by Paul Goleb

You have all certainly heard the expression “good things come to those who wait.”  Since our first days of pre-school, the virtue of patience has been constantly reinforced as a valuable trait.  For years we have stood in lines and waited for our turns.

In the fast paced life of a physician, in which potential decisions must sometimes be made in a matter of seconds, patience is sometimes an undervalued trait. In the realm of medicine, “waiting” almost seems to be a dirty word for both patients and physicians alike.

Nowhere is this more evident than in the life of a medical school applicant, a life in which waiting for days, weeks, and even months at a time is commonplace.  If you have ever applied to medical school, I am confident that you have spent more than your fair share of time waiting.

As pre-med students, we are notorious for our constant worrying and over-analysis of the most minute details and the long gaps in correspondence with medical schools do little to ease these anxieties. Months between application submissions, interview invitations, and potential acceptances often seem like cruel punishments to over-anxious pre-meds like ourselves who interpret no news as bad news.

I, like many other medical school applicants this year, was placed on a wait-list over the course of this past admissions cycle. I, like almost every other applicant placed onto a waitlist reacted to the news with a sense of disappointment, disenchantment, and (at best) a slight sense of hope. I, unlike many others was eventually admitted to the medical school of my dreams in a matter of days following my placement on a waitlist (twice to be exact).

Ironically enough, the only day out of the past eight months in which I did not fervently check my e-mail or anxiously pace to my mailbox since the submission of my primary application was the day I was accepted to medical school. The one day that I stopped trying to find what I was looking for, what I was looking for somehow found me.

The morning before I was accepted off a waitlist, I found myself coming to the realization that I would have to re-start the arduous work associated with the application cycle: re-taking the MCAT and re-submitting my primary application only days after I had graduated from college. The prospect of studying, writing, applying, and traveling for interviews again had been wearing on me over the course of the past several months.

As I usually do, I went to my neighborhood park to play a game of pick-up basketball to clear my head. About twenty minutes later, to my surprise, I saw my mom frantically walk by the court in a pace that suggested she had very good or very bad news (or had to find a bathroom ASAP). My surprise grew when my mom ran onto the court, stopping a game of basketball in its tracks to give me a hug and tell me I had just been accepted to medical school. I stopped, the game stopped, my mom grabbed me and tried her best to hug me (or squeeze the life out of me) and slowly, I realized what I had waited for since this past August had finally arrived, in May, multiple weeks after I had graduated college with no sure-fire post-graduate plans and plenty of anxiety.

The remainder of the day became a blur of congratulatory phone calls, text messages, and visits from neighbors. This euphoria created such a sense of stunned disbelief that I almost forgot to return my paperwork indicating I would actually accept my admission into the class of 2013 (a minor detail). Waking up with plans to begin studying for the MCAT again and eventually going to bed a soon-to-be medical school student made for quite the exciting day. I was honestly astounded by the good news I had almost given up hoping for.

It took nine months to the day for the secondary application I submitted in August to lead to an acceptance in May. The application, interview, and waitlist process certainly made the year seem like an eternity. Also, I like to think I took the longest possible path to my eventual acceptance. My application was put on hold after my initial secondary application submission, I received a post interview hold, and to top that off, I was placed on a waiting list following this marathon year of waiting and hoping.

It is tough to say if I honestly did believe I would get off my waitlist. Based off of anecdotal evidence from peers, friends, and professors, I thought my chances to get accepted off of a waitlist were one in a million (at best). Waitlist statistics are typically not released by medical schools, which are the sole institutions that know exactly how many students (if any) were admitted via waitlist. I have been told that not even AMCAS, the veritable treasure trove of pre-med statistics and semi-pertinent percentages possesses this information.

The entire situation repeated itself two weeks later in a much less dramatic fashion when I eventually received the same good news at the second school where I was wait-listed. I could not believe my good fortune. While I do not know the exact probability of these two independent events occurring, it seems to be a very rare occurrence. The utter surprise I felt in getting accepted off of my initial waitlist became a sense of sheer disbelief when the process repeated itself.

By no means do I intend for this article to sound like a personal pat on the back, congratulating myself on my two, equally miraculous waitlist acceptances. I believe readers can search various SDN acceptance threads for that type of writing.  I find myself writing this for a much different purpose. In writing this, I hope to give a sense of hope to those currently on waitlists or those who may soon find themselves on a waitlist at some point in the application cycle. Additionally, August is an interesting point for applicants in the medical school process. Past year’s applicants who have been wait-listed find themselves still hoping (with good reason) for a last minute acceptance into a medical school class beginning this year while a number of current year applicants are just beginning what could potentially be a very long application cycle. It is a busy, stressful time for applicants both former and current.

Reflecting on the process, our teachers and parents may have been right about this whole waiting thing, as much as it hurts me to admit. I consider myself a habitually impatient and multitasking person, but patience is the key to surviving the medical school application process. In my experience, I have found it is true what they say; good things come to those who wait, or in my case, to those who are wait-listed.

By Jessica Freedman, MD
President of MedEdits: Medical Admissions

Because the competition for admission to medical schools in the United States is extremely strong, many applicants consider attending medical school in the Caribbean. In fact, a great many bright and talented applicants are now opting to obtain their medical education in the Caribbean.

How can you decide what is the best choice for you? What must you consider in evaluating these schools? And will you be able to obtain a residency in the United States after you graduate? To help you decide if attending a Caribbean medical school is a good choice, this article provides a framework for evaluating these schools and the success of their graduates.

A Little Background

In the last four decades, the Caribbean has seen a steady increase in the number of medical schools on the islands as well as the size of their student bodies.  In the late 1970’s three Caribbean medical schools were established: American University of the Caribbean, originally located on the Island of Montserrat, Ross University on the Commonwealth of Dominica, and St. George’s University in Grenada.   Since their inception, these schools have educated many US citizens seeking a medical education outside the US,  and now about 60 medical schools in the Caribbean are listed in the Foundation for Advancement of International Medical Education and Research (FAIMERs) International Medical Education Directory (IMED).

The physicians who graduate from Caribbean medical schools play an increasingly important role in the US health care system by supplying residency programs with qualified applicants and helping to meet a well documented physician shortage, particularly in primary care medicine.  While accreditation, didactic studies (first and second years of medical school), and clinical rotations (third and fourth years of medical school) differ among institutions, requirements for graduate certification in the United States, as outlined by the Philadelphia based Educational Committee on Foreign Medical Graduates, are the same for all students graduating from all international schools, including the Caribbean.

Caribbean Medical School Accreditation

An article by van Zanten et al published in the June 2009 edition of Academic Medicine reviews some of the processes by which Caribbean medical schools undergo external quality assurance.  Accreditation for Caribbean medical schools is on several levels, including local Ministry of Health accreditation by some  individual Caribbean country’s government, regional accreditation by organizations such as The Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP). The World Health Organization (WHO) does not accredit medical schools but maintains a list of schools that are recognized by local governments. In the United States,  The National Committee on Foreign Medical Education and Accreditation of the US Department of Education (NCFMEA) of the United States Department of Education determines whether the process conducted by an accrediting organization is comparable to the Liaison Committee on Medical Education (LCME) process of accreditation. This is a voluntary process so not all schools undergo this evaluation. If a school’s accreditation is deemed comparable to the LCME process, then that country can apply for US federal loans for those students. Currently, only 3 schools in the Caribbean are eligible for these loans.

