Dear Reader,

As a major concern for many, the commonly spoken health care reform and its improved accessibility for the previously underprivileged just might stir up a few more questions along with the newer technology in medicine that walks on the borderline of ethics. Should a doctor put a dying patient to sleep in order to save another? Should parents have the luxury of selecting for certain traits in their future child? While doctors and many health professionals are trained to work with given facts, like scientists, they often find themselves confronting issues with elusive boundaries. For this issue, our staff explored a wide variety of ethical questions ranging from eugenics to the globalization of health care. In addition, we are delighted to have the opportunity of interviewing Professor Winickoff, who teaches a course on Bioethics and Society (ESPM 162).If you are interested in joining our staff, please send an email to premedperspective@gmail.com.

Happy reading,Sarah PanEditor in Chief

editor’s note

about the newsletterEach month, our newsletter covers a themed topic and includes

feature articles related to this theme that may be relevant and of interest to the pre-med community here at Berkeley. Every month the newsletter includes interviews with important figures in healthcare, as well as graduate/medical school information and lo-cal volunteering highlights. Working in conjunction with various pre-medical organizations, we seek to educate the community on events held by these organizations for the betterment of the entire pre-med population.

staffEditor in Chief: Sarah PanDesign/Layout Editors: Larry Cai, Stephanie NgFinancial Coordinators: Aditi Gupta, Eric TrieuPublicity Coordinator: Youngwon YounCopy Editor: Kristi JhangianiAssociate Copy Editors: Ayesha Punjabi, Eric TrieuContributing Writers: Youngwon Youn, Eric Trieu, Stephanie Ng, Jacquelyn Hoffman, Aditi Gupta, Ayesha Punjabi

The PreMed Perspective is not an official publication of the Associated Students of the University of California (ASUC). The views expressed herein are the views of the writers and not necessarily the views

of the ASUC nor the views of the University of California, Berkeley.

THE PREMED PERSPECTIVE

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3THE PREMED PERSPECTIVE

in this issue

4med school profile | Warren Alpert Medical School at Brown University

6-7 interview | Learn about the importance of biotechnology and its impact on society with Professor Winickoff.

8 eugenics | Designing the perfect person

9 class perspective: bio1a/1al | DNA cloning, dissections, molecular biology, genetics, physiology

global healthcare | 10 Inequality in healthcare administration raises numerous ethical questions for physicians across the globe.

undergraduate research | 11 Any questions about doing research? Perhaps this article will help!

THE PREMED PERSPECTIVE

4

med school profile Warren Alpert Medical School at Brown

{ Aditi Gupta }

| history | | student life |

| academic requirements | | feature: medical ethics |

The student life at Warren Alpert Medical School caters to medical school students who are strongly

engrossed in their field of study as well as those that wish to continue their other passions. From sympo-siums on hot-button medical topics to athletic facilities and art galleries, students are encouraged to follow not only what feeds their mind but also their spirit.

This medical school requires 1 semester of biol-ogy, calculus, and organic chemistry as well as 2

semesters of organic chemistry, physics, and social or behavioral sciences.

The Concentration in Medical Ethics is a self-pro-claimed “multidisciplinary pursuit.” Because of the

nature of medical ethics, as well as medicine in general, as a bridge between the scientific as well as the social, political, and economic realms of study the concentra-tion in medical ethics provides students with everyday situations in which the ethical capabilities of a physician are often scrutinized. This concentration is offered once a year as a two-week intensive program and is open to all medical students.

Located in the prestigious Brown University cam-pus grounds, the Warren Alpert Medical School

program was actually founded in 1811 to be shut down only after sixteen years of operation. In the 1950s, however, the medical program was reinstated and opened its doors to develop an award-winning curriculum centered on not only the core knowledge that bases medical school programs across the country, but also scholarly concentrations which allow future physicians to develop interests and skills vital to their chosen profession, including the medical ethics pro-gram.

| just the facts |Type of School: Private

School Uses AMCAS? : Yes

Average GPA: 3.70

Average total MCAT: 34

Sourceshttp://www.medschoolready.com/app

http://med.brown.edu/education/concentrations

In-State-Tuition: $39,824

Out-of-State Tuition: Same

Total Applications: 6016

Interviewed Applicants: 230

Accepted Applicants: 96

Average Class Size: 410

{ Aditi Gupta }

Test names are the trademarks of their respective owners, who are not affiliated with The Princeton Review. The Princeton Review and The Princeton Review logo are trademarks registered in the U.S. Patent and Trademark Office by The Princeton Review, Inc., which is not affiliated with Princeton University.

