Charting a Course to Medical School: The AMSA Map for Success

So here you are... done with the MCAT, and probably feeling like a great deal of weight has been lifted off your shoulders. You are relieved, happy, and excited about what is about to happen next -- your application to medical school. Yes, in many ways, the worst is over, but that does not give you an excuse to let up now. In fact, you should be more vigilant than ever. You are about to make some very important decisions, decisions which will affect the rest of your life.

To help you understand this whole process, we've split up this section into five parts (note: we've given "Interviewing" it's own section since it's such an important part of the process):

• Choosing which type of doctor
• Selecting medical schools
• AMCAS, AACOMAS and secondary applications
• Personal Statements
• Letters of Recommendation
• Preprofessional Committees
• Tips on Applying

Choosing which type of doctor

There are two types of physicians in the United States. One is an M.D. (doctor of medicine) and the other is a D.O. (doctor of osteopathic medicine). So what is the difference?

A physician is one who has graduated from an accredited medical program and has fulfilled the prescribed internship/residency/specialty training program. D.O.s and M.D.s are alike in that they both utilize all scientifically accepted methods of diagnosis and treatment, including the use of drugs and surgery. The educational requirements are the same for both, and typically, both physicians are examined by the same state licensing board.

The real difference between D.O.s and M.D.s arise from the different point of view and emphasis taken by each. The D.O. recognizes that the musculoskeletal system comprises over 60% of body mass, and that all body systems, including the musculoskeletal system, are interdependent. The D.O. believes that emphasis on the relationship between body structure and organic function gives a broader base for the treatment of the patient as a whole. The D.O. uses structural diagnosis and manipulative therapy in addition to the forms of diagnosis and treatment which allopathic physicians use. The D.O. believes in the 'whole body concept,' and feels that an illness is not just concentrated in one area or system, but that the whole body is affected.

The American Osteopathic Association (AOA) places a greater emphasis on community-related medical treatment. This is reflected by the high percentage of D.O.s who enter primary care specialties. The AOA believes all patients should have the right to select the kind of health care they prefer.

It is important to realize that both D.O.s and M.D.s are physicians. They both can care for a patient's problems, but the fundamental perspectives from which they approach medicine are somewhat different.

Selecting Medical Schools

Where do I apply, and how do I know this medical school is for me?

Every year, the Association of American Medical Colleges (AAMC) puts out an updated copy of Medical School Admission Requirements. The book contains valuable information regarding names, addresses, and locations of every allopathic medical school in the United States and Canada. It also contains data pertaining to every medical school, including GPA/MCAT score ranges associated with accepted students, class size, curriculum, requirements for entrance, selection factors, financial aid, class composition, tuition, et cetera. For students interested in osteopathic medical schools, there is a comparable book published by AACOM called the "Osteopathic Medical College Information Book."

With over 125 schools to choose from, how do you know which ten or so schools best suit your hopes, expectations, and qualifications? There are a number of ways that schools can be chosen. Examine the following factors:

1. Curriculum
What are you interested in pursuing once in medical school? Do you want to learn mostly via traditional lectures (traditional curriculum), via classes focused on learning information arranged by organ systems (traditional systems-based learning), or by case studies of clinical problems (problem-based learning). Every medical school has a reputation for coursework or programs unique to itself.

2. Class size/composition
Do you want to be in a class of 200 students, 100 students, or even fewer students? What types of student have been making up the class in the past few years? What percentage are women or come from minority groups?

3. Location
Where do you want to be when you are studying anatomy, biochemistry, physiology, and need a break? Do you want to be somewhere cold? Warm? Rainy? Sunny? Or is there a particular state or city in which you would like to spend four or more years?

4. Tuition and financial aid (be sure to see the financial aid section)
Is there sufficient financial aid available? Will you be able to afford tuition, fees, and books? Are there good loan and grant programs available?

5. Cost of living
Even if you can afford tuition, will you be able to afford the necessities, including food, clothing, and housing?

