What category are you in?

[Skip Intro]

I posted this in another thread, but I thought it deserved its own space.

As I see it, there are basically five categories of medical school applicants (and I think it probably fairly evenly distributes along the Bell curve):

1. Definite acceptance: These are students who have killer recommendations, high MCAT scores, high GPAs, and high-achieving. They are probably good looking too. They will usually have their pick of programs and get multiple acceptances.
2. Probable acceptance: We're talking MCAT in the 30 range, GPA 3.4 or higher, good recommendations, okay-to-above average undergrad pre-med program with good recommendations. If they apply broadly, they will usually get in somewhere. If they don't, then there was probably some tactical mistake made (late application, too few applications, no "back-up" schools, unrealistic geographic limitations, etc.).
   
3. "On-the-cusp": There may be a minor blemish on their transcript somewhere. They might have a very strong GPA, but were only able to get a 28-29 on the MCAT, with at least one 10 in one of the categories (preferably biological sciences). Their pre-med sciences GPA is above a 3.4-3.5, but their overall GPA may be lower in the 3.0 range. They will have very strong recommendation letters nonetheless. A lot of these students will end-up not getting into a U.S. M.D. program and will go the osteopathy route.
4. Not likely: These are the students who have broad deficiencies in their applications. Their MCAT score is 27 or less. Their science GPA is is below a 3.2. Their overall GPA is maybe at or below 3.0. If they have good recommendations, they're lucky.
5. Should rethink their dream: These are students who are entirely below the first 4 categories, but nonetheless hold onto the dream of becoming a doctor. Sometimes even despite a decent application it's an intangible thing to the individual, like a glaring personality disorder, that has sabotaged them, but no one has the heart or honesty to tell them.

Needless to say, the first two categories don't have much to worry about. The Caribbean essentially caters to the 3rd through 5th category.

Many of the students who choose the Caribbean, other than being older and "late bloomers" in life, fall into the 3rd category. Probably if they had persisted and worked on their application (and had been willing to wait), they would've gotten into a U.S. program somewhere.

Most of the Caribbean students, I surmise, are in the 4th and 5th category. With good effort and determination, the 4th category can go and do well. But, for some (or more than some) of them, they will find the challenges of being in the Caribbean too difficult to surmount and will drop out or otherwise not succeed. This is because the problems that they had in undergrad could not be put past them.

The fifth category - the one that gets the Caribbean all the bad press - are the ones that will undoubtedly fail. In my opinion, this is the category that the schools have to do a better job of identifying and not taking their money in the first place. It would go a long way to cleaning up the image of what Caribbean medical school, especially at the big well-established schools, means. The other totally unscrupulous schools who will take anyone with a heartbeat and a checkbook... well, no one should attend them. That's just my opinion.

-Skip

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[el_duderino]

Solid post.

 

[wolfvgang22]

Maybe this should be a sticky. This information is fundamental to understanding where you are as a prospective student.

 

[BestDoctorEver]

@Skip Intro... I dont agree with #3. Why would someone go to the caribbean with 28-29 and 3.4+ sGPA even if their cGPA<3.0? Someone in that category can easily get into DO by retaking a few classes to get their cGPA above 3.0.

 

[el_duderino]

@Skip Intro... I dont agree with #3. Why would someone go to the caribbean with 28-29 and 3.4+ sGPA even if their cGPA<3.0? Someone in that category can easily get into DO by retaking a few classes to get their cGPA above 3.0.

My comments:

1) Some people would rather a Carib MD than US DO.
2) 3.4+ sGPA with a 2.8 cGPA doesn't guarantee admission, even to DO.
3) Retaking classes to end up with 3.4+ sGPA and a 3.05 GPA doesn't guarantee admission either.
4) Retaking classes takes time, and some people would rather enter med school now instead of spending another year taking classes just to take another shot at a US MD school. You're looking at a 2-year difference in graduation date.

 

[BestDoctorEver]

@jonnythan... I know nothing is guaranteed when it comes to getting into med school, but someone with 3.1cGPA, 3.4 sGPA and 26+ MCAT has very good chance in getting into DO school. It might be newer or low tier DO, but it is a heck of lot better than going to the BIG 4... I think a US citizen or resident in category #3 who is less than 30 years old that choose carib instead of DO has bad decision making skills.

Edit... I don't have any problem with carib schools (big 4) as I considered it myself, but I think it is wise for someone to exhaust all your US options first...

 

[el_duderino]

@jonnythan... I know nothing is guaranteed when it comes to getting into med school, but someone with 3.1cGPA, 3.4 sGPA and 26+ MCAT has very good chance in getting into DO school. It might be newer or low tier DO, but it is a heck of lot better than going to the BIG 4... I think a US citizen or resident in category #3 who is less than 30 years old that choose carib instead of DO has bad decision making skills.

