Medical School Admissions

More Medical Schools Announce Withdrawal from U.S. News Rankings

A week after Harvard Medical School announced its plan to withdraw from the U.S. News Best Medical Schools Ranking, other prestigious programs followed including Columbia’s College of Physicians and Surgeons, Stanford Medical School, Penn’s School of Medicine, and the Icahn School of Medicine. 

In announcing their decisions to withdraw from the rankings, the schools—in line with Harvard—all noted that the U.S. News’ ranking methodology is no longer in line with their values. The Deans at Columbia, Penn, and Icahn also specifically called out the methodology’s negative effect on building a diverse and inclusive medical class. Dr. Katrina Armstrong, MD and Dean of Columbia’s Vagelos College of Physicians and Surgeons, wrote, “The USNWR medical school rankings perpetuate a narrow and elitist perspective on medical education. Their emphasis is on self-reinforcing criteria such as reputation and institutional wealth, rather than measuring a school’s success in educating a diverse and well-trained cohort of doctors able to change medicine for the better and meet society’s needs.”

Each of the schools noted the value that comes from data transparency and they committed to making data available for prospective applicants. 

Worried About Medical School Debt? Financial Advisors Weigh In.

Medscape’s 2022 Medical Student Lifestyle Report found that med students’ top concerns deal with managing finances, debt, and contracts. As a follow-up to these findings, Medscape ran a poll of medical students to learn more about their financial issues. Over two-thirds (68 percent) of the 151 respondents said that they always/often worry about finances. Among first- and second-year med students, this percentage jumps to 75. Over half said that they are confused about money and only 42 percent—just 26 percent of female respondents—said that they feel prepared to manage their finances.

Most students named debt as their primary concern (86 percent). This was followed by investments (52 percent), contracts (27 percent) and business operations (16 percent). Some addressed their difficulty in balancing spending for necessities and “fun” items, and cited issues with budgeting for the residency application process in the fourth year. 

Financial planner and advisor to young doctors, Paul Morton, spoke with Medscape, noting that medical students are often asked to make binding decisions, many of which they don’t feel confident making, about loans and investments. He also acknowledged that student loan rules have become more complex.

James Nutter, Director of Client Experience for IM Wealth, also spoke with Medscape and reassured medical students that loans for medical school are a remarkably safe investment for their future.

In addition, he encourages medical students to consider the following:

  • Examine your relationship with money. Are you being overly influenced by your childhood experiences, your parents struggle with money, or other external factors such as social media? What personal experiences may be driving or coloring your spending behaviors?

  • Take note of exactly how you spend your money on a monthly basis. What types of items are buying? Detailed knowledge of your spending habits can inform how much you need to borrow.

  • Identify three core values, and spend your money in ways that align with those values. This will help to reduce the noise of external pressures on your spending and ensure that your spending is reflective of who you are.  

Harvard Medical School Withdraws from the U.S. News Medical School Ranking

Harvard Medical School’s Dean, Dr. George Daley, just announced this morning that the school will no longer participate in the U.S. News & World Report “Best Medical Schools” ranking. 

In an open letter to the Harvard Medical School and Harvard School of Dental Medicine community, Daley noted that his concerns rest not simply on criticisms of the ranking methodology, but more fundamentally on his, “... principled belief that rankings cannot meaningfully reflect the high aspirations for educational excellence, graduate preparedness, and compassionate and equitable patient care that we strive to foster in our medical education programs.” He also described the negative unintended consequences that he sees rankings promoting within academic institutions, which include schools reporting false or misleading data, creating policies intended to boost rankings rather than educational objectives, and emphasizing financial aid for recipients based on scores rather than financial need. Daley noted that while he has contemplated this move for years, the “courageous and bold moves” made by leaders within the law school community—including Harvard Law’s Dean, John Manning—have “compelled” him to act now. 

Daley did acknowledge the need for data and transparency for prospective medical students, and urged them to review the data shared on the HMS admissions website. He also recommended the AAMC MSAR database, which contains meaningful data for all U.S. medical schools.

Related: Former Medical School Deans Call on Medical Schools to Withdraw from the U.S. News Ranking

Thinking of Retaking the MCAT? Here’s What You Need to Know.

It is not unusual to retake the MCAT. Data from the AAMC shows that between 2019 and 2021, 38 percent of test-takers were “repeaters,” who had taken the test at least once before. And “repeaters” tended to achieve score improvements. 

--Those with an initial score between 472 and 517 saw a median score increase between two to four points. 

--Those with an initial score between 518 and 528 saw a median score increase of one point.

The analysis also found that the longer the period between your first and second exam, the bigger the point gain. Many factors likely play into this, one of them being as simple as completing helpful college or postgraduate coursework. 

How many times can I take the MCAT?

