Planning for and Navigating the Medical School Application

I wanted to take a brief break from telling my story to discuss medical school admissions and the AMCAS – the standard medical school application. My hope would be someone in the pre-med years, or perhaps earlier, who is planning to apply to medical school would read this and start to think ahead. Applying and successfully matriculating into medical school is no small feat. It’s much more than just getting good grades and taking an exam. Medical schools are performing a more holistic review of students. They want to know that candidates have researched the profession and contemplated the reasoning for their decisions.

Disclaimer: I do sit on the admissions committee where I currently work. There are no trade secrets in this post. My goal is simply to point out some things every student should consider when they are applying to medical school.

The application can be daunting. Trying to distill oneself into a few pieces of paper can be a challenging task. It is not something that any student should do alone. Seek out advice. Ask questions of people who understand the process. Work to create an application that will differentiate you from the thousands of applications that every medical school has to sort through. Because the competition can be so stiff, simple things such as misspellings and bad grammar can lead to the quick rejection of an applicant. Check and double-check the accuracy of your application. Don’t let an overlooked fact or accidental misrepresentation screw up an application.

The personal statement is the first thing many people will read when reviewing an application. Try to write a story that doesn’t just recapitulate the rest of your application. At the very least, answer the question, “Why do you want to be a physician?” Talk about what led you to make that decision. Have something in your application that needs to be addressed? Address it in the personal statement. Write and re-write your statement. Give it to someone to read who will tear it apart and question everything you write. Continue this process until everything is perfect. Remember, it’s often the first thing that people read when reviewing an application, and first impressions are everything!

Don’t be passive about getting letters of recommendation. Talk with the people you ask to write letters. Ask them upfront if they are willing to be supportive and personal. Ask them if they can discuss what characteristics would make you an excellent medical student and, eventually, a competent physician. Where I work, grades are deleted for application reviewers and interviewers. A letter that just says you were ranked X out of X in a large chemistry class is not very helpful to you. If all the letters are like that, it will likely actually hurt the application, not help.

Find a longitudinal research experience and stick with it. A semester washing glasses in a lab doesn’t cut it these days. You don’t have to have publications to get credit for research, but you do need to prove that you have learned and applied the scientific method. Understanding research is fundamental to be able to judge the scientific evidence in the literature. Not everything that finds a way into a journal is good science.

Shadow physicians and get a sense of what the job entails. It’s vital to prove that you have explored the day to day life of a physician. Getting into medical school and then finding out midway that it’s not for you can be a costly mistake. Not sure where to start? Ask your pediatrician or family physician if you can spend a half-day with them. From there, they might be able to help you get in touch with other physicians to shadow. Have a specialty you want to see? Call a local physician’s office and ask to speak with the practice manager. Tell them who you are and what you want to do, and they will often help you out!

Get involved in community service. You can volunteer in the hospital or another medical setting, but you don’t have to. Again, try to make this a longitudinal experience. Four individual experiences that last a day or two are not looked upon as favorably as one experience where lots of time and energy were applied to help others. This is a place where an applicant can differentiate themselves from others. Having a unique experience on your application differentiates you when screeners are looking through a lot of applicants that look very similar or makes the interview memorable when an interviewer is preparing for a presentation to the admissions committee.

Be a leader. Show that you can lead others. Explicitly state where you have leadership experience. Is it a supervisor position at a job? Were you elected to be in charge of a volunteer experience or fraternity/sorority? Make sure to lay out exactly what your experience involved. This is the area where I see applicants struggle the most. It isn’t that most applicants haven’t been leaders. It is more that they just don’t highlight that in the application.

Consider working while in college. Learning how to be an employee, following instructions, and showing up on time are qualities that will make one an excellent medical student and eventually a good co-worker and responsible physician. Medical school is a lot more like a job than like previous educational experiences. Admissions committees (and residencies down the road) really look favorably on an applicant who has prior work experience.

Grades are not everything, but they are part of the holistic review. Don’t have a 4.0 GPA? That’s fine. If you have a lousy grade somewhere, make sure you address it. Maybe there is a reason why. Perhaps you start with a bad grade in a class. Consider dropping that class and re-take when you can focus primarily on that course. Some universities provide a tool that shows all sections of a given course and average grades for each professor. Don’t take the hardest section of organic chemistry if you have that sort of information available to you! Talk with an advisor about course timing. Again, perhaps it is a good idea to schedule a challenging course in the summer so that you can focus on that particular course and grade.

The MCAT, unfortunately, is required. Just like other standardized tests, one of the most important things one can do to be successful is to practice taking the MCAT. Get and utilize question banks. Do as many questions as possible. You probably won’t improve your score by just reading a book. Do the questions. Learn the right answers and read and study explanations. There are only so many concepts that they can test. Many studies show that the only thing that can successfully predict success on a standardized test is the number of practice questions completed.

