Premed Prep

Advice From A Medical School Admissions Dean

Sunny Nakae

• Publisher: Rutgers University Press
• Year: 2020
• ISBN:
  9781978817241
• Topic: Manuali di studio
• Subtopic: Guide di studio

If you're a student hoping to apply to medical school, you might be anxious or stressed about how best to prepare. What classes should you take? What kinds of research, clinical, and volunteer opportunities should you be pursuing? What grades and MCAT scores do you need? How can you stand out among thousands of applicants? Premed Prep answers all these questions and more, with detailed case studies and insider tips that can help premed students authentically prepare and enjoy the journey from the very beginning. Dr. Sunny Nakae draws from her many years of experience as a medical school admissions dean to offer wise and compassionate advice that can help premed students of all backgrounds. She also has specific tips for students who are first-generation, minority, non-traditional, and undocumented.Both forthright and supportive, Dr. Nakae's advice is offered in a keep-it-real style that gives premed students a unique window into how admissions committees view and assess them. The case studies are drawn from her years of supporting students en route to medical school. Premed Prep covers how to approach preparation with a focus on exploration and growth, and how to stop obsessing over med school application checklists. This book will do more than help you get a seat in medical school; it will start you on the process of becoming a successful future physician.

PART I

Getting a Solid Start

1

Premed Basics

“Be Quick, but Don’t Hurry”

The prevailing advice I give about academic progress in premedical preparation is a quote from the great John Wooden, one of the most successful coaches in NCAA college basketball history: “Be quick, but don’t hurry.” This seems contradictory, but in fact it’s not. Go as fast as you can without your speed compromising your performance. If you sacrifice performance for speed it will not pay off. If you are in a hurry, you might make mistakes and not perform your best. This will lead to having to spend extra time addressing deficits, and that does not actually help you in the long run. What is the point of graduating in four years with a 2.9 grade point average? You will just end up taking at least a year of postbaccalaureate courses to really show you are prepared. Better to be intentional about your pace from day one.

My second most salient piece of advice is this: Your grade point average (GPA) will NOT get you in, but it can keep you out. You absolutely must safeguard your GPA during this process. The GPA is like a token that unlocks consideration for admission. Think of it like a key that determines how much the door is open. A lower GPA does not necessarily mean you’ll be excluded, but it will mean that the number of schools that will consider you will be fewer than if your GPA were higher.

Notice I said it opens the door to “consideration.” Schools typically prioritize their candidates by GPA to varying degrees, at least initially. How much consideration you receive is usually preliminarily based on your numbers. Some schools that are holistic have a minimum threshold that you have to meet before holistic review happens. Even schools that consider postbaccalaureate applicants may have minimum undergraduate GPAs that all candidates have to meet before they consider your postbaccalaureate performance. Admissions practices vary across schools, and as a rule having a solid GPA always helps.

Know the Rules

Before you begin, it is critical that you know this important rule for the American Medical College Application Service (AMCAS),¹ the common application to allopathic (MD-granting) medical schools. Every course you have ever taken for college credit will appear on your AMCAS application. You cannot repeat courses to improve your GPA. If you take a biology course for four credits and you earn a D, and then you repeat that course and earn an A, AMCAS will average in four credits of D and four credits of A into your GPA. Your university most likely will replace the four credits of the D grade with the four credits of the A grade. This makes getting off to a strong start and taking charge of your premed course journey that much more important.

Withdrawals

Let’s have real talk with this important fact—withdrawals are not good, but they are better than Fs or Ds. Fs and Ds do real damage to your academic record and are hard to make up over time. You should enter college knowing the important dates for registration and course management at your school. You should know the last drop date and add date for courses. Know the minimum credits you have to take each semester. Find out whether you can take a class pass/fail and what the deadline is to switch that option to a graded course. Most schools do not allow pass/fail courses for the premedical coursework, but pass/fail courses do not affect your AMCAS GPA. If you are not sure if you can do well, you may wish to pursue a pass/fail option in order to preview the class if auditing is not allowed or if you need the credits for financial aid purposes. If you fail a pass/fail class, your GPA calculation in AMCAS will not be impacted, but it will be noted on the academic summary page. (Your academic standing with your school might be affected.) Know if you are allowed to audit and if there are fees for auditing. Know when the final allowable withdrawal date is. Be aware of the academic progress, tuition refund, and financial aid policies related to withdrawing or dropping classes.

