The Role of Your Counselor Recommendation

Most colleges request a letter of recommendation from your high school guidance counselor. This letter serves a unique function in the college admissions process. The counselor is expected to describe your high school environment, place you within the context of your peers, and discuss your unique attributes. “Many college and university admission officers use the counselor recommendation to learn more about the school and the community of the student applying for admission,” says Shawn Abbott, assistant vice president and dean of admissions at New York University.

While your teachers will focus on your academic strengths, your counselor can provide insights about your character, values, and goals. As stated by Cooper Union for the Advancement of Science and Art, recommendations “help us look past the numbers and learn more about who the student is.”

Hamilton College’s admissions office advises counselors to “take the time to tell us things we wouldn’t learn elsewhere in the student’s application… To be sure, the single most important factor in our decision-making process is the high school transcript. But your comments and insight provide us with perspective and help us assess fit with our community.”

What questions are asked of counselors?

Beginning with the 2015-16 application year, the Common Application developed a new form for counselors to complete. The Counselor Form consists of several prompts to help admissions officers learn more about who you are as a person and as a student:

  • The duration and context in which you’ve known the applicant (short response)
  • The first words that come to mind to describe the applicant (short response)
  • A broad-based assessment addressing topics like academic and personal characteristics, contextual comments for the applicant’s performance and involvement, and/or observed problematic behaviors that an admissions committee should explore further (long response)

Understanding the recommendation process

The ratio of students per guidance counselor varies widely around the country, but the average is a staggering 476 students per guidance counselor. At most public high schools, there is no dedicated college counselor; instead, guidance counselors incorporate college advising within all their other academic and disciplinary responsibilities.

Some high schools have put procedures in place to help counselors obtain personalized information on students. At Midwood High School, in Brooklyn, which has two counselors for 800 seniors, the guidance office prepares a folder for each senior that includes their contact information, test scores, teacher recommendations, a student profile and autobiographical essay, and a “parent brag sheet” with anecdotal information.

But not all high schools have such an organized and comprehensive system for collecting personalized information about seniors. As a result, the more you can do to help your counselor understand who you are personally, the more effective his or her recommendation letter will be.

How can you help your counselor describe you as effectively as possible?

The strongest recommendations paint a well-rounded portrait of who you are. With that in mind, here are some tips:

Develop and maintain a strong relationship with your guidance counselor. Make regular appointments throughout each school year. Keep your counselor informed of your achievements in academics and activities. In the fall of senior year, stop by to discuss how you spent your summer.

Create a detailed resume that describes your extracurricular activities, internships, employment, and volunteer work in detail. Try to be as descriptive and authentic as possible, and don’t use generic phrases.

Write a 1-2 page letter to your counselor describing your strengths, values, and goals—if your counselor does not ask you to complete a form or essays. Reflect on the following questions, and provide thoughtful responses. If possible, provide specific anecdotes to illustrate your points:

  • What are a few significant experiences that have influenced who you are today?
  • What obstacles or challenges have you been faced with, and how did you overcome these?
  • How do you approach your schoolwork?
  • What are your relationships like with peers, teachers, and advisors?
  • How have you improved your community?
  • What academic areas of study in college interest you? How do these areas relate to your academic accomplishments in high school?
  • Do you have specific career goals at this point?

In addition, provide your counselor with a list of colleges you are currently considering applying to, as well as specialized academic programs if applicable.

For guidance on recommendations and other aspects of the college admissions process, feel free to contact us at As always, we’re happy to help!

Seeking Out Local Scholarships

Faced with the rising price of a college education, students and parents often look for ways to lower costs. As a result, scholarships for need, merit, athletics, community service, hobbies, and other interests are often highly sought after—especially large scholarships offered on a national level.

However, students should also consider scholarship sources closer to home. Local businesses, religious or ethnic organizations, and other venues often acknowledge hometown students by helping with college costs through scholarships that are awarded on a yearly basis. And while a $1,000 local scholarship may seem small in comparison to the large sticker price of college, winning several of these scholarships could help to offset the cost of room and board, books, and some tuition.

According to the CollegeBoard, local scholarships have an advantage over national scholarships: they are only available to a smaller pool of applicants from a specific geographic region. Because there is less competition, the chances of winning are higher. Students should still apply to national scholarships that are meaningful to them, but it is also important to research the scholarships offered to your specific high school, town, county, and state.

