Your Pre-Med Priorities: How to Find Clinical Experiences for Your Gap Year(s)

If you've already graduated and are taking a gap year or two, you can find summer and full- and part-time pre-med research assistant gigs that require a BA on job boards like Indeed, Glassdoor, ZipRecruiter, etc. You can find work as a medical scribe in these regular job listings too. EMT programs are a pipeline to EMT jobs, ditto CNA programs to CNA jobs. The Commission on Accreditation of Allied Health Education Programs maintains a list of accredited paramedic programs. (Just bear in mind that becoming a paramedic is more intense than becoming an EMT.) You can also try the following:

1. Use your club contacts. If you're a member of your college's pre-med club, you have access to some alumni and/or guest speakers who are interested in helping prospective doctors. If they can't let you shadow or work for them because of their schedule or because their specialty doesn't match up with your goals, they may recommend someone for you to contact or even give you an email intro. Go Greek too. If you're a member of a sorority or fraternity, your organization may be able to set you up with a physician alumnus who is eager to help. 

2. Call a volunteer center. Sometimes a cold call is the way to go. Free clinics tend to be understaffed and are therefore aching to be your clinical experience. But they might not have a job posting up online. Call or email them and ask if they need volunteers. For a hospital volunteer center, go with: "I'm a pre-med student at (or recent graduate from) ABC University. I'd love to speak with someone about shadowing a physician and a volunteer position. I'm most interested in X, but I'm open to all opportunities." Academic affiliated hospitals are probably your best bets. 

3. Connect with a local physician for shadowing. Reach out to someone who specializes in an area you're interested in and is hopefully close to campus. (It would be ideal to shadow them multiple times.) You can call or email their office or direct message them on LinkedIn. Younger doctors are going to be more familiar with shadowing because they did it. Ask your own doctor about shadowing too. Yep, you're really hitting up any doctor who you know. 

4. Sign up for virtual shadowing. There are third-party organizations who can hook you up with a virtual opportunity. If you have other, more substantial clinical experiences, this is just going to be a bonus to your application. Virtual shadowing should not be your sole clinical experience. (It can be your sole shadowing experience.) Virtual can be great if you want to follow a physician with a certain specialty and can't seem to lock down a local one. Just remember, virtual group sessions tend to be large, so you're not going to get one-on-one mentorship.

Related:

Your Pre-Med Priorities: Gain Clinical Experiences

Your Pre-Med Priorities: Clinical Experiences that Medical Schools Love

Your Pre-Med Priorities: Finding Clinical Experiences as an Undergraduate

Your Pre-Med Priorities: Finding Clinical Experiences as an Undergraduate

Your school is built to help you find clinical and research experiences, be it through fellowships abroad, local summer internships, or work in the university's research labs. And many prospective medical students use personal connections to land volunteering gigs and shadowing experiences, which is great. Get these however you can… 

But, what do you do if your school isn't automatically flooding you with information on opportunities and your aunt's fiancé isn’t the top brain surgeon in your city? Try this. 

1. Seek out your pre-health advisor and pre-med professors. “[An on-campus pre-health advisor] may be in the academic dean’s office, a science professor, or a counselor in the career services office,” says AAMC. If you don’t know of an advisor on your campus, you can find out if there is one through the National Association of Advisors for the Health Professions (NAAHP) database. No advisor on campus? Contact the NAAHP to find a volunteer advisor. Can your advisor or a pre-med professor help you connect with someone at your university's medical school so that you can help in a lab or at an affiliated hospital? Can they give you the contact info of a physician alumnus who you can shadow? Your advisor and professors are motivated to help you; they want your application to be a success. You just might have to be the one who makes the first move. 

2. Hit up your school's medical school and science department. Same DIY deal. If, for whatever reason, your pre-health advisor isn't available to you, go ahead and contact these folks yourself. It shows initiative and you could make valuable connections on the administrative teams. 

3. Check out the Student Doctor Network's Activity Finder. We're big fans of SDN, a nonprofit, and overall terrific resource. Their Activity Finder is a one-stop shop that will guide you towards NIH and other research opportunities, volunteering gigs with Americorps and more, virtual shadowing experiences, and clinical work by location and position. 

4. Check other online listings—for research opportunities, especially. Besides SDN, some university websites have databases of summer research opportunities at both their college and others. (You don't have to go to a certain school to work at it. We had a client who went to UConn do her summer research at Yale.) And definitely peruse AAMC's database of summer research opportunities for undergraduates. 

Related:

Your Pre-Med Priorities: Gain Clinical Experiences

Your Pre-Med Priorities: Clinical Experiences that Medical Schools Love

Your Pre-Med Priorities: How to Find Clinical Experiences for Your Gap Year(s)

Your Pre-Med Priorities: Clinical Experiences that Medical Schools Love

There are a variety of clinical experiences that medical schools like to see in your W&A section because they inform your understanding of a medical career and the day-to-day work it entails.

They include: 

Medical Scribe: This is one of our favorite types of clinical experience. Working as a scribe allows you to see doctor patient interactions up close; you'll expand your medical vocabulary, read about things touched on in appointments (there's that intellectual curiosity!), and be a valuable part of a medical team. You can scribe at a top hospital or a CityMD clinic. What matters is exposure. Don't just describe the job to the school (they know what it is); share a meaningful story. 

EMT: You'll learn basic life support (BLS) and work in high-pressure scenarios. We had a client who worked as an EMT, and performed CPR on a patient, tag teaming with an experienced colleague so neither would become too fatigued and lag in compressions. Their persistence paid off; their patient survived. As an EMT, you'll have opportunities to help people and maybe even save lives. You can learn a lot from your colleagues, too. They've seen it all. 

Certified Nursing Assistant (CNA): This job will require a 4-to-16-week state-approved training program at a local community college or through the Red Cross. It will also involve major grunt work. You'll be responsible for multiple patients, taking their vitals, making sure they're moving, eating, and drinking water. You'll work closely with a medical team. You don't have to work full-time, and the hours are flexible. It's also a paid gig, and actual clinical jobs can look more impressive than volunteering. 

