Tag Archives: med 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!

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!

The MCAT2015 has Arrived!

 

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

New Structure of the MCAT2015

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

Screen Shot 2014-11-04 at 8.03.17 PM

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

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

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

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

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

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

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

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

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

Screen Shot 2014-11-04 at 8.03.52 PM

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

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

Score Scale

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

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.

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

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

 

Trends in Residency Matching for 2015

 

matchday7

Earlier this month, hopeful and anxious medical school students gathered at Match Day ceremonies across the country. Match Day, an annual rite of passage for budding physicians, is the day students learn which U.S. residency programs at which they will train for the next three to seven years.

This year was record setting in several respects and, as usual, Collegiate Gateway is here to bring you the most important trends and developments.

More people, more positions

The National Resident Matching Program (NRMP) recently announced that 2015 is the largest Main Residency Match in NRMP history. This year included 41,334 total registrants, the largest number on record. This growth in the number of U.S. seniors is attributable to rising medical school enrollments and the development of new medical schools across the country. In keeping, more than 30,000 total positions were offered in 2015, another record high.

MRM-2015-Largest-in-History-Infographic-with-photos

Good News for US Graduates

Of this year’s 18,025 U.S. allopathic seniors participating in the match, 16,932 were matched to first-year positions, achieving an overall match rate of 93.9 percent. Of those, 51.6 percent matched to their first choice for training. In addition, 2,949 osteopathic students and graduates submitted program preferences, an increase of more than 200. Their match rate rose to 79.3 percent – another record high.

Osteopathic medicine is very similar to the traditional allopathic approach, but with a greater emphasis on hands-on physical diagnosis techniques, as well as a more personal, holistic approach. In the past, there had been distinct accreditations for allopathic (MD) and osteopathic (DO) residency programs. However, in February 2014, the accrediting agencies decided on a single system for residencies and fellowships to begin in 2015 and be fully implemented by 2020. Keep an eye out for our upcoming blog that will delve deeper into the similarities and differences between MD and DO training.

According to a recent report in Slate, the outlook is also good for those who have not, unfortunately, been matched:

“Although failure to match is chastening, U.S. graduates have an excellent chance at finding a program the next year. In the meantime, many of them get a master’s degree, or they teach or work in a laboratory to strengthen their applications. If they decide not to pursue a residency, it’s almost always by choice. Despite the pressure of Match Day, life is pretty forgiving to U.S. medical school graduates.”

Another option for unmatched applicants is the Supplemental Offer and Acceptance Program (SOAP), during which unfilled positions are made available to unmatched applicants. In fact, there were 1,193 unfilled positions offered during the 2015 SOAP.

For Internationals, Challenges Remain

In keeping with previous years, however, graduates of foreign medical schools have a more difficult time matching. This year, 12,380 doctors attempted to match from medical schools outside the United States. Only 6,301 were successful, yielding an approximately 50 percent acceptance rate. Though low compared to the numbers for U.S. medical school graduates, 50 percent is actually a somewhat inflated statistic; these students often apply for programs such as family medicine that generally have difficulty filling their many available positions.

Couples matching

The NRMP allows those with spouses, partners, and significant others, to participate in the Match as a couple: any two candidates can link their preference lists together in the hopes of being paired to the same or nearby programs. An all-time high of 1,035 couples participated in the Match – 110 more than last year – with a 94.8 percent match rate.

Trends in Specialties

Over the next decade, the AAMC predicts that the US will face a shortage of as many as 90,000 doctors. As such, efforts to expand residency positions are common, with particularly high growth in several key areas. Notably, nearly 60% of all new positions were attributable to primary care, an area particularly in need of new doctors.

 

Specialty                     Total positions             New positions           % Filled

Internal Medicine 6,770 246 98.9
Family Medicine 3,195 86 95.1
Pediatrics 2,668 28 99.5

 Some of the most competitive specialty areas included the following, which filled 100% of available first-year positions:

  • Dermatology
  • Medicine-Psychiatry
  • Obstetrics and Gynecology
  • Orthopedic Surgery
  • Pediatrics-Primary Care
  • Physical Medicine/Rehabilitation
  • Thoracic Surgery

Additionally, General Surgery, Neurological Surgery, Otolaryngology, Plastic Surgery, and Radiation Oncology had fewer than 5 unfilled positions remaining after the matching algorithm was processed. Watch for our upcoming blog on the differences between various specialty residency programs.

The road to becoming a doctor is a long and complex one. For more information on the residency match process, or any other part of the process, contact Collegiate Gateway – as always, we’re happy to help.