Now, local scholarships may seem like a great idea, but how to begin? We hope to guide you on a path to finding your best-fit local scholarships in this blog.

When should I start looking for local scholarships?

It is best to start researching scholarships by the spring and summer of junior year, as most deadlines for these awards are in the fall of senior year.

How do I find local scholarships?

High school
The way to begin is to ask the guidance office at your high school for a list of local scholarships. For example, Schreiber High School in Port Washington, NY, has an extensive list of local scholarships available to its high school students. Another group to ask within your high school is the PTA. Scarsdale High School in New York offers a PTA scholarship that awards college-bound seniors a one-time grant ranging from $1,000 to $7,500.

Local businesses
Next, look into scholarships from the companies or organizations where your parents are employed. Many companies offer scholarships to the children of employees, and the Human Resources department or your supervisor will most likely have this information. Many employee scholarships are also merit-based, rather than solely need-based.

Religious and ethnic organizations
Additionally, explore the groups that you and your family belong to. Religious and ethnic organizations often have scholarships that are awarded to the children of members. For example, the Ancient Order of Hibernians, Knights of Columbus, Elks, and Lions Club all offer national as well as local scholarship opportunities. If applicable, your place of worship may be aware of local scholarship opportunities that hope to assist members of your faith.

Additional sources
Other places to check include your town or community website and local media websites (TV, newspapers, and radio stations). Additionally, your library’s reference section may have a list of scholarships offered by town businesses or civic groups, and in casting a wider net, you can research the offerings of your state grant agency.


What are the requirements?

Local scholarship competitions often ask for a completed FAFSA form, and may ask for tax returns/W2 forms (from student and parents), a copy of your transcript, letters of recommendation, and student-written essays. Many local scholarships also require you to take the PSAT/NMSQT by the fall of your junior year.

Finally, it is important to meet all scholarship deadlines, follow scholarship application directions, and gather your application materials early.

Here at Collegiate Gateway, we are happy to help you throughout your college search. Feel free to contact us!

What is a High School Profile and What Role Does it Play in College Admissions?

College admissions staff always view your transcript within the context of your high school. Colleges recognize that schools vary greatly. As Northwestern states, “Every secondary school is different in its level of competitiveness and in the range of courses offered. These factors are also considered when admission decisions are rendered.”

Each school’s guidance office develops a 2-4 page “school profile” that describes the community and high school.  While there is no standard format for the high school profile, typical information includes the curriculum, grading system, grade distribution, average test scores, and college acceptances.  The profiles tell colleges how rigorous and competitive the high school is, and this information impacts the way a college will evaluate a students’ grades and course selection.

Your GPA

The high school profile typically explains how your GPA is calculated, which includes what courses factor into the GPA, and whether advanced courses receive a weighting. For example, Schreiber High School in Port Washington, NY gives an extra .5 weighting for Honors courses and 1.0 for AP courses.

Students often wonder how they can possibly be compared with students from other high schools. The answer is that in addition to viewing your high school’s approach to your transcript, colleges typically recalculate an unweighted GPA using a standard formula, so that they can compare students from different schools with different GPA scales.  Usually, colleges will use a 4.0 scale, where A+ and A = 4.0, B+ = 3.7, B- = 3.3, B = 3.0, and so on.

Grade and Test Score Distribution

High school profiles also typically include a grade distribution chart showing the percentage of students at different GPA brackets or the distribution of each grade for each course; as well as average standardized test scores for the SAT and ACT.

When viewed alongside average standardized testing scores, GPA information reflects the degree of grade inflation or deflation, and for private schools may also reflect the selectivity of admissions to attend the school. For example, if most students at a school earn As, but have average standardized test scores compared to national or state figures, colleges would conclude that the school has grade inflation.

Rigor of Curriculum

Colleges also evaluate whether you have challenged yourself in your coursework.  Again, colleges view you within the context of the curriculum offered at your school. The variety of curricula include International Baccalaureate, Advanced Placement, both, or neither. Each high school profile clearly describes the curriculum available at the school.

For example, if your high school offers a minimum number of AP courses, you will not be expected to have taken the same number of APs as students with access to a large number of AP courses. For example, Great Neck South High School, a public high school, offers 31 AP courses, as compared with Chaminade High School, a private Catholic school, offers none.

