Tag Archives: AAMC

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!

Everything You Need to Know About the New MCAT!

In April 2015, the Association of American Medical Colleges (AAMC) officially launched a new version of the MCAT, the MCAT15. According to the AAMC, the test was changed “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. Medical schools vary in their policy about whether they will still accept the old MCAT for the 2018 application cycle.

Before we provide you with a detailed look at the new MCAT, it’s important to keep in mind that the MCAT is just one of various factors used by medical schools. The evaluation process also reviews college grades, trends in grades, extracurricular activities, and medically-related experiences such as research, shadowing, and clinical work.

New Structure of the MCAT2015

The MCAT changed in several major ways. Most notably, it has doubled in length. The MCAT2015 consists of 230 questions over 6 hours and 15 minutes.

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.”

The new content 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, observed:

“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.

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)

MCAT Test Dates and Centers

The MCAT is offered 30 times throughout the year, from January through September, with scores released five weeks after administration. You can find a local test center here.

MCAT 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 test is not graded on a curve, and there is no penalty for wrong answers.

Below is the distribution of total scores for the new MCAT taken in 2015 and 2016 for a total of 150,893 exams. 18% of test-takers took the exam multiple times. The mean for each of the four individual sections was about 125.

The score reports provide details on your test performance, and combines MCAT scores, percentile ranks, confidence bands, and score profiles. See the sample score report below.

 

What Are Percentile Ranks?

Percentile ranks are included so examinees can compare their performance to others who took the new exam. Percentile ranks are updated May 1 of every year. This info has been particularly useful to med schools in the first 1-2 years after the new MCAT was implemented, before sufficient historical data was available to evaluate applicant’s scores.

Importantly, on May 1, 2018, the percentile ranks will be based on the MCATs from the entire three preceding years; having this history will provide much more useful information to both students and med schools.

What Are Confidence Bands?

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. According to the AAMC, “non-overlapping confidence bands show a test taker’s likely strengths and weaknesses. Overlapping confidence bands suggest that there are not meaningful differences in performance between sections.” For instance, in the example above, the student would have strengths in the BBFL and PSBB areas, and relative weaknesses in the CPBS and CARS areas, but would have comparable strengths between BBFL and PSBB; and between CPBS and CARS.

Note that the confidence bands for each of the four section scores are two points, whereas the confidence band for the overall total is four points. So if your total score is 501, and you retake the MCAT, you have a reasonable chance of scoring anywhere from 499 – 503.

Who Has Taken the New MCAT?

According to the most recently published data of the AAMC, over 125,000 students took the new MCAT in 2015 and 2016. This included 54% females, 46% males; 48% whites, 27% Asians, 11% each of African-American and Hispanic; and 3% other; 18% repeaters (having taken the new MCAT before).

Average MCAT Scores for Selected Medical Schools

Below are the median new MCAT scores and GPAs for accepted students at a variety of medical schools.

Medical School US News Rank MEDIAN
GPA
MEDIAN NEW MCAT SCORE
Columbia 6 3.87 519
Drexel 83 3.73 511
Emory 23 3.79 515
Georgetown 45 3.74 5.12
Harvard 1 3.92 518
NYU 12 3.9 520
Stanford 2 3.89 518
Temple 55 3.79 512
Washington Univ 7 3.89 521
Univ of Miami 48 3.8 513

 

Policies About Accepting Old vs New MCAT Scores

For the 2018 application cycle, many medical schools are only accepting the new scores, but some are still accepting the old scores, and others express a preference for the new test but will still accept the old. The following charts shows a selection of med schools with each of these policies:

ONLY NEW MCAT EITHER NEW OR OLD PREFER NEW BUT WILL ACCEPT OLD
Brown University (Warrren Alpert Medical School) Albert Einstein College of Medicine Northwestern University Feinberg SOM
Dartmouth (Geisel SOM) Boston University School of Medicine U Chicago (Pritzker SOM)
Hofstra North Shore Emory University SOM U Rochester
Mount Sinai George Washington University
Johns Hopkins U SOM Harvard Medical School Medical School
USC (Keck) UPenn Perelman SOM
NYU SOM Stanford U SOM
Weill Cornell Medical College Tufts University SOM
Vanderbilt University
Wash University in St. Louis
Yale SOM

 

Applying to medical school is a long and challenging process. 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.

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!

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.

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.

 

What an MD/MPH Can Do for Your Career

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 poised to tackle some of healthcare’s most pressing challenges, which include disparities in access to care, high costs, and controversial reform.

