways to get his school fees paid; however, if I did the change, the damage to his responsibility and mindset may not be that easily reversible.

This incident taught me that I should not only focus on the short-term gain or loss, but to look at things in long term - bring out the best in the long run. As a future healthcare provider, I will also apply the same principles which I believed for many years: make sure that everything I do is worthy of the patients' trust. When making decisions, do not only look at the immediate effects, but also long term effects, and decide what is best for the patient, while trying my best to help them in every way I can.

Graduate / 'An investigative research project in Singapore' Research experience Essay - Duke NUS [4]

"Have you participated in or conducted investigative research? If so, please describe your involvement in the project. If you have published or are listed as an author on a publication or manuscript in press, please provide the title, authors, and name of the journal. If not, please describe an instance where you solved a problem you had never faced before.

How do you envision incorporating research into your ideal career?"

There is no word limid but feel free to help me cut it down. I have this problem of being long-winded... All suggestions, corrections, critism are welcome!

SEE BELOW

From May 2005 to March 2006, I undertook an investigative research project as my Honors Year Project in the National University of Singapore. The aim of the project was to study the effects of Hydrogen Sulphide (H2S) on KATP channel activity in myocardial ischemia-reperfusion model. Hydrogen sulphide has been known as a toxic gas and an environmental pollutant for decades. However, in recent years there has been accumulating evidence to show that H2S is also an endogenously-generated biological gas exerting pronounced physiological effects, particularly in the central nervous system and the cardiovascular system. These findings place H2S well in the novel family of endogenous gaseous transmitters, termed "gasotransmitters", together with gases like nitric oxide (NO) and carbon monoxide (CO). What primarily interested me to undertake this project was the fact that these seemingly quite harmful gases can actually be produced by the human body and can exert important functions there - a fact that is hard to believe! Therefore, I chose to do this project to find out more about H2S and its physiological effects.

The results of my study demonstrated that the H2S donor, NaHS, exerts a marked protective action against injury during myocardial ischemia-reperfusion, in a way similar to the cardio protection induced by ischemic preconditioning (IP, single or multiple short periods of ischemia or hypoxia). The cardio protective effects of H2S was glibenclamide- (a non-selective KATP blocker) and 5-HD- (a selective mitoKATP blocker) sensitive, supporting the involvement of H2S -induced KATP channel opening in the cardio protective mechanism. In addition, HMR1098, a selective sarcKATP blocker, did not affect the cardio protective effects of H2S, indicating that the protective mechanism is via preferential opening of mitoKATP channel, but not sarcKATP channel.

I did the project largely on my own, under the supervision of my supervisor Dr Zhu and a research fellow. It was challenging experience but exciting and fulfilling. I had to learn a lot of things that I have never done before such as performing intraperitoneal injection on rats, preparing chemical solutions that I have never heard of before, learning to use numerous different machines, techniques and assays etc. One important thing that I learned while doing this project was how to face frustration positively and not give up easily. Being an undergraduate student without much experience in research, the initial learning phase was really overwhelming and sometimes frustrating. A big difference between course work and research is that in a classroom, there is always someone there to help you to clear your doubts; whereas in a lab, everyone has his own job to do and if you need help, you must learn to rely on yourself and find out the solution.

The instance where I solved a problem that I had never faced before is not a big discovery or a significant improvement. I don't think anyone in my lab would still remember it, but I remember it very clearly. When I was preparing the paraffin sections of the heart tissue to do my TUNEL assay, I had to use a microtome to cut my specimen into 5 ľm sections and then mount the sections onto glass slides. I spent many days practicing my cutting and mounting skills to make sure that I am competent enough to handle the actual specimens. However, I just could not get the sections properly flattened on the slides - and this is detrimental because it is important to be able to view all the cells clearly when doing the TUNEL assay. I consulted everyone I know who had done paraffin sections before, but all I got was just "practice more and be patient". When I returned to the small room, instead of start cutting again, I stared at the microtome and started thinking what other factors may have caused the problem. The microtome is not a complex piece of machine. There were others using it so I knew it is functioning well; I had changed the blade to a new one but it did not solve the problem. What else can it be? I looked around and finally stopped at the cooling device. The cooling device is used to harden the paraffin with the tissue within it so that it can be cut easily. Being a person who enjoys cooking, I suddenly recalled the difference between cutting fresh meat and frozen meat. "Maybe the specimen is not cold enough", I told myself and selected a lower temperature on the cooling device. To my joy, it worked and I could lay my sections perfectly flat on the slides! After confirming with my supervisor that this is not going to affect my results in any way, I prepared all my slides for TUNEL assay using this adjusted temperature to cool down the paraffin. This may be trivial, but I was glad that I could use my own knowledge, experience and thinking to overcome a problem in my research. It also taught me the importance of keeping an open mind and flexibility when dealing with pre-set parameters in experimental protocols.

