Mr. T, the dean of admissions

August 29, 2008 at 5:04 pm (Applying to med school)

As we enter the month of September, premeds from all across the country are nervously awaiting the outcome of their applications to medical school. This special brand of obsessive-compulsive disorder, bred by the ridiculous admissions standards set forth by medical colleges, forces many premeds to develop a whiny, helpless personality that quickly annoys everyone around them. I was wondering what would happen if my personal hero, Mr. T, were to become the dean of admissions at my university. I’m sure that the telephone calls would go something like this:

Caller #1: Hi, I understand that AMCAS limits us to 5300 characters for our personal statement. Do we really have to keep it at 5300? I feel that I’ve done so much in high school and college that I really need more space to discuss all of my life’s achievements.

Mr. T: Quit your jibber jabber, fool! You haven’t accomplished anything. You’re 21-years-old and the only thing you’ve ever done that’s significant is to make out with a drunk girl at a party. Now put down the telephone and go do something meaningful with your life.

Caller #2: I’m really worried about the way your school delivers lectures. I understand that you refuse to allow videotaping to encourage students to attend class. I’m really afraid that I won’t get to see all the lessons if that’s the case. What if I’m sick?

Mr. T: Fool, the only lecture that you’re about to receive is a lesson in pain. Get yourself a textbook and start reading if you think that you’re going to miss class.

Caller #3: Has the waitlist started to move? What’s my position on the waitlist?

Mr. T: I’m going to refer you to my assistant dean, Pain. We’ve just started the application cycle. I haven’t even accepted anyone this early. If I’m interested in taking you off the waitlist, you’ll be the first person I call.

Caller #4: Not all of my rec letters have come in yet. What should I say to the letter writers to get them moving? I’m really afraid that since I only have three letters so far, your school won’t consider me.

Mr. T: What you need to tell them is, “You better get in front of the keyboard, fool! If you don’t get these letters out, I’m coming to get you, sucker.”

Now that’s a medical school worth attending.

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How to write a personal statement

August 20, 2008 at 7:38 pm (Applying to med school)

Thanks to my success in an earlier post about writing essays for secondary applications, I decided to offer some help in writing the personal statement for the primary application. There are three steps and writing a personal statement: first, discuss your excitement for medicine. Second, demonstrate your compassion for helping others. Finally, show that you’re dedicated to the field. Let’s review each of these items.

1. Excitement for medicine. Your personal statement needs to come off with a bang that ensures readers that you are absolutely passionate about becoming a physician. Admissions committees don’t want to come away from your application thinking that the only reason you’re applying to medical school is to say, “My mother’s child is a doctor.” To that end, you want to leave no doubt in your readers’ minds that you have seriously considered this path. Avoid using terms such as “like” and “enjoy” because they are too wishy-washy. Instead, use phrases such as, “I was so excited that I came in my pants.” That way, admissions committees will certainly understand where you’re coming from.

2. Compassion for helping others. Physicians are somehow thought of as being humanitarians — at least by the admissions committees who pick the next generation of doctors. Granted, I’ve never actually known that many attending physicians who have gone on to volunteer their time. But that doesn’t mean you get off easy. You need to do something meaningful which is have a great impact on the lives of others and then sell it to no end to everyone within earshot. Keep in mind that helping some people is more desirable than helping others. Your compassion level is a direct measure of how far you’ve traveled and how dark the skin is of the people you helped. In other words Africa > South America >> Asia >>> Europe. Remember, you aren’t joining medicine because it’s an enjoyable job. You’re joining it because you’re a selfless wanker who wants nothing more than to give your entire life to the pursuit of other people’s happiness.

3. Dedication to the field. Admissions committees want to know that you did not take the decision to apply to medical school lightly. Talking about your decision to become a doctor that was made at the age of 20 is the kiss of death. Instead, pick a more reasonable number such as the age of nine. Tell a story of how you watched your grandfather take his dying breath in an ICU and that you decided right then and there to put an end to the suffering of all people. From that moment forward, everything you did in elementary school and middle school was related to the field of medicine. For example, you petitioned to ban monkey bars because they were a risk to public safety.

