Dec 18, 2019

Dr. Chan: What's it like to move from Italy to the United States before ever learning English? What's the difference between Italian medicine and medical practice in the United States? What's it like to get your acceptance to your top choice medical school on Valentine's Day? And how does one prepare for the multiple mini interviews?

Today, on "Talking Admissions and Med Student Life," I interview Ludovica, a first-year medical student here at the University of Utah School of Medicine.

Announcer: Helping you prepare for one of the most rewarding careers in the world, this is "Talking Admissions and Med Student Life," with your host the Dean of Admissions at the University of Utah School of Medicine, Dr. Benjamin Chan.

Dr. Chan: Well, welcome to another edition of "Talking Admissions and Med Student Life." Ludovica.

Ludovica: Yes.

Dr. Chan: How are you doing?

Ludovica: I'm doing well.

Dr. Chan: Brand new first-year student.

Ludovica: Yes. This is my first official week.

Dr. Chan: First week of class. Oh my gosh. All right. So we're going to get to it. Okay. So timelines, go back to the beginning. Where did you grow up?

Ludovica: So I'm originally from Italy. I grew up in Rieti, really close to Rome. And then I moved to Utah when I was 12. So I did half and half, I guess, my life. Half in Italy and half here.

Dr. Chan: And did you speak English before you came to Utah, or did you just kind of pick it up here?

Ludovica: I picked it up here. I had to learn it. Actually, I was first in Virginia, and then I moved to Utah. And over there, they did a little English second language course. So they taught me all the basics, and then I had to learn it on my own.

Dr. Chan: Did you get a chance to go back to Italy?

Ludovica: Yes. I go back usually every summer. And during the first few years, I was back over Christmas as well.

Dr. Chan: And then your Italian is strong? People can't tell you live in America now, or are you starting to get a little American accent when you speak Italian?

Ludovica: So my accent is good. I will occasionally say some things, like the sentence structure will not flow as well if . . . for example, I was back in Italy over the summer, and I hadn't been back in a while. So when I was speaking to people, there were some things that sounded off. But I like to think that I try to keep it still at a pretty college-level Italian.

Dr. Chan: That's good. All right. So when did you decide to go to medical school? Where did that start? Why did you want to be a doctor?

Ludovica: So my uncle was a doctor when I was in Italy, and he was a little traveling doctor. So he would go to the little tiny towns in Italy and visit patients there. And he was also my doctor, which is kind of weird because he was my uncle but . . .

So, from there . . . I don't know. I just developed this passion for medicine. And I really liked looking at stethoscopes and just trying to learn I guess how it worked, how he was able to diagnose my diseases, because I was sick a lot as a kid for some reason. So that's where the interest developed.

But then when I came to the U.S. and I started becoming more involved mainly when I was in college, that's when I truly developed the passion for medicine.

Dr. Chan: And do you remember . . . like, is there a big difference between visiting the doctor in Italy versus the U.S.? I mean, do you have those memories, or . . .

Ludovica: Yeah, I do remember. So even when I used to go back to Italy over the summers, even after I had moved here . . . for example, there was a time that I fell and I had to go to the emergency room for stitches. And, as you know, in Italy there is the system that is universal healthcare. So it was a little different in the sense that I would just walk in and then they'd take care of me. And then I did have to wait, unfortunately, in long lines. But other than that, I guess the treatment was very similar, but just the way the healthcare system is managed is a little different as well.

Dr. Chan: So you're thinking about med school and then, you know, came to Utah when you were 12. And then you went to undergrad at The U, right?

Ludovica: Yes, I did.

Dr. Chan: What prompted you to stay in state? Why did you pick The U for your undergrad studies?

Ludovica: I really liked the research opportunities that were present at The U, and it was a larger university so I knew that there would be a really good pre-med program. And from other friends, I knew that they had really good pre-med advisers. So I wanted to make sure that I had all the right resources to go to. And also, at the time, I was volunteering at the Huntsman Cancer Institute, so it was really close to The U, and I knew that it would be great for all the opportunities.

Dr. Chan: What did you do at Huntsman?

Ludovica: So I was in their patient and family comfort care unit. I started in 2012, so back then, not everyone had their little iPads, and MacBooks, and whatnot. So I used to bring movies to patients and snacks too. And so it was a very simple task, but it also gave me the opportunity to just chat with them and let them talk to somebody who wasn't just a family member or a doctor.

