The Premed Years

By Ryan Gray, MD of Meded Media

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Description

The Premed Years is an extension of MedicalSchoolHQ.net. Started by Ryan Gray and his wife Allison who are both physicians, it is another means of bringing valuable information to pre med students and medical students. With interviews with deans of medical schools, chats with trusted, valuable advisors and up-to-date news, The Premed Years and MedicalSchoolHQ.net are the goto resources for all things related to the path to medical school. We are here to help you figure out the medical school requirements. We will show you how to answer the hard questions during your medical school interviews. What is a good MCAT Score? What is the best MCAT Prep? What the heck is the AMCAS? What is the best undergraduate program? What is medical school like? What so you do to volunteer and shadow? Get your questions answered here.

Episode Date
339: Overcoming Organic Chemistry On Her Path To Medical School
47:28

Edleda struggled with organic chemistry and at times the class made her doubt if she could do this. Today she discusses overcoming ochem and finding balance as a premed.

May 22, 2019
338: How to Start Thinking About Improving the Healthcare System
39:04

Session 338

This week, we talk all about process involvement and healthcare systems engineering. Find out exactly how adding this into your knowledge base can help you get better as a premed student, a medical student, a resident, or one day, as a physician.

Ana-Iulia Alexandrescu is the Director of the Healthcare Systems Engineering Program at Lehigh University.

Also, be sure to check out all our other podcasts on the Meded Media for some more tips and resources to help you along your medical school application process and beyond!

[02:26] What is Process Improvement?

Ana explains it's about how to plan, design, manage, and run systems of healthcare delivery. Healthcare is a very complex system. Systems engineering is how you think about such a system and how you put together processes and systems.

You think about how all those parts can work together in unison so you end up with good patient experiences. It has a myriad of applications in any part of the healthcare system that you can think of.

[03:40] A Brief Background About Ana

Ana has a background in industrial and systems engineering with an emphasis on operations research. She got into healthcare by accident. She learned more and more about various aspects of healthcare and the way in which healthcare doesn't work the way it should work or could work.

Once she graduated, she worked for a boutique consulting firm focusing on business process reengineering. Currently, she works with students and industry partners on various healthcare delivery, system-related problems. She solely comes from the engineering perspective, with no clinical background whatsoever.

[05:05] Why Is This Important to Students

As a premed or future medical professional, look at healthcare system engineering as everything that happens outside of the pure interaction with the patient.

For instance, if you're an emergency medicine physician, you work in a chaotic environment, People keep coming and wait for a very long time. Sometimes, they wait at the emergency department without being seen. Or they wait after being seen and before being transferred to an inpatient bed.

As the ED physician, all of this affects you, your environment. or how care is delivered to the patient. It affects everything about how the emergency department operates.

With a background in healthcare systems engineering, you can look at ways to organize and manage the operations of that emergency department.

People would then have to spend less time waiting. Physicians can then use more time with their patients and on clinical duties rather than on other things that keep them away from practice.

Similarly, the operating room is another environment that has a lot of moving parts and complex operations involved with it.

Do you start a colon cancer surgery with a robot or a do you start it open? What if you can predict the risk of having to switch from robot to open because of the likelihood of complications based on information available before the surgery?

How do you sequence your surgeries? Do you put the longest surgery first, or the shortest surgery first? How do you manage your day such that you minimize disruptions, spend less time idle and waiting for things to happens so that you can get on with your day?

How can you be more effective and more efficient, and therefore provide overall better care in a more pleasant and well-functioning environment?

[08:16] Your Edge as the Physician

Additionally, as an engineer, Ana can look at your schedule as a surgeon and give you recommendations on how to improve that schedule or make it less likely to run long or for certain surgeries to be canceled. She can help you be better at predicting how long the surgery will take.

That being said, there are decisions that Ana doesn't have access to because of the lack of clinical information. So while she can give you the reasoning or the logic behind some decisions, but she lacks the clinical context to push that beyond a certain level.

But you as a clinician with this kind of mindset, you don't have that barrier.  You can design new ways of approaching diagnoses and new ways of practice. You can have better care delivery models and so on.

[09:30] A Case Study: Application in Colorectal Surgery

Ana worked with a resident in colorectal surgery and a colorectal surgeon to look at predicting the likelihood of success in doing robotic surgery versus open surgery.

So the questions were two-fold.

First, are the outcomes for patients worse when they start off with the robotic surgery then switch to open surgery part-way thru because of a complication during surgery?

Second, based on the information available prior to the surgery, could they predict the likelihood of that switch happening?

Given the risk tolerance and the surgeon's evaluation of that risk, can they make an informed decision whether this surgery is better to be done by a robot? Or is it better to switch to open surgery, to begin with?

They used data from over 600,000 surgeries performed in the U.S. The results showed that the outcomes are worse for patients that start with robotic surgery and switched open versus those that completed open surgery.

The predictive model also achieved a relatively good performance. This could be further improved. But it's a starting point to at least build that kind of reasoning in the decision-making process prior to colorectal surgery.

[13:00] The General Idea

Looking at the patient outcome difference is just one aspect of it. There are operational implications to making that decision even if there may not be patient outcomes.

For example, there were no differences between patients who started with robot and switched to open versus those who started with open surgery. So from a patient recovery and experience perspective, it didn't make a difference.

But that doesn't mean it didn't make a difference from a system perspective. What disruption does it cause to other surgery schedule that day? To the patient recovery planning, robotic surgery would be much less invasive versus open surgery, where patient recovery is a lot longer.

What implication does this have, not just on the patient level, but also on all the operations in the hospital, around that particular surgery?

This is also bad for the patients in the ICU because it's a very restrictive environment. A number of different services a patient might need are not actually available or possible in the ICU. Overall, this results in less optimal patient care for the patients stuck in the ICU longer than necessary.

However, the number of decisions that are being made are staggering doing many and deeply clinical, so as a pure engineer, Ana doesn't have the authority or the basis to make specific recommendation on how to fix it. She can have many ideas and analyze many ways in which this could be made better.

[17:35] Application of Process Improvement in Your Daily Life

A lot of these principles have been applied in other industries and other processes and systems. And you see the results in a lot of everyday life.

A lot of us that have prime membership get deliveries in two days, pretty much everywhere in the United States. This is only possible through a very robust analytical platform. It takes a way of thinking, predicting demand, and trying to anticipate what will be required. You have to be relentless in improving operations for delivery. There's been an announcement that Amazon is experimenting with one-day delivery.

Another example is if you get a credit card statement, it's usually easy to read. If you get a healthcare bill, many people can't read them as they're much more complicated.

[19:23] Process Improvement in the Airline Industry

Another example is a comparison of healthcare and airlines. If you're trying to fly from New York to Seattle, you're probably going to have to connect. But you don't have to buy your luggage pass separately. You don't have to manage how your luggage makes it from one connection to another.

However, the healthcare is not as streamlined as this. People oftentimes have to piece together across the system what they need.

And even when you buy an iPhone, you're guaranteed for it to be the same as the next iPhone. The fact that iPhone is in some way better or superior to the previous iPhone is the same idea, which is this relentless pursuit of better, improved, and excellent product.

[20:52] The 5S Methodology

The 5S methodology talks about how you manage your tools and your work environment. You can apply this even to how you organize your desk or closet. The idea is having a place for everything and putting everything in its place. This makes it easy for you to figure out when you're missing something.

In surgical cases, this would translate into having a tray that has all the necessary instruments in their proper place. So when one of them is missing, you can notice immediately that it's missing.

You can also shorten the amount of time it takes to retrieve the correct instrument. Because it's always in the same place, you don't have to search for it. This is especially helpful when you're doing many different surgeries. And if you have to search for an instrument every single time across a set of 50, this can add up.

[22:15] Root Cause Analysis

We always say you should treat the cause rather than the symptom. Root cause analysis has many different flavors or variations. But essentially, it's a systematic approach to trying to understand why a certain symptom or effect has been observed.

One way to do this is through the Toddler Methodology where you keep asking why. They recommend five times. Sometimes, you may need to ask more than 5 why's. You can do that and get to the bottom of things.

[26:18] The Kitchen Example

For instance, you're emptying the dishwasher, you don't put your silverware in the drawer in another room. You put it in your kitchen drawer. That makes the most sense as you don't have to walk around the different parts of your house.

When you take something out of the fridge, do you need to put it on the counter or do you need to wash it or chop it? You don't want your sink and fridge to be far apart.

When you wash things or drain things, you usually want to go from the sink to the stove top. You don't want those to be across the room either. You would be surprised how many poorly designed kitchens there are out there.

[28:58] Learning Process Improvement in Healthcare

Residency programs have started requiring process improvement projects as part of the residency. There is an increased understanding in perspective from the clinical community. They now recognize the need to train healthcare professionals, medical students, and residents in how to think and approach improving processes and systems.

One of the hardest things to change is to change something that you've been doing in one particular way forever and ever. Getting into that habit of thinking critically at how you do things and how you do them better is a really important skill to have.

More recently, AMA has launched new guidelines for the kinds of things you should be studying in medical school. There's this push for the idea of healthcare delivery system science.

[31:05] Courses Offered at Lehigh and Recommended Resources

Their university offers courses dedicated to understanding process improvement and understanding finance in relation to a hospital level and a physician's perspective.

They also have courses in information systems. Students will understand how they can utilize information systems to drive decision making.

Everything they learn in medical school overlays on a different concept of medicine and care delivery.

Ana recommends different books students can check out on process improvement including The Innovator's Prescription: A Disruptive Solution for Health Care by Clayton M. Christensen

as well as books about the Toyota production system.

Examples of organizations that have adopted the mindset of continuously improving and striving for better include Virginia Medicine, ThedaCare, Intermountain Healthcare, and Mayo Clinic.

Find out more about Lehigh University and the courses they offer on their website. Also check out the different resources you can link to from their website.

In 2014, the President's Council of Advisors on Science and Technology (PCAST) published a report on the need for systems engineering and system thinking in healthcare. This wasn't only limited to clinical professionals but also touching all the different areas of healthcare.

They provided examples of specific applications of systems engineering in healthcare in many different settings. They laid out why this kind of mindset is needed in healthcare and why it should be built.

Personally, I would not recommend this Master's program if you're looking at improving your GPA so you use this as your postbac program. But this is the program for you if you're really interested in process improvement and healthcare systems engineering.

You can have this knowledge base for your future practice or if you're thinking about going into administration. That being said, you don't really need to go through a Master's program to start learning all this information.

Links:

Lehigh University

Meded Media

Book recommendations:

The Innovator's Prescription: A Disruptive Solution for Health Care by Clayton M. Christensen

The Goal by Eliyahu M. Goldratt

PCAST Report 2014

May 15, 2019
337: How to Overcome Test Anxiety and Take Back Control
38:06

Session 337

Do you always get nervous when taking exams? This is definitely not something you want to deal with especially on the MCAT.

Dr. David Puder is a psychotherapist and today, he talks about text anxiety and how to reduce it. He also hosts his own podcast – the Psychiatry & Psychotherapy Podcast.

Text WILDMED to 44222 and get a chance to come to Colorado so you can learn and be part of the University of Colorado Wilderness Medicine Course (where I teach). Get out of the classroom and get into the wilderness!

[02:05] Interest in Medicine

It wasn't until his senior year of high school that he decided to get into medicine. By college, he was focused on giving his best shot.

Basically, he did a year of internal medicine and later went on to take Psychiatry. He was fascinated by the mind and workings of human behavior. To him, the psychological part was always so much more fascinating to him.

His interest in helping students with overcoming text anxiety began when he as moonlighting at a local university, where he worked one day a week. This was something he did for about five years.

He noticed that a lot of the kids that would come to see him would have anxiety around test taking as well as depression, ADHD, and procrastination issues. David got interested in it and feels satisfied being able to treat it and see the response. They take the test and they do well.

[04:30] David's Personal Journey with Text Anxiety

Not coming from a family of doctors, no one prepared him for what it would be like taking the MCAT. Until he showed up that day, he didn't have any idea what a lifechanging exam it felt like.

He remembers having a dizzy feeling at the beginning of the test. It took him a while to ground himself. And he didn't score well because of that.

[05:45] The Science Behind Text Anxiety

David describes the symptoms of students with severe anxiety or anticipation during the exam. In fact, they do worse than their IQ would estimate. They may do well in the prep but then when the actual exam comes, their anxiety is high.

They have palpitations or shortness of breath. They feel derealization or depersonalization, where you feel out of body or the world is in a fog. Then as they look back to the test, they realize they totally knew it but they just had difficulty pulling information out of their brain.

These people can hear everything around them and it's distracting them. You have increased obsessional thoughts. You get obsessed about one question and you spend a ton of time even if you probably should move on.

Another symptom is poor working memory, which is the ability to move pieces of knowledge around in your brain.

The people that have high anxiety before the actual test may procrastinate, may be disorganized, and have reduced effort. They may have failed the MCAT or some standardized test before.

They may have no evidence of other types of mood issues, no chronic anxiety, social anxiety, or depression. They may not binge on alcohol on the weekends or smoke marijuana, or have any secondary gain for failure. They don't have ADHD or any learning disorder like dyslexia.

In fact, David says that some of his most interesting patients are those who fail because they don't want to go to medical school because their parents are pushing them too hard.

[09:00] Test Anxiety vs Learning Disorder

David recalls being disappointed by his MCAT score and getting told by his mentor to get psychological testing. He felt an intense feeling of shame. So he never went to get tested.

But now, David actually recommends getting psychology testing done.

For instance, you get a referral from a psychiatrist or a learning disorder specialist. Then they test you for 4-6 hours. They can check whether you have ADHD. They can check your IQ. They can check for specific learning disorders.

Then you get this huge 40-page writeup about all of your strengths and areas where you may not be as strong. David believes this is a good place to start. You might also want to go see a psychiatrist who has seen a number of people in similar situations.

You know you have dyslexia or a learning disorder when for instance, you're smart in math but reading is really hard. There's a big step to different functions of your IQ.

There are benefits to getting tested and having a diagnosis. This means you can work around your deficits just in time before you take the MCAT.

[12:12] Knowing Your Learning Style

Part of developing a good learning plan for yourself is to understand where your strengths are and meeting those needs.

For some people, they may not go to lectures but they may spend time reading books. Others learn through auditory hearing. Once they get psychological testing, they can go through the Braille Institute and get every textbook on audio. So they just listen to the material.

For David, he finds auditory learning to be more effective than reading. (The same way for me.) This being said, it's not impossible for somebody to have a diagnosis of a learning disability and still do well.

Regardless, you can still be a good doctor. You may have to put in more work. But keep going.

[15:08] Ruling Out Text Anxiety

Before we talk about the actual treatment, David outlines the things to be ruled out first.

For instance, when he sees a patient coming in, he figures out whether the person has a primary mood disorder.

Could they be struggling with depression or anxiety? Maybe they have difficulty motivating themselves. They may have lots of guilt or self-hatred. They may have panic disorders and have random panic attacks during the day.

They may have difficulty controlling their worry in most situations in life. For those with OCD, they may have obsessive thoughts that get in the way of study time or life in general.

They may be on substances. Marijuana can increase your anxiety long term and alcohol as well.

They may have underlying medical issues that are not controlled such as hypothyroidism, hyperthyroidism, asthma attacks, seizures, etc. There may be medical issues that are not controlled that are affecting your ability to focus and concentrate.

Maybe they're also on medication that decreases their cognitive function. There are drugs like Topamax for migraines. One of its side effects is a decreased ability to find words. Benadryl can cloud your thinking.

Once students have gone through this list, and none of these resonate for them. They can get ruled out by a doctor or a psychiatrist and that they only have text anxiety. Then we move on to the treatment.

[17:40] How to Treat Text Anxiety

David tries to get his patients on an exercise routine just to bring down their physiological system. He gets them off caffeine, tobacco, alcohol, or marijuana.

The next step would be some behavioral treatments – progressive muscle relaxation, systematic desensitization, and behavioral rehearsal. Yoga is another great way to calm your body systems down.

Behavioral rehearsal involves recreating every situation possible on what it's going to look like on test day itself.

For instance, if your test day is on a Friday, so you do it on a Friday. Drive in the same way that you're going to drive on test day. Eat the same food. (Get some slow-burning fuel in your system like avocado and oats.)

Create a pattern for how you're going to start your day on the actual test day. Do it and rehearse it. Go and take a trial exam. Sit in the same room. Pretend you're taking the real test.

When you get overly stimulated, practice muscle relaxation and calm breathing. If you do this enough, you can extinguish the level of fear you'll feel on the day of the exam.

[20:24] Apps and Mindfulness Exercises

David doesn't recommend particular apps but his patients have found this to be useful. What he generally does is walking mindfulness with patients. They walk together. They walk slowly and feel their feet on the bottom of the ground.

He would also do some chocolate mindfulness at times. They would sit and eat the chocolate for a minute or two. They chew on the chocolate, not swallowing. They're tasting all the flavors.

When you slowly eat, walk, and breathe, you're strengthening the part of your brain that is in connection with your body.

Derealization and depersonalization in an exam would refer to the feeling of floating away from your body. Come back to your body. Feel your butt on your seat. Feel your feet planted on to the ground. Walk around if you need to and feel your feet on the ground.

These things actually pull you out of that state of dissociation and can keep you in a state that lowers anxiety. So you can perform but not freak out.

[22:50] Dealing with Anxiety During Test Day

Come test day, David suggests some tips to help you deal with potential anxiety. Learn breathing techniques. Feel your body in the position it is. Feel your feet on the ground. Move your feet. Squeeze your toes.

You can also practice test-taking strategies. For instance, if you find a specific question to be really hard, just skip it and move ahead. Then come back to it if you have time.

When you regulate and calm your body, there is a bio-directional thing. That's why parenting can be so hard because you can feel the chaotic dissociative energy of the kids.

So you breathe mindfully to calm your own body. Then when you look a child, the child takes in that energy and calms down. This is the same as what David does with his patients who are anxious.

[25:45] Dealing with Negative Self-Talk

Cognitive therapy is an effective way of dealing with negative thinking. We put our own thoughts on trial and judge the accuracy of the thoughts.

For example, one cognitive distortion is over generalization. You take one bad experience and extend it to all the experiences that will happen in the future. "I failed this test. Therefore, I will fail all tests." And you know this is not true.  So you try to move into a more truthful state.

Another example is black and white thinking. "I didn't study 40 hours a week then I will not pass this test." So you go all black or all white on things.

There's also emotional reasoning – "I feel stupid, therefore, I am." And this is the system that we live in.

Once you realize that your goal is to make other people not look stupid, you'll do a lot better. There is no way you can know everything. You have to get used to the fact that you can't be perfect. You can only work hard and continue to try to learn.

Ultimately, it just comes down to practice. People spend hundreds of hours learning stuff. Instead, spend 50 hours just learning on yourself. Learn some of this emotional stuff. Get into a place where you can counteract these negative thoughts that come into your brain. It really is a discipline of practice to be good at doing this.

[30:00] Use of Medications

David says that sometimes medications can help. He has treated some cases where he gives Propanolol. It's a beta-blocker that decreases the physiologic experience of stress.

He recommends that you start with 10-20 mg Propanolol. Try it on a weekend when you're studying just to see if there are any side effects. Some people feel lightheaded or really tired, but that's rare.

Try this another time when you're taking a trial test. See if this decreases your anxiety. Then take the same dose during the test.

The other class of medications would be antidepressants. They tend to decrease overall anxiety. But you have to be on them for six weeks for the anxiety to come down. It's not something you want to take a week before the MCAT.

[31:53] Listen to the Psychiatry & Psychotherapy Podcast

Please take time to check out and listen to David's podcast. He goes through a series on microexpression, where you learn how to read people's facial expressions, and how to use that information.

Microexpression is that ellipse of emotion that flash on people's faces. And most of the time, they people would score it 50% right and 50% wrong. Learn how to read it and use it! Once you can get that feedback, you can learn from your experiences.

So much of what we do in medicine is face-to-face human interaction. If you're able to connect with people on a day-to-day basis, you will experience so much more gratitude from your patients because your patients will appreciate you. It’s one of the areas we can influence and decrease burnout actually.

Links:

Meded Media

Psychiatry & Psychotherapy Podcast

Follow David on Instagram @dr.davidpuder

May 08, 2019
336: How to Ace the MCAT Psych/Soc Section & Improve Your Memory
46:54

Session 336

Phil is a Master Level Tutor at Next Step Test Prep. He shares with us some tips in mastering the Psych/Soc section of the MCAT. Today's episode is very helpful as you prepare for your MCAT as well as even in your premed courses, and eventually when you get to medical school. The reason Phil wants to come on the podcast is to talk about Psych/Soc because about 25% of his private MCAT students are getting perfect scores. Find out how you, too, can ace this section on the MCAT!

[02:40] Phil's Background

Phil went to the University of Nebraska as an MD/PhD student where he did his PhD in Neuroscience. He has been through the process itself and attributes his MCAT score to a big part of that. Phil actually left during his second year of medical school. He did some research over the summer. The reason he went to med school is that he wanted to become an instructor. He finds performing research less exciting as compared with sharing knowledge. Due to an illness in their family, Phil took a leave of absence from medical school to be around family. Upon which, he got contacted by Next Step Test Prep, where he now helps write and edit content, as well as teach and run the office hours.

"Med schools want to know that when students come to the med school, they're doing it because they want to be a practicing physician and not just because they watch Scrubs."

[06:55] How Can Students Learn Better?

The brain is very good at learning certain things. There are things inherent to us like recognizing faces and understanding social interactions. The idea is to hack and hijack the way your brain naturally wants to learn. Just like a screwdriver, your brain is very good at certain things. A screwdriver is used to drive a screw. You can use it as a hammer but it's not going to be as efficient. This could work and you could build a shelf that way. But when you try to do a bigger task like instead of building a shelf, you're now building a house. Obviously, a screwdriver as a hammering tool is not going to work.

Many times, students are using their brain like a hammer. They're using it in an inefficient way. They're smashing their head into a pile of equations. This will work if it's a small enough task. But then it's already a different story if you start to deal with bigger things like the MCAT or medical school. Pysch, specifically, involves vocab recognition. And Phil has taken different approaches.

[12:13] The Psych/Soc Section

This section contains a lot of neuro-related content such as disorders, cause, syndromes, etc. These are things a student needs to know at some point. It's also important to understand terms like influences, groupthink, and things like that. They want to test and make sure students are aware of.

In terms of doing prereqs to prepare for this section on the MCAT, Phil thinks this actually depends. If you want to do well in your Psych/Soc, Phil recommends taking a Neuro course.

It can be disconcerting to spend a lot of time on your bio and chem courses but so little on psych. But it's Psych is the second highest yield content area on the test. The first highest is Bio and Biochem. 1 out of every 3 questions is a bio question on the MCAT, including the CARS section. After psych, the next highest yield would be Chemistry and Physics. In fact, there are more psych questions than chemistry and physics combined.

"Psych is the second highest yield content area on the test. The first highest is Bio and Biochem."

There are tons of students that will spend 3 weeks studying organic chemistry and 2 weeks studying physics since those were the scary undergrad courses for them. And we spend a little time on pysch. But organic chemistry is less than 5% of the test. It's also the one area that's easier on the MCAT that it is in undergrad. That being said, you should spend minimal time on Organic Chemistry compared to the time you spend on Pysch and Bio.

[18:03] Where to Start

Go straight to the AAMC for all the sections. But Phil doesn't find the stuff on Chemistry and Physics as useful. When you get to the psych/soc section, it's very granular as they break it down. Surprisingly, they find specific things but they're on the AAMC outline for Psych. And so this is something they will hold students accountable for it.

A word of caution: Many students are just compiling different psych/soc documents out there and flip through them. However, this is very passive learning. You are just reading something that someone else has put together.

Rather than reading definitions and books, Phil would make students go through tasks so they can describe whatever experience for themselves. Once the students can describe it in their own language, that encodes differently in the brain.

"Using different regions of the brain sticks a whole lot better than if you just something in the book."

Moreover, the idea of being able to hold on to some information for 4-5 months to even a year is very difficult. And if you're just reading something that somebody wrote and put together, that doesn't work either.

[20:40] Knowing the Terms

If for example, if schizoid personality disorder is the correct answer, what would you expect to be the incorrect answers? A schizoid personality disorder is a disorder where people just don't have any interest in interacting with others. It's not that they hate other people. They just don't have the drive to interact with other people. They don't see the point.

Now, there are a lot of other personality disorders that students might be confused about. For somebody not interested in socializing, one might pick the antisocial personality disorder. 90% of students will pick that if they're not aware of the difference of these things. Or they will pick avoidant personality disorder.

These are terms MCAT is holding students accountable on the AAMC list. So make sure you're able to dive in and pull those apart. The AAMC expects you to already have that kind of information so just stick to that outline.

[24:20] Learning Styles: Writing, Typing, and Flash Cards

Your learning style can change in medical school because the volume has changed. Instead of just trying to memorize something, it's about complex stories. In your mind, you imagine this person has a disease and you treated them. You screwed up and now you're going to remember this forever. Nothing actually happened to anybody. But in your mind, there's this traumatic thing that you really need to know the difference between this and that. This is one of the best ways to hold on to information forever rather than just read a definition.

Both writing it down and saying it out loud are better than just reading. They're more active. There's also been research showing that handwriting stuff can increase encoding better than typing.

One region of the test that Phil encourages students to use flashcards is when you're trying to memorize little vocab things. There are a lot of this in psych/soc. Flash cards are also useful for studying amino acids. But Phil doesn't think they're useful for equations. This is probably one of the number one errors that students make.

"Instead of just memorizing a pile of equations, it's really important to do questions."

Phil recommends doing questions when trying to memorize equations. If you can do 4-5 questions using one specific equation, your brain will hold on to that. Because once you finish a question, there's that dopamine rush where there's a reward pathway in your brain. And your brain thinks that whatever that was, it holds onto that so that you can have the dopamine rush again in the future. Do 4-5 questions and your brain will remember that equation without trying to because it was a useful tool to it.

Downloading flashcard apps is nowhere near as useful as making flashcards yourself. It does take time, but overall, it's going to take less time. The act of making the flashcard is the most important part of the memorization process.

[31:10] Using the Power of Stories

For terms that are similar sounding, first off, notice how things can be confusing. The best way is to use stories. For example, paranoid schizophrenia is going to have delusions. Paranoid personality disorders is based on real life in a non delusional state but still being paranoid. For paranoid schizophrenia, I could probably see their neighbor walking down the street. Then the neighbor looks towards the house. And I know they're working for the Russians. This is delusional. While with the paranoid personality disorder, someone is just paranoid about non delusional things. For example, you don't let anybody hold your first child afraid they're going to catch diseases. Diseases do exist, but they're just being unrealistic. So stories like this would stick with you long-term versus just reading the definition in the book.

[34:37] Application vs Memorization

There are stories running that the psych/soc is a lot of application and not as much straight vocab and memorization. And this is how the MCAT is across the board. But you still need to have the concept underlying it memorized.

For example in Physics, instead of asking you about which of these capacitors are strongest, they're going to have a setup. Say, the membrane of the neuron acts as a capacitor where charges can build up on either side. Switching from oleic acid to linoleic acid will do what capacitance of that membrane? This is something no one would probably study about. But when you understand that when the two plates of a capacitor get closer together, the capacitance goes up. So if you switch out large fatty acids for smaller fatty acids in the membrane, this brings the charges close to each other. So this increases the capacitance.

In order to understand that question then, you therefore need to understand how distance affects the distance between plates. You need to memorize the equation for that. Phil says there are two sides to it.

"Memorization is crucial but it is not all of it though because there is the application side."

A lot of the MCAT deals with data interpretation, how to pull the passage apart, how to figure out what they're actually asking you. The MCAT likes to twist things around across borders. Hence, you have to see the bigger picture and application is a huge part of that. Again, it's not just content, but it is underlying everything.

[38:25] Content is Still Crucial

Taking a lot of practice tests is great if your problem is timing, endurance, stamina, data interpretation, and trying to figure out what the question is asking and making those connections. But if you don't know what schizoid personality disorder is, no amount of practice test is going to help that. So the content side is really important.

[39:35] Next Step Test Prep Course

Next Step has hundreds of hours of videos. Some of the core lesson videos contain a lot of strategies, high-yield content that everyone needs to see. There are also other content review videos that Phil has made. Some of the content review stuff are designed to help you focus more on your weaker areas. That said, their course is designed around the idea that every student is different. They also have quizzes built in all of their content review videos and lesson videos. They're pushing active learning so students are reinforced and space repetition is included as well.

Next Step also have office hours, a big part of what Phil does. He does at least 10 hours of office hours. Students can just come in and talk about whatever questions they have. Additionally, they do public webinars, giving specific advice and strategies in tackling different topics as well as studying methodologies. They have free resources students have access to and some forums to make sure questions from students are being answered.

"Whether or not you go to med school shouldn't be based on how much money you have."

Links:

Next Step Test Prep (Promo Code: MSHQ to save $50 off the MCAT course)

MCATCourseReview.com

May 01, 2019
335: Rebounding From Two Low MCAT Scores to Gain an Acceptance
38:21

Austin didn't have perfect grades, had two low MCAT scores, and gained an acceptance. I always say that you do not need to be perfect, Austin exemplifies that.

Apr 24, 2019
334: What to Be Prepared to Discuss in the Med School Interview
21:40

Session 334

When you walk into your medical school interview, if you’re not prepared for specific types of questions, it may throw you off completely. Let’s talk about them!

Today, we talk about the things you need to prepare for to discuss in the medical school interview. When expectations don't meet reality, that's when there's a lot of anxiety, fear, upset, and anger. Otherwise, you're going to freak out during the interview. The goal of this podcast along with all the other services we offer.

Also, be sure to check out all our other podcasts on MedEd Media to help you on this path towards becoming a physician.

[03:40] Abortion

During the medical school interview, you're going to be asked a lot of moral and ethical questions. How are you going to handle those scenarios? Therefore, you need to be prepared to talk about abortion. Regardless of your background, this could come out in the medical school interview. So you need to be able to discuss it. Talk about why people are adamant against it or for it. Be careful not to say you're "pro-abortion" since nobody is. Instead, you should be saying you're pro-choice. You want women to have the "privilege" to make that decision for themselves. There's the pro-life camp and the pro-choice camp. Talk about both sides and why they're so diametrically opposed to this topic. More importantly, be able to talk about why you have your point of view.

[05:25] Euthanasia

This topic is big in the news these days. An eastern state actually just recently allowed terminally ill patients to die if they wanted to. "Right to life" is the more politically correct way to put it. And you have the "physician-assisted suicide" or euthanasia. But the Right to Die law is very big in Colorado, as well as in Oregon and California. More and more states are going to have right to die laws. Their positioning is that keeping people alive in terrible states of health is not really fun. It's very expensive. You don't necessarily want to think about it from a monetary standpoint. But you have to because you have limited resources. Also, you have to consider whether the person is really living the life they want to live. Be able to talk about why you agree with Right to Life and why otherwise.

For the right to die laws, a lot of students will say that the Hippocratic Law says to do no harm. And that their job is to save, protect, and heal the patient. First, "do no harm" is not in the Hippocratic Oath. That is a very butchered quote. But dig a little deeper as to why you are against the Right to Life or Right to Die. Be able to talk about your thought process behind it.

You also have to be okay with the understanding that the person standing across from you may have different views from you. You still have to be able to speak your mind and not worry about what is going to happen if you're talking about something that 's different. Hopefully, they're a professional and that you're not attacking the other side.

[08:14] The Healthcare System

Be able to talk about not just the healthcare system in the U.S. but also about the healthcare system around the world. Obviously, you're not going to know what the healthcare system of certain countries would be. But at least be able to understand some of the bigger generalities of different healthcare systems (i.e. Canada, UK, China, Japan, Australia, etc.) Think about those other countries and what healthcare systems they have. What works and what doesn't work.

Also, be careful with the term "socialized" medicine. Any term that has "social" or whatever political aspect that carries "social" in it gets very heated responses from people. Instead, refer to things as universal healthcare or single payer healthcare. There are some truly socialized medicine systems out there with the UK being one of them. It means the government is paying for healthcare and delivering it at the same time. The majority of hospitals in the UK are government-run hospitals. This is socialized medicine.

This is different from the system in Canada where they follow a single-payer system. They take the tax money you pay, turn it around, and give it back to you in terms of healthcare. This is delivered by non-government hospitals and employees.

It's something similar in the U.S. healthcare system where we moved to what's known as Medicare for All system. It's a single-payer, government-run system. But it's only for people of certain ages. The care is being paid for by the government through taxes being delivered by private institutions.  Regardless of age, the system would be the same.

[11:25] Pharmaceutical Industries and Politics

Be able to talk about the pharmaceutical industry and what they're doing to hurt or help our healthcare system. Know about the astronomical prices of medications in the news lately. Also, think about the possible solutions. What would you do to reduce the cost of drugs in this country?

Understand what the current administration is doing, what the previous administration has done, and what is going on in the world of politics.

[13:45] About Yourself

You need to be prepared to talk about yourself. Many students wouldn't want to talk about themselves.

Moreover, you need to understand why you're applying to that school and why you want to go to that school. It can't be as generic as going therebecause the school can make you become a competent physician. You need to be super specific about why you want to go to that school. Find out what programs they have, curriculum types, etc. Just dig deeper and specific things about that school. There's going to be overlap with schools but don't use super generic things.

[15:00] Serving the Underserved

One thing that a lot of students say too is that they serve the underserved. Then you better have proof in your application that this is your mission. Secondly, the majority of medical schools serve the underserved. So you are there to learn how to be a doctor. You need guinea pigs to work on and the underserved need people to take care of them. So it's the perfect mix of supply and demand.

[16:00] Why They Should Accept You

A majority of students may answer this from more of a bragging sense of this is who they are. They talk about what they've done and how ready they are. Instead, think about your experiences and traits. How can you add to the educational environment of your peers?

So you don't need to know everything about the questions because that's not the point of this interview. Rather, you just need to have some info about them. You can't just say you don't like socialized medicine because you think it sucks. But you have to be able to support that. Be careful with anecdotal stories in supporting what you're saying. As best as you can, try to get information.

Links:

MedEd Media

Apr 17, 2019
333: From Canada to the Caribbean to the US: This MD's Journey
46:56

Session 333

Emma is Canadian, played D1 basketball in the U.S., and then went to Ross in the Caribbean for medical school. She is now starting her residency in the U.S. She takes us through her journey and shares helpful tips for Canadian students. I found Emma on Instagram with her handle @d1todr.

A lot of you are probably thinking about going to the Caribbean. Emma did poorly on the MCAT but did well in the Caribbean. She even matched at a very prestigious residency program in the states.

[02:25] Interest in Becoming a Physician

Emma went back to medical school at 27. But her interest actually stemmed from her sister having been diagnosed with both rheumatoid arthritis and Grave’s disease. They were on a vacation in Florida and her pills for her rheumatoid arthritis interacted with medication for Grave’s disease. She got so stiff that they had to bring her to the hospital. At that point, she wanted to know why that happened. This was that little seed that got planted onto her at 17. So she took the undergrad courses as premed, majoring in Biology.

She was playing D1 basketball at that time and she was told that it wasn’t going to be possible to do both basketball and the necessary science courses. Everyone basically said she wasn’t going to make it.

“When the ball stops bouncing one day, what do I have to show for it? I wanted a degree that I was proud of and that I wanted… I fought every single day to do my degree.”

[06:03] Shadowing in Canada

Volunteering was initially challenging for her during undergrad. So she went to Canada after undergrad and took some years to shadow at a local hospital as well as some volunteering. Especially in Canada, finding some shadowing opportunities can be very, very hard. What she found very effective was to volunteer first. She volunteered at a Queen’s University’s affiliate school in Ontario. So she volunteered at the health program at the hospital’s elder care program, where she was doing physical therapy exercises with elderly patients.

Volunteering allows you to meet doctors that come in and that’s when you can make those connections.

“Make sure you do volunteering and make those connections first and then the shadowing will happen after.”

[08:44] From U.S. to Canada to the Caribbean

Emma graduated with honors with a 3.7. She was the first of the players to graduate with a science degree. It was a nice feeling for her to be able to pass on stage and nod at her coaches, letting them know that she did it! However, she knew that applying back home in Canada was going to be tough. Although she did her undergrad in the U.S., she always knew she wanted to go to medical school in Canada with the dream to be an Olympic sports doctor. So she applied for two application cycles but both were unsuccessful. She got tired of waiting so she ultimately looked at the Caribbean route as she didn’t get any interview.

The Canadian application is very similar to the application in the U.S., but still it’s different. There’s no rolling admissions in Canada and no application services outside of Ontario. There are six medical schools in Ontario that’s why an application service helps – all six of which are part of the application service.

Emma applied everywhere. Out of 17 medical schools in Canada, four are in French. So you’re now only left with 13 options if you’re an English speaker and this just limits you incredibly. And there’s no point applying to those unless you’re a fluent French speaker.

[12:43] Canadian and CARS

One of the things that always comes up in the Premed Hangout Group is a student getting a 517 and having to take it. They forgot to mention they’re Canadian and their CARS score is only 127. A lot of the programs in Canada only take a certain part of the MCAT. For instance, McMaster University only takes the Verbal and Saskatchewan only takes Biology. So it’s tough to study for these exams since the overall grade doesn’t matter. A lot of the Canadian medical schools don’t even take the MCAT. But there are other parts of the application that you need to consider. As with McMaster, you have to make sure you do well on CASPer.

“The MCAT in the U.S. is what separates great and good students...it’s tough because there are less chances to prove that you’re worthy of it and that’s what’s really hurting in Canada.”

[15:15] Getting Rejected the First Time and the Feedback Process

The first time Emma applied, she already had volunteering done and the other extracurriculars. Thinking she had good leverage, she applied broadly and mass provincially but she didn’t get anything. She blames this on her poor MCAT score at 17 – which is really bad. She basically took it three times, and 19 was her highest.

So what went wrong? She was doing great during undergrad. And she couldn’t really pinpoint what she’s done wrong. She admits she didn’t really know how to study until she got to medical school. She did do an MCAT prep course to keep her on track.

“I didn’t really fully get the grasp of how to study, how to get this information in my brain. I just wasn’t a good standardized test taker.”

During her first attempt, her mindset was that she was doing good in undergrad so the MCAT should be fine. But she didn’t pass. So she took a course before her third attempt and still only improved by two points. But then again, a lot of Canadian schools don’t look at the MCAT at all. So removing this factor from her application, she really couldn’t figure out what else could she have done better.

[19:00] Applying to U.S. Medical Schools and the Caribbean

Interestingly, Emma didn’t consider applying to U.S. medical schools. She heard of Ross though and wasn’t sure about the DO route either until she met a couple of DOs. Instead, she did apply to Ireland, Australia, and the Caribbean.

There are so much horrible things to be found on the internet about Caribbean schools and Emma highly suggests to not read them at all. This paved the way for her to start her blog and her social media presence to tell people that they can do it.

“If you want to be well-informed, just stop reading them. They’re filled with crazy stats. They’re filled with people that are just too afraid to make the huge jump themselves. So they put a huge stigma on it.”

So she ended up applying to Ross. She listened to the seminars and she just loved it. She encourages students to go to seminars since this is a way for you to meet people. You get to meet several alumni and ask them specific questions.

When Emma applied four years ago, there was no real student’s perspective on the Caribbean route. That’s why she ended up starting a blog to answer questions each week.

[21:53] Fighting Against Nature and the Attrition Rate

During her time in medical school, the Caribbean was hit by hurricanes two times. Emma describes it as being tough. However, the really good thing about it is you have no distractions. You’re secluded and away from family and friends.

Emma gets asked a lot about the attrition rate. And she believes it’s not that high. There were 200 people in May 2015 when she started, and 180 in their class got off the island at the same time she did. The people who failed are the people who were there for family pressures. They think they’re just there to party and they have the money so they do it anyway. They’re also those people who aren’t sure if medical school is right for them. The attrition rate is high because of the people that don’t want to be there.

“If you want to do medical school and you’re not here because of family pressures, you’re not here just because you have money, you will pass and you will be fine.”

Ross is one of the most prestigious schools in the Caribbean, Emma explains that the attrition rate is relatively high compared to the U.S. and Canadian medical schools. But look at who are the people failing. And even based on personal experience, Emma says she would already know who are the people who aren’t going to make it, even on the first day. So you just have to focus on yourself. There are people who are not taking it seriously and those are the people who fail.

[24:55] Finances and Loans

For Canadians who study abroad, you have to get a bank loan. Ross costs $24,000 (USD) every four months. Emma points out how the conversion rate is eating up the loan. Every time she paid her tuition, she’d lose $10,000. So it’s expensive. Their provincial loan, OSAP gives a maximum of $10,000 a year. It’s enough to pay your necessities. So you may have to get a bank loan. Examples are CIBC, TD, and RBC are the best three that she’s aware of.

“The conversion rate is what eats up your loan.”

The loans would usually give you a six-month grace period, enough time for you to get on your feet, grab a couple of paychecks, and then you get to decide how much you pay back. You can decide how much you want to put up towards the capital and how much towards the interest. The great thing about Canadian loans is that it’s only 2.3%. So the interest is not that bad.

[28:20] Rotations in Canada

Your third year of medical school is going to be at one hospital in the U.S. and fourth year, you can do as many electives as you want in Canada. They have 9 electives – each is composed of four weeks so it’s a total of 36 weeks. You can stay there for as long as you want.

The sad part is that the fourth year electives for the IMGs (International Medical Graduates) is done through a lottery system. So you don’t really know if you’re going to get it or not. And if you don’t get any in Canada, then you can still find some in the states.

The second time Emma was rejected in her application to Canadian school, she knew she wasn’t going to go back to Canada. She believes that if they’re not going to want her as a medical student, then they’re not going to want her as a physician. So as soon as she got into Ross, she knew she wanted to become a sports med doc in the states. And this has been her path since so she did her electives in the states.

[30:05] Picking Her Electives

During her fourth year, they were given a list of programs where they could choose to do their electives at. The IMF or the Internal Medicine Foundations is an 8-week course before you start your clinical rotations. At the start of IMF, Ross gave them a list of potentially starting clinical rotations at that time. Part of her thought process in choosing was to go to a state where her husband could also teach. So she had Chicago, New York, California, and Atlanta. He couldn’t teach in New York. They didn’t want to live in California and they didn’t want to live in Chicago, being sick of the cold. So she ultimately chose Atlanta, specifically Emery, which is an amazing sports med institution. She did two electives during her fourth year and she was just in love with it.

[32:00] Matching at a Prestigious School

Emma explains that what got her to Emery was really hard work during third and fourth year. She tried to meet as many people as possible. She also went to a sports medicine conference in Kansas City, which she highly recommends students should do. In fact, most of her interviews was about the conference. She was very active in their community. She would find out where Emery didactics were and she would show up. She also met the Associate Director of Sports Medicine Fellowship at Emery, who came to be her mentor in the past couple of years. She asked if she could do an elective with him and he was okay with it. So attending that conference gave her that connection. He also helped her get a Sub-I and he rooted for her. The interview went well and the rest was just history.

Emma is basically a perfect example of a student where it’s all about who you are as a person, not where you went to medical school. You just have to show yourself and be yourself. Go to conferences. Show your interest and involvement. Show your dedication. Put in the work and effort. She had gone to a Caribbean school but she didn’t let that limit her. More importantly, her attitude was how she really got through. She just didn’t take no for an answer.

“It’s all about who you are as a person, not where you went to medical school.”

[36:15] Caribbean as First Choice?

Emma wouldn’t recommend students to apply to the Caribbean right out of the gate. It took her two application cycles before she went to Ross. Instead, try in your home country. Try more than once if you want. Emma thinks she could have applied to Ross right after her first application. That said, there were students who went directly from college to Ross and they loved it. So it basically depends on where you are in your life and if you’ve tried back home.

“Definitely try back home and look for the Caribbean second.”

[37:33] Overcoming the Stigma

The only instance where Emma said she experience this was with these certain surgery attending physicians who were traditional. She feels that the stigma comes from the online forum. Because of this, it’s been her mission to create a safe haven on the internet for Caribbean grads and alumni.

There were a couple of states where the programs didn’t look favorably at Caribbean students. That’s okay.  There are also those programs that are IMG friendly.

[40:00] Practicing in Canada

If you did your residency in the states and you want to practice in Canada, Emma explains that it’s specific to the residency program. For family medicine, it’s a 2-year training in Canada and three years in the states. In this case, you’re actually “over” trained which is good. You don’t have to do anything else. Internal medicine is four years in Canada and three years in the states, you’d actually have to do one extra year of training. Or you could do a year in fellowship and cross back over. If you want to do residency in Canada, you have to take four extra exams on top of your U.S. boards.

[41:50] Figuring Out How to Study

Ross offers the Medical Education Readiness Program (MERP) where they look at which areas a student need more prep on. The program basically ran for 15 weeks and Emma was glad she found her learning style. She realized she loves studying alone and just studying for herself. So she just learned to listen to lectures by herself and do things by herself.

“Find your study style early and stick to it.”

[44:26] Is the Caribbean Doable?

Emma says it is! It’s about who you are as a person. Put in the hard work and it’s definitely doable. Don’t worry about the name of the institution. Again, it’s about who you are as a person.

Links:

PMY Session 303: How Can I Prepare for the CASPer?

Emma on Instagram @d1todr

Checkout Emma’s YouTube Channel

OSAP

Apr 10, 2019
332: 5 Biggest Mistakes Students Make During an MMI Interview
23:49

Session 332

Today, we're going to talk about the biggest mistakes students make when preparing for and during the Multiple Mini Interview or MMI. It's a new interview format that's sweeping the medical school nation. The MMI was originally from McMaster University in Canada, the same institution that brought the CASPer test that a lot of schools are using as a secondary screen. The MMI came before CASPer.

The MMI is supposed to help medical schools and admissions committee members really dive into more about who you are. It supposed to have less subjectivity when it comes to interviewing. Listen to Episode 152 where I had a great conversation with Dr. Rivera from NYU. We talked about everything you need to know about the MMI.

I do mock interviews with students and one of those formats is an MMI. The good thing is that students fall into very common traps that are really easy to fix.

"MMI is not a scary interview. It should be a fun interview."

Also, as I’m preparing a book about MMI, I would like to know your thoughts. What information do you want there? Send me an email at ryan@medicalschoolhq.net with the subject line: MMI Book and let me know!

[03:20] Every School Can Be Different

There is no one set standard MMI format. Every school is different. For instance, some schools have a specific number of stations wherein at each station, you read the scenario outside of the room. You go into the room and do whatever the scenario says. Then you come out of the room and rotate to the next room. This is the traditional MMI setting. Other schools are doing a mix of MMI and a traditional one-on-one interview.

Again, every school is different. So what one school looks like, what one student tells you the MMI is like, may not be applicable to what you will see on your MMI. The best thing to do is to ask the school.

"Every school can be different. Don't assume what you hear about one school is going to transfer over to another school."

[05:18] Different Types of Scenarios

A station is a room with a facilitator inside and a scenario outside the room. The scenario can be in the form of a problem to test your problem-solving skills. Or there could be an actor inside the room and you have to work through the situation. It could be a moral or ethical dilemma that you have to work through. There could also be a station where you're working with another student to figure out a puzzle or drawing.

"There are many different types of scenarios that you could walk into and reading the scenario on the outside is one of the most important things you need to do."

Reading the scenario appropriately is very important so this is something you need to keep in mind. In fact, not reading the scenarios is also one of the common mistakes students tend to make when it comes to MMI. Basically, you have two minutes to read the scenario. You go into the room and then you have 6-8 minutes inside. Then you come out and rotate through the different stations.

[07:00] Mistake #1: Structuring Answers

Several students read the most common MMI book out there right now. They structure their answer and put it into an algorithm of how to answer MMI questions. But they fail miserably because they've removed the conversational aspect of the MMI. Interviewers want to make sure that you're going to communicate well with their loved ones who are in the hospital.

"Interviews are there to test your ability to communicate."

However, if you come in with a very structured and algorithmic answer, you're removing the conversation piece, which is the whole point of the MMI. If they see that you're just coming with pre-prepared answers, they might think you couldn't think on the fly.

I'm actually writing a new book because several students that I do mock interviews with do this during the MMI portion of our mock interview.

[09:15] Mistake #2: Asking for Permission/Acceptance

Students come into the room and they will recap the scenario and ask the interviewer whether they got that right and understood it correctly. Never ask the interviewer whether you've read the scenario correctly. Otherwise, this only proves you don't have confidence in your reading skills. This is a high-stress, high-pressure environment of being at a medical school and interviewing to get an acceptance. And when students are stressed, sometimes they may not be able to read appropriately and they may miss something. This is something you have to work on to make sure you don't do that. Figure out how to calm your nerves as you're reading and really understand what you're looking at.

[11:37] Mistake #3: Not Reading the Scenario Properly

Because there are different types of scenarios, you have to understand and ask yourself the question of what you're walking into. Are you walking into a room where there are patients screaming at you and you're, say, a nurse or doctor? Are you walking into a room where there's an interviewer sitting there and you're just going to have a conversation about the scenario? Are you walking into a room where there is somebody else and you have to interact with them and collaborate with them over a project?

"You have to understand what you are walking into."

So could be walking into an interviewer-based scenario and then an actor-based scenario. Then the student walks into the room and thinks they're in another actor-based scenario when it's just the interviewer wanting to have a conversation. Failure to read appropriately would only show them that you don't have the reading comprehension skills that you should. You let your nerves get to you and you just didn't properly read the scenario. These are well-created scenarios so there's not going to be much room for interpretation in the scenario.

Moreover, if there's something that's not clicking in your mind while reading it or you have a followup question, you can ask for clarification. So when you walk into the room, introduce yourself. Tell them that before you start the scenario, ask for clarification on a specific part. You're not asking for reassurance that how you read it was correct but you're only asking for clarification on something. You're asking a specific question about a specific part of that scenario.

[15:10] Mistake #4: Stumbling Through the Laws Around Healthcare and What You Can and Can't Do as a Physician or Medical Student – and the Medicine Around Healthcare

This can be a medically based scenario and students will stumble because they don't know whether, for instance, surgery was supposed to be the option. The schools obviously don't expect you to know that you know this stuff. You're not expected to know the laws around ethics and how to treat different diseases and what medications work, the side effects, and all those other stuff.

As soon as you feel you can't answer a question because you don't know and realize you're not supposed to know, realize that it's okay to not know. They're not expecting you to know. You're not getting marked off because you don't know. The goal again is to hear your thought processes. They want to hear how you communicate.

"Part of that communication is communicating that you don't know, and how are you going to find out the answer."

Then you could tell the interviewer that you don't know the answer and here's what you're going to do. You're probably going to ask this or that person to see what your options are. Remember that you're never alone in these scenarios. You can ask for help. What specific laws do you want to know about? Don't assume you know everything. Help the interviewer understand what you're thinking and why you're thinking it.

"You're not alone in medicine. You can ask for help. Treat this as real as possible and the easier they will be for you."

[18:18] Mistake #5: Not Listening

This is very common, especially in actor-based scenarios. Remember again and again that the role of any interview is communication. How well do you communicate? And a huge part of communication is listening.

"You have to be a good listener."

Yes, this is a stressful situation. You're in a room with an actor screaming or doing all these things. And students make the mistake of thinking about what to say next. But what they miss is what the actor is saying in the situation. What they're saying is important because it's going to lead you down the path that's going to help you in the scenario. Remember that not everything is going to be in the scenario. Not every piece of information that you have to know is going to be in the scenario. The actors may say something that's going to help elaborate on something that was in the scenario.

Be very, very careful especially in actor-based scenarios. Listen to every work coming out of their mouth. You have to really understand what they're telling you so that you can properly move forward with your response.

[20:30] Mistake #6: Talking Too Much

With the MMI, you're given a range of time, usually two minutes, inside the room. Then you have anywhere between 6-8 minutes inside the room. Students think that you have to fill up the whole time. That is false. There are usually followup questions that the interviewer has. You don't really want to be talking the whole time and you're not giving any chance for the actor to talk to you. Give your answer and then shut up. Let the interviewer or the actor talk.

"Give your answer. Don't fill up the entire time. Listen for the followup questions that are going to lead you down another path."

[22:25] Final Thoughts

By understanding some of these traps and mistakes students make, as you prepare with your MMI, hopefully you won't be making these mistakes. And hope you really enjoy the MMI!

As I’m preparing a book about MMI, I would like to know your thoughts. What information do you want there? Send me an email at ryan@medicalschoolhq.net with the subject line: MMI Book and let me know!

Links:

PMY 152: The MMI: Everything You Need to Know About the Multiple Mini Interview

CASPer test

ryan@medicalschoolhq.net

Apr 03, 2019
331: 4 Things You Need to Do Now to Prepare For Your Applications
26:56

Session 331

Whether you’re applying to medical school this year, or later, we’re going to discuss what you should be doing to help your medical school applications.

Today, I’m discussing what you should be doing right now, specifically, four things you should be doing to prepare for your applications. If you’re a freshman in college and getting ready to apply to medical school, and you're planning on applying in May or June of this year, or whatever year you're listening to this, then this one will be a little bit more applicable to you.  

[01:40] Next Step Test Prep

Kindly check out Next Step Test Prep and their new Medical School Admissions Consulting, where they’ve partnered with me to help students with their medical school application. Save some money on those admissions services using the same promo code MSHQ.

[03:05] Letters of Recommendation

Depending on where you go to school, your pre-health advising office may have requirements for letters of recommendation. If you are at a school that uses a committee letter, talk to your advisers to find out if they’re able to write you a committee letter. Also, find out from them what letters of recommendation they require.

The general rule of thumb is getting letters from two science professors and one non-science professor. You may add a physician into that mix as well for an extra one.

“Students ask if they should get a letter of recommendation from a patient who wants to write a letter. I wouldn't go that far.”

Just as I don’t advise students to get a letter of recommendation from a patient, I wouldn’t suggest getting one from a nursing manager either. Two science, one non-science, and a physician you've shadowed are enough.

Now, if you are applying to an osteopathic medical school, a lot of them will have in their language that they strongly recommend a letter of recommendation from an osteopathic physician. Some of them will require it so I strongly recommend it. However, if you are struggling to find an osteopathic physician to shadow, this shouldn’t be a reason not to apply to osteopathic schools. Go ahead and apply, and continue to look for an osteopathic physician to shadow. If you continue to struggle, and the school reaches out to you, then you can open up a conversation and ask them for some recommendations as to where to shadow.

[05:52] FindShadowing.com – Soon!

We are hopefully starting a new website called www.FindShadowing.com. We just hired someone full-time to reach out to physicians to get them into our database so that we can then open it up to students looking for physicians to shadow.

If you have a shadowed a physician, please help hook us up with them and send them to www.FindShadowing.com. There's a link that physicians can use to sign up and enter their information. Our goal with it is to kind of put some protections in for the physicians so they're not overwhelmed with 100 student requests the first day it's open. So we'll figure all of that out as we go. It'll be a free service. We're thinking about potential value adds to where if you want to maybe sign up to be the next person to request, maybe there's a small charge to hold your place. But other than some small things like that, it'll be a free service to use for you guys. So that's www.FindShadowing.com.

[08:15] Asking for a Strong Letter of Recommendation

Let’s say you’re a nontraditional student. You haven't been in your undergrad in many, many years, and you've taken a postbac recently. It’s probably easy for you to get science letters of recommendation because you have been taking your science pre-reqs and a postbac. But what about that non-science?

To help you with this, go through your school list. Try to figure out the schools that you're most likely to apply to. Reach out to them and see if they're willing to alter their requirements to fit you as a nontraditional student. If they won’t, that is a very good sign that they’re just not very friendly to nontraditional students. So just go and be happy that you now know that.

One thing that you want to clearly do 100% is to ask for a strong letter of recommendation. Just because you got an A from a physician, when you only had little interaction with them, isn’t enough. You need to be able to develop a relationship with your professors.

“It's not just about getting an A. It's about that connection with that professor, the relationship that you've built.”

Hopefully, they've learned who you are, and you've had conversations with him or her. You have to have that relationship. So as you are starting a course, go to the professor and introduce yourself. Let them know that you are premed and that you will potentially be asking for a letter of recommendation at the end of the course. Ask them if this is something they do, and if they do, what do they expect from you so you can get a strong letter of recommendation from them. Set those expectations early on in the process.

“Set those expectations. That's how you get good letters of recommendation.”

If you are applying early on, one of the services that I've always recommended is Interfolio. Meanwhile, Medical School Headquarters is also in the process of creating a site that will give students more information about letters of recommendation – how to ask for them, who to ask, and what school requirements are. We will also teach you where you can upload all of your letters. We will also interact with the application services to get that data into your application.

We're in the process of starting to look through that right now. If you have any feedback, please shoot me an email at ryan@medicalschoolhq.net, with the subject “LOR service feedback” or something along those lines.

If you're not applying this year, you should be thinking about letters of recommendation, getting those stored, asking for them, getting them ready to go. If you are applying this year, you should be asking for these as soon as possible – preferably January to February. You don't want to wait until the last minute because you don't want a letter to hold your application up from being complete. I've heard horror stories of students waiting on a specific letter they needed, and the professor didn't turn it in until September. Then the applications complete in September.

“You want to apply as early as possible because of rolling admissions.”

[13:55] Personal Statement & Extracurriculars

The second thing that you should be doing right now to start preparing for your applications is to think through your personal statement and extracurriculars. If you're applying this year, you want to start writing drafts. If you're applying next year or the year after, you just need to start thinking through it.

“Personal statement and extracurriculars take a lot longer to write than students expect. So you have to take your time to go through it, to do it well.”

If you are early on in this process and you're not applying for a couple of years, one of the most important things you can be doing right now with your extracurriculars is to journal everything. This is, in fact, another service that we're thinking about creating here, a service that will allow you to track all the stuff online. Nevertheless, you can use a good old pen and paper, and track all of your extracurriculars. Every time you leave a shadowing experience, a clinical experience, whatever it may be, journal. Journal, journal, journal it. Write it down. What did that experience mean to you? What did you do? How did it make you feel?

Don’t worry about tracking the hours and all that stuff, which you need as well. But worry about the emotional side of things. So that when it comes to writing your extracurriculars and your personal statement, you have these feelings to draw upon when it comes to writing your application now.

Moreover, if you are applying this year as you're listening to this, you should already be writing drafts of your personal statement. If you need help with your personal statement, check out my book, The Premed Playbook: Guide to the Medical School Personal Statement. I have a video course that includes access to office hours every other week where I look at personal statements and give feedback.

If you need more one-on-one help, check out the personal statement editing service that I offer, or you can use through Next Step as well. There are lots of ways to get help out there on your personal statement, but you really need to just start thinking through the process of what you want to say in your personal statement. Remember, the personal statement should be about why you want to be a physician.

“The personal statement is all about why do you want to be a physician, not what type of physician you want to be.”

Extracurriculars are hard to write. It's hard to write a story, it's hard to write something meaningful and impactful in 700 characters, or 600 for AMCAS, or 300. It's impossible to do it in 300 for TMDSAS. It's 700 characters, it's what you get. Can you tell a story? Of course. But it’s going to be hard and it takes time.

[17:50] Maintain Your GPA

If you're two years out from applying or four years out from applying, you need to continue to maintain your GPA. You don't want to have to overcome struggles in your GPA because you are focusing too much on one thing and not another.

“The application process is a huge balancing act, making sure that you can do it all, and do it all well.”

A lot of students are taking gap years now so that they don't have to do it all. They understand that this is a hard process to do it all. Because of this, a lot of students are purposefully taking a gap year so they don't have to take their MCAT during a normal timeframe.

They can take it after the majority of their classes are done, or maybe they take it after they graduate. Then they apply when they don't have to take the MCAT or they aren't taking courses.

All this being said, you really need to keep up with your MCAT and GPA. Those stats are very important. It's not the only thing you need to focus on for your application, but they are very important. You still need good enough stats. You still need a good enough GPA and good enough MCAT.

Again, don't let those things slip. Don't let focusing too much on writing your personal statement hurt you in preparing for a test that is going to drop your grade. That downward trend, if you're getting bad grades near the end of school versus the beginning, is a completely different story to the admissions committee. So don't let that happen.

[20:33] Secondary Applications

A lot of students don't understand this whole process – the primary application, the secondary application. Once you submit your primary application, depending on when you submit it, medical schools are going to send you secondary applications.

Most medical schools will send you a secondary application regardless of your stats. So you really have to be prepared for this process. If you are applying to twenty or thirty or forty schools, know that each school is going to send you a secondary application.

The majority of them are going to send you a secondary application that includes two to five more essays on all of those. So as soon as you are done with your primary application, or even before, you need to start thinking about those secondary applications. They, too, are important.

Some schools even prefer to read the secondary applications especially when they think the personal statements had been written poorly. So secondary essays are important. Don't just focus all your time on the primary application and skimp on the secondaries.

Good news! Check out www.SecondaryApps.com, where we have a whole secondary essay database on our website now. And we're working on some more tools for it, some more videos to help you explain how to answer specific types of questions. All of that stuff will come in the near future. Every school is listed there and If there's something you see that's wrong or maybe updated, there's a link in there to send us those updates as well.

But the majority of schools don't update their essay prompts every year, and so what you see in there is likely what you're going to get. So start thinking through stories that may answer the questions they’re asking. Start thinking about who you are as a person, and your journey, and why you want to go to specific schools. Those are the questions that they're going to ask that you're going to have to fill out.

“As much as you can, as best as you can, have all of your secondary essays done by the time you get them from the schools. That way you can just copy and paste and be done with it.”

Again, for students who are listening to this who are still a year, or two, or three away from applying, go to www.SecondaryApps.com and start browsing around at some of the schools you’re interested in. Just check out the types of questions they’re asking so that you can start thinking through the stuff now. A super common question that gets asked in interviews and on secondary essays is, 'Tell me a time when you've advocated for somebody who's not like you, somebody different than yourself.' Start looking at those.

[24:24] Final Thoughts

Here’a quick recap of everything I’ve discussed today. Check out www.FindShadowing.com for some help with your letters of recommendation. Again, if you have any feedback on that, let me know, ryan@medicalschoolhq.net.

For personal statements and extracurriculars, go get The Premed Playbook: Guide to the Medical School Personal Statement. It will help you write your personal statement. If you need more help, we have our video course that gives you some access to me. We also have office hours where you can ask questions and get answers. And if you need more personalized help, we do one-on-one as well.

Next, MCAT and GPA are super important so keep those up as best as possible. Don't get overwhelmed with everything else that you let your grades or your MCAT score start to slip. And then for secondaries, our new secondary essay database, go to www.SecondaryApps.com. Even if you are not applying this year, go check it out. Browse through the site and see the types of things that are being asked of you when it comes to writing your secondaries.

Links:

MedEd Media Network

Next Step Test Prep’s Medical School Admissions Consulting

www.FindShadowing.com

Interfolio

ryan@medicalschoolhq.net

The Premed Playbook: Guide to the Medical School Personal Statement

Check out Medical School HQ’s personal statement editing service

www.SecondaryApps.com

Mar 27, 2019
330: Getting into Med School after a Community College Postbac
32:53

Session 330

David had to take do postbac at a community college to be able to work full-time and support his family. He was asked why by the interviewers and what that meant for him in his future in medical school. But he was still able to receive multiple acceptances.

If you're in this process and currently taking classes at a community college, this episode will hopefully encourage you that's it's okay to take classes at a community college. Meanwhile, be sure to listen to all our other podcasts onMedEd Media Network and get all the resources you need to help you along this journey towards one day becoming a physician.

[01:25] Interest in Medicine

David wanted to be a doctor as a default since he was in elementary years. But he had no idea what it meant. Back in undergrad, he felt the pressure to pick a career that was going to provide for him and his family. And he felt the pressure to figure something out quickly. He admits to never really liking school that much, although he likes learning. He was sure he wanted to help people but he wasn't sure whether he could do all that schooling. Ultimately, he had to wait until his wife graduated from her master's program was when he decided to pursue his dream.

Initially, becoming a doctor was not on top of his priority list. He actually got married during his second year in undergrad and had their first daughter during his junior year. So he'd work from 8 to 5 and run to school at 5:30, take his classes in the evening and go home to take care of his wife and kid. In short, he wasn't able to give his full effort to schooling.

[05:20] Going Down the Premed Path

He worked at a company for five years doing software development. He recalls chatting with his colleagues and talked about the one thing they would do had they not been doing software. And he knew he always wanted to do medicine but he was afraid of the debt and time commitment involved. So he told them he wanted to become a doctor and his friends encouraged him to go do it. They were simply supportive of him. So he talked this out with his wife and told her this was something he really wanted to pursue. Luckily, his wife gave him all the support he needed.

He didn't hate his software job as it paid the bills and he loved doing it, but there was already that seed being planted on his mind which pushed him eventually over the edge. Being a very determined person, and once he decided he'd take on this path, he knew he was going to follow it through.

[09:05] Gathering Premed Resources and Following the Process

David went online to check what prereqs he had to take and what studying for the MCAT looked like, etc. He then signed up for a few classes at their local community college. He took a general chemistry class back in undergrad but that was 11 years before and got a C in that class. So he decided to take the class and if he made an A then it was going to kick him up to the next step and keep pursuing his goals. He and his wife agreed that if kept meeting his goals then they'd go all in on it.

He took the first chemistry class and seeing he did well in the class, he thought he didn't want to invest a couple of years and money into this so he decided to take the MCAT immediately to see how he'd do. So he started studying for the MCAT after he took the first full-length practice exam. He took the first practice test and his score wasn't so great. This was back in 2015 when they started doing the new MCAT. He then decided to slow down and take it one step at a time and just finish a couple more prereqs before taking the MCAT. It was a slight setback going on in his mind but good thing he saw how people were reacting to it pretty strongly that this got him to take it slow.

David admits being the kind of person that just wings things. He doesn't necessarily follow the beaten path. At that point, he decided to do things by the books and follow the process the way it's supposed to be done for once in his life. And he was glad he did! Now, that he's in medical school, David clearly appreciateshaving done all those. David highly suggests you listen to the people who have gone through this process before you and were successful. The better you can learn it in undergrad, the easier time you're going to have in first year of medical school.

[15:25] Working While Studying

At that time, he already had one child and another one on the way. He wanted to only disrupt his family as little as possible throughout the whole process. And the easiest way for him to do this was to take classes at a community college. They had evening classes which fit his work schedule and had cheaper classes than the university.

For him, the hardest thing for him was keeping all the balls in the air and trying to only drop as few as possible. He describes how time-consuming the process was. You leave straight from work and go to your classes then run home hoping your kids are still awake so you can say goodnight to them. Eat, study, go to bed, get up in the morning – rinse and repeat. As for his extracurricular activities, he'd take a couple of half days and go shadow in the morning.

[18:38] Going Through the Interview Process

David had several interviews and he posted in the FacebookPremed Hangout Group and warned students that being at a community college came out every time during interview.  He was caught off guard being so excited walking into the interview room. He sat down with a couple of interviewers and the first thing they said was he had a good application but why community college and ruin his application by doing that. So he gave them his reasons and he was questioned by the PhD telling him he hasn't shown them why he's ready to come to medical school. She just wouldn't buy it. He was even wondering if she was just testing him. All has been said and done, but he got accepted two weeks later.

Out of his 170 hours of undergrad course work, he took 80 to 90 of those at a community college. He was still able to make it. Sure, you'd get some pushbacks and your school list will definitely be affected by which schools will accept community college credits or not. But don't let that deter you. You can absolutely get into medical school.

[21:05] The Waiting Game and The Key to Success

David was surprised at how much waiting was involved. You rush to submit the applications and then just wait. You may or may not get interviews early on. And more waiting and waiting for an interview if any will come. There was just a lot of downtime he didn't expect.

The hard thing he considers about the application itself was talking about himself which he hated. And so getting comfortable with talking about himself was a challenge for him.

Moreover, what he believes has set himself up for success was the practice. He did a lot of interview prep with him so he felt very comfortable walking into every interview he did. Because by then, he had already rehearsed the types of things he wanted to say or the way he wanted to speak, not word for word, but the message he wanted to get across. He thought practice was very much a key. You have to practice beforehand so you'd have an idea of what to expect and an idea of how to approach things.

[24:10 Choosing His Medical School

David was fortunate enough to choose from a number of medical schools he got accepted in. His considerations included the proximity to his family. He ended up choosing a school where he had his parents spending a lot of their time in the state as well as his brother. Family support was huge.

He also wanted to go to a school that showed him that they cared about the students, and not just lip service. A lot of schools talk about student wellness and so on but they never really show you a lot of what they've done or what they do for their students. When he came to the school he got interviewed in, they were so straightforward about the things they do and the students talk about the concrete things the school does for them. They even provide wellness grants, which impressed him.

Moving to a new state was pretty challenging. He did have his expectations but going the actual thing of going through it was another animal for him. He underestimated how much work and time it would require to do the whole family thing along with school and keep up with all the social stuff at school. But he's thankful for the support system he has who has sacrificed for him so much.

[26:36] Typical Day and Dealing with Family Time

His typical day would be running at 8 am and going to school to study until 5-6 pm. He'd come home and have dinner with family and go back and recluse himself and study again. Then go to bed around 11 pm. Rinse and repeat.

David describes going to medical school as very selfish as there are dates you can't just move around. There's a schedule that you just have to follow. So the people in your life have to bend around you and sacrifice around you. So keeping those communications open between you and your spouse is so important.

Be in communication about who's doing what and when, where, what the expectations are, the things you need from each other. He advises people going into this who have spouses and family to try and make sure you make those communication boundaries. Set them ahead of time.

[28:55] The Biggest Misconception

For David, the biggest misconception he had about medical school was that he was going to be able to approach it just like a job. And the first anatomy block was just a rude awakening for him.

Ultimately, he wishes to impart to other students who are on this same journey that it's very important to write down your goals and what you want to do and when you want to do it and how you're going to accomplish those goals.

Having a grand idea of becoming a doctor is great. But you're not going to accomplish that as easily as if you were to write down those steps you need to take. Be honest about where you are today and look where you need to be. Then set out a plan. Once you reached that goal, set the next step.

And for those students out there who are doubting themselves, David says you have to believe in yourself. Believe in the people around you who believe in you. If you're struggling with motivation, go find a physician to shadow if you can. See what the end result can look like for you. Volunteer in a medical field and see the kinds of people you're going to be treating. Use that as a motivation for your goal.

Links:

MedEd Media Network

Premed Hangout Group

Mar 20, 2019
329: Premed 101: Motivation Overload—My Talk from AMSA 2019
52:33

Session 329

I had the awesome privilege to talk at the 2019 AMSA Convention to an awesome group of premed students. I wanted to share the encouragement with all of you. In the talk, I also busted a bunch of premed myths and so much more!

Hopefully, this gives you the motivation to continue waking up everyday, happy to be a premed and motivated to continue on to medical school and beyond.

If you’re new to this, please visit all our other podcasts on the MedEd Media Network for more resources to help you along your journey towards becoming a physician. If you haven't taken the MCAT yet, be sure to check out The MCAT Podcast and The MCAT CARS Podcast. If you're looking for some motivation about different specialties out there, listen to Specialty Stories. If you're a nontraditional student, visit The OldPreMeds Podcast.

By the way, Learn more about AMSA and reach out to them. Their main organization is for medical students but they also have premed chapters. If you don't have one at your college, see what it takes to start one at your college. Stay tuned for Premed Fest AMSA which happens every year! Also, check out the annual AMSA Convention in April 2020 in DC. In June 2019, I will be in Toronto for a conference so if you're in the Toronto area or interested in going there, I'm doing a meetup on the 9th.

[04:13] Some Common Myths About Going to Medical School

Myth #1: If you fail a class, then medical school is not right for you.

This is not true at all. You can fail a class and still get into medical school. You don't have to be perfect to get accepted to medical school. I was going to have somebody on this podcast who has 16 F's in her undergrad, 5 withdrawals who got into medical school this year.

Which medical school you go to doesn't matter either. Getting into one school or five schools, there's still that struggle. So if you're going through this process and had a terrible semester or year and this is what you want to do, fix it, move forward, course-correct, and figure out how to improve the next semester, the next class, the next year. You may have to take a little more of extra time like take more classes after you graduate. But if that's what you have to do then you have to do it.

In short, you don't have to be perfect!

[08:45] Myth #2: You need to have a checklist to get into medical school.

You don't have to do research to get into medical school. When you look at the stats, schools put out information showing 90% of students doing research and only 70% doing clinical experience. But that's not the best data.

Instead, you have to prove to yourself that you want to be around sick people. Taking care of your grandma is fun and endearing, but taking care of someone else's grandma when the family is yelling at you or mad at you is not going to be so much fun. What you need to do through this process is not check off all the boxes. Prove to yourself that this is what you want to do. And to do that, you need shadowing. You need to experience what a day in the life of a physician is.

[11:13] You Need to Shadow

If you're a nurse or PA or NP, and you're working with a physician all the time, you still have to shadow. Yes, you work with them in that one setting. But what are they doing when they're leaving that setting? They're on the phone or on the computer. They're arguing with insurance companies. Are you going to enjoy doing that?

A Hopkins study looked at resident hours, specifically how much time residents spent with patients. And they actually only spend around 11% on direct patient care. Hence, shadowing will help you experience what the physicians are doing day in and day out. It's not all glamorous or saving lives all day long. You're not going to be thanked all the time. Patients can be annoyed by you or mad at you. They could resent you since they think it's you causing health insurance prices to skyrocket. When in fact, the doctors are getting paid less, so we have to do more to get paid the same amount.  

Being a physician is an amazing career. But you can't go into this thinking that it is more glamorous than what it is. Too many physicians come out of training burnt out thinking it was going to be different than what it is. So you need to go out and shadow. Understand what a physician's life is like and what you're going to be doing day in and day out.

[14:20] Shadowing vs. Clinical Experience

Shadowing is different than clinical experience. Shadowing is a passive experience where you follow the physician around. You're listening and observing, not interacting. On the other hand, with clinical experience, you need to be interacting with the patient. You have to be close enough to smell the patient. You have to interact with the patient. You have to be there, care for them, support them.

Moreover, being in the hospital isn't necessarily a clinical experience. Just because you're mopping the floor in the hospital is not clinical experience. If you're ER volunteering and only stocking shelves or putting towels on the warmers, that's not clinical experience. You need to be interacting with patients and their families. You need to understand what it's like to have somebody relying on you for support.

[16:45] Nontraditional is the New Traditional

If you have any doubt in your mind that this is what you're supposed to be doing, slow down and figure it out. You don't have to go from high school to undergrad and start medical school right after.

Nontraditional is the new traditional. The majority of students are now taking gap years. They're figuring out if this is what they want. They're taking the time to get more experience. They still want more knowledge to see if this is what they're supposed to be doing. So take that time.

[17:40] You Don't Need Research and Research Doesn't Have to Be Clinical

Again, you don't have to do research. You can try it to see if you like it. You don't even have to be a Biology major or microbiology major. Major in whatever you want – language, art, etc.

Some premed advisors tell people they can't get into medical school since their white as they're accepting less and less. Not true!

When I applied the first time, I didn't get in. I made some phone calls and figured out why my application was weak. I reapplied and was ultimately accepted at New York Medical College. I didn't do research but still became a physician. So it's not going to hold you back.

Also, research isn't only about sitting in a lab. You can do clinical research. Find a physician to shadow and ask if they're doing any sort of clinical research where they're studying their patient population. That's research.

[22:05] You Don't Have to Be Perfect

You don't have to check the boxes or do everything you think you have to do. The admissions committees want you to be you. Enjoy who you are and everything you're doing. Ultimately, you're going to be one person in a class of 100-200. And you will add diversity to that class. They are building a class – a community of students. They're not looking for a perfect 4.0 or 528 MCAT students. They're looking for people who have diverse experiences.

For instance, if you're a soccer coach and love it, keep on coaching soccer as coaches are leaders. They're teachers. The experiences you're getting from the activities you want to do and the passion that will come out in your extracurriculars, personal statement, and interviews will far exceed anything if you're doing it just because you think you have to do it.

You can get into medical school without clinical experience or shadowing or research. However, you need to do some of them. You need to prove to yourself that this is what you want to do.

[25:55] You Don't Need to Have the Best Scores

You don't need the best GPA or MCAT scores but they need to be good enough so you can make it to the next step of the journey when you apply. Medical schools will tell you that they don't screen up applications. While some don't, the majority will do. Medical schools get 5,000 to 14,000 applications each year so to quickly sort and filter, they'll drop students who are below a 3.0 GPA or 500 MCAT score for instance. They will set criteria so they can more easily manage the application process.

That student that had 16 F's took classes. She fixed her application to get above certain thresholds so schools would take a look at her. This may take longer for you or cost more, but if this is what you want to do, then you have to figure it out.