Op does say this about category 3:
"Probably if they had persisted and worked on their application (and had been willing to wait), they would've gotten into a U.S. program somewhere."

 

[BestDoctorEver]

Op does say this about category 3:
"Probably if they had persisted and worked on their application (and had been willing to wait), they would've gotten into a U.S. program somewhere."

oops... I just saw that.

 

[Skip Intro]

I've even met a rare "4" whose gotten into a U.S. MD-granting program. "Not likely" doesn't mean it's not going to happen. Just that it's not likely. How do I know this? A friend on the adcom at the school when I was in training told me about certain "quotas" that they had to meet. That's all I'm going to say about that.

FWIW, I was a "3" but because, at the time, there were limited spots and too many applications from the state I lived in, I was unable to realistically get a spot. I couldn't wait any longer being over the age of 30 when I started and gamble that the situation was going to change for me. The osteopathy route was not something that I considered because I have a fundamental disagreement with OMM philosophy and didn't want to endorse it by attending (which isn't a consideration for a lot of people but was me). Most schools in states (especially ones that have/had a disproportionately low number of medical schools spots-to-applicants ratio) give preference to in-state applicants.

It's all a numbers game ultimately. That, and meeting certain criteria that the adcoms feel is important and/or what they have to fill to show "diversity" in their class.

-Skip

 

[el_duderino]

I was a 4. Not a URM.

 

[deleted92121]

I fall between categories 3 and 4.

Cumulative GPA < 3.0 (2.6-2.7)
Science GPA > 3.0 (3.3-3.4)
Numerous retakes
8+ years in EMS/Trauma Center as paramedic
Good ECs
Excellent LOR specifically from prominent MDs
MCAT on 7-24, averaging ~30 or so on practice exams

I am late twenties and am considering DO heavily but am not against SGU or Ross. Any of these choices make me happy, though I would prefer to stay in the country.

 

[BestDoctorEver]

I fall between categories 3 and 4.

Cumulative GPA < 3.0 (2.6-2.7)
Science GPA > 3.0 (3.3-3.4)
Numerous retakes
8+ years in EMS/Trauma Center as paramedic
Good ECs
Excellent LOR specifically from prominent MDs
MCAT on 7-24, averaging ~30 or so on practice exams

I am late twenties and am considering DO heavily but am not against SGU or Ross. Any of these choices make me happy, though I would prefer to stay in the country.

Your cGPA might be too low for DO... Is there anyway you can retake classes for a couple of semesters to bring up that cGPA to 3.0+? If you do that and you end up with 26+, you chances for newer and low their DO schools will be good IMO.

 

[deleted92121]

Your cGPA might be too low for DO... Is there anyway you can retake classes for a couple of semesters to bring up that cGPA to 3.0+? If you do that and you end up with 26+, you chances for newer and low their DO schools will be good IMO.

This is a strong possibility.

But here is my devil's advocate response. DO schools may look down at the multitude of retakes. It took me three times to pass Gen Chem and still only earned a C+. What that shows is I make mistakes, the same ones, over and over. But I didn't give up. I learned to manage my dyslexia/ADD. I stopped focusing on work and thinking I could just pass a class easily. I had to learn how to study. And I really have.

But the issue remains that I am a mediocre applicant and a risky student to admit to medical school. All things being equal, I would take a better student over me too. But I have a ton of intangibles and medicine, for better or worse, is my passion. I have read most of Harrison's. Who does that?!

So maybe SGU or Ross will be willing to take a chance on me. I don't desire a competitive specialty except maybe EM or Gas. But even those are not even close to out of reach if I do well in medical school, decent test scores, and good LOR.

 

[BestDoctorEver]

This is a strong possibility.

But here is my devil's advocate response. DO schools may look down at the multitude of retakes. It took me three times to pass Gen Chem and still only earned a C+. What that shows is I make mistakes, the same ones, over and over. But I didn't give up. I learned to manage my dyslexia/ADD. I stopped focusing on work and thinking I could just pass a class easily. I had to learn how to study. And I really have.

But the issue remains that I am a mediocre applicant and a risky student to admit to medical school. All things being equal, I would take a better student over me too. But I have a ton of intangibles and medicine, for better or worse, is my passion. I have read most of Harrison's. Who does that?!

So maybe SGU or Ross will be willing to take a chance on me. I don't desire a competitive specialty except maybe EM or Gas. But even those are not even close to out of reach if I do well in medical school, decent test scores, and good LOR.

