Med School Confidential

by Robert H Miller

  Start broadly, gradually narrowing your search and shortening your list as you receive feedback from your premed advisor and learn more about what schools offer.

  Choosing which medical schools to apply to will be an ongoing process over the next six months or so, so don’t feel that you need to make any final decisions today. (Chapter 6 covers this process in detail.) Gather information and advice from a broad range of sources. Remember that family, friends, mentors, and your premed advisor will all weigh in, but ultimately, the decision about where to apply is yours to make.

  Take the MCAT in the spring

  As mentioned previously, it is optimal to take the MCAT at the April administration of your junior year, or, if you are applying postbac, in the April prior to application season. Ideally, you will have just completed your premed studies and will be primed to perform on the test. By taking the test in April, you will ensure that you have your scores back in June—well before your applications are due, which will give you more insight into your strength as a candidate and more opportunities to hone your strategy.

  Soliciting letters of recommendation

  By midspring of your application year, your file should really be starting to take shape. The next step is soliciting your letters of recommendation. Most schools require at least three letters, two of which should be from science faculty at your undergraduate or premed institutions. Typically, you will solicit four to six letters and ask the writers to send them directly to your premed committee. As discussed above, the committee will, in turn, review the letters and your academic record and then write a cover letter of recommendation. They will then send all the letters directly to the schools you’re applying to. If your school does not provide a premed committee or if you have been out of school for some time, you may elect to hire a commercial service such as Interfolio (www.interfolio.com) to handle your letters of recommendation for you. For a fee, such companies will collect your individual letters of recommendation and send them to specific schools by specific dates. This spares your letter writers from the need to send individual letters to each school you apply to.

  The key to getting a good letter is identifying someone who knows you personally, can speak to the quality of your work and work ethic, and can address your fitness to be a medical student. In general, letters from celebrity figures like senators, governors, or hospital CEOs do not carry much weight with admissions committees unless the celebrity recommender can actually comment substantially about your candidacy. Similarly, letters from family members or direct personal friends without a professional tie are of limited value. Further, professors who are just looking at your resume and don’t know you personally rarely write convincing letters.

  “But wait a minute,” you say. “The premed courses at my school all had several hundred students in them! How was the professor supposed to get to know me personally?”

  We’re glad you asked that.

  If you find yourself needing letters from faculty who don’t know you, you’ll need to help them get to know you! Schedule appointments with those professors during their office hours. Drop off a copy of your resume and a one-or two-page prose “bio sheet” in advance to help highlight who you are. At the meeting, discuss your resume, your life experiences, and your broader goals and intentions with them. Help them get to know you as a person so they can illuminate your recommendation with some personal observations.

  “When I was a premed student, I shadowed my own primary-care doctor every Tuesday morning for about two months,” one mentor explained. “I would meet her at the hospital, do rounds, and then spend a few hours in her office seeing patients. It was an extraordinary experience for me, but it also helped her get to know me better and, thus, to write me a more meaningful recommendation.”

  “I used a potpourri approach for my letters,” Pete notes. “My first and strongest letter was from a physician mentor who knew me very well personally and professionally. My graduate school advisor wrote one for me, as did my employer in Oakland. My premed advisor from my postbac program did a phenomenal job in collecting comments and putting together a letter on my behalf. I do recommend getting a variety of people to write for you, and making sure they know you well is certainly the most important piece.”

  “I think getting letters from professors is good, but I think it is best to get letters from people who know you well,” Carolyn says. “I felt okay about getting a letter from a TA, because I felt he had a good grasp of my potential.”

  Asking for letters of recommendation should not be an uncomfortable task. Most of the people you will ask have had to write many such letters and are accustomed to such requests. Be forthright and polite, and go to them at least eight weeks in advance of the date you need the letters. Be clear about the deadlines, and also give them an out by explaining that you need a strong endorsement of your candidacy for medical school, and if they don’t think they can provide one, they should decline. If you request a letter from someone and find them waffling, politely withdraw your request and move on to someone else on your list. The last thing you want is a lukewarm recommendation.

  Be sure to provide each of your recommenders with the appropriate forms, and stamped envelopes addressed to the premed committee or wherever you want the letter sent. Write your full name on the inside flap of the envelope to ensure that the professor’s assistant puts the right letters in the right envelopes. While you technically have the right to review all letters written on your behalf, it is best to waive this right. Most admissions directors put more stock in candid letters and are wary of students that feel they need to see their letters of recommendation. In many cases, your recommenders will provide you with a courtesy copy of their letters anyway.