6. Competitiveness
Do you just want to get through medical school, or do you want to excel among your peers? Do you want grades in your classes, or do you want to be on a pass/fail system? (Yes, many medical schools are pass/fail, and one school, Yale, has no grades!)

7. Reputation
It cannot be denied that some schools have established national recognition in particular areas of medicine. If you are already leaning toward a certain field, this may be something to consider.

8. Out-of-state acceptances
You may decide that you want to attend a medical school outside of your home state. This may be particularly true if you do not come from a state with many medical schools (e.g., Maine, Montana, Wyoming, and Idaho). Check the AAMC's Medical School Admission Requirements for out-of-state acceptance rates and tuition (which may vary for in-state and out-of-state students).

9. Other
Is there anything else about a medical school that captures your interest (your great-grandfather graduated from there, et cetera)?

How many schools should I apply to?

This number is up to the individual, but applying to medical school is expensive. The average per student is usually about 10 schools.

AMCAS, AACOMAS and Secondary Applications

The American Medical College Application Service (AMCAS) is a non-profit central processing unit for applicants to participating allopathic medical schools, and AACOMAS is the comparable entity for osteopathic medical schools. Most medical schools participate in the AMCAS or AACOMAS application process, and they are rather efficient services. The application is only a four-page "academic autobiography" that is sifted and sorted into a one-page sheet which is sent to all of the medical schools to which you wish to apply. For all of its benefits, the AMCAS or AACOMAS application process is expensive. There is a fee waiver program for financially disadvantaged applicants, but there is a separate application for a fee waiver, requests for which may be submitted beginning May 15 of each year.

The AMCAS and AACOMAS application packets contain an overwhelming amount of paperwork. There is an acknowledgement postcard (which is sent to you when they receive your application), designation forms, an application form, a code booklet, a GPA calculation sheet, a fee waiver request packet, an official transcript inventory form, a pre-addressed return envelope, and four transcript matching cards. There is also a 36-page instruction booklet which is reminiscent of registering for the MCAT. Letters of recommendation are not included in your AMCAS or AACOMAS application. They are sent with the secondary application. The only piece of personal datum, initially, is your personal essay.

The personal essay is one of the most important sections of the AMCAS or AACOMAS application. It allows you to demonstrate who you are by giving you an opportunity to explain your motivation to pursue medicine, or even to explain why your grades or MCAT scores were, perhaps, not so good. Whatever you decide to write about in your personal essay, remember that you want to express yourself in an honest, dedicated, and coherent manner.

The AMCAS and AACOMAS applications are usually available in mid-March and can be obtained either through your preprofessional advisor or directly through the services themeselves. Or, you can choose to utilize AMCAS's electronic application (AMCAS-E) or AACOMAS's electronic application. Electronic applications have their advantages and disadvantages over the paper version, but we recommend that you at least give it a shot. It will save you a lot of paperwork, and you don't have to mess with a typewriter! Check the resources section of this guide for more info.

The sooner you get your application in, the sooner medical schools will be able to evaluate your application. AMCAS and AACOMAS begin accepting applications June 1, and they begin accepting transcripts March 15. Both services suggest that you have transcripts sent to the application services (from all colleges that you have attended) prior to submitting your application so that your application can be processed more quickly. AMCAS and AACOMAS do not make any admissions decisions, and they do not advise applicants where to submit applications. Each participating school is totally autonomous in reaching its admissions decisions. AMCAS and AACOMAS only provide a central application processing service to your chosen schools. It is up to the individual schools to send you secondary applications, an interview invitation, and, hopefully, an acceptance letter. Remember, not all medical schools use the AMCAS or AACOMAS services. Check with the schools you would like to attend to determine their application procedures.

After AMCAS or AACOMAS receives your complete application, they will process it and send copies of it to all of your designated schools. They will also send you a transmittal notification. This notification is an exact replica of what the medical schools will receive. As soon as you receive the transmittal notification, check for any errors. Contact AMCAS or AACOMAS in writing immediately if you need to have something changed. If everything is correct, then AMCAS and AACOMAS have completed their jobs.

