Coming to medical school as an MD/PhD, I thought a joint degree would be an opportunity to delay choice. I both love medicine and science, and was not sure what I really wanted to what I ultimately wanted to pursue. I felt privileged to have this great opportunity, but for me there was the constant tension of the realization that to do something great, one would need to specialize and ultimately choose one passion. I hoped that over the course of eight years, I would be able to better understand myself and can reevaluate my choices and options. I thought a joint degree would give me more exposure to both science and medicine, and the tools to pursue both.

But having finished my first year in medical school, I have conclusion that a joint degree is not simply the sum of medicine and science training. It is something different – in the middle yet entirely distinct. It is not equal parts medicine and research, it is an intersection that can only be described as medical research that takes elements from both but also rejects characteristics of both. And with this training comes the implicit expectation that one would end up doing medical research, not medicine or research. Although not entirely explicit, I felt MSTPs had a subtle sense of disapproval for those who ultimately ended up in solely medicine or solely science, so many graduates end up in the twilight zone I’ve termed medical research.

For me, being MSTP felt like a source of constant conflict. When doing research, I dream about being back in school and in clinic. When bored in class, I daydream about what I could do with these idle hands back at the lab. There was a tension, partially driven by a sense of urgency in knowing that the training is so long and wondering why I am wasting time, but mainly driven by a sense of mistaken identity.

Truth be told, I never felt truly comfortable in the role of MSTP. They are big shoes to fill. I never liked it when there were jokes about MSTPs being smart. In fact, I actively disagree. I think MDs are no different from MSTPs in terms of ability, just a different in interests and background. I squirm when singled out as an MSTP, because with the title comes expectations. An expectation that I enjoy all kinds of science and all types of research, when in fact developmental biology and other vast fields of science bore me to death. An expectation that I don’t enjoy the “touchy-feely” stuff, although like science, there are aspects I really like. The conflict has struck at the very heart of me – ultimately, this past year, I was not sure who I am and what my identity was.

Conversely, If there is anything I am sure about, it is that one needs to focus to succeed. To have too many fingers in too many projects, one will surely fail at them all. Throughout both high school and college, I always got myself involved into many projects, many interests, and many activities. I had a hard time distinguishing “many” from “too many”. Although I was fortunate to never crumple under the weight of too many responsibilities – things always worked out, I see now that this is a sign of immaturity. It is a sign that I do not know what I am truly called to do. I reminded of a good quote – “beware the barrenness of a busy life”. Despite the constant pressure to be busy and productive, I will take the next month to be still, to be calm, and rest before I start again.

I am extremely apologetic. I understand what I have done. Accepting me into this amazing program has meant one less spot for one less peer, one less mentee, and one less classmate interested in finishing the MD/PhD. For this is truly an amazing program, one that many others would love the opportunity to join. Being MSTP has meant that I was funded for this past year. But you have no idea how many sleepless nights, frantic calls to my parents, and the constant tension that I was under this entire year. The constant feeling of uncertainty, of guilt, and of defeat. The feeling that I might be taking someone else’s money on false pretenses. I think others will have to take on face value that I never intended to be on this detour, if only because I would not wish this upon anyone else.

No more. Ultimately, money is not important to me – no amount of money is worth the angst and turmoil of indecision. That is not how science, medicine, or anything flourishes. I rather be under no expectations, to admit defeat, and work on problems that interest me without outside influences. I have decided that life is too short to live by other people’s expectations. There is a quote that really stuck with me – “The measure of a person is a how many uncomfortable conversations he or she can initiate.” In fact, I am glad that I had a difficult year. I had the opportunity to grow as a person and more realistically solidify my self-identity and expectations for the future. The discomfort is only a sign of growth.

I look forward to living for myself again.

But ultimately, what is my identity? Identity is supposed to be something that is inherent in oneself – that is constant across situations and expectations. In church, the pastor is going over a series seeking to define identity, in particular, what it means to have an identity in Christ. What is common to me? What is the whole of me, that is true regardless where I am and who I am with?

Outside of Christ, people seek identity in three main areas. They define themselves by what they do, what they have, and what they desire.