  Do not underestimate the impact that a strong letter of recommendation can have on your application. A comprehensive letter from a solid source who knows you well can speak volumes about your integrity and the quality of your work. “My recommendations and my essay were the highlights of my application,” Adam notes. “They helped compensate for some middle-of-the-road numbers in terms of grades and scores. People choosing future doctors know that your success in medicine is not directly related to your ability to test well; rather, it is determined by your ability to relate to people and earn their trust. This has become increasingly apparent throughout my residency.”

  Crafting the perfect personal statement

  You should begin working on your personal statement no later than the beginning of June of your application year. For most people, this is the most difficult component of the application process.

  “As with most things of this nature, I agonized over my essay,” Deb recalls. “I really wanted to come up with something original, but in the end took the age-old approach of ‘why I want to go to medical school.’ My essay was not very original, but it allowed me to discuss my experiences and how they led me to medical school.”

  At its best, a personal statement can make your application truly stand out and will make the admissions reader say, “Wow, I’ve got to meet this person.” At its worst, an essay that is rife with errors, poorly constructed, arrogant, or offensive can immediately and utterly derail your candidacy. Your personal statement should, at the very least, give an admissions committee a window into your life and a good sample of your writing and communications skills.

  “My essay was pure self-promotion,” Pete says. “I knew as an older student with multiple former careers (all of which happened to be tropical), as well as an acceptable but hardly exemplary undergraduate performance, I had to spin my unique background into a statement showing what positive impacts those experiences had on my life and on my decision to go into medicine. I would advise choosing a topic that sets you apart from the mob of students applying for each spot, without coming across as too esoteric.”

  So how do you go about writing an effective personal statement? Like everything else in this process, start early, think creatively, and keep at it. In the end, the best persona
l statement is one that is sincere and demonstrates something about you and your desire to be a doctor. Reflect on your experiences and achievements and on the decision-making process you’ve experienced to this point. See if you can tease out themes or experiences that were especially formative or unique.

  “I wrote about how I made the decision to go to medical school specifically because it wasn’t an obvious trend in the rest of my biography,” Ben explains. “As such, I cited specific examples of events that contributed to my thinking process.”

  Once you have settled on your subject matter, start putting together a first draft. Your essay should ultimately be about one thousand words in length. It should have a clear and logical structure, harkening back to the standard five-paragraph essay (an intro, three main points, and a conclusion) from eighth-grade English class. Remember that admissions directors read thousands of these statements each year, so do your best to make yours clear, readable, and interesting. While creativity is absolutely a plus, bizarre, outlandish, or offensive material is a definite no-no. Find someone who is a good editor and get them to read your drafts. As you get closer to a final edit, solicit reactions from a wider audience. Capitalize on the opportunity to explain who you are as a person. Make sure you have anyone and everyone look for errors, and make the message come alive on the page.

  Putting it all together

  It’s now late summer of your application year. You’ve met with your premed advisor, solicited your letters of recommendation, completed the MCAT, sought additional clinical experience, and finalized your course work. Your personal statement is in final form.

  Now it’s time to put it all together.

  This may seem like the easiest part, and in many ways it is. However, it’s also one of the more intricate and important things to be done. Just as you spent hours perfecting your personal statement, so you should devote serious attention to making your application perfect. Start by uploading all of your relevant scholastic and work experience. Review your uploaded transcripts and make sure they reflect your most up-to-date work. Describe your extracurricular activities and experiences using active, vibrant verbs, and craft your descriptions of them to address the overall objectives presented in the beginning of this section. Carefully upload your personal statement. Once you have all the information in the application, print it out and review it in detail. Make sure it is properly formatted to look good on the printed page, since the admissions committees will typically print and read it in hard copy. Get a trusted editor to review it for you one final time. The hard-copy pages in front of you will be your first opportunity to shine for the admissions committee, and first impressions are lasting ones. When you can’t stand looking at the thing one second longer, look it over one more time and submit it.

  Now it’s time to move on to choosing your schools.

  CHAPTER 6

  Choosing Your School

  The wise man bridges the gap by laying out the path by means of which he can get from where he is to where he wants to go.

  —J. P. MORGAN

  WITH YOUR INITIAL AMCAS application uploaded and online, you’re ready to pick your schools. As with all of your previous application decisions, this is one you’ll want to linger over and consider carefully.

  RESEARCH RESOURCES

  The first step in choosing a school is learning about the options. Again, your best friend here will be the Internet, and specifically the AAMC Web site (www.aamc.org). It has a complete listing of all 125 accredited allopathic medical schools in the United States as well as the seventeen accredited Canadian schools. The site also features various tools to compare and contrast different schools based on location, curricular innovation, admissions statistics, and the like. The admissions contacts page contains links to each medical school’s home page, allowing you to delve further into the schools you’re interested in. Similar information is available on The American Association of Colleges of Osteopathic Medicine’s (AACOM) Web site (www.aacom.org) for the twenty accreditied D.O. schools in the United States.