Dr. Chan: It sounds like a comfort care.

Ludovica: Yeah, exactly.

Dr. Chan: So, if it's at Huntsman Cancer Institute, probably the patients were getting infusions or treatments.

Ludovica: Yes. I was mainly in the in-patient unit, so all of them were staying there for a few days. Some of them were actually coming from other parts of the U.S., mainly from Nevada, Wyoming, the area surrounding Utah.

Dr. Chan: Oh, cool. All right. So you're doing Huntsman Cancer Institute. What other activities did you do in undergrad?

Ludovica: So I became a CNA. That's Certified Nursing Assistant.

Dr. Chan: Interesting.

Ludovica: So I worked in an assisted living facility for a year. And it was a very small one. So there were only 12 patients and there was myself and another CNA. And so we'd take care of all patients who had Parkinson's disease, Alzheimer's, or dementia as well.

And then we'd also . . . not only were we taking care of them, we'd also be cooking them lunch and dinner. So it was very busy because there were only two people.

But it was a really good experience. I think it really did help me understand the progression of certain diseases more so than just doing research. I think I could actually see it. I could see the visual effects of Parkinson's, and it was really impactful for me.

Dr. Chan: Wow. So you go through a CNA training, right?

Ludovica: Yes.

Dr. Chan: And that's like 20, 30 hours?

Ludovica: The course I did was through the Salt Lake Community College, and it was a month of training and then you had to do clinical hours. So a month of, I guess, taking courses and then clinical hours, and then you have to take a written exam and an oral exam.

Dr. Chan: Okay. Obviously, you did well.

Ludovica: Yes.

Dr. Chan: And then how did you pick the Parkinson's space? How did you pick that unit to work at?

Ludovica: So it was really close to my home, to where I live. I live just 30 minutes from Salt Lake. So it was a smaller facility, and it was one of the first people that responded to me when I had applied for a job. And I really liked it. I wanted to have more, like, one-on-one time and eventually I wanted to work my way to the hospital and being a CNA there, but I really enjoyed being there.

Dr. Chan: Cool. So you're a CNA, comfort care, patient care up at Huntsman Cancer Institute, and then you mentioned research. So what kind of research did you get involved with?

Ludovica: So I coincidentally met an Italian doctor, who at the time was living in Utah, and he worked in the neurology department. And so I worked on his project on Lewy body dementia, which is a type of dementia where these little protein plaques will form in the nerves of the brain, and it causes dementia and then motor symptoms as well.

And so I helped him create kind of a database where all the Lewy body dementia symptoms were entered, because sometimes it's misdiagnosed with Parkinson's disease. So that's an important thing to note. They are very similar, but there are some critical differences that are important to note if you're trying to find the exact treatment for the patients.

Dr. Chan: So were you looking at, like, imaging or are you looking at rats? I mean, what did you do for the research exactly?

Ludovica: So mine was mostly analyzing the reports that the physicians would write on the patients. And so I would go in and look at the key symptoms that would often appear in people that were diagnosed with Lewy body versus Parkinson's disease.

Dr. Chan: Okay. I see. All right.

Ludovica: So it was a lot of charting and data analysis.

Dr. Chan: Chart review. Data analysis.

Ludovica: A lot of it.

Dr. Chan: Okay. Wow.

Ludovica: Lots of reading.

Dr. Chan: And you mentioned this physician is also Italian.

Ludovica: Yes.

Dr. Chan: Is there a large Italian community that you're a part of in Salt Lake City or Utah?

Ludovica: It's not very large. It's quite small. But I would go to occasionally little meet-ups that they had so I could keep talking to some Italian people and just meeting people from . . . they're not from the same part of Italy as me, so from other regions. It's very small though. Compared to New York City or San Francisco, here, it's very tiny.

Dr. Chan: All right. So you're having these great experiences. You're progressing through your undergraduate career. Walk me through what was your philosophy or strategy when it came to applying to medical school? How many schools did you apply to? What did you look for in these schools? How did you approach that?

Ludovica: So I was looking . . . of course, the University of Utah was my top choice because it was really close to my university, I was able to stay in-state, and I loved all the opportunities that I would have here. So I tried to find schools that were similarly ranked to my university just so I could see if I could be a potential good candidate for the other schools as well. So, initially, I had 16 schools.

Dr. Chan: You applied to 16?

