M1 at the Johns Hopkins School of Medicine
Ishu Sivakumar
TL;DR
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First generation immigrant
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First in family to attend medical school
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Studied abroad at the University of Oxford
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Took a gap year
Overview
Hi everyone, I hope you’re staying safe and well! My name is Ishu Sivakumar, and I will be starting at the Johns Hopkins School of Medicine in August. I attended Hopkins for undergrad as well, and stayed for my gap year. While my extended time in Baltimore may suggest that I don’t enjoy exploration and change, I have experienced a lot of it, which I hope this narrative will illustrate.
I was born in Chennai, India surrounded by an enormous family. A few months later, my parents and I moved to Oman, and then to the United States. I grew up in Herndon, Virginia and was fortunate to be surrounded by diverse classmates and a great education. However, when we first moved to the United States, we were not in a stable financial situation and relied almost entirely on cheap, fast food. I therefore struggled with severe childhood obesity. This condition negatively affected my relationship with my classmates and the world around me, and it tarnished my relationship with myself. As I grew older I worked out constantly and watched my diet, but it was only until high school that I lost a significant amount of weight in a healthy manner.
It was hard to be judged for something that was not entirely in my control. I won’t go into detail about the negative comments I received about my weight, but to say that they harmed me would be a huge understatement. People who are overweight are often stigmatized as lazy and a drain on taxpayer dollars, but there are so many systemic factors that can negatively affect this condition. As I lost weight I reflected on my privilege and the hardships of populations that may not have access to food, gym memberships, or transportation. How can we judge those that never had a shot? Moreover, I recognized the toll my weight had taken on my self-esteem and mental health, and I realized how impactful society can be on individual wellness.
When I was young, I was hyper-aware of my weight, and my hobbies were a way to distract myself. Art, math and reading were my refuge. As the first child in my family to immigrate here and with no relatives in medicine, becoming a physician was not on my mind. It was through my long standing personal experience that I understood the role of healthcare in overall wellness. As this interest grew I pursued more activities in high school that related to science, but also to humanity. I competed in the Science Olympiad, founded a club for UNICEF, and started my lasting involvement in Model United Nations. These activities meant a lot to me because they tied science to society, and this is the sentiment I have carried throughout my medical journey.
Starting Undergrad & Studying Abroad
Growing up in Northern Virginia, I was surrounded by a competitive community of immigrants. I knew I wanted to go to college out of state, in a more diverse environment, with a focus on STEM. I applied to Hopkins for undergrad knowing that it emphasized research, service, and strong academics, but I didn’t expect to learn this much from Baltimore and stay for so long.
When I first started at Johns Hopkins University, I felt like a small fish in a massive pond. I had intentions of becoming a physician, but doubts about my intelligence and my lack of connections plagued my mind. Now I know that imposter syndrome weighs heavily on many students (and you should check out SS2M’s recent one-pager on this common problem). Freshmen are told to pull all-nighters, eat unhealthy food, and work themselves into an oblivion, but this caused me to burn out and feel quite lost. In the spring of my freshman year, I was sitting in a lecture, exhausted, when a professor presented an opportunity to study Biochemistry at the University of Oxford for a year. She spoke of previous students benefiting from new learning styles, exploring their academic interests, and generally loving their time there. This seemed like an exciting second chance: something clicked inside me and I was resolute to turn my experience around. Many people told me that it was a bad idea to study abroad, as I would be gone my entire sophomore year and it would interfere with my clubs, leadership, research, and resume. But I applied for myself and not my resume, and this decision led to one of the most self-fulfilling experiences I have ever had. I was accepted into the program in the spring of my Freshman year, and left for England in August. It was a bit nerve-wracking going to a new country with a group of students I had never met, but I was also proud of myself for taking this leap of faith.
My experience studying abroad strongly benefitted my academic, social and personal life. Oxford uses the tutorial system, which supplements regular lectures with small group sessions. Homework in major science courses was heavily essay-based, requiring a lot of reading and self-studying. We were asked questions that required us to think beyond the basics and develop our intuitions. I began to find my voice in science and develop more useful study habits. I also had so much fun– something that we, as pre-med students, often undervalue! I made incredible friends, travelled, took up photography, and even joined a rowing team. Opening up my mind to new experiences made me happier and healthier, and it was a positive turning point in my pre-medical journey.