USC-Keck-Medical-School-Quad

USC’s School of Medicine

How Can an MPH Help You as a Physician?

MD/MPH programs lie at the intersection of patient-based medicine and public health. According to the UNC School of Medicine, the MPH provides a broader social context and a focus on improving quality of care. Those pursuing this degree are often seeking a role beyond patient care, which could include policy-making, disease prevention, health education, or health research.

According to Dr. Judith Green McKenzie MD-MPH, Professor of Emergency Medicine at the University of Pennsylvania Perelman School of Medicine, the value of the MPH lies in its ability to expand a physician’s perspective:

“The physician is not only able to take care of one patient at a time but can also use the knowledge gained from the data available to implement changes that would affect the patient population as a whole. This is important towards preventive measures. The impact is not just local (one patient) but global (many patients).” 

Potential Career Paths

There is a broad array of career paths associated with the MPH degree that span public policy, private industry, research and community outreach. According to Brown’s PLME program (Program in Liberal Medical Education), these include the following:

  • International work
  • Environmental health, such as regulation of toxic elements in water
  • Behavioral health: diversity across populations; ethnic/racial group behaviors
  • Health promotion and disease intervention
  • Health management
  • Community outreach and serving the underserved
  • Working with the CDC: regulation of health policy and health education
  • Public policy: federal and state government
  • Special population groups, such as aging and gerontology, maternal and child health
  • Private industry, including epidemiology, pharmaceuticals, health education
  • Research
LSH-Poster-Boards-Mosquitoes

London School of Hygiene and Tropical Medicine Research Poster Board Presentation

Practitioners with a combined training in medicine and public health can treat individual patients while at the same time contributing to public health discourse. Dr. Christina Tan, MD-MPH, Assistant Commissioner for Epidemiology, Environmental and Occupational Health for New Jersey, serves as the top epidemiologist for the state. Last fall, she had the responsibility for assessing the readiness of New Jersey to handle the possibility of Ebola. With regard to her training, she says:

“The MPH program helped solidify and enhance my understanding of epidemiology and public health policy, as it’s important to have an understanding of the historical, legal, and scientific context of public health practice (which is very different from clinical work).”

Differences in MD-MPH Programs

It is essential for prospective students to compare programs in order to find the right one for their specific interests and goals. According to the Association of American Medical Colleges (AAMC), more than 80 medical schools sponsor activities to help students pursue an MPH.  These range in structure from the fully integrated program offered by the University of Pennsylvania Perelman School of Medicine, which houses both the MD and MPH programs within one professional school, to the combined MD-MPH program offered by Yale University School of Medicine and Yale School of Public Health, to Duke University School of Medicine’s partnership with the University of North Carolina’s Gillings School of Global Public Health. These programs differ greatly in their curriculum, concentrations, length and cost

Concentrations

Make sure to check out whether the program includes concentrations that match your interests!  For example, whereas Boston University’s curricular program is flexible, offering concentrations ranging from environmental health to health policy and management, New York University’s MD/MPH degree strongly emphasizes a global health perspective.

NYU-International-Health-Program

Many MD/MPH programs offer standard concentrations such as public health, global health, maternal and child health, and epidemiology.  But if you are interested in less conventional specialty areas, do some research to find appropriate programs. For example, the Harvard T.H. Chan School of Public Health offers Law and Public Health, Columbia University’s Mailman School of Public Health offers Biostatistics and BU offers the interdisciplinary concentration of Health Law, Bioethics and Human Rights. Tufts University’s School of Medicine Public Health Program takes a different approach, offering a generalist MPH degree without any concentrations.

Location

You may want to consider the state in which you ultimately want to practice, so that you can begin to make contacts with nearby related organizations. Or perhaps the location has value for other reasons, such as wanting to stay close to home or in a particular region of the country.  For example, New York has 10 MD-MPH programs, including SUNY Downstate, Einstein, Columbia, Mount Sinai, NYU and University of Rochester. On the other hand, some states such as Alabama, Oklahoma and Wisconsin, have only one MD-MPH program, part of the state system.

