What is the biggest flaw in med admissions process, and how would you change it?

[NickNaylor]

I'm a very tactile learner, and the cadaver dissection is almost a rite of passage in medical education in America it seems. I would not want to miss out on that. I may want to go into surgery, and I'd prefer to be able to do a dissection. Otherwise I might as well be learning on models and not human bodies.

Anatomy becomes pretty routine and extremely boring after about week 1. It's tedious work that, all things considered, is a pretty poor use of time. To boot, it's absolutely nothing like surgery beyond the shared "cutting on some tissue with scalpels." I hope you enjoy it, but apart from the people that seem inherently interested in surgery and "being cutters," not many of my peers found anatomy a very enjoyable experience. If I could've avoided the 3 hours per day spent dissecting and just looked at prosections, I would've taken that opportunity without thinking.

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[darkjedi]

Man, I must be one of the only people that actually enjoyed the dissections in anatomy. It's still one of my favorite classes in med school.

 

[chillaxbro]

If you really wanted to pay anything to get into a medical school, you'd be better off cutting a check for $10,000 to one medical school, as a donation, than to paying a $500 application fee to each of 20 schools.

Why not just limit it to 4? Making it $500 would just put the poor in an even bigger disadvantage in medical school admissions.
Someone can just pay $2000 and have twice the chances of getting into medical school as everyone else

 

[NuttyEngDude]

I think it would be beneficial for the MSAR to have more things included such as if the curriculum is pass/fail ranked, unranked, etc so you dont have to ask every school on interview day. It would be even better if it was a searchable term in the online MSAR.

Also, food is a huge thing to make you feel better on a stressful day. Having bad food is like having a bad massage, you dont feel better afterwards and possibly can feel worse. This is not a deal breaker in any way.

If more money is to be charged for applications, let it be used to process them. The extra money could be used to manage the volume better, not to limit total applications, but I understand the point. From the other side of the fence it can be a daunting process to have so many to sift through, perhaps there is some money to be made from an entrepreneur to help adcoms with this.

Let the candidate know if the interview is open, closed, MMI, etc prior to attending. This can help prep and allow them to put their best food forward. (EDIT: some of this is in the MSAR, but it would be nice if it was more standardized. Some schools provide number of stations, the nature of MMI, if it's a hybrid structure, etc)

Finally, I think a lot of the post-interview notifications and openness can be better among some schools. I think a more uniform update system could be followed, with some schools wanting every update you can give them and others wanting no communication. If this was standardized it would make life easier, and in some cases fairer, for all. I think the lack of openness and perceived fairness are the big complaints in all these threads, the rest (such as food) is minor in comparison.

 

[NickNaylor]

Man, I must be one of the only people that actually enjoyed the dissections in anatomy. It's still one of my favorite classes in med school.

The complexity of the anatomy and the elegance of it was super cool, but at the end of the day that just wasn't enough for me. Cleaning out fascia and isolating structures was just booooooring. I had two guys in my group that were eager cutters, so I would just spent the lab day walking around looking at other bodies and trying to study as much as possible. But there were definitely people that were very much into it. I don't think that was most people, though.

 

[Planes2Doc]

So much time is wasted in the actual dissection, plus there were so many instances where we dissected something incorrectly or cut a nerve or something that it would actually be nice to have faculty do the dissections. The majority of the learning is done once the dissection is complete and you're just looking at the structures. I don't see that much of a flaw in that school's system.

I would have killed for prosections! We spent way too much time in anatomy lab, and a majority of it was sifting through fascia. I feel like I learned way more outside of lab, particularly with the Thieme Atlas on my iPad, than from those horrible messes which were dissected by students. Lab practicals would have been far easier if they were also dissected professionally by the staff, and looked more like the atlas. Student dissecting makes things way worse than they have to be.

 

[chenzt]

Let the application cycle be more like the NRMP. Everyone finds out all at once in March and they can celebrate or cry together. No wait list, no need to crossing fingers until orientation for a possible seat.

EDIT: I can't imagine the sh*tshow that would result on SDN.

 

[Redpancreas]

Less Subjectivity; More transparency and accountability.


The biggest flaw in my opinion is the interview process.

1. It's necessary to incorporate human elements into the process, but the subjectivity to it these days is unfair. What if one person connects well with interviewer and another one doesn't? How do we know if that's due to the applicant not connecting well not having people skills or if that's due to an interviewers bias? You can't know but you can be more certain if you increase the number of people evaluating the interviewee and standardize the questions asked. In science, this would analogous to doing multiple trials and setting up defined variables. Frankly, I don't know why the MMI is so slow to be implemented. One notable exception is at highly ranked research schools and MD/PhD applicants. They need a one-on-one discussion about their research experience.