What I do: I am a medical student. I am one who has worked hard for many years for the privilege of treating people in need. I am one who has stretched oneself, and continues to stretch oneself to fit in this conforming standard of one who is compassionate, professional, intelligent, and authoritative. Ignoring Christ, I am one who is prideful – feeling that spark of pride when I wear white coat and can answer someone’s question. As a medical student, I am selfish with my time – in service, in relationships, and in many other things I am always nagging by this sense of “let’s make sure I’m not wasting my time”, “how can this help my career”, and “should I be studying now? Is this activity worth my time?”. Despite the best motivations, my career in medicine is not Christ centered, and despite my best attempts, I cannot put to death my worldly ambitions.

What I have: I am an Asian American. I come from an upper middle class household, with a strong nuclear family. I love my parents, my sister, with the fullness of my heart. Yet because of this, I am not willing to accept Christ. In Mark 10:37: it is written, “He who loves father or mother more than me is not worthy of me; anyone who loves son or daughter more than me is not worthy of me.” After reflection and contemplation, I think even in the here and now, that has not changed. I do not love the rest of the world, any of it or all of it, or even God, with the fervor with which I love my parents and sister.I love them because they have loved me unconditionally. My parents would love me regardless of what I do and who I become. I love my family because they have taken care of me when I am weak, when I am broken, and when I am distraught. When I feel abandoned, tired, alone, or isolated, I know that I am only as far as I am from my family. I do not feel the same love for Christ as I do for my parents and sister. Jesus’s love has never been as real to me as the tangible love that I feel from my parents and sister. Anything anyone can say about God and why they love God, is true, infinitely more true, for my love of my family.

What I desire: I desire a girlfriend. I desire to be loved by someone who I love. I want to be in her thoughts as she is in my thoughts. I want someone who is intelligent, funny, pretty, and can appreciate me. In this, I too am prideful. I want someone who is from a good university, someone who is “intelligent”, as if I am intelligent. I want someone who is pretty, as if I am one who is pretty and can match someone in that dimension. I am someone who is interesting and awesome, when I am so inflexible, stubborn, and difficult – and not able to chase after what I want. My desires are selfish.

To be perfectly honest, in many ways, I rage against this idea of Christian identity. In the things I do and the things I prioritize, I very much want to live for myself. For me, is Christ my identity – at the core of my being – or is it just a Circle – just a shell that I put on and off when I am in certain environments?

Dear CCF Freshmen,

In a few short weeks, I will be graduating. It’s so hard to imagine that just a few years ago; I was in your shoes – relieved that I’ve survived my first year of college, anxious and waiting for summer to start. (I was super-nerd and took MCAT this summer. CRAZY right? But Aron, my summer roommate, has some pretty hilarious stories). As I sit here in my room today, I am also looking ahead at what is before me. Although I don’t feel much different than when I first entered Rice, I am certain that I have changed and have been greatly blessed by the people, the opportunities, and the fellowship here at Rice. To that end, I am extremely grateful to have met each and every one of you.

You have been an inspiration to me – you are passionate about God, hard-working in your academics, and kind to everyone. I know some of you better than others of you, and I wish I had more time to get to know each and every one of you, but I am confident that you are the ones to make CCF great in the future. In just a few short years, I am sure you will become great seniors too.

Before I leave, I wanted to share with you some of my favorite essays. Although they aren’t necessarily written with a Christian perspective, I think these authors hit upon some universal truths on how to live life and how to choose your life’s work. When I was a freshman, I wasn’t sure on major or career path, and although I am not sure whether any of you are wrestling with that question right now, I think these essays really bring life into perspective. When I need some motivation or encouragement, I turn to them (I’ve read essay one a ridiculous number of times.) Some of these aren’t exactly light reading, and it’d be crazy to try to read them all at once, but these are, in my opinion, the best articles that I have stumbled across on the internet. Ever.

When I was a freshman, I had no clue what I wanted to do with my life. In terms of career and interests, I was a blank slate. This was a little disconcerting, because I was falling under the trap described in essay 5 – that is working towards a goal simply because it’s a challenge, it’s prestigious, and it’s what everyone else was doing. Through a combination of factors – looking for a challenge and knowing I can do it if I set my heart to it, having a certain amount of pride in that I am trying something hard, and being stuck with high expectations for myself – I decided to become premed. In some the default choice for “smart” Asian-Americans, in retrospect, my choice was naïve and not thoroughly thought out.

