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Your Questions Answered

ON APPLYING TO MEDICAL SCHOOL

The New Physician September 2004
How important are Medical College Admission Test (MCAT) scores and grade-point averages (GPAs)? Should I consider an off-shore school? What are my chances as a nonscience major? To find answers to these common questions, The New Physician has asked several premed advisers for their insight into the admissions process.


BESIDES MCAT SCORES AND GPAS, ON WHAT ELSE WILL PREMEDS BE JUDGED?


“Medical schools certainly want to know that a student has academic ability, an affinity for science and the foundation necessary to begin medical school studies,” says Carol Baffi-Dugan, Tufts University’s program director for health professions advising and the editor of The Advisor, a journal published by the National Association of Advisors for the Health Professions. “But just as importantly, they want to be sure the student has the experiential foundation and the personal foundation necessary to become a competent, caring physician.”


What is this? “Students need to know for themselves that medicine is the right path, and only then communicate that to medical schools,” she says. “A variety of experiences in health or human service settings can help students develop a sensitivity to and respect for others, an appreciation for the complexities of patient care and public health issues, a commitment to serving competently with integrity, and a sense of responsibility to do things correctly, completely and effectively. I talk to my students about the two parallel paths of preparation to med schools—the academic and the nonacademic. They are equally important.”


Tom Bond, a retired provost of the University of California, San Diego, Revelle College who has advised about 300 premeds during the past 20 years, agrees. “First, it seems to me that most premeds claim they want to become doctors to ‘help others,’ but it is those with a track record of doing so that are more successful…,” he says. “A second weakness occurs when premeds simply don’t know a lot about the current status of health care in this country. Such applicants are often idealistic, but out of touch with reality.”


WHAT CAN LIBERAL PREMEDS DO TO INCREASE THEIR CHANCES?


“For this person, the MCAT scores make all the difference in the world,” says Angela Frey, an assistant professor of biology and a premed adviser at Alverno College. “If a science person scores average on the physical science part of the MCAT, the admissions committee may look at their individual grades in the courses. Unfortunately, the liberal arts major does not have that opportunity.”


Baffi-Dugan doesn’t advise nonscience majors too differently from other premeds. “If the student has an interest in getting a bit stronger background or he/she had a slow start in his/her sciences, I do advise additional course work, usually in biology courses such as genetics, physiology, cell biology, molecular biology or biochemistry,” she says. “With strong basic science credentials, though, a nonscience major has an equal chance of admission, in my experience.”


Barbara Huntington, the director of San Diego State University’s preprofessional health advising office, agrees. “Take some upper division science [courses] and do well. In most cases, [nonscience majors] have an equal chance or better, as they tend to do better on the MCAT verbal and sometimes the science.”


WHAT ELSE SHOULD PREMEDS DO TO PREPARE THEMSELVES?


“Above all, demonstrate a genuine interest in helping others,” Bond says. “This is more than simply four hours a week for 10 weeks volunteering in a hospital. It should be something the student really loves to do and…not something for a résumé.”


“I encourage students to engage in three things; these can overlap,” Baffi-Dugan says. “A student must gain some experience in the health field—this is more for the student than the admissions officer. How can a student make such a monumental decision without having some objective contact with healers…and patients, and judging how they see themselves in this setting?


“I also urge a student to pursue some interest or activity outside the classroom to develop leadership, organizational and communication skills.


“Lastly, I encourage all students to perform some service during their college years.”
Huntington recommends getting clinical experience by becoming a certified emergency medical technician, among many other health profession options. “[Also], become a leader for a service activity or club; get to know [professionals]; for certain schools, do research; [and] know the issues in medicine,” she says.


DESCRIBE A STRONG APPLICANT:


“The great danger in any answer to this …is the implication that there is a formula,” Baffi-Dugan says. “There is not.”


Bond offers a starting point, at least from his familiarity with California schools: “In my experience, grades and test scores come first—lots of students who might become caring, competent physicians won’t make it…because their GPAs are low—below a 3.3—or test scores [are], say, less than a total of 29 to 30. Such students, if really committed, may need to consider other careers or other routes to an M.D. [like off-shore schools]….


“So a strong applicant first is intelligent…and a person who has shown they can handle a tough curriculum. Then, they should be a person with good communication skills and some proven commitment to helping others. [Also], maturity counts a lot, especially in the interview phase,” he says.


And having a perfect GPA doesn’t make one a perfect applicant, Frey says. “Good grades and MCAT scores [are important]…, but not all 4.0 students make good doctors or should be medical students. They must demonstrate that they have an idea what the health field is really like…and [that] they can be understanding to those in need.”


WHEN SHOULD PREMEDS SUBMIT THEIR APPLICATIONS?


“The first day possible,” Huntington says.
“The minute the [American Medical College Application Service] window opens,” Frey says.


Bond believes this is controversial. “Some of the rip-off MCAT prep courses give the impression that if your application isn’t submitted June 1, you are out of it. Not so, in my experience, but July 15 seems like a good target. April MCAT scores are available. Students who plan to submit August MCAT scores with their application are at a disadvantage, unless there are some special factors involved,” he says.