Other factors:

2. Also, as a suggestion, why can't we have online EC sheets for supervisors to fill out?

These should have:

Applicant Name:
Recommender Name:
Recommenders Relation to Applicant:
Position of Applicant
Brief Description of Applicant's Role:
Number of hours done by applicant:
Contact Information:

Let me be clear that this form wouldn't turn into a recommendation of any kind and should take less than a minute to fill out. This would really reduce the amount of forgery we see in these ECs and making it online would limit the amount of administrative BS adcoms have to sort through. This form should be for every AMCAS activity excluding ones you have letters of recommendation for.

3. MSAR is great but it can be better. How about actual tuitions rather than first year tuitions as it turns out tuition's vary year to year by a lot at some schools and sometimes MSAR will take the cheapest year's tuition.


4. For the prices they charge for secondaries and for the money we invest to make it to an interview, schools should be willing to give personal feedback in form of an appointment, phone conversation, or non-generic email (at the very least) explaining to the applicant what he or she can improve on to be more competitive for the school next year. If the reason is a shallow one, then the school should be honest. I don't see why this process needs to be so unpredictable.

5. Get rid of the requirement for an undergraduate degree. Just say one must complete 90 credits for matriculation. The new pre-med requirements are already composed of about 60 credits so the remaining 30 is plenty to have a student do other things. Colleges will need to adjust to this and offer pre-professional, flexible majors. Let's be real here...how many students need bio, chem, physics, orgo, writing, and math..? Pretty much all the health professionals students which is like a huge chunk of all students. Unfortunately, colleges are not going to do this though because that'll be a huge loss in revenue.

6. Increase the screening at all levels of the application process. When checking the boxes for medical schools to send AMCAS to, there should be a notification that when you're applying to MUSC, for example, that applicants are strongly recommended to have ties to South Carolina or the surrounding areas. Screen more harshly before sending out a secondary. I would be willing to pay double the money a secondary fee costs right now if it meant that I had atleast a 50% shot at an interview. I interviewed at 7 places this round but applied to 25 schools with an average secondary cost of $81.50 (total:$2145). The fee for the schools I received interview invites to was (20+100+75+80+100+35+100=$500). This is just my case but if only 14 schools (50% II chance) sent me secondaries I would literally be paying only $100 dollars if ALL THE SECONDARIES cost TWICE AS MUCH. This definitely means at least in my case, if schools screened better, I would be fine with them charging more for secondaries. Also, I would be willing to spend 3 days (slight exaggeration) at a school if it meant I had a 80-90% chance of getting in. What's stupid is that a lot of schools pre-screen applicants by GPA/MCAT and send out automatic-like interview invites only to seriously consider a student's background/experiences after he's paid his or her secondary fees and made his or her way to an interview. I don't see the point in showing someone the shiny new medical school if they've only got a 25-75% (usually 50%) chance of going there.

7. University of Michigan: Emulate this admission's office enthusiasm!

 

[corndogger]

Less Subjectivity; More transparency and accountability.


The biggest flaw in my opinion is the interview process.

1. It's necessary to incorporate human elements into the process, but the subjectivity to it these days is unfair. What if one person connects well with interviewer and another one doesn't? How do we know if that's due to the applicant not connecting well not having people skills or if that's due to an interviewers bias? You can't know but you can be more certain if you increase the number of people evaluating the interviewee and standardize the questions asked. In science, this would analogous to doing multiple trials and setting up defined variables. Frankly, I don't know why the MMI is so slow to be implemented. One notable exception is at highly ranked research schools and MD/PhD applicants. They need a one-on-one discussion about their research experience.

Other factors:

2. Also, as a suggestion, why can't we have online EC sheets for supervisors to fill out?

These should have:

Applicant Name:
Recommender Name:
Recommenders Relation to Applicant:
Position of Applicant
Brief Description of Applicant's Role:
Number of hours done by applicant:
Contact Information:

Let me be clear that this form wouldn't turn into a recommendation of any kind and should take less than a minute to fill out. This would really reduce the amount of forgery we see in these ECs and making it online would limit the amount of administrative BS adcoms have to sort through. This form should be for every AMCAS activity excluding ones you have letters of recommendation for.

3. MSAR is great but it can be better. How about actual tuitions rather than first year tuitions as it turns out tuition's vary year to year by a lot at some schools and sometimes MSAR will take the cheapest year's tuition.


4. For the prices they charge for secondaries and for the money we invest to make it to an interview, schools should be willing to give personal feedback in form of an appointment, phone conversation, or non-generic email (at the very least) explaining to the applicant what he or she can improve on to be more competitive for the school next year. If the reason is a shallow one, then the school should be honest. I don't see why this process needs to be so unpredictable.

1. Honestly I think the best would be an MMI and traditional interview (shortening each one a little bit so you don't spend 2 hours interviewing). Best of both worlds, and they could note any discrepancies between the two styles for an applicant (ie someone who kills the panel interview but fails the MMI miserably might be a little phony).