[27:17] The Application Process: What Do You Need

Your primary applications open up in May every year to be accepted for the next year. If you want to start medical school in 2020, you have to apply this year in 2019. The things you need for medical school application are letters of recommendation from professors or physicians (not a patient). You need your MCAT score. You won't need it when you apply but your application won't be complete until your MCAT score is turned in.

You need a personal statement. Please check out The Premed Playbook: Guide to the Medical School Personal Statement. The personal statement is there to tell the admissions committee why you want to be a doctor and not how great of a doctor you think you're going to be. And you need to understand that in your core.

You have to write extracurriculars and your experience descriptions. Write about all the things you're doing – research, clinical experience, work, hobbies, etc. Your experiences need to paint a picture of who you are.

Everybody freaks out about the school list. There is no perfect list of schools. Every medical school is looking for something different. When you're putting together your school list, ignore the numbers. But where do you want to go? You have to be reasonable and realistic in the process. Consider the geographic location, weather, class size, proximity to family and friends, curriculum type. Do some self-reflection to understand which school you really want. Applying to medical school is a lot about you and whether the schools fit you.

[32:50] Apply Early

There is a deadline but ignore it. In fact, set in your mind that the deadline is two months after the application opens. Applications open June 1st to submit for MD schools. Texas and DO schools, you may submit as soon as you're ready to submit.

A majority of schools in this country are based on rolling admissions. The sooner your application is submitted, the sooner your secondary essays are complete or your MCAT score is complete and submitted to the schools, then the sooner your application is reviewed. The sooner you'll be invited for an interview. And the sooner you get an acceptance.

Each day that passes, more students are being verified in the application system. Interview invites are being sent out and medical schools only have a limited number of days that they interview students and a limited number of people they can interview each day.

A certain NIH professor told students that applying to medical school is your first medical school test and it's open book. You know everything that's on the test. And if you've submitted your application in October, then you'failed your first medical school test. This just shows that you can't prioritize your time or that you can't organize, or you're not just motivated enough to figure it out.

You can get in applying the last day but those students are amazing applicants though or have something that just stands out above everything else. TMDSAS released stats that around 85% of students who get interviews applied by July.

[36:55] The Waiting Game, Interview, and Acceptance

This is probably the worst part of the process. Be sure to prepare for the interview process early. Do mock interviews with your advisors. Check out The Premed Playbook: Guide to the Medical School Interview.

[40:20] Q & A Session

Q: How do you approach when asking for letters of recommendation?

A: First, ask who you're going to get a letter from. When you go into a class, set expectations with your professor. Meet them early on, tell them hopefully you're going to be able to build a relationship with them so you can eventually ask them for a letter of recommendation. Hopefully, the professor will set his expectations in return and tell you what they expect from you if you really want a good letter of recommendation from them. Again, ask first. Don't delay asking, so you can perfect your resume, CV, personal statement, etc.

There are going to be professors that are going to ask a draft from you. See what they want. Others would say you write them a draft and they'll just tweak it and sign it. This is technically against the rules. But a lot of professors do that.

Q: Is there anything outside the academics that you can do better?

A: Form study groups and help each other where one person is weak and another is strong. Help your classmates because this will not hurt your chances of getting into medical school. Focus on collaboration, not competition.

Q: Tips for writing a personal statement?

A: Talk about why do you want to be a doctor. Humans are drawn to stories so stories resonate the most in a personal statement. Show the reader what's going on, don't tell them what's going on. Show the reader what it was like to be there for a patient. Most importantly, reflect on the experience in your personal statement. Tell them why it's important for your journey. Show the reader why you want to do this. Reflect on your journey and help them understand why the experiences have solidified in your mind that this is what you want.

Q: What are the different curriculums? How do we know what different schools offer?

A: Most schools have websites that have their curriculum there. If you can't find it, just call them or email them and ask. The traditional curriculum is like in undergrad and you learn it all separately. A systems-based curriculum is one where, for instance, you learn about the cardiovascular system in a "block." And in that block, you learn anatomy, physiology, histology, pharmacology, etc – everything is integrated into the cardiovascular system so they're all fit to make sense altogether.

Some schools will integrate problem-based learning in whatever system they have. This consist of small group settings where you're given a clinical vignette. They will either create or buy from a source these long drawn-out clinical vignettes of a patient. As a team of students, you then need to figure out what to do and how to diagnose it or treat it, figure out the complications from the treatment, or what happens when you don't diagnose it properly, etc. There's usually a moderator, typically a physician, to help if you get stuck.

The flip classroom is when instead of going to a lecture, you get to learn the material at home and then use the classroom to interact and ask questions and build upon the knowledge you're learning yourself.

Links:

MedEd Media Network

2019 AMSA Convention

Premed Fest AMSA

The MCAT Podcast

The MCAT CARS Podcast

Specialty Stories

The OldPreMeds Podcast

The Premed Playbook: Guide to the Medical School Personal Statement

Mar 13, 2019
328: This Student Was Her Own Advocate and Earned Two Acceptances
43:34

 

Session 328

Janet is a nurse who switched to the premed path a few years ago. Listen to how she overcame a 499 on the MCAT and advocated for herself during the application process!

Meanwhile, make sure to check out other podcasts on the MedEd Media Network to help you along your journey towards a becoming a great physician!

[01:40] Janet's Nursing Path and Why Medicine

Having a family member diagnosed with cancer, Janet wanted to help take care of them so she ended up doing a CNA course. See how nurses did with their care she found as something high level and more of critical thinking. This led her to dive into the nursing path to be able to help people more.

One night, she had a patient who was very ill but on the monitor showed a perfect rhythm but when she went to his room, he was pulseless. So they had to call code blue and had to resuscitate him. As the nurse there, she had to tell the story and why the patient was there to get the doctors up to speed. She then saw that the role she had in nursing wasn't enough. She was part of the plan but she wasn't really the person inputting as much as she really desired to.

"The role that I had in nursing wasn't enough. I wasn't able to be that agent of change in the patient."

Janet's mom is a doctor of medicine, specializing in Somatology. She has worked with her in rural Tanzania and moved around a couple of places. So she got to see different things like it's a ward full of a hundred patients with not enough room. They're trying to give everybody the care they can. And she has seen so much of this as a child. She's very fortunate to also have everything explained to her. When it came to nursing, she was getting a picture but it wasn't the overall picture. And this was what she found as the bloc between nursing and medicine.

[07:20] A Need to Work and Her Initial Steps

Janet initially thought that this was going to be a longer road for her, knowing too, that she had to work through school. She has been working since 15 and so she knew this had to be practical. She also thought she wasn't going to be smart enough to do it, not having the time and the resources to be able to fully immerse herself in taking classes and being able to do her extracurriculars.

"This has to work with me also paying bills...no matter how much education I have, if I can't pay my bills, I'm not going to make it in life."

Ultimately, she signed up for Chem 101 which she thought was a horrible idea being in a  class where you had to take it before to get in. But with her nursing prereqs, she had taken a similar class. They took the credit for the class, but once she got to the class, she had no idea what was going on. At that point again, she was telling herself she wasn't ready yet. So she took the first exam and got a 25 out of 100. She just didn't know what was going on. So she went to her instructor and explained that she had to take the class before it since her previous class didn't teach her what she needed to learn. Good thing, her instructor was gracious enough to let her switch classes four weeks into school. She took a W for the first class. Then she got to take the class before that and ended up doing well and didn't feel crazy. Janet decided and made a promise to herself to do things one step at a time.

"The breadth and the depth of the knowledge are important because everything compounds upon each other."

[12:10] Juggling Things at the Same Time

Janet was working night shifts. But she strongly advises people to do otherwise. She worked at night and went to class during the day, which she did for a year. Then she did the extracurriculars as well. She did activities for living facilities from 4pm to 7pm. So she couldn't work 12 hours and do that, therefore she had to do it on the day she had school. Eventually, she realized she couldn't do this anymore so she started going to school on MWF and then do the things she needed to do on Tue/Thu/Sat and one day off to recuperate.

[14:05] Extracurricular Activities and Advocating for Herself

Janet basically did the things she was personally interested in. She used to work at a senior center but working as a nurse, she didn't get to spend much time doing activities with them. So she wanted to do something she was genuinely interested in but never really got the time to do. Then she also did the Girl Scout and troop leader. She did student government while she was still in school. She also did research for her cell biology class which came as something unplanned when she ran into her instructor from the last semester. She asked if she needed any help in the lab and she made her send an email. Before she even walked away from her, Janet had already sent her the email.  During research, she got to work with Master's and PhD students who taught her so much. All this being said, it's about being vulnerable enough to say that this is who you are, you can help, and what else do they need you to do.

"This is who I am. I can help. What do you need for me to do?"

Janet got her shadowing experience from a physician she knew working with the geriatric population and hematologist/ oncologist. She described it as a very different experience, giving her a bird's eye view of what's going on. She also appreciates how being a nurse has trained her to be very detailed-oriented.

[18:00] Deciding Not to Apply in 2017

"If you take your AAMC exam and you get a score that is not what you want on the MCAT, do not take the MCAT."

Janet warns that if you get a score on your AAMC practice test that you don't want, then don't take the MCAT. You might want to overshoot than undershoot because nerves can get to you on the real test day.

I've helped Janet working with her application as her personal statement was "sterile" being too focused on trying to convince the admissions committee of how great a doctor she would be. And in doing so, she actually forgot who she was as a person. So the MCAT was a big thing for her in 2017 and she wasn't as prepared as she should've been.

During those two months, she decided to retake it. But this time, she learned how to re-study and just take a second and heal. You really need some time to just heal, breathe, and gather yourself because doing this again will not be easy.

The first time you take the MCAT, it feels nice; but the second time. you have to pick up your feelings from "I'm not good enough, I can't do this" to – you actually have a score that proves that you're going to do it and then having the strength to do it again. You've got to fight all that. That's a lot harder than the first time. It took her a lot longer to take the exam. That being said, she thinks it was the best decision she could have ever made because she wasn't mentally ready to go through that again.

[23:25] Improving the Application During the Time Off

Janet found solace working with patients and doing the activities she was doing for. Then she started working with cardiac devices. She spent kids with Girl Scouts, drawing inspiration from them to keep going and doing.

"Your activities help you with your why because books, studying, and whatever can only take you so far, but it's those real people and tangible things that remind you why you want to do this."

So she retook the test and improved 8 points but 1-point shy of 500. Getting back that score the second time she took it, she only allowed herself 3 seconds of heartbreak. She decided that she was going to deal with it or move forward since she can't live in MCAT land forever. She recalls she couldn't spend any more time studying. She had to work. She had to survive as a person.

[27:03] Advocating for Yourself

Janet submitted her application relatively early and she submitted to both MD and DO in June. She didn't hear of anything still by October. So I told her about the UC Davis Conference coming and if she can, she could attend to meet some people and advocate for herself.

Her GPA was great, her clinical experience was great, and the MCAT was the only thing holding back. But for Janet, those conferences are pivotal. She talked to different schools that she applied to and Janet says they actually take you seriously. They'd even ask for your MCAT ID number.

"Don't not walk up to a table because you feel "I'm not good enough" because it can really surprise you what might come from those."

That conference wasn't really as successful as she hoped for, but she went to another conference and get in front of more people. She also landed a couple of interviews. Janet points out the need to know what the aim of the conference was. The second was a minority conference. Although the first had a lot of diversity and inclusion, the medical school personnel at the AAMC Minority Conference were there as it was what they were there for. They were seeking out minorities so that became easier for Janet.

Interestingly, she skipped the school (she's matriculating into now) five times walking around the table. She had some targetted schools in mind initially until realizing she just had to go over there and good thing she did.

Attending that conference, she got a lot of positive feedback and she got to really network with people. So she left for the conference on Saturday and the interview invite came Monday.

[37:00] What Got Her the Acceptances

Janet ultimately got two invites, went to both, and got two acceptances. She thinks what got her the acceptances was because of her entire journey. She thought she was going to be scared during interview, but she didn't. She knew herself and she knew she needed to go and meet these people and get them along the way. It's not just one-way.

"You're going to be married to the school for four years. You also need to genuinely get to know them."

Her final school choice came down to the programs they had and the time they allot to students for board prep time. Rural health was also important to her and the school she's matriculating in has programs that would give her the opportunity to go to Tanzania and do work in global health. Finally, what drew her to the school was how they did it like not having lectures and more of case-based studies realizing that lectures are not the best learning form for her.

"All medical schools would teach you the same thing – the difference is how they do it."

[41:00] Final Words of Wisdom

Janet's advice to other students who are also on the same journey as hers is to just focus on your journey. There's no one else like you! There are people out there who may be smarter, better, or brighter. But just take the time out to appreciate the things going on in your life and focus on those. Just keep working hard. It won't be easy and you will have pitfalls but just remember your why. That is what's going to keep you going. There is no such thing as balance. You will have to sacrifice time with family and friends.

Links:

MedEd Media Network

Mar 06, 2019
327: From College Athlete to Accepted Medical Student
44:58

 

Session 327

Jeff was an accomplished athlete, but struggled to gain an acceptance to medical school his first two times. Listen to an amazing story of a student who had all the odds stacked against him coming from a lower socioeconomic household and broken house to turning it all around. Today, he talks about getting scholarship to college, the failures of applying to medical school three times, some life lessons along the way, and how he's continued to fight back.

Meanwhile, if you haven’t yet, please be sure to check out all our other podcasts on MedEd Media Network so you get to have more resources to help you along your path towards going to medical school and becoming a physician one day!

[01:25] Interest in Becoming a Physician

Jeff’s mom was diagnosed with breast cancer and as he would go to the doctors with her, he has seen the type of compassion and the things that they were doing with her. And this initially sparked his interest in medicine. It was the seed that was planted.

When he got to high school, he joined a club that exposed him to a lot of different healthcare fields, specifically medicine, which drove him to decide to go ahead and pursue it.

Each week they would spend time with nursing, or go to PT/OT, and then one week would spend time with some physicians. From this, he got to see a lot of different aspects of the medical field as a whole, but medicine in itself really drew him more so than the other parts of it.

[03:25] Challenges Growing Up From the Hood

Jeff tells about his challenging childhood, growing up in a really rough neighborhood. This and considering his mom having breast cancer, he never really thought he could pursue medicine. In fact, they lived in a city that had mostly black African-American people, and in all of their hospital visits, he never once saw a black physician. Plus, he had to work at a young age of 13-14, working at a barber shop, sweeping floors to help pay for rent.

Eventually, he ended up moving with his father later on in high school. This was when he started seeing a different side of things, started seeing more prominent African-Americans, and this got him thinking that if they could do it, then he could too.

Moving in with his father, there was just more discipline, which got him on the straight path. He put in a strong foundation and he started telling him about the importance of school. He would make sure he was in class. He started going to parent teacher conferences.

[06:07] Attending College and Adopting the Mamba Mentality

Jeff did consider going to college during the latter part of his high school year but he really didn’t think this was possible considering the cost. They were still financially struggling at that time. So once he decided to really pursue medicine, he had to find ways to pay for it.

He didn’t qualify for academic scholarships because of his grades, but he had one year of football left, so he thought of getting a football scholarship. At this time, he was already three years into school. He communicated with his dad and his coaches.

With hard work and determination, he ended up being the top running back in my state, that he began receiving multiple college offers off of one year. However, he knew he wasn’t doing it for the NFL, but it was to get to college so he could ultimately chase his dream of becoming a physician.

When he got to college, Jeff considers football as becoming more of a job than high school was. They were practicing, working out, and all that – thirty to thirty-five hours a week. ALongside, he was trying to try to juggle all of that with his classes. This gave him a tough time adjusting to college life.

Jeff’s favorite athlete of all time is Kobe Bryant and around this time, Kobe came out with his little vernacular Mamba Mentality, which Jeff adopted.

Basically, you have to be ready for opportunity once it comes so you’re able to maximize that. So he would recite 'Mamba Mentality' every morning upon waking up at 5:00 to go train before school. He just used that and it turned on a different animal.

[11:33] Pushbacks as a Premed Student

Not only was Jeff a premed student and an athlete, but during his freshman year, he also had a child. And so he was working as well on top of all of that, and so such mentality just got him through his days. Nevertheless, he also experienced a lot of pushbacks. He got low grades in general chemistry and general biology during second semester of his freshmen year. They got a new coach who called him into his office one day, reminding him about how the school is paying for his school so he was there to play football while the school came second. So he was made to choose between being a biology major or playing football. He chose the former, thinking it was his way of getting into medical school. However, he knew he couldn’t pay for school if he wasn’t playing football. Upon his coach’s advice, he shifted his major.

“You didn't have to be a biology major to get to med school, and once I found that out, I revamped everything and took on the path of trying to become a doctor again.”

[14:42] Juggling Between Being a Father, an Athlete, and a Student

There were obviously many days that Jeff wanted to give up, even days he spent crying and doubting himself as to whether he could do this. But then, he knew this was what he wanted. So just like football, when he got tackled and knocked down, he always had to get back up, and it was the same thing with this. If he got knocked down by a test, he just had to get back up and prepare himself for the next test. He just had to prepare himself for the next thing. He would have given up if not for his son. But he has another life to take care of, and something to live for. He didn’t want him to have the same life that he had growing up.

“This is what you're called to do, and so whatever you have to do to do it, this too shall pass and you will be able to accomplish it. It might take longer than the next person, but you're going to do this."

[17:34] The Premed Path - Preparing for the MCAT

Jeff would describe his premed path as rocky. He didn't really have any guidance, and  just saw things on Google or on SDN, and just kind of went for it. He figured out the classes that he needed to take, the prereq's, and he took them.

He did extremely well in all of them, and then the MCAT came and I didn't know what a good score was for the MCAT. He didn't know how to prepare for it, which hit him like a truck.

Thinking he had A’s in all of his classes anyway, he thought that was enough to pass the MCAT. So he signed up and went to the test, without even knowing how long the test was. So he got a 491 score. However, he wasn’t really aware of what a good range of score was. In his mind and because he didn’t have any guidance, he just took the test and applied regardless of the score. He really didn’t know how to judge it at the time until he went through the application cycle.

He applied with the 491 score and he didn’t get news from anybody. But he ultimately started getting more vigilant in his research in terms of what it takes to get into school. He knew he had to do something different. At that time as well, he didn’t really want to reach out to others for help so he became a lone wolf.

“ I felt like I had to do it on my own, and so I really didn't seek out anything. I was just like, 'I'm just going to fix what I think needs to be fixed,' which turned out to not be a great plan either.”

[21:30] Applying the Second Time Around

Jeff then had to retake the MCAT, and he studied a little bit for it this time, but still didn't study correctly. And so he had to take it again. He basically would just read the content review and the books, without any practice exams. He did answer very few practice questions  and that was it. He took the MCAT again, and still didn't do very good on it. He got a 495, and then he applied again.

He thought being an athlete would do it, but that was obviously not the best thing. He had a few shadowing experiences and a few clinical experiences. Basically, he didn’t really know what he was doing. The cycle came through and he got the same result – none.

Again, no interviews – just silence. At this point, he knew he definitely was doing something completely wrong. He needed to start seeking out resources and advice from people who have done it before, because he has proven twice now that he wasn’t able to do this on his own.

“I never once thought that I couldn't do it. It's just I just realized now that I need help, and whatever it takes to get in is what I need to do. Instead of beating myself up, I sought out advice, and that changed my whole process of how I did things and how I was working.”

[26:25] Jeff’s Sources of Motivation

Jeff ended up getting a degree in business. He ran some sort of a cost benefit analysis and knew he was going to have to take out loans, and stuff like that. So he just looked at it as an investment.

He knew that the cost was going to be extremely high and that he wasn't going to be able to pay for it out of pocket. But he also started preparing a plan of how he was just going to pay that stuff back, being with the business background that he had. He was confident about that, plus the fact that he has a son so he knew he could not just give up as someone is counting on him. These were what kept him going.

[27:44] Jeff’s Application Timeline

Jeff applied one year, and then the very next year. Then he had a two-year gap between that time. This time, he knew all the things he needed to do – clinical experiences, shadowing, etc. - all this in order to become a competitive applicant.

So he ended up shadowing a lot of the different specialties, volunteering at different hospitals, and working as a tech in two to three different hospitals. He wanted to prove to whoever was making the decisions that this is something that he really wanted to do.

Out of college, he had a pretty substantial job offer in terms of what is good at an entry level. But he turned it down because that wasn’t what he wanted to do. It wasn't his passion. And so instead of taking the business job, he took a tech position at a hospital, and just doing what he needed to do to prove to admissions committees that he was serious about becoming a physician.

[29:55] Retaking the MCAT the 3rd Time

Jeff had to retake the MCAT the third time around. What changed was his focus on doing practice questions and full-length exams. In fact, he had 6 of the full-length exams plus doing practice questions everyday.

This time, he had a good hold on the material in terms of the content. He went back to the Mamba Mentality, and whatever he needed to do to succeed, he was trying to do it. So he took the MCAT again and didn’t really get the score he would have wanted. However, what he got was enough to get him in somewhere.

“I think it was the whole picture, and I think that everything coupled together made me a better applicant.”

This time, he was able to show how much of a well-rounded applicant he was, more than just being a football, although it played a large role of it. He had volunteering, shadowing, clinical experience, better essays, better personal statement – all this was what got him into medical school.

[32:55] The Interview Process

Jeff was pretty well-prepared for the interview. And his struggles came up during interview but he didn’t make any excuses for it. Instead, he explained his situation as well as what he learned from this whole experience. He told them that he doesn’t believe that it won't be any hindrance going forward because he has learned from his mistakes and he has now moved on. He is now a different student from those early days.

A lot of his interviews actually brought up his athlete years. In fact, the one interviewing him shared the same passion for football. But this wasn't a coincidence. A lot of students don't realize that medical schools try their best to pair you up with somebody who has a similar background so that you guys can connect. Because remember part of the interview day is them trying to sell you on the school too. So they 100% did that on purpose.

Moreover, there were some ethical questions that have been brought up that really threw him off. Although he was prepared for some, but a couple of them just were way out there, that he had to take a moment to think about it. Nevertheless, he gave his best answer.

[38:00] Getting an Acceptance

When he got his acceptance, Jeff was ecstatic as he wasn’t expecting it, He was at work and got a phone call from the school and they congratulated him. Finally, he accomplished the thing he has always wanted. Sure, he still has a long way ahead of him, but he’s confident having a strong support system, with his wife helping him along this journey, as well as his parents.

“It was just joy. I mean, it was everything that I had ever worked for. I felt like I accomplished it at that moment. I knew that I had a long road ahead of me, but just to even get to that point to where I came from, it was really a good feeling.”

[40:15] Getting More Minorities Into the Field

When I asked Jeff about getting more minority men and women into this field, he explains that it really starts before you get to college, and even really before high school.

You have to create certain pipelines and mentorship programs, because if you don't, it's really hard to become something if you don't see it.

You have to change the mindset, and you have to be present starting off at a young age. Jeff is following Dr. Dale Okorodudu, who has a platform called Diverse Medicine, where he interviews different African-American male physicians, and just getting those videos out to the community and into the minds of the younger generation.

He also follows Dr. Quinn Capers from the Ohio State University doing his work on implicit bias.

So it’s about implementing more programs and stuff like that and seeing it as a young age, and helping students learn science and getting interested in science at a young age because it's hard to go from not having any math and science classes all throughout high school to going into college, and now you're expected to take physics, and organic chemistry, and biochemistry. And more importantly, mentorship plays a huge role.

[42:27] Final Words of Wisdom

If this is your passion, if this is your dream and this is something that you really want to do, there is no plan B. Plan B is to make Plan A work. Plan C is to make B work to make A work. You have to just keep pushing.

When things get tough, just know that if it was easy, everybody would be doing it. And it takes a certain type of person to be a physician, and you're destined to do it, but you'll never be that if you give up. So just continue to keep pushing and seek out help.

Seek out help and improve in the areas that they ask you to improve in, and whatever you have to do. Make investments and all of that. Know that it's not the end-all be-all. It's for this moment now, and it's always going to pass, and you're going to make it through, and once you make it through, you'll have another set of problems that you'll have to go through but you can look back and say you conquered this, and this is the next step, and so you can conquer this as well. And then it'll just continue to go on and go through until you get to where you want to be.

Links:

MedEd Media Network

Feb 27, 2019
326: How Reapplying to Med School was Successful for this Student
37:46

Session 326

Amanda had to apply to med school twice. We talk about her premed path, her first application, her struggles, and how she succeeded and received three acceptances.

Check out all our other podcasts on MedEd Media Network.

[02:01] Drinking From a Fire Hose

Amanda agrees with the analogy of drinking from a fire hose with all the information coming in and the exams they've got to prepare for.

[02:38] Being a First-Generation College Student

Being a first-generation college student, she was just focused on getting into a school. Once she got there, she was just trying to adjust and did research on her own. But it was really her interest in science that got it all started. She likes working one on one with people. She likes learning about the body. She recalls shadowing for the first time and seeing the atmosphere, it gave her that seed to really want to do it although there were moments she'd question whether she could do it, which is pretty normal.

As a first-generation college student and she didn't have her parents to lean onto for academic support, she reached out to programs in her school and joining clubs and reaching out to others. She even sought the advise from her high school counselor. But she considers the internet as a huge help which led her to this podcast later on in her college years.

"Educating myself as much as I could to prepare myself and learning from each mistake instead of dwelling on it."

[05:28] The Biggest Mistakes During Undergrad

Amanda just got so bogged down into her grades and classes that she didn't see the bigger picture. So she ended up applying just two schools because she realized it wasn't working. She did end up going to one of the top schools she wanted to go to. However, looking back, she was just not seeing the bigger picture and instead, she was focusing on that quiz she was going to have on a Friday.

She was in her honors program when she started undergrad where she went to a liberal arts school. When she attended an advisory premed meeting, she realized there were so much more to do. She went to the internet and came across this podcast.

She believes the liberal arts school was able to help her as there were so many discussions that got her to engage in small conversations which she thought benefitted her science classes. Her biggest science class in organic chemistry consisted of 38 people. They didn't have any teaching assistants. She also met incredible people and felt being in a tight-knit family.

[08:45] Finding a Physician to Shadow and Being the Resource Queen

Amanda was struggling hard to get there having no one in the family who's in the medical field. But she reached out to people such as her college roommate, who connected her to an internist, who also gave her name to different specialties.

Due to her diligent research on everything that needs to be done as a premed or med school, she was even named by her colleagues as the resource queen. Now, she's braver to reach out to people, even physicians.

What made her successful as a medical school applicant and she wants other students to know that you have to do things because you want to do them. Don't do them because you feel that you need to do them. She did struggle with this back in high school doing sports she didn't really like. Then in college, she felt she need to do research and do this and that. But when she graduated, she wondered what things she needed to do and ended up being a behavioral therapist for kids with autism. It was clinical but it was something she really wanted to do and experience.

"Do things because you want to do them. Don't do them because you feel that you need to do them."

[12:30] Preparing for the MCAT the First Time

Amanda actually took the MCAT twice. In fact, this came up in a few of her interviews because she had an 8-point jump between her two scores. She was doing research at a nearby hospital in Chicago while studying for the MCAT with no defined schedule. She took it in the first year of the new MCAT so it was also another process to learn about that. She studied on her own and ended up taking it just as she had applied. She also didn't take enough practice tests and ended up only applying to two schools that cycle since she felt her MCAT wasn't as good as it could have been. She knew she could do better so she decided that she needed more experience. She didn't realize the amount of diligence and planning required that it should have taken to do well.

She sent out six primaries and ended up going to two of them. Both were MD schools and she only shadowed an MD. She didn't really look into DOs and didn't know anything about it so she didn't apply to DO schools. She didn't get any interviews but she got a callback and got good feedback from one of the schools which she ended up getting accepted on the next cycle. She didn't go there though.

[17:50] Lack of Clinical Experience and Making Up During Gap Year

Her clinical hours were so minimal and she had volunteered for hospice care and volunteered in the ER. They were all low hours compared to what she gained during her gap year.

To get more experience, she became a therapist for kids with autism. It wasn't entirely medicine but that therapy gave her the experience. She worked as a scribe which helped a lot and she continued to shadow.

[18:50] Taking the Next Steps and Taking the MCAT the Second Time

Although she would advise otherwise, Amanda was already planning on what to do on the next application cycle. So she planned on enjoying her senior year and making the best out of it. She still did well in school and continued volunteering the entire time. Then she studied for the MCAT the following summer. She spent the whole summer studying. Unfortunately, an MCAT course wasn't going to work for her financially. She found a Kaplan book and Examkrackers online. She gave herself a strict study schedule and stuck with it.

"I just made a strict schedule I gave myself during days off and what test days and I stuck with it. That is what I needed to succeed."

At that time, she was applying for a job and was going through the onboarding process. She was also babysitting here and there to keep some cash flow. But it was an MCAT study-focused summer.

[20:38] Fee Assistance Program (FAP)

Initially, she thought she was going to combine her income with her family's which would be the percent poverty level so she brushed off the idea of applying for it. She did probably qualify and it could have helped her during the application.

Applying for the FAP wasn't too bad. She was living at home so she was easily able to access all the documents she needed to and upload everything. Basically, she had to provide proof of income for herself and her parents and fill out some expenses. She submitted it and got back very quickly. What she got really helped her save a lot. At that time, she also continued doing her own "fee assistance" trying to save as much money as she could.

[23:00] The Gap Year Experience and Applying the Second Time

Amanda waited for a cycle in between and took a gap year. She took the MCAT and got more experience. She had more confidence going into the application cycle. In terms of picking schools, she used the MSAR (Medical School Admission Requirements). She was considering her geographical location, especially looking at the midwest region. This time, she applied to both MD and DCO schools. She looked at schools she could get cheaper flights to and places she would enjoy living. During her downtime as a scribe, she would look at schools and list what she liked about them and averages. With the FAP only offering 16 schools, she applied to 22 MD schools and 7 DO schools. She didn't get the AOA assistance program for DO schools. So she was being strategic with how many schools she was applying to. She applied to two neighboring states but she got denied very quickly – not even a secondary from them. But she only did two of them and the rest were private schools.

As to why she applied to DO schools this time, she got to work with many DO doctors and had discussions with them about their experience and the schools they went to. In fact, some of her favorite doctors where DOs.

"I would be happy to go to either just a medical school in general. Finally, when I understood that there was barely a difference...I felt comfortable applying to both schools."

[25:50] Getting Her Interview Invites and Acceptances

Amanda got her first interview invite on her birthday in mid-July –best birthday present ever. She was glad that she was in a gap year since she appreciated the need for having time off and figuring out travel plans which would have been otherwise hard to do had she been in school. She also tried to save money when she could so she didn't stay in a hotel. She would always stay with someone she knew and drive herself there.

She had five interviews for MD schools and four acceptances. And out of the 7 DO schools she applied to, she had all interview invites and went to three interviews and got accepted to those three schools.

She thinks her gap year has made her a very well-rounded applicant. She was done well with her undergrad in terms of grades. Her MCAT wasn't amazing and only medium range at 508. So what she believes made her really stand out was her experiences and just being herself. She had intimidating interviews but she just took it as a conversation. Plus, she read The Premed Playbook: Guide to the Medical School Interview.

"I think what really made me stand out was my experiences and just truly being a person during the interview."

She ended up deciding between two schools but then she got a partial scholarship from one school so she went for it. Again, she had to save as much as she could. But then, she liked the school environment and their community involvement. She liked the aspect of diversity and helping the community around you.

[32:32] Getting Financial Aid

Amanda though med schools don't give you anything. But when she got her financial aid letter and was listed and just got it. She assumed it was due to her financial aid situation as she was growing up and being part of the financial aid program. So she felt she earned it that way.

Now that she's in medical school, she's very happy with her school pick. They're on their second year now and she's happy overall. She loves going to school everyday and has met amazing people and met with great professors.

[34:45] Final Words of Wisdom

If she had to speak to her old self, Amanda would tell herself to just be confident in the process and everything that's happening might feel like it's the end of the world but she is growing from it. Take it step by step and not be so bogged down by feelings of failure.

Links:

MedEd Media Network

MSAR (Medical School Admission Requirements)

Medical Schools Applications Cost Estimator

The Premed Playbook: Guide to the Medical School Interview

Feb 20, 2019
325: How Do International Medical Graduates Practice in the US?
30:22

When you go to an international med school, including the Caribbean, there are many steps you need to take to practice in the U.S., including going through the Educational Commission for Foreign Medical Graduates or ECFMG.

Specifically, we talk about the process of coming back to the U.S. (if you're a U.S. citizen), if you go to an international medical school; or the process of coming to the U.S. if you're not a U.S. citizen but you want to come to practice and do your training in the U.S.

ECFMG Vice President of Communications and External Affairs, Liz Ingraham, shares with us all information about the process for students coming back to the U.S. to practice.

Meanwhile, be sure to check out all our other podcasts on MedEd Media Network.

[03:03] The Role of ECFMG

ECFMG is a 62-year-old private, nonprofit organization that has been responsible for evaluating international medical graduates who wish to come to the United States and train.

They define an international medical graduate as a student or a graduate who received the basic medical qualifications or degree from a school outside the United States and Canada. Liz stresses that it's the location of the medical school that makes one an international medical graduate, and not citizenship. U.S. students who pursue medical education abroad and receive their degree abroad are considered international medical graduates. Their first step in returning from education to pursue U.S. residency would be ECFMG and its program of certification.

"It's the location of a medical school, not citizenship that makes one an international medical graduate."

[04:25] Why Go Through ECFMG?

The ECFMG was formed by prominent organizations in what they call the house of medicine. These organizations are responsible for the assessment, education, and training of physicians. They formed ECFMG in 1956 because of the number of interns and residents who were coming into serving U.S. hospitals and coming from schools abroad.

There are nearly 4,000 operating medical schools around the world, which vary widely by curriculum and facilities. The purpose of the certification is to assess whether international medical graduates regardless of what school they're coming from and what their education has been like, whether they're ready to enter U.S. training programs accredited by the ACGME.

Liz clarifies that ECFMG is not involved in the accreditation of medical schools. In fact, ECFMG has a three-fold requirement classification, many of which focus on the individual position. There are examinations in the medical and clinical sciences and clinical skills, USMLE Step 1, Step 2 CS and Step 2 CK. Those are among the same examinations taken by U.S. medical school students and graduates. Additionally, ECFMG has a credential requirement where they look at the final medical diploma, final medical school transcript, and they verify their authenticity back with the medical schools that issued them.

They also have a certain set of requirements for the medical school, one of which is for them to be listed in the World Directory of Medical Schools, the premier resource on medical schools around the world. And that their students and graduates be eligible for licensure in the country of medical education.

If you're interested in learning more about their Accreditation 2023 Initiative, check their website. By 2023, ECFMG will require that an applicant's medical school be appropriately accredited. This means it will be accredited by an accrediting agency recognized by the World Federation for Medical Education. So there will be some additional requirements for medical schools coming in the future.

In addition to their 2023 requirement, they published a medical school selection guide, which is a checklist of things students should be looking at if entertaining an international medical school.

[09:20] Common Issues IMG's Face Going into the U.S.

International medical graduates need to come through the ECFMG, which means they have to meet the requirements for medical schools, exams, and primary source verification of those scored medical education credentials.

The number of U.S citizens pursuing medical education abroad is trending upward. About a third or even more of physicians they certify every year are U.S. citizens who have gone to international school and they're coming back for residency positions.

ECFMG certifies about a thousand applicants each year and well over 3,000 physicians every year that are going through the ECFMG process, competing for residency positions. As far as challenges, U.S. citizens thinking about going to school abroad really need to educate themselves about match rates that U.S. citizens and non-citizens have in obtaining that first year of residency position.

For 2018, the match rate for U.S. citizens IMG was in the high 50s. This means that 40+% of the U.S. IMGs did not match for a first-year residency position.

That said, they're not involved in helping international medical schools meet requirements or promote their schools. So they encourage students to do their due diligence and do the research themselves.

The USMLE pass rate information on the USMLE website is a good starting point.

[12:15] When to Start Contacting ECFMG

Medical students and graduates can begin the ECFMG certification process by getting a USMLE ECFMG number and then apply for ECFMG certification, which is a very brief application. Once completed, they can apply for the first examination as long as one has met the ECFMG requirements, which have generally been completed during the first two years of medical school. The exact requirements are listed on the ECFMG website. Many of their applicants have already graduated from medical school by the time the organization hears from them.

[13:30] Finding the Proper Timeline

The response rates per school basically vary. ECFMG is increasingly doing electronic web-based verification and so they're very quickly eliminating the paper-based process. The current process is they mail a copy of the credential to the school and wait for a response mail.

Moreover, one may not need the credential requirements for certification to engage with the match. For the rank order deadline for the match, one only needs to have passed all the exams required for ECFMG certification. However, this process needs to be complete before the program start date typically around July 1.

"One does not need to have the credentials verified by the school in order to participate in the match."

[14:43] Examinations

ECFMG uses the United States Licensing Examination or USMLE to meet its examination requirements. USMLE is owned by the National Board of Medical Examiners and the Federation of State Medical Boards. It is used primarily to grant the initial license to practice medicine and therefore is also taken by U.S. medical students and graduates at various stages in their career.

Other exams are Step 1 and Step 2 CK and they are given in Prometric test centers around the world. Step 2 CS, the second component of the Step 2 examinations is the clinical skills component and ECFMG does partner with the National Board of Medical Examiners to deliver that examination at six test centers in the United States. So ECFMG has a role in running the test centers and administering the examination.

[16:30] The ECFMG Process

Students have to complete the two initial steps of the application: applying for the identification number and then applying for ECFMG certification, a short six-question web-based application. It includes an identity verification component. Then once they meet the medical examination requirements, they can apply for the exams which can be taken in any order as one meets the educational requirement.

[17:45] The Process for Non-U.S. Citizens

Liz says the process is almost identical to that for U.S. citizens who go to medical school abroad and then come back to the United States. Again, an IMG is one who goes to medical school and obtains that final medical school qualification from a medical school outside the U.S. and Canada. The steps are identical. The one place in the process that they've not talked about beyond examinations and certifications is that those individuals will likely need an appropriate visa to engage in graduate medical education in the United States. U.S. citizens do not need that visa should they match to a position and want to participate.

You can't apply for the two appropriate visa types until you have a contract. First, you need to meet the exam requirements for certification, participate in the match, and successfully match to a program. Once you have that contract for the residency program, then you can begin the process of applying for a visa. That process really starts during match week in March. The individual has those several months until typically July 1 to obtain that visa.

"ECFMG is the sole sponsor for the most common visa by non-U.S. citizen IMG to participate in graduate medical education and that is the J-1 Visa."

The two visas that are commonly used for non-U.S. citizens to participate in U.S. graduate medical education are the J-1 visa and the H1B visa. For the J-1 visa, ECFMG is the sole sponsor designated by the U.S. Department of State. So they sponsor all positions in clinical training programs in the U.S. who are not U.S. citizens. It is a cultural and educational exchange visa. On the contrary, the HIB visa is a temporary work on a specialty occupation that is an employment visa. It's sponsored by the employing hospital.

[21:00] Visa Challenges with the Current Administration

Liz admits that the last couple of years have been challenging with respect to the immigration environment in the U.S. At ECFMG, they're watching this carefully. They're concerned that they continue to be a great training location for the best and the brightest. Currently, the visa restrictions in place are essentially not accepting the ability of folks to attain visa sponsorship, obtain the visa, and come in. As a result, people may choose another training location.

That being said, people from North Korea were impacted and so they no longer have applicants from North Korea as well as those from Syria and Venezuela. For now, there are no legislative barriers for the majority of folks who are non-U.S. citizens who want to train in the U.S.

[22:25] Addressing the Shortage of Physicians

ECFMG doesn't recruit physicians to come to the United States. But they're here for the students when they make that decision to pursue training in the U.S. They're here to evaluate them, certify them once they meet the requirements, and maintain a qualified pool of IMGs from which program directors can select. That said, a full 25% of IMGs both in training and practice in the U.S. are international medical graduates. That's more than 260,000 physicians as of the end of 2017. Hence, IMGs play a huge role and ECFMG's role is to ensure that those who compete and enter those positions meet minimum qualifications to do so.

“In order to meet the examination requirements for ECFMG certification, an individual needs to obtain the USMLE recommended minimum passing score."

ECFMG does not set requirements that are different or separate from those set by the USMLE program. Individual medical schools, in fact, thousands around the world, may set individual requirements. So they highly encourage students to check in on requirements for progression with their medical school.

ECFMG doesn't get detailed information or track folks as they are matched as they enter and progress through graduate medical education, with the exception of those positions they sponsor for the J-1 visa, which has to be renewed annually. They're in touch closely with these folks and their host institutions to make sure they're meeting the sponsorship requirements. Currently, there are about 11,000 non-U.S. citizen physicians at all levels of training in the United States.

[25:40] The Risk of Losing a J-1 Visa

Check out ECFMG's J-1 visa sponsorship section to learn about their requirements for obtaining and maintaining J-1 visa sponsorship though ECFMG.

Ultimately, Liz recommends that those students who want to study internationally and come back to match at a U.S. program, should engage with ECFMG early, not necessarily as an applicant, but one who is engaged with their social media, their email newsletters, fact sheets, etc. Over time, the readers will absorb information about some of the issues, requirements, and some of the important points they need to deal with.

Liz names the top resources available such as the ECFMG Reporter Email Newsletter. Read the Certification Fact Sheet to give you an overview of the process from the moment one applies for an ID number, all the way through getting the visa and progressing through. It's not easier as a U.S. citizen to obtain the ECFMG certification and get back into the United States for graduate medical education and training. That being said, there are a number of organizations that asses and train physicians as they progress from medical school, through training, and ultimately to licensure. The more prepared they are, they're more likely to keep everything organized and not miss deadlines.

"ECFMG is really just the start of the process."

[28:35] Ask Those Hard Questions

We highly encourage you yo look at the NRMP match data as well as board passing rates and match rates for the schools. Really dig deep and ask those hard questions. For instance, about what percentage of students do they let sit for the USMLE exam. International medical school and U.S. medical schools will have a competency exam for students to make sure they're ready to sit for the exam.

"Ask those hard questions to make sure that you're going to school that is going to serve you well."

Links:

MedEd Media Network

ECFMG

Accreditation 2023 Initiative

World Directory of Medical Schools

ECFMG medical school selection guide

USMLE website

ECFMG requirements

NRMP match data

 

Feb 13, 2019
324: Free Summer Programs for Premed Students through SHPEP
34:15

Session 324

SHPEP, or the Summer Health Professions Education Program, is a free summer program for underrepresented premed students at twelve locations throughout the U.S.

Today, we have Chantez Bailey and Dr. Norma Poll-Hunter. from SHPEP to share knowledge about this program, why it was started, and so much more. If you're interested in applying to this program, visit their site.

[02:15] About the SHPEP

Chantez serves as the team lead for the Communications and Outreach access of the initiative. She makes sure she increases the visibility and overall awareness of the SHPEP initiative, serving as the voice of the program.

Norma serves as the Deputy Director of the SHPEP, funded by the Robert Wood Johnson Foundation (RWJF), AAMC, and the American Dental Education Association as the National Program Office. They help provide technical direction and assistance. As a deputy director, she's responsible for the oversight of the national program, implemented at 12 institutions across the United States.

Started 30 years ago, RWJF conducted a study to understand the lack of diversity within the physician workforce. They found that they were qualified applicants from minority communities, many of the students didn't know exactly what to do. They weren't socialized in the process of applying to medical school, the interview process -- basically a lot of unknown for students who came from underrepresented communities.

Based on the research, they decided to develop the program in 1989 that started as a minority medical education program to provide students from underserved communities, particularly, at that time, African-Americans, Mexican-Americans, American Indian, and mainland Puerto Ricans -- to be able to support their interest in pursuing medicine as a career.

[05:20] An Increase in Diversity

The SHPEP has robust data demonstrating that the program has been significant in increasing the diversity of the applicant's pool as well as the matriculants and graduates from medical school.

Their data shows that about 67% of those who participate in the program actually applied to medical school and of that group of applicants, about 66-68% got into medical school. To date, they have a little over 7,000 individuals who participated in the program who are physicians and dentists (which they expanded in 2006).

"The program has evolved over the 30 years to really broadly define diversity and who is underrepresented in medicine."

AAMC does a lot of great work into the research and data. It shows that the overall majority of medical students semi-income are at the top 5th quintiles of U.S. income. So basically, it's a lot of rich people going to medical schools.

[07:00] Defining Underserved

When you say serving the underserved, that's very broadly defined as individuals who come from an economically disadvantaged background, not only those that are historically underrepresented in medicine, but also students who come from rural communities, urban communities, individuals who are not well-represented in medicine.

"The program has evolved to think about representation much more broadly beyond just race and ethnicity."

[08:10] Students the Program Caters To

The program considers high school students, upperclassmen, junior, and seniors to consider during their first or second year of college to get ready for the SHPEP application process. This way, you can keep the ground running as soon as they become a freshman. The program caters to freshmen and sophomore college students and/or students who have 60 college credits or less. This is important for students who might be attending community college.

As to why they're starting it early, they found that sometimes getting to the junior or senior year is that there a lot of missed opportunities to build a strong profile to be competitive to a medical school, graduate school, and other graduate programs. And so the research found that getting students earlier was the most beneficial.

"The focus is to build their strength and to focus on academic enrichment."

[10:24] What is SHPEP? (And The Benefits Students Get)

SHPEP is a free program for freshmen and sophomore college students interested in one of eight health professions — with medicine, dentistry, pharmacy, public health, nursing, physical therapy, optometry, and physician assistants.

For the residentially based program in the summer, students get to stay at the academic health center on their campus where they get everything they need to know about that profession.

In medicine, for instance, the students live on campus with other students, usually about 80 students per site. They have an opportunity to participate in academic enrichment so they get to the basic sciences, math, and studying and learning skills. They also get to shadow (which makes up 5% of the program) and get to see surgery or baby being born or working at the lab.

"Students have a very well-rounded view of what it would be like in the future, but also prepare them for what they need to do now as a student to prepare for that pathway."

Not only will students understand how to study, but they will also understand how to use money because financial literacy is key. It's a significant investment of money in the future, but it's definitely doable.

It really tries to capture the students' experience holistically to prepare them for that pathway.

The six weeks is really a lot about career enrichment. It's also the time for applicants to get that shadowing experience and realize whether it's the career for them. So a lot of students may leave the actual program afterward they decide to transition or go to another career field or another health career track.

Moreover, students also get to establish relationships with other students since they're all together for six weeks going through this unique experience together. And for students who can't afford to travel to a site, they have a travel scholarship and a stipend. All that being said, other aspects will also be integrated into the program.

"It's meant to provide a fully acceptable program for students."

On weekends, students get free field trips. Depending on what program site they're located, they'll get to explore that state and within that particular city and around that campus. This allows them to network with other healthcare professionals.

[16:05] Forming Relationships

What's great about the program is being able to get close with your peers. you also get a sense of what it's like to be in a medical school, or a dental school, or a pharmacy school. You're not only surrounded by your peers but also, individuals who truly invested in seeing you grow and be successful.

"That's what really makes the difference for SHPEP is the environment and the culture that is embedded within the program experience."

Through SHPEP students are able to build their social capital because sometimes students really never have someone they can call to come shadow with. But through the program, they're able to shadow a physician who is really invested in their development. And that makes a huge difference!

[18:00] Is It Really Free?

Yes, it's free! There are travel scholarships and some students may have to travel in advance, but they will be reimbursed. There's no cost to participate but students may have to pay their travel upfront depending on how the site manages that process. But there's no application fee and no fee to participate. Students also get a stipend of $600 which will hopefully offset other costs.

[19:32] SHPEP Locations and How to Apply

SHPEP program is available in 12 sites across the country including Columbia University, Howard University, University of Alabama, Rutgers, UCLA, University of Florida, University of Iowa, University of Louisville, University of Nebraska, University of Texas University of Washington, and Western University in California.

Some of the schools have undergraduate campuses while others don't. So they're always found within the academic health centers. Some of the classes may be in the medical school, the nursing school, or the pharmacy school. It just depends because each program offers different health professions but they will be in the same environment setting where the medicals and other health profession students are in.

Visit their site and find a list where you can choose what career track you're interested in and they'll show you the link of that program site. But all sites have medicine and dentistry tracks.

Students can take charge in terms of which site they want to choose so they get to pick up to three program sites across the country. They encourage students to get outside of their residency so they can get out of their comfort zone and take a leap to another program site that's out of your state. They also encourage them to choose up to three health career tracks because they encourage students to learn other health career tracks as well. And then it depends now on what program site they get selected. Sometimes, they're selected in all three and they have to make a decision on what program site they like to choose.

[23:09] The Application Timeline

For 2019, the application deadline is February 15. If you're interested, the first thing you should do is get your transcripts sent in. One recommendation is also required. The application to the program is similar to a college application. Plus, you only need to do one essay.

Here’s how to apply!

[25:00] How Is This Valuable in Your Medical School Application Process

The program is grounded in the many years of experience around what works. They're going to get a really good inside view of what they need to do to be successful along the pathway.

As a freshman/sophomore college student, this is a prime time to really understand if this is a pathway for you. Their data also shows that individuals are more likely to get accepted to medical school and dental school as a result of participating in this program.

"It's really a good investment because you're investing in yourself, in your own knowledge and opportunity."

[27:10] Opportunities for an Alumnus to Stay Involved in the Program

SHPEP is working hard to reconnect with their alumni. They have alumni-based events to celebrate the 30th anniversary throughout the year. They encourage all of their alumni (now estimated at 27,000) to touch base with them and email shpep_alumni@aamc.org. Send your contact information and they will connect with you and keep you informed of all the great alumni based resources they have available.

“It’s a summer opportunity that lasts a lifetime.”

[29:20] The Admissions Process

They have a little over a thousand slots across the U.S. It's actually the program site that makes the admissions decisions. At their national program office, they just help facilitate the process. They would look at your essay What is it about your experiences tell them that you need this program? The GPA is 2.5 because they recognize that students sometimes need support and the GPA doesn't always reflect their talents or their skills. So it's really about the holistic view of the students and how that fits with the program's objective.

Out of the thousand spots, they would usually get completed applications of about 3,500-3,700 on average.

They encourage students that if you apply as a freshman and you don't get in, you can actually reapply again as a sophomore.

[31:05] Final Words of Wisdom

There are so many programs out there that support students. It's important you know about them as students don't have access to information. Many medical schools have similar programs so they encourage students that if they have medical schools in their space or region, to reach out to those institutions to find out what programs are available. AAMC has a great list of programs and resources on their website. And if you're beyond the point of applying, please do share this information with others!

Links:

Summer Health Professions Education Program

shpep_alumni@aamc.org

AAMC

Feb 06, 2019
323: From Premed to Physical Therapy School—Back to Premed
38:02

Session 323

Madeleine struggled early and got some bad advising which caused her to doubt her abilities to get to medical school. A pivot to physical therapy didn’t work out.

First off, secondaryapps.com is finally live. The secondary essays are a big part of the medical school application process.

It's a database of secondary essays for every school that offers them. It's an easy way for students to inform us about the new essays for the year. Most schools reuse secondary essays year after year. Some schools change them and we have an easy way for you to let us know that those secondaries are updated so we can keep you fully updated as well. More great stuff is coming as well including videos and posts -- all about how to answer the most common types of secondary essays.

Back to our episode today, Madeleine has always wanted to be a doctor and didn't want to due to her advisor telling her she could never get in with the grades she got. So she went the PT route, got into PT school and realized she was meant to be a doctor after all. Today, she talks about her jjourney, what she thinks set her apart that she got three interviews right off the bat, and multiple acceptances that she cancelled the rest of her secondary essays.

[04:15] Her Interest in Becoming a Physician

Ever since she was a kid, Madeleine has always wanted to become a doctor. When she got to college, she didn't think she wanted to become a physician anymore. Madeleine's mom is a freelance writer and she grew up not knowing her dad.

When she went to an honor's college at University of South Carolina, which she describes as a very intense environment. Since she wasn't doing well during her Freshman in college, she started doubting herself especially that she didn't have a strong reason that she wanted to do it.

By second semester of her Freshman year in college, she began doing competitive powerlifting and there were a lot of physical thersapists who trained at her gym. While having injuries during her training, they were able to help her with making her feel better. She thought it was so cool that she wanted to be a physical therapists. So she began shadowing them and being around them very frequently, training for 2-3 hours a night, 2-3 days a week. So she took the GRE three times and applied to physical therapy schools and got into one. However, although she was relieved to be in physical therapy school for figuring out what career she wanted to do, she wasn't excited about it. There was no real passion about it, and this haunted her a little bit.

Then her best friend introduced her to the idea of osteopathic medicine where she learned she gets to do physical therapy and medicine. So she emptied her savings account and signed up for organic chemistry. At this point, she had already graduated.

So she scoured the internet for her next steps. She descibres it as a similar process to applying to physical therapy school. However, she hadn't fully committed to it at that point as she had put down a deposit on physical therapy school in case it didn't work out so she had a backup plan.

[11:45] Shadowing Experience and a Bad Advice from Her Premed Advisor

Madeleine had a great shadowing experience with a DO who just does neuromuscular medicine. Again, at the back of her mind, she knew she wanted to be a physician. But she just doubted myself so much that she convinced herself she didn't. So she shadowed this DO and saw what she could do in terms of helping relieve people's pain and helping them feel better in their life. She needed that experience to solidfy things for her.

"I always knew I wanted to be a physician. I just doubted myself so much that I convinced myself I didn't."

She never did this earlier due to her premed advisor. She talked about how she wanted to do medicine but this advisor just straight up told her that there was no way she was going to medical school with her grades that first semester.

Basically, Madeleine admist she didn't know how to study andshe didn't figure this out until organic chemistry. So this was a big thing for her. Part of that too, was figuring out how to live a balanced life.

[15:25] Figuring Out Her Stdying Strategy

How she got to learn how to study during organic chemistry was the motivation she got from shadowing the DO and finally now having this concrete, tangible thing that she wanted to be a physician. She also found a group of nontraditional students she could study with and she figured out she studied well in a group setting.

"Having that goal, having a motivation to keep studying, that was a big thing."

As a nontrad, she felt older and out of place around her classmates so she felt like there wasn't anybody to talk to in class. Until she found a person she knew from before that she approached and talked about studying as a group.

[17:05] Making It Work to Work While in School

Wanting to graduate without any student loans, she got scholarship money but she still needed stuff to live on. She figured out what jobs would be flexible enough for her to be able to study and make her own schedule and go to classes. She would usually take two jobs. At one point even, she had four. She didn't have long hours in each one but she was able to pace together enough hours between all of them to make it work. She got to graduate without any debt.

As to what could have contributed to her poor grades, she though it was because of lack of clarity with the goals. She was actually balancing everyhting well but learning how to do all of that took a toll on her grades. She was working as a personal trainer so she'd be working with client schedules and also go to class that she forgot to schedule any time to study.

[19:00] Rushing to Take the MCAT, Ditching the SMP Idea, and Retaking the MCAT

Madeleine took the MCAT twice. The first time she took it, she was debating about doing the Special Master's Program. She knew that they required that for entry. She didn't intially expect to do well on the MCAT and took it late summer/early fall, right after organic chemistry. In short, she was rushing the MCAT because of SMP applications. She knew she wasn't ready to take it but she was still telling herself she needed to take it so she can do SMP. Ultimately, she didn't take the SMP and she's thankful for this podcast.

"Premeds, by default, are all perfectionists... we feel like we have to correct that and make it perfect because med school's not going to let us in unless we're perfect."

At this point, she decided she was going to apply and just see what happens. A lot of students actually think it's crazy. The second time she took the MCAT, she did much better.

She never carved out specific time to study for it but she had a friend shome she also studied with helped her with editing personal statements etc. They'd meet up to study every week for 4-5 hours and on the weekends. So she had somebody keeping her accountable and be able to work through things together.

She also did the Next Step course which she found really great! She got access to the test and for her this made a very big difference. She'd be taking the test over and over so she would have the mental stamina to do it and be able to tackle the length of the test. Finally, she got the score she was hoping for. She was shooting for a 505, something that she knew was realistic for her. Also, she already had an upward trend with organic chemistry, and biochem, and genetics. So she was already proving to med schools that she figured out how to study and she can do well in med school.

"I knew that I had an upward trend there so I was already proving to med schools I've figured out how to study and I can do well academically in med school."

[25:52] Applying to DO Schools Only and Asking for Letters of Recommendation

Madeleine only applied to DO schools she wanted to be able to use OMT practice, not solely neuromuscular practice but she wanted to have this in her tool box as a physician. The hardest thing about the application process for her was getting letters of recommendation. The physicians who wrote the letters for her were great and on time. But her organic chemistry professor was about to retire at that time. She went to his office everyday for two weeks to make sure she was going to get it. Madeleine submitted the letters through Interfolio. She recommends applicants to use Interfolio since the letters are stored there and if you need them for whatever reason, they're there. Plus, somebody misspelled her name and Interfolio was able to pick up on it and she was able to get back before she sent anything.

Interfolio isn't just a repository and they can have your letters sent. But they also check spelling of names, the letterhead, whether it's signed, etc. And they'll let you know so you're not scrambling the last minute.

[28:50] Getting Acceptances and How She Stood Out

Madeleine applied to 10 DO schools and filled out secondaries for three and she got accepted before all the other ones got back to her with the secondaries. She submitted mid June so appyling early was a big part. Then she made sure she was different and that everything she wanted them to know about her stood out. She used the Medical School Headquarters to edit her personal statement and extracurriculars to make sure it was immaculate and that was what she needed to be. She had to make sure to present the best possible package for herself that by the time she had to hit submit, she knew there was not anything in there that she could make better.

"Just making sure I presented the best possible package for myself that I could and by the time I hit submit, I knew there was not anything in there that I could make better."

In being different, for her it wasn't intentional since she wasn't planning on going to med school. Everything she did she loved to do. She was an award winning powerlifter with a couple of records which stood out. She volunteered for the Animal Shelter training dogs which was something she also liked to do. So there was nothing on her application that she didn't love and couldn't talk with and be passinate about. And this passion she had was what came across. Just tell your story, instead of selling to them why you're going to be an amazing physician.

"I was just me - there was me presented in the best way that I could be presented."

[31:22] The Interview Process and Getting Her First Acceptance

Madeleine actually did the beta group for my interview course and so we talked about the things in an interview process. During the interview, she was asked about why DO, which wasn't hard for her to answer, why she wanted to be a physician, and why this school. She got to talk about her powerlifting as it was something she was passionate about that set her apart, not to mention it was a big part of her wanting to become a physician.

"Different is better than better."

The first acceptance she had was her number one school. And she had her interviews done in a span of three weeks. She didn't actually know about getting into her first choice until after she already finished her second interview. And by the time she got to her third interview, she almost didn't go to it. But then it ended up being where she was actually going so she was glad she went. At this point, she stopped filling out other secondaries as those interviews were her top three schools so she figured she might as well save some money. She chose the third over the first since although it's a big school, they've done efforts to retain a small environment. So she was getting all of the perks of the small school but also getting all the resources of having a large school. They have 3-4 mental health professionals that serve as therapists for students. They have research opportunities -- everything a big school has and also have done things to foster a small school environment.

[35:30] Preparing for Medical School

Madeleine is currently working as a medical scribe. When she decided she wanted to apply to medical school, she signed up to be a medical scribe, which she's still doing up to now -- doing everything she can to get exposed as much as possible, preparing for medical school without really preparing for it directly.

"Let the medical schools tell you no. Don't let anyone else tell you NO."

Links:

Secondaryapps.com

Follow me on Instagram @medicalschoolhq

Next Step Test Prep

Interfolio

Jan 30, 2019
322: What to Write About In the Personal Statement and More Q&A
30:36

Session 322

The personal statement is such an important part of the application, yet many students don’t respect it enough. Today, I’m taking your questions about it.

Please also do check out all our other podcasts on MedEd Media Network. Listen to the podcast and learn more about our Personal Statement Course.

[01:20] Reapplying

Q: What's the tactic in terms of reapplying? Should you be going back from the beginning to why you want to medicine or should you go back to what you did between application cycles?

  1. The personal statement doesn't change between the first time you apply and the time you reapply. The goal is to explain why you want to be a doctor and typically, that motivation doesn't change. So

This is the same as the "seed" analogy where while the seed does not change, how you water those can. You can just tweak your stories in the examples you're giving to still paint a similar picture but with different pieces of a puzzle.

"The goal of the personal statement is the same. The goal is to explain why you want to be a doctor."

[04:00] Do You Need Timeline for Your Experiences

Q: "I'm currently applying to postbac program and I'm writing my personal statement for that. A majority of my "why medicine?" came from time in community college which was 3 years ago. My goal throughout my time at the college, was mostly to reaffirm my goals of becoming a physician. My question is how much space would you recommend me to include my experience so I can have something a little more recent and I just graduated last quarter?"

A: The timeline doesn't matter for the personal statement. When you're writing it, there shouldn't be a timeline for your experiences. You have to figure out based on the experiences that you had, which are the ones that you want to write about that are going to show the reader why you want to be a doctor. It's what are the experiences that have led you to want to become a physician and not your experiences in general. So it's all about what was that seed to make you want to check out this health care thing.

"The personal statement is about the most impactful experiences you've had on your journey."

[08:10] Low GPA Due to Depression

Q: I had depression for a couple of years and it got really severe so my studies and grades got really low. I'm taking summer classes to raise the GPA. But I wonder if I should mention that year with the low GPA in my personal statement and explain what's going on?

A: If that semester looks very different from the rest, it's enough of a red flag to briefly mention it. In The Premed Playbook: Guide to the Medical School Personal Statement I talked about how just briefly touch on the red flag. Don't make your whole essay around it. As to mentioning depression, I don't think that is any of the admission committee's business. Again just briefly talk about it and if you're lucky to get an interview then they can ask you about it more in-depth.

Depression is a very personal thing for a lot of people. So I advise you not to mention it but if you're tied to depression and the journey you've been through with depression and it's something you identify with and it's one of the core reasons why you want to be a physician, then maybe you want to talk about it. But you just have to know the risks involved with bringing it up.

"If you need to talk about it, go ahead. Just make sure you understand the repercussions."

[12:00] What Experiences to Put in Your Personal Statement

Q: "When you share experiences that you've already had like in the parts of the MCAT where you're asked for experience and research. I just a hard time understanding how to elaborate on that without repeating and when we can do that and when we can't."

A: There are going to be experiences in your personal statement that are going to be in your extracurricular list. For instance, you're volunteering in the emergency department. You're going to write a description of it on your extracurricular list and market it as your most meaningful. But in your personal statement, you're not going to describe and just say you did it. Instead, you're going to tell a story about your experience from that extracurricular that further confirmed that you wanted to be a physician. Be as specific as possible with only one example, if possible. So write down what was the seed that was planted that made you explore health care followed by one or two stories about a patient encounter and experience you've had that reaffirmed this was the right path for you.

Additionally, mentioning any family hardships is okay. It's common that several people go into medicine because of experiences either with their own or their family member's health. That was their first exposure to health care and to a physician impacting their life. So it's not cliche, it's common.

Hence, you have to tell your story. Where students go wrong is they avoid to talk about it and then their personal statement doesn't make sense since you can't connect the dots as to why they're doing this. Or their whole personal statement ends up being about grandma and how she was sick -- nothing about the student and the journey the student has been.

So let's say your seed is your experience of having a family member or you going through a health condition and seeing how the medical practitioners were providing care to patients. Be careful with the seed like that as it's not immediately when you knew you wanted to be a doctor. It was when you decided that you want to explore health care. Then from shadowing, being in urgent care, and wherever else, that's the confirmation of being a physician.

[17:52] Summing Up Your Personal Statement

Q: When summing up your personal statement, what is the point that you want to end on?

A: A great conclusion would be to answer the question: What do you hope to accomplish with the education that the school is going to give you? What kind of physician do you hope to be? What kind of impact on the world would you like to make?

[18:30] Too Personal?

Q: How do you know whether your story is too personal? How do you know it's related to your pursuit towards the medical profession versus like your resume? Because you don't want to come off that way.

A: Really, it's just a story of your journey. And that should be whatever that seed was that was planted that made you interested in healthcare and what are the experiences after that which confirmed it's really what you want to do. To figure out if it's right, you just have to write.

In my book, I provided a worksheet that you can give to other people and ask them to rate your essay. But people may not understand what a good personal statement should be so you have to be strategic with who you're asking feedback from such as your premed advisor or a mentor. Physicians and medical students aren't really the best people because just because they got into medical school doesn't mean they understand what a good personal statement should consist of. And plenty of people got into medical school with not very good personal statements, but they got in because their stats made up for it.

[22:54]

Q: We hear a lot about how medical school admissions want to see that their prospective students know what they're getting into. But also, we don't want to come off like we sound like we already know what it's like to be a doctor. And I'm trying to figure out

[22:54] Understanding What Being a Physician is Like

Q: "We hear a lot about how medical school admissions want to see that their prospective students know what they're getting into. But also, we don't want to come off like we sound like we already know what it's like to be a doctor. And I'm trying to figure out a way to convey passion about going into medicine and then coming off like I do understand what I'm getting myself into but also, at the same time, not trying to sound like I know what it's like."

A: Showing them that you know what you're getting into can be done through your experiences. So as an admissions committee member looking at your application. So it's better them seeing that than you having to say that you understand what the medical world is like. Just you being seen that you've shadowed or scribed or whatever it is you've done, it's enough proof that you've experienced those. And now, they just need to hear your reflection and why those experiences further solidified in your mind that this is what you want.

[26:46] Thrilling Experiences in the ER

Q: "Majority of my experiences are here in the ER. I'm a little bit concerned that my personal statement is sort of coming off like I've only seen the exciting stuff, and not having as much understanding of the importance of primary care."

A: It's not an issue. You can only do so much. Just tell the stories and talk about the impact on the patients, not that your experiences are so exciting.

"Focus on the impact to the patient and the care for the patient, and not just the exciting and thrilling scene of the emergency room."

[28:47] Personal Statement Course

Check out our Personal Statement Course and get four different modules (plus one bonus module). The first model covers how to find your seed. The second module covers reviewing outlines and what to avoid, as well as reflections in watering the seed. Module 3 is about red flags and the conclusion. Module 4 is editing your personal statement, getting feedback, and finishing it. The bonus module has a ton of personal statements that we've reviewed. We're also adding to the module all the time since we have bi-weekly office hours, every other Monday 3pm Eastern. They're recorded on Zoom and uploaded into the course. This is your opportunity to send your personal statement and get feedback.

Additionally, you get access to our secret Facebook group where you can interact with other students in the course and get feedback from students and from me.

Links:

MedEd Media Network

The Premed Playbook: Guide to the Medical School Personal Statement

Personal Statement Course

Jan 23, 2019
321: Premed Q&A: All of Your Instagram Questions Answered!
39:19

Session 321

We had a ton of questions come in from you on Instagram, covering letters of rec, shadowing, research, and so much more. Follow me on IG—I’m @medicalschoolhq.

[01:25] Shadowing vs. Clinical Experience

Q: Does shadowing count as clinical experience? If not, what can I do to gain more clinical experience?

A: A very common question, yet a very misunderstood part of the premed process is extracurriculars. In the application itself, you can mark something as shadowing and as medical/clinical experience. So shadowing is not counted as clinical experience. You need separate shadowing and clinical experience.

"Shadowing is not clinical experience."

Clinical experience is defined as being close enough to smell the patient. For instance, patient transport in a hospital can go both ways. Some schools don't consider that as clinical experience. So even among clinical experiences, there's still a bit of greyness to that as how each medical schools is going to view that.

But the general rule of thumb is that which is close enough to smell the patient such as being a phlebotomist, EMT, medical assistant, paramedic, nurse, or medic in the air force of the military. Being a scribe is another good clinical experience but there are some schools that don't consider it. But I beg to disagree and think it's a great clinical experience.

Volunteering for hospice is another amazing clinical experience. And it's easy! You don't need a certificate or anything and there are lots of patients who don't have family members and loved ones around. So they need hospice volunteers to be with them at the end of their life.

[04:10] Letters of Recommendation

Q: How many letters of recommendation can you submit in the application?

A: This is one of the hardest parts of the medical school application. Every medical school requires something different. So you have to go through the process and look at all the schools you're applying to and try to figure out what each medical school wants in terms of the number, the minimum and maximum, what are the required ones. The general rule of thumb is two letters of recommendation from a science professor and one letter of recommendation from a nonscience professor.

"I generally don't recommend throwing in more letters of recommendation than what the medical schools are requiring."

If you're thinking that more is better, then this is not the case when it comes to letters. As medical schools are only going to look at their bare minimum so don't give them a chance to not be able to pick the best ones. So just send in the best ones possible that meet their requirement and no more than that.

[05:47] Committee Letter

Q: For a letter of recommendation, what is the committee prehealth most schools talk about wanting letters from?

A: If you have to ask, you probably don't have a committee. The prehealth committee is typically the prehealth office or the advising office that will write a committee letter, which is usually written by a group of advisors in that office that get together to interview you and get parts of your application. Then they review it and write you a committee letter based on other letters of recommendation that go to the committee.

Personally, I don't like committee letter since they're geneally watered down versions of a letter of recommendation. Some schools have them and some don't. If your school has it, go ahead and try it and use it. However, a lot of times, the letter writers at your committee will write a letter and submit it in September. You want your application to be complete right before then. So it's best to just submit the individual letters. If the committee ever gets around to submitting your letter, then you can add that to the mix but at least your application is complete before then.

[07:20]  Asking for Letters of Recommendation

Q: How do you ask for a letter of recommendation from professors you haven't kept in touch with?

A: Don't ask for a letter of recommendation from professors you haven't kept in touch with. Those are hard letters to get. The letter is supposed to be about who you are as a person and how your personality, traits, etc. are going to help you be a physician in the future. Check out AAMC's letter of recommendation writer's guide to help you have an idea about what the letter writer should be writing about and focusing on. Take that info and give it to the letter writer.

"Don't ask for a letter of recommendation from professors you haven't kept in touch with."

So look for somebody you've kept in touch with. If you have to have a letter from somebody you haven't kept in touch with, just reach out and send them an email to see what they say. But the general rule of thumb, it's not going to be a good letter because if you haven't kept in touch with them then you don't have that relationship to get a very strong letter of recommendation.

[08:50] Special Master's Program

Q: I have a 3.3 GPA, do you recommend doing 1 year Master's that mimics first year of medical school?

A: The general consensus seems to be that medical schools like your undergraduate GPA more than your Master's GPA. So if you have a 3.3 undergraduate GPA, I would work on improving your undergrad GPA which means doing postbac work at an undergraduate level.

Now, the Master's that mimics the first year of medical school is called a Special Master's Program, in most cases. Often, you're doing classes with the medical students. That may be beneficial especially at the specific medical school you're doing the SMP at because they're seeing you in the environment you're going to be in as a first-year medical student and see how you can handle yourself.

"Work really hard doing undergraduate level work to get that positive trend up."

Try to work so hard in your undergrad level work to get a positive trend. Because if you already have that degree, then your denominator is so big that it's not going to move the needle much. But that trend will work really well. It is shown separately as postbac GPA and it will affect your undergraduate overall and science GPAs.

I haven't been recommending Master's much anymore, especially for the cost. You can take the classes in undergrad on your own through DIY postbac at a community college or a four-year university and it would be much cheaper.

[10:40] Shadowing a Nurse Anesthetist

Q: Is shadowing a nurse anesthetist who does all the anesthesia valid?

A: It is shadowing, but don't use it as a main shadowing for medical school. Instead, you can put it in your application. But then again, don't rely on it as shadowing because your goal is to shadow a physician, not a nurse anesthetist. And while they're doing a lot of things similar to what a physician does, they're not a physician and not acting as a physician. So be careful with that one.

[11:17] From PA to Physician

Q: How will being a PA be viewed on a medical school application?

A: It's viewed favorably. I've helped a lot of PAs transition into medical school. And it's all about the story you're telling, Why do you want to be a physician? A lot of students will focus on why they don't want to be a PA and this could come out as something negative. Rather the focus is on why you want to be a physician. What is it about being a physician that you need that you can't get as a PA. Again, why not PA, but why a physician.

"It's really all about the story that you are telling. It's why do you want to be a physician?"

Being a PA is an amazing clinical experience where you can talk about all the things you're doing and just that it's not enough and that you want to get that MD or DO.

[12:25] Clinical Experience in Third World Countries

Q: Is clinical experience in a third world country looked worth less than experience in Americas?

A: Just make sure you're doing the right things while you're there.

[12:43] Getting a Job at a Hospital?

Q: Do we need to find a job at a hospital or is it enough to shadow and volunteer?

A: You don't have to work in a clinical setting. You don't have to get paid to work in a hospital to do all of that stuff. If you can swing a job working as a scribe then do that. It may not pay that well but it's a great job while you're in the middle of your application. But you don't have to do that.

[14:10] Advice to Freshmen

Q: What's the best advice you could give to an undergrad freshman?

A: Slow down, relax. You don't have to do it all right now. Your main focus should be learning how to be a college student. Get good grades. Meet some friends. Have fun. But most importantly, get good grades! The rest of the volunteering, clinical experience, etc. can come later once you figure out how to be a college student.

"Your main focus should be learning how to be a college student."

[14:47] MCAT Prep

A: Which practice test besides AAMC are proven most helpful for the MCAT?

Q: The feedback I get from students is that Next Step Test Prep's full-length tests are the second best full-length exams, second to the AAMC as they obviously write the test. Next Step sells packages from 4, 6, or 10 full-length exams. Get 10% off using the promo code MSHQ. Also, be sure to listen to The MCAT Podcast to help you with your MCAT prep.

[15:46] When and Where to Send LORs

Q: When and where should you letters of recommendations be sent?

A: There are a couple of options here. First, you can send them directly to the application services but you have to wait until they open up for that year you're applying. But I don't recommend this since you're waiting, basically to the last minute since you need to time it perfectly as to when the letter writer has to send in the application to the application service. And if you're applying to both AMCAS and AACOMAS and TMDSAS, then that professor has to send to all three application services. So I recommend sending to a letter of recommendation service like Interfolio. Be sure to check in with them if they're still working with all the application services.

Submit all your letters to them and then they disperse the letters of recommendation out to the different application services. Then you don't have to time it right. They can send them in January and then you submit your application in May or June and the letters get out as they need to be. They also do some quality checking.

[17:25] MD/PhD

Q: Explain about the MD/PhD.

A: MD/PhD is all about research. You don't have to do an MD/PhD to do research as a physician. You can go to any medical school and do research. So you don't have to have a PhD.

"MD/PhDs are typically very academic, very research-driven, with very little clinical experience."

[19:10] Leadership and Nonclinical Related Activities

Q: Would being promoted to a manager at a restaurant count as leadership if I include it in the application?

A: Of course!

Q: I work all throughout college that was mostly restaurant related. Should I include this in my app?

A: Yes. Students think that the application needs to b 100% focused on medicine or health care. And that isn't the case. In the application, there is a section there where you can put in your hobbies as well as your non medical or non clinical activities. So put all these other things because it paints a picture about who you are as a person outside of you liking science and wanting to help people. (That's obviously a given!) By doing all the restaurant staff, you're able to tell a story about leadership or personal interaction.

"The application should paint a picture about who you are as a person."

[20:35] Deposit at a DO School

Q: What do you do if you get an offer from a DO school but their deposit is too much money?

A: Shame on AACOMAS AOA for not regulating the deposit amount from medical schools. It is disgusting how much some of these DO schools are charging for non-refundable deposits to students. All you're doing is increasing this divide of students who can afford it and those who can't. If a student gets an acceptance and is faced with a $2,000-deposit which they don't have, what are they supposed to do?

What you can do is reach out to the school and say you want to come and whether you can just give them your first born. Try to work with them and see what they can do.

On the other hand, the AAMC (for MD) regulates this and this has changed a bit with the new AAMC Traffic Rules this year. Historically, it's been $100 deposit. The AOA needs to do the same thing for DO schools.

[22:17] Getting "Quality Clinical" Experience

Q: Can you distinguish what is it that makes and extracurricular provide quality clinical experience?

A: Quality clinical experience in terms of medical schools liking it, it depends on how you pitch it. For instance, you have this amazing clinical experience as a medical assistant. But then you write the most basic job description. This is not a very good description. But if you told a story of one of your patients you saw regularly and you saw the impact that patient had on his or her life and how you had impacted someone's life, that makes for a quality clinical experience. Because you're telling the admissions committee how "quality" it was.

"Job descriptions are horrible extracurricular descrptions."

[24:00] Bachelor's Degree

Q: Does it matter for medical schools how many years it took you to get your bachelor's degree.

A: For the most part, you're fine. But if you only make one class a year, they may question your ability to handle a full course load. But if you're just taking an extra year or withdraw from a semester or two for whatever reason, then don't worry about this.

[24:23] Three Physician Letters From the Same Specialty

Q: Does it look bad to have three physician letters from the same specialty?

