Category Archives: Medical School Admissions

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.

GPA

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.

MCAT

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 www.collegiategateway.com. 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.

Cost

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!

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!

Summer Activities for Pre-Med Students

You’ve decided you want to go into medicine, and to embark upon the arduous path to becoming a physician. You’re busy studying for biology exams, conducting experiments in chemistry lab, trying to squeeze in some volunteering and (if you’re really ambitious) conducting a bit of research. Now, January rolls around and it’s time to start thinking about the summer. Regardless of how far along you are in your undergraduate pre-med training, carefully choosing your summer plans is essential.

Summer provides an excellent time to further explore the areas of clinical medicine, research, or global health, while also enhancing your medical school application. In fact, according to Liza Thompson, a medical school admissions consultant, “pre-med students who are productively engaged during the summer months have an advantage during the medical school application process.”

It is essential to dedicate sufficient time, often during the summer, to study for the MCAT, take classes if needed, and prepare your medical school application by writing your personal statement and brainstorming for secondary applications. However, many experts including the Princeton Review stress the importance of expanding your learning beyond the classroom setting.

Clinical Experience

Clinical experience will enable you to directly observe the patient-physician relationship. The importance of clinical experience cannot be stressed enough; in fact, Emory University School of Medicine lists “exposure to patients in a clinical setting” as one of its application requirements. This can take a variety of forms, including shadowing a family member or friend who is in the medical profession or participating in a more formalized summer program.

Some of the more structured programs can be very demanding, but the rewards are quite evident. For example, Project Healthcare created by the Bellevue Hospital Center Emergency Department is an immersive program involving participation in clinical rotations, research and informational lectures, as well as extensive engagement with the community. If you’re hoping to make money while gaining clinical experience, certain jobs, such as a hospital scribe, may be of particular interest.

Research

Doing research is another ideal summer activity, as pre-med students can often continue research already started during the school-year or pursue an entirely new area of interest. There are a multitude of structured summer research programs at various institutions across the nation. A comprehensive list by the AAMC can be found here.

Similar to clinical experience, research experience is yet another critical element of the typical medical school application. Northwestern University Feinberg School of Medicine reports that 92% of their entering class of 2019 engaged in research at the undergraduate or graduate level.

Volunteer Work

Summer volunteering can allow you to continue pursuing an existent volunteer placement from the school-year or an entirely new volunteering experience. US News stresses the importance of carefully considering the nature of the volunteering, as well as how long you’re doing it. It may be most beneficial to volunteer in a medical setting, such as a nursing home, where you can continue to gain relevant experience.

Any sort of volunteering is certainly valuable as it reflects an innate desire to help others: a trait that every pre-med student should possess. Some students choose to engage in more extensive types of volunteering, such as obtaining an EMT certification or volunteering overseas. Volunteering internationally can be particularly valuable for pre-med students, as many are not able to study abroad during the school-year due to course requirements.

With any volunteering experience, you must carefully assess how meaningful your actual involvement in the activity will be. To start, it can be helpful to explore global health organizations that may have chapters at your university, such as GlobeMed or Medical Brigades.

Additional Options

Although these ideas provide a starting point, they do not provide a comprehensive list of all available opportunities for pre-med students. If you have more specialized interests in the area of public health for example, you may want to explore internships through the Centers for Disease Control and Prevention. Additionally, your undergraduate institution may be a valuable resource for identifying summer opportunities. For example, Swarthmore provides a comprehensive list of summer options for pre-meds that can be found here.

The summer provides an ideal time for pre-med students to further clarify their interest in medicine and explore the various facets of a profession in healthcare. For guidance on pursuing a pre-med track and applying to medical school, feel free to contact Collegiate Gateway. As always, we’re happy to help!

Applying to Med School: The Importance of Secondary Applications

If you are applying to medical school for the Class of 2022, chances are you have completed your AMCAS Personal Statement, and are in the final stages of perfecting a powerful discussion of why you want to become a physician.

Take a breath… and then begin to prepare for individual medical school’s secondary applications! The purpose of secondary (or supplemental) applications is to further differentiate among candidates, and to determine whether you’d be a good fit for the particular medical school.

