What do US med schools want and how can I give it to them?

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Becoming The Best Applicant

To get into the medical school of your choice, you will naturally have to be the best applicant when compared to everyone else. Given that only a third to a half of all applicants get accepted each year, you are going to have to prove yourself against the rest of the pre-meds. This chapter will tell you what you need to do before applying to become the top candidate. The sections that follow are ranked in their order of importance.

GPA (tie)
MCAT (tie)
Letters of Recommendation
Research (tie)
Volunteering (tie)
Clinical Experience (tie)
Leadership
Other Extracurriculars

You should strive to complete the higher listed items before moving on to the lower areas.

1 GPA
2 What to Pick as a Major
- 2.1 Double Majors
- 2.2 Required Courses
3 The MCAT
4 Letters of Recommendation
5 Research
6 Volunteering
7 Clinical Experience
8 Leadership
9 Other Extracurricular Activities

GPA

Your GPA is the single best indicator to medical schools as how good of a student you are. Sure, people will always bemoan the problems of using grades as a factor for acceptance—that students who work full-time cannot study as much as students on loan, that a GPA does not say anything about someone’s personality, etc . . . However, admissions committees typically have thousands of applicants each year. The quickest way to separate the candidates is to look at the numbers. Further, the U.S. News and World Report’s annual ranking of medical schools is based upon objective measurements such as GPA and MCAT. Therefore, you must do all that you can to increase your grades. Use the techniques in our Tips for Better Study Skills to boost your scores.

One note: medical schools would rather see a steady increase in GPA over semesters (i.e., 3.2, 3.4, 3.6, . . . ) than a steady decline (i.e., 3.6, 3.4, 3.2, . . . ). The former scenario shows that you are serious about your studies. The latter demonstrates that either the upper-division courses are too difficult for you, or that you are getting too involved with your extracurriculars as time goes on.

What to Pick as a Major

A common source of anxiety for many entering freshmen is picking the right major. While the vast majority of pre-meds are in chemistry- or biology-related ﬁelds, bear in mind that your major really does not matter. Most people go into these areas because the pre-med requirements make up the required courses for microbiology and biochemistry. Also, applicants try to impress admissions committees with difficult or medically-oriented majors such as biotechnology or health professions. The Association of American Medical Colleges (AAMC) publishes statistics every year about the majors with the highest acceptance rates and highest MCAT scores (visit www.aamc.org). As of this writing, while most medical students did chemistry and biology as their undergraduate majors, the ﬁelds with the highest acceptance rates were biomedical engineering, physics, philosophy, and music. Some of the lowest acceptance rates are found amongst the biologists, chemists, nurses, and health professionals. (Medical schools are reluctant to accept nurses because they see the move as contributing to the nursing shortage). The take home message is that your major really does not matter. Pick something that you enjoy. In my case, I did a double major in physics and religion and then went on to graduate school in materials science. I’ve met nuclear engineers, psychologists, and business majors who are pursuing a medical education. Any unique background will give you a different perspective to practicing as a physician. In the case of the business major, just keep in mind that many doctors do work in private practice—they’re business owners!

A word of warning is in store for the liberal arts majors. Please realize that rejections do occur. If you should end up with a stack of thin envelopes at the end of the application season, you will have to move to your backup plan (see Section 4.3). If your major is not marketable, you will have a hard time ﬁnding a job during the 1–2 years that you take off to re-apply. While I encourage you to major in whatever interests you, just keep in mind that you must have a backup plan should you not get accepted to medical school.

Double Majors

I have already mentioned that your major is unimportant. You can well imagine that a double major would be a colossal waste of time if you pursued two degrees only for the sake of impressing an admissions committee. At my alma mater, for instance, the difference between a biochemistry major and a microbiology major is about three classes. From a medical school’s point of view, there will be no difference in the educational background between these two ﬁelds. Therefore, if you are going to double major or add on a minor, you must ﬁrst be genuinely interested in both areas. Second, you should pick two ﬁelds that are polar opposites such as chemistry and business or mathematics and philosophy. Third, you must be able to justify your decision in such a way that both majors seem relevant (i.e., that the chemistry degree will help you understand medicine as a science, while business will help you understand medicine as a practice.)

