Medical

Parenting a Pre-Med

This past application cycle was brutal—I’ve struggled to sleep and to concentrate; I have pored over SDN’s waitlist support group addictively, creating theories for how to get off of the list; and paced hallways impatiently waiting for that letter, email, or phone call of acceptance. But I’m not an applicant, only an applicant’s dad. 

For months, I have watched my intelligent, accomplished daughter –who has only ever wanted to be a doctor– go through the psychologically and emotionally draining ritual that is the medical school application process. Where’s the Eighth Amendment when you need it? At the end, bloodied but unbowed, she was ultimately accepted into two schools and will soon begin her training in the City of Brotherly Love. (She promises never to cheer for any Philadelphia sports teams, as doctors are meant to be ethical and show good judgment.) But there is no delight or, rather, it evaporated soon after the acceptances arrived. The abiding emotion for all our family is that of exhausted relief.

Many applicants fill out the forms in a flood of enthusiasm during their junior year of college. This presents a tough challenge for moms and dads, as parental currency is not highly valued at that stage of life. After a couple of years slogging their way through the world of work, some kids begin to appreciate what their parents have sacrificed on their behalf. In college, not so much. College students are independent and enjoying their freedom, often from those same parents who are footing the tuition bills. So how can we help?

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In a way, we can’t. Our kids are meant to grow up, make their own decisions, and stand on their own two feet –even more so if they aspire to become physicians. But as parents, we can bring experience and, dare I say, some wisdom to this application process. We’ve been roughed up a little as we’ve gone through life, and now we see the same happening to our children. We may not know our way around the medical school application process, thrill to the joys of organic chemistry, or understand the importance of Mongolian throat singing as an extracurricular activity, but we do know heartache and disappointment, and we can see it coming.

Our kids are great. They never needed our help with homework, were always in the top handful of their high-school class, the top dozen in their college major. They pulled As and Bs without effort, and are used to being the smartest kid in the room. Trouble is, they face off against 50,000 other smartest kids in the room, but there are only 20,000 slots. As my mom used to say, there’ll be tears before bedtime. Of those who do get in, only 40%, a mere 8,000, are first-time applicants. Chances are, your child may not absorb these facts. After all, they have only to finish in the top 40% to attend med school, and they’ve always been in the top 10% in any academic competition. Top 40? Easy!

A deadline exists after which you can hold no more than three acceptances. Surely, your child may think, I’ll be awash with offers. If not, why establish such a timeframe? The cold mathematical truth — that of those who get in, less than half have a choice of which school to attend — is not information they can easily hear. After all, the only thing they might have failed so far is a driving test. Something as academically focused as the MCAT- and GPA- driven med school process is surely a piece of cake. Multiple acceptances, dream school acceptance, free rides – guaranteed! So, prepare your darling child to experience disappointment.

If your child did well on the MCATs, rejoice and celebrate. And then, counsel caution. After all, if she has a 520 and gets an interview at a Top Ten school, chances are everyone else interviewing that day has a similar MCAT score. The 520 did its job – it helped her get that interview. To get the acceptance takes a lot more—those extracurricular activities, the interview, and the poise and maturity shown in the primary and secondary essays. Perhaps one reason why reapplicants do relatively well is that they have learned that the process is about far more than the MCAT, that they have matured, and by reapplying they show, rather than merely tell, that they are indeed committed to a lifetime in medicine. 

Urge your offspring, though, to avoid comparisons with other applicants. This can be self-destructive, soul-destroying behavior. For those who delight in all things numerical, it can be gutting to read of people with far lower MCAT scores sitting on a pile of acceptances letters while you have none. But, in the end, applicants select different bands of medical schools, based in part on MCAT scores. Med-school success is more than just a score: it’s about how you stand out against people who have similar scores. And to stand out, life experiences are key, and these cannot be quantified by numbers unlike the MCAT, GPA, LizzyM, WARS, and the other alphabet soup of the application cycle.

You might also point out, if needed, that being an MD isn’t the be all and end all of human existence. If your offspring’s MCAT and GPA scores are relatively low, what’s wrong with applying to a DO school, or a dentistry, a podiatry, audiology, or optometry school? Don’t let your child’s desire to serve others in the medical professions be swamped by an “MD or bust” attitude. After all, until your child applied to medical school, did you know – do you know now – whether your primary care physician is an MD or a DO? If so many people don’t know the difference, or care, why should it be important to a young applicant? You might want to ask!