Who Receives Secondaries

Most schools, such as Columbia University Vagelos College of Physicians and Surgeons, Yale School of Medicine and the University of Michigan Medical School, send all of their applicants a secondary. Some schools, such as Harvard Medical School and the Warren Alpert Medical School of Brown University, send all “verified” applicants a secondary, meaning that they wait until AMCAS verifies the student’s transcript.

Others review the primary AMCAS application holistically, and are selective in determining who receives supplemental applications, such as Emory School of Medicine. For example, Vanderbilt University School of Medicine has three independent evaluators review the AMCAS application for academic accomplishment, motivation, personal qualities, leadership skills and educational background, and offers secondaries to only about one-third of its applicants.

A few others have no secondaries, such as University of Rochester.

The Timing of Secondaries

Try to submit your primary AMCAS application as close as possible to June 5th, the day that the 2018 AMCAS application submission begins, and certainly by the end of June. The sooner you submit, the sooner your application will be reviewed.

You can expect to receive secondaries from late June through December. You may even receive secondaries before your AMCAS application is verified. If you submit your primary AMCAS application in June, you will likely be completing your secondaries in July and August. Secondary applications are time sensitive, in that the faster you return them to the institution, the more strongly you convey your enthusiasm for that school. A quality secondary application submitted within one to two weeks will increase your likelihood of getting an interview.

Secondary Essay Prompts

Once you submit your primary AMCAS, you can begin preparing for secondaries, which typically include a variety of essays on assigned topics, such as the following:

  • Define a physician.
  • Tell us about your diverse talents, experiences, opinions, and backgrounds. What would you bring to the medical school community?
  • Why do you feel that you are a good fit for our particular medical school?
  • Are you expecting to go on to medical school directly after completing your undergraduate degree? If no, explain.
  • Describe the personal accomplishment that makes you most proud. Why is this important to you?
  • Where do you see your future medical career (academic medicine, research, public health, primary care, business/law, etc.) and why?
  • Please describe a challenge you faced and how you addressed it.
Unusual prompts

While there is great overlap among many of the secondary prompts, some medical schools offer unusual prompts such as those below:

  • What challenges do you expect to arise from living and working in a complex urban environment? How will you meet them?
  • Are there any areas of medicine that are of particular interest to you? If so, please comment.
  • Write a sentence that is not true, then tell us why you wish it were.
  • What is the most fun you’ve had lately?

Secondary Application Tips

Start brainstorming, outlining and drafting the above essays so that you can respond quickly. Here are some tips for writing the most effective secondaries:

  • Provide new information.Remember that the admissions committees have already seen your transcript, primary AMCAS personal statement and activity essays.
  • Show your fit with the program.Make a compelling case for why you are a good fit for each medical school. Research the school’s academic programs and approach to clinical practice. Follow them on social media to learn more. Does the school require research or a thesis? Be specific about the resources at the medical school that you will take advantage of, and the unique strengths you will bring.
  • Answer the prompt. Though it is sometimes effective to recycle other essays (see below), always make sure you’re answering the question fully and directly.
  • Connect your past, present and future.How have your past experiences influenced the person you are today? How do your future goals link with your talents, accomplishments and values?Proofread and edit. Carve out enough time in your schedule to edit several drafts for each essay. It takes time to ensure that your essays are well-written and represent you both strongly and authentically.
  • Stay organized. Create a spreadsheet listing your medical schools, dates that you received and submitted secondaries, secondary essay topics, and dates of interviews.
  • Take advantage of overlaps.Evaluate the various secondary essay prompts of your medical schools to see if there are any commonalities. Adapt essays for additional medical schools, but only if appropriate.

Applying to medical school is a challenging process, and the secondaries are no exception. For more information and guidance, contact Collegiate Gateway – we’re always happy to help.

Summer Activities for Pre-Med Students

You’ve decided you want to go into medicine and you embark upon the arduous path to becoming a physician. You’re busy studying for biology exams, conducting experiments in chemistry lab, and trying to squeeze in some volunteering and (if you’re really ambitious) a bit of research. Now, January rolls around and it’s time to start thinking about the summer. Regardless of how far along you are in your undergraduate pre-med training, carefully choosing your summer plans is essential.