Baffi-Dugan recommends a similar timeline. “Students should definitely submit their applications…by mid-summer, regardless of whether they are taking the April or August MCAT of that year. Anyone who has worked so hard for years to prepare herself for medical school should take advantage of the plus of being an early applicant.”


SHOULD OFF-SHORE SCHOOLS BE CONSIDERED?


Bond says this is a difficult question to answer but offers this advice: “When students with relatively weak records tell me they really want to be a doctor, but then say they won’t consider an off-shore medical school, I sometimes question that commitment.”


Baffi-Dugan agrees that premeds should keep their options open. “In my view, all students should consider all options and all careers,” she says.
And while Frey says international medical graduates desiring to practice medicine in the United States may face more challenges than U.S. graduates, “If they are at the top of their class in the off-shore medical school and can get a good residency, it may pay off.”


ANY ADVICE FOR OLDER PREMEDS?


“I have run a postbac program for 15 years, and I find that older applicants are judged on the same basic criteria as traditional applicants,” Baffi-Dugan says. “Perhaps it is more important for the older applicant to explain his/her motivation for medicine given their circuitous route, but they need to demonstrate the same foundation…as the traditional applicant.”


“Age discrimination,” Bond says, “is, of course, illegal, and the med schools… don’t need to be reminded. But they are looking at what kind of a physician they will graduate and how much that person will be able to give back.”


Frey says some schools may inquire about an older applicant’s personal life. “Unfortunately, asking these types of questions is probably not legal, but, honestly, they are still asked. Some admissions committee members are probably truly concerned for someone’s future,” she says. “In this case, someone with children or a spouse needs to demonstrate that they have a strong support system. A single, no-kids, older applicant needs to demonstrate why a change of career now and that this is not some midlife-crisis, flash-in-the-pan thing that will soon pass.”


SHOULD PREMEDS WHO ARE GAY OR LESBIAN COME OUT DURING THE APPLICATION PROCESS?


“If a student’s sexual preference has had a significant impact on some life experience, career decision, leadership on campus, etc., then it seems reasonable to discuss it as part of the application,” Baffi-Dugan says. “If not, it is no more critical or relevant than mentioning that you are heterosexual.”


Other advisers agree. “It should be like any other piece of information in the personal statement—only write about what has influenced their career choice,” Frey says.


Bond recommends coming out in an application, or admitting strong political or religious preferences, only if it’s essential that the school know this. “I always recommend telling the truth. I wouldn’t make a big deal out of it, but if something is important to an applicant, they would not be happy at a school where that might be a problem—just as applicants who are strongly pro-choice might not be happy at a school where that might be a problem.”


In fact, advisers tell premeds to be honest about anything that has significantly affected their decisions to enter medicine. “If their strong beliefs had an impact on their career choice or what kind of physician they will be, then yes, [mention it],” Frey says.


DESCRIBE SOME COMMON MISTAKES:


“Sounding arrogant in an essay, applying with an extremely low MCAT or GPA, calling too often and driving admissions officers crazy” are behaviors Huntington recommends against. Another is not beginning the process soon enough, whether that be contacting a premed adviser or applying to medical school.


Bond says some premeds aren’t careful with all their applications. “People spend hours on the primary, get outside people to proof it and comment on it, and then crank out secondaries without a second thought.


“Another mistake is trying to project yourself as something you are not…,” he says. “When the application, letters of [recommendation] and interview don’t all reflect the same person, an acceptance is rare.”


On a scale of 1 to 10 (10 being the most), how subjective is the admissions process?
“I would say a 5, and thank goodness,” Baffi-Dugan says. “Of course, you want some relatively firm criteria for admitting students, but you also want experienced admissions individuals to make judgments based on less tangible factors in the application.”


Bond says a 6.5. “It’s a little more subjective than some applicants would like…. [But] if it were purely objective, I think MCAT scores and GPAs would be the only factors used, and that would be a disaster.”


Huntington agrees. “7—MCATs and GPAs are big, but, thankfully, many admissions officers look at the whole person.”
Frey points premeds to schools’ admissions policies. “It depends on the school…. If the school is a 1 and looks only at the numbers…, a student with great numbers and not-so-great interview skills or experience should apply there. If the school is a 10 and looks at other important qualities like service and experience, a student who has more experience but less punch in the numbers should apply there. I advise students to contact the admissions officer at the school to find their criteria for admissions.”


IF YOU COULD GIVE ONLY ONE PIECE OF ADVICE, WHAT WOULD IT BE?


“Stick with your dream, but put your money where your mouth is—i.e., be willing to work hard to get there, not just talk about how much you want it,” Baffi-Dugan says.


And start sooner, rather than later. “Be prepared and get your information early,” Frey says.
Bond advises to “be sure you know what the profession is like, and be sure you know what is involved in getting an M.D.”


And finally, Huntington offers: “Be sure you really care about healing. If you do, you will do everything you need to do to be a good candidate while preparing yourself as a caring human being.”
Rebecca Sernett is editor of The New Physician. Direct comments about this “PremedRx” to tnp@ amsa.org.