Tools of the Trade: Med School Admissions

Having successfully navigated the process of medical school admissions, I hope to offer a few broad principles and a framework to structure one’s approach.

In addition to my work to provide free materials for MCAT prep, I intend for these resources to principally benefit students from underrepresented or disadvantaged backgrounds. One needn’t be especially wealthy or well-connected to be admitted to medical school.

Note that this piece is designed to be a comprehensive guide and, as such, is particularly long. Free feel to click through and return back to this post as you progress through the application process.


I. Preparing to Apply

TL;DR:

  • Complete all prerequisite coursework
  • Crunch the numbers
  • Establish strong relationships
  • Determine whether or not you are going to take a gap year(s)
  • Do research on different programs

The path to medical school is especially arduous and winding. A number of twists and turns can easily lead an aspiring physician to be “weeded out” or otherwise crestfallen.

The following are a few considerations to take into account when preparing to apply to medical school.

Complete All Prerequisite Coursework

The first pass along this path comes in the completion of your pre-medical coursework, which is traditionally comprised of the Big Four,

  1. general biology
  2. general chemistry
  3. physics, and
  4. organic chemistry

Notably, most medical schools require applicants to take additional courses in biochemistry, mathematics (often calculus and/or statistics), English (or equivalent “writing-intensive” courses), and, less frequently, psychology or sociology.

These courses, while required for medical school admission, can also be taken during the application process and do not have to be completed beforehand. (There might be a slight advantage to having these grades in-hand while applying, but by no means is it necessary.)

Most undergraduate institutions have dedicated pre-medical advisors who are familiar with these prerequisites and the courses that fulfill them.

Medical schools also stipulate these admission requirements on their websites.

Be sure that you have completed this coursework! If you haven’t, considering taking these classes during a gap year either in a piecemeal fashion or through a dedicated post-baccalaureate (post-bac) program.

Crunch the Numbers

In preparing for the MCAT, which I cover more substantively here, among the most important considerations is defining your goal score, that which makes you a competitive candidate for your desired programs.

The AAMC regularly publishes exhaustive data on MCAT scores as well as application and admission rates. Here are a few of the most compelling data:

You can find more applicants and matriculants data on the AAMC’s website. (Note that “matriculants” refers to applicants who have been accepted and will attend medical school.)

In addition to these data, researching the average MCAT score and GPA for matriculants at various medical schools can also you to pinpoint your goal score. This information is usually available on each institution’s website.

For students who qualify for the Financial Assistance Program offered through the AAMC, the Medical School Admissions Requirement (MSAR) guide is provided free of charge. (It can alternatively be purchased for $28 and some pre-medical advisors might also have access to it.)

The MSAR provides exhaustive information regarding average MCAT scores, among other components, of applicants accepted to every allopathic (MD) program in the United States.

Defining this goal score can be a significant motivator as well as enable a student to more effectively set the pace in their MCAT preparation.

Establish Strong Relationships

As a physician, cultivating a strong rapport with your patients will be absolutely vital.

This bedside manner can dictate the degree to which a patient divulges their medical history, adheres to a treatment plan, perceives their quality of care, and, indeed, even returns to see that clinician.

Similarly, developing relationships with professors, research mentors, advisors, healthcare providers, managers, and supervisors is paramount in both receiving helpful advice about the medical profession as well as strong letters of support for your application.

A few principles can do much to allow these connections to develop organically:

  • Show up and be present.
    • Be consistent in how you conduct yourself around others, being punctual to lectures, shifts at work, and meetings, and displaying genuine interest in the subject matter.
  • Ask questions and stay hungry.
    • Perhaps the best way to display that “genuine interest” is to ask thoughtful questions of others and determine how you might be able to increase your knowledge on a given subject, your responsibilities in your position, or your contributions to the group or organization.
  • Be flexible and enjoy the ride.
    • There might be weekends (perhaps every weekend) in which you’re asked to come into lab or into work. Within reason, be ready to adapt to these evolving expectations and demonstrate your commitment and dependability.
    • When facing obligations that aren’t especially appealing, remember that the skills and knowledge you’re accumulating may directly benefit your patients, or at the very least make you a more attractive candidate to medical schools.
  • Continue to check-in.
    • Even after your course or position ends, continue to follow-up with the instructor, mentor, or provider with considerate messages that inquire about their well-being and update them about your current activities.

