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The 5 Stages of Studying for the MCAT

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doctororbust:

Good luck on the MCAT!

Originally posted on doctororbust:

1. Denial and Isolation

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The denial phase of the MCAT won’t start until you’ve taken your full length. At this stage you’ll find yourself saying things like:

“Maybe the answer key is totally wrong?” — after grading & receiving your practice score.

“Well, I’ve heard of time dilation, maybe I was in one, and that’s why I actually ran out of time” — after realizing how little time you actually have to finish the problems you’ve glanced at while doing the content review and thought “I totally got this”.

2. Anger

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This phase usually comes after the first full length, and remains through a few practice tests when you see no improvement, and you realize the number of practice test (AAMC officials) are a limited resource:

“Brownian Motion?!?? What the expletive does this exam have to do with being a doctor?” — says a premed after no improvement from first…

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Interview with Incoming Stanford M1 Accepted

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 Hello Everyone!

As promised, here’s the confidential(identity) interview from the accepted Stanford student. They’ll be starting this year as a M1. As a nontraditional premed, switching majors several times before finally deciding to apply to medical school.

It’s interesting to note we both applied to Boston University and Stanford, however we both never received interview invitations from each other’s respective current medical school – it really goes to show there’s interpretation about what constitutes a good fit for their institution, and we found our own fit.  For myself another interesting point of this person is that, like me, it took them many years to finish their college career — we both took multiple breaks for work and switched majors innumerable times before deciding on applying to medical school.

Anyways, I had to distill a nearly two hour conversation where we easily went into tangents (mostly entirely my fault). After laughing and removing the tangents, here is the more educational and likely useful results:

Q. 1. When did you decide that medicine was for you, and why?

Basically, I realized medicine could be a career for me because of the position it occupies in relation to other fields. As a community college student, I had the opportunity to take a wide variety of classes in different fields, without needing to prematurely declare a major. I had always been interested in fields where I thought I could make a difference, I dipped my toes in psychology, sociology, political science, “hard” sciences (thought about a PhD), public health, and even art (documentary photography). For me, medicine fits snugly between public health and the hard sciences, and gives me the best of both worlds (well, what I feel is the best of both worlds). Public health was hard for me because it was a bit far removed from the individual level, obviously since it’s more focused on populations. This is great of course! But that was hard for me to work with, because actually seeing change takes a LONG time, if you see it at all. Bench research is cool too, I still love it, but couldn’t see myself devoting my life to it because it was easy to get caught up in the little things, without the human perspective, and I felt a little lost there, honestly. Medicine allows me to inform both fields with a clinical perspective, work with both fields as part of the health team, and still enjoy what I do

 

Q. So, do you think being a nontraditional gave you a different point of view? For example while studying.

I think so. I can’t say that more traditional premeds didn’t learn the same things I did, but I can say that I wouldn’t have the perspective I do without doing it my way. Having studied a variety of topics, I kind of felt that medicine was just one career path that could be taken. It fits a small niche in between all the other things people can do with their lives, or to help others. Plus, being nontraditional, working through school, all of that…I had to learn to prioritize and really figure out WHY I needed to do some of these things. I think premeds often get caught up in “the list”, the list of shit we’re supposed to do to be competitive. And a lot of us end up with huge resumes of shit we did that had no impact on us or our communities

The end goal is to be a great doctor…so these experiences should be towards that goal. Activities aren’t just there for filler. Med schools look for these activities because they think we have something to learn from them. And as a nontraditional student, I think I may have had an easier time figuring that out

 

