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Interview Advice: Grades?! Part 1

Created 07.28.10 by Jeremiah Fleenor, MD, MBA
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Originally published 11 January 2007

“Doubt is not a pleasant condition…” Voltaire (1694 – 1778)

If you are concerned about your grades (GPA, MCAT, etc.), you are not alone. As an advisor and interviewer, it’s one of the most common issues I encounter. Nobody thinks they have perfect scores. It’s the equivalent of looking in the mirror and being a little displeased with that sag or roll. We all wish something was different. Applicants view their grades the same way. The good news is that changing your scores doesn’t involve a nip or tuck.

The topic of grades is a big one. There are several key concepts that need to be addressed and are paramount to your success. It’s too large and important to adequately cover in one column. That is why the next two articles will be dedicated to this subject.

Making the cut on paper

When I was an EMT applying to medical school, I had an ER doctor tell me that, “You have to make the cut on paper.” He was absolutely correct. He went on to say that you need to demonstrate your mental ability by means of a good GPA or MCAT score. Some might argue that due to increasing competition, you need to have high marks in both areas.

The concept to grasp is that there is a minimum cognitive ability that you must possess to be a physician. In other words, a doctor’s brain literally needs to be able to crunch data at some baseline level. When you think about it, this concept is in line with the general societal view we hold of physicians. Namely, we see physicians as intelligent people.

The way in which most admissions committees determine an applicant’s “brain power” is via their GPA and MCAT scores. There are a couple of reasons for this:

  • Research indicates a student’s GPA and MCAT scores correlate highly with academic success in the first two years of medical school.
  • Together these scores provide a reasonably objective and fair way to compare applicants.

Is this a perfect system? No way! But it is the present reality. The key to success is in demonstrating to the admissions committee that you are smart enough to be a good doctor. I can’t stress this enough. At the end of the session, your interviewer needs to be sure that you have the cognitive ability to get through the academic rigors of medical school and a demanding career as a physician.

The rub in all of this comes when there is a mismatch between an applicant’s abilities and their scores. Many applicants truly are smart enough to be good physicians but are unable to demonstrate their mental ability via these narrow measures. Conversely, there are plenty of people who can perform well on standardized tests and have great GPA’s but would make horrible physicians. In either case the applicant loses. And when you think about it, in the end, so does the patient. I think of grades as a balance between two extremes: the applicant’s true mental capabilities and the ability to prove or demonstrate such abilities.

Here’s a story that might help explain one end of the spectrum. There were two women in my organic chemistry class who were very bright. Both were interested in going to graduate level healthcare programs. Accordingly, they needed high marks in the class. Unfortunately, they weren’t as happy with their grades as they wanted to be. So on the last day of class they walked into the final wearing shirts that said, “I’m not my organic chemistry grade.” No truer words were ever written.

The other end of the spectrum is this: to be a safe and competent physician, you need to have a certain level of cognitive ability. For good or bad, this is primarily measured via your GPA and MCAT scores.

In between these two extremes is where you want to be. You’ll be most competitive there and likely most happy.

Although a sobering message, it is not meant to be discouraging. There is hope! Now you know that you need to demonstrate your cognitive ability to the admissions committee. You know what they’re looking for and can focus your attention on these key areas.

Please look for part 2 in the next column. We will cover how to maximize the scores you do have and how best to demonstrate your cognitive ability to the admissions committee.

Please email your questions about the medical school interview to [email protected].

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  1. Sag says:

    The basis of this article is that there is a difference in mental ability between people. That is to say, there are stupid people, and their are smart people and there is nothing you can do to go from stupid to smart.

    I generally have tried to lean more towards the idea that different people are “smart” in different areas and the key is to evaluate your interests and your talents and go in that direction.

    As sad as it may seem, the notion that people are genetically code to be of different “levels” of intelligence may have some weight (simply because I have no proof to the contrary). But the again I guess that’s based on whether you measure you self worth/success based on if your smart or not. It’s an interesting discussion though (whether cognitive ability is genetically encoded) and I’d like to get the author’s viewpoint on this.