Coming Home
When I returned to Hopkins as a junior, I thrived. I continued my major in Molecular and Cellular Biology, but also committed to a minor in Bioethics to tie small scale mechanisms to the large scale ethical questions in healthcare. I stopped framing my studying around exams and tried to understand major concepts for my own comprehension. This was more fulfilling, allowed me to make connections between classes, and drastically improved my GPA. I dedicated more time to clubs I was passionate about, including an undergraduate medical journal, the Hippocrates Medical Review (HMR), and the pre-health honor society, Alpha Epsilon Delta (AED). Connecting organizations to the community, including increasing access and variety in the journal and expanding community service in AED was important to me. I believe my sincere interest and confidence led to my leadership roles in these organizations. By considering how we could improve organizations and taking feedback, I developed leadership platforms. If you have genuine interest in an organization, you should ask about leadership positions, develop your ideas for improvement, and apply to make an impact!
Another notable realization I had in undergrad was my interest in combating systemic inequalities through service and research, as I pursued my bioethics minor, worked with organizations around Baltimore, and developed my interest in sickle cell disease. My experiences as a child drove me to think of solutions, both in the community and through research. When looking for positions, I relied heavily on my University’s Pre-Professional Office, which sent out newsletters with opportunities. I also looked at the pre-professional websites of other universities, which listed opportunities for the public. When applying to research experiences I recommend doing your homework on the lab’s website and publications, and showing genuine, specific interests when contacting them. Briefly discussing your previous experience is also great (and if you don’t have any, that’s okay– just show an eagerness to learn)!
I interned at the NIH Sickle Cell Branch during the summer after my sophomore year and was stunned by the physiological impacts of sickle cell on patients, most of whom are of African American descent. Chronic pain, retinopathy, opioid dependence, and organ damage are just a few complications of this condition, which intersect with the systemic issues African American patients face already (food insecurity, housing inequality, lack of representation in medicine– the list goes on). I then started volunteering at the Johns Hopkins Sickle Cell Center for Adults, where I worked on clinical projects and interacted with sickle cell patients: hearing about their experiences from their perspectives. I have so much more to learn, but through these roles I took small steps on this greater path to educate myself. As future physicians we need to pay attention to the experiences of marginalized communities, or we will not become the conscientious providers that this world so desperately needs.
My work at the NIH also piqued my interest in basic science research and prompted me to join a lab as a junior in the Johns Hopkins Radiology Department. I felt at a disadvantage starting long-term research as a junior, but with resilience and extended support from my mentors I was eventually able to present and author my work.
Balancing all of these activities with classes and my wellness was not easy. Personally, I liked to plan my weekly schedule on my Google Calendar, which helped me identify times to relax and hang out with my friends. I also realized when I had too much on my plate. If there was a hard week, I wasn’t afraid to ask for support: you are not weak for taking a break and letting others know that you are having a hard time. In organizations I was a part of, I communicated to my team members if I needed help, and they were extremely understanding (and I tried to empathize with others when they needed it).
Being transparent with my PIs, supervisors, and clubs about my schedule was helpful. If you’re in a supportive learning environment, your supervisors will understand that you are a student and you have other commitments. I set up times to come into the lab at the beginning of my experience and stuck to them. Of course, there were weeks that I came in much more, stayed later, or even had to skip lab because of other commitments. But my team appreciated my communication skills and consistent effort. Overall, my college experience was more meaningful and I was more certain of my passion for medicine.
MCAT
My newfound study habits were useful when I started preparing for the MCAT, which I took in the winter of my junior year (mostly because I was still deciding between taking a gap year or not). To succeed on the MCAT one must understand their personal learning style and realize that this exam is a marathon. Because I had honed my study habits through trial and error, I knew that I am a visual learner who needs to write things out and apply knowledge. Therefore, I took practice tests every week for three months before my exam. I made my own flashcards and physically wrote out information to internalize it. I felt confident walking into the exam because I had been taking it for so long, and I scored exactly how I was doing on my practice tests.
Although I felt confident, studying for the MCAT was still stressful and I tried to practice wellness throughout the process. Communicating with my family and friends about the pressure I was feeling helped them support me. By starting to study early, I made time for sleep, exercise, and hobbies. It is extremely important to not completely lose oneself in any part of the pre-medical journey: your mental health should be a priority.