800-2Review (800-273-8439) PrincetonReview.com/

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chattahbox.com

7THE PREMED PERSPECTIVE

As I sit down next to a student in the third row of 159 Mulford Hall, I ask the girl next to me, her

hands eagerly placed on her keyboard which sits atop a thick ESPM 162 reader, “Is that the professor?” An affirmative nod. I am baffled; I was on the lookout for the traditional Berkeley instructor we know all to well: the grey-haired, rambling on the board with illegible chalk scratches variety. But Bioethics and Society Professor and Berkeley Science, Technology, and Society Center Co-Director David Winickoff does not fit this mold; the energetic, well-versed pro-fessor stood in front of the attentive students and spoke of genetic screening, interjecting anecdotes of his research experience in Greenland. I sat in on Winickoff ’s course to get a real flavor of what it’s re-ally all about. By the time the ninety-minute lecture culminated, I became engrossed and found myself taking notes on the course material instead of gather-ing information for my article. The lecture likewise engaged students who boldly shared their thoughts on the subject and provided synopsis of the reading to the class.

At this point you are probably pondering what the course exactly covers and more about the pro-fessor who lectures every Tuesday and Thursday af-ternoon. The course is divided into four sections: Human Genome Projects, Ethics of Life Science Re-search, Ethics and Political Economy of GMOs and Plant Biotechnology, and lastly the Ethics and Reg-ulation of Food. Integrated into the Ethics of Life unit is a sub-unit titled “The Group” as the Subject of Research. Winickoff ’s interests and experience in issues such as biomedicine, food, environment, and agriculture are reflected in the course. The Professor notes that he is “most interested in questions of so-cial and distributive justice as they play out in techni-cal arenas of biotechnology and society.” With these topics, I was curious as to the Professor’s goals for his students in grappling with these complex areas. He wants his students to transcend emotional response in ethical debates in order to explain why they feel the way they do and to propose solutions to what is presented: “My focus as a professor is to teach both substance and thinking process...I do want them [the students] to be able to articulate WHY they believe

something is right or wrong, in addition to simply feeling it to be so.” He adds that he wants students to think instead of “consumptively” reading texts; something I believe Cal students forget to do. He acknowledged the challenging nature of decision-making in the course. “That’s the point of this class...to agree or not,” he blatantly told the students. The class is dedicated to delving into issues but also to de-veloping a dialogue for discussing these very issues. He adds, “The hardest thing is to get scientists and non-scientists to think critically about science and technology, and to see that they have a politics and a strong connection to power.”

Winickoff has a distinguished and vast academic past and appears to be at the forefront of a progress-ing, rich field. With roots at Yale University, Cam-bridge University, Harvard Law School (founded the Ethics, Law, and Biotechnology Society), and Harvard’s Kennedy School of Government, he cur-rently holds a research position and teaches within Berkeley’s Department of Environmental Science, Policy, and Management in the College of Natural Resources. He was an Adjunct Lecturer at the Ken-nedy School of Government and as a Post-Doctoral fellow, conducted research at the intersection of sci-ence, technology, law, and public policy. He speaks of his interest: “I’ve been interested in the intersec-tion of science and society for a long time. I did a senior history thesis as an undergraduate on the evo-lutionary ideas of Alfred Russel Wallace and how they were shaped by his travels to the Malay Archi-pelago. I traveled there myself during college (to Borneo) to study environmental politics. I still do research on environmental politics, especially look-ing at the intersection of international trade law and food safety law, including the trade law and politics around GMOs.” Winickoff ’s most recent academic talks in January covered stem cells, “Opening Stem Cell Research and Development: A New Agenda for Funders” and genomics at the University of British Columbia. The grants, fellowships, publications, and many more are endless and represent the depth and passion the professor brings forth in his course. by Jacquelyn Hoffman

E u g e n i c scustomizing your own baby

The possibility of designing your own baby through spe-cific genetic manipulation would have seemed impos-

sible and irrational centuries ago. However, although much of the original Eugenics movement has faded with the end of World War II, it has been resurfacing its head in current med-ical and ethical issues. Eugenics involves the manipulation of human reproduction to engineer desirable traits into future generations. Much of today’s society associates this topic with Adolf Hitler and his horrifying attempt to “purify” rac-es. However, one fact to be understood about eugenics is that it was a shared movement, making its way around the world. Some prominent people who supported it include, Winston Churchill, Theodore Roosevelt, and Margaret Sanger. This idea of an imaginary decontamination of the human race may sound irrational, but there is always a positive and a negative face to every issue; such is the case with eugenics.