Ludovica: Yes, primary application to 16 and then narrowed down secondaries to 14, which probably wasn't the smartest idea, but I eventually researched and decided that two of those schools were not for me.

Dr. Chan: What did you see in those schools that didn't resonate with you?

Ludovica: So some of them, there were application letters, so letters of recommendation that I didn't have, that would not fit the application for one school, and so I knew automatically that I would not be qualified for the interview. So that's how I limited one school.

And then another one was . . . I think some of their philosophies didn't line with what I wanted to do really, and then the location too.

And then another thing I did was look at my . . . the pre-medical office at my university offered a list of schools where the majority of University of Utah students are accepted.

Dr. Chan: They got this master list.

Ludovica: Exactly.

Dr. Chan: So historically, these medical schools have taken our graduates.

Ludovica: Yes, and because I wouldn't want to apply to a school where only one University of Utah student in 10 years was accepted because then my chances would be lower. So I looked at that.

And then I also tried to look at schools that were very heavy in volunteering, especially with underserved communities, because I did do a lot of that. So I was trying to fit my application with the school instead of having the school fit with me in a weird way.

Dr. Chan: So you applied to 16, did 14 secondary apps, and I assume those kind of came at you in waves. What was your strategy in doing all those? Because we're talking more essays and more information.

Ludovica: It was so many essays, a lot of essays. So I tried to look at other pre-med forums. I made two lists. So one of them had the schools with very lengthy secondaries, and the other one had the shorter secondary applications. So I tried to divide my time a little bit equally, but mainly focused on the shorter applications so I could get them out sooner.

And, ideally, the time that I saw was you should be returning them within two weeks. So I tried to follow that.

And then I tried to have some people edit my applications as well. So that was a little rough because I was trying to keep up with the two weeks, but also I wanted to make sure my secondaries were written thoroughly and they were written well. I knew they were the main reasons that the school would offer me an interview, looking at the secondary applications, so I tried to be as thorough as possible.

Dr. Chan: Awesome. All right. Sent out 14 secondaries back. How many interview offers did you get?

Ludovica: Actually, the first interview was at the University of Utah.

Dr. Chan: Oh, okay. All right.

Ludovica: Because it was my top choice school, I waited a little bit, and I waited to see if I would get other interviews, but mainly my focus was The U. So, as soon as I was accepted to The U, I didn't really go to other interviews.

Dr. Chan: So I think we interviewed you pretty early in the process then. So when did you interview and when did you get the call?

Ludovica: So the interview was . . . for me, it was December, December 17th, I remember the date. And then, after the interview, I received the call. It was Valentine's Day.

Dr. Chan: Really?

Ludovica: So February 14th. Yes.

Dr. Chan: I remember that. I remember your name. It was hard for me to pronounce your name, so I remember that.

Ludovica: It's very different. It's a difficult name. And so, honestly, one of the happiest days of my life. I was not expecting it that soon.

Dr. Chan: What were you doing on Valentine's Day of this year? What was going on? What were you doing when you got the phone call?

Ludovica: So I was actually at home. I was working a weird schedule where I would work for a week and then be off for a week. So that day, luckily, I was not at work. Otherwise, I wouldn't have been able to answer the phone. But I was just at home hanging out with my dog, and then I received the phone call. And then I, of course, called my parents and everyone I knew to tell them the good news.

Dr. Chan: Awesome. And then I know I kind of jumped over this . . . MCAT. How did you study for the MCAT? Did you use any special services, like a Kaplan or Altius? Because it sounds like you were so busy. How did you make time to study and take the MCAT? Because you did really well.

Ludovica: So I did do a prep course. I did Altius. Since it's also local, I was able to go to one of their classes. I think they were twice a week. So there were classes very often, and then I was able to meet with a tutor.

So I decided to do the course where you were able to receive tutoring tests to practice on, and then they had their practice Altius sessions. I needed that structure. So I knew myself really well. Some people don't need that and are able to study just fine without the course, but I knew I needed to go to a class and I needed to have a tutor to kind of help me out with any questions I had.

So what I did is I decided to take less credit hours during that semester. I was finishing my . . . I think at that point, it was my senior year. I was one of those super senior people so I took an extra year mainly because during the MCAT I was only taking eight credit hours. I think I was taking biochemistry, and then a course through the Honors College. So I was not taking many classes.

Dr. Chan: And then when you interviewed here, did you have any practice MMI before you came here?

Ludovica: Yes.