Having said that, it is possible to take courses outside your high school to fulfill your intellectual passion and also demonstrate this to colleges. If you have strong interest in a particular academic area in which coursework is not sufficiently offered at your school, you could consider taking courses outside of school – at a local college or online. For example, students interested in pursuing engineering or other STEM fields sometimes opt to take Multivariable Calculus or Computer Science at a local college or through online courses if their high school does not offer these classes.

For guidance on how to reach your academic potential, feel free to contact us at As always, we’re happy to help!

Becoming a Doctor: Med School Admissions

The traditional path to becoming a physician in the United States is to obtain an MD (allopathic) degree from a US medical school.  This blog will provide a brief overview of the application process to medical school, and is part of a series discussing a variety of paths to practicing medicine.

Over the past decade, the number of medical schools and the number of applicants has steadily increased. The AAMC (Association of American Medical Colleges) has recommended a 30 percent increase in the number of physicians, in order to address a physician shortage and increased longevity of patients.  Indeed, there are now 151 US med schools, including almost 20 newly accredited med schools in the past decade. During this period, enrollment in US med schools has increased 19% from 75,800 in 2008-2009 to 89,900 in 2017-18.

Yet during this same period, the number of applicants has increased at an even higher rate of 23%, from 42,200 to 51,700. As a result, medical school admissions has become increasingly competitive. The most important factors in admissions remain the numbers, while qualitative factors serve to further differentiate the applicants.

Quantitative Admissions Factors

Your GPA and MCAT score play a significant role in medical school admissions.


Medical schools look at your overall GPA, as well as your GPA within science and math specifically.

Generally, applicants to medical school are required to take the following courses:

  • 1 year of biology
  • 1 year of physics
  • 2 years of chemistry (through organic chemistry)
  • 1 year of English
  • 1 year of calculus

Some medical schools are more specific about their requirements. For example, Harvard Medical School requires that the chemistry courses include inorganic chemistry, organic chemistry, and biochemistry; and that the math includes 1 semester of calculus and 1 semester of statistics (preferably biostatistics). Stanford Medical School also recommends that students take courses in the behavioral and social sciences.


In April 2015, the Association of American Medical Colleges (AAMC) officially launched a new version of the MCAT, the MCAT15 “to help better prepare tomorrow’s doctors for the rapidly advancing and transforming health care system.” The new MCAT is double in length, includes a fourth section on the social sciences, and has a revamped scoring system. The four sections include:

  • Biological and Biochemical Foundations of Living Systems
  • Chemical & Physical Foundations of Biological Systems
  • Critical Analysis & Reasoning Skills
  • Psychological, Social, & Biological Foundations of Behavior

Each section receives a score ranging from 472 to 528, with 500 as the mean.

See our blog for a detailed discussion of the structure and scoring of the MCAT, and average MCAT scores for selected med schools.

The chart below shows the strong impact of GPA and MCAT scores on acceptance rates. An acceptance rate of about 50% or above requires an MCAT score above 506 (500 is the national average) and a GPA of about 3.6.  For example, a student with a GPA of 3.4-3.59 and an MCAT score of 498-501 would have a 20% acceptance rate; where a student with a GPA of 3.6-3.79 and an MCAT of 506-509 would have a 54% acceptance rate.

Qualitative Admissions Factors

While the academic factors of grades and test scores serve as a screening mechanism, qualitative factors impact which students progress to the next level of receiving secondary applications and interview requests.  The primary qualitative factors are a student’s medically-related experiences and recommendations.

Medically-Related Experiences

The education required to become a physician, as well as the practice of medicine itself, are so rigorous that medical schools want to see evidence that an applicant is thoroughly aware of these demands and has engaged in relevant activities throughout college. These include the four pillars of:

  • Research, including either bench work in a lab, or clinical research with patients.
  • Clinical work, such as volunteering at a nursing home or hospital, or helping doctors with patient research.
  • Shadowing doctors, preferably in a variety of specialties.
  • Community service that shows compassion and your desire to help people.

There are many paths to becoming a doctor.  Some students are passionate about pursuing a career in medicine, but are not competitive for US allopathic medical schools, as a result of grades, test scores, or relevant experience.  In this situation, two viable options are to attend a US osteopathic medical school and receive a DO degree, or to attend medical school in the Caribbean.

For further guidance on the medical school admissions and application process, contact us at As always, we’re happy to help!

What Is an MD/MPH? And Why Get One?

