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A couple of years ago I had a physician tell me that he was burned out from dealing with all the bureaucracy and paperwork. He was especially frustrated with the electronic medical record and the computerized order entry that we just instituted. Without having another job lined up he told me he wanted to quit and go to work at an ER where they didn’t care so much about patient satisfaction scores, paperwork or the electronic medical record. I looked at him and just said “I don’t think that such a place exists. But, if you find one let me know and we will both work there until they are forced to change which should be a matter of months.”Medicine in the United States is the most paperwork intensive job there could ever be. No matter your specialty you will have to fill out a massive credentials packet for every single payer and insurance company you want to contract with. That means, Medicare and Medicaid, Blue Cross, Humana, Aetna and many more. Oh, and they don’t share information or have any sort of uniform verified application to avoid redundancy. Massive waste involved here. Then, you have a massive credentials packet for your malpractice insurance as well and another for each hospital where you intend to work. Of course you will have to obtain a state license as well. Let’s not forget you will also need a Federal Drug Enforcment Agency permit. Your State may also make you get one for them as well. And, all of this before you ever work your first shift and it doesn’t matter what specialty you are in.Once you get to work the paperwork just intensifies. In order to get reimbursement you have a ton of hoops you have to jump through. Most of the time it is disguised as “quality” but instead, it feels like a carnival game that is rigged to keep you from winning. If it were about quality then the US healthcare system would be the best in the world and it is seriously not. Your health care organization will have a lot of requirements concerning chart completion as well. Typical turnaround for chart completion depends upon your facility, but it is never much more than a week. They will start hounding you like crazy to get caught up through emails and phone calls and nasty notes and so forth. Then you will eventually have a case or two that will end up in peer review which will require a lot of written explanation. If you ever have the misfortune of being sued like I have, then you will get to generate even more massive amounts of paperwork in the form of depositions and so forth and it will follow you for the rest of your career like professional herpes.I think that all of this is pretty unrelated to what specialty you choose. The volume of crap is the same. It just changes in flavor. If you want to reduce this, then consider not being in the USA. I have had friends that have practiced in New Zealand and loved it in every way. Same for Australia and pretty much every medical mission to places in need. These experiences can be especially gratifying and will tie you back to the reasons you wanted to go into medicine in the first place.

It might be. Without knowing the specifics of your situation and the individual school policies, no one cannot tell you definitely. You need to contact each admissions office and ask them.There are certainly some events a school’s admissions office will want to know about. Some examples:Winning a major (e.g., State or National level) academic award or competition - I know that certain international math and computer competitions don’t occur/end until after application deadlines. Caltech still added the results from those to applicant’s files.Publishing a paper (peer-reviewed) - Theoretically, you should have mentioned the submission in the original application, and the update will just be a note that the paper was accepted. (Yes, this really happens).Receiving a patent - Similar case to publishing a paper.Winning an Olympic medal - I know Stanford will add a note to the admissions packet for Olympic results. I assume other universities, particularly those with relevant athletics programs, would do so as well.There are also some life changes that the financial aide office will need to know about, but which will not be added to an admissions packet:Death of a parentFinancial ruin of a family (depending on the specific events, but house fires, hurricanes, and other significant loss of property can be factors)Financial windfall (e.g., winning the lottery)Major illness (either student or family member)Birth/death of a sibling or childAll of the above examples are events that would have occurred after the initial application submission. Anything that occurred before the deadline (or was known to be probable) should have been in the original application packet. Any update should be about information that was not previously available, but which could dramatically impact an admissions decision. It should also be presented to the admissions office in a way that the information is both easily verified and summarized.