Eugenics was first coined by Francis Galton, a cousin of Charles Darwin and an accomplished scientist in his own right. With the help of Darwin’s and Mendel’s theories, eu-genics flourished by the 1900s. The concept that people were

controlled by genes in combination with a social reform wave that was sweeping Western Europe and North America, triggered the eugenics movement. Consequentially, people began attributing criminal behavior and poverty to genetic make-up, rather than flawed social structures. In addition, with rates of immigration increasing, society became insecure about the influx of lower income immigrant families. Thus, the combination of all these factors led to the rise of eugenics during the early 20th century.

Although today, we know that genetics cannot be held accountable for the social flaws of populations, eugenics has still managed to survive in the medicinal fields of science. As recently as the beginning of this year, headlines were made of a private practice that was making hundreds of “designer baby” offers. The private clinic in Scotland, offered embryo implantation: embryos free of any deadly genetic diseases through process known as PGD, preimplantation genetic diagnosis. Some genes that they were able to “screen out” in-cluded, BRCA, a cancer-causing gene. In addition, they have also been able to filter out genes associated with cystic fibro-sis.

With positive developments in purging these diseases, hot debate has arisen in the ethics revolving around these novel technologies. Marco Gaudoin, who is the medical di-rector of the clinic states, “There’s an ethical debate about how far we go. My view is that this is for genetic diseases. We are not screening for brown hair or for the perfect human person. We recognize that preimplantation genetic diagnosis offers choices for carriers of the cystic fibrosis gene. This can be a liberating opportunity for some families and an undesir-able option for others.” Adversaries on the other hand, such as the Catholic Church in Scotland states, “This is not a cure for any disease, but a way of destroying those afflicted at the earliest stage of life. It is completely unethical and shouldn’t be supported.” Despite these opinions, the choice ultimately relies on the personal ethics of the individual. by Youngwon Youn

Sourceshttp://scotlandonsunday.scotsman.com/latestnews

www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1127045

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http://www.martinfrost.ws/htmlfiles/mar2007/anthropometry_exhibit.jpg

E u g e n i c s

9THE PREMED PERSPECTIVE

The memory of Bio 1A is still fresh in my mind, having taken it just last semester. With its multitude of read-

ers, all of which are helpful study resources, Bio 1A was a difficult class, especially with its additional hefty lab course. The keys to being successful in this course are preparing for the labs and not underestimating the lecture portion.

The first thing I realized about Bio 1A was that the Bio 1AL takes up a lot of time. It is necessary to read all the assigned material to prepare for the quizzes, which are pretty detailed. Do not neglect your weekly quizzes because they can definitely boost your grade if you are on the bor-der after the lab exam and lab practical. Also, the lab exam consists mostly of problems that you have to work out by hand, and only a few require spitting out memorized facts. Studying for the quizzes each week is usually good enough preparation for the less conceptual questions.

Moreover, labs usually run for the entire three hours (or more!) because they are crammed with so many differ-ent activities—for example, in the dissection labs, we often had to dissect two or three organisms within three hours. I remember getting out early only twice (chordate diver-sity and the bioinformatics labs), as opposed to Bio 1B, for which I currently have finished early each time.

As for the exams in Bio 1AL, I was surprised by the number of word problems on the first lab exam; the exam seemed to be more concerned with theory and facts rather than application. Thus, it is important to go to the reviews because this is when Mike Meighan most clearly explains how to approach the word problems. Also, take advantage of those old exams provided in the reader! Repetition is the key to remembering how to solve the questions during the quick-paced exam. Meanwhile, the lab practical exam was easier for me because it really just required a lot of memori-

zation of facts. One of my regrets about Bio 1A is that because I spent

so much time on Bio 1AL, I really neglected the lecture portion of the class. Cramming only a couple days before the midterms was not good enough preparation, even with previous years’ exams on hand. It would be a good idea to review each week’s lecture material over the weekend to fa-miliarize yourself with the concepts and vocabulary. If not, you have to surmount a huge heap of information by the time the midterm rolls around. And of course, do not fall behind on your webcasts!

