If you’re currently applying to medical school, you’ll likely soon start to receive secondary applications, congratulations on making it this far. Please pay particularly close attention to your first couple of secondary applications, you’ll be able to use the husk but not the heart of essays you’ve already written from other institutions. Also, during the beginning of this period, it’s easy to rush things out the door and wish you hadn’t afterwards. So, before we start I’ll remind you to proof read for typos and word transpositions (this will happen if your word processor auto corrects). Also, most importantly, make sure to never make the mistake of confusing one school’s content for another on an essay. To help avoid these mistakes use your friend Control + F to find your mistakes quicker, then print out the real secondary. Take a high lighter and lots of coffee, and make sure you don’t misidentify a school and caught most grammar and typos issues. On your computer I suggest that you make a folder called AMCAS Secondary Entries, make sub folders for each school and place their secondary essays there. Inside the main folder, AMCAS Secondary Entries, keep an Excel sheet to keep track of what types of essays you’ve written already and the character length — this will help you to make a strategy later when you’re exhausted and can’t imagine writing yet another secondary.
How to handle the “Why this area?” question
There is probably a plethora of reasons you want to go there, most of them are hopefully genuine. From your genuine reasons, pluck from them the reasons that best align with the mission and strengths of the program and their surrounding area. Also, you can tailor this entry by doing background information on the school and who they intend to serve — if you’re admitted, these are the people you will be serving. When you see similarities between those you will serve it’s a good thing. Note, this cuts across class, race and gender. What you’re trying to do in this entry is convince them that if you’re admitted you’ll be happy about your choice, and you gave it some thought. While it’s true that from the applicants’ perspective any medical school is good as long as they are accepted, The reciprocal: all accepted are good for the medical school, that is not necessarily true. In other words, a school will not invite you for an interview if they feel you haven’t really given it thought of why you want to be there — and that’ll either be obvious in this entry or during the interview if invited. Here’s one of mine:
A mentor once taught me that insensitivity makes arrogance ugly; and empathy is what makes humility beautiful. If accepted, my new mentors will forever craft my philosophy as a future humble physician. For this reason, I chose Meow-Mix Medicine School (MMMS) because the school’s core values of excellence, collegiality, and integrity. I believe becoming a medical scholar, in a new community, will prepare me for a successful career as a physician and advocate for the underserved.
MMMS integrates science theory and medical practice early; this is reflective in the school choosing to concurrently teach the basic sciences and the principles of medicine. MMMS hones medical student’s clinical problem solving skills by integrating the basic sciences patient care through small groups. My own experience in electrophysiology lab, and leading small lab discussions on preeminent research and physiology, taught me that often the best way to learn was to correlate theory with application via experience and in-depth discussion with mentors and peers. MMMS learning style encourages collaborations between training physicians; I believe this learning environment will foster excellence in the student body, as delivering stellar health care is a team effort.
MMMS keeps its medical scholars connected with the local community by providing comprehensive healthcare to vulnerable subjects by providing free health screenings to the local Kitten community at the Meow-Mix Area Health Education Center. A family shouldn’t have to choose between food and proper medical treatment. Additionally, I find it encouraging that MMMS has strong patient advocacy for underserved populations through organizations such as the Meow-Mix Meow for Health Program.I believe MMMS has a strong emphasis on patient beneficence without discrimination. MMMS commitment to the community, research, and education will prepare me for a life of service as a physician.
This the longer version (recall that you’ll different schools have different character count requirements), and experience with writing a bunch of these will allow for your to better tailor your entries. I found all of the information by data-mining (stalking) the medical school: checking their Tweets, blogs, Facebook entries, Youtube. Even if a school is huge, the department medical school PR “concept team” is usually rather small and intimate, so sometimes being the only person who watched that “wonky” video with 200 views puts you ahead of the pack. Of course I looked at their website and MSAR, but that’s sort of a basic requirement nowadays. By the time I wrote the “Why Here” essay I knew so much information about each school and area that it actually made the decision of where to matriculate to an arduous one because I taught myself to love each program I interviewed.