A: You don't need three physician letters. As mentioned above, make sure you're getting the required letters the schools want. Now if you only have one physician letter, then great. But three is just a complete waste of time for everybody.

[24:43] Building Relationship with Your Letter Writer

Q: Do you have to take a class with science professors who write your letters or can you work for them?

A: You don't have to take a class with the people who are writing your letters of recommendation. If you've worked for that professor, you're going to have a much more relationship with him or her, and they're going to be able to write you a much stronger letter of recommendation because they know who you are.

[25:25] Not Too Much ECs and Applying Next Year

Q: Advice to almost no ECs because they started the process late but are still applying next year.

A: Don't apply next year. There is no rush. If you want to apply with no ECs or rushed ECs, don't apply just yet. You've got time so be sure to get some quality extracurriculars under your belt and then apply.

"Take a year off. It's not going to kill you. It's just a year."

[26:40] Science Letters, Updates

Q: Do science letters have to come from hard science only?

A: Yes.

Q: If you have no updates to submit during the application cycle, will it hurt me?

A: It will hurt you if you're lacking something in your application and you're not fixing that to send an update letter. Hence, if you're lacking clinical experience or missing something in your application and you're not fixing it and you're not showing an update letter to show you're fixing, then this can hurt you. If your application is great, you don't need to send an update letter.

[28:15] Cost of Attendance

Q: When, if ever, should cost of attendance stop mattering if deciding between acceptances.

A: When you're looking at the school budget, which is tuition cost, living expenses, etc., this comes in at the very end. Hopefully, you can get a financial aid or if one school is offering some financial aid and the other one isn't, you can potentially go back and forth with the schools to see who can offer you the best.

[29:35] Online Course for the MCAT

Q: I took AP Psych in high school. Should I fit in an online course or do self-study for MCAT?

A: It depends on whether the schools you're applying to require it as a prereq. If it is, I wouldn't recommend taking it online. Schools don't like their prereqs done online for the most part.

If you're looking at the school requirements and it's not a requirement, then take an online course. Or you can self-study so you won't have to study in the other big courses for the MCAT.

[30:15] Upward Trends

Q: Is it okay if it does take a little longer but carrying heavy course load with upward trends?

A: Of course, it is okay.

[30:30] Essay Contest Winner

Q: When do we find out who won the contest?

A: For those who still don't know, we will be doing a quarterly essay contest. We doubled the prize money and did that for six months instead of every quarter. First place is $4,000, second is $1,500, and the third is $500.

Go to premedscholarship.com to learn more about this!

[31:37] Undergrad GPA and Community College Classes

Q: Will community college classes taken after graduation get added to undergraduate GPA?

A: Yes, they will get added separately as postbac classes. But it will be counted towards your undergraduate GPA.

[31:50] 3.1 GPA

Q: 3.1 GPA but good MCAT applied to Master's or bridge program, we're trying to apply it one cycle.

A: So if you have a 3.1, it depends on what that looks like. A 3.1 as a steady score all across the years. The upward trend is much different to tell the person about who you are, what your struggles are...

"That 3.1 can be many different things."

As I've mentioned, I'm not high on Master's programs anymore and just more sold on just doing postbac work at an undergraduate level to improve your GPA because medical schools seem to worry more about your undergrad GPA vs. the Master's GPA.

[32:52] Tuition, Minority in Medicine, and Research

Q: Fortunately, I am debt-free from my college career. Where can I get info for medical school tuition?

A: Just go to the medical schools' websites and you'll get all the information there.

Q: I am one-quarter Hispanic. is that significant enough to put on my application. Does it help?

A: You're good but just make sure you're following the rules. Being Hispanic helps definitely. It's an underserved and underrepresented minority in medicine.

Q: Is it okay if I did a lot of research and was published twice a year and a half ago, but haven't done much.

A: If you've done research and you've stopped, that's great. You don't have to worry about consistency with research unless you're trying to apply to MD/PhD.

"Consistency with volunteering and clinical experience and shadowing is much more important than consistency with research."

Q: 2.6 cumulative, 3.4 science, 514 MCAT - will I get accepted to U.S. schools maxed out units?

A: This depends on the medical school. Some schools may scream that out while others may screen out cumulative and science. So just apply and see what the medical school stell you.

[35:15] Single Mom with Limited ECs, Shadowing Opportunities, and Transfer

Q: I'm a single mom and with a great GPA, will they understand that my ECs aren't amazing?

A: Yes, they will. They will understand that you have to put food on the table first so those are great.

Q: What is the best way to find shadowing opportunities?

A: Just go out to the hospital, to the private clinics, and physicians and ask. Ask, ask, ask and hopefully, you get some yeses.

Q: Does transferring multiple times make an impact on medical school decisions?

A: It basically depends on why you transferred, as long as you have a good reason.

[36:25] MCAT Prep, 3.5 GPA, and School List

Q: At what point should the students begin studying for the MCAT?

A: The majority of students study 3-4 months then take it in April or May of the year you're applying.

Q: Is a 3.5 cumulative GPA competitive enough to get my foot in the door?

A: Yes, that score is decent.

Q: How can I make the list of schools?

A: I recommend not looking at the MSAR. Most students go straight to it and look at the median GPA. But they forget it's a median number. Pick schools you want to go to based on location, weather, class size, curriculum, locations to residency programs, etc. Then at the very end can you possibly look at the MSAR and those medial ranges. And look specifically at the 10th percentile of the GPAs in the range on the MSAR. If you are near that 10th percentile, at or above it, then apply. If you're pretty far below it, then maybe don't apply.

Links:

@medicalschoolhq

AAMC's letter of recommendation writer's guide

Next Step Test Prep's full-length tests (Get 10% off using the promo code MSHQ)

The MCAT Podcast

Interfolio

AAMC Traffic Rules

Jan 16, 2019
320: From Military Special Operations to Med School Acceptances
40:58

Session 320

Justin is a former military special operations medic who grew a stronger fascination with taking care of patients. Now he has multiple acceptances to med school.

Please check out MedEd Media Network for more podcasts. I'm also doing great video courses about the personal statement as well as for the medical school interview where you get access to many hours of video content, including access to a secret Facebook group and some live office hours.

[02:10] Interest in Becoming a Physician

Justin realized he wanted to be a physician while he was training as a medic in the special operations. Fascinated by the sciences and found success in it, he also loves the hands-on portion of it and be able to affect change immediately with bare bone resources.

Prior to joining the military, he just finished a four-year degree back in the financial crisis. At that time, his degree didn't bode well for job prospects. However, he has always planned on joining the military. His parents stopped him from doing it back in high school, even had a special friend sit down with him where it was explained to him the importance of having a backup plan. So out of his business degree, he went on to try out at the special operations unit and made it.

He went down the path through a series of tests and with his test scores, he was encouraged to work at the medic area. Initially, it didn't come to his attention that he was going to be a doctor but he has always had that commitment to his service.

What really solidified in his mind to go to medical school was when he started seeing patients and treating people. Having gained experience and confidence in his abilities, it was crystallized that his path to becoming a doctor was what he was set to go on.

In the military, medics are left with several situations where there were no other doctors present but them. Justin points out that you should be constantly aware of your limitations. That being said, he considers this as a fantastic opportunity. But at the same time, you need to be aware of your limitations. Additionally, they always get in contact with the physician overseeing their medical situation. And it's a good thing he had a good relationship with the physician that oversaw his scope.

"You're constantly aware of your limitations and what you can and cannot bring to the table to help the person in front of you."

[08:37] Serving as a Medic in Special Operations

For Justin, the coolest thing he had to do was to be able to help guys who got hurt during the mission. Just being there for them was very powerful enough. He adds that he was able to provide the medical capability for a unit he was conducting operations with.

Still, on active duty, Justin was still able to do things while active duty before he had the opportunity to completely separate to become a civilian. He made his intentions known to his Command near the end of his enlistment. Good thing they supported him and his endeavors. And he just made it happen, taking classes in the evening. He also had very supportive teachers who were aware of his scheduling and his priorities, especially to the mission.

"Everybody supported me and we just made it happen!"

[11:40] Finding the Next Steps

He initially asked his friends and sought out people who have gone on the same journey. He came across this podcast and did some research - seeing the first steps like the prereqs he had to get and which exact classes he needed. He would also ask schools and asked them about some resources and guidance. Basically, he just went on and sought as many resources he could find.

Unfortunately, this is something a lot of students don't do enough of considering we live in this day and age with so many resources, websites, podcasts, etc. Yet students are still coming in naive to the whole process because they're not going out and finding information.

He was actually concerned about his grades having a GPA that was not as strong. And knowing that, he just prior military training into practice and set a goal. He set timelines. and sought out every resource that could help and he practically worked his butt off.

[14:35] Thanks to Military Training

"I had some training where I learned a lot about himself, about discipline, about personal responsibility, and the classic story of the military making into a disciplined person."

Justin points out the importance of having a specific, measurable, actionable goal that you can set your sights on. And just his time being in the military and doing all those hard stuff in life, allowed him to learn more about himself and become more responsible.

He also felt very fortunate being supported by people who push each other to become better, stronger, faster, and smarter. He has always been in an environment where he was being pushed to improve on a personal level.

[16:50] From Military to Taking a Postbac

Out of the military, Justin's first priority was location as he wanted to be close to family. Other priorities included cost. He was a career changer so going into the AAMC site, he found out about the postbac and saw which postbac programs were the closest and compared cost, location, etc. and then he applied to all of them.

Not having any science background, he thought he was going to spend day and night studying knowing he was surrounded by people with science background. But he went down all his class list and got contact information of his professors. He got the syllabus and what resources they needed. And a month before the class started, he'd go through the textbooks and did some advanced studying.

"I pretty much started to learn as much as I could before the class even started."

[20:00] Figuring Out Your Studying Approach

Read the material beforehand even before it's just ten minutes of glancing through the material. You're going to be better off than a student that doesn't do that at all. In the process of doing this as well, Justin found out what worked for him and what didn't. He found out it didn't work to read through the entire text and highlight or make outlines. He found out it worked best to skim through once, read over again, and ask questions. So he had gone through the process of figuring out what worked best for him in a certain subject since it was different for each subject.

"It was different for each subject. You wouldn't approach studying for physics in the same you would approach studying for Biology. It's different."

Taking the time to start figuring this out even before the class was really important to him since he wanted to do well in his classes, which he ended up doing so.

[21:50] The Medical School Application Process: Telling His Story

For Justin, telling his story was the hardest obstacle of this whole process - to just sit down and put into paper and writing about himself. What he did was come up with a brief outline of what he wanted to talk about and he jotted down a couple of sentences about stories he wanted to tell. And then he'd stop for the day and just let it simmer at the back of his mind. He'd then approach it the next day and try to write from a different perspective. Or he would write a different story the next day. In short, he doesn't try to force anything and just let it come to him.

When you sit down and try to write a story, it's hard, especially talking about yourself. But if you revisited it a couple of days later, by simmering in your subconscious, maybe things flush out in a couple of days. All that being said, Justin says that although it's challenging, the rewards you gain out of it are more than worth it.

"It's such an introspective process. It forces you to think about your life and why you're doing things and motivations and your goals."

[25:37] Don’t Sell Yourself to the Admissions Committee

Initially, I gave Justin the feedback that he was trying to sell himself as a teacher, especially as a medic. He admits this was an easy mistake to admit. But you have to do your best to avoid and understand and have the self-awareness that you're probably going to make that mistake. Also, be deliberate in your attempts to avoid making those mistakes.

As you go through the editing process, try to shift towards imagining an admissions committee member and you're telling them from the bottom of your heart why you want to become a physician.

"If you were in a face-to-face conversation, you don't want to be having that salesman type pitch. That's not the natural thing that you do."

Justin says telling your story is really huge in your medical school application success. It helps to tell your story in the interview and have that seamless, connected story that puts together all these different facets of your life and winds them into one narrative that tells your story. This is easier for the admissions committee to look at instead of being scattered all over the place.

[28:25] The Interview Process

When asked about his red flags in one of his interviews, he talked about his undergrad grades. But the interviewer assured him that it happens and it's common so it's nothing to worry about. The majority of his interviewers wanted to talk about his experiences in the military and serving abroad.

Students might think being in the military might be a common story but it's your story! So don't be afraid of your stories no matter how common you think they are because they're your story.

Justin added he's not even the first person with that background to apply to medical school. There were others more who applied that had similar experiences but it's just like any other form of art, books, movies, or poetry — we stand on the shoulders of giants.

"It's about the specific aspect of your story and the new interesting details that you can bring to the table."

[30:55] Playing the Waiting Game and Narrowing Down to His School of Choice

Waiting for the results is real and Justin emphasizes that you have to focus on something. For him, he had another job that he buried himself in. Since you can't sit all day and wait for the email to come or you're driving yourself crazy. Instead, invest in something constructive and you find joy in.

Having had multiple acceptances, his major factor in choosing his school was location to family or location in part of the country where he had a lot of friends and acquaintances. Another factor was cost — private vs public schools. And he was going to apply for the VA benefits as a military service member. And the VA doesn't pay for 100% of private schools. So finances come into play as well.

Also, he looked at what the school emphasizes and how he felt about the school, people at the school, and specific curriculum, and ultimately, how the interview day went and how he felt with everybody he interacted with.

At the end of the interview day, he would make a pros and cons list — cost, weather, location, curriculum, facilities, opportunities for research and community service, and the general gestalt of the whole day. He also looked at the disposition of students and faculty.

[35:00] Justin's Final Words of Wisdom

To those who may also be in the military who are thinking about transitioning towards becoming a physician, Justin encourages them to reach out to your friends and friends of friends. Seek out as many resources as you can find. Start taking some type of science class now whether it's a physics class or just an intro to chemistry class. Prove to yourself that this is what you want to do and that you can do this! Prove that capability to yourself.

Going through this entire process, the hardest thing for Justin was the sacrifices he had to make like missing certain events with family or friends, long nights studying instead of having fun.

Ultimately, having that balance is a key, It's hard and it's a challenge to find balance between getting good grades, and balancing with work and time for self-care. You need to work out, eat right, get good sleep, spend time with friends and family. These are things you need to do as well. So Justin makes sure he gets to do all that as well.

"You can't just put all to the wayside and hard charge yourself towards 100% study-work, you can't do that. That's unsustainable."

[39:49] Check Out Next Step Test Prep for Your MCAT Prep

Looking at MCAT prep? Check out Next Step Test Prep. They have an online course, live office hours, the full-length exams which are second best to the AAMC exams (as they write the test). Use the promo code MSHQ to save some money on the tutoring, course, or on their full-length exams.

Links:

MedEd Media Network

Medical School HQ Services

Next Step Test Prep (promo code MSHQ)

Jan 09, 2019
319: Disclosing a DUI Didn't Hold Him Back from Med School
34:31

Session 319

Matt is a premed with multiple acceptances to med school, even with a big red flag on his application—a DUI. Learn what happened and how he talked about it on his medical school application.

Meanwhile, we have a lot of resources available for you as you go through this path. Do check out all our other podcasts on MedEd Media Network. Join a collaborative community of premed students on the Premed Hangout group. If you’re also interested in some readings, check out The Premed Playbook: Guide to the Medical School Personal Statement and The Premed Playbook: Guide to the Medical School Interview.

[02:03] An Interest in Becoming a Physician

Matt knew he wanted to do something health-related since he was in undergrad. Born with a permanently detached retina on his left eye, he was able to overcome and adapt to live a relatively normal life. He didn't have driving disabilities, and in fact, he became a high school varsity quarterback. Aware that there are so many people with these debilitating diseases and disorders that aren't able to adapt by themselves, this was his motivating factor to go into health care.

Being able to play ball while having his disability, Matt says this involves a lot of muscle memory, where he spent a lot of time practicing. Even when he played basketball, he shot a lot of free throws to get his muscle memory down that he became the designated free throw shooter during his junior and senior year.

For him, being blind in his left eye was an extra motivator, which he felt was helpful to talk about in interviews and application.

[03:55] Talking About HIs Disability on the Application

Matt actually had his left eye removed the past semester but before that, it looked abnormal. So growing up, he would have people asking about it. So it kind of just became part of his identity and he got used to explaining. And as he learned the science behind it, he was able to explain it more. Being comfortable talking about it somehow helped in talking about it in medical school application and interviews.

A lot of his interviewers would bring this up and make a big deal about it. They're trying to picture themselves living with one eye and how that would be different. Matt had to balance between making it seem like it's not big an adaptation for him as it would be for them, but also try not to downplay the importance of it in developing him as a person.

[06:24] The Push to Becoming a Physician

Growing up, his family moved around a lot. And with each move, he'd get to meet a new primary care physician. He'd get in touch with an ophthalmologist he'd go regularly. So being able to see a wide range of MDs and DOs, his exposure to them at a young age was what really pushed him into that field.

Both Matt's parents were medical technologists while his dad eventually switched to hospital administration. He considers this level of exposure as a huge help, even just hearing the stories about their jobs.

[07:55]  Becoming a Physician vs. a Medical Technologist

Being a sports enthusiast, he was thinking physical therapy would be interesting. So he shadowed a physical therapist and talked to his dad about it. Then his dad challenged him to do more research on being a nurse, physician, etc. The more he was looking into it and shadowed and researched, he felt like being a physician in a multi-disciplinary, across the entire health care spectrum, leadership role fit his personality and what he really wanted to do.

Matt has been a phlebotomist for almost two years now so he has gotten to work with medical technologists for a bit but he doesn't think there is that much level of patient contact that he would enjoy.

"I've gotten to work with medical technologists quite a bit and I don't think there's that level of patient contact that I really would enjoy."

[09:38] The Hardest Thing in His Journey to Medical School: DUI Charges

The hardest thing for him was the past mistakes he has done related to multiple alcohol violations in undergrad. During his freshmen year, he got an on-campus alcohol violation which he just shrugged off. Then the following semester, it happened again. Matt admits the lack of maturity, without thinking about how this would affect him in the future, not only externally with jobs, but also internally, his thought process and the way he'd spend his free time.

Then he went through the sophomore year and then the summer following that, he met a couple of buddies who were on active duty military leave. They went up to one of the cabins and they went out to a bar. Although they had a designated driver at that time, his vehicle broke down on their way home so he made the decision to get in the driver's seat to figure out what was going on. Until he got charged for operating the vehicle while intoxicated.

"The fallout of that both legally and mentally was definitely difficult to overcome."

[12:38] Talking About His DUI on the Application

He did reach out to medical schools and asked them in a hypothetical way to find out how medical schools would react to this. Many of them said they'd still consider the application as their main focus is not so much on the mistakes but on how you've changed what you've done to learn and grow from them.

Matt found it difficult to talk about this in the primary application. Not only because there are limited characters provided, but there's also a law in the State of Wisconsin where the first offense of driving under the influence is not a misdemeanor or felony. So it's not a criminal charge, but just like a "very expensive" traffic ticket. But you still get your license taken away for a period of time. So he had this dilemma whether he wanted to include this in his primary application or was there a need to disclose it.

So he asked a lot of advisors but there were a lot of gray area answers, being told that no one has dealt with this before and that it was up to him. At that time, his mindset in trying to learning and growing up from this mistake was owning up to it and be honest.

"My mindset in learning and growing up from the mistake was owning up to it and just being honest to myself and others about what happened."

Ultimately, he decided to include this in his primary application. He tried to fill the limited characters up with a detailed explanation where he could get the point across about what happened and how he has learned and grown.

In hindsight, Matt says he must have talked to a lawyer about it first just to get a more comprehensive outlook. But at that time, he was focused on his personal growth and owning up and being honest about what happened.

He marked this under the Misdemeanor. His thought process was that in other states, it would be considered a misdemeanor that's why he included it. Then at the very beginning, he included a disclaimer that says it wasn't considered a criminal charge or misdemeanor in the State of Wisconsin so it may not appear on criminal records.

Looking back, Matt admits he may have thought of doing it differently. He did understand what he did at that time with the mindset he had. But for the reasons of being honest and being open about it, just in case it were to come up in any search results, he didn't want to sound like he was trying to hide it.

[17:50] Talking About DUI During The Interview Process

Matt got asked about this during two interviews. He got the chance to practice with me a week before his interview and so he was able to practice in his mind what he wanted to say to them about it, without really memorizing it word for word. And the interviewers took it positively, making him more comfortable talking about it. The second interview was a panel-type which he felt was intimidating. He had to keep his thought process going while maintaining eye contact with all of them.

For him, he had this strong desire to get into medical school which was his motivating factor. It made him realize that he had to remain optimistic amidst what happened. He has always kept this mindset of positivity that he was really going to get into medical school.

[21:42] Other Premed Struggles

Another challenge he had to go through as a premed was balance. He had to balance his leadership role, and volunteering, shadowing, along with maintaining a healthy lifestyle where he would still have time to cook healthy meals, workout, and relax.

"Finding that balance in the time management skills was difficult at first but it's definitely improved since then." 

To find that balance, he'd relax watching sports or playing video games. He also enjoys working out. He also finds naps to be helpful.

[23:27] Choosing Schools to Apply To

His potential red flags didn't really weigh into where he went to but more on how many schools he applied to. He ended up applying to 43 schools (30 MD and 13 DO). He was living off ramen noodles since his money was directed towards the applications. Check out this medical application cost estimator tool to give you a rough estimate of how much your application might cost.

Matt got a total of five interviews and he recently rejected withdrew the rest of his applications. Matt had great GPA and MCAT scores so these were not hurting him. Other than that, it was how he worded his personal statement. He gives credit to The Premed Playbook: Guide to the Medical School Personal Statement. He also made sure he had consistent volunteering and clinical experience.

Out of the five interviews, Matt got three acceptances. He ultimately chose the Medical College of Wisconsin Spring Bay Campus due primarily to proximity to his parents. Also, they focus on primary care which is something he's strongly interested in. Plus, when he went there during interview day, he felt so at home and welcomed. He describes how personalized they were, calling him by name. Lastly, it's a three-year medical school so he believes he can save a year of time and money.

[28:40] Talking About His Disability During the Interview

Matt got asked how being blind in one eye could impact what field of medicine he gets into, and he was just honest about his limitations knowing that there are some things out of your control. Being prepared for this question beforehand would definitely give you that reflection and self-awareness to talk about it. Matt adds you need to make sure you don't think you're going to be the perfect applicant or the perfect doctor, but that you're able to talk about your own limitations or weak points and owning up to it.

"Just be honest about your limitations and there are some things out of your control."

This is the same as being asked what your weaknesses are, where you don't turn them into strengths. You simply just have to be honest about your limitations. The medical school interview is not a job interview. Check out The Premed Playbook: Guide to the Medical School Interview.

[31:25] Final Words of Wisdom

Reach out to fellow premeds either physically or on Facebook, including the Premed Hangout group. There's a large, diverse group of premed students out there who have the same goal as you have. And they may be able to give you advice that you wouldn't have otherwise gotten from an advisor or family and friends that aren't premeds.

Links:

MedEd Media Network

Medical School Application Cost Estimator

The Premed Playbook: Guide to the Medical School Personal Statement

The Premed Playbook: Guide to the Medical School Interview

Premed Hangout group

Extreme Ownership by Jocko Willink and Leif Babin

Jan 02, 2019
318: The Pros and Cons of Global Healthcare Experiences
38:28

Session 318

Lawson is the executive director at Atlantis, a leading global healthcare experience fellowship that gives you the chance to explore other healthcare systems.

Today, we cover what you should be looking for, what you should be avoiding, and much more!

Based in Washington, D.C., Atlantis does international programs for premed students. Lawson has been working with the company for over three years.

[03:03] Is it Worth the Experience?

What is the value of this is a question they commonly get. Whether it's a good fit for them or not or how do medical schools look at these types of experiences. Lawson thinks the answer basically depends on the student.

"Like any good premed student preparing for medical school, be very thoughtful about the story that you're crafting."

Assuming that you have a strong GPA and MCAT, beyond that, medical schools are looking for what is the story of this person they're seeing on the resume or in the interview.

With this being said, global experiences can be a big part of that story for some candidates. You certainly don't want it to come across as manufactured or fake and this is the fear that some students have. They fear it's not real or it's not as valuable in the medical school process.

But Lawson believes that properly done and understood, this can be a really significant part of the student's application.

[05:12] How It Can Come Across as Manufactured

Sometimes, you need to ask good questions. Sometimes global experiences or global programs in health are not done responsibly or where the incentive structure is going to be helpful for the education of the student. Lawson says there are two sides to this.

On one hand, for instance, the program may make a big payment to a physician and maybe the student to physician ratio is not very good. Sometimes, the program itself could seem like a high priority but when you get there on the ground, in a foreign country, you meet the healthcare partner and realize the priority is not really towards the student's education or experience.

The other side is that as a premed student when you're thinking about crafting your narrative in your story, students often think that everyone else has global experience so they have to have it to be competitive. But that's not true.

"You definitely don't need to have global experiences to get into a great medical school."

As a result, sometimes students would rush into just checking off the box and go abroad to volunteer. However, Lawson points out this is not a thoughtful way to approach this either.

[06:58] Volunteering in the U.S. and Abroad

Over 90% of the programs of Atlantis are in first-world European hospitals. Lawson says there's a conflation in the U.S. premed community of this idea of global health in more developing or under-resourced areas. That said, there are so many opportunities to do that in the U.S. and there is so much need. Not to mention that you don't need to deal with some strange ethical situations or some of the cross-cultural things as much if you did this in the U.S.

Students don't often look at rural healthcare or urban poverty as much as they should when thinking of volunteering programs but if you're bent on going abroad, it is particularly challenging to find a professional and ethical global health program for premed students if you're going to under-resourced environments. It's just harder. Lawson warns there are lots of shady volunteer programs. As a premed student, you can get into situations that you might not want to talk about in your medical school application.

[10:05] A Backlash of Shadowing Abroad Among Medical Schools

It saddens Lawson that many students are wary about global experiences because he thinks there's so much that can be learned from a good global health experience. But there's been pressure both from the inside of medical schools as well as influencers and thought leaders outside of medical schools that have been pushing this.

Some admissions committees are very concerned and very particular about this while others don't care quite as much. And the very thing they're concerned about is this general principle that a person should not be practicing medicine in an unlicensed way. So you should not do things you're not trained to do.

Lawson explains that it's miscommunication and the need among underserved communities that have led to students being put into positions where they're asked to help with things like delivering babies or stitching someone up. The local healthcare practitioners are pushing them and they may not understand that they're not trained. Plus, there could be language barriers. So it's a very difficult situation.

"Premed students don't really realize that doing any sort of practical medicine without training is really not smart and not ethical."

Many premed students don't realize that doing practical medicine without training is not ethical so they sometimes like to brag about this on their application. And this is when you start to get into trouble if you talk about it and if you talk about it extensively in a personal statement or an interview.

There are extremes of this and a lot of times are the minor things like takinga physical or taking blood pressure, denoting grey area on some of these practices. What some admissions committees might look at badly upon is when they're taking a patient's blood pressure even if they don't have the qualifications to do that even if they're supervised.

"I don't think you should treat global health experiences as a venture where you can try out things on foreign patients."

[15:50] Why Shadow Abroad

Lawson reveals that only about 15% of students they surveyed said it's easy to get shadowing experiences in the U.S. While the vast majority of 55% said it's hard to get shadowing opportunities but they can figure it out. Then about 28%-30% of students say it's very hard to find quality shadowing. And students, who have found a quality global health program that does things in an ethical way, say it's easier. The way hospitals work and their incentive structure in Europe for instance, are more open to training and observation. They even have extra capacity that sometimes U.S. hospitals don't have. And the physicians have a different mindset on compensation and the value of time than U.S. physicians do.

Another reason is the comparative health care aspect. Europe's health care system is a single-payer health care system. But the U.S. has struggled with this internally although there are parts of our policy now that's headed in that direction. But it's helpful for students to really live in and understand the pros and cons of the single-payer system especially if you want to have any sort of activity or voice in policy health care.

That said, Lawson doesn't think everyone needs to go abroad to shadow. At the end of the day, it has to be the quality of shadowing you're getting.  A lot of students look at shadowing as to check off for clinical experience in general.

At Atlantis, they educate students on the idea that shadowing is not a check off that you can put on your resume. Instead, look at t as an opportunity to understand medicine and to understand the life of the doctor because this is what you want to do for your whole life. So they want to give their students extensive and varied exposure to real medicine.

"Look at it as an opportunity to understand medicine and to understand the life of the doctor because this is what you want to do for your whole life."

Additionally, they could get very important takeaways from shadowing abroad. But if you can do it in the U.S. then by all means. Lawson says that while there's a degree to it where students really struggle to find clinical experiences in the U.S. so they go to Atlantis for the clinical experience. But that can be rare. He says it's typically someone who has an interest in global things and global health experience.

[22:35] Financing Global Health Experiences

Their programs are not cheap and there isn't a super easy way to go abroad in general without spending thousands of dollars. On their end, pay attention to financial aid, scholarships, fundraising, etc. There are organizations that give financial aids. Don't think of going shadowing abroad as a luxury and only rich people can do. A majority of their students don't come from wealthy families but a lot of them are contributing a lot financially themselves from their savings, work, and fundraising, etc. With that said, they get more experience at the end of the day since they do take these more seriously.

Moreover, Lawson points out that education is usually not free. even if you get unpaid internship, that's costing the hospital or the intern provider something. Everyone is used to spending money on tuition. And people are spending all this money on their GPA or their brand of college. But they're not willing to spend even $5,000 on great MCAT prep or interview prep, which are other things that are extremely important for getting into medical school. Although this makes sense since these are going to be out of pocket, which is an upfront cost.

When you spend your dollars on education, you should be thoughtful about what really do you need in order to move to the next step. It's not only the GPA that's important but other things too.

"It's really smart to invest early on in your education because of the compounding returns on that."

[28:27] An Overview of Atlantis Programs

They try to keep the focus of the program on the hospital. They partner with public hospitals in Europe and with the National Ministry of Health in Italy, considered as the best public university hospital in Italy, regional services in Spain, and private and public hospitals in Portugal and Greece. That said, they're more focused on hospital experiences. They spend a lot of time preparing departments, doctors, the hospital administration for their student groups every summer.

Mondays through Thursdays would be hospital focused. So students spend the majority of the day in the department doing one to one shadowing or sometimes with one other student. By 3 pm, doctors would be wrapping up their day and students would already be coming back to their housing to relax. There are group meals but Mon-Thurs is mostly hospital-focused. Friday, they do a full day excursion so they take students to something cultural or local, going to a historic or cultural site or some outdoor activity like hiking, kayaking, etc. So they try to have some fun activities on a Friday. Then weekends are free. They used to do a lot of scheduled programming but they realized a lot of students weren't showing up because they wanted the free time.

"Shadowing is more exhausting than students usually realize. You're on your feet most of the day."

[31:00] Basic Logistics When Going Abroad: Safety

A lot of people are concerned about safety and the actual international travel (cost, etc.). For the first time international traveler, safety and the travel aspect can be daunting. Flight costs can vary a lot depending on different factors like dates, times, etc. So be willing to invest a good bit of time comparing flight prices and different options. Research on the best flight because you could literally save hundreds of dollars just by tweaking little variables like departure airport, return date, etc. And a lot of students don't realize that so they can get intimidated by the cost of the trip to Europe. Students on the east coast should be able to find a flight if they're booking 3-4 weeks ahead of time in the 600-700$ range. This is way less expensive than students think it would cost.

On the safety side, you can use the U.S. Department State's safety ratings. There happen to be some attacks in Europe in the past few years but as a whole, most cities that students reside or stay in the U.S. are more dangerous than any place where they operate in Europe. They have more challenges with students in alcohol, than anything else, but no violent crimes whatsoever.

Check out Atlantis' website to learn more about them and the programs they offer. Call them and they'd be happy to help you understand what's a good fit for you.

[36:00] Should You Really Shadow Abroad?

Don't use this thinking this is going to put you over the top of your medical school application or going to get you into medical school. Don't think of this as something that would stand out in your application.

If you can afford to go on one of these experiences without going into debt, then it's something to look into. But if you can't, that's okay. Not going to one of these isn't going to put you behind any other students who are going on them.

What these experiences will do is give you the experience of traveling around the world, exploring other cultures, seeing other healthcare systems, and meeting a group of students in a different setting and really bonding and forming relationships with those people.

Links:

Atlantis

MedEd Media Network

Dec 26, 2018
317: Building Better Study Skills for the Sciences and MCAT
45:24

Session 317

Kathleen is an expert in helping premeds and medical students better prepare for their exams. With her evidenced-based practice, she’ll help you too. Today, we talk about how you can study better -- what you should be doing before, during, and after class -- and so much more!

Please check out all our other podcasts on MedEd Media Network to help you along your journey to becoming a physician.

[01:50] Kathleen's Background

Kathleen started in 1988 working for a company to work with the medical office of academic advising. Just after finishing her Master's program, she was looking at reading strategies and how students learn to read. She realizes that at that time, medical students were required to read about a thousand pages a week and it has only increased since then. So she wanted to figure out how to be a more efficient reader. She then got hired by Eugenia Kelman, who eventually became her co-author and mentor and a really good friend. Together, they have put together an entire system for med students to be really effective and really efficient in their study strategies.

[03:05] How Is It Humanly Possible to Read that Much?

The secret as that you're probably not going to read every single word. One of the strategies is to read to make notes. You're going to be actually extracting material from the textbook to make your own notes of information that you don't know. However, a lot of students spend much time studying information they do know but if you already know it, then obviously, you don't need to spend as much time. This is a hard shift for students but it's going to be a more efficient use of your time.

"Spend more time on the information you don't know."

If you're studying for the first time, what you can do is perform a self-test. There's research behind that called the Testing Effect. What they found is that if you self-test, it helps you remember more of the information. Then you're going to know where you're going to be spending your time.

[04:44] How to Self-Test

If you have review books you're going to need in the future, you can do a self-test from that. Or if you have a good set of notes, self-test to know what you do and don't know.

Resources you can use include Clutch Prep, Khan Academy, and Cheggs as well as Quizlet and Anki. They often have questions you can use. This is going to be a shift in the way you think about preparing but it's going to be really good.

[06:36] The Biggest Mistake Students Make

Even when preparing for the MCAT, the biggest mistake students make is they don't do enough practice tests to understand where their strengths and weaknesses are. So they can focus on those weaknesses. Instead, they just read content, thinking they're just going to read and read and read and they'll be fine.

Reading and reviewing are putting information in your brain, but the exams aren't really testing what's in your brain. They're actually testing what you can pull out of your brain. This is where the self-testing is when you get to practice the opposite, which means pulling it out of your brain. They call this retrieval practice.

"Exams aren't really testing what's in your brain. They're testing what you can pull out of your brain."

These have just been underutilized. You haven't worked them enough. They don't know what to do. Or even if you did, maybe not in a timely manner. Maybe you've thought of it right after you left the testing room.

[08:30] Medical Students Relying on Brute Force Intelligence

Kathleen worked with some university students. They did it after the first round of exams before they actually offered the workshop. After they scored lower for the first time in their entire life, they've literally got students lined out the door to come to the workshop to see what they could do to improve. So they needed a proof that they needed help before they would seek it.

As to why such switch upon going to medical school from doing so well, say during undergrad, Kathleen thinks they've been relying on their native intelligence. Some students call it brute force intelligence. They've been using strategies they've always used and it worked until hitting medical school and find out that the pace and the volume are something they've never experienced before. This is where the efficiency needs to come in.

[10:25] Frameworks to Develop Your Study Habits

Depending on where you are on your premed journey, you can get a 1, 2, 3, or 4-year headstart and have these study strategies just to be a natural part of how you study. Kathleen, in fact, helped a senior in college and she said some freshmen walked up to her one day telling her how she's studying wrong and showed her how. Now she's a third-year med student.

Some frameworks you can use include time management, which is how you spend your time while you're awake; mind management, which means all the thoughts going through your head; and then body management, which is how you take care of yourself through sleep, nutrition, etc.

Within the time management part, that's where the learning process flow chart comes in. They teach students how to prepare before they go to lecture and then they teach them what to do with the information, their lecture, and textbooks. They also teach them how to review and self-test. This used to be the last stage but they've added in another stage where they teach students how to score and analyze their self-tests. So when they walk into a class exam or an entrance exam, they know the information.

[12:20] Good, Better, and Best

For instance, you have an hour-long lecture coming up, the time you put into pre-read depends on what approach you want to take. Kathleen has three different approaches you can take she calls, Good, Better and Best.

Good: Just take ten minutes and look over the material before you go in so at least you're familiar with the vocabulary words because this is going to help you during your lecture.

Better: Do your quick pre-read but then go back and read the chapter to give you even more information.

Best: Pre-read and make notes before you go to class. Then the class becomes a review of information instead of an introduction. You walk out of class with a complete set of notes then you go on to the next topic.

A lot of schools are actually moving to this Flip Classroom framework where they expect the students to learn the material outside of the classroom and then the class is only for discussing and asking questions and following up and flushing out the material. This is what Kathleen is setting up for these students since as you get to the higher levels in education, more and more of the learning is put back on the learner.

"With the native intelligence, the students can do very well but often, they're working hard than they have to and getting way stressed out, not getting the sleep they need."

[14:50] Teaching as Part of Learning

Now, the next steps again depend on what you do before class as well as after class. Kathleen cites an example of her student who got hold of her book and went over it before he started first-year college. He wasn't satisfied with just knowing the information for himself. So he'd pre-read then get together his group of friends who were in the same class he was, and he'd the information he had already learned to them so then everybody went to class prepared. It saved the work they had to do afterward because of the work they've done before.

"Working in groups or teams is becoming more and more popular in the educational setting in order to prepare students for teamwork in the professional setting."

Moreover, teaching has been shown to be one of the best ways to not only solidify your knowledge but to also know and give you confidence that you know it because you're able to teach it. Hence, we highly recommend study groups, specifically for the MCAT. One person is good at one section, and another is good at another section. So you're teaching other people.

[16:40] The Biggest Struggle for Students

Time is always a huge issue because we're only allotted 24 hours a day and learning to use that time efficiently and effectively is really huge. Next is being systematic in your approach to your studies. Most students are not used to having a system because they've been smart and been able to get through just their native intelligence. So it's a struggle for them to incorporate new habits.

Kathleen sees a lot of mental barriers among students to change. That said, she has seen many students who have faced all sorts of challenges that most of us will never have to face. They were able to overcome incredible things because of the way they've talked to themselves. This is the mind management part and the determination they have.

One of the things Kathleen requires from her students who wish to work with is they have to be motivation. Otherwise, how can somebody else help you if you don't care as a student? So a lot of the internal dialogue is a big part of it.

[21:15] Dealing with Devices and Distractions

In terms of using your mobile phones and other devices, they're becoming a problem for efficiency and effective learning. Literally, the farther the phone is away from you, especially if it's not in your line of sight, the less distracted you are by it. What you can actually do is put it off first and then put it in a different room.

Upon surveying her students, Kathleen found out that they still prefer reading from their textbooks than they do from any of their devices. Kathleen thinks that reason for this is because of your intent for doing this. Since when you hold a book, your only intent is to read it, rather when you use your phone, you could be doing so many other things with it aside from reading.

"Research is showing that we retain more whenever we are looking at a physical piece of paper in a book or their own notes than we do on our devices."

[25:20] Developing Self-Awareness

Kathleen has developed a number of tools and exercises that help students discover what those triggers may be for you. And until you're aware of it, you obviously can't do anything about it. She'd often have students guilty of their past behaviors but they didn't know. But now that they know, they've got a choice to make - either change things to change that behavior or just pretend it's going to be okay if you wish it to be.

[26:30] Does the Pomodoro Technique Work?

Kathleen says this could be helpful when you're in college, but at some point in time, you're going to have to learn to study for longer periods of time and you'll earn a longer break afterward. It's because you've got so much information to get through once you get to professional school. So there's a level of training for study endurance that needs to take place.

[27:02] Gaining Focus and Concentration

Kathleen's co-author, Eugenia Kelman, is a behavioral psychologist by training and she came up with 7 different factors that affect concentration. They have quizzes and exercises in the books they've written together. Kathleen explains that when you think about concentration, you talk about it like it's just one thing. But there are 7 levels that she found and using these exercises can help students learn to focus and concentrate better. Some include being awake and alert such as the location you're in.

Internal distraction is one of them too. So if you're worrying, you can write down what those thoughts are so they'll quit swirling around in your brain. Then you'll have something concrete to act on later.

An example of external distraction would be like beds or if you try and study at Starbucks and they have those noisy machines. Again, location. Another one of them is your mood or attitude control. If you're going to a study session and think it's so boring, then you're going to have a less efficient study period than being positive about it.

[31:55] The Best Times of the Day to Learn

Figure out what is the best for you. We can have habits we do over and over and we think it's what we do best but it may not be. Kathleen has a concentration monitoring sheet where students are able to monitor their concentration levels throughout the day.

"A lot of students are surprised to find that they concentrate better in the morning even if they're not morning people."

And they found out that students are better able to concentrate better in the morning. It's probably because after a good night's rest, you tend to be fresher and you don't have the weight of the day on you yet. You have the whole day ahead of you so you just have a better state of mind. But base this on reality instead of just how your past habits have been.

[33:40] Different Techniques for Different Classes?

Kathleen explains that different classes have different requirements for how you're going to take in the information and how they're going to be taken out for the exams. Som certain classes lend themselves to certain types of notes. For instance, in the Anatomy, you're going to be making a lot of diagrams and probably category charts so you can learn the differences. But for the Physiology portion, it's going to be tons of flowcharts because you need to learn the different processes. So yes, different classes are going to primarily require different note styles.

This said, always be prepared before you go to class. And whenever you're reading, read with a purpose, which is to be able to make some notes from it. Then always review at some point, self-test, and then score and analyze that.

[35:08] How to Maximize Studying, Sleep, and Caffeine

Kathleen stresses that body management is so important. When we sleep, that's when consolidation of information takes place. It puts information into your long-term memory. And it only takes place if you've been through all the different sleep cycles. But a lot of our students, or Americans in general, are not getting enough sleep, between 7 and 9 hours.

Moreover, dehydration is another factor that can make you all fuzzy. As for taking coffee, some researchers looked at caffeine and its effectiveness, and they've found that having it spread over the day is a better way to stay alert and awake without getting the jitters. You can take it 50 mg per hour until you're within 6 hours before going to sleep. Since the half-life of caffeine is 5.7 hours. You can take in a lot less coffee and still get your level of alertness without overdoing it.

[39:10] Advice for Students with Learning Disability

The strategies they currently teach work for students with learning disability too, such as eliminating classroom distractions as well as avoiding someone using a computer. Interesting research found that a person taking notes with a computer is not the most distracted, it's the person sitting next to them. There's also that power of just using a pen and paper. Because when you're typing, you can type a lot faster than when you write so you don't tend to process anything. You're just trying to transcribe word for word versus writing with a pen and paper where you get to think and reflect on the most important thing to write down.

"Make the information your own You're internalizing it, putting it in your own words. That's shown to be something that helps put information in your long-term memory."

[42:05] Check Out Their Books!

Kathleen has written three books with co-author Eugenia Kelman. Visit her website Study with Precision. Kathleen emphasizes to students that if they want to be professionals, learning to be precise in how they think, talk, and study is an important part of that process. Check out Study Without Stress, a book for medical students. They've also written one for nursing students called Vital Skills. And recently, a book for premed students is called Six Steps to College Success. They have also broadened this to include others in the STEM field.

[43:45] Final Words of Wisdom

Finally, Kathleen's message to students is that there is a way to learn to be more precise and you'll see better results. She'd be delighted to work with you!

Get a chance one of her books by going to medicalschoolhq.net/317 and leave a comment about what you're struggling with in terms of your study habits.

Links:

Study with Precision (Kathleen’s website) Kathleen’s books:

MedEd Media Network

Clutch Prep

Khan Academy

Cheggs

Quizlet

Anki

Dec 19, 2018
316: Premed Q&A: Pregnancy, Canadian Students, and Much More
32:59

Session 316

I reached out to our amazing premed community in the Premed Hangout Facebook Group and got on the phone with several of them to answer their questions. What you're about to hear here are recordings with the premed students.

Please also follow us on Instagram @medicalschoolhq. I'm trying to get 10,000 followers. I'm at almost 8,300. We're trying to see if I can get to 10,000 by December 31, 2018, This is the deadline for our first quarterly scholarship essay contest, where the winner gets $2,000. Second place gets $750, and third place gets $250. Now, if we can hit 10,000 followers by the deadline, I would double that scholarship entry.

[02:22] Telling Your Story in an Interview

Q: It's good to be unique in an interview but how "out there" is too out there? Can you be that liberal with jokes in an interview?

A: I would not try to joke in an interview because you have no idea how it's going to be received. So completely avoid it at all cost. You really just have to tell your story. If the question came up like what's something that people don't know about you, then you could work in a story somehow but avoid the joking part of it.

“Try to avoid jokes and just tell your story.”

[04:33] A Bad Semester

Q: I had a really bad semester this semester and I'm kind of a nontraditional student starting over. And I'm wondering, is it better to just move on or should I be retaking classes? (Two Cs in Statistics and Chem)

A: You don't go on typically and take higher level Statistics. But for Chemistry, you're going to have to take higher level courses. The question is whether you understood the material and didn't test well, or you didn't understand the material enough to move on to a higher level course. If it's the latter, then don't retake it. Especially for DO schools with grade replacement going away, retaking the course doesn't really do anything to the original course. It's still going to be there. Grades are going to be average no matter what. So retaking it isn't going to make a difference other than on your application, it's going to be marked as a repeat course so that the admissions committee can see the difference. But I don't think a C in one chemistry class is going to kill you. Just make sure you don't make it a habit. Again, there is no grade replacement anywhere, anytime. Texas application has the Texas Academic Fresh Start Program but this is only specific to Texas medical schools.

“There is no grade replacement anywhere, anytime.”

[07:10] The Best Clinical Experience

Q: I'm trying to get clinical experience in for my medical school application. I was wondering if scribing is the best option or do medical schools doesn't necessarily care about what clinical experience you get?

A: Technically, there isn't the best option. Scribing in some admissions committee's minds isn't clinical experience, although the majority of schools out there would consider it. As a student, don't bother figuring out which ones consider it clinical and which ones don't. It's just what it is. You're not going to please every school or admissions committee with everything you're doing. The best one is the one that you enjoy the most, the one that you're going to take away the most from. It's the one that you're going to be the most passionate writing about and talking about in your interviews.

“The best one is the one that you enjoy the most."

[08:27] Not Taking a Gap Year

Q: How do I better prepare myself in my application so as not to take a gap year? I'm a sophomore in college and I'm trying to plan it out so I would have enough experiences and all of my prerequisites done, and all of my shadowing done so that I would be able to apply to medical school right away. Right now, there's a big tendency for people to take gap years but for me, it works out better if I don't. Speaking from a financial point of view, I don't have to pay back loans unless I'm working full-time. But from the community I come from, they all push toward not taking a gap year. I'm not burned out or anything like that so I don't mind starting medical school right away.

A: Most students still go right into medical school from undergrad. It's still the norm to go straight through. Although the age is creeping up and gap years are becoming more and more common. So in order to prepare to not take a gap year, do exactly everything you're doing. Get prereqs in. Understand that preparing for the MCAT while you're taking classes, while also potentially preparing your application is going to be a super crazy busy semester. You just deal with it. But the fact you're already thinking in advance as a sophomore means that you're more thane likely going to be fine since you're planning for it so far in advance.

There are a lot of variables and small pieces to the puzzle when it comes to the application. When you're done with your shadowing, make sure you're not racking up 50-100 hours of shadowing by the end of your sophomore year and then you're done with that and you can now focus on another thing.

“Make sure you stay consistent with your shadowing, clinical experience, volunteering, and everything you're doing. You don't want to just rack up the hours and then stop doing those things.”

[11:04] Ideal Number of Hours for Clinical Experience and Shadowing

Q: Coming from as a student who used to be a pre-PA kid, I used to have this mentality that I have to grab a certain number of clinical hours and volunteer experience. For medical schools, is there a certain amount of hours that I need to do volunteering versus actually having a health care job? Is it better to volunteer or to actually have a job? Or do medical schools even care about that?

A: Pre-PA is much different than medical school. For pre-PA, the emphasis on clinical experience is huge. You need a thousand plus hours for clinical experience and for most people, that means having a job. But for medical school, 100-200 hours is already plenty. It could be a job or volunteering, it doesn't necessarily matter what it is as long as you're getting it.

[13:17] Endurance Training for the MCAT

Q: How to better prepare for endurance for the MCAT? I'm starting MCAT prep this winter break. And after taking my first really long test for the EMT certification exam, I found out that I don't have as much endurance that I thought I'd get in test-taking. So how do I build that up?

A: In marathons, you train. How you prepare for the MCAT is that you sit down and you take lots of full-length practice exams to prepare your body for sitting there. The AAMC has three scored full-length exams and one unscored. Next Step Test Prep has ten full-length exams so you can do this as well. Save 10% by using the promo code MSHQ. So practice exams - 100%!

"Practice tests are one of the most important parts of the preparation for the MCAT."

[14:55] Pregnant During Interview

Q: For nontrad women who are thinking about having children before they start medical school. What would they think about being pregnant during interviews?

A: If a medical school is going to judge you on being a female and wanting a family and being pregnant, they suck as a school anyway. But in reality, they could potentially see that as a hindrance and getting in the way of your education as kids can definitely do that. So ask yourself, is it worth the potential of the repercussions of being pregnant? Or would you plan it as strategically as possible to only be 10-12 weeks pregnant during the later part of the interview season so that you have most of your interviews before it starts showing?

[17:15] Shadowing in a Military Medical Facility

Q: I work at a military medical center. I've worked here for five years. Now, I'm doing shadowing during lunch break, for example, I'd go to some of the docs. Since I also look to shadow in some civilian facilities because they are run very differently in a lot of ways…

A: Should you go out to the civilian world and shadow? I don't think you need to. For the purposes of medical school, you are being around patients and physicians. You're seeing what that interaction is like. Yes, it's in the military setting but that's okay.

[18:55] Study Strategies

Q: I'm a nontraditional student. I graduated from college with a degree in Biology in 2011. And then I graduated with a degree in Nutrition in 2014. I just took a look at my prerequisites and finished Physics this semester. I'm focusing on studying for the MCAT and take it on March 15. Do you have any suggestion for people who are so far out from their core classes?

A: Study strategy is so specific to every student. The way one student studies best is different in perception that another student studies. Because the MCAT requires you to have a base level of knowledge. Even though the test is more on critical thinking and analysis), you still have to know that content. For somebody like you who had that content so long ago, make sure you're planning in and scheduling in more than average content review before you start diving into a lot of the QBanks and full-length exams. Make sure you go back and reteach yourself a lot of the core knowledge you're going to have to have.

"Study strategy is so specific to every student."

[21:18] Taking a Diagnostic Test

Q: Some of the guests on your show have suggested taking a diagnostic before you start your study process, the time I have from how long it's been, do you think it's fair to give myself a chance a full review of the content before? At least I want to make it through all the material before I take my first diagnostic.

A: Take the diagnostic. Just bite the bullet and take it. Understand the score you're going to get probably isn't going to be super reflective on your knowledge or your ability to score well on the real thing.

"It's a good thing to do just to get into that mindset and understand where you're at and hopefully, where you're going to go."

[22:12] Research Prior and During the Application Process

Q: I haven't ever applied to med school before and so I'm not totally sure what I'll encounter once I start working on my actual application through AAMC. But I do read a lot about what you're doing for research and about just reflecting your research to different schools. I'm in the process of basically applying to a research study through my work. I've had this study approved by my institution and right now, I'm in the process of applying for IRB and tribal review board approval. And so I'm expecting that when I apply at the beginning of the cycle in June, that will probably be at best, may have just been approved and I'll be starting the research process. But then hopefully when I actually interview, I'll be in the progress of research but I won't actually have anything published or completed. Is that something I can still mention? Is there a room for that?

A: The application is not only what you've done but a lot of what you're planning on doing as well. As long as you have started the process, put it on there. The end date for the activities, you can put out until the anticipated start date of medical school. It's typically a year and three months or so that you can work your way out towards and work those hours in. The fact that you've gone through the process and you've had an approved IRB hopefully, shows that you're working toward this and just talk about what you're hoping to do. In the future, as you're going through the application process, you can potentially send some update and update letter to show where you are in the process.

[24:45] Canadian Applying to U.S. Medical School

Q: I'm a Canadian applicant and I was looking into some American med schools. What's the main thing you would suggest for a Canadian applicant looking to apply to America?

A: As a Canadian applicant applying to U.S. medical schools, the biggest question I'm asked is what medical schools are the most Canadian friendly. It may change from year to year but the only school I know is Michigan State University College of Osteopathic Medicine. They actually hold 25 seats for Canadian students (the last time I looked) because they have a relationship with Canada and the Osteopathic Society in Canada to try to boost osteopathic medicine in Canada. But any medical school, potentially, where you have significant ties may be Canadian-friendly. Last year, one Canadian student applied to the University of Kentucky, a public state school where one would assume she wouldn't have any chance. But when they asked why she's applying to them, she answered her uncle lives in Kentucky, and as a family, they go and visit Kentucky every year. And she was invited for an interview. She obviously has great stats but because she had ties to the state, she was granted an interview. She got 3-4 interviews in the U.S. and is now at a U.S. medical school.

So just do your homework and see which ones explicitly won't take Canadian students. Looking at the MSAR helps because it shows you how many international students apply and how many were interviewed. Schools may say that they accept Canadian students but then when you look at how many they interviewed, it's zero. Some schools may consider Canadian students out of state applicants and not international applicants.

"Every school is so different. It just takes some time to do some research."

[27:35] Researching for Schools to Apply To

Q: I'm looking to apply in next year's cycle. When should I start my research into looking at schools? Right now or during Christmas break?

A: It doesn't hurt to start now if you have time. There's a lot that goes into the application to be able to apply on time, right around the beginning of June - your personal statement, extracurriculars, and all that fun stuff, and MCAT if you haven't already taken it. School list for students I'm working within the states is one of the last things we work on because it's really not that important. But for you, as you're trying to figure out what schools will actually take a look at your application as a Canadian applicant, there's no harm in starting to research now and just chip away at it as you go.

[28:23] U.S. Graduates Coming Back to Canada

Q: I hear some people say that it's needed to come back to Canada and I hear people say the opposite. So is it harder for a U.S. medical student to come back to Canada if you're from Canada?

A: I don't know enough about the Canadian medical system post-medical school. Whether they consider U.S.-trained MD international medical graduates. I think they do. But I will put a big asterisk on this.

[29:35] What's a Good MCAT Score

Q: What's a good score for the MCAT?

A: The average MCAT score for matriculants, the newest data updated in November 2018 is a 511. If you're a Canadian looking to go to a Canadian medical school, you know that CARS is a huge section for Canadian medical schools and they want to see 130-131 in the CARS section and "ignore" the other stuff, although since you're already doing well in your CARS, you're probably doing well in the other sections as well.

[30:29] Competitive GPA Scores

Q: American schools have that BPCM GPA, like the science GPA. I calculated my GPA at 3.7 and science was about 3.5. Is that a competitive GPA?

A: That's about average. A competitive GPA is at 3.8 plus. But the application is much more than stats. As long as you can get over the thresholds that schools have, and you end up on the desk of somebody reviewing your application, as long as you have good enough MCAT score and good enough GPA, and you have the story - the personal statement, the extracurriculars, to back up who you are and why you want to be a doctor and you're a good fit for the school, there's always a chance of getting in.

[31:45] Extracurriculars

Q: Do medical schools want to see that balance sports and clinical stuff for the extracurriculars? Does that matter or you just do something you love?

A: Do what you enjoy.

Links:

Premed Hangout Facebook Group

Join the scholarship essay contest!

Texas Academic Fresh Start Program

Next Step Test Prep

MSAR

Dec 12, 2018
315: When Should I Give Up On My Medical School Application?
27:32

Session 315

The medical school application is a long and grueling process. If you’ve been rejected, haven’t heard anything, or are confused, listen to this podcast episode!

Check out all our other podcasts on the MedEd Media Network include The MCAT Podcast, the OldPreMeds Podcast, the MCAT CARS Podcast, and soon - the Board Rounds Podcast.

Board Rounds is what's next for premed students. Once you get into medical school, you'll have the Board Rounds waiting for you. It's a podcast I'll be doing with BoardVitals, the USMLE Step 1 and COMLEX Level 1 test prep company.

[02:20] When You Should Start Thinking About Giving Up on Your Application

As of this recording, it's the beginning of December and the application season has been opened up for several months. What happens if you haven't heard anything? What happens if you've not heard something after being interviewed? Maybe it was good and maybe it was bad. That’s what we’re going to talk about right now.

[03:00] Be a Part of Our Team!

I have another announcement for you guys. We're arranging some things and I'm making more room to create more content and I'm hiring actual employees to help me do this. One of them is a fellow premed in the application cycle now and the other person, who has an amazing background in marketing and project management, will be driving a lot of the changes you'll be seeing here soon at the Medical School HQ. If you want to get involved in some way, just reach out to team@medicalschoolhq.net. Whether you're a designer, a photographer, a writer, or any skills you can bring to the table to help our team, let us know!

[05:22] Doing an Honest Self-Reflection

Still haven't received any interviews yet? At this point in the game, it's probably not likely that you will receive any interviews. Can you still receive interviews? Absolutely. But is it likely? Probably, not. If you're at this point in the game and you haven't received any interviews, the question is why. The biggest challenge students have with this whole process of failing to get into medical school with the application is the honest, self-reflection of their application. If you're wondering why you're not getting interviews when you're a strong applicant, then maybe you're not strong an applicant.

"If you are at this point in the game and you haven't received any interviews, the question is why not. Why haven't you received any interviews?"

[08:45] Looking Holistically vs. School’s Thresholds

So you have to go down this checklist. What's your MCAT score. Is it low? By low, I mean below 500. Is it really low? Is there a subsection that is really low - like 122, 123 - that is potentially filtering you out?

We all like to talk about holistic admissions. In our Facebook Premed Hangout, people will post questions about their stats and applications and a lot would say you're more than your numbers and I totally agree with that.

"If your numbers aren't good enough, holistic has nothing to do with it."

You need to overcome a certain threshold of GPA and MCAT score to get to that holistic application review. If you do not have a minimum MCAT score and a minimum GPA to get into the school that's reviewing your application, then you're not going to be reviewed. If your MCAT score is too low, the school is going to assume that you're not going to be a good student. There are schools out there that when they accept students below 500, they say they're more likely to fail a class or not finish school.

Schools have their own data for all of this. Hence, they have cutoffs. The generic cutoff that I throw out there all the time is less than 500, less than a 3.0, cumulative. If you have less than a 500 and 3.0, you might start thinking about taking some more classes or retaking the MCAT.

Sure, you can get in with those stats. We've had students on the podcast who have gotten into medical school with those scores. They either took postbac classes and maybe they have a super strong upward trend. Maybe their science GPA is high because their science courses were done during a postbac and they did well. They were maybe a history major in school and they have a couple of sciences but they slacked off and partied and so cumulative was less than 3.0 but their science is high.

"There are so many nuances that go into MCAT and GPA."

Your story is important and that's where the holistic comes into play. But if you can't get past the digital shredders of filters that school set up when they download the data from AACOMAS, AMCAS, or TMDSAS, you're likely not going to get an interview.

[10:32] Advocating for Yourself

Sure, you can reach out to the school and explain your situation. I know a student who traveled around different premed conferences and she's got a 499 on her MCAT. She talked to schools and got face-to-face. She laid down her story and she got some interviews. Hopefully, she'll get in. She wasn't going to get any interviews unless she met people face-to-face.

"You can advocate for yourself. Go to conferences. Get in front of these people."

Get in front of people. At this point in the game, it's a little late. But if you're listening to this and haven't applied yet and you're stuck in the situation, try to get to conferences. Beginning mid-October is UC Davis Conference and there are also some conferences in November. Get in front of people. Reach out to schools. Just check first how they would want you to contact them. Or do they want you to contact them at all.

[11:57] There's Still a Chance

Some schools interview up until April so there's still a chance to get an interview. It's a slim chance but it's there.

“There's a lot of movement in the application cycle.”

If somebody has four acceptances and they finally make the decision on which school to go to and they turned down the other three schools, now the school has an open spot. And maybe they want to invite some more people for an interview. This is possible.

[12:30] Be Honest with Yourself

Again, be honest with yourself. Where are you struggling? If it's an MCAT thing, retake the MCAT. Don't apply again next cycle. Or if it's just an MCAT thing and your clinical experience is great. If your extracurriculars as a whole, paint a picture of who you are, and you've written a good personal statement and you've submitted your applications and secondaries on time and the only thing you know is what's holding you back is the 495 MCAT score, then retake the MCAT and apply again. That's if everything else you think is there.

Back in episode 171, I did an interview with the former Dean of Admissions at UC Irvine, she mentions that one of the common reasons students aren't getting in is lack of clinical experience. And one of the most common mistakes re-applicants make is applying too soon without fixing their application.

"One of the most common mistakes re-applicants make is applying too soon without fixing their application."

[14:02] Are Poor Grades Holding You Back?

Now, if you think it may be poor grades holding you back, this is a long-term process. First of all, why do you have poor grades? Was there an upward trend? Or was it a downward trend or just a flatline, but still not very good grades? You have to be honest with yourself and figure out why you didn't get into school or why you didn't get good grades. Did you not try? Or did you try hard but you have some other learning disability?

There are lots of reasons for struggling in school. So you need to figure out why. Otherwise, it's useless to go back and take more classes and get the same poor grades. If your GPA is holding you back, you need more classes. But you haven't figured out why you're struggling, then it's useless to go back and take more classes.

There are lots of options such as taking more classes at your four-year university where you went to undergrad and just take classes as a non-degree-seeking student. You can take postbac classes, a Special Master's Program (SMP), etc.

If you're taking your classes, you'll get one semester under your belt for when the applications are due. Take that full year. Get a full 3-4 semesters under your belt and get your grades up. Show a positive trend in your classwork and grades, and then you can reapply.

[16:00] Lack of Clinical Experience

Going back to episode 171, one of the most common reasons students aren't getting accepted is lack of clinical experience. How is an admissions committee supposed to take you seriously if you haven't stepped foot in a hospital to see, interact, to smell, and to be a part of patient care?

"One of the most common reasons students aren't getting accepted is lack of clinical experience."

[17:00] Other Possible Reasons

Figure out whether it's clinical experience or shadowing that you're missing. Or maybe you're applying to research-heavy schools and you don't have any research. Ask yourself those questions.

Assess if you did a poor job on your personal statement, or writing your extracurriculars. Check out The Premed Playbook: Guide to Medical School Personal Statement. I also have a Personal Statement course now. Go to store.medicalschoolhq.net and get access to private facebook group where we have office hours every other week.

Unfortunately, students automatically decide on doing a postbac because they're not getting any interviews. But if your GPA is high, say a 3.8, you've already proven that you can handle courses. You've already proven that you are a good student. You don't need a postbac. There's something else in your application that is holding you up. You have to be honest with your evaluation and your reflection of your application.

[18:45] What If You've Been Waitlisted

If you've already been interviewed at the school but you've been waitlisted or hadn't heard anything, there's still lots of time. By the beginning of December, there are lots of movement with applications or acceptance list.

Some schools will rank their waitlist and some won't Those that do will just take the top person and call him up. Now, the student has the option to accept or decline. If you don't accept it, they'll go to the next person until they find a student who's willing to take that seat.

Moreover, for schools that don't rank their waitlist, they're going to reevaluate everybody. So there are lots of movements when it comes to the last several months of the application cycle.

"It's never over until it's over."

[20:56] If You've Been Interviewed

So if you've interviewed, there's still hope. At this point in the process, you update schools that accept updates. Continue to strengthen your application with the assumption you're not going to get in. Reflect back on your application, what's wrong with it, how you can improve it.

If you've gotten an interview, your GPA and MCAT scores are good enough. But maybe you're lacking something in clinical experience. Try to dig deeper while you were there, maybe it was a poor interview. Back in Session 241, Natalie talked about having six interviews, six waitlists, and she did some mock interviews with me. She had 7 interviews, 6 acceptances, and one waitlist.

"If you're getting the interview and not getting in, maybe you have to improve your interviewing."

If you need help with this, check out my book The Premed Playbook: Guide to the Medical School Interview. I also have a course on this that's being updated right now.

[22:10] Several Parts to the Process

There are so many things to this process. I am aware that a lot of other websites have students there talking about how they've got great stats but are not getting in. Reason that other students freak out about this.

It's not that they are not good enough stat-wise. But it's because there's something else in their application that's missing. You don't have to be perfect. You don't have to have perfect personal statement, extracurriculars, GPA, etc. You have to be "good enough." So these students who have high GPA and MCAT scores are obviously falling flat somewhere else.

"You don't have to be perfect."

They could be failing in an interview because they don't have social skills. They could be writing a very poor personal statement or poor extracurriculars. They may not be painting a good picture of who they are as a person. You have to understand that there are so many variables that go into this.

Or ask yourself the following questions. What kind extracurriculars do you have? What clinical experience do you have? Shadowing, volunteering? When did you turn in your application? If you threw it in on the deadline, well that's why you didn't get in. You need to apply early.

You don't have to just focus on the MCAT and GPA. The first immediate reaction you should have is that you need to take more classes. But it should be, WHY did you not get an interview/acceptance? It could be poor grades, poor ECs, poor MCAT score, poor interviewing, poor personal statement, etc.

Consistency is also another key here. You may be lacking consistency with your ECs, say you have 1000 hours of shadowing but it was all from two summers during your freshmen and sophomore years and you have nothing since.

[25:30] When Should You Give Up?

If you haven't received an interview invite at this point (December), it's highly unlikely that you're going to get one. It's possible, but not probable. So start having that conversation. Where did you go wrong and where can you improve? Have this type of conversation with your advisors, or if you have none, other medical students who have gotten in. Reach out to the medical schools to see if they can do a review of your application. A lot may say no, but it doesn't hurt to ask. You can also reach out to me on store.medicalschoolhq.net and we'll try to do a critical analysis of your application to figure out where you went wrong.

If you've interviewed and you haven't gotten any acceptances yet, again, start doing that critical analysis. Where did you go wrong? Did you interview poorly? Your application may be strong enough but still continue to work on it as much as possible. And then prepare for your interviews next time. Do better next time.

There are so many things you can do, but when should you give up? NEVER.

"If this is what you want, you never give up. You figure out where you went wrong and you course-correct. Never ever give up if this is your dream."

Links:

BoardVitals

team@medicalschoolhq.ne

Facebook Premed Hangout

MedEd Media Network

The MCAT Podcast

OldPreMeds Podcast

MCAT CARS Podcast

Session 171: Reapplying to Med School - What You Need to Know to Improve

Session 231: Third Application Cycle was a Charm for this Premed!

The Premed Playbook: Guide to Medical School Personal Statement

The Premed Playbook: Guide to the Medical School Interview

store.medicalschoolhq.net

Dec 05, 2018
314: Jackie Shares Her Path from Community College to Med School
58:29

Session 314

Jackie is @jackieplans on Instagram. She has a following watching her journey through medical school as she creates beautiful notes that you can buy.

So we actually did an Instagram Live but I decided to put this here on the podcast. We talked about everything from her journey to premed, her struggles, financial concerns, doing the FAP and getting it when she doesn't have a relationship with her parents. For some reason, even if you're already 40 years old or married and have kids, the FAP still requires your parents' financial statements. She also talks about the process so you won't have to go through that.

We’re also answering some questions from the audience.

[03:50] Who is Jackie?

Jackie is a second-year medical student at UC San Diego. She started out at a community college and then did two years at UC Irvine. She took a gap year and worked multiple jobs.

[05:12] The Story Behind Her IG Account

Jackie has always had a planner, needing to see her life on paper to get anything done. So she got into a bullet journaling. It started as a way to show her artsy stuff and it grew from there. Then she began writing her notes the way she likes to make them and sharing those. Recently, she's selling them too.

[07:33] What Are Your Chances?

"I didn't do well in my prereqs courses because I wasn't studying and trying like I should have. I took Orgo 4 times. I didn't finish my prereqs and I'm about to graduate. I have evaluated what I did wrong and I still really want to become a doctor. Do you think I still have a chance?"

Jackie says she got a C in Physics. Then she got a B and an A as the quarters went on. So she showed improvement and managed to get into medical school.

Kain, a 43-year-old medical student now, went to undergrad many years ago and was academically dismissed. He thought school wasn't for him and he went on his life and ended up having some life experiences that made him reevaluate what he wanted to do. He decided that he wanted and needed to become a physician. He explored the idea and was told to be too old or not smart enough.

So he started back at a community college, taking classes with his son until working his way up to a four-year university and eventually, medical school. He's now at the University of Florida as a third-year student.

Therefore, you always have a chance to get into medical school. It may take some time. or you may have to take a lot of classes. You may even have to go to the Caribbean.

"There's always a chance if you want it and you're going to work for it. So always stick to it if that's what you want."

[11:15] Jackie's Medical Application Process

She decided to wait until she graduated to apply, knowing she was going to take one gap year because she wasn't ready yet. She has not taken the MCAT yet and she had a paper she was working on that was nearing publication. Then based on her MCAT score, she picked where to apply. She started working on it before the application cycle opened so she could apply right when it opened. This made her less anxious going through the process knowing she's done it as soon as she could.

"It made me much less anxious going through the process knowing I've done it as soon as I could. It's out of my hands."

She then started working on her secondaries as soon as she had submitted. She has prewritten those that were generic and she knew would come up so she could turn them around quickly and get them in. She picked out schools from a broad range of places and not get just get set into one particular place. This being said, location wasn't so important to her. She's from Southern California but she's willing to go wherever.

Picking out schools based on your MCAT score is something I actually discourage students from doing. Although it's one of the more popular ways to pick out schools, instead of looking at the MSAR because it's discouraging for students who may be a few points below the median. When that median just tells you that half of the students are below that score. Hence, I highly discourage people from doing it because they may be leaving off schools that are looking for something specific that one student has in their application. Moreover, applying broadly is a really good, smart thing to do.

"That's the hard part of this application process is you have no idea what the admissions committee is looking for."

[15:33] The Hardest Thing About the Application Process

The hardest thing about the application process for Jackie was being patient. She used AAMC’s Fee Assistance Program but she didn't have a relationship with her parents. So she had to have a doctor, a therapist, and a third party in her life - all write letter - so she can be emancipated (even though she's married and they paid for school without her parents' help). So this was very frustrating for her. When she started medical school, she was worried she'd have to do it again. She talked to the Financial Aid Office they got the stuff from the AAMC and so she never had to look at the FAP stuff again. Nevertheless, this was the worst part for her.

The FAP is so time-consuming and such a headache and they only have a limited amount of funds every year. If you're taking the time to gather all this paperwork, you may apply and they won't have any left for you. Luckily, this didn't happen to Jackie. Once she got it, it was all good.

[17:25] Getting Letters of Recommendation

"As a transfer from community college to university, should we have a LOR for both sides or is it okay to have most of them from a community college?

Jackie got one from community college because she had a good relationship with the teacher and she felt like she knew her. The rest came from a different school where she did her research fellowship and a job that turned into a publication.

She had the teacher from the community college write her letters for scholarships in the past while she was still in community college and was transferring. At that time, she asked her if she could ask her for another one in the future when it's time for medical school and she was okay with it. So she reached back out to her and got it.

You really need to set that expectation. At the beginning of your Physics class or whatever it is, set that expectation from the beginning. Tell the teacher you're taking their class and you're hopefully going to ask them for a letter of recommendation. Then you also show up everyday. You've already introduced yourself and know you. They're expecting you to ask for a letter. This makes it much easier to ask for one at the end of the semester.

[20:00] Plans for the Future

Jackie is keeping an open mind although she likes surgery and peds. During her gap year, she worked as a scribe in a pediatric ENT office, which she liked very much. That said, ENT is where she might just end up.

Jackie points out that sometimes when you have a really good mentor, you also feel like going through the same path. But you've still got to keep an open mind. In the same manner, a lot of students look at match list for school and look at which is high for a certain specialty. So it kind of pushes students towards that one thing. And if there's that one really good teacher in that school, then it's drawing students to that specialty because there's one awesome personality out there that everybody wants to emulate.

"You can't look at the match list because you have no idea what variables are going into that match list."

There are so many different things that are causing people to apply to the specialties. Just because Ortho matches high every year doesn't mean that the school is particularly preparing students well to match in Ortho. There's just some other stuff out there that are doing that.

[22:11] Planner Apps

Jackie uses the pen and paper for writing stuff as well as Google Keep, where you can put in little pictures and write notes and make a to-do list. She has this synced to her phone and her computer when she's on the go. She puts in notes to herself on her phone and it will pop up on her computer.

[22:50] Reading LOR and About the Fee Assitance Program

Reading the LOR is a no-no before sending it to the AAMC or TMDSAS. You're not allowed to and not supposed to.

If you run out of money during the application process, you can apply for the Fee Assistance Program through the AAMC. You get MCAT at half price and some of the MCAT material for free. And one fee for the application where you get to apply to 15 schools. Plus, most schools will waive your secondary or some give discounts at $150. Jackie says it was easy since you only had to forward to them the FAP email when asked for verification

[25:50] The Interview Process

Jackie got two interviews, both in California. She got 516 on the MCAT and her GPA was around 3.85. Anyway, the reason she thinks she only got two interviews because she was just picking schools based on stats alone and not really looking deeper. Again, there are so many variables that go into the application. Nevertheless, Jackie had a ton of research and volunteering. But her clinical experience was lacking. Hence, she decided to work as a scribe during her gap year to give her something to talk about during those interviews. She worked as a scribe at the children's hospital at a county and at Disneyland!

[28:07] Plan the Finances Around Your Application

It's important to plan your application so you don't run out of money. I actually made this calculator to show students how expensive it is to apply to medical school, FAP or not -since FAP is not helping with travel which is something to consider, as well as hotels, buying a suit, deposits, etc. So a lot of students play this credit card game but it's a dangerous game to play. But they need it just to get through that process. Use the calculator and just estimate and start saving.

[29:20] Extracurricular Activities

Jackie spent four years working on nonprofit that set up surgery and specialty procedures for uninsured and underinsured people. This was her biggest and where she spent the most time. This was also where she thought she got the most benefit. She also ran their social media as well as the free clinic at UCSD.

[30:35] The Process for Getting Financial Aid

Knowing she didn't have any familial support of any kind, and as soon as she knew where she was going, she got in touch with a financial aid office and laid it out for them. They had a fair number of grants and the rest was loans. They have been great at helping her navigate the process and helping to minimize the amount of debt she will have at the end of this.

"It's scary to have $200k-$300k in debt, but you're making good money as a physician... be living like a student so you can pay back your loans as fast as possible."

Check out The White Coat Investor, which is a great resource for students to help them with planning their finances.

[33:05] What is a Nontrad?

Anybody who has done anything different than a traditional student of going high school to a four-year university right into medical school. This is the technical definition.

"The saying out there is that nontraditional is the new traditional because so many students are doing things differently."

This could be someone who purposefully took a gap year so they could study for the MCAT on your time and not be worried about classes and application process all at the same time. This is a smart thing to do actually.

[33:50] When to Apply for the FAP

Jackie took her MCAT the summer between her 3rd and 4th year and her mother-in-law paid for it as a present. So she didn't use the assistance program for that, also, because she didn't know it was included. She applied for fee assistance during Winter (Jan-Mar) when she knew she'd be applying by June.

According to the AAMC, if you're application is approved anywhere between January and December, you're good until December of the following year.

[35:10] Finances Covering Step Materials

Also, the cost never ends. As a premed, you'd have to prepare for the MCAT and all the prep material. Then when you're in medical school, the tests keep coming. Step 1 or the boards for the allopathic schools and Level 1 for osteopathic schools. Jackie's school only covers one practice exam for Step. That being said, they have reps giving them giveaway prep materials. Other than that, you'd have to buy them. They also have group discounts.

She has maxed out on her resources because there were so many different things being thrown at them everyday. So she's resisting to buy every type of material. In addition, they have a lending library in their student lounge where all the 2nd-4th-year students leave their old books there.

"There is a psychological effect to that something is free, you value it less, so you're less likely to look at the stuff."

Ultimately, it's worth it if this is what you want. But what this really comes down to, is are you really sure this is what you want?

[39:25] Clinical Experience and Best Age to Start Medical School

If you're working as a phlebotomist to pay for school, yes, medical schools count this a clinical experience. Jackie's bulk of her clinical experience came from scribing.

In terms of age range, their school's average was 23, but some of her classmates are in their 30s. It's a wide range actually. Some of them already have kids or went and did PhDs and other work and came back. So there is no one best age. Just jump in!

[41:30] How to Relax During Medical School

Jackie reads something nonmedical every morning at 630 am. Then she sits on the bed for 15 minutes to read a chapter of a book while drinking her coffee. Their classes usually start at 8 so it gives her enough time to wake up and get ready for school. She also takes her dog for a couple of walks everyday.

