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Diversity — The Impact of Premed Financial Diversity

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I have been asked, “Why is diversity even a subject of discussion for the inclusion criteria of medical school at all?”

So, I’ve decided to take some time to write an article (or two) about diversity in the AMCAS/AAMC process, and speculate as to why diversity is an important selection factor. The assumed priori against the inclusion of financial diversity as an selection factor is that all applicants have equal access and opportunity; in other words in a perfect world it’s challenge of brain versus brain and we all start off on equal footing.

1) Parental income is positively correlated with applicant MCAT average scores in both the AMCAS and TMCAS (not shown, you can find the trend here), the more income the higher the score is the trend.

2012 EO-1 Applicants' who's parents less than bachelor degree, EO-2 applicants' parents with at least bachelor and unskilled labor as a profession. EO-3, EO-4, and EO-5 all represent bachelors, masters, or doctorate degrees with executive or professional positions.
2012 EO-1 Applicants’ who’s parents less than bachelor degree, EO-2 applicants’ parents with at least bachelor and unskilled labor as a profession. EO-3, EO-4, and EO-5 all represent bachelors, masters, or doctorate degrees with executive or professional positions.

We see a rather straight forward trend with the data from the AAMC, the more well off the applicants’ parents the more on average you could expect their MCAT score to be. Of course, this doesn’t mean well off in the EO-5 will score higher nor does it mean their parents will be all that supportive either. The vice versa is also true, you can be in the EO-1 and still destroy the MCAT — it’s just that either way would “buck” the trend projected here. Long story short, the more money your parents have the more likely you are to have a higher average score — we should also note that the applicants with very elite parents (EO-5)enjoyed a comfortable average around the accepted MCAT score level (around 31 in 2012).

2. Graphing the application year versus average GPA scores we see a subtle creep in grades. Overall, applicants and matriculants have higher GPAs every year; assuming individual effort is equitable, there’s a trend of the more affluent (SES D) achieving higher GPAs versus their poorer friends (SES A).

Data take from report, and graphed with Sigma Plot.
Data take from report, and graphed with Sigma Plot. Most to least disadvantaged :: SES A to SES D * We’ll revisit this chart in the next article.

Interestingly, there is also a slight but definite change upward movement in both the applicants and accepted over a 10 year period. While there are likely other factors (such as re-applicants), we can then start to wonder is everyone getting smarter or is the application pool just trending more towards the EO-5 group. We can only wonder what the new MCAT will do to scores.

3) There is a trend that accepted students are growing part of the upper class (US census data):

The average median income for applicants' parents was $57,000 in 1987, it is now $100,000.
The average median income for applicants’ parents was $57,000 in 1987, it is now $100,000.

The AAMC states that the median income for applicants’ parents was $57,000 in 1987, it is now $100,000 — even with inflation, this is a remarkable growth. As we can see from the image furnished by AAMC, there hasn’t the bottom financial quintile of applicants has barely increased at all, whereas the top quintile are pouring into acceptance bliss. This can be reflected by merely looking at the next figure, this figure demonstrates the national average of the make up of applicants’ financial standing:

makeup
About half of the medical students will have parents in the top quintile.

From the graph above we can see that there really isn’t all that much “financial diversity” in the economic standing in the make up of the average medical school class. Around 50% of the class is expected to be at least in the highest quintile. around 10-15+% in the fourth quintile, ~10-15% for the second quintile, and 2-5% in the lowest quintile. Though, not shown here, it should be noted that many colleges also trended towards similar break downs in parental income.  Therefore it’s not as if medical schools are trying to build their ranks with wealthier applicants, it’s just happens that survivors from the premed hunger games are the more wealthy.

So, for what it is, the data suggests that parental income is positively correlated with applicant MCAT average scores in both the AMCAS and TMCAS (see link), the more income the higher the score is the trend. There is some reports not discussed here that finances are positively correlated with successful completion of college degrees in the US. There is evidence that there is a difference between applicants when it comes to finances and it’s effects, therefore it’s warranted that socioeconomic standing is indeed an area worth it to diversify in if physicians are truly one day to mirror the cut of society they serve; because at this time there isn’t all that much diversity in income and it’s getting worse.

It would be inappropriate to assume that money buys success or hard work. I can guarantee you everyone in medical school worked for it, but this story isn’t medical students it’s about the applicant pool. Instead,

Part 2:  the effect of SES status, diversity and GPAs

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AMCAS II Question Ex.1: Why This Area? — My Example

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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

Why I Chose to Go to Prison

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Why do you have a whistle on your key-chain?”, said the random stranger at Starbucks.

“For self-defense in case I’m shanked in prison”, I replied while sipping my latte.