California, Florida, New Jersey, and New York require individual school review and approval for Caribbean students to do rotations in that state.   In California, not only must the individual school be approved for clinical clerkships but the student’s clerkship and course work must be approved by the state medical board to obtain residency and subsequent physician licensure.  Any deficiencies in clinical training, as determined by the state, may need to be remediated to practice in California.  Many other states defer to California’s approval for the purpose of licensure because most do not have their own approval process. Also of note, New York has the largest number of international medical graduates in residency training and about one third of residency programs in the US are located in the state of New York.

It is important to know which organizations have accredited any school you consider attending.  Knowing if the state in which you intend to practice recognizes your school is also important.  Caribbean medical schools proudly display these accreditations on their websites so if an accreditation is missing, be wary.

Quality of Medical Education in the Caribbean

Another recent study by van Zanten and Boulet published in Academic Medicine examines the quality of medical education in the Caribbean. The report finds tremendous variability in both the quality of undergraduate medical education and in students’ performance. The only way to evaluate the education Caribbean medical students received was to examine students’ scores on the United States Licensing Exam (USMLE) Step 1, which is taken after the second year of medical school. Investigators calculated the average USMLE Step 1 first time pass rate for each country in the Caribbean. In evaluating this data they also took into account that some islands have more than one medical school.  The countries with the highest percentage of students passing the (USMLE) Step 1 on the first attempt were Grenada (84.4 %) and Dominica (69.7%). Countries with the lowest pass rates were Saint Lucia (19.4%) and Antigua/Barbuda (22.9%).

Preclinical Years

Students typically spend the first four to five semesters of medical school in the Caribbean completing basic science courses before taking USMLE Step I.  Basic science curriculums in the Caribbean are similar to US curriculums.  Some schools offer a fifth semester, either in the Caribbean or in the US, to help students prepare for the USMLE Step 1 and transition to their clinical semesters.

Living in the Caribbean can present many challenges for those who have never lived outside the United States. For many students, it will be their first time away from the United States for a prolonged period of time. Many of the luxuries found in large US cities, such as restaurants, movie theaters, shopping malls, and commercial gyms, are not available on the islands, and friends, family, and religious support groups are thousands of miles away. On the plus side, many students form strong relationships with classmates and also enjoy learning about the history and culture of the local West Indian population. Former students also have fond memories of celebrating yearly holidays such as Carnival, the colorful, festive, and historical event celebrated annually throughout the Caribbean.

After successfully passing the USMLE Step 1, students proceed to their clinical rotations, which usually are outside of the Caribbean.  When evaluating schools, it is important to ask what percentage of students who initially enroll in each class actually take and pass the USMLE Step 1 and successfully proceed to clinical rotations.

Clinical Years

Core clinical rotations and third and fourth year curriculum in Caribbean schools resemble those of US medical schools. Caribbean schools that offer clinical training in the US have strict guidelines about the location and quality of students’ clinical training.  All core rotations and subinternships must be completed in hospitals with which the Caribbean medical school has an active, written affiliation agreement and which have appropriate clinical faculty members. Rotations must be approved by the Accreditation Council for Graduate Medical Education  (ACGME). In addition, it is preferable that hospitals have approved residency training programs (or their British equivalents) in the specialties through which students rotate.  Students also take both parts of USMLE Step 2 (clinical knowledge and clinical skills) after the third year.

Hospitals in which electives are taken should also have approved postgraduate programs in those specialties.  For example, it is best to do an anesthesia elective at a hospital that has an anesthesiology residency. Regardless of school affiliation, however, individual hospitals still reserve the right to screen individual students for elective clerkship acceptance. Some individual hospitals and departments do not accept international rotating students, which can limit the away electives in which students can participate. From a competitive perspective, it is always preferable to participate in clinical rotations located in hospitals that not only have ACGME accredited residency programs but are academic teaching hospitals rather than community hospitals.

If I Go To a Caribbean Medical School, Can I Get a Residency?

Graduates of Caribbean medical schools have tremendous success in obtaining residency positions, even in competitive specialties. It helps to attend a well-established Caribbean school, perform well on the USMLE Steps 1 and 2, and obtain strong letters of recommendations. (See my previous articles: Getting Into Residency Part 1 and Part 2 for more information.) Before applying for the residency match and early in medical school, students should strategically plan their clinical clerkships in the US, ideally arranging rotations in the settings where they prefer to match.  In recent years, Caribbean students with strong academic and clinical performances have been able to obtain competitive residency positions at an increasing rate.  However, the largest number of students pursue less competitive specialties, such as internal medicine or family practice.  Some students are also able to ”prematch” into residency positions outside of the National Resident Matching Program (NRMP).

When evaluating the success of a Caribbean medical school’s graduates, it is important to find out specifically where and in what specialties students match. Also determine what percentage of fourth year students match into categorical programs. This information may not be easy to obtain. While schools typically publish their match results, it is unclear if these lists are truly comprehensive.

After residency, Caribbean medical students, along with their domestic colleagues, will obtain board certification and must meet specific requirements for state licensure. The quality of one’s residency training usually carries more weight than the medical school attended, so obtaining the best possible residency and even fellowship can help Caribbean students overcome some of the bias foreign students face when competing for competitive attending positions.

Educational Commission for Foreign Medical Graduate (ECFMG) Certification and Graduate Medical Education Programs

To be eligible for ACGME accredited residency programs in the United States, and for licensure in many states, students who graduate from a Caribbean medical school must obtain an ECFMG certificate. Eligibility for this certificate includes graduating from a medical school listed in FAIMERs online International Medical Education Directory (IMED) and passing the USMLE Steps 1 and 2 (both clinical knowledge and clinical skills).  For more details, see the ECFMG website at www.ecfmg.org.

Questions to Ask

School History

• When was the school established?
• What percentage of students are US citizens?
• By whom is the school run and what are the credentials of the academic faculty?
• Has the school had any recent changes in leadership? Are any leadership changes expected?

Caribbean Medical School Accreditation

• By whom is the school accredited and is the school accredited by the states of California, Florida, New Jersey, and New York?  Is the school listed in FAIMER’s IMED?

Admissions, Medical Education and Curriculum

• The quality of your medical education begins with the advice you receive prior to attending a Caribbean medical school. Is your premed advisor well versed in the pros and cons of attending medical school in the Caribbean?
• If interviews are required, by whom are they conducted – alumni, administrative staff, faculty and/or current students?
• What are the mean overall and BCPM (biology, chemistry, physics and math) GPAs and MCATS of accepted students? Are MCATs required to submit an application?
• Does the school have more than one matriculating class annually and are admissions rolling? Unlike most US schools, Caribbean medical schools typically have two to three first year classes that begin at different times during the academic year.
• What is the average size of each entering class? Does the size vary depending on the start date?
• How many students enroll in each first year class? What percentage of students who enter as first year students start third year rotations as scheduled?  What percentage of first year students match into categorical residencies in the United States during their fourth year? What percentage of first year students graduate? (Understand that graduating does not necessarily mean matching, so both of these questions must be answered.)

Financial Concerns and Living Conditions

• Do most students fund their education using outside loans or scholarships? Are these loans backed by the US government or are they private loans? Does the school offer financial guidance to help students choose the best loans and make responsible financial decisions?
• Where do students live and what are the housing conditions? Does the school provide housing?

Clinical Studies

• Where do students do their clinical training? Can students choose where they do core rotations? Are the rotations ACGME accredited? Do students work alongside US medical students?
• Are students allowed to do elective rotations? How many? Can students do away electives at nonaffiliated hospitals? Does the administration or faculty help students obtain away electives?