Although AMCAS and AACOMAS provide the primary applications to medical schools, the medical schools to which you are applying will themselves send you a secondary application. Each school will send you a secondary application which you are required to return along with an application fee in order to be considered for an interview. The fee varies from school to school. Most schools will waive this fee if you were earlier granted an AMCAS or AACOMAS fee-waiver.

The secondary application is different from the AMCAS and AACOMAS applications in two major ways. This is where your letters of recommendation and more personal information are requested. For instance, they may ask you to explain your best and worst traits or why you chose to apply to that particular medical school. Warning: if you're lucky, secondary applications can start piling up quickly. Try to commit yourself to returning each secondary application you recieve no later than 2 weeks after you receive it. Sticking to this goal will make your life much easier. Once you have completed and returned the secondary application, you can sit back, relax, and wait for your interview invitation.

Letters of Recommendation

How do you go about getting a letter of recommendation from a professor when you are only one student out of a class of a few hundred? That is one of the questions most commonly asked by pre-medical students coming from large undergraduate institutions. There are many ways to circumvent this situation and as you read on, please keep in mind that these are generalizations. your particular situation and methods of obtaining letters of recommendation may be different.

In larger classes, approach the professor near the beginning of the term and explain to him or her your situation. That way they know who you are and may pay special attention to your performance in class. Also, make an effort to attend your professor's office hours to ask questions about material that you do not understand. After the term is completed and your grade is determined, approach the professor again about writing a letter of recommendation on your behalf. Do not feel nervous or intimidated. You probably are not the first one who has asked him or her for a letter of recommendation. They will most likely ask for a copy of your CV (curriculum vitae) or resume, and maybe even a copy of your personal essay. Some professors like to sit down with you and ask you about your interests, activities, and, of course, your desire to become a physician. With all of this information, they will write a letter of recommendation for you and send it either to the medical school or the preprofessional committee. Needless to say, you must let them know where you want it sent.

In smaller classes, it is much easier for you to get to know a professor. In addition, the professor of a small class is much more likely to remember who you are and how you performed in class, i.e., participation, essays, questions, etc. They also may ask for a copy of your CV and personal essay because they may not know about your life outside of that particular class. In most cases, schools will also accept letters of recommendation from teaching assistants if they know you better than a professor of a certain class, that is, if a professor of the same class would not be able to give a comparable evaluation.

In addition, letters of recommendation can come from a large number of fields and are not restricted to academia. Although a few letters from the basic sciences are generally preferred, your other letters of recommendation can come from other departments, i.e., environmental sciences to English literature. Letters of recommendation can also be written by former (or present) employers and volunteer supervisors. You should try to get letters of recommendation which highlight your strengths in several areas. Letters from friends, family members, and politicians are usually not a good idea.

When to ask for a letter of recommendation is up to you. Most students do not begin asking for letters until their junior year, when, traditionally, they begin the application process and may be in smaller, upper-level classes. Generally, it is better to ask a professor just after you have finished a course with him or her, especially in a large class, because they will most likely still remember who you are. Common sense will also tell you that it is important to ask for a letter of recommendation at a convenient time. When a professor has a grant proposal due the following week, or an employer has a major deadline to meet, they may not be very receptive to your requests.

Also, here are a couple of tips to help you with your recommendations:

• When asking for a recommendation, ask "Can you write me a strong letter of recommendation for medical school?" Most recommenders will be straightforward with you, and you should obviously not ask for a recommendation for someone who can't answer "Yes" to this question.
• Approximately 2 weeks after you ask for your recommendation, send your recommender a Thank-You letter. This should be done for 2 reasons: 1) It's the polite thing to do and 2) It may serve as a reminder to any recommender who may have been too busy lately to complete your recommendation.
• ***Check with your preprofessional committee and with the medical schools to ensure that your letters are being sent where they need to be sent when they need to be sent. It is YOUR responsibility to see that everything in your application is accurate and complete, not your premedical advisors's responsibility.***

Finally, letters of recommendation are just one of several facets that the admissions committee examines. Remember, if you choose to go through the service of the preprofessional committee, the letter of recommendation sent to the medical school will be a result of all of the letters that you have obtained. People who are most knowledgeable about your strengths, character, and commitment to medicine will most likely give you excellent letters of recommendation.