I see... Multiple retakes for gen chem won't look good. I think SGU, ROSS or AUC might be a good choice in your case. GL

 

[deleted92121]

I see... Multiple retakes for gen chem won't look good. I think SGU, ROSS or AUC might be a good choice in your case. GL

Thank you, I will need it.

 

[Skip Intro]

I learned to manage my dyslexia/ADD. ...
But the issue remains that I am a mediocre applicant and a risky student to admit to medical school.

The problem for you is going to be the timed, standardized tests (USMLE Steps, Board Certification exams, re-certifications). While you might be able to file for a "special needs exception" if you have a clinical diagnosis of dyslexia and a physician who is willing to help attest to that, these are still very difficult tests that contain questions that are sometimes paragraphs long. This may be a real challenge. I would just factor that into your considerations.

And, as an aside, my aunt reads the Merck Manual like it's the Bible. She has probably read it in its entirety cover-to-cover a dozen times or more. While I love her to death, it's incredibly frustrating the conversations we have because of how she misconstrues much of the information contained therein. I can't tell you the number of times that she's called saying, "I have 'x' diagnosis." She tells me the problem and I reply, "No, you don't." She then snaps back at me, "But I read it in the Merck Manual and this is exactly the symptoms!"

Part of learning medicine and becoming a physician, which is not completed by a long shot when you're handed your shingle at graduation, is the "hidden curriculum" of learning how to develop a differential and work through it, as well as how to make difficult decisions, revise those decisions and plans when new information comes to light, and to stand-by and defend those treatment decisions not only to the patient but also your colleagues. A lot of this more "hardcore" training comes in residency.

So, I mean this with all due respect, but being fascinated by the human body and disease is not the only trait required to be a physician. It's a good and admirable trait and, in my opinion, those that truly keep that fascination throughout their careers make the best doctors. But, it's also a lot of hard work, focus, managing burn-out, dealing with challenges that you cannot possibly foresee right now, and it is a profession that will literally change your brain and the way you think about and see the world. You can't and won't really know this until you experience it.

Of course none of us knows you and the range or severity of your dyslexia/ADD, but starting medical school with a language processing disorder is, and I mean this in the clinical sense, a handicap that might prove to be difficult for you. Only you know yourself, though. A lot of dyslexics have managed other compensatory ways to process and retain information that are amazing, overcoming this obstacle and being leaders in business, law and other fields. And, of course, dyslexia has nothing to do with native intelligence or ability.

Whatever you decide, best of luck!

-Skip

 

[deleted92121]

The problem for you is going to be the timed, standardized tests (USMLE Steps, Board Certification exams, re-certifications). While you might be able to file for a "special needs exception" if you have a clinical diagnosis of dyslexia and a physician who is willing to help attest to that, these are still very difficult tests that contain questions that are sometimes paragraphs long. This may be a real challenge. I would just factor that into your considerations.

And, as an aside, my aunt reads the Merck Manual like it's the Bible. She has probably read it in its entirety cover-to-cover a dozen times or more. While I love her to death, it's incredibly frustrating the conversations we have because of how she misconstrues much of the information contained therein. I can't tell you the number of times that she's called saying, "I have 'x' diagnosis." She tells me the problem and I reply, "No, you don't." She then snaps back at me, "But I read it in the Merck Manual and this is exactly the symptoms!"

Part of learning medicine and becoming a physician, which is not completed by a long shot when you're handed your shingle at graduation, is the "hidden curriculum" of learning how to develop a differential and work through it, as well as how to make difficult decisions, revise those decisions and plans when new information comes to light, and to stand-by and defend those treatment decisions not only to the patient but also your colleagues. A lot of this more "hardcore" training comes in residency.

So, I mean this with all due respect, but being fascinated by the human body and disease is not the only trait required to be a physician. It's a good and admirable trait and, in my opinion, those that truly keep that fascination throughout their careers make the best doctors. But, it's also a lot of hard work, focus, managing burn-out, dealing with challenges that you cannot possibly foresee right now, and it is a profession that will literally change your brain and the way you think about and see the world. You can't and won't really know this until you experience it.

Of course none of us knows you and the range or severity of your dyslexia/ADD, but starting medical school with a language processing disorder is, and I mean this in the clinical sense, a handicap that might prove to be difficult for you. Only you know yourself, though. A lot of dyslexics have managed other compensatory ways to process and retain information that are amazing, overcoming this obstacle and being leaders in business, law and other fields. And, of course, dyslexia has nothing to do with native intelligence or ability.

Whatever you decide, best of luck!

