Charting a course to Medical School: The amsa map for Success



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APPLY EARLY!
Practice questions with a friend before interviews. Be sure to be able to answer Why do you want to be a doctor? because they do ask this question. If you can't answer it, you're in trouble.
Send thank-you letters (but not gifts). They can't hurt you, and they definitely can help you. For the medical school, thank-you letters are definitely in order for your interviewer, as well as perhaps the person whose name appears on your interview invitation letter and anyone else at the school who may have helped you during your interview day. At your college, thank-you letters are in order for your recommenders (it may even serve as a sort of "reminder" to any of your recommenders who may be slow in submitting your recommendation) and your premedical advisor.
If you are waitlisted, be sure to continue to express your interest by calling your interviewers, writing letters to the admissions committee, and updating your application with any exciting news (e.g. awards, honor theses, academic transcripts, etc.)
Reapplying
The decision to apply to medical school forces many students to review their values and ethics. It is essential that students aspiring to be physicians have great dedication and motivation. With the arrival of rejection notices, it is expected that the self-confidence of students may begin to deteriorate. In this case, the dedication and motivation within the student must revive the self-confidence. Once the initial decision to apply to medical school has been made, tenacious students must pursue their dreams and reapply.
What if I don't get in the first time?
If you do not get accepted the first time that you apply to medical school, do not worry. It is NOT the end of the world. Take some time off, reevaluate your goals and make sure that becoming a physician is indeed the path you want to pursue. If you know medicine is for you, apply the following year. Medical schools often have so many excellent applicants that it is difficult for admissions committees to determine who will be in their entering class. Not being accepted does not necessarily reflect on your ability to become a physician. It is important for you to be confident about yourself and your desire to become a physician. When you reapply, your confidence and dedication will undoubtedly be even stronger.
In a study undertaken at the University of Texas Medical School at Houston (1), medical school performances of initially-rejected students were evaluated. In contrasting the initially accepted and initially rejected groups, academic and demographic factors made up only 28% of the group difference. The remaining 72% of the group difference was related to admissions committee preference. The procedure of admissions was standard, including faculty interview of applicants with final choice of acceptable students by the admissions committee. Approximately three-fourths of the difference can be attributed to a subjective impression created in the short period of one interview. By accepting fifty initially rejected pre-medical students, the study revealed that there were no meaningful differences in academic performance between initially-rejected and initially-accepted students. This observation implies that the traditional interview process may overlook many qualified applicants. "There are no generally accepted criteria for identification of the 'good physicians,' nor are there valid predictions of effective performance." (2) With this in mind, it is possible for any pre-medical student who is absolutely sure that medicine is her or his future to reapply to a variety of schools with a spectrum of good qualities to find the school that can accommodate what the student has to offer.
If you thought there was a particular area in which you were weak, and this was the primary reason why you were not accepted, you may want to try to improve that area. For example, if your MCAT scores were very low, but all other aspects of your application were outstanding, you may want to consider retaking the MCATs. If your grades were low, then taking more challenging courses and doing well in them may help you to prove yourself academically.
Studying at Foreign Medical Schools
It is widely believed that pre-medical students apply to foreign medical schools only after being rejected from several U.S. schools. In a special article printed in the New England Journal of Medicine, analysts disprove this myth by revealing that fifty-five percent of a study group did not even apply to a U.S. medical school. A possible explanation is that substantial numbers of U.S. citizens study abroad because of the inability of the U.S. medical education system to accommodate them. Students who are interested in studying in a foreign medical school must take a test administered by the Educational Commission for Foreign Medical Graduates (ECFMG). The study shows that the number of U.S. students applying to foreign schools is steadily increasing. In fact, at least ten new medical schools with curricula designed to attract applicants from the U.S. opened in the Caribbean Island countries during the 1970s. The most popular foreign countries are Mexico, the Caribbean, Europe, the Philippines and Israel. There seems to be a fair chance of acceptance to a foreign medical school since the overall pass rate was 68% in 1982 for those U.S. students taking the ECFMG. Students looking at foreign medical schools, though, should be aware that getting into the residency of their choice may be tougher coming from a foreign medical school. Be sure to ask any foreign medical schools that you are interested in for some statistics regarding their students' success in "the match" (the process by which medical students are placed in residencies).
Other Health Careers
If you decide that being a physician is not what you really wanted to do, but you still want to be in a situation where you can care for people in a medical setting, there are still numerous opportunities available. You could follow the academic route, pursue a graduate degree, do research in the biomedical sciences and more! Careers in the clinical setting include public health, physical and occupational therapy, pharmacy, nutrition, nursing, and more. In addition, you could have a profound effect on health care through health policy, epidemiology, and public health. The possibilities are limitless.
Caring for people requires the cooperative efforts of persons in many different areas. Whether you are in a clinical or academic setting, the most important thing is that you are enjoying what you are doing and are dedicated toward improving the care of people in both sickness and health. A physician is only one of many who help to accomplish this goal.