Finally, you should close your personal statement by listing a review of all the items from your AMCAS just in case your reader missed it the first time around. A good summary statement looks something like: “Back when I was a server at the Rain Forest Cafe‚ I spent my spare time developing a clean energy solution for my research lab. I would then leave the restaurant to travel to the pool for my water polo practice in the pursuits of joining the Olympic team. I have always hoped of playing in Beijing, China, because I could continue my medical missions in the rest of Asia shortly after the games have finished. My parents, both of whom are physicians, have taught me and my adopted homeless person that we can do anything that we put our minds to.”

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Help for the secondaries

July 29, 2008 at 10:51 pm (Applying to med school)

Since many of my readers are currently applying for medical school, I figured that I would do a public service by helping them with their secondary applications. The application process is divided into three phases: the primary application, the secondary, and interviews. The first phase is run through AMCAS, a clearinghouse under the direction of the American Association of Medical Colleges. Here, eager premeds will enter biographical information, submit their transcript, and provide a personal statement. They will then select between 5-30 schools to send their application to.

If the universities like them—and the applicant can provide the necessary fee—a secondary application will be sent out. This secondary is unique to each college. It will ask for additional information and will carry with it several essay questions such as “Who has had the most influence on your life?” or “Have you been convicted of any felonies?” The most common question is “Why do you want to come here?”

Use this template for writing your secondary essay. Simply print it out and circle the parts that apply to you.

I want to go to (Columbia/Stanford/Emory/Vanderbilt) because of the amazing (teaching ability/research opportunities/student culture) fits so well with my life’s goals. I first became interested in this university when I saw it (clone a dog on national news/create a cure for restless leg syndrome/win the 1992 lacrosse national championship). Ever since then, I’ve been eagerly awaiting the day that I could go to medical school here. After looking through the faculty profiles, I’m interested in working with (Dr. Wu/Dr. Han/Dr. Lee/Coach Zeke) in the field of (particulate biochemistry/cardiovascular physiology/bioethics/building homes for the uninsured). I understand that this school has a strong (psychiatry department/trauma surgery program/women’s basketball team) that I was hoping I can get involved with early in my first semester. While I don’t know which specialty I want to go into, I am sure that (insert same name as above) could prepare me for whatever lies ahead.

Also, I must confess that I have family in (California/Arkansas/Wyoming/Washington, DC) and wish to be with my (aunt/uncle/second cousin) who is suffering from (Parkinson’s disease/irritable bowel syndrome/peanut allergies). He/she has had a great influence on my life and has taught me that I can do anything so long as I put my mind to it. For example, when I was growing up we used to go (fishing/knitting/clogging/building model rockets). Now, I wish to be by his/her bedside during his/her time of need.

Do not think that my decision to apply to this school is based on a whim. I diligently read every issue of (Nature/the New York Times/Wired magazine) looking for the next great article published by (insert name of school) faculty. I know that you can train me to be the doctor I’ve always wanted to be.

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Ask the Half MD: is there a best pre-med school?

June 27, 2008 at 8:32 pm (Applying to med school, Ask the Half MD)

A reader asks, “My daughter and I have been reading your blog for a while now.  She will be starting her freshman year at XXXXX College this fall.  She is worried that by attending a less famous university she is at a disadvantage when it comes to applying to medical school.  She is wondering if she should transfer to the University of XXXXX to better her chances of getting in.”

First, no parent should ever write me to ask about a child’s interest in medicine.  If you want to go to medical school and have a question about how to apply or what life as a med student is like, then you need to be the one who writes me.  Don’t let your mommy do your work for you.  As for the question regarding if there is a best pre-med school, the short answer is no. 

Your application to medical school is based upon your GPA, MCAT, letters of recommendation, extracurricular activities, personal statement, interview, and a host of other factors.  Your application—and all of the things that make it up—are solely you’re doing.  Granted, if you go to a university with grade inflation, your GPA will naturally be higher than other students'; however, you still must work hard to become a competitive applicant.