STOP FLUSHING YOUR MONEY DOWN THE GRE/GMAT COACHING DRAIN.August 2010,Pune, India.I had just taken my GRE and TOEFL and had a pretty crappy score on verbal. I had no intentions of re-taking the exam and was getting started on my applications with the guidance of the internet and a couple of well-wishing mentors I had reached out to. Despite my strong protests, my mom went behind my back and met with the admissions folks at Dilip Oak Academy, one of the most famous names in Pune. One look at my scores and grades and they told my mom that I stand no chance of getting an M.S. admission in a decent school; at most I should expect a Tier 3 or lower ranked university and even then be prepared to pay a lot. Of course if I paid them 40K, they were willing to help me “prepare” better. So naturally I told them to go f#$k themselves.I reached out to a bunch of students at Stanford and CMU, the two universities I was very keen on attending. A couple of them were willing to help me and guide me. One of them also took a small fee; he asked me to donate $10 to one of the three charities he supported and send him a screenshot of the receipt. That was without doubt the best INR 500 I’ve ever spent. It showed him that I was serious and willing to pay that token for his help and guidance and in return he gave me his valuable time which reaped monetary benefits for a cause he cared about. It was a complete win-win.If you are an Indian student thinking about higher education in the U.S., there’s a very high chance that you have already enrolled or considered in enrolling in one of your local “academies” who claim to help students realize their American dream. It is highly likely that you have been told by your parents/teachers/friends/well wishers to attend one of these.The problem with these academies is that they are a heavily for profit business based solely on arbitrary data points and assumptions. The counselors never applied for or attended grad school in the US themselves and their entire knowledge and experience is hearsay. They will always prepare your resume, SoP and LoR according to the template that they use for thousands of students and that completely takes away any chance you have of standing out in the crowd. I’ve seen hundreds of SoPs and LoRs in grad school and after and can instantly spot those that came from a template from one of these premium coaching classes.Most of the students who go to these classes are naive and inexperienced; they do not have anyone else to guide them and are from middle class families that dream of a better future for their children. This exact sentiment and lack of experience and knowledge is heavily exploited. These classes will always, and I mean ALWAYS, recommend very safe universities to you. The list they will make you pick will be a much lower band than what you should actually be aiming for. The reason is obvious, the lower they set the bar, the higher the likelihood of you meeting it. They get to show ~100% placements as a result. For a candidate and family who are utterly clueless about what is going on, they take the advice as Gospel and when the student eventually does end up with an admission letter, they feel eternally grateful and indebted; not realizing their lost opportunities because they never knew about them to begin with.What is something people need to understand?You have more potential than what a template tells you. Spend some time to do your own research. There is a plethora of information available on the internet. Use it. Reach out to students who are currently studying at universities you hope to attend. Request their guidance. Some of them are always willing to spare some time. Be mindful and respectful of their time and be prepared when you speak to them. Take control of your destiny and don’t let someone else write it.I do try and spare as much time as I can to help students with their applications as well. If you need help reviewing your SoP or short listing universities for your profile, I’ll be happy to help. I only ask that you come well prepared from your side with specific questions and do your homework and due diligence. Save yourself the INR 40K, and instead, the next time you see a hungry child on the streets, buy him a plate of Biryani on my behalf. Consider it a token. Also, there’s a chance I will be quite harsh and brutal in my feedback so if you won’t take kindly to feedback and constructive criticism, I’m probably not the right guy to reach out to.p.s. I won’t be sharing my SoP for your reference. I’ll be happy to review your drafts but please don’t ask me to share my application packets. Thanks for understanding.Footnotes:Rohan Kamath's answer to How do I make my SOP for an MS in CSE stand out when my resume falls short on research papers?Rohan Kamath's answer to To what extent does a resume and LORs matter?Rohan Kamath's answer to What were some of the major factors that help people get into Stanford? What are some tips for the admissions process?Rohan Kamath's answer to What would you advice a graduate thinking about MS in really good universities like Stanford? Like the approach one should take. How challenging could it be?Rohan Kamath's answer to What made you stand out in the Stanford admission pool?Rohan Kamath's answer to Is studying in a top ranked university and being average better than studying in average ranked university and being a top scorer?In case we haven’t met before, I’m Rohan Kamath.Thank you for reading. I hope I could help you smile today. :)