Summer provides an excellent time to further explore the areas of clinical medicine, research, or global health, while also enhancing your medical school application. In fact, Liza Thompson, a medical school admissions consultant and former director of the Johns Hopkins University and Goucher College Post-Baccalaureate Premedical programs told USA Today that “pre-med students who are productively engaged during the summer months have an advantage during the medical school application process”.

It is essential to dedicate sufficient time, often during the summer, to study for the MCAT, take classes if needed, and prepare your medical school application by writing your personal statement and brainstorming for secondary applications. However, many experts including the Princeton Review stress the importance of expanding your learning beyond the classroom setting.

Clinical Experience

Firstly, consider pursuing some clinical experience, as this will enable you to observe the patient-physician relationship firsthand. The importance of clinical experience cannot be stressed enough; in fact, Emory University School of Medicine lists “exposure to patients in a clinical setting” as one of its application requirements. This can take a variety of forms: shadowing a family member or friend who is in the medical profession or participating in a more formalized summer program.

Some of the more structured programs can be very demanding, but the rewards are quite evident. For example, Project Healthcare created by the Bellevue Hospital Center Emergency Department is an immersive program involving participation in clinical rotations, research and informational lectures, as well as extensive engagement with the community. If you are hoping to make money while gaining clinical experience, certain jobs, such as a hospital scribe, may be of particular interest.

Research

Doing research is another ideal summer activity, as pre-med students can often continue research already started during the school-year or pursue an entirely new area of interest. There are a multitude of structured summer research programs at various institutions across the nation; a comprehensive list by the AAMC can be found here.

Similar to clinical experience, research experience is yet another critical element of the typical medical school application. Northwestern University Feinberg School of Medicine reports that 92% of their entering class of 2019 engaged in research at the undergraduate or graduate level.

Volunteer Work

Summer volunteering can also be a continuation of an already existing volunteer placement from the school-year or can be an entirely new volunteering experience. US News stresses the importance of carefully considering the nature of the volunteering, as well as where and for how long you are doing it. It may be most beneficial to volunteer in a medical setting, such as a nursing home, where you can continue to gain relevant experience.

Nonetheless, any sort of volunteering is certainly valuable as it reflects an innate desire to help others: a trait that every pre-med student should certainly possess. Some students choose to engage in more extensive types of volunteering, such as obtaining an EMT certification or volunteering overseas. Volunteering internationally can be particularly valuable for pre-med students, as many are not able to study abroad during the school-year due to course requirements.

Again, as with any volunteering experience, you must carefully assess how meaningful your actual involvement in the activity will be. To start, it can be helpful to explore global health organizations that may have chapters at your university, such as GlobeMed or Global Medical Brigades.

Additional Options

Although these ideas provide an excellent starting point for determining what to do over the summer, they do not provide a comprehensive list of all available opportunities for pre-med students. If you have more specialized interests in the area of public health for example, you may want to explore internships through the Centers for Disease Control and Prevention. Additionally, your undergraduate institution may provide a valuable resource for identifying summer opportunities. For example, Swarthmore provides a comprehensive list of summer options for pre-meds that can be found here.

The summer does indeed provide an ideal time for pre-med students to further clarify their interest in medicine and explore the various facets of a profession in healthcare. For guidance on pursuing a pre-med track and applying to medical school, contact Collegiate Gateway. As always, we’re happy to help!

Taking a Gap Year before Medical School

Deciding when to attend medical school—and therefore when to apply—is one of the most important decisions that you’ll face as an applicant. Sometimes, taking a gap year before applying can be a beneficial decision, both personally and academically. To make the best use of a gap year, students should reflect on their career goals, and use the time to both confirm their interest in medicine and strengthen their candidacy for medical school.

According to Washington University in St. Louis, students should choose gap year activities carefully, and seek ways to grow as a competitive, interesting applicant.