Required Courses

The following classes make up the pre-med core courses. They are required by all medical schools:

English Writing I & II (one year)
General Biology I & II (one year, plus any associated labs)
General Chemistry I & II (one year, plus any associated labs)
General Physics I & II (one year, plus any associated labs)
Organic Chemistry I & II (one year, plus any associated labs)

Many schools also require a semester each of biochemistry, calculus, and statistics. In addition, I recommend that you take the following classes to prepare for the MCAT and to get a introduction to what you might see in medical school:

Analytical Chemistry
Anatomy
Genetics
Physiology
Optics & Modern Physics (if not a part of your general physics class)

Other than what is listed here, you are free to take whatever you want to in college. Again you’ll notice that major is irrelevant for getting accepted to medical school so long as you take the courses above. However, with a list this heavy in biology and chemistry classes, you can see why so many pre-meds go into those respective ﬁelds.

A note of caution about these classes: I’m sure that many of you have taken Advanced Placement classes in high school. While AP credits are great for getting gen-ed requirements out of the way for college, some medical schools do not accept AP classes as a legitimate fulﬁllment of the pre-med core courses. In other words, you might be required to take these classes a second time, even if you aced them the first go around. In rare instances, some universities will not even recognize courses that you’ve taken at community colleges. Be sure to carefully check the admissions requirements at your preferred schools to make sure that your classes meet their stipulations.

The MCAT

The Medical College Admissions Test is a vitally important exam that just might be the single biggest determining factor as to whether or not you get a second look from an admissions committee. It is offered by the Association of American Medical Colleges, the same organization that controls the application process. To register for the exam, you must use the AAMC’s website. Current registration cost is US$200; and you should register as early as possible – about three months before your exam date. Fee reductions may be granted for individuals with extreme ﬁnancial hardships. The information presented in this section should be considered up-to-date as of May 2005. Visit our MCAT Page to find out more details about the exam itself and advice on studying for the exam.

Letters of Recommendation

After admissions committees have had a chance to review your scores, they will then look to your letters of recommendation to get a feel for you as a person. While the vast majority of letters are positive, writers give clear indications as to how well they know an applicant. Therefore, you are required to get to know your professors outside of class so that they will be able to comment on your strengths. Go to their office hours every week. I don’t care if you are acing the class and have no difficulties with the subject. You should go to office hours so often that your teachers begin waiting for your arrival. You should also get a chance to know them. Ask them about research, family, opportunities on campus. You’ll be amazed at what a valuable resource your profs are. However, I cannot stress this point enough, do not suck up to your professors. They have been around long enough and have written far too many rec letters to be fooled by someone who just wants to score points. You should be genuinely interested in that person. If you don’t care for a particular teacher, move on to someone else.

Medical schools typically require 3-5 letters. At minimum, one will be required from a science professor and one will be required from someone who knows you outside of the classroom—usually an adviser or a coach. Because each school has its own nuances of how many letters it wants, you should get one letter from a physical science teacher, one from a biological science teacher, one from another science professor, one from a research adviser, one from an activity adviser—sports, volunteering, hospital work—and one from a friend. There is a growing trend among medical schools to request rec letters from peers. Make sure you pick someone who not only knows you well, but is a good writer and can make you look good in words.

Since I recommend applying to medical school during the summer, you should ask your letter writers for their recommendations at the end of the spring semester. They will need enough time to begin work on writing those stellar essays—so ask early. You should make writing a letter as easy as possible for your reviewers. First, schedule an appointment to come in and talk with your teachers about getting a letter—some of them will want to interview you. Second, bring a folder with your resumé, vita, unofficial transcripts, personal statement,16 picture (in case the class was a while ago), waiver (see below), and stamped envelope. Put your name on the outside of the folder along with the words “Letter of Recommendation” so that if your prof loses the folder, it will be easy to ﬁnd later.

Then the waiting begins. You’ll need to check in with your writers about once a month to make sure that they actually ﬁnish the letter. Don’t be surprised if at least one person loses the folder and you have to generate another. Also, you should send a thank-you note when he/she is done. Finally, and most importantly, please tell your reviewer where you were accepted to, rejected from, or if you decide to withdraw from applying altogether. Keep in mind that your writer has a vested interest in seeing you succeed. They deserve to know what happened.