  2. AB says:

    Honestly, I personally don’t think there is such a thing as “smart” and “stupid” people, Sag. I think it all comes down to how determined and motivated you are. I am not naturally talented, but with a lot of hard work I can get good grades. Like you said, I do think everyone excels in different areas, but I don’t think it necessarily means that you are smart if you are good in that area. Some things just click easier for some people than others. When someone tells me that I am “smart”, I find it insulting because I am not- I absolutely study my butt off to get the grades that I do. And I think the people who realize that this is possible are the ones who are the most satisfied because they know that they’ve tried the absolute best they can.

  3. Daniel says:

    How about the fact that people that would be great doctors suck at taking standardized type exams?

  4. yamaraja808 says:

    It kind of irritates me when admissions committees or even the different institutions of medicine have this “that’s the way it is” attitude with medical school applicants. There seems to be barely any progress on their end as to how students should be evaluated. Why can’t their be more diversified ways to test an applicants abilities that is on par with GPA or MCAT scores? What do they need to get that ball “really” rolling?

  5. Cane2011 says:

    To some extent I feel that the science GPA is an accurate reflection of whether you can succeed in medical school. Since the science classes in college are paced slower than those in medical school and if the student gets a lot of Cs in them, then it leaves the admissions committee to question whether the student can handle the rigorous medical school curriculum. I don’t feel that grades reflect intelligence at all, but simply ones ability to handle coursework and that that is probably what med schools are looking at. I agree with AB. It all depends on how much time you put into the classes.

  6. PaxAmericana says:

    Cane2011, an interesting study was recently published from Mount Sinai Medical School, where over the course of the years between 2004 to 2009, Mount Sinai accepted some 85 students who had been admitted to their “Humanities and Medicine Program” (HuMed). These students were exceptional high school students who became humanities and liberal arts majors at their undergraduate institutions, and part of their acceptance in to the HuMed program was that they were not to take any MCAT-preparatory / classic pre-med required courses (no bio, no gen chem, no orgo, no physics). After graduation, they matriculated into Mount Sinai without taking the MCAT. The study shows that these 85 students fared just as well in the medical school curriculum as the other matriculates during those 5 years of the study. Not only that, the doctors produced by these HuMed matriculates were less likely to become surgeons and more likely to go into psychiatry or other more “feeling” areas of medicine.

    David Muller and Nathan Case – Challenging Traditional Premedical Requirements as Predictors of Success in Medical School: The Mount Sinai School of Medicine Humanities and Medicine Program

  7. surfdocSD says:

    Numbers, numbers, numbers—-do these *really* represent people and their aptitude to become the world’s greatest docs? Heck no! A college advisor once told me, “you don’t know what’s going on in someone’s life and why they may get the grade(s) that they do—they could be working a full-time 40 hr/week job while taking classes just to survive b/c mom and dad or finaid aren’t paying for their ugrad. Do you expect this person to have enough time to study for o-chem, bio, physics exams and get an A? No, not so likely. But if they had 40 more hours to study they would be fine.” I totally agree and I think there’s a fundamental disadvantage built into the system for people like this who simply cannot make the cut on paper due to life circumstances but may be the most potentially talented applicants out there. I think there should be a more psychological and social evaluation weighed into the whole process. I think applicants should have personality tests to see if their personality fits the role of a physician. We’ll get better docs in the end as a result of this sort of screen. IE: Compassion, empathy…how do we measure such essential components of a physician via the MCAT or grades? A lot would change if this sort of metric was more heavily thrown into the equation! I think interviews can only measure these dimensions in one way and are ultimately insufficient….

    1. I'd says:

      I’ll have to disagree with you on the idea of personality tests. Although I like your idea of social and psychological examinations, I feel that personality tests would not be useful. I don’t think people should be examined based on who they are and what they like. The most important attributes in consideration should be moral capacity and other similar characteristics. Who says an introvert can’t practice medicine just as well as an extrovert?

  8. GMazo says:

    @AB: i share the same sentiment.As far as my doctor friends are sharing me,venturing the life of a med student is really difficult.We might not just need extra brains to dig notes and books but we must also have the willingness to do it. Learning is not just to keep pace with a subject matter but we must embrace it as if its a once in a lifetime chance to discover what we really are and what are we really capable of. I am not smart, I’m just an average student once, took up a degree with no idea what lies ahead of me, but challenges are always there embrace and learn from it, I am a Registered Med technologist now.We don’t have to be someone from a prestigious family of brains,we just have to “study for life”.

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