Feedback from a parent whose kid recently went through the med school application process

Pre-Med & Medical School Pre-Med Topics
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Kid applied to med school, and got in, to go straight through from college, and learned some things in the process. What we learned may not be as applicable for those who are being preferentially admitted, but for those not in one of those categories, the following info may be useful.

Unless you have some reason to be admitted preferentially, you need to meet some minimum standard, whether specific or undefined, in several areas. GPA. MCAT score. Meaningful volunteering. Meaningful clinical contact experience(s). Something that you can call “leadership”. Research. The simple fact is that med schools want you to at least check the box on this, and better yet, have your name on published papers.

For those who are in undergrad, or about to start undergrad, and are not already in a BS/MD program, realize that, currently, having research (and preferably, your name on some publications) is crucial, even though the reality is that probably >95% of physicians will focus on treating patients, and not on research. (This is even more of an issue when applying for residency - it’s gotten so out of hand that “how to stop the research arms race” has become a very hot topic of conversation among residency program directors.) This is something that one needs to start exploring as soon as one gets to college, because it cannot happen all at once, over a summer. It takes time to make the connections to get involved in a research project, time to run it, time to get it presented as a poster at a meeting, time to get it published. Unfortunately, it’s not always the quality of the research that’s important - it’s simply the fact of being able to truthfully put it on one’s application, and better yet, have one’s name on a publication or even more than one. It takes a lot of time and effort to do this, but no matter how strong the rest of the application, no research, no interview.

MCAT prep doesn’t start right before you take the MCAT. It can/should start as soon as you start your premed courses. Learn about ANKI and other online prep question banks like U world before you start your premeds, and get access to the decks for the subjects you’re taking, while you’re taking the class. The student who is doing the ANKI decks or UWorlds or other appropriate review questions for that specific premed science while they take the class, and then continues to practice using these prep resources to maintain their knowledge, is going to be setting themselves up for a very high MCAT score, without the massive 3-6 month full-time prep that most students need to do well on the MCAT. It takes some discipline to get in the routine of doing, say, an hour or even two of ANKI or UWorld review every day, but this is the path to a very high MCAT score, for a student who intends to go straight through, and needs to take the MCAT in the early spring of junior year, without taking two gap years so one can prepare for it after one is out of college. The question banks help the student to focus on the specific material and format tested, without wasting time later on on unfocused subject review. Reddit and Student Doctor Network will have the latest advice on the best resources to use for this.

Of course, the student also has to have meaningful volunteering hours, clinical hours, and a high GPA. They also should consider the schools that they are targeting, and meaningfully shape their experiences and application to match the school’s mission of what type of clinician they’re trying to produce. Schools that hope to produce rural primary care physicians who intend to stay in that locale are not looking for the candidate whose clinical, volunteering, and research experiences are in a specific fellowship-trained specialty.

Many schools require a “situational judgement” test - the CASPER or PREVIEW. The schools use these in an attempt to weed out candidates who lack certain skills (ethics, judgement, professionalism, etc.) that are necessary in medicine. The problem is that these tests have not been validated; in fact, it is not that unusual for a student who takes both of them to get a very bad score on one, and an excellent score on the other! Too bad, this is the game, and if you want to apply to schools that use these tests (and most now do), you have to play it. One can most definitely prep for these tests, and learn what is expected as an appropriate response, in order to get an okay score. The good news is that it appears that schools are only using this as a weed-out, meaning that only those who rank quite badly (bottom quartile) in comparison to their peers, might be adversely affected by their results on these tests. So while it’s necessary to take them, it’s not that difficult for most students to do enough prep to learn how they have to answer, in order to not be in the worst category.

Hoping that what we learned, in the process, is of some use to others who are early enough in their premed path for it to make a difference.

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The research arms race came about after STEP 1 became P/F and RDs needed another way to stratify residency applicants. So Step 2 became more important, but so did other factors, in particular specialty specific research for certain competitive specialties. (Undergrad research really isn’t considered for residencies. Not even publications.)

If you want to read how a Yale RD ranks the applicants his department interviews:

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RE: SJTs have been validated.

Canada uses CASPr extensively and has found it has moderately predictive relationship with how a physician scores in certain section of the Canadian national licensure exam assessing personal and professional characteristics years after the test-taker originally took the test.

https://www.researchgate.net/publication/379305837_Incorporating_a_situational_judgement_test_in_residency_selections_clinical_educational_and_organizational_outcomes

Also UColorado’s Physician Assistant program uses CASPr for screening applicants for professionalism and found there was a “statistically significant” correlation with a negative CASPr score and a student later receiving a professionalism infraction.

Additionally, AAMC’s research shows that while MCAT and GPA are good indicators for academic risk in med school, PREview scores were strongly predictive of whether a med student is likely to be terminated for non-academic (professionalism) reasons.

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Can you elaborate on this? Who are those who are preferentially admitted?

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Could you elaborate on your research comment? I have a friend on faculty at a major med school and they are very dismissive of undergraduate research as a meaningful part of med school applications. They felt that strong clinical experience carried much more weight in the process. My nieces pre-med advisor made similar comments to her when she was planning her gap year.

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I can name 10 friends who are faculty in medical schools who are not dismissive of undergrad research.

Research is like sports. We all “play” a sport, but we recognize when someone is truly talented, engaged in something interesting and worthwhile and “usually” can spot a poser who did something for resume buffing. Most research undergrads do for a summer, is not meaningful – we know you can’t get anything done in a few months. Anything student has to pay is worse.

But the student who worked in a lab for years, can explain a big picture understanding of the work, may have presented a poster or two, doesn’t need a paper published, and can get the faculty to write a letter, that is helpful.

And your comment on clinical, unless a student is connected, I doubt someone can just walk into a hospital/clinic and start doing “strong clinical” work. Exception is the people who took time to work as EMT, lab tech, Phlebotomy, CNA while going to school. We’re not impressed about the “clinical” part, but just you have the time and can balance school and work.

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The comments were basically this (the above), not that (research) and came from my friend who is on faculty at a T10 med school and my kids advisor (who is a Harvard med school grad and work at Harvard for years before moving to my kids school). My kid attends a SLAC with a very high med school admissions rate.

I am asking because my niece and nephew both did the ‘heavy research’ route at their large R1 and didn’t do nearly as much of the above other than scribing/medical assistant during their gap year. One had great results, the other not so great results.

I am genuinely confused on this one.

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Research is only a part of “the package.” The proverbial saying, do not place your eggs in one basket hold true.

But from what I know, most undergrad who do research do not appreciate the “what” as much as the “do” and many are unable to intelligently discuss their research and that is more of an issue, than to have spent time in a lab instead of pushing a wheelchair around a hospital or be a shadow.

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Many DO schools interview and accept tons of students with no research experience.

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So do many MD schools.

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