Although I do not have much experience in independent research, my ideal career in medicine definitely cannot be separated from research. I believe that research is an intrinsic part of medicine and a good physician needs to be a good researcher as well. Most (if not all) the clinical practices come from extensive research, especially in today's society. Take pharmaceuticals as an example. Every potential pharmaceutical product must undergo years of research and development, including in vitro and in vivo testing in animals and humans before it can be approved to ensure its safety and efficacy on patients. Being a good physician, it is not only important for us to know what to use to fight a disease, but also to understand how it works and how it came about. Therefore, my aim as a doctor will be to make medical research into an integral part of my clinical practice, so as to improve the current practices while looking for better and potentially more effective ways out.

Graduate / 'My motivation to study medicine' - Duke-NUS graduate Medical school [3]

Dear all:
Below is my PS for applying to Duke-NUS graduate medical school. The deadline is near so I need some urgent help in correcting grammar mistakes, advice on how to shorten it (there is no word limit, but i feel it's way too long, probably due to the fact that i am not a fresh graduate so i have a lot more to say), any awkward sentence etc. Please feel free to criticize! THank you in advance!

SEE BELOW

My motivation to study medicine came from a variety of sources over many years of my life. When I was in secondary school, I truly enjoyed learning biology especially the chapters about human body and systems. The curiosity in biology let me choose to study life sciences in National University of Singapore and I graduated with a Bachelor's degree with Honours in life sciences (concentration on biomedical science) in 2006. In the same year, I received a Teaching Award from Ministry of Education to pursue a Postgraduate Diploma in Education in the National Institute of Education to teach biology and chemistry in secondary level. After completing my studies in NIE in 2007, I have been teaching biology in NUS High School of Math and Science for two years and Shuqun Secondary School for two years till present. At the mean time, my dream of being a doctor has never left me. Due to various reasons I was not able to study medicine at undergraduate level. I once thought it was going to be a dream that would never come true. However, the founding of Duke NUS Graduate Medical School in Singapore offered a second chance to people like me, and I am very excited about it. To me, studying medicine and becoming a doctor is an excellent platform to combine my knowledge, practical skills and personality. The prospect of life-long learning and exploring the human body and its diseases indefinitely is really exciting and attractive to me.

From 2000 to 2007, I volunteered in three hospitals in my hometown - Urumqi, Xinjiang, China. The first one was an ophthalmology hospital in which I helped patients with sight problems in walking, eating and other basic needs such as talking to them and reading newspapers or books to them. The second one was a children's hospital. My role involved helping the children with their daily needs as well as playing with them and keeping them happy (or at least positive). The third one was a general hospital with a variety of patients with diverse conditions and needs. Besides assisting patients in their basic needs, I also had the opportunity to help in some administrative work such as typing medical records into the computer for the nurses, and even following doctors and observe their daily work. I enjoyed the experience very much and found it very rewarding that I was able to care for other people and help them in their difficult times. I also learned a lot of skills which I would never learn in school such as some basic clinical care skills, administrative tasks and communication skills. The volunteer experience provided me with a better understanding of patients' emotional and physical needs as well as the importance of empathy and effective communication. Working in a hospital requires one to be able to communicate with people from very diverse backgrounds and needs, so it is critical to be able to communicate clearly with not only patients but also other staff members. The work experience in hospitals also provided me valuable perspective on the stress and challenges a physician faces everyday. Being a physician is not simply about helping people and saving lives. A good physician should also be a good team worker, a good leader, a good communicator, and a good friend. It is definitely rewarding to be able to have a significant impact on patients' lives, but a good physician will find it equally important to stay strong and face situations when they can't save a life.

