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Premed Advising

Advice from a CSUF Alum and Physician

The following article was written in 1994, but the advice applies today. Now, the MCAT is now an online exam offered on 19 different days, but the advice to have the primary application and MCAT scores available as soon as possible is sound for increasing your chances of admission.

Getting Admitted to Medical School

A Guide for Premedical Students Attending CSU Fresno

Written by:
Matt Mazurek, B.A., English, CSU Fresno, Class of 1994
[Updated information provided in brackets]

Welcome to California State University, Fresno! If you are reading this guide, you have every intention of becoming a doctor in the future. As a premedical student, you have many decisions to make in the next few years, but right now, you want to know how you can increase your chances of gaining admission to medical school.

[For any given medical school, there are around 6500 applications for roughly 100 seats, an acceptance rate of around 1.3 - 2.0%. Therefore, getting into any one given med school is quite difficult. However, in the academic year 2010 - 2011, there were 42,742 applicants to US medical schools, and 18,665 of these were admitted, which gives an overall admission rate of 44%. This is why most applicants to med schools apply to, on average, 25 different schools: while chances for admission to any one school is quite low, overall chances are much better if applications are made to a broad spectrum of schools.]

What you can do as a premedical student is make your application as strong as possible and hope a medical school accepts you. This guide will help you make important decisions and provide insight into the process of "getting in."

So, how can you increase your chances of gaining admission to medical school? First, buy a copy of the Medical School Admissions Requirements or MSAR (available in the Kennel Bookstore). [A copy for your perusal and online access to the data on the website can be found at the Science and Health Careers Information Center, Science Building 1, room 136.] It contains valuable information for pre-meds on the medical schools here in the United States and Canada. You will refer to it often while applying, and even though you are just starting, reading a current copy will help answer many questions you now have. Second, read the rest of this guide. Third, see the College's premed advisor [Dr. Riley].

One of the most important factors determining your chances for admission to medical school are your undergraduate and/or graduate grades. If you have a GPA below 3.3 at the time you apply to medical school, your chances for admission are significantly less. If your GPA is below a 3.0, your chances are less than 2%. Getting the highest GPA is possible is your goal! I cannot emphasize this more. Many books have been written on how to get good grades, but remember there is no substitute for hard work, and studying smart is more efficient in the long run.

When you apply to medical school, your GPA will be broken down into a non-science and science GPA. In other words, medical schools have access to two different breakdowns of your undergraduate record. All of your science and math courses will be lumped together and a separate GPA will be calculated often called the BCPM GPA (B for biology, C for chemistry, P for physics, and M for math). All other courses will be lumped together for a non-science GPA. Without a doubt, applicants with low science GPAs and high non-science GPAs have a more difficult time gaining admission.

Preferably your non-science and science GPAs will be relatively close (within .1 or .2 grade points). You will appear to be a student capable of handling any new material effectively. If your science GPA is significantly lower, this is a "red flag." It means you have difficulty with science courses, and you already know medical school is nearly 100% science!

In conclusion, get A's in all your courses. By earning a high GPA, you increase your odds of gaining a coveted position as a medical student.

Choosing a Major
The myth about a pre-med major is still a popular one. There is no pre-med major. All you need are the core prerequisite courses to apply to a medical school. Some schools require an additional year if upper-division biology. Here at Fresno State you may take the courses listed.

Biological Science 1A and B; Chemistry 1A and B; Physics 2A and B or 4A, B, and C.; Organic Chemistry 128A and B AND 129A and B; English 1 and 20, or 30, Math 75 and 76.

Recommended Courses:
Biological Science 140A and B, Biochemistry, and Physiology.

For the MCAT, Physiology will help you a great deal!

Some schools require calculus, Math 75 and/or 76. UC Irvine requires Biochemistry and UCLA strongly suggests you take Biochemistry. (Check the Medical School Admissions Requirements for each school's specific requirements).

Once you take these courses and have a Bachelor's Degree in any major, you are considered qualified to matriculate to most medical schools in the United States.