In our constantly evolving healthcare environment, physicians with interdisciplinary skill sets are becoming increasingly valuable. Those graduating with dual degrees such as an MD/MPH are uniquely situated to tackle some of healthcare’s most pressing challenges, which include disparities in access to care, high costs, and controversial reform.  MD/MPH programs lie at the intersection of medicine and public health, as they combine an individual patient-based approach with a wider population health perspective. Those pursuing this degree may be looking for a role beyond patient care, which could include policy-making, disease prevention, health education, or health research.

Those who pursue an MD/MPH do so for a multitude of reasons. Many utilize this additional skill set to enhance their standard, day-to-day clinical practice. According to the UNC School of Medicine, the MPH provides a broader social context, an emphasis on preventative medicine, and a focus on improving quality of care. Up to 25% of each class graduates from its well-established Health Care and Prevention MD-MPH program.

Differences in Programs

It is essential to consider your professional goals when choosing where and how to complete your dual degree, as one may be a better fit for your particular interests. For example, NYU’s MD/MPH in Global Health degree strongly emphasizes a global health perspective, and includes coursework in community and international health, epidemiology, and public health. In contrast. In contrast, BU’s curriculum is more flexible, offering areas of specialization ranging from Environmental Hazard Assessment to Health Policy and Law. The Association of American Medical Colleges (AAMC) notes that “over 80 medical schools sponsor activities to help their medical students pursue a master’s degree in public health.” As such, it is essential for prospective students to compare various programs in order to find the right one for their specific interests and goals.

When to Apply

MD/MPH programs can also differ in a number of other ways – including when you would actually apply. At some schools, prospective students apply for the dual degree as they are applying for medical school admission, while others encourage you to apply once you have already matriculated.  Still others, such as New Jersey Medical School and the Rutgers School of Public Health, offer the opportunity to add the MPH degree after extending acceptance letters for the MD degree.

Length of Program

If truly integrated, the two degrees can be achieved in four years, as is the case at the University of Miami. Yet, the majority of MD/MPH students require a fifth year to obtain this additional degree. Harvard’s combined degree program requires a leave of absence from the medical school between the third and fourth years. Thus in choosing where to pursue your MD/MPH, it is important to consider your willingness to interrupt your medical training, as well as your ability to balance the demands of an accelerated program.


Now for the all-important question: how much is this going to cost you?  This additional degree will likely come at an extra cost, yet financial assistance opportunities and discounted tuition are quite common. Tulane for example, offers both merit-based and research-based scholarships, in addition to need-based financial aid.

Is the MD/MPH Right for You?

To successfully navigate our complex healthcare environment, the AAMC cites the natural and essential overlap between medicine and public health. But despite the prevalence of MD/MPH programs, not every medical school offers one, and not every student interested in public health will pursue one. Today’s aspiring physicians will likely receive some public health education regardless of whether they are involved in an MD/MPH program or not. Many medical schools­­—often in addition to offering an MD/MPH­­—have now integrated public health concepts into their standard curriculum. Recent policy initiatives such as the Affordable Care Act, with its emphasis on preventive care and population health, further underscore the need to effectively integrate these two disciplines.

Depending on your personal interests and professional goals, an MD/MPH might very well be the right path for you. It is not only a decision about whether or not to pursue this dual degree, but also a matter of which program is the best fit.

And if you have any questions or are in need of guidance, contact Collegiate Gateway—we’re always happy to help!

Why Attend a Caribbean Medical School?

Due to the extremely competitive nature of medical school admissions in the United States, many applicants opt to obtain their medical education in the Caribbean. To provide context, the admit rate at St. George’s Medical School in Grenada, West Indies, is 41%. This contrasts markedly with the admit rates at the most selective medical schools in the U.S., such as Harvard, with admit rate of 3.7%, Johns Hopkins of 3.9% and Stanford, at 4.7%.

To help you decide if attending these schools would be the best option for you, let’s evaluate their curriculum, accreditation, admission requirements, residency outcomes, and the overall success of their graduates.

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St. George’s Medical School. Source: The New York Times 

Choose Wisely: Regional vs. Offshore

 Caribbean medical schools fall into one of two categories: regional or offshore.

  • Regional medical schools train students to practice in the country or region where the school is located, and are typically the choice for Caribbean residents who wish to practice in their home country.
  • Offshore medical schools in the Caribbean predominantly train students from the United States and Canada who intend to return home for residency and clinical practice after graduation. Most offshore schools are dual-campus programs, where students spend their first two years of medical school in the Caribbean learning basic sciences and prepare for Step 1 of the USMLE (United States Medical Licensing Examination). Their clinical years are then spent in the United States. Offshore schools find clinical rotations for their students through partnering agreements with U.S. hospitals.