[42:50] Jackie's Typical Week

Their schedule changes but they would usually have lectures on weekdays from 8-12. Then they have the practice of medicine one day a week in the afternoons. She's also involved in the free clinic, where she runs two clinics. She's also in the process of handing this off to the first year students. Additionally, they do apprenticeship where they set you up with one doctor for the first two years and you go every other week to see patients. Jackie was assigned to a pediatric endocrinologist's office. If she doesn't have a class in the afternoon, she goes there. And one or two afternoon or nights a week, she does more clinical stuff. She loves this as this makes her want to study. In the afternoons, she comes home to take care of the dog and study.

[44:44] Writing Notes

Jackie writes her beautiful notes during class because she learns better by writing. She also had a professor at the community college who taught them how to filter things out and only write down what was really important. So doing it in real time helps her not get overwhelmed.

Additionally, there's so much information out there about actually physically writing your notes versus typing on a computer. We highly encourage students to physically write notes. All their lectures are podcasts but she prefers to be in class and spread her pens out everywhere. All their lectures are podcasts but she prefers to be in class and spread her pens out everywhere.

"Doing it in real time helps me not get overwhelmed from lecture."

[46:25] Most Memorable Experience in First Year

Jackie watched a kidney transplant during her first year. She saw the harvest from a living donor, which was something cool.

[47:25] Pre-Studying before Lectures

Jackie strolls through her lectures the night before. She read somewhere that the way she was studying wasn't working. So she spent five minutes scrolling through and come up with five questions that she wanted to be answered during the lecture. But she dropped this real quick because she didn't feel like it was paying off. So now she scrolls through what's coming and this helps her space her notes.

Making those notes actually helps her concentrate. There's actually even a study about doodling your notes, which is actually now becoming a popular thing. When you're doodling, you're writing words and drawing pictures describing situations. This seems to help a lot more. Doodling is just like storytelling just in picture form.

[49:50] Studying for the Step 1

Jackie picked out the end of April for her Step 1. They have from the end of March through the first week of May. This has been set by their school. She's planning to take it ten days early so she can have a break. As of now, she's been just studying stuff they've covered so far. So she's just trying to learn well during the blocks, the first time through, so there would be less to review.

"The best predictor of a good score is doing well during the blocks."

[51:27] Describing Medical School and Family Support

Jackie would describe medical school as like high school. The class has 134 students, all of them with big backpacks, moving from one classroom to another. She finds the intermingling fun! She's part of the group, the called the Married Ladies Club - though they're not all married.

Jackie gives a shoutout to her husband for helping her out with everything. She takes care of everything around the house and through the tough times whenever she's being cranky and neurotic about things.

[53:45] Jackie's Final Words of Wisdom

The only way through it is to just keep doing it. Therapy is great, too. The only person you can limit what we do is ourselves.

[56:10] Join Our Scholarship!

In October, we launched a scholarship through an essay contest. Find all the information on the website. This is open to all premeds in the United States only. The deadline is December 31st so there is no need to rush. This will happen every quarter where we will have new topics and you have the ability to enter the contest to win some money. The first place is $2000, second place is $750 and third place is $250. Follow me on @medicalschoolhq. If we get above 10k followers on Instagram by the deadline, I will double the scholarship for the first quarter.

Links:

Follow me on @medicalschoolhq

Follow Jackie @jackieplans on Instagram.

PMY 174: Academically Dismissed to Medical School Acceptance

Google Keep

AAMC’s Fee Assistance Program

The White Coat Investor

Join the Scholarship!

Nov 28, 2018
313: Army Vet, Mom of 3, Wanted to Quit During Her MD/PHD Journey
46:45

Session 313

Adrienne is in her 3rd year of her MD/PhD program and things are getting easier. She's the mom of 3, an Army Vet, and an amazing example of striving for your dreams. She has done the first two years of med school and now she's in the first year of her PhD portion of the grad school. She shares her story, struggles, and successes along her journey. Find Adrienne on Instagram @ssg.to.mdphd.

If you haven’t yet, check out the newest addition to MedEd Media Network - The MCAT CARS Podcast. This will help you score higher in every section of the MCAT.

[03:02] An Interest in Medicine and Joining the Military`

Adrienne wanted to be a doctor since she was 8 years old. She was a big reader as a girl and is fascinated by the conjoined twins surgery. She grew up in a single parent household and her mom worked multiple shifts to take care of her and her brother, still struggling financially. She got inspired by Ben Carson, the famous neurosurgeon turned politician. There's a film about him being played by Cuba Gooding, Jr., a good story that every premed should watch. Being a minority, seeing someone who can represent you from the same background is something huge.

When she was 16, Adrienne was starting to look at college and was a good student but her mom would just look at her with defeat since she can't afford to send her to school. So Adrienne joined the Army when she was 17 so she could pay to go to school.

She was actually more motivated to accomplish her goals than she was intimidated for joining. She'd describe it as a fun experience doing the basic training. The hardest thing for her was the physical training. Nevertheless, she had a great time as long as she just stayed out of trouble.

When you're looking to join the military, you're signing up for several years. Her first was four although she was told they were required to do 8 years (4 active duty and 4 inactive, where they can just call you back at any point). This is actually the same for the HPSP program, which I enrolled in. Adrienne was in military intelligence where she works on drones which she finds really fun.

[10:41] How the Military Prepared Her to Be a Student

The military plans things in advance and they have very detailed training calendars. So she's used to being able to plan long-term and stay focused on the plan. Another key is discipline.

"If you don't have that internal motivation, it's very easy to get sidetracked. With science and medicine, you can't really let external distractions take you off your goal."

[11:44] Second-Guessing Her Journey

Adrienne admits she ended up loving being an Army. She initially signed up for four years but she ended up serving for ten. She knew her unit was short-handed that's why she enlisted again so that when they were ready to re-deploy, they'd have enough personnel to carry out their mission. Moreover, she loved being developed into a leader. For her, it was a difficult decision to separate and go back to her original goal of pursuing medicine. Eventually, she knew it was time.

After ten years of service, she didn't really want to separate, having made all kinds of relationships. She felt like she was leaving her soldiers behind and not being able to mentor them and work with them was difficult for her. But she knew that dream of becoming a physician didn't go away so she knew she had to do it.

[13:55] Starting a Family and Pursuing School

Adrienne met her husband in the army. They started dating in 2004 and got married in 2008. They have three kids. She separated from the army back in 2013 when she was pregnant with her son.

So she went back to school pregnant and pursuing science. Being a mom in this new environment made her feel so different, being a veteran and older than everyone. Not to mention she has this whole life she's responsible for and then you're growing a person.

But Adrienne is a planner so she thinks about things ahead of time. She talked with her instructors, she took her midterms early because she knew the baby was coming. She then got back to school six days later.

[15:55] Financing School

Their initial plan was for her husband to stay in the military until she graduated from medical school. But he didn't do it. So she had her GI bill, which she used for undergrad. Then she got a Pat Tillman scholarship in 2014 that helped her focus on school and tend for her family. This also allowed her husband to separate and go to school.

Pat Tillman used to play for the Arizona Cardinals and then he joined the military and was killed by a fratricide. Fratricide means friendly fire. It wasn't an enemy bullet. A foundation was created in his honor, the Pat Tillman Foundation, where they select veterans and veterans' spouses, or active duty service members that are pursuing education and provide them with scholarships. Their scholarship has 7500 applicants and only select 58-60 people a year.

When you apply to medical school, there's no easy way to know where you're going to go. It's a hard thing for a lot of people to hear you should wait for 3-5 years until your significant other separates. Nevertheless, Adrienne and her husband were willing to take on the challenges.

[18:40] Homeschooling Kids

So they're both in school and they've got three kids, whom they homeschooled. They have a detailed, color-coded calendar that goes to every electronic device in her house.

Everyone in the house knows what's going on in any given day. Her girls are now pretty independent with their schooling so they can do lessons on their own throughout the day. Then when either she or her husband gets home, they check their work or answer any questions they may have. While their son is in first grade so he's doing simple reading, math, writing. His lessons taking about 2 hours. The girls take five hours to do their lessons with breaks and lunch.

Adrienne's mother helps them around the house, taking care of the day-to-day stuff and making sure they get started on the lessons. Her mom is disabled so she's on social services and can't afford to live on her own and she doesn't drive. Because of this, they've been taking care of her for seven years.

Her kids are aware she goes to school everyday and she'd sometimes bring them to campus so they'd have an idea of where she is whenever she loves her house early in the morning. She stays on campus until 5 or 6 and then goes home. She'd then spend time with them until she goes to bed.

[24:32] Her Premed Journey

"I learned really quickly that the kindof student that I wanted to be, I had to put more effort in to get the grades that I wanted."

Adrienne has been out of college for over ten years so she was a little over enthusiastic. She took several science classes in the summer semester. She learned that she had to put more effort if she wanted to get the grade she wanted. And once she learned that, each subsequent course became easier for her. She did double major in Biology and Chemistry. She finished in three years but she double-majored since she had the time and she wanted to be more competitive for medical school. For her, the hardest part was the labs, the classes, having to be away, plus working and studying.

"Science is challenging. But once I figured out how much attention it needed, it went better."

[26:58] Why MD/PhD

Adrienne tried to make sure she hit everything she could to be a good applicant so she did in undergrad. She loved it so much she couldn't let it go. She didn't even know there was such a thing as MD/PhD until her PI in undergrad recommended it to her. She researched it and applied to medical school. Then she added an extra essay in the letter of recommendation right before she turned her application in.

"I couldn't imagine going forward without having research as part of my life."

Furthermore, she felt the PhD was needed to be able to answer complex questions in her head. Particularly, Adrienne loves microorganisms so she took an MD/PhD in Microbiopathogenesis. She likes bench research and wants to know why we get sick and wants to study these microorganisms. Plus, you have to do it for the right reason otherwise just going that path to have extra letters of recommendation is not worth it. A lot of the spots are also funded so a lot of students do it for the pay. But Adrienne warns it's a struggle.

"This is the work and if you don't like it, it's just a struggle."

[29:20] Applying to Medical School

When Adrienne got her acceptance, she got a letter in the mail for medical school and then a phone call for the MD/PhD program.

For her, this was a dream realized which she has been hoping for since she was 8. So to see it come to fruition was a huge bust for her that she ran in their yard for 15 minutes upon knowing the result.

"If you are worried about the application process because it's very expensive, look into the fee assistance program."

Adrienne got three acceptances. Going through the whole application process, Adrienne applied to 15 schools for free through AMCAS' fee assistance program for underprivileged students. When she got accepted into the program, her applications fees were waived and only had to pay half of the MCAT. She also got access to the MSAR as well as some MCAT study materials.

She took the MCAT the first time it came out. She applied to MD/PhD only to all schools because she knew that's what she wanted to do. Out of the three schools that accepted her, she chose Maryland. Adrienne did shadowing, research, volunteering.  She had to stack all her cards to make sure she gets in.

"I wanted to be an applicant where if they looked at my application, they had to say we want her. There'd be no option to say no."

[35:30] What Medical School Was Like and MD/PhD

Adrienne admits struggling at medical school. He had to learn to be more efficient. You don't have weeks to master materials but only days before you move on to the next thing. It was a steep curve.

For her, second year was more difficult than first year. You have the same volume of information and the same expectations but you have more external requirements like into to clinical medicine stuff, exams, etc. - a lot of extra stuff.

For MD/PhD, you have to take Step 1 before let you do your grad school. Now that she's in grad school, they're still being integrated with med school. While in med school, they do a journal club type thing for the first two years. Once a week, they meet up, discuss papers and things. While in grad school, she had to do 100 clinical hours and then case-control studies where they go over different current medical cases that each student presents throughout the year.

"They try to make you realize that you're a physician-scientist, not an MD/PhD."

Her school did a very good job to make sure you don't forget either part. They go together. They're synergistic. You're not just an MD or a PhD but you're a physician-scientist.

Her classmates are all in the hospital and barely sees them although they keep in touch with each other on social media. She describes it being a difficult transition to go from medical school to grad school for the reason you don't have that group of people you relied on. But you also have your PhD cohort, so you still have the same people you know are experiencing what you're experiencing.

At their school, they start with their third year of class or do a delayed entry back to medical school up to January 1st, depending on your dissertation schedule. And you have to have your first author paperwork to go back to med school. So depending on when that paper gets accepted, they have a system where you can go back up to January 1st. They prefer you go back with the third years because you get that intro training for the med school. They also have a dean for dual degree students who work with them as they transition back to medical school.

[40:41] Dealing with Mommy Guilt

Adrienne is very on top when it comes to spending time with their children. She makes sure she's there every occasion. But that being said, she feels like she's not being their mother which is so hard for her as well as making sure that their childhood isn't traumatic because she's doing this whole process.

For her, this was all harder than she expected. She never felt so unprepared, not because of her med school education, or the kids, but the combination of everything together. You only have one shot to take this exam. So it was much more difficult than what she anticipated.

There were times she questioned why she did this. In fact, one of her classmates kept a tick mark tracker every time she threatened to quit (just about everyday.) But she points out the support of his family and classmates, rallying around her to make sure they can all get through this hump. She also describes the collaborative environment in their school.

[44:25] Adrienne's Final Words of Wisdom

First, know the entire process in terms of application, interview, the programs, etc. because you want to know what you're getting into. Be able to plan through that process. As far as being an applicant, being different is okay because you bring something different to the table than everyone else. You have experience and insight your patient may need so don't let that intimidate you. Finally, you can do it! And it's possible to live your life and pursue your dreams at the same time. It's a challenge but you can do it.

Links:

Follow Adrienne on Instagram @ssg.to.mdphd.

MedEd Media Network

The MCAT CARS Podcast

Gifted Hands: The Ben Carson Story

Pat Tillman Foundation

Nov 21, 2018
312: He Got Into Medical School and Didn't Have to take the MCAT!
32:20

Session 312

Examkrackers’ Janis Stott joins me to talk about the common misconceptions she sees from students about the MCAT. We also talk about EKs new MCAT Hotline. Janis has been in the MCAT game for a decade now. And she's bringing her experience talking to premed students everyday about the MCAT and their struggles.

As well, we're going to talk about the misconceptions students have with the MCAT and MCAT prep, including a new service they're offering. This is a very great service especially for those who need a bit of extra tutoring. You can call them four nights a week for two hours at a low fee.

[03:45] A Bit About Janis' Background

Janis Stott has over ten years of experience with Examkrackers and is now the National Program Director. They're an MCAT prep company that helps students with their MCAT. Janis used to be a musical theater major in college. Her dream was to be on Broadway but back in the real world, she worked with another corporate company for a while until she found Examkrackers. She helped manage concerns and issues of students. Basically, she has learned the ins and outs of being a premed student.

[08:00] The Most Common Misconceptions About the MCAT

Students think they need to prep or they feel as though the material they've gotten through their college education has already prepped them for the exam. Yes, you've had an excellent education. But for this test, you're going to get hit pretty hard by the MCAT pretty fast.

"Nobody wants a bad mark on our application and while you can have more than one MCAT score, why would you do that to yourself? You should only have one."

Not actually getting yourself familiarized with the actual exam itself and what this crazy critical thinking exam is all about and how to approach it - it's such a misconception to feel like you don't need to do anything, and that you just jump in and take it to see how you can do.

Sure, you can take the MCAT multiple times, but why would you even put yourself through that in the first place? The worst case scenario is you've wasted a little bit of money because you voided it. But the worst part about voiding a score is that you never know how you did it. It's just that infinite question mark of was it okay or wasn't okay. You'll never know because they're not going to tell you. You've voided out your score.

"If you haven't gotten yourself to the point that you feel prepped and ready to go for this exam and you know what you're about to tackle, you're not in a good spot to take it."

[11:22] Misconception #1: It's Just Another Test (Or Is It?)

Janis says people are naive about what the exam is actually going to ask from them. It's not their fault. As students, we're put through standardized testing since our 3rd or 4th grade. So we're sick of this already. We follow this testing all the way up through college and you're rewarded for trying to predict what the questions are going to be. So we follow this certain pattern and it just continues.

Because of this, sometimes students feel they're going to be a good test-taker and because of that, they know they'll be fine. But with MCAT, you're not going to be fine. It's not about speed reading, it's not about reading for keywords. It's about reading for content and reading for the main idea, what this person is trying to tell you in a very interdisciplinary approach which can be extremely confusing for students who a lot of times like to stay in one lane.

It's learning those skills of the interdisciplinary science. Together, the overall critical thinking side of the exam and basic reading comprehension, which unfortunately a lot of students have sometimes lost by the time they hit the time to take the MCAT.

"You've got to rewind back a little bit and just remind yourself how to read. What's the main idea? Who wrote it? Why would they write it? What's the process?"

[14:00] Do You Need to Prep with a Prep Company?

Janis' job at Examkrackers is working with students all day long and not everybody works with Examkrackers which is fine. But making sure that students understand what it is they're up against or how to best get through the exam and come out with the score they're looking for is really how Janis would do her job. Ultimately, she wants you to get the best score you're trying to achieve. Regardless of whether you become an Examkrackers student or not, you definitely have to prep for the exam.

"You definitely have to prep for the exam. This is not something you want to walk in cold. This is not something you want to think, 'I'm good."

To say the least, get your hands on some prep materials at your advisor's office. Do your research on the AAMC website. Grab a couple of practice exams. That's baseline. That's without even really getting into actually prepping. Do your research. Figure out how you want to tackle this exam and then set aside some good solid time to prep for it.

[15:52] Practice Exams Are HUGE!

Although there may not be an AAMC data that shows this, Janis knows there's a huge percentage of students who never take the full-length exam because they've talked to a lot of them after they come with a bad score. That being said, Janis points out that shouldn't even be a thought.

"This is an exam like no other exam that you've taken. You have to PRACTICE... you have to practice what it's going to feel like to sit there."

You really have to practice how it feels like to sit there for long hours - when is your butt going to start to hurt, when are you going to get hungry, when are you going to have to go to the bathroom. All of these nuances are things that can psychologically distract you. You have to realize that all of that is going to come at you in some way, shape, or form, that could be three, four, five, six points off your score, just from psychological misunderstanding.

This is just one side of things. The other side is you have to practice the exam for the comfort of the way the questions are going to be put in front of you.

With Examkrackers, the way they put their books together and the way they deliver materials to students, whether you're in a class or studying on your own is all about practice. They do five full-length practice exams for their course. You do it once at the very beginning. Then they do one every two weeks. You get to the second one, and students don't want to take it inevitably. They want to hoard it even the third one until the fourth. And so Examkrackers had to push them if they don't take it. You may not score the way you want to in your practice tests but it's the constant study that will get you to the score that you're looking for.

"You have to practice every two weeks. No, you're not ready. No, you're not going to score the way you want to. But it is that constant study practice that's going to get you the score that you're looking for."

Students commonly think they still have content to learn so why take the practice test? But understand that the actual art and practice of taking the exam. You need to understand how questions are going to be presented to you and determine which of the three choices would be the best. The practice of the actual exam itself is not equal to the concept, but it's a big part. You have to learn the critical side of the exams.

"A majority of students probably know their concepts really well, but they don't know the exam. They don't understand the critical thinking side of the exam."

[20:38] Misconception #2: Timeline

You don't want to feel like you have to take it when everyone else is taking it. If you're not ready by the Spring of your Junior year of if you happen to have a really heavy semester when you don't have the time to devote to doing your courses as well as doing your prep, then don't take the exam. You need to make sure you're taking this exam when you're ready to take it.

"You need to make sure you're taking this exam when you're ready to take it, not just when someone else tells you should be taking it."

This can be disheartening for some. But a gap year is not the end of the world. It's a year. It's a little bit of time to breathe, to do something for yourself before you get back into school, which you're going to be in for a long time when you do wind up in medical school. So it's definitely something you want to make sure you're taking when you're ready.

Again, there's no reason to have more than one score when you go in for the application. You can, but there's no reason for it. And you want to make sure you're taking it when you're ready to take it and if that means you need an extra semester to get it done then do so. Everything's going to be okay. The world will keep turning and the medical school will still be there.

Additionally, there's that balance of being able to still take it this year when you're ready and apply or should you wait to push your application forward until next year. And all that comes down to making sure you're looking at your own personal timeline in advance. So you have to have a realistic outlook on when everything is going to get done and that includes when you are going to have the time to put in for prepping for the exam. Quality over quantity is also very important to understand when it comes to study time.

[25:33] When is the Time to Register

Early planning is very important. Make sure you set aside a certain time to help you schedule your time. You have to pay close attention to your course load, planning, and getting everything in line if you want to follow that guide to make sure all your ducks are in a row.

If a hiccup happens along the way because life is full of hiccups and we all get them... just take a deep breath. Talk to your advisor or contact Examkrackers. If that means delaying you then just follow your guideline one year later instead of the year you're in. It's just a year!

"Students need to have a guideline and have a structure but also understand that life can happen. If that means adjustment has to be made, then adjustments have to be made."

[29:45] Misconception #3: It's All the Same!

Prep materials and companies are not all the same. It's the job of the student to really determine who it is you're going to work with. Make sure the way the material is being presented to you or you're processing through it works for you as a student.

"Make sure you connect with the prep material you're working with."

Getting your hands on the material and being able to connect with them, it's where you're getting your score from in the long run. It doesn't matter which branch of tree you're on, it all comes back to that material. And you have to connect with the way they approach the MCAT.

Janis advises against creating your own MCAT library as this can be too overwhelming. Again, do your research. Go to premed fairs. Talk to companies out there. Particularly, check out Examkracker's free MCAT consultation and they'll give you a call for a 15-minute chat to see if it's a good fit or not. Their company is not looking to sell but to see if you're a good fit. Moreover, talk to your advisors. Some of them have MCAT study books and try to get your hands on the material to check them out. You will see the differences between different materials.

What Examkrackers sets them apart, as Janis points it out is that their goal is to make sure you're obviously getting the MCAT score you want. They try to make it as engaging as they can along with a dynamic teaching style. We're not going to ask you to go back and learn your entire undergraduate education, it's not necessary and you don't have time to do it anyway.

"We're going to ask you the high points and really understand them in that critical thinking mode that is so key."

Always keep in mind this something you're going to be looking at over and over again for a long period of time. You want it to be something you're going to at least be interested in looking at.

[37:06] Examkrackers Hotline

Examkrackers offers the Examkrackers Hotline, which offers online office hours with their instructors. If you're studying, whether you're doing self-study or not, the hotline is a nightly bookable session with their instructors. It's open from Mondays through Thursdays from 9-11 EST. Go in and book your evening, and get open access to one of their instructors in their online classroom. If there are multiple students in the classroom in the same evening, then the instructors can go round-robin with everybody. They'd answer the question and you go to the back of the queue and you can sit and listen to everybody else's question if you want to. Learn from other people or if you want to ignore them then you can do so until it's your turn again. But it's open access to their top instructors for content, clarity, and clarifications.

Especially if you're a self-study student, you can just book one night and then ask all the questions you want for two hours. It's a phenomenal resource! You can book one night at a time or you may also use it for three or four multiple nights over the course of a week, two weeks, or six months. Book the night as you go for only $35 a night!

Note: Their instructors are approved to answer any of their practice exams, their materials, and any of the AAMC materials. However, they cannot answer for other text prep companies' materials.

You also need to book one day in advance. A lot of students, too, don't stay for the full two hours. It has a screen interface and the instructor is able to draw and pull up screens to show examples.

[43:35] Last Words of Advice

Janis encourages students saying that you can do it! It can be terrifying and disheartening but don't let those emotions or feelings eat you up! This is exam is totally doable. You can do this! It just takes the right tools and the right understanding and the right prep and you will be in the spot you want to be in. The MCAT is not out there to keep you out of medical school.

Examkrackers is here for you! Again, take advantage of their 15-minute free consultation to help you figure out what's going on. They boast of offering engaging material that ultimately connects with students and doesn't overwhelm them, and ensures they are ready for the MCAT. Browse through their wide selection of materials. As Janis puts it simply, "You name it, we do it!"

For the first 30 students, use the promo code EKMSHQ and save $10. So you only have to pay $25 for the hotline.

Links:

Examkrackers

Examkrackers Hotline

Nov 14, 2018
311: Common Misconceptions about the MCAT and a New Tool from EK
49:04

Session 311

Examkrackers’ Janis Stott joins me to talk about the common misconceptions she sees from students about the MCAT. We also talk about EKs new MCAT Hotline. Janis has been in the MCAT game for a decade now. And she's bringing her experience talking to premed students everyday about the MCAT and their struggles.

As well, we're going to talk about the misconceptions students have with the MCAT and MCAT prep, including a new service they're offering. This is a very great service especially for those who need a bit of extra tutoring. You can call them four nights a week for two hours at a low fee.

[03:45] A Bit About Janis' Background

Janis Stott has over ten years of experience with Examkrackers and is now the National Program Director. They're an MCAT prep company that helps students with their MCAT. Janis used to be a musical theater major in college. Her dream was to be on Broadway but back in the real world, she worked with another corporate company for a while until she found Examkrackers. She helped manage concerns and issues of students. Basically, she has learned the ins and outs of being a premed student.

[08:00] The Most Common Misconceptions About the MCAT

Students think they need to prep or they feel as though the material they've gotten through their college education has already prepped them for the exam. Yes, you've had an excellent education. But for this test, you're going to get hit pretty hard by the MCAT pretty fast.

"Nobody wants a bad mark on our application and while you can have more than one MCAT score, why would you do that to yourself? You should only have one."

Not actually getting yourself familiarized with the actual exam itself and what this crazy critical thinking exam is all about and how to approach it - it's such a misconception to feel like you don't need to do anything, and that you just jump in and take it to see how you can do.

Sure, you can take the MCAT multiple times, but why would you even put yourself through that in the first place? The worst case scenario is you've wasted a little bit of money because you voided it. But the worst part about voiding a score is that you never know how you did it. It's just that infinite question mark of was it okay or wasn't okay. You'll never know because they're not going to tell you. You've voided out your score.

"If you haven't gotten yourself to the point that you feel prepped and ready to go for this exam and you know what you're about to tackle, you're not in a good spot to take it."

[11:22] Misconception #1: It's Just Another Test (Or Is It?)

Janis says people are naive about what the exam is actually going to ask from them. It's not their fault. As students, we're put through standardized testing since our 3rd or 4th grade. So we're sick of this already. We follow this testing all the way up through college and you're rewarded for trying to predict what the questions are going to be. So we follow this certain pattern and it just continues.

Because of this, sometimes students feel they're going to be a good test-taker and because of that, they know they'll be fine. But with MCAT, you're not going to be fine. It's not about speed reading, it's not about reading for keywords. It's about reading for content and reading for the main idea, what this person is trying to tell you in a very interdisciplinary approach which can be extremely confusing for students who a lot of times like to stay in one lane.

It's learning those skills of the interdisciplinary science. Together, the overall critical thinking side of the exam and basic reading comprehension, which unfortunately a lot of students have sometimes lost by the time they hit the time to take the MCAT.

"You've got to rewind back a little bit and just remind yourself how to read. What's the main idea? Who wrote it? Why would they write it? What's the process?"

[14:00] Do You Need to Prep with a Prep Company?

Janis' job at Examkrackers is working with students all day long and not everybody works with Examkrackers which is fine. But making sure that students understand what it is they're up against or how to best get through the exam and come out with the score they're looking for is really how Janis would do her job. Ultimately, she wants you to get the best score you're trying to achieve. Regardless of whether you become an Examkrackers student or not, you definitely have to prep for the exam.

"You definitely have to prep for the exam. This is not something you want to walk in cold. This is not something you want to think, 'I'm good."

To say the least, get your hands on some prep materials at your advisor's office. Do your research on the AAMC website. Grab a couple of practice exams. That's baseline. That's without even really getting into actually prepping. Do your research. Figure out how you want to tackle this exam and then set aside some good solid time to prep for it.

[15:52] Practice Exams Are HUGE!

Although there may not be an AAMC data that shows this, Janis knows there's a huge percentage of students who never take the full-length exam because they've talked to a lot of them after they come with a bad score. That being said, Janis points out that shouldn't even be a thought.

"This is an exam like no other exam that you've taken. You have to PRACTICE... you have to practice what it's going to feel like to sit there."

You really have to practice how it feels like to sit there for long hours - when is your butt going to start to hurt, when are you going to get hungry, when are you going to have to go to the bathroom. All of these nuances are things that can psychologically distract you. You have to realize that all of that is going to come at you in some way, shape, or form, that could be three, four, five, six points off your score, just from psychological misunderstanding.

This is just one side of things. The other side is you have to practice the exam for the comfort of the way the questions are going to be put in front of you.

With Examkrackers, the way they put their books together and the way they deliver materials to students, whether you're in a class or studying on your own is all about practice. They do five full-length practice exams for their course. You do it once at the very beginning. Then they do one every two weeks. You get to the second one, and students don't want to take it inevitably. They want to hoard it even the third one until the fourth. And so Examkrackers had to push them if they don't take it. You may not score the way you want to in your practice tests but it's the constant study that will get you to the score that you're looking for.

"You have to practice every two weeks. No, you're not ready. No, you're not going to score the way you want to. But it is that constant study practice that's going to get you the score that you're looking for."

Students commonly think they still have content to learn so why take the practice test? But understand that the actual art and practice of taking the exam. You need to understand how questions are going to be presented to you and determine which of the three choices would be the best. The practice of the actual exam itself is not equal to the concept, but it's a big part. You have to learn the critical side of the exams.

"A majority of students probably know their concepts really well, but they don't know the exam. They don't understand the critical thinking side of the exam."

[20:38] Misconception #2: Timeline

You don't want to feel like you have to take it when everyone else is taking it. If you're not ready by the Spring of your Junior year of if you happen to have a really heavy semester when you don't have the time to devote to doing your courses as well as doing your prep, then don't take the exam. You need to make sure you're taking this exam when you're ready to take it.

"You need to make sure you're taking this exam when you're ready to take it, not just when someone else tells you should be taking it."

This can be disheartening for some. But a gap year is not the end of the world. It's a year. It's a little bit of time to breathe, to do something for yourself before you get back into school, which you're going to be in for a long time when you do wind up in medical school. So it's definitely something you want to make sure you're taking when you're ready.

Again, there's no reason to have more than one score when you go in for the application. You can, but there's no reason for it. And you want to make sure you're taking it when you're ready to take it and if that means you need an extra semester to get it done then do so. Everything's going to be okay. The world will keep turning and the medical school will still be there.

Additionally, there's that balance of being able to still take it this year when you're ready and apply or should you wait to push your application forward until next year. And all that comes down to making sure you're looking at your own personal timeline in advance. So you have to have a realistic outlook on when everything is going to get done and that includes when you are going to have the time to put in for prepping for the exam. Quality over quantity is also very important to understand when it comes to study time.

[25:33] When is the Time to Register

Early planning is very important. Make sure you set aside a certain time to help you schedule your time. You have to pay close attention to your course load, planning, and getting everything in line if you want to follow that guide to make sure all your ducks are in a row.

If a hiccup happens along the way because life is full of hiccups and we all get them... just take a deep breath. Talk to your advisor or contact Examkrackers. If that means delaying you then just follow your guideline one year later instead of the year you're in. It's just a year!

"Students need to have a guideline and have a structure but also understand that life can happen. If that means adjustment has to be made, then adjustments have to be made."

[29:45] Misconception #3: It's All the Same!

Prep materials and companies are not all the same. It's the job of the student to really determine who it is you're going to work with. Make sure the way the material is being presented to you or you're processing through it works for you as a student.

"Make sure you connect with the prep material you're working with."

Getting your hands on the material and being able to connect with them, it's where you're getting your score from in the long run. It doesn't matter which branch of tree you're on, it all comes back to that material. And you have to connect with the way they approach the MCAT.

Janis advises against creating your own MCAT library as this can be too overwhelming. Again, do your research. Go to premed fairs. Talk to companies out there. Particularly, check out Examkracker's free MCAT consultation and they'll give you a call for a 15-minute chat to see if it's a good fit or not. Their company is not looking to sell but to see if you're a good fit. Moreover, talk to your advisors. Some of them have MCAT study books and try to get your hands on the material to check them out. You will see the differences between different materials.

What Examkrackers sets them apart, as Janis points it out is that their goal is to make sure you're obviously getting the MCAT score you want. They try to make it as engaging as they can along with a dynamic teaching style. We're not going to ask you to go back and learn your entire undergraduate education, it's not necessary and you don't have time to do it anyway.

"We're going to ask you the high points and really understand them in that critical thinking mode that is so key."

Always keep in mind this something you're going to be looking at over and over again for a long period of time. You want it to be something you're going to at least be interested in looking at.

[37:06] Examkrackers Hotline

Examkrackers offers the Examkrackers Hotline, which offers online office hours with their instructors. If you're studying, whether you're doing self-study or not, the hotline is a nightly bookable session with their instructors. It's open from Mondays through Thursdays from 9-11 EST. Go in and book your evening, and get open access to one of their instructors in their online classroom. If there are multiple students in the classroom in the same evening, then the instructors can go round-robin with everybody. They'd answer the question and you go to the back of the queue and you can sit and listen to everybody else's question if you want to. Learn from other people or if you want to ignore them then you can do so until it's your turn again. But it's open access to their top instructors for content, clarity, and clarifications.

Especially if you're a self-study student, you can just book one night and then ask all the questions you want for two hours. It's a phenomenal resource! You can book one night at a time or you may also use it for three or four multiple nights over the course of a week, two weeks, or six months. Book the night as you go for only $35 a night!

Note: Their instructors are approved to answer any of their practice exams, their materials, and any of the AAMC materials. However, they cannot answer for other text prep companies' materials.

You also need to book one day in advance. A lot of students, too, don't stay for the full two hours. It has a screen interface and the instructor is able to draw and pull up screens to show examples.

[43:35] Last Words of Advice

Janis encourages students saying that you can do it! It can be terrifying and disheartening but don't let those emotions or feelings eat you up! This is exam is totally doable. You can do this! It just takes the right tools and the right understanding and the right prep and you will be in the spot you want to be in. The MCAT is not out there to keep you out of medical school.

Examkrackers is here for you! Again, take advantage of their 15-minute free consultation to help you figure out what's going on. They boast of offering engaging material that ultimately connects with students and doesn't overwhelm them, and ensures they are ready for the MCAT. Browse through their wide selection of materials. As Janis puts it simply, "You name it, we do it!"

For the first 30 students, use the promo code EKMSHQ and save $10. So you only have to pay $25 for the hotline.

Links:

Examkrackers

Examkrackers Hotline

Nov 07, 2018
310: Improve Your CARS Score with the MCAT CARS Podcast!
35:13

Session 310

Jack Westin was featured in Session 259 almost one year ago. Now we've launched the MCAT CARS Podcast and it's going to change the way you prep for the MCAT.

Link to the full article: http://time.com/5405778/walking-after-eating-good-for-you

Text pulled from the article to read for the podcast:

At the end of a long day, it’s tempting to dive into your social feeds or Netflix queue the minute you’ve finished eating. But back before screens bogarted all our free time, an after-dinner stroll was a popular activity and one associated with improved health and digestion. “Italians have been walking after meals for centuries,” says Loretta DiPietro, a professor of exercise science at George Washington University’s Milken Institute School of Public Health, “so it must be good.”
Research backs this up. One small study co-authored by DiPietro found that when older adults at risk for type–2 diabetes walked on a treadmill for 15 minutes after a meal, they had smaller blood sugar spikes in the hours afterwards. In fact, the researchers found that these short post-meal walks were even more effective at lowering blood sugar after dinner than a single 45-minute walk taken at mid-morning or late in the afternoon.
The human digestive system converts food into the sugar glucose, which is one of the body’s primary energy sources—so after a meal, glucose floods a person’s bloodstream. Hormones like insulin help pull that glucose into cells, either to be used immediately or stored away for later use. But for people with diabetes and impaired insulin activity, too much glucose can remain in the blood, which can cause or contribute to heart disease, stroke, kidney disease and other health problems.
“Insulin secretion in response to a meal tends to wane later in the day, and this is especially so in older people,” DiPietro says. She points out that many of us eat our largest meal of the day in the evening, and we also tend to sit around afterward. As a result, “blood glucose levels will rise very high and will stay elevated for hours,” she says.
What good does walking do? “The muscles we use to walk use glucose as energy, drawing it out of circulation and therefore reducing how much is floating around,” says Andrew Reynolds, a postdoctoral research fellow at the University of Otago in New Zealand

Jack Westin was featured in Session 259 almost one year ago. Now we've launched the MCAT CARS Podcast and it's going to change the way you prep for the MCAT. Expect to get a new episode each week as we break down written content. Learn how to read the way that the MCAT wants us to read. Also, check out all of our other podcasts on MedEd Media Network.

[02:03] Improving Your Reading Comprehension

This podcast is very different than anything we've done before because we're not just doing passages from the MCAT. But we're really going down to the bare bones of reading comprehension, which is where most students struggle with the MCAT, specifically the CARS section.

Our hope, at the end of the day, is you will improve your reading comprehension, which will improve your CARS score and improve the scores in every other section as well. Reading articles from different online websites and magazines and journals will help your Science section scores. Again, it's all reading comprehension.

[02:55] The MCAT is a Comprehension Test

Remember, the MCAT is a comprehension test. It's not a content-based test. You obviously have to know the content, but the way they present the information and ask the questions, you really have to comprehend and analyze. The MCAT CARS Podcast is here to help you maximize your MCAT score, not just your CARS score. Learning good CARS techniques will help you improve everywhere.

So our 100% goal for this podcast is to help you better comprehend. In this podcast episode, we're going to break down a Time magazine article. I will ask questions and try to figure them out while Jack teaches us different skills and strategies. Ultimately, we go to a point where your scores will start going up.

Save $100 by going to the Jack Westin site for the coupon to be automatically activated. Or text CARSCOUPON to 44222.

[03:08] The MCAT CARS Podcast

Whether you're an ESL (English as a Second Language) student, you lack confidence while reading, or are a slow reader, Jack Westin and The Medical School Headquarters are here to help you score higher in every section so that you can be confident you're ready to get the MCAT score of your dreams!

This week, we have an article from Time magazine.

The Case for Taking a Walk After You Eat

At the end of a long day, it’s tempting to dive into your social feeds or Netflix queue the minute you’ve finished eating. But back before screens bogarted all our free time, an after-dinner stroll was a popular activity and one associated with improved health and digestion. “Italians have been walking after meals for centuries,” says Loretta DiPietro, a professor of exercise science at George Washington University’s Milken Institute School of Public Health, “so it must be good.”

Research backs this up. One small study co-authored by DiPietro found that when older adults at risk for type–2 diabetes walked on a treadmill for 15 minutes after a meal, they had smaller blood sugar spikes in the hours afterwards. In fact, the researchers found that these short post-meal walks were even more effective at lowering blood sugar after dinner than a single 45-minute walk taken at mid-morning or late in the afternoon.

The human digestive system converts food into the sugar glucose, which is one of the body’s primary energy sources—so after a meal, glucose floods a person’s bloodstream. Hormones like insulin help pull that glucose into cells, either to be used immediately or stored away for later use. But for people with diabetes and impaired insulin activity, too much glucose can remain in the blood, which can cause or contribute to heart disease, stroke, kidney disease and other health problems.

“Insulin secretion in response to a meal tends to wane later in the day, and this is especially so in older people,” DiPietro says. She points out that many of us eat our largest meal of the day in the evening, and we also tend to sit around afterward. As a result, “blood glucose levels will rise very high and will stay elevated for hours,” she says.

What good does walking do? “The muscles we use to walk use glucose as energy, drawing it out of circulation and therefore reducing how much is floating around,” says Andrew Reynolds, a postdoctoral research fellow at the University of Otago in New Zealand.

[09:35] Paragraph 1, Sentence #1:

At the end of a long day, it’s tempting to dive into your social feeds or Netflix queue the minute you’ve finished eating.

Jack says:

We don't know what the author is talking about just yet, but here, they're kind of setting up a scene. If it's tempting, it's probably something you're going to enjoy or people mostly enjoy and something that isn't good for you all the time. So they're probably associating something positive or a bit on the guilty side of social feeds or Netflix queue.

[10:52] Paragraph 1, Sentence #2:

But back before screens bogarted all our free time, an after-dinner stroll was a popular activity and one associated with improved health and digestion.

Jack says:

Here, it seems like the author is making a distinction between walking (after-dinner stroll) and big screens (Netflix, mobile phone, etc.), which seem to be not as healthy. They're saying what's better for your digestion is walking.

The word "bogarted" is probably something students don't know what it means. Does it even matter if you know what that means? If you look at the context around the sentence, you can probably guess what it probably means. Now, most students who read this sentence tend to focus so much on that word that they lose picture of the surrounding words, of what it's truly trying to convey.

Try to not let one word mess with you in that way. Instead, at the end of the passage or article, go ahead and underline those words and notecard them when you have time. Then test yourself on those kinds of words later down the road.

It's not something that's super important but if you have basic English under your belt and you've taken senior year high school English, you're going to be an okay reader, strong enough to really read anything the MCAT throws at you.

[13:33] Paragraph 1, Sentence #3:

“Italians have been walking after meals for centuries,” says Loretta DiPietro, a professor of exercise science at George Washington University’s Milken Institute School of Public Health, “so it must be good.”

Jack says:

This is self-explanatory.

[14:10] What Paragraph #1 Means:

So the author here is probably saying that maybe we should be walking after we eat, or at least, walking seems to be improving our health or better for our digestion after we eat.

Even the first sentence said, "the minute you finished eating." So everything we talk about is after eating. It has nothing to do with just walking in general, but after-eating activities.

This then seems to be the topic or theme.

[14:52] Paragraph 2, Sentence #1-2:

Research backs this up. One small study co-authored by DiPietro found that when older adults at risk for type–2 diabetes walked on a treadmill for 15 minutes after a meal, they had smaller blood sugar spikes in the hours afterwards.

Jack says:

So far, what we know is that walking after dinner will improve your health. So the author tries to support this idea. You may not know anything about blood sugar spikes. It may be good for you or bad. You may not even know what Type II diabetes is. But the fact they're bringing this up as evidence for why it's good for you, the fact you know they're setting this up as a reason it's good for you, tells you that maybe "lower blood sugar spikes" is the better help.

This has nothing to do with your background knowledge of diabetes. You just have to be aware of how things are going on and how this may be fitting into this conversation.

[17:57] Paragraph 2, Sentence #3:

In fact, the researchers found that these short post-meal walks were even more effective at lowering blood sugar after dinner than a single 45-minute walk taken at mid-morning or late in the afternoon.

Jack says:

So here, the author says short walks after dinner are better than longer walks mid-morning or late in the afternoon. And that there's data that support this, so you should be walking post-meal to reduce blood sugar spikes.

[19:11] What Paragraph #2 Means:

So far, we've had two paragraphs that go in one direction - walking after dinner.

[19:42] Paragraph 3, Sentence #1:

The human digestive system converts food into the sugar glucose, which is one of the body’s primary energy sources—so after a meal, glucose floods a person’s bloodstream.

Jack says:

Again, you don't need to know how this works exactly. They're teaching it to you. They're literally teaching you as you explain it. That's the beauty of CARS is that you can read something and learn something every time you read.

Also, they now call the sugar, glucose. But they're not just saying sugar. They're calling it glucose. So be careful. They may just use that word glucose on its own. But you don't have to necessarily know sugar anymore, but you now have to use the word glucose. So just remember that glucose is synonymous with sugar.

[21:20] Paragraph 3, Sentence #2:

Hormones like insulin help pull that glucose into cells, either to be used immediately or stored away for later use.

Jack says:

If you notice, they're not using the word sugar anymore. And this could throw a lot of students off. So as long as you read the sentence before this carefully, then you should be fine with this sentence. Now, you know that insulin tries to take insulin and put it into cells.

Moreover, Jack warns that highlighting stuff on the MCAT can be a huge distraction. It's okay to do this with dates and names, as those could be things that show up. But if you become a habitual highlighter, you're no longer reading, but just zoning off and trying to highlight things. That said, there are many students comfortable with highlighting and do it properly. They do it well enough to do really well on this test. But over time, this could become a bad habit. Instead, just be more attentive. If you keep reading in this way and analyzing what you've read, you're going to start picking up on those details that you might not have otherwise picked up on. And this only comes through review and experience and practice.

Just remember that reading this way and understanding what you're reading is not enough. You also have to understand how it relates to the bigger picture, how the author feels about it, etc.

[24:02] Paragraph 3, Sentence #3:

But for people with diabetes and impaired insulin activity, too much glucose can remain in the blood, which can cause or contribute to heart disease, stroke, kidney disease and other health problems.

Jack says:

Again, they're educating us. They're literally telling us that if you have diabetes, you have this impaired insulin activity. That means that there's too much glucose in the bloodstream and that causes problems.

[25:10] What Paragraph #3 Means:

We don't know how this really relates to the other two paragraphs just yet. It seems the author is interjecting with some kind of mechanism. And maybe this will play a role in the bigger picture.

[25:52] Paragraph 4, Sentence #1:

“Insulin secretion in response to a meal tends to wane later in the day, and this is especially so in older people,” DiPietro says. Jack says: The key here is with respect to the prior paragraph, brace yourself. When you're going into a new paragraph, you're probably going to touch on what you just read. And what you just read right before this sentence was there were problems with insulin.

So when thinking of what wane refers to here, based on everything we talked about, you can assume it's something that's bad or a problem because it lowers or weakens. So it seems insulin secretion is not working as well later in the day, especially in older people.

[28:00] Paragraph 4, Sentence #2:

She points out that many of us eat our largest meal of the day in the evening, and we also tend to sit around afterward.

Jack says:

The insulin is not working at a time we're eating the most. It means we have a lot of sugar in our bloodstream right afterward.

[28:49] Paragraph 4, Sentence #3:

As a result, “blood glucose levels will rise very high and will stay elevated for hours,” she says.

Jack says:

The big picture here is that a large meal at the end of the day, just sitting afterward, what happens is our blood glucose levels go high and remain high. And as Paragraph #2 says, this can contribute to health problems so it's a bad thing.

[29:25] What Paragraph #4 Means:

The big picture here is that insulin doesn't work well at the end of the day and then we compound that with eating the largest meal of the day and sitting around afterward.

[29:37] Paragraph 5, Sentence #1:

What good does walking do?

Jack says:

So the author is trying to cycle back to the beginning of the article. The author is trying to bring back the walking, after the education given to us.

[29:55] Paragraph 5, Sentence #2:

“The muscles we use to walk use glucose as energy, drawing it out of circulation and therefore reducing how much is floating around,” says Andrew Reynolds, a postdoctoral research fellow at the University of Otago in New Zealand.”

Jack says:

Basically, you have to know that active muscles help with reducing blood sugar levels. That's what they're trying to convey here. Take note here, that the author didn't mention muscles of the legs, but just muscles in general. It's good to have a picture in your mind of what kind of muscles but the MCAT could confuse you. They could ask you a question about a different muscle that might not be associated with the legs. And this could distract you if you're too focused on the legs.

So just have a broader sense of what they're trying to say. Always keep an open mind. This is very important.

[32:07] Final Thoughts

This may seem easy to read but it could still be difficult if you're not careful and not attentive. Just because the words seem easy does not mean it's easy. You have to be careful with what you're reading.

Just because you know a thing or two about diabetes doesn't mean that you're going to know exactly what they're talking about. So don't bring an outside knowledge and be careful with what you're reading even if it's an easy read.

Finally, for those who don't know much about the topic, you don't need to. Just go in and embrace what you're learning. Embrace the reading aspect. A lot of students aren't willing to embrace what they're reading because they're under pressure. They don't want to sit there and read so they start skimming what they're reading. Instead, just enjoy what you're reading. Take it in and you might learn something new!

[33:23] Check Out Jack Westin

If you are new into the MCAT prep world, sign up for the Jack Westin Daily CARS MCAT Question of the Day. You get a free question delivered to your inbox everyday. It simulates the actual MCAT test environment and you're getting prep for free everyday.

Text MCATCARS to 44222 and get a link to how to sign up for the MCAT Question of the Day from Jack Westin.

Links:

MCAT CARS Podcast

Jack Westin

PMY Session 259: How Can I Improve My CARS Section Score on the MCAT?

MedEd Media Network

Jack Westin's MCAT Question of the Day

Save $100 by going to the Jack Westin site for the coupon to be automatically activated. Or text CARSCOUPON to 44222.

Oct 31, 2018
309: 5 Medical School Interview Questions Premeds Struggle With
30:42

Session 309

The medical school interview can make or break your chance at an acceptance. Don't walk in unprepared. Check out these questions that students struggle with.

If you haven't yet, check out my books The Premed Playbook: Guide to the Medical School Interview, The Premed Playbook: Guide to the Personal Statement, and The Premed Playbook: Guide to the MCAT.

Meanwhile, listen to our other podcasts on the MedEd Media Network so you can hopefully get all the resources you need to help you along this path to becoming a physician. Also, we've got a new podcast, check out The MCAT CARS Podcast with Jack Westin.

Today's episode is basically an addition to the previous discussion we had on Session 233 about the 5 common medical school interview questions, where we covered things like why you want to be a doctor, tell me about yourself, your greatest strength, why should the med school accept you, and why come to this school. So

I wanted to add more questions and asked the community on the Facebook Hangout Group, which if you're not a member yet, please register for free. So I've picked five questions that students commonly struggle with as I'm doing mock interviews with them.

[03:05] Just Be Yourself

The fun thing about interviews is you think every student is going to answer this the same way. But having interviewed hundreds, or even thousands of students, they don't answer questions the same way.

Hence, just be yourself. Every student is bringing their own experiences to the table. So when they're answering the question, they're answering it based on their own life experiences.

[03:40] Question #1: Why Do You Want to Be an Osteopathic Physician?

Where students go wrong with this question is they just spit out the marketing that osteopathic schools put out - believing in the holistic philosophy, treating the patient holistically, having OMT in addition to their belt. And this is marketing stuff from osteopathic schools.

"Good physicians treat patients holistically. It's not owned by the osteopathic world."

But what does holistic care mean to you? Use your own definition. What does holistic look like to you? Break that down into those parts. Then try to highlight parts of your experience that show the interviewer why that's important, instead of just saying you like the holistic treatment.

You have to look at it from the medical admissions committee's perspective. They want to make sure you have a bit of an understanding of what the DO world is. And that you have some respect for the DO world.

Again, when asked why DO? Break it down what holistic means. Don't just use the buzzwords. Then add in your life experiences, highlight them and tie its importance to a person's health.

"Break it down what holistic means. Don't just use the buzzwords."

[08:00] Question #2: What Your Biggest Weakness?

Maybe you don't want other people to think you have some weaknesses. But we all have flaws. We all have weaknesses.

The bigger flaw is not owning up to your weakness. If you can't own up to that, then that's an issue. Because once you're a physician, being able to own up to your weaknesses is very important to your patient's care. Knowing your limitations as a physician is very important. And part of that is understanding and acknowledging that you're not perfect.

"A bigger flaw is not owning up to your weaknesses."

So when asked about your biggest weakness, they don't want to hear what's something you can turn into a strength either. They really want to hear what you think is your weakness. If you need help with this, go ask your friends and/or family members. Reach out to them and try to get their feedback. Then you can talk about this in the interview.

Again, don't spin your weakness into a strength. Moreover, you just don't stop with telling your weakness. You need to talk about what you're doing to fix your weakness. Tell a story about how this affected you in the past and what you're doing to work on it.

"Do not turn your weakness question into a strength. That's not what they want to hear. They want to hear that you understand you're not perfect. That's okay!"

One of the things you have to stay away from would be communication skills. This is part of being a physician. This includes communicating with patients, and their families. And telling them your biggest struggle is communicating, that could be a problem. So don't tell something that could be a red flag. So what then is the best answer? Whatever that is, the best answer is always what is your truth. Hence, I recommend you ask your parents, friends, and family about your biggest weaknesses.

"What is your truth? Don't look for what is a good answer."

[13:35] Question #3: Health Care Questions

Never go into an interview unprepared that much, that your first response to a question is you don't really know as much as you should. If you are admitting to the fact that you should know more but you don't, then it tells the admissions committee that there's something wrong with your planning, motivation, or initiative to do well in this interview. The fact you know you should know more about this topic, specifically healthcare, but you don't know more about it, that's not good. And they might pass on your for an acceptance.

"You have to understand our healthcare system here in the U.S., as screwy as it is."

You have to understand the Affordable Care Act. The current administration (as of this recording) is trying to dismantle it. It hasn't passed and they're trying to push their own, The American Health Care Act. It doesn't matter. What matters is you have to know what's going on in our healthcare so that you can talk about it during an interview.

Understand what the Single Payer System is. That's the same with Universal Healthcare. Understand what that looks like, what countries have it, and the difference between the systems in the UK and in Canada.

Anytime you're given a "thoughts on ____" type questions, talk about the pros, cons, your side. Give some specifics. If you're asked about the Affordable Care Act, talk about it more - what preexisting conditions it got rid of, extended care for kids, preventive care treatments for free, mandatory coverage, etc. Name the good things and bad things. Talk about it. Understand them.

As to where to go for information, read The Healthcare Handbook. Also, listen to the podcast Congressional Dish, by Jen Briney. In Session 48, she did an episode all about the Affordable Care Act. In her podcast, she reads the bills. So she read all 2000+ pages. And then she did a podcast episode on it. She also had followup episodes about the American Healthcare Act.

"Go get more information on these topics, it's very, very important."

[19:55] Question #4: What Diversity Can You Bring to the Class?

A lot of students think this is an unfair question especially if they're white thinking they can't really bring any diversity. But that's not the question they're really asking. Answer this the same way you answer the question, why should they accept you?

Don't focus on yourself, focus on your classmates. Focus on your future colleagues at that medical school. What experiences, skills, traits do you have that will add to the educational environment of your peers? That is diversity. Not just skin color, race, ethnicity, etc. They want to know real-world experiences and real-world skills and traits that you've gained. Don't talk about stuff like just because you took philosophy or psychology, you'd be an asset because you can think differently. Don't talk about that. There are also several other students who have the same major as you do.

"What experiences, skills, traits do you have that will add to the educational environment of your peers? That is diversity. Not just skin color, race, ethnicity, etc."

For instance, you're a former college athlete and former team captain, talk about how you can also be a leader in the med class. It's a skill that he has and what he wants to do with the class. So think about your experiences, traits, and skills and how can you add to the class.

[23:25] Question #5: Tell Me Your Thoughts on Abortion

Again, when you're asked about your thoughts regarding certain issues, there should be a pretty standard framework around the question. First, tell them about your thoughts. Then explain your thought process behind that. Tell them why there are pro-life people out there. If you're pro-life, give some thoughts on pro-choice people out there. Having that understanding of the other side is called empathy. And that is important to be a physician. And even if the other side may have reasons you may not agree with - still this shows you have empathy and you can understand the other side.

"One of the biggest mistakes students make with this question and other moral ethical questions is that they play the middle road."

One of the biggest mistakes students make with this question (and other moral ethical questions) is that they play the middle road. They're worried about what the interviewer will think. They're worried they're going to be dinged. But you're actually dinged more for not taking a stance, than if you chose a different side than the interviewer. Their job is not to judge you based on your answer if it differs from them. Rather, their job is to understand your thought process behind your answers to determine if you and your thought process are sound. Again, show empathy for the other side.

As of this recording in October 2018, Judge Kavanaugh was confirmed for the next Supreme Court Justice. And there's a lot of talk about the possibility of overturning Roe v. Wade, the big court case that allowed abortion in this country.

So really be aware of what's going on in the news because the questions that may come out can be completely flipped and twisted based on what's going on. So you need to be prepared.

Links:

MedEd Media Network

The MCAT CARS Podcast

The Premed Playbook: Guide to the Medical School Interview

The Premed Playbook: Guide to the Personal Statement

The Premed Playbook: Guide to the MCAT

PMY 233: 5 Common Med School Interview Questions and How to Answer Them

Facebook Hangout Group

The Healthcare Handbook

The Congressional Dish Podcast Session 84: The Affordable Care Act

Roe v. Wade

The MCAT CARS Podcast with Jack Westin

Oct 24, 2018
308: The One Thing You Need to do to Stand Out as a Premed!
21:22

Listen up premeds! I talk about this a lot, but I need to have a dedicated show on this. You have to be yourself in your med school applications and interviews.

Oct 17, 2018
307: Moving Forward with Student Doctor Network and It's Founder
01:00:57

Session 307

Dr. Lee Burnett founded Student Doctor Network or SDN to connect students. Little did he know how big it would get, and how negative the internet would turn. He's hoping to change that.

I've been doing this podcast for six years now. I actually started this podcast back in 2012 after I realized that there wasn't good enough positive information out there. Particularly, SDN had a ton of negative information. And I talked a lot about that site. In fact, I have actively discouraged students from using that site.

Previously, I reached out to them and met with the founder, as well as the people running it day in and day out. I initially didn't get any positive reception from them. Until recently, Lee reached out to me and expressed his interest in collaborating with me in some way to figure out how we can move things forward.

I was very happy hearing from him considering how SDN is a very big site and students are finding it and using it. While I'm just a small piece in this premed puzzle and I can't shepherd everybody away from SDN. But if we can work together and make SDN a better place for you, then I'm all for it.

"Collaboration, not competition, is key to our success."

[04:25] Lee's Interest in Becoming a Physician

Lee recalls being told by his mom when he was in high school back in the 80s to pick a profession he wanted. And being a doctor was what appealed to him. His dad worked for the State of California while his mom worked for a nonprofit organization. And both ended up working together to help promote family medicine in California. So it was natural for him as he got to meet the doctors his parents were working with who were all residency program directors.

Following college, he went into an osteopathic medical school in California. After he graduated, he did a year of DO program, specifically unopposed residency program in internal medicine and surgery. Then he finished the next two years in family medicine at UC Irvine. By unopposed, it means there are no other residency programs that are competing for patients at whatever facility you're at. So the whole clinic or facility is just for a specific residency program. Hence, he got to see everything, which something he recommends to students as he might not have had the same opportunity from other programs otherwise. Aside from such program, UC Irvine also had a local community hospital, which they got to do rotations at as well as in UC-Irvine in Orange, CA.

"It's very important when you're in primary care to try to find a program that is unopposed meaning there are no other residency programs that are competing for patients at whatever facility you're at."

[09:08] Location as a Deciding Factor and an F in Genetics

Born and raised in California, Lee wanted to stay there. He went to UC Davis for undergrad, had a good Science GPA, but got some really bad advice. In fact, it was what led him down the road to eventually create Student Doctor Network.

At that time, he was struggling with Genetics and decided to drop out of the class so he got an F. The advice he got from other people was not to worry about an F as they're going to drop it from the GPA calculation and could just retake it and get an A and everything is going to be fine. Of course, that was a terrible advice.

So his GPA and MCAT scores were pretty good but not good enough to get into a UC program. Consequently, he got advice to look to DO schools. He wasn't aware of it and so he tried to research it. But understand this was before the internet days so there wasn't much information out there. He went to the school and took a look at it and thought it was legit with a solid core program. He also saw that their graduates had very good residency slots. Hence, he went with such school, especially knowing he would stay in CA and had a good primary care program.

[12:15] Osteopathic Manipulative Technique (OMT) in Practice

Lee admits to not doing OMT in his practice. He thinks it's great but it's something you have to do constantly.

"You always have to be practicing to maintain your skills and if you don't continuously practice it, then you're going to lose it."

When he went into his own practice back in 2000, he just didn't put the effort into continuing to maintain the skill. And it was something he actually regrets. He currently works full-time with the army. When he was working with pilots, they didn't want to take any medication otherwise it grounds them so they really want osteopathic manipulation as they could feel good without taking any medicine. So a good DO who keeps on top of their OMT schools can really do absolute magic.

[13:45] Getting Into the Military and Watching the Saddam Trial

Back during his residency in Downey as an intern, he considered himself dirt poor and buried in student loans and car payment. He was having a hard time making ends meet. Then he got recruited and in return, he had to give a certain number of years back once graduating from residency. While in residency, you don't have to serve any time at all. To him, this sounded like a pretty good deal. He got to serve the military while getting some financial help which he desperately needed. So he got money for the next three years of his residency. And when he graduated in 2000, he owed two years in the reserves for every one year he took a paycheck from the army, 6 years in total.

After 9/11, everything in the military just completely changed. The reserves had a large chunk of army's medical capability so physicians were being deployed on a fairly routine basis. Instead of getting deployed in Iraq, they ended up sitting at Fort Lewis, WA. Following that, he went back to his practice in CA. He then decided to finish his six years until he got called up again in 2005 for a routine rotation and served at a combat hospital in Iraq for four months. Plus, he got to watch the Saddam trial and being the physician there in case something happened. Because of this, he considered staying in the army for longer. And ultimately, it was something he wanted and decided to do it full-time, being able to make a huge difference serving the country taking care of soldiers and their families versus treating patients back home. So in 2009, he went full-time with the Army Reserves in North Carolina and in 2011, an active component and ultimately volunteered in the Air Force infantry division for two years. Then he spent a year in Kansas and four years in Korea. Now, he's in Fort Brooke, Louisiana serving at a combat support hospital.

"That was really something to be there and watch history in front of you, not be a part of it, but just watch it."

[23:10] From a Need for Money to Finding His Calling in Life

What Lee appreciates as a physician is it's a single healthcare system. Having to deal with different insurers, you can't order some of the tests you had to order, it could be frustrating. Not to mention all the amount of paperwork and effort, it would just crush your soul. And he felt it got worse and worse every year he was in private practice.

But being in the military work with a single healthcare system, you can order what you need to order and get the medications you need to get. And Lee finds this to be very refreshing.

[24:24] The Impetus for Student Doctor Network

Back in 1993 as Lee started medical school, there were 17 osteopathic medical schools across the country. And they had no idea what issues these schools had. As he and his friend met people at conferences and other events, they decided to publish a newspaper, The Osteopathic Pulse in 1994. It had articles from each of the different osteopathic schools in the country and they distributed it for free to all the schools. Basically, it reached the first and second-year students since the third and fourth-year people were on rotation.

By 1996, they figured out how the internet worked and all those stuff. He learned how to do HTML programming and took all the articles from the newspaper and put them into the internet so the third and fourth-year people could see it online.

They also had a chatroom and a forum back in 1997-1998, where everytime you updated a page, it created a new page in and of itself. So there wasn't any database. And everything just evolved from there.

By 1997 as he was graduating from medical school, they weren't doing the newspaper anymore but he continued developing stuff on the internet. They sought to create quality content about other schools and interesting stuff. At that time, there were only 2-3 websites for medical students and dental students, whom he got together with online. They decided to create one thing for everybody, hence, they created the Student Doctor Network.

They weren't that focused on the forum, but on everything else like how to get into medical school or dental school, articles, etc. So the forum was just an afterthought. But over time, in 2001-2002, the forum just got bigger and bigger (now with over 3,000 members), that people would now equate SDN to forums and not the other components of the site.

"It was the one place where people could go and get advice or do peer-to-peer support. It was a lot of fun. It was a meek community. And over the years, it just got bigger and bigger."

As Lee mentioned earlier, this was born out of a crappy advice he got from other friends and over time, that kind of drove what they were doing in making sure they had good, reliable information, along with peer support through the forums.

[30:30] The Evolution of SDN

Lee describes how the internet has dramatically changed over the last 20 years. In the early days, they would just have 40 up to 200 people in the forum. It was quite slow. But it has changed the dynamics of how people relate to each other on the internet. Back in the days, people weren't as jaded as they are now. It was a very positive community. But it has changed a lot over the years.

As to when he noticed this change from being collaborative to more of the trolling and heated flame wars, Lee would describe it like a boiling frog syndrome, where you just kind of sit there and not notice it. The culture changed gradually. It wasn't like an overnight thing. But he didn't see it until around 2008-2009. And he wasn't quite sure whether it was related to the economy, generation shift, etc.

"People had the anonymity of the keyboard and gotten into bad places where they wouldn't have gone had they not had that same level of anonymity."

Additionally, he noticed that more people came on the internet and things became even more anonymous. People had the anonymity of the keyboard and gotten into bad places where they wouldn't have gone had they not had that same level of anonymity.

At that time, SDN had old rules where that if users don't want to be moderated, they'd just leave them alone. And if something really gets out of hand and they'll go in there. But usually, the forums would take care of themselves. And it worked pretty well. Then again back in 2008-2010, they began to see a shift where self-regulation wasn't happening as much anymore. And for some reason, people were no longer using the "report the post" button as much as Lee would have wanted. So in a way, it was like people just expected that behavior and tolerated it. And Lee admits he's sad to see where they are as a whole as a nation and across the internet globally that they are having all this negative discourse so frequently in public forums. Presently, at SDN, they had changed their moderation over the past few years, from being hands off to really keeping a close eye on what people are saying. They've begun being aggressive in getting in and removing people who were being negative, trolling, etc. So they had to change the way they moderated.

"It's sad to see where we are, as a whole, as a nation, or across the internet globally that we have such a negative discourse so frequently in public forums."

Lee saddened by all the negativity right now but if they really wanted to provide free information to students and have a place for them to support each other, then they knew they wanted to provide that protective environment.

[36:25] A Little Back Story of How MSHQ Began

I started the Medical School Headquarters in 2012 for the reason Lee started SDN because of poor premed advising but also because SDN back then was the negative place for information. So when I started it, my goal was if I could take one person who goes on SDN and reads something or asks a question and gets answers back and think they can never become a physician and discouraged, I want to put out information to show them that they can no matter what, although it's not going to be that easy and it may take longer.

So what has now become my life's work was a result of the downturn of the forums in SDN and all the negativity that was around. So I'm thankful for SDN as I wouldn't have been here if not for that loose moderation. It's funny how all this have come full circle.

Lee adds that other forums have popped up over the next few years and branched out because they felt SDN was negative. To some degree, things were negative back in 2010. By taking SDN on a balance, Lee would beg to disagree that by and large, the information was very positive and people were very supportive.

He goes on to say that Reddit even has an interesting way of having this bias forum based on up and down votes, which SDN doesn't have to prevent any bias. But human nature is that you're going to lock on to those one or two negative posts out of the 20 positive ones. But they've been working with individuals who would give truthful advice in a way that doesn't crush a soul and they've been doing this for the past couple of years.

[41:30] A Soul Crushing Example

One of my favorite threads on SDN was from a student I did some mock interviews with. The student got kicked out of his undergrad 20 years ago and finally realized he wanted to be a physician. After he got his acceptance to an allopathic medical school, he went to SDN for some reason and presented his stats and asked what he would do. The response would be that he'd have slim to none chance. But one response he got who was supposedly a faculty member, advised him not to go through this career path. So this was like the core of what SDN used to be.

So I raised the question to Lee whether this kind of reply would now be moderated. He explains that if the statement was honest and reasonable, then it would stay up. But if someone was trying to be a jerk and trying to crush somebody's soul, then this would not be tolerated. Hence, it's a case by case basis.

[44:00] Osteopathic Bashing

As an osteopath himself, Lee thinks that the bashing going on right now against osteopaths is because of insecurity. And people can get really fired up, even going back to the early days of SDN, that he even had to post telling them that regardless of them picking MD or DO, it really doesn't matter. Just do whatever is right for you. We don't need to have these MD vs DO discussions. They don't provide any value. Lee says he never had a problem as a DO since graduating in residency. So he couldn't really figure out why people have this kind of discussion at all.

"People don't really care about what your degree is, what they care about is what their friends said about you."

[47:05] The Future of SDN and How You Should Use the Forums

Lee reiterated that SDN was created to provide good quality information and to help students as they go through their journey from high school all the way to residency. It's a nonprofit organization so they're not getting any money from it. But they want to remain true to their mission of providing good quality content to help students make good decisions.

And so Lee reached out to me about a month ago in the hope of being able to work together, along with other organizations that provide good quality and free information to students.

Lee recommends to students trying to dip their toes into the SDN site, is that first, be open to what people are saying. But on the flip side, if somebody says something you don't agree with, just ignore them and drive on.

Second, if you see something you think is inappropriate or condescending or just not a part of a community you don't want to be a part of, then press that Report Post button. That way, the moderators can get in there and take care of it. They have about 60 moderators and there are millions of posts, so they can't look over every single post everyday. So they're relying on their community to give them a heads up when there's something inappropriate.

"Take everything with a grain of salt and don't engage with somebody and try to have a flame war. Just respectfully disagree. And if you see somebody being an absolute jerk, please report them so our moderators can get in there and take care of that."

[51:00] More SDN Projects to Check Out!

Lee says that although the forums are the biggest part of the site now, his passion is really in creating all these other free areas such as the StudySchedule, that gives you free and customized study plan. Another is the Scutwork, where people get to post reviews of the different residency programs. Review2.com is another project where they've taken reviews from Yelp, Google, and their own database. So if you take the MCAT, PCAT, or DAT, simply pick up which exam to take, which center, state, city, and it will show you a compiled report of all the different reviews from previous test-takers. This way, people can make a decision whether they want to take that test in that particular center or not.

Interview Feedback is another one of the key components of the SDN site where students provide feedback on their interviews and school experiences to help other students.

LizzyM Score Calculator is a tool where you enter your numbers and it will generate which schools are in the zone you select. Then you're provided with a list of schools you can look at.

Medical Specialty Selector is another tool that provides helps students find a residency match based on their interests, abilities, and personality.

The SDN Experts tab will let you post any question and their experts will respond. There's also the Application Cost Calculator that gives does the calculation of what you might be spending and how much you need to budget for your medical school interviews.

[56:00] About the LizzyM Score

I believe there's a huge pushback against things like LizzyM because it's taking the "holistic" view out of the admissions process from a premed's perspective. And the premed is told that information just based on stats. And the schools that may be a great fit for the student aren't getting to see that student's application because LizzyM said the student didn't have a chance there.

Lee thinks this is a valid point. However, he adds that as long as medical schools continue to use systems that automatically screen people based on GPA and MCAT score, then LizzyM score is going to continue to be pretty valid. This is based on years of evidence. But that being said, Lee insists people should do what they want to do. It's just an option they provide if you don't have a lot of money and you can't spread yourself across every single school application. So here's where you're going to be best targeting. So this is what it's best used for.

"People should do what they want to do. This is not the AAMC telling somebody this is where you need to apply."

[58:25] Final Words of Wisdom

Lee welcomes everyone to use the site. As a nonprofit organization, they're completely free. It's entirely supported by the ads you see on the site. Whether they have the forums or not, Lee says they're there to help students achieve their dreams. Don't get wrapped around the axle based on one or two posts that you see on an anonymous forum. Take it as a whole.

"Look at all the other resources that we offer and understand where you fit in that bigger picture."

Links:

MedEd Media Network

Student Doctor Network

StudySchedule

Scutwork

Review2.com

Interview Feedback

LizzyM Score Calculator

Medical Specialty Selector

SDN Experts

Application Cost Calculator

Oct 10, 2018
306: Introduction to Premed Diaries: Helping Premeds with Burnout
21:55

Session 306

The is the very first episode of Premed Diaries, a podcast dedicated to you. With Dr. Allison Gray as the host, you are the featured guest by calling 1-833-MY-DIARY.

This is actually part of the series of podcast, called MedDiaries. The podcast played here today, is Episode 1 of the Premed Diaries. MedDiaries will have four new podcasts including the Premed Diaries, Med Student Diaries, Resident Diaries, and Physician Diaries.

Call 1-833-MY-DIARY, leave your voicemail, and share your thoughts with us for 30 minutes. Talk about your struggles and successes at any stage of your journey. We're also going to have feedback shows. Just call the toll-free number and press #5 for leaving your feedback. (1 is Premed Diaries, 2 - Med Student, 3 - Resident, 4- Physician Diaries, 5 - Feedback). All our episodes are part of the MedEd Media Network. Be sure to take a listen to all our other podcasts.

Ready?

[03:00] The Premed Diaries Episode 01

Hi! I'm Dr. Allison Gray. This is our first episode of the Premed Diaries. We created this podcast, along with the other Med Diaries podcast so physicians and physicians in training could have a place to speak their minds, vent, unload, and hear one another in support and solidarity.

The premed journey is not easy and there are many stressors, roadblocks, and frustrations. But there are also incredible joys, like that first time you got to shadow a physician or that first interview offer, or that first acceptance to medical school.

Here at Premed Diaries, we want to help you on this journey to avoid and deal with burnout - an ever growing threat and serious problem for our physician community. And as a premed student, it's never too early to start.

In each episode, we will hear from a premed student and I'll share some of my thoughts as well. You may also hear from others who have called and left a response for the caller on a previous episode.

Today, we will hear from a premed student who is dealing with lots of stress and the feeling of needing to be his best in every endeavor and how this is very emotionally draining.

[04:15] Caller #1: Feeling the Stress and Pressure

Our student today transitioned out of the military in 2016. He went to a premed school following his transition, which he considers as an enormous blessing in his life, and one of the most convincing factors for him to pursue medicine.

Right now, he's been dealing with a lot of stress and pressure. He finds it very difficult to convey to the people in his life that things are high-stakes for him. He is working as a paramedic and since then, things feel high-stakes. He expresses the feelings of pressure to get a 4.0 and do well on the MCAT. Alongside, he's also starting his own podcast.

"It's a lot to deal with at once."

He is working in the emergency department so he gets cases that affect him from time to time. So going and bouncing back from school being so high-stakes to showing up to work and feeling like he needs to be perfect for the sake of the patients, he sees this as a very emotionally draining process.

"I feel like everything hangs on a really delicate balance, too. When I go to class, there's pressure to do the best, to be the best, and you still have to show up to work the next day and take care of patients."

Not to mention, he has to take care of his family and dealing with being a former veteran along with all the stuff that goes with that. He admits dealing with a lot of stress and anxiety on almost a daily basis. He's trying to manage all these different things at once. He feels like he never takes a break.

Fortunately, listening to The Premed Years podcast and the OldPreMeds Podcast  has been therapeutic for him, which he does on his commute to work and school. He still finds it hard for people in his life to realize this. Although he feels so blessed with the podcast they're starting and with him doing well in school, but that doesn't discount the daily grind that can really get at you.

He encourages people out there to segment your time as best as you can and take things one at a time. Just keep going and find a little bit of peace and solitude in what you're doing. It's impactful and important to the people who are affected by it. See the bigger picture and things will pan out.

"Everything is hanging in such a delicate balance that you feel like you need extra hands and another brain in order to manage it all."

Finally, our caller feels great being able to send out this recording since he was able to get all this off his chest. As his way to manage things, he has had a lot of personal growth on time management and dealing with stress, grief, etc. And he hopes all this would help him carry through to medical school and residency, and hopefully become an attending physician. All the skills he learned as a paramedic, in the military, and during training will all be a driving factor.

[11:09] Share Your Thoughts With Us!

If you also want to share your thoughts with us, call 1-833-MYDIARY and you also can do so anonymously. We would love to hear what you have to say!

[11:40] It's a High-Stakes Game

Our caller has touched on so many great things many premeds are struggling with. First, is the high-stakes game of being a premed student. There so many pressures you're all dealing with. You could be looking for someone to shadow with or that you're trying to pay your bills. Or maybe, you're changing your career and you still have to take care of your family. You may be a college student and you're also paying your bills. Many of you could probably relate to this high-stakes feeling.

"There are so many stressors out there as a premed and it feels really high-stakes because you feel like you can't really do a crappy job at any of it."

[12:42] Family and Friends Not Getting It

This is an important thing to recognize and acknowledge. Your family and your friends are your biggest fans and heroes and they're rooting for you. But the reality is that a lot of times, they really can't understand what you're experiencing. This is true as a premed student, and more so as you get into medical school and then eventually becoming a physician.

"Your family and your friends are your biggest fans and heroes and they're rooting for you. But the reality is that a lot of times, they really can't understand what you're experiencing."

Our caller is already a paramedics so he has experience working with patients and working in a very busy environment. So this already shows him how difficult it is. Seeing patients in life-threatening situations and having to be on is a hard thing to do, regardless of your role in healthcare.  This is really tough.

And trying to explain what this is like and articulating it in a way that a family member or a friend can really understand when they don't live in that world is really hard.

Fast-forward when you're on the wards. It's very hard for people not working in health care to understand the pressure you're under. These hard situations where patients are dying or dealing with incredibly difficult diagnoses.

So try as best as you can to vent and talk to your family and your friends. And if they don't get it, then they don't. Good thing you have peers you're going through things with. And they get it a lot more than others. They may not have the close relationships yet as you do with your family and friends but they do get it.

[15:00] Needing to Be Perfect

We can never be perfect. Physicians and physicians in training, we hold ourselves to this incredible expectations. We think that we really have to be perfect but the reality is that we are human. Being human means that we make mistakes. It's impossible for us to be 100% all the time. We can really only do the best we can.

"The reality is we are humans and being humans means that we do make mistakes."