You can take the MCAT up to three times in one calendar year and four times across two calendar years. There is a lifetime cap of seven times. We recommend taking the MCAT a maximum of three times—really, you should aim for two. Medical schools prefer it. 

How do schools use updated MCAT scores? Will they use my best score?

Different schools use different strategies for multiple score submissions. In an AAMC admissions officer survey (2017), representatives mentioned the following methods: 

  • Review all submitted scores in conjunction with respondent’s explanation of the score change

  • Use only the highest score

  • Average all of the submitted scores

  • Use only the most recent score 

If you are considering retaking the test in order to target a particular school, we recommend that you contact the admissions office first to ask how they will use the updated MCAT score. This is because achieving a particular score can be more challenging if a school averages the submitted scores, rather than using either the best or most recent exam result.

What do I need to consider as I think about retaking the MCAT?

--First and foremost: is it necessary to retake the test? 

Review the average MCAT scores for the schools that you are interested in. Are you within the average range of scores at your desired schools? Would you consider adding schools to your list that do match your performance? 

If you fall below the average for your target schools and you do not want to reconsider your school list, you will likely need to retake the test. MCAT scores are often used as a preliminary filter for secondary applications. 

--How are the other components of your application?

A low or borderline GPA creates a stronger case for retaking the MCAT. You want to be sure that your application demonstrates your ability to thrive in a rigorous academic environment, so if both scores are on the low end, you should consider how to bolster at least one of them by retaking the exam or taking additional classes. 

--Is it clear why you didn’t achieve the score you had expected and/or do you understand how to improve your test prep process?

Is your score much lower than your practice exams? Did you have a stressful situation or an illness that impacted your performance? Is there good reason to believe that with some changes in your preparation, such as hiring a tutor, you will do better on the test? If you only achieved a point or two below your typical practice exams, do you have a plan to reinvigorate your efforts? If you do retake the exam, you’ll want to improve your score. So, consider carefully if you have a clear path to do so.

--Do you have the time to retake the test?

If you retake the test, you’ll want to commit to a study plan that will ensure you improve your initial score. Doing so will take time away from other endeavors including extracurricular activities, research, and clinical experiences. Consider your overall application and where you are most likely to benefit by spending time. 

We encourage you to make the decision that will best help you to meet your goals. You will need to achieve an MCAT score high enough to keep you in the running for the schools that you’re interested in. But you’ll want to balance that with gaining other meaningful experiences that will also prepare you for medical school. Admissions committees review applications holistically because they’re looking for great candidates, not perfect ones.

Former Medical School Deans Call on Medical Schools to Withdraw from the U.S. News Ranking

A recent Stat News op-ed, co-written by former University of Chicago Pritzker School of Medicine leaders, is calling on medical schools to follow Yale, Harvard, and other leading law schools in withdrawing from participation in the U.S. News rankings. The authors, Holly Humphrey, a physician and current President of the Macy Foundation, and Dana Levinson, Chief Program Officer of the Macy Foundation contend that the current U.S. News ranking system, “is in direct opposition to medical schools’ goal of educating a well-trained, diverse, and culturally competent medical workforce.” 

Humphrey and Levinson argue that the rankings’ methodology is “ill conceived” and fails to include critical output metrics. The two claim that, across most included metrics, the data tends to favor large and wealthy institutions over smaller ones with no clear demonstration of how each metric directly benefits student education. For example, the inclusion of total federal research dollars favors larger institutions, although that money may or may not directly fund students’ education or participation in the research. The authors also note that the survey response rate, which drives the reputation score, falls far below the standard of a peer-reviewed publication. Additionally, the use of average MCAT scores and undergraduate GPAs unduly advantages schools with students from higher socioeconomic backgrounds as well as incorporates bias that may exist in the educational system. Finally, Humphrey and Levinson note that including the acceptance rate in the rankings can lead a school to encourage applicants to submit applications, regardless of if those applicants have a reasonable likelihood of admissions success. 

The authors also point out what is missing from the rankings. Namely, data on the quality of the education including the clinical skills, scientific acumen, and abilities of a schools’ graduates. The authors’ position, which is in line with that of Yale and Harvard Law, is that the rankings are not just potentially misleading but that in some cases they actually do a “grave disservice” to applicants by reinforcing bias or poor admissions practices. Humphrey and Levinson believe that if medical schools take the step of removing themselves from the rankings, they can play a more “honest and forthright” role in assisting applicants as they “...navigate the process of finding the right school to help them become the doctors they aspire to be.”

Related: Medical Community Lauds Addition of Public Health Priorities to Methodology of U.S. News’ Medical Rankings

Medical Schools Incorporate More LGBTQ-Focused Programs into their Curriculums

Studies show that individuals who identify as LGBTQ report worse health care experiences and poorer health outcomes. But in following the lead of the AAMC, medical schools are working to remedy these health inequities by incorporating more LGBTQ-focused initiatives into their curriculums. 