Q. Lately, schools have really been pushing for diversity, how do/will you bring diversity to your program?

As for the diversity question…I STILL have trouble answering it. I think it’s because there’s no single factor that stands out as HI THERE DIVERSITY. I’ve mentioned before that I am certain that all of us are really diverse. We have our collections of scores and activities on the applications that look the same in bullet-point form, but different students get into different schools. In any case, I think being a nontraditional premed has given me some interesting opportunities. I took extra time in school; it took me eight years to finish up my degree, so I was able to explore a number of different areas of study and work part-time throughout undergrad.  After all of that…I can’t help but see medicine as integrated with every other field, and my approach to healthcare in general requires that we don’t separate “health” from the rest of our patient’s lives. I also had time to make big commitments to projects that I cared about, and learned more than I could have imagined. I helped get a nonprofit global health organization started, which taught me as much about public health as it did about team work, leadership, and resource management. I worked in a research lab for a few years doing more engineering-based health projects, and was inspired by the potential future of stem-cell based diagnostic devices and therapies. I think the biggest opportunity I had while being nontrad, and perhaps bringing some diversity to the mix is my restaurant work history. I got my first job at 16 working in a cafe and bakery, and from there moved on to other cafes and finally ended up serving and bar-tending at a restaurant as I got older. It seems like working during undergrad isn’t typical for a lot of premeds, so I’m so glad I had a chance to do it. Of course, I hated it at the time and it was stressful, but being forced to talk to strangers day in and day out will probably help my bedside manner more than any amount of shadowing doctors could do. I learned a lot about making people feel comfortable and responding appropriately to misplaced anger by waiting tables. Although it isn’t directly related to medicine, waiting tables taught me a lot about professional communication in strained situations. People can get really upset about their food, it seems! Or parking, or having to wait for a table…about a lot of things outside my control. And I feel that happens in everyday medical practice often, so having a little bit of experience managing those situations will likely help me in the future. Waiting tables was also a great teamwork exercise; you really can’t survive the floor without working together, even if you don’t always get along with your coworkers. Maybe that gives me some of that coveted diversity? Who knows, I think it’s the summation of our experiences that gives all of us a unique perspective.

 

Q. So, as a nontraditional or traditional premeds was there anyone who mentored you? Also, applying to medschool is pretty nebulous; have any guidance or tips along the way?

I’m lucky to have had a great mentor in this whole thing. I think as you’ve pointed out a few times, there are a lot of people who are just waiting for us to fail, to not make it. So, I had my mom, who is a doctor and a teacher. When I have questions about how to be a great doctor, I always turn to her. For the premed-y things though, I kind of just went with it. Internet-searching. Berkeley doesn’t have official premed advisors, so I kind of went at it based on anecdotes from friends and the internet

As for my tips…I think the best ones I have are to do what you love…pick a few key activities that will help define and shape you, and give them your all. Don’t mess around with 100+ random activities that you only contribute 10 hours to.

Also, keep a journal of everything. Not only does it make it so much easier to learn from and reflect on your experiences, but you will thank yourself SO MUCH when applications roll around.

And surround yourself with good people, even if they’re not premed or doing the same things you are. Don’t let negative folks discourage you, don’t take SDN too damn seriously, and don’t put other people down because we never know where they’ve been

Regarding the question of, “For premeds without a committee or reliable advisors do you have any tips?” that’s a hard one. Reliable information is difficult to come by, and you don’t want to get sucked into the anecdotes too much, because they may be wrong! I think some of the books out there are pretty good –the ones written by previous admissions officers. I guess my major tip for anyone is just always frame your activities or potential activities by thinking “How will this make me a better doctor? What am I learning or contributing?” If you can come up with solid answers to that, then it’s a worthwhile activity lol.

And the usual: don’t let your GPA slide, set study schedules to keep it up, check school websites to meet prereqs, and don’t think the MCAT will be a breeze.

 

Q. I suppose you should probably jot down that answer [from the journal etc.] as well for later during secondary/interviews?

  • YES, absolutely. Take notes, always. Makes life so much easier down the line when time is of the essence. I was lucky that I had some notes and journals, but I WISH i had an updated CV.
  •  Oh…another pro tip. Start saving a lot of money — like yesterday. Charging app fees to your credit card is awful (that was me, it sucked).

