Category Archives: Medical School

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!

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.

Accreditation

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.

USMLE
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

 

300

 

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

 

707

 

2.5%

512

 

3.70

Drexel University

 

1,083

 

4.2%

513

 

3.62

New York Medical College

 

818

 

5.7%

513

 

3.58  

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 http://www.colleagiategateway.com. 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!

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!

The Clinical Years of Med School: What to Expect

Once medical students complete their time in the classroom, they move on to what many consider to be the real reason they went to med school in the first place: treating patients. This transition usually occurs during the second or third year depending on the length of a school’s pre-clinical curriculum, and is comprised of clerkships, selectives, electives, sub-internships, away rotations, and various other scholarly pursuits. If you are considering medical school, here is an overview of the opportunities and experiences during these clinical years.

Clerkships, Selectives and Electives

The core clerkships beginning in the second or third year of medical school are mandatory for all students. They typically include rotations through some variation of the following: neurology, internal medicine, obstetrics and gynecology, pediatrics, psychiatry and surgery. Each core clerkship lasts several weeks, with many schools also mandating a certain number of selectives interspersed throughout.

A selective will be in a more specialized area as compared to the more general core clerkships. Georgetown University School of Medicine offers a multitude of selectives ranging from anesthesia to child psychiatry. Schools also require a certain amount of elective time, which can span a variety of areas. Thus, even in the universal core clerkships, there is still substantial room for personalization during the clinical years.

Sub-Internships

During a sub-internship, the medical student assumes even more responsibility than he or she would during a clerkship or elective. According to Dartmouth Geisel School of Medicine, the level of clinical responsibility expected during a sub-internship is comparable to that of an intern (someone who already graduated medical school). Students typically choose their sub-internship in an area that they are considering applying to for residency.

Away Rotations

Away rotations provide a unique opportunity for fourth year medical students to explore residency opportunities at other institutions. To streamline the process of applying, there is a universal application through the AAMC, known as VSAS. However, policies vary by school so it is important to carefully research the specific program you are planning on applying to. Pritzker School of Medicine explains that some specialties, such as dermatology and emergency medicine, essentially require students to complete away rotations before applying for residency.

Other Opportunities

There are a number of additional opportunities available to medical students during their clinical years. Many schools offer a focused, in-depth experience in a specific area of interest. Several medical programs, such as Weill Cornell Medical College, Alpert Medical School, and Columbia University’s Vagelos College of Physicians and Surgeons offer a scholarly concentration program, which allows students to participate in an in-depth study of a particular area of medical practice or research under the mentorship of faculty. Certain schools, such as Duke University School of Medicine, dedicate an entire year to scholarly research.

Another important element of these years is dedicating sufficient time to prepare for the United States Medical Licensing Examinations (USMLE) Step 1 and Step 2. However, it should be noted that the timing of these exams varies widely among different medical schools.

The clinical years of medical school are fundamental in shaping students’ future paths. During this time, students gain in-depth clinical experience while pursuing scholarly endeavors and delving deeper into their individual interests. It is essential to carefully compare the curricula of various medical schools so that you ultimately attend one that is compatible with your future goals.

For guidance on navigating the medical school application process, feel free to contact us. As always at Collegiate Gateway, 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.

Medicine and Tech: Where Do They Meet?

Like every other industry today, healthcare is being profoundly impacted by advances in technology. Medical students perform CPR on mannequins that blink and perspire, and practice their surgical techniques using virtual reality. Several top medical centers are even providing remote consultation services through telemedicine programs.

If they are to successfully practice medicine in such a dynamic environment, physicians must adapt to these developments. Similarly, it is essential for students considering or currently pursuing medicine to be aware of these wide-sweeping changes in medical training and healthcare delivery.

Innovative Strategies for Medical Training

Medical training has changed significantly in recent years, largely due to novel technologies. Simulation centers with computerized mannequins serving as “patients” have become quite prevalent at medical institutions across the country. At Johns Hopkins Medicine, their Simulation Center is used to assist current and future healthcare professionals in “refining advanced techniques and learning valuable social interactive tools for delivering important news to patients.”

The NY Times discussed The New York Simulation Center for the Health Sciences (NYSIM) as a site where emergency personnel can train for a variety of disasters. Additionally, medical, nursing and dental students, residents, and other healthcare professionals use the center for comprehensive training in specific clinical areas. NYSIM offers an extensive array of partial task trainers that allow for the practice of procedures on the head, airway, neck, chest, abdomen, spine, pelvis, and extremities. Microphones and cameras record each of the simulations, which allows for more helpful and productive feedback and debriefings.

Advances in virtual reality are also creating unique training methods for medical students and residents. For example, Rush University Medical Center will start training its obstetrics and gynecology residents utilizing virtual reality technology. According to the NY Times, residents will use a joystick or surgical tools while they see a virtual patient on the screen.

Telemedicine 

Similar to medical training, healthcare delivery has undergone substantial changes in recent years. This is especially visible in the advent of telemedicine, which enables doctors to communicate with patients remotely. In fact, doctors can now connect with patients, and each other, through a variety of means: phone, email and webcam.

Even more importantly, telemedicine is enabling physicians to reach areas where medical care is not as readily accessible. For example the London School of Hygiene and Tropical Medicine is in the forefront of using telemedicine to screen for diabetic retinopathy in underserved areas in India through the use of sophisticated iphone apps. The American Telemedicine Association estimates that 15 million people used telehealth services in 2015. In fact, Forbes discusses a unique initiative that links children in rural areas to psychiatric and counseling services.

Although the benefits of telemedicine are widely apparent, there are certainly still concerns. According to the Wall Street Journal, many worry that this novel system may compromise high-quality care for convenience. It is critical that aspiring physicians are well aware of these potential drawbacks, so that they can ensure that high quality care is maintained.

Health Information Technology

Just as telemedicine is transforming healthcare, health IT, specifically electronic health records (EHRS), are as well. Again, it is absolutely critical that aspiring physicians are familiar with these developments, as they will define their future work environment. Federal subsidies were provided to encourage the adoption of these EHRs; according to the NY Times, between 2008 and 2014, the number of hospitals using EHRs increased from 9% to 75%. HealthIT.gov notes numerous benefits of EHRs, including improved patient care, improved care coordination and cost savings.

However, the implementation of these systems has proved challenging. Many believe that EHRs have negatively impacted the physician-patient relationship, and unfortunately have not reached their potential in reducing workload and improving efficiency. According to Advisory Board, a survey conducted by the American Medical Association and AmericanEHR Partners found that only 34% of physicians said they were satisfied or very satisfied with EHR systems. Nonetheless, if future physicians are able to effectively integrate these developments into their medical practice, health IT will hopefully begin to reach its full potential.

These represent only some of the many technological advances in the healthcare setting today. Novel medical devices, techniques, and treatments are being developed each day. For example, the formerly low-tech area of stroke rehabilitation has seen many recent developments. According to the Wall Street Journal, new methods to promote stroke recovery include a simulated canoeing device, robotic exoskeletons, and interestingly enough, videogame devices. Patient-generated data is yet another area to look out for, as there are a growing number of individuals utilizing mobile health apps and other tools to track their health from home.

For additional information about the dynamic world of medicine or guidance on applying to medical school, contact Collegiate Gateway. As always, we are 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.