Below, we highlight a few medical schools with notable LGBTQ-focused programs. 

For prospective medical students interested in pursuing an education that includes rigorous preparation in LGBTQ care, U.S. News recently published useful tips from medical school administrators and professors that will assist you in gauging the strength of a program’s curriculum. 

  • Inquire about how LGBTQ+ topics are integrated into the required coursework. "Offering it as a requirement really does put the teeth behind it in the curriculum, saying this is something for all students," Dr. Steven Rougas, Director of the Doctoring Program at Brown University's Warren Alpert Medical School, said.

  • Look for LGBTQ+ clinics and/or institutes for study and research. "Looking for centers is how I would go about doing it," Dane Whicker, Clinical Psychologist and Director of Gender and Sexual Diversity initiatives in the Office of Equity, Diversity, and Inclusion at Duke University School of Medicine, said. He also noted that a particularly good sign is a center that conducts research and provides comprehensive treatment programs. 

  • Ask about how LGBTQ+ courses are developed and updated. "One key question is how the institution plans for change," Dr. John A. Davis, the University of California-San Francisco School of Medicine's Associate Dean for Curriculum, wrote to the U.S. News in an email. "Areas particularly involving gender identity and expression and sexuality are rapidly changing, and curriculum must keep up with that. How an institution plans for that type of rapid change says a lot,” he wrote.

AAMC’s President and CEO Addresses Top Challenges Facing Academic Medicine

Last weekend, the President and CEO of the American Association of Medical Colleges (AAMC), David Skorton, MD, addressed over 4,200 leaders in academic medicine on the “four things that keep me up at night.” These include structural and cultural inequities in academic medicine, deteriorating student wellbeing, external threats to the doctor-patient relationship, and a lack of mutual respect. On these challenges, Skorton called for collective action. “The health and mental well-being of our communities and our colleagues are at stake. Through meaningful, open, and honest dialogue, partnership, and collective action, we can and will tackle these problems in service of the greater public good,” he said. Below, we summarize his concerns. 

Diversity, equity, and inclusion and anti-racism. Within academic medicine, Skorton noted that this work includes diversifying medical schools’ student populations, faculty, and staff. It also goes further. Each academic institution should review their culture to ensure that the climate supports every student with the “opportunity to excel.” 

Student well-being and mental health. Skorton notes that medical students show higher rates of depression and risk of suicide than their age-matched peer populations, and that the comparisons have worsened in recent years. He encouraged academic leaders to prioritize the mental health and wellbeing of students by understanding their existing stressors (financial, academic, and social) and reducing them, as possible. Medical school faculty and staff should also ensure that they make mental health and wellbeing resources accessible to students. 

External threats to the doctor-patient relationship. While not speaking to abortion rights specifically, Skorton spoke to the more generalized threat that legislation and/or judicial opinions can impose on a physician’s ability to exercise clinical judgment in partnership with the patient. He encouraged leaders to “stand firm” against such external action in order to protect the doctor-patient relationship.

Humility and mutual respect. While Skorton emphatically noted that physicians are duty-bound to speak out against racism or hate speech, he called for greater mutual respect. He noted that leaders in academic medicine should show humility in their interactions and discourse, and called for physicians to model using an open-mind and empathy in encounters with those holding differing viewpoints or conflicting ideologies. 

Biden Administration Works to Improve Nutrition and Health Education in Medical School Curriculums

Despite the prevalence of obesity and related diseases, including type 2 diabetes, hypertension, heart disease, cancer, and stroke in the US, there is little training on nutrition in American medical schools. 

Dr. Stephen Devries, a cardiologist and co-lead of the Nutrition Education Working Group at the Harvard School of Public Health, spoke about this gap in the medical curriculum on a recent AMA podcast. “Nutrition just hasn't been recognized as a priority in medical education, despite the fact that dietary changes are well recognized to be the leading risk factor for premature death and disability in the United States. On average, medical students spend about 19 hours over the course of four years in medical school on nutrition. But much of that is related to biochemistry and topics that are important but not directly clinically relevant for patients. So in the absence of meaningful nutrition education, what are medical students to think when they graduate, other than the fact that nutrition must not be very important in their training because they only learned about drugs and procedures?” he said. 

Due to the public health concern and the costs related to poor nutrition, government representatives are starting to speak up. From the House of Representatives to the White House, there are calls for action to improve education and outreach on nutrition and diet-related disease from medical schools to elementary schools. Earlier this year, following a congressional briefing with the Nutrition Education Working Group at the Harvard School of Public Health, Congressman McGovern (D, MA) and Congressman Burgess (R, TX) passed a bipartisan resolution in the House calling for “medical schools, residency, and fellowship programs to provide nutrition education that demonstrates the connection between diet and disease.” The resolution will encourage federal agencies to prioritize funding for medical “programs that incorporate substantive training in nutrition and diet sufficient for physicians and health professionals to meaningfully incorporate nutrition interventions and dietary referrals into medical practice.” 