I didn’t think too much of it then, and I hoped that if I just worked hard, God will deliver. But I believe having faith in God does not mean living life passively – and this was the worst kind of passiveness. Too often in the past, I had the mentality of “head down and plow through this” instead of stopping to smell the roses. In high school, I was “Aite, let’s get through SATs and all this junk. If I sacrifice now, I can chill out in college.” Then, in an abrupt about-face, in college, I was “OK. I’ll just dominate MCAT and hurdles, I’ll find more time to relax in med school.” How short-sighted am I? What’s next, hardcore through med school, so I can “chill” in residency? Life is a journey, and it’s quite a beautiful and exciting one at that.

But this is one of the most difficult choices one can, has to, make. It’s much harder to actively think and take time to decide what you want to do, than to go through the motions of take some tests, working hard, and doing extracurricular activities. I am absolutely convinced that each and every one of you will excel at what you do – you have been intelligent and hard-working to get to where you are today – and I think the more important question is deciding what you want to do and determining your reasons to do so. I hope these essays will drive you to think more about these last two questions.

So in summary, I wanted to encourage you to continue the good work you have been doing this past year and to let you know that y’all have been an encouragement to me. Walk with Christ. Pursue your passions. Grow strong relationships. And consider this letter as an open invitation to free boba if you want to chill out or talk. I might be busy next year (med school and all, right? ), but I want to encourage you to email me with questions or need some advice – I will always make time.

With love,
David

Some Essays
1. My favorite essay – Paul Graham’s very inspirational high school graduation speech on how to live your life and choosing a career – http://www.paulgraham.com/hs.html

2. Steve Job’s Commencement Speech (here’s a transcript and a youtube video).

http://news-service.stanford.edu/news/2005/june15/jobs-061505.html

A part that really stuck with me was: “When I was 17, I read a quote that went something like: “If you live each day as if it was your last, someday you’ll most certainly be right.” It made an impression on me, and since then, for the past 33 years, I have looked in the mirror every morning and asked myself: “If today were the last day of my life, would I want to do what I am about to do today?” And whenever the answer has been “No” for too many days in a row, I know I need to change something.”

3. The disadvantages of an Elite Education – I consider this article and the next article to be good reminders whenever I feel too prideful or too content with where I am. http://www.theamericanscholar.org/the-disadvantages-of-an-elite-education/

4. How to be a genius – A description how raw intelligence is trivial compared to effort. http://www.newscientist.com/article/mg19125691.300-how-to-be-a-genius.html?full=true

5. The Competence Trap – the danger of living life on autopilot, and unfortunately how many people live their lives. http://calnewport.com/blog/2010/04/09/corrupted-callings-the-subtle-difference-between-finding-your-lifes-work-and-loving-your-life

6. There is no speed limit – Why I am trying to graduate early. http://sivers.org/kimo

7. Randy Pausch’s last lecture – Really famous talk from a dying computer scientist, describing the importance of obstacles and brick walls in achieving our goals. (here’s a transcript and a youtube video). Unfortunately it’s really long – listen to it in the background while you do some work! http://www.youtube.com/watch?v=ji5_MqicxSo

http://download.srv.cs.cmu.edu/~pausch/Randy/pauschlastlecturetranscript.pdf

8. Outliers by Malcolm Gladwell

On the scientific and medical level, transplant is just as amazing.The very idea of transplant, the practice of moving and implant another individual’s organ to help prolong another individual’s life, underscores a deep fundamental understanding of physiology, cell biology, and biochemistry. Physicians build upon a tremendous body of knowledge of physiology – an understanding of how each organ functions and what purpose each tissue serves. For a successful transplant, physicians need to identify the signs of what organ is failing, surgeons need to perfect the technique of resecting an organ while minimizing ischemia and preventing blood clots, and a large body of knowledge must be available to understand how to perfuse the organ and minimize the immune response of a foreign organ.

The play-by-play:
At around 8:30PM, I got a call from Alexandra. I did not have the pager and she had just gone to a procurement earlier that day, so she asked if I wanted to go. I had just gotten home from preceptorship and was making dinner. Having been in the ED the entire day, I was rather tired, but really excited for this opportunity – particularly when I heard that it would be in Fresno.9:45PM, I got into an unmarked van in front of Moffitt Circle. I met up with Alex, the transplant coordinator, Stephen, R3 from Fresno on transplant rotation here at UCSF, and Ingo, the transplant fellow. We drove to SFO and got on a private jet to Fresno. An anesthesiologist from the transplant network met us at the airport and we headed off.