That's something I have really tried to keep in the back of my mind all these years, that I'm doing the very BEST that I can. And as long as I'm doing that, then I feel ethically and morally grounded. That if it's not perfect and I make mistakes along the way, at least I'm doing the best I can. So you have to keep this in your mind as well.

[15:54] Use Your Resources and Take a Little Break

Listening to resources like podcasts such as The Premed Years podcast and the OldPreMeds Podcast  is HUGE, especially when you're feeling that you don't get a break and that you're doing so many different things. It's really important to find anything that gives you a little bit of a break, even if it's just for 20 minutes. Find a TV show you love or sing really loudly in the car. Listen to a podcast that inspires or encourages you. Go to the gym.

It's hard to make time for that but a little bit of that even if it's just for 5-10 minutes can get your mind back on task and give you that encouragement you need to keep going when you're feeling really worn out and spent. So use your resources and lean on other people as you can.

If somebody offers to make you a meal, take them up on it. If somebody offers to watch your kids, take them up on it.

"Just find a little bit of time, even for 20 minutes to get a breath of fresh air so that it can feel like you're getting at least a tiny break."

[17:22] Take Your Time and Growth Coming from Pain

With all things in general, it's okay to step back and just focus on one thing at a time. If you have kids, you can't just focus on premed stuff because they need your help or you need to make them dinner. But this is an idea in general, where if you have so many different things you're focusing on, in any one minute, try to just focus on one thing. It can help to just step back.

It's a cliche that what doesn't kill you makes you stronger, but that's true. There's so much growth you will see as a premed and as a med student. Your capacity to just take on will just expand. It has to. Your body and your brain just adopt as you have to take on more and more. So you grow ever more. This concept that as painful as it might be to grow from that and not letting it stop you is huge.

Lastly, encouraging your peers is huge. As what Ryan's mantra is, collaboration, not competition. So encourage your peers no matter what phase you're at.

[19:00] Get Things Off Your Chest

This is why we're here. We want to give you the freedom and encouragement to reach out and call so you can get things off your chest. I'm here to support you and offer some thoughts every week. This is a great way for us to all support one another.

[20:00] Respond to Our First Caller

Call 1-833-MYDIARY and let us know you're calling in response to this. I will play your response on subsequent episodes.

Thank you for joining us on this first episode everyone! As you move through this journey, listen to this podcast along with all out other series. Let's support one another in fighting this very scary and serious problem we have in this world of burnout.

Links:

Call 1-833-MYDIARY and share your thoughts with us!

MedDiaries.com

OldPreMeds Podcast

MedEd Media Network

Oct 03, 2018
305: Instagram Q&A: Deferring, Nursing Majors, LORs and More!
16:28

Session 305

I had so much fun the last time we did an Instagram Q&A, that I decided to bring it back! We had a ton of great questions, and hopefully some good answers!

And if you’re looking for more resources to help you on your medical school journey, check out MedEd Media Network to listen to all our other episodes. Ask Dr. Gray: Premed Q&A follows a question and answer format taken from Facebook Live and I'm trying to figure out where I can use these IG Q&As and integrate those into this podcast.

The OldPreMeds Podcast is another Q&A type of podcast for nontrad premeds where the questions are taken directly from the Nontrad Premed Forum.

The MCAT Podcast is something I do with Next Step Test Prep. If you're looking to get into the MCAT and getting study materials, tutoring, or an MCAT course, check them out and use the promo code MSHQ to save some money.

Specialty Stories is an interview type podcast where we feature physicians from every specialty to help you give an idea of specialties are currently available.

New podcasts coming up! Stay tuned for the Step 1 / Level 1 podcast for medical students. So here, we're taking you from your premed to your med school years. Plus, another MCAT-related podcast that we will be releasing soon.

So this week, we're bringing in questions from Instagram. And if you haven't yet, follow me on Instagram @medicalschoolhq or send me an email at ryan@medicalschoolhq.net.

[04:27] MCAT Questions

Q: Where can I find a good source of practice questions for the MCAT?

A: Next Step Test Prep is where you want to go. They have QBanks and full-length exams. In fact, the feedback I usually get from students is that it's the second best, next to the AAMC materials. Use the promo code MSHQ to save some money. They also have an MCAT course, books, etc.

Q: When should I take the MCAT? Junior year?

A: Taking the MCAT is a tricky proposition. It's usually the year before you plan to start med school. Ideally, you take it in March or April of the year you're going to apply so you have enough time to get your score back then you know what you're applying with. Taking it later may delay your application and may ruin your chances of getting in because you didn't get the score you want. So this is usually the year before you start medical school.

[06:20] Keeping in the Know

Q: If you could tell a student to research one current health topic or interviews, what would it be?

A: You need to be aware of everything that's going on. You need to be aware of what's going on right now with Judge Kavanaugh and his nomination for the Supreme Court because that affects Roe v Wade and abortion. You need to be aware of what's going on with euthanasia and marijuana laws. The student in California was just allowed to go to school with epilepsy with her marijuana. So you need to know it all.

"I wouldn't recommend just knowing one thing. I would recommend knowing it all. So stay in contact with all of the news sites with what's going on in the world."

[07:12] Reaching Out to Medical Schools

Q: Tips on reaching out, making connection with schools before one applies in May?

A: Reach out to med schools before you apply. However, don't reach out with stupid questions but with thoughtful things. Tell them who you are and ask them what they think. Make sure you have a thought-out question and ask for a specific advice on something. Reaching out to med schools is very important. Don't do it after you've applied as it may be a bit too late. Really be thoughtful and reach out to schools you want to go to, especially if you're struggling with something. Ask them what they recommend to help you become more competitive at their school.

"Reach out to med schools before you apply."

[08:20] A Question on Self-Awareness

Q: At what point do I have to realize that premed is not for me if I can't do well in 100 level classes?

A: The question is why are you not doing well? Are you doing poorly because you're not studying properly? Or because you're bored or because you don't like it? You have to figure out what is the problem and from that point forward, figure out if this is something you still want to do. If this is what you want to do, you figure it out. Ask for help. Get a tutor. Exhaust all of your resources - again, only if this is what you want to do. If you're not sure, then move on.

[09:14] Don't Play It Safe

Q: What are your thoughts on taking bio electives that interest me vs. not risking taking a hit to the science GPA?

A: Take the classes that you enjoy and do well in them. If you do poorly in them, then it's going to obviously take a hit to your science GPA. But take the classes you want to hear and don't play it safe.

[09:40] Different Kinds of Curriculum

Q: Please go over the different kinds of curriculum.

A: When it comes to medical school curriculums, there's the traditional curriculum, which is all of the individual courses. There's also the systems-based curriculum where you learn the cardiovascular system and anatomy, physiology, pathophysiology, pharmacology - all in one. Or there are problem-based learnings and lots of other curriculums. So just go out there and look at the different schools you're interested in to see what kind of curriculums they have.

[10:20] Letters of Recommendation

Q: How early should you request a letter of recommendation? For example, I asked a professor last semester and they want to send in through TMDSAS or AMCAS, but you're not applying until 2019. What do you do with those letters of recommendation that you get early? I don't trust to wait until the application season opens. They act like they don't want to hand you the letter of recommendation personally.

A: You can't ask for a letter of recommendation too early especially if they're going to send it in directly to the application services. You can only send to the application services the year you're applying. You can use a service like Interfolio and have the letter stored there. But it's always ideal to have those letters dated the year that you're applying. So talk to the professor and let him/her know that you're going to want a letter of recommendation and you stay in touch with them. Keep them updated on what you're doing. Then when you're ready, ask for that letter.

"You can't ask for a letter of recommendation too early especially if they're going to send it in directly to the application services."

[11:30] Secondary Applications

Q: More detailed advice for secondary applications?

A: Secondary applications are pretty easy. You just have to answer the question being asked of you. There's a lot of questions and essays to write, but just answer the question and don't overthink it.

[12:00] Prereqs, Deferring a Year, and Favorite Color

Q: How hard would medical school prereqs be coming from a recently graduated nursing degree?

A: It all depends on who you are. Every student is going to be different. Your prereqs are going to be different. It just depends on your level of comfort with those science classes and how well you did in your nursing degree to determine how well you're going to do in your prereqs.

Q: What do medical schools think about deferring for a year?

A: Every school is going to be different, you just have to have a good reason why.

Q: What's your favorite color?

A: My favorite color is blue. What's yours?

[13:00] Medical Assisting: Shadowing or Clinical Experience?

Q: Is a medical assisting a good job for a gap year and doesn't count as shadowing hours?

A: Medical assisting does not count as shadowing hours. While you are working, you may potentially get shadowing hours in there. But the actual work of medical assisting is a clinical experience. And yes, it's a great job!

[13:20] Chronic Illnesses and Disability

Q: For someone with chronic illness who's applying to med school, how should they approach this topic in their applications?

A: Avoid talking about it as much as possible. You don't want to give medical schools any easy reason to automatically reject you to put your application in the "do not interview" pile. So tread lightly.

[13:50] Personal Statement

Q: What do I do if I feel like I don't have a compelling story for my personal statement?

A: Step one, go buy The Premed Playbook: Guide to the Medical School Personal Statement and get that out of your head that you don't have a compelling story. Because ultimately, your job is to not have a compelling story, but just to talk about why you want to be a physician.

"Your job is to not have a compelling story, but just to talk about why you want to be a physician."

[14:25] Long Undergrad Years

Q: Does it matter if you graduate in more than four years and how to make up for that?

A: There's really nothing to make up for. Take as much time as you want and need. There is no right answer to how long it takes to finish your undergrad.

Links:

MedEd Media Network

OldPreMeds Podcast

Ask Dr. Gray: Premed Q&A

Nontrad Premed Forum

The MCAT Podcast

Next Step Test Prep (promo code: MSHQ)

Specialty Stories

Follow me on Instagram @medicalschoolhq

Interfolio

The Premed Playbook: Guide to the Medical School Personal Statement

The Premed Playbook: Guide to the Medical School Interview

ryan@medicalschoolhq.net

Sep 26, 2018
304: How to Choose a Medical School & Put Together a School List
53:26

Session 304

This will hopefully be the most in-depth look at what medical schools you should apply to. Putting together your school list is an important part of your app. So how do you create your medical school list?

Meanwhile, be sure to check out all our other podcasts on MedEd Media Network to help you along your medical school application journey!

[03:00] The Don'ts When Choosing Medical Schools

Don't look at your GPA and MCAT scores. Sure you need to understand to understand the key schools you're applying to but creating a full school list is the last thing you need to do. Why? Because it can be distracting. You can be tied up into so many details at such an early point in the process when you should only be focusing on personal statement, ECs and so much more.

Don't think that you're only applying to MD schools or only to DO schools. If you want to be a physician then apply to both since this increases your odds of getting into a medical school.

Don’t apply to more than 30 schools. The average number of schools students apply to is 14 for AMCAS (for MD schools) and 9 for AACOMAS (DO schools). This is outside of the public schools in Texas since they have a different application system. I personally don't know the average for Texas schools but I'm assuming it's around 9 as well. So how many schools do you need to apply to? Well, it depends on your budget and how many schools you want to apply to. It depends on how many secondaries you want to write or how many interviews you want to go to. Check out this medical school application cost estimator to help give you an idea of how much you might be spending when applying to medical schools.

So the average number of total schools you can apply to is around 23, but I wouldn't really recommend applying to more than 30. Sure, it could be easy clicking all those buttons, but the hard work comes on the back end once all those secondaries start coming in. And you realize you don't have enough time to write all those essays. That's a waste of money especially if you have do not have the intention of filling out those secondaries since you're overwhelmed with all the others.

Moreover, you have to understand that secondaries come in in one big rush (except for those schools that will screen their secondaries). But this is the scenario for the majority of the schools. And you've got to turn them around as fast as you can. It's therefore recommended that you pre-write your secondaries. Another thing to consider is if you're able to follow through with all those secondaries if you are invited for an interview. So there is a lot of what if's when applying to that many schools.

[13:05] Narrowing Down Your School List

Most students look at their MCAT and GPA so they're going to look at the MSAR (Medical School Admissions Requirements), an AAMC tool that you pay for. You sign up for an account there and then input your scores. Then you'd see that you fall short of the average scores on a particular school and you decide you shouldn't apply since your score is below their average. However, that is not their average.

The number you're looking at on the MSAR is the median number - half of the class is below it, half of the class is above it. If half of the class is below that number, why would you not apply if your number is below that median number? What this means is that half of the students who are already at that medical school have scores that are also below their median number. And when you’re looking at the median score, that’s doesn’t really matter.

"Do not use MCAT and GPA to narrow down your list."

Moreover, don't assume that you can't get into any of these schools for whatever reason. These schools are putting together a community of students they're hoping will mesh together well for the next four years of their lives. So there could be something in your application that the admissions committee is looking for such as your background and experience. And who knows, you could get invited for an interview. Your chance of getting into a school that you don't apply to is zero percent. But if you apply then it's more than that.

"Don't assume you can't get into any school because there's always, always a chance."

[17:10] Tiers and Safe Schools

If you've gone to SDN or Reddit, you might find that students talk about tiers in medical schools. That is a premed tier system. When you're applying to residencies, medical schools will only matter a little bit. Instead, YOU matter. You, as the student, matter - board scores and your performance in your rotations and electives, not the school name.

Are there great medical schools? Sure. And they're hard to get into. But are they going to teach you more than any other medical school? No. They may offer you more experiences and different exposure to things. Hence, don't look at a list based on what are some high tiers or mid or low tiers. That's just a premed thing so don't worry about that.

"What you learn is on your own. Knowledge is a commodity. That knowledge is everywhere now with the internet. There are no tiers when applying to medical schools."

On that same count, there is no such thing as safe schools. Of course, you have to be realistic. You need to have some basis in reality and some level of competitiveness to assess your GPA based on all matriculants last year. Have some knowledge of that as you're looking around and thinking through these things. But that shouldn't be the end all and be all. Getting into a medical school is hard no matter what school you're applying to.

[21:05] The Match List

The match for the medical school should have no bearing on whether or not you apply to that medical school. You might see schools and wonder why the match rate for a certain specialty is so high, but the question is why. Correlation, not causation. Is there an amazing attending physician at that medical school that gets a ton of people excited about it and writes amazing letters of recommendation? So you don't really know the circumstances behind that match list.

The student, and not the school, matches. Your board scores, which is how well you do on your national board exams will determine your ability to rank. Your performance will determine if you will rank and match at these programs.

"The student, and not the school, matches... Your performance will determine if you will rank and match at these programs."

So don't just look at the match list when choosing your schools and basing it on how popular the match rate of a certain specialty is. Again, you don't know what's happening behind the scenes that are dictating these numbers. What matters is your performance and your board scores.

[25:00] Beware of Tools Predicting Your Application Chances

There are tools out there that would predict your chances of getting into a medical school. If you do, look at it with a HUGE grain of salt.

"No tool will predict your chances of getting into medical school."

There is no tool that can predict your chances of getting into medical school, no matter what kind of information you give them. What it's doing is showing you past data as to who got in last year or the year before that.

[26:04] Things to Consider When Choosing Medical Schools

"Don't go to a great medical school. Go to a medical school that will make you great."

Location

Where is it located? Is it close to family or far away? Or do you want to be away from them? Or do you want to be near them to get that support structure? So find a map of medical schools in the country. See where the medical schools are clustered around and find those areas where you want to be. Look at the weather.

Class Size & Curriculum

Are you looking for a more intimate relationship with your classmates? Or are you looking for a lot of opportunities to meet new friends? What's the curriculum? Is it problem-based learning or systems-based? Be true to who you are to determine what you want and where you think you will thrive.

Residency programs

Data shows that about 75% of the students who go to medical schools thinking about a particular specialty will change their mind. So now let's say you go through the process and pick your school based on the match list or access to a residency program. Then you get to a medical school and you start your required rotations in your third year and you realize it's not what you really want and you want something else. But then the residency program of that specialty that you now like at that hospital is not really good. What do you do?

Again, when picking medical schools based on potential residency, don't do it from a match list perspective. Instead, look at the proximities of that medical school to where those teaching hospitals and programs are.

Tuition

Tuition would fall at the very end. In fact, tuition is really only there if you're looking at multiple medical school acceptances. See if you can have financial aid packages and compare them. Try to pit them against each other so they can throw more money at you. But right off the bat, don't use tuition as your basis for choosing medical schools.

"Don't look at tuition until you have multiple acceptances."

[32:37] State Residency

If you're a California resident applying to California public schools, there's the in-state residency. And most public state schools will have preference for their in-state applicants. There are some private schools that have preference for their in-state applicants, but not all.

So if you're a California resident applying to the University of Colorado, you're at a lower chance of getting into Colorado because you are an out-of-state applicant. If you're an out-of-state applicant, ask yourself why you're applying to this public out-of-state school? Figure if you have ties to the state or the school. If you don't have either of those things, why are you applying? Otherwise, you better have really solid stats.

"You better have really good stats for an out-of-state applicant."

Out-of-state tuition depending on where you go may take a year and it's usually substantially more than an in-state. For most states, the state is subsidizing the in-state students. And as an out-of-state student, you are not being subsidized so you are paying the difference of what the state was paying for medical school. You're not necessarily paying more for medical school but you're just paying what the state was paying for the other students who are in-state.

All this being said, don't apply to a lot of out-of-state public schools because the chances of getting into the school are generally a lot lower. Now, this is where the MSAR comes handy because it shows you the number of in-state applicants, out-of-state applicants, acceptance levels, etc. The MSAR is for the MD schools while the CIB (College Information Book) is for DO schools, but it's not as data-rich as the MSAR.

[36:36] Q&A Portion

Q: How do you choose a medical school and how do you really have time to research?

A: You make the time to research for medical school.

Q: Are state schools easier to get into than out-of-state schools?

A: They're not easier to get into but they give you preference if you're an in-state applicant. Some schools have a rule that they will interview every in-state applicant.

Q: What are the different types of teaching styles that medical schools have?

A: There's the traditional curriculum, system-based curriculum, problem-based learning, split classrooms, and more. So research what you like. Some schools have different tracks and they'd ask you which track you prefer.

Q: Should I do the TCOM early decision program?

A: Applying an early decision program is not advisable unless you have really good stats and very super strong ties to that medical school. Otherwise, it's more of a risk than it is a benefit.

Q: How should those with children search out more family-friendly schools?

A: Go on to different forums and ask those questions. Find students at those schools and ask those questions.

Q: How should we consider the support and prep offered for Step 1 when choosing a school?

A: You don't. The school may give you six weeks of prep or they may pay for different prep materials, great. But it's you who are still going to prepare for Step 1. You can pay for those on your own too if you go to a school that doesn't offer it. All schools are teaching for you to prepare for Step 1. Now, it's up to you to learn it and integrate it, act on it, and execute it on test day.

Q: What's a good strategy to shorten the list?

A: Residency, class size, location, curriculum, etc.

Q: How do you get scholarship money?

A: Hopefully, you get a financial aid package from a school. Then if you get accepted to another school that you really want to go to and they haven't offered you any financial aid package, you can tell them that another school accepted you and offered you money. Ask the school then if they can match it or if they can do better. Just have an open and honest conversation with them.

Q: What is the most important quality for selecting schools to make sure it's a good fit?

A: It's hard to judge culture and fit just by reading a website and looking at the MSAR. Unless you go to a school and their open house and talk to students, it's hard to understand what that fit will look like.

Q: Do you choose a school by ranking? What factors help you have the most success after?

A: 100% don't choose a medical school based on U.S. News and World Reports Ranking. Majority of the data they use is subjective and the rest of that data has nothing to do with the quality of the medical school.

Q: Do medical schools have preferences for certain universities?

A: There are some schools that may have preference for specific students as they may want to train students for that area who will stay in the area and provide care for patients in that area. Think of all public schools that way. That's why they have preference for in-state applicants. They want to train future physicians to treat patients in and around the area where the school is.

Q: Should you visit every school you think you may want to go to?

A: In an ideal world, yes. But realistically, you have no time to do that.

Q: What should you know about beyond the mission, curriculum, research opportunities, etc.?

A: This video will show you how to research these medical schools, where I will show you how to research on Instagram, Twitter, Facebook, and YouTube.

Q: Going to a school where rotations are at a community health center?

A: DO schools generally have rotations set up at more community-based hospitals whereas MD schools are typically at these large urban academic medical centers. Should you choose your medical school based on that? It depends on the circumstances such as whether you have a family and you'd have to consider that you have to travel a bunch when doing rotations.

Q: Should you look at whether medical schools are nontrad friendly?

A: Medical schools are looking for students to create a community in their class. So it doesn't necessarily mean they're nontrad-friendly or not.

Q: Are there med school cutoffs?

A: Medical schools have cutoffs for GPA and MCAT scores. It is worthwhile to find out what those cutoffs so you would know whether your application will be filtered out.

Q: How do you get to NYU and get free tuition?

A: You work really hard as a premed student.

Q: Should you apply to pass/fail schools?

A: A lot of medical schools are pass/fail. They don't rank their students as it's part of when you're applying to residencies and you get a dean's letter which talks about who you are. It aggregates information from the feedback on your rotations. And a lot of times, they will give a ranking of you based on your peers. Some schools are going away from that to make medical schools less competitive. That said, some pass/fail schools still rank you. It won't hurt you for residencies but they just have different ways of classifying who you are.

[50:50] Final Thoughts

Apply to medical schools or you get into 0% of medical schools you don't apply to. You don't know what the medical schools are looking for. Therefore, you should apply. Be realistic about everything, but apply. The worst thing that can happen is they tell you no. Don't be scared of rejection.

Ultimately, you won't know if you're a fit to that medical school until you go on that interview. Try to ponder on this story of a student who had a school that was last on her list, and she left that interview with that school now being her number one choice after going to the medical school, talking with the students and faculty, and seeing the culture.

Links:

MedEd Media Network

Medical School Application Cost Estimator

MSAR (Medical School Admission Requirements)

Medical School Facebook Hangout

Here’s a video of how you can research medical schools!

MedSchoolReviews.com

Sep 19, 2018
303: How Can I Prepare for the CASPer, What is CASPer and More
48:57

Session 303

Today, Dr. Kelly Dore, who is one of the brilliant minds who developed and researched CASPer, will talk about what it is, how it's scored, and hopefully, listening to this will help relieve some of your anxiety and fear over this test. Over 30 schools now in the U.S. as well as in Canada are using CASPer in place of or in addition to the secondary essays. CASPer stands for Computer-Based Assessment for Sampling Personal Characteristics.

Check out all our other podcasts on MedEd Media Network including The MCAT Podcast, where we talk about MCAT prep. The OldPreMeds Podcast is for nontrad premeds where we take questions from the forums. The Specialty Stories features physicians as they share their specialty. We also have the Short Coat Podcast from the University of Iowa Carver College of Medicine and the TMDSAS Podcast for those applying to Texas medical schools. Please help us spread the word and share this podcast to even just one person today!

[02:40] A Little Background About Kelly

Kelly is a full-time faculty member at McMaster University in the Department of Medicine and the McMaster Education Research, Innovation and Theory Program in Canada. She did her undergraduate and PhD at McMaster University, specifically in Cognitive Psychology and Health Research Methodology, where she specializes in Cognitive Psychology and Medical Education or Health Professions Education.

During her time at McMaster, she worked closely with several medical school groups. She had a role in the medical school admissions committee where she had to look at the equivalent of what would have been their secondary examination. She would look at the autobiography submissions of students who wanted to come to McMaster for medical school where they would write short essays.

"I got involved in seeing the limitations and problems with that process, trying to figure out a different way."

Seeing the limitations and problems related to the secondary essays they were giving to students, she worked with another colleague to figure out a solution that's better. Hence, CASPer was born at McMaster University.

[04:21] The Inherent Problems of Secondary Essays

"The secondaries, these references, letters, and personal statements, they just don't tell us anything about how the applicant's going to perform in the future."

When Kelly was reading the essays, she found it hard to differentiate applicants. They had probably studied the school's website so they came in so prepared to give the key talking points. So at the end of the day, it was difficult for them to identify who the applicant actually was and separate applicants from each other. This is the main reason they needed an additional piece to the process. They didn't want to eliminate applicants from the pool by just using grades because she admits their secondaries cannot really predict too much.

Kelly points out the importance of leading people with a sense of who you are and why you want to do this, not what you just think is on the website or what you googled is the right answer because this doesn't set you apart.

"Lead people with a sense of who you are and why you want to do this, not what you just think is on the website."

[07:15] Behind the CASPer Idea and Developing the Test

Kelly recalls figuring out this process began back in 2004-2005 and they didn't really implement anything at McMaster until 2010, as part of their local solution. So they took that time to figure out what the better answer would be.

First, they looked at what was going on. And at that time, they saw there was a huge push for social accountability. They wanted to ensure that people graduating were more than just competent, knowledgeable physicians, but people who could communicate with everybody. They wanted people who were the holistic practitioners who would put themselves in other people's shoes.

At that time too, Maxine Papadakis' work came out, where she did an incredible review of graduates from UCSF medical school in California. She looked at those graduates who had professionalism problems in practice. She tracked that back by looking how they were performing in school. And she found a strong correlation between those problems in training and professionalism problems in practice. So, McMaster wanted to pay attention to that. They weren't just creating an assessment of nonacademic attribute to tick a box. So they wanted to create something evidence-based so they can be informed. As a result, they were graduating practitioners who aren't just smart but who could also adapt and function within the complex healthcare environment.

"We wanted to make sure that we weren't just creating an assessment of nonacademic attribute to tick a box."

[09:45] Situational Judgment Questions vs Behavioral Descriptive Questions

Additionally, they were looking at the way they were asking questions. Kelly describes a lot of the secondaries tend to be about behavior descriptive questions, like "tell me about the time when you..." But these are questions you can easily google. And they found that those questions tend to create the superhero phenomenon. People had to create a complex scenario that they then solved. But that doesn't tell you about the applicant.

Instead, they looked at situational judgment test questions or SJTs, which unlike behavioral descriptive questions, they give you a scenario you need to respond to. This then positively levels the playing field. You're not giving an advantage to people who didn't have the opportunity to volunteer elsewhere. For instance, applicants coming out of university, even if they had no healthcare experience, could respond to these scenarios.

"You can construct these SJTs in a way that actually allows you to get a sense of the applicant and how they respond."

[11:22] Moving to an Online Model

As with the online nature of the exam, Kelly admits this has taken awhile actually. After they started to create the test in 2010, the technology was barely there to create an online platform. But they knew they needed to push this online test. But along with the high cost that comes with the idea of putting this test in a testing center, they also know they didn't want to disadvantage applicants coming from remote regions to have to travel to testing centers in major cities and have to incur hundreds or thousands of dollars in additional cost just to write a test.

They also tried audio recordings as well as having longer test times. They looked at all the nuances to try and create this final version of what they think the best CASPer test is.

[13:20] What is CASPer?

CASPer is an online, primarily video-based situational judgment test. Out of the 12 scenarios, 8 of them are video-based. You get to watch a 60- to 90-second video that presents the scenario. In the other 4 scenarios are text-based questions. After seeing the scenario, you answer three open-ended questions about your response to that particular scenario. You have 5 minutes for each scenario to type your response to the three questions. After the 5 minutes is up, it then moves you up to the next scenario.

The scenarios have been developed in a way that there's no requirement of the healthcare system. It also blinds you in terms of needing to have special knowledge or skills or access to be able to answer these. Hence, it really doesn't require any knowledge of any of the individual's schools or any of the nuances of what's expected of early medical students.

The test was developed in a way that leverages the value of a bell ringer or multiple mini interviews where you get multiple independent assessments of an applicant's performance. Kelly adds that this is great for the applicants in that your performance on one scenario has no influence over how you're going to be scored on the other scenarios. So if you feel you didn't do well on one of them, that doesn't influence any of the other scores.

So if the applicant is nervous or doesn't feel like they gave a good answer to a question, it doesn't impact you, as much as a traditional interview or panel interview where your answer to one question can actually bias the way your other responses are seen.

"Your performance on one scenario has no influence over how you're going to be scored on the other scenarios."

And because this test is done online, there is no need for students to go to a test center. The CASPer is aimed at assessing your nonacademic qualities complementary to things like GPA and MCAT, to give the admissions committees a larger sense of who you are as an applicant.

[16:00] MMI and CASPer Both Come From McMaster!

Kelly was also involved in the Multi Mini Interview at the very beginning of its implementation and development. She has also been involved in a lot of research around it subsequent to its implementation.

Their admissions chair was engaged and excited to push the envelope in terms of thinking. He wanted to make sure there was evidence behind everything they were using. That said, Kelly describes McMaster as the perfect petri dish for the development of these things. They were creative in looking at these things, aside from the like-minded individuals working there who were keen and excited to try and develop something better than the status quo.

[17:15] What They Look For in Students

Kelly explains the reason for CASPer's implementation is they want to have good psychometrically strong, evidence-based measures of cognitive ability. The wanted to have the same on the other side for these measures of nonacademic abilities. So they hope to give added value to the information you get from applicants outside their academic performance.

They can tell when somebody is strong academically, but they weren't seeing the same from a nonacademic professionalism side. Now, the degree or the nuance of that would already depend on each individual school.

"The hope is that we're bringing in applicants now who have strength in both areas."

[18:35] How CASPer is Scored

The schools would get a Z score which tells the admissions program how the applicant has scored relative to the other applicants who wrote that test. So you end up with a cumulative Z scores and profile of your applicants.

First off, they have data that demonstrates minor spelling and grammar mistakes don't count in terms of CASPer score. So this is not something to worry about, as Kelly points out. They also have information that the faster you type doesn't improve your CASPer score. They encourage you to use bullet points.

"There is no influence of minor spelling and grammar mistakes in terms of your total CASPer score."

Meanwhile, Kelly breaks down the different CASPer raters. A CASPer rater is somebody different than some admissions committees. They're not all faculty members or academics. They want to make sure their raters are representative of the population that the applicant may one day hopefully be serving when they become a health professional. This being said, their raters are a combination of demographically diverse raters - from community members to stakeholder groups, advocacy groups, faculty members. etc. The goal is they have different ages, backgrounds, and different perspectives they're bringing in.

"We want to make sure their raters are representative of the population that the applicant may one day hopefully be serving when they become a health professional."

[21:13] The Onboarding Process for the Raters

Raters would have a large onboarding process. They'd have to write their own CASPer test to give them a sense of what it's like. They're only also seeing your response to a single scenario. They'd also be given a background in theory. This will give the raters a sense of what they're looking for within that particular scenario. Kelly also reassures that in every scenario, there's no single thing they're looking for, or single right or wrong answer. They convey this both to the raters and applicants. So both applicants may say they'd do completely different things but both for very appropriate reasons. Raters are trained to know that there are diverse ways to approach the problem. It's not just what you're going to do but why you're going to engage in that course of action, which is valuable to understand.

"The value of having open-ended responses is that it's not a cookie-cutter. It's not a single type of response."

In CASPer, they're using the theory of planned behavior to try and understand the values and belief systems of the applicant. This way, it would give them a better sense of how and what the applicant is going to do in the future in these complex scenarios.

[23:40] What Are CASPer Scenarios Like?

Kelly describes a good scenario is one that she wouldn't want to answer personally since it's hard, tricky, and complex. It forces you to think through it. And the reason being is that these are the scenarios people are going to struggle with later on. The applicants are always given a role so they would know how they're supposed to engage in the scenario.

Here's one example of a scenario. Somebody is trying to return something to a store. They don't have the receipt but they need it. This is against policy. But the manager is away. Your role in the scenario is the more experienced employee. The junior employee is at the desk trying to manage the situation and the expectation of the customer who wants a refund. And it turns out she needs to buy her daughter a prescription so she needs to have a refund immediately and needs it today. She can't wait. Since it's against policy, what are you going to do? The junior employee turns to you and asks you what to do.

Then there would be three probing questions, not what you'd do in that scenario, but why. It's the process of being able to express the reasoning behind it to make sure you're not making assumptions. Additionally, this enables you to give answers they would never have thought of. This is the very reason Kelly loves open-ended responses to see the things applicants come up with.

[25:40] Fixed Response SJTs vs. Open-Ended Response

Although not in the CASPer test, other forms of SJTs would, for instance, give five options and then you'd have to rank them in terms of appropriateness. The limitation with this is that what if your answer isn't one of those. So you're forced to say this is the closest to what you would have done. So here, you're trying to read the mind again of what you think the admissions committee would want you to do. As opposed to actually talking about yourself and what you really would do. Kelly adds that raters are also able to adjust their scores. Sometimes, when you do your early scoring, you may think later on that it has to be higher. So they give raters that flexibility to go back and make sure they're rating applicants relative to each other.

"Some of these answers that we're getting blow you absolutely out of the water and shock you. But unless you came from that person's background and their context, you would never have thought of it."

[27:27] Adjusting for Individual Biases

Kelly explains there's always individual bias that's going to come into play in terms of any assessment. Even if it was just a pool of faculty members evaluating the test, there would still be a variation in their perspectives and biases.

"What they strive for as an assessment is to be as objective as possible but there's always subjectivity in everything we do."

All this being said, there's a large amount of quality assurance done at the moment for their raters. After a test has been written and sent to the raters to be scored, they also have to score a variety of CASPers that are old ones before they're actually released into the test itself. So they're not able to move on to scoring a CASPer test until they're ready and have achieved a certain level of thoughtfulness in their marking.

As part of the quality assurance, they also overserve responses to make sure their raters are scoring properly. They also look for raters who are spending enough time on responses. They also try to remediate raters who they don't think are performing well.

[29:35] Background in Theory

In helping raters with their scoring, they're given a background in theory. For example, they'd know what is hoped for to be generally covered such as empathy, communication, collaboration, or whatever the combination is for that particular scenario. They also explain why this thing is important in medicine. So they want to make sure it's not just the word "empathy" that's shining brightly to them. But they also have to understand how that plays in creating the next generation of physicians who have strong nonacademic qualities. They want applicants to always make sure they've unpacked their thinking in their response. This is one of the tips they give to each applicant.

"It's the process of knowing where these constructs fit within the bigger scheme."

[30:55] Preventing Leakage of Scenarios

Students will be made to sign a confidentiality agreement so by posting the scenarios, they would be breaching that. But if they see them posted elsewhere, they would put forward a cease and desist. Ultimately, each CASPer test is comprised of new content. So they make sure it's blueprinted to a general test pattern but each test has its unique videos, questions, etc.

So preparing for a test using old content would not help you, Kelly says. In fact, they've actually done a study around this. One year, she released four videos to everybody writing CASPer. On test day, she used two of them for their CASPer test but she changed the associated probing questions. So they had the chance to see the video but they've switched the content around. They found that applicants even did worse on those previously seen videos than they did on those they haven't seen.

"Because you only have a five-minute response time, it's very hard if you have pre-prepared responses to get that cognitive flexibility to actually answer the question."

Pre-preparing the materials actually can do you more harm than good. They encourage people that if you want to practice and take notes, feel free. But just find a quiet space. Sit back. Pay attention to the scenarios and just be yourself answering it and you're going to do better.

[34:00] Preparing for the Test: Would It Help to Go to a Test Prep Company?

In 2010, when McMaster implemented CASPer for the first time, there was already a test prep company that popped three months before. While unavoidable, they want to make sure they're able to level the playing field.

"We don't feel that there's any advantage to these coaching test prep companies, but we're going to make sure you have access to the way to prepare for the test."

On the CASPer site, when you sign up for the test, they're outlining a few things. First, as you go through the technical requirement test, it will take you to the actual CASPer test itself. There are also questions online for you to practice that are CASPer scenarios. Some scenarios she has seen from other companies are nothing like the CASPer scenarios so Kelly warns not to use those.

Kelly adds that on the actual website, you can sign up and you can take the practice test as many times as you want. This way, you can become familiar with the format, even spend a thousand hours if you want to. But Kelly suggests you write your responses then go back and look at them. Answer the response within the five-minute time constraint. Then go back and look at it and do a personal reflection on your own response.

Before you write your test, everybody gets an email about maximizing your success on CASPer. There are helpful tips they've created in terms of actual evidence they found on test. First, take the full five minutes to respond. They found that people who were only spending 3-4 minutes aren't doing as well as those spending longer on their scenario. SO make sure the full amount of test time.

They've also done a webinar to unpack some of the nuances of CASPer people can go to for helpful tips and preparation.

[36:50] The Effect of Typing Speed on Getting Their Ideas Out

Kelly explains that once people reach a certain minimum threshold, they're also looking for a Grade 7 reading level. After you hit that level, your score doesn't improve. They think it's important that when you think about not how you're saying it but what you're saying. They don't need a master's level English pros to write the test. Kelly recommends using bullet points. Just make sure you're organized in your thoughts. You can answer them in any order you want.

"Take a few moments and become familiar with the test format. Take the practice test to see what it's like to get your thoughts down."

Give yourself additional time as to what else you didn't think of within those five minutes. Again, ultimately, Kelly stresses it's finding that quiet spot to do it. And because they let the raters also take the CASPer test, they know what it's like. So don't panic if your thought gets cut off. Don't worry about it. Take a deep breath and move on to the next scenario. As previously mentioned, you have a completely unbiased rater who's ready to look at your next response.

[38:50] U.S. Medical Schools Using CASPer and Registration Basics

As of the moment, there are 35 U.S. medical schools using CASPer and they estimate that about 80% of the applicants would be writing a CASPer test. In Canada, they've got 8 of the 17 schools using CASPer. They also have a few DO programs using it as well.

[39:27] Registration Basics and Some Things to Consider

Kelly explains that there are set test windows that you can sign up for. For U.S. medicine, the test runs between May and February each year. But note particular schools you want to apply for. Some of them have smaller test windows. Make sure you're going in early and that you can write in enough time.

There are multiple test slots each month. Go in and register for a CASPer test. Create an account. If you wake up on test day and you're ill, you can reschedule your test up until you've started it. Just make sure you don't apply too late to give yourself enough window for that in case you do get sick.

Once signed up for your test window, they encourage applicants to do that technical requirements test to make sure your computer meets all the technical requirements.

Other things to think about is that when you're doing the test, make sure your family members won't be downloading videos at that particular time as well. There are also live help chats both before and during the test.

You can only write the test once a year. They've shown no advantage to writing the test multiple times. Also, your results are shared with the programs you choose to distribute it to. If you want to update that, you can always go back in. If you apply for the FAP (Fee Assistance Program), all CASPer fees are waived as well.

"You can only write the test once a year."

Generally, be sure your speakers are working, as well as your webcam since it will be turned on during the test. When you register, you're required to present a valid ID that's authenticated. Before you start your CASPer test, a photograph is taken and facial recognition software is used to make sure you are you. If you do things like wearing a hoodie or sunglasses or a mask, it won't let you start the test. Or if you do any of that during the test, the test stops since the webcam is running the whole time.

They also found no advantage to group test taking. In fact, people who had done the test previously, prefer to write it independently the next time.

[44:55] Other Things to Know About

Kelly underlines the fact that part of the reason they developed this was a sense of fairness. They didn't want to advantage people with a healthcare background, neither go through the process of double-counting. The raters wouldn't know all the other aspects of your portfolio (GPA, MCAT score, etc.) so that it's just the CASPer test they're looking at. Students usually receive their score in 2-3 weeks. The raters are all online so they complete the test online by the time they do quality assurance.

Ultimately, Kelly's advice to students who are still hesitant about taking the test is to avail yourself of all the resources to reassure yourself about the value of the test.

"The more you take a deep breath and be yourself, that's going to make you shine through in this test."

Links:

CASPer

MedEd Media Network

The MCAT Podcast

OldPreMeds Podcast

Specialty Stories

Short Coat Podcast

TMDSAS Podcast

Sep 12, 2018
302: Instagram Q&A: HPSP, Picking Med Schools, SMPs and Postbacs
26:13

Session 302

I asked on Instagram (@medicalschoolhq - follow me!) for questions for this episode. You did not disappoint! Here are some questions our students asked and I’m tackling them one by one.

Oh, and if you haven’t yet, please check out MedEd Media! We have a new podcast, the TMDSAS Podcast. The TMDSAS stands for Texas Medical and Dental School Application Service, which is the application system for the public Texas medical schools. And while you’re at it, be sure to listen to all our other podcasts to help you on your medical school journey!

[01:55] Visiting Medical Schools Prior to Application

Q: How strongly do you suggest visiting all, more than half, or at least a few medical schools before applying to them?

A: Ideally, you visit medical schools before you apply to them to get the vibe and culture of the medical school, which you can't get just by reading online.

Soon, we have a tool for you where you'd get to go to medschoolreviews.com and see medical students' reviews of their school. They can tell you the type of support they have as well as their culture and everything else at the school. So stay tuned for this!

The best way is to travel to the medical schools. It's not feasible to do that of course. But if you're local to some medical schools, then you can definitely do this. Contact them and find out about open houses. Nevertheless, it's not very feasible to go to all the medical schools you're applying to or even half of them. And because of this, you have to do all your research to figure out what you need to figure out before applying. Look on social media, websites, etc.

"Ideally, you visit medical schools before you apply to them."

[03:35] Studying Sciences

Q: How do you do well as an older nontrad to take sciences when they're not one's strength?

A: Practice, practice, practice. Tutors, tutors, tutors. You just have to put your head down and figure it out. Use Khan Academy. If you need help with organic chemistry, check out Leah4sci's organic chemistry tutorial videos. There are plenty of resources out there. Ask for help! A lot of students don't know how to ask for help.

"There are plenty of resources out there. Ask for help! A lot of students don't know how to ask for help."

[04:07]  Special Master's Program or SMP

Q: What are your thoughts on an SMP?

A: An SMP is something you can do if your grades aren't good enough. The GPA counts as graduate level coursework, not undergraduate level coursework. So it's not going to affect your undergraduate GPA but it's a way to prove to medical schools and to yourself that you are ready for it.

"It's not going to affect your undergraduate GPA but it's a way to prove to medical schools and to yourself that you are ready for it."

[04:40] MCAT Courses and Tutoring

Q: Is an in-person MCAT course during a semester for accountability worth it? First attempt was poor.

A: MCAT courses, tutoring, and prep are completely personal. Accountability is the key part here as some students need that accountability. They need that class where they know somebody's going to be waiting for them. Then taking the in-person MCAT course would be a good decision. But if it's not possible to travel to a local MCAT in-person course, then maybe doing a live online course may help. And there's also tutoring. So it all depends on your level. Tutoring is the ultimate level of accountability where you're meeting one-on-one with somebody. Again, this is a personal decision. Think about what you need. If you need accountability, then you might just need the in-person course.

"If you don't have that discipline to sit at home and do the self-paced MCAT prep then you probably should go to an in-person course."

[06:06] Premed Coaching Services

Q: What kind of information do you offer on your personal premed coaching services?

A: I help students with personal statements, interview prep, general applications, and more. Check it all out at store.medicalschoolhq.net.

[06:24] Second Bachelor's Degree

Q: Would you suggest a second bachelor's or a master's when trying to finish prereqs? I asked because it's difficult for non degree seeking students needing prereqs so which is the best route?

A: A second bachelor's degree is typically an overkill. You don't need it. The key part of the question is the non-degree seeking students. Nobody said that you can't register to take another degree and you just don't finish. A lot of schools will limit your ability to register for courses if you're a non-degree seeking student. They want to reserve spots for students who are seeking degrees. And so you can do a degree and take the prereqs you need and then not really finish it. Now, is it worth a master's? Probably not.

[07:30] Palliative Care and BSN

Q: Is it okay to talk to your interviewer about your interest in palliative care?

A: Of course. I wouldn't force it in there if it comes up about what you're interested in.

Q: Is getting a BSN for RNs on an online program going to affect the application outlook?

A: It's an online program. It's for your nursing degree so it doesn't cover your prereqs so it isn't going to affect your application. However, your prereqs probably shouldn't be online. Most schools don't accept online courses for that.

[08:00] Freshmen Premeds

Q: What should freshmen premeds focus on?

A: Freshmen should focus on doing well in their classes. Focus on being college students. Once you figure out how to be a good college student and how to do well in your courses, then you can start adding extracurriculars on top of it.

"One of the biggest mistakes that freshmen make is adding too much too fast to their plate."

[08:30] Contacting Medical Schools

Q: Do med schools look to see if you were an honor in college?

A: No.

Q: What should I ask advisors of other med schools from other states?

A: Ask them what you need to know. When you're reaching out to medical schools, a lot of students will ask complete bogus, BS questions. They think if they initiated contact then they're going to see you're motivated. But with a dumb question, they're probably going to think you're not trying very hard and you're just wasting their time.

"Don't ask silly questions you can easily look up."

[09:13] Premed Advisors

Q: What do you do if your advisor doesn't believe in you? How do you still get a good letter?

A: You don't get a letter from your advisor. Your premed advisors are not there to tell you no. They're there to help you figure out what you need to do based on where you are right now. So if your advisor is not willing to write you a letter then great. Go get your own letters.

[09:42] MCAT Prep and Timeline

Q: How detailed do institutional action statements need to be to match the violation?

A: They need to be as detailed as possible to explain the situation.

Q: How do you prepare for the MCAT if you go to a community college and when should we take the MCAT?

A: You prepare for the MCAT just like everybody else, regardless if you're in a community college or any college. You study for the MCAT the same way. Get some books, learn the material. Do well in your core classes. Join a study group. Take practice tests to prepare yourself for the MCAT. Take it no later than March or April of the year you're planning to apply. This allows you to get your score back and to figure out where you stand before you hit that Submit button.

"The later that you take it, the later that your application is considered complete so be careful with that."

[10:46] Canadian Nontrad

Q: As a Canadian nontrad, if I have to go international for medical school, where is my best option? The U.S.?

A: the U.S. is hard to get into, especially for Canadian students. The Caribbean is probably the best bet if you have to go international.

For U.S. students, Canada doesn't have a lot of medical schools and they're highly provincial. If you think about our public medical schools, each state has it. So they're very biased towards their in-state applicants. This is the same thing in Canada with their provinces. So it's very hard especially if you're in a province with just one medical school.

[11:27] Studying for the MCAT Too Early

Q: Is there such thing as studying for the MCAT too early?

A: Of course. A lot of students will start Freshman year with their Bio 1 and Chem 1 and they'll have an MCAT book with them just to browse through to see what kind of content, questions are framed around the content they're learning in classes. This is okay. Just don't really go deep into question banks and full-length exams too early otherwise you're just going to forget those stuff.

"Don't worry about it too soon."

[11:55] Top 10, Volunteering, Med School Fair

Q: Is it true that with a high GPA and MCAT score, you either get in the top 10 or nowhere?

A: This is absolutely not true.

Q: I have a gap in volunteering. But now, I'm volunteering again. Is that a red flag? How do you go about it?

A: Consistency is best.

Q: At a med school fair, what's the best way to start a relationship with a school in the 5-10 minutes that you have?

A: Have a conversation and introduce yourself. Talk about why you're interested in the school. Ask them questions about what they're looking for in applicants. Give them your card or any information you can give. A lot of medical schools will keep a little book and write down names and email addresses of students they've interacted with.

[12:55] Practicing Medicine

Q: Why did you choose to stop practicing medicine?

A: I am not practicing medicine anymore. I have decided to focus on podcasting and helping students. I also teach at the University of Colorado Medical School. I got out of the military and stopped practicing medicine partly because of some health issues. I was originally diagnosed with MS. At this point, it was over four years ago. I don't think it's MS though. I think I just had some random demyelinating incidence. It's called a clinically isolated syndrome. But at that time, we didn't know it wasn't MS. So the thought of going back into the residency with this new diagnosis of "MS" was scary so we decided to give podcasting a go. I'm glad I did because I'm here everyday for you.

[13:55] What to Do Post-Submission

Q: What is the best thing to do as an applicant to increase chances of getting interviews post-submission?

A: You can't really do anything post-submission. The best thing to do is just to wait and see. When you're freshman, do well in your classes and get good grades. Prepare for the MCAT. Write a good personal statement. Check out The Premed Playbook Guide to the Medical School Personal Statement.

[15:00] A Constant Reminder of Why You're Doing This

Q: In the daily struggles, how do you consistently remind yourself that you want to be a physician?

A: This one of the reasons we're starting Med Diaries (Premed Diaries, Med Student Diaries, Resident Diaries, and Physician Diaries). It's going to be a podcast where you are the star of the show. Call in 833-MYDIARY and you have 30 minutes to leave a voicemail. Explain your situation and we talk about that on the podcast and elicit feedback from the audience.

Moreover, make sure to continually put yourself around patients. One of the biggest mistakes that students make when they're studying for the MCAT is they shut out everything else.

When you only study for the MCAT, you're going to go crazy because you're not putting yourself around patients, which are the people who are going to remind you why you're studying for the MCAT. Think about that big picture and the impact you're going to make on the patients and their loved ones.

"Continually put yourself around patients."

[16:20] More Than You MCAT and GPA

Q: Will published undergrad research help me match into residency programs in the future?

A: Potentially, yes.

Q: What are the chances for admission with a 3.4 GPA and a 510 MCAT?

A:  You can't really answer this question as the chances are whatever they are. You can look back at historical data and their chances of admissions. But that doesn't tell you what your chances are because there is so much more to an application than MCAT and GPA.

"There is so much more to an application than MCAT and GPA. You are more than your MCAT and GPA."

Great news! I have a potential future collaboration with Student Doctor Network. I talked with the founder about how we can make the site better for you! One of my biggest contentions from this site is the "What are my chances?" threads which all need to go. Students worry too much about their chances and not actually going and doing the work to improve your chances.

[17:55] Military Med and Interviews After Multiple Acceptances

Q: I'm interested in military medicine. How do I get the process started on HPSP?

A: You have to find a military medical recruiter. Just google it - medical recruiter Air Force, Army Navy - and get that process started. Talk to a recruiter.

Q: Tips on deciding which medical school interviews to attend after receiving multiple acceptances.

A: If you are lucky enough to have multiple medical school acceptances, when you get another interview invite, try to do a visualization exercise. Visualize getting that acceptance letter from that school that's inviting for you for an interview. Are you more excited about that acceptance than you are about the acceptances that you already have? Don't go just because they invited you.

Again, you don't know the medical schools until you go and visit them. If you have the financial means to go to these interviews then go. Unless you really already have a school you're going to and you got accepted there, then turn the others all down. Otherwise, go and see more.

I know of a student who went on an interview to a school that was last on her list and she left with that school now at the top of her list because of what she experienced on interview day. As long as you have the financial means and you have the time, then go to as many as you can.

"Don't count out the schools until you actually go."

[20:00] Having a Plan B

Q: How to know when to keep pushing forward or when to just go with your plan B.

A: Don't have a Plan B. If you want to be a physician then be a physician and don't have a plan B. Otherwise, you won't be putting as much effort into plan A. You are sabotaging yourself. So get rid of Plan B. If this is what you're meant to do and you're meant to be a physician, then be one. Figure it out. It may take a bit longer than you want. But you're going to be a physician at the end of the day.

"Don't have a Plan B."

[20:50] Biggest Challenge Applying to Medical School

Q: What is the biggest challenge you faced when you were applying to medical school?

A: It was a lack of understanding, reason that I started the website and the podcast to begin with. I didn't really understand the whole process. I didn't understand that you needed shadowing and clinical experience and all of those. So it was a general lack of understanding.

When I applied back in 2001, the internet wasn't as solid as it is now. But the information is out there now.

[21:20] HPSP and the Future Residency

Q: What is your advice when considering the HPSP Air Force Scholarship related to the future of residency?

A: If you're going to HPSP, you have to apply to the military match as well as the civilian match. But the military match will dictate what happens to your future. And you have to understand that. If you know in your heart that you want to be a dermatologist, it's hard to get into dermatology in the military and in the civilian. So they might instead let you go into a general practice flight surgeon. This is what they told me after I applied for orthopedics, which is another super competitive field.

[22:18] Chances of Getting into a Residency

Q: Does a school increase your chances of getting into a certain residency?

A: It may expose you to a residency program. There may be a residency director or residents who may have some influence on their program to help you get in. But the name of the school has a very small effect on your residency chances.

[22:45] A Calling to Medicine

Q: What was the most defining moment in life that showed your calling to medicine?

A: I initially wanted to be a physical therapist. I hurt my shoulder from playing baseball in high school and so I wanted to be a physical therapist. I can help people get back to their level of functioning. I can help people get back to the sport they love. Then I dissected a cat and got that interest to be an orthopedic surgeon. Now, I'm a podcaster.

[23:19] Taking a Gap Year and Getting Letters of Recommendation

Q: Nontrad wondering when to apply. ASAP? Or add a year for less financial stress?

A: Less financial stress is good. ASAP (September 4 as we're recording this) so it's going to be late in the application cycle already. So you would want to delay just because of that.

Q: Is it a good idea to get a letter of recommendation for a physician you have shadowed for MD school?

A: It's good to have letters of recommendations from physicians or a letter of recommendation from a physician. It doesn't hurt to gather as many letters as possible. Store them in Interfolio. And when you're ready to apply, select the letters that you want to use eventually.

[23:55] Dealing with the Naysayers

Q: What do I do if my premed advisor isn't helpful and telling me I shouldn't go to medical school?

A: Ignore them! My premed advisor told me not to apply to medical school because I was a white male, had a good GPA, an okay MCAT (didn't have that score while I was talking to her though). So I ignored her and applied to medical school.

[24:23] GPA Cutoff for SMP

Q: Is there a certain GPA cutoff that you would recommend for a postbac or an SMP?

A: If you have less than a 3.0, you're probably looking to do something to improve your GPA. There's a lot that goes into a GPA though. Look at the OldPreMeds Podcast early on and we did a podcast about a GPA and how it isn't just your GPA.

[24:53] Volunteering

Q: What to do if you haven't volunteered all your undergrad until your senior year?

A: Volunteer as much as you can and hope they don't ask about it.

"Consistency is key when it comes to every sort of thing in your application - shadowing, clinical experience, volunteering."

Links:

Follow us on Instagram @medicalschoolhq

Med Diaries (Call in 833-MYDIARY and you have 30 minutes to leave a voicemail.)

TMDSAS Podcast

Premed Coaching Services

Khan Academy

Organic Chemistry Tutorial Videos

The Premed Playbook Guide to the Medical School Personal Statement

Interfolio

Sep 05, 2018
301: Near-death Experience Led This Physician to Help People Die
51:45

Session 301

BJ Miller is a hospice and palliative care specialist at UCSF. A near-death experience as a teenager left him with a unique perspective on disability and death.

BJ Miller is a hospice and palliative care specialist at UCSF. A near-death experience as a teenager left him with a unique perspective on disability and death.

Back in 1990, he became a triple amputee after he got into an accident when he was in college. He was climbing aboard a train in the hourly hours and getting shocked with 11,000 volts from the overhead electrical current. He woke up in a hospital seeing his two legs and one arm having been amputated.

He then went on to finish his degree and work until finding his path to become a physician and went to UCSF. He is now a palliative care physician at UCSF. He has an amazing TED talk and he has been featured on New York Times.

BJ talks about his resolve for how we'd look at dying and death. It's something every premed student should be thinking about as you go through your medical training.

[03:45] His Interest in Medicine

Navigating healthcare and disability early in life due to his accident, BJ got turned on about the idea of being a doctor. No lifelong dream to become a doctor really, but it was seeing healthcare from a patient's point of view that got him interested.

"I've got no lifelong dream of being a doctor, it was really just from seeing healthcare from a patient's point of view that got me interested."

BJ talks about how he was bathed with medical issues at a very young age. His mom had polio and post-polio syndrome and was progressively disabled from that. He also draws a picture of this tension between the disabled population and medicine, which he finds ironic. So growing up, he was very much tuned into disability issues but it seemed to be anti-medical on some level.

It wasn't until those issues were brought home for him personally when he was in those shoes that she got turned on into the medical issues and the medical system issues underlying all this. That being said, he didn't really think about being a policymaker to have a bigger impact on the system, although he was more interested in this.

"My first impulse was to get involved with patient care and work one on one with people and their families. Medicine was a skillset I could learn to be in that position."

As an art history student in college, he did premeds after college in postbac programs. So his way in was all coming from a different angle. His first impulse was to get involved with patient care and work one on one with people and their families. Medicine was a skill set he thought he could learn to be in that position with individuals.

He points out that even if you love patient care, at some point pretty soon, you're tuned into all the things that make practicing medicine and giving care and receiving care harder than they need to be. So he never saw himself in politics but as time went on, he became interested more in those things.

[07:55] Handling the Course Work and Fear of Failing

BJ was confident with is academics. But the biggest thing that he came across was death and this really changed his relationship to fear and the fear of failure. And it was at that time coming out of his injury that he had a different confidence. He was not so caught up in comparing himself to others nor was he caught up in any fear of failure. Because for him, he has been through an enormous failure in where his body was coming apart. And to come back from that, the idea of medical school wasn't scary.

"The idea that I might fail at it or I might not be good at it had lost its teeth. It wasn't longer such a barrier."

Mostly, his experience was from a patient's point of view. He was filling his imagination of what it would be like to be on the other side of the white coat. He did have a little bit of shadowing back in Chicago, where he spent a day with a medical director. He describes this as an extremely impactful experience, both in terms of the realities of practicing medicine and watching someone how has honed his craft. This was also an eye-opener for him towards hospice.

[11:20] Creating His Narrative as a Triple Amputee for the Medical School Application

This was an internal conversation he had with himself. He was talking himself out of worrying if he failed. When medical school application time came, he applied to about 15 schools and got invited to around 3-4 interviews.

"You can tell that people really didn't know how to discuss it. Was it okay to ask me about it? Was it legal to ask me about it? Everyone was prickly."

There were a couple of schools that were enlightened on this issue. They quickly saw that not only his disability as something he could get beyond but in fact, it could actually be a really important part of what would make him a potentially good doctor. That was key.

Moreover, the coaching he got was from his own impulse in his own life's work to make this disability as not something he "overcomes." Disability should be something that you get beyond and then get back to being a normal person kind of mindset.

Also, the language can undermine all the lessons and benefits you gain from the experiences of being disabled, which is indirectly relevant to patient care.

So he was careful to come to the interviews and come to medical training with a pretty good narrative, not just as a sales pitch, but for himself. He was understanding what he was doing there and what he was bringing to the table. Part of that was being puzzled with death and having dealt with all the modifications one makes to accommodate disability in their life. And to really learn from it to explicitly lean into his disability as a teacher and as a means to learning more, and not to have a life of less.

"I was wearing that narrative. I believe in it wholeheartedly. That's what got me that far and there were few schools that really saw some wisdom in that."

[15:00] The Hardest Challenge in Medical School

For BJ, the challenge has been less mechanical. He thought he really didn't need that much accommodation through medical school. Just by the details of his disability, he didn't really need a lot of practical accommodation.

On the other hand, the biggest challenge for him is working within a system and bumping up against colleagues in that system who have a worldview that ends up accidentally otherwise dis-including a lot of people.

He has always been aware of watching the medical system responds to people whom it cannot fix. That's the central theme in palliative care. That's been the theme in his life and he has observed it and felt it. The barriers were more of a moral distress. He's working on behalf of the system who has really good intentions but by virtue of its training and its structures.

"I have always been aware of watching the medical system responds to people whom it cannot fix. That's the central theme in palliative care."

It keeps life harder than it needs to be for its patients and the people working in it. There is no medical training around coping and what it means to live with the illness, the philosophy, the spirituality, etc. All this was absent from his medical training.

It's stuff they had to figure out for themselves. The most basic part of being a healthcare worker is having dealt with those kinds of issues, adaptation, what does it mean to be a human being, how to handle loss, how to deal with things you can't change or can't control. For BJ, that was and still remains the biggest challenge for him in healthcare.

[19:00] How to Change the Thinking

BJ says it's things like these - the podcast, conversations, the whole entire field of palliative care. He thinks there is a sense of wider conversation going on around patients and families speaking of burned out doctors and nurses. It's not a secret to most people that the American health care system is an enormous mess in so many ways. BJ sees an increased awareness as well as a sense of other modes of thinking into the mix.

"It's going to dramatically change the conversation just working from the demand side of the equation."

BJ says that the disabled population has a group of anxieties. They have learned some things by adapting to those changes and then return to some old thoughts with new answers.

As to how you can make people become aware of this issue, BJ says he has been left with all sorts of suffering internally. If you look really close enough, the keys for empathy are already in there. Most human beings have suffered even the ones who look like they're the luckiest ones in the world. And if we're somehow okay to admit that and deal with that with lessons, the work for empathy is in us already. We've got to own our pain a little bit. We all have access to it. If we can do that, then we'll get better at grieving. We'll get better at acknowledging loss. We get better at sitting with things we can't change. It doesn't have to be dramatic. Everyone suffers. You just need to own it a little bit.

"We've got to own our pain a little bit. We all have access to it. If we can do that, then we'll get better at grieving. We'll get better at acknowledging loss."

[24:50] What is Palliative Medicine?

BJ defines it as an interdisciplinary pursuit of quality of life. Or some say that their job as a palliative care clinician is to help patients and their families as good as possible.

For the future orthopedic surgeon or dermatologist, they should think about palliative care. In fact, he thinks every clinician needs to know at least about the basic tenets of palliative care. If you really want to feel good in your job and feel connected with your patients, you will be aware of why it's important for their conditions to be fixed. As an orthopod, if you want to connect with your patients and be as good, you still need to remember why patients need to be fixed in the first place and why it hurts to have it broken and what they would want to do with that fixed ankle.

"The biggest cause for anyone landing in the doctor's office on some level has to do with them searching for meaning in their life."

As clinicians, people are going to come to us looking for help to fill in those gaps. So it's not just good enough to take a pure technician's view on the body. If you have no sense of why it's important to have molecules in the first place, you'll be missing on a much bigger, much more interesting game of health.

[28:40] Solving Resistance to Palliative Care

BJ admits there is a ton of resistance to palliative care. A lot of health care professionals say they care a lot about their patients. But bring palliative care into the mix to make sure someone is caring about your patient. The truth is that most clinicians have this notion that somehow someone has to care about the patient when they really care about the patient. This is a big piece of the puzzle.

Additionally, some of us are intoxicated with the mode of cure. And that's their rabid to cure and that's their impulse. But the bigger narrative is that it requires us to think about the person as an individual and the subjective sense of life.

Not everyone has to do everything though. The third piece is to really understand what is palliative care as it's hard to define. It still is vague and this is why it's often being associated with hospice and end of life care since it's what's most people are accustomed to knowing.

"We don't make much money in those fields. In this culture, we follow the money to see what's valued. If we follow the money in healthcare, money doesn't lead you here."

Fourth, the reimbursement system undervalues palliative care and geriatrics. We don't make much money in those fields. In this culture, we follow the money to see what's valued. If we follow the money in healthcare, money doesn't lead you here.

BJ recommends to physicians to realize that the field needs to be returned to the older way of care. Primary palliative care has the basic tenets that every physician should know. Then there's specialty palliative care. So before you write a palliative care referral, take some extra training in palliative care so you can do it better yourself.

[36:50] State Laws on the Right to Die

BJ shares his insights into different states having this law on the right to die. A lot of people really did long for this option. They say that death was coming no matter what and death was a meaningful exercise for them. And he thinks that choosing when you leave is a very meaningful choice. So he is glad that the aid in dying is a small but a very important piece of palliative care.

Alongside there are limitations to palliative care too since you can't ease every kind of suffering and help create meaning oto people. For all these reasons, he sees aid in dying as a useful piece of attending to patient suffering and meaning-making. Nevertheless, this is a small issue but it's a very important, symbolic piece of legislation and policy.

Finally, it's one thing to condone this for an individual who knows this situation but it's very difficult to move to the abstract of legislation and to craft policy around it to protect people and allows access for the right people. Why is the fervor around access to palliative care? Why are we up in arms that we human beings suffer so much more than we need to? BJ thinks this is too convenient from a policy type point of view.

"These aid in dying laws are a tip of a very long spear with a lot of complex issues."

Some people struggle unnecessarily when there is an antidote in the medicine chest. And he thinks this is a disgrace making him less proud of his country. But he also understands that the details in policy and legislation are complicated. He also thinks there are things lacking here in terms of communication and conversation around this issue. As people, we need to soul search if this is something we need to be part and a common denominator we want to rely upon education and access to health. He personally believes there are other ways to fix it moving towards a value-based system.

[44:50] Resources on Palliative Care and Where to Next

BJ recommends the play Wit. There is also a documentary on Netflix that just came out about end of life. Extremis is also ICU-specific documentary on Netflix. Most of the music and art often revolve around love and loss in some ways.

"So much of the reflective human world does contend with these issues on some level if you choose to see it."

Marinate in what it means to be a human being and what it means to lose, what creativity means. Bathe in those kinds of issues to see them.

Moreover, BJ is currently writing a book, The Beginner's Guide to the End, which is meant as a practical guidebook for people and their families facing the end of life. So watch out for this on bookstores soon! BJ is also considering creating other resources like an app for people seriously ill as well as training centers or libraries where people could go and get good information. He also wants to create a version of UK's Maggie's Centres. Or he could just open his own clinic and provide palliative care.

"There's access to so much information, it's an overload. The hard part is it's not checked information. You can also be exposed to a bunch of lies online."

[49:07] Final Words of Wisdom

It's basic impulse as a human being to care for others. The root impulse in medicine is so beautiful as BJ describes it and it needs protecting. The health care is not a lost cause, it's frustrating, but it's very gorgeous and essential. So you need to have an activist heart these days, and if you do, bring your energies into this work

Links:

BJ Miller’s TEDTalk

New York Times article about BJ Miller

UK's Maggie's Centres

Extremis

Aug 29, 2018
300: Burnout in Medicine and Our Newest Project to Help With It!
19:59

Session 300

This week, we're joined by Allison who has previously shared her story of burnout. We discuss burnout as well as the birth of MedDiaries - our newest project to help with this prevalent issue..

We're celebrating our 300th episode and it's been our tradition to state the Hippocratic Oath every 50 episodes.

"I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures that are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks.

But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter.

May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help."

[04:50] The Prevalence of Burnout in the Physician Community

Allison talks about there are bad days as much as there are good days, which is highly prevalent in the physician community. In fact, 42% of physicians in the 2018 Medscape Report are burned out.

Based on personal experience, Allison is passionate when it comes to this topic. She also works in the field of Neurology which ranks second on the list of fields that are most likely to experience burnout, second to Critical Care.

More and more people are now researching burnout due to its prevalence in the community of physicians, residents, and medical students.

Allison describes how burnout has affected her emotional wellbeing, feelings of self-worth, and even the ability to care for herself.

"If you can't take care of yourself, you can't take care of other people well. All too often as physicians, we are sacrificing our own wellbeing so that we can take care of other people."

[06:25]  Burnout as a Sign of Weakness

In the onset of burnout, you begin to feel detached, dissociated, resigned, and separated in some way from the job you were trained to do. And even though it's a high percentage of physicians having burnout, it's not something you experience with other people. You experience it by yourself.

"Burnout isn't something you experience with other people. You experience it by yourself."

In medicine, what has been taught to us is that if you're strong enough to do it then great; but if you can't handle it, then you shouldn't do it. So if you're struggling with emotional difficulty or feeling exhausted, or if you're experiencing the human side of how difficult it is to be a physician and you talk about it or complain about it, or let it affect your work, then that's seen as a weakness and that it's not acceptable in medicine.

This is a subconscious thing, but at the same time, it's something directly taught in a lot of places. You would then have to bury that way deep down inside of you, not in the hospital or in the clinic, but someplace else. If you can't handle it, then there's got to be something wrong with you. This is all a bunch of hullabaloo, but this is what we're taught, unfortunately.

But it's not we, the people practicing medicine, who are at fault here as we are all human beings. The problem is we're surrounded by unbelievable pressures and so many different obligations, and other things that take away from the ability for us to practice medicine. For instance, these are things like clicking boxes and EMRs, filling out authorizations - things not about practicing medicine but fulfilling guidelines and nothing to do with directly looking after a patient.

"The numbers and pressures on physicians, the number of things that people are being asked to do these days just gets bigger and bigger. The list gets longer and longer."

[09:10] Premeds Experience Burnout Too!

Premeds experience the same things as well, trying to live up to the standard they think they need to live up to - being a 4.0 student, 520 on the MCAT, and getting all the extracurricular activities in - shadowing and clinical experience. You try to get into the best medical schools and best residencies and be the best doctor.

"Burnout is prevalent at every stage of the game. Unfortunately, suicide rates are high among med students and physicians."

We can't fix the systemic issues and reason we're discussing it now so as you're going through this process, you get into a position of power where you can make some of these differences. It may be not on a national scale, but on a local scale, specifically for your hospital.

That being said, we can change the discussion around burnout. This impetus behind our new project.

[10:20] Are You One of Us?

Are you a physician and feeling down or burned out? Have you had a terrible day and just need to vent and get something off your chest?

Are you a resident working 80+ hours a week in a hospital and watching your patients suffer without any dedicated space or time to talk about it?

Are you a medical student feeling the toll of studying all night after working in a hospital all day and wondering if life will look any better when you're an MD or a DO?

Are you a premed student with a dream of becoming a physician but you're feeling discouraged by a bad grade or rejection letter, and wondering if you'll ever get there?

Wouldn't it be wonderful if there were an anonymous safe place where you could speak your mind and have your voice heard?

In this time of extraordinary demands on physicians with 42% of physicians feeling burned out in the latest 2018 Medscape Report, we need a place to be heard.

All over the United States, medical centers and medical schools are trying to find ways to help physicians with burnout. Wellness groups and conferences and employee assistance programs have formed. Some residency programs have created programs to help their residents process their grief and other emotions that arise in medical training. There are islands of awareness popping up to try heal and support our exhausted physician workforce and help prevent them from self-destructing and from leaving medicine altogether.

[11:40] We All Need Support: Join the Movement!

But we cannot do this alone in silos. we need support in a way that we feel connected to all those around us, those who are feeling the way we do but never discuss it openly for fear of looking weak.

As attending physicians we are often told to meditate, exercise, and do whatever we can to "fix" our burnout. But we argue that we are not the problem. The systems around us create untenable demand that inevitably leads to burnout. EMRs and endless boxes to check, notes to write, prior authorizations, loss of autonomy, fear of litigation, and lots of reimbursement for doing the incredibly hard work this profession demands everyday.

As residents and medical students, we are told to bury our feelings deep down and just get the work done. Yet, we lose a part of ourselves when we don't acknowledge the depths, the fear, the enormous responsibility of telling a family member that their loved one is gone no matter how hard we try to save them.

While we don't know the fix for this, one thing's for sure: talking about it helps.

Welcome to MedDiaries...

When you're having a down moment, call 1-833-MYDIARY and leave an anonymous voicemail.

Speak your mind. Drop your guard. Say whatever needs to be said. You will be heard by others feeling the weight of burnout too.

This is a place to be heard. Join the movement!

[13:19] MedDiaries as Your Trusted Resource

All over the country, people recognize there's a problem with burnout. Physicians and people all through every stage of training need a place to talk, and people to talk with about how hard this whole process is. The journey never stops right until you die.

"There are pockets all over the place and there isn't a place where people can go to just have their voices be heard."

MedDiaries is creating a space where people at every stage of this journey - premed, medical student, resident, physician, or attending physician - can go anonymously and talk about what's going on.

We're not going to "fix" it but talking about it is a starting point. And this is what's really missing across the board.

Under the MedDiaries umbrella, we're going to have four podcasts:

  • The Premed Diaries
  • Med Student Diaries
  • Resident Diaries
  • Physician Diaries

And Allison is hosting the shows!

So, whether you're happy because you saved somebody for the first time. Or you're struggling because your boss yelled at you. Call 1-833-MYDIARY. You will be allotted 30 minutes to leave a voicemail.

While it's anonymous, you're also welcome to say something about yourself. But we want to keep you protected as well as who you're talking about protected.

Tell us what you're feeling. There's no right or wrong. Treat us as a diary.

There is healing in speaking what's in your mind and getting it out of your mind and out into the world.

"You will be amazed at how much what you say can benefit other people."

We're targeting releasing two episodes per week where we get your voicemail. We listen to it, play it, and Allison gives her comments. Then we're going to ask the audience to call in and leave feedback.

Again, we're not trying to fix anything. But we're all in this together. When we start sharing our struggles and successes, you'd be surprised at the impact this can make!

Links:

Medscape National Physician Burnout & Depression Report 2018

Call 1-833-MYDIARY

Stay informed of the MedDiaries launch. Get notified!

Aug 22, 2018
299: High School Dropout to Highest Ranking Physician in the US
52:24

Session 299

This is a beautiful story of triumph, dedication, determination, hard work, and grit. Today’s episode is packed with amazing stories along with great insights and immense wisdom from someone who has gone through it all.

If you’re on this medical school journey and probably thinking you can’t do it, then take some time to listen to this and be inspired!

Dr. Richard Carmona served as the 17th Surgeon General of the US. After being homeless at one point, a high school dropout, and special forces medic, he found his calling for medicine. Then he worked his way up to being a Surgeon General, the highest position for any physician in the U.S.

For more resources, check out all our other podcasts on the MedEd Media Network to help you along your whichever point you are in your medical school journey.

[01:40] Interest in Becoming a Physician

As a kid, Richard enjoyed science and learned on his own voraciously. Even in junior high school, he'd read books about anatomy and physiology. He never lost that interest even when he dropped out of high school.

Raised by immigrant parents, they struggled and they were homeless. He'd describe their life as being in a survival mode almost every day. Along with that, there were a lot of distractions. On his third year in high school, he was asked to leave and then came back on his senior year, still taking freshmen and sophomore courses. He was 17 at that time. His counselors were very encouraging offering him resources. In hindsight, he thought that if worked harder at that time, he could have done it. But he didn't. So at 17, he was a drop out with no job and not much future ahead of him. So he enlisted in the army.

[03:40] Enlisting in the Army

Richard describes enlisting in the army as transformative. Without any tangible skills and with little knowledge of the world, he was made into a citizen and he was taught about duty, honor, country, responsibility, how to complete a mission. All those skills were so invaluable, which helped him through medical school. In fact, he believes this is what set him apart from any of his colleagues.

"Having been in the military, having gone to combat, and all of the stresses associated with that - it made me a stronger person, a better person."

In the army, he went to the infantry. There weren't so many jobs for kids with no experience in training so most of them were taken into the infantry. They are the guys who do the fighting. They teach you weapons and combat. He then went to jump school and became a paratrooper and volunteered for special forces. He got accepted and did pretty well in the testing so he became a pilot and chose special forces. Shortly after, he almost lost it saying he had to be a high school graduate to be in special forces. So he went to the education office, took a GED test, and so he got his high school diploma. He then completed his training in special forces for less over a year. He was a special forces medic and weapon specialist, where he got the training on top of the basic tactical training.

[06:36] Being a Military Medic as His First Exposure to the Medical World

Richard says being a medic in the military allowed him to gain exposure to medicine. He found it to be a humbling experience, making him see how little he knew even though he knew a lot more than people by the time he finished his training.

"In the advanced provider program, which is a special operations medic, you're trained to be the doc. You're in austere environments."

Being a special forces medic, you're the medical support for your teams in the most austere environments where there is no doctor or nurse. And back then, there wasn't any reliable radio communication. At 19-20 years old, he took care of gunshot wounds and indigenous forces with parasitic diseases and malaria, as well as delivered babies (twins) in rice paddies, which he did one time in the middle of a firefight.

He found it to be very humbling being the only out there and you stand between a person living and dying if you haven't learned your lessons. You're the doc on the team but then you have the same responsibilities in conducting combat operations as the other team members. In the special forces team, they're all cross-trained so they can help each other out. What they had in common were being kids who had an immense responsibility to carry out missions with no supervision. As he looks back, he thinks it's scary to think what they're entrusted with.

He served the military for a total of ten years until he ultimately became a Surgeon General, which is a four-year term.

[10:15] Leaving Active Duty the First Time

After finishing his first combat tour, he was already reconciled that he was going to make the military a career. He got promoted to being a commission officer and had a bigger responsibility. He was just going to stay in special forces and make a career. But his teammates and friends encouraged him to go to college. But he thought he wasn't really prepared for it. He recalls his high school counselors writing him letters in Vietnam, encouraging him to go to college when he comes back.

In fact, one of his high school counselors contacted one of the local community colleges in New York City and found out they had an open enrollment program for Vietnam combat veterans. And even if you're a high school dropout, they'd give you a chance to matriculate for a year. So he got accepted.

"I was more comfortable about going to combat than I was about going to college. I wasn't prepared."

Though still young, Richard felt he was already like an old man with all the experience he had. And Vietnam was a tough time for them where most of them who were combatants were blamed for the war by the public. When really, they were just the pawns of the game and the agents of execution. They were only given orders and carried them out.

Nowadays, people already understand that whether you agree or disagree with the war, the young men and women who serve are heroes no matter what because they're serving the country as what the leaders asked them to do.