In late September, the White House hosted its first Conference on Hunger, Nutrition, and Health in over 50 years where they unveiled a formal strategy to promote better nutrition and improve food security. The administration announced $8 billion in commitments, underneath five pillars, involving stakeholders from non-profits to universities to tech start-ups. The second pillar, “Integrate Nutrition and Health,” is most heavily geared towards medical students and physicians. Some of the named actions include:

  • A commitment by the American College of Lifestyle Medicine (ACLM) to make an in-kind donation of $24.1 million to improve nutrition training for medical professionals

  • A first-ever Medical Education Summit on Nutrition in Practice organized by the AAMC and ACGME to convene 150 medical education leaders

  • A signed pledge by many leading health organizations (including the National Medical Association and National Hispanic Medical Association) to take action on strengthening health professionals’ nutrition education

  • A commitment by The University of South Carolina School of Medicine Greenville to make a $4.8 million in-kind donation to assist in the implementation of its Lifestyle Medicine curriculum for interested medical schools and to provide content guidance to the National Board of Medical Examiners

Waitlisted? Here’s What to Expect.

News you have been waitlisted at one of the medical schools on your list is disappointing. But the game isn’t over. 

You can influence your chance of being selected from the waitlist of any school by continuing to showcase your interest in their program through update letters, visits, and meetings with professors, admissions directors, and current students. You can also craft a letter of intent to your first-choice program. This letter will be similar in content to an update letter, but it will include the key yield protection statement: “Medical School X is my first choice and, if admitted, I would attend.” If you can make such a statement, it will be impactful. Keep in mind, however, that you should only make this promise to one school. For other programs, you may send an update letter that expresses your continued interest without this level of commitment.

As the waiting game continues, keep in mind that the number of students who are admitted each year from the waitlist depends on the school. Competitive programs typically admit fewer because they have a higher yield (acceptances resulting from initial admissions offers). But other schools will admit up to half of the class from the waitlist. It is also important to note that many schools do not use “rolling waitlists.” Instead, they often delay until they have received final admissions decisions from prospective students on April 30th. After this date, you will only be able to hold a seat at one medical school. While you can withdraw from a school if you are accepted from the waitlist into a preferred school up to the point of matriculation, you cannot hold a seat at both schools. Familiarize yourself with school-specific waitlist policies via the AAMC website. 

Good luck!    

Related: The Medical School Application: Sending an Update Letter

Study Finds Perseverance the Most Common Theme of the AMCAS W&A Entries of Highly Successful Medical Students

Earlier this year, researchers Joseph M. Maciuba, Yating Teng, Matthew Pflipsen, Mary A. Andrews, and Steven J. Durning published findings from early research into the qualitative differences in the AMCAS applications of medical students identified as high performing (via entry into a medical school honor society) and low performing (referred for administrative action). The study’s scope included 61 students who graduated from the Uniformed Services University in Bethesda, MD from 2017 to 2019. 

The researchers found significant differences in the AMCAS Work and Activities submissions: 

  • Among the high performing students, seven themes emerged frequently in their Work and Activities submissions: teamwork, altruism, success in a practiced activity, wisdom, passion, entrepreneurship, and perseverance. High performers, on average, referenced the themes 7.86 times per application as compared to the low performers’ 3.81 times. 

  • High performers also showcased a more diverse array of themes within their applications than low performers. On average high performers referenced 4.5 different themes in their applications, while low performers averaged 2.5.

  • The most notable differences between high and low performers occurred in use of “perseverance.” Fifty five percent of high performers referenced the trait (19 percent of low performers). 

  • 73 percent of high performers included a reference to their success in a practiced activity (38 percent of low performers). 

  • Among low performing students, common themes emerged as well: Witnessing teamwork (taking a passive versus an active role in a team environment), describing a future event (event that has not yet occurred), and embellishing an achievement.

The Medical School Application: Sending an Update Letter

The autumn is often a waiting game for medical school applicants. You will wait for interview invitations and admissions decisions. It can be excruciating! But there’s more to do. You can begin writing your update letters. If you haven’t heard anything from a school for six weeks (after submitting your application or interviewing) or you’ve been waitlisted, you will want to send them a letter that includes recent career or academic updates since submitting your application, reiterates your interest in the program with specifics, and makes the yield protection statement where applicable (if admitted, I will attend). Below, we have provided additional guidelines:

  • Confirm that the school accepts update letters, as some admissions committees do not. Once confirmed, address your letter to the Dean of Admissions or the Admissions Director, rather than “To Whom It May Concern.” 

