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The Competency Manifesto: Part 6

Advising the 2018 Class 

Welcome, Entering Year 2018 applicants! This is your required session on the application process for medical school admissions for those of you who intend to apply during the summer of 2017. I wanted to give you an idea of how the steps you need to take now to submit a timely application for screening and review by admissions committees.
First do you know what the characteristics most likely predict success as a future health professional? A blue-ribbon committee organized by the Association of American Medical Colleges identified six competencies that are critical pre-professional characteristics for successful professionals. Those six areas are:

  • Integrity and ethics: Behaves in an honest and ethical manner; adheres to ethical principles and follows rules and procedures; resists peer pressure to engage in unethical behavior and encourages others to behave in honest and ethical ways.

  • Reliability and dependability: Consistently fulfills obligations in a timely and satisfactory manner; takes responsibility for personal actions and performance.

  • Service orientation: Demonstrates a desire to help others and a sensitivity to others’ needs and feelings; demonstrates a desire to alleviate others’ distress.

  • Social and interpersonal skills: Demonstrates an awareness of others’ needs, goals, feelings, and the ways that social and behavioral cues affect peoples’ interactions and behaviors; adjusts behaviors appropriately in response to these cues and treats others with respect.

  • Desire to learn: Sets goals for continuous self-improvement and for learning new concepts and skills; assesses own strengths and weaknesses; solicits and responds appropriately to feedback.

  • Resilience and adaptability: Demonstrates tolerance of stressful or changing environments or situations and adapts effectively to them; is persistent, even under difficult situations, recovers from setbacks.

 
Many of you believe that these traits are self-evident, and that you already have these characteristics. When I sampled applicants in a past survey, I find that most of you already believe you are a master or expert in these six areas (see table below). Thus it should be easy for you to embrace being evaluated and tested regarding the depth of your experiences that exhibit these traits.

Table: Self-Assessment on AAMC Competencies among EY2012 Applicants
How are the schools going to evaluate you? First, you need to be able to communicate all your experiences throughout your life and most importantly the last two or three years where your characteristics were developed. On the pre-application, we ask you to provide that evidence in separate essays that focus on each of these evaluation criteria. This was done to prepare you for similar questions you will encounter including questions on the central applications and school specific applications you must complete.
Moreover, you will be faced with fictional situations which test your performance and these characteristics. These tests are obviously asked of you in the multiple mini-interview format that has been adopted by a significant fraction of schools (medicine, dentistry, etc). These timed tests can come as short impromptu essays, role playing, and team exercises. You may also be tested with standardized cases you may encounter, especially on national entrance exams that you must take. Finally, your references will all be asked to comment on the development of these competencies in their letters of recommendation, so it is important that your references have a close mentoring relationship to you that goes beyond just your attendance and exam performance in class.
It is so vital and important now to realize that you already have developed these characteristics over your entire lives so far. The hardships you endured while growing up or being in school, the jobs you may have lost or quit in order to pursue your career, the relationships you have made with those in need in your community, and your experiences getting up from some of the most difficult times you have ever experienced are all important in your application profile. The choices you made or were made for you five to ten years ago influence your preparation now for a competitive application. The activities you have made now while you are in college influence your preparation too. Moreover, the failures you have had, the mistakes you made and the habits you set for yourself since you were maybe back in 2010 and adjusted to succeed presently have put you in a position now to be tested about your preparation for this future on entrance exams to school or licensing exams to practice.
You may have a hard time accepting this fact: you may not actually be ready. It may take some time for you to develop your competencies to a point where you are ready for professional training. If your motivation is to become a physician, then you need to realize you will always be working on these competencies before, during, and after your anticipated acceptance to a school. Every school expects you to not just be competent in these areas; they want you to be excellent or exceptional. In most of the admissions data I have accumulated, being externally validated as exceptional through awards from supervised activities in a combination of these traits makes you someone the schools want to watch. Being a Dean’s List member isn’t enough.
Every school has a different threshold, and you can see what that threshold is in the Admissions Requirements section of each website when you review the ranges of “pre-professional characteristics” competency score from those who were accepted two cycles before. If it is not there, you should be able to get this information from current students in open houses, panel discussions, and online forums, though always put no more weight than a grain of salt in whatever you view on predents.com, MDApplicants.com, or Student Doctor Network; you don’t ever see the whole picture.
I give you this warning to look at your life in the same way the Ghosts from “A Christmas Carol” presented Scrooge with his. In spite of a painful past of sacrifice and prolonged gratification, Scrooge changed his present-day life to give himself a future where he was respected and revered as a compassionate, caring leader and provider to his community. You have the opportunity to make that future for yourself and fully develop these characteristics to be the best health care professional that any clinic, hospital, community, or specialty would ever value. It should involve continued self-reflection and hopefully some honest “coaching” from mentors and your pre-professional advisors, from faculty and student life administrators, from work peers and volunteer supervisors. Most importantly, your future will come from learning about yourself from the patients you observe and have the privilege to eventually care for, and being able to tap everything about your life to provide the best care possible to that patient and his/her caregiving team.
By being a pre-health student, you are fully recognizing these six competencies and others that will complement the technical skills you need to be an expert, even if you have been working on them for the last 10 years of your life. You must be able to see your own blemishes, your own image, and your own competencies honestly. There will be times where you will doubt yourself as being less than “the perfect candidate”, but I assure you no one is perfect. Everyone – including the Surgeon General – constantly reviews his/her own competencies and checks against the standards with one’s mentors or advisors. If you are or want to be a serious applicant, the days where you show up at your advisors’ doorstep without their help saying “I’m ready to apply” are over. Too many advisees simply “ghost ride” their pre-health careers by simply being passive as they check off what they know are required activities.
So if the Ghost of Health Professionalism Past shows you what made you who you are in your competencies, is there any evidence that you have truly made yourself committed and exceptional to your career direction? Will the Ghost of Health Professionalism Present give me insight on the activities and questions you are pursuing to show that you have the promise of being an exceptional health professional? When the Ghost of Health Professionalism Future visits you, what do you see for yourself 10 years from now? In all these cases, have you earned the trust of everyone you have ever met when it comes to serious decisions? Have you spoken up for the resourceless or for those who easily fall through the cracks? You may not need to open an orphanage, but have you truly taken advantage of everything your school offers you in your education and training (activities, equipment, faculty)? Finally, do you have the courage to see yourself in a completely different future?
Good luck with developing your professional competencies and the upcoming application process.
Source: “Stepping Outside the Box” presentation, AAMC 2010 Annual Meeting https://www.aamc.org/download/161252/data/stepping_outside_the_box.pdf