The "rumor" is true: English, philosophy, history, and music majors have higher acceptance rates typically above 50% (check the MSAR). Believe it or not, biology majors have one of the lowest acceptance rates at about 35%. [This may be because there are relatively few non-science majors who apply to medical school compared to science, and especially Biology, majors.] Knowing this, don't let it influence your decision on what you want to study. If you like biology, by all means major in it because you will enjoy it, and if you enjoy it, you'll usually get better grades. Think of it this way: would you want to spend four years studying a subject you have little interest in? Just pick a major you like and can succeed at. If you decide to major in humanities, your science grades in the prerequisite courses become very important. One "C" grade can significantly drop your science GPA. If you major in a science, however, one "C" grade can be offset by several "A" grades in upper division courses.

Volunteer Activities
Volunteer activities show medical schools you have the desire to find out what you are getting yourself into. There are some premeds who only want the glory of becoming a doctor, believing such shows as ER, John Quincy, M.D., and Chicago Hope are truly realistic representations of what being a doctor is like. The only way to find out "how it really is" is to volunteer in a doctor's office, local emergency room, or clinic. You'll prove you have the motivation to become a doctor, assist others, and you'll see if the job is really what you thought it would be. As a result of volunteering, if you don't think medicine is the career path for you, you won't continue to waste your time trying to get into medical school.

What if you volunteer at the Poverello House, Big Brothers/Big Sisters, etc.? If you have volunteered or want to volunteer for any of these organizations, do it! Any willingness to help others is the hallmark of a good physician. However, at least one of your volunteer positions should be in a medical setting.

So when should you start volunteering? Now! The sooner you volunteer, the more hours you can put in as a volunteer and you will look eager and enthusiastic. Medical schools know the difference between volunteering for two years versus a last minute decision to volunteer for one month or two. Don't delay and once volunteering, stay committed! It is far better to have one or two long term volunteer positions than a long list of short ones. Admissions committees want committed applicants, not ones who think a smattering of many activities make them "look good." I know of one candidate who was a member of two dozen clubs and participated in a dozen activities. He put all these activities down on his medical school application. No doubt, admissions committees were suspicious when they looked at the myriad number of activities he was involved in. I added up the total number of hours he was involved, and it exceeded the number of hours in one week! Obviously, padding your application won't help you. Pick a few activities and do the long hours necessary to do a good job. You'll so more for the organization, yourself, and others if you don't spread yourself too thin. The keyword here is quality, not quantity.

Extracurricular Activities Join a club and become an officer. Being a member and being an officer require entirely different responsibilities. If you can become President of the Chess Club, Democratic Students, Fellowship of Christian Athletes, etc., etc., more power to you. Leadership skills are a big plus on any application because it demonstrates your ability to handle responsibility and juggle a busy school and/or work schedule.

Hobbies are another source of spicing up your application. Do you build clocks? Flyfish? Build telescopes? Perform magic acts? Collect baseball cards? All of these activities are who you are and what you do. They make you interesting, and if an interviewer or admissions committee sees unusual hobbies or interests, you'll likely stick out in their mind. Sticking out from the rest if the pack is exactly what you need to do, so always list your hobbies on your application and in your fact sheet when you ask for letters of recommendation.

Work Experience
Some schools ask you to list your work experience, and on the AMCAS (American Medical College Application Service) application, you'll find a large blank space on the front page for volunteer and vocational experience. No matter what job or jobs you have done, list them. Working and going to school is not easy, and it demonstrates you have the commitment to work hard for a goal you wish to achieve. If you can obtain a research internship during the summer, by all means try and get one. They are not only fun, but if you can be a part of a research team, you will have experience working with scientists on a daily basis. If you can't find a research job, make sure you either work or try to spice up your application by volunteering extra hours, etc. Several interviewers asked me, "What did you do during the summer?" or "What have you been doing?" Thank goodness I didn't respond, "Sitting on a beach in Maui surfing all day!" Medical school admissions committees want students who demonstrate interest. Make the most of the summer months.