Some undergraduate schools offer a letter writing committee, where you are interviewed by a panel and then a group letter is put together. Usually, this panel letter serves in lieu of multiple letters that would otherwise be written by individual writers. Other schools may have a pre-med adviser that takes care of the letter. Some will even have a collection service where all of the writers submit their letters to a single repository. Ask around to ﬁnd out which method your school uses.

As an added bonus, some professors will ask you to write the letter of recommendation. They then sign and mail it off. If you are told to write your own letter, make sure that everything is true and known to the professor. Otherwise, your writer may use your actions to show that you are delusional or dishonest. Also, according to the Education and Family Privacy Act of 1974, you are legally allowed to read anything that a school has in your application folder, including your letters of recommendation. The law does grant a provision that allows students to waive their right to access. In other words, you’ll be given a form that says something to the effect of, “I waive my right to read this letter.” Given that most writers are going to be uncomfortable with your reading their essays, I suggest that you waive your right. You professors will be able to write more honest opinions about you.

Research

This section kicks off the explanation of the three most important extracurriculars that you can pursue while in college. Although your scores will grab the attention of an admissions committee, you’ll fall ﬂat if you cannot show schools that you are interested in medicine outside of the classroom. In every interview I’ve ever had, I was always asked, “Tell me about your research. Tell me about your volunteering. How do you know you want to become a doctor? Do you have any experience in health care?” You should follow the advice presented in these sections to the letter to gain the approval of medical schools. I start off the discussion of extracurriculars with a statement about research.

Given that the progress of medicine relies on science, all doctors are expected to have scientiﬁc leanings. Further, the majority of admission committee members are made up of professors, who themselves are usually researchers. Therefore, you should get involved with a lab to see how the information from your organic chemistry and genetics classes is actually used. You do not necessarily have to do something medically related. You can study botany, astronomy, oceanography, you name it. Whatever interests, give it a try. Just get into a lab and try to become an integrated team member.

Finding a project is actually a lot easier than you might imagine. Professors post announcements on their websites or outside of their offices to alert potential research assistants of available positions. You can also try talking to your teachers to see if they are willing to have you join their lab. If all else fails, get online and start reading professors’ websites both within your major and in other ﬁelds that interest you. I’m sure that you can get on board with a project somewhere.

As an added beneﬁt, you may receive research/individual work credits that can be applied to your degree. These credits will usually boost your GPA. And if that’s not enough, professors will occasionally pay their undergrads. Simply put, there is no reason why you should not get involved with a lab for at least 10 hours a week.

The National Science Foundation funds a program every summer called Research Experience for Undergraduates (REU) - Visit www.nsf.gov/home/crssprgm/reu/start.htm for details. The basic idea involves your spending ten weeks at a national lab or another university. All expenses are paid and you will receive a stipend worth nearly $3000. In return you work more than 40 hours each week in a lab on a set project. There are REU’s in a variety of ﬁelds—nano electronics, mineral science, toxicology, you name it. Although I never did an REU while in college, I was a mentor during graduate school. The students really enjoyed the program, the research they did, and meeting people from around the country.

Volunteering

Doctors hold many titles — researcher, teacher, philosopher — but the most important title is that of humanitarian. Physicians are expected to dedicate their whole lives to working with others, especially the marginalized of society—namely, the poor, the sick, and the elderly. If you want to get accepted to medical school, you must show that you care about others. The only tried and true method of serving others is to take up volunteering.

Just like research, you do not have to volunteer in a medical ﬁeld. You could work with Habitat for Humanity, the Boy Scouts, or any other group that has interests similar to yours. There are many organizations that are looking for counselors, skilled laborers, or anyone who is willing to work; they’re usually willing to train you.

You are not expected to save the world or commit to a thousand hours each semester. Simply ﬁnd something you enjoy doing and spend one afternoon a week doing it. Many pre-meds volunteer in hospitals thinking that they will gain some kind of clinical work experience. I can’t speak for all hospitals, but most of them do not support their volunteers very well. If you were to join some of the hospitals in my area, your job would consist of handing out lollipops, ﬁling paper work, and pushing wheel chairs. These hospitals would not even teach you CPR, much less let you touch a patient unless it’s a discharged person going home. If you want to gain clinical experience, you will have to get a medical or nursing license of some kind.