The secondaries follow. Your child applies to 25 schools, say, and gets 20 secondaries. Ponder that — five schools are so unimpressed with your child they want no further information. Zilch. Nada. They are so underwhelmed, they’ll forgo the application fees they would cash had your offspring filled in the secondaries—after which the school could subject them to a silent rejection, or treat them to the indefinite pre-interview hold for several months before mailing the rejection letter sometime the following year. Thank you for your interest in us; we have no interest in you. These things hurt. Sure, your child still has 20 schools who want to learn more about them, but five dismissing you out of hand? That’s tough for a young person to face.

But even if the darling child scores an impressive seven interviews out of 20 secondaries, it means that 13 medical schools think your child is not fit for purpose. Or, at least, not yet. That dream school they yearn to attend may not invite a secondary, or an interview, or – if the interview comes – there may be only the waitlist or a heart-breaking post-interview rejection. All of these – having some schools uninterested in your secondary, others rejecting you post-secondary, another batch placing your child on pre-interview hold – take their toll on your previously highly successful child. Dreams are dying, hopes are being dashed. And if interviews are not coming, be pragmatic. Remind them that some schools to which they have applied may interview extremely late into the Spring. As philosopher-catcher Yogi Berra shrewdly observed, “It ain’t over ‘til it’s over.”

Some applicants are fortunate enough to obtain more than one acceptance. After going through such a numbers-dominated process, they may simply want to go to the highest ranked med school. But should they? Again, do you know which med school your own doctors went to and, if so, what their ranking was? It may be time to talk of a triangle comprised of kudos, cash, and kinfolk. Yes, going to a school with a good reputation is great, but what if it’s far more expensive than another school your child could attend? Either way, your offspring will an MD at the end, but she could have far less debt. Going far away from family and friends might not be optimal, either. When they tire of drinking information from the MS1 fire hose and yearn to come home and hang out with family and friends, it’s tough if they are the other side of the continent.

For those without acceptances, the waitlist is where the worrying starts and panic grows— in the sleepless nights where the gremlins of second guessing run rampant. Nights spent reciting a litany of “if onlys” – if only I majored in music not in biochemistry; volunteered at a homeless shelter rather than a football camp; applied to this school, not that. Taken Spanish, not German. These are the things that can ruin our kids’ lives from the moment that first waitlist notification arrives until the first acceptance quashes them. And that acceptance may not come this year.

Our children are under huge amounts of stress on those waitlists, perhaps feeling humiliated by not having an acceptance; feeling helpless to change anything; and possibly distraught about not knowing what went wrong, what caused them to be overlooked, and so not knowing how to “fix” their applications. They are not sleeping or eating well, probably, but are still taking all those pre-requisite higher-level classes, shadowing, and volunteering in order to update that application or incorporate into a letter of interest or of intent. Badgering them by repeatedly requesting the latest med school updates won’t help– no matter how much we crave that information. Let’s not turn our pre-med Bruce Banner into The Hulk. Instead, try to model the compassion and understanding they will need to show when faced in the future with comforting a suffering patient.

In Pandora’s box, after all the evils of the world had been set loose, there remained a precious gift. Hope. At the end of a draining application cycle, seeing others with worse MCATs, GPAs, and fewer extracurricular activities receive acceptances while he has none, your child’s box may seem empty. Our kids have worked so hard, for so long, to achieve a dream. It may be hard to accept that this year, medical school will not be for them. But as parents, we can provide the hope. Remind them that there is always next year, no matter how much cold comfort this may seem. MCATs can be retaken to improve scores. Low GPAs can be overcome by a post-bacc. Volunteering more and shadowing more can help build a better application. And carpet-bagging, relocating to a state with large numbers of medical schools that show a great fondness for in-state applicants, might bring about an A in the future. Don’t stand in the way if they want to move to Florida or Texas – they are growing up, moving away, and showing commitment to a cause.

If an acceptance doesn’t come, cry with them and love them, helping them on whatever the next step of their journey may be. But if it does, cry with joy for them and sing their praises, preferably using Mongolian chant. And sprint to the computer to load up on med school swag.

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Slight correction: ophthalmologists are MDs. Optometry is a separate degree.
Very well written and guide other parents who are on same journey.
H