“For example, a student with a marginal GPA would be best served by using that GAP year to strengthen his or her academic record more than taking time off to travel abroad to engage in volunteer work. Likewise, someone with strong academic credentials but no experience in medically related activities would best be served using that time to engage in activities that demonstrate a capacity and passion for such work. Either way, it’s best to always “stay connected” to medicine during this year off. Unless you are an academic superstar with a stellar record in every way, I would be very careful using your GAP year to simply travel the world and nothing else. Use your time wisely. For a great list of ideas, check out GAP Year Resources.”

Taking a gap year or years before medical school is common and encouraged. In 2015-16, the mean age of applicants at anticipated matriculation to medical school was 24 years old for women and 25 years old for men (AAMC).

Robert J. Mayer, faculty associate dean of admissions at Harvard Medical School, has noticed an increasing trend of applicants taking a gap year over his ten years in admissions at HMS. “[When I first started] about 60 percent were coming out of college. Now, it’s about 35 percent.”

According to Duke University, more than 75% of Duke students apply to medical school after they graduate, and the average age among the incoming Duke Medical School class is 24. Duke’s Office of Health Professions Advising states, “Students who engage in a year or more of experiential activity after graduation and before entering a health professions school are more mature, resilient, confident, and accomplished… and competitive.”

Northwestern University’s Academic Advising Center notes the struggle pre-meds face in managing the application process alongside the responsibilities of being an upperclassman:

“Balancing school, extracurricular activities, clinical volunteer experience and research is difficult enough. Throw in the MCAT, medical school applications, and interviews and the task can be truly overwhelming. A year spent working, completing a post-bac program, volunteering or doing research prior to applying to medical school, known as a “gap year” or a “bridge year” can be a great option! In fact, about 60% of NU students who are accepted to medical school take at least one (sometimes more!) gap/bridge year(s).”

In addition to taking a break after college to recharge and reflect, there are a number of ways you can use your gap year to make yourself a stronger applicant.

Strengthen Your Academics:

Improve your GPA. Most students see their academic records improve during their senior year; you have more control over the courses you take, you’re used to the college environment, and more of your courses are within your chosen major. The transcript you submit to medical schools during your senior year might look different than the one you’d submit a year later, after you’ve finished your undergraduate coursework. Waiting a year to apply to med school gives you an additional semester to take extra and/or high level coursework that could strengthen your academic record. Moreover, taking extra time gives you the opportunity to enroll in a post-bac program (more on these below) to improve your GPA during the year you are applying. If you are concerned that you may be applying with a less than ideal GPA, here are some more helpful tips.

Study for the MCAT exam. Studying for the MCAT while balancing a full-course load, an internship, and the rest of your many responsibilities can be quite challenging. Taking time off can be a great way to give yourself extra study time. Most importantly, it allows you the flexibility to retake the test if you are unhappy with your results the first time around.

Gain Medically-Related Experience

Gaining real-world perspectives on medicine can reinforce whether medicine is the right path for you; and if so, help you explore which areas of medicine most interest you. In addition, it can also strengthen your admissions chances. There are many ways in which you can gain experience in the field. Here are some the best:

Research: Participating in laboratory or clinical research is a phenomenal way to explore the field of medicine with an especially scientific focus. While many students pursue research while on campus during the school year, there are also numerous research opportunities at medical schools and research centers over the summer and beyond. Just like finding the right job or internship, it is important to find a research position that is a good fit for your abilities, interests, and goals. So do your research!

Volunteer Work: 
Medically-related volunteer opportunities are a great way to give back while also gaining hands-on experience. Working with patients in a clinical setting is beneficial for your own professional development and in the application process. Almost all volunteer efforts will help you to develop communication skills, motivation and teamwork. And sometimes, they’ll provide you with a good reference!

It can be equally beneficial to work for a local organization, such as a hospital or community clinic, or a national organization, such as Americorps or GlobeMed; it depends on the particular opportunity available, and whether it matches your interests. There are many resources to help you find volunteer opportunities, including the American Medical Student Association (AMSA), and the International Medical Volunteers Association. As always, the trick is to find an opportunity that matches your interests and rounds out your experiences.