[13:01] Community College Experience

Richard was under a reserve status and went to community college. He describes it as a humbling and sometimes embarrassing experience. He took remedial courses for almost a year. During those times, he worked various jobs being a police officer, paramedic, registered nurse, and a PA. They're basically all the skills that he learned in the military that he was able to translate to the civilian world so he could work and make a living to go to school.

While he may not be the smartest, what he had was discipline. He understood he had a mission and that he had to achieve certain milestones. He knew the timeline and what resources he needed. He got up earlier than most kids. He does his personal training every day to keep himself in shape, taking night runs and doing all his exercises.

He eventually applied to a number of medical schools and got into several of them. He already transferred to California to finish his college in Southern California. He did very well, being an A student and got honors. He ultimately decided to go to the University of California, San Francisco. There were 150 kids in the class, all were A students in college, and all they wanted was an A in medical school. But his goal was to become a physician so whether he graduated with 1 or 150, at the end, people are still going to call him doctor.

[15:50] Fighting the Impostor Syndrome

Richard says you just need to push on. He was humbled many times sitting next to people that fully understood equations and science that he was interested in but didn't have the knowledge they had so it took him a while to catch up.

"My mission was to get through this, and to get through it, I need to catch up with these people. And if I could, maybe surpass them in some areas."

Richard admits you'd feel unworthy at times and like you don't really belong there. But he just kept driving forward. He wasn't going to give up. So he worked as hard as he could, volunteering for every rotation that nobody wanted. He hardly took any vacations. During his free time, he'd go to a clinic and volunteer for something. He actually finished medical school in three years. He skipped his last year, graduating number one in his class. Then he started a surgical residency at the University of California. Richard explains that he had superhuman persistence, perseverance, and judgment which were all skills he learned in the military which made him look smarter than he was.

"I was average intelligence but I had superhuman persistence, perseverance, and judgment, as well as the ability to focus on my mission. All skills I learned in the military."

[17:45] An Immigrant Story of Perseverance and Dedication

Richard talks about his family. His parents were good people. His dad had trouble expressing his love for his children. While his mom was almost like a single parent. Though married, she took the burden of raising them. There were times they had no money, became homeless, and bounced around. She'd take a job working night shift and then during the day, she'd come home and dress the kids to school.

Richard has two brothers and a sister who passed away of cancer a year ago. His sister had a tough life as well as a little girl. His younger brother followed him into the army and spent 30 years in special forces. He retired as a Sergeant Major. He was also a high school dropout coming in, but came out with a college education, and spoke Russian, Arabic, Spanish, and English. At one time, he completed all of the special forces courses and became one of the special forces team leaders.

His other brother chose a different path, worked hard his whole life and retired working in different businesses. Consequently, they all made it.

"We all made it. But my mother's encouragement, my mother instilled in us this: the land of opportunity, don't let it go to waste, and get your education because nobody can take it away from you."

All that being said, Richard credits his mom for all the encouragement and instilling in them the value of education. His mother often spoke in Spanish and English, but she spoke 5 languages which are self-taught. She knew music, arts, geopolitics, etc. She challenges them everyday with stuff they have to know to be productive in the world. She'd encourage them that they don't have to get pulled down like everybody else in the neighborhood. She told them that they can escape and their ticket to escape is getting an education. So she'd make them read and go to the library.

The women in his life were the ones that drove Richard the hardest and made him appreciate that he could achieve much more than anybody in the family had ever achieved but he just had to work hard.

[21:10] His Journey in Medical School

Richard points out that what really drew him to become a physician can be summed up in one word - caregiver. He loves being a caregiver. He loves helping others. Whatever it was, he felt good helping people. Today, he does things on a policy level and big business where he could have an effect on the population and work with underserved communities, do things that will improve the health, safety, security of population and family. And he feels good about this.

Coming into medical school, he already knew he wanted to be a trauma surgeon. He loved every rotation though so he'd have second thoughts each time. After doing a month in the psychiatric unit, he left with more questions than he learned. To him, every rotation was a gift. Each rotation was just incredible.

He remembers the day they took their final exam on microbiology and parasitology in his second year of medical school and aced it. He explained it was the same final exam that he took in special forces 20 years back, where he treated malaria and a bunch of other diseases.

"A lot of the things I learned in the military helped me to understand the context of what I was learning since I had gone through it reverse order. I was doing those things long before learned the in-depth science that we learn in medical school."

By the time he got past his second year, he wanted to be a surgeon but he couldn't figure out how he could do everything since he loved everything he was doing. By the end of his third year, he actually didn't realize that he had already completed medical school and he had done really well. An intern had dropped out of the surgery program in the first week of July so the dean told him that the chairman of surgery wanted to talk to him and offered him the internship without having to match. He initially declined knowing he had a year of electives that he wanted to but he eventually did it to save money. So he wanted his internship during the first week of his fourth year which was all electives. He graduated

After he finished his internship, he still went back and graduated with his class to be with them even if had already technically graduated the summer before.

[26:50] Stop Blaming Others, You Can Get It Done!

Richard shares his wisdom with those students who still continue to blame their surrounding, their friends, their parents, the system for why they can't be a physician even though they're trying.

"You can go through life blaming everybody else for problems. Nobody said it was going to be easy... the only easy day was yesterday."

Richard says that sitting around and blaming your parent or the environment, etc. won't get you anywhere. But figure out how to navigate that system. Figure out how to beat the system. Work a little harder. He failed many times but he kept coming back. He didn't give up. The military is what really helped him to understand how much potential he had when he didn't have confidence in himself. While his path in the military worked for him, it might not work for anybody else. But he explains there are many success stories of people who just looked beyond the headwinds of struggles and challenges. They did succeed but they stayed focused.

Richard tells kids in a similar situation to his as to what is holding them back. There are scholarships available and schools. You just have to work and you may have to work harder but it can be done. You just have to put your mind to it.

"You could work and you may have to work harder than somebody else but you can get it done if you put your mind to it."

[28:50] Succession Planning

"When you make it to the top and you take that elevator to the top, make sure you send it down for somebody else."

And once you become successful, you can help others behind you and you become their role model. Richard recalls that when he was working as a registered nurse when he was in college, a lady who's the head of social work, told him that he's going to do pretty well. And she reminded him that "when you make it to the top and you take that elevator to the top, make sure you send it down for somebody else." And he never forgot this!

Years later, he understood what she meant. For those who have received the benefits that a society can give, not just doctor, anything, and you come from those humble beginnings, what are you going to do to make it better for the people? Richard calls this succession planning, getting other people in there and helping them. So he does the best he can to spread the word.

Richard admits he was still having the impostor syndrome in spite of all the As he's getting. But it was the focus and discipline that really got him to do all of it.

"You have those doubts until the day they hand you the diploma. And even when you get the diploma and you're a doctor, it starts again when you're an intern or a resident."

[33:20] His Role as a Surgeon General

Richard never planned on being a surgeon general. When he got out of medicals school, he thought he was going to be an academic surgeon, finish his training. He was a general vascular surgeon sub specializing in trauma, burns, and critical care. He was going to climb the academic food chain and just do that.

"Life is what happens when you're planning."

Over time, he got drawn into being chief of service and head of this and that and studying the first trauma EMS system, etc. He ended up running a hospital and a health care system in a public hospital. He never planned any of those things and just opportunities that arose and people with authorities that approached him.

As a professor at the university, he went back to get a Master's degree because he knew he needed more information to be competitive in these new areas he was working in. Then he was called and asked if he was willing to go back on Active Duty as the president was looking for a new surgeon general. Thinking he didn't have the pedigree, not politically connected, and didn't hang around with those people, he went ahead and did the interviews anyway thinking there was no downside. Eventually, he kept moving and got the White House and the West Wing interviewing him and he was the last guy standing and got the job.

"It's an extraordinary responsibility to be the so-called top doc. You pretty much subordinate your life for those four years at that terms because there are so many things happening."

As the Surgeon General, his job description is "to protect, promote, advance the health safety and security of the United States." He's the commander of the U.S. Public Health Service Commission Corps where your officers are at CDC, SAMSA, NIH, all the federal acronym agencies, state health departments, and has medical officers in embassies around the world, WHO, the Pan American Health Organization etc.

Richard describes how immense the portfolio is that you're dealing with areas of prevention, preparedness, health disparities, health literacy, global health, health diplomacy. Moreover, this changes with each generation as well as the needs of the nation at the time the surgeon general comes in.

"My definition of luck is the intersection of preparedness and opportunity, and recognizing opportunity when it's at your doorstep."

[40:00] Breaking Up the Plague of Politics

Richard imparts his wisdom to students who are starting on their journey to medicine when many people in it are trying to get out of it. Don't forget the immense opportunity and responsibility you've taken on. Don't shy away from the challenge.

"It's you that has the potential to fix the system. The system is broken. It is perversely incentivized."

Richard reveals the perversity of politics. In fact, in one of his presentations, he talked about the plague of politics. Often, it's one of the malignant things we face because it's about partisanship and you can't have rational discussions in these political environments.

Instead of having a reasonable discussion with elected officials about the needs of the people and how to accomplish that, instead, you get to witness a fight where one party blames the other. And nothing gets done. Each party blames the other for it. Unfortunately, people don't get the representation we need, the selfless service that the public deserves. One side wants to take all and they spend more time and resources beating up the other.

Richard says that the challenge before all the new young doctors coming out is how to crack that system where we can get people to represent us. Whether you like it or not, it's the political system that we have that gives authority to all of those agencies that pay our healthcare, that gives the rules and regulations for healthcare, CMS, Medicare, Medicaid - that all comes from the elected bodies that we have elected.

"Let's figure out how we can crack this problem of this hyper-partisanship that creates a gridlock that doesn't allow us to use all of our faculties to the best benefit of the people."

[43:55] How to Get Involved as a Premed Student

Richard suggests getting involved with organizations that are there to help improve the health safety and security of the nation, like the American Medical Students Association. Many medical schools have free clinics that you can participate in. Primarily, start to learn about the political system where you live. Where is the power, where is the authority? Learn about the committees that have jurisdiction for funding programs and projects at a local, state, and federal level.

"Learn how the system works so you can become part of that system and influence decisions so that they will be made in a selfless manner for the better of our society."

Sadly, most elected officials are more worried about getting re-elected and keeping their party in power. Therein lies the problem. Understand those dynamics and figure out what you can do to change those dynamics so you can have a rational discussion and begin to incrementally solve the problems before us on behalf of the American people.

There are always people who won't agree with you. But democracy is predicated, uncompromised and if we can do as much as we can for most people, that's about as good as we can do on democracy. But be fair and partial.

Serving as a surgeon general, Richard's job was to always look through the lens of science and make decisions and recommendations based on the best science that would benefit the people of United States, and in many cases, allies that we work with.

[47:00] Richard's Last Words of Wisdom for Premed Students

You can do it. Do the best you can in any one of those jobs to make whatever geography, society, that you're responsible for, better. And never forget that it's an immense privilege to serve. When you get there, it's an extraordinary privilege.

"It's about selfless service, subordinating one's own interest for that of the patient. You will miss birthdays, parties, and vacations sometimes. But to me, that's a privilege because you get to help another human being through maybe the most trying times of their life."

And if you're working with underserved populations, often, you may be the most important person that person ever interacts with their whole life. And sometimes, all the patient needs is a hug or a handhold. Develop a patient-doctor relationship because it has therapeutic value. Again, this is a privilege of being a caregiver. So don't lose sight of it. It's never going to be easy. The only easy day was yesterday.

"Every patient doesn't need a prescription, but almost every patient needs a hug or a handhold or a reassurance that you're going to help them through whatever they going through."

Stay focused on your mission and work through all the variables that contribute to you being successful in that mission. You can do it! You don't have to be smart. An average person working hard can get through medical school. It's a privilege to serve. Never forget that privilege. And once you get there, you'll be humbled. You'll love what you do. But your whole life you're going to be second-guessing yourself because all medical school does is open the door for lifelong learning.

"Only a few people are afforded that privilege so don't forget it and just work hard for it."

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Aug 15, 2018
298: Professor to Premed, How Indentifing as LGBT Affected Apps
41:02

Session 298

Sarah is starting med school this fall and is excited to begin. Listen to her story and how identifying as LGBT affected her med school applications.

I helped Sarah with her applications. She took a nontraditional journey to get to medicine. As a college premed, she found another passion and then came back to premed. Ultimately, she's now starting medical school.

If you need any help in your medical school application, maybe we can help. Find out all the services we offer and let us be a part of your journey to medical school. Also, don’t forget to check out all our other podcasts on MedEd Media Network.

[01:30] Interest in Becoming a Physician

Sarah describes it as a long and winding road. Her mom passed away from breast cancer when Sarah was 7. At 11, her dad remarried a surgeon. So she was around medicine at a very early age.

Going to college, she was premed and shadowed her stepmom in high school and thought it was actually cool. On the other hand, her brother was accepted to medical school when he was a senior in high school. That said, she had a lot of medical influence from her family.

When she was in college, she started tutoring and discovered she loved teaching. So she decided to be a teacher than a doctor. Hence, she began to pursue a career in education. She then got her Master's and taught for three years. After which, she felt not as satisfied and started thinking again about going back to medical school.

Although the school got rid of this now, but part of the early acceptance program (which his brother got) was to initially give premeds more flexibility. This means no need for MCAT or they didn't have to major in science and take all the prereqs. Apparently, they could take whatever they wanted.

[05:40] Her Love of Tutoring and The Premed Culture

Sarah admits to really like tutoring and she actually got into it by accident since she needed a job. She saw an ad and applied for it. In the sense of seeking opportunities in the premed field, she wasn't very active.

"I thought I knew everything already about it having doctors in my family and so I didn't think that I needed to see more."

Sarah actually lived with a bunch of premeds in the dorm during her first year which she found to be very interesting. But she didn't really pursue going to the hospital and shadowing. Why? Because she thought she already knew everything about it having doctors in her family. But she thinks this is wrong. But at 19, it wasn't that surprising for her to think such.

Additionally, she really didn't think she connected well with the premeds she lived with on that floor. So she didn't feel like they were her people and this pushed her away from it. In hindsight, she realizes she may have found premeds that were her people.

"I didn't necessarily connect with some of the other premeds who lived on my floor. I didn't feel like those were my people. That kind of pushed me away from it."

By "not her people," Sarah describes it as it felt like everybody was out there trying to prove themselves and that they were more interested in medicine than you were. Also, she was curious about other things and to explore other parts of life, something those other premeds didn't have so she saw their personalities diverging.

[09:00] The Life of a Physician's Child

Interestingly, most people think that just because you're a child of a physician that you want to do that as well. For Sarah, she describes that having physicians in her family both helped her and also kind of discouraged her to do medicine. As you can really see from a close perspective of how much work it can be and how challenging of a career it can be.

So this has given her a lot of great perspective. But in as far as going through college, this pushed her away a little bit.

While she was tutoring, she was pretty committed to working in higher education. In fact, she did put medicine off the table completely. But the rest of her family didn't, encouraging her to take medicine every now and then. So for a while, her focus was on her higher education until she realized it's not what she wanted to do.

[12:10] The Aha! Moment

After getting her Master's she realized she no longer wanted to get PhD in Geology. And this has put her in a place where she wanted to move forward in her career but she wasn't happy with where she is. However, she doesn't want to get a PhD and move on in higher education. So she was trying to look for a career where she had everything she was looking for.

"What I love about teaching and I think there's a ton of overlap with medicine, is that you really impact people, you help people, you work with people everyday."

Seeing the commonalities between teaching and medicine, Sarah began to consider becoming a doctor. So she started having discussions with family members and friends. Then she also started to shadow and continued on to do volunteering and getting more involved to make sure it was something she really wanted to do.

She discovered that she loved everything she was doing that was medically related - shadowing, science, patient interaction, and impacting people. These were all important to her. She also volunteered in hospice to test if she would really like working in really hard situations with patients. She also found surgery as the coolest thing ever!

[16:15] Figuring Out the Next Steps: Call the Medical Schools

Being several years from being a "premed," Sarah went to one four-year university and talked to their premed advisors, who were negative about her application. They said her academic coursework was so old (nobody's going to accept it) and she was told to take a year to do some clinical or patient care experience, saying she didn't have very much of it.

True enough, some of the courses on the MCAT she took eight to ten years ago. Anyway, she did her research. She called other universities and asked them. She got different results from the medical schools. Some said it was okay, others were a bit concerned but they said they still wouldn't reject the application just because of that. Predictably, the ones that said they'd be concerned, she didn't get interviews from.

"I do think it's really worth listening well if you do call a medical school and talk to them to how they respond to your questions."

Sarah was interested in these two school and so called them and tried to build a relationship with them. For her, one school worked while the other wasn't very open to it. But she thought it was advantageous that she had not yet applied.

Another barrier she ran into is that she has been out of school for so long. She did her premed requirements back in undergrad, except for one class. But that was a while ago. Plus the fact that schools ask for two letters from professors. So she called and asked about this telling them she only had one letter and asked what else she needed to do. Again, some were open to it, others weren't.

Sarah recommends that if you're calling schools is that be mindful of when you are calling them. During interview season and during application season, they're very busy. So be  more polite as to not take too much of their time.

[23:30] Picking Schools to Apply To

Sarah only applied to MD schools. She did seek a lot of advice regarding this and she found out that there certain things more fluid at MD schools such as clinical rotations.

Okay, to help you understand this better, the majority of DO schools aren't affiliated with big, academic hospitals like the majority of MD schools are. And so it can make things a little bit more complicated for DO students.

Also, having two MDs in her family, she was told going to a DO schools i s great, although clinical experience might be significantly different. Also, they reminded her in terms of the bias in terms of the clinical specialties. So she didn't want t put herself into a position where she would have trouble matching.

"The majority of DO schools aren't affiliated with big, academic hospitals like the majority of MD schools are."

As far as geography, she wasn't opposed to the fact that she'd be moving since she's single anyway. She did look at midwest schools to be closer to her family. And then a few in the west, a few in the east, and a few in the south. In short, she applied broadly to a total of 20 schools.

As part of her sorting process, she read stuff like mission statements and looking at programs she felt were aligned with who she was as a nontraditional student. She also looked at places where she could do rock-climbing which she loves.

[28:11] Challenges During Medical School Application and Identifying as LGBT

For Sarah, the hardest thing was the waiting game as it could become a year-long thing and this was very stressful for her.

"I was just waiting and you don't know how long you're going to be waiting."

Moreover, Sarah identifies herself as and LGBT and this is a big part of an application. So many schools now for secondaries are asking questions about this. For her, incorporating this into her application was a very difficult decision for her. She was very worried how people would take it but she realized that identifying herself as bi and how it shaped her and her experiences has a lot of influence on what she wanted to do in medical school. She wants to be involved in LGBT groups and advocacy. And she wanted to be a physician advocate for obese populations.

"Identifying as Bi and how it shaped me and the experiences I've had with that really is going to influence my future career. It influences what I wanted to do in medical school."

So she really things being LGBT ties strongly with her career what she was looking forward to in medical school. Hence, it's very important to her that she did include this.

When she was doing her research on schools to apply to, she did look for this and got mixed results. Most schools have this statement that they have an LGBT student group. But she thinks you don't know what it really looks like. So it was something she didn't want to seek out the information for. It's funny even how one school listed that they had a group but when she asked some of students, they didn't even know about it.

Surprisingly, Sarah said no interviewer has brought this up. She thought this was interesting. In fact the questions she got about diversity were more general questions. So it didn't come up unless she directly brought it up.

Sarah recalls using a variety strategies. She had four interview by the way. In her first couple of interviews, she was open about it and talked about it. Some seemed to be positive while she felt the others were the opposite, saying the interviewing would cool off as they didn't really know how to respond.

As a result of the mixed experiences she got, she became more cautious about talking about it. So she didn't talk about it in her last interviews. So she only talked about diversity in general and how she wanted to be an advocate for underrepresented groups, without necessarily singling out one group.

[35:55] What Led to a Successful Application

"It's a multi-faceted thing."

Sarah explains there are so many factors going into the application. It helps to have good MCAT and GPA. It helps to work hard to fill in everything - volunteering, research, leadership. In particular, she found it very important to spend time in self-reflection thinking about who she was and how this was going to play out in her future career and how that formed her to be who she is today. By being really honest and spending a lot of time into this, really helped her a lot throughout this whole process. Sarah and I worked together on her personal statement. She actually had 15 or 16 drafts of it.

Sarah's advice for those who are part of an underrepresented group and wondering whether they should bring it up in the application or the interview is that you have to spend a lot of time thinking about who you are and what's important to you. Although it was scary for her to talk about it since it was really personal to her, she also felt it was something meaningful so she thought it was something she should share. Again, this all goes back to knowing yourself, do you want to do this, do you think this makes your application meaningful, and is this important for you.

"Spend a lot of time thinking about who you are and what's important to you."

Links:

If you need any help in your medical school application, maybe we can help. Find out all the services we offer and let us be a part of your journey to medical school.

MedEd Media Network

Aug 08, 2018
297: What If You've Applied and Your MCAT Score Is Not Good?
20:42

Session 297

If you've not taken my advice and pushed your MCAT back until June or July, you may be in for a rude awakening when you see your score. What should you do?

A brief story, the MCAT scores were released at the end of this month (July) and two students I’m working with specifically got scores that aren't what they wanted,not what they expected it to be.

“Their scores weren't where they wanted them to be, not they weren't where they expected them to be.”

Meanwhile, don’t forget to check out all our other amazing episodes on MedEd Media as you walk through this journey towards medical school and beyond.

[02:10] Applying to Only One School

This a strategy several students do, for which I was used to be against this. But now, I'm starting to come around to it a bit. I can understand from the perspective of students the safety it gives you. That said, I'm not 100% sold on it.

I'm talking about only applying to one school when you submit your application because you don't have your MCAT score back yet.

Now, if you've followed my advice from the beginning, you would have taken the MCAT at the latest, March or April of the year you're applying. That means you would have your score back by the time you submit your application. You would know your score and hopefully, have the confidence to apply to more than one school.

But if you're not taking the MCAT until you submit your application, then you're lacking confidence in your score. But you know you have to apply early. So you end up only applying to only one school.

Talking with this student, she got a 495 and her highest score on the practice test was 500 and the other AAMC full-length exams were 494s. So it was the score she was supposed to be.

[04:40] Practice Tests: How Far Are They From Your Real MCAT Score?

I always talk about how practice tests being the best way to practice for the MCAT. And what you're scoring on the practice test should be about equivalent to what you will score on the real thing. But they don't take into account the obvious fact that stress happens. Real test day jitters get to you.

Walking into the library to simulate an MCAT test don't affect you the same way that the real MCAT will. Hence, it's not unusual to score lower on the real MCAT than you did in your practice test. So don't be surprised and think it's a glitch in the system. It just happens. Sometimes, some students score much better on the real test. But then again, you can't expect for a miracle on the test day.

"Your anxiety levels are different during the real test than doing the practice test."

[06:35] Using the URM Card

So this student had a mediocre undergrad GPA with great extracurricular activities, great background, great story. She's a URM (underrepresented in medicine) and that adds to it. So what do you do with a 495? Do you apply and hope there's something in your application medical schools will like? Are you a URM? Do you play that card?

"There's a reason we use race in admissions because we need diversity in medical schools. We need diversity with our practicing physicians."

Data shows, unfortunately, that because of the biases built into our system, that African Americans were significantly less or lower on the MCAT than Caucasians and Asians. But this doesn't mean they should be punished for it. That's why when you look at acceptance rates, MCAT score-wise they're lower. As to why, there a lot of reasons for that.

So what do you do then?

[08:40] Option #1: Apply.

One thing I always tell students along this process and in the Medical School Hangout Group is to ask the admission committees of the schools you're interested in applying to and lay out your cards. Tell them your story and that you're an URM. Ask whether they have minimum cutoffs for URM students. They may take a 495 and they'll look at you. Or they may say no.

"Ask the schools. Go to them. Don't ask your premed advisor. Don't ask Reddit. Don't ask SDN. Don't ask in the Hangout. Ask the schools."

Ask the school what to do next and where do you go from here. They may tell you to apply, or not. Or they may tell you to apply and retake the MCAT. Hence, the first option is to apply. Spray and pray.

"Spray and pray. Spray your application to as many schools as possible and hope that one looks at it and goes, we'll take a chance and write you for an interview."

[10:55] Option #2: Retake the MCAT

Since you've already applied and pushed forward, the other option is to retake the MCAT. This depends on when you took the MCAT, when you got your score back, and when you can retake the MCAT. Hopefully, you get to practice to raise your score otherwise if you get the same score in your practice test, there's no point in retaking the MCAT.

If you're scoring higher in your practice test and then you took the MCAT and got lower, then something went wrong on test day. Go and take the test as soon as possible. Refresh your memory if it's been a month since you've taken it. Go take some more practice tests. Take the test as soon as you can. Keep your applications going as well as your secondaries. Go and do the best you can do on the MCAT.

[12:00] Option #3: Withdraw Your Applications

The third option is to call it quits for this cycle. And it's just this cycle so it's not a failed attempt. This doesn't mean your dream of becoming a physician is over. It just means it's going to be delayed for another year. And that's okay. This may give you time to save up some money for the next application cycle and for some MCAT tutoring.You can save up some money so you could reduce your work hours so you can focus on the MCAT and do more volunteer activities, more shadowing, and more clinical experience. You have more time to focus to bolster your application.

"You're not a failure. Scoring low on the MCAT does not mean that you can't be a physician. It just means you didn't do well on the MCAT."

But since you're looking at your MCAT score and thinking it's not what you wanted to be, then obviously, focus on the MCAT. Don't distract yourself with thinking you're taking a year off to study for the MCAT, might as well do a Master's. You're supposed to be studying for the MCAT. That is your kryptonite, at least right now. So go study for the MCAT.

[13:41] Be Self-Aware and Get a Tutor

If studying on your own has proven that it didn't work for you then get a tutor. Have a tutor look at you, at your studying, your techniques, your test-taking abilities and have them offer you advice on how to move forward.

You can check out Next Step Test Prep and get a tutor. Use the promo code MSHQ to save some money. Ask them to help you figure out where you did wrong with your practice tests. Not all of you are going to need a tutor to go all over the content or the practice tests. While some of you need that, others don't.

So if you think you've got the content under control, maybe it's worth a phone call to Next Step. Tell them you need a tutor to go over a practice test or two with you to figure out where you're going wrong and help you break down the questions and see where your thought process is leading you astray. Otherwise, you're just shooting yourself in the foot and end up in the same place as you are right now, scratching your head wondering why and if this is meant for you.

"You have to also look at the process that led you to the score that you got, and that process needs to change."

[17:00] In Prep for the Boards

Keep in mind that once you're in medical school and you're taking the boards, there's no retaking it unless you fail. You get the score you get. So you need to start practicing to do really well in these kinds of tests. You need to figure out how to do well in large standardized tests and that starts today.

So as you move forward and you're already in the middle of the application and you've submitted your applications, there are several things to do.

[17:50] Why It's Great to Delay It to the Next Year

"Understand that this is not the end of the line for your medical career. This is just a hiccup in the road."

If you only applied to one school then maybe that's great, because when you apply to schools next year, you're not a reapplicant to them and they haven't seen your personal statement so you don't have to change that much. If you're prewritten your secondaries while waiting for the MCAT score, all that stuff is already done so great! You've already asked for letters of recommendation. So you're stress-free. If you're going to reapply next year, most of your work is done. You'd only have to focus on the MCAT.

But then again, you have to know why you failed in the first place. Do not go running to forums and strangers. They can tell you to go apply to a Caribbean school or a DO school. Anybody who doesn't have a say in the medical school admissions world, you should not be asking questions to.

"But unless you're hearing it from an admissions committee member at a school you want to apply to, ignore it. It's just noise."

Lastly, if you're taking some time off, continue to be consistent with your shadowing and with your extracurricular activities and all of that. Because since you're applying in a year, you still need to do all those stuff and you need to be consistent with it.

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Aug 01, 2018
296: What are Med School Red Flags & How Do You Talk About Them?
37:38

Session 296

Red flags seem to confuse a lot of students. They come up in applications and interviews and you need to be prepared to talk about them. But what is really a red flag? And how do you overcome them? Do you talk about them in your application? These and more in this episode today!

Do you need some help with your interview process? Start with episodes found in this podcast including Episode 19 with Dr. Norma Wagner, the former Dean of Admissions at three different medical schools. Then work your way through and find those interview episodes to get you going.

The Premed Playbook: Guide to the Medical School Interview is now available at Barnes and Noble and Amazon. If you need more help, check out the interview platform, an anytime mock interview platform where you log in and get access to it monthly. It records you as questions pop up on the screen in front of you. The key to interview prep is recording yourself and getting feedback. This platform allows you to record yourself. Just click a button and email it to a mentor, advisor, or whoever to get some feedback. It also includes a built-in assessment for you. Coming soon, we have an interview course. So stay tuned!

[03:35] What is a Red Flag?

There's this mentality that as a premed student you have to be perfect. Otherwise, your dreams of becoming a physician is all over if you get a C+. But a C+ is not a red flag. I see a lot of students applying to medical school and they have horrible grades. Then they work themselves back and they showed that they can handle it. So when you see one C+, don't worry about that. There are a lots of students who got C+ and they did just fine.

"Most of the students I work with are nontraditional students so they have horrendous grades. They have horrendous MCAT scores. Then they work themselves back and they showed that they can handle it."

So what is a red flag? What should you be concerned about as you're preparing your application? How can you start to think like an admissions committee member so that you can start evaluating your application from their eyes? Once you start thinking like them, then things get a little bit clear for you. Then hopefully, you anxiety levels come down.

The red flags I’m going to discuss here are potential red flags. They could be or not, it depends on your situation and whether you’re doing something about them to prove to the medicals school admissions committee that you own them and that you can handle the coursework.

"Own it, learn from it, and move on."

[07:05] Red Flag #1: Arrest

If you've been arrested for anything or charged or convicted of anything, all of those are potential red flags. Depending on how questions are asked of you in the primary and secondary applications and during interviewers, and anything you have to fill out, you may still have to say yes, even if you think it's been erased. Check out Episode 197, where Larry Cohen, a lawyer, talks about how to answer these questions, and what you can and should and shouldn't say. So if you've been arrested and you've been asked by the admissions committee whether if you've been arrested, even if you haven't been convicted, you still have to say yes.

"If you have a huge red flag in your application, you need to own it."

You have to own whatever red flag you have in your application. If you don't own it, you're probably not going to get an interview. I had a discussion with the Director of Admissions at an osteopathic school a few weeks ago when I was in DC for an advisors' conference. They cited one example of a student who got arrested but didn't own it so they didn't accept him.

Again, you have to own it. Then talk about what you've learned from it. Don't make excuses. How have you grown form it and how have you grown more mature? How have you learned your lessons? Tell them what you're doing to work on you as a person so that this doesn't happen again. Some of these red flags may be unavoidable, but at least they're explainable if something comes up. All these red flags are potential red flags because the school doesn't understand the whole picture, especially if they see gaps in it.

"Own it and talk about what you've learned from it."

Being a physician is all about judgment and being arrested for anything show potential poor judgment. As kids, we're expected to do so. But if they see you’ve been arrested over and over, then that’s a red flag.

[15:22] Red Flag #2: Disciplinary Actions for Cheating

If you had any cheating or plagiarism on your record, that's a huge red flag. Cheating your way to medical school is not going to look good. If it happened during Freshman year and you've learned from it and you've grown, with no other issues the rest of your time, then great. Again, own it. Don't make excuses. Say what you learned from it.

But if you got caught cheating in your Junior or Senior year, that's going to be a lot harder to overcome because now you don't have a track record of personal growth.

"Anything further back from the past is much easier to overcome than anything recent."

[16:35] Red Flag #3: Downward Trends

If you have a downward trend in your GPA recently or by around the time you're applying to medical school then that's a red flag. If you're stumbling into your application grade-wise then something is up. Are you burned out? Take some time off. Medical school is going to be a lot harder and you're just going to continue to do poorly.

But if you have a downward trend early on, for instance, you take on too many extracurricular activities during Freshmen so you're struggling with your grades, but then you rebound back up and finish strong. As long as you have a good track record past that, and long enough to appease the admissions committee so you can show them that you're okay and you can handle the coursework.

If you have a downward trend going into the application, that's going to be a much harder thing to overcome. And if you get an interview, you have to talk about what's going on.

[19:00] Red Flag #4: DUI

This is another judgment issue. But a lot of good people get behind the wheel and get a DUI. Do you tell the school?

Again, own it. You would rather that you told them about it than them knowing about it from the background check. Own it and learn from it. As humans, we make mistakes and schools understand that.

"It happens. We are humans. We make mistakes. Schools understand that. It just depends on how big the mistake is."

What the medical school is going to think about is the safety of you during school, your classmates' safety during school, and your ability to pass medical school and do well on the boards. They're also thinking about patient safety as you're rotating through hospitals. On top of that, they have to think about your ability to get a medical license after you graduate. As soon as you start thinking like that, and you get those kinds of questions thrown at you, just think about those things.

[22:20] Red Flag #5: Failing Semesters

Even if you have failures in a row, that's a red flag but if you're able to explain that and show them that you've grown from that and you can handle coursework, then no problem and move on. The goal is for you to be able to remove their fears, then they can just move on.

So if you failed out of college or got kick out of it, what are the issues? Own the reason behind it. Don't blame others. Own it. Again, if you failed earlier on, it's going to be easier to apply. But if you fail a semester right before you apply, it's going to be a lot harder to overcome that. You may need to take some time off and do a postbac to get that upward trend going again.

"If you fail a semester right before you apply, it's going to be a lot harder to overcome that."

[23:50] Red Flag #6: Too Many Withdrawals

Again, this depends on the situation. If you withdrew one semester or one year, then it's possible something went on in your life at this time and so you had to withdraw. This shows a level of maturity. Whereas if a student has 16 Fs, it shows a lack of maturity. But that's okay if you're able to give your reason and prove an upward trend.

It will come up of course, but that won't stop you from getting into medical school. Own it. What did you learn from it?

As long as you can explain what happened and the rest of your application looks great, then no problem.

But if you have a couple withdrawals after semester or that you've withdrawn from the same class a couple of times and then you took that same class at a community college and got an A, that is a red flag. Why did you withdraw from the class at a four-year university and end up taking it at a community college?

If you have a great GPA but you're withdrawing every semester from classes, are you just protecting your GPA? That's a red flag.

[26:06] Red Flag #7: Not Enough Shadowing or Clinical Experience

Not enough clinical experience, shadowing, or volunteering, those are red flags. How can they know that you want to be a physician if you don't have enough clinical experience. You have to show them that this is what you want.

Moreover, your application has to be able to show to the reader why you want to be a physician, not what. So you did all these extracurriculars, but why do you want to be a physician? Again, it's the why, not the what. This is a tough one as you may not know about it, until you go in and get grilled during the interview.

"When you're writing your personal statement or secondary essays, everything needs to point to why, not just what."

But what is enough shadowing or clinical experience? There is no set number. It's whatever you want. Just get enough and be able to show the interviewer why you want to be a physician.

[28:22] Red Flag #8: Big Gaps in Your Application

This could mean big gaps in your volunteering, clinical experience, and shadowing. Maybe you shadowed for 300 hours in your first two years of college and nothing since then. That's a red flag. This shows the admissions committee that you just aren't really dedicated to be a physician otherwise you've spent more time being around physicians.

"Consistency is key in all of your extracurriculars. And a lack of consistency with big gaps in it is going to stand out as a potential red flag."

Another example is if you've taken a prolonged time off school. You may have a reason but it's a potential red flag and that's going to get asked. So be prepared to explain why.

[29:39] Issues International Students May Face

These are just of the other red flags out there. But the key here is to put yourself in the shoes of the admissions committee member. Think about safety. Think about being able to pass the boards. Think about matching and are you going to be able to get a medical license?

As for international students where it's so hard to get accepted into medical school, one issue that could prevent you from getting a medical school license is getting a visa. Is this going to be an issue? You could graduate from medical school and you match. But there's an issue with your visa for some reason. This is a huge problem. And medical schools see this as a very big risk so they accept very few, if at all, international students.

[31:45] What is Not a Red Flag?

C+ is not a red flag. F could be a potential red flag. Again, it depends on what happened. Own it, learn from it, and move on.

Your poor first MCAT score is not a red flag. If you've done well the second time, then it's not a red flag. If you take the MCAT back to back or even with some period in between and you get the same score, or worse, that is a potential red flag. What happened that it didn't work the second time?

Below average MCAT score and GPA are not red flags. Be less anxious when going into your interview. If you are there for the interview, that means they've looked at your application, your GPA, and MCAT score. So they've determined based on your application that you are qualified enough to be a student. Not amazing, but not a red flag. They may bring this up but again, tell them about what you've learned.

[34:33] Are Community Colleges a Red Flag?

Community college classes are NOT a red flag. I really hope community colleges are going to be the norm in the future. Not every student knows they want to go to college right after high school. So community college is a good way to figure that out. It's inexpensive. And in some states, it's free. So taking those classes are not a red flag.

There's a lot of discussion in the admissions world that diversity of medical school classes are getting hurt because historically, lower socioeconomic students or minority students are going into community colleges. And the less affluent students are the ones going to four-year universities. But this is going away since many schools frown upon community college classes. So it's hurting the more diverse students coming in.

"It's not a red flag. The tide is changing in that world. So don't worry about your community college classes."

[36:40] Final Thoughts

Be prepared for anything on your application. Know your application inside and out. Have reasons for everything. Own your red flags. Talk about what you've learned from them and how you've moved forward.

Links:

PMY 19: Interview with a Medical School Admissions Expert

The Premed Playbook: Guide to the Medical School Interview is now available at Barnes and Noble and Amazon

mock interview platform

PMY 197: Can You Become a Doctor If You've Been Arrested?

Jul 25, 2018
295: Ignoring Advice, He Disclosed His Bipolar Disorder in Apps
46:37

Session 295

If you're struggling with mental illness and you're debating whether or not to put that in your application, today's interview is something you must listen to.

Logan is currently a rising second-year medical student at Pacific Northwest. He decided to reach out to me after gaining an acceptance and after originally being discouraged way back in Episode 194, where I interviewed Jeff who is legally blind and decided not to disclose his disability in his second application because he didn't get in the first time.

So Logan decided to ignore my advice of leaving off any huge red flags from the application. He was very open about his bipolar disorder.

[02:00] From YouTube to Podcast

Logan was originally a YouTuber, and his first taste of disclosing his bipolar disorder publicly was through this platform. But not being a tech guy and hating filming, he just felt he was putting a facade. And it was through a podcast that he realized he was being his natural self.

Logan likes to be a psychiatrist in the future and so he likes his future patients to be at ease with him in telling him their embarrassing, dark secrets.

[04:03] Interest in Becoming a Physician

Logan only realized he wanted to be a physician some five years ago. He got diagnosed with bipolar disorder at 22, right when he graduated undergrad. Then he worked in insurance and finance after it and hated it. He found it so depressing, even more so than he was diagnosed with the disorder.

So he knew he needed a change. He then started working as a public speaker in the mental health sphere and was giving his story to different institutions and he loved what he was doing. He also worked various roles within mental health but he wasn't sure what he wanted to do initially.

However, having talked with a lot of people, he saw the frustration they had with the medications they were taking as well as the diagnosis. So he wanted to take out a lot of subjectivity around mental health. And rather, find some objective means of understanding these mental illnesses and how to better correct them.

"What really led him to medical school is being able to take out a lot of subjectivity around mental health."

[05:40] The Motivation to Tell His Story

Logan was initially warned by the doctors and social workers about the stigma around mental illness. There could be discrimination and it could jeopardize his career and relationships. So they told him it's not a good idea to tell people outside of your most immediate circle. He was frustrated by this and listened to their advice. He was ashamed of his disorder and didn't tell anybody.

"I lived almost with this cloak of shame and I was really embarrassed about my bipolar disorder. I didn't really tell anybody. It was a horrible way to live."

He continued to live this way for about 18 months until The Sandy Hook Shooting. He grew up in Connecticut, about an hour north of Sandy Hook. So how after that incident gave a perception that people with mental illness were violent, and that they were ticking time bombs, he just found it to be so absurd. He knew it wasn't him. He's not a violent person, never been arrested and never been in a fight. He knew he was a good person and so he wanted to share his story. He wanted to prove everybody wrong. He then joined the Speaker's Bureau and started posting on YouTube about his experiences.

"I want to share my story and show that people with mental illness are not like this. They can be normal people that contribute to society."

[07:30] What Bipolar Disorder Looks Like

Logan describes his disorder as experiencing depression at first. He studied in Scotland and when he got there he was struggling with insomnia that actually lasted for months. He started to have really bad anxiety. He thought all his friends hated him and that his family was disowning him. He was having all these negative thoughts that weren't true and these kept him up late at night. This was what led him to alcohol abuse. He as self-medicating with alcohol to sleep, every night for a year and a half, still getting 2-3 hours of sleep every night.

He describes his moods being all over the place. Then when he graduated from undergrad, it was the same time he broke up with his college girlfriend, resulting in his first manic episode. He describes it being too weird, not sleeping the first night. And by the second night, his words and speech were all over the place. He was rambling. People would come up to him asking him if he was on coke or meth. Not having slept for so many days in a row, he started having auditory hallucinations. He thought the FBI was following him around and hacking his computer. Thankfully, his circle of family and friends was able to intervene and had him check into the psych ward. He also knew that gene existed in his family. His uncle had bipolar disorder who eventually committed suicide. So growing up, he always knew he was susceptible to something like that. It wasn't until that manic episode that he realized something was going on.

He thought it would have come out no matter what but at that time he was experiencing insomnia, he knew he needed sleep. He knew he wanted to sleep but he was still so ashamed of talking to a therapist, much less telling anyone. He didn't tell his parents or his friends about what was going on. But then had he told anyone sooner, it wouldn't have gone so acute. It could have been a little bit friendlier means of diagnosis.

"I wish I just would have talked about it sooner. And I think having that social support and network was really what helped me manage this disorder better."

[12:40] Going to Medical School with Bipolar Disorder

At first, Logan really didn't think he was going to be smart enough for medical school. He was initially looking into nursing programs thinking medical school was just far outside of his capabilities. Then he met a friend in Sacramento who took all the premed requirements at University of Michigan but wasn't sure if it was something he wanted. Dan also knew about Logan's disorder and his interest in improving medicine around bipolar disorder, that he encouraged Logan to try to be a doctor. He gave him some ideas about how to do it, especially that he wasn't a science major. So he began reading articles online. And this was how he eventually found this podcast.

Logan's favorite episodes were those featuring the nontrads who had a similar path to him, going back to school and applying. I fact, his friend told him that he was going to stick out being a nontrad because he might just have a great story to tell.

"You might not be the smartest kid in your class, but you'll be able to stick out in an application, so why not go for it?"

Not coming from a family of doctors, when he told his parents he wanted to abandon his career in insurance and go to medical school, they thought he was out of his mind. It was really that friend who never cast any shadow of doubt. He was super encouraging, telling him he could really do it. And he also realized this was also what he really wanted. Now, he's a year ahead of him Logan in medical schoo.

[15:45] Bringing Up Red Flags in an Application

Jeff, back in Episode 194, was diagnosed as legally blind and he applied to medical school the first time around. He wrote his essays and everything was around being blind and how it affected him that led him down this journey. Unfortunately, he didn't get in anywhere. So his logical conclusion was they must be scared of his disability so he decided not to talk about it when he had to apply again. He was able to see during the day that he really didn't need a walking stick so he was able to go through the entire application process and was accepted. It wasn't until the letters came asking if he needed accommodations that he revealed his condition.

And I've talked about this several times since, about bringing up red flags. I have always recommended trying t not disclose things that are going to be an easy out for the admissions committees.

So when you look at a disability or mental illness, DUIs, alcohol abuse, arrest, etc. they'd be thinking that there are 10,000 other applications here that don't have this so why should they even bother wasting a second with this application.

But Logan decided to tell his story instead. Logan was a voracious listener of this podcast. He describes listening to it every Wednesday when it gets first released. He was just always looking forward to it. And when that podcast 194 came on and he listened, he was just heartbroken. He didn't have any premed advisors but he considered just me and Dan as the closest things to it. In fact, Dan had the same similar stance that it wasn't a good idea to bring it up in the application.

This discouraged Logan that he stopped listening to the podcast for a while. But he bought The Premed Playbook: Guide to the Medical School Interview and he has already been listening a lot to this podcast about developing a personal statement. What he took away from this was that he needed to tell a story.

"Why do you want to go to medical school? That's really the key that every medical school wants to know."

So he sat down trying to figure out any way he can tell his story of why he wanted to go to medical school without disclosing his disability of his mental illness. But he couldn't find any. He knew he would be lying. Unlike Jeff who has always wanted to become a doctor even before his disability, really for Logan, the only reason he wanted to go to medical school was because of his own personal experience. So he thought there was no way he can do this without saying it. He knew it was a big gamble. But he also knew he wanted to be physician no matter what and he didn't care if no US medical school would accept him as he'd go to Canada or Mexico or wherever.

[21:15] Telling His Story and Dealing with Physician Burnout

Logan thought it would have been much harder to tell his story if he didn't disclose otherwise and put on the big face of being the perfect applicant. So during interview days, he would sit there with the other applicants, telling himself that they're not going to say what he was going to say. So he knew he'd be memorable, be it for better or worse.

"I just try to always put it in the perspective of patients. How am I going to be able to help patients feel better because of my experiences?"

His dream is to be able to sit down with patients and just say he's been in their shoes and they can do this. Speaking of the future, where you're being treated for depression and you need to get license by the state, this could be a red flag and there could be potential issues. As to how he would be dealing with this possibility, Logan just thinks of it from another perspective of physician shortage, and especially, psychiatrist shortage. He's aware he could be shutting his doors to certain opportunities. This could be frustrating but he also thinks that people like him are going to be ones leading the future who will be ending this physician burnout or medical student burnout epidemic right now.

In fact, he was so open about his experiences during the interview that he was making other students around him feel more comfortable to seek their own mental healthcare.

[24:40] From the Admissions Committee Standpoint

Logan says one of the things he got asked at almost each school was how he was going to be able to handle this, considering this is probably the most stressful thing he was going to go through. So he knew he had to convince them by telling them that he's not going to tell them that his disorder is perfectly managed. There are going to be days he'd feel depressed and days he'd feel manic. But by being open and allowing people around him, they could help him identify what's going on. He also credits his wife for being the biggest supporter and his family. He recognizes how it's so important to still have a relationship with his therapist and psychiatrist. He had to convince them he'd still be able to do all this.

"I'm not going to sit here and say I'm perfectly recovered because that's just not how mental illness works. But I really had to be strong and challenging when they would ask those difficult questions."

Out of around 28 schools he applied to, he got five interviews, all from osteopathic schools. He thinks this is because maybe they think he's trying to present a holistic recovery to his own recovery of mental illness. It's not just because of the pill that he got better. But he's seeing a therapist, he's actively participating in daily meditation and exercise, and just this holistic philosophy he wants to bring to psychiatry.

"So many patients show up at a psychiatrist's office and they think that they can get a medication that's going to make them feel better tomorrow."

Historically, osteopathic schools are more lenient towards nontrad students and students who have had issues. They like those stories and they think they make better physicians. And I would agree.

And for some reason, the MD world still doesn't value that experience as much, just based on anecdotal stories like Logan's. But I just came from a conference with premed advisors and admissions committee members. I had a conversation with a Director of Admissions for a medical school and we talked about mental illness. She said when something comes across their desk, it's prior drug use, alcohol use, mental illness, they have to think about "what if" or it's irresponsible not to. First thing is safety. Second thing is whether other students are going to be safe. So they think about safety for everybody, especially the students. Then they also think that if they'd give the seat, is this student going to be able to finish school? Otherwise if you had to delay the school for a year for some reason, that's going to be a black mark on the school since the student couldn't finish in four years. And schools are very risk-averse to this kind of stuff. So it's very easy for them to just pass on that sort of application.

[30:35] Being Aware of the Risks

At the end of the day, if this is your story then you have to tell it. I never tell the student not to talk ever talk about the mental illness or whatever. But only that if you talk about it, here are the risks.

"Is there stigma around mental illness? Of course. Should there be? No! We just need to be aware. There are risks."

Logan adds that identifying the risks in your application makes you become a stronger candidate because you're ready. Then you can practice those types of questions that you're going to get in the interview which you know they're going to ask. He recommends really taking an honest look at yourself and just be able to think of yourself as an admissions committee and asking why shouldn't they accept you. Then you yourself becomes a better interviewer.

[32:10] Framing the Story and the Interview Process

Logan admits having a hard time doing it himself, saying there's a lot of bias. So what he did was send his personal statement to as many people as he could. He asked them for the most honest feedback and told them whatever they say won't hurt his feelings. In fact, he did my webinar on interviewing and he got his butt kicked but this really humbled him.

"I got my butt kicked but it really humbled me. And it made me really develop how I want to tell my story in the best light."

For anyone struggling with mental illness or disability, if you're telling your story and you're going to write about it and you get an interview, I think you can relax since they're seeing you as a person and not as someone with a disorder. Sure, they're going to ask you about your disorder. They would want to find out if you're ready for this.

During his first interview, he didn't think he was going to be asked about his weaknesses. He was just too brutally honest saying he wasn't that good in Biology. So he redeveloped this response for the subsequent interviews.

Ultimately, Logan got in at Pacific Northwest. He actually got into a waitlist here as well as another waitlist at another school. But as soon as he got off the waitlist, he was just ready to go and got accepted right away.

Logan suspects the reason for being waitlisted at the school he's at now is that they're very regional focused. So they want students to be from the pacific northwest because of the huge shortage. And Logan is from Connecticut so he definitely didn't fill this aspect. As for the other school, he just really never got the call so he didn't have to go through any decision process in terms of selecting schools. That being said, he was happy with where he ended up.

[36:44] Disclosing His Disorder to His Classmates

In his YouTube channel where he talked about his bipolar disorder, he just posted this on their school's Facebook page. He was terrified aware that people might not like him after that thinking all his classmates around him were just perfect. But he found that there were also people around him dealing with mental illness but they just didn't disclose it to the admissions committee.

"I found there's so many other people around me also dealing with mental illness."

Then they started talking to him a lot more. This was what motivated him to start his podcast. His first nine episodes have all been his medical school classmates talking about various mental health challenges they've gone through. He has interviewed people with OCD, depression, PTSD, ADHD, as well as women who have dealt with sexual assault.

"One of the best things he has ever done is making other people feel that it's okay to not be perfect and not be this little square on an application."

[39:30] The Impact of Medical School on HIs Mental Health

Logan describes going to medical school as extremely challenging, especially they had to take Biochemistry early on. It was something he didn't do great it prior to medical school. Nevertheless, all the techniques he used to benefit mental health (meditation, exercise, family time, traveling, etc), he would sacrifice all of those things thinking he had to study and pass the course.

"I was sacrificing really everything that was proper to my mental health. I was sacrificing sleep. I was consuming way too much caffeine."

So he could see himself going down a bad road that even during the Spring semester, he injured his back that he couldn't exercise at all. Then he started to really feel depressed and so he knew he needed to go back to a therapist. He knew he had to get back to committing to exercising everyday. He had to schedule date time with his wife every week. He won't have to study as much but his mental health is going to be better because of this.

Aware that medical school is a marathon, not a sprint, he just continues on with this mentality that he just has to start preparing for stuff early. He also understands why medical students get burned out. Additionally, having prior experience using the mental health system, he was no longer ashamed. He already knew what he wanted to get back to his healthy state of mind.

If you're starting to go this path of not sleeping and too much caffeine and not exercising, and eating poorly, Logan recommends really looking at who in your life can you call up no matter what. People oftentimes go to their therapist when they start feeling depressed. But just start small. So just disclose and open up to someone you feel comfortable with and they're going to be able to reconcile with you and connect with you. Hopefully, you do get motivated to seek out therapy and a physician if necessary. But with that said, start small. Don't be intimidated by opening up to a best friend.

"I don't think people with mental health illness are the only people dealing with mental health challenges. Every single person has some sort of mental health challenge throughout their entire life."

Ultimately, Logan ends this interview with an advice to always dream big and to never give up even if you fail the first time.

Links:

PMY Session 194: Overcoming Disability and Biases

The Sandy Hook Shooting

The Premed Playbook: Guide to the Medical School Interview

Logan Noone’s YouTube Channel

Logan Noone’s Podcast: Talk Mental Health with Logan Noone

Follow him on Instagram @logannoone

Jul 18, 2018
294: Premed Hangout Q&A: Interviews, Mistakes, and Much More!
23:15

Session 294

For today's episode, we took a handful of questions that students asked in our Facebook group, the Premed Hangout. We cover a variety of topics. Join now!

If you're listening to this before August 21, 2018, the release date of my next book The Premed Playbook: Guide to the Medical School Personal Statement. Preorder it on Barnes and Noble and submit the receipt at submitbookreceipt.com.

Then you will get access to over $150 worth of stuff including a 5-day Personal Statement course I did with students where we broke down their personal statements and they asked a lot of questions. You will also get access to a private Facebook group where we do Facebook Live sessions every other week.

Get access to the Personal Statement Starter Package calls where a student comes on the phone with me as they try to figure out what they should be writing about. You get five of those recordings as well as the PDF version of the book so you can take it with you.

Back to today's episode, we're answering questions from the Premed Hangout group. It's a free group you can join. Facebook is actually doing a trial right now in charging for group access. But for now, we're not charging anything. The group has over 5500 students. Also follow me on Instagram @medicalschoolhq.

[04:05] Interview Prep

Q: Can you discuss the most common mistakes students make preparing for interviews and during the actual interviews? How can we avoid these mistakes?

A: Check out The Premed Playbook: Guide to the Medical School Interview. Go to your library and to your premed advisor. Ask and see if they have the book since I gave out 180 of each of book series (the personal statement book, the interview book, and the MCAT book).

Second, go and listen to previous podcast episodes I've done, starting back in Episode 19, where I interviewed Dr. Wagoner, the former Dean of Admissions at three different medical schools.

The most common mistake is not preparing for the interview. You need to prepare for the interview. You can learn skills preparing for the interview. Those skills are going to help you whether you prepare one month, six months, one year before your interview.

"The most common mistake is not preparing for the interview."

You have to learn how to talk about yourself and how to handle the stress of the situation. You're going to learn how you respond to that situation. Do you sweat a lot? Do you have nervous tics? You have to figure out how you're going to respond.

And the solution is easy. Go and do mock interviews. Find your advisor and a career counselor. Whoever you have access to, use them. If you don't have access to somebody, try to find somebody. If you still can't find anybody, go to go to the medical school interview question generator. Choose a topic, and click, Ask Me!

It just throws up a random question that you can use to practice. You don't know what questions are coming so it keeps you on your toes.

If you like that and you decide to keep it up a notch where you can record yourself and email it to somebody for feedback, use our Mock Interview Platform at $47. It's very similar but you will find videos of me asking you questions. Then your webcam will record you. Then you an use it to review your answer.

"The best way to prepare is recording yourself so that you can give yourself feedback or somebody else can give you feedback."

[07:35] Talking About Mistakes

Q: What is the best way to address essay and interview questions, asking you to explain a weaker portion of your application? More specifically, how do you recommend an applicant can reassure admissions committees that the "mistake" won't be repeated and doesn't define the applicant without sounding unprofessional or losing confidence, for example, in the case of a poor grade or weaker GPA?

A: When you have the ability to talk about mistakes in your application, whether it's an essay, your personal statement, or during interview, always, always, always offer up either what you've learned from it and/or what you've done to fix it so that's not a problem in the future.

A very common thing that students have a problem with they're in undergrad is that they take on too much - too many credits, too many clubs and organizations. And they fail to realize early enough that they are over extended and they have time management issues. They have organization issues. As you're talking about this stuff, then say that "from this experience, I learned that xyz, so that in the future, it won't happen again." This said, you need to throw that solution in there. Whenever you're talking about personality flaws or your greatest weaknesses, whatever it is, always offer up what you have done, what you're doing to correct the issue so that it's not a problem in the future. Now, if you only talk about why it's a problem and what happened, then the question is going to come up whether you're doing anything to fix it. Are you bound to commit the same mistakes over and over again? Is this going to be a recurring theme? So always provide that extra step.

"Always offer up what you have done, what you're doing to correct the issue so that it's not a problem in the future."

[09:46] Fee Assistance Programs

Q: As a financially independent student, how do you balance working full time and going to school full time? How do you manage to pay for all the fees associated with applying to medical school? Are there any programs to assist premed students with the medical school application process?

A: The AMCAS and AACOMAS both have fee assistance programs. They have a limited number of funds every year and so it's on a first-come-first-serve basis. So apply earlier. With this program, you get reduced MCAT pricing and reduced application prices, etc. Check out the Fee Assistance Programs if you're struggling financially. But there's a caveat with those programs is they'd ask for your parents' income.

"This is medical school applications 101. Whether you're looking for the fee assistance program or you're just looking to get into medical school, the earlier you apply for it, the better."

There is a process to appeal and to try to get your parents' income to not be a factor in the FAP determination. This may be a long process, but this might be worth checking out.

[11:15] Balancing Working Full Time and Going to School Full Time

As to how to balance working full time and going to school at the same time, it's chaotic. You don't balance it. It's crazy. You do what you need to do. The issues that come up with that is there is probably no time to do everything else you need to do such as shadowing and clinical experience, and volunteering, maintaining relationships, and being a good son and daughter, etc.

"A lot of things get pushed because you're working full time and going to school full time."

The question is, do you need to work full time? Or do you need to go to school full time? And you stretch out the process a little bit by going to school half time to save your sanity for a little while. Or you can go to school 3/4-time and use the extra hours for studying or for volunteering or clinical experience, etc. Then you can slow down in that way.

[12:15] Managing the Cost of Applying to Medical School

Soon we will have a tool on the website where we will have a slider as to how many schools you're planning to apply to and what the cost looks like. Applying to medical school is expensive. If you apply to 20-25 schools, you're looking at $3,000 to $4,000. So you need to budget. If you're two years from applying, divide that by how many dollars per month to start saving.

Other students will get a 0% interest credit card for 18 months and use it to pay for everything upfront with the hope of paying it off in the future.

"Credit cards are dangerous for a lot of people... be careful with that if that's something you have an issue with."

[13:30] Attrition Rates

Q: Something I see little data or statistics on is about medical students, intern residents who don't graduate, match, complete their program. I'm assuming some sort of exit interview is conducted. What are the primary reasons? Is it academic? How can we better prepare ourselves as premeds so we don't end up in that situation? If it's family issues, is there a common theme. I know depression and burnout are frequently mentioned but are they possibly correlated with those students who fail to thrive, match, or graduate?

A: The attrition rate once the student is accepted to medical school is less than 2% for the majority of schools out there in the US. If you're looking at Caribbean schools, the attrition rate is much higher because they're accepting a lot of students who probably shouldn't be accepted to medical school in the first place.

"In the U.S., attrition is very, very, very low which is why applying to medical school is so hard."

In the U.S., the attrition rate is very low that's why applying to medical school is so hard. Schools are trying their best to figure out which students are going to be the most successful. To do that, they need to find students who are going to complete their coursework, their boards, etc.

Once you're a resident, you're not dealing with academic issues anymore, but now you're dealing with the burnout, the stress, and the second thoughts whether this is something you really want to do. The attrition rate is not very high still. It may be in the single digit percentage. There are programs out there that are always looking for PGY2 spots because students drop out or they change residencies or specialties.

[15:37] Talking to Your Premed Advisors About The Premed Years

Q: How do you politely tell your premed advisor at your university to pull their head out of the sand and listen to The Premed Years?

A: When I was in Washington, D.C for the National Association of Advisors for the Health Professions National Conference 2018, my goal was to get in front of premed advisors and talk about collaboration, not competition. I'm not here to steal their students but I'm here to educate them so they're better informed when they come and talk to them.

There are going to be advisors out there who still won't like that because they may not agree with my message. So they will just shut it down completely. There are a lot of advisors, on the other hand, who love what I'm doing. I explain this to advisors that I started this 6 years ago to be the anti-Student Doctor Network. I wanted to put some positivity into the premed process and show to them that you don't have to compete with your classmates. I wanted to show them that if you do work together and you are good enough students, you can both get into medical school.

Use this sort of language to your premed advisors and let me know. If they want to reach out to me, I can send them books and whatever they need. I'm here to help them.

"I started this 6 years ago to be the anti-Student Doctor Network."

[18:07] Secondary Application Questions

Q: How do we know what the applications ask before applying? Can we see them somewhere?

A: I assume this is talking about secondary applications since the primary application is the same through and through every year for the most part. For the secondary applications, there are databases online that are available.

I am creating my own database of posts and resources for secondary applications. I created a form that as you are applying, go to medicalschoolhq.net/secondarysubmission, choose the school and submit the secondary for that school. This will help us keep our secondary database up to date so we can provide the most valuable resources to the students.

If you're applying to Texas schools, the secondary applications are through the actual medical schools websites. Whereas for AMCAS and AACOMAS, they email you their secondaries.

[20:05] When to Reach Out to Schools

Q: Is it a good idea to reach out to schools after you submit your secondary and before interview to show your interest? What's the best way to go about that?

A: As you're going through this process, once you submit an application, you're kind of off-limits for the most part for advice. So there's no point in reaching out post-secondary pre-interview. There are times where it takes too long before they contact you. Some schools don't want any contact. So follow the rules for each school. If you're clicking submit on your secondary and you're sending an email right after submission, don't do that. But if it's been a while and maybe you have an update and if they allow updates, then add that and say you're still interested.

The best is to reach out to the school before submitting your applications. They have different rules of engagement because you're a pre-applicant and not an applicant. So go with solid questions as you reach out to them.

"The best is to reach out to the school before submitting your applications."

Links:

Premed Hangout

The Premed Playbook: Guide to the Medical School Personal Statement

The Premed Playbook: Guide to the Medical School Interview

@medicalschoolhq

Session 19: Interview with Medical School Interview and Admissions Expert

AAMC Fee Assistance Program

AACOMAS Fee Assistance Program

Submitbookreceipt.com

medicalschoolhq.net/secondarysubmission

Jul 11, 2018
293: Can You be an Alcoholic and Still Get Into Medical School?
44:59

Session 293

If you're listening to this before July 6th, 2018, I'm giving away 100 copies of each of my books. 100 winners will get one copy of all three of my books. Text BOOKGIVEAWAY to 44222.

Michael joined me to talk about his struggle with alcohol since middle school, failing his first application, and what he did to succeed the second time. He was raised in a family that dealt a lot with alcoholism and addiction and he struggled from middle school through college until he got himself together to clean up his life and succeed on his journey to medical school.

If you're struggling from alcoholism or addiction, please seek help by calling the Substance Abuse and Mental Health Administration Helpline at 1-800-662-4357.

Ultimately, there's still hope and Michael proves that this can be done!

[02:50] His Interest in Becoming a Physician

With Michael's mom as an RN, he got exposed to medicine at a young age. He thought being a doctor was cool although he didn't really understand what it meant then. When he was a kid, he just wanted to be able to do what doctors do.

A very common story for a child of a healthcare. But as to asked why not a nurse, Michael recalls asking his mom questions about anatomy and physiology. Oftentimes, his mom wouldn't have an answer for him and would refer him to the physician. So that was put into his mind that if he was going to know those things, he would have to learn what the doctors knew.

[04:50] The First Stumble: Battling Against Alcoholism

Michael explains his first stumble was at middle school. Her mom was an alcoholic but she has been sober now for about 21 years. His dad, meanwhile, was a meth addict and moved away when he was 8 years old to get away from troubles in their hometown. His older brother also used to get into a lot of trouble. And for him, he was his sort of his role model. He was hanging out with him and so he got into drinking beer and smoking pot when he was in middle school.

At the same time, he always wanted to do good at school. He knew as a kid that if he wanted to be a doctor, he had to get the best grades. But he found himself not doing this in middle school. At this time, his mom was already sober and she noticed what was going on. She sat down with him and talked with him and encouraged him to get Bs. From then on he started doing it and his grades just took at upward trend. Eventually, he started to get straight As. This was his first turnaround.

By the time he got into high school, he was getting straight As and was in the football team. He was doing all sorts of extracurricular stuff. On top of this though, he was still doing alcohol. Good thing, Michael was able to relegate his drinking and smoking to the weekends or couple of times here and there.

Michael admits that his grades and being a student athlete actually took cover for him as people wouldn't be expecting him to be doing the wild stuff. But throughout high school, it got worse.

By the time he sent his college apps in and football season ended in Fall of 2004, he went on vacation. He felt he was working so hard while he had these friends he'd party with on the weekends who had it easy. He wanted the same. So after most of his responsibilities were done, he really took advantage of it. He went on vacation for 7 years.

"Alcoholism is a progressive disease. It got a point where I couldn't control it anymore. I didn't have the say and I lost the power of choice."

He got to the point he was cutting classes and just wasn't in control anymore. He hoped it was just a phase. He had friends who went through the same and they just got out of it and had their stuff together. They left all the drinking and drugging behind. But this was not the case for him.

He saw his mom got to AA (Alcoholics Anonymous) and got sober and she changed completely. He knew that if he got to a point she did, then he'd seek the same kind of help seeing how it works. But then got to the point that he no longer thinks he can ever quit and that if he ever will quit. There were times he wanted to but that's the cunning nature of that disease. He simply describes it as pure insanity.

After graduating from college, he squandered four years of an incredible education. He didn't realize how many opportunities are afforded to matriculated undergrads until he left. He graduated from one of the best public universities in the world and spent the next year putting tags on clothes on the back of a surf shop. It was his choice. He saw it didn't fit but he couldn't do anything about it. It wasn't in him to stop what he was doing and just found himself in this vicious cycle.

[12:55] Failing Grades

He graduated from college with a 2.59, not medical school material though. He also remembers during sophomore year, the last semester that he had taken premed courses. he spent his first three semesters on the premed track and failed miserably. He failed classes, getting Ds and Fs. Then he got sent to a "save your semester" workshop where they were guided as to what they can do to do better. Then he switched majors.

Another reason he did well in school is because he didn't want the party to end. He was motivated to keep his grades up because he didn't want to leave school and have nothing to do. It motivated him to keep showing up.

[14:44] Time to Change

In December 2010, a year and a half after he graduated, he was hanging out with his buddies and living in the pad with amateur skateboarders. As they went out to a bar, he had just enough money in his bank account to pay his rent. He had no savings. He then gave his rent check to his roommate and still wanted to go party. The next day, his friend cashed the money. He was then left with no resources. Until he just got to the point the point that he was tired of hustling and stealing. He was tired of lying and cheating people. And something inside him just changed. He realized he didn't want to do what he was doing anymore.

"My bottom wasn't any one particular point, it was just day after day, waking up to this terrible realization that all those great plans I had for my life were not going to happen."

He knew to his core then that it wasn't something he wanted to do anymore. So he turned to his parents and asked her for some help. They then got him hooked up in a program and it took him 6 months relapsing and drinking. But eventually, he got sober and he has been sober for 7 years now.

[17:50] Was There Still a Chance to Go to Medical School?

At that point, Michael just didn't know what he wanted to do. And he had convinced himself that becoming a physician was not an option for him anymore. But his AA sponsor encouraged him to do what he wanted to do, which was being a doctor. And so he pushed him to just try. So he went for it.

"Wouldn't it be worthwhile to just make the effort even if it took half a decade?"

He didn't really know how to go about it. He did some internet searches but didn't know who to talk to. He did find out what a postbac was and he only knew of formal postbac programs that had minimum GPA requirements which he didn't meet obviously. So he just started to go to a community college and took difficult classes just to prove that he could still do hard work. He also applied to a couple postbac programs and got rejected from all of them. He then found one postbac program that was informal and had an open enrollment. Unsure if it was legit, it turned out they were. At this point too, he was working full time. He worked with his father and they started rekindling their relationship as well. For the last six years, he has been working with him and out of that he was able to develop a relationship with him. While he was working there, he started going to this informal postbac program in 2013.

"I just took some difficult classes just at community college just to prove that I could still do hard work."

Moreover, he started volunteering at a hospital where he lived. And he did all of this for four years and at night on the weekends. The first two years, he took three classes and nonstop, every quarter, there were no breaks. He describes it as being crazy. The university where he did his postbac had a spring break but for some reason, they didn't. He took a final Saturday morning and the next Monday, he was starting his next quarter. Looking back at those two years, he was wondering how we were able to do all that.

[22:22] Applying the First Time and Failing

Luckily, Michael didn't have any criminal records. Reason for this is that at the back of his mind, he always knew he wanted something for himself in the future so he was always very careful. Whenever hanging out with his buddies, he was always the annoying kid who would stop them from doing crazy stuff. He still had that little voice in his head and it paid off because he never got caught.

Looking at his chances, Michael admits he felt overconfident. He thought that if could just great straight As then they're going to look past the 2.59 GPA and the lack of extracurriculars. But it wasn't the case the first time around.

Applying the first time, he applied to 21 MD schools and got zero interviews because he admitted his alcoholism. This is what he thought was the reason for it. And he was advised by many people to not include this part of his story. Not because it has no value but because there's a lot of stigma out there about mental health and about alcoholism in physicians and drug addiction.

"There's not a lot of faith in the plasticity of the mind and in the value of the lessons that are learned by somebody who's been to the bottom."

Michael feels like he can look at other people's behavior now and can understand them and that he gets them now. As to why everybody's advice and deciding to tell his story, he didn't know how else to explain his undergraduate performance. He didn’t realize 2.59 is not good, but you don't have to blame all of them on the alcoholism.  He also thought it made him a strong candidate since it shows resilience and that it shows a potential that he has a lot of compassion which he can have for his patients.

This is what I tell students that in the perfect world, it wouldn't matter. But if you have 8,000 applications and there's a potential risk of the stress of medical school that can cause a relapse of alcoholism or worsening a polar disorder, there is the stress of medical school is something you've never faced before, and this is a risk.

So he told his story and didn't get any acceptances. No interview.

"In the perfect world, being sober shows your resilience and that you've overcome, but it's also still potential risk for that medical school. Are you going to be a safety threat to yourself, to fellow students, to whoever?"

[28:25] His Second Time Applying

Michael reapplied without mentioning alcoholism. And reconciling this, he did feel a little disingenuous but at the same time, he felt he only needed to put down the most pertinent information. So he left that part out of this story and he got three interviews, two acceptances, and one waitlist.

"While it is my story, it may not be appropriate for this venue."

All his interviews were close files and in one of them, they asked for his resume where he put his GPA and MCAT score. So they asked him about it. And he told them he was a young man who lacked maturity and the fortitude to address his responsibilities. And this was true. He just basically did everything on his own. In short, he didn't mention about alcoholism during his interviews.

As to whether he will reveal his past struggles to future patients, Michael says he wouldn't want to jeopardize his position wherever he's working and potentially negate his ability to help other people in the future. But he would practice the principles he learned over the years like compassion.

"In order to respond appropriately to what's in front of me, I have to be able to perceive it accurately. I have to seek to understand what I'm looking at."

[35:30] How to Stay Away from the Temptations

Michael says that the temptations have been removed. After taking the course of action, he feels he's now at a place of neutrality where he no longer needs to shield himself from booze or difficult situations. He adds that he needs to keep an open mind and not tell himself how well he should be doing with something he hasn't done before. He will also take advantage of the support he has. He recognizes how this is a team effort. He knows he needs to be able to ask his fellow students for help and honor that relationship by coming up with his end of the bargain. In the last 7 years, this has been such a big part of his life being of service to the people he is involved with and this was very helpful for him. Additionally, he still is going to AA meetings and he is still going to be calling his sponsor everyday. There are three guys he sponsors and they call him everyday. He will try to maintain this over the next four years and be of service to them.

"It's a team effort. I need to be able to ask my fellow students for help and then also honor that relationship by coming up with my end of the bargain."

[38:36] Choosing the School and Specialty

Michael looked in a little bit as to which school to choose in a way that it can support him from a mental health standpoint in the future. Ultimately, he went with the school that when he went to the interview, he looked at how invested were the people in their students. The school he chose appeared to be the most involved, interactive, and invested in their students.

Also, he didn't have the chance to investigate the 12-step community in those areas but it's a global thing anyway so it's available everywhere you go.

Although he has dealt with alcoholism, he doesn't find himself interested in addiction medicine so far. As it stands right now, the approach he took is a spiritual one so he doesn't think it coincides well with what how medicine is addressing addiction. But the way he approached addiction has worked for him and it worked well in a lot of people's lives. He recently read a book by Michael Poland called How to Change Your Mind. It's about a psychedelic research going on right now. So this is something that interests him. As well, he likes internal medicine and he likes surgery. So eventually, he will have to make a decision.

[42:02] Final  Words of Wisdom

Michael had a lot of doubts and fears. And after getting 21 rejections and has done so well in school and on the MCAT and his volunteer program, it didn't make sense to him. And once he got his last rejection, he got sick for four weeks. He thought he wasn't able to do it again. But there's always somewhere deeper you can go to dig to find that energy and inspiration. It's there even if you can't see it at the moment. It's there, you just need to keep going.

Links:

How to Change Your Mind by Michael Pollan

If you're struggling from alcoholism or addiction, please seek help by calling the Substance Abuse and Mental Health Administration Helpline at 1-800-662-4357.

Jul 04, 2018
292: President of His Caribbean Med School Class to Failed Match
39:47

Session 292

Dr. Yousuf is starting his Emergency Medicine residency after failing to match. Learn from his failures and triumphs and how you can avoid similar mistakes.

If you're listening to this before June 30, 2018 and you're in or around the DC area, come to our meetup. I'm in town for the National Association of Advisors for the Health Professions meeting. It's a national meeting for the health professional advisors. And I'm having a meetup on Saturday, June 30, 2018. Go to the Premed Hangout for an RSVP or email me at ryan@medicalschoolhq.net to get all the details.

Last week, we had Dr. Buck Parker on the podcast talking about being an IMG, struggling with his studying, going to the Caribbean, and learning how to fix it. He's now offering his Secret Study Hacks course which you can sign up for and get a discount. If you want to know more about it, listen to Session 291, where I talked about it at the end.

Back to this week's episode, we have another IMG, a Caribbean graduate. Dr.  Ibbad Yousuf who is @dr.bad_md on Instagram. Ibbad when to AUA after struggling in his undergrad and he thrived in that environment. He still struggled with classes every now and then and still picked himself back up. But he was class president. He didn't match the first time and he talks about that today as well as what he did during his time off, until how he figured out how to match.

[02:40] Going to a Caribbean School

A lot of people think I am anti-Caribbean when I tell students you shouldn't go to a Caribbean school. I am not anti-Caribbean schools, but I'm anti-non transparency coming from Caribbean schools. They tell you a lot of things, similar to the military recruiters. They tell you what you want to hear, when in reality it's probably a lot different. This is why I'm bringing on Caribbean grads because they can talk about their experiences. There are a lot of issues with going to a Caribbean school. But you can go to a Caribbean school and be a great physician. "Going to a Caribbean school doesn't mean you get less education, but a lot of students who go to Caribbean schools aren't prepared for medical school."

[04:00] Interest in Becoming a Physician

Ibbad began having interest in becoming a Physician at 13-14 years old when he started taking an introductory to a science research course. Obviously, he likes science. But the human part of taking care of people came into the story when his mom got sick. He took care of her in and out of the hospital and the doctor's office. He realized he wanted to be able to scale helping people. By this, it means, he seeks to be able to help more than one patient at a time. His goal is to be able to help millions and billions of people. And for him, medicine was his way for him to get there - the influence and the ability to work with patients and having that clinical background is more applicable for the science he likes. And he once he got to  that, he wants to scale that to possibly a biotech startup or a wellness startup.

"I love the science and medication is the application of science to helping people."

[07:00] Undergrad Years and Premed Struggles

Ibbad thought that if he had to learn all this in med school so why would he have to take premed now. So he was trying to figure out how to get the most value from education. He started with Business and then shifted to Journalism, until he changed to Sociology and Health Sciences for his major. And ended up getting a Women's Studies for minor.

"The end goal was always getting into med school."

The biggest thing he struggled with as a premed student, he admits, was studying. He graduated from high school early and got into college. But he didn't know how to put together the volume of information. His undergrad courses were very large in the premed sciences. And this didn't help him with his own focus.

So he failed out after his Sophomore year after a combination of life and not knowing how to study. Plus, he was working at that time and partying. So he failed but got back in that same semester with the stipulation that he was going to have to do well until he graduated. He actually got that wake up call after receiving a snail mail telling him about the failing and dismissal. And he realized the process was getting in touch with the dean.

His parents didn't get mad but they were startled knowing how Ibbad used to do so well back in undergrad. Being asked by the dean about what happened and why his grades were low, Ibbad admits it took a lot of self-awareness in figuring out what he needs to balance better and focus more on.

And he remembers there was an organization that votes on your ability to come back and your maturity level. Again, being self-aware is critical here. You have to be able to acknowledge your mistakes.