About the Author

Emil Chuck

Emil Chuck, Ph.D., is the Director of Admissions at CWRU School of Dental Medicine.  He has worked with Kaplan Test Prep & Admissions as an admissions consultant, student advisor, and test prep instructor.  There are no conflicting relationships that are relevant or associated with the information in this article.

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Emil Chuck, Ph.D., is the Health Professions Advisor and Term Assistant Professor of Biology and Bioengineering at George Mason University. He has worked with Kaplan Test Prep & Admissions as an admissions consultant, student advisor, and test prep instructor. There are no conflicting relation... Emil Chuck, Ph.D., is the Health Professions Advisor and Term Assistant Professor of Biology and Bioengineering at George Mason University. He has wo...
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    Hmm
  • October 24, 2011
Dr. Chuck is trying to hard to analyze all these "factors" that he's making up and defining himself. Being a graduate from GMU and getting into a medical school, I can say that I did not fall into any of these "competencies" and still made it. Looking back on it, I feel like the prehealth community is set up to have students jump through way to many loops for a committee letter, making it seem like the committee letter is the end all/be all of their acceptance. Although I went through the committee with my paperwork, I know several people who were in my class, that got acceptances, without going through the legwork that Dr. Chuck has set up, and none of the interviewing schools ever asked why there was no "prehealth committee letter"
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    Sam
  • October 24, 2011
I feel that a lot of pre-health students in my classes would make terrible doctors (within the scope of personality traits) and I wondered if they ever realized this, would they still pursue that career path? I bet a lot of them would still pursue. I think they have every right to pursue the career of their dreams but for sake of their patients, should the pre-health committee be empowered to make the decision? Reluctantly, I say yes...sort of. I view the pre-health committee as a sieve that filters out the less morally developed students or those with the wrong view of medicine. But these students who see medicine as only a means to attain money or prestige, should not be totally discarded. I think they could still make great doctors in getting the right treatment for the patient but could use some work on patient interactions and work ethics. (Patient satisfaction is marginal in significance compared to actually healing them.) On the other hand, I don't think we should only set up such a filter at the point in time between undergraduate and the first year of medical school. I think it would be more appropriate to set up the moral/competency sieve after you were given the proper time to train yourself in medical school. It just doesn't make sense to filter these students without even giving them the chance.
Regardless, some of my undergraduate peers are obviously immature at the moment. They're naturally complainers. They express little interest in science and only want the superficial good marks. Some are selfish and it is evident in how they spend their time. They get terrible grades. They would obviously make terrible doctors. Medical schools don't need a pre-health committee to not give these students even an interview.
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      Sam
    • October 24, 2011
    If the job of the pre-health committee were to determine whether an applicant is competent enough to become a doctor, then their job is indispensable to the future of medicine and their opinion should be well trained and hold a great deal of significance. But at this moment, it is NOT their job to determine whether or not applicants would be proficient doctors. It is ONLY their job to determine whether they would make good medical STUDENTS. If AAMCAS were to figure out a way to ensure only the best doctors are able to practice, they should set up pre-"Practicing Physician" committee.
    I do appreciate your work, Dr. Chuck, nonetheless.
    :)
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      ....
    • October 25, 2011
    All, how young and naive, looking at the world through rose colored glasses. Once you start medical school, you will figure out what really constitutes a huge percentage of the classes, A-Type personalities that are in it for the prestige, if anyone tells you they are in it solely to help people, you better check to make sure everything else they have been telling you isn't a lie.
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    Reality Check
  • October 26, 2011
Reality check:
Get ready for Obamacare. Get ready for more med studs than there are residency slots. Get ready for high tuition, low reimbursement, and noctors taking over your jobs.
Get ready to get a 4.0 and 35+ on the MCAT to get into a decent school.
Get ready to work like crazy. Get ready to be denigrated by anyone and everyone in the world. Get ready for little sleep for years (life?).
In other words, get ready for medical school.
Can you work hard, and at a high level, while being bitter about lack of reimbursement and bureaucracy, on little sleep, and not kill anyone? Congrats. You're possibly ready to be a doctor. This is coming from an MD, not a PHD premed advisor.
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    uh_oh
  • January 18, 2012
what does he have to say about reapplicants or dismissed students. is it more promising to go to a carribean school? i want to write to aamc or lcme but i don’t know who’s the proper authority and i don’t want to wage war. just stand up against mistreatment. legit in contrast with the policies

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