Post Baccalaureate Programs:  Post-bac programs are especially useful for students who need to bolster their GPAs. They also allow college graduates to fill gaps in their academic record by taking one or all of the courses required to apply to medical school. Some post-bac programs cater to career changers (those who need to complete most or all of the science core), and others to academic enhancers (those who have completed the core but are taking advanced science electives to improve their science GPA, or prepare for the MCAT), and some accept both. Programs are offered across the country, by colleges large (e.g. CornellUSC) and small (e.g. BrandeisBryn Mawr)

Additionally, some programs, such as those offered by Columbia University and NYU, offer “linkage programs” with their affiliated medical schools. These programs help especially competitive students “link” directly into the university’s medical school following the completion of the post-bac program. 

Pay Down Debt

According to the American Association of Medical Colleges (AAMC), the median debt for medical students graduating in 2015 was $183,000.  It’s important, therefore, to try to limit any other debts you might have beforehand. A recent US News article recommends paying particular attention to credit card balances, as having a high amount of consumer debt can limit your ability to borrow money to pay for medical school.

There are many reasons, both personal and professional, to take a gap year before applying to medical school, and there are a variety of ways to use that time productively and effectively. For more information, or to talk about the best options for you, contact Collegiate Gateway. As always, we’re happy to help.

The Three-Year MD Program

The three-year medical school program is a fairly new development in medical education. And while there are many benefits to pursing these accelerated programs, but they’re not for everyone. In this blog, we will take an in-depth look at three-year MD program requirements and formats, as well as which schools currently offer this alternative, in order to determine which students it serves best.

What are Three-Year MD Programs?

Three-year MD programs satisfy a demand for shorter medical school programs. They save the student a year of tuition and living expenses (as well as a year with no income), and the student is often guaranteed a spot in a specialized residency. The education and training to become a doctor can often take up to a decade, and so taking a year off of this process is very alluring to some students.

According to the Washington Post, “Some medical school administrators and policymakers see three-year programs as a way to produce physicians, particularly primary-care doctors, faster as the new health-care law funnels millions of previously uninsured patients into the medical system.” And given that specialists are now making double the income of primary care doctors, primary care physicians are at a particular shortage.

With four-year medical programs, the last year is focused on electives and the process of securing a residency position. But there is some debate as to the value of this final year. According to Ezekial Emanuel and Victor Fuchs, writing in the Journal of American Medicine Association, “Years of [medical school] training have been added without evidence that they enhance clinical skills or the quality of care. This waste adds to the financial burden of young physicians and increases health care costs. The average length of medical training could be reduced by about 30% without compromising physician competence or quality of care.”

Which Schools Currently Offer 3-Year MD Programs?

At present, there are very few opportunities to pursue a 3-year MD program. Of all the options, NYU offers the broadest program. Most others are limited to primary care or family medicine, and some carry an obligation to practice within the state.

Students must choose their residency of interest prior to application to the 3YMD Pathway. For the Class of 2018, there are 34 positions, across 20 residency programs. Students can apply at the time of acceptance or in February of their freshman year. The Three-Year Pathway program starts six weeks before the Four-Year Pathway program, and students work in a summer fellowship between their first and second year. Students can transfer to Four-Year MD pathway, if necessary, due to residency change or otherwise. The graphic below gives a detailed summary of the timeline differences between the 3-Year and 4-Year MD Pathway programs.

Three-Year MD Pathway

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Four-Year MD Pathway

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FMAT’s goal is to prepare primary care physicians more efficiently with lower cost. This program culminates in the M.D. degree and leads to a standard three-year family medicine residency at one of three Texas Tech programs, in Lubbock, Amarillo, or the Permian Basin. FMAT is limited to 16 students per year in each class. Students may apply for the FMAT program when they apply for admission or during the fall semester of the MS1 year. Tech School of Medicine provides scholarship support to FMAT students for at least one year of medical school. Students may choose to return to the regular four-year program at any time. However, any FMAT scholarship support will revert to loan status and must be repaid.

  • UC-Davis, School of Medicine: ACE-PC

This program is only for students committed to careers in primary care. ACE-PC students start working in Kaiser Permanente primary care clinics within the first few weeks of starting the program and continue in these clinics for three years. Unique curricular content includes population management, chronic disease management, quality improvement, patient safety, team-based care and preventive health skills with special emphasis on diverse and underserved populations. ACE-PC is limited to six students and classes begin in June. Students can apply for the program during the secondary application, and may choose to return to the four-year program at any time.