Free Clinic Volunteer: You'll interact with patients, doctors, and other medical professionals while providing care essential to your community. You'll meet patients with a variety of medical needs, and your entry about working at the free clinic should be about direct patient interaction. (You need at least one patient-interaction in your W&A.) Runner up for the best entry focus is a learning experience you had with a staff member. Showing yourself as a problem-solver is great. 

Research Jobs with Clinical Exposure: A twofer! You'll learn about one area of medicine in-depth and get to know patients. As a hospital research coordinator, one client became a passionate advocate for sickle cell disease (SCD) patients' health and dignity. Through surveying patients at every appointment, he developed strong bonds with them and their families. He learned about the daily trials of the disease and the stigma surrounding its most common treatment: opioids. Hospital staff often treated patients in extreme pain as drug-seekers. One 19-year-old told our client: "I just want to be respected." It affected our client deeply. His involvement in this clinical research project spurred him to join two studies investigating new SCD drug treatments. 

Shadowing: Shadowing is great introductory clinical exposure and prevalent among applicants—88% of Johns Hopkins' 2018 accepted students had shadowing experience. But to med schools, shadowing weighs less than volunteering at free clinics, doing clinical research, or working as a medical scribe, etc. That's because it typically doesn't lead to significant patient interactions. Still, shadowing someone in a field you're very interested in is informative, and you can have poignant experiences. 

Since patient interaction isn't common in these scenarios, you want to emphasize how else a shadowing experience helped you build clinical skills or expanded your knowledge of a medical specialty, preferably one you're interested in pursuing after medical school. If these things don't apply to your shadowing experience, here are some other things to consider: What did you see—and how did it affect you? Did a doctor calmly handle an angry patient? Did you seek more information on any condition a physician diagnosed in front of you? Did you learn something about a doctor's day-to-day life that you didn't know before? Unless you had one incredible experience or really need to fill up your W&A, grouping your shadowing experiences in one entry is a great idea.

Related:

Your Pre-Med Priorities: Gain Clinical Experiences

Your Pre-Med Priorities: Finding Clinical Experiences as an Undergraduate

Your Pre-Med Priorities: How to Find Clinical Experiences for Your Gap Year(s)

Your Pre-Med Priorities: Gain Clinical Experiences

The most important W&A entries are about your clinical experiences. Admissions committees need to know: Does this candidate have enough clinical experience to know what they're getting into? 

"You have to have clinical exposure," Keith D. Baker, PhD., assistant dean for admissions at Virginia Commonwealth University School of Medicine told US News & World Report. "That's sort of fundamental. That experience lets us and other medical schools know that you have a reasonable expectation of what lies ahead, and if you don't have that, we simply don't have confidence that you're a serious candidate.” 

Schools need to know that you have seen medical care in action and gained experience with patients. "If you're not interested in working with patients, we're not going to be interested in working with you," Paul White, assistant dean for admissions at Johns Hopkins University School of Medicine said in a 2019 interview with Case Western Reserve University's All Access: Med School Admissions podcast. In another podcast interview, this one with Admissions Straight Talk, White reiterated that while applicants might assume Johns Hopkins would favor research roles above all other things, the school wants applicants with clinical exposure (though that can be through their research roles). "Most students who are successful in our admissions process have had significant clinical interaction, and that goes well beyond shadowing," he said. "I’m talking about actually interacting with patients…in a position where they interact on a regular basis." The numbers back him up. Matriculation data for the 2018 entering class at Johns Hopkins showed that 91% had medical or clinical volunteer experiences and 24% had some type of paid medical or clinical employment. 

Jorge A. Girotti, PhD, MHA, and associate dean at University of Illinois College of Medicine, believes that the impact that clinical experience has on an applicant's career goals is the most compelling part of their application. "I feel that it makes sense to postpone applications until you have accumulated at least one year of clinical experiences," he told the AAMC. Taking a gap year to acquire more clinical experience is not looked down upon by medical schools. 

Related:

Your Pre-Med Priorities: Clinical Experiences that Medical Schools Love

Your Pre-Med Priorities: Finding Clinical Experiences as an Undergraduate

Your Pre-Med Priorities: How to Find Clinical Experiences for Your Gap Year(s)

Let’s Talk MD-PhD. Here’s What You Need to Know Before You Apply.

MD-PhD programs are competitive. Let's get some numbers out of the way: The 122 U.S. programs that grant an MD-PhD dual degree had a collective 2,091 applicants and 750 matriculants in the 2021 cycle. That means approximately 36% of applicants got into a program. (There are also 13 Canadian schools and the NIH MD-PhD Partnership Program to consider.)

Who should be interested in an MD-PhD?

If you're passionate about research but also want to work with patients in a clinical setting, the physician-scientist path might be right for you. A strong applicant should have a research background already. "Most MD-PhD candidates earn their PhD in biomedical laboratory disciplines such as cell biology, biochemistry, genetics, immunology, pharmacology, physiology, neuroscience, and biomedical engineering," according to the AAMC. But there are some programs that allow you to pursue non-laboratory interests as well (epidemiology, healthcare policy, etc.).

How can I improve my odds of acceptance?

There are fantastic MD-PhD-focused summer research programs for undergraduates that will amp up your resume and Work and Activities entries. The AAMC provides a helpful list of such programs. 

If you're an underrepresented applicant, The Gateways to the Laboratory Program of the Tri-Institutional MD-PhD Program focuses on helping underrepresented students prepare for MD-PhD programs. That program is open to freshman and sophomores only, but Tri-I offers other research opportunity programs for undergrads further along in their studies.

Wait, it's HOW long?!

On average, an MD-PhD program lasts eight years. Schools have different ways of covering both bases, but you might attend medical school classes for two years and then switch gears to a PhD program, and then post-thesis switch back to an MD-focus and do clinical rounds.