2. They have something similar at some canadian schools (applicant fills it out but it's sent to the referee and they confirm whether it's accurate). I think it would reduce the BSing, but I've heard of people who make something up and just get a friend or relative to confirm it. Still, I think it would force the average applicant to be a bit more honest.

3. Agree as well. As a canadian, there are a number of schools that say they accept international students on MSAR, but really don't in practice.

4. This is the biggest one for me. Why make me waste my time (and theirs) reapplying if I didn't even come close? I think this also relates to transparency. Release the weighting that is given to GPA, MCAT, ECs, letters, and essays both pre and post interview. Include how much the interview is worth. If they don't have a formula of any sort, they should say this and indicate that they more or less go completely subjectively.

 

[LizzyM]

Why not just limit it to 4? Making it $500 would just put the poor in an even bigger disadvantage in medical school admissions.
Someone can just pay $2000 and have twice the chances of getting into medical school as everyone else

The application is not a lottery ticket and one does not get in "by chance" so having twice as many applications does not double one 's chances of getting an offer of admission. Fact remains, more than 50% of all applicants will not get in anywhere! Some applicants will not get in after two cycles, some applicants will not get in after three cycles. With twice as many applicants as seats, there are some folks who are not going to get a slot no matter how many appliations they submit.

 

[Spinach Dip]

Let the application cycle be more like the NRMP. Everyone finds out all at once in March and they can celebrate 0r cry together. No wait list, no need to crossing fingers until orientation for a possible seat..

The amount of panic and drama that this would cause would admittedly be huge, but I think it could also be extremely helpful in giving everyone a date (say, March 1) when they WILL hear an answer. No more silent rejections.

Less Subjectivity; More transparency and accountability.

...

4. For the prices they charge for secondaries and for the money we invest to make it to an interview, schools should be willing to give personal feedback in form of an appointment, phone conversation, or non-generic email (at the very least) explaining to the applicant what he or she can improve on to be more competitive for the school next year. If the reason is a shallow one, then the school should be honest. I don't see why this process needs to be so unpredictable.

AGREED.

Did school X reject me because they didn't like my personal statement, or because my ECs were not what they were looking for, or because one of my LoRs was weak........

 

[LizzyM]

I wonder if silent rejections give schools the option of interivewing someone very late in the season if they exhaust their waitlist and still have open seats. A rejection is forever but a silent rejection means you are still under consideration.... I don't know i any schools do this but it is a possibililty with some logic behind it.

 

[circulus vitios]

Why not just limit it to 4? Making it $500 would just put the poor in an even bigger disadvantage in medical school admissions.
Someone can just pay $2000 and have twice the chances of getting into medical school as everyone else

Or have a progressive application cost.

School #1: $150 or whatever it is right now
School #2-10: $35
School #10-15: $50
School #15-20: $150
School #20-whatever: $350

edit: Better yet, if the goal is to reduce number of applications, then tie those amounts to a percentage of the applicant's income.

 

[Pacna]

More seats + residency slots would be ideal.

Tons of well qualified and driven individuals don't get to be physicians because of the BS system we have.

Also, more docs will drive salaries down and will do something to decrease the cost of medicine.

 

[Spinach Dip]

edit: Better yet, if the goal is to reduce number of applications, then tie those amounts to a percentage of the applicant's income.

just their income? Or their + their parents income? Or their + their parrents + their........



If schools want to cut down on the # of applications received, I think the best way would be to charge one fee ($500 or w/e) and allow them to apply to up to 10 schools. They have to choose the 10.

 

[corndogger]

I wonder if silent rejections give schools the option of interivewing someone very late in the season if they exhaust their waitlist and still have open seats. A rejection is forever but a silent rejection means you are still under consideration.... I don't know i any schools do this but it is a possibililty with some logic behind it.

I had a school take back a rejection this year. don't think there's a reason for it to be set it stone, unless the applicant accepts elsewhere in the meantime.

 

[Gauss44]

Eliminate the "formula" to getting into medical school. Get rid of the checklist that goes: 1 year of research, 1 year of volunteering in clinical setting and helping the disadvantaged, etc. This makes it too easy for ANYONE (with a decent adviser) to play and fake the role of the perfect candidate.

There's many ways to eliminate this formula. Here's one idea:

1. Screen by GPA and MCAT then:

2. Replace (research, volunteer, etc.) with a system UNIQUE to each medical school. Every ADCOM could vote on the top 7 or so QUALITIES that they believe makes a good doctor. The ADCOMS can then subjectively rank candidates based on how well they believe the each applicant demonstrated the qualities chosen (overall).

 

[Gauss44]

Make it possible for a candidate to show how much he did all at once.