Note: there’s a good chance that I changed the name of the university for mutual privacy, or the proper nouns I used really exist — equally likely =D
I’m sure I was asked,”So, what type of doctor do you want to be?”, in several hundred forms. When I was a premed, I didn’t openly declare it, so I was pelted by this query too frequently early on. I sort of did premedical classes on the side, not really thinking much would come of it, besides the physiology minor that had overlapping courses. It was really much later, when I started studying for the MCAT that I started to be asked this question. During the MCAT, I found it easier to concentrate when I wasn’t at home, so I studied almost exclusively at Starbucks — I’m a proud gold member. There’s a consequence to being the MCAT Starbucks hobo, you engage in a lot of random conversations and you get asked the dreaded “What type of doc?” question. It may surprise you that a lot of people, both premed and medical students, may struggle with this question — neither the less it’s true.
To illustrate my point, at BUSM I met an attending physician who started off with the intent of going into family medicine, but they are now a trauma surgeon at the busiest trauma center in the region. So, I know I’ll probably waver in my choice, so I’m not that interested in pinning down what I’ll specialize in yet. There are over 120 specialties and sub-specialties, so I’d like some time to mull over my choices more during my M3 time. During that time, I’ll be during rotations so for now I’d rather focus on just making sure I’m competent during M1 and M2 — with a strong foundation anything else is possible.
What I think I’ll do…maybe…
Though, it’s not like I’m going into the process completely blind, I do have a vague idea of what I’d like to do; though, both choices are pretty far apart. I’m interested in cardiovascular medicine (preventative and/or possibly invasive). There’s two reasons for this: 1) my research during college involved me interpreting and crunching numbers from an oscilloscope on muscle tissue and heart is just a specialized type of muscle tissue, and 2) I like many others have seen cardiovascular disease take loved ones away (and a lot of it is rather preventable). During the course of my research project we had to work more with molecular biology, and although I studied a different signaling cascade, I became interested in cellular signaling disruptions and it’s relation to cancer. Later, I volunteered in a children’s oncology ward where I taught science and math to inpatients to help them keep up with school. For totally different reasons I was a constant inpatient growing up as well. Spending time with these kids was probably one of the highlights of my life for a variety of reasons.
Specialty according to survey
Well, I did take one of those specialty finding surveys last year while I was interviewing for fun. You can find a few medical specialty surveys out there if you Google around for them. There’s also one sponsored by the AAMC, but you need a “careers in medicine” upgraded account to access it (free for medical students, cash membership for others). Anyways, here were my survey from results said (several months back):
Surprisingly, cardiovascular medicine didn’t show up in my top 10, but medical oncology and radiation oncology came up as my #1 and #5 respectively in this survey. I really have no idea what I’ll do to be honest, but I’ll definitely will keep medical oncology research opportunities in mind. Though OB/GYN part shocked me, I’m not even sure what to do with babies when they’re near me — I tend to hold them lack a sack of musky potatoes. Hematology wasn’t that big of a surprise either, but plastic surgery in general was. I used to have to do micro dissections of a mouse palm, pulling two muscle groups out without significantly damaging the muscle fibers. If you were sloppy, and “manhandled” the muscle fibers the whole surgery was a waste of time, as was the whole experiment day. I both loved and hated this type of task, I suppose it’s not that far off from surgery. I liked the physical part of the task. But, what made it annoyingly tedious was that you had to pin muscle groups down with pins, handled by tweezers, and do the whole procedure with tiny tools using a dissection microscope. That means that all of my movement was always backwards and upside down. I suppose in human surgery I’ll be able to see straight, that might be a lot cooler. So, I’ll keep surgery in mind as well.
Well, if you’re like me and have no idea what you’ll specialize in, don’t feel alone! I have a hard time even deciding what I’ll eat for lunch.