From that point forward, he got a 4.0, a huge turnaround from failing. Ibbad accounts focus for this. He realized there needed to be certain levels and certain areas of focus.

"There needed to be certain levels and certain areas of focus."

[11:50] Taking the MCAT and Going to the Caribbean

Applying to medical school, he still had to show his grades and that he had that academic dismissal and overcoming that. Not having a lot of guidance, he just studied for the MCAT like he would have normally done in college. Study for three weeks and take it. Because that's what he learned to do in college. He didn't realize he still sucked at taking standard exams. This is aside from the fact, that the MCAT is a whole another beast. So he took the MCAT and didn't do well obviously.

As a result, he went the route of going to the Caribbean. As he went through the application process, Ibbad recalls receiving news about a new Caribbean medical school expanding. So he took a couple different applications and then he went from interviewing to getting admitted, almost within a month and then he moved to the island.

[15:00] The Course Correction

Ibbad says self-awareness is the key. He knows his weaknesses and he failed a bunch f his block exams in medical school. He realized he didn't know how to study properly. And medical school taught him how to do that. So every time he had to level up, he taught himself something new to bring up that weakness. So it's that self-awareness, determination, and drive are key. It's important to know this is where you want to get to, where you are right now, and how you can get there.

"I realized I didn't know how to study properly. But being in med school taught me how to do that."

Having known many people who have given up, he sees things as passing anyway. So what can you be doing in the mean time to allow you to get to where you want to be next? He adds that sometimes you need to take a step back from what you're doing to get a more wholistic picture of it. And this is what got him to course correct through time.

[17:50] The Caribbean Environment: Dealing with High Attrition

Ibbad describes the diversity in the Caribbean. A lot of people had careers before wanting to get into medicine. A lot of them didn't have the direction or physicians in the family. And he saw strength in this diversity.

The attrition rate for Caribbean schools is much higher than U.S. schools, and Ibbad explains there are two ways you can take that. You can see it and realize this isn't for everyone. And then you can also see how this is a survival thing and this, he used to drive himself. He saw the attrition was high, and part of what he was working on as a class president was working with the dean and administration to reduce the attrition rate. Their discussions involved troubleshooting, figuring out why their students aren't doing well.

"It's not like they take students and then not care. They're actively, and myself as a student included, we're working to see how can we make this better."

In fact, he remembers looking at a roster of a few hundred people and within the first two weeks, there were some who didn't show up to the island. Some may have been accepted or off of the waitlist to a U.S. school. So he realized that a large chunk was taken out that way. Then after the first two weeks to a month, they had their first lab exams. This was another reality check if this is going to work for you.

[22:45] The Hidden Number System

Many Caribbean schools boast their USMLE pass rate. But it's not really a real number because there are exams the schools give to see how well you're potentially going to do when you sit for the exam. And if you don't do well on those comprehensive exams, they'd tell you you're not ready to take Step 1 yet so they're not going to let you take Step 1. And they may never let you take it because you may never get to that point where you're going to pass.

The way Ibbad sees is like the quote, "Statisticians are just liars with data." That said, he thinks there are numbers that get moved around in their individual ways. Even premed offices do it. So for them, Ibbad admits having to take comprehensive exams before they were allowed to sit for the Step exams. But he didn't think it was a way to weed you out. Ibbad did pretty well in his exams at 90 percentile above.

"A lot of it has to do with, are you going to do well enough to secure the residency?"

[26:10] Not Matching the First Time and Realizing It's a Number's Game

For Ibbad, not getting a match was tough knowing he had dedicated his summers while he was 15 years old to doing good research and having leadership skills. He got the grades he needed to get on the boards. But this said, it gave him a different perspective of the overall process.

He explains that applying to Emergency Medicine is very competitive and he was aware of that. But he was also the kind of guy that's focused on one thing. The match rate for IMG in 2018 was 1.6%, which means there's a chance.

"Emergency Medicine is very, very competitive and I was aware of that. But I'm also the kind of guy that my focus was on one thing."

As to why he didn't match the first time he applied, Ibbad says one of the reasons is that it's a number's game. He didn't have enough interviews. He only applied to Emergency Medicine, with 170 plus programs. He also understands his limitations coming from the Caribbean. It was a matter of understanding those red flags. The optimum number to match was 13 as they say, and it's supposed to be higher for IMGs, but he only had a third of that.

So this year, he did something differently, He applied to other programs. After all, his goal was to become a practicing physician. He also had to put his ego aside, telling himself it doesn't matter what specialty you get into. And the numbers just worked out.

"I applied to other programs knowing that the dream was to be a practicing physician and wanting to pivot that into other bigger things."

[30:10] Opportunities Available If You Don't Match

Ibbad says there's different opportunities when you don't match. But you have to be realistic enough to create your own timeline and realize what you did wrong and what you can improve on. Otherwise, there are investment banks that love MDs on board, even without a business background. There are also a lot of educational companies out there where they need MDs to help create content and courses. So you can do this to either pass your time or make it your full time career.

Ibbad was one of the medical scholars at Techmonic. Having not matched, he was looking for jobs with pharma and business end. Good thing, a research opportunity opened up and he took that opportunity. But he knew he needed money to live.

"You figure out what you need to do get a monetary employment and then you get that research employment and you go out of it from every angle."

If you aren't in a program and you have student loans, you still have to start paying them back. It also depends on the loans. Ibbad explains that a handful of Caribbean schools have federal loan. He didn't have some leeways with the private loans but the schools have to be around for at least ten years to get that U.S. federal loan process in place. So his first few semesters were private loans. These were the ones that needed repayment. All this being said, the loan companies and the bank work with you, so it's not a massive hit that you'll be paying. Fortunately, it's doable.

[33:05] Reapplying for the Next Match

Being asked what he has been doing in the last year he didn't match, Ibbad was creating medical content so it was related. He was teaching students how to learn and how to troubleshoot and change paths like what he had done. And he was also working on some research. Currently, Ibbad is now transitioning and starting residency. He's also getting back into the study more a few hours of the day.

"You can speak about it passionately. That comes across in a genuine way."

[34:55] Ibbad's Advice to Those Going to the Caribbean

Try to reach out to other people who have been through the process (like Ibbad). He believes having that first person perspective is very important. Secondly, be extremely self-aware. Thirdly, know that your timeline may not work out the first time around for what you want to do. You can take a gap year for research. You don't necessarily get the first residency you want on the first try. Just know that and keep doing what you have to be doing for yourself. It's not bad on the other side when you finally get there.

"Keep doing what you have to be doing for yourself. It's not bad on the other side when you finally get there."

Ibbad would usually tell people that it's easy to get into the Caribbean but it's harder to stay in. He lived in the beach ten feet away from him but that was also his study break. Nevertheless, preparation and self-awareness are huge.

"You get into anything what you put into anything. I think that applies to anywhere."

Links:

National Association of Advisors for the Health Professions

Premed Hangout

ryan@medicalschoolhq.net

Secret Study Hacks

The Premed Years Session 291: Dr. Buck Parker: Academic Struggles to an 'A' Student

Jun 27, 2018
291: Dr. Buck Parker: Academic Struggles to an 'A' Student
39:20

Session 291

Dr. Buck Parker shares his journey of struggling during undergrad to success in medical school and his new course, Secret Study Hacks. Listen to his journey

If you're listening to this before June 24 midnight Pacific time, enter to win a giveaway prize from Next Step Test Prep. Get one free MCAT course from Next Step Test Prep (worth $1,600). We're celebrating the 100th episode of The MCAT Podcast. Visit www.mcatpodcast.com/giveaway or text MCAT100 to 44222.

Back to our episode today, Dr. Parker used to be on the reality TV show and now has a thriving Instagram account. He is also now helping students learn and study. He is a general surgeon who specializes in trauma and he talks about his journey today and why he started Secret Study Hacks program to help students learn how to study. Buck has a special deal for you for his program.

[02:20] Interest in Medicine: Failing and Learning How to Study

Buck's dad was big on hunting when he was younger, in fact, he began hunting at 10. Then he got into big game hunting. As he was seeing the organs of the animals, his curiosity grew and thought it was something he should look into. By 19, he saw a documentary about surgeons, which he thought was the coolest thing in the universe. Ultimately, being a surgeon has what he has always wanted to do.

Not getting good grades in high school, he also just went to college because his parents told him to. He didn't think he'd do well. He was a Biology major, but he didn't really believe in himself. He was just partying and he barely went to class.

It was during his second semester that he got a 1.7 and his parents told him they weren't sure if they'd still shoulder college. After failing chemistry, he knew he had to do something. So he started studying in organic chemistry, but he admits not to have done it right. Obviously, he still wasn't doing well in the tests.

"I started going to this guy and he just started teaching me some basics of studying and what not to do and how to prepare."

Then he decided to get a tutor for physics and he was teaching him the basics of studying and what not to do and how to prepare, etc. After taking the first test in class, he got the highest grades in the class! They literally didn't believe him thinking he was cheating. And the same trend went on test after test. Basically, it built his confidence.

"I'm the guy who aced Physics, I could do anything."

[09:45] The Culture of Studying

After medical school, Buck started reading other books besides medicine and he realized there is a lot of productivity area a lot of people have studied a lot. He explains that studying is very cultural, in fact, even micro cultural, which means on a family level. So for instance, your parents never really passed on that cultural information so when you go to college, it's almost random how you learn to study.

"The more I read about it, the more I think it's very cultural, even like microculture."

[12:15] Life as an International Medical Graduate and Not Having a Plan B

The counselors at college that he approached totally brushed him off. But Buck had a family friend from India and he talked with him one time. He told him he could go to any school outside of the U.S. as long as he comes back and that he's eligible to get a residency. True enough, he did just go to any school outside of the U.S. But looking back now, he wished he could have researched a bit more and found a better school. There are programs through in the Caribbean that are very strong.

As an international medical graduate, Buck wanted to do surgery and nothing else. And this was a challenge for him during interviews when asked about his backup. Too confident, he was so dead spot on surgery. Period. And so when asked if he didn't get in that year, he told them he'd still apply next year.

"It's not so much confidence. but it was that I had only one goal."

There's data that shows form a psychology standpoint that if you have a plan B, you're less likely to put everything into your plan A. With Buck, he didn't have any plan B and stuck with Plan A the whole time. He put his effort all into that.

Buck thinks the reason people ask you for a backup plan is they want you to be okay. But what they don't realize is by doing that, you're sabotaging the person. They want you to be the safe.

"The most unsafe thing you can do is go after something you don't want because you're guaranteed to be miserable."

[20:15] Buck's Study Habits During Medical School

Once he was doing really well, his study habits didn't really change a lot. Only that they've become more frequent. He says you end up incrementally improving. In fact, he was initially so scared that he was studying so much. Over time, you develop those very specific things as well as the motivational habits. You get to build on your momentum and use other people to help you.

But as for the big chunks like studying everyday and reading before the class, or getting some information and repeating it and doing some association in your mind - all those things have already been there. All he had to do was refine what he did for medical school.

[22:27] The Biggest Study Mistakes Students Make

Buck believes that students tend to underestimate everything. Personally, it was a huge problem for him to have underestimated the effort it would take to get a certain grade in a certain class. So you result in cramming for an exam. Another thing is that students can't do delayed gratification that what's happening around them can distract them from sitting down and studying.

"When something is further away, we don't feel the importance of it. We just have this natural bias as humans."

Buck adds there's this bias that we have just like the object in the mirror is farther than it appears.  And this is our bias as humans. So we have to bring that two months away to today. Today is imperative that you have to do x 100% today! Do today what you can do for two months. Develop that kind of "healthy paranoia" in studying because if you can develop that then you're like super focused that you're going to get this thing done today. And tomorrow is the same thing and so on.

"Develop that kind of "healthy paranoia" in studying because if you can develop that then you're like super focused that you're going to get this thing done today."

The easiest way is just to break it into small chunks and set them as what you're going to do today. Some days, you get more while other days, you're going to get less. Overall, try to keep that schedule then you're going to be in a lot better shape. Buck admits he wasn't keeping his schedule but he was still so far ahead of everybody else as he was still doing well.

"It's so much information, but it's even more if you take a break."

[27:20] Secret Study Hacks: Mindset Change

Buck things the reason studying is so hard for people is due to culture where we're just not taught, or that our micro-cultures have not delivered that while we were younger. And studying is really not pleasurable, for most people. Not everybody wants to do the delayed gratification. But you have to go through all this pain right now in order to get to your goal and be able to treat patients.

"Not a lot of people really enjoy everything they read in medicine but you've got to do it."

With Secret Study Hacks, Buck's goal is to inculcate in the belief of students that it's possible. Buck reveals that a lot of students he has talked with were speaking as if it wasn't possible. So first portion, step one is a change of mindset.

The second step has to do with building the correct habits and learning about habits and how our brain works. We have neural pathways and our brain automates programs. If you can build the automated programs to study the right way, then that would be that much easier. And you won't have to spend a lot of energy choosing between studying or not since you will no longer have any choice.

"Once you've built that habit, there's no choice. This is what you do everyday and it's less pain."

Next, figure out the actions and how you can get yourself to do that even if you don't want to do that. Again, think about how you're going to fix your mindset. It's like hacking your thoughts and emotions by "hacking" them so you'll be able to complete your task with less pain.

[31:14] Secret Study Hacks: Motivation and Environment

Buck stresses the importance of staying motivated for a long time and throughout the day. What's going to keep you in your seat when all your friends want to go out?

Lastly, the third piece of this is your environment and how your environment affects what you do, how you make decisions, how you study, and how can hack your brain in a performance sense. Buck says that nutrition has a lot to do with that and the things around you as well.

[32:20] Resources for Mindset Change

Buck recommends the book, The Power of Habit by Charles Duhigg. He thought that had he known about it before then he would have been able to set up so many more things to help himself, especially during residency, which for him was really hard. If he understood how his brain worked a little bit better, he would have set some habits for himself that he didn't have to go astray so many times.

[33:30] Final Words of Wisdom

Buck says that anybody with an average IQ can go into medicine. He was in a position he didn't think he was smart enough. But he learned that it's not so much about that. Instead, it takes dedication and the right kind of tools to pursue medicine. Anybody can do it. But you have to be able to study correctly first. Stay motivated and have a purpose.

[34:23] Review About the Secret Study Hacks Course

Buck gave me free access to his course. When you sign up for my link I get an affiliate commission. But let me do a quick review about the course. So you will find some videos on the site and you will notice how Buck breaks down everything he has learned about studying. You're paying to expedite the process of reading all the books he has read and learning the takeaways he has learned. Most importantly, you can put those into practice. So he's taking all the things he has learned and combining that with the knowledge he has gained from the books. He's breaking down all of that information and that's given to you in a video format to help you expedite the process of learning how to study.

The great thing about Secret Study Hacks is that they're all condensed into a course that Buck has put together for you. The program costs $97/year and with that, you get access to the course and some other add-ons and bonuses including weekly live calls with Buck and a membership to their Facebook group.

If you need help studying and you find you don't have the time to go out and read all these books about studying yourself, perhaps you can subscribe to his program for a year and get all those access. It's up to you. I've asked students about it and they said it wasn't new information BUT, it was all information gather together and packaged up nicely so you get it concisely and quickly versus going out and reading all the information yourself. Plus, you're getting it from somebody who has been through the process and been through medical school and knows what you're about to encounter. So he's framing everything around that.

Go to medicalschoolhq.net/studyhacks to sign up for Buck's program.

Links:

Follow Dr. Buck Parker on Instagram @DrBuckParker

Secret Study Hacks

Next Step Test Prep

www.mcatpodcast.com/giveaway

Follow us on Instagram @medicalschoolhq

Jun 20, 2018
290: How Do You Focus on Your Health While a Premed Student?
31:16

Session 290

Caroline is a second-year med student who runs the @carolinecooksclean Instagram account. As a former athlete, she tries her best to stay on top of her health. So her account is all about eating clean and eating healthy. Caroline shares all about how to prioritize health, eating right, and exercise before everything else, and why this is important.

If you've been struggling with eating healthy or exercise, listen to this episode. Remember, we can't be there for our patients unless we take care of ourselves first.

The podcast is part of the MedEd Media Network, which includes The OldPreMeds Podcast, Specialty Stories, The MCAT Podcast, Ask Dr. Gray: Premed Q&A, as well as The Short Coat Podcast, a production of the Carver College of Medicine at the University of Iowa.

[02:00] An Interest in Becoming a Physician

Caroline has always loved science throughout school and her grandpa being a practicing OB/GYN back was a great inspiration for her. The town he was practicing in was where she also grew up so she knew his patients. And those patients telling her how her grandpa changed their lives has impacted her.

It was a collection of experiences that she had throughout her life that continually just made her feel like becoming a physician is exactly what she was set to do. In fact, she talked about her grandfather on her personal statement because that was her "seed." She points how the personal statement is supposed to explain who you are so the admissions committee gets to know who you are. And not talking about it would just not be right.

"The personal statement is supposed to explain who you are and let the admissions committees get to know who you are."

Caroline adds that just because it's cliche but if that's what shaped you, then you should talk about it. That being said, she never second-guessed becoming a doctor. She was just so driven to becoming a doctor. Sure, it's really hard and challenging but this never swayed her from the thought of becoming one.

[06:55] Major Struggles as a Premed and the MCAT

Caroline admits inorganic chemistry was the biggest thing she had to overcome. She didn't put much effort on the first exam so she obviously didn't do well, in fact, having the second worst score in the class. But it was great that she acknowledged it was a mistake on her part for having taken it for granted, thinking it was easy but it wasn't.

"I did horrible on the exam... I think probably the second worst score in the class and I was used to being the top student so when I saw that was really shocked."

Again, it's a matter of figuring out where you went wrong and doing what you can to course-correct. So Caroline did a complete turnaround and worked on it 100%. So from the worst score in the class to getting 100% on the orgo 2 final was just incredible and from then on, she knew she could do anything.

This was also before her MCAT so she used this as her motivation to get a high score on the MCAT having gone thru failure and was able to get back up. Speaking of MCAT, she studied for four months for it, while she was still studying because she took it in January. It was hard for her to study the same stuff for that long and to see her first couple of practice scores to be pretty low or not near her goals. Additionally, she took a prep course which she thought really helped a lot. She even had a tension headache a week before the exam but she knew she had to relax but she took comfort in the encouragement from her friends.

"It's so easy to see your score after you just took an 8-hour exam and beat yourself up and be like what is all the studying even for them if I'm getting this, but you have to trust the process."

[11:55] Clean Eating and Exercising on Her MCAT Journey

While taking her classes and studying for the MCAT at the same time, she completely dedicated her time to MCAT study. And for health was very important. That said, exercise was something she looked forward to during the day since it was the one time she wasn't studying. It was something she set as her goal too that kept her motivated - both the MCAT goal and the fitness goal. So she found it helpful to separate herself from the MCAT while exercising, and that included eating healthy as well.

"Exercise was the thing that I looked forward to everyday because it was the one time that I wasn't studying."

She finds that when eating a diet high in vegetables or more wholesome ingredients, she notices she gets to have a clear brain. This is very important when you're taking an exam and trying to remember all those things. She also noticed that whatever she ate before practice exam, she had better stamina with the healthy meal. Caroline recommends you should find what works for you and focus on health during that time because it will definitely show in your score.

The truth is though is that students think that exercising would just take their time away from studying. But Caroline stresses that exercise helps in the consolidation of your memory, and this is proven.

"Exercise is helping with memory consolidation and it's proven that it does."

Aside from memory, exercise does help keep you more sane and prevent burnout. In fact, it's the number one thing to prevent burnout. Caroline adds, it helps reduce the risk of developing chronic diseases, which you should care about as future physicians. These are all good reasons to instill exercise in your daily routine. If you really feel the need to, then bike while reading. Nevertheless, it's really super helpful to get away from the information for a small amount of time.

[17:30] Struggles During Medical School Application

Caroline emphasizes the importance of having a mentor as well as listening to podcasts like this. For her, she found essays to be a real struggle (as anyone would). Writing a lot in a small amount of time is very difficult, but you have to remember your why. Always talk about that and make sure you're talking about things with passion. Additionally, Caroline initially struggled with finding words to express herself. She would have writer's block with her secondaries, etc. And then just dedicate a little chunk for a day, like three or four hours to write them since it's better to do it with a fresh mind.

Most definitely, don't submit a secondary after just one sitting. Make sure your essays are going to be clear and succinct and actually describe who you are. You want them to know who you are. So make sure it's explaining who you really are. Also, make sure you're addressing the question and making it clear that this is the school you want to go to, not doing the copy-paste thing. Or you end up with the mistake of copying the wrong school name.

"You have to remember your why. Always talk about that and make sure you're talking about things with passion."

[19:55] Starting the Medical School Journey

In terms of exercise and eating healthy during medical school, Caroline already made a plan of what she likes. However, med school is a different ball game, she admits. Especially with the way their curriculum is set up, their first 8 weeks are anatomy. So you're constantly in the lab and dissecting. You don't get to eat when you're there so when you come out, you're scavenging for food. It's hard to be healthy!

That being said, Caroline says she was fortunate to have friends who are also very health conscious. They fed off each other in a good way. She also packed her lunch to make sure she gets to eat healthy, not to mention it's a cheaper option. You know what's in them.

The biggest thing she's still struggling with is the late night eating, as this is bad and can cause gastric reflux. She tries to go to bed around midnight every night. But if she has to stay up late, she tends to eat more than she should. And it becomes a cycle. So this is still something she tries to balance. What she does is eat her midnight snack when she has an exam the next day and then sacrifice that for her exam day since she's able to focus better with snacks.

To add to this, she found planning to be very helpful. She buys her groceries and prepare her meals when she can. She has things on hand like frozen chicken burgers so she's not tempted to eat pizza.

"Any type of digestive issue can be exacerbated by eating right before you go to bed."

[23:22] Meal Preparation Tips

Caroline shares some tips to prepare your meals so you don't have to prepare them every day. She recommends getting a Crock Pot which is helpful for her. You can also roast vegetables on Sunday or Monday or whichever night you're free. Roast enough of them and put them inside your fridge and you can just microwave them. This is 45-min dinner turned into a 2-min microwave.

Also, be sure to make things that you like. If you hate broccoli and you meal prep it, you're not going to warm it up afterwards and order a pizza instead.

"Be creative with your health and figure out what you actually genuinely want to eat and then prep that."

Don't compare what someone else is doing to what you actually want to do. Just figure out what works for you. Caroline guarantees there is healthy food that everyone likes. Just search hard enough for it especially, now with so many health foods out there. Just make simple things since less ingredients are better anyway and it's easier to cook too. Salmon is also good.

[26:33] Taking Her Passion for Clean Eating into Professional Practice

Caroline says there's not enough research right now on nutrition and practical applications to nutrition and stuff. The reason being is that it's hard to get funding for it. And she hopes she could be a part of it in the future. But she wants to use exercise and nutrition recommendations as preventative measures with her patients. So it's definitely something she wants to continue in practice because she knows how this is very important.

"A lot of people reversed their diagnosis or help them prevent chronic disease in a huge way just by changing the way they eat."

[27:45] Final Words of Wisdom

Caroline wishes to impart to premed students out there that exercise and eating well will help you with your grades. It also helps reduce stress. And sleep has a huge role in decreasing stress and maintaining wellness, and memory consolidation. If getting a good grade is your main goal, you should also think about the implications of living a healthy life and how that will help you reach your main goal. If you're worried about your weight or struggling with that, don't be too hard on yourself. You can't judge yourself so hard, criticizing yourself so much because there is more to life than that. Don't get hung up on it. Just find what works for you. Don't take the MCAT so seriously that it would affect your health. We're going to be better physicians if we do take care of ourselves.

"Respect your body as much as you hope to respect others and take care of yourself as much as you hope to take care of other people eventually."

Links:

@carolinecooksclean

MedEd Media

@medicalschoolhq

The Premed Playbook: Guide to the Medical School Personal Statement

The MCAT Podcast

Hangout Group on Facebook

Jun 13, 2018
289: Stop Wasting Space in Your Personal Statement and ECs
33:42

Session 289

After reading hundreds of personal statements and extracurriculars this application cycle, I'm seeing the same mistakes over and over again. Don't do it too!

The Premed Playbook: Guide to the MCAT is finally available in Paperback ($9.99) and in Kindle ($4.99) formats. Also, stay tuned for The Premed Playbook: Guide to the Medical School Personal Statement, coming out soon! I'm actually giving away 100 books.

And if you preorder it on Barnes and Noble, I'm giving away a bonus, a personal statement course which I did with 30 students, where we broke down personal statements. You get access to this for free.

[04:10] The Goal of Your Personal Statement

It's important that you have someone look at your personal statement and ECs and give you feedback. This is crucial in the process. Your only goal when writing your personal statement is just to show who you are, in terms of why you want to be a physician. What has been your path to get to this point?

"Once you understand what the goal is, just knowing that will help you prevent the mistakes many students make."

Listen to last week's podcast, Session 288, where I interviewed Leila Amiri, the Director of Admissions at the University of Illinois College of Medicine. She talks about how their review personal statements. Your goal is to talk about why you want to be a physician. What has been your path to get to this point?

If your reason is a cliche reason like a family member getting sick, just because it's common, you really need to talk about this because this is your story. In other words, talk about that seed and when was it first planted that made you want to become a physician.

"Don't think that your story is cliche if it is your story. It may be common and that's okay as long as you highlight why that experience affected you."

While your story may be common, it's not cliche. Talk about why that experience made you want to be a physician or exposed you to medicine for the first time. You have to be true to your story.

[08:05] The Goal of the Extracurriculars

The goal of the ECs is to show the impact that you've had on each of your experiences. Tell why this meant something to you. It could be that the experience impacted you in some way.

Please take note that extracurriculars are not job descriptions. The admissions committee knows what a scribe does so don't write what a scribe does. If you really have to say what you do, explain it in just one sentence. And then go to impact.

Make sure you're showing through that and what does that look like in your life. How does that experience affect you? And how did you impact that experience?

[10:00] Personal Statement Mistake #1: Selling Yourself

Stop trying to sell yourself. You don't need to sell yourself in your personal statements or your extracurriculars or your interviews. The goal of this process is to show who you are, not why you think you're amazing or what amazing skills you have.

Here are some examples of students I've worked with where I saw some mistakes. The first is a student who was working at a suicide hotline. But he was trying to sell to me that he really cares for people. You don't need to write that. Tell the story that shows you connected with the person on the phone, and hopefully, prevented a suicide. Show how you actually cared by telling it through a story.

Another example would be trying to sell that you have to address the person's social support system. This is not telling the admissions committee anything.

One student says, they had to prove to themselves that they could solve problems in a medical setting. Saying you're a problem-solver is the same thing as selling yourself.

Remember, you're wasting space in your personal statement if you're talking about these things. I don't care what you learned from the experience. What I care at this point, is you're showing why that experience made you want to be a physician.

"The goal is to show why you want to be a physician, not that you have the skills necessary."

[17:40] Personal Statement Mistake #2: Wasting Space

Don't put double spaces in your personal statement after punctuation. Set it at single space after punctuation. So if you have 50 periods and you have double spaces after each of those, those are 50 extra characters you could get back that you need.

"Don't waste space with the names you don't need."

Don't waste space in your personal statement, talking about names of places where you're volunteering. Just say you volunteered at an emergency department. The names are going to be in your ECs anyway.

You don't have to name drop, either. This is also a wasted space. Personally, too, research is a waste of space to talk about in your personal statement.

Research is exciting. It helps you tie together science with the clinical side of things or patient care. It may help you understand things and see those connections. But it's not driving you to be a physician. You may want to do research as a physician in the future, but it's not driving you to be a physician. For the majority, if not all, the driving force of people wanting to become a physician is because they want to take care of people. Focus on the people, not the research.

"For 99.99% of people, the driving force behind wanting to be a physician is to take care of people."

[21:37] EC Mistake #1: Don't Sell

One student I worked with previously sold herself on her ECs. She wrote about her experience as a college athlete and its demands. Another example is working in a research lab. Again, don't sell all the skills you've learned. Don't sell the skills. Instead, focus on the impact you had. Focus on a story or interaction with a patient. Don't try to sell to the reader what's going to happen.

Another student talks about how this taught her to thrive under pressure. This is still selling. This just doesn't work.

"Don't sell your skills or traits in your extracurriculars... Focus on a story or interaction with a patient. Don't try to sell to the reader what's going to happen."

[25:33] EC Mistake 2: Wasting Space

You are wasting space if you compared what you're doing to what a physician is like. You can't really say this until after medical school. You can say this all afterwards, but not before.

So don't assume they're looking for anything. Don't sell yourself. Each EC is wasting space if you're putting a takeaway at the end of each of your ECs. This shows the readers what you've taken away from that extracurricular.

[28:55] Other Common Mistakes

Try to switch things around and putting your focus on the future, of what you hope to do, with all the knowledge you gained from this experience.

Repeating details is another common mistake to avoid. Don't repeat information in the descriptions that are already in detail section.

Instead of saying numbers, talk about the impact the physician had on you and vice versa. Don't waste space by selling, repeating information, or the number of hours per week.

Links:

PMY 288: This is How UICOM Reviews Your Medical School Application

The Premed Playbook: Guide to the MCAT

The Premed Playbook: Guide to the Medical School Personal Statement

Connect with us on Instagram @medicalschoolHQ.

Jun 06, 2018
288: This is How UICOM Reviews Your Medical School Application
01:07:27

Session 288

Leila Amiri is the Director of the Office of Medical College Admissions at UICOM (University of Illinois College of Medicine). We go step by step through the admissions process at her medical school.

Leila talks about how she has directed her team to evaluate applications. We look at day one, when your application gets processed and sent to the medical school. How do they look at secondary applications, the full application, and the MCAT score to determine who gets an interview invite? Once somebody is interviewed, how do they determine who gets an acceptance? Learn how all this process happens.

Additionally, if you're somebody who has applied to the University of Illinois and you've been rejected, now you can see behind-the-scenes, what goes on and maybe where your application fell short.

[02:45] A Brief Background About Leila and Her Moral Obligation

For Leila, it all started with her being a peer advisor as a Biology undergraduate, working her way through the ranks as an advisor and becoming the Director of Advising. Then she got really engaged with and appreciating the passion in the premed students. She began to look for an opportunity to be able to work with them exclusively. So once the position opened up in the admissions at the medical school where she was working, she took advantage of it. So she started working as an Admissions Director back in 2009 in Florida.

Being on the other side of the table is what Leila found as a struggle. Believing in her students, she knew what they needed was a chance. And if one medical school would give them the opportunity, they could go there and prove how great they are and how they can enhance the lives of everyone that they touch moving forward.

“We want good people and and who have traveled the distance. We want students who will really put their heart out there for their patients.”

Being on the other side, she realized the moral obligation with admitting students. They want good people and and who have traveled the distance. They want students who will really put their heart out there for their patients. And the other piece of it is looking at the student's capability to make it through the curriculum. This was the piece she says she really learned about once she came to the side of the table.

The fun part of being on the admissions side is interacting with students while letting those students who don't make it the first time, know that there's always hope. There are ways you can do to make your application stronger and better. Or submit it to the school that's the right fit for you.

[06:30] Behind the Scenes: What Should the Next Class Look Like?

Every year, the application cycle opens and medical schools get their first big batch of applications by the end of June so they can start sift through and see who they want to interview.

Leila works for a mission-driven school, specifically working for social justice and the commitment to the under represented and underserved communities. Every year, they have a process for screening applicants. But their committee sits down and revisits the process to make sure they're looking for the right intangible pieces of the application.

At their school, their faculty are okay with students who had some hiccups along the way. The records may not be outstanding but they've stuck to it and they've persevered and they've tried as hard as they can to make it through.

The other part of the application would be all the experiences and activities the student has spent and invested to make sure they understand what it means to be a physician. They should understand what the job looks like and who they will be serving. Do they understand that this is a lifetime commitment? This isn't a job, this is a lifestyle that they're choosing. So it's expected of them to be able to take care of people as long as they can.

"Do they understand that this is a lifetime commitment? This isn't a job, this is a lifestyle that they're choosing."

Leila explains that they usually start with revisiting their screening process from last year. The mission is the same but who did they accept last year, were they happy with who they brought in, and what they would want it to look like next year.

[09:25] How Students Can Align with the School's Mission

If you look at the mission of University of Illinois, they're similar to other schools where they have the 3-pronged mission relating to research, service, and providing care. What Leila likes about their program is that as they bring students in, about a third of them fit each part of the mission.

All this being said, not everyone is going to be interested in research. These are the students who have spent a lot of time and effort working with communities and patients. So they're meeting the service mission and the providing care mission.

"It's not that each student has to present themselves as excellent in all three areas of the mission."

As they looked at the students they've admitted this year and last year, they see that aside from the fact that they've seen a third of the students fitting each of their categories, they're also exhibiting excellence. They've had students spending thousands of hours doing research and have had couple of publications. They were awarded some of the grants in their institutions. They've had some time in the clinic as well as doing service. But those hours are much less compared to the time they've spent doing research. This is okay.

[11:30] The Step by Step Screening Process

Leila says they don't have a minimal threshold where below it students won't be considered. But they're one of the schools that doesn't release secondaries to all students. This is their first pass. If a student doesn't receive an invitation to complete a secondary, that signals to them that based on the academic credentials presented to them, they don't think there's a possibility that the student passed. Leila describes this bar as being very low. This would mean a student who struggled in every single science class they took, have had a few failures, had to retake them, and those repetitions weren't all that good.

Then they come to the students who have received the secondary. They're average was sitting around 3.6-3.7 but this range is so broad. They will see students with 2.5's and 2.9's who even got admitted as well. What they want is a student who's taken a broad range of science classes. They struggled in the beginning but they managed to understand how to do well in science and they've held an upward trajectory as far as they could until they graduate.

Additionally, they also have a postbac program. For students who have done well in terms of their service and have done extremely well in terms of their patient care but their life circumstances have prevented them from dedicating their time to their studies, they would invite students to join their postbac or prematriculation programs. This way, they have opportunities to learn with their faculty to give them the academic skillset they need to be successful.

"As far as the MCAT is concerned, we don't have a minimum threshold but when we're looking at percentiles or the single digits, those are the students we're not considering for admission."

[14:15] How They Look at a Low GPA

Leila explains there are reasons students don't do well in school. They could just be having a lot of of fun time in college. And a lot of times, these students could be involved in a lot of things like leadership, sorority or fraternity, service, etc. So basically they were spreading themselves too thinly. Because everyone is an A-type personality, they aren't willing to give those things up. They don't give themselves the opportunity to do well.

So if that distraction was removed from you and you only had the time to study, what will it look like? Either you're reapplying or maybe a couple years had passed and you want to do medicine now, you really need to take some science classes in order to show them what you have. Leila explains this is where the manual process begins. Because when they calculate the GPA, it includes all the undergraduate classes. And sometimes, it's hard to get that GPA to move. So once they see this separation, they look at it separately. They will calculate it manually just to see where the student's GPA is. This means looking at them one by one and looking at what they've done.

"Either you're reapplying or maybe a couple years had passed and you want to do medicine now, you really need to take some science classes in order to show us what you have."

One of the process their committee has approved is to remove a full year of course work from a student's record. So if a student comes in and freshmen year is really tough, and the GPA is bad but then everything is great, then they'll take it out. So they go from being a 2.7 to now 3.5 or 3.6 because they've removed all of that.

Then there's another scenario where if they have the good grades and all these extracurricular activities and the MCAT, they know it was just freshman blunder. What's important is for students to be clear with us. If there's a dip like that in their GPA or maybe a life happens along the way, let the committees know. Otherwise, if they don't give an allowance for you to make a mistake, you should be looking elsewhere.

"Not every school is the right place for a student. If that school can't give student a wiggle room for being a human being, that school probably isn't the best place for them to go."

[18:35] How to Improve Your GPA: When to Take a Traditional Postbac vs a Master's Degree and Other Factors to Consider

Leila describes the drawback to the traditional postbac in that the undergrad classes feed into the GPA. Getting that GPA to move is very hard. If you tried as hard as you could and still couldn't get the As then do a postbac. It's going to be a longer process but you need to figure out how to do well in undergraduate classes before you can move forward. But if the reason you had low GPA is because you weren't paying attention to school because you were to busy enjoying life, then think about the next level. This could be a master's degree. The beauty with this is that the GPA sits separately. So they no longer have to look at the 2.5 but only at their Master's GPA which could be 3.89. But this should only be done only if the reason you didn't do well was because you were spending time doing other things rather than studying.

"The beauty of the master's degree is that the GPA sits separately."

Now if you were studying, the master's isn't your best option because if you come in to the master's and do poorly, you've proven to the admissions committee that science really isn't your thing because you've tried it twice and it didn't work out. Then you know it's the issue of how bad was the undergrad GPA. Or is your master's enough or not.

If you jump into a master's degree right at the end of the undergrad and applies the same year, the master's isn't helpful because the transcript they get is the undergrad transcript.

Also find out if they school takes updates or no. If you apply to schools that don't take updates, there's no point in applying because you can't update anything. If they do, then you can consider this. But Leila points out that what does one semester of As (about 9 hours) do in light of the past 4-5 years where the student had not done well?

Also, is one year enough? Sometimes, the one-year master's degree only gives students only about 20 hours of science. Some committees will say 20 hours isn't enough. So Leila says the better option for that is to do a regular two-year master's.

For career-changers, they go for the one-year master's and if you're going to do fine in this, then move forward. But if you didn't do well as an undergrad, then you need to complete the one year master's and then apply the following year with the full transcript, which then becomes two years. Leila says it's all about the timing.

[22:00] Screening Process for the Interview

Their screening process, as Leila explains, is to look for mission-related aspects of the application. They look for certain attributes to show they're able to blend well with their community and have an appreciation of them. Academically, they will look at the times you were on the Dean's list, etc. And if you're as strong as the students they've admitted the previous year or even stronger, they'll invite you for an interview.

Another important piece for them is that having multiple campuses, two of which have different emphasis, they want to make sure the secondary really addresses the student's fit to any part of their community.

"The secondary really addresses the student's fit to any part of our community."

The things they ask of them to do are things related specifically to what they have available on the different campuses. After that, they want to make sure to look at the application as a whole - well-written personal statement, etc.

[24:25] What the Admissions Committee Look for in a Personal Statement

Leila explains that when she's done reading a personal statement, she wants to be breathless in wanting to meet this person. That being said, the personal statement should help the admissions committee understand where your motivation and commitment to dedicating your life and alleviating the suffering of others come from. And how do you maintain that? So you really have to dig deep. Do not regurgitate what you've done in your experiences since it's all there. But help them understand at the deepest level. So Leila wants it to be a conversation, almost, between the student and the admissions committee. They want the personal statement for you to really highlight who you are.

"When I'm done reading a personal statement, she wants to be breathless in wanting to meet this person."

Additionally, Leila reveals some red flags which you might want to avoid talking such as talking about the skills of a doctor and what a physician should be like or when you use an analogy that's not something you're not familiar with, this is problematic. Or when you talk about a bad experience you had with another physician and so how you're going to change the world of medicine. None of those speak to them because it comes from a place of lack of knowledge.

Until you've gone through the training and you've been there and you've held the hand of the dying patient, it's hard for them to say what the skills are.

It's different from saying you've been a patient and these are the things you saw and you'd love to emulate this, then this shows you have this understanding. Ultimately, it has to be a personal sharing of what it is that motivates you to be out there to take care of people.

"It's a risky perspective to take when writing a personal statement because there's always someone on the other end who's judging it."

Leila also goes on to say some of the best personal statements she has read are based on their experiences and the reflection that leads them to understanding it's where they have to be otherwise nothing else will work. So walk the admissions committee through how you reflect it on life and how you can use your special skills to make it better for the rest. The entire application shows reflection even when you write your experiences. Moreover, it's not all about you. Otherwise, the patients will be lost in all of that. So you need that reflection.

Leila says students forget about that because told to make themselves shine and to share  about themselves and they don't think the admissions committees can already look in the grades so you don't have to tell them this.

[35:38] How They Use Secondaries

Leila explains they use the secondaries for the interview invites and for inviting students into different campuses. Again, they're looking for the reflection piece and to make sure students know what the school has to offer. The school therefore needs help in order to figure out where they need to be placed especially that they have different campuses.

"The secondaries are very important for us to determine where the student will interview because it's very likely that they'll be placed there and how much do they really know about us."

The reason they ask applicants what they're interested in doing because they want them to be active members of their community. Ultimately, it allows them to determine whether they're the right fit. On the other hand, they're on their best behavior to prove to applicants that they do deserve them as students.

[38:10] Verifying the Truth: How Do They Validate What Students are Telling?

Leila explains they have rural county indicators in Illinois where they start all the way back from where they grow up, high school, and are they understanding of the rural community. They also have a specific program for rural medicine called RMED located in their Rockford Campus. They have a special application process separate from their regular admissions process. Students would go through both processes. Literature out there suggests that students who've been engaged in rural communities are the students who will have the greatest likelihood of going back.

Moreover, they ask for the student's history in their state, where they've lived, rural activities they've participated in. They usually conduct a committee interview with community members from all across the state including hospitalist, politicians, faculty members, care providers, members from the farming community. So there is expertise in this that goes beyond just the admissions office.

"What they're looking for is rurality. How much does this individual understand the needs of the local communities?"

But for students that don't go through this track, Leila says it's all about looking at the entirety of the application. So if you use the analogy of running a marathon and you haven't done that and if you talk about rural medicine knowing that's a big area of interest for them and there's no indicators in your application, it doesn't matter how strong you are. Leila admits it's going to be difficult for them to get you an interview invitation due to the disconnect between what you've done and what you're saying.

[41:45] What They Look for on Interview Day

As previously mentioned, they want you to match what they read about. It's that first impression when you come in. They look at your ability to communicate effectively with them. Interviewers are generally two faculty members and a student or faculty or staff member. The faculty will be looking at the student for fit as a future mentee. The same for the student there who looks at you if they can see you as a classmate. And for Leila, as an administrator, is she tells interviewees to think of her as a future patient. So she will look at you for communication. How well are you able to articulate your responses to the questions?

"The interview is just the chance to communicate with them and see how they are in person... a good part of it is recruitment because we know students have lots of options."

Moreover, Leila admits the interview process is also more of the recruitment side knowing that students also have their options as to which school to go to. So they will also try to prove to students that they appreciate everything they've done, they have the resources and the people who can help them get to the next stage. So it's both recruitment and making sure you're going to be a good fit with their community.

[44:20] Comparing Between Students and What to Do When You Don't Get Accepted

Leila explains they take everything they have at their disposal. So it's the entire application, performance during interview, and can the person come in and add to what they have or need in their community. So they basically look at the student who makes a better fit to them.

If you don't get accepted, Leila recommends that if you had the interview and it didn't go well, it's important to reflect on what happened as you were going through the interview day. You may have three really good interviews, but if you were unkind to a staff member or to another student, this might hurt your application. So you have to reflect on the entirety of the experience you had that day and what happened during the course of the interview.

The biggest comment she gets from interviewers, for which she feels the same, is that the person didn't give them the opportunity to meet them. You're sitting across them who are asking questions and you're so concerned about their opinions, well, you should have your own opinions. Whatever they are, you should be able to justify them.

"I promise, I really don't care what the answer is unless, of course if it's something really bad. But generally, no one cares what the answer is. We want to see why you have that opinion."

So for her, the worst thing that happens in interviews is if the student doesn't allow the opportunity to meet them. Plus, there are things like using bad words or not paying attention and fidgeting or on the phone.

She also recommends that you take full advantage of all resources available to you. Go to your advisors. Be honest about what happened during the course of your interview. Ask your advisor to contact the medical school as there are things that an admissions director may be able to tell an advisor and not the student. Then the advisor can help the student understand that.

[50:27] The Timing of it All: It's a Rolling Admissions!

Leila points out that timing is everything. Being a rolling admissions schools, as most are, it's easier to shine in 500 than it is 7,000. As applications come in and they're completed, students are invited and admitted. They reserve seats all the way through the process. But by that time, they've already seen a lot of students come through.

"They need to apply as soon as they can because seats fill up and while we reserve seats, I don't have 305 when I'm interviewing in January unlike I do when I open up the doors in the beginning."

So be sure to submit your application as early, but then you need to be ready. So don't just submit it just because people tell you to apply early. Request your letters way ahead of time. Keep reminding your faculty members and get the letters in. Leila says that every year, they have close to a hundred students whose applications are not completed and rejected because they didn't get their letter in time. It's true it's not your fault since you're not the one uploading the letter but it may be your fault because you asked too late. MCAT, for instance, you don't take it until September and you won't get scores until October. And many schools are done inviting for that year in October. So they're looking for Spring invitations.

"Apply when you're ready, but timing is really important for everything."

Nevertheless, it's not the end of the world if things can't happen this year and you wait to apply the following year. Have all your science classes in place. They will look at students who don't have everything in place. Have you met all the required classes and how did you do in them?

You have to understand the "deadlines" for applications for medical schools don't mean anything. Since students are so used to having deadlines, they think the applying to medical school is the same. But it's important to change that verbiage that instead of a "deadline," it should be that applications are open and it's first come, first serve.

Leila adds students shouldn't be taking a test after November because the score won't come in on time and they wouldn't have fulfilled all of the requirements. She doesn't really know how to change this culture.

However, this is reflective of the individual. If you can't follow very simple directives on how to do paperwork and when to send things in, then you might have it all together to be a great physician either.

"If a student is unable to follow follow very simple directives on how to do paperwork and when to send things in, I'm not sure they're going to have it all together to be a great physician either."

[57:30] CASPer for Screening Students

As with the CASPer, they haven't been using it explicitly in the admissions process as they're still studying it. But for those who use them, it's for considering students whom they might have otherwise considered just based on the metrics. But because they've got other great personal or ethical attributes, they could make a good addition to the class.

I would always like to describe CASPer as a personality test on steroids with a lot of moral ethical stuff and as fast as possible, you need to give your answers to the scenarios given to you. A lot of students are worried about it but there's really no need. Just give your initial responses to the different scenarios. For the most part, this could challenge your typing speed which is something you should start practicing.

Leila adds that non American students don't do as well on the CASPer because their responses are judged from an American lens. First generation or even second generation immigrant students with strong heritage presence in their home may not do as well. So this is something you may want to work on as well.

[01:01:30] Letters of Recommendation

Leila highly advises students to review their letters, meaning really think about who you're asking letters for you. They get letters from faculty members who don't really know the students well. They've also received letters from faculty members who haven't been supportive of the candidate's application. So think long and hard about who you ask to write letters for you. The letters are supposed to give them additional information. They are a pain to ask but they're so important because as she puts it, it's the only other thing they have to help them with the application. So make sure the letters are good.

At their school, their letter process is manual. Oftentimes, their application can't be competed because they've not yet manually reviewed them. So if you haven't heard from them in a week once your letters are complete, call the office and ask. With 7,000 students with three letters each, this is a huge amount!

[01:04:05] Final Words of Wisdom

Ultimately, Lelia says there are multiple ways to do this. This is your dream. And if you want to realize this dream, no one is allowed to take it away from you as long as you're doing the things you need to be doing. Don't give up. But there have to be enhancements. This means don't keep applying with a 2.5 and 498 on the MCAT and wonder what's going on. Don't keep applying when you haven't done the spot check. Look at the different parts of the application and see what's going on. There's a lot of opportunities for you to be a physician. Talk to them. Work with them. And good luck!

Links:

University of Illinois College of Medicine

May 30, 2018
287: This Student, and Dad, Overcame a Poor GPA to Get Accepted
38:16

Session 287

Nick is a former premed student-athlete who didn't do well in school and went into business but he knew he was always missing something. Now, he's accepted to medical school, multiple acceptances in fact, after fixing his GPA.

The Premed Playbook: Guide to the MCAT is finally available in Paperback ($9.99) and in Kindle ($4.99) formats. Also, stay tuned for The Premed Playbook: Guide to the Medical School Personal Statement, coming out soon!

[02:15] Interest in Becoming a Physician

Nick initially wanted to do medicine and then a total shift came until he finally found his way back.

Realizing he had a strong interest in healthcare as a kid, his grandpa had some obesity and health issues and took some interest in his health. Having followed his health journey, he took a great interest in making sure he's taking all his medications.

Then he worked in a nursing home as a teenager, which he considers as another formative event being drawn to people facing health issues.

Nick comes from a family where education wasn't really valued and he grew up in a small town in Iowa surrounded by blue-collared jobs.

[05:55] Transitioning from High School to College, the Business World, and Back

Nick was an athlete so he did get a little guidance and went to a college where he could play football. He had an early injury and not basically being prepared for college, he didn't have the study habits he needed to have. So his first semester was so bad and he was close to failing by the second semester.

"I didn't have the study habits that I needed to have to be successful in college."

Four to five years in, Nick realized the business world wasn't where he should be but it took him a long while to come to terms to it. He realized he took a wrong turn somewhere along the way. In fact, he processed this for several years before he decided it was really time to take the plunge. That being said, he worked for a couple different careers, one for three years and another one for six years before deciding to quit and go back to pursue medicine.

Nick admits he had to deal with a lot of fear having decided to go back to medicine. Since also at that time, his wife was pregnant. So there was fear as to how he was going to take care of his family. There was fear as to whether he had what it takes to be a medical student. And just that general fear of change.

So he had a hard time approaching the subject with his wife. But her support and enthusiasm really helped put him at ease. He also knew he had been successful at other things, both academically outside of undergrad years and in business. So he thought he was capable and he had what it takes. Plus, having the support of his wife was priceless.

"It's so continue doing what you're doing, especially if you're good at it and your road is typically successful. Why leave something you're good at even if maybe you don't totally love it?"

[11:50] Dealing with a Significant Other

I recently talked with a student whose significant other isn't as supportive as they should be and so this is hard as to where do you follow - your passions or the marriage certificate?

Nick adds there needs to be an open dialogue here. Figure out why you're thinking this or why this is dream. Then try to understand what the concerns are from the spouse and really break that down and see if there's somewhere you can meet in the middle.

There are times both Nick and his wife are questioning why they're putting themselves through this, and then something good happens along the way. So it's brought back to that idea once again that this is where they want to be. Additionally, there's that desire of changing his family legacy of impacting the community.

[13:15] Reach Out to Your Premed Advisors

There are two huge variables when it comes to thinking about potentially going back to become a premed for someone who's been through college already. Number one, is this what I want to do?

And the other huge variable, is that is this something realistic? Is this something that I can do? In Nick's case, it's from a GPA standpoint. His GPA undergrad wasn't very good but when he got on the phone with a premed advisor, he told him it basically depends on the schools. And that a lot of schools will look at what your most recent work is. His advisor had seen he has done some graduate work, his advisor said it can be done. This was they kind of encouragement every student needs. And Nick encourages students to reach out to their premed advisors and ask a lot of questions. Even better, reach out to the medical schools themselves, specifically the admissions committees and lay down your story and ask them what you can do. Just keep the lines open. Show them you're interested and let them know you want to go to their school because that helps a lot.

"Reach out to those premed advisors and ask them a lot of questions."

[17:00] Questioning the Decision

Nick did come to think and question this a lot. It could have been so much easier if he had just stayed at his job. Although he was doing great at his corporate job, Nick really didn't find much joy in it. He stresses the importance of really following your passion.

He does like to help people and he does like science - and if you're going down this path, then those reasons are the given ones of course. But the biggest setback for him as a postbac student was his Statistics class. He went in thinking he had to get all As due to his ugly GPA. But he realizes you don't need to get all As even with a bad GPA. It's okay since a good school will still be interested. Nevertheless, he was struggling in his Statistics class. Although he was able to work back from those and get a B. So this was his first downer.

"You don't need to get all As, even with a bad GPA."

Secondly, he thought he was studying so hard for the MCAT. But he didn't get the score he wanted. It was a good score but it actually hit him whether it would actually work out having gotten the score he really didn't want. It wasn't the score he needed to get to get into the schools he wanted to get into. He got into his first choice of school and his MCAT score was below their median (which is actually just completely normal).

[21:00] Studying for the MCAT

Studying for the MCAT, he got the books. He studied and set time aside. He took a light course load. Literally, he spent a big chunk of his time studying for the MCAT everyday. But he didn't see his score move on the practice test. And he believes the MCAT is a test on how to take that test, not so much the content. He even over performed on some of the sections that he struggled with his preparation. But he under performed on a section he normally did really well on.

"I think the MCAT is a test on how to take that test, not so much the content."

From his first practice test to his last, his score almost didn't change. And that's what he got on his MCAT. The diagnostic he took was one point below the actual score he got. He actually took a lot of the practice tests. And as far as reviewing them, he admits having reviewed all of them. For some, he performed well and for others, he didn't do as well. But his average was about the score he got which was what he started with.

Having figure it out, Nick says he wasn't taking the test the right way. So it's more of the method of taking the test. He think it's about managing the time he should have. And he admits there could be other things he could have learned from a class on how to actually take the test versus content.

"I don't know that I struggled as much with content as I did with the mechanics of the test."

So maybe a little help through a course or just a couple hours with a private tutor to help him work on his test taking skills might have helped. Nick encourages people to do this even if you think you can manage to study on your own. The change itself is challenging as well as the mechanics of the test.

[24:50] Choosing Which Schools to Apply To

Discussing this with his wife, the agreed he was going to apply broadly. There were also schools he interviewed at that his wife was not so sure about for geographic reasons. This means uprooting the family and going to a different region of the country. But in the end, she was very supportive of him. For most schools, she went with him during the interview to check out the place. But for his first interview in Arizona, she didn't go with him.

Nick recommends you let your significant other to go with you to where you're interviewed at so they too can have a glimpse of the area. And if you have kids, you can actually turn this into a family vacation.

"Bring your significant other. Drive around. Think about what it would be like to live in that area and logistically, what it might look like."

[27:30] Telling His Story on His Personal Statement

Basically, what Nick wrote in the beginning was nothing like what he ended up with. When your path is so long and there's so much to include, you don't do any of it justice. So he focused more on those formative experiences and those experiences that talked about why he wanted to be a physician.

During his interviews, he didn't think his personal statement ever did come up. Except for one interview where they looked at his personal statement and talked about his experiences and that he was a nontrad. But other than that, sometimes he often wondered if they do even read personal statements.

"Focusing more on those formative experiences and focusing on experiences that talk about why you want to be a physician, that's really where I tried to focus on the personal statement."

[29:00] The Challenges of Being a Nontrad

Nick explains there's a culture in the premed world where you're always questioning whether you've done enough or whether you've checked enough boxes. And he fell into this. He knew this is wrong but he still couldn't help but wonder if he did volunteer and put in enough hours.

He didn't put in as many hours as a lot of many people he was volunteering with. It's understandable since he has a family and a lot to take care of at home and his coursework. But he leaned on a lot of those experiences he has had in the past. For instance, he wrote about his work he did for Hurricane Katrina relief which was ages ago. But it was very impactful for him. But this being said, also show that you've still been volunteering and doing things recently. Try to talk about all of it.

"I think we put all these things on us that we haven't done enough, we need to do more. Especially as a nontraditional student, lean a little more on your experiences that you've had in the past."

[30:40] The Interview Trail and Early Acceptance

Nick admits going into the interview trail with a lot of fear. He got an early acceptance though so this helped him a lot. He got it back in August. He applied both in MD and DO schools and it was DO school that gave him the early acceptance. He felt really good having an acceptance so he had that as a fallback plan. It was a school he didn't know anything about but he found out he really liked the school but it was a long way from home. But he thought that if he couldn't get into some of those schools he was more interested in, then that school was still a great place for him to be.

So going into that first interview was the greatest fear he had. But realizing he put in all this work, he got an acceptance two weeks after the interview. Also, he said having had those experiences have made his MMI much easier.

Nick did wish he got his MCAT back but ultimately, he got into the top schools he wanted to get into from the beginning. Still, he knew he could still have improved on the MCAT. There could have been some classes he could have done a bit better in. There were some more classes he wanted to take that would have helped prepare him for the MCAT more. Also, had he done research, he thought he was going to get a lot in. There were times he spent too much time focusing on the studies that he wished he spent more time just with his family. In the end, your extra 2-3 hours probably doesn't matter as much and he could have spent that time with his family instead.

"There were times where I've probably spent too much time focusing on the studies and I wish I would have spent a little more time just with my family."

[34:40] Future Worries and Final Words of Wisdom

Nick says it's about trying to maintain a healthy balance between studies and family. Trying to get that time with family is a big fear for him. But he has been talking to people who have said he can make this work. It's about scheduling your time and setting time blocks for studying and then for family.

Finally, he wishes to impart to students to stop doubting yourself so much. Be persistent on the studies but take your breaks too. If you're really struggling with your classes, get help. Most schools have free tutoring or study sections that can help you get there. Take advantage of the resources available to you. Lastly, call the med schools you want to apply to and establish an early relationship as this can help you along the way. Make those connections early on.

Links:

The Premed Playbook: Guide to the MCAT

The Premed Playbook: Guide to the Medical School Personal Statement

May 23, 2018
286: Common Mistakes and More About Financing Medical School
33:29

Session 286

Travis Hornsby went from trading bonds to figuring out how to pay off his wife’s medical school loans as fast as possible. Now he makes it easy for every student.

First off, The Premed Playbook: Guide to the MCAT is now available on Amazon, Kindle, and Paperback. Just a reminder, you don't have to have a Kindle device to read a Kindle eBook. You can use a Kindle app on every device you have. It's $4.99 for the Kindle at this point and $9.99 for Paperback.

Today, Travis is going to help you figure out how to pay for medical school, how to pay back medical school loans, how to avoid common mistakes students and physicians make, and so much more!

Any questions? Reach out to Travis thru email at travis@studentloanplanner.com.

Here's the free student loan calculator that Travis site to help you figure out all the loans in this whole process.

[02:35] Money as a Taboo in Conversations Around Medical School

Money is such a taboo when it comes to medical school. Nobody wants to talk about it. How much loans did you take out or who did you get your loans from? Topics like the interest rates and options for getting it back are things no one wants to discuss - perhaps only except for their financial aid.

So it's important that the more you go out there and talk with other students about this and make it less taboo, the better it's going to be.

"Money in this country is a very taboo subject, not a lot of people want to talk about it. And that hurts us as we go through this process."

[03:10] A Brief Background

Travis is a former bond trader turned helper of graduate students, specifically medical students among others. He's married to a physician and has helped students with over $250 million in student loans.

Travis met his wife during her last year of Fellowship in Philadelphia. After dating for some time and having a serious conversation about money, he didn't really realize how big student debt is in the medical world. Being a bond trader, he made a model out of an Excel spreadsheet and figured out how he can help his wife then girlfriend. eventually she asked him to figure the same for her friends and just charge them for it. This snowballed when he actually put it online, garnering thousands of views and people reaching out to him and asking questions about it.

[06:25] How Long Can You Pay Back Those Loans?

Travis explains the two approaches physicians take when paying back loans, where they either work for not for profit hospital and going for a loan forgiveness approach. But for a person who is supposed to pay back the debt and working for private practice or trying to pay down as quickly as possible, the people making good incomes are paying it down for around 5-7 years. This is for the high-income specialties. While for the modest income specialties, he gives it around 10-15 years. His wife's boss even still have student loans and to think he's now on his late 40s.

"Because of the higher than average incomes, the people eventually become attendings, their payment periods on average are still reasonable and approachable."

[07:45] Live Like a Resident Even After Training

Travis considers physicians as low risk borrowers compared to business people for example. So banks aren't always going to make terms very attractive to lend you money. He stresses that you're supposed to live like a resident for at least a few years out of training. Say you're buying a house, just pretend you're a teacher and that's your income for the next four or five years. And live like that until your net worth is about at least zero.

"The adage with Jim Dahle that you're supposed to live like a resident for at least a few years out of training is super accurate and it's a big problem."

[10:55] For the Nontrad Students

Travis thinks that people in their 30's and 40's who feel like they haven't gotten out of the career they want and they feel like they have to work until they're 70s then that's fine. But if the decision is becoming a physician and working until your 70s or not becoming a physician and working until you're early 60s or late 50s - which one of these is more appealing?

"Make sure you have an absolute passion for medicine. You'd have so much regret if you ever haven't experienced a life for the rest of the career when you didn't become a doctor."

For nontraditional students, with limited number of years that you're going to practice, it basically boils down to a decision of the heart and emotions. But just make sure you have an absolute passion for medicine. You'd have so much regret if you ever haven't experienced a life for the rest of the career when you didn't become a doctor.

[12:25] For General Premed Students

Travis stresses that they keep very close tabs on the Prosper Act. Being debated in Washington currently, it's basically change in the student loan system. And the policies being discussed right now involve curtailing a lot of these loan programs that have made people to not feel the full cost of medical school.

Travis said the big changes would be repealing public service loan forgiveness for all students who start medical school after July 1st, 2019. This being said, this wouldn't impact anybody who's applying, accepted, and going to medical school this Fall. Instead, this could financially affect the folks that are going to fall after that.

If you don't have access to that program, you won't be able to work for ten years at a not for profit hospital and wipe your hands clean with your loan; rather, you'd be responsible for the whole thing.

And if you're thinking about going into primary care or one of the lower earning specialties, this could be a major financial burden on you if you're going to medical school beyond July 1st, 2019.

"Be very cognizant and really follow closely so you can make a fully informed decision about how you're going to finance med school."

Right now, doctors have access to this public service loan forgiveness and it's the most generous backdoor scholarship program in history. Just work 10 years and paying based on your income at a not for profit hospital. Then at the end, your loans are forgiven - without tax consequences.

[14:30] Determining Your Opportunity Cost

For example, you're an engineer and you make $90K a year but you enjoy your job and you like the lifestyle. Compare that to being a primary care physician and taking on a big debt and just pretend you invested money along the way, while you're working. It takes a long time for the break even math to make the physician's job win with a bunch of debt.

The finances could work with $300K and a $150K of income, the thing Travis would usually ask is what's the most optimal way to pay it back? You could pay the $300K back, living like a resident, being extremely frugal, getting really motivated with these debt pay-off programs. But what's the right thing based off of your lifestyle and the math.

Travis has run into a lot of cases of lower paying specialties where people will have that $300-$400K of medical school debt. They may be in a private sector job and they've hit that income they feel like they're going to be at for a while. But they went out of town and have kids or they want to work a few hours to have a more flexible lifestyle.

A lot of times, you can make the cost at today's dollars, like "pay as you earn" for 20 years. Even though you have to pay a tax bomb at the end of it, makes more sense than actually paying the debt off just from a pure number's perspective.

[17:40] Be Aware of Your Options

If you take out direct federal loans and this is a great question to ask your financial aid person before you go to the first dance class and get the big bill, "are my loans for the first semester going to be on the federal direct program?" If your answer to this is yes, then everything the government is saying, you're going to be locked in to being allowed to borrow in that program with all the sweet repayment programs and all the great stuff and you're going to keep it for the duration of your medical school career. But if you go to school and you're given what's called the Federal One loan or whatever they end up coming up with that's not a direct loan, then that's when you really have to run the numbers and think about how much you're going to have and know you have to pay all that back.

For some of the high cost private schools out there where you're going to come up with $400K, you can go look into other career possibilities like the military. Look at some other way to do a program to get some assistance. There's the HPSP, NHSC, and NIH Scholarships, where you can get assistance from them if you're doing research at a hospital.

"Be aware of your options. One of the difficult things with medicine is that the loan programs are so dispersed that there's no centralized source where people can really get access to everything."

[19:45] Where Loans Are Coming From and Where You're Getting Your Money

Travis explains that the unsubsidized Stafford loans are those you want to max out and take. They've got a 6% interest rate, origination fee is about 1%. This is good considering you've got all those benefits from the federal loans programs. That's about $40,000 a year that you can take out, so $20K each semester. Most people will need more than that. Travis suggests asking yourself, how do you come up with the answer to the questions of "where do I get that more than that money?"

So if you need more than $20k in loans a semester, where is that going to come from? If you're planning on having an academic medical career, you like the idea working at hospitals then make sure all of your debt is with the federal government.

You don't want to take loans that are not direct loans because those direct loans are the only loans that have access to the Public Service Loan Forgiveness (PSLF) program. This is a general rule, which means 40K a year of unsubsidized Stafford Loans and everything above that is going to be on the Grad PLUS program.

"If you're planning on having an academic medical career, you like the idea working at hospitals then make sure all of your debt is with the federal government."

If you're planning on going to private practice, then the Grad PLUS program, everything you need above $40K a year, that is at a 7% interest rate instead of 6%. On top of that, the origination fee (the amount of money they charge you upfront that they take into the loan) is about 4.27%.

[23:28] Private Loans

Travis warns students that you should only do this if you're 100% certain you're going to go into private practice. Because if there's any chance at all that you're going to want to go down the not for profit road with the hospital system then taking a private loan is a disaster.

"If you it ever does make sense to take up private loans, you would never want to take up the full cost of med school and private debt. You want to exhaust the Stafford resources first."

Travis goes on to say that the issue with private debt is that the payments during residency or fellowship could be troublesome. A number of them will refinance residents' private student loans to nominal payments during their training. The payments are not an issue because they'll keep it very low after the training for the private debt. And then when you come out, you can refinance the whole thing or part of it.

This is only a strategy Travis can suggest. It might save you $20K in interest, perhaps 10-40 if you go down the private practice route. That's the reward.

If you go on the not for profit road that you have private debt and you took out private loans instead, it could cost you hundreds of thousands of dollars to take out private single loans instead of federal student loans.

Weigh the risk-reward.

Weigh your future career goals. Think whether the way you're taking your student loans out reflecting how you think your future looks.

"Is the way that I'm taking my student loans out reflecting how I think my future looks? A lot of people just don't think about that."

[26:22] Travis' Advice for Premed Students

Be very cautious with credit card debt during training and during medical school in general. The student debt is better to have than credit card debt for a host of reasons. Resist the urge to equalize your consumption patterns with what you expect they're going to be as an attending.

"Be very cautious with credit card debt during training and during medical school in general."

Travis also suggests having $5,000- $10,000 in the bank even during training, during medical school. You always want to have enough financial cushion in case any crisis may happen to you.

"The general rule that keep your debt as low as possible still ring true."

Additionally, Travis recommends going to the lowest cost medical school you can get into to. Compare costs and think whether you want to have more options in your life or fewer options. A person with a $200 debt has definitely more options than the one with $400K. So every medical school places people into prestigious specialties. If you're checking out multiple places, go to the expect cost of attendants on the Financial Aid in each school's website and look for whatever the estimated cost of attendants is for four years. Multiply it by 1.25. You're growing that number by 25% and that's what you'll leave with in student debt if you borrow the full amount. Compare that number at each place and then heavily weigh the decision as to which one is the most attractive for your cost.

Links:

The Premed Playbook: Guide to the MCAT

HPSP

NHSC

NIH Scholarships

Public Service Loan Forgiveness (PSLF) program

Grad PLUS program

May 16, 2018
285: Hear How This Immigrant Got An Acceptance to an Ivy League!
55:00

Session 285

Fernando immigrated from Brazil and has been on the long, slow road to medical center. After some experiences in the LGBT community, he needed to be a physician.

First off, The Premed Playbook: Guide to the MCAT (Kindler version) is now available on Amazon. You don't have to have a Kindle to read Kindle books. If you have an iOS or Android device, Amazon makes that Kindle app for your device. Go ahead and buy the book right now for only $4.99. It's going to give you the information you need to know so you can better understand everything about the MCAT - when to register, how to register, getting fee assistance, how to best study for it, etc. This is a book I co-authored with Next Step Test Prep. They offer full length practice exams, they’re the second best next to the AAMC practice exams. Use the promo code MSHQ to save 10% off their practice tests.

Back to today's episode, Fernando took a long time to finish his undergrad. But through this application cycle, he has had multiple acceptances to amazing medical schools. He will be going to an Ivy League medical school soon.

[03:35] An Interest in Becoming a Physician

Fernando never thought being a doctor was for him until he was 26 years old when had to move to New York City where he became part of the LGBT community. He considers it as a calling that brought many different aspects of his life together.

Basically in Brazil, they were able to pick their major and he got impressed after touring a school of medicine there. But he didn't feel he had the discipline or that he was smart enough. At 18, he wanted to move from a small part of the city and wanted to see the world. And the thought of studying medicine in Brazil for six years in medicine wasn't something he could see doing. He knew he loved sciences but he also knew that if he had to study something, it had to be related to life.

Fernando came out of the closet at 19 when he was still in Brazil then he moved to the States when he was 21. He wanted to become more independent and be able to live in a country that wasn't homophobic. And moving to the US was eye-opening for him having been able to understand the problems his community was going through, particularly relating to HIV. Having friends coping with HIV and seeing the American healthcare system, he thought how fascinating it would be to learn the tools and bring that back to his community.

"I became more mature and I was able to face and understand some of the problems that my own community was going through. It was really related to HIV."

In Brazil, he went to a very good university with a GPA of 2.8. When he moved to the States, he found the system to be easier to navigate. He also became more mature and more aware of what he needed to achieve as a student. As a result, his grades started to get better and better. And so he thought he could really do it.

[12:20] Gathering the Resources to Begin the Process

Initially, Fernando didn't know where to start especially looking for someone that has the same background as he does - being a gay Latino. There was no role model for him so he began figuring out some resources - one of them is The Premed Years Podcast.

He could hear stories of other nontraditional students that really motivated him. However, attending college in New York, he didn't really find that tailored mentorship that he needed. But this has changed with time as he found great help from them.

Additionally, he waited a long time to tell people that he was a premed. But from the time he began sharing, it took him a year and a half in between looking for the resources and deciding where he was going to volunteer in and why there.

Fernando actually did three years of Biology in Brazil and then on his last year, he came to the states and so he quit college in Brazil. Then he had to start from scratch. He took two years off and resumed his studies at Missouri State University where he did two years there. Then he moved to New York City and decided to study something that was much more applied where he could impact society.

[17:00] Did Leaving School in Brazil Hurt His Application?

Fernando thought medical schools are going to laugh at his application for not always finishing what he stated. He thought they were never going to understand what he went through.

"Crafting my story was going to be very instrumental to my application and being able to explain what led me through the motions of my life and how I am where I am right now."

But Fernando was quick to realize the power of being able to craft your own story so you can well explain to the admissions committee what led you through the motions of your life and where you are right now. He adds that one thing he never compromised in this whole process despite the breaks in his education were his grades. They were consistently good so he could always say that his grades speak for themselves.

He even recalls one time where he was told to really make good on the MCAT to make up for his breaks in education. But he never let anyone or any advice get into his mind.  He has heard so many negative comments and have slept on them, but he knew he wasn't going to let those stop him from trying.

Because he went to undergrad in another grad, he didn't have to report those grades on his application. But he reported pass/fail so he put the classes there. Missouri State University accepted some classes from Brazil while Hunter College accepted all his classes from Brazil. After reading the MSAR again and again, he realized that he actually had to pick the school in the United States that accept most transfer credits from Brazil and then report the classes on that transcript. This way, AAMC could verify that he had actually taken the classes. All this being said, Fernando thinks he has benefitted from this fact knowing that he only had a 2.8 GPA. But to be fair, he started from scratch when he went to the US.

"The medical schools have the interest to know the depth of your education. Even though they might not see the grades but it's interesting for them to know what you've taken."

[23:00] The Struggles of a Premed

Fernando articulates that his whole journey was what made him who he is. The hardest part was juggling multiple jobs and schooling while still having time for family and friends.

"The hardest part was how am I going to tell my story so people think that I actually have something to bring to the table."

Another hard part for him was that question of how he was going to tell his story so people think he actually has something to bring to the table. Basically, I've worked with Fernando on his personal statement and he initially didn't some of my advice. In fact, he applied a little late in the cycle and his personal statement was what's keeping him from hitting submit. In his eyes, it was never good. But now thinking about it, he knew that was exactly what he had to say.

Now, he's helping other students in writing their personal statements. He stresses on what the personal statement is all about and it's to tell admissions about why you want to become a doctor. You can talk more about those other things in your extracurriculars, etc. And this is something I have helped him realize. Before Fernando was giving me this feedback of why I was't telling him what to write. Because my job is to ask the pertinent questions to get the information out of people so they can write about them.

"Students fail on understanding that that personal statement to tell admissions about your life and your drive relating to medicine."

[27:10] Where to Apply to Medical Schools

In figuring out where to apply to medical schools, again, seeing  the health disparities within his own community in New York City was very instrumental for him to decide that he wanted to become a doctor. And since day one, he has always wanted to stay in New York City. That said, geography was something very important to him.

And he also likes to live in a big city with a very diverse demographics. But he also opened his mind in other cities like Boston and Miami. Then as the application progressed, he was opening his mind to other great schools that are not necessarily in a huge urban center. Although he initially worried about MCAT and GPA grades, still he went on to pick schools he felt he would feel comfortable. Fernando's MCAT was at 76th percentile and it was one of his biggest sacrifices. At that time, he was coming out of a divorce and he literally had to move out one month before MCAT test day.

"I was a little bit worried about MCAT and GPA grades but I decided to just not worry about that and just pick the schools that I would feel comfortable in."

[31:10] Dealing with Relationships During the Application Process

Fernando explains that in order for a relationship to work, the other person has to be willing to be with you 100%. They have to be by your side during those four years and the years to come. They have to be just as focused and as driven that they would understand what it means to sacrifice so much. And he felt his husband at that time was not there with him. Although it was hard then, he realizes that it actually a good thing that happened.

"In this journey, you have to learn how to be selfish at times because it's about you. It's about where you want to go and where you want to be."

He adds that being a physician is more than just a profession and it's really about who you are. So the other person needs to be okay with that. They have to cheer with you and understand what it means when someone calls in the middle of the night and you have to work. And he admits this is hard to find since medical students have a passion that can be hard to find in other people.

[34:20] What Led to Getting Multiple Acceptances and HIs Thoughts on Diversity

Fernando believes that what led to his success in getting a lot of acceptances is the fact that he was just himself. He was truthful. He had to show how genuine he was throughout the whole process and how that translates into him wanting to become a physician was key.

Fernando's advice to premed students who think they're not as diverse as he is being a gay Latino, is to understand that diversity is much more about the color of the skin or your sexual orientation. Diversity is what makes you different. Everybody has something that is unique about them.

"Diversity is much more about the color of the skin or your sexual orientation. Diversity is what makes you different. Everybody has something that is unique about them."

By genuine, wear your uniqueness with pride. So you have to do the work to reflect on who you are and what makes you different than others. We all come from different places. We all have different experiences growing up. Those things are what's going to set you apart.

The more the admissions committee can see that you are truthful to yourself and that you did things because you really cared for and not just because you wanted to check the box then the better your application is going to sound for them.

[41:30] How to Become More Self-Aware to Create Better Personal Statements

To help you write your story better, you need to be more self aware. Fernando says you can improve your self-awareness by writing more about yourself. Look at the prompts for secondary applications earlier so you have an idea of what they ask.

Additionally, you have to ask yourself everyday why you're doing this. A lot of students can not actually answer this. They don't know what their drive is behind that activity. Most people do it because they think they have to. But the admissions committees can see through this.

So when picking activities, try looking for those that resonate who you are, your passion, and an issue you care about. Then it's going to be so much easier for you to talk about it and write about it. So when interview day comes, the admissions committee will really get impressed by how you know so much about this issue.

[44:40] Narrowing Down His Acceptances

Fernando actually ended up with seven acceptances including some great schools in New York City. But he decided not to stay in New York City as opposed to what he really wanted. So he chose Brown because he at Brown, he didn't feel like he was a number. Out of 10,000 applications, they always interview around 360 people whereas other schools interview a thousand people. So Brown picks who they're going to interview. And for him, this small number translates into a very tailored interview, application, and acceptance processes. He also thinks the school shares a lot of values that he wants in medicine - humanism, social justice, and other sensitive issues in medicine. Brown also offers some financial assistance. In short, he felt he's going to be at home at Brown. All this being said, he finds this as a very powerful, yet humbling experience. At Brown, Fernando plans to do an MD and a Masters in Public Health.

Fernando advises students to really take your time to write your application because your application is really going to tell your story. It's going to open that door for you to go. And if the schools like you and accept you, especially the schools of higher caliber, they're willing to fight for you.

Fernando also had a great offer from Cornell. In fact, he also did his shadowing and volunteering there. But he knew he wanted to go to Brown. So he laid this out to Brown and told them he got a financial aid offer from Cornell but he really wanted to go to Brown so they were willing to beat it.

"It's worth the effort because once you get that acceptance, you are really an asset for the school and they're willing to fight for you."

[51:30] Be True to Who You Are

Finally, his parting words of wisdom is to not let other people tell you that you can't do it or that it's not worth it or that it's too expensive. He thought he wasn't going to afford medical school. People would ask him how he was going to pay for it and he didn't know the answer. But he knew that if he worked hard enough, he's going to be able to do it.

A lot of people are going to tell you about how hard it is, but you have to stay true to who you are and to your passion. And if you do that, the world can see it and you're going to get there.