The first factor to consider is that not all Caribbean medical schools are accredited and not all have access to clinical rotations. So before you decide to attend a particular medical school in the Caribbean, make sure that the schools you are considering will allow you to practice and attend clinical rotations in the United States.

Beware of medical schools that use the terms “approved” or “recognized,” which do not connote accreditation. In addition, make sure that the schools have received the official accreditations that truly matter:

  • Caribbean Accreditation Authority for Education in Medicine and Health Professions (CAAM-HP): a peer review process adopted by CARICOM (Caribbean Community) to accredit educational institutions within the medical, dental, veterinary and other health professions. Of the 17 medical schools in the Caribbean that requested assessment over recent years from CAAM-HP, only American University of Antigua, St. George’s, and Ross have been accredited.
  • Other countries’ accreditation. Several Caribbean medical schools are located on islands that are owned or accredited by other countries. American University of the Caribbean School of Medicine (AUC), based in St. Maarten, is accredited by Accreditation Commission on Colleges of Medicine (ACCM), in Ireland, recognized by the the US DOE’s National Committee on Foreign Medical Education and Accreditation (see below). Saba University School of Medicine (located in the Dutch island of Saba), is accredited by NVAO, the accreditation organization of Netherlands and Flanders.
  • S. State Recognitions and Approvals. Only a few states in the US have individual review processes to approve students to receive clinical rotations, residencies, and licensure in that state; accreditation by these states is typically recognized by other states as well:
    • New York State Education Department (NYSED)
    • Medical Board of California (MBC)
    • Florida Department of Education (FL DOE)

Tiers of Accreditation

Caribbean medical schools are ranked in three tiers (top-tier, middle-tier, and bottom-tier) based on approvals and accreditations. In order to have the greatest options of practicing medicine within the U.S., aim for top-tier programs.

Schools such as St. George’s, Ross, Saba, American University of the Caribbean (AUC) and American University of Antigua (AUA) College of Medicine operate in the top tier and offer a medical education equivalent to that of U.S. schools. All four have been approved by the licensing boards of New York, California, and Florida. AUA, St. George’s, and Ross have also been accredited by CAAM-HP.

These medical schools have thousands of alumni in residency or practicing throughout the U.S. and Canada.

Eligibility for US Funding

In addition, the National Committee on Foreign Medical Education and Accreditation (NCFMEA), within the U.S. Department of Education (DOE), plays a central role in determining whether American students at foreign medical schools are eligible for federal student loans. NCFMEA is not an accreditation agency. Instead, it reviews the standards that a foreign country uses to accredit its medical schools, and determines whether those standards are comparable to the US. If so, any accredited medical school within that country can apply to participate in DOE’s federal student loan program.

Admissions Selectivity

U.S. medical schools place strong weight on applicants’ MCAT scores and GPA. Therefore, regardless of your passion for medicine and the strength of your medically related experiences (such as research, shadowing, and community service), if you don’t perform well on these numerical criteria, your chances of acceptance drop dramatically.

While the average MCAT and GPA of applicants to U.S. medical schools has remained fairly constant over recent years, the stats of matriculants has increased, along with the numbers of applicants, showing greater selectivity and therefore competition. While the number of applicants increased 14% from the 2012-13 application year to 2017-18, matriculants only rose 9.3% since medical schools are not significantly adding capacity. Admit rate in just this six-year period dropped from 43% to 41%.


Applicants 2012-2013 2013-2014 2014-2015 2015-2016 2016-2017 2017-2018
Total MCAT 28.3 28.4 28.6 28.3 501.8 504.7
GPA Total 3.54 3.54 3.55 3.55 3.55 3.56
Total Applicants 45,266 48,014 49,480 52,550 53,042 51,680


Matriculants 2012-2013 2013-2014 2014-2015 2015-2016 2016-2017 2017-2018
Total MCAT 31.2 31.3 31.4 31.4 508.7 510.4
GPA Total 3.68 3.69 3.69 3.70 3.7 3.71
Total Matriculants 19,517 20,055 20,343 20,631 21,030 21,338

On the other hand, Caribbean medical schools accept students with lower GPAs and MCAT scores and typically do not have minimums. At AUC, the average accepted student’s GPA is 3.27 and the average MCAT is 469. At St. George’s, the average overall GPA for enrolled students entering fall 2016 was 3.3, with the undergraduate science average of 3.2.