PreProfessional Committees

Many undergraduate schools have a preprofessional committee in order to make the application process to medical school a little less cumbersome. Each school's procedures are a little different, but they all operate on the same general principles. The committee members, comprised of faculty in different departments and, perhaps, the preprofessional advisor, will review several items compiled in a preprofessional committee application. These include your overall grade point average, science grade point average, major grade point average, trends in grade patterns, honors courses (if any), personal essay, letters of recommendation, previous employment records, volunteer experience, and extracurricular activities. Some committees will also have a personal interview.

The committee members will then produce a single letter of recommendation, based on the application information and interview. Many schools will also rank you with ratings such as "outstanding, strong, competitive, above average, and average."

The preprofessional committee facilitates the application process by enabling you to send the composite recommendation to each medical school to which you are applying. This would be much easier than requesting an individual letter of recommendation from several people for every medical school to which you intend to apply.

Whether or not your school has a preprofessional committee, you are not required to use its services. It is designed to help make the application process to medical school smoother for you, but if you think that it would be more of a detriment than an assistance, no one can force you to use it. The decision is entirely yours. Do realize, however, that most medical schools prefer that you use your school's preprofessional committee if one in fact exists.

Contact your preprofessional advisor or undergraduate advisor if you are interested in learning more about the preprofessional committee.

Tips for Applying

• APPLY EARLY! And when we say early, we mean turning your AMCAS or AACOMAS in by the end of June (the earlier the better, but no need to FedEx it or anything and do NOT submit it before June 1st) and returning your secondaries within 2 weeks of receiving them. We know that you have heard this a million times before, but it is one of the most important elements of the application process.
  
  
• Make sure to apply to a range of schools so that you can keep your options open and give yourself the best chance to get admitted to medical school.
  
  
• Be prepared to spend a lot of money as the AMCAS and AACOMAS fees, individual school application fees, and interview costs (flights, hotels, meals, etc...) add up quickly. Some schools have hosting programs, but make sure to contact them early because they usually can't place you at the last minute.
  
  
• Distinguish Yourself! Each school receives about 7000 applications for 100 spots. Try to make your application distinctive in order to separate yourself from the masses. Before they accept you, they have to remember you.
  
  
• APPLY EARLY!
  
  
• Some schools are non-AMCAS schools (see your MCAT registration booklet for a list). If you are interested in applying to these schools, write them for applications in the spring of your junior year, and, again, send them in as soon as possible.
  
  
• At interviews, you will be grouped with people from all different schools, from Ivy League schools to schools you have never heard of. On your interview day, all of you are on equal playing field for the day, so don't be intimidated or condescending.
  
  
• Show interest in the schools during your interviews, as schools want students who want them. If the school is your number one choice, be sure to tell them.
  
  
• APPLY EARLY!
  
  
• Practice questions with a friend before interviews. Be sure to be able to answer Why do you want to be a doctor? because they do ask this question. If you can't answer it, you're in trouble.
  
  
• Send thank-you letters (but not gifts). They can't hurt you, and they definitely can help you. For the medical school, thank-you letters are definitely in order for your interviewer, as well as perhaps the person whose name appears on your interview invitation letter and anyone else at the school who may have helped you during your interview day. At your college, thank-you letters are in order for your recommenders (it may even serve as a sort of "reminder" to any of your recommenders who may be slow in submitting your recommendation) and your premedical advisor.
  
  
• If you are waitlisted, be sure to continue to express your interest by calling your interviewers, writing letters to the admissions committee, and updating your application with any exciting news (e.g. awards, honor theses, academic transcripts, etc.)
  
  

MCAT	Reapplying