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January 18, 2016

Six Essential Lessons for Getting Into Medical School - Part 2

By: Rob Humbracht

Last week, we dove into the first three lessons that successful students can teach us about how to get into medical school.  Let’s continue with our final three lessons:

4.  DISCOVER WHY DOCTORS ARE INCREASINGLY CYNICAL ABOUT A CAREER IN MEDICINE.

"Why on earth would you want to be a doctor?  It's not the same profession as when I got into it."  This was a quote from a doctor that one of my students was shadowing, and by the time you apply to med school, you will probably have a similar interaction.  

A great article in the Wall Street Journal summed up some of the discontent expressed by doctors:

"Today medicine is just another profession, and doctors have become like everybody else: insecure, discontented and anxious about the future. In surveys, a majority of doctors express diminished enthusiasm for medicine and say they would discourage a friend or family member from entering the profession. In a 2008 survey of 12,000 physicians, only 6% described their morale as positive. Eighty-four percent said that their incomes were constant or decreasing. Most said they didn't have enough time to spend with patients because of paperwork, and nearly half said they planned to reduce the number of patients they would see in the next three years or stop practicing altogether."

Source: http://www.wsj.com/articles/the-u-s-s-ailing-medical-system-a-doctors-perspective-1409325361

This quote isn't meant to dissuade you from becoming a doctor; rather, I want you to look hard at the profession to determine whether you're trying to become a doctor for the right reasons or for the wrong reasons.

THE RIGHT REASONS FOR BECOMING A DOCTOR:

  • You like helping others* (also on the wrong reasons, see below)
  • You love science
  • You like making tough decisions
  • You love being the best, being the leader of a health care team and striving to be at the top of any endeavor you take on
  • You have a high tolerance for paperwork and administration
  • You don't mind blood, guts, and gore

THE WRONG REASONS FOR BECOMING A DOCTOR:

  • You like helping others

why: You can help people in lots of ways.  Go be a physician's assistant.  Go be a teacher.  It's great that you want to help, but if this is the only reason you want to become a doctor, it's not enough.

  • Your family wants you to become a doctor

why: This reason is not enough to sustain you through impossibly long days and nights in medical school, residency, and beyond

  • You think being a doctor will make you well-respected

why: Doctors are increasingly looked upon as just another profession, not commanding the automatic respect (at least in the US) that they once did

  • You want to make a lot of money

why: the cost of medical school ($200,000+), the low pay during residency, and the decreasing salaries of physicians make this a dicey proposition

Everyone's reasons for choosing medicine will differ, but you will be more likely to get in (and more likely to stick with your career choice once you’re in) if - before you apply - you acknowledge the problems doctors face these days and why those problems do not deter you from wanting to join the ranks of the cynical.

HOW SHOULD YOU DISCOVER YOUR OWN REASONS FOR BECOMING A DOCTOR?  

a) shadow a doctor (most doctors will allow you to shadow if you ask politely).

b) volunteer in a clinical setting

c) become a medical professional (a scribe, an EMT, and a phlebotomist all get to interact with doctors, and each requires only a brief training course)

d) volunteer abroad (volunteers in the US face restrictions about what they're allowed to do; volunteers abroad, not so much).

5.  DO AT LEAST SOME RESEARCH.

You don't have to do research to get into medical school.  Some schools accept up to a third of their class with students who have never set foot in a lab.

Other med schools, though, are very research-oriented.  Here's a list of the top 10 medical schools for research:

THE TOP 10 MEDICAL SCHOOLS FOR RESEARCH

  1. Harvard
  2. Stanford
  3. Johns Hopkins
  4. UCSF
  5. UPenn
  6. WashU (St. Louis)
  7. Yale
  8. Columbia
  9. Duke
  10. tie - Chicago (Pritzker)
  11. tie - Michigan (Go Blue!)

