How to Get Into Medical School

Once in a while, I interview pre-med applicants to my school. While the medical students' evaluations are probably influential as only a low-NPV serial-killer screening test, I still very much enjoy doing them. This is because, if the applicants are eventually admitted, I get profuse thank-yous and friendly hellos for the entire subsequent year. Other than this experience, I have no knowledge whatever on the inner workings of the admissions chambers, so my insights are based on some post-call Gladwellian blinks.

Please note that Numbers 1 and 4 should not actually be followed by anyone, and are akin to obtaining a Golden Ticket by serially eating thousands of candy bars, or harassing hundreds of factory employees to unwrap them. It's just not worth it.

1) Take Physics for Poets.
And Literature for Actuaries. PE for Hobbits. Enroll in the easiest courses that fulfill pre-med requirements, and for which you almost certainly can earn an A- or above. The caveat here would be that you'd have to choose a somewhat traditional-sounding major, so it cannot be Fashion Merchandising, Liberal Studies, or Communications. Slightly newer, but still well-respected (and sometimes difficult, depending on your school- be careful!) majors, such as Women's Studies, as well as many interdisciplinary majors (i.e. Latin-American Studies) are considered fine.

My reasoning here is that, when it comes to course-work, admissions committees care mostly (though not exclusively) about Overall and Science GPAs, as well as a notable absence of Cs. A B- in "Physics for Future Nobel Laureates" is worth less than an A- in your standard Calc-based Mechanics course. Don't take any high-stakes gambles.

(For those now tuning in: Do NOT actually follow this advice. Take 4 years of Russian, a Combinatorics class, and a seminar on James Joyce. Keep your life joyous and a bit irrationally exuberant.)

2) Do your Undergrad at State School.
State school makes sense in general, and especially so if you are pre-med. It's generally easier to get an A in the science classes there. I know this statement may draw some contrarian personal testimonies from people who attended The University of Somewhere. The thing is, I know that many of the kids there are just as smart as the ones in Someone University, and that the teacher quality is likely the exact same. But the same student can often be in the top 10% of his Orgo class in a public school (also improving his chances for getting an excellent recommendation), rather than in the middling middle of an equivalent Ivy course.

3)Sign up for at least one test prep program, but not for any live classes.
Study by simply doing as many sample test questions as possible, starting on day one. Then go over the explanations and the reading material for anything you get wrong. You may get many or most questions wrong in the beginning. Still, do not waste time reading through the review books before you start taking practice tests. Take your MCATs in April, not August. Try to get at least a 30, unless you funded your school's infectious diseases institute (Treating Burmese children suffering from infectious diseases is not an acceptable substitute).

4) If Short on Time, Don't Dedicate a Huge Amount of Time to Clinical Experiences
While you should have some shadowing or hospital volunteering experiences, you do not actually need much of it. An EMT who has transported five patients looks roughly the same on an application as an EMT who has worked since age 16, has delivered a hundred babies, and can already interpret EKGs. The AMCAS does ask you how many hours per week you spend on each activity, but 5 hours vs. 10 hours per week probably doesn't get noticed. If stressed and cynical, think of marginal benefits.

(Repeated disclaimer: This advice is about what gets you into medical school, not about what you should do. To become a good doctor, take advantage of every opportunity you can to gain clinical experience. Some people cut corners without any one else ever noticing, but don't allow your values and ambitions to conform to this strategy).

5)Be Specific in your Essays.
When answering questions for your secondary applications, do not write "I am passionate about..." Have a strong, unique opening, even for those one paragraph answers. When addressing why you want to attend a particular school, refer to specific professors or programs. Don't use generic phrases like "Exceptional academics," "Excellent location," or "Outstanding research." Instead, say that you've always admired the [Insert Name] Free Clinic that Dr. [Insert Name] started, and you would like to volunteer there because he sees a lot of patients with [Insert medical condition], which is a disease you may want to specialize in.

(Don't lie. No one will ever know whether or not you are truly interested in that clinic, but to maintain your dignity, try to identify specific features of a school that you do actually care about.)

I know my take on medical school admissions is a bit cynical. However, even the most caring and mission-minded committee members must focus one eye on the US News rankings. The subsequent diplopia means that the theoretically best choices for pre-meds are not necessarily those that insure a successful application. If you find yourself sacrificing too many opportunities, I'd recommend dropping pre-med, enrolling in PA school, keeping your specialty of choice, and becoming a happy, dedicated, and productive clinician.

Application Essay Advice for Pre-Meds

Because it's pre-med season in town, I will try to post some advice for applicants trying to get through it unscathed. My first topic is about the AMCAS essay.

My suggestions are:

1) Tell a story

2) Feel free to brag, but be descriptive and specific (Not "I worked closely with patients," but "I held so-and-so's hand when she tearfully told me that she was ready to enter the OR."