The Ever Changing Abortion Laws…
No matter where you stand on the issue, abortions are a medical procedure, so it’s under the purview of what it means to practice as a physician. Prior to even becoming a physician most medical school applicants will leap frog around state to state, with each state having it’s own politics, laws, and culture. This idea may sound odd for both US citizens who haven’t traveled much and my foreign readers. To put it bluntly, each state has its own constitution and bill of rights. Each state entered a binding agreement to join a union, hence the United part of the United States, and we are all binding together by federal law. In general, federal law trumps local state law — for example, it’s legal to buy 28 grams of marijuana if you of legal age in the states of Washington and Colorado, however it’s still against federal law so technically you can still be prosecuted by the district attorney representing the federal courts. This situation leads perplexing, and often conflicting laws that physicians must abide by that are state dependent. This is true as well for abortion, because despite a federal ruling (Roe v Wade) there’s still a contentious debate about the issue, and the results are disparate state laws.
Keeping track of the laws is a job within itself, however, we should count ourselves lucky that Mr. Roberto Villalpando compiled a series of charts with “pretty colors”. But, remember that abortion legality and policy is a moving target so remember to check for applicable updates or revisions for your state of interest:
Temporal Allowance of Abortions: all states allowing for abortions have windows where abortions are allowed, there’s a wide spectrum in what’s considered a legal abortion.
In some states abortions are requiring abortions to be performed at hospitals as opposed to out patient clinics — the grey states have no laws on the books specifying if they patient needs to be admitted into a hospital to have the procedure performed.
Some states require a licensed physician to perform the abortion. States in the grey also allows for other health providers to perform abortions, for example in California both Physician Assistants and Nurse Practitioners may perform abortions without direct supervision of a licensed physician.
Some states require a waiting period prior to abortions (typically around 24-hours). In some states this rule is waived if incest or rape occurs. These waiting periods are somewhat controversial, in some states pregnant mothers are mandated to receive “educational material” in an effort to get them to “rethink” their decision. A few states even mandate that at least two visits are required to receive an abortion. Whether you agree with the laws is a disparate issue, thus you should know that the laws exist whether you agree with them or not.
A lot of premeds don’t know this, but in a lot of states the parents of a minor do not have to be informed that their child is receiving an abortion. Regardless of your personal beliefs do note that violating a minors privacy in some states may constitute a breach of patient rights.
Other interesting notes on abortions laws:
* Most states have a provision allowing for a physician to refuse to give abortions due to their own personal beliefs in a life (maternal) threatening situation.
*I encourage you to become aware of your state’s law, whether you intend to stay local or travel for medical school and future potential residencies. http://www.guttmacher.org/statecenter/spibs/spib_MWPA.pdf
Source date May 1st 2014
Updates to end 2014
This year (2014) in Missouri, a bill being submitted to shape a law that would require written approval of the father consenting of the abortion to allow abortion, as stated in the bill:
“No abortion shall be performed or induced unless and until the father of the unborn child provides written, notarized consent to the abortion.”
The bill does make one noteworthy loophole to gaining consent for women who become pregnant as the result of rape or incest: legitimate rape.As quoted in an interview, the Republican sponsor of the bill Rick Brattin defines the argument as such
“Just like any rape, you have to report it, and you have to prove it… So you couldn’t just go and say, ‘Oh yeah, I was raped’ and get an abortion. It has to be a legitimate rape.” — Rick Brattin
If you’re scratching your head about the term “legitimate rape”, you’re not alone as this author is also bewildered — I could digress into a whole other article on the term. Unfortunately for women public health and those perhaps not represented by such far-right conservative principles (especially as from 2014 until 2016 these parties will be in control of both the Senate and Congress), we should expect more laws created to chip away at Roe v. Wade in the years to come.