  Your premed advisor will be another useful source of informational guidance. He or she is specifically tasked with helping you find a seat at the best possible medical school for your needs and preferences. Your premed advisor should also be clued in to the very latest trends and issues in medical education and to the current status of the various programs across the country. When you meet with your advisor in the spring of your application year, have at least a tentative list of schools to discuss. This discussion will help you assess how realistic you’ve been in your selection of schools and help your advisor understand what criteria you’re using to select your schools. This early calibration will be a real asset in helping to ensure the success of your admissions process.

  Friends, colleagues, and mentors in medicine or in medical education may provide additional insights. Be cautious in relying too heavily on this information, though, since it may reflect personal biases or be out of date.

  Many people also use the U.S. News & World Report annual ranking of medical schools. While these rankings are widely consulted and often quoted in the popular media, the reality is that the criteria they use to rank the top medical schools may have little to do with the factors you are most concerned about. The AAMC Web site features an interesting treatment of this issue, which you should review. While all of your mentors admit to consulting the U.S. News & World Report rankings when developing their lists of preferred schools, most used it only as a launching pad to further research, and none cited it as the determining factor in their ultimate choice of which school to attend.

  Finally, before you start casting your net, it’s a good idea to start closest to home. Your state school is not only almost always your cheapest option, it also tends to be your most certain option. Although not all states have their own state medical school, the ones that don’t almost always have an affiliated school in a neighboring state. You should almost certainly submit an application to this state school, even if it’s not a top choice for you. Spend some time evaluating this program, perusing its Web site, and if possible visiting the campus and talking to students. Learn all you can about its program so that as you begin to research other schools you have a baseline against which to compare. This initial effort will help you to hone your investigative skills and develop an intelligent wish list for your ideal program.

  FINALIZING YOUR LIST AND WEIGHING YOUR DECISION

  Now that you’ve surveyed the field and gotten a sense of what’s out there, the next question is: how do you determine which program is best for you? As you begin this process you may be saying to yourself, “I don’t care where I go, I just want to get in somewhere.” Or you may be saying, “I have to go to Yale.” But spend some time considering the primary differentiators likely to affect your school decision—location, curriculum, reputation, and cost—and develop your list accordingly.

  Location

  Location is the first way most people start narrowing their list. As mentioned, your state or state-affiliated school usually offers you the twin advantages of lower cost and increased likelihood of admission. It also offers you the opportunity to attend school in an area you already know and stay near family and friends—resources you may need to draw on during the stressful times in medical school. Location may also be a factor if you have a spouse or significant other who is tied to a specific job or industry that has geographic constraints.

  As you consider schools outside your geographic location, think about places you’d like to live and work for four or more years. Is the school in a big city or a small town? What activities outside of school are available there? How easy is it to travel to and from the school? What is the ethnic mix in the area? Where do most people who attend the school come from? What is the medical community like in the area where the school is located? What is the climate like? Answer as many of these types of questions as you can, then try to pare down the list of 125 schools accordingly.

  “Location wa
s very important for me,” Kate explains. “I wanted to stay in the New England area. My free time was precious, and I did not want to have to spend time traveling back to New England. I wanted to be close to family and friends for support.”

  “When I decided to reapply, I applied to only one school—the University of Colorado,” Deb adds. “I had been in Denver since college and really enjoyed my life in this locale. All of my friends were here. I was in a serious relationship with my future husband, Steve, who had all of his friends and a great job here in Denver. We loved the mountains, skiing, the weather—we just didn’t want to move. We decided that I would apply to CU only and see how things went. If I didn’t get in, the next year I would expand my list. Looking back now, if I hadn’t gotten in, I probably would have just kept reapplying to CU. Location was huge!”

  Curriculum

  The next major differentiator will likely be curriculum. This is a vitally important attribute to consider, yet a difficult one to evaluate from the outside. As discussed in chapter 2, the last decade has seen radical innovations in the way medical school curricula are constructed and evaluated. At many schools, the traditional curriculum, with monolithic blocks of two years of basic sciences followed by two years of clinical rotations, is gone. Many med schools have recognized that students need and desperately want an integrated curriculum in which the clinical relevance of material is emphasized, and in which they have the opportunity to develop a foundation of medical knowledge and the nascient clinical skills simultaneously.