I, for one, believe that the most impressive thing about me is how much I accomplished at any one given time. The application process does NOT allow me to make that point ANYWHERE.

 

[Lucca]

Eliminate the "formula" to getting into medical school. Get rid of the checklist that goes: 1 year of research, 1 year of volunteering in clinical setting and helping the disadvantaged, etc. This makes it too easy for ANYONE (with a decent adviser) to play and fake the role of the perfect candidate.

There's many ways to eliminate this formula. Here's one idea:

1. Screen by GPA and MCAT then:

2. Replace (research, volunteer, etc.) with a system UNIQUE to each medical school. Every ADCOM could vote on the top 7 or so QUALITIES that they believe makes a good doctor. The ADCOMS can then subjectively rank candidates based on how well they believe the each applicant demonstrated the qualities chosen (overall).

This creates a different type of game where the bottleneck is at many schools rather than one. Since medical school is so competitive with uniform "requirements" already it would place greater pressure on applicants to drill really hard into 7 possibly arbitrary categories in order to maximize acceptance at a smaller number of schools rather than have a reasonable chance at a lot more schools. Admission pressure up, gamification constant.

More importantly, it reduces admission transparency which is exactly the opposite of what needs to happen.

 

[ThisCouldBeYou]

1. No more silent rejections
2. No more "thank you for your admission fee. You've been rejected" (You know who you are.)
3. More schools should evaluate first before sending your secondary.
4. No more dragging out this process with too-numerous-to-count our WL. Am I in or out?
5. Cut down on those ridiculous admissions fees! Pre-med students aren't made of money!

 

[plumazul]

The application is not a lottery ticket and one does not get in "by chance" so having twice as many applications does not double one 's chances of getting an offer of admission.

I understand what you are saying, that the probability of being accepted is not random chance (the lottery model) but is instead a very complicated conditional matrix. Nevertheless, a probability can still be associated with each test/event. A better model would be a sport such as baseball, basketball, hockey etc. Each player(applicant) brings a skillset(CV) to the game and is confronted by opponents(adcoms) with varied skillsets(forms of selectivity). The probability of each player scoring a goal, getting a hit or making a basket is determined by the interplay of these conditions. In the case of baseball, even the weakest hitters, given enough at bats, will eventually hit the ball hard enough to get through.

Fact remains, more than 50% of all applicants will not get in anywhere! Some applicants will not get in after two cycles, some applicants will not get in after three cycles. With twice as many applicants as seats, there are some folks who are not going to get a slot no matter how many appliations they submit.

Yes, this is true for any given cycle or set of cycles, but the fact remains the probability of being accepted with a given skillset at a particular MS is not zero. So the more attempts are made the more likely an acceptance will occur. There are many examples of this on SDN and MDApps. People with marginal qualifications(as determined by metrics currently in use) who applied to 30+ schools, were rejected almost everywhere but did get accepted off a WL in summer. If that student had only applied to 10?, 20?, 30? schools would the final outcome have been the same?

 

[EMDO2018]

Not taking into account universities differ in difficulty.

 

[corndogger]

Not taking into account universities differ in difficulty.

there's no good way to assess this. Even within the same university, different programs have different difficulties. More importantly, different people will find different environments and subjects more difficult, and therefore someone might do well at a "hard" university that's big on testing large volumes of info than at an "easy" school that's more assignment and group work based.

you can't even just look at the percentage of the students that have a high GPA, because that could indicate both bright students or easier marking.

people should recognize that if they want to go into medicine, they should pick a program that interests them and that they can do well in. don't take engineering at a school that has a reputation for brutal marking unless you excel and are interested in that field.

 

[LizzyM]

Yes, this is true for any given cycle or set of cycles, but the fact remains the probability of being accepted with a given skillset at a particular MS is not zero.

It certainly can be zero if you don't have the state residency in a state school that is strict in that regard or if you lack the language skills to be admitted to Puerto Rican schools, etc, etc.

As for the "at bat" analogy, we have a whole lot of applicants batting 0.000. At if we have 45,000 batters and we let each have unlimited at bats but we stop after 19,000 have gotten a hit, there will still be 26,000 who will go hitless.

 

[plumazul]

It certainly can be zero if you don't have the state residency in a state school that is strict in that regard or if you lack the language skills to be admitted to Puerto Rican schools, etc, etc.

But you're reinserting the "randomness" that I agreed with you was not an appropriate model. A college baseball team does not select students at random to play on the team. There is an implied fitness.

As for the "at bat" analogy, we have a whole lot of applicants batting 0.000. At if we have 45,000 batters and we let each have unlimited at bats but we stop after 19,000 have gotten a hit, there will still be 26,000 who will go hitless.

Yes exactly. And such a system would be relatively fair. I am willing to accept that there may be some cohort within the 45K applicant pool who are unfit(will always bat 0.000