 

Q. As you already know, I don’t report MCAT scores; but, you did very well, do you have any study tips?

Well, since everyone studies a bit differently, it’s kind of a hard thing to say for sure. The one thing that I think will work for everyone is to set a study schedule. Like map out every single day, what you’re going to review, how many problems you’re doing to try, etc. Even map out your break days

  • I also tend to think that you shouldn’t review all of one area, then the next. Should probably do one chapter of physics, one chem, one orgo, one bio, then repeat with the next chapters
  • Practice problems are golden, obviously. do as many as possible, but I think it’s best if you don’t re-do the same ones. I saved all my AAMC practice exams for the last month
  • Flashcards are great for random facts, and can be taken anywhere for quick review (on the bus, between classes, etc)
  • Always focus on understanding and connecting concepts, rather than memorizing shit

*Doctoorbust: a caveat, remember pick tips that work for you, ignore any that don’t.

 

Q. I know you’re tired of hearing this but, any idea what you’re going to specialize in?

Not a clue! I’m trying to go into it with an open mind, simply because I know I haven’t seen even half of what specialties are out there. Even for the ones I have “seen”…it’s difficult to know if my experience in them as a premed was anything like the way they actually are. So, I’m trying to be open.

Plus, it’s hard to know where the field will be in 4-5 years. Things change. The structure of medical practice is undergoing some pretty significant changes, and I’m not really sure where it will all end up.

 

Q. How do you feel about the coming changes (healthcare)? There’s a lot of anxiety in some groups about it.

I honestly don’t know. I see it as a good thing, a step in the right direction for expanding patient coverage, but I can also understand the concerns from a doctor’s point of view, as far as who is getting reimbursed for what, and additional constraints on their time I think it is easy for us to say, as folks who have yet to enter the medical field for real, that expanding coverage is GREAT and it’s easy and things like that. But I’m not sure we really know what it’s like in the trenches. I’m thinking specifically of primary care, it seems that it’s going downhill fast for those currently in family practice and internal medicine.

For the record, my personal opinion is that expanding coverage equates to awesome. But I don’t think we can neglect the concerns that have been brought to the table by our colleagues, either.

 

Q. What are some things you wish you did as a premed now that you’re going into medschool?

I wish I had traveled more, and taken more time for non-premed activities. I definitely enjoyed all the work I did in preparation for becoming a doctor, but I let some things slip too

I would just advise people to always make time for hobbies, for themselves. This is because hobbies are every bit as important as engaging in research or volunteering. Being healthy and happy will make you a better doctor, too.

Maintain relationships! Friends, family, don’t let it slide because you’re too busy studying.

 

Q. Now, you’ve been there and done that. What are some misinformation points you’ve heard about being a premed or applying that you believe to be false, at least from your experience?

 The biggest thing I think is that you need a perfect GPA and perfect MCAT score, or that having X hours of these activities are all it takes. Or that it’s guaranteed to get in if you have those things. And you see this everywhere. “My friend has a 4.0 and a 42 MCAT and thousands of hours of volunteering and research and didn’t get in” or the other commonly seen thing “I need a 4.0 and a 42 etc in order to have a shot.”

Yes, you need decent numbers, but that will only get you so far. We have to learn from our experiences in order for them to count. The hours spent doing an activity are usually correlated with learning and reflecting, but the hours themselves don’t mean anything

The other thing about applying that I saw a lot is the obsession with school rank and the numbers. It’s not all a numbers game. Schools have different missions, different focus points that they look for in their applicants

The smart applicant will choose schools that they will fit into, whose goals are in line with the applicant’s, or the applicant feels he/she can contribute to

The process feels like a crapshoot. To some extent, it probably is, but that doesn’t mean that applicants can’t maximize their chances. Obsessing over numbers won’t get you anywhere. and the thing is, just because your experiences don’t fit into one school doesn’t mean they don’t fit somewhere else. For instance, I was rejected outright from BU! But I got in somewhere. And you got into BU! And were rejected from other places we all have different strengths, just have to play to them. it takes some serious self-reflection and honesty on the applicant’s part. Still, no one’s saying it’s not competitive. But…always remember the numbers aren’t everything. My GPA sucked, and I got in somewhere.