If you are pressed for time when studying, I would not bother with the textbook, other than reviewing the dia-grams and pictures, because sometimes the textbook goes farther than what is necessary to know, but other times it does not go deep enough. My professors (Malkin, Fischer, and Firestone) said the same; focus on their readers and what they say in class. Thus, taking good notes is vital. And remember, classes in college are a lot more conceptual than in high school, where you could get by with pure memo-rization. The same goes for biology courses; an example exam question would be: if you are given a process, such as electron transport chain during cellular respiration, and a certain compound was introduced into that process, how would the rate of the reaction be affected?

Overall, even though Bio 1A and 1AL may seem devastating, they are entirely doable with the appropriate amount of study and preparation. You do not have to do endless amounts of practice problems, as in Chem 3A and 3B, but it is still important to continuously review the mate-rial, so that you are not overwhelmed for the exams. Good luck! by Stephanie Ng

“ The keys to being successful in this course are preparing for the labs and not underestimat-ing the lecture portion.

class perspective: bio1a/1alfor those of you who have yet to take bio 1a/1al

”

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told to live by the Golden Rule, it has been instilled in us that every human being is valu-able and thereby entitled to a particular level of respect. In the context of healthcare especially, there remains a need to bear in mind the Gold-en Rule even as adults, because both historically and contemporarily, the world has found itself in unfavorable situations that would not exist if people treated each other in the way that they would expect to be treated. There is a tendency towards taking for granted individuals who are not citizens of one’s own nation and this has not only resulted in vast disparities in health-care administration across the world, but, perhaps even more disconcerting, ignorance and complacency towards these discrepancies on the parts of more fortunate nations.

The constitution of the World Health Organization states: “the enjoyment of the highest attainable standard of health is one of the funda-mental rights of every human being…” There exist three questions associated with the WHO’s assertion: In our globalizing world, who are the people who lack access to competent healthcare? What are the ethical obligations that the medical field as a whole has towards these people? What must physi-cians do in order to fulfill these obligations?

The WHO reports that ten million chil-dren under the age of five die each year. Fur-ther, thirty percent of these children die be-cause they are malnourished. Annually, half a million women die because of complications associated with pregnancy and childbirth that could be prevented with basic maternal care. Despite the fact that we now know much about the prevention/treatment of HIV/AIDS, it is still the leading cause of death amongst adults in Africa; the WHO blames weak healthcare systems and shortages of human resources for this.

Another issue associated with healthcare as a global phenomenon is pharmaceutical test-ing in developing countries. A famous example

of this is Pfizer’s testing of trovafloxacin (brand name Trovan), an antibiotic for meningococ-cal meningitis, in Nigeria. Eleven out of the two hundred children studied died, and many more became afflicted with mental or physical disorders after the study. It is 10-50% cheaper for countries to run clinical trials in developing countries, but companies performing such tri-als are often unmonitored in these settings.

Entities such as the WHO and the World Medical Organization (which issued the He-linski Declaration, establishing ethical guide-lines for clinical trials on human subjects) are formulating a response to the issues discussed

above. Certainly, systematic rec-ognition of the ethical status of individuals living in disadvan-taged nations is a very positive step. Furthermore, organizations such as Doctors Without Borders actively set up clinics in the third world, working to raise the qual-ity of healthcare for societies that reside in these areas.

It is undeniably crucial, then, to view medicine as something

beyond an ordinary career field. Physicians and medical researchers possess the skills nec-essary to fundamentally improve the quality of life for people around the world. Of course it is impossible to overstate the healthcare needs of our own nation, and in no capacity is this article meant to urge every pre-med student to consider moving his or her entire career to the third world. The most realistic steps that we can take in order to correct injustices in the global health realm involve awareness and open-mindedness – the knowledge that dis-crepancies in healthcare exist, that they are un-just, and that there exist opportunities for us to correct these discrepancies, even if we’re cor-recting them in some small way by disseminat-ing information about these issues at medical symposia or attending week-long mission trips. And that’s how grown-ups follow the Golden Rule. by Ayesha Punjabi