The National Institutes of Health (NIH) MD-PhD Partnership Training Program provides an accelerated track for recent college graduates, current medical students, and NIH Graduate Partnerships Program (GPP) students that can be completed in approximately four years.

Can I apply to both MD and MD-PhD programs simultaneously?

Yes. And it's a good idea since MD-PhD programs are so competitive. You can always apply to an MD-PhD program again after you have a year of medical school under your belt. The first year of an MD-PhD program is basically the same thing. If you're rejected by one school's MD-PhD program, they'll still consider you for their med school.

When should I apply?

At the same time as you would (or will) apply to MD programs. Ideally, you would have your application in decent shape by April. AMCAS opens in May for a sneak peek at the application requirements (you should already be familiar with those). You can submit your application in June. Your program will start the following year sometime between June and August.

Who quits MD-PhD programs?

A 2020 study on MD-PhD dropouts found that students who left programs either lost a passion for research, felt isolated or had a "lack of social integration" during training, had poor experiences with PhD-advisement, or had "unforeseen obstacles to completing PhD research requirements, such as loss of funding." A separate study found that a lot of post-docs suffer from imposter syndrome, which is the inability to believe one’s success is deserved. We know this information is disheartening, but it's good to know before you walk in, the reasons why you might consider walking out. Preparing yourself for these possibilities could prevent your early exit from a program.

Choosing Allopathic (MD) Programs: Our Top Tips

In our last post, we discussed the reasoning behind applying to a large number of medical schools. Now, we'll walk you through what else you should know about the school selection process, starting with a real biggie.

• Apply to a bonkers number of schools. For the 2021-2022 cycle, the average applicant applied to 18 schools, according to the AAMC. We typically recommend 25 to 35 schools. If you have the resources (and an MCAT score below 510), it's not a terrible idea to apply to even more. The average medical school acceptance rate is 6.5%, according to a 2020 U.S. News & World Report survey of 121 ranked schools. (The acceptance rate between schools runs the gamut from barely 2% to around 20%.)

• Apply to every state school in your state. If you're going to apply to a state school outside of your state, that school should matriculate at least 25% of their students from out of state, à la the University of Vermont and University of Iowa.

• Consider newer medical schools, which have higher acceptance rates and take on students with lower average GPAs and MCAT scores. The AAMC reported that the mean GPA of 2021-2022 matriculants was 3.74, and the mean MCAT score was 511.9. 

• Your scores are important, but they are not everything. It is possible to have a higher GPA/MCAT than a school's average and still not get into it. Incidentally, this is why your Work and Activities, Personal Statement, and Secondary Essays are so important. They show a whole person—and that's often what lands you an interview. 

"Something we consider beyond an MCAT score and GPA is the balance of the class," a six-year medical school admissions veteran told us. "We look at personalities. Does this applicant have leadership qualities? Are they collaborative? Are they resilient? What unique perspective could they bring to our community? And frankly, is this a person who fellow students and faculty are going to want to be around for years?" 

• Don't underestimate seeming compatible with a school. Each campus is a close-knit environment. Research schools. Find your commonalities with each, express them in your essays and interview, and you could find yourself with an acceptance letter. Researching schools also helps you connect to a school that you're feeling iffy about—say, you don't love the location or were hoping to attend a smaller program. Knowing a program is aligned with your values and goals will allow you to stay open-minded.

Related: Choosing Allopathic (MD) Programs: Take a Broad Perspective

Choosing Allopathic (MD) Programs: Take a Broad Perspective

The Association of American Medical Colleges (AAMC) recommends researching schools several months before submitting your AMCAS application. In a perfect world, we like our clients to start by February or March at the latest. 

You've likely thought about your top picks—but you need to apply to many more than those. The biggest mistake you can make when applying to medical schools is not applying to enough of them. We recommend applying to between 25 and 35 schools. The second biggest mistake is wasting your attention and money on long applications for only shot-in-the-dark schools. You should apply to one or two of those and a slew of target schools where your GPA and MCAT numbers are at or above the average of accepted students. 

We're often asked: "How on earth am I going to find 25 to 30 schools that I like?”

Our answer: It's not about like. It's about where you can get in. There are only 155 accredited allopathic medical schools in the U.S. Having so few options makes this much more competitive than the undergraduate process. But it's not all bad news. Because while campus vibes and research and clinical opportunities will vary, all medical schools MUST teach you the same thing. Going anywhere is going towards your goal of becoming a physician. Did you get into one school of 30? Congratulations, almost-doc! 

This doesn't mean that you shouldn’t push hard on your application to your favorite school. Every year, our clients go to top-ranked programs and ones known for their desired area of interest. We're just advising you not to get into your head that there's only one to five schools for you. Many clients are laser-focused on school rankings; that can take some reprogramming to correct. Because of overall low acceptance rates, there is no such thing as a "safety" allopathic medical school. Yes, attending an upper-tier school could land you incredible research, residency, and career opportunities. But schools that aren't your first choice can also lead to first-choice experiences. (And frankly, residency is kind of what matters most.)

Related: Choosing Allopathic (MD) Programs: Our Top Tips

The Med School’s MMI Interview: Final Thoughts

Small But Giant Prompts. Not every MMI prompt will be hypothetical-scenario-based. Some will be like those comically brief traditional interview questions encouraging huge, important answers. Yes, "Why our school?" could rear its head again. To answer this, connect the dots between your past experiences and current interests, with what is happening at the school, what resources they have, etc. Be ready for “Tell me about a time that you failed” and “Tell me about a time when you had a conflict” again too. Review your secondary essay responses and go right ahead and reuse any applicable content. Those were your experiences and your takeaways, after all. There's no need to invent a whole new self.  

Critical thinking. Every question you’re asked in an MMI is going to require critical thinking and explaining your thought process. We’re simply adding this short selection of questions that obviously require critical thinking so that you can more consciously practice meeting those goals. 