Residency Match and Professional Guidance

• Does the school provide guidance to help with the match process? Do students have an assigned advisor to help them?
• Where and in what specialties did students in the most recent graduating classes match for residency, and what percentage of fourth year students matched into categorical residencies?
• What percentage of students do not match annually? What percentage of students must enter the “scramble”? For students who enter the scramble, does the school provide assistance to find an unfilled residency spot?

Alumni and Student Support

• Where do alumni practice geographically, in what specialty and in what type of practice (community or academic)?
• Will the school provide contact information for alumni and current students with whom to speak?

Medical School in the Caribbean

Going to medical school in the Caribbean can be a good option as long as you do your research and make an educated choice. The medical education you will receive in the Caribbean varies tremendously, and the success you will have after graduation depends on many factors. Attending a top Caribbean medical school is a great option for some students but, just as for US medical students, once in school you must “do the right thing” to secure an excellent residency, (See my article Getting Into Residency Part 1 and Part 2.) I have had several Caribbean medical student clients earn residencies in competitive specialties, including anesthesia, emergency medicine, and internal medicine so, yes, it can be done!

Jessica Freedman, MD, a former medical admissions officer, is president of MedEdits (www.MedEdits.com), a medical school, residency and fellowship admissions consulting firm. She is also the author of the MedEdits blog, a useful resource for applicants: (www.MedEdits.blogspot.com).

The author would like to thank Marta van Zanten for clarifying parts of this article.

References

1) van Zanten M, Boulet J R. Medical education in the Caribbean: variability in medical school programs and performance of students. Academic Medicine. 2008;83: s33-s36.

2) van Zanen M, Parkins LM, Karle H, et al.  Accreditation of undergraduate medical education in the Caribbean: report on the Caribbean accreditation authority for education in medicine and other health professions. Academic Medicine. 2009;84: 771-775.

Ahh, simple childhood games. Music playing. Walking around a circle of chairs. I’m eyeing the one closest to me.

*the music stops*
I scramble for a chair.

“I’m sorry, Joe. You can’t sit in a red chair. Those are for people with Outies. Your belly button is an Innie. You need to find a blue chair.”
“But the kindergarteners took most of the blue chairs for their game…”
“I’m sorry. Just see if you can find a left over one.”
I cry.

While this never actually happened, it is a recurring nightmare I have (and may explain my deep seated phobia of blue chairs). This game represents how health professional school admissions, particularly medical school admissions, work.

For medical schools, there are a good number of chairs that are spoken for before you’ve even submitted your AMCAS. How many depends on the types of alternate acceptance programs the school offers, but these programs contribute to the ultimate class size and subsequently are fewer seats available during the AMCAS application cycle.

As an informed applicant, what you can do is realize that you’re only going to be competing for the blue chair.

What alternate acceptance pathways are there?

BS or BA/MD Programs
These programs offer medical school acceptance to exceptional students either directly out of high school or early in their undergraduate careers. After completing their undergraduate and program requirements in anywhere from two to four years, students in these programs join the entering medical school class at the institution affiliated with the program.

Early Acceptance Programs
Similar to the above, some schools will offer early acceptances to students at linked universities or within their home state. This generally occurs sometime following the junior year. These students also matriculate with the entering class.

Special Masters Programs
Many medical schools offer Special Masters Programs. These programs allow students to take classes with M1 students in order to show they can excel at medical school coursework. While the degree of linkage between SMPs and Medical Schools varies from program to program (few, if any, offer a direct acceptance), many will at least interview every SMP student and SMP students will traditionally be accepted to their home institution with a higher rate than the general applicant pool. SMP students do apply through AMCAS, but they are deceptively competitive for the school in question.

Where else do the spots go?

Deferrals
Every year, there are students that are unable to matriculate the year they’ve applied. These students defer and subsequently join the next year’s class. This is a small number of students and this happens each year, so it may be negligible, but these students are already holding acceptances in the application year that the entering class is applying so they may be considered as drawing away from the total number of available seats.

The Innie/Outie Factor
State residency is a large issue at state funded schools. Unless the school is private and state residency is not a factor, there will be separate pools for in state and out of state students. This is a division of seats you’ll need to consider.

A Note on Gender
A false impression exists that schools hold a specific number of seats for males and a specific number of seats for females. While researching this article I was informed by an admissions committee member that the approximate 50/50 ratio of male to female students is not a function of intentional admissions selection, but rather a function of the proportion of male to female applicants.

Applying the Math

Those were some nice observations, but what does it all mean?

Let’s take a hypothetical state medical school trying to fill a class size of 200:

• This school had 5 deferrals from the previous year.
• It accepts 20 students per year from an Early Acceptance program from its Undergrad.
• It accepts 20 out of 30 students per year from its SMP program.
• The In State Acceptance Rate is 70%
• No BS/MD program.

Now let’s pretend you’re an In State applicant applying to the above school. How many seats are you actually applying for?

200 seats
x.7 In State student acceptance rate
140 Seats for In State Students

That doesn’t seem too bad, but wait, the linkage programs and SMP programs are predominantly for in-state students. Deferrals are able to attain IS residency in some states.

140 Seats
-5 Deferrals
-20 Early Acceptances
-20 SMP Acceptances
95

While there is a 70% acceptance rate for in state students, the applicant is only applying for 47.5% of the seats in the class. Out of State applicants are essentially unaffected by these programs.

Below is a table of the make up of that class mentioned above:

Where can I find this information?
One source would be the school’s website. You can search for info regarding any alternate admissions programs or Special Masters Programs. Additionally, the AAMC publishes the Medical School Admission Requirements (MSAR) annually. This gives the best breakdown of admissions stats and class profiles. Check both of these and combine the results to give you the best understanding of what programs are operating and their scope.

What can I do about it?
When looking at a medical school, or any health professional school, it helps to know your odds. A lot of money can be wasted for spots that were filled years ago. A little research can help. Know how many spots a school has open for you. This will tell you if that long-shot application is worth the money.

By Sameer Apte
SDN Senior Moderator (MCAT Forum)

Modern medical education is a surprisingly young field. If you were to travel back only 90 years and enroll in medical school, you would find yourself in the midst of the greatest paradigm shift in the history of American medical education.

At the time, medical training curriculums were non-standardized, schools were largely profit driven, physicians were required only to have a diploma to practice, and the selection criteria for medical students were either sparse or non-existent (1-3).

At the request of the newly formed Council on Medical Education (CME), Abraham Flexner, a noted educator and scientist, visited every medical school in North America and wrote a scathing review of their educational practices (2). The “Flexner Report”, as Flexner’s review is commonly called, was the first step in the standardization of medical education.

Flexner’s findings, backed by the CME’s influence, not only prompted a re-evaluation of how medicine was taught, but also who it was taught to. Physicians-in-training were often not required to have a high school or university education, and entrance tests were proprietary and variable in rigor (1-3). As a result, attrition rates for medical school freshmen ranged from 5% to an astounding 50% in the 1920s (3). Furthermore, the quality, or lack thereof, of those that did graduate was harshly regarded by Flexner himself (2).

In 1928, in an effort to ensure the readiness of matriculating medical students, F.A. Moss created the “Moss Test”, the first standardized Medical Colleges Admissions Test (MCAT) (3, 4). Through a series of true/false and multiple choice questions across six to eight subtests, an applicant’s memorization ability, scientific vocabulary, reading comprehension and logical reasoning were evaluated (4, 5). In conjunction with the admissions reforms suggested by the Flexner Report, the implementation of the MCAT slashed medical school attrition rates to 7% in 1946 (3, 6).