As a future physician it is your duty to have sound “scientific literacy”. In in fell swoop I’ve answered the question stem to my blog entry, job well done me, time for a pint — oh wait, you were expecting an actual entry, back to work me. Alright, so you’ve decided to take the physician plunge (make sure you learn the secret premed handshake) so let’s discuss those arduous prerequisites. It’s a time honored tradition for premeds to bemoan the seemingly esoteric course work required just to get into [US] medical schools. But, I believe most premeds miss the intent of the rigorous coarse work, falsely associating it with some type of twisted sadism created with the sole intent to crush your soul. As a reminder, the typical premed course work consists of a year of:
- General Chemistry
- Organic Chemistry
- Biochemistry *optional at most schools
- Upper level math
Along your coursework you’ll probably eventually encounter this famous quotation incantation or another “Biology is just chemistry, chemistry is just physics, and physics is life”. If that doesn’t encapsulate the importance of the medical school prerequisite consider that, as a physician, you will be expected to not only have an empirical understanding of medicine, you are also expected to be able to understand and even take educated guesses. The prerequisites will serve as your foundation, when you become well versed in these courses making the leap into the MCAT will seem less intrepid. In addition to science content topics, the MCAT will test scientific inquiry and reasoning skills:
- Knowledge of scientific concepts and principles
- Scientific reasoning and evidence-based problem solving
- Reasoning about the design and execution of research
- Data-based and statistical reasoning
(Hilborn & Friedlander, 2013)
Medicine is changing faster than ever, and it will likely continue to do so. To stay in lock step with this evolution requires physicians to not merely be clinicians, and this requires premeds to obtain more than a sophomoric understanding of the core science breadth.
Don’t get me wrong, you can get pretty far on empirical data, typically it’s more important to know which medicine to use at a given instance than understanding which amino acid residue is phosphorylated. However, at the same time, if you limit yourself to not understanding how things work you’ll be doomed to memorize everything because you won’t notice the patterns except from experience (not that there will always be one). Personally, I feel doctors should understand the medicine and tools they are using: you should know how hydrogen atoms correlate to MRI scans while searching for tumors, understand how lens properties effect focal length and power of the eyes, and why high doses of potassium can be fatal. There’s a lot more to being a doctor than being a scientist, but if you don’t revel in the thought of science meshing with medicine than you have long torturous journey ahead of you.
There’s a lot of ways for you to deliver positive outcomes to your fellow man, and a lot of them wouldn’t require these prerequisites, MCAT, nor over a decade of education and nearly a quarter million dollars in debt. But, it takes a special type of sadomasochist to enjoy what it takes to serve people as their physician. I don’t want to discourage anyone from medicine, but just remember if you’re going to be a patient advocate, a physician, you better be okay with having deep ‘scientific literacy’. It’s just your responsibility.
twitter: https://twitter.com/doctorORbust For more research literature about the MCAT see:
SO, what is the admissions process?
You’ve probably scoured the internet trying to find the answer to just this question. The good news is that there are not many steps, the bad news is that each step is challenge in itself. In a nutshell all you need to do is take the premed prerequisites of the programs you want to enter, take the medical school admissions test ( referred to as the MCAT), and turn in a primary application through a system called the AMCAS and turn in secondary applications to individual schools. And if all goes well you interview, and well get in. Biggest advice I can give is get that application in early, that is the first week or two when the application window opens. If you want a concrete and concise road map for applying to medical school I’d highly suggest picking up a book off of Amazon called The Medical School Admissions Guide by Suzanne M. Miller, MD, you can follow her on twitter @MDadmit.
Step 1: Finish or finish off most of the prerequisites for medical school.
This can be trickier than it may appear, because there is some variation in what each medical school you apply to requires as prerequisites. Ideally, you want to apply broadly, so don’t get lulled into the trap of taking a narrow set of prerequisites just to fit your dream program. Admittedly, no matter your stats applying to medical school is somewhat of a numbers game, so it’s important to apply broadly. Moreover, the prerequisites aren’t simply hurdles meant to weed people out, instead they are meant to prepare you for the rigors of medical school; and ultimately these courses will serve as your science foundation as a physician later. Interestingly, when medicine schools first hit the US the most important prerequisite was anatomy. At some point they realized that memorizing gross anatomy didn’t necessarily have a positive correlation with training good physicians. So, over time the current stereotypical required course lists evolved into what we see now:
- a year of General Chemistry (lab + lecture)
- a year Organic Chemistry (lab+lecture)
- a year of Physics (lab + lecture)
- a year of Freshman English (this should include a critical thinking course)
- a few upper level math courses (Calculus and/or Statistics)
However, as science and our understanding of what it takes to make a good physician evolves so does the need to add more courses to your breadth. Don’t shy away from the “recommended” courses as they’ll give you a leg up during the admissions process (well, if you do well on them) and on the MCAT:
- Molecular Biology
Step 2: Take MCAT — hopefully only once.