–end–

Thanks for reading!  I’ll try to keep posting while moving!

 

AMCAS II Ex. 6 — When Have you Faced Criticism?

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Eventually along the way you’ll find a secondary question asking you about how you deal with criticism. It’s an  important question for innumerable reasons. The question for this essay is pretty much asking you, “Have you learned how to accept criticism and then do something constructive without having tantrum?” Medical students receive critiques to hone their skills prior to being flung into residency.  Once there in their internship, they’ll be a lot more of it, most will be legit some unwarranted. Other physicians may criticize new interns, these new doctors find themselves bombarded by critiques that are no longer didactic exercises, but are now instead life and death lessons. Patients will berate you for being late, how could they know you were doing chest compression upstairs in room 215 for 20-minutes?  But, without getting too far ahead of ourselves, let’s just remember that the medical school wants to see how you will handle criticism when they dish it out to you — there is also an undertone of show your maturity here please.

If you’re not used to handling criticism, you should get used to it. I finally learned what criticism meant when I was just accepted as the co-principal investigator for a project. I turned in my research thesis for my senior project to my principal investigator. He gave it back a few weeks later, but for some reason he had changed all of the font to red. I was wrong, he meant the whole thing had to be scrapped. I faced more criticism during lab meetings where we had to present new or class electrophysiology research articles and our interpretation. After some time, you just learn how to take criticism and become better from it. If there’s room to criticize then there’s room for improvement.

During this essay you’ll try to do several things:

1. Show that you know how to take criticism, i.e. you don’t bite off people’s jugulars when they give you an honest critique.

2. Show that you understand that accepting criticism can be a learning experience — this can be true regardless of who’s “right or wrong”.

3. You can show that you have some real world experience, i.e. will the school also need to teach you “life skills” or do you already have some.

Tell us about a time where you’ve received unexpected feedback or critique. And, how did you react to the situation?

As an Institutional Review Board (IRB) [title redacted] my first and foremost goal is to ensure that research projects meet ethical and regulatory standards. However, principal investigators (PI) often have disparate concerns, namely the timely completion of their investigative study. In one particular protocol conducted by a well-established (PI) I found the protocol didn’t meet my interpretation of ethical compliance. In response, I received a deluge of emails noting my incompetence; it became apparent to me that my review didn’t sit well with my (PI) colleague. I’m not infallible, and there’s a lot of “grey areas” in law interpretations, so I launched an investigation into my own decision. I poured through ethical reference texts and case studies to establish an ethical precedent for my decision, after I proved my case I reported my findings to the IRB and PI. After the protocol was modified, the study was approved and I have a good working relationship with that same PI.

The hardest part of this entry was actually writing it in such a way that I could still be professional, and be certain to represent both sides of the argument. Also note that I decided to not defend some of the criticisms against me, and instead accept it and show how I grew from it.

Good luck!

Nominated for Liebster Award

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This evening I received a message from a mutual reader:

“Hello! I’ve nominated you for the Liebster Award! Your blog is extremely helpful and it’s nice to read about other premed majors”

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My first step of course was to immediately thank them, then Google what it mean, because I’m a blog newbie. So I found out that the Liebster award is a ceremonial award for bloggers by bloggers. The word derives from German, and is a term meant to invoke feelings of endearment — I won’t try to butcher the translation here. I suppose one could argue that the Liebster is the bloggers equivalent of the Academy Awards (without a centralized panel).

In order to “accept” my award, I need to follow the rules:

The Liebster Award Rules

  1. Thank the nominator and post a link to his/her blog
  2. Display the award on your blog
  3. Answer the eleven questions provided by the nominator
  4. Nominate 5-11 blogs which have less than 1,000 followers, and let them know they’ve been nominated
  5. Make up and Post eleven questions for your nominees to answer
  6. Post these rules on your blog

My nominator was Simplexvita, thanks for nominating me. I hardly write about the details of my life, so I guess people will find out more about me tonight.