Since Abraham Flexner’s time, the MCAT – administered by the Association of American Medical Colleges (AAMC) (7) – has undergone a number of major restructurings, each one aimed at adapting the test to better suit the medical landscape of the era (3, 8).

The second iteration of the MCAT came in 1946 and featured the section “Understanding Modern Society” (later renamed “General Information”) (8, 9). The inclusion of this sub-test reflected the emerging idea that physicians should be well versed in areas “over and above those which may be related to medical school grades (3)”. Medical school admissions committees, however, reportedly placed the greatest importance on the scientific sections of the MCAT, and did not give the general information sub-test much credence (3, 10).

In the 1970s, the AAMC put forth substantial effort to enhance the ability of the MCAT to assess personal qualities. “Compassion, coping ability, decision-making ability, inter-professional relations, realistic self-appraisal, sensitivity in interpersonal relations, and staying power-physical and motivational” were characteristics deemed important for practicing physicians (3). The project, however, was abandoned; in the MCAT of 1977 to 1991, the general information section was eliminated, and the remaining sub-tests covered only scientific knowledge, reading comprehension, and quantitative skills (11).

Today’s MCAT features three separate multiple-choice sections covering physical sciences, verbal reasoning, and biological sciences, as well as a long answer writing sample section. Results from each section of the MCAT are statistically analyzed and a grade distribution is generated that closely approximates a bell curve.

The multiple choice sections are scored on a scale of 1-15, while the writing sample is scored on a scale of J-T. Because the MCAT aims to accurately assess a very wide range of applicants, the AAMC goes to great lengths to reduce the effects of cultural and social bias, as well differences in testing conditions. Thus, the performance of examinees on the MCAT can be reliably compared (12).

For 18 years, the current structure of the MCAT has been the mainstay of standardized testing in medical school admissions; however, as the face of medical education continues to adjust its mission and objectives, the AAMC will continue to review and revise the exam (13). For instance, concordant with the recent integration of modern technology and medical practice, the MCAT has moved from a paper-and-pencil format to a computer-based format (14).

More recently, in October of 2008, a committee to comprehensively review and re-design the MCAT for the fifth time was commissioned by the AAMC (15). The Committee, called “MCAT review 5″ (MR5), consists of current physicians, medical school administrators, faculty members, and medical students. Because the MR5 committee is still in the evaluation process for the current MCAT, it is not known how the test will change, only that the changes will be drastic16. If MR5 meets its projected time-line, MCAT examinees in 2013 will most likely be faced with a standardized exam that bears little resemblance to the MCAT of today.

It is in the criticisms of Abraham Flexner and the creation of the Moss Test that the origins of the MCAT can be found. Since that time (only 90 years ago), the MCAT has kept pace with the remarkable evolution of medicine by constantly changing its own nature. With the advent of the MR5 committee, the time has come, once again, for the MCAT to don a new face. Although it may soon be unrecognizable to those of us who took it today, the MCAT will always be a part of the medical school admissions process, in whatever form it may present itself.

***Be on the lookout for an upcoming article revealing what might be in store for the future MCAT. MR5 committee members, MCAT administrators, and other medical education experts will give the Student Doctor Network information and insight.

Citations:
1.    Beck, A.H., STUDENTJAMA. The Flexner report and the standardization of American medical education. Jama, 2004. 291(17): p. 2139-40.
2.    Flexner, A., Medical Education in the United States and Canada (Bulletin Number Four). 3rd ed, ed. T.C. Foundation. 1910, New York: W.B. Updike & The Merrymount Press. 1-363.
3.    McGaghie, W.C., Assessing readiness for medical education: evolution of the medical college admission test. Jama, 2002. 288(9): p. 1085-90.
4.    Moss, F.A., Scholastic Aptitude Tests for Medical Students. J Am Assoc of Medical Coll, 1930. 5(2): p. 90-110.
5.    Moss, F.A., Report of the Committee on Aptitude Tests for Medical Schools. J Am Assoc of Medical Coll, 1941. 16(4): p. 234-243.
6.    Mullin, F.J., Selection of Medical Students. J Am Assoc of Medical Coll, 1948. 23(3): p. 163-170.
7.    AAMC. Official Medical College Admissions Test Website.  2009  [cited 2009 March 4th, 2009]; Available from: www.aamc.org/mcat.
8.    Erdmann, J.B., Separating Wheat from Chaff: revision of the MCAT. Acad Med, 1972. 47(9): p. 747-749.
9.    Young, R.H. and G.A. Pierson, The Professional Aptitute Test, 1947 A Preliminary Evaluation. J Am Assoc of Medical Coll, 1947. 23(3): p. 176-179.
10.    Glaser, R.J., Appraising Intellectual Characteristics. J Med Educ, 1957. 32(10): p. 31-45.
11.    McGuire, F.L., The New MCAT and Medical Student Performance. Acad Med, 1980. 55(5): p. 405-408.
12.    AAMC. MCAT Essentials.  2009  [cited 2009 March 4th, 2009]; Available from: http://www.aamc.org/students/mcat/mcatessentials.pdf.
13.    Mitchell, K., R. Haynes, and J. Koenig, Assessing the Validity of the Updated Medical College Admissions Test. Acad Med, 1994. 69: p. 393-401.
14.    AAMC. Medical College Admission Test will Convert to Computer-Based Format.  2005  [cited 2009 March 4th, 2009]; Available from: http://www.aamc.org/newsroom/pressrel/2005/050718.htm.
15.    AAMC. Medical College Admission Test to Undergo Review.  2008  [cited 2009 March 4th, 2009]; Available from: http://www.aamc.org/newsroom/pressrel/2008/081016.htm.
16.    AAMC. AAMC Launches Review of MCAT Exam 2009  [cited 2009 March 4th, 2009]; Available from: http://www.aamc.org/newsroom/reporter/feb09/mcat.htm.

The Medical College Admission Test (MCAT) is an anxiety-inducing process for pre-medical students and for many it is hard to know where to begin.

Well for those of you who are lost and don’t know where to turn, this is a great place to start.

What is the very first thing I should do?
I would highly recommend bookmarking the SDN MCAT Discussions page and then reading the AAMC MCAT Essentials.

What is on the MCAT?

The MCAT is presented as follows:10 minutes of Tutorial (optional)
5 minutes of Non-Disclosure Agreement
70 minutes of Physical Sciences (52 Questions)- 50% Physics and 50% General Chemistry
10 minute break (optional)
60 minutes of Verbal Reasoning (40 Questions)
10 minute break (optional)
60 minutes of Writing Samples (2 Prompts, individually timed-30mins each)
10 minute break (optional)
70 minutes of Biological Sciences (52 Questions) – 75% Biology and 25% Organic Chemistry
5 minutes Void Question
10 minutes of Survey

Total Content Time = 4 hours, 20 minutes
Total “Seat” Time = 5 hours, 20 minutes

What topics are on the MCAT?
Biological Sciences and Physical Sciences Topics & Writing Sample Items

Where can I sign up for the MCAT?
All MCAT registration issues can be resolved by going here: http://www.aamc.org/students/mcat/registration.htm

What are the dates and deadlines for the 2009 MCAT?
Registration for the 2009 MCAT will begin in October 2008. The schedule for the MCAT examinations can be found here: http://www.aamc.org/students/mcat/deadlineandscorerelease.htm

Is one date preferable over another?
No, each test has a pre-determined curved according to its difficulty and there is no advantage between any two dates.