Make sure to give yourself enough time to not do well on the MCAT. If you aren’t as successful as you would like to be, it can be important to re-take the test. I often see this question asked of applicants who have MCAT scores that don’t necessarily match the rest of their application. “Well, why do they only have one subpar MCAT score on their application?” It’s one thing to have an initial score in the 75th percentile and then improve on a second attempt. It’s quite another just to have one score.

Athlete, those who work or someone who devoted a lot of time to an extracurricular activity? Credit is given for these types of activities, but there are students out there who have competitive applicants, even with one of these activities. An applicant may not need to demonstrate thousands of hours of research if they play a varsity sport at a Division I school, but it is imperative that they still do research. The moral of the story is the holistic review. No one thing gets a person into medical school, but it is essential to present a complete application to be competitive.

It is important to embrace diversity and even a disadvantaged status. We can’t change where or how we grew up. In this setting, ensuring that it is part of the application story is very important. It seems that, at times, people attempt to downplay or leave this out of their application because they feel that they might be looked down upon. This is not the case. Medical schools are actively seeking to include individuals from a broad range of backgrounds into their classes. Just as our patients come from differing backgrounds, so too should our physicians! The comfort that a person might be able to provide their future patients will go a long way to providing them the healthcare they need and desire. In addition, the insight that students from different backgrounds can bring to their education will help their classmates who may not understand how to better care for everyone.

Gap years are important to be able to explain on an application. There is nothing wrong with not going straight from an undergraduate institution to medical school. On the other hand, if time is needed to strengthen an application or perhaps an applicant just has some goal they have set for themselves before entering medical school – waiting for a year or two is not a big problem. It is just important to be able to explain the purpose of that time. If it isn’t addressed in the application, one should be ready to discuss it in an interview. If it isn’t brought up in the interview and the time is not explicitly accounted for, bring it up in an interview. If an admissions committee understands the reasoning behind gap years, they are much more likely to accept them.

There is a lot to consider when preparing the medical school application. It takes years and planning to ensure that all of the experiences necessary are present and completed. In a lot of ways, a person interested in going to medical school needs to start planning as soon as, or very soon after, they start college – or sooner! Having mentors and advisors that understand the process is vital! Seeking out resources at a University is an excellent first step. Developing mentorships with physicians is an important step, as well. Those of us who have been successful in the process are more than happy to help the next generation along!

Choosing Where to Go to College

Deciding where to go to college was a bit of a struggle. As I mentioned, I went to a small high school. I graduated with about 65 people. After my experience with high school, I was looking forward to going somewhere bigger. I wanted a place that offered a wide range of experiences and some more diversity than where I grew up. I had a scholarship that would pay full tuition to any school in Indiana, so I really couldn’t pass that up. Indiana University was my target. I wanted to go to a large University.

My guidance counselor had a different opinion. The feeling was that I had done well in a small classroom setting, and I should continue that. I was told a horror story about another student who went to a larger university and didn’t succeed. The concern was that I’d never be able to achieve my dreams at a larger university because I would be a number, and I’d get lost in the crowd. My guidance counselor’s heart was in the right place. They wanted to see me be successful.

I visited a couple of smaller schools. It felt, to me, like I was visiting another high school. When I visited IU and spoke with one of their biology advisors, we attacked the concept that I couldn’t succeed in a larger university head-on. I received some excellent advice from that advisor. They recommended that I work to shrink the size of the University: go and talk with my professors, visit office hours, speak up in class, and ask questions. I was comforted by their advice and spoke with other students who had been successful.

Gotta do Work!

My parents expected me to go to college and fulfill the goals I had set for myself. They didn’t have the means to get me there, however. That was never a secret. If I wanted to go to college, I was going to have to work hard and get some scholarship monies or perhaps get a job or two that would help pay the bills.

I started working at the local swimming pool in the summers after I turned 15. My first job was in the concession stand, followed by office worker, lifeguard and finally the manager by the time I graduated high school. I worked there every summer. Lifeguarding was a rewarding way to spend the summers. It will probably be my favorite job forever. What other job can one do where they sit outside in the sun every day, only to hop in the pool when it gets a little too hot out? The job is serious, and bad things can happen, but lifeguarding and the preparation for the job, continuous practice, and learning are an excellent preamble to lifelong learning in medicine.

During the school year, around sports and other activities, I worked at a locally-owned movie store. This was another fantastic job that allowed me to work around my schedule and make money to support myself. Not to mention, I got the privilege of watching all of the latest movies on VHS and then DVD before others could. My job wasn’t to support the family, but it helped that I was able to support myself.

I continued working throughout college. I had jobs at the recreation center, teaching CPR, first aid, and lifeguard classes. I continued my summer work at the swimming pool until the summer after my second year of medical school. In addition, I was fortunate to earn some scholarship monies to help support my undergraduate education.

What are the benefits of work beyond money? I would say there are a lot. Medical school and residency admission committees look very favorably on students that have worked. Having a job teaches responsibility and work ethic. It teaches how to prioritize and manage time. In addition, it teaches people how to be employees and work well with others.