Trends in Medical School Curricula

As our healthcare systems continuously evolve, medical education must follow accordingly. Although each medical school continues to offer its own unique curriculum, curricula as a whole are following several overriding trends. These changes, outlined below, are intended to strengthen the academic experience of students, while creating more versatile and well-rounded physicians.

Starting clinical work earlier

Many schools have begun to phase out the traditional structure of medical education: two years of pre-clinical, basic science work followed by two years of clinical work. By starting clinical training earlier on in their education, students are able to utilize and expand their hands-on doctoring skills right from the start. This helps students hone their clinical skills, and enables them to apply knowledge from the classroom to relevant real-world situations.

However, med schools are approaching this change in very different ways. On one end of the spectrum, schools such as Duke and Vanderbilt have moved to an extremely accelerated curriculum with only one year of the core basic sciences, followed by core clinical clerkships beginning in year two. Similarly, Harvard has announced that in August of 2015 they will launch a new curriculum, Pathways, that also condenses the basic sciences to the first year.

On the other hand, Mount Sinai has maintained the structure of starting formalized clinical clerkships in the third year, but during year one, med students are partnered with patients to begin a longitudinal clinical experience. Several other medical schools, including Weill and Perelman, have struck a middle ground: students learn the core basic sciences for one and half years, with core clinical clerkships beginning in January of year two.

More flexibility

By finishing core clinical work earlier, students are granted greater flexibility in the third and fourth years, allowing for research opportunities and an abundance of elective choices. At Duke School of Medicine, students dedicate a full year to a scholarly research experience. During this year, students may pursue research or a dual degree, while also completing electives, some standard coursework, and studying for the Step 1 Exam. Similarly, Weill Cornell students are required to select an Area of Concentration (AOC) midway through their third year; these range from global health to neuroinflammation. Students choose their AOC based on personal interest, and then work to obtain in-depth knowledge, skills, and a scholarly project within that particular area.

More interdisciplinary coursework

Physicians must develop a diverse skill set to successfully navigate an increasingly complex healthcare environment. As a result, several schools have carefully crafted their curricula to include courses and themes that span beyond the basic and clinical sciences. This fosters a more interdisciplinary approach, with an emphasis on topics such as health policy, ethics, and population health. In fact, Albert Einstein College of Medicine incorporates a theme of population health into already existing courses and clerkships.

To cater to students with more interdisciplinary interests, many schools offer dual degrees, including an MD/PhD, MD/MPH, and MD/MBA. Certain schools also offer dual degrees in areas such as health policy, clinical investigation and bioethics.

Shortening the duration of a medical education

Partly as a result of the earlier clinical training, several med schools, such as NYU, have begun to offer a pilot “three-year pathway” program. The 3-year program is very similar to the core 4-year MD program, except that 3-year MD students start rotations in their chosen specialty six weeks earlier and spend their first summer pursuing a research fellowship in that same department. These students declare their specialty when they apply, and are guaranteed residencies in an NYU-affiliated hospital. This way, students don’t have to worry about matching into residency programs that may still be wary of the 3-year medical degree.

There is ongoing debate as to whether or not shortening the medical school education is beneficial. In a New England Journal of Medicine perspective piece, Drs. Goldfarb and Morrison state “Given the growing complexity of medicine, it seems counterproductive to compress the curriculum into 3 years, reducing both preclinical and clinical experiences.” Yet, in another Perspective piece, the authors claimed that a shorter medical school education could alleviate the physician shortage by producing physicians at a faster rate, and substantially reduce student debt. Dr. Steven Abramson, vice dean for education, faculty and academic affairs at NYU School of Medicine, predicts: “You’re going to see this kind of three-year pathway become very prominent across the country.”

Emphasis on problem-based learning

Medical education is also increasingly incorporating problem-based learning (PBL) into the pre-clinical years. This technique utilizes clinical cases to stimulate discussion among a small group of students, thereby creating a real-life, collaborative and active learning environment. For example, at Feinberg School of Medicine, each PBL is comprised of 6 to 9 students and a faculty facilitator. The overall PBL process “mimics the manner in which a practicing physician obtains data from a patient.” This enables students to further develop skills essential to becoming a successful physician, such as teamwork and communication.

Most schools have established an effective mix of PBL and standard lecture-based teaching. The Integrated Pathways Curriculum at SUNY Downstate, for example, offers reduced lecture time in favor of a greater emphasis on small-group learning such as PBL. 

For more information on medical education 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
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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.

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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!