11:45PM We got to Community Medical Center, changed into their scrubs, and began preparing for the surgery.  There was a little bit of downtime, where we got some coffee (bad idea, I was trembling a little when closing) and the fellow went through all the paperwork.

12:15AM. The surgery began. The nurses were super helpful – I don’t have too much experience scrubbing in, but they were really nice in helping me pick out gloves and put on the gown and gloves.

It was an amazing process, with the cardiac team working in parallel with the abdominal team. I won’t go into too many details, but it always astounds me the amount of finesse involved in surgery. Great delicacy is used to maintain the blood supply of the organs, and I could tell the

3:00AM The surgery began to wind down. The R3 and I got to close up the donor, while the fellow focused on the actual organs. I helped tear down the surgical field and package the organs.

4:00AM Back to the Fresno airport, which was then only a skip, hop, and a leap back to SF. I couldn’t sleep the rest of the night, and stayed away the rest of the time until I got back home.

This was truly an amazing experience, and really highlighted the joys of surgery. Through finesse and technique, there is an unparalleled opportunity to make a great impact and impact someone’s life. The task before you is directly tangible and the responsibility is directly on your shoulders. It is truly a different experience, and I really felt the rush of adrenaline in helping out and knowing what I was doing would make a difference.

Part One: Cargo Cult Science

During the Second World War, American and Japanese forces fought over a large swath of territory across the Pacific Ocean. This area including many previously unexplored islands and archipelagoes and many indigenous cultures inhabited these distant lands. Isolated by large jumps of distance and previously unknown, these indigenous cultures were exposed to modern technology for the first time during the war. Imagine their amazement as, for the first time, they saw the metallic glare of fighter jets and battleships and heard the deafening roar of jet engines.

Food rained from the skies and the new arrivals literally changed the landscape, as both American and Japanese soldiers used airdrops and created landing strips and airports. To these indigenous cultures, the new arrivals must have seemed to be Gods or, at the very least, demons. Introducing the indigenous cultures to canned foods, medicine, clothing, and other manufactured goods, this outside intervention must have seemed incomprehensive –completely changing their world view and turning their lives upside down as they stood in the middle of a battle between two technological powers.

But then, after the conclusion of the Second World War, the soldiers left as quickly as they had come. Without a war to fight, there was no longer the same incentive to stay at these remote islands. For the indigenous cultures, it must have been quite confusing. Where did all the nice clothing, tools, and medicine go? How come food no longer dropped from the skies? Not fully understanding the reason why the soldiers came to their land or the mechanism behind the new supply of food and supplies, some indigenous cultures became cargo cults. They wanted access to the benefits and tangibles of technology without truly understanding how it worked. Mimicking the soldier’s actions and creating the outward signs of complexity, cargo cults sought to recreate the conditions required for attracting the cargo. Creating life-size replicas of airplanes, building control towers made of wood and thatch, and even clearing land to recreate runways, cargo cults mirrored the conditions of a technological society without fully understanding the reasoning and mechanism of their actions.

Richard Feynman famously used the term cargo cult science to describe research that is done without a full understanding of the underlying mechanism and using “reason” to justify the results post-mortem. Although these imitations can be quite accurate – Feynman mentions that the straw antennas of these make-shift airplanes were strikingly close to the length of actual antennas – without having any kind of result. Although mimicking the routine of developing hypotheses, using controls, and performing experiments, cargo cult science describes work that seeks to create results while lacking the fundamental understanding of what is actually happening. Cargo cult science is the justification of empirical observations without a true understanding of underlying processes.

Part Two: Medicine as a Cargo Cult

By this definition, medicine is a cargo cult science. This says nothing of medicine’s efficacy or its ability to help people, but 21^st century medicine is ultimately an empiric science. As much as we understand cell biology and systems physiology, the human body is still an incredible mystery, full of individuality, complexity, and beauty. With the level of current understanding and knowledge, biology (especially human biology) is a black box. As a first year medical student, this is the fundamental challenge in learning medicine – the knowledge gap between physiology and pharmacology.

As much as we understand human organs (the heart is a pump, the kidneys are a set of filters, and etc), with the current level of understanding, it is still fundamentally impossible to deduce the efficacy and the side effects of pharmaceutical agents. We can conceptually think about what happens when we increase or decrease blood flow, but it is still very difficult to determine a drug’s effect given its molecular structure or even what protein it targets. As an example, different approaches are needed to learn physiology and pharmacology in medical school. We want to understand how to body and various organs works in physiology, but we are forced to memorize the characteristics, half-lives, toxicities, and efficacies of drugs in pharmacology.

