Hypoglycaemia is a condition that occurs when the blood sugar (glucose) level falls below what is expected for a healthy individual, which is typically around 70 mg/dL or 3.9 mM/L.  Typical symptoms include rapid heart rate, dizziness, anxiety and sweatiness. If the glucose level continues to drop, it can lead to confusion, slurred speech, blurred vision and even seizures. These symptoms are caused by the direct effects of low glucose on the brain and the activation of the nervous system to increase glucose production. At the same time, cortisol is released from the adrenal gland and growth hormone from the pituitary gland to kickstart a counterregulatory response that stimulates glucose release from the liver to restore blood sugar levels. Hypoglycaemic symptoms can be alleviated by eating food or drinking beverages that are high in simple sugars.

Several factors can lead to hypoglycaemia such as excessive production or intake of insulin, decreased glucose intake or absorption, or insufficient counterregulatory response due to certain drugs or endocrine diseases. Some specific conditions where this can occur are: 

Since glucose is mainly stored in the liver, conditions such as alcoholic hepatitis and viral hepatitis as well as non-alcoholic fatty liver disease can additionally impair glucose release from the liver and cause hypoglycaemia in individuals who have poor nutrition or do not eat for a prolonged period of time. Consuming alcohol can also worsen hypoglycaemia by interfering with the liver’s ability to release glucose. Thus, limiting alcohol intake and eating regularly can help reduce the risk of hypoglycaemia in patients who are at risk for alcoholism. 

Some people develop hypoglycaemia-like symptoms several hours after eating, in a condition known as “reactive” hypoglycaemia.  This may occur when excessive insulin is produced in response to meal overshoots, causing hypoglycaemia-like symptoms.  However, there is no consensus among endocrinologists for this diagnosis since the blood glucose levels of many of the affected individuals do not fall into the hypoglycaemic range. It is possible that some of these individuals experience hypoglycaemia-like symptoms whenever their blood glucose level drops rapidly, even if it remains within the normal range. 

A lack of work experience does not necessarily put prospective students at a disadvantage as we review all applications holistically. This means we don’t only look at academic qualifications; we also look out for individuals who have the potential to become not only outstanding clinicians but who can think beyond practising medicine to improving care as clinician-scientists, innovators, entrepreneurs and leaders. This is what we refer to as Clinicians Plus.

To be successful as a Clinician Plus, we look for attributes including communication and interpersonal skills, integrity, teamwork, altruism, resilience and critical thinking. We also encourage our applicants to include instances where they have been involved in leadership, volunteerism and clinical and research experiences.

Aside from the Grade Point Average (GPA), the Medical College Admission Test (MCAT) and Graduate Medical School Admissions Test (GAMSAT) serve as another measure that allows us to gauge applicants’ science proficiency. It’s important to note that because of our holistic assessment approach, we do not have strict cut-off scores for the MCAT and GAMSAT.

Lastly, we require applicants to submit a personal statement and one assigned essay, as these provide us with an opportunity to better understand our applicants, what motivates them and why they aspire to pursue a career in medicine. They assist the Admissions Committee in their deliberations and are particularly valuable in helping us understand our applicants’ unique qualities and experiences.

For the essay component, we offer applicants a choice of two prompts: for the Dilemma/Adversity essay, applicants are asked to describe a situation where they either took a different course of action or wished they had, based on ethical or moral concerns. The second topic prompts students to share an instance where their decision-making process was significantly influenced by principles of ethics or integrity. Such situations could involve personal or academic integrity, affecting either the applicant or others.

More information on our admission requirements is available on our website.