Length of Program

Combined MD-MPH programs last either four or five years. The typical model for 5-year programs is to complete the MPH between the 3rd and 4th years of the MD program, as at Boston University, Columbia and Harvard. Several schools offer a 4-year option through a more condensed approach that includes the three summers between academic years. At SUNY Downstate, you can complete coursework over three summers; at the Keck School of Medicine at USC, you use three summers to complete a 150-hour practicum. The University of Miami Miller School of Medicine has a fully integrated program that culminates with a capstone field experience of 300 contact hours. In choosing where to pursue your MD/MPH, therefore, 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

The cost of adding this additional degree may also be an influential factor, yet financial assistance opportunities and discounted tuition are quite common. At Feinberg School of Medicine, the cost of an MPH is simply a surcharge on top of the standard medical school tuition. Other schools, such as Tulane, offer their MD/MPH students both merit-based and research-based scholarships.

When to Attend

The experience of undertaking a Masters in Public Health varies greatly, depending on how you time your work experience. You could undertake a dual MD-MPH, or you could receive your MD degree and subsequently obtain an MPH immediately or after working. Yet another option is to “intercalate” a Master of Science degree in the UK in the midst of your MD program. The London School of Hygiene and Tropical Medicine offers an outstanding one-year MSc program that students can take between their third and fourth years of medical school. Thirteen MSc courses are available, such as Global Mental Health, Nutrition for Global Health and Public Health in Development Countries.

LSH-Library

London School of Hygiene Library

Dr. Tan elaborated in an email about the pros and cons of attending an MPH program before or after work experience: “Because I got my MPH about 10 years after my MD degree (and after working at governmental public health agencies), I wanted to use the MPH as a way to “fill-in-the-blanks” regarding what I was already doing in my work.”

TIMING

PROS

CONS

PRE-WORK
  • Acquire skills for a public health job
  • Build a network of contacts
  • Add an analytical component to your MD curriculum
  • You may not yet know your field of concentration
  • You will need to obtain required fieldwork experience while at university
POST-WORK
  • You will be aware of your knowledge deficits from your actual work experience
  • You will be a stronger candidate due to your real-world experience
  • It may be difficult to return to a classroom environment after work
  • You may find it challenging to forego income at a later stage in life

 

When to Apply

MD/MPH programs can also differ in a number of other ways, including when you would actually apply. At some schools, such as SUNY Downstate and USC, prospective students apply for the dual degree as they are applying for medical school admission. Others, such as NYU, encourage you to apply once you have already matriculated.  Still others, such as UMDNJ-Robert Wood Johnson Medical School and UMDNJ-School of Public Health, offer the opportunity to add the MPH degree after extending acceptance letters for the MD degree.  In addition, there is always the option to apply years after receiving your MD degree and practicing medicine.

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. Additionally, today’s aspiring physicians will likely receive some public health education regardless of whether or not they are involved in an MD/MPH program. 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 institution provides the best fit. Check out the resources offered by the American Medical Student Association (AMSA) MD-MPH resource guide and the Association of Schools of Public Health.

Choosing to pursue an MD/MPH is a complicated process that varies greatly for different individuals. For more guidance, contact Collegiate Gateway – we’re always happy to help.

Applying to Med School: the Rise of the Multiple Mini Interview

The interview is an essential component of the medical school admission process. It enables the admissions committee to evaluate applicants based on qualities that cannot be conveyed through a paper application. An analysis by the AAMC reports that medical schools typically use the interview to assess applicants’ non-academic characteristics and skills, including compassion and empathy, personal maturity, and professionalism.

The Traditional Interview (And Its Drawbacks)

The majority of US medical schools continue to utilize a traditional interview format: students are interviewed one-on-one by a member of the school’s faculty, admissions committee, or student body. These traditional interviews can vary considerably in terms of length, structure, content, and scoring. Some schools conduct just one interview, while others conduct two or three. At certain schools, the interviewer has limited to no information about the applicant, while others allow the interviewer to have complete access to the interviewee’s application.

The reliability and validity of the traditional medical school interview has long been in question. The results of a 1996 study demonstrated significant variability among interviewers’ ratings and only moderate validity in interviewers’ ratings of an applicant’s true level of performance. The study also discussed the potential for error due to the fact that certain interviewers are more strict or lenient than others.

The Multiple Mini-Interview (And Its Advantages)

Recently, several US schools have transitioned to a novel type of interview: the Multiple Mini-Interview (MMI), which originated in Canada and Australia. The rationale behind the MMI is twofold: to address some of the weaknesses of the traditional interview format and to better assess an applicant’s potential for success in medical school and beyond.

An MMI typically consists of 6 to 10 stations through which applicants rotate, each with a different scenario, question, or topic. At each station, the student has a few minutes to read the question and prepare, and then spends 6-8 minutes discussing the issue with the interviewer and answering questions.