Letters of Recommendation
Letters of recommendation say a lot about you as a person. Strong letters of recommendation can mean the difference between rejection and acceptance, so don't take them lightly. Most students tend to put them off obtaining letters of recommendation until they need them. Do not procrastinate! That last think a recommender wants to hear is, "Dr. Jones, could you please write a letter of recommendation for me? I need it by tomorrow!" You can imagine the quality of letter coming from a professor who has been given little time to write a letter of recommendation for you. When you approach your professors about writing letters for you, ask if they will write strong letters on your behalf. If they enthusiastically respond and say they will support you 100%, great, but if they give the slightest hint all they will do is write a perfunctory, luke-warm letter, just thank them for their time and don't get a letter from this individual. Also, make sure you hand a fact sheet with employment history, hobbies, etc. to your recommender along with a self-addressed stamped envelope. If you don't supply a fact sheet, the recommender will have less to say; this doesn't mean a poor letter will be written about you, but it makes the job easier for the professor.

Who do you ask for letters? Ask your professors who know you well. Just because you received an "A" in a course doesn't mean a good letter will be written about you. Pick professors, your boss, your supervisor, anyone who knows you well and can vouch for your character, motivation, and potential as a student. Don't ask friends, relatives, your pastor (unless you were in charge of a Sunday school or youth program). Get to know your professors. Not only will this help you learn the material more effectively, it will make you stand out as a student. Professors rarely remember the quiet students who say nothing and ask nothing. They do remember the students who actively participated in class discussions. How many letters do you need? I collected 7 letters for my application. The minimum number is 3. I would try to get about 5-7 letters. Any more than 7 is overkill, and less than 3 is not enough. Just remember to ask your recommenders early and send them thank-you notes after the letter is written. It is a kind gesture for their time, and it shows them you have common courtesy and good manners.

The Dreaded MCAT
Take it in April, Take it in April, Take it in April

April, not August, April

Together with your grades, the MCAT is one of the most important factors medical schools use to weed out potential students. Good scores will get you interviews and acceptance; poor scores will hurt you more than you can imagine. So what is a good score on the MCAT? Each section you are tested in is scaled to a score from 1 (low) to 15 (high). Most students average 8 in each section of Biological Sciences (BS), Physical Science (PS), and Verbal Reasoning (VR). This means a composite score of 24 is average. The Writing Sample (WS) is graded and scored on a scale from J (low) to T (high). The writing sample is not as important as the other three scores, but this doesn't mean you can score a "J" and expect a lot of success! Most students who matriculate into medical school obtain MCAT composite scores of 27 or higher. In other words, 9s in each section can get you in. But a high MCAT score is no guarantee you'll be admitted, but it definitely boosts your chances. I have met students who earned 12s across the board and didn't matriculate! The MCAT score is usually used in the beginning of the application process and is only one of many factors. If your MCAT scores are good enough, you will be mailed a secondary application or invited for an interview (more on the application process later). If not, you will be rejected immediately. An MCAT score of 30 or above will certainly earn you some interviews provided your GPA and letters are good as well.

So how do you prepare for this important test? You can pay about $800 [$2000 now] for the Stanley Kaplan MCAT course or Princeton Review. I studied alone because I didn't have $800 or the time. Several guides are available for purchase. BETZ produces a great review book, and if you have a friend who took the Kaplan course, ask if you can borrow the books. The are a great review of the essential material tested on the MCAT. Two other guides have also been published; one is the ARCO Supercourse-MCAT and the other is the Princeton Reviews Flowers and Silver MCAT Review.

If you sign up for Kaplan, they guarantee you will improve your scores from the free diagnostic test they administer every February and June. The diagnostic test is about three hours long and there are not as many questions on it as there are on the real MCAT, but it will give you a feel for the "Big Test Day." Kaplan usually posts flyers in the science building about three months before the test, so look for it in January and May. Whether you sign up for a course or study alone, you must study for the MCAT as if it s the final exam for all your science courses. Start reviewing early and study hard. During the spring of the year you are applying, take fewer courses so you can review for the MCAT. You don't want to take the test again. I made a habit of studying about four hours per day for three months before the exam, and it paid off (9VR, 10BS, 11PS, R-WS). The Association of American Medical Colleges sells practice MCAT tests (actual WS). They currently offer three exams for about $10 each and all of them are available in the Kennel Bookstore. Buy them and use them to practice the test. In other words, wake up, set the clock, turn off your telephone ringers, and take a full-length exam. This exam is long and difficult, and the more you practice, the better you'll do. If you set up a steady routine, take the practice tests, and discipline yourself, you will be rewarded with higher than average MCAT scores, just what you need to put yourself well above the rest of the applicant pool. On the day of the test, you will likely be nervous; this is a natural reaction considering what's riding on this exam. You will probably do better than you think on the test. At the end of the exam, you will be given the option to NOT release your scores. Unless you feel you royally bombed the MCAT, release your scores. Basically, the schools will find out your scores eventually anyway, so make life a little easier and have them sent to the schools right away. If you don't, you'll pay because your applications won't be revised until the school has your scores. Additionally, you want to appear confident. Not releasing your scores only demonstrates your lack of preparation and confidence, a "red flag" to many admissions committees.