• A patient with breast cancer is curious about Eastern Medicine, particularly acupuncture. How would you discuss this topic with her? 

• How would you handle multiple patients leaving negative reviews about you online? 

• What should be the primary focus of medicine—preventing or treating disease? 

• What is responsible conduct in medical research?

On Blowing It at an MMI Station. You obviously want to do well at all these stations. But what if you blow one of them big-time? Welp, take a deep breath and move on. At your next station, you’ll be assessed by a new interviewer who has no idea what just happened. If you come in strong at other stations, having one fumble will not lose you the game. Your score is cumulative, with each station being worth between one and 10 points. And it is relative. Your performance will be compared to other applicants’. (Maybe the other applicants bombed too!) You almost certainly will make a mistake at some point—probably right out of the gate. “There is research on it—the first response is shakiest no matter what competency is being tested,” said a test facilitator. “Most applicants will get better at this in a matter of minutes. And by mid-interview season, they’ll be a pro.”

Related:

The Med School’s MMI Interview: Moral & Ethical Situations

The Med School’s MMI Interview: Healthcare Policy Questions

The Med School’s MMI Interview: Role Playing Scenarios

The Med School’s MMI Interview: Teamwork Activities

The Med School’s MMI Interview: Writing and Picture Stations

The Med School’s MMI Interview: Writing and Picture Stations

The Picture Station. It’s possible that your MMI will include a picture station, where you are presented with an image and asked to describe it. The image could show something emotionally evocative or medicine-related or look like a vacation photo. Like most MMI stations, this one tests your communication   skills. The most important thing to do here is to deliver a comprehensive response. Don’t just share what is in the image, share how the image is presented. (“On the right side…”) If the image is related to a current event or medical task, share what you know about it. If the picture makes you feel a certain emotion, share that too.

The Writing Station. Not every school will have a writing station, but the ones that do will present you with their prompt (or two and you can pick one) and a time limit. That could be eight minutes, it could be 30.  Our previous blog posts cover the type of material you might be presented with at the writing station—it could be a scenario, policy, or personal question. The only thing that makes this station different is that it is testing your written communication skills.

As we have often said, you’ll want to focus on clarity in your writing. If you complete your answer, don’t feel the need to add more. You’re allowed to be done early. You might find that you run out of time and that you’re cut off before you complete your response. That’s a shame—but it happens. Don’t dwell on it. The content you have hopefully expresses some strong reasoning, etc. You likely did just fine.

Related:

The Med School’s MMI Interview: Moral & Ethical Situations

The Med School’s MMI Interview: Healthcare Policy Questions

The Med School’s MMI Interview: Role Playing Scenarios

The Med School’s MMI Interview: Teamwork Activities

The Med School’s MMI Interview: Final Thoughts

The Med School’s MMI Interview: Teamwork Activities

Medicine is a team sport. To gauge your collaboration skills, some schools will assess you in teamwork activities that you complete with another applicant. The pair of you might be asked to create an action plan together or one of you may act as an instructor and the other as a doer. (And then that gets flipped in a second exercise.)

An interviewer might ask you to build something with Lego blocks or do a puzzle together within a short timeframe. Only one of you can see a picture of the finished product, and the other person must listen to verbal instructions to assemble it. Medicine is intensely collaborative, so as silly as it seems to build a primary-colored train together, this activity will show some important communication skills. (And because more medical schools are shifting towards small group learning experiences—they want to see how you'd behave in them.)

Other schools may ask you and a larger team to find a solution to a problem or create a plan for a future program together. Things can get a little more heated here because opinions play more of a role. The most important thing to remember is that your teammates are not your competition, they are your colleagues. Listening to and empowering your teammates is a big deal. If you notice someone being left out of the conversation, be the person who asks, "What do you think, Tony?” If you're blocking out what a teammate is saying because you're waiting for your turn to speak, you will not do well in this team activity.

What if I don't finish?

That's okay! This isn't really about building the Lego train. You might be paired with a complete dud of a partner, someone who is so nervous that they can't focus. If you're the instructor in this activity, keep your cool and show patience with your partner. Search for new ways of explaining the same concept. If you are the doer, ask thoughtful questions. This is going to reflect well on you, finished project or not.

Related:

The Med School’s MMI Interview: Moral & Ethical Situations

The Med School’s MMI Interview: Healthcare Policy Questions

The Med School’s MMI Interview: Role Playing Scenarios

The Med School’s MMI Interview: Writing and Picture Stations

The Med School’s MMI Interview: Final Thoughts

The Med School’s MMI Interview: Role Playing Scenarios

"Enter the room and…" Not every school that utilizes the MMI will use role-play. But if they do, you could be presented with scenarios—in an in-person interview, it is sometimes taped to the door of a room—in which you must enter the room and speak to the actor inside as if they were your patient, a patient's family member, your colleague, or a close friend. An interviewer might be in the room watching, or there might be a camera in the room catching your big debut. (Since more schools have moved to doing interviews remotely, the “room” might be on Zoom or Kira.) Time yourself doing these practice prompts. In addition to other MMI prep, if you’re working with Apply Point, your AP advisor can act as a patient and give you notes at the end of the session.

You're not always going to "win" these scenarios. Your fake patient could continue to push back against your advice, etc. The point here is to show your empathy, thought process, and—this is the part people mess up—your ability to listen. Ask your partner questions about their thoughts, fears, or concerns. Don't give a soliloquy. Yes, this is your interview but in real life, these interactions would be conversations. Encourage an exchange. And don't be afraid to be quiet sometimes.

Think about how you'd handle these scenarios:

• A patient is refusing a treatment that would prolong his life because of its side effects. The patient's family passionately wants him to submit to treatment. Speak to this family.

• A physician’s assistant in your gynecology practice has repeatedly misgendered a trans patient. Your patient is upset. Talk to this PA.

• Your patient is terminally ill. Tell them.

• A hostile patient is demanding an opioid prescription for a supposed back injury—his X-ray does not show such an injury. Talk to this patient.