  1. "U.S. Citizens Studying Abroad: Their Backgrounds and Test Performance." D.G. Johnson and others. New England Journal of Medicine. Dec. 11, 1986.




  1. "Medical School Performance of Initially Rejected Students." R.A. Devaul and others. Journal of American Medical Association. Jan. 2, 1987.



Interviewing
The interview factors greatly in the decision making process of an admissions committee. It is important, though, to remember that it is not the only factor. Prior to an interview, the admissions committee only has statistics on a piece of paper to try to deduce what type of person is behind the facts. They use the interview to see if you possess the qualities necessary to become a successful physician.
Interview times range from half an hour to an hour, and often, students are given more than one interview at each school. At some schools, there are medical students who conduct interviews as well as faculty members. The interview day should not be treated lightly. Every activity, from the briefing to tours are part of your interview, and your reactions to everything will be taken into account.
In most cases, the interview is not meant to be a pressure cooker of facts and figures. You, the interviewee, are not on trial (although you may feel like it). The committee is trying to find out what kind of person you are, what your interests are, and what your motivations are. There are a few interviewers who will want to see how you react in stressful situations. When this happens, take a deep breath and think before you speak.
Some interviewers have a standard set of questions, but many questions will come from essays submitted with your application. Be honest in your essay, because the interviewer may ask you to expand on parts of it. If you exaggerate, it may become apparent to the interviewer. Your answers may then become the basis for further questions.
Political and health-related issues may come up, so it would be a good idea to be familiar with the news. (For links to potential issues in the news, be sure to check Today's Health and Medical News published on the AMSA website daily.) Make sure you are able to back up every answer, especially if you are taking a stand on a particular issue. If you do not know what the interviewer is talking about, it is better to be honest and say "I don't know," instead of dancing your way around an answer. Interviewers like to see that you are not too proud to admit that you do not know everything. Remember that the interviewer is usually more knowledgeable than you, and can tell if you are insincere or if you really know what you are talking about.
The interview does not have to be one-sided either. If you have questions in mind about relevant topics, especially about the school, ask them. This shows that you have really taken an interest in the school and also gives you time to relax. The interview also gives you an opportunity to discuss certain aspects of your application.
Remember, the interviewer must be able to present and defend your case to the rest of the admissions committee (either in person or in writing), so they must be able to learn much about you in a short amount of time.
What do interviewers look at?


  • Nonverbal & verbal communication skills.

  • Appearance & behavior.

  • Use of vocabulary.

  • Confidence level & honesty.

  • Sincerity.


What should you do?


  • Ask questions of the interviewer.

  • Inquire about the school.

  • Ask schools in the same area to coincide interview dates.

  • Relax, be yourself.


Additional Resources


  • InterviewFeedback.Com



Financial Aid
Financial aid is becoming more scarce today for students pursuing careers in the medical field. Some alternatives are employment, aid directly from a private source, federal scholarship programs and grants, and federal loans. The funds necessary for medical education today can no longer come directly from medical schools. Students must seek financial aid alternatives outside their college.
Aid granted directly from private sources is very difficult to find. Nevertheless, there are many foundations willing to support your education. The best scholarship foundations are those with large assets located within your state and particular area of interest. For example, some hospitals and other large health-care-providing organizations offer scholarships to students willing to commit a few years of service to their organization ("support-for-service" aid). Some states offer their own loan-repayment programs (largely support-for-service), but these vary widely from state to state.
Federal scholarship programs for medical students are very limited. There are two such programs: The Exceptional Financial Need Scholarship, which requires primary care commitment, and the Financial Assistance for Disadvantaged Health Professions Students Scholarship. In general, scholarships -- gift aid -- are largely need based only.
The National Health Service Corps (NHSC) Scholarship Program is an excellent program sponsored by the United States Department of Health and Human Services Public Health Service. The NHSC offers competitive support-for-service scholarships for tuition and educational fees, books, supplies, as well as a monthly stipend. All citizens enrolled in U.S. allopathic or osteopathic medical schools are eligible. Recipients are obligated to serve in physician shortage areas as assigned by the NHSC. The minimum service obligation for this program is two years. The NHSC gives preference to persons with primary care specialty goals and students who come from disadvantaged backgrounds (and/or come from primary care deficient areas). Highest priority is given to individuals who are former recipients of the NHSC Scholarship Program.
Most of the financial aid money available to medical students comes in the form of loans, e.g. the Federal Stafford Loan for students ($8,000 for two semesters), the Federal Supplemental Loan for students ($10,000), and the Health Education Assistance Loan (HEAL). Other types of loans include MEDLOANS, Health Professions Loans (primary care commitment only), and Loans for Disadvantaged Students.
To receive federal loans you must first find a private lender (all lenders are required to charge the same interest rate on federal loans) and consider the individual nuances of each type of loan in relation to your situation. For instance, although Federal Subsidized Stafford Loans are more difficult to qualify for, the government pays the straight eight percent interest for these loans as long as students do not work; the government does not do this with Federal Unsubsidized Loans.
The search for financial aid is very tedious. The first step is to find out whether your prospective medical college and/or university processes loans and other aid; the second is to seek them out for advice. Most schools have financial aid advisement centers and all schools have an office responsible for processing financial aid. Use both of these resources to create a realistic budget and find advice about locating the kind of aid most appropriate for your situation.
The links below are a good start in your search:
FastWeb (http://www.fastweb.com )