Also, take the test in April of the year you plan to apply or August of the year before you plan to apply (provided you have finished all the prerequisite courses and have the time to study). Do not take the August test the year you are applying! The August test scores won't become available until October, long after those who took it in the spring. What does this mean? Those who take it in the spring have already completed their applications and are patiently waiting for interviews. You, having taken the August MCAT, won't have a completed application until October or November. This puts a significant disadvantage because most schools admit students on a rolling basis. This means fewer and fewer positions are available as the year progresses.

Applying to Medical School Apply Early!
So the MCAT is over. No, you can't rest, your job has just started! The number one rule is to apply early! Currently, you can submit your AMCAS application as early as June 1st. Apply June 1st or within the first three weeks of June! The earlier you apply, the better your chances of admission, so remember to apply early. You must also choose where you apply. You will not have your MCAT scores when you send off your application, so use a shotgun approach when applying.

You must apply to at least ten schools. Even great students with lots of activities, good letters, etc., are not guaranteed acceptance. You never know exactly what schools are looking for in potential applicants, so apply to a spectrum of schools of varying reputations. For example, I applied to 35 schools. 18 of them were in the top 30 or so as far as reputation is concerned. The other half were schools which accepted a high percentage of out-of-state applications (mostly private schools). When choosing which schools to apply to, look at how many out-of-state applicants they accept. If they only accept a dozen or so students, don't waste your money. And if they don't accept ANY out-of-state applicants, don't apply. Nearly all of the schools in Florida and Louisiana only accept in-state applicants! This leaves Fresno State students the choice of applying to all 8 schools in California (even Stanford and Loma Linda--because you never know) plus another 8 or 10 private, out-of-state schools. Don't let funds limit the number of schools you apply to. The more schools you apply to, the better your chances of admission. Beg, borrow, but don't steal, to pay for applying. I spent $3,000 on applications plus another $1,500 on interviews! [These days you are looking at $6000 - $8000 to apply.] It is expensive, but you have little choice. If you are a low-income student, you may be eligible for fee-waivers. If you limit the number of schools you apply to, you limit your chances, and if you are strongly motivated to be a physician, then forget about the cost and apply. After all, your undergraduate education will cost you at least $30,000 for four years. Medical school will cost at least another $80,000 [$200,000 these days] if not a whole lot more! With this in mind, $4,000 dollars for applications is a drop in the bucket.

AMCAS is the association you will send your initial application to. Once AMCAS processes your application, they will send it to the schools you designated. The schools will then review your AMCAS application, GPA, and MCAT scores. Once they have processed this information, they will send you a secondary or reject you. The secondary application requires more essays and always more money. Some schools just require a photo of you and some money...anywhere from $40 to $100. Your bank account will definitely feel a pinch during this stage. Once you have sent out your secondary applications, you wait for interview requests or rejections. Rejections can arrive at any stage in the process after you apply, and your first rejection will sting a little--don't let it discourage you!

So, tell me a little about yourself? Given the fact there is a huge push for primary care doctors, how do you feel this will effect medicine? How do you feel about abortion? Would you treat a patient with AIDS? Do you think marijuana should be prescribed? Why did you do so poorly in Ancient World Literature? What kind of practice do you want? Teach me something.