• Your best friend has been struggling with depression and is self-medicating with alcohol. Talk to her.

• You overhear a colleague using a racial stereotype when talking about a patient. Enter the room and talk to him.

• Your patient wants to hold off on starting a cancer treatment plan until after a family vacation in three months. Her condition is advanced, and you don’t think she should do this. Talk to this patient.

“Teach Me How to Tie a Shoe.”

Another potential task you might do with an actor or interviewer is walk them through a process step-by-step. One example is telling someone how to tie a shoe. Now that you’ve thought about that for a sec, you see how this might be difficult, right? Be patient with the other person and

yourself. Choose your words carefully and if you make a mistake, backtrack without panic. The point of a task like this is to test your communication skills. Are you being clear? Are you being comprehensive? Are you asking your partner what they want to know more about? Are you keeping a calm tone the way we’d want a doctor to when they’re explaining a complex treatment plan?

Related:

The Med School’s MMI Interview: Moral & Ethical Situations

The Med School’s MMI Interview: Healthcare Policy Questions

The Med School’s MMI Interview: Teamwork Activities

The Med School’s MMI Interview: Writing and Picture Stations

The Med School’s MMI Interview: Final Thoughts

The Med School’s MMI Interview: Healthcare Policy Questions

As you move through the MMI stations, a blunt quiz show question on healthcare today may be in the mix. Something like: "What is an HMO?" While interviewers will never ask you to diagnose anything, they will try to find out how much you know about the world of healthcare. How well read are you? How informed? The only way to answer a question like this is to be informed. So, know some basics.

And follow the news: Is there an antibiotic shortage? Is there a controversial new Alzheimer’s treatment? Did research scientists recently grow a human nose on a pig’s back? You don’t have to have read every behind-a-paywall study that has been written in the last two years, but certainly be up on the stuff that’s in the mainstream media. The New York Times is great for current events related to health care, as are MedPage Today, MedScape, and Stat News. We also recommend that you set up Google alerts for key phrases related to healthcare and/or your research interests and desired specialty to ensure you’re up to date.

An interviewer may ask for your opinion on hot-button issues in healthcare. Think: "What are your thoughts on stem cell research?" If you don’t have an opinion on a topic because you don’t know much about it, acknowledge that it is an important or controversial topic, then pivot to something relevant that you know about in-depth. Something like: "I have not done a ton of reading on stem cell research. But because of my clinical research position, I have worked with a novel treatment and believe that…" will have to do. 

Here are some other Healthcare Policy Questions to ponder: 

• What would you say is the biggest challenge facing medicine today? Why? 

• Do you think doctors are paid too much? 

• What are your thoughts on predictive and presymptomatic genetic testing?

Related:

The Med School’s MMI Interview: Moral & Ethical Situations

The Med School’s MMI Interview: Role Playing Scenarios

The Med School’s MMI Interview: Teamwork Activities

The Med School’s MMI Interview: Writing and Picture Stations

The Med School’s MMI Interview: Final Thoughts

The Med School’s MMI Interview: Moral & Ethical Situations

In an MMI interview, the Moral & Ethical Situation prompts are the ones that terrify applicants. They feel so high stakes. For example: Decide which of these two patients gets an organ transplant. Geez Louise.

Many MMI questions—especially the ones about morals and ethics—may omit details you might've considered when contemplating your answer. Fill in those blanks and consider them still because your answer could be conditional from an ethical or legal standpoint. "Conditional" does not mean wishy-washy but rather "If X factor is present, then my answer is Y."

Think about how you would answer this ethical question: A minor teenage patient asks you for a prescription for birth control pills—and doesn't want their parents to know about it. How would you handle this request?

You might reflexively have an answer to this—but pause and consider potential conditional factors, even if you ultimately dismiss them. Beyond answering your patient's request, what else might you discuss with your patient? You might ponder these questions:

• Are there legal matters to consider?

• Are there health risks to consider?

• Is your patient sexually active already or considering becoming sexually active?

• Is your patient 13 or 17?

• Will your patient be using a second form of protection to prevent STIs?

• Are they being pressured into a sexual relationship?

• Is there anything you should know about their partner/partners—like how old they are?

• If those things were not factors in your decision-making, why not?

Here's an example of a response to this question:

"If there are neither state laws limiting my ability nor significant health risks present, I would give my teenage patient a prescription for birth control without their parents’ knowledge. I would not tell their parents because the teen is my patient and deserves doctor-patient confidentiality. But there are things I would want to discuss before providing this prescription.

I would first provide my patient with information on all their birth control options. I'd advise my patient to use condoms as a secondary form of contraception to prevent STIs and ask them what they know about STIs.

Next, I'd want to establish that they want to have sex and that this isn't a case of a partner pressuring them to have sex. If the latter is true, it wouldn't determine whether I'd prescribe birth control, but it would influence our conversation, as I'd want to take care of my patient's mental health as well as their physical health. I'd also ask about their partner's (or partners’) age. Many age of consent laws have a close-in-age exemption, but some do not. I’d inform my patient if that was the case in our state, just so they’re aware of certain risks. If my patient revealed that they were already sexually active with a partner who was older than 18, I'd refer to my state's age of consent. I am required by law to report any suspected child abuse. I would also direct my patient to information on predatory behaviors.

If their partner was their same age, I likely would not weigh in on a 16- or 17-year-old’s choices beyond asking the aforementioned questions and providing helpful resources. But I might respectfully discourage a younger patient from having sex in the same way that I'd encourage a young patient to take care of their still maturing body and mind in other ways. (I know I'd advise my 14-year-old cousin or niece to consider waiting to have sex.) But again, I would still give a prescription to any patient that I legally can prescribe to, whether I was a family doctor or practicing at a sexual health center."