Free scholarship search. Enter in student specific information and keep receveing updates on scholarships offered nationwide.


FinAid (http://www.finaid.gov )

"The smart guide to Financial Aid". A "what's what" guide, good place to start with definitions and explanations.


US Department of Health and Human Services (http://www.hrsa.gov )

Various financial aid programs.


National Health Service Corps (http://nhsc.bhpr.hrsa.gov/ )

Scholarship and loan programs in underserved areas of the US.


US Army (http://healthcare.goarmy.com/flindex.htm )

Career opportunities, scholarship and loan repayment programs.


US Navy (http://www.navy.com/jsp/career/career_details.jsp?cid=1&pid=20 )

Career opportunities, scholarship and loan repayment programs.


US Air Force (http://hp.airforce.com/index_fr.htm )

Career opportunities, scholarship and loan repayment programs.


National Institutes of Health (http://www.nih.gov/ )
NIH Loan Repayment Programs (http://www.lrp.nih.gov/ )
US Department of Health and Human Services: Indian Health Service / Division of Health Professions Support (http://www.ihs.gov/JobsCareerDevelop/DHPS/index.asp)

Loan repayments and scholarships


U.S. General Services Administration (http://www.pueblo.gsa.gov - click on "money" on the left column)

Consumer Information services, personal finance. Good reference.


AAMC (http://www.aamc.org/ )

American Association of Medical Colleges: great section on financial planning.


Access Group (http://www.accessgroup.org/ )

Debt management for graduate and professional students.


Sallie Mae (http://www.salliemae.com/ )

Lender, good info for students.


Credit Report Information

Equifax (http://www.equifax.com/ )

Experian (http://www.experian.com/ )

TransUnion (http://www.transunion.com/ )



AMSA Medical Student Debt Resources (http://www.amsa.org/AMSA/Homepage/About/Committees/StudentLife/StudentDebt.aspx )