In 2000, at the age of 17, when all my friends were busy preparing for the national exam to enter college, I started volunteering in hospitals. It was because I personally witnessed doctors' job from the perspective of a patient, and that experience reinforced my commitment to study medicine. On 8 Sep 2000, an ordinary afternoon on my way home, I experienced a bomb explosion. According to the government's explanation, military trucks were transporting some old weapons to another warehouse and the trucks were stopped in traffic jam when the bomb (or bombs) exploded due to unknown reasons. I was in a bus and soon realized it was an explosion. When I stood up I saw blooding coming off from my head and everything turned red. I heard people crying and shouting. After realizing the door could not be moved, I jumped out from the bus window and started running and soon lost my sight. I cried for help and luckily someone grabbed my hand and run with me until the help arrived and sent us to hospital. I spent 4 hours in darkness lying helplessly on the hospital corridor, unable to contact my parents because I cannot see anything. There were too many people who were injured and the doctors just could not handle so many people at the same time. I still remembered how happy I felt when a doctor finally came and talked to me, pulling open my swollen eyelids and telling me that I would not be blind. It was later found out that my lost of sight was due to injuries of my eyelids and glass residues on my cornea. All my injuries were external and mainly on my face, neck and arm. I spent two months in the hospital before I fully recovered. I experienced fear and a lot other emotional changes during that period of time. As I got better, I learned to face it positively with the encouragement of doctors and nurses who I sincerely appreciate. I started helping them with their administrative work and daily checking on patients. I talked to other patients and encourage them with my own experience. This was how I first started my volunteer work. Since then, I wanted to study medicine and become a doctor to contribute back to the society.

This incident happened 10 months before my National College Entrance Exam. After NCEE, I chose medicine as my major for all my choices of university. However, my first choice was too competitive with only 2 vacancies for medicine in my province and I did not get in. I did not get my second choice either because all the vacancies were fulfilled by first choice students. In the end I got into my third choice university which offered me Engineering. Being a third choice student, I was not able to choose medicine. During matriculation, I was informed that I was eligible to take part in a selection exam to study in Singapore under scholarship. I took part in it and was eventually selected to study in NUS. However, we were only allowed to study computing, science or engineering. In the end I chose life science because it is most closely related to medicine. It seemed to me that my dream of studying medicine had turned further away from me since then until I heard of the founding of Duke-NUS.

I have been working full-time as a secondary school teacher since Dec 2007. The subjects that I have taught include general biology, lower secondary science, molecular genetics, inheritance and population genetics etc. Besides teaching, I have also taken up CCA duties such as Student Leadership and Environment Club. My work experience has provided me with valuable attributes such as communicating with different people (students, colleagues, parents etc), actively keeping my content knowledge updated, exploring different strategies of teaching (using ICT, Self-Directed Learning, Collaborative Learning, alternative assessment etc) and being a good team-worker. I believe the experience will have a positive impact on my medical training.

In my fours years of teaching I have also learned to work and study well under pressure. While studying in NIE, I went through my pregnancy and childbirth. I spent my third trimester doing practicum in NUS High School and gave birth one week after completing my practicum. 3 weeks after giving birth to my daughter, I went back to NIE to complete the remaining two modules of the program. In Nov 2007, when my daughter was two months old, I successfully completed my training and received my PGDE with Credit. In 2009, I started my part-time Masters study in pharmaceutical science and technology because of my interest in pharmaceuticals. For two and half years, I took multiple roles as a full-time teacher, a part-time Masters student, and a full-time mom. It was challenging, tiring but fulfilling. I have learned to work and study under a lot of stress, prioritize tasks, meet deadlines and balance my work, study and life. I am glad that I went through it and the experience will certainly provide good grounding for the rigor of medical curriculum and practice.

I am a keen traveller and I enjoy going to different places to experience diverse cultures and scenes. I especially enjoy trekking and mountain climbing which I believe helps strengthening one's mind. I like singing since a very young age and have performed in numerous occasions such as school concert, charity concert and in music cafes in Singapore. Though not a professional singer, I really enjoyed working with other people with similar interest for a common goal such as putting up a concert. Singing is also a good way to de-stress myself. As a Chinese, I love Classical Chinese poetry. I began learning to recite them at the age of 3 and have lost track how many I can recite now. My favourite poems are mainly those written in the Tang and Song Dynasty. I began learning Japanese language as electives when I was in NUS. I took 5 Japanese modules, Japanese 1 - 4, and Business Japanese. It is quite a unique language with very rich culture and history which I enjoyed learning. After learning it for 3 years, I passed level 1 (most advanced) of the Japanese Language Proficiency Test (JLPT), which is the most prominent standardized test offered by the Japanese government.

I believe I have many of the personal attributes necessary to become a doctor, such as being patient, caring, compassionate and being able to work well in a team. My passion in medicine makes me a self-motivated learner with an inquisitive mind. I feel that my many years of volunteer experience has given me a realistic appreciation of the challenges and requirements involved in a physician's job, but I also believe that my personal experience has given me the strong motivation and perseverance to go through medical training and become a good doctor to contribute to the medical field in the future.