Over the past 40 years, St. George’s University has graduated 17,000 alumni and Ross University has graduated 14,000 alumni. At these schools, a 3.4/3.5 gpa is competitive. If you did poorly freshman year, your admission chances at a U.S. medical school decrease, but Caribbean medical schools will consider you.

Academic Performance

Now that we have established the rationale for attending Caribbean medical schools, let’s look at how their graduates actually perform. How prepared are they for the practice of medicine, and how is their education valued? Two leading measures are the pass rate for the USMLE (Untied States Medical Licensing Examination) and residency placement, respectively.

The USMLE consists of Step 1, Step 2 Clinical Knowledge, and Step 3. A passing score on all three parts is required to practice medicine in the US. The steps assess the following:

  • Step 1: Basic science knowledge that is foundational to the practice of medicine; understanding principles underlying health, disease, and modes of therapy.
  • Step 2 Clinical Skills (CS) and Clinical Knowledge (CK): Application of medical knowledge, skills, and understanding of clinical science to provide supervised patient care.
  • Step 3: Application of medical knowledge and understanding of biomedical and clinical science to provide unsupervised patient care.

At SGU (St. George’s University School of Medicine) the pass rate in 2017 was an impressive 95% overall, and 95% for US and Canadian students. This compares favorably with the pass rate of 96% at US and Canadian medical schools. The pass rate at SGU has surpassed 95% for five consecutive years. In 2017, the pass rate at other foreign schools was 77%, and the pass rate at US and Canadian DO schools was 95%.

Residency Placement

Residency placement is the all-important next step after medical school, on the path to the practice of medicine.

SGU posts its lists of residency placements online. As an example of the quality of placements, for the Class of 2018 graduates who placed in New York, hospitals included top programs such as Albert Einstein, Mount Sinai, and New York University. Specialties consisted of the full range, including anesthesiology, emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, pathology, pediatrics, psychiatry, and surgery.

In 2018, 936 St. George’s University grads procured PGY1 positions. There was 93% residency placement in PGY1 the year of graduation. For U.S. students at Ross University there was 94% residency placement.


Fast Facts – Caribbean Offshore vs. US Medical Schools Features


Selected Top Tier Caribbean Medical Schools

University Total Enrollment Attrition Rate Median MCAT Median GPA Residencies
St. George’s University 6,021 10% 497 3.33 937
American University of the Caribbean (AUC) 400/ year 13% 496 3.27




Ross University  3,500  27%  496 3.22 627


Selected U.S. Medical Schools

University Total Enroll Acceptance Rate Median MCAT Median GPA
Harvard University 726 3.5% 518.72 3.92
George Washington U








Drexel University








New York Medical College








Factors to Consider

Various factors are important to consider when gauging the quality of the medical education you will receive at a particular Caribbean medical school. Ask the following questions:

  1. What are the school’s average USLE Step 1 scores?
  2. How is the curriculum structured?
  3. What are the mean overall and BCPM (biology, chemistry, physics and math) GPAs and MCATS of accepted students? Are MCATs required to submit an application?
  4. Where do students complete third and fourth year clerkships?
  5. Does the Caribbean school encourage away electives?
  6. What percentage of 4th year students earn residency placements?
  7. Where and in what specialties did students in the most recent graduating classes match for residency, and what percentage of fourth year students matched into categorical residencies?

Students should always apply to a few of their dream schools, but they should also consult the MSAR (Medical School Admission Requirements), or individual schools’ websites, to determine a list of five to seven additional schools at which they would be competitive grade-wise. Students should also create a list of three or more schools at which their academics are on the very high end, to maximize the chance of securing an acceptance.

Overall, Caribbean medical schools offer less competitive applicants less selective options, a faster application process, and comparable education and residency opportunities as medical schools in the U.S. For many US students, these options provide you with the chance to successfully pursue your passion for a career in medicine. For more information about applying to medical school, in the US and Caribbean, contact us at As always, we’re happy to help!


Should You Take the SAT or ACT with Essay?

Few colleges now require the essay when you take the SAT or ACT. In fact, in 2016, the College Board made the essay optional, stating: “While the College Board remains steadfast in its commitment to the importance of analytic writing for all students . . . one single essay historically has not contributed significantly to the overall predictive power of the exam.”