So, here are the questions and my answers:

The 11 Questions:

1. What is one thing that you would change about the world and why?

Just listen to Imagine by the John Lennon I agree with every single naive lyric, though most of all I wish for violence to stop around the globe. You may say I’m a dreamer, but I’m not the only one, and I hope one day you join us, and the world will live as one.

Why? because look at what we do to each other — to each other.

2. Your favorite color?

I actually don’t have one, well I do but it changes depending on the object. For example, I like navy blue, however only on shirts and bags. Yet, I don’t feel comfortable in navy blue pants. I like red, but own no red clothes, however I like red objects and when others pull off red. This could last all day, so let’s just say I really like natural tones.

3. Tell me about your best friend. Why are you guys friends?

My best friend, we’ve been friends since we were kids, I was his best man. I think one of the things that keeps us friends is that he’s good at things I’m not, and I’ve learned a lot about life from him. He’s really good at living life to the fullest, I’ve picked up a lot of good tips from him about what’s important in life.

4. What is your accomplishment that you’re most proud of?

I suppose getting into medical school ranks pretty high up there. But, actually I think the biggest accomplishment for me was overcoming my speech problems as a child. In elementary school I had to go to speech therapy because I had a difficulty speaking and interacting with people. So, it’s funny that now one of the things I’m known for are ‘motivational’ public speeches and interviewing skills. I’m proud that people could be duped into thinking that of me.

5. What do you most fear?

Well, if you saw #4 you’d think it was public speaking (haha). This may have been true before, now I really don’t care. Right now, my biggest fear I think is that I’ll never be satisfied — I know that sounds weird.

6. Would you ever run for president/prime minister/ruler of your country?

No. I don’t want them to ask about my transcripts to prove I’m smart. =)

7. Favorite scent?

I think baby powder is the most awesome smell in the world, it’s scientifically designed to smell like comfort.

8. Cat or dog person?

Dog. I like cats though, I’m just too aloof to have a cat, we’d just ignore each other all day.

9. Guilty pleasure show?

Judge Judy. I like seeing her reason through a usually intentionally convoluted story, and eventually finding the truth with a matter of minutes. There’s a bonus that occasionally I get to learn legal advice.

10. What was the best day of your life so far?

Getting into my top choice for medical school. My interviewer called to tell me, I was sure she was calling to let me down gently.

11. Are you involved in any clubs?

Not at all.

Well, with me out of the way, here are my nominations:

1. Dreamer Doc

2. The Health Scout

3. This Medical Life

4. MD PhD to Be

5. Nurse with Glasses

My questions for them:

1. If you could change something about yourself what would it be?

2. If you could be fluent in another language, what would it be?

3. Have you traveled to another country, if so where, if not where would you go?

4. What was the proudest moment in your life?

5. If you had a super power, what would it be?

6. Do you have a talent most people don’t know about?

7. What’s the most risk taking thing you’ve done?

8. Why do you write, did you enjoy writing growing up?

9. If you could keep to your future, by passing all of the hard work to get to your goal, would you?

10. Can you tolerate spicy food?

11. Are you a morning or night person?

 

Blog Agenda for the Remainder of July

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As the count down till the big move continues (14 days now), I see that I have a lot of things to accomplish in 14 days:

  • Currently writing a guest article for a premedical advising website, I’ll link you all when it’s up on their site.
  • I may start a new affiliation with a premedical student advising service. If I do, I’ll post this affiliation in my “About” page to be transparent to my readers and friends here.
  • PreMD Tracker application review, co-creator interview,  and tips on usage –the  interview is completed, I just need to whip it into an article. This is actually taking a lot longer than I expected, this is because there’s so much in the application, making it that more laborious to present my positive comprehensive review. Fortunately, it’s taking so long because the free phone application is just that good that I wanted to do more with the article than I anticipated.
  • Complete article with medical student advising service ProMEDeus. The creator/physician and I spoke on the phone, informally, for several hours a few weeks ago. We’re still working together to get that article up, as you may imagine he’s also a tad busy, especially as an attending.
  • Interview with an anonymous Stanford accepted medical student. She just moved into her place, and I’m moving out of mine, so our schedules are sort of not aligning. But, we’ll get it done.
  • Pack!
  • Attend three parties this week:  friends  only party (Friday, not classy), friends & family (Saturday, medium classiness), and a BUSM luncheon in California (Sunday, total class). They all fall back to back somehow, so it’s party central this weekend. I had to pick up a sports coat for my semi formal look (all I have other than that are charcoal suits).
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I’ve gotten questions a lot about how did I wear my hear during my interviews, like this photo above. I usually have my hair tied except when out and about, except after showering because the center of gravity and weight of my hair can give me a neck ache (seriously).
  • Finish the remainder of my aid paperwork. It’s a long story, but a while back quite a bit of money was stolen from my account, after a police report and what not I don’t owe the money. But, it did totally screw my credit while my accounts were closed and I didn’t have access to my own checking account (thanks Wells Fargo!). Anyways, so now I need to get a cosigner (parents can’t do it), I think I have one. The amount that I’m requesting is petty, in comparison to my actual debt, about 7K per year for living expenses. I’m trying with a cosigner now,  finished the paperwork, but the site is down, so we have to mail it in thus it’ll take time to learn the results. If you’re super rich and want to cosign for me let me know boy to become a doctor just let me know =).
  • Oh yeah, I also want to try to write stuff about myself every now and then, you know seeing as this is my blog =x.
  • Find time in there to relax.

If you decide to apply to medical school, you’ll soon be asking yourself too most likely, “How will I spend my final days”.

 

 

Moving to New England: Boston in 15 Days

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So, how long exactly does it take for a person to get ready to move from one coast to another?

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As I look around my room I see that I’ve packed and prepared absolutely nothing. Instead of packing I’m strategically procrastinating, not making my packing check-list, and instead choosing to: bake cheesecakes, write articles like this one, etc. Surprisingly, I’m not too caught up with the stress with the geographic transplant, somehow flying across the country just hoping you’ll get into medical school makes that one flight to revisit as a student a lot more bearable. In general, here’s my packing plan:

1. Get books to east coast somehow.

Probably, the most stressful part for is figuring out how to move my library of books. There’s several ways to accomplish this goal: toss em, ship em, leave them, or replace them electronically. I weep when books are destroyed, and it’s prohibitively expensive to ship these ‘bricks’. Thus, I decided to either box them up to store or to download digital copy’s of the books I already own. I’ve been rather successful at finding digital copies of my books at either Gutenberg.org or by enough sniffing around the web for PDFs. Though, bear in mind it’s easy to find copies of books when you read old books or stick to science and math — so, fortunately, I’m a boring person so it’s easy to find my books.

Book list that made the cut either with a digital copy or packed along:

1. Calculus Made Easy, Thomas (found digital replacement, but bringing original) — who doesn’t like a novel written on math from 100 years ago? I rather prefer the way math was explained before as opposed to now, so I prefer this book.

2. Age of Propaganda (digital replacement) — it’s a good book on both propaganda and advertisement, it was a mandatory read from an English course and I kept it. When applying to jobs, medical school, or residency it’s a good skill to know how to “sell yourself” and make your self “wanted” (although you’re probably not necessarily needed).

3. Medical Physiology Boron, Boulpaep (digital replacement) — this was the physiology book I had to refer to and present from during lab meetings, so I’m just familiar with the layout. My program will use another medical physiology text, but I will keep mine as well.

4. Communities of Discourse: The Rhetoric of Disciples, Schmidt, V. Kopple  (soft cover)– tackles rhetoric from various angles. This is a great book if you want to find your favorite writer to emulate. This is another book I received in class that I couldn’t part with after purchasing.

5. The Feynman Lectures on Physics , Feynman, Leighton, Sands (digital) — this book covers everything from physics, to quantum physics using vector calculus. I recently picked up volume I, but returned it after realizing I should just wait till I settle in to get all III volumes. I’ve now read all of volume I and have made it through most of II, and have dabbled into III. I won’t be wining in bets with Hawkings any time soon though.