Yet despite its status as a cargo cult science, I find partial assurance because medicine is an empiric science. We choose what pharmacological therapies to give because it worked for the last hundred thousand people with your illness, and while we might not understand completely the mechanism of its effect, we can be reasonably confident in its efficacy for you. In fact, if you think of it this way, the FDA is the simply the clearinghouse of cargo cult science. The FDA does not simply ask pharmaceutical companies what the mechanism of their drug is (actually it does, but if you follow my logic of medicine as a cargo cult science I’d say that’s misguided.), but actively seeks to test and validate its efficacy.

But more than an effect on clinical outcomes, medicine as a cargo cult has great implications on the speed of medical progress and how medicine will progress in the future. Despite the rapid pace of basic scientific discovery, the difference in attitude and perspective between medicine and science will only widen the gap between scientific knowledge and clinical treatment. The next part will try to explain what I hypothesize will happen and why that is.

Part Three: Science Fatigue in Medicine

Unfortunately, it is far too easy for smart people to think of explanations and justifications of what they observe –regardless of whether or not it is true. Anecdotally, I can remember quite a few instances where I was asked to explain a concept, and while I wasn’t completely sure, was able to describe a reasonably sound explanation. Then, in retrospect, the explanation turns out to be completely wrong. Prior to Galileo’s claim that the Earth revolved around the Sun, humans lived normally and comfortably for hundreds, if not thousands of years. Prior to Galileo, there were many scientists, astronomers, and great thinkers – yet were they not troubled with what we now recognize as errors and fallacies of critical thought? Intelligent people, if set in a particular framework of thought, are especially difficult to persuade.

A prime example in medicine would be the recognition that Helio pylori, bacteria in the stomach, can cause ulcers. The scientists were initially ridiculed and scorned – “How can bacteria grow in the acidic environment of the stomach?” – before overwhelming evidence was obtained. It took the efforts of a brave scientist to ingest the bacteria and give himself ulcers before the scientific community could access the truth of his statements. With such a discovery, the entire framework of treating stomach ulcers was changed and Barry Marshall and Robin Warren won the Nobel Prize – but before this discovery, when haven’t other physicians and scientists recognized this link? Hindsight is 20/20, but the question of stomach ulcers is a large part of gastroenterology.

I can think of two main reasons, why medical advancement lags behind scientific understanding. There are undoubtedly more, but I think there are two main causes in relation to perspective and the framework of research. First, medicine works. This gets back to the initial idea that medicine is an empiric science – despite all its shortcomings and gaps in understanding, medicine is highly efficacious and we are at a point in history were previously fatal diseases and symptoms are routinely treated and cured. Just as Galileo was focused on something that seemly had no direct bearing on day-to-day life, many of the problems of medicine are not focused on the day-to-day treatment of patients. If someone has a heart attack, there is a standardized protocol and all in all, it works well. There is a standard of care for most diseases that guide how physicians treat patients. When things work, there is much less of an incentive to figure out why it works and how it works. This is a simplification, but I feel like this especially true when people are overworked, fatigued, and worrying about hundreds of other concerns (such as patients health, regulation, and even healthcare reform).

For the second reason, I would like to suggest a new phrase: Science fatigue. The idea of compassion fatigue is a concept that argues that the media has caused cynicism and lack of initiative in society by saturating newspapers and news shows with decontextualized images and stories of suffering. This inundation of similar images has been cited to cause the public to become cynical, or become resistant to helping people who are suffering – I would argue that this is same case with science. The general public, and physicians in particular, are flooded with so much news of scientific breakthroughs and innovations that seem to never materialize in concrete advances or meaningful change in care. We are always hearing about the latest device and the newest therapy, but the standard of care has changed so slowly that it is difficult to not become cynical about the marketing and showmanship now pervasive in medical science.