  • Ensure that your updates are significant enough to merit communication. Examples of sound updates include: 

    • Publications: You contributed to a research article accepted for publication, authored an article published in a regional or national magazine or journal, or were interviewed for a published article

    • Professional Development: You presented at a national/regional conference, played a major role in organizing/executing the conference, just finished a successful project, or received a promotion with additional responsibility at work in a related field

    • Awards/Recognition: You received a prestigious award (e.g., Phi Beta Kappa), fellowship (Fulbright), or other honor 

    • Extracurricular Achievements: You took on a leadership position in a club/organization, significantly expanded the scale or reach of a club/organization, started a club/organization (not previously noted in your application), or a club/organization you lead received an honor or award

    • Significant positive changes to your GPA

  • In crafting your letter, take the opportunity to tie your updates back to the school’s offerings as another way to reiterate your interest in the program. If you presented a research paper at a national conference, you may mention, by name, the school’s professors who are engaging in similar research efforts. 

  • Keep the tone formal and the writing crisp. Your update letters deserve the same detailed review as your personal statement and secondary essays. 

  • The length should run no longer than a page. 

  • Do not send more than two letters per admissions cycle. 

AMCAS Work & Activities Section: Hobbies

Hobbies. They are not a make or break component of the medical school (and later, residency) application, but they are an opportunity to provide the admissions committee with a view of the person beyond the test scores. Hobbies are also an effective way to demonstrate how you will add to the diversity of the incoming class, showcase qualities you will need as a medical student/physician, and/or provide insight into how you may relieve stress during medical school. 

Within the AMCAS application, hobbies belong in the Work & Activities section under the extracurriculars category. Applicants can provide up to four experiences under each category type, with a 700 character (with spaces) count, unless the experience is designated “most meaningful” (requires an additional 1,325 characters with spaces). 

Below are our guidelines for adding hobbies to your AMCAS application:

  • Be current. If you played the trumpet in the high school band, but haven’t picked it up since then, consider what hobbies are more relevant to your life now. What do you turn to for fun, and what do you see yourself doing for stress relief in medical school?

  • Be specific in your description. Provide a sense of how often, and how long you have been pursuing the hobby, as well as what the hobby entails. It’s great that you love to read, do yoga, and travel, but so do many others. In what unique ways have you engaged with your interests? Did you launch a monthly book club for discussing the NYT best sellers? Write book reviews for the school paper? Did you gain a yoga teaching certification or take part in a unique yoga retreat? Do you travel to particular destinations or participate in medical experiences abroad?

  • State how your hobby has impacted your personal growth. Did an experience within your hobby contribute to a change in your perspective or influence your decision to apply to medical school? What attributes have you developed through your hobby that will benefit you as a medical student and physician (resilience, effective communication and collaboration skills, empathy, the ability to thrive in a diverse environment, etc.)? 

  • When possible, provide an experience or milestone that differentiates your involvement in the hobby. Many people play an instrument, but fewer start a quartet or play in the university band. Many people enjoy running or fitness, fewer run the NY marathon to support a favorite cause/organization or start a running club. Providing the specific way(s) that you’ve engaged with your hobby will demonstrate to the admissions committee what you may offer to your incoming class. 

Are you a Premedical Student with a Nonscience Major? Check Out These Schools.

All premedical students are required to take prerequisites in life sciences before applying to medical school. But the humanities also offer valuable preparation for prospective physicians. In the fall of 2020, about 12 percent of the entering students in the U.S. News top 10 programs in research (11.9 percent) and primary care (11.4 percent) came from a social sciences/humanities background. And, in the fall of 2021, ten schools boasted entering classes with a significant proportion of social sciences/humanities undergraduates (see chart below). If you are a premedical student in the social sciences/humanities, you may want to consider one of these schools.  

Additionally, in your applications and interviews to other schools, be sure to articulate the value of your social sciences/humanities background. A study from 2014 found that while medical students with undergraduate degrees in the humanities maintain consistent academic performance with those from science majors, they also tended to show “…better empathy and communication skills, and a more patient-centered outlook.” Similarly, Rishi Goyal, MD, PhD, and Director of the Medicine, Literature, and Society major at Columbia University, argues that college is an ideal time for exposure to the humanities. “It’s a great time to capture students, to help them develop different parts of the brain,” he said. “It’s more difficult to do that in medical school. Students are already so busy, and it’s harder to convince them at that point that memorizing the Krebs cycle is not as important as holding a patient’s hand or talking to them in their same language.” 