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6. Ion Channels of Excitable Membranes, Hille (found digital copy, but probably bringing hardcover anyways) — this was the field and research that helped me get into medical school. But, really it’s more symbolic than anything, it was a mandatory read assigned to my by my old PI. It reminds me of those days.

7. The Human Brain Coloring Book, Diamond, Scheibel, Elson (soft cover copy only) — so, I bought this book during Neuroscience for undergrad but never actually colored in it. But, I did read the information, that’s actually all I needed at that time as I would draw out the brain structure. This time however, I’ll use it for anatomy in medical school as this coloring book series is popular.

I have another 60+ books (all science related), but the rest of them will get left behind in Sharpie marked boxes at my parents house. I made it a point to keep my undergraduate books, occasionally I like to read through them to see how far I’ve come or how much I’ve forgotten (something to justify all that money I spent on my education).

Clothes to pack

This is the easiest part. I live in California, we have four seasons: hot, really hot, kinda hot, and not that hot today. In Boston there will be spring, summer, autumn and winter. Therefore, my clothes from California are likely only useful for between a 1/3 or 1/2 of the year at best. So, most of my clothes can be left behind. The bulk of my clothes will be donated, undergarments with questionable structural deficits (holed-up knickers) will be tossed. I only need to worry about enough clothes to last a month or two, the rest has to be purchased while I’m out there (winter wear etc). I’m very sentimental with my blankets and my towels (I never got over the blanket phase?), so I’m bringing some items I’m already familiar with for comfort.

Electronic Stuff

The laptop obviously goes, not because it’s a good laptop, but just because of the data and programs on it — as you may imagine I’ll also be bringing my portable hard-drive  (Library of Alexandria) as well.  I’ll also be bringing my set of speakers (non passive speakers), and my favorite guitar.

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That’s actually just about it. I like starting from scratch, it doesn’t bother me to move around. Californians move around the state a lot, it’s rare for us to grow up in one neighborhood or one domicile, we’re known to even move around during elementary school — not that kids want to. So, I’m accustomed to losing everything and starting over from scratch, it’s practically “spring cleaning” for me.

Hm, it seems that be writing this article I’ve accomplished one of my goals, writing a check-list. I procrastinated my way into success.

 

 

Diversity — Undergrad Costs Harms Financial Diversity

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In the last two articles on impact of finances and financial diversity in medical school we’ve covered several topics:

  • The AAMC and the TDMSAS have recognized a correlation with MCAT & GPA and parental finances (this also includes other factors, such as parental education, household size, etc). Therefore, both agencies encourage medical schools to consider socioeconomic class (SES) within their holistic review of applicants. SES effects all ethnic groups and both genders, though some groups are more likely to have more applicants applying and designated SES.
  • We have noted that despite SES consideration, there hasn’t really been an appreciable change in the number of SES designated accepted medical students — calling into question the myth perpetuated by some that SES students are unfavorably gobbling up seats.
  • We also covered the obvious caveat to aggregated data, you can’t say much about an individual, all we can do is speak of trends.

Today, in this last installment, the last idea: undergraduate education is growing prohibitively more expensive, therefore it’s a moot point to later hope for SES applicants to flood the application gates.

The key to understanding what cost of living in a temporal sense is something called the Consumer Price Index (CPI) — it gives us a barometer of how much more stuff costs now than before on every day items. A rough explanation of CPI versus time is: a flat CPI trend would mean your money is worth just as much now as before, positive slopped CPI would then mean you can buy less of that item you’re using as an index, while if the CPI slooped down it would tell us we’re somehow getting more bang for our buck.  So, looking the graph below as an example:

This graph tells us that overall day to day items costs more than before, they were practically giving away houses in the early-mid 80′s, housing wasn’t a get rich scheme yet in the early-mid 90′s, and now housing is rather un-affordable, though there was a “crash” in prices that hurt you if you owned a house after 2008 (aka housing bubble). And the future of housing prices is unknown, you’d need a good risk analyst to give you a good prediction; but it looks like CPI will continue to rise regardless. That was a very long winded way to say stuff costs too much.