This program is only for students interested in practicing Family Medicine who have a strong desire to remain in Georgia. Students apply during the Spring of Year 1 and may opt to return to the four-year program at any time. The curriculum is very similar to their four-year MD program, but is compressed into 131 weeks of instructional time and offers more educational contact opportunities between students and the Family Medicine faculty.

Columbia’s accelerated program is only open to students who have already earned a PhD in biological sciences and intend to pursue biomedical research as a physician scientist. To this end, applicants are restricted to studying cognitive specialties, such as internal medicine, pediatrics, neurology, psychiatry, or pathology. You can apply for this program when you receive the secondary in the regular medical school application process. The program is divided into preclinical courses (18 Months), major clinical year (12 Months), and subinternship and electives (6 Months). Students begin in August of their first year and finish in May of their third year, working over the summers.

PCSP students must commit to complete a residency in family medicine or general internal medicine, and practice primary care medicine for a minimum of five years upon completion of residency. If a student does not fulfill these requirements, they will be asked to return the scholarship award (one year of medical school tuition). There are about 12 positions available in this program each year. Students complete all courses and learning modules required in the first two years of preclinical education in 18 months, as well as several courses during the summer months. Students participate in a sub-internship at the hospital where they will continue their clinical training after graduation. In addition to saving the student from paying for the fourth year of medical school, this program includes a scholarship for the third year of medical school.

In Conclusion…

Accelerated three-year medical school programs are often geared towards careers in primary care, but have the opportunity to expand to more specialties (as at NYU) as they experience increasing success. The shortened programs are extremely academically rigorous, and if students are not meeting academic benchmarks, they are transferred back to the four-year program.

Three-year medical programs mark a specialized pathway of study for those students who are already committed to the type of doctor they wish to become and who are willing to work at an advanced pace to opt out of a year of medical school. Nevertheless it is important to weigh the pros and cons of these programs in order to determine whether or not they might be right for you. Pros of the three-year program include lower costs, practicing medicine a year earlier, and knowing where your residency will take place from the start. Cons include less time off for vacation and test prep, committing to one specialty before gaining experience in medical school, and losing out on a fourth year of consolidated learning.

In the New England Journal of Medicine, Dr. Stanley Goldfarb and Dr. Gail Morrison argue that the fourth year of medical school is a valuable year that should be enhanced with more intense clinical training in outpatient and inpatient settings, as well as increased advising and mentoring, creating a better transition to residency.

“There may be exceptional students capable of accelerated learning and small programs that create unusual opportunities for such students, but we believe that for the typical student seeking an M.D. degree, the duration of medical school should not be shortened.”

Graduate medical study offers many options, and Collegiate Gateway has extensive experience in understanding and weighing the pros and cons of medical training opportunities. Feel free to contact us to find out more!

Pass/Fail, and Other Trends in Med School Grading

In recent years, there have been vast changes in the way medical students are evaluated and graded. Most notably, many medical schools have replaced their letter or tiered grading system (honors, high pass, etc.) with a much simpler one: pass or fail. According to a recent AAMC initiative, the number of schools using a pass/fail system in the pre-clerkship increased to 87 in 2014 from 71 the previous year. A school’s grading policies have far-reaching implications on its academic culture and community, informing everything from stress levels and competitiveness to the methods by which students are evaluated. As such, it is important that prospective medical students take grading policies into careful consideration as they evaluate different opportunities. 

Rationale for Pass/Fail Grading for Pre-Clerkship Years

This change can be largely attributed to a greater concern for medical student’s overall well-being. One study in Academic Medicine found that the class of University of Virginia (UVA) medical students who were graded pass/fail showed a significant increase in satisfaction as compared to their counterparts who were evaluated using a standard letter grading system. An even broader study surveyed students from seven different medical schools, and found that students evaluated using grading schemes with three or more categories had higher levels of stress and emotional exhaustion, and were more likely to experience burnout than those who were graded pass/fail. Many schools also find that a this system fosters a greater sense of collaboration and cooperation among students, while diminishing competitiveness.