That said, we should not discount undergraduate institutions entirely.  The American Association of Medical Colleges keeps a list of which undergraduate universities applicants attended the year that they applied for medical school.  According to their data, the five universities responsible for having the most applicants in the United States are:

1. University of California at Los Angeles
2. University of California at Berkeley
3. University of Texas at Austin
4. University of Michigan at Ann Arbor
5. University of Florida

In a way, these programs send so many students to medical school every year that their pre-med offices are very familiar with the application process.  If nothing else, going to one of these universities—or to any place that is affiliated with a medical school—can help a person in so far as preparing him/her for the road ahead.  Many of these programs have staff that are very experienced with the cumbersome medical school application process.  Going to a small liberal arts college might very well make you the only pre-med on campus.

That’s not to say that if you are a high school student you should base your decision on where to go to college solely upon the number of pre-med applicants getting churned out every year.  You should certainly attend the school that is the perfect fit for you, whether it be a large state university with tens of thousands of students or a smaller location where all of the professors and deans know your name.  But if you are utterly lost and looking for ideas of where to apply, this list can serve as a good starting point.

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Leave the adcoms alone

June 24, 2008 at 8:51 pm (Applying to med school)

This is a short post and directed at the pre-meds who are waiting to hear back from admissions committees regarding their movement on the waitlist.

Stop calling! Leave the adcoms alone!

The admissions committees do a fine job of organizing the alternate list. They are very quick to admit more students as spots become available. They will ensure that a full class matriculates in August. And they will do all of those things without your constant calling to see if the waitlist has moved, what’s your position on the list, and if the person answering the telephone thinks that you have a chance of getting accepted.

Your whining about the slow process of medical school admissions isn’t going to move the list any faster. And if you’re planning on enrolling at my university, I hope you don’t get your shorts in a knot so quickly and tightly that your medical school career is labeled as “that guy” who gets on everyone’s nerves.

Remember that conversation we had about not being a jackass when applying to medical school? The same rules apply for harassing the admissions committee. Stop calling!

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How to behave on an interview: advice for the tour guides

April 14, 2008 at 11:32 pm (Applying to med school)

Previously, I’ve written on this blog tales of bad behavior by interview applicants. Examples include asking about the student:body ratio in the anatomy lab, challenging people about the school’s current ranking, and trying to lead the tour as a pre-med. This time I want to address those medical students who volunteer their time to serve as tour guides and lunch hosts: don’t be a jackass either.

I’ve taken a step back from giving tours due to time constraints in third year. I still try to meet with the applicants on a regular basis to discuss my experience here at the university and to answer any questions they may have about life as a student here. I always try to answer their questions honestly such as mentioning that we do a poor job of preparing students for the boards, that we waste a lot of time in Physicianship Training learning about things such as medical informatics and Medicare billing structure, and that while many opportunities abound at this university, students are generally left on their own to make use of those opportunities. I try to answer the applicant’s questions by highlighting both the positives and negatives so that they have a good generalized picture of what to expect should they matriculate.

You can imagine my frustrations then when I see medical students selling our campus as if it’s some kind of used car. I’ve seen numerous people say, “Our school lets students have lots of hands-on experience starting within their first month. You won’t find that if you go to Harvard or Yale, where you’ll just stand in the back of the room and not be allowed to touch the patient.” First, unless you’ve actually attended Harvard or Yale, don’t ever make a comparison between your institution and someplace else. Second, making these comparisons makes it seem as if you are trying to compensate for something. I am reasonably sure that the tour guides at Harvard are not going around saying, “Don’t go to State University because you won’t get the same kind of experience as you’ll receive here.” I don’t think that there is a person alive who would choose our school over Harvard if given the choice.

I also hate it when students feel the need to say that our school is a noncompetitive environment and that attending any other university will only be met with constant fighting with classmates. I repeatedly hear “I hear from my friends at other universities that students hide books in the library so that other people can’t study.” To this day, I have never met a medical student at another university who can confirm these rumors. Without exception, every one of my friends at other institutions has stated that their classmates are generally friendly and will freely provide their notes to the rest of the student body. I really don’t see what makes our students so special. I’m pretty sure that attending any medical school will result in the same experiences and the same knowledge.

Finally, don’t cuss in front of the applicants. I watched in horror as a graduating fourth year medical student dropped the F-bomb four times during an applicant lunch. He tried to present himself as some kind of jock or frat boy, but came across as a royal a-hole. I wouldn’t be surprised if none of those people end up coming here due to his disrespectful attitude.