3) Avoid phrases like "The experience taught me..." and "It was rewarding because...." Just make those things implicitly clear through your writing.

4) Show, don't tell!

Savvy readers will note that all of the above snippets of advice are basically the same. But that is because pretty much all boring application essays make the same mistake.

Pretend you're trying to impress the hot girl in Italian class. Are you going to pick her up by listing all of your extra-curricular activities, or by just making her feel like she'd have fun going kayaking with you this weekend? In other words, show your personality, not your CV.

And now, for your final viewing pleasure, my AMCAS essay. (All of the names that appear in the essay are names of people I met that summer, but none refer to the actual child being described. I will readily admit that I'm a bit of a braggart in the essay, and I will trust my audience to assume that I don't usually try to come off like I have all my **** together (which I don't). I should also note that, although I did at the time want to do international medicine, I am no longer sure that that is the case):

Exiting the subway in the Brownsville section of Brooklyn to begin my first day as head of a camp infirmary, I conjured up childhood memories of my own camp's infirmary, where scraped knees earned Ninja Turtles band-aids, and sore throats were soothed by a good dose of ice pops. This reminiscence, however, was tempered by recollections of my previous summer as an EMT serving in an economically disadvantaged neighborhood in Israel. The realities of domestic violence, acute physical illness, and emotional dysfunction in a population of Ethiopian and Russian immigrants, Ultra-Orthodox Jews, and Israeli-Arabs had dispelled my naive notions of emergency medical care. Would my experience in East New York also bring unexpected challenges? These musings were cut short by my arrival at a dilapidated public school building on a graffiti-filled block, with throngs of boisterous children running around in Camp ******* T-shirts.

As the individual responsible for the physical well-being of the campers, I felt that my primary task was to secure a safe and healthful camp environment. Thus, after helping to organize game of "Simon Says" until all the counselors arrived, I found an unventilated storage closet to function as a medical office, brought in a fan, and, over time, decorated the space with the children's artwork. Ascertaining that there was only one working water fountain for over 100 campers, I coordinated with the counselors to supervise the ongoing refilling of the children's water bottles. After noticing that soap was absent from the bathrooms, and learning that the facilities staff were too budget-strapped or overloaded with work orders to replace them, I bought and allocated soap myself. Finally, I aimed to make the medical office a safe haven for the kids, often playing games or reading with my visitors.

I soon discovered that, while there were few medical emergencies in the camp, there were plenty of ethical, practical, and cultural challenges confronting me. What should I do if, before breakfast, a child says that she is starving because she did not eat dinner the night before? What was my role if a mother told me that she cannot bring her child to the doctor because she lacks health insurance? What of the child who is afraid because she says that her brother often beats her mother? How do I effectively empathize with a child who suffers from sickle-cell anemia? Many of these problems, such as violence, depressive moods, and general illnesses can be found in any community, rich or poor. However, some issues were disproportionately prevalent as this was an economically disadvantaged community.

When I encountered these complex issues, I often dealt with them by consulting with my supervisors and peers. The counselors were role models for me, as most of them were college students from the neighborhood, and brought a wisdom born of experience. At other times, I relied on my own judgment. As an oldest child in a family whose youngest brother is fifteen years my junior, I have had my share of dealing with interpersonal conflicts, scraped elbows, and negotiated truces. Thus, when it became clear to me that five-year old Bianca was manufacturing the illnesses that required her visiting me during reading session, I proactively offered that she read with me during that time-slot.

What impressed me most of all that summer was the incredible power of a caring community. Despite the difficult realities surrounding them, the children were ambitious, intelligent, friendly, and playful. Many would pass my makeshift office, and announce, somewhat inaccurately, "Hi nurse!" Tafari informed me whenever he won relay races, while Kyana always showed me new stickers, earned for good behavior. The parents were kind and supportive, as evidenced by their filling the auditorium on "performance day," as well as the generous home-cooked soul food that they brought.

This interface of medical practice and real-life ethical and practical challenges draws me to public health, international medicine, and perhaps, specifically epidemiology. I want to address issues such as the Ebola virus or the effects of unsanitized water, but also how to make health care economically efficient and sustainable, and to explore the relationship between doctors and the communities they serve. I hope to listen to patients talk about their lives, their assessment of their illness, and their collaborative thoughts on the healing process.

On the last day of camp, many campers came by my office to sign messages on my staff T-shirt. This included eleven-year old Najee, who, while recovering from a stomach ache, had related to me some difficult emotional issues that she was facing. I had developed a good relationship with her and encouraged her to visit the camp social worker. Najee's note to me summed up my goal for the summer and my future goal as a doctor- to develop a meaningful relationship with each patient: "Dear nurse," she wrote. "Thank you for letting me talk in your office and listening to me.”