The benefits of this pass/fail grading scheme extend beyond the students themselves, as it may also be helpful to schools as they seek to attract the best and brightest to their institution. In fact, a survey at UVA Medical School found that 81% of the entering class cited the pass/fail grading system as somewhat to very important in their decision to accept the offer of admission.

Examples of Pass/Fail Medical Schools

Schools that employ pass/fail grading during the pre-clerkship years include  Case Western School of Medicine, Albert Einstein College of Medicine and Rochester School of Medicine.

Even within the standard pass/fail grading system, however, there are small differences that distinguish one school from another. Students at Harvard Medical School, for example, are given grades of “satisfactory” or “unsatisfactory” during their pre-clerkship years, but students of exceptional merit can receive a Letter of Excellence that is added to their permanent file.

Many students are wary of pass/fail schools that may still track grades and establish ranking orders behind the scenes. However, schools such as Yale School of Medicine explicitly state that “there are no grades and there is no class ranking.”

Concerns (and Rebuttals)  

As expected, there are some concerns associated with a pass/fail grading scheme. Some worry that a non-tiered grading system may negatively impact students’ residency placement, scores on medical licensing exams (USMLE Step 1 and 2) or overall academic performance. If students are placed into only two categories, is there less incentive and, therefore, less motivation for them to work hard?

These concerns, however, have largely been refuted. The study cited above, involving UVA students, found that a change from a letter grading scale to a pass/fail system did not result in a decline in students’ academic performance or USMLE Step 1/2 scores. Furthermore, there was no negative affect on residency placement, as demonstrated by the quality of residency programs to which students were matched.

Alternatives to Pass/Fail for Pre-Clerkship Years

Despite the hype about pass/fail grading, there are still a significant number of schools (~81 according to AAMC) that evaluate their students using greater than two categories during the pre-clinical years. Pittsburgh School of Medicine, for example, employs a three-tiered grading structure: Honors/Satisfactory/Unsatisfactory for the first two years. The University of Maryland School of Medicine employs a letter grading approach: Honors, A, B, C, D, F.

Different Grading Approaches for Different Years

 Schools often employ different grading schemes depending on course types or year of medical school. The pass/fail system discussed above largely applies to the pre-clerkship years of medical school, when students are learning and reviewing the sciences before entering clinics. The majority of schools recently surveyed by AAMC also use the simple pass/fail system for grading students in electives. However, many schools utilize an entirely different grading scheme when evaluating students in their later years of medical school. In fact, the majority of schools surveyed by AAMC use a four-tiered grading system: honors, high pass, pass, and fail for required clerkships and fourth year electives and sub-internships.

Evaluation Components

In the same way grading frameworks are changing, so are the actual methods used to evaluate students. Schools not only assess their students using standard written exams, but now also use a variety of novel evaluation techniques. Although Yale does not give grades for the first two years, it still employs unique forms of evaluation such as direct questioning during seminars and laboratories to deem acceptable performance or not. Feinberg School of Medicine at Northwestern provides feedback to students using conventional methods such as examinations, as well as skills assessments, and narrative evaluations. Moreover, as of 2012, students at Northwestern build an electronic portfolio that is continuously reviewed with their mentors to ensure they are meeting the school’s required competencies.

Schools such as Perelman School of Medicine at UPenn utilize particularly innovative assessment methods, including simulations and standardized patients. Made possible by recent advances in technology, these assessments involve a patient simulator in a realistic hospital environment. Standardized patients, however, are trained individuals or in some cases, actual patients who help to create real-life medical scenarios.

Academic Honors

Often, these evaluation techniques are used to identify students for academic honors. Boston University School of Medicine awards Latin honors (e.g. summa cum laude) based on a number of factors: performance in courses, scores on medical licensing exams, and other more subjective criteria, such as “extreme initiative and talent.” Other types of academic recognition include membership in the medical honors society Alpha Omega Alpha, as well as distinction in research, and various clerkship and departmental awards.