Dr. Chan: So tell everyone how you did that. How did you prepare for MMI?

Ludovica:So through the pre-medical office at my university, they offered mock multiple mini interviews at their office. So I definitely took that opportunity, and it was incredibly helpful because they gave feedback. Each individual interviewer gave us feedback and said what we did well and what we should maybe work on for the University of Utah interview.

And then, on top of that, I had two other friends that were applying with me. So we had Skype sessions where we would practice on each other.

Dr. Chan: Oh, good idea. And then did you feel that helped you on the day of the MMI?

Ludovica: Yes, because I had lots of repetition. And so, it was nice to know that those questions that were being asked were not unfamiliar. Like, I knew how to prepare for them. And then the timing too, knowing how long to . . . I think you have two minutes to prepare, if I remember correctly, and then you're with the interviewer. And so, I had to think kind of on my feet.

Dr. Chan: I remember you did very well, Ludovica. You did extremely well.

I want to kind of just pivot. Your first week of school, how is it? How did it feel? I mean, you've worked so hard. Now that you're here, how is it?

Ludovica: It was very exciting. I loved it. I got to meet all my classmates. So we had two weeks, I guess. The first week was our transition week into medical school. So it was mainly kind of an orientation week. And then now I'm into my official first week, which I guess is the second.

And it's wonderful. It's a little bit overwhelming, and by a little bit, a lot. But it's just an adjustment. I think adjusting my study method to fit the requirements of medical school has been a little difficult. Because studying for my undergraduate classes, I think after five years I understood how to do it. I knew what worked for me. For example, I'm a visual learner. I need to write things on the board and practice them over and over. And I'm trying to apply that to see how it will fit into my medical school curriculum.

Dr. Chan: What's been the biggest surprise so far?

Ludovica: The amount of material that I need to cover. It's intense. I will come to school early, and I try to study everything, and then as soon as classes start, there are 27 more things to study.

Dr. Chan: It can be very daunting. I'm just amazed when I see the students because you have all these different ways you learn material, that you assimilate it, that you practice it and . . . yeah, the students, you have online materials, and Anki, and online textbooks. It just seems, from the outside, it can be overwhelming.

Ludovica: It is. And I'm trying to learn how to use those resources to fit my study strategies. So I have used Anki, for example, for the MCAT. So I was studying it to try to remember everything. But back then, when I used to make flashcards, they were not nearly as effective as they think they should have been. So I'll need to modify that to fit the curriculum of medical school. I think focusing more on concepts rather than just memorization.

Dr. Chan: I mean, I'm not going to hold you to this because you're at the very beginning, but where do you see yourself practicing? What do you want to do down the road with your M.D. one day?

Ludovica: So I'm trying to keep an open mind currently. But I definitely have had a lot more experience shadowing neurologists. And so, I think currently that would be an avenue that would be good for me. I think that would be something I would head towards just because it's really interesting to me to learn about motor disorders and seeing how you can impact patient's lives by doing research at the same time as being a physician. So I kind of want to do that one day, kind of blend it a little bit. Not as much as an M.D./Ph.D., but definitely still do some strides, for example, in Lewy body dementia research or maybe exploring Parkinson's too.

Dr. Chan: You know, I think about your arc, Ludovica, it sounds like you've had this passion for working with underserved populations, vulnerable patient populations. Really, you have this background in just helping those with neurological disorders. Where do you think that came from, that passion, that desire?

Ludovica: I think it was definitely from this mentor that I met early on, the Italian doctor that I had met. He really did show me how to be truly a compassionate physician. I remember he used to spend so much time with the patients, just talking to them, not even just, you know, about their disease, but even just getting to know them.

And so I first followed him in the clinic, and then I followed him during his research. So it was nice to have both of those experiences because I could see what he would do to help the patients and then not only in the lab, but also while he was there with them.

Dr. Chan: Neurology is really hard because a lot of the diagnoses, a lot of the conditions are very chronic. You know, there are some interventions, there are some really good medications out there, but these things sometimes last entire lives. So it's hard. It's really hard.

Ludovica: It was. It was very difficult to witness too, especially if I would shadow him maybe one week and then in a couple of weeks later the same patient would come back. And maybe not a matter of weeks, maybe months, but I would notice a difference, a significant difference. Even in my own patients when I was a CNA, I would see the progression of the disease, and it was sometimes very difficult to watch.