Previously, I may have mentioned that I volunteered with inmates at a correctional facility for academic advising and tutoring. As I was a premed at the time, this may come as a surprise as it did to the inmates I served. They had a hard time wrapping their minds around why “they” were included in my schedule at that time: I was also working as a tutor (premed stuff) and a low income tutor for free (this was supposed to be paid actually haha) K-8th grade, taught for various elementary school science enrichment camps, and volunteered a few hours a week teaching science/math to long term inpatients in pediatric oncology — I took a gap year after graduation and the MCAT, so I had a lot of time to see my community. After explaining my background to them, I even noted the strangeness of how it all sounded compared to my cohort who were usually there interest in working within the corrections system.

As a tutor, I usually the best way to start a  tutoring session is to give some background about ourselves, including my own experiences and why I’m tutoring at all — I suppose people enjoy me sharing my vulnerabilities when they too may feel vulnerable. So, I did the same thing with the inmates, I told them about when I almost gave up on school completely.

You see, I was held on suspicion of armed robbery for a bank that I’ve never: seen, been to, or even knew of its existence. You’re probably wondering how this went down. Well, this happened many years ago when I was still at a community college, so right after high school. I had a college fling, and I was on a date at the time. So, as dates do require money, I decided to withdraw additional petty cash. I left my date in the car, leaving my date and my car out of sight by about 200 meters. I’m not even remotely close to the bank yet, and a squad car pulls into the drive way and rushes to cut me off. And then came the repeated questions of why was I in the area, what was I doing, what was my major, who was I with. Every 5-minutes one officer would ask me the same battery of questions, no less an attempt to catch me in a lie. However, I was simply on a date, so it was easy I just told the truth. That went on for about 45-minutes, as I stood at the cop car with my pockets turned inside out, hands on the dash, all while curious passers by stare and are likely proud one less ‘criminal’ is on the streets. Things did get a tad more serious when they decided to detain me, in the back of the police car. Until that time, I had never been in the back of a police car — it’s very uncomfortable.

So, finally, I asked my captors, “So, why exactly am I here?”.

To that they replied, “There was an armed robbery at X bank, in Y city, and you match the description”.

“Well, what’s the description”, I responded, chuckling at my fate all the while.

To that they replied, “Black male, blue jeans and a white or grey t-shirt”.

“Awesome”, was the only thing I could then say.

Well, I knew I was pretty f*****d at that point haha. Fortunately, I was eventually released two hours later, but not before being another police officer, not knowing that I was going to be released soon, yelled “Go get some chicken boy!”. That was my first time being called “boy”, despite the fact that I was pretty sure I was a man. Prior to this experience, I was an honor roll student in high school and placed in the top 5% in my HS class in testing, I had even won a scholarship I was holding onto. But after, I almost dropped out of school completely and started working. I suppose I was just disenchanted with society, where I could play by the rules and still be treated like I did something wrong. At the same time, I started to wonder how many other people got fed up, and fell into a bad cycle themselves.

My second brush with the law was when I was the victim. I was teaching my friend how to drive stick in a parking lot at night, some drunkard through a beer bottle through my driver window hitting me square in the face. Then he proceeded to punch me in the face while I was still strapped into my seat belt from the broken window. In his drunken tirade he was screaming about local cars being stolen, and I suppose he figured it was me? He then ran off, it happened so fast even my friend who was now covered in my blood had no time to react. We called the police, told them what happened and they called the ambulance because I had blood bubbling and frothing from a hole in my cheek. During my questioning, the police dismissed my report of what happened. Instead, they argued that I was likely in a gang and didn’t want to share the details of the brawl. I went to the ER, they stitched up my face and told me I’d best call off work/school because my face is going to well like a bowling ball — it did. I still have a scar that people confuse for a dimple now, good job doctors!

Yes, first I rob banks without showing up to them, and I’m also unwittingly in a gang. This was another blow to my outlook on life.

When I was still in elementary school my mother told me that it was very important that I comply with the police, and it didn’t really matter if I did anything wrong or not because the end result was never good for us. It pains me to say that she was right. Though, I never told my mom this story, I don’t think she’d take it well. The only reason I was released that day was because my date didn’t match the getaway driver’s description. If not by chance, I might of been in prison or at least in court to fight something I had never done. So, convicted or not, guilty or not. I just want to see a person, and I wanted to learn how to see people and not their pasts; therefore the prison experience with the inmates was a great time for me. Besides, whether or not you like it, those people will eventually be released back to your community. Thus, we can either help to rehabilitate them or lot them rot in crime college, I chose the former.

When I tell them my story, they usually reciprocate with their own stories about when they were teens. Suddenly, you have a room of buff tattooed men in different gangs/races, who usually don’t speak to each other, having a heart to heart about their feelings. The trick was, as it was for me, to turn those negative feelings into positive action and break the mold others set for you.