Sourceswww.globalmedicine.nl/index.phpc

http://www.who.int/hhr/en

THE PREMED PERSPECTIVE10

www.holistic-medicine-alternatives.com

My Take On The Research Experience

Many pre-med students often wonder what it feels like to be an undergraduate researcher in a biology lab, to

be involved in a research project, and to work on an honor’s project. The research experience, of course, is not at all uni-form across different labs, nor is it necessarily similar for students who work within the same lab, so any personalized depiction of undergraduate research is inevitably incomplete. Having stated that, I think it would still be beneficial for me to give my own take on how it feels to be an undergraduate researcher.

First, let me state that working in a lab is not, as some may say, “just pipetting all day.” I believe that this phrase—“pipetting all day”—has done more to deter students from pursuing research than the Berlin Wall did to prevent East Germans from traveling to West Germany. Quite frankly, if all you’re physically doing in any lab is “pipetting all day”, then you’re not working in a lab; you’re working in a factory line.

Secondly, doing research at Berkeley is just as rewarding as it is time-consuming. Of course, this is just another way of saying, “How much you get out of it will depend on how much effort you put into it.” For instance, if your research experience consists of pipetting things into a container—and nothing else—then you will most likely be an amazing pipetter by the time you leave your lab and decide to join a better one. On the other hand, if your research experience consists of dif-ferent lab techniques (and the knowledge of when to apply each one), an honor’s thesis, and a working relationship with your research mentor—then you’ve likely secured at least a strong experience to list on your resume/medical school ap-plication as well as a positive letter of recommendation to take with you no matter where you go in the future. Moreover, if you are working in a biology lab, then biology lab classes will seem dramatically less intimidating (at least from what I hear, anyways). One of the best things about research—re-gardless of your major—is that it actually allows you to apply

what you learn in class in a day-to-day fashion and in a way that actually matters to someone other than your grader. In science classes, students are often taught the “scientific method”, but generally do not get a chance to practice it in real-life scenarios. After all, doing well in science classes does not involve much “hypothesizing and testing”; rather, on an exam, students either repeat other researchers’ hypotheses or propose their own hypotheses but do not actually carry out any tests. Research gives us the opportunity to physically see for ourselves that there is a tremendous difference between giving an answer to a test question and empirically confirming the answer. There is a large gap between being able to under-stand the concepts in a textbook and being able to validate a hypothesis to the extent that it gets included into a textbook in the first place, and working as a researcher allows us to par-ticipate in the bridging of that gap. It can be an enlightening and enjoyable experience, especially for those who choose to dedicate significant amounts of time to it.

Here are a few tidbits of advice for those who are look-ing to enhance their undergraduate experience with their research: 1) You must be aggressive about expressing to your research mentor that you want to learn new things, 2) It is best to sincerely care about the research being done in your lab (but this is something that can grow over time), 3) Keep going for a while even if it feels like it’s tough on your schedule, and 4) It is okay to look for a new lab if you feel like your current one isn’t giving you what you want. Finally, for those of you who are looking for any research experience, I recommend that you send as many polite e-mails to as many professors as you can. Programs such as URAP are nice, but sending short personal e-mails to professors from different disciplines will dramatically increase your chances of getting accepted into a lab. E-mail us at premedperspective@gmail.com if you have any questions regarding research and/or getting research positions! by Eric Trieu

11THE PREMED PERSPECTIVE

“Biology majors: Fa-miliarize yourself with this pipet! ”

Ask the Premed Perspective Staff

What is on the MCAT and how is it scored?

The MCAT has four parts Physical Sciences (Physics, math skills and general Chemistry) Verbal Reasoning (similar to the SAT or the ACT), Writing (consisting of 2 essay ques-tions) and the Biological Sciences (Biology and Organic

Chemistry). The science sections are each 70 minutes and the Verbal and Writing sections are each 60 minutes. Each sec-tion on the MCAT is scored on a 1-15 scale except for the writing component which is given a grade J through T. The

writing component is scored by one human and one comput-er grader. Most competitive medical schools are looking for a

10 on each section with a writing score of P or Q.

Want to know more about being pre-med? Send your questions to premedperspective@gmail.com

and we’ll answer them in the following newsletter.