Lastly, it’s not about what you look like or where you’re from to get an acceptance to medical schools. But it’s about showing them who you are!

Links:

The Premed Playbook: Guide to the MCAT

Next Step Test Prep

May 09, 2018
284: What Do You Need to Do When Med School Applications Open?
29:39

Session 284

When this podcast goes out, the medical school application cycle for students wanting to start medical school in 2019 is opening. What do you need to do now?

The Premed Playbook: Guide to the MCAT Kindle version is available for preorder right now! It's $4.99. While the paperback version will be launched on May 7,2018. This is "the" book to help you understand what the MCAT is all about, when to register, how to register, how to study, what to look at, tips, and tricks of trade before even diving into the actual prep itself. If you're a premed student and you haven't taken the MCAT yet, this is the book for you.

Also, shoot me an email at ryan@medicalschoolhq.net and we will be giving out a batch of Bluetooth devices that sends out notifications on Android phones about our podcast. Help spread the word!

Back to today's episode, as of this recording of May 1st, the TMDSAS (Texas Medical and Dental School Application Service) for 2019 has opened up. It is application season! Listen in to find out things you need to know before even clicking on that submit button. Meanwhile, AMCAS (American Medical College Application Service) and AACOMAS (American Association of Colleges of Osteopathic Medicine Application Service) are opening up in the next couple of days as well. These three services are what you need to apply to medical schools in the United States. For Canada, there's the OMSAS (Ontario Medical School Application Service).

[05:10] Step 1: Don't Freak Out!

This is just another day in the process. Specifically for AMCAS, it opens on May 3rd and you can't submit until May 31st this year. And the applications don't get submitted until June 29. This being said, you have the whole month where the application is open. This means you can work on everything and not freak out.

"You have a whole month where the application is open that you can work on everything and not freak out."

However, for TMDSAS and AACOMAS, there is no separate open date and submit date. This means you can submit as soon as you want for these application services. Listen to Episode 245, where you hear about the common issues with applying thru TMDSAS. Some students out there are clicking submit before they put in the personal statement or extracurriculars.

Again, the opening of the application process doesn't mean you have to get everything in there right now and submit it right now.

[07:50] Step 2: Read the Instruction Manuals

Application services have their own respective instruction manuals and you have to read them. Find out what the nuances are between each of the application services so you understand. You want to make sure you're doing everything properly.

"The last thing you want to happen is to submit your application and get it kicked back because there's an error with it."

What's worse is if you submitted your application and has an error on it and then the school sees that error so they write you off for not being able to follow the directions.So you really need to read the instruction manuals.

[08:50] Step 3: Get a Transcript Request Form

Once you go into the application service, you open up an account. The first thing you should do is to get a transcript request form for this new application cycle year. Then you get this sent out to every school you've been to.

"Any place where you're taken a class or attempted to take a class, you need a transcript from that school."

Additionally, make sure that when you send off the transcript request for that you also get an unofficial one sent to you. You're going to use this to help you put in your grades in the application service.

You have to manually put in each class, each grade, all the credit hours, line by line in the application service. This is probably one of the, if not the most, tedious parts of the application service and is the longest thing to do.

One of the hardest parts with transcripts and putting in grades is putting in incorrect transcripts or classes. When you put them in and being reviewed by a human, they'll get kicked back to you if there's anything major. Or they will change it for you to review. Again, go line by line by line as you enter all the information you need to. Make sure you're transferring all the credits and grades properly.

Read the instruction manual based on how your school/s has/have given you grades. Read about how you can properly translate that for the different application services.

Should you wait to request transcripts until after your spring grades come back?

This actually depends on when your semester ends and when the grades are required to be submitted. So find out from your registrar and ask when the final grades required are to be in. Since you can't actually get official transcripts until those final grades are actually in the system and submitted by the professors.

If that is going to delay your application and you can't request an official transcript with those Spring grades until the end of May or mid part of June then maybe it's not worth it.

There a lot of variables in this. Are those grades important in your overall application? Do you need to show a strong upward trend and those Spring grades are going to really help paint that picture? You will have to think through this process. You have to look at your specific situation whether it's something worth waiting for you or not.

"There is no blanket advice when it comes to the application process. Every student is different."

[13:50] Step 4: Follow Up

Make sure you're continuing to follow up with your supervisors, professors, PIs, whoever it is that you requested letters of recommendation from. Follow up with them to make sure the letters are either in the Interfolio (if you have an Interfolio account). Or now that the application services are opening, you can give them the instructions to submit the letter directly to the application services.

"The last thing you want is a letter of recommendation to delay your application. That will hurt a lot."

[14:40] Step 5: Personal Statement, Extracurriculars, and Other Essays

Continue writing your personal statement and your extracurriculars. Just because the applications have just opened up, you don't have to have finalized versions of all this. Don't rush through the process just for the sake of having them done so you can submit your application tomorrow. Make sure you're going through the normal editing process and all the normal feedback, draft processes, etc. Also, check out The Premed Playbook: Guide to the Medical School Personal Statement to help you guide through the process.

Again, don't rush just to be able to get your application in. It's better to delay it a week and make sure your personal statement and your extracurriculars are polished and error-free before submitting it.

Additionally, take note that TMDSAS has extra essays - one is required, another is optional. The optional essay (I think) is actually probably a "required" essay so you might as well write something for that optional essay.

One of the common mistakes students make is in writing the required essay for TMDSAS. It's a personal characteristics essay and a lot of students misread or don't answer the question properly. The question is "how are your personal characteristics going to help the educational environment of your classmates?" If you analyze this, it's actually asking how you can help the educational environment of your classmates based on your history, skills, traits, experiences, and characteristics.

You may also need to write other essays such as when you're planning to mark a disadvantage on AMCAS, you can write that essay and get 1,325 characters. You have the most meaningful essays for three of the extracurriculars on the AMCAS application. If you've had any disciplinary actions against you, you'd have to write essays about that as well. So make sure you continue to go through that process as you are doing everything else that's required on top of probably school or MCAT prep, etc.

"All of these other things need to continue to happen to make sure that the application is ready to go earlier rather than later."

With regards to demographic information, you need to know what your name is, your siblings, your parents, their level of education, contact information, etc. So be ready to answer all of that. It's probably the easiest part of the application itself.

Also again, make sure all of the translations from your transcript to AMCAS, AACOMAS and TMDSAS are properly done. Even if you'd had a class removed from your transcript, if your undergraduate or community college have some sort of repeat policy where that grade is removed from your transcript, you still need to put that in your application service.

[18:50] Step 6: Complete Your School List

The school list is one of the last things you put into the application. Basically, you put in the schools you want to apply to. With TMDSAS, you only have to pay one fee so there's no reason to not apply to all of them. Obviously, it increases your chances of getting in. You will also have to pay secondary fees for most of the schools. It's just a bit of extra money but that's okay. Apply to all Texas schools. However, if you could never see yourself living in the Rio Grand Valley, then don't apply there.

School list is important. Rule of thumb: Do not apply to schools based on MCAT and GPA. Apply to schools based on location, class size, curriculum, and many other things outside the MCAT and GPA. On average, students apply to 14 MD schools and 9 DO schools.

A lot of students in the premed world are groomed on SDN and Reddit to apply based on MCAT and GPA. But I go against that trend.

"Do not apply to schools based on MCAT and GPA. Apply to schools based on location, class size, curriculum, and many other things outside the MCAT and GPA."

[20:28] Step 7: Make Sure There Are No Typos and Other Grammar Issues

After you're done with your school list, then you're basically done with your primary application. Now you need to go through the application over and over again. Check for typos and weird characters. Remember that if you're copying and pasting from Word or Google Docs, there may be some weird characters carried over into the text box of the application service itself. Generally, you can copy from Word or Google Doc into a plain text editor first. The application services don't have any sort of formatting options. So if you need to emphasize something, all those stuff will not be carried over to the application.

One of the tools I recommend is Grammarly. It's a plugin for Chrome and Safari where it checks for grammar. There's a web app version of it as well. Simply paste in your text and it will show you some corrections you need to do. As you're going thru the application cycle, it's recommended you get the paid full version of it because it will greatly help you in writing better.

"Having an app that helps you write better is invaluable."

[23:40] Step 8: Submit Your Application, Then Pre-Write Your Secondaries

After checking for typos and other issues, you're basically ready to submit. Again with AMCAS, you can't submit until the end of May. With AACOMAS and TMDSAS, you can submit as soon as possible.

Applications don't go out for AMCAS and AACOMAS until end of June or mid-June respectively. And then you'll get secondary essays. Don't wait to get back your secondary essays to start writing them. Go online and search for Secondary Essay Database, which we will have our own one soon.

"Most schools don't change their questions so pre-write those secondaries. Once you have your school list and once you submit, start working on those secondary essays."

After you do the first five or six schools, they tend to be repetitive so it will get easier as you go. That way, you're ready when secondaries start to roll out from AACOMAS (the first wave of application goes out on June 15) and AMCAS (the first wave of application goes out on June 29). For TMDSAS, you would have to go to each school's website and look for instructions on submitting a secondary essay.

[25:25] Step 9: The Waiting Game - Prepare for Your Interviews

Once done with your secondaries, then it's just a waiting game. You should be preparing for your interviews leading up to this point. Reach out to your premed advisor, your career counselor, mentors. Get mock interviews under your belt before you actually interview. Not preparing for the interview is like not prepping for the MCAT. You need to do it. Check out The Premed Playbook: Guide to the Medical School Interview. I have gotten a ton of feedback from students telling that it has helped them on their interview days. So if you don't have the time or resources to do private one-on-one interviews and if your school doesn't offer them, at least get the book.

If you want to invest, I have the $47/month Mock Interview platform where you sign in. Use your webcam or your phone and a video of me asking you a question. Then it records your response so you can watch yourself from there and critique yourself from there. There's an assessment afterwards so you can send it to somebody so they can give you feedback as well.

Again, this entire process runs from now (May) to next April and May. The process never ends actually. In fact, you can be accepted to medical school all the way through when medical school starts, which is in August of the next year. It's a very long process. Make sure you're staying sane through the process. And if you may have to apply again, that's okay.

"It's expensive so make sure you do it right the first time so you don't have to do it again."

Still have questions about the process? Let's continue this process on The Hangout Group, our free, private Facebook group made up of a super collaborative community of like-minded students.

Links:

The Premed Playbook: Guide to the MCAT

The Premed Playbook: Guide to the Medical School Personal Statement

The Premed Playbook: Guide to the Medical School Interview

TMDSAS (Texas Medical and Dental School Application Service)

AMCAS (American Medical College Application Service)

AACOMAS (American Association of Colleges of Osteopathic Medicine Application Service)

PMY 245: Why Does Texas Have Its Own App and More TMDSAS Questions

Interfolio

Grammarly

Mock Interview Prep

The Hangout Group

 

May 02, 2018
283: Common Questions Premeds Have About Osteopathic Medicine
41:38

Session 283

Today, I speak with Dr. William "Bill" Mayo, the President-Elect of the American Osteopathic Association (AOA) and a practicing ophthalmologist. He graduated from medical school in 1981 from Kansas City University of Medicine and Biomedical Sciences College of Osteopathic Medicine or also known as KCCOM. He shares things about osteopathic medicine - the merger, dealing with the stigma, residency, exposure, and so much more!

In 2017, I published The Premed Playbook: Guide to the Medical School Interview, which has been well-received by students. This year, we are releasing the second published book in the series called, The Premed Playbook: Guide to the MCAT. Visit the MCATbook.com to get notified. The Premed Playbook: Guide to the Medical School Personal Statement will also be out later this year. Check out personalstatementbook.com to get notified too or pre-order them now on Amazon and Barnes and Noble.

[03:20] Realizing His Calling

Having a father who was a doctor, Bill's mother died when he was three so he practically grew up seeing what his father was doing at the hospital. Then his father died when he was 17, reason enough for him not to do really well in school at that time but did well afterwards. Because of this, the admissions committee didn't really look at his application as favorably as he would have wanted. So he asked for a help from a doctor his family knew who helped him get connected with an osteopathic school. At that time, he didn't know what an osteopathic medical school was.

When he did his interview, the osteopathic school accepted him and he came to appreciate the humanistic approach of osteopathic medicine. Except for the manipulation part, Bill saw this in the way his dad approached his patients. As a result, he became an advocate for that approach to medicine due to his experience.

"I really came to appreciate the humanistic approach, the holistic approach of osteopathic medicine. They're really approaching body, mind, and spirit."

[09:10] An Interest in Ophthalmology

During his senior year in medical school, he did an elective in ophthalmology to be a better family physician and then he fell in love with it. He did try the ENT and liked the microsurgery but much of it didn't really appeal to him. As with ophthalmology, he saw some opportunities to create relationships for better patient care. In short, he fell in love with the field in 1980.

[10:55] DO Then and Now

Bill had an ACGME residency which was outside the norm at that time. He looked at residencies in his area and ended up liking the residency program at the University of Mississippi. He knew they didn't know what a DO was before as they never had one. But he also believed his education had the quality and caliber as their students. So he was able to arrange for an elective rotation for two weeks. During that time, he was really assessed for his knowledge. Then the department chairman called him in the end telling him he could have a spot if he wanted it out of 140 people who applied for four spots. He got one of those four and he was the only DO out of the whole bunch. Bill believed in his education and so he stresses that he was even able to do it a long time ago, much more so now.

"One in four medical students today is an osteopathic medical student."

At the end of the day, it's all about you, who you are as a student, what you've accomplished, how well you've done in terms of your grades, boards, and your elective rotations.

[13:45] The Roles of a President-Elect in AOA

As the President-Elect and the President, they lead the Board of Trustees of the AOA. They implement the policies that are informed by resolutions from their house of delegates.

The American Osteopathic Association and the American Medical Association each has a House of Delegates. made of representatives from each of the states as well as the specialties. They set the policy for what they believe in and what they want to support. It's then the role of the President-Elect and the Board of Trustees to carry it out. They also serve to address issues in between Houses of Delegates.

Their role also entails a lot of traveling, having to go to Washington, D.C. to testify and advocate for certain causes. They also visit state societies and specialty societies, as well as medical schools to make sure there is clear communication and ensure they're listening to what's going on.

As president, he appoints people to COCA or the Committee on College Accreditation for Osteopathic Medical Schools (the equivalent of LCME for MD programs). Both the COCA and LCME have the deaning authority from the US Department of Education to basically manage the osteopathic or allopathic medical schools.

Once the people are on COCA, the American Osteopathic Association has an arm's length relationship with it. This said, they cannot dictate to them what they will do. They can testify to COCA about the AOA would like to see but it's up to COCA to decide.

[17:12] What They're Looking for in Applicants

In general, their profession looks for that holistic individual. Bill also stresses that you don't have to have the perfect numbers to be a good doctor.

"You don't have to have a perfect MCAT and a 4.0 to be a good doctor."

There is this misconception that if you don't have good enough scores, then you just apply to DO schools. Bill disagrees and explains that it really depends on the individual. You could have the best numbers but you may still not be fit to be a DO. You may have the credentials, but Bill says, it's not what I look at people when he writes a letter of recommendation. Instead, he looks at the person.

That being said, you've got to have a certain level of grades or a certain level of MCAT to feel like you can make it through the rigors of medical school and your COMLEX or USMLE test to be able to get a license to practice medicine. Once you get past those barriers, they're now looking for good people.

[21:00] Haven't Heard of Osteopathic Medicine?

For students who have no prior knowledge of osteopathic medicine, just go to the AOA's website and look up Find Your DO. You can type in a ZIP code or a city to find DOs in that area. Then comes your challenge of cold calling and asking them if you could come shadow them to see what it's like. Then out of that can grow a letter of recommendation.

[22:30] Removing the Stigma Against Osteopathic Students

Prior to July 1, 2015, there were separate osteopathic residencies that only DOs could get and there were ACGME residencies that both DOs and MDs could get. In this regard, AOA and the AACOM had an understanding with the ACGME, the larger group of residency programs. They agreed that over a certain period, they were going to create a single system of residency programs.

"From a practice standpoint, we're viewed as equivalent. There's no discrimination there."

They're migrating all of the osteopathic residency programs into the ACGME system, which was made of five separate organizations. Now, it has become seven, with the addition of the AOA and AACOM.

Each group has four representatives on the board that runs ACGME. In addition, they have the residency review committee. It's made of specialists in that particular field that review and approve all the residency programs in the country.

Every residency review committee that had osteopathic residences now has DOs. So you've got MDs and DOs in the room, no matter which room you're in. They're all there working.

There are some program directors that may, for whatever reason, have given more preference to one over the other. But they see these barriers have fallen down over the years.

The profession has actually been growing so much in the last 30 years but the public just wasn't aware of it. So they've actually started a brand campaign over three years ago to get the name out, which they continue to do in the hope of becoming a household word.

"We actually started a brand campaign over three years ago to get the name out, just what osteopathic medicine is, of what we do, so that we are much more known now. We are continuing that as well so we are becoming more of a household word."

[26:30] Why Even Have Osteopathic Medical Schools?

Since they will be merging anyway, I raised this question of why not convert every medical school into an MD medical school and have OMM as a Fellowship. Bill explains that osteopathic medicine has offered something very distinctive with their approach to the patient.

A Brief History

When osteopathic medicine started by an MD, Andrew Taylor Still, there were no antibiotics. Medicine was very different and they used leeches in blood letting patients. He came up with the osteopathic manipulative techniques to enhance the medical care of the day. And when he couldn't get the allopathic medical schools to add to the curriculum, he started his own school. He looked at the body's natural ability to heal itself and how to enhance that and look at the patient at a holistic approach.

That being said, this is still something they do more so than the average allopathic medical school does. If anything, they'd like to see all of medicine as holistic like they are.

The Empathy Study

Moreover, Bill mentions the Empathy Study originally done in the Cleveland Clinic. They were comparing the empathy levels of osteopathic medical students versus allopathic medical students. They found there was more empathy among osteopathic medical students than the allopathic medical students.

Another longitudinal study is using almost all of the DO schools and several MD schools, looking longitudinally to see the long term effect on the students in terms of empathy.

[31:25]  What Students Should Be Worried About with All the Changes Coming

Bill explains that students need to be realistic whether you're going to be a DO or an MD. Be realistic about your future practice options. If you're thinking about a high demand specialty like Dermatology and if you're not near the top of your class and have very good board scores, the odds of getting in wouldn't be as good. It doesn't mean you won't, but it means you really have to work hard and perform well to get considered. But there's still that point of selling yourself in audition rotations. And if you get that opportunity, it makes a world of difference.

"There's still the point of 'selling yourself' in audition rotations because if you get that opportunity, that makes a world of difference."

However, this is not any different than an MD who has poor board scores that wants a competitive specialty. At the end of the day, it's about you. Moreover, what I was initially concerned about is if a weak DO student goes to osteopathic medical school and doesn't go too well. Then at the end of the day, they're applying to a relatively easy, non competitive osteopathic residency. But now with the single accreditation, the MDs can also apply to that residency program as well as the international MDs. So what may have been a shielded spot for a weaker DO student is now going to struggle. Again, it all comes down to the individual student but these are the students that are going to be the most affected.

[34:00] DO's Complete Transition by 2020

Bill explains that each year, there are some students, whether MD or DO, that just don't match for whatever reason. So they ended up having to try to get to match the next year which would even be more challenging. But 98% of DOs matched. And of the osteopathic residencies that were traditionally osteopathic residencies that are now transitioning, they already have 69% that have transitioned over. They're either accredited or pre-accredited. By July 1, 2020, everybody should be accredited, metric the use every year. And over the last 10 years, 44 programs closed on average per year.  If they didn't have residents matching for three years, they go away. And this trend has been the same since 2015, with a total of 119 programs closed. All this being said, they expect over 90% to transition. And looking at different specialties for instance, say for anesthesiology, over 72% of their Anesthesiology residencies are already accredited by the ACGME and over 80% of their Pediatric residencies.

[36:50] Canadian Residencies: Spreading the DO Love in Canada

A lot of students in Canada look to come to the US for medical school. The feedback they get for residency if they want to go back to Canada is that osteopathic students are less competitive than even Caribbean MD students.

Bill says that the AOA's legal counsel has worked with the Canadian Osteopathic Association where each of their provinces can have different rules as opposed to a national standard. In this regard, AOA has been assisting them to get the recognition. In fact, many Canadian stay in the states and do their residencies and want to go back to Canada to practice.

[38:40] Bill's Final Words of Wisdom

Bill's two cents for those wanting to be a physician is that if you want to go into this, then your goal is to help people. If you have a servant's heart, osteopathic is a great field to look into. You're there to serve your fellowmen. By and large, both DOs and MDs do a good job at that.

[39:30] Last Thoughts

The goal of this specific episode is to try to reduce the amount of negativity among the premed world towards osteopathic schools. The general consensus out there among physicians is that there's no difference. Among premed students, DOs are going to osteopathic medical schools only for students who can't get into an MD school. Or that applying to DO school is only something you should do when you don't have good enough GPA or MCAT score. And this is not the case.

If you want to be a great physician, apply to MD or DO schools. Osteopathic schools, apparently, start students earlier with learning that holistic philosophy of treating patients - mind, body, and spirit.

Links:

The Premed Playbook: Guide to the Medical School Interview

MCATbook.com

personalstatementbook.com

AOA Find Your DO

Empathy Study in Cleveland Clinic

AOA

AACOM

COCA or the Committee on College Accreditation for Osteopathic Medical Schools

LCME

Apr 25, 2018
282: Premed Q&A Coaching Calls - HPSP, Clincal Experience & More
30:58

Session 282

I decided to get on the phone with premed students and answer their questions about relationships, HPSP, secondary essays, and so much more!

By the way, The MCAT Podcast is put on by the Medical School HQ and Next Step Test Prep. Aside from this, we have written The Premed Playbook: Guide to the MCAT. This book is for a student just starting out on their premed journey. They're trying to figure out all the pieces of the puzzle. Just to clarify, this is not a test prep book to help you get a higher score on the MCAT (although there's some of that stuff in there). In short, this is a book you'd buy the moment you realize there's this thing called the MCAT. It's coming out very soon so get notified by going to MCATbook.com or find out how to buy it.

Back to our episode today, we're answering questions from premed students raised on our Facebook community, The Premed Hangout. Be a part of this community that's now close to 5,000 members. And if you have questions where you want to sit down and talk with me, we also provide some personal Premed Advising Services.

Let's get on with our Q&As:

[02:45] A Foreign Degree and Which Schools to Apply To

Question: What would be the first steps when applying to medical school if you have a foreign degree? How would you choose schools to apply to?

Answer: Assuming you are a foreign student (which is pretty much the general assumption), are you a foreign resident, a citizen, or are you just here on a student visa? A huge factor in applying to medical school is that if you're not a permanent resident or a citizen, it could be very hard. You can go and look up MSAR for schools that accept internationals students butt most schools don't.

Moreover, as a citizen with a foreign degree, have you done your prereqs here in the U.S.? This is also another huge factor for most medical schools. A lot of medical schools have this 90-hour rule where they want 90 credit hours of classes taken here at a US school whether it's a four-year university or a community college. However, every medical school is different, which is the most frustrating part of this process. According to the student who asked this question, he has seen some schools want other specific hours in in a four-year university versus a community college.

"Read the instruction manual for each of the application services you're using."

In regards to international transcripts, the instruction manual has changed recently. Previously, you needed to request the transcript if you had credits transferred to a university or a US school. But this has now changed and you no longer need to request a transcript. But if the credits are transferred then you need to get the grades and classes listed on AMCAS. Therefore, there are a lot of hoops you need to jump through as an international graduate of an undergrad institution.

As to what schools to apply to, apply to those that you want to go to. it's your home work to go to the MSAR. Contact the schools you may be interested in applying to. Talk to them about your situation and lay out everything and ask if there's anything else missing before you apply to their school. See what they have to say and if you're good, then apply.

Having had a degree from a foreign country added with a community college, some school may have a negative bias to this. But with a great GPA, you should be fine. Just do well on the MCAT and write great personal statements. Put your extracurriculars together well and tell your story well. And you should be good!

[09:47] HPSP and Air Force Surgeon Experience

Question: How do you think your time in the Air Force influenced you as a physician and how do you think it would be different if you had not done the HPSP?

Answer: I went through HPSP at a civilian hospital, not a military medical school. Then I did a civilian internship. So that was the only time I practiced medicine outside of the military. But looking back at my time as an Air Force Flight Surgeon, I think of it as that you're a physician - period. Your employer just happens to be the US government and the Air Force. That being said, I don't really know how much being in the Air Force has influenced me as a physician. If at all, I think being a physician influenced me a ton as an Air Force person.

Had I not gone through HPSP, I would probably have gone on to do an orthopedic surgery residency. So the military dictated whether you could move forward with the match or whether you do match in the specialty you want. They said no to orthopedics and this started my flight surgeon career.

"Doing HPSP limited me with my residency choices because you need to apply to the military match before."

Nevertheless, I do not regret my choice as I've made amazing experiences. I've flows all around the world at the back of different military aircraft. I have flown an F-16 - great memories!

Having no direct family members in the military, I was naive and didn't know anything. I assumed that the Air Force would fly over to places and they go home at night. While the army is on the ground and fighting the battle and the Navy is on the boat all day long. Hence, I chose the Air Force.

Then once I was in the Air Force, I was surprised we ran the military hospitals in Iraq and Afghanistan and everywhere else and we're down there. We were deployed with the army and on the ground. Either way, it worked out in the end since I love the Air Force.

[15:00] Should You Do the HPSP Scholarship?

Something as specialized as pain management, there are different ways into it such as Anesthesia, Radiology, PM&R, etc. But there are "issues" with going into a subspecialty in the military since usually, the specialities are few and far in between. It makes it that much harder to be able to do that.

So if you're a premed thinking that you're really interested in pain management, I'd caution you to pigeon-hole yourself so soon. Since 75% of students change their mind once they're in medical school. Secondly, I would caution you against an HPSP scholarship because of what happened to me. I went in knowing I wanted to be an orthopod.  I had a little hiccup going through OB/GYN but I applied to Orthopedics and the Air Force said no. Therefore, this depends on how flexible you are. If you're flexible and resilient enough once they say no, then you can do a flight medicine and do your four years as a military doctor then get out and apply to a residency and go do what you really want. Are you willing to do that? This delays your specialty training but you come out debt-free.

"Don't do it just for the money."

[17:35] Shadowing and Clinical Experience When You're Already in the Healthcare Field

Question:  What can count as shadowing experience when you're already in the healthcare field? Are there stipulations to it? Or does it never count as a shadowing experience and only clinical?

Answer: Even if you're already in the healthcare field, this still wouldn't count as shadowing. It's very specific. It's outside of your job. You're not working. You are going to a physician's place of business outside of your role as a nurse or a PA and you are observing and watching and learning.

While you’re already seeing what the physicians are doing, that is true about 75%-80% of the time because there is so much more that a physician does outside of that clinical interaction you have with them. Shadowing allows you to see that extra 15%-20%, whatever that may be. This could be phone calls with the insurance companies or the grand rounds where the physician is presenting or learning.

"Shadowing is very specific. It's outside of your job. You're not working. You are going to a physician's place of business outside of your role as a nurse or a PA and you are observing and watching and learning."

Shadowing is something that you need to do above and beyond what you're doing already if you're in healthcare. From a clinical experience standpoint, you've got that covered being a nurse. You're already interacting with patients all day, everyday. So you're fine on the clinical experience side.

[19:55] Dealing with Relationships

Question: How do you make it work when you're in a relationship with someone who's not a premed? How do you convince them that the journey is going to be worthwhile? How can you best prepare them for what's ahead with medical school, residency, and fellowship?

Answer: Back in Episode 251, I tackled how to protect your relationships as a premed and med student. i recommend you listening to that with your significant other, together. You'll get to hear from a spouse of a physician and how they made it work. That episode was with Sarah, a marriage and family therapist. She comes from a psychology standpoint of communication and all these other tools she's learned as a therapist. And what it comes down to really is communication.

"The question is what do you communicate? How do you communicate? I want to communicate but how do I prepare them?"

I honestly hope that you don't need to convince a significant other if it's worth it. A significant other should be there by your side. If you think it's worth it, you shouldn't have to convince them that it's worth it.

In terms of preparing them for what's to come, what medical school, internship, or residency is all about is your significant other supporting you probably more than they ever thought they would need to in the hardest times and the busiest times in your life.

It's about being there unconditionally for you and understanding that your busy. It's not all about them and you will try to make it about them when you can. This can be in between tests and those weekends when you come off of the test and you have a couple of days before you have to start studying for the next one. Or when you're in internship and on night float so you'd have to sleep all day long since you work all night long. So it's really just about supporting you and being there for you. Make sure they understand their role and that's what you need them to do.

When I went through medical school, a lot of relationships going into medical school, did not survive medical school. It's a very, very hard time. And it's hard when somebody either doesn't want to support somebody through it or doesn't think it's worth it. Maybe they don't want you to be a physician because they know physicians are busy.

"There are a lot of reasons for relationships not to survive medical school."

[20:07] Common Mistakes in Secondary Essays

Question: What is the most common mistake when writing secondary essays besides sending them in late?

Answer: Discounting sending them in late, which is the most common mistake, another one is not pre-writing them. Although this does go hand in hand with sending them late. But secondaries are one of the easier parts of the application since they're asking you a specific question. One example is how are you going to add to the diversity of the class. Or if you're planning on taking a break before you start medical school, what are you planning on doing?

"Secondary essays are probably one of the easier parts of the application process because you are answering a specific question."

So the biggest mistake is not pre-writing them. And when you work yourself backwards for why that happens, that's because most students are taking way too long to write their personal statements, to write their extracurriculars, to submit their applications. They're taking their MCAT late. All of that stuff is happening at the same time. And as soon as they submit their application, usually a little bit later in the cycle, they will immediately get back secondary applications from medical schools. Once you're past the first wave of applications that go out, medical schools see you applied to their school as soon as you submit, prior to being verified. And most of them will send you a secondary within a day or two. Imagine you're submitting your application, wanting to get your feet up, and then you start getting back 10, 20, 30 secondary applications. And you're behind at that point.

All this being said, I believe prewriting your secondaries is a must. And always, always, always, do story telling. That's the power of written and spoken words is through stories. So as much as you can answer the question with a story, then do it. It doesn't even have to be related to medicine. In fact, stories are more powerful when they're not related to medicine.

"Writing secondaries with stories becomes much easier."

Links:

The MCAT Podcast

Next Step Test Prep

The Premed Playbook: Guide to the MCAT

The Premed Hangout

Premed Advising Services

MSAR

PMY 251: How to Protect Your Relationships as a Premed and Med Student

Apr 18, 2018
281: What Does the Med School Application Timeline Look Like?
24:21

When should you start writing your personal statement, your extracurriculars, taking the MCAT, asking for letters of rec and more application timelines?

Apr 11, 2018
280: Finishing Prereqs Early, Nursing as a Backup and More Q&A!
21:37

Session 280

This week we’re taking questions directly from the MSHQ Premed Forums. If you’re not familiar with the forums, check them out and join the conversation!

For The OldPreMeds Podcast, we have a sub forum called the Nontrad Premed Forum. We also have the General Premed Forum where traditional students (nontrads welcome too!) can ask questions.

In this episode, we have pulled out questions from the forums and discuss them here. Also, make sure to register there so you can join an amazing, collaborative community of students and feel free to throw in some questions there.

Meanwhile, here are some special announcements:

First, we have The MCAT Book coming out soon! Go to mcatbook.com and click on the "Let Me Know" button. Put in your name and email address so you can get notified.

Second, I'm currently working on The Premed Playbook: Guide to the Medical School Personal Statement. Just go to the personalstatementbook.com and sign up to get notified once it comes out.

Back to today's episode:

[03:58] Nursing Major or Premed?

"I'm a freshman in college and I've been dealing with "which major problems" since high school. I'm indecisive once it comes to choosing a major. I want to choose nursing not because it's a shorter education route but because I plan on having it as a backup plan if medical school doesn't work out for me. Except, I want to go to medical school but I have lots of self-doubt about my ability mentally and physically to graduate from med school.

I also consider having my major be premed because I know if I don't get any prereqs done at the end of four years, I'll have to go back for another two and a half years of college to complete those prereqs before even applying to medical school."

You don't need to worry about your major. When it comes to applying to medical school, you don't need to worry about what major you have. It just doesn't matter. The thing that matters the most are the prereqs.

"A lot of schools are getting away from having prereqs but you still need those to prepare yourself, to give you that science foundation to do well on the MCAT."

Now, a lot of medical schools are getting rid of a lot of prereqs, but you still need to do well on the MCAT which means you still need to take the prereqs anyway And most of the prereqs are centered around doing well for the MCAT.

[05:30] The Backup Plan

This student has some self-doubt and that's normal. We all have self-doubt. But if you let that dictate having a backup plan, you definitely do as little as possible to succeed in your goal of becoming a physician. Being a nurse is a great career, but if you want to to be a physician, get rid of that backup plan and bite to the nail to achieve that goal.

At almost every point of the medical journey, there will always be that self-doubt - as soon as you start medical school, during clinical rotations, internships, or as soon as you becoming an attending. It doesn't end. It's called impostor's syndrome. So you have to let that go and fight through it. Know that if this is what you want, you would do whatever it takes to do it and not have a backup plan to fall back to.

On a side note, most schools don't have a "premed" major although there are a few schools that do. But most don't. You can just major in chemistry, biology, exercise physiology, history, Spanish. You can major in whatever you want as long as you get those prereqs.

[07:42] Taking Prereqs Classes Out of Order

"Some of the classes which I'm retaking were originally taking decades ago. And so, I've forgotten much of the material. Recently, I went to a premed admissions fair where several admissions advisors from some east coast medical schools told me to redo my course work to "prove" that I could still handle academically rigorous material.

For example, one advisor told me to retake physics. Because when I last took it decades ago, I got a B in the first part. I could never full understand forces on inclined planes. So to retake physics, I need calculus which I have forgotten. I originally took three semesters of Calculus back in the 80s and did well on all but the third part. That was for my first non-science degree. Then for my second degree, I had to retake these Calculus courses in 2006. I got a B in part 2. Although I realized that Calculus has not changed much, I found the material much harder to understand and comprehend during my second time through. I have been out of school for many years and this challenge to keep up with college students half my age.

Now I have the opportunity to retake Calculus I and III on the quarter system on a more rigorous school than the one at which I took the original Calculus courses. However, because of my work, Spring quarter which starts next month, I cannot take Calculus 1 before Calculus 2 and only Calculus 2 fits my schedule this spring quarter.

I could then take Calculus 1 during the summer. I've asked others in my program who have gone through the same sequence. Some took them simultaneously, some also took other measures of classes. For example, several students were taking Biochemistry and General Chemistry at the same time. Usually, General Chemistry comes before Biochemistry."

"You don't have to keep up with college students. Your only competition is yourself."

[09:39] Will It Hurt Your Application?

Can you take the out of order? Yes. Is it ideal? No. There's a reason there's a 1 and 2. Each class is supposed to build on each other. Of course, you can do it. You're going to have to teach yourself some of the concepts.

The biggest question is whether it will hurt an application? No. The admissions people are telling you to do it. It's only going to help your application assuming you do well in the classes.

This is common for nontraditional students. They take courses a long time ago. The go out and have their career and have their family. Then at one point, they wake up and realize they've always wanted to be a doctor. From that point forward, they seek out what they need to do to get into medical school. A lot of them will contact schools and a lot of them will advise to take more recent course work to "prove" that you can handle the coursework.

It's not wrong. Medical school is hard. Just because you were a good or decent student 20 years ago, doesn't mean that you have the same aptitude today or the same willingness to do it. Going to school and being a student are different than being an employee.

"Are you really that interested in being a student or is the idea of being a physician greater than the allure of retaking classes and being a student first?"

And this is where "prove it" comes from. You need to do well in the classes and succeed. You also need to get that upward trend going. At the end of the day, you have to show the admissions committee that you can still be a student and you have a semester or two of coursework to show them that. So this is not going to hurt your application (as long as you don't do poorly in those classes.)

[12:10] Clinical Experience in a Podiatry Clinic

This is another common question that comes up. What constitutes clinical experience for your application to prove to medical schools that this is what you want to do?

"I'm currently working as a medical assistant/scribe for a local podiatrist. I have lots of good experiences I don't think I would get a lot of other places especially because I don't have any special licensure (EMT, MA, CNA, etc.). I was recently in a discussion with my premed advisor who suggested to me that this experience might not be viewed as actual clinical experience by MD and DO admissions offices.

I was surprised by this due to the scope of my experiences. Is this true? Should I try finding a different opportunity to replace this one or will this be able to compare with other experiences in "actual" clinical settings?"

So is this clinical experience? Yes, 100%. But is it good clinical experience? No. But it doesn't mean you avoid talking about it in your applications. But it means you should go and try to get clinical experience with physicians (MD and DO). Podiatrists are physicians as well. They're allowed to call themselves physicians. They're as close to MDs and DOs as any other health professions. They just happen to specialize in a certain part of our body. They do surgeries, they operate. They go to medical schools. They have a long curriculum in medical school. They do clinical experiences.But it's still podiatry.

Medical school admissions committees are going to look at your experience and ask for the rest of it. Where's the time you spent being around non-podiatry patients? They want you to show them those experiences. Show them how those experiences have led you to want to be an MD or DO.

"There's a huge difference in how your actions are speaking to the admissions committee."

Scribing at a podiatry clinic, solely, can send a signal that you only want to be a podiatrist, not an MD or DO. Instead, you want to be a Doctor of Podiatric Medicine. There's a difference in how your actions are speaking to the admissions committee. So while it is a good clinical experience, it's not the right clinical experience for your ultimate goal of becoming a physician. It's the same thing for any other clinical experience - dentist office, chiropractic office, naturopathic office, etc. If you want to go to medical school, then you need to get clinical experience around MDs and DOs.

[15:47] Graduating Early and Applying Early

"I'm a first year premed nutrition student but I came into college with nearly 45 AP credits so I can graduate a year early with only taking 12 to 13 credits per semester. everyone has told me that I should a minor or take extra classes and graduate in the Fall of 2020 instead of the Spring of 2020 and apply for admissions for Fall of 2021 instead of Fall of 2020. I would really like to go straight into medical school after I graduate though. So I'm thinking about applying next Spring for the Fall of 2020. I'm just concerned about my extracurriculars. I'm just concerned about my extracurriculars. I didn't realize I wanted to be a doctor until this past Fall. So I haven't gotten involved in any premed clubs or shadowing or research or volunteering. I plan on starting research and volunteering very soon.

But I'm worried that if I apply in about a year, I won't have extracurriculars on my application. I'm also worried about the MCAT. I am planning on taking it next spring and there's really no room for error if I don't do well on that attempt since I'm trying to send in my application as early as possible. I'm not sure how setting is going to go yet since I'll be taking OChem 2 and Biochem that semester as well. I guess I'm just wondering what do you all think? I really want to graduate on time without taking a gap year but are my extracurriculars going to be too weak. Will it be too hard to study for the MCAT while taking those difficult courses next Spring?"

Graduating early is great. There's less debt that you're going to incur being a student for an extra year. But I also don't agree on applying that early.

As mentioned, you haven't done any shadowing, research, or volunteering yet. How do you know you want to be a physician? How have you proven to yourself that this is what you want to do? I would challenge you that you have no clue yet. It may sound great. You may have this great idea of what's next but you don't know. You need to go out and get some clinical experience. You need to go out and shadow. Put yourself around patients. Put yourself around physicians. And then start confirming that this is what you want and then start going down the path of when to take the MCAT and when to apply and so on.

I don't think it's a good idea to take the MCAT while still taking Ochem 2 and Biochem. That is a lot! Those are some heavy-hitting courses that are well-involved in the MCAT. To take those courses and to be studying for the MCAT at the same time is going to be very hard. So on top of not being super prepared for the MCAT because you're still taking courses, you're also rushing everything else. And you're still not sure that this is what you want to do. You may think you know, but you don't. You haven't proven to yourself through your actions that this is what you want.

Go out and shadow. Go out and get the clinical experience. And prove to yourself that this is what you want. Then after getting that shadowing or clinical experience, you can concisely state in your application - personal statement, extracurrriculars, interviews - explain why it is that you want to be a physician.

"Why do you want to be a physician? That is a key question that you have to answer. And it is only through those experiences where you will be able to formulate a solid answer to that question."

So go out right now. Take that gap year. Prepare for the MCAT. Get those clinical experience and shadowing experiences. Prove to yourself that this is what you want. Continue those things consistently through the application process and into matriculating into medical school. Taking a gap year is not that big of a deal. Travel. Go out and get some life experiences.

Links:

Check out the mcatbook.com

MSHQ Premed Forums

The OldPreMeds Podcast

Nontrad Premed Forum

General Premed Forum

Apr 04, 2018
279: From a Cocktail Waitress to Physician and EM Doc
35:24

Session 279

Dr. Elaine Reno is an Emergency Medicine physician. She joins us to talk about her journey to medicine and her role with the Wilderness Medicine program at CU.

If you're interested in working with me for your personal statements, essays, and extracurriculars and need any help with editing those, save 15% off my services using the promo code MAR2018.

Back to our episode this week, Elaine helps run the Wilderness Medicine program at the University of Colorado. Back in Episode 202, I had Dr. Todd Miner talking about the Wilderness Medicine program. He is not a physician but he's just one of those other kind of doctors. But Dr. Elaine Reno is part of the medical side of the Wilderness Medicine program.

Today, she talks about her journey into medicine, what she has learned, and her experience being on the residency admissions committees, and what you should be doing as a student.

If you're in the Colorado area, they're actually looking to give scholarships to students like you. Reach out to the Wilderness Medicine Program at the University of Colorado. It's actually run through the University of Colorado, Boulder, the undergrad program. So you get an elective credit for it for your university.

By the way, Elaine was also on our Specialty Stories podcast this week, so be sure to check her out there as well!

[02:50] From an Art Major to Molecular Genetics

As she finished her undergrad, Elaine was working in a research lab debating what she wanted to do next. She was considering MD versus PhD. Part of her job in the research lab was to consent patients where she gets tumor samples from an operating room. She'd consent patients to let them use their tumor samples. She then realized that the favorite part of her job was not the day to day bench research or the things they were learning fro the research. Rather, she liked the conversations with the families and getting to meet the patients. She loved getting to sit with them pre-op and talk to them. She felt her favorite part of her job is the human interaction.

So Elaine was at least a year out of college. She did two years of basic science research before she went to medical school. During undergrad, she really had no idea what to do going in. She started as an Art Major and switched to Molecular Genetics while still doing some of the Art stuff. So she had no idea what she was going to do with her degree. She grew up in a small town so she really didn't know a lot of doctors and she didn't know anyone who has gone to medical school.

But her plan growing up was going to college and so she did. And she thought that if she had been more talented, she would have pursued being a professional artist. But she really didn't think she was talented enough to do it.

As to why the shift to molecular genetics, Elaine explained how she has always like science and she liked art. So she simply took things that interested her in college so that's what she landed on.

[06:17] Interest in Patient Interaction

When she left undergrad, Elaine didn't have any idea what to do with herself. So she had no plan. She had no job. And her parents said she had to support herself. Her sister moving to Laughlin, Nevada, offered her to pay for her rent if she moved with her. Being a casino town for retirees, there were no jobs available except for being cocktail waitresses So she became a cocktail waitress in a casino.

Realizing it wasn't definitely a long term job prospect for her, she did undergraduate research as a summer job. She basically had two criteria. One was to live somewhere she could ski, and second, she wanted a job that didn't involve her wearing a corset and shiny tights to work. So she found a research job at the University of Colorado as a professional research assistant, she applied, and got the job.

[09:27] Her Transition into Medical School

Although she likes the research she did, she knew she had to obtain some graduate level education if she wanted some grant funding. For her, the best of both worlds would be a doctor that could obtain grant funding and do research but also had this clinical practice and take care of patients. And this dichotomy started to appeal to her and this is when she considered applying to medical school.

She was working full time at that time and she couldn't take the summer out to study for the MCAT. So only studied in the evenings for a year and then took the MCAT. She has been a Chemistry TA so this definitely helped.

The hardest part of medical school for her was to always be studying. And she believes in the importance of wellness. In those extra hours she spent studying, she thought she could have focused more on wellness. Because she felt that anytime she wasn't studying, she should be studying. And this was one of her biggest struggles in medical school. She also thought how isolating medical school was. The first two years were just the classical textbook lecture learning. So for her, it was hard to see how this biochemistry you're memorizing is going to be applicable to taking care of the patient one day. This is different from most schools now that are slowly adapting to problem-based learning.

"It just felt like anytime I wasn't studying, I should be studying. I struggled with that a lot in med school."

Initially wanting to be an OB, she thought she would love the operating room and wanted to be a surgeon. But she discovered she didn't like it. Then she was trying to consider between outpatient and inpatient medicine. She likes hospital-based medicine and the lure of the ER that everything is different and things are always changing. There's always new things coming in and there's always things to learn. There are busy and slower times. Practically, she loves how Emergency Medicine can be different everyday.

[14:55] Interview and Personal Statement Tips: They Just Want to Have a Conversation

As part of the admissions team for their residency program, she remembers being a premed and going to her medical school interviews and being a med student doing residency interviews. She was always nervous and she'd get really quiet. And one thing she learned while she was interviewing people was that they're looking people with great communication skills of course and so on. But when you're in those interview settings, you need to relax. This person is not micro analyzing every single word you say.

They already know so much data about you based on your application. So the interview is done to see if the person is nice, normal, and can communicate. It's less about you trying to "sell yourself" in the interview and more about you just making a connection with that person.

"They're just trying to figure out if you're a normal person and if they feel you're someone that can sit and talk to patients."

In fact, one of the best interview conversation she had was talking about gardening and their mutual pain in trying to grow strawberries. Totally unrelated to medicine, but Elaine considers it as one of the best conversations she had. Again, how well can you communicate? This is what's in the minds of admissions committee.

In terms of personal statement, what she really doesn't like is when people tell you what it is like to be a doctor. When she went to Costa Rica with students as part of their Wilderness Program, she'd sit down with each of them and review their personal statement and make them rewrite it. But for someone who doesn't really know what it feels like to be a physician, and you're saying generally what it's like to be a doctor, she doesn't like this kind of answer. That said, students can get some appreciation from shadowing or scribing, but until all the pressure is on you, you have no idea.

[22:00] Interest in Wilderness Medicine

Aside from being an outdoor lover, Elaine says there's a big Wilderness Medicine group at the University of Colorado. So she was basically drawn to this due to her love of outdoors and skiing. A PhD, Dr. Minor, who was here on the show previously, he was starting a course for undergraduates where students get elective credits.

The idea was to spend your time in your premed years, first, to get clinical knowledge and experience in younger students. So getting clinical knowledge to students much younger and getting them through medical experience much younger.

Secondly, she recognized how students before had limited resources to advisors. So they've developed this class that combines these two things. Feeling having no idea what to do and now having an idea on how to navigate it, Elaine feels this is important to create that framework for them and allow them to explore this career. And so she wanted to be able to created an elective curriculum for them that could help them.

[26:03] What is an Elective Credit?

They tend to work with each student but they've had students from all over the country do this. They do an aversion twice in the summer and once in the winter in Colorado. In the winter they promise to big. Then they go an aversion in Costa Rica and do hiking, white water rafting, ziplining, etc. They're pretty remote from the town being a small surf town.

This course is for students from all of the disciplines. She even had a student who wanted to get a PhD in Toxicology but wanted to learn Wilderness Medicine skills, so it draws pre-health students of all different varieties.

And for people who love the outdoors and just want to gain some skill t o be safe in the wilderness, Elaine says that this does the whole gamut. They work with each student to make sure they're getting what they want out of the class.

[29:00] Writing Personal Statements

As to when you should write your personal statement, you should start writing personal statements depending on different factors. Elaine thinks each student comes in with a different goal. When do you want to sit down and get new skills get some actual critical care, knowledge and the ability to take care of other people.So when do you really want to expose this.

If you're a Junior or Senior and still have no idea about what to do next, she thinks this is the right time to take the class. For her, the best time she would have taken the class was after she graduated and while working as the lab. Nevertheless, she thinks this is an individual preference.

[32:10] The Biggest Takeaway

For Elaine, she felt like she really had to pursue the things she wanted to be on her application. She had that mindset of always checking the box. For her, it all boils down to pursuing your passion. Lastly, she wants to imparts to students to pursue your passions and pursue them aggressively rather than to check each box. It's important to pursue the things that's really drawing you.

"Pursue your passions and pursue them aggressively rather than to check each box."

Links:

Save 10% on Personal Statement and EC Editing

Episode 202 with Dr. Todd Miner on Wilderness Medicine Program

Wilderness Medicine Program at the University of Colorado

Specialty Stories

Mar 28, 2018
278: Your MCAT and GPA Don't Matter As Much as You Think They Do
25:30

Session 278

You shouldn't be surprised to read online that a student with near perfect stats didn't get an interview invite or acceptance. You're more than your stats.

Today, I'm sharing my insights into stats and school list, which is contrary to what you may see out there, specifically, I'm sharing my thought process on how to choose your schools. By the way, check out all our other podcasts on MedEd Media.

[01:52] Your Stats Don't Matter: They Do, But They Don't

I've heard of students applying to schools with great MCAT scores and almost perfect GPAs, decent extracurriculars, but the students didn't get interviewed anywhere. Looking at their school list, they applied to four California-state schools. They're California residents going to school in the midwest area. California medical schools are really hard to get into.

Your stats don't matter. Your stats don't matter and to think, California medical schools are so hard to get into. This may seem counterintuitive. But really, in the end, they don't. They do, but they don't at the same time. Now, these students also applied to several east coast schools, which are also very hard to get into. Your stats don't matter. They do, but they don't.

And in another website, a student posted his stats with 4.0 GPA, 525 MCAT score, and then gives out their school list. Then they ask whether they should add more "mid-tiers."

"There's no such thing as mid-tier, high-tier, or low-tier. It's a premed thing."

Are there programs out there that will discriminate you based on the medical school you go to? Yes, there are. However, I strongly disagree with painting broad strokes about residency admissions based on the medical school that you've gone to. If you're concerned about the residency program you're going to, stop! You shouldn't be worried right this minute as a premed student about the residency program you think you want to go to.

First, your choices of specialty are likely going to change. Based on the last AAMC data I could find, 75% of students change their mind when it comes to specialty selection. The majority of students change their mind, so you shouldn't be thinking about a very specific residency program right now as a premed student.

Even if you do stick with that residency program you're interested in, getting into one of those top programs shouldn't be your goal. It would be nice or great. You shouldn't decide what medical schools you're going to apply to because you have one specific residency program in mind.

"Getting into medical school is hard. Don't make it harder by limiting your chances, because you're limiting the schools you're applying to."

You can get into Neurosurgery by going to a "low tier" school. There's no data out there that shows that you have to go to a top medical school to get to a competitive residency. Your medical school doesn't matter. Don't make it harder for yourself by only applying to top tier medical schools because you think you have amazing stats.

[08:40] Do Stats Really Matter?

Your stats don't matter. Your stats open the doors to places. They matter up to a certain extent or point in the application process. And then everything else takes over. As an applicant, you have to work on the rest of your application as they matter even more than your stats. Once that door is opened, if you have a bad personal statement, your door will shut quickly. It's the same way if you have bad extracurricular descriptions or if you can't talk about why you want to be a physician. If you can't talk about the activities you've done and how they've impacted you, those doors will shut, regardless of your stats.

"Your stats don't matter. Your stats open the doors to places. They matter up to a certain extent or point in the application process."

Now if you're applying to "top tier" medical schools, that doesn't mean they're better schools than "low tier" schools. When you're applying to medical school, you need good enough stats to pass through the digital shredders, the filters the school set up. If your stats are good enough to pass those filters and to be sorted in a way that your application lands on the desk of somebody, your stats have to be good enough to get to that point.

[11:25] You're Just Like Everybody Else: How Do You Stand Out?

And when you apply to these top tier medical schools because you have great stats, guess what? There are a lot of other students who have the same stats. So when you start comparing yourself to other students who are also applying to those other "top tier" medical schools, you now all of a sudden look like a normal student. Because they're comparing you with other students with 525 MCAT scores and 4.0 GPAs. And when your personal statement doesn't line up or hold up to the personal statement of another student, then you're probably not going to get an interview.

Your application matters as well as your letters of recommendation, most importantly, your personal statement. Speaking of which, check out The Premed Playbook: Guide to the Personal Statement.

Your personal statement is probably the most important thing outside of your stats. Your stats open the door. Your personal statement gets you through the door. Your secondary essays land you a seat. And your interview hopefully seals the deal for that acceptance. So when you start looking at your school list

"Your stats open the door. Your personal statement gets you through the door. Your secondary essays land you a seat. And your interview hopefully seals the deal for that acceptance."

[13:35] Things to Consider When Preparing Your School List

So when you're looking at your school list, don't look at MCAT and GPA. Instead, look at schools where you want to apply to. There are so much more out there that you need to consider - the culture of the school, mission/vision, programs, clubs, activities, support, etc.

As you're preparing your school list, consider where you want to live, weather, proximity to family, class size. And as you're going through this process, try to visit schools so you can see firsthand what it's like. There are several students who had a school ranked as their top choice before interview day and then ranked it at the bottom after interview day. And students who ranked it at the bottom before interview day, now ranked at the top post-interview day. All because they saw how amazing the school was after visiting it and after talking to students.

The MSAR (Medical School Admission Requirements or the College Information Book (CIB) don't do justice to what you will see when it comes to the medical school and what you will experience at that medical school.

"There are several students who had a school ranked as their top choice before interview day and then ranked it at the bottom after interview day."

[15:31] You Have No Control Over Medical Schools

You have no control over what the medical school is looking for. So when you look at creating your school list, you have no control over how medical schools are going to look at your application. There are students who have the same stats and apply to the same school and one gets immediately rejected while the other one got an interview and accepted. If it was all about stats, this wouldn't happen. But it's not all about stats. It's about who you are.

It's about how you're able to add to the diversity of the class. Show that through your extracurriculars or secondary essays. If you can't do that, then you're probably not going to get interviewed.

"It's not all about stats. It's about who you are."

Let's just try to paint a broad brush and talk about students with 4.0 GPAs and 525 MCAT scores. They're probably super nerd. And if you picture somebody like that, maybe they don't know how to write a good essays or personal statement. They just talk about loving science and helping people. They've proven themselves in their stats. So they should get accepted. They think that because they have the stats, that medical school application is as easy as offering the acceptance now. They probably think they don't need to be interviewed.

But there are also those "normal, non-nerd" students out there who are getting 4.0 GPAs and 525 MCAT scores who are able to write amazing personal statements and secondary essays. They show that diversity through their extracurricular descriptions. Those students are getting those interviews and get accepted.

All this being said, it's so much more than MCAT and GPA. You can not apply to medical school based on your stats alone. You can not choose the medical schools you're applying to based on your stats alone. Your stats should have zero bearing on the schools you are applying to. Do not apply to medical schools that you are not going to be happy at because you have the stats that you think will get you accepted there.

"You can not choose the medical schools you're applying to based on your stats alone. Your stats should have zero bearing on the schools you are applying to."

[18:42] Every School Is Different

Harvard Medical School has a very different culture than the University of Florida Medical School or that of University of Kansas Medical School, and so on. Every school is going to be different. This may be hard to understand but you need to do your homework and find out what that is like. You won't know if you're truly going to be happy at a certain school unless you go there. Step foot on the campus and see what it's like. Even then, it's hard to gauge so you need to also talk to students. Talk to people and talk to graduates and the alumni of the school. Ask them about what they like and didn't like.

As you're going through this process, hopefully you've got great stats. However, don't mistake those stats for an acceptance to whatever medical school you want to get into. Getting into medical school is hard even with amazing stats because there are so many other pieces to the puzzle that you are probably not thinking about. The biggest part of that puzzle is who you are and do you fit with that medical school. And if that medical school admissions committee looks at your application and determines you're not a fit for their school, you're not going to get interviewed even with amazing stats.

"There are so many other pieces to the puzzle that you are probably not thinking about. The biggest part of that puzzle is who you are and do you fit with that medical school."

[21:21] Don't Be Discouraged!

So don't be surprised or get alarmed as you go on these websites and forums and students are posting about how great their stats are. Don't look at that and determine that you're now not good enough to get into medical school. They are amazing stats for sure but they don't guarantee an acceptance.

One student I helped with during interview prep ended up only receiving one interview even when he had great stats. Reading his application before me helping him out, I told him why he wasn't getting any interview at first. His personal statement was terrible and it's why he probably didn't get any interview. What you put in your application matters. The MCAT and GPA are important. But beyond a certain point, they're not important anymore. The rest of the application is just as, if not more, important as those stats.

Links:

www.personalstatementbook.com

MedEd Media

Join our Facebook group

MSAR (Medical School Admission Requirements)

College Information Book (CIB)

Mar 21, 2018
277: This Student Didn't Let Her Fear Overcome Her
44:03

Session 277

In this episode, you will hear about another success story of a premed student who got into medical school on her first try after not doing very well in undergrad and more specifically, on the MCAT.

Before we move on to the interview, please don’t forget to subscribe to this podcast in whatever your device is. And checkout all our other podcasts on MedEd Media.

Back to today’s episode, Holly initially didn't think she could become a physician and let her fears dictate her path. She then conquered her fears and has been successful. Holly is a perfect example that you don't have to be a perfect student to get into medical school.

She found a school that matched what she was interested in. She allowed her goals to overcome her fears. And if you find yourself in this situation where you fear something and you don't think you can do this, this is a must-listen episode for you.

"My goal was more important than my fear."

[02:20] Her Dream to Become a Physician

Growing up, Holly didn't have any aspirations of being a doctor until she was working as a caregiver when she was in high school. This was the first introduction she got with patient care. A couple years of working, and she decided to go back to school, still around health care being a lover of the sciences.

"I fell in love with patient care but I just got really frustrated with the lack of knowledge that I had."

Holly would describe living in a "low socioeconomic status" and not many people in their area ended up going to college or having those big career aspirations. So it just never occurred to her that being a premed was an option.

[05:20] A Slight Detour and Going Back to School: Pregnancy and Getting Family Support

A couple of months into working as a caregiver, she got pregnant with her son. So she felt this was holding her back from pursuing any sort of big career. She wanted to but she didn't think she would have the time to go full board doctor while raising a son and all the things that went along with that.

Then she started working as a cashier at a local grocery store and one day, she just realized it was not she really wanted to do, nor would she want to do this for the rest of her life. So that week, she quit her job and took a risk. She registered for school and took classes in the Summer, which were accelerated classes. Instead of taking them in a ten-week quarter, they're reduced to five weeks. Seeing she was doing pretty decent, it gave her the confidence that she could do this.Once she jumped in, she didn't feel it was really hard as she thought and she could actually manage her time and do it.

"This is not what I want to do. I don't want to do this for the rest of my life. And if I don't get up and do something now, that's what I'm going to end up doing."

Holly feels lucky for having a husband who's 100% supportive of her career goals and she considers him as a huge rock in her journey.

[08:25] From Poor to Great Advising

So when she signed up to take classes at a community college where she was still pre-pharmacy, they were made to talk with an advisor. And one of the things the advisor told her was she needed to think of a different career path because there was no way she was going to be able to accomplish it since she has a family. Holly took this to heart and sadly, she didn't really get any that much of a help from her advisor.

A year into community college, she decided to switch over to premed, thinking that being a pharmacist just didn't feel right for her, also having shadowed a pharmacist and realized it wasn't something she wanted to do.

Then Holly got into Portland State University three years later and she got a premed advisor who guided her and pointed her in all the right directions. The school worked really closely with the local medical school OHSU. And they were strict in terms of what classes you need to take. But what she like about her advisor was the fact she was very supportive and very aware of going for upward trends.

A year before she graduated with her bachelor's was when she stumbled upon this podcast which she has found as very helpful.

[11:11] Juggling Family Life and Medical School

Holly says that while this may not be the path for everybody, what you really want to do is to make sure you're taking classes with professors who have either worked there before or that you know their teaching style works with your learning style. Or make sure that her schedule worked where she gets to go to school full day but only two days a week. This would give her three days out of the week to study and make sure she was doing her homework.

Luckily, the community college she went to had a Head Start Program. Due to this, she's able to bring her son with her to school and drop them off there. She'd also visit them on lunch breaks, on the days that she needed child care, while she was at school while her husband was working.

Moreover, the hardest thing for her was the transition from working to going to school. Holly explains that most of the schools have that delayed gratification where you have to put in the time. But sometimes you kind of lost sight of why you're doing it. At the same time, Holly was feeling this guilt from being away from her son. So it was hard for her to keep the end game in mind. But once she had the clarity and constantly reminding herself that she was doing this for her family, then she was able to overcome some of that difficulty. In addition, time management was something she needed to relearn.

"It was probably one of the most terrifying decisions I've ever made in my life... but I just hit a boiling point with my current work."

[15:55] Finding Time for the Extracurriculars

Holly admits having had very little direction on her first three years while at community college. And then it took her three years to start out there. She realized she was pretty behind in high school because of her full-time work so she had to relearn her techniques. That said, she had very little direction until she got into a university.

It was actually a year and a half when her advisor was asking her about when she's going to do these extracurriculars. So she found some volunteer opportunities at the premed fair they had at the score.

After finding some volunteer opportunities at a premed fair they had the school, one of them being The American Red cross. And as someone who donates blood often, this just drove her to it. Another thing that drove her to this was how flexible they were. They on'y had a minimum requirement of 4 hours a month.

Then she got pregnant again, now with her second child about a year before she graduated from the university. Feeling unsupported, she was taking a gap year and it was the bulk of her extracurriculars done. So Holly decided to get work with direct patient care, and her degree, which she has been doing for the last two and a half years.

Holly did a year working as a psychiatric technician for a nonprofit, specifically in the mental health sector. She worked with youth just below hospital level and did patient care with kids which she did for a year.  Then she landed a job at the company she's still working at until now. It's another nonprofit mental health company, but this time, she's working directly with a child mentalist and psychiatrist as a psychiatric care coordinator. She has been doing this for the last year and a half. It still involved direct patient care as she would have to room patients in the same way you do at a primary care doctor's office. She also does medical case management.

[19:40] Taking the MCAT Twice

Holly didn't register for the MCAT until a year after graduation because she just gave birth around that time so she had to juggle several things, taking care of the baby which meant being sleep-deprived most of the time as well as some personal issues. So she made that decision to take a gap year. Six months into her job, she decided to register for the MCAT. At this time, she didn't know that you have to register early. The soonest day available was, say, May 19 and she didn't study that much. Apparently, she did the MCAT twice.

She knew she didn't do well the first try since she tried to cram everything into a month before she took the test so she ended up getting a 492. Around this time, she discovered The MCAT Podcast after randomly searching for MCAT resources. She then learned all the things she should have learned before she took the MCAT the first time. Take it early and don't procrastinate studying. Take the practice tests.

"I didn't take any practice test so I didn't really have any idea of what I was doing until I got in there. I would not suggest this route for anybody."

So the second time she took it, she registered for it again, taking a May test date to give her time plenty of time to study. And she crushed it this time. She also had to change jobs at this time which gave her a lot of flexibility. She was able to study during lunch breaks. She also developed a good working relationship with the doctor she was working for, who kept her motivation up. After over two months studying for the MCAT, there was construction happening in her apartment, so she and her family had to move out to a hotel. They spent a month there with her husband, two kids, and her MCAT books.

In the end, she reckons she didn't study as much as the content that she would have wanted to. She debated pushing the test date but she couldn't afford it financially. So she pushed through with it anyway, took it again. Not having reviewed any of the psychology stuff, putting it off at the last minute and confident that she was a Psychology major and worked at a mental health institution. But this was another mistake she's now pointing out.

[26:25] What Went Wrong?

There a a few factors that she thought was wrong in her planning. First, living in a hotel set her off by about a month. So she really had a hard time finding quiet with what was going on. Though she knows this is just her excuse. She had a study plan and she was really doing well sticking with it until that point she had to move and she got behind it. Then she decided she was going to focus on the areas she struggled with the most - Physics and Chemistry. And she also focused a little bit more on Biology, being a bigger chunk on the MCAT since every section has a little bit of Biology in it, as well as the CARS section since she got a low score in that section the first time. She decided to do a "smart" study instead of a "bulk" study.

"I focused a little bit more on Biology, since there's a bigger chunk of it the MCAT because every section has a little bit of Biology in it."

In the end, she didn't get the scores she was looking for. She had gotten off track her study schedule. Then two weeks before the test, she noticed something about her mom's health. And right before the test, she found out her mom had severe COPD. This bugged her when she went in there. It was what was running on her mind on the first section.

Although she got the score that she didn't really want, she ended up applying to medical school still. She talked with her advisor and she was just very supportive of her. They can say yes, no, or maybe, but at least you've got to reply.

[29:27] The Application Process: Choosing Schools to Apply To

Holly says not limiting where she applied to just because of her MCAT scores otherwise she would have applied to many more places. She got a 499 her second time. Part of her thought process in picking places to apply to was choose those she was passionate about and where she thought her personal statement would resonate with. Basically, she picked places that she thought would fit her personality. Alongside, she applied to places where she knew she wasn't going there but she applied anyway. She did take a couple of rejections but as they say, it only takes one acceptance.

In doing her research on schools to see her personality fit, she looked to MSAR that had all information about GPA and MCAT. Then she narrowed it down. The top tier ones were out as she describes it as a level of "self-described prestige" which she doesn't think her personality fits with.

Some of the things she looked for in the programs were international medicine, the ability to go abroad. She also researched more into the school like volunteering opportunities. She's passionate about working with underserved populations and homeless populations. So if she saw it was something they allowed or encouraged in their volunteer opportunities, then she included them into her list of schools she was interested in applying to.

[33:17] Writing Her Personal Statement

Holly finds herself talking about her kid in every job interview. But when it came to the personal statement, she listed all the things she has done. She presented this with her premed advisor and told her not to do it. And it was the same thing she heard on this podcast.

She then attended an event from an osteopathic school in Oregon, which was a personal statement workshop. They were reading out loud a couple of the personal statements from some of their students who got accepted. Although they had different styles, one thing she learned was that it's about you and your personal style.

Holly wrote so many versions of her personal statement that she even struggles to remember what ended up making into the final cut and what didn't. Especially that she applied to both MD and DO schools so she had to cut some of that personal statement for the AACOMAS.

Nevertheless, she started with a story about a patient she interacted with at the place she worked with. But her premed advisor gave her a feedback that it was all about the patient. And asked her it should be about her and why she wanted to be a doctor and why this is relevant to her.

"This is a wonderful story, but where are you? This is all about the patient and I want to know more about you. Why do you want to be a doctor? Why is this relevant to you?"

So she started out with her story and what had held her back from starting her journey until what really pushed her towards becoming a doctor. She talked about that moment she wanted to be a doctor and blended it with the story of the patient about how this shaped the kind of doctor she wanted to be. She talked about how patient care was her passion.

[37:07] Talking About Her Family in the Application

It was a long process but when she talked about how she got to where she's at from where she came from, she had to talk about it and she talked about her family as part of her story because it was who she was.

She got two interview invites and one was an MMI. Molly explains how there are specific questions that you kind of expect to pop up like why medicine and what got her to that point. So she had to talk about her journey.

As with MMI, although there are lot of different stations with questions on ethical debates, but a lot of them can be very standard interview questions as well. She was so nervous about her MMI. She had a bulk of her time practicing the ethical questions so getting a very basic one as her first question got her choked up a little bit. But more than anything else, it was just more of her nerves. But by the time she got to the 6th to 8th station, she was getting less and less nervous.

"Instead of practicing what to answer for a specific question, I spent more of my time practicing how to answer just random questions that I wasn't expecting."

[40:10] Holly's Advice to Students

"My goal was more important than my fear."

Holly admits having questioned many of her steps. But in the end, her goal was more important than her fear. Though she knew that had she been more confident about herself and what she wanted to do with her life, she would have started the process a lot sooner.

She's now 31 years old and was one of the oldest people in her interviewing group. She doubted herself along the way, in fact, so much, but she just kept pushing forward. At the end of the day, it's not about the little moments or the quiz you failed or even the three Cs you got. But it's about looking to that bigger picture. Shadowing and clinical experience are a huge piece for her to push forward because it just reminded her that it's what she wanted. Her end goal was working with patients and being a doctor. Keep that end goal in mind and keep pushing forward. If this is what you want, it doesn't matter if you're the smartest person or not, it's all about the hard work. Just keep working. Break it down into smaller, obtainable goals.

"If you don't try, that's an automatic no. But if you do try, there's a chance. And even if it's a small chance, it's worth it."

[42:40] Share Your Success Story with Us!

If you have a success story you want to share on this podcast or you know someone who has overcome some obstacles, let me know by emailing ryan@medicalschoolhq.net. If you know any dreamers out there in medical school and working as physicians, let us know too!

Links:

MedEd Media

The MCAT Podcast

MSAR

ryan@medicalschoolhq.net

Mar 14, 2018
276: Q&A From the Premed Hangout Facebook Group
27:57

Session 276

Today, we're talking MD vs PA, DO shadowing, physician letters of recommendation and other questions premed students have asked in the Hangout!

The Hangout is our private Facebook group for amazing premed students like yourself. With almost 4500 students currently, the group fosters a collaborative environment. If you're used to online communities of premed students packed with fighting and narcism that you don't want to be around, then the Hangout is the place for you. Join the group, ask questions, and we will get you approved as soon as possible.

[02:35] Some Amazing Books to Help You on This Journey!

If you are struggling or thinking about preparing for you medical school interview and struggling with how to prepare for it, check out my book, The Premed Playbook: Guide to the Medical School Interview. It's available on Amazon, Barnes and Noble, and wherever you buy your books.

Also, make sure you pre-order my next book, The Premed Playbook: Guide to the Medical School Personal Statement. Its paperback version is coming out in August and the eBook will be out before then.

Just to also give you a bit of a teaser, I've been working on the next book for 2019, The Premed Playbook: Guide to the Medical School Application which will cover all about the application process.

Now, let's move on to some questions posted on the Hangout that I want answered here on the show today.

[04:18] Taking Credits at a Community College

Q: "I'm a non-trad premed looking at summer classes. I did my first year of credits at a community college but I'm now at a four-year college. Would it be okay for me to take those summer classes, Physics 1 and 2 at community college? I will still return to my four-year college in the Fall. But the summer classes at the community college would fit into my life schedule better."

A: This is a super common question for students. They worry too much about "too much" minutia, all the little details. Stop worrying about all the small details. They will not keep you out of medical school. Rather what will keep you out of medical school is having a poor GPA, poor MCAT score, applying late to medical school, applying to the wrong medical schools, poor extracurriculars, not having the right extracurriculars. Those are the big picture items that you need to make sure you handle when it comes to applying to medical school. Then all those other questions beyond these are minutiae that you shouldn't be focusing on

"Stop worrying about all the small details."

So yes, you can take classes during the summer at community college. Understand that there may be some medical schools that may question that. They may never ask that question during the interview. They may wonder why. But a lot of students actually do this. They go to their university during Fall and Spring. And then for summer and winter break, they will take something at home. And a lot of times, they go to a community college.

[06:58] Will It Hurt Your Chances to Get Into Medical School?

Most likely, this will not hurt your chances in getting into medical schools. There will be 3-4 schools that will prefer all premed prereqs be taken at a four-year university.

"There are going to be some of those schools out there who are going to put their nose at community college. That is changing though, so you shouldn't worry about this."

Yes, you can do all your prereqs at a community college. This may pose a bigger red flag to some schools. But yes, you can. In everything you do, do well. Whether that be taking classes at a community college or a four-year university, however you're studying for the MCAT, whatever it is, do it to the best of your ability. Again, stop worrying about these small details.

[08:08] Shadowing a DO Physician

Q: "I've never shadowed a DO physician before, but I will be applying to several DO schools this cycle. Will I be at a significant disadvantage?"

A: This is another common question for students applying to DO medical schools. The CIB (College Information Book), which is the DO equivalent of the MSAR (Medical School Application Requirements), will tell you some application requirements for DO medical schools.

"A lot of the osteopathic medical schools want you to shadow a DO physician."

A lot of the osteopathic medical schools want you to shadow a DO physician and on the CIB, they would, for instance, state that they strongly recommend that you shadow a DO.

While you don't need to shadow a DO to apply to DO schools, you probably should. I talked to a student before here on this podcast, where she applied to DO schools. She was given a conditional interview that stated that she can only interview at their school provided she shadowed a DO prior to coming to medical school to make sure this is what she wanted to do.

[10:10] DO vs. MD

Being a DO and MD are very, very similar. But osteopathic/DO medical schools often have an inferiority complex They want to make sure that you understand what an osteopath does. Even though at the end of the day, an osteopathic physician is a physician. And there are a lot of osteopathic physicians out there who don't practice OMT (Osteopathic Manipulative Treatment). So if you go to find a DO to shadow and they don't practice OMT, then you're practically just shadowing an "MD." A lot of students will ask themselves this.

I don't believe in the DO holistic philosophy as they sell it. I think that to be a good physician, MD or DO, you need to to treat patients holistically. That's not a monopoly that DO physicians have. They may have some secret sauce in their curriculum that helps students do that. But at the end of the day, treating patients holistically is something that good physicians do whether you're an MD or a DO.

"To be a good physician, MD or DO, you need to to treat patients holistically. That's not a monopoly that DO physicians have."

Back to the question, would you be at a significant disadvantage if you don't shadow a Do before applying to DO schools? Yes. But there are students who get accepted to DO schools without shadowing a DO. But a lot of the DO schools want you to shadow a DO. A lot of them want a letter of recommendation from a DO. So don't limit yourself by not shadowing a DO.

[12:50] How to Find a DO to Shadow

Google the state osteopathic medical society in the state you're in. Contact them and tell them you're a premed student. Tell them you're interested in shadowing a DO and ask if they can put you in touch with one. Google around and ask. Ask your friends and family members. Call hospitals.

"Finding a physician to shadow is hard. Finding a DO is a little bit harder because the majority of physicians out there are MDs."

[13:50] At a Crossroads: PA School vs. Medical School

Q: "I'm currently at a crossroads. Do I want to go to PA school or do I want to go to medical school? I have all premed prereqs done but I haven't taken the MCAT. I have taken the GRE but don't have all PA prereqs done depending on the school. Something unique about my situation is that I'm actually married to a physician in residency. The prospect of adding toward debt and my not contributing to the family income for four years is quire daunting. I just have so much regret that I let a false friend sway me from applying to medical school while I was in college. I feel like I wouldn't be that stellar of a candidate for either path just because it has gotten so hard to gain entrance to either type of school. I have a B.S. in Biophysics with a 3.73 GPA and an MPH 3.51 GPA. I don't have a ton of volunteering hours in the last few years. Also currently, I am underemployed as a tech at a hospital and a substitute teacher since we are only in our current city for one year for my husband's intern year. And there were no job openings in my field. Has anyone been in a similar situation? What has been your thought process?

A: After four years, you're either going to be a physician in residency or internship or you're going to be a practicing PA. Now, sit down. Close your eyes. Picture what your life looks like. Which one feels right?

You have to ignore the debt as it's going to be there as a physician. And the debts will go away as a physician. It could take five years to get rid of medical school student loans. If you plan appropriately and don't overspend, you can pay off your loans very quickly as a physician. You cannot be concerned about the debt. This is actually a big point of contention I have with how expensive it is to go to medical school.

A lot of underrepresented minorities are thinking about debt and not going to medical school because of that. However, you should not worry about the debt. It will be there but it can be easily handled as a physician. It does add an extra layer of stress in your life, just like mortgage and car payments.

"It's a debt so it can be stressful. But if you manage your money properly, it can be handled."

If you want to be a physician, be a physician. Don't be a PA just because you don't want to not contribute to the family for four years. Or just because you don't want to add to the debt burden of your family.

[18:10] Letters of Recommendation

Q: "Is having a letter of recommendation from a physician we shadowed an important thing for medical school apps. I've seen some schools that ask for it and some that don't."

A: A lot of DO schools want letters of recommendation from DO physicians. While a lot of the MD medical schools don't specifically mention letters of recommendations from physicians.

I talked with a Dean of the Admissions Committee one time and he thought letters of recommendation are basically pretty useless. Who isn't going to write a letter of recommendation that isn't positive? You're actually hard-pressed to go find somebody that's going to out of their way to write you a bad letter of recommendation. So the majority of letters out there are going to be positive.

All this being said, students worry too much about letters of recommendation. Go and get what's required. Start thinking about the schools you're planning on applying to. Then look at what they require.

The general rule of thumb: Have a couple of science professors. Have a non-science professor. Have a physician (have a DO if you're applying to DO schools). Research PI is not that important. But if your PI was a science professor who taught you, then that'