Determine whether or not you are going to take a gap year(s)

Around sophomore or junior year of college, pre-medical students should begin considering whether they plan to take a gap year after graduation. At present, the average age of entrance for medical school is 24 (AAMC), suggesting that the majority of matriculants to medical school are taking a few years off after college graduation.

Applicants may consider taking a gap year, or multiple gap years, for the following reasons:

  • To take additional coursework to fulfill admission requirements or bolster academic standing, provided that an applicant’s GPA or MCAT score does not provide a competitive advantage
  • To pursue research opportunities in a formal position or degree-granting program
  • To gain additional clinical exposure through working as a medical assistant, medical scribe, certified nursing assistant (CNA), or a emergency medical technician (EMT), or shadowing healthcare providers
  • To work in other capacities to save up funds for medical school tuition and fees, or to pay off debt accrued during college
  • To pursue opportunities, such as service work through the Peace Corps or AmeriCorps, or taking care of a loved one, that you find personally rewarding, which may also contribute to your career as a physician

This consideration must be taken into account early as the medical school admissions process takes more than one year to complete in full. (The time horizon is somewhat shorter for those applying to osteopathic (DO) programs, which have later deadlines.)

As such, those planning to matriculate to medical school directly after undergrad will start applying the summer before their senior year of college. At that time, they will have already sat for the MCAT and are expected to have gained meaningful experiences related to healthcare.

The AAMC provides a substantive timeline for pre-medical students here.

Do research on different programs

Once you have established the timeline in which you will apply for medical school, further research should be conducted into the programs offered at different institutions and the resources available to students.

  • How well do your GPA and MCAT score align with the averages in each program? (see the Crunch the Numbers section above)
  • How important is the location of the program (close to home, close to a major airport/train station) and the setting of the program (urban, suburban, rural) to you?
  • What’s the average cost of attendance (would you qualify for in-state tuition if offered?) and the average student debt load upon graduation?
  • What financial aid, grants, and scholarships are available to students?
  • How well does the program align with your interests in healthcare? (For example, serving marginalized populations or performing global surgery)

Gathering this information into a spreadsheet or other document can be especially helpful. Here is one example:

II. Taking Action

TL;DR

  • Determine how many programs you will apply to
  • Begin working on your application ahead of time
  • Apply early 
  • Keep track of the process
  • Send update letters if appropriate

Now that you’ve sufficiently prepared to apply to medical school, let’s start taking action!

Determine How Many Programs to Which You’ll Apply

Students who qualify for the FAP are able to apply to 20 allopathic (MD) programs free-of-charge as of February 2019, an award worth $911. (Previously, this amount was 16 schools, the baseline used for the graphic below.)

While conventional advice holds that an applicant should “cast a wide net” and apply to as many programs as possible, that prospect quickly becomes cost-prohibitive.

Here’s a visual of the costs associated with applying to medical school:

Serious thought should be given to accumulating sufficient savings to pay for the costs of applying to medical school. Indeed, an astute applicant might choose to take a gap year to both gain clinical exposure and save up funds for this process.

Moreover, conventional advice holds that applicants should “cast a wide net” and apply to as many programs as is feasible for them. Anecdotally, the trend is for applicants to apply to about 20 schools.

I’ve known applicants who have applied to as few as seven programs and to as many as 30, allopathic and osteopathic programs included. The right number of programs is ultimately the one that you decide.

Begin Working on Your Application Ahead of Time

Although you are not able to submit AMCAS until 1 June, there is nothing restricting you from preparing your materials early.

There are several components to your application:

List of extra-curricular and work activities

  • You may list up to 15 activities in total, up to three of which can be denoted as a “Most Meaningful” experience
  • For each of these activities, you’ll include the following details:
    • A start date (MM/YYYY) and end date (MM/YYYY)
    • The total hours devoted to the activity
    • Contact information for an individual at the organization (usually your PI, supervisor, or manager)
    • Description of the experience, limited to 600 characters (about 100 words)
  • If the experience is one of your most meaningful, you’ll also write another description of about 200 words touching on the components of the experience that made it worthwhile

Letters of evaluation

  • The conventional guideline is to have at least 3 letters of recommendation and no more than five to six
  • There is no hard and fast rule about who should write these letters. Conventional advice holds that one letter should be written by a physician or other healthcare professional, a previous research mentor (if you conducted research), and professors who teach in the natural sciences or the social sciences.
  • For reference, I had four letters, two of which were written by previous research mentors, another by a professor of psychology, and another by the director of a non-profit at which I served throughout college.