The MCAT (Medical College Admissions Test) is often billed as the hardest entrance exam in the US. As the MCAT itself also evolves its important to go straight to the source: https://www.aamc.org/students/applying/mcat/. The MCAT has three sections, Physical Sciences, Verbal Reasoning, and Biological Sciences, each section is scaled so that each section has a value of 15. The maximum score is 45 (3 sections, 15 points each), but typically the highest score achieved each year hovers around 42 — not a score to laugh at. The average score among all test takers ends up being about 24 with a standard deviation of about 3 points, scoring at or over two standard deviations means you had a pretty good score i.e. the magic 30 or higher score we all lust over. So, your goal is to get your 30 or higher on the real test, and to never take the test again unless you believe you can do significantly better than the first time (within a standard deviation or two). After you take the real MCAT, it’ll take about a month to receive your score, so you must include this month in your time table of medical applications. It may comfort you to know that the MCAT wasn’t designed to keep people out of medical school, it was implemented because the drop out rate in medical school was atrocious, so they’ve done more to mentally prepare people before taking the medical school plunge. Ideally, you should finished your prerequisites prior to taking the MCAT, though merely anecdotal I have known one person that did just fine on the exam without finishing all of the Organic Chemistry sequence — but, that person was an exception to the rule and Organic Chemistry is only glossed over on the MCAT compared to the rigorous year sequence. Though, if you got destroyed in Organic Chemistry lectures you may differ in my opinion of how lightly Organic Chemistry is covered on the exam. To prepare for the MCAT you have several avenues:
- take a preparation course
- self study
- take a preparation course then self study to fix you weak points
There are pros and cons to all of the options above. The pro of taking a prep course is that you’ll have a guided and structured method to prepare for the MCAT. Some prep programs also have the benefit of teaching test taking strategies, though it’d take a lot of practice to actually be able to depend on them come test day. The con is the cost, and perhaps lack of flexibility to deviate from the schedule. If you can afford to take a prep course I would suggest you do. I self studied, so I can’t make any specific suggestions about which prep program is the best. Typically people end up taking Kaplan, but this is probably because it’s a lot easier to stumble upon a Kaplan prep center than any other prep course in my opinion. What ever you pick be ready to shell out several hundred to a few thousand dollars. Again, having self studied for the MCAT and I did just fine, so it’s by no means impossible to pull it off by yourself. The largest pro to self studying is costs (if you’re internet savvy you may find quite a bit for free). Another pro is that, you get to learn at your own pace, but that could also be a double edged sword. The cons are blatant, you’re on your own when it comes to everything from understanding to scheduling. Be honest with yourself, if self discipline isn’t your thing then a prep course may be the way to go. If you decide to self study, then you’ll have to find a self study prep package that works for you. I used ExamKrackers study package plus their Audio Osmosis. Later, after to get more exposure to material I added in a Princeton Review science workbook. If you have the time and the money, I think the best route would be to take a prep course then take several months to self study, this worked exceptionally well for a friend. [I may add an additional entry on the MCAT should it come up]
The most important part of prepping for the MCAT is taking practice the official AAMC practice tests. Until you have a few of those under your belt don’t even consider taking the real test, because nothing in your prep material is going to be as close to the MCAT as the MCAT. Just go to the official AAMC they’ll have plenty of information about how to purchase access to legit MCAT tests, a little birdie told me that some of the old versions can also be found on bittorent.
Step 3: Fill out an AMCAS primary application and all it entails.