This is not a gut reaction—it's thoughtful, it's careful. This response considers legality—that's important. It involves a thorough conversation between doctor and patient. Wanting to connect shows empathy and asking the patient questions and providing answers to questions that they have or haven’t asked shows strong communication skills. The answer also expresses the respondent's personal beliefs; they would advise a 14-year-old relative to think more before having sex at such a young age. You might think this info has no place in the answer, but the interviewer wants to hear your internal monologue, not only what you'd say aloud to the patient. What matters most is that your resulting action is based on facts and that you showed your patient respect, not harsh judgment. You may not agree with this sample answer—but you should understand why it's a strong one.

Related:

The Med School’s MMI Interview: Healthcare Policy Questions

The Med School’s MMI Interview: Role Playing Scenarios

The Med School’s MMI Interview: Teamwork Activities

The Med School’s MMI Interview: Writing and Picture Stations

Considering Applying to a Caribbean Medical School? Meet the “Big Four.”

Students with lower MCAT scores and GPAs are more likely to be accepted to allopathic schools abroad than in the U.S. Due to Israel’s 2022 announcement that foreign students may no longer matriculate to Israeli medical programs, you'll be looking at the islands. Schools in the Caribbean are especially interested in students from the U.S., Puerto Rico, and Canada.

While attending a school outside of the U.S. may not be your first choice, it's likely that way more doctors than you think graduated from international schools. From 2010 to 2020, the number of licensed physicians who graduated from international medical schools increased by 24%. "About one-quarter (24.7%) of active physicians in 2020 were international medical graduates (IMGs)," according to the Association of American Medical Colleges. "This includes U.S. citizens who studied abroad."

When to Apply

Off-shore schools have rolling admissions (and have multiple start dates). We think you should start submitting applications to these programs with your U.S.-based allopathic applications in June.

Where to Apply

Of the 80 Caribbean medical schools, we recommend "The Big Four" to clients. All have key international accreditations; they are recognized by the World Federation for Medical Education/Foundation for Advancement of International Medical Education and Research (WFME/ FAIMER). They are also recognized by stricter state medical boards (like California's). These top Caribbean schools also have competitive residency placement rates and other boast-worthy qualities.

Let's take a closer look at each of The Big Four:

St. George's University / Grenada, West Indies: As of December 2020, the average MCAT score of matriculants was 498. Their average undergraduate GPA was 3.3. St. George's has a strong reputation for students passing the USMLE Step 1 (95%), USMLE Step 2 (91%), and for residency placement. SGU secured more than 990 U.S. residencies in 2022. The Grenada-based program has been the largest provider of doctors into first-year U.S. residencies for the last eight years.

Get ready for a Data Fest! SGU reported that 93% of its eligible 2017 U.S. graduates obtained a PGY-1 (a.k.a. first postgraduate year or internship year) position. (In 2022, the National Resident Matching Program (NRMP) reported that 92.9% of U.S. allopathic graduates matched into a PGY-1 position.) For even more perspective here, collectively, the 80 Caribbean medical schools had a PGY-1 match rate of 59% in 2019. (We're using different years here because the NRMP doesn't break down data by school, so our data sources are varied.) According to the FSMB, St. George's is the number one source of new primary care doctors in the U.S.

Saba University School of Medicine / Saba: Saba told us that as of April 2022, the average GPA of matriculants was 3.19 and the average MCAT was 497. Saba is smaller than SGU, so it has fewer graduates becoming residents—but their stats are strong. Between 2019 and 2021, 94% of graduates obtained residencies. The average first-time pass rate for the USMLE between 2015 and 2020 was 99%. Another thing the school highlights: The Saba Scholars Grant will pay the full tuition for the first semester of an academically qualified matriculant and can be combined with other scholarships. They also seem to weigh work history and recommendations heavily when offering U.S. students scholarships. Even an American student with a 480 MCAT or an overall GPA of 2.5 can qualify for a Faculty Scholarship of up to $25,000. A student with a 510 or above or a GPA of 3.7 can qualify for a Future Physician Scholarship of up to $110,000.

American University of the Caribbean School of Medicine / St. Maarten: In January 2022, the average GPA for matriculants was 3.27; the average MCAT score was 496. AUC has a 93.2% pass rate for the USMLE Step 1, a 92.8% pass rate for the USMLE Step 2 CK, and 96% of 2021-2022 graduates attained residencies. AUC's clinical rotations take place at Accreditation Council for Graduate Medical Education-approved hospitals. It has clinical teaching affiliates in the U.S. and the U.K., and students can take global health electives in the Dominican Republic, Russia, Uganda, Vietnam, and Zimbabwe.

Ross University School of Medicine / Bridgetown, Barbados: RUSM emphasizes remedying systemic bias in healthcare in their curriculum—and on campus. Diversity in the student body and faculty is highly valued. They have rolling admissions; prospective students can apply anytime. Matriculants can start school in January, May, or September. The majority of clinical training takes place in the United States. 2022 graduates had a residency match rate of 96% and the school has consistently had a 91% first-time pass rate for the USMLE Step 1 and Step 2. The school gave $50 million in scholarships and grants in 2020. 

Your Medical School Interview: Ways to Wing It

If you're doing interviews with multiple schools, you'll inevitably encounter an interviewer who has gone rogue. They might ask something completely bizarre because they're new at this or (and this is rare) in a terrible mood that you must ignore and overcome. Try not to visibly react to either. Instead, try this:

"Can you repeat that?"

If you're unclear on what they are talking about, ask for a repetition. Often, they won't just repeat what they've said but explain it differently, more clearly. If they repeat it verbatim, at least you'll have had 20 seconds to absorb it. If you did understand the question, you can ask for a repeat to give yourself that 20 seconds. Travel back to that childhood spelling bee. Sometimes you asked for the judges to use the word in a sentence because you were looking for contextual clues. Other times, you were buying yourself some think-time. Revisit that strategy.

You could also respond with: “That's an interesting question. I want to think about that for a moment.": Slight flattery, followed by a second to gather yourself. We had a client who was asked what she would do if she did not become a doctor. She took a beat and confidently answered a question she had not seen coming.