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Despite Stress and Burnout, Most Students Feel that Medical School Prepared Them Well for Board Exams and Residency

In Medscape’s 2022 Medical Student Lifestyle report, which included responses from over 2,000 medical students, many respondents reported experiencing burnout: 37 percent of students reported occasional burnout, while a full third of respondents (33 percent) reported frequent burnout, and 12 percent reported constant burnout. And while 37 percent said that they rarely or never experience doubt about becoming a doctor, many said they did experience doubt sometimes (44 percent), frequently (15 percent), or constantly (4 percent).

Despite many medical students experiencing stress and even doubt, most reported feeling that their medical schools prepared them for the future. The majority of students (64 percent) noted that they felt prepared or very prepared for the USMLE, with half favoring the move to a pass/fail format for the test. Just over two-thirds of students, 67 percent, reported satisfaction with the relationships they formed with their professors. And 59 percent reported feeling prepared or very prepared for residency, with that proportion increasing to 75 percent among fourth year respondents. 

Many students also reported that they found meaning during the pandemic. Over one-third of respondents, 39 percent, reported that Covid reinforced or strongly reinforced their drive to become a doctor. In terms of specialty selection, 24 percent noted that Covid slightly or somewhat influenced their specialty choice, and 12 percent said that Covid influenced or strongly influenced their selection of a specialty. The majority of students (54 percent) said that they felt satisfied or very satisfied with how their medical school handled Covid. 

Let’s Talk About CASPer. Medical School Admissions

To gauge an applicant’s ability to critically evaluate a complex scenario and employ sound judgment and effective communication skills, a growing number of allopathic medical schools (currently, more than 40) have turned to CASPer. 

What in the world is CASPer?

CASPer (Computer-based Assessment for Sampling Personal Characteristics) is a situational judgment test that a school might ask you to take before interview season. As of 2022, it takes between 100 to 120 minutes to complete. The test presents you with 15 scenarios and follow-up questions about them. Some of the scenarios will be about real-life experiences that you've had. (These Qs are similar to Secondary prompts and interview questions.) Other scenarios will ask you to take on a role. For example: "You're a store manager and someone is trying to return something without a receipt." The CASPer raters use your answers to assess your empathy, ethics, self-awareness, motivation, teamwork, and communication skills, among other qualities. 

The test is presented in two sections—a typed response section and a video response section. The exact length of and balance between these sections has changed from year to year, but this is what it is like right now. 

In the typed response section, there are three written and six video-based scenarios. You'll have five minutes to answer three questions about each in writing. (If you finish early, you can hit the submit button; your answers will automatically submit at the five-minute mark whether you're finished answering or not.) Focus on content over perfect grammar. The raters know this is tightly timed and they want to see your personality and critical thinking more than a flawless polish. After you've answered five scenarios, you'll have the option of taking a five-minute break. Take it. There's no pausing this party once it's started. At the end of the section, there will be another optional ten-minute break. Take it—you might need some of that time to prepare for the next section.

In the video response section, you'll be presented with two written scenarios and four video-based scenarios. For each, you will respond by video. You'll be asked three questions and give a one-minute video response to each. At the one-minute mark, your video will automatically upload. Altus Assessments, which owns CASPer, notes that many applicants run over their video answer time and it's not a big deal. If it happens, let it go, and reset your brain for the next prompt. Being calm and collected in the next video is going to make more of a statement than your "oops."

Are my CASPer results going to keep me out of med school?

Not every school requires the test, and it alone is not used to weed out prospective students. It's more like a school is lining up who you presented in your application next to who you appear to be according to CASPer. They're looking for great disparities between these two things. For example, if your application showed you as a modern-day saint, and your CASPer score for empathy was middling at best, that's a little interesting. Maybe you're a person who checked off a list of the right things to do before medical school and you're not actually aligned with the school's values. An introverted applicant who is shy in their interview could benefit from a strong CASPer score that shows they have the other qualities needed to be a top student and doctor.

A complete practice test is available, as is a sample test for video answers only. Your answers won't be reviewed by anyone at Altus. This is just so you can get used to the test's format. The takealtus.com website has information about other ways to prepare for your test day.

Last Year’s Graduating Medical Students Reported Satisfaction with their Education, Fewer Instances of Bullying, and Less Debt

The 2022 Medical School Graduation Questionnaire is an annual survey that asks graduates of accredited U.S. Allopathic medical schools about their medical school experience. Last month, the aggregate results for 2022 were released, and included responses from over eighty percent of the medical school graduates from academic year 2021-2022. Over half of the respondents, 53.7 percent, were women (compared to 51.2 percent of the population) and 17.8 percent were underrepresented minorities (compared to 18.9 percent of the population).

We’ve summarized key findings below.

Most students report satisfaction with the quality of their medical education and their school’s support of their development as physicians.

  • The vast majority of students (88.4 percent) agreed or strongly agreed that they are satisfied with the quality of their medical education.