If you are still stuck on where to volunteer, the United Way generally has a directory of your area’s organizations and can point you in the right direction.

Clinical Experience

Finally, the last thing that will show medical schools that you are interested in becoming a doctor is if you gain some kind of experience working with patients. Again, most pre-meds are duped into thinking that volunteering in a hospital will give them insight into the difficulties of becoming a physician. An easier way to get this kind of knowledge is to shadow a doctor regularly. Many primary care physicians are willing to pass the torch by allowing undergraduates to follow them around the office as they conduct physicals and consultations. You’re on your own to ﬁnd a doctor to shadow. A good place to look, however, would be to ask your own physician for advice.

If you want to gain real, genuine clinical experience, you’re going to have to bite the bullet and become licensed. Either become a certiﬁed nursing assistant, medical assistant, or an EMT and get direct full-time hands-on experience. The upshot is that you’ll be paid for your time. The bad news is that you cannot count working as a CNA or EMT as volunteering. You would have to join a second organization to fulﬁll the volunteering requirements. Also, given that every state has different requirements with respect to licensing, you are again on your own to ﬁnd the laws regarding training, testing, and employment. With the advent of the Internet, however, ﬁnding the necessary information is much easier.

Whatever you do, make sure that you have proof that you really want to be a doctor. The information presented in these last few sections is the best demonstration of your desire to practice medicine. You may ﬁnd other ways of putting a personal side on your application. If so, all the better to making you stand out.

Leadership

In addition to being scientists and humanitarians, doctors are expected to be community leaders. Though not absolutely required, many medical schools would like to see you take some kind of leadership role. You don’t necessarily have to be president of a fraternity or become a senator of your student government, but you are expected to take some kind of role in organizing and planning events. Given that you’re about to be given a lot of power as a physician, schools have an obligation to ﬁnd out if you know how to use that power. Find something that you have a passion for doing and convince others that you are ready for putting together social functions and meetings. You can still be a leader by working behind the scenes.

Other Extracurricular Activities

At the very bottom of the list of “Becoming the Best Applicant” are the miscellaneous extracurriculars that do not ﬁt in anywhere else. Most jobs, sports, and campus organizations do not matter one bit to medical schools unless you speciﬁcally played a major role and made quite an impact through the group. Unless you worked a summer internship for a Defense contractor or were a teacher, your employment history is not important. Unless you were an Olympian or NCAA champion, your membership on a sports team is not important. Unless you spent a year-long journey through Africa as a missionary, your membership in a religious organization is not important. And by far, the biggest waste of time as an undergraduate comes from social fraternities and other self-interest groups—especially, as mentioned above, if you did not take on a substantial leadership role. Remember, everything you do needs to beneﬁt a future doctor, not a future socialite.

Honor Societies Many students are under the delusion that membership into an honor society will increase their likelihood of acceptance. Groups such as Golden Key and Alpha Lamda Delta typically require that students have a 3.5 GPA and pay $25 in initiation fees. These societies are usually viewed as resumé-padding organizations. Your name on the Dean’s List every semester is an easy enough indication that your grades are good. I suggest that you save your money and try to invest in more worth while endeavors. There are, however, some honors that you can receive that will make you stand out. Graduating magna cum laude or summa cum laude usually requires that students complete a research project and write a thesis. Departmental and university-furnished awards are generally based upon the recommendation of your professors and carry some weight that shows what your teachers think of you. Finally, Phi Beta Kappa is a prestigious organization in which membership is limited to students with amazing grades and leadership skills. It is the only honor society that I would recommend joining.

If you disagree with me and feel that you absolutely have to join an honor society, at least pick a reputable one. Many of the phony organizations have low standards of admissions and require large initiation fees. I can’t list their names here for fear of slander, but I’m sure that you know the ones. Legitimate organizations will belong to either the Association of College Honor Societies (www.achsnatl.org) or the Professional Fraternity Association (www.profraternity.org). Be sure to check with these groups before ﬁlling out an application.

Now that you are the Best Applicant, it’s time to apply to medical school.

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