The stations comprising the MMI are intended to assess various applicant characteristics including communication and problem solving skills, as well as ethics and judgment. There are many different types of MMI scenarios, which may involve a patient actor, a writing task, an ethical dilemma, a healthcare policy question, or a standard interview question. Some schools that have recently switched to using MMI are Albany Medical College, Duke School of Medicine, NYU School of Medicine, and SUNY Upstate.

During an MMI, the same interviewer is assigned to evaluate all prospective students at a particular individual station, which reduces some of the inherent variability in traditional interviews. As all interviewees are asked to respond to the same set of prompts, the overall process achieves a greater level of standardization.

A post by the AAMC cites the following reason for more schools moving toward an MMI format: “Because students interact with multiple interviewers in multiple assessments over the course of the MMI, opinions of a single interviewer are not over-emphasized.” According to NYU Admissions MMI FAQ, the overall process is fairer considering “applicants who do poorly on one station have the opportunity to perform better on another.”

Preparing for an MMI

With such a wide array of potential topics, applicants often find MMI preparation quite daunting.  As a student does not know the questions in advance, an AAMC post states “the best way to prepare is to practice expressing yourself articulately and logically in a timed environment.” It may also be valuable to familiarize yourself with some broad, yet relevant topics such as bioethics, current events, and healthcare policy issues.

Takeaways

Both the MMI and traditional interview enable medical schools to assess certain applicant qualities. Yet the MMI differs from the traditional interview in significant ways and in doing so, aims to address several concerns surrounding the traditional interview structure. By interacting with several different interviewers over a variety of scenarios, applicants are judged more holistically and consistently in MMI interviews.

If you have any questions about the medical school application process, contact Collegiate Gateway—we’re always 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 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. Those pursuing this degree may also be looking for a role beyond patient care, which could include policy-making, disease prevention, health education, or health research.

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 degree strongly emphasizes a global health perspective, whereas BU’s program is more flexible, offering concentrations ranging from environmental health to health policy and management. 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 UMDNJ-Robert Wood Johnson Medical School and UMDNJ-School of Public Healh, 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. At Feinberg School of Medicine, the cost of an MPH is simply a surcharge on top of the standard medical school tuition. Other schools, such as Tulane offer their MD/MPH students both merit-based and research-based scholarships.

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!

The MCAT2015 is Coming – Will You Be Ready?

The Association of American Medical Colleges, or AAMC, will officially launch a new version of the MCAT, called the MCAT2015, next spring, with the first exam scheduled for April 17th, 2015. 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 MCAT2015 is changing in a major way. Most notably, it’s going to almost double in length. The MCAT2015  will include 230 questions over 6 hours and 15 minutes versus the current 144 questions in 3 hours and 20 minute. Because of this, the new test will require a lot more stamina and focus of its test takers.

Screen Shot 2014-11-04 at 8.03.17 PM

The MCAT2015 will also include 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 reasoning about scientific theories and models.

 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?

A.    1   104

B.    2   107

C.    4    109

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

 Screen Shot 2014-11-04 at 8.03.52 PM 

The US News blog, “Medical School Admissions Doctor,” is estimating that the vast amount of information covered on the MCAT2015 requires “a year of biology, a semester of biochemistry, a year of chemistry, a year of physics, a year of organic chemistry, a semester of psychology, a semester of sociology, and a recommended year of humanities – several requirements above the standard medical school prerequisites.”

Score Scale

Each of the four sections will be scored individually, from a low of 118 to a high of 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.

Screen Shot 2014-11-04 at 8.04.36 PM

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.

Should You Take the Old, or Wait for the New?

Some students are wondering if they should hurry to take the MCAT before the change. “The Medical School Admissions Doctor” reminds potential applicants that the current MCAT still requires a solid college-level background. The blog recommends that students who “can get two semesters each of biology, chemistry, physics, and organic chemistry all done before January 2015” might benefit from taking the current MCAT before it is removed from testing options after January.

Just because the MCAT2015 will propose new challenges, doesn’t mean you should rush to take the current exam before you’re ready. Bonnie Miller, senior dean associate for health sciences at Vanderbilt University advises her students to wait before taking the MCAT. “Honestly, I think you’re better off taking an exam that you’ve had a while to prepare for,” she says. Since most medical schools accept scores from two to three years ago, many students will be able to keep their options open when it comes to choosing what scores to use.

No matter which test you take or when, be prepared!   And if you have any questions, contact Collegiate Gateway – we’re always happy to help.