  • Just over nine in ten respondents agreed or strongly agreed that they have acquired the necessary clinical skills to begin residency (91.2 percent) and that their medical school has done a good job fostering and nurturing their development as a future physician (91.0 percent).

More Students are graduating without medical school debt, and many who do have debt are exploring loan forgiveness programs.

  • Just under one-third of respondents (30.9 percent) reported that they would graduate with no medical school debt; this proportion has been increasing modestly over the last several years, up from 27.7 percent in 2018.

  • Among those who are graduating from medical school with debt, the median amount is $200,000.

  • Among students graduating with debt, about half (49 percent) reported that they plan to enter a loan forgiveness program, with most (83.9 percent) interested in the Public Loan Forgiveness Program.

Students continue to select specialties based on personal fit; the proportion of students who experienced “away rotations'' has almost returned to pre-pandemic levels.

  • Most respondents reported that “fit with personality, interests, and skills” influenced their choice of specialty (86.4 percent). This was followed closely by “content of specialty” (82.4 percent), “role model influence” (48.6 percent), and “work/life balance” (47.6 percent). These options have consistently been the most frequently cited in the survey over the past five years.

  • An increased number of students reported participating in away rotations (45.9 percent), which is up compared to 2021 (18.5 percent). But this is not quite as high as in previous years (55.5 percent in 2019; 54.7 percent in 2020).

  • Fewer students reported participating in elective activities compared to 2021, which includes working at a free clinic (69.8 percent), home care (18.8 percent), nursing homecare (16.2 percent), or a global health experience (14.2 percent). Slightly more reported authoring a published paper (62.6 percent, compared to 61.2 percent in 2021 and 55.1 percent in 2020).

Students are aware of mistreatment policies and slightly fewer reported experiencing mistreatment in medical school this year compared to last.

  • Almost all respondents reported awareness of school policies on mistreatment of medical students (97.6 percent), and said they were familiar with reporting procedures for mistreatment (90.2 percent).

  • Over one-third of students (39.4 percent) reported experiencing one of 16 named types of mistreatment—including public humiliation, derogatory remarks, and discrimination based on gender, race, sexual orientation, or other personal traits or beliefs—one or more times during medical school. This number dropped slightly from 40.3 percent the year before.

  • Among students who experienced mistreatment, most said it occurred during a clinical clerkship (87.6 percent). Mistreatment occurred most frequently during rotations in surgery (55.2 percent), obstetrics and gynecology/women’s health (30.2 percent), and internal medicine (22.6 percent).

The Medical School Post-Interview Thank You Note

After completing your medical school interview, you will want to follow up with your interviewer(s) by handwriting a thank you note. This is just another opportunity to express gratitude for their time and consideration, emphasize points of connection you had during your interview, reiterate your interest in the medical school with specifics and, where it applies, make the yield protection statement (“If admitted, I would attend.”) 

We encourage you to keep the following guidelines in mind:

  • Handwrite your note and send it promptly, ideally within 24 hours of the interview.

  • Keep it focused. Your note should not be used to introduce new information.

  • Keep it brief. Your note should be no longer than two paragraphs in length.  

  • Make it personal. Ensure that your note feels specific to the recipient and institution, rather than overly general. 

Frequently asked questions:

Who should I write a thank you note to?

You will want to send a follow-up note to your interviewers, and you should also consider sending a note to anyone with whom you spent an extended period of time (student tour guides, etc.) or from whom you gleaned meaningful insight into the school or the application process.

Does it have to be handwritten or can I send an email? 

Handwritten is best for interviewers, but feel free to use email to follow up with students you had meaningful interactions with. 

Should I include any updates related to my application?

No. Direct all application updates to the admissions committee. 

Should I let them know that the program is my first choice?

Yes, if their program is your first choice, you must let them know in the interview, and again in the thank you note.

I participated in an MMI, how should I approach the follow-up thank you note?

After an MMI, you should try to send a thank you note to all of the interview station leaders. 

Related:

AMA and AAMC Urge Supreme Court to Continue Allowing Medical Schools to Consider Race/Ethnicity in Admissions Decisions

The U.S. Supreme Court is taking two cases that could prevent medical schools’ current practice of considering race/ethnicity in admissions decisions: Students for Fair Admission Inc. v. President and Fellows of Harvard College and Students for Fair Admission Inc. v. University of North Carolina et al. The first considers if Harvard’s admissions processes penalize Asian Americans and in turn violate Title VI of the Civil Rights Act. The second North Carolina case asks if the Supreme Court should overturn a 2003 decision, Grutter v. Bollinger, which allows race to be used as a component of admissions decisions. 