Now back to college stuff, undergraduate education costs are surging. In fact, the rising costs of college greatly dwarf the rising CPI and even the housing price increase we saw in the 2008 bubble.

Credit: Carpe Diem
Credit: Carpe Diem as referenced in a citation on BubbleBubble

The graph above demonstrates that while in general housing is pretty expensive, it’s eclipsed by the burgeoning tuition rates compared to CPI. Overall, undergraduate education is becoming less and less affordable to those with more meager financial support, and it’s likely the only mediation for these groups is either to qualify for more grants and scholarships or to take out additional loans. It’s also interesting to note that in the same period of time, there was a 4x raise in the cost of housing and medical school (when adjusted for inflation 2011 dollars), but during that same period undergraduate education rose by 10x.

Census Bureau data 1967-2011. Graph credit to Advisor Perspectives. Note that the top two quintiles are new additions, previously we restricted conversation to 1st-4th quintiles.
Census Bureau data 1967-2011. Graph credit to Advisor Perspectives. Note that the top two quintiles are new additions, previously we restricted conversation to 1st-4th quintiles — the first four quintiles are the same values as cited in previous articles.

This graph tells us what we already should of ascertained by now: some slivers of society are enjoying a better rate of average income growth given the same period of time, and there is a growing gap between the top quintiles an the lowers. Though, to get a more accurate picture we’d have to include the rate of inflation as in the graph below:

Adjusted for inflation (2012). Census Bureau data  1967-2012. Credit source Advisor Perspectives.
Adjusted for inflation (2012). Census Bureau data 1967-2012. Credit source Advisor Perspectives.

When we look at the data, and it’s adjusted for inflation, we get a more accurate financial picture. All the quintiles, with the exception of a slight creep up in the top two quintiles, all of them were more or less in line of each other from 1967 until about 1984. After 1984, the top 5% (the dash line) left all the other quintiles in the dust– though “top” quintile did see a steady increase. All the other quintiles pretty much make as much in 2012 as they did in 1965.  Now, if we look at this self reported household income survey from Berkeley, we can get a snap shot of one college (though it is scant evidence with n =1). I chose Berkeley simply because they were transparent with their data, there was no other reason other than it being a premed generating university:

Self reported income survey from the University of Berkeley.
Self reported income survey from the University of Berkeley.

From a snapshot of Berkeley alone, we can see that in fall of 2010 about 27% of the class claimed parental finances of $80,001-$150,000, 20% claimed $150,000+. While 53% claimed $80,000 and below –not allowing for us to figure how many actually got in from the lowest quintiles. In terms of who’s usually in medical school (the top and 2nd quintiles as displayed above),  the 53% Berkeley group would easily consume the bottom till the third quintile and still have enough breathing room to also constitute some of the top quintile. Whereas, the other 47% of Berkeley would be high flying into the top quintile with no reservation. From the start some undergraduate institutions already contain an unusually high family income, especially considering that the average family income is around $65,000. Therefore, unless a dis-appropriate amount of low financial quintile applicants are applying in waves, medical schools are somewhat destined to select from crowds who could afford to be at some universities anyways.

Unfortunately, there isn’t much medical schools can do to stop the undergraduate education finance bubble. Furthermore if college continues to become less affordable, medical schools will likely keep having difficulties recruiting SES applicants (regardless of race) in the first place. While offering pipelines and grants is a good start, to make a real dent in the problem college has to become more affordable — unless someone can explain to me why my 4 year medical school bill would be less than a 4 year degree from Columbia in Fine Art (Columbia tuition is ~$56K per year).

I would like to thank Jesse Columbo for pointing me towards sources. He’s an astute financial analyst, contributor for Forbes; and also given credit by the London Times for predicting the US housing crash in 2008. His articles make for a good sobering read, he’s currently leading the scoop on the education bubble as well, click here to read more of his work: http://t.co/31Is0NjYnt