Yet, for the Class of 2017, 1.2 million students wrote the SAT essay (70% of total test-takers), and 1.1 million students wrote the ACT essay (53% of total test-takers).

Currently, there is a strong movement among colleges to no longer require the SAT or ACT essay. According to the Princeton Review, only 19 colleges still require the essay, of which 9 belong to the University of California system. In fact, no colleges state that they use the essay for admission, though some state that they use the essay for course placement.

Harvard explained that its decision was part of the Harvard Financial Aid Initiative (HFAI), to broaden its outreach. Registration for the ACT costs $46 without the essay, and $62.50 with the essay; the SAT costs $47.50 without the essay, and $64.50 with the essay. The university emphasized that students still have a variety of ways to demonstrate their writing skills – through the Personal Essay required by college application platforms, Harvard’s own Writing Supplement, and an optional writing portfolio.


Claremont McKenna College
Martin Luther College
Schreiner University
Soka University of America
The University of Mary Hardin-Baylor
United States Military Academy
UC, Berkeley
UC, Davis
UC, Irvine
UC, Merced
UC, Riverside
UC, San Diego
UC, Santa Barbara
UC, Santa Cruz
University of Miami
University of Montana Western
University of North Texas *
Wellesley College *

*only requires essay with ACT
Source: The Princeton Review


We recommend that for upcoming SAT or ACT tests, you do not register for the essay unless you plan to apply to a college that requires the essay. In other words, even if a college recommends the essay (without requiring it), we feel that you do not need to take the essay because typically it does not play a role in the college admissions review process. Alternatively, if you excel at writing and do not mind the additional expense or time, you certainly can opt to include the essay in your standardized testing plans.

There is increasing complexity surrounding the requirements for taking and reporting standardized testing, including the ACT, SAT, Subject Tests, AP exams, and IB exams.  If you would like guidance, feel free to contact us at As always, we’re happy to help!

Osteopathic Medicine: The DO Degree

There are a variety of paths to practicing medicine, and an alternative route to the MD (Doctor of Medicine) degree offered by traditional “allopathic” medical schools is the DO (Doctor of Osteopathic) degree offered by “osteopathic” medical schools. Over recent years, there has been a boom in the number of osteopathic schools and graduates, largely stimulated by the shortage of primary care physicians.  As a result of baby boomers becoming eligible for Medicare, combined with the increased patient population under the Affordable Care Act, the country is expected to face a shortage of 45,000 primary care doctors and 46,100 surgeons and specialists by 2020.  60% of DO-trained physicians enter primary care, compared to 30% of MD graduates.

A principal difference in the two approaches is that MD programs offer the traditional approach of Western medicine, whereas the DO philosophy is more holistic. DO medicine believes in the unity of the body, the impact of lifestyle and environmental factors on health, and the potential of the body to self-heal.

DO doctors practice primary care to a greater degree than MDs, including the specialties of internal medicine, family medicine and pediatrics, and help fill physician shortages in these fields.  Many DO programs also have an added mission of providing doctors to underserved populations (poorer neighborhoods and towns that have doctor shortages). For example, Touro’s Osteopathic Program is located in Harlem.

How are DO and MD Doctors Similar?
  • Attend 4-year medical school
  • Complete specialty training through internships, residencies, and fellowships
  • Require licenses from state medical specialty boards to practice
  • Can practice in all 50 states in any specialty and provide all medical services
  • May prescribe medications as appropriate
How are Osteopathic Students Unique?

According to Steve Toplan, Director of Admissions at Touro College of Osteopathic Medicine, “The biggest difference [between MD and DO programs] is the fact that in the OM realm, students are taught osteopathic muscle manipulation (OMM). Other than that, the medical school curriculum is virtually the same.”

Interestingly, while OMM is the big differentiator between MD and DO training, “only 5% of DOs use hands-on techniques; mostly it’s in their heads in terms of the philosophy of how the body fully integrates,” said Brooke Birdsong, Associate Director of Admissions at Kansas City College of Osteopathic Medicine,.

Why Pursue a DO Degree?

There are several reasons why students may choose to pursue a DO degree.

Some students may feel that the holistic philosophy is more aligned with their values regarding medical care. Dr. Jennifer Caudle, DO and Associate Professor at Rowan University School of Osteopathic Medicine, says that she was drawn to its “mind-body-spirit whole-body approach to medicine.” In addition, she felt that historically DO schools were more open to non-traditional applicants, as well as a more diverse pool, noting that “DOs were some of the earliest institutions that accepted women and people of color.”

