Balancing T1D With...Medical School Interviews

Because many people in hospitals wear pagers on their hips, an insulin pump fits right in!

Because many people in hospitals wear pagers on their hips, an insulin pump fits right in!

The medical school application process is not one for the faint of heart. If an applicant was not completely convinced of joining the medical profession, it's safe to say he or she would have been weeded out in Organic Chemistry, the MCAT, or the detail-oriented steps to apply. And this is only a prelude to what actual medical school will be like. Our doctors are VERY dedicated people. As much as a kick in the butt I know medical school will be, I wouldn't want to spend my life any other way (ask me that in a few years and I may tell you sleep would be a nice way to spend it, too).

After the MCAT, the first round of applications opens in May...over an entire year before students start medical school. Those applications are submitted in the summer, and then schools send out a secondary application more specific to their school. IF your first application catches an admission committee's eye AND they like your secondary application, they invite you to interview at their school anytime between September to March. This is a pretty big deal. Only ~10% of applicants will get interviews and only ~1/4 of those who interview will receive slots. Sometimes more or less depending on the school. It's school applicants are WONDERFUL people. I've already met some new friends on the interview trail...and probably people who will be saints one day. No jest.

Needless to say, when I have gotten interview invitations, it's a call to be on my A-game. Nothing less than my best...which of course, requires in-range blood sugars. Since every interview is set up differently (many have interviews mixed with walking tours and a provided lunch with unknown carb content), this has been a major challenge. Although I have had a few inevitable hiccups along the way, here are six things I have tried to do to make interview day go smoothly: 

1) Start super-monitoring the night before. 

Waking up in range is a nice way to start the day and reassuring. To help get there, I'll check before bed and whenever I wake up in the middle of the night.

2) Pack strategically.

Food is a tool and having options that we can tailor to unpredictable changes in our blood sugars or the day can help. I pack almonds for an option if I'm hungry but don't want blood sugar spikes, a protein bar and banana for options with medium glycemic impact, and fast acting glucose for low blood sugars. Water is smart no matter what.

3) Keep things relatively low-carb.

This way if we go on a walking tour or an interview is farther away than I expected, I will not be worrying about having a lot of insulin on board with the additional activity. My go-to breakfast is plain Greek yogurt and an apple (~30g carbs).

4) Wear medical ID.

Nuff said.

5) Be open about needs.

One interview format is called multiple mini interviews (MMI). With this, you read a scenario, have 2 minutes to formulate an answer, and then enter a room and speak with an interviewer for about 10 minutes. You don't know anything about your question or your interviewer, and they know nothing about you. This happens 7-10 times in a row and can be very intimidating. 

Before my first MMI, my blood sugar went low. I had followed all of the steps above and this STILL happened. I immediately told the dean who was with us that day and she was more than understanding (she even offered me part of her own lunch!). I was allowed to go back to my belongings and eat glucose and then take my tester/glucose with me upstairs to the MMI, which would not have been allowed had I not spoken up. 

6) Continue to super-monitor. 

Testing often and wearing a CGM can help us see dips/ spikes before they happen and take steps to prevent them. In the situation above I was NOT wearing a CGM (still waiting for a replacement...), but it's very possible I could have had part of my banana while walking to the interview to prevent the dip. 

That's all for now, folks! What strategies do you use to make interviews or important events go more smoothly?