In response to the Supreme Court’s review of the upcoming cases, the AMA and AAMC, along with 40 other organizations, submitted an amicus brief urging the court to “take no action that would disrupt the admissions processes the nation’s health-professional schools have carefully crafted in reliance on this court’s longstanding precedents.” The brief notes the key role that diversity in medical school admissions plays in reducing health disparities by increasing the number of minority practitioners, who are more likely to serve in minority communities, and also by increasing the effectiveness of all physicians through a more diverse learning and training environment. The brief points to scientific research and studies showing the benefits of diversity, saying that “Preventing medical educators from continuing to consider diversity in admissions … would literally cost lives and diminish the quality of many others.” The brief also suggests the possibility that overruling the use of race in admissions decisions may, “...potentially trigger a spiral of severe and self-reinforcing decreases in diversity in the health care professions. States that have banned race-conscious admissions have seen the number of minority medical school students drop by roughly 37% as a result.”

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Biden to Announce Student Loan Debt Relief for Earners Making Less than $125K

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According to the New York Times, President Biden is expected to announce today that his administration will cancel $10,000 in student loan debt for Americans earning $125,000 or less per year (or households earning $250,000 or less per year). The administration will also extend the payment moratorium until December 31st of this year, with borrowers expected to resume payments in the new year. 

Along with this announcement, the President is expected to report that college Pell grant recipients will receive an additional $10,000 in debt forgiveness. 

Legal challenges to the loan forgiveness program are expected, which may make the timing for implementation uncertain. 

Pandemic Spurs Medical Residents to Unionize

Residency is known to be grueling. And during the covid-19 pandemic, the pressure upon residents only increased. As a result, a growing number of residents at hospitals within the U.S. are forming unions to formalize decisions related to pay and working conditions. Sunyata Altenor, Communications Director for the Committee of Interns and Residents (CIR), the nation’s largest resident’s union, said, “Every year, we had one or two new organizing campaigns, but once COVID hit, that number pretty much tripled.” She continued, “It was a massive wave, and we anticipate that it will continue to grow.” Currently, 15 percent of medical residents in more than 60 hospitals are unionized and represented by CIR, while a smaller proportion have either formed a local union or joined a larger medical provider union. 

Oversight organizations, including the AAMC and the AMA, provide high-arching policy guidance on unions but leave the decision-making to the hospital and the residents who work there. According to Janis Orlowski, MD and AAMC Chief Health Care Officer, “The AAMC leaves it to each institution and its house staff to determine how to achieve the best possible education, working conditions, and patient care.” The AMA, for its part, notes that its policy on resident unions strongly encourages separating academic issues from union-covered employment conditions. They note also that unions must abide by the AMA Principles of Medical Ethics, which disallow “such organizations or any of its members from engaging in any strike by the withholding of essential medical services from patients.”

The benefits of unions include providing medical residents a collective voice to negotiate more favorable pay and working conditions. The Accreditation Council for Graduate Medical Education (ACGME) regulates the maximum number of working hours for residents, but not salary. In 2021, according to AAMC data, first-year residents earned just below $60K on average, with many working up to 80 hours weekly. And while working conditions vary by hospital and department, unions can also provide residents more control over their intense work schedules and demands. For example, University of Washington’s Resident and Fellow Physician Union-Northwest (RFPU) won the right for pregnant residents to decline 24-hour shifts. 

Other union benefits include encouraging departments to clearly delineate the rules and rights of residents, and improve social justice efforts through additional support and means to report racial (or other) discrimination for residents of color or sexual minorities. Proponents of resident unions including Kaley Kinnamon, MD and Resident at the University of Vermont Medical Center, which recently voted to launch a residents’ union, noted that unions also bolster the conditions that allow residents to focus on providing the best patient care. “In order to take good care of others, we need to be able to care for ourselves,” she said. “We love being residents and caring for patients. But we can’t do that well if we neglect ourselves.” 

There are also downsides to resident unionization. For one, there is a significant financial cost, particularly post-pandemic when many hospitals are still financially vulnerable. While hospitals receive federal funding to support resident salaries, most come from the hospital itself. There is also a drawback in creating blanket conditions for all hospital residents during training, as there is a need for flexibility and differentiation between departments based on residents’ learning needs. One resident, interviewed by AAMC, noted that surgical residents are required to fulfill a certain number of cases and hours—regardless of union negotiations—in order to qualify for board certification. Furthermore, hospitals have raised the concerning nature of a strike, which would make it almost impossible to adequately staff the hospital.   

Jason Sanders, MD, and Executive Vice President for Clinical Affairs at the University of Vermont Health Network, suggests that hospital leaders pay attention, but look beyond immediate questions of unionization, to focus on the bigger picture. “Whether or not residents have a union, their concerns exist. The question we leaders need to ask ourselves is, how are we going to address them?” he said.

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