What are the Testing Center Regulations and Procedures?
http://www.aamc.org/students/mcat/about/regulations.htm

How are the MCAT scored?
Physical Science: 1-15
Verbal Reasoning: 1-15
Biological Sciences: 1-15
Writing Sample: J-T
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Highest Composite score = 45T

How is the Writing Sample Scored?
Click here to see how the Writing Sample is Scored

Is There a Curve on the MCAT?
Each test is curved slightly different depending on difficulty, to find more information on this, go here: http://forums.studentdoctor.net/showthread.php?t=505032

Can I Write On My Scratch Paper Before the Test Starts?
Yes. This question has been asked here: http://forums.studentdoctor.net/showthread.php?t=527021

I Just Finished My MCAT, Where Can I Find My Results?
Results should come in within 30 days and all scores will be released electronically here: https://services.aamc.org/mcatthx/

How are the scores reported from the AAMC displayed on THx?
Here is a good illustration of what it would look like: http://forums.studentdoctor.net/showpost.php?p=7083947&postcount=6

Which MCAT Prep Company is the best?
Well everyone has their own style of studying. I can’t answer which is better for you, but I will tell you what is out there and what you should expect from it. Other books as well as these can be found on the SDN Bookstore. An SDN user attempted to answer this question before with his own opinion here but keep in mind this is all subjective. Also check out this link to see how others have rated each company: MCAT Preparation Method Ratings and Opinions

Kaplan
Kaplan adapted pretty well for the new MCAT CBT (computer-based test) and has made virtual everything online. The syllabus contains 25 Quizzes, 20 Subject Tests, 41 Topical Tests, 27 Section Tests, 11 Kaplan FLT (Full-length Tests) and access to the 8 AAMC tests. This is all online and also includes a Kaplan Q-bank that allows you to create a quiz by picking topics you want questions on. The review books are fairly detailed and the classes go over the more important topics of the MCAT. The lesson book does go over very important topics, however, the instructors go over the main concepts and refrain from going too much into detail. Most of their strength relies on the volume of their practices. Their FLT scores are quite inflated and give a false sense of hope, but they are still quite good practices. Many on SDN compare Kaplan and AAMC to the difficulty of the real test and you can read more about that here: http://forums.studentdoctor.net/showthread.php?t=524676&highlight=Kaplan+to+real+test

Princeton Review
Many have taken note on the extensive detail The Princeton Review books and classes have. That being a pro or a con is quite debatable, however, knowing too much information is never an issue with the MCAT. The Princeton Review also has 9 Online Diagnostics and a great feature that has been implemented is an online writing grade. This means that you can submit your writing online to be evaluated by Princeton Review experts (normally takes 24-48 hours). The Princeton Review also has a Science Workshop book which contains 800 pages (including solutions) of passage based and stand-alone questions. These passages are actually quite good and many people have found the Princeton Review bio and G-chem to be great, however they lack the same support for their verbal passages. Their Online Diagnostic scores are quite deflated, but their practices are well worth it.

Berkeley Review
There are ten class books: two for biology, two for general chemistry, two for organic chemistry, two for physics, one for verbal reasoning, and one for the writing sample. Each of the science books is divided into sectional lecture topics. Each section begins with information important to the MCAT and ends with MCAT-style passages and questions and detailed solutions. The verbal reasoning book contains ten practice sets of ten passages each, and the writing sample book has twenty essay topic statements, suggestions for good essay composition, and numerous samples of good writing. Taken together, these books contain about 2,600 pages of material, including more than 550 MCAT-style passages. The books can be bought separately and can be used as supplementary practice or as a complete prep (includes classes as well) package. The Berkeley Review has excellent G-chem and Physics practice, but I have not found the same support on their biology. There are also three full-length practice tests if you would like to purchase and after taking the first one, they give the same vibe as the other simulated tests. This thread thought very highly of Berkeley Review, however, remember that it is only an opinion and everyone is DIFFERENT, you must find what is best for you: http://forums.studentdoctor.net/showthread.php?t=466138

ExamKrackers
For those of you who prefer the self-study approach, ExamKrackers is an excellent self-study prep. They have been noted as one of the best verbal practice book from those of us on SDN; however they do not receive the same recognition on their other books. They include the EK Bio, Physics, G-Chem, and O-Chem review books and the, 101 VR, 1001 bio, g-chem, and physics book. The bio review book is amazing in the fact they hit on the key MCAT topics and basics with easy to read visual illustrations and mnemonics, however they lack the thorough detail that is needed to score well on the MCAT. Overall, the EK bio review is a great supplemental book for those who just started and have a hard time understanding those thick textbooks however it will need to be reinforced later down the line with more detailed resources. I did not have the experience to use the EK 1001 science practice problems and will leave that for others to comment on. They do have simulated practice tests, 1g (1h if you bought the complete package), 2f, and 3g. They are good practices but are more like the old paper-based test than the new CBT and have been known to have a few print errors. To find more information about ExamKrackers, it has been discussed more over here: http://forums.studentdoctor.net/showthread.php?t=280566&highlight=EK+1001

Gold Standard
I did not have the privilege in using Gold Standard MCAT, however, from most previous poster it seems like a last option when most of your resources have been exhausted. There are 10 GS CBT, all of which are curved very unfavorably. They do present unique approaches to solving problems in the sciences, however, others have noted that their verbal passages are short and not like the real test. Yet, the tests are cheap and good to use if you are low in cash and remaining tests. They also have a complete study package that includes review books, DVDs, and more however I am unfamiliar with them and you can find more information here: http://forums.studentdoctor.net/forumdisplay.php?f=409

Audio Osmosis
Using the philosophy of listening is sometimes better than reading yourself, Jordan and Jon use humor and charm to sink in the MCAT concept in a 12 set CD called Audio Osmosis. You can listen to it in your car, at home, or even in your sleep. I am a little skeptically of this approach, since I prefer reading however others have testified that this approach does work and it was helpful. This, however, would be more of a supplemental tool since visualizing diagrams and practicing problems would be key in doing well on the MCAT but I could be wrong. I did not actually use Audio Osmosis but others have commented on its success here: http://forums.studentdoctor.net/showthread.php?t=490819

Nova Press
Actually, I don’t know much except that it does exist and it can be purchased here: The MCAT Physics Book.  If you are interested in finding more detail I advise you to do a Google search or ask around on SDN.

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Also a good thing to note is that most companies allow you to take a free practice test. Try one from each company and see which you prefer best. It sometimes pays to be a little choosy.
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I just did very poorly on my first diagnostic, is it possible to do well on the real test?
Of course it is! No matter what your score is now, it can always get better. Unless you have a 45T, but I never heard of anyone actually scoring that. Also remember, most companies (if not all) deflate their first diagnostic and you may actually be potentially higher. Remember there is only one score that truly matters though and that is your MCAT results. All others are just to give you a ball park of where you are. So don’t be so fixated on your numbers and concentrate more on learning from your mistakes.

Here is a great thread that explains why diagnostic tests are worthless:
http://forums.studentdoctor.net/showthread.php?t=557231

I just did sub-par on my MCAT, is it possible to get into medical school?
Of course it is! Check out MDapplicants or this thread out: http://forums.studentdoctor.net/showthread.php?t=351659

Are you having trouble on the MCAT? Here is a list of strategies and guides that others have applied to become successful.