Every medical school differs slightly in its approach to grading, and it is imperative to thoroughly research schools of interest in order to properly understand these nuances. For more information on medical school grading or any other part of the medical school application process, contact Collegiate Gateway – as always, we’re happy to help.

 

The MCAT2015 has Arrived!

 

The Association of American Medical Colleges, or AAMC, officially launched a new version of the MCAT, called the MCAT2015 on April 17, 2015. Approximately 8,200 individuals took this new version of the exam. The test has been changed for the first time since 1991, and AAMC is calling it “a better test for tomorrow’s doctors.” It was designed “to help better prepare tomorrow’s doctors for the rapidly advancing and transforming health care system.”

New Structure of the MCAT2015

The MCAT has changed in several major ways. Most notably, it has doubled in length. The MCAT2015 consists of 230 questions over 6 hours and 15 minutes, whereas the previous version consisted of 144 questions over 3 hours and 20 minutes. But despite the greater overall length, students taking the newer exam actually have more time to complete each question.

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The MCAT2015 includes both new topic areas and different types of questions. The first three sections are organized around “big ideas” in the sciences. According to the AAMC, these sections “reflect current research about the most effective ways for students to learn and use science, emphasizing deep knowledge of the most important scientific concepts over knowledge simply of many discrete facts.”

Here is a sample question from the MCAT2015 from the section, “Chemical & Physical Foundations of Biological Systems.” It focuses on using scientific theories and models to solve a specific problem.

The radius of the aorta is about 1.0 cm and blood passes through it at a velocity of 30 cm/s. A typical capillary has a radius of about 4 10-4 cm with blood passing through at a velocity of 5 10-2 cm/s. Using this data, what is approximate number of capillaries in a human body?

  1. 1   104
  2. 2   107
  3. 4   109
  4. 7   1012

The new sections will also test additional skills, including research design, graphical analysis and data interpretation. Kaplan claims that the “passages will be restructured to test all of the natural sciences within biological systems,” giving the test a more medical focus by showing the application of the sciences to medicine.

The new section, “Psychological, Social, and Behavioral Foundations of Behavior,” comprises 25% of the test, and recognizes the role of social science in treating patients effectively. Catherine Lucey, a member of the MCAT review committee and vice dean of the UC San Francisco School of Medicine, observes:

“One hundred years ago, all you really needed to know was the science. We were all looking for the magic bullet that would cure disease. Now we have problems like obesity and diabetes that require doctors to form therapeutic alliances with patients and convince them to change their lifestyle.”

Ripal Shah, an MCAT test prep tutor for Advantage Testing, agrees that training in the social sciences is beneficial for a career in medicine, because “many studies have shown that communication skills are often the most indicative of patient satisfaction and medication compliance.”

The following visual, from Kaplan Test Prep, illustrates the structural and content changes between the two tests.

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The US News blog, “Medical School Admissions Doctor,” estimates that the vast amount of information covered on the MCAT2015 requires significantly more than standard medical school prerequisites:

  • One year of biology, chemistry, organic chemistry, and physics
  • One semester of biochemistry, psychology, and sociology,
  • A year of humanities (recommended)

Score Scale

Each of the four sections will be scored individually, from 118 to 132, with a midpoint of 125. Scores are combined to create a total score ranging from 472 to 528, with a midpoint of 500. The new score reports will provide details on your test performance. “The AAMC envisions a score report that will bring together MCAT scores, percentile ranks, confidence bands, and score profiles in a way that highlights applicants’ strengths and weaknesses.” The MCAT Score Report Prototype released by the AAMC illustrates each of these aspects of scoring on a sample score report.

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Percentile ranks are included so examinees can compare their performance to others who took the new exam. Confidence bands show the ranges of scores an examinee could expect on another MCAT attempt. Score profiles provide information about applicants’ strengths and weaknesses across the four sections of the exam.

Applying to medical school is a long and challenging process. Not to mention competitive: just under 50,000 students applied to medical school in 2014, with an average MCAT score of 28.6 and GPA of 3.55. Of those accepted, the mean MCAT score was 31.4, with a 3.69 GPA.

For more information or guidance regarding the MCAT, or any other aspect of the admissions process, contact Collegiate Gateway – we’re always happy to help.