Ready for more acronyms? Well, after you finish your MCAT you’ll likely become very ‘intimate’ with the AMCAS (American Medical College Admissions System), affectionately uttered as one word by all those who toil under its rule. The AMCAS is a general application that you feel out, called the primary application. And at the end your click some buttons to select schools and drop loads of cash (unless you qualify for Financial Assistance Program, I didn’t fyi). The primary application will consist of:
- the BEST Personal Statement (PS) you’ve ever written
- course work plus grades (all college level work regardless of institution)
- MCAT score
- Letters of Recommendations (LORs)
- Resume / Curriculum Vitae
- Submitted Transcripts to verify your entries
It goes without saying that your PS and resume sections should be well written and concise. Don’t feel pressured to push the character limit, don’t fall into the college trap of feeling compelled to reach a good ‘number’. Instead, focus on being succinct, what can be said in ten words is always better than blathering about it for 100. Also remember like most things: quality trumps quantity. So, for your LORs it’s better to have 5 stellar LORs than 10 generics. With that line of thought, don’t feel compelled to jam space filling entries into the resume section. I will tell you that I went well under the character limit for the PS and didn’t use all of my resume entries because I didn’t feel it was necessary. Though, in the end the primary application is mainly a test of how good you are at data entry. It may take up to 6 weeks for the AMCAS to verify your course / grade entries you self entered. Each time you enter a course you must also classify it, this is usually the trickiest part. Though, I’ll save you the stress and tell you that you can easily find most of proper classifications if you follow the link and DL the pdf here. If you did everything write, and everything is received, AMCAS will ‘verify’ your application, as well as give you a two new GPAs one for the sciences / biology and another for everything else. If you AMCAS finds issues with a lot of your entries they may return it to you for corrections. After verification you’re ready for the next phase of applications, choosing schools to apply to. If after verification you find issue with AMCAS evaluation of your transcripts and GPAs you have about 10 days to petition. I petitioned successfully, this helped me raise my science GPA up, so it’s worth the effort if you think you have a case.
Step 4: Choose schools after being verified. *Though you should already know which schools you intend to apply to.
Getting verified is quite a relief, you earned a beer if you got this far. After AMCAS recalculates your GPA don’t be surprised if it drops (though typically it’ll be nearly the same). Now its time to pick schools, this can be hard to figure out. In general I suggest purchasing the Medical School Admissions Registry (MSAR), look at each school, and make your own ranking depending on what’s important to you. US News rankings are useless in my opinion, find a program that fits you as far as mission statement, stats, costs, location etc. Also, the first school you apply to will cost about ~250 (I forget the exact amount) and each additionally school after that will cost about 35 dollars. Make this cycle your last cycle and try to apply to as many schools as you can both afford and finish secondary applications to. For most people 15 schools is a good number, 20 if you are nervous. Anything after 20 is a waste of time because you probably can’t complete more than 20 secondaries without them starting to drop in quality.
Step 5: Fill Out Secondaries as they arrive.
Pretty much enough said. Some schools will automatically generate a secondary for all applicants with a verified primary application, while others may screen applicants prior to asking them to fill out a secondary. Sadly, a few schools even ask for you to pay for them to screen you application in the first place. Secondaries range from school to school, so you will no longer be doing a general application, instead you’ll be inundated with various log-ins and passwords to use to enter your entries per school. The content of the secondary varies greatly from writing many small entries, to writing very lengthy essays, all the way to just slipping a check in the mail. Each secondary will run from 75 to 150 dollars — make sure to save that tooth fairy money.
Step 6: The waiting game: Interview Invites & Rejections
Schools will call or email you to invite you to interviews, or the worst case scenario to email you to let you know they are not interested in you. If you did things right you’ll have a few interviews lined up, and you’re ready to think about “interview day”. If you receive nothing, you probably already have a good idea of what may be the problem i.e. grades, MCAT, PS quality, experiences, so do what you need to do to address your shortcomings. After your interview there are three fates: accepted, wait list, and rejected. The best news would be an acceptance, after a school makes an offer you pay a deposit to hold your seat. You can accept as many offers as you’d like to, but you can only have on offer after May 15. If you get wait listed, there may or may not be a priority wait list, also schools may or may not rank you by number. If/when the matriculate dust settles they offer spots to fill up the remaining seats prior to school starting. Being on the wait list is probably stressful, I was fortunate enough to not be left in limbo, and was accepted straight out to the program I wanted into. I’ve heard of people being wait listed all the way until the day before the school year starts, so there’s hope for those who wait list even to the last second. Now, you could also be rejected (received two myself), you’ll have to learn how to get over it, and move on. Just remember all you need is one acceptance, and a rejection doesn’t necessarily mean you’re not fit to be a doctor instead they may just feel you don’t fit their program. Best of luck, for more info drop a comment or message me on twitter https://twitter.com/doctorORbust