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The new rankings are out; patients continue to get quality care

April 6, 2008 at 8:37 pm (Applying to med school)

The pop-culture magazine U.S. News & World Report recently released its latest edition of the university rankings. This list—published on or around April 1 each year—attempts to tell readers which colleges are the best in the country. A look at this year’s rankings reveals that Harvard and Johns Hopkins University are once again the top two medical schools in the country. The magazine then goes on to record 60 other names in sequential order as if going to medical school at #10 somehow produces a better doctor than #20. While I’m glad to see that my school is named amongst these ranked universities, I wonder if these numbers mean anything. Besides, who’s ever heard of Washington University (#3) anyway?

Each medical school goes through a rigorous accreditation process and is forced to turn out some of the world’s best physicians. I’ve looked at the match list for several universities this year and noticed that medical students can land top residencies no matter where they get their initial training.

Further, patients really don’t care where their doctors have gone to school. There is no shortage of people waiting to get treatment from my university’s attendings. As much as I like to rail against the inefficiency of my medical school, our alumni fare well after graduating. They can enter any specialty imaginable, have published tons of papers on various diseases, and can do a pretty good job of taking care of patients, too.

To this day I have never heard of physicians say that finding a job is difficult. A quick glance at any set of classified ads for doctors will reveal that there is a huge demand for our services, regardless of where we did our training. Heck, I even had one psych patient asked me if I had gone to Yale, Harvard, or Princeton for medical school. He was shocked to find out that my program even existed. My own personal internist went to a Caribbean medical school. But if his American residency program believe that he was good enough to become an internist, I’m certainly willing to continue seeing him.

The take-home message is that the ranking system does more to inflate the egos of people who are applying to medical school than it does to instill confidence with patients. I don’t know why med school applicants put so much stock into these numbers.

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How to turn down an interview invite

December 21, 2007 at 8:07 pm (Applying to med school)

As December winds down, the interview season for medical schools is in full swing. Although your semester is over, the admissions committees are working furiously to try to build next year’s class. Since you are a reader of this blog I expect that you’re smart enough to have gotten multiple interview invites. I also don’t doubt that you have several acceptances at this point, too. Many of the invitations for Spring interviews will come from schools that are part of your backup plan.

Instead of spending another $500 on airfare and hotel accommodations, you’ve realized at this point where you’re willing to go to and where you’re not willing to attend. Therefore, you need to let schools down gently when you alert them that you won’t be interviewing there during the next semester. Your goal is to be cordial to these medical schools so that you keep an open relationship with them. Since you’ll have to decline their invitation in writing, I suggest you use the following template:

Dear Admissions Committee,

After a thorough consideration of your university, I have decided not to attend your institute. With over 120 medical schools, the competition was fierce this year. In the end, I had to select the school that would most closely match my goals for residency. This letter is not meant to say that you can’t turn out great physicians. It’s just to say that I got accepted to a better school. And by “better” I mean higher ranked school.

Good luck in your admissions process. I’m sure that with your stats, you’ll find someone willing to go there.

Sincerely,
Soon-to-be M.D.

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How to behave on an interview 2: rankings

December 12, 2007 at 11:59 pm (Applying to med school)

I’ve begun working with the admissions committee again this year. I meet with applicant’s steering their lunch break and discuss with them the merits of our program. While most students are very nervous about the prospects of interviewing at a medical school, a few people are able to give us questions about life at our university. While subjects such as housing, scholarships, and even dating are to be expected, there is a few things that you should never ask during an interview—even if the medical students that are providing lunch promise they won’t go back to the admissions committee. This past week I had a one student who’s very first question of the afternoon was, “Why isn’t your school ranked higher in the rankings?”

Upon hearing his question, I wanted to jump across the table and beat them over the head with his orientation folder. Naturally my first response is to scream out, “Does it matter what our ranking is? You would come here regardless of what we were ranked if we were your only acceptance!”