Personal statement

The AMCAS prompt reads, “Use the space provided to explain why you want to go to medical school” and provides 5300 characters (including spaces) for your response.

The following information is also provided:

I found the following guides to be invaluable in forming a cogent narrative around my experiences and values:

  • Video from Mike Frazier, who sat on the admissions committee at UCLA med school
  • Guide from Shemmassian Consulting

Transcript

The AMCAS requires you to submit a complete transcript from the institution(s) you attended. There might be some administrative legwork involved in having these documents sent to AMCAS.

Be proactive and see if you can complete any requisite paperwork ahead of time to prevent your application being delayed.

Secondaries

Long before you are offered secondary applications at any institution, you can begin outlining and drafting your responses.

ProspectiveDoctor has compiled a list with the prompts to nearly all secondary applications. This is an invaluable resource that can save you immense amounts of time and also allow for a tight turn-around when you are invited to submit secondary applications.

Note that these prompts are subject to change each application cycle, so the most productive use of time is drafting response to the three most common prompts, which appear in a number of forms on secondary application. They are,

  • The diversity essay (that is, how would you contribute to the demographic and/or intellectual diversity of the given institution)
  • The adversity essay (write about a challenge you’ve faced, how you overcame the challenge, and what you learned as a result)
  • The “why us” essay (touch on the particular elements of the school, e.g. curriculum, service work, ethos/mission, research, that are most appealing and motivate you to apply)

Keep Track of the Process

Even if you’re planning to apply to fewer than 20 schools, keeping diligent track of your application to different programs will pay dividends later in the process.

I recommend keeping track of when you’ve submitted secondary applications, update letters, and thank-you messages following your interview.

Here is an example:

Send Update Letters if Appropriate

If you find that you have accumulated meaningful experiences in the time after submitting your secondary application, but before receiving an invitation to interview, you may want to consider sending an update letter.

This letter should summarize your activities since submitting your secondary as well as the reason why you’re sending this letter.

Here is an example:

III. Interview Season

TL;DR

  • Know the interview format
  • Prepare appropriately for MMI
  • Practice, Practice, Practice!
  • Prepare questions of your own
  • Write genuine thank you messages

Congratulations! After navigating the labyrinth application process, you’ve been invited to interview at one or more institutions. Here are a few helpful principles to help guide your preparation:

Know the Interview Format

Odds are you have some previous experience interviewing for jobs and positions. Although many medical school interview will feature similar behavioral prompts (such as, “What’s your greatest weakness?” or “Tell me about a challenge you’ve faced”), there are a number of nuances.

As part of your invitation to interview, the medical school will likely provide information on whether they hold traditional behavioral interviews, MMI stations, or utilize a mixture.

If this information isn’t immediately evident in the school’s invitation email, their interview format can often be found on their website. If it’s not, email their office of admission.

Prepare Appropriately for MMI

Perhaps the most prominent distinction among medical school interviews is the use of MMI, multiple mini interviews, at a number of institutions.

Similar to case studies used in interviews at consulting firms, MMI stations typically pose a scenario to an applicant, who is then asked to reason through the case and explain their thinking process.

These scenarios may sometimes feature a challenging ethical situation.

For example, pretend you are a physician and a fourteen-year-old girl presents asking for birth control medication. What would you do?

In your response, you would be expected to detail how you would approach the situation, the additional information you’d want to know, and the ultimate decision you’d come to.

Other MMI situations may instead ask traditional interview prompts, such as “Tell me something you’re passionate about” but in a time-constrained environment (five to six minutes) with an interviewer who lacks access to your application.

Thankfully, there is a panoply of resources available for MMI. I found the following to be the most helpful:

As part of practice scenarios and questions, I would frequently record a video of myself practicing MMI questions and review my performance directly afterwards.

A word from the wise: don’t attempt to practice MMI after a night of drinking

Practice, Practice, Practice!

In addition to practicing MMI questions, I also recommend spending a bulk of your time reviewing the most commonly asked behavioral interview questions during traditional one-on-one interviews.

Here are some guidelines around which you can structure your behavioral interview preparation:

  • First, plan out your responses to each of these questions, acting almost as if you’re responding to an essay prompt rather a verbal prompt
    • This exercise can help to ensure that you access all of the relevant thoughts, ideas, and beliefs you hold in order to more effectively answer the question
  • Spend at least two to three weeks rehearsing your responses every day to these questions, getting to the point where you no longer sound rehearsed in providing your cogent answer
    • Similar to MMI preparation, you might also want to consider recording yourself responding to each prompt

Prepare Questions of Your Own

Although your responses to the interviewer’s questions will be the focus of your conversation, you will often have the opportunity to pose questions of your own as well.