These are the kinds of questions you will be asked, and you can prepare for them. Read books on healthcare, euthanasia, health care reform, etc. Robert Marion, M.D. has written two good books on being an intern, Learning to Play God and Intern Blues. Both books give detailed accounts on what it is like to be an intern and resident physician. Harvard Med is another good book to read about medical school in general. Even though it is about Harvard specifically, it gives a great account on a medical student's lifestyle. The Libraryis full of good books on current health care issues. Check some out and read them. You will have more to say in your interviews, and you can start forming your own opinions. Also, most interviewers will ask you if you have questions. Have some questions ready. Ask about research opportunities, what the worst aspect of the school is, what the best aspect of the school is, student competitiveness, etc. I called each school in February and March of the year I was applying and requested a catalog. Most schools responded and sent substantial information. Read all material they send you because the school catalogs will answer most questions you have.

If you are invited for an interview, make sure you can provide a good answer to the question, "Why did you apply to ***.?" I was asked a very difficult question during my interview at UC Davis. The interviewer looked straight at me and said, "If money is no object, and you were accepted to Harvard and UC Davis, which school would you choose?" It was what I call the "million dollar" question - or, using a baseball analogy, a fast ball, low and outside!

What do you wear for the interview? A professional business suit for men and a conservative skirt suit for women or nice dress. Do not wear a slack-suit. Also, for you men, give up the earring and long hair or pony-tail. Now is not the time to make a statement about the inequities about the business world and conformity.

Practice interviewing with someone and videotape your sessions. Any weird facial ticks or annoying habits will come alive on your television, and its best to correct them before a "real" interview. Practice makes perfect, and remember, you only get one chance to make a first impression! Keep in mind that the purpose of the interview is to supplement the paper application. Aspects of your personality which can't be put on paper can be easily assessed with an interview. Are you easy to talk to? Shy? Confident? Arrogant? No doubt, medical schools are looking for applicants with personality traits which will not only make them successful and competent physicians, but kind and gentle ones as well. When you greet your interviewer, smile and be content - it will help you relax, and you will probably be remembered as a dynamite candidate!

For Fresno State students, winter interviews on the East Coast are quite a shock because it is very cold in the Midwest and Eastern United States. Take a heavy coat and umbrella with you on your interviews, and make sure you carry all luggage on the plane with you--do not check it in!! To drive this point home, let me tell you a little horror story. I was scheduled to interview at New York Medical College on Monday, January 13, 1997, so I scheduled a flight from Fresno to LA and LA to New York City on Friday, January 10, 1997. So far, so good. The commuter plane from Fresno was delayed due to fog, and this delay caused me to miss my connecting flight in LA, so I had to board a different carrier to New York. Needless to say, my luggage didn't exactly follow me; 1 was cold and had to wear the same clothes for three days! My luggage finally caught up with me at 9 P.M. on Sunday--the night before the interview! Because I didn't know if I would get my luggage in time, I had to buy an extra pair of shoes to wear for the interview because my shoes were with my luggage. I luckily carried my suit with me on the plane. The moral of the story is this: carry all luggage on the plane with you and avoid any possibility of losing your luggage!

Also, carry a credit card with you on your interviews. You never know when you'll need it. To reduce the cost of the interview, many schools have established a program through which you can stay with a medical student during your interview. If the school gives you the option of lodging with a student, take it! By doing so, you'll not only save hundreds of dollars if you go on several interviews, you will be the recipient of an added bonus - you get to see what it is like to be a student at the school. The students will tell you the straight scoop on what is good and bad about the school, and though you are under scrutiny during the interview, so is the school. They want you to be impressed enough to attend their school. And if you are lucky enough to have several offers- of acceptance, you will make a more informed decision if you ask the students good questions and take notes.

Acceptance, Rejection, and Reapplying
If you are accepted, congratulations all of the years of hard work have paid off! If you are rejected, don't be too discouraged and reapply again next year, but call the schools and see why you were rejected. If your MCAT scores were not above 27, retake the exam. Get new letters of recommendation and rewrite your personal statements and essays. Also, if you can do anything to enhance your application, do it research, more volunteering, etc.

Stay committed and don't give up on the process. If you are applying for a third time, your chances of being admitted are significantly reduced. You can either give up and try an alternate career or apply to schools in foreign nations or the Caribbean. Of course, these are last ditch efforts, but if you want to become a doctor, this will be your last opportunity. Gaining admission takes lots of hard work, planning, and dedication - good luck with your studies here and on your journey to becoming a physician - it's worth it!