It's a safe bet that to have a good shot of getting into any of these research-oriented medical schools, you need to do (and excel in) research.  This is not to say that these schools exclusively look for students who excel in research (medical schools are communities that value a variety of perspectives).  But because of the quantity of research dollars at these top research schools, they offer more opportunities for students who want to participate in research, and as a result, they will often seek students with a strong research background to fill those opportunities.

On the other hand, schools that are more focused on primary care will be more willing to consider candidates with weak or no research:

THE TOP 10 SCHOOLS FOR PRIMARY CARE

  1. University of Washington (Seattle)
  2. UNC (Chapel Hill)
  3. UCSF
  4. Nebraska
  5. tie - Oregon Health and Sciences University
  6. tie - Michigan (Go Blue!)
  7. UCLA
  8. Colorado
  9. Wisconsin (Madison)
  10. Minnesota

You may notice that two schools appear on both lists: UCSF and Michigan (Go Blue - sorry, can't help myself as a Michigan grad).  Like many med schools, both schools have a strong research program and produce many graduates that go into primary care fields.  In this case, they may accept students into a primary care-oriented track without requiring that they have much research experience while taking other students with extensive research backgrounds.

Just because you CAN get into med school without doing research, though, does not mean you shouldn't.  Every medical school says they value research experience, and it's an important experience in the path to becoming a physician.  Understanding the painstaking - and uncertain - process of creating new knowledge in science helps complete your own understanding

My recommendation is to try research for at least a summer or a semester, and if it's not your thing, then don't worry about continuing for longer.  If you enjoy it, then by all means keep doing it, as it is indeed helpful for your chances of getting in, especially at the more research-oriented schools.

HERE ARE SOME TIPS FOR HOW TO GET MEANINGFUL RESEARCH EXPERIENCE:

a) Find a lab that has lots of undergrads.  You're going to have to pay your dues at any lab, but labs that have lots of undergrads will typically be places that give meaningful experience to those who have worked there for a while.

b) Use your connections to find a lab position. Have a professor whose class you enjoyed?  Take him or her to coffee and ask whether you can help out in their lab.  Or maybe you know an older pre-med who's about to leave for med school.  See if you can take over the position that she's vacating.  Rather than apply for positions online (like everyone else), using a connection can help make you more comfortable with knowing what to expect and help the PI trust you from the start.

c) Look for opportunities to do research for credit.  Many (most?) universities offer a program like this, including:

* BISP 199 at UCSD

* URAP at Berkeley

The beauty of these programs is that they often require that the participant (i.e. you) get meaningful exposure to research design, which medical schools love to see.

Have tips about how you've found a great research opportunity? We'd love to hear from you. Share with us on Facebook, Twitter or comments at the bottom of this article. We'd love to get additional tips to pass along to future pre-meds.

6.  BE PATIENT.

It's a long road, not just for getting into medical school but for becoming a doctor.  You're inevitably going to face setbacks. You'll get a bad grade or two. You won't do as well as you'd like on your MCAT.  You may even be among the majority of people who get rejected the first time around. You will probably worry a lot that what's happening to you will ruin your chances of getting in, but in all likelihood, you'll be wrong.

Obstacles take time to overcome. You may fall off the original timeline that you set for yourself when you first decided to apply to medical school, but you'll get there eventually.

A COUPLE OF STATISTICS TO HELP YOU KEEP THINGS IN PERSPECTIVE:

  1. The average age for those entering medical school is 24 years old. That means the average student takes two years off between undergraduate and medical school.
  2. During the 2015-16 application cycle, a full 27% of all applicants (14,000 of the 52,500 who applied) were re-applicants. In other words, if you have to apply to med school again, you’re not alone!
  3. There are several international and Caribbean medical schools with USMLE pass rates above 95%. In other words, while it’s not ideal, you can absolutely still become a practicing physician in the US after attending a school abroad. For more information see our previous articles:
  4. The Best Caribbean Medical Schools
  5. The Best Non-Caribbean International Medical Schools

Getting into med school is indeed tough, but tens of thousands of students get in every year, and so can you. Make smart choices, stay focused on what you can control, and keep grinding away, and you should be able to make your dream come true.