Keep Calm and Carry On

Interviewing is a nerve-wracking process. Ninety-nine percent of interviewers will encourage you to relax. They want to know you, not grill you. Then there is that one percent…

An interrogative interviewer might be testing your ability to maintain your composure. Or they might be a jerk who loves being a jerk. It doesn't matter. What matters is your focus on why you'd be an excellent addition to their school and a top-notch physician.

Once, an interviewer interjected as a client shared a college experience to say: "I've never even heard of where you went to college." Without displaying any negative emotion or slamming another school to praise her own, she explained that it was the college that offered her the most academic scholarship money and that she'd had so many hands-on experiences there. She was even credited on a professor's academic paper. Her response was calm and detailed because she'd utilized her brainstorm notes about her formative experiences so often when preparing her application. She nailed it: She was able to naturally remind this guy of her academic scholarship, prove her practicality, and mention a noteworthy accomplishment. Even her interview adversary had nothing negative to say about this response.

Related:

What to Expect in Your Traditional Medical School Interview: Wildcard Questions

The Medical School Interview: Don’t Forget, You’re Interviewing Them Too.

Your Medical School Group Interview: A Team Sport

Your Medical School Application: Win the Waiting Game

After you’ve submitted your medical school application and/or completed your interview, you’ll want to be proactive as you wait for a school's decision. In the weeks after your interview, for example—say, two to three weeks in—you should send a letter reiterating your interest to keep the admissions office thinking about you. 

Here are your choices:

The Update Letter. 

We're going to go ahead and say that you should send an update letter to every school where you’ve interviewed, unless you absolutely hated one or two and are confident that you'll get in elsewhere. You should also be writing to schools you’ve yet to hear from to remind them that you’re eager to connect. 

You want to send a maximum of two Update Letters over a six to 10-week period that reiterate your interest in each school with program-specific details. And only send letters that include a substantive accomplishment. If you don’t think you have one—you do! You just have to find it. We like these examples of accomplishments that one might include in an Update Letter: 

• "Since submitting my application, I have increased my overall GPA to 3.8, earning an A+ in Biochemistry." 

• "As I mentioned during my interview, I began an internship doing clinical research at My Local Hospital in October. In the ensuing weeks, I have pre-screened 75 potential study subjects, gaining valuable research and patient-facing experience." 

• "Since applying, I gave a poster presentation on a novel postpartum hemorrhage treatment at The Very Cool National Conference." 

The Letter of Intent.

If a school is a top contender for you, go a step beyond an Update Letter, and send a Letter of Intent. Send a Letter of Intent one or two weeks after your interview or the instant you have been waitlisted. Your letter should include relevant updates since you submitted your application (what you'd put in an Update Letter). Plus, a reiteration of your interest in the program with shoutouts to favorite offerings. Be specific about why you are interested in the medical school and try to relate those interests to your background, accomplishments, and goals. Have you worked on a study that relates to something happening in one of their labs? Do you want to be a pediatric surgeon and they are affiliated with one of the best children's hospitals in the country? Tell them. 

And finally—and this is what makes a Letter of Intent different from an Update Letter—include the yield protection statement: "If admitted I will attend." Keep it tight. No more than one page. Three paragraphs, max. 

Medical schools have several reasons for wanting to accept people whom they know will attend. First, they want enthusiastic students who will add to the morale of the student body. They also like to know, especially as the date of matriculation nears, that the applicant they accept will attend because no medical school wants an open seat on the first day of classes. Finally, medical schools like the percentage of accepted applicants who matriculate to be as high as possible since this reflects the desirability of the medical school. (That's their "yield percentage" stat.)

The Quasi-Letter of Intent. 

Along with your updates, you can also tell up to two schools: "I will likely attend" or "X school is one of my top choices." But ensure that your language is tight. You can only send an "I will attend" letter to your top choice school.

The Medical School Interview: Don’t Forget, You’re Interviewing Them Too.

As your interview wraps up, your interviewers will ask if you have any questions. You must have them. Being interested and thoughtful demonstrates your commitment to the program. Perhaps you've visited this school before your interview day or spoken to current or past students. Terrific. But if everything you know about a program came from their website, this is your chance to find out more. You should be open to every school you're applying to—so this is about engaging, not interrogating. This Q&A flip is also a chance to show that you've done your due diligence. Be precise instead of broad. A weak question such as "What research opportunities are currently available?" will require your interviewer to launch into 1,000 things, most of which won't apply to you—oh, and that you could have read about on their website.

You should also keep your focus on the program. Asking an interviewing physician: "What made you choose your field?" is something you do at a lunch mixer. The questions you ask during an interview session should relate to how you and the school will fit together. If you're going to ask three questions, ask at least two meaty ones. You want to include details in your questions that show that you've done your homework on the school. After your third program-related question, close out by asking if you can contact them with other questions in the future. And if the school is your top choice, tell them right now. As we cover elsewhere in this guide, schools want to accept students who will definitely attend.

Some questions you might ask a faculty or admissions committee member include:

• I read about X clinical opportunity currently offered to medical students in their second year. Is that going to be available in the future? Can you tell me more about that opportunity?

• I worked on a Y study as a research coordinator, and I'm very interested in the Y research happening here. Are there plans to expand that?

• How diverse is the student body? Are there support services for minority students?

• I have not lived in an urban setting, but I have worked with underserved patients in a small town. About how many patients does the student-run clinic see a year?

With student interviewers, your questions can be more personal, but you still want to show that you know something about the school. It's also a good idea to ask a question that relates to something you've just discussed or about a commonality that you two share, or that you share with the school:

• You mentioned that you're involved in researching X. I, too, have a background in researching X. Or, if you’re into completely different areas of research: I’m very interested in pursuing research at Specific Lab. Can you tell me more about your work at Specific Lab?

• My grandfather was in the Army, and I value our veterans. I know that the medical school has partnered with the local VA center to address both chronic pain and mental health issues. Have you worked there? What is it like?