Part IV: Conclusions

The combination of relative efficacy and inundation of information is especially noticeable in medical education. In medical school, one is expected to learn and understand a large and ever-growing body of knowledge related to basic science and treatment. We are flooded with a huge volume of information – more than enough to occupy us for 24/7 for the next four years – and thus we need to prioritize what is important and what we choose to be curious about. The standard of care is undoubtedly important (medicine first and foremost has to work), so treatment is often emphasized. Science and the basic mechanisms often seem more nebulous and intangible. There are still many aspects of medicine that we do not understand, and the mechanisms we understand are sometimes barely better than the educated guesses of intelligent people. To reiterate, it is far too easy for smart people to think of explanations and justifications of what they observe – and without true understanding of the underlying mechanism, is medicine much better than a cargo cult? With the pressing urgency of patient care and the great body of knowledge expected of every physician, is it possible to function above the level of a cargo cult scientist?

A great clinician once told me that the most important skill to learn in medical school is the ability to deal with uncertainty. When we treat patients, we can never truly be completely certain that our diagnosis is correct or our therapy is the most efficacious. Physicians need to be comfortable with the uncertain variability in disease presentation, drug response, and even human physiology. This uncertainty begins even at the level of molecular mechanisms. Even as basic science pushes our understanding of biology, science cannot be the only force that drives the practice of medicine. Patient needs, cultural barriers, and pragmatic considerations all divide the worlds of medicine and science.

Since coming to UCSF, I have realized that many of the greatest challenges of medicine come not from the science, but from quality of care and from access to care. The most intractable problems of global health and health within our own community come from deciding how and where to deliver care that is currently already available. Healthcare reform seeks to answer the questions of how we can improve our quality of care without bankrupting the economy. Learning to deal with people is an incredibly important issue -  even though we have incredibly efficacious drugs for treating hypertension, asking people to take pills (with noticeable side effects) for a disease that is subtle, often symptomless, is tremenendously difficult. There are many questions that cannot be answered from the benchside and while I still greatly admire and respect science’s ability to alleviate suffering and cure disease, much good can be done in improving the potential we already have in front of us now. For better or worse, medical is truly different from science.

One example could the relative respect and ranking of European universities and American universities. Going back to the 19th century, Europe, particularly England, was the center of the world – there is no doubt that Oxford and Cambridge were the undisputed centers of education and learning. Harvard would seem like a backward backwater professional school. As we progress to the 20th and 21st century, America’s relative standing in the world improved, and I think this coincided with a rise in names such at Harvard, Stanford, and MIT. This might be due to my America-centric background, but I think these schools can hold their own against most others throughout the world.

Much more than educational models and philosophies of teaching, the relative importance of the region that a university encompasses is the leading indicator of future success. That is not to say the educational mission is unimportant, but I think other factors pale in comparison to the irresistible attraction of proximity. Choosing a college a few years back, I had no idea what is really important. Apart from an ambiguous idea for “prestige” and the spectrum of unique but equally impressive architecture, I remained ultimately ignorant of the different characteristics of each institution – and I get the impression that I was not alone. With all else equal, I would imagine being close to family and friends would a significant pull to the empty vessels we call students. The law of large numbers would suggest regions that can attract intelligent adults will inevitably attract intelligent students.

The real question is: Where is this going? What implications does this have for the future? I think it is particularly telling that one of the major movies of the past year chronicles the journey of bright young student moving from the more traditional prestigious halls of education and power to a new area of excitement and potential. The Social Network, in part, described Mark Zuckerberg’s move from Boston, Massachusetts to Palo Alto, California, and foreshadows the gradual shift of America’s center of gravity towards the West.

It is difficult to predict the fall of hegemony – and Harvard is undoubtedly an educational hegemon. But just as we are transitioning into a multi-polar world and Facebook is challenging the internet dominance of Google, such shifts seem natural, almost inevitable, in hindsight. And that is my guess for the improvement of Stanford over Harvard in the near future. As the United States moves ever more towards an information-based economy and the traditional powers of finance and trading is seen as a non-productive Ponzi scheme, the center of gravity shifts towards the West. The importance of Silicon Valley will only increase and in turn, the significance of Stanford, UCSF, Caltech, Berkeley, and other schools in the west will continue to grow.

Mozilla Labs and the Metrics Team, together with the growing Mozilla Research initiative, are hosting a Open Data Visualization Competition based on Test Pilot data. This is my second attempt after sorting through demographic, use, and survey data. First, the distribution of the self-reported computer proficiency is not normally distributed. There was a much greater number of individuals selecting a high proficiency on the internet than those selecting a low number. Although I believe this is definitely a biased population (the individuals opted in, implying they understand how to opt in and care for the development of Firefox), I also think there is truth in the saying “90% of college graduates believe they graduated in the top half of their class”. There are negligible differences in responses to the amount of time spent using Firefox and age distribution. When faceted both by age of the respondent and self-reported number of hours in front of the computer, the distribution remains roughly the same.  However, there are substantive differences in terms of use of extensions and the types of activities performed – perhaps enthusiasm is more important than raw amount of time.