Official Please Help Forum – http://forums.studentdoctor.net/showthread.php?t=535393

BloodySurgeon Verbal Guide – http://forums.studentdoctor.net/showthread.php?t=509702

QofQuimica & Shrike – http://forums.studentdoctor.net/showthread.php?t=516521

30+ MCAT Study Habits – http://forums.studentdoctor.net/showthread.php?t=503250

Tips for MCAT Studiers - http://forums.studentdoctor.net/showthread.php?p=3719232

A Very Good Verbal Guide – http://forums.studentdoctor.net/showthread.php?t=206944

mterp45 - http://forums.studentdoctor.net/showthread.php?t=526316

Vihsadas Verbal Guide – http://forums.studentdoctor.net/showpost.php?p=6022602&postcount=96

Bozz – http://forums.studentdoctor.net/showthread.php?t=499207

gecko45 – http://forums.studentdoctor.net/showthread.php?t=499808

Rabbit36 – http://forums.studentdoctor.net/showthread.php?t=578461

Are there any additional websites that can help me on the MCAT?

SDN Suggested Links – http://forums.studentdoctor.net/showthread.php?t=279209

MCAT mnemonics and memory aids! – http://forums.studentdoctor.net/showthread.php?t=42149

Prep101 – http://www.prep101.com/mcat/study_aids.html

StudyTips – http://www.studytips.org/mcat_test.htm

HyperPhysics – http://hyperphysics.phy-astr.gsu.edu/Hbase/hph.html#hph

Organic Chemistry – http://riodb01.ibase.aist.go.jp/sdbs/cgi-bin/cre_index.cgi?lang=eng

MIT Classes – http://ocw.mit.edu/OcwWeb/Biology/index.htm

Medical School Material – http://www.medicalstudent.com/ and http://forums.studentdoctor.net/showthread.php?t=298847

The SDN Bookstore – http://www.studentdoctor.net/bookstore/shop.php?c=mcat&x=MCAT

The MCAT is stressing me out and I don’t know what I am going to do about medical school applications!
First of all, relax! The MCAT is a stressful period for all of us. It is a right of passage for all medical students and it foreshadows the rigors of a potential future. Take comfort in the fact that the MCAT is only a piece of the application and medical school will look at other facts. To help with this stressful period, I have gathered links that I hope you will find resourceful.

The Official SDN Medical School Admissions Guide

The Not So Short Introduction To Getting Into Medical School

MCAT Scores and GPAs for Applicants and Matriculants to U.S. Medical Schools

The Official Personal Statement Guide and PS Readers List

The Official Guide to Special Masters Programs and List of Post-Baccalaureate Programs

Great tips for entering your “Work/Activities”

AAMC Grade Conversion Guide

Offical 2008 Secondary Essay Prompts

Why Applying Early is Important

Final Note
I wish everyone best of luck and if you have any question or suggestions you may PM me at bloodysurgeon on the SDN Forums.

Gaining admission to medical school is a multifactorial process. Almost all medical schools require the MCAT, specific course work, and an undergraduate degree. There are also many extracurricular activities that may not be required per se, but are absolutely necessary to be a competitive applicant.

Some schools will not only consider you a weak applicant if you cannot show some of these activities on your application, but also will deny an interview outright if they don’t don’t see enough of them.
What do medical school admission committees look for?

Most pre-med advisors will probably agree that maybe 70% to 80% of the admissions decision depends on your GPA and MCAT scores alone (for most schools). However, there is more to the admissions decision. The various application components are weighted differently from one school to the next. Some medical schools emphasize the MCAT heavily and don’t consider much else. Others almost completely ignore MCAT scores unless they are very low, focusing instead on extracurricular activities and a well-rounded application.

Generally, the following are the main areas used by admissions committees to evaluate candidates:

1. GPA
2. MCAT scores
3. Application material
4. Recommendation letters
5. Personal interview

Note that recommendation letters are written by people who have interacted with you in extracurricular activities or in the classroom–faculty, physicians, or supervisors, for example. These letters serve as a reflection of your involvement in the activities that you listed on your application and offer insight as to what kind of person you are.

The personal statement of your application, the personal interview, and recommendation letters all have one thing in common: they provide the admission committee a glimpse at who you are as a person, beyond the collection of academic statistics comprising the rest of your application. Numbers on a page, while necessary to the admissions process, offer evaluators little by which to assess you as a person. Within an applicant pool of comparably strong GPA’s and MCAT scores, these other factors can prove the difference between you and a competing applicant.

Your application, scores, grades, and recommendation letters will get you the interview. Your personality, character, and interview impression will get you the spot in the class.

Additionally, many medical schools will not seriously consider you if you have never been in a clinical setting. How would you know what physicians do or that you like what physicians do? Also, some schools absolutely require some exposure to research; without it, they won’t consider your application. Other schools may not care about research at all. Therefore, a lot depends on the specific medical schools you are interested in.

School-specific requirements
Some schools are more helpful than others at distinguishing required activities from merely recommended ones. The list of requirements or recommendations looks similar for most medical schools.

The following list should serve you well when applying to any school and was actually provided by an established medical school (not Ivy League or super competitive, but not one of the least competitive). This list is particularly useful because, instead of merely listing recommended activities, it details very specifically what must be done to meet each goal on the list. These numbers were compiled by analyzing the activity profiles of the school’s recent applicants. As a result, meeting these guidelines should make you a more competitive candidate for admission.

In order to qualify for an interview, a candidate has to meet at least the average values in five of the eight categories and the minimum value in the other three. The average reflects the true average for all of their applicants each year. Performing below the minimum in any one category automatically disqualifies applicants from receiving interview invitations.

Time spent in these areas can overlap. For example, volunteer tutoring hours would be considered leadership and volunteer time. Time spent in a volunteer clinic would count as volunteer/service time and clinical exposure.

The weaker your MCAT score and GPA, the more important are all the other areas to strengthen your overall application. If your MCAT or GPA are average or below average, you will need to make your application stand out in other areas, to prove to the admissions committee that your GPA and MCAT alone don’t tell your whole story.

The goal of all of this
Your goal, obviously, is to score well on the admission committee’s applicant evaluation and obtain an offer of admission to the school. Investing adequate time and effort toward each of these areas will make you a much stronger applicant and, hopefully, pave the way to future success. Good luck!

Christian Becker is the creator and operator of www.medschoolready.com and an SDN Contributor.

by Jeremiah Fleenor, MD, MBA

Another summer is upon us. As you enjoy the warm days and break from classes, let’s consider another commonly encountered interview question. This one is almost certain to pop up during your interview conversation.

What would you do if you couldn’t be a doctor?

I’ve seen this question take many an applicant aback. When asked this question during my interviews I recall being confused and wondering whether there was a hidden meaning. Here’s what would go through my mind: “Why do they want to know what I’d do if I wasn’t able to be a doctor? Are they somehow trying to see if I’m really serious about my career choice? Is it appropriate to say there is no other option and that becoming a physician is the only reality for me?”

Perhaps you’ve already faced this question. If you hesitated or felt uncomfortable don’t feel badly –most of us have been there! In this article we will discuss how to give the interviewer a succinct, informative answer.

The Question Behind the Question

Often times an interviewer is looking for specific information but will ask the question in such a way that is not necessarily obvious. There is a question behind the question. Think of these questions as “fronts” for something else. Some common examples are listed below:

• What symbol or object describes you?
• If you could invite one person, living or dead, to dinner, who would it be, and what would you discuss?
• If I were the president of my town’s chamber of commerce and you were a new doctor here, why should I recommend you?