Dr. Chan: Any tips or advice for someone out there who's thinking about applying to med school, might feel a little discouraged? What would you say to them? What would you tell them?

Ludovica: I think I would definitely tell them that if this is something that they truly want to do and it really is their dream, to not let little obstacles discourage them along the way.

For example, I was not the best at organic chemistry, and I had some difficulties with it. So classes were a little difficult, and then even studying for the MCAT, there were constant obstacles that I would encounter. Sometimes I would think, "Maybe medicine isn't for me. Maybe this wasn't the path I was meant to go through," because my grades were not as amazing as some of my classmates, but there's more than one thing to your application. It's not just about your grades. That is an important part, but it's also about how you structure your application and then how truly passionate you are about medicine.

I think, hopefully, that came across in my interview. I really wanted to make sure that the interviewers could understand that this was something I really wanted. And then even throughout my activities that were not necessarily medically related, I learned a lot of things about myself that I guess intensified this interest in medicine.

Dr. Chan: All right. Well, I have a list of questions I was going to ask you, but they have nothing to do with medicine. Are you ready?

Ludovica: Yes.

Dr. Chan: Okay. Best Italian restaurant in Salt Lake City? I'm putting you on the spot here. These are a lot of Italian questions.

Ludovica: There are a lot of restaurants in Salt Lake. Okay. One of them is called Per Noi, which means "for us" translated. And it used to be in Sugar House. I think now it's on Highland Drive. But it's really good. It's authentic. I think the owners are from Sicily. So that is good Italian, not Olive Garden.

Dr. Chan: Can you go into Olive Garden and eat, or is that just too much? Is that a bridge too far? Because that's not truly Italian food.

Ludovica: You know, I was one of those people . . . well, one of those Italians that refused to set foot into Olive Garden for years. And then I did a few years ago, and I liked it. I don't consider it Italian. To me, it's American food, but I like it.

Dr. Chan: It's an Americanized version of Italy.

Ludovica: Exactly. Yes.

Dr. Chan: Best Italian movie? Because Italians are known for their cinema and having a certain style.

Ludovica: I really liked this comedy that I watched while I was in Italy over the summer. It's a little older, and it's with Roberto Benigni, the one who did "Life Is Beautiful."

Dr. Chan: I was going to say that. It's my favorite, "La Vita Ë Bella". Buongiorno, Principessa. Did I say that right?

Ludovica: Yes.

Dr. Chan: All right. Good.

Ludovica: That was a good one. But he also made another movie called "Johnny Stecchino." And it's about this guy that is involved with the mafia, and then they have to find a duplicate of him to kind of help him escape the people that are the . . . I guess he's being followed by other members of the mafia that are trying to kill him, and so he tries to find a duplicate of him so that he can escape it. And it's very interesting.

I think it's funnier maybe in Italian because they have a lot of kind of jokes that would only make sense in the language, but I thought it was a good movie.

And then of course, "La Vita Ë Bella." It's very good.

Dr. Chan: Is Roberto Benigni . . . am I saying that right?

Ludovica: Yeah.

Dr. Chan: Is he a rock star in Italy? I mean, can he walk down the street and he gets mobbed or . . .

Ludovica: I think so. Yeah. I saw him . . . I think he was . . . I think he's from Tuscany. I've never seen him, but I think he's very popular definitely. He's in a lot of TV shows. He gets interviewed because he's famous internationally. I love him.

Dr. Chan: All right. Last Italian question. Best gelato place in Salt Lake City? Because they're popping up everywhere. I'm seeing a lot of gelato places.

Ludovica: I think there is one called Sweetaly. That's good. That was the one I've been to. And then there's another one in Sugar House. I think it's called Dolcetti. So those are really good. But I'm a bit of a snob when it comes to gelato, so I can't really say that they're the best I've ever tasted, but they're good.

Dr. Chan: Okay. Very cool. Well, Ludovica, I am so glad you're here. It's so good to hear about your journey and where you come from, and just you're here and you become a doctor. And we'll have to have you back on the pod just to talk about it as you progress.

You know, I wish people could see just how bright and radiant your face is, like first week of school. Wow. It's just amazing. Cool. Well, thank you for coming on.

Ludovica: Well, thank you for having me.

Announcer: Thanks for listening to "Talking Admissions and Med Student Life" with Dr. Benjamin Chan, the ultimate resource to help you on your journey to and through medical school. A production of The Scope Health Sciences radio, online at thescoperadio.com.

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