If something happens during the semester and you know you will not be able to earn at least a C, consider withdrawing and taking the W instead of a very poor grade. This is not to be taken lightly, of course, because a persistent pattern of withdrawals can be concerning for committees. Withdrawals also mean that you likely paid for the class and will have to do so again. Schools do not want to see someone continually withdrawing for fear of not getting perfect grades! But believe me, a W or two on the transcript will not affect your GPA, and you will live to tell the tale. You may still have to explain what happened during your interview, but you will be more likely to reach the interview phase of applying, rather than losing consideration because your GPA has sustained real damage. Let’s talk more about customizing your path and the importance of starting strong.

Alejandro

Alejandro entered the university from a public high school in the same city. He was very interested in a career in medicine and had participated in a health careers program at his high school. As the first child in his family to attend college, he sought mentorship and guidance for his journey right away. For his first meeting with me, he brought in the premed track handout that the prehealth advising office had given him. According to the schedule, he needed to take Biology I with a lab and General Chemistry I with a lab his first semester, then Biology II and General Chemistry II with labs his second semester. This was nine science credits the first semester and eight science credits the second. Twelve credits is full-time. Did it make sense for Alejandro to take these courses right away when he had liberal arts, history, and writing requirements? What was he interested in studying as he adjusted to college? We talked about his science background and his high school courses. He did not have any lab classes in high school because his school did not have a science lab.

Alejandro and I created a class schedule that included an Introduction to Lab Techniques his first semester and an Introduction to General Chemistry his second semester. The rest of the courses were in writing, history, behavioral science, and recreation. Through the introductory classes he became familiar with resources in the College of Arts and Sciences and the pace of science classes in college. He did well and was able to build confidence in his ability to step up to a more rigorous schedule his second year. When it was time for him to take labs in biology, chemistry, organic chemistry, biochemistry, and physics, Alejandro was more comfortable in his surroundings, and by his third lab he served as a peer instructor. Alejandro graduated with his degree in five years—which, by the way, is the average time it takes a student in the United States to complete a bachelor’s degree.² His grades were not a perfect 4.0, but he was well prepared and confident when he started medical school. He did not have to explain any massive blemishes on his record.

Customize Your Path

Map out a path that makes sense for you. Do not pressure yourself to finish or “stay on track” if that track is not your own. At most colleges these days, premed is one of the most popular major declarations for incoming first years. Thousands of students begin the journey intending on medicine as a career, but only a fraction of those remain premed at college graduation. So what goes wrong? Let’s start with a little history lesson.

PREMED COURSES AND MCAT TIMING

In 1910 a man named Abraham Flexner was hired by the American Medical Association (AMA) and the Carnegie Foundation to study medical education in the United States.³ Before Flexner there were all types of doctors (e.g., apothecaries, bonesetters, botanists) and many pathways for training. Anyone could hang a sign up that said “doctor” and how they trained was not regulated or verified. Nothing was standardized, and although there were legitimate doctors then, there were also many bogus practitioners. The AMA was eager to standardize medicine so that the term “doctor” was consistently associated with someone who had undergone a standard training pathway. So Flexner declared in his report that a year of specific university courses should be required for entry to medical school. This began the standardization process for allopathic medicine. These course recommendations have largely gone unaltered since then.

Fast-forward to modern times where the Medical College Admissions Test (MCAT)⁴ is a required element of the application. When testing was done with paper and pencil, it was only offered twice a year—April or August. Thousands of tests had to be securely collected and scanned, so it took at least eight weeks before scores were released. Applicants who took the August test were at a big disadvantage because their scores came out in October (late in the application cycle). So colleges aimed to have their students prepare for the exam in April. Back in 2000, most students applied right out of college, meaning they started during their third year of undergrad with applications and matriculated to medical school after graduating the following spring. Why does this matter?

Many university premed course tracks will set you up to finish all your premed courses by the first semester of your third year, despite it being unnecessary now. Even though the sequencing of the MCAT has changed, some premed course tracks have not. That’s roughly five semesters to complete one year of biology, one year of general chemistry, one year of organic chemistry, one year of physics, plus biochemistry, genetics, and any other classes that schools may require. (The requirements may not be exactly the same for every medical school.) That is a f...