Others are drawn to the “hands-on” osteopathic manipulation approach.  David Abend, DO, has had his own private practice for almost a decade. He began in primary care and now exclusively practices OMM because “I enjoy using my hands.”  He treats a variety of physical ailments beyond neck and back pain, which is the traditional application. He also treats “arthritis, headaches, fibromyalgia, babies born with misshapen heads, patients with CP, Down Palsy, even reflux.”

Finally, DO programs are typically less selective than MD programs, so students who are not as competitive a candidate for MD admissions in terms of GPA and MCAT scores, or extracurricular activities, may benefit from the higher admit rate of most DO programs.

For example, Ben Kramer, a DO student at New York Institute of Technology College of Osteopathic Medicine, was always motivated to become a doctor, but did not realize how important it was to pursue medically-related activities during college, such as research, in order to be a competitive MD applicant. He spent the year after college as a scribe in the Emergency Department of a hospital, which provided patient contact and shadowing. He is now thriving at NYIT, and seeks to become a cardio-thoracic surgeon.

DO Programs MD Programs
2014 Mean GPA 3.45 3.69
2014 Median MCAT Score 26 31.4
2016 Mean GPA 3.45 3.7
2016 Median MCAT Score 499.32 508.7
2017 Mean GPA 3.45 3.71
2017 Median MCAT Score 501.1 510.4

Finally, cost may be another factor to consider. For the 2017-2018 school year, the majority of private medical schools charged more than $50,000 in tuition and fees (U.S. News). In contrast, 7 of the 10 least expensive private medical schools are osteopathic schools.

What is the Availability of DO Medical Colleges?

There has been a significant increase in the numbers of osteopathic medical colleges (from 5 in 1968 to 34 in 2018), as well as the numbers of osteopathic graduates (increasing from 971 in 1978 to 6,015 in 2017). This compares with 141 accredited MD schools and 89,904 MD graduates in 2017. For example, New York State has two osteopathic medical colleges:  New York Institute of Technology and Touro, compared with 14 allopathic medical schools, including Columbia, NYU, and Weil Cornell.


Changes Ahead in Residency Matching

After graduating from medical school (either with an MD or DO degree), the next step in medical education is to participate in a residency program to obtain clinical experience. The process of applying for a spot occurs through a “matching” system in which students and programs rank each other, and are then matched by an algorithm. Up until now, there have been two separate processes for MDs and DOs.

DO students have the option of participating in the AOA Match (matching program for osteopathic students), the NRMP Match (National Resident Matching Program for allopathic students), or both matches. The AOA Match takes place earlier than the NRMP Match, which currently can create a dilemma for students who wish to participate in both.

But in 2014, the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA), and American Association of Colleges of Osteopathic Medicine (AACOM) announced that they would create a single graduate medical education accreditation system that would integrate all allopathic and osteopathic residencies under a single authority by 2020. Once finished, it will streamline applying to all residencies for DO applicants.

According to Thomas J. Mohr, MS, DO, trustee for the Association of Osteopathic Directors and Medical Educators (AODME), “If your top choice is in the NRMP Match and your next three choices are in the AOA Match, you have a bit of a dilemma. If you match with an AOA program, you will be removed from the NRMP and have no shot at your top choice. But, if you don’t enter the AOA Match and don’t get your top choice in the NRMP, you have lost the opportunity for your back-up selection. This will no longer be an issue once all programs have transitioned to the ACGME.”

The participation of DO students in the NRMP residency match program has increased by 68.6% from 2014 to 2018. In 2016, 99.61% of DO graduates seeking graduate medical education (GME) achieved a residency position. 4.33% attained a Military Match, 48.97% received an AOA Match, and 45.84% were awarded an NRMP Match.

Which Path is Best for You?

 It all depends! If you are passionate about primary care and think the osteopathic approach to medicine could be an asset to your education, a DO program could be the right fit for you.

According to Alan Stricoff, DO FACP, Cigna Medical Director for Onsite Health, “If want to become a highly competitive specialist, like an ophthalmologist, dermatologist, or specialty surgeon, the path is easier from a good MD program. However, if you are interested in primary care, there is no difference, and you may even be better off coming from a DO program, because of the focus on primary care.”

Navigating the many tracks to medical school can be daunting, but here at Collegiate Gateway, we are happy to help you in finding the best path to reaching your goals. Feel free to contact us!