For faculty interviewers, a few good questions include,

  • What do you think is most appealing about this institution? (Curriculum, student culture, specific programs or initiatives)
  • What do most people not know about this institution? Or, what has been most surprising for you at this institution?
  • What do you like to do in the area?
  • What sort of student would thrive at this institution?

For student interviewers,

  • What drew you to this institution? (This can be especially revealing if the student had multiple offers of admission and chose this program over others)
  • What has been a good surprise and a bad surprise about your experience at this institution?
  • What would you change about your program? Would the administration be amenable to those suggestions?
  • What do you like to do outside of medicine? Is there flexibility for you to pursue your other passions?
  • Did your impression of the institution on interview day (as well as second look/revisit weekend) match your ultimate experience?

Write Genuine Thank You Messages

Depending on the format of your interviews, you may receive contact information about your interviewers ahead of time. Their full name, and at times their email address, will often be listed on your itinerary for interview day.

If an interviewer’s email address is not provided, near the end of the interview, ask for their business card or for their email address. They are frequently open to responding to additional questions you may have after interview day.

A few key components to a genuine and concise thank you message, include

  1. Expressing sincere gratitude and thanks for making the time to interview you
  2. Reviewing a few of the specific topics from your application you discussed
  3. A summary of their responses to your questions

These aspects show that you sincerely enjoyed the conversation shared, remembered what you discussed, and found value in what the interviewer had to say.

Here is an example,

Dear [NAME],

Thank you for sharing your time and your perspectives with me this past [DAY]. Our conversation was undoubtedly the highlight of my interview day at [SCHOOL]. I took genuine delight in the opportunity to discuss my path to medicine, the sacrifices my grandmother made for my education, and my vision to practice primary care in a community health setting and move the needle towards social justice.

Your candor in discussing your experiences, particularly as a member of [group or community], also provided refreshing insight into the social and academic atmosphere I can expect at [SCHOOL].

Thank you again for sharing your time with me.

All the best,
Fred

As a guideline, aim to send a thank-you message to each of your interviewers within 48 hours of your interview.

(Note that it is not customary to receive contact information about the interviewers who oversee MMI stations or send follow-up messages to them after interview day.)

IV. Additional Resources

TL;DR

  • Take the “W” and withdraw
  • Use scholarships and financial aid as leverage
  • Elicit advice from mentors and advisors

These consideration fall into a catch-all category of their own.

Take the “W” and Withdraw

If you are fortunate to be admitted to multiple institutions, in particular your top choice, I recommend withdrawing from other programs to release interview slots to other applicants and admission offers to students on waitlists.

This message should be concise, yet cordial. Here’s what I sent to some programs:

Dear Admissions Committee,
Thank you for extending the opportunity to attend the [SCHOOL]. Unfortunately, I was recently accepted to my top choice medical program and will be releasing my seat at [SCHOOL] and withdrawing my application.
I apologize for any inconvenience this brings to your office.
Sincerely, [YOUR NAME]
AMCAS: ########

Use Scholarships and Financial Aid as Leverage

One of the most important considerations in weighing offers of admission from different institutions is the amount of financial aid, need- or merit-based, you receive.

In many cases, accepted students receive information on scholarships and financial aid later in the cycle, around February or March.

Some schools may be willing to match aid you’ve received at other institutions. If your preferred program offers less aid compared to other institutions, strongly consider using that aid as leverage to increase the amount received from that preferred program.

Often, an email or a phone to the office of financial aid will suffice.

Elicit Advice from Mentors and Advisors

Although I have attempted to provide exhaustive advice in this piece, there will surely be nuances about your particular circumstances that other mentors are best suited to advise.

Additionally, I hope to offer myself as a resource as well! Click on the email icon on the top bar of this webpage, or send me a line at fayres _ @ _ wesleyan.edu.

V. Additional Resources

I regularly utilized blog posts from Shemmassian Academic Consulting, in particular,

3 thoughts on “Tools of the Trade: Med School Admissions”

  1. Phenomenal, thorough outline of the medical school process! Highly recommend this for any and all inquiring pre-meds!

  2. Your care to share the formidable steps necessary to achieve admission to medical school serves to reflect why this field is a very appropriate one for you. Well done.

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