-Skip

Skip,

Thank you for the time and effort to reply. I agree with you completely on your assessment of the situation. My dyslexia has been challenging and I think the MCAT will be a good standard to measure against. I have worked hard to adjust and on previous standardized tests, such as the national paramedic registry exam, I have scored well and passed on the first attempt. Now please don't mistake me, the national registry was not a critical thinking exam per se, and certainly not in the vein of difficulty as the MCAT or Step 1. But I think doing well on that is at least a start, albeit a very small one. And I would respectfully contend that reading Harrison's or any other medical text as a paramedic is somewhat different than a person not in the medical field reading one. But yes, medicine in general fascinates me.

I have been lucky to be part of an ED with excellent physicians that encourage my pursuits and help me understand what I am attempting to get into. I certainly do not have first hand experience the way a medical student, resident, or attending does. But I do have enough significant experience that I believe I am making a decision with my eyes open to the realities of medicine, including the clinical, political, and business aspects. I am sure I will learn more and my opinions/views will evolve.

Once again, thank you for your reply.

dxu

 

[Skip Intro]

And I would respectfully contend that reading Harrison's or any other medical text as a paramedic is somewhat different than a person not in the medical field reading one. But yes, medicine in general fascinates me.

I didn't mean to insinuate you were like my aunt, and I'm sorry if it came across that way. It truly sounds like you have a solid grasp of the situation and a passion for learning medicine, which is... well, if you don't, then what's the point, right?

My only point was that, much like her, non-physicians (from true laypeople even to advanced-practice nurses) cannot fully understand unless they go to medical school what it takes to become a "doctor" (i.e., the "hidden curriculum" of medicine). That, as a discipline, there are multiple ways you acquire, process, and utilize the medical information you learn, sometimes being required to do so at the limit of exhaustion.

In other words, going online and Googling or perusing medical textbooks may be interesting, but it is not how medical knowledge is fully acquired. But, you already know that. Learning medicine is part auto-didactic, part apprenticeship, part indentured servitude. And, you will be expected to produce that information on-demand at various points in your career.

My aunt's own interest and fascination with the Merck Manual, I think she falsely believes, conveys in her own mind that she has "physician level" knowledge on ailments. She simply does not. Knowledge is only part of it, and experience applying that knowledge is paramount. You can't get the latter from a textbook. What it takes to be an excellent doctor (and is inherent in the ones whom I consider excellent) means being able to acquire, synthesize, and apply knowledge to individual situations with appropriate judgment. (That last part is key.)

People entering the field of medicine with a language processing disorder, like dyslexia, can certainly become excellent physicians. It just makes it more challenging along the pathway. And, as I said before, it has nothing to do with inherent intelligence or ability.

Good luck!

-Skip

 

[deleted92121]

Skip,

It's so funny you mention the "hidden curriculum". One of my friends is a trauma attending and said the same thing to me the other day. I know this is an uphill battle and I have tried, and I mean really tried, to think of something else I would like to do. Another career that would be satisfying and meets my criteria.

Anyway, it looks like the Caribbean is my best bet. I am fairly certain I would be a very good physician. In no way am I attempting to be arrogant but I am an excellent paramedic for a number or reasons. So from the clinical standpoint, I like to think I would be strong. As you mention though, there are other intangibles. Those are the things that only time will uncover for me.

Hopefully my MCAT goes well and Ross or SGU are willing to accept me. Should that happen, I can guarantee all my energy will be spent on being successful.

DXU

 

[bedevilled ben]

I am an excellent paramedic for a number or reasons. So from the clinical standpoint, I like to think I would be strong.

First lesson of med school: You suck at everything you thought you were good at, and you suck at it in ways you never thought possible. At least that's been my experience, anyway...

 

[deleted92121]

First lesson of med school: You suck at everything you thought you were good at, and you suck at it in ways you never thought possible. At least that's been my experience, anyway...

I wish I could have laughed at that but that has certainly been the consensus on what to expect.

Funny little anecdote. I was in the ED one evening and a patient needed tubed. Massive ICH with shift. I happened to be at the head of the stretcher. Had thrown an EJ in and was ventilating with BVM. My attending, a close friend, looked at me and said you're in charge of the airway and I'm going to treat you like a resident. Man did he bark and berate me. Nervous and as frazzled as I've ever been. Questioned every med choice I made for RSI and made me justify. Sunk the tube first shot but needed a drink after that. Still quizzes me and teaches me to this day but I still get scared in a resus with him.

 

[Qester]

Great post skip! Also consider the Canadian students who go to the Caribbean, many of who by my guess would be a #1 or #2.

 

[Skip Intro]

Thanks. To be clear, I originally meant your chances at an LCME-accredited school.

-Skip