These “front” questions can be completely hypothetical, physically impossible and seemingly unrelated to medicine. These characteristics can make them easier to spot. The key to these questions is to determine what information the interviewer is trying to “get at” and answer accordingly.

For example, the interviewer asking the second question in the list does not really care whether you choose to have dinner with Albert Einstein or Madonna. She doesn’t necessarily care if you talk about the theory of relativity or the perks of being a rock star. What she wants to know is what characteristics you posses (likely typified in the person you select) and what aspects of this person you find most interesting. It’s a question about character and values.

“What would you do if you couldn’t be a doctor?” is a classic “front” question. I think the two items of focus behind this question are:

• What are your interests outside of medicine?
• What are your personal drivers? (What motivate you?)

Outside Interests

Your outside interests are more than casual hobbies. They may be indicators of your passions. Perhaps you volunteer time to a specific organization or there is a business venture you’d like to pursue. Or perhaps you assist in an area of research that you find captivating. Although volunteer jobs may not necessarily relate to being a doctor they are important to you. They help to show the admissions committee who you truly are … the depth you possess.

Motives

More important to the interviewer are your personal drivers. What is it that causes you to get out of bed every morning? Maybe you’ve never thought about this but it’s an important question to ask.

The answer to “What would you do if you couldn’t be a doctor?” is a clever way to determine what drives you. Simply put, your motives shouldn’t change just because your career does.

Sometimes it can be tricky to determine what motivates us. These questions may help in your discovery.

• If you had the day off and didn’t have any responsibilities to attend to, what would you do?
• What activity would you choose to do, even if you weren’t going to be paid?
• What discussion topic really gets you fired up?
• Is there a particular injustice that is very upsetting to you? If so, why?

For example, I know someone who loves to build. Furthermore, he loves to incorporate new technology into his projects. With or without a paycheck he would choose to design buildings. He loves investigating new, better materials and construction techniques. He is constantly interested in ways to be more environmentally friendly. If he had his way he would devote the majority of his time to this area of interest because it’s what drives him.

What drives you? This is important for you to know and equally important to convey to the admissions committee.

The Approach

Once you know the information the interviewer is actually trying to obtain it becomes much easier to answer the question. Try this three-step approach as you prepare:

1. Express sadness over the possibility of not being able to practice medicine.
2. Share the things that motivate you and would make you a good physician.
3. Answer the question in the context of an important outside interest.

Express Sadness

Remember, the interviewer just took away what you believe is your life-long goal and passion. It would be inappropriate to say, “That’s cool. I’d just go work at my dad’s warehouse until something else popped up.” The goal is to play along, but to also convey your conviction that medicine is the best place for you.

Motivation

Discover for yourself those things which motivate you and would make you a good physician. Character traits and values such as compassion, discovery, strong work ethic, diligence, creativity or social justice are good examples. In an interview these would be expressed in the context of certain activities ( e.g. building a new house, volunteering, research, etc.).

Outside Interests

This allows the interviewer to get to know more about you and to remember you long after the interview. It is a great opportunity to demonstrate the depth and breadth of your character. Your passions and the time you devote to them are important to admissions committees. They make you unique and memorable and are glimpses into your inner person.

In Action

A sample answer might look like this:

“Wow, I’d be pretty upset not to be able to practice medicine, because I really believe it’s the best profession for my talents and personality. However, if I couldn’t be a doctor, I would probably go into R&D (research and development) at a biotech company. I love to figure things out. New discoveries excite my imagination. During a summer internship at _____ I really enjoyed the analytical, research component of the work. It was very demanding and required a high level of commitment, but my enthusiasm stayed. I felt excited about my work. Also it was nice to know we were working on projects that would eventually help people.

This would likely satisfy my passion for science, but I would still feel something missing. I really need meaningful human interaction. I’d likely do volunteer work abroad. Some of my travels have opened my eyes to the extreme hardships people face in other countries. [Perhaps tell a quick story of a personal experience]. It’s important for me to stay close to people in need and to develop strong, meaningful interactions.”

From what this applicant said I see that she would be saddened by not being able to practice medicine. She is analytical, diligent and likes to solve problems. This is someone who has a strong need to connect with people on a fundamental level, in order to help them. To an interviewer, that’s valuable information.

Summary

Don’t be thrown by the question, “What would you do if you couldn’t be a doctor?”. Now that you know what the interviewer has in mind you can take advantage of this opportunity. Use this question as an excellent way to demonstrate important aspects of your character and personality, as well as your drive to become a physician.

Please email your medical school questions to Dr. Fleenor at: jdfleenor@gmail.com

The application process for medical school is long and intense. It actually begins much earlier than the point where you fill out the application to send to schools. It includes completion of many premed requirements, meetings with your premedical advisor, taking the Medical College Admissions Test (MCAT), and participating in a variety of extracurricular activities.

Understanding What Happens Is Important
Most medical schools will review applications on a rolling basis, as they are submitted. They extend interview invitations to selected applicants and ultimately offer places in their classes in a similar manner. This means that the majority of schools fill their classes on a first-come, first-served basis. For example, a given school may start the application season with 150 seats to fill. With each passing week of interviews, the admissions committee meets and extends offers to fewer and fewer students. At the same time, the school is still receiving additional applications, driving the competition for the remaining seats up even further. In these situations, all things being equal, the applications submitted early stand the best chance of receiving an offer of admission. 

Major Phases of the Application Process

1. Meet with your premedical advisor.
   Do this first during your Freshman year (or as soon as you decide to pursue medicine. Meet often and keep them apprised of your progress.
2. Complete prerequisite courses.
   Most schools require two semesters of college biology, chemistry, physics, and organic chemistry. Some schools may require biochemistry or calculus, so be sure to research schools in which you are interested. Plan to complete the bulk of these courses prior to sitting for the MCAT.
3. Participate in extracurricular activities.
   You want to be able to list these on the application, so you should have participated in them for at least one semester prior to applying.
4. Take the MCAT.
   Sit for this exam before May, if possible.
5. Interview with your school’s premed committee.
   Not all schools have these, but the premed committee will often review your application and write a letter of recommendation on your behalf.
6. Fill out applications and write your personal statement.
   It may take several weeks or months to perfect your personal statement, so start early – right after the MCAT. Have people you trust proofread it and make suggestions; be sure to include your premedical advisor in this process.
7. Return secondary applications as you receive them.
   Try and turn these around within 7 days from the date of receipt. If possible, return them 2-3 days after you receive them.
8. Interview!
   Remember that earlier interviews are better, so try and accept the earliest interview date you can.
9. Acceptance.
   Many schools will notify you within 2-3 weeks, some even within a few days. Others take several months after your interview to tell you your status: accept, reject, or waitlist.

Apply Early, Early, EARLY!
One of the most important aspects of your application relates to timing. You can talk with many applicants who applied late because they took the MCAT late (August) or they just procrastinated on their applications. You will hear loud and clear that they would recommend applying as early as possible. I strongly agree. Applying as early as possible, interviewing on the first day possible, etc. gives you a huge advantage.

As already mentioned, as time passes with a rolling admissions process, your chance of gaining admission decreases due to spots being filled with students and more applicants still arriving to be considered. Besides this factor of increasing competition, there is also peace of mind when you have received an offer early. Let’s consider each step of the application process in detail now, in light of timing.