For the education of my readers, let me explain to you why using the results of a ranking system such as U.S. News & World Report is bad for applying to medical school. While university administrators and even students and alumni look to the ranking systems is boasting the quality of their education, using a pop culture magazine to dictate your future educational endeavors is like asking a used car salesman if you need to purchase a new vehicle. These ranking systems are bad for several reasons.

First, let’s take a look at what the U.S. News & World Report uses in its algorithm.

1. Peer assessment by deans and residency program directors.

2. Money received in the form of research grants from the National Institutes of Health.

3. Mean MCAT, GPA, and acceptance rate.

4. Student:faculty ratio.

The peer assessment is largely based upon the title of the university and fame, rather than direct contact between the deans and the faculty and students at other universities. An administrator at a Northeastern university would be hard-pressed to discuss the merits and pitfalls of the program in the Midwest. Therefore, it’s a wonder why so much weight is put upon a popularity contest.

Looking at the money issue, we can immediately see problems with using NIH grants as the sole indicator of a university’s ability to perform research. There are numerous organizations besides NIH that provide grant money for medical research, including the Environmental Protection Agency, the National Science Foundation, the military, and others. In addition, private donations are not included as part of research funding according to the U.S. News & World Report rankings. A university could receive a donation of well over $100 million from a philanthropist, yet that money will never play a role in the school’s ranking.

Further, the amount of money that a particular university pulls in for funding does not tell the applicant if the research that is conducted at that program is even interesting or in-line with one’s professional goals. For example, a school can pull in over $30 million in funding for genetics research, but if the student isn’t interested in genetics that funding is meaningless.

While the MCAT and GPA are useful for applicants to determine where their scores are a fit, these numbers are the only part of the ranking system which is controlled by the students who attend the university. The acceptance rate is problematic for two reasons: out-of-state students rarely apply to expensive private schools, and popular universities such as the Ivy League will receive more applications than state schools, perpetuating the very numbers that push them higher in the rankings.

Finally, the student:faculty ratio is by far the most worthless piece of data in the U.S. News & World Report ranking system because it sets up a false sense of what the class size will be in medical school. For the first two years, most students will sit in a large auditorium with 100 other people—and only one lecturer. So whether this student:faculty ratio is 8 or 16 is meaningless because you will always sit in an auditorium with only one faculty member and 100 classmates.

You’ll notice immediately that the rankings do not include any information such as student evaluations of teachers, clinical experience, or even the average USMLE scores. I would argue that these three factors are the most important determinants of where an applicant should go to medical school.

So the next time you’re on an interview, remember that rankings are of little importance for applying to medical school. And if you should ever ask, “Why isn’t your school ranked higher in the rankings,” don’t be surprised if you get hit in the head with an orientation folder.

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Quick post: extracurricular activities for an application

May 24, 2007 at 9:06 pm (Applying to med school)

Lots of pre-meds want to make their applications stand out by getting involved with extracurricular activities. The most popular things to do involve shadowing a physician, volunteering, clinical work experience, and research. Here’s my take on the issue of EC’s. The big thing is that your activities need to be meaningful. Most pre-meds don’t grasp that concept and somehow think that the application is a series of check boxes for them to join a dozen campus organizations without any real contribution.

Shadowing is pretty worthless. Most people do it to get a sense of what medical practice is like, but few applicants spend any significant time working with a physician. What’s worse is when students try to use these attendings for rec letters. If someone can’t immediately list ten positive traits about you with stories to backup each claim, move on to another letter writer.

Volunteering is good for an application as it shows altruism. However, you should only volunteer in a field that is meaningful to you and the people you’re serving. Pushing wheelchairs is not something I would regard as substantial volunteering.

Clinical experience is also good because you’ll get a taste of medicine. Again, hospital volunteering doesn’t count unless you actually worked with patients. One applicant wrote a personal statement in which he detailed watching doctors work in an emergency department. My take on his essay was that he hadn’t ever worked with patients and was clueless as to how a hospital functions. Some of the more common routes for clinical experience are CNA, EMT, and surgical tech.

Your “research” doesn’t count if it was for a class. If you want research, find a lab and start working with the graduate students. You’ll need at least a year—preferably two—to get into the scientific mindset. Bonus points for publications. Again, what was your contribution?

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