First, individuals self identifying as being more proficient are also more likely to use a greater number of Firefox extensions. This is to be expected as Firefox prides itself on having a vibrant sandbox of developers and a large array of functional and entertaining extensions. I would guess that more proficient users would take the time to create a more customized and optimized experience with the internet and this begins at browser extensions. I would also venture to guess that at least a portion of the sample includes web developers and individuals intimately involved in the development of Firefox (Who needs 100+ extensions?!?) and they would self-identify as professional users.

The internet is not a one-way mirror. As we use the internet, the internet changes and influences our behaviors. There is also a strong positive between the self reported proficiency and the number of activities one performs on the internet. In the survey, one of the questions on the survey asks how individuals use the internet, binned into large categories of activities ranging from social networks to online shopping. As users become more proficient, perhaps they discover a greater variety of functions that can be performed online.

Finally, more frequent users use the internet for a great number of reasons. This is intuitive as to use the internet for more functions, more time would be spent in front of the computer. As entrepreneurs continue to discover and create new ways for the internet, inevitability more and more of our life will be tied to our online personas and internet use. As such, the browser experience is vitally important. (Carry on Mozilla!)

There was a really blog post on how people use Private Browsing Mode based on usage data. I wanted to see if I could go one step further, by testing their conclusions and cross-referencing individual usage data with their survey responses. I was able to confirm some of their conclusions, such as the fact that most people spend about 10 minutes in Private Browsing mode, but because location data was stripped from the dataset, was not able to verify the spikes according to time of day. From PDT it looks like there is large peak throughout the afternoon, but this probably skewed by different numbers of users in each time zone.

A Greater Proportion of Male Users than Female Users use Private Browsing Mode

The dataset is skewed towards having more males represented in the sample population (94% male), but in terms of most metrics, there is gender equity. Males and females use roughly the same number of extensions, have similar age distributions, and have very similar self-reported number of hours in front of the computer. Females do seem more modest in self-reporting of proficiency with a computer. The most striking difference was the difference in use of Private Browsing Mode, with almost four-fold increase in the proportion of males. Further statistical analysis based on gender, either of the duration or frequency of the use of Private Browsing Mode seems suspect due to the small sample size.

Younger People Tend to spend more time in Private Browsing Mode

In addition to gender, there appears to a slight, admittedly weak, relationship between the age of the individual and the average time spent in Private Browsing Mode. The data is colored based on gender, with blue for males and red for females. There appears to be a slight bump in the 18 to 25 age category, although this could be due to differences in sample size across different ages. Note: This plot is of individuals which use Private Browsing Mode – if examining the population at large, there would be a ton of data points with a duration of 0.

Self-Identification Affects Private Mode Usage

Question 12 of the survey posed the question “What are your most frequently visited websites?”. The survey allowed for a variety of responses ranging from “Search engines” and “Social networking sites” to “Adult pages” and “Gambling and online betting”. I was curious whether this self-characterization would be a good metric to identify individuals who use Private mode more often. I was able to separate out the survey responders based on whether they chose each website different categories. For example, I subsetted the entire survey into individuals who chose ”Social networking sites” vs. individuals who did not choose ”Social networking sites”. A priori, if this self identification did not matter, there should be little to no difference between the average time in Private Browsing Mode between the two populations.

For each category, here is the absolute difference in the two populations.

[1] 5.594305
[1] 3.84167
[1] 0.2490019
[1] 0.7180658
[1] 3.601866
[1] 0.3737534
[1] 1.408243
[1] 1.525824
[1] 3.27257
[1] 6.79226
[1] 4.651107
[1] 5.669116
[1] 1.027911

There was the smallest difference in individuals who claim and do not claim to use the internet for “News sites”, “Social networking sites”, and “Shopping”, while there appears to be a bigger difference in individuals who claim to use the internet for “Forums”, “Adult pages”, and “Gambling and on-line betting”. There appears to be a noticeable difference in usage between individuals selected any of the “riskiest” 3 categories and individuals who did not.