Early MCAT
You should take the MCAT by May 1st so you can get your scores back by June 1st at the latest, which is about the first day you can submit your AMCAS application. The exact date may vary each year, but should be sometime in the first week of June. Taking the MCAT later during the summer will put you behind in the application process. Many applicants have already received interview invitations and some have already been extended offers as the admission cycle progresses. Most medical schools will not consider your application and do not offer interview invitations until your MCAT scores are received, so timing your MCAT is essential for timing your application.

Early Applications
Make sure you start working on your AMCAS (MD) and/or AACOMAS (DO) applications right after the MCAT is out of the way if you didn’t have time for this before you took the MCAT. It takes a few months to get the applications put together, so you should ideally start about two months before June 1st to fill out the applications or at least gather the required information and start working on your personal statement. The online applications are made available online sometime around May 1st each year, although they cannot be submitted until June 1st at the earliest. It is recommended that you submit your completed applications (AMCAS and AACOMAS) within a week of receipt of your MCAT scores. It is critical to submit your applications as early as possible.

Early Secondaries
Fill out all secondary applications received from medical schools immediately and try to return them in less than seven days, ideally within two days along with the money and other information they require you to submit. Turn these around as fast as possible. Some secondaries are more involved than others and all cost money. Do not procrastinate. To obtain early interviews, turning these around quickly is a must!

Early Interviews
If you have completed the previous three steps promptly (early MCAT, early application, rapid secondary turnaround), you will see early interview invitations and will have the opportunity to interview during the first few weeks of the cycle.  Try to pick the earliest day for interviewing the school offers. Ideally, you want the first day available on their schedule to interview, but realistically the first few weeks of interviewing are all excellent.

Early Offers
Most medical schools extend offers within two to three weeks. However, the notification time varies greatly from school to school.   Some take only a few days (literally) and others take up to six months.

Why the Hurry?
You should know the answer to this question by now. If not, re-read this post again from the beginning! Do yourself a favor and do things early. It’’s the one factor of your application you have complete control over— – and it really pays off!

Early Decision Program (EDP)
Don’’t confuse the Early Decision Program (EDP) with applying early – this is a separate admissions program and not really part of the regular admission process. Not all medical schools offer the Early Admissions Decision Program.

This is how it works: You can only apply to one medical school’s early Early decision Decision Program. The medical school has to make a decision by October 1st and must notify you of acceptance or rejection. If you are accepted to the school, you are obligated to attend that particular medical school and cannot participate in the regular application cycle at any other medical schools that year. So, you have to be sure the medical school you apply EDP to is really the school you want to attend since there is no changing your mind later.

There are also some huge drawbacks to the early Early Decision Program, as you might have already guessed, since you can only apply to one medical school. If you are not accepted, you have wasted valuable time to get your application submitted to the other medical schools.

You cannot start applying to other medical schools until you have received a rejection letter from your EDP school. That’s two to three months late in the application cycle! You are essentially in the same spot as if you had taken the MCAT late.

Note that if you were rejected during the Early Decision Program, you can still apply to the same medical school through the regular admissions process again – and you will be considered for regular admission independently from the EDP decision. You may be offered a spot in the class even if you were rejected for EDP admission.

The Early Decision Program can be useful for very strong (exceptional) applicants or for candidates who have specifically been encouraged by the school to compete for early admission. Generally speaking, if you are a strong enough applicant for a spot through the Early Decision Program, you will also get a spot in the class through the regular process.

EDP drawbacks in summary:

Personally, I think the Early Decision Program only limits your choices and is not very useful. Especially if you apply early (not through the Early Decision Program), you can also get offers by the middle of October. Also, the timing issue is a huge disadvantage, – putting you way behind in the admission process if you are rejected. I would therefore strongly discourage going through the EDP at any school.

Christian Becker is the creator and operator of www.medschoolready.com and an SDN Contributor.

The Student Doctor Network.  Ten years ago it was just a catchy name.  It has since evolved into a trusted resource for over 130,000 pre-health and health students in over 10 doctoral fields of study.  Our staff, comprised of volunteers at all stages of their professional education, has worked tirelessly to diversify SDN’s offerings as part of our continuing effort to bring you what you need to succeed.

Our latest endeavor, SDN Premed Secrets, is a free CD containing some of the best content we have to offer in an ultra-portable format.  Read popular physician profiles, advice columns from Christian Becker and Jeremiah Fleenor, and read Ryan Aycock’s Not So Short Introduction to Getting Into Medical School!  This is just a sampling of the exclusive content provided on each CD.  Soon, you’ll be able to order your copy online to discover the additional sponsor content not available anywhere else!

With this, our Premed Secrets CD, we continue to expand our reach by putting some of our most valuable resources in your hands so you can get your SDN fix – online or not!

SDN Staff Writers

For some, the answer to the question, “Why do you want to study medicine?” is a simple one: to make money.  These individuals, however, are in a shrinking minority, a recent survey has found.  Kaplan Test Prep and Admissions examined the responses of 914 students in its medical and law school preparatory courses to examine their motivations for professional study.  It seems that even as the traditional financial windfalls associated with medicine continue to wane, students’ passion for medical study is as fiery as ever.  In fact, less than half of pre-med respondents indicated their future earning potential “very much” or “somewhat” influenced their decision to study medicine.  But what does this mean?  Pre-professional students are notorious for their exaggerated claims of altruism while the true and ulterior motivation remains the big salary.  …or at least that was the belief. 

So, what’s the primary reason pre-meds gave for wanting to pursue medicine? “We wanted to get a better understanding of why our students chose medicine. We wanted to know what makes them tick,” said Matt Fidler, Kaplan Test Prep and Admissions’ Pre-Health director, “The biggest reason was the desire to help others and make a difference.”  As verboten a response as it is during medical school interviews, Fidler’s survey suggests there may just be a hint of truth in it.  Skeptics have long maintained that “helping others” and “making a difference” are merely lip service made by pre-professional students to get into school so they can earn the big bucks.

The survey by Kaplan found that while only 49% of pre-meds reported being primarily motivated by money, 71% of pre-law students indicated as much (based upon survey results of 453 Kaplan LSAT students in February 2008).  Since law and medicine are both potentially lucrative fields, what could account for the difference?  Of the over 400 pre-medical students surveyed, 89% listed either a desire to help others, a genuine interest in the sciences, or personal exposure to medicine as the impetus for their decision.  “We think it’s great for them to pursue medicine with such passion,” Fidler said.

And passion they must have!  While many individuals may report feeling squeamish at the mere mention of blood, these pre-meds are aware of and feel prepared for what they will face: a mere 12% say that the sight of blood makes them feel dizzy or faint, and only 11% are concerned about working with cadavers.  The survey results further indicate that these iron-stomached students decided to pursue medicine as their career path in large part during adolescence, giving them ample time to prepare academically and emotionally for the road ahead.  While the ability to earn a decent wage is a concern for students in all fields, perhaps it is not the critical factor for pre-meds it was believed to be.

These statistics are based on the responses of 461 Kaplan MCAT students in January 2008.  To what extent these results are generalizable to pre-medical students as a group remains to be seen.  This is the first time Kaplan has asked its students questions of this type, though it does survey its students on other important topics on a regular basis). Fidler indicates they plan to continue to do so in the future.  “We just think students are interested in learning about their peers’ motivations to go to medical school,” he says.  It will be very interesting indeed to see if this trend is observed in future Kaplan courses as well as outside the classroom!