Despite the difficulties I had at the beginning of college, I managed to graduate a semester early with a strong academic standing. By distancing myself from toxic habits, making decisions for my happiness, and allocating time for my wellness, I was able to focus on being the best version of myself. I would also like to stress that I had the privilege to access resources and take time for my personal wellness throughout college. There are so many applicants who are disadvantaged, which strongly impacts performance and well-being. My experience in college was hard, but it’s nothing compared to the experiences of students who work multiple jobs, support family members, lack appropriate mentoring, etc. More resources need to be made available for students facing obstacles, and equity needs to be achieved in the application process. I believe this platform is a small piece in that larger effort.
Gap Year and the Application
My gap year in Clinical Research did not look exactly how I would have liked because of COVID-19, but I still was able to pursue my passions and work as a clinical research coordinator in the Johns Hopkins Hematology Department. I continued my work with sickle cell and also pursued some projects concerning coagulation in COVID-19. This position integrated my interests in research and patient care, but also addressed the major lack of research towards conditions affecting underrepresented populations.
As COVID-19 broke out and healthcare workers were strained, many people asked me if I still wanted to pursue medicine. Since the pandemic started, I have felt an intense sense of helplessness. I have hated being on the sidelines. Patients I work with were at high risk because of their chronic conditions, and existing healthcare gaps were made to be more apparent. For the past few weeks, I have seen COVID rip through India, affecting my entire family, and crumbling the country’s healthcare system. The effects of COVID on minority communities, the ongoing violence worldwide, and the uncertainty of the world is disturbing. But these issues have honestly been a strong motivating factor throughout the application cycle, and I hope I can have an impact on them as a physician.
According to the AAMC, there was a 18% increase in the number of applications in the 2020-2021 cycle. This significant increase is a testament to the attitudes of pre-medical students driven by the issues our world faces, and I am so honored to be a part of this collective motivation. As an applicant I was daunted by this increase, but I knew that I was prepared and my newfound confidence was a huge advantage. My biggest piece of advice for anyone applying to medical school is to take the time to reflect upon yourself and be realistic with your expectations. A high GPA and a solid MCAT score will surely help, but you need to show your passions through your writing and verbalize your experiences. If you believe in yourself and your cause it will come across to the admissions committee.
Choosing a School!
Applying to medical school is a formidable achievement in itself, regardless of the outcome. We tirelessly take exams, write essays, and interview hoping for a chance at admission. Before I discuss my medical school decision I sincerely commend anyone who has gone through this application process– you should be so proud of yourself, and the outcomes of your cycle do not define you as a person. Your drive, resilience and compassion (which you must have if you are applying in the first place) most certainly do.
I recommend that anyone applying to medical school think of their priorities before applying and consider factors that will contribute to their quality of life. Sure, there are metrics and people care deeply about prestige, but you are ultimately the person that has to go to this school. Prioritize your happiness! Some of my particular interests include urban health, minority health, and working with the underserved. Therefore, I knew that I wanted to live in a diverse, urban environment and have a shorter preclinical curriculum, so I could spend more time exploring my clinical interests. I don’t know what specialty I want to pursue, so I want more time in these clinical experiences, which I greatly enjoyed in undergrad. I also almost entirely applied to institutions on the east coast to be closer to my family and existing support network, which was a major priority of mine. Medical school is difficult, and I knew that being near my loved ones would help immensely.
Making a decision is exciting because you finally feel like you are in control: this is your time to pick the best fit for your future. After I received my decisions, I was very fortunate to be deciding between a few schools that fit my criteria. My choice to attend Johns Hopkins was simple when I thought of everything I wanted: it is close to loved ones, I know I enjoy living in Baltimore, and the financial aid was generous. My positive experiences working with Hopkins faculty thus far assured me that I would be supported as a medical student. Something that was incredibly valuable to me was the supportiveness of the student body. Growing up in a cutthroat environment and going to a competitive university was hard, and I really wanted to attend a school where students are happy and collaborative. Talking to current students, paying attention at second look, and meeting my potential classmates made it clear that I would enjoy my time at Hopkins. There were many additional factors, including access to research, opportunities for service, and so on. But possibly the most important (and cliché): there was also a gut feeling that this was where I would thrive.
I hope that this synopsis shows you that you need to value yourself to be the best student, physician, and person possible. Throughout my journey I realized that in order to advocate for others, I needed to learn how to advocate for myself. Now, I am thrilled to start medical school and serve in the city that has taught me so much already, with the community that uplifted me so highly.