In some instances, having a job means managing others. This provides a whole other set of experiences that makes one an excellent medical student, resident/fellow, and eventual attending physician. The person who has had the responsibility of interviewing and choosing employees, organizing employees and scheduling them, and disciplining when necessary will be way ahead when it comes time to deal with the ins and outs of patient care and navigating the complex medical system.

Back to Indiana and High School

The summer before 6th grade, we moved from Kentucky to Edinburgh, Indiana. My dad took up a job helping our aunt and uncle run a Waffle House. My dad would eventually go on to work for Cummins, maker of Diesel engines, headquartered in Columbus, Indiana.

The remainder of my primary and secondary education occurred in the Edinburgh Community School District. Edinburgh is a small town of not quite 5,000. It’s most known for its outlet mall and Camp Atterbury, a national guard base that serves as a training center for troops headed into combat overseas.

Coming back to the story of my path to medicine, Edinburgh High School was a crucial stop along the way. One might think growing up in a small school district would be a disadvantage. I was lucky to say it was quite the opposite. I may not have had access to an AP course in every subject, but I had smart and dedicated teachers that were committed to education and success for all of their students.

I wasn’t the only student who had an interest in education in the sciences. We didn’t have a chemistry two or physics course, but our teachers created one for us. They made sure we had calculus to get our math up to par. The only goal was to ensure that we were adequately prepared to excel in our post-secondary education. I’m not sure there are many other schools in the country where you would find teachers who exhibit that sort of dedication to their students!

Perhaps the one thing that I was missing was an early education in standardized test-taking. I always did fine on state exams but didn’t have any teaching to the SAT or ACT – the first important multiple-choice exam required to gain entry into college. Not only are these exams important for entrance, but they can also be the quickest way to earn some much-needed merit monies to pay for a college education.

The most important preparation for standardized tests like the SAT, the ACT, or even board exams is to learn how to answer those specific test questions. My test scores were more than adequate to get into many schools. I got 1020 on the SAT (TWICE – with really no preparation other than the PSAT). Had I completed formal test prep, maybe I could have done better. I took the ACT and got a 32. The SAT score is nothing to write home about, and higher scores very likely could have gained me some more scholarship monies to help pay for college. I didn’t know that there were resources to prepare. I just assumed that the test was something like the state style tests. They are supposed to be tests of your knowledge, not necessarily tests of your test-taking skills. That is definitely only partially true.

If you’re reading this and working on the way to college, make sure you seek out a resource to help with test prep. If paying for prep is challenging, search the internet or talk with a guidance counselor to see what resources are available at a discounted rate or perhaps for free. Look for a resource that provides questions and do all the questions you can get your hands on. Give yourself time to take the test, fail, and then do it again.

Early Years – The Intro to Medicine

I was born in Bloomington, Indiana, and my family lived in Indiana until I was 7. We moved to rural Kentucky the summer before I started 2nd grade. We moved to a town called Avawam, Kentucky – in Perry County. Perry County is a small and impoverished county in southeast Kentucky. Coal mining is a big industry. My parents moved there to help family friends start a church.

We lived in a trailer when we first moved in, situated in the middle of a large field. We were lucky to have running water and central heat. Our neighbors across the creek drew their water from a well, heated their homes and cooked with coal and raised their animals and vegetables for food.

My dad worked with the pastor of the church, sewing tarps to cover coal trucks. It was enough money to provide basics, but we certainly weren’t rich, and there were plenty of times when we had to scrape by to make ends meet.

This part of the story is important because this is where I was first introduced to medicine – by way of a now-retired pediatrician named Dr. James Miller and his wife, Jane – who was a retired circulating nurse.

Dr. Jim (as everyone called him) was our pediatrician. He took care of my four younger siblings and me whenever we were sick or for general well-child stuff. I remember him coming to our home to take care of one of my brothers when he got pneumonia right after we moved to Kentucky.

After church services, Dr. Jim and Jane would often take a look at a sick kid or two, looking in ears or at tonsils and prescribing something to help kids get better. I made every attempt to hang around to see what Dr. Jim was doing and accompanied my siblings to office visits when I could. I found his knowledge and professionalism to be fascinating. I wanted to mimic him when I grew up.

I started telling everyone after meeting and observing Dr. Miller that I was going to be a pediatrician. While that didn’t exactly pan out, my dedication to medicine started there.

To this day, I owe my career in medicine to Dr. James Miller.

Introduction

My name is Ryan Harrison. I am an orthopaedic trauma surgeon at The Ohio State University.

I have been thinking a lot about writing recently. It is something I have always enjoyed doing, but don’t do enough of. Twitter has been a great experience so far, but I don’t think it goes far enough to allow for a complete sharing of ideas. I hope that this blog will do just that. I plan to use it as an expansion of Twitter involvement and to spark conversation and learning.

I plan to use this blog to write a series of cases or thoughts. For my first series, I want to write about my history and the choices I made during my education and training to get to today. I see a lot of talk about economics and wealth influencing the path to medicine and beyond. I did not grow up in a wealthy family, quite the opposite. I hope this story will encourage others who may be in a situation similar to my own to pursue their dreams and know that resources are out there.

Stay tuned!

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