Non-Traditional Applicants
The seemingly endless and arduous path to becoming a physician has been worn out by the traffic of a homogeneous mass of "traditional" students. These sojourners were the ones who attended college the four years immediately after graduating from high school and then proceeded to enter medical school without taking time off to explore other interests. Recently, many detours have attracted potentially traditional students off the worn path into new fields. These forerunners have charted new pathways leading to the legendary treasures of medical schools. Nowadays, medical schools have the luxury of choosing their classes from a high quality applicant pool, the members of which can offer diversity, special talents, new perspectives and character to any university. Becoming more and more accepted are these students who break from the pack and take a year or more off from academics to satisfy other pursuits, stay an extra year at their undergraduate institutions to obtain a more encompassing background, or work for a while to earn money before applying. Others trek back to academics after taking time off to raise a family, realizing their discontent with their current occupation, or even being initially rejected. Still others are nontraditional in the sense that they decide to cross the oceans and apply to foreign medical schools.
A Student's Experience
Pre-meds often wonder if it's a good idea to take a little time off from academics to reevaluate their commitment to medicine without it adversely affecting their application later. Other students consider it a risk to stay an extra semester or year at their undergraduate institutions in terms of both delaying their entrance into medical school and again affecting the application itself. Still others contemplate working for a year after graduating to either gain experience, put to rest their doubts about the medical profession, or earn some money for the expensive schooling that lies ahead. First year Stanford University medical student Amy Alkire has had a pre-med experience that addresses all these situations. Amy finished her first two undergraduate years at Smith College and then took a semester off to work, earn money, and reevaluate her goals. Then she transferred to the University of California at Berkeley, staying for two and a half years, and after graduating, worked for a year in the Department of Radiology in the University of California at San Francisco. During this time, her interests ranged from writing to animal research to neurobiology.
Amy's semester off was spent working two jobs: the first as a retail salesperson at a local variety store and the second as a receptionist at a medical office. This time off from academics helped reinforce for her the value of education. Then, while she was at UC-Berkeley, she took advantage of the educational opportunities by taking at least one humanities class per semester and staying an extra semester to get a complete education. Amy remembers thinking as an undergrad when she took time off, "How is this going to affect what the medical schools thing of my application?" She said that everyone had a different opinion. At a certain point she decided that she had to do whatever she needed, and if the medical schools had a problem, then she would just keep applying.
Aside from giving her experience and valuable talent, Amy's position in the Department of Radiology at UCSF during the year immediately following her graduation served as the final decision-making step in committing her to the medical profession. She admits that getting such a position should not be counted on, but don't take the opportunity lightly if it's offered to you. She adds, "people just really need to feel comfortable doing whatever they need to do and they need to make the decisions that are important to their lives as they see it rather than forcing themselves to figure it out when they ar twenty. If you decide you need to take the time out to figure out whether you want to go to medical school or not, then that's a very sincere thing to do. It's still very honest, and I think it will help more than it hinders."
What Amy learned from having that time off affected her views about the medical profession and her views of medicine as a job and a commitment, both of which made an impact on her perspective as a mature, experienced adult. Medicine became an occupational as well as an academic field. In this way, her "diversions" most affected her as an applicant. It's not a question of recommending this course of action. The message from medical schools in terms of admissions is that people shouldn't be afraid to do whatever they feel they need to do."
Once a student gets accepted to medical school, he/she will be in a class with perhaps a couple of nineteen year olds and several students over thirty, with most students between the ages of twenty-one and twenty-four. How does a "nontraditional" student fit in? Surprisingly well. Amy says that at Stanford, and probably at many other medical schools, most students actually have taken two years off away from academics to search out and develop a particular interest that they have.
Performance-wise, there are definite differences. "Traditional" students who may not have experienced much else outside the classroom tend to get more stressed. They are more critical of themselves in terms of how well they do. The older students may be a little anxious and unsure because they haven"t done this much studying for a while. But for them to consider beginning medical school at their age, they must be committed and could possibly contribute some experiences and talents that younger students cannot. Those who have taken perhaps a couple years off, such as Amy, realize that they can still turn to other professions if they need to. This helps them get through medical school without feeling overwhelmed.
Older Applicants
The childhood longing to become a doctor has resurfaced, but this time it is here to stay. Now that the decision is final, there is one stop left, apply! The older student may experience more difficulties and criticism than traditional younger students. This is because they may have responsibilities to a family or a previous occupation. The admissions officials may question the late decision to enter medical school and the ability of older students to compete with intense, fresh students. On the other hand, older applicants have an edge over the naive traditional students. With the experience of life or another profession, many older applicants have unique talents to offer medical schools. Qualities and skills learned from other interests during the past years may be decisive assets to entrance into medical school. For example, Dr. Melvin Konner entered medical school at the age of 33. He had always wanted to be a physician, but early in his life decided to study human behavior by becoming an anthropologist and then a Harvard professor. He is a well-known scholar, tenured professor, respected writer (cf. The Tangled Wing and Becoming a Doctor), husband, and father. Using his life experiences and his versatility, Dr. Konner easily impressed all the admissions officers and accomplished his life goal of becoming a physician. His book, Becoming a Doctor, is inspiring and may be useful to those leaning towards a medical profession.

Minority Applicants
Applying to medical school can be a difficult and anxiety-producing process. For minority pre-medical students, there are often additional issues to be considered in the application process. Although factors such as location, curriculum and cost are of key importance to any student selecting a medical school, it is also important to investigate such issues as recruitment and retention of minority students at a particular school under investigation.
It is often extremely important for a minority medical student to have the support of a strong minority affairs office and other minority students at your medical school. Often the number of minority faculty and housestaff at most institutions are scarce, if not non-existent, increasing the importance of these support bases.
It is important to get a feel for these factors in your interview as well as during visits to schools to which you are applying. Many schools sponsor special weekends for accepted minority students which gives you an additional opportunity to address these issues, as well as to interact with minority students already enrolled at the schools. Remember, you are choosing the school, just as it is choosing you.
It is recommended that you seek as many sources as possible to get differing viewpoints and further advice.
For additional information, you may want to contact the American Association of Medical Colleges (AAMC). AAMC publishes a yearly guide entitled "Minority Student Opportunities in the United States." This is an excellent book which lists, by school, numbers of minority students enrolled, minority affairs office contact persons, and summer programs designed for minority pre-medical students.
Interviewing Tips
The interview trip can be a truly informative experience and it is important to approach it with well-defined goals so that you can get the most out of it. When interviewing at a school, try to arrange to stay with a minority medical student. Many schools have systems set up to arrange such a match and allow you to meet with other minority students at the school on the interview day. Also try to set up a meeting with the minority affairs office director/dean and financial aid office.
Financial Aid
Minority students graduate with higher than average debt when compared to the general medical student population. It is important to seek out sources of financial aid to help tackle this problem.

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