• I’ve read about X, Y, and Z organizations here. What clubs and student organizations do you belong to? Have they proven valuable to you?

Your Medical School Group Interview: A Team Sport

In a group interview, multiple applicants are interviewed at once. And, typically, by multiple interviewers. The most important thing to remember here is that the other interviewees are not your competition but your colleagues. You won't impress your interviewers by bulldozing the other applicants and dominating the session. Of course, you want to speak up, express your thoughts and opinions, and show leadership—but you must have a team in order to lead. 

Here are some helpful tips to keep in mind for a successful group interview:

• Introduce yourself to your compatriots before you enter the room; try to remember their names and drop those names in throughout the interview. 

• Listen to and converse with the other interviewees and the panel. Your interviewers are looking to see your communication and collaboration styles. 

• When you answer a question, be sure to build on something someone else has said or compliment how others answered the question at the start of your own response. You don't have to compliment them if it doesn’t feel natural, but at least know what they've said so that you're adding to it. You don’t want to just repeat another’s answer. 

• Prep for a unique question mix. Some of the questions they'll ask in the group interview are similar to those used in a one-on-one, while others are more like the MMI prompts that place you in hypothetical ethical or teamwork scenarios.

Department of Education Increases Transparency in Graduate School Outcomes

Prospective graduate students are about to gain access to a lot more financial outcomes data, which they can use to compare programs. Last week the U.S. Department of Education (DoE) announced that it finalized the Financial Value Transparency framework to consolidate financial outcomes data.  

All qualifying graduate programs will be required to submit data to the DoE on program cost, debt, sources of financial aid, and graduates’ earnings starting next July. As applicable, the data compilation will also include licensing outcomes for graduates. For example, law schools will provide data on graduates’ admission to the bar. The data will be consolidated, published, maintained, and made available to the public on a DoE website. As of 2026, the regulations will also stipulate that programs that do not meet an established debt-to-earnings ratio will be subject to a disclosure requirement. For these programs, all prospective students must acknowledge that they have reviewed the data and understand the financial risk, prior to matriculating in the program. 

For medical schools, the DoE’s final regulations acknowledge the lengthy nature of medical training in the U.S. where medical school graduates continue in lower-paying residency training programs post-graduation. To accommodate this practice, the DoE extended the horizon for collecting earnings data for medical schools to six years post-graduation. 

For business, law, and other graduate programs, the data provided to the DoE will use graduates’ earnings three years post-graduation. 

Medical School Applicants: Are You Taking Care of Yourself?

If you're going to dedicate your life to healthcare, start at home. Medical students have a significantly higher rate of mental illness than similarly aged postsecondary graduates, according to a 2019 study in Academic Medicine. One harrowing quote: "Higher rates of distress and burnout in physicians and medical learners have been linked to poor academic performance, increased thoughts of dropping out of medical school, lower levels of professionalism, decreased empathy, increased medical errors, increased substance abuse, and increased suicidal ideation." 

Despite the intensity of the medical school application process, preparing yourself for the stress of attending medical school is important. Practicing mindfulness, getting rest, and being a person in the world are part of being ready for a rigorous academic environment and career. 

Stay social. This is not to say that you should be partying the night before a medical school interview. But you do need to leave your desk—or at least have interactions beyond your study group. Keeping your relationships strong also provides a safety net in hard times and helps you to be empathetic. 

Sleep. When sleep is in your control, try to maximize the opportunity. A study published in the December 2021 Journal of Clinical and Diagnostic Research found that anxiety and stress directly impacted medical students' sleep during the second wave of COVID-19. One thing that you can do to combat that right now is to put away your phone every night. You've heard it before—but it's especially relevant to you. In a study published in the January 2022 Journal of Affective Disorders, medical students’ anxiety was associated with problematic smartphone use and sleep deprivation. 

Move. Do whatever you comfortably can do in terms of a regular exercise regimen. You don't need to run a six-minute mile to be a strong candidate for medical school —exercise is just another way to relieve stress (and reduce your risk of a meltdown). A study published in Academic Medicine in 2017 surveyed 12,500 medical students across the country and found that those who met the CDC's exercise recommendations had a lower risk of burnout and a higher quality of life. 

Get professional help. Even if you're not feeling extreme turmoil right now, this could be something to explore. "Studies suggest medical students experience high levels of mental distress during training but are less likely than other students to access care due to stigma and concerns regarding career progression," according to a 2020 study published in BMC Medical Education. The University of Cambridge developed a mental health program for medical students. Cognitive Behavioral Therapy, Interpersonal Therapy, Eye Movement Desensitization Reprocessing Therapy, or Cognitive Analytic Therapy was provided to 189 students. Stress, anxiety, and suicide risk were "significantly reduced" and students' functioning "significantly improved." 

Meditate. This is just a suggestion, if it's not for you, it's not. But you could try it. (And cynically speaking—schools might be into it if you mention meditation during your interview. It shows both openness and dedication.) Meditation isn't about having a blank mind; it's about acknowledging and letting go of intrusive thoughts and accepting what is happening at the moment. This can aid performance, according to George Mumford, a mindfulness coach who taught Kobe Bryant and Michael Jordan how to meditate. "Mindfulness is the process of making yourself flow-ready," he says. And don't all doctors want to be ready for whatever happens next?

Another benefit of incorporating these healthy behaviors into your life is that they can strengthen your tolerance for ambiguity. Studies have measured this quality in medical students and physicians for years, and they have shown that a physician's ability to tolerate ambiguity correlates to their level of psychological well-being. Those with a low tolerance for ambiguity and uncertainty "tend to report a higher rate of referrals, burnout, and anxiety, and lower level of satisfaction, less comfort in dealing with dying patients, and higher levels of dogmatism, rigidity, and conformism," according to a 2017 study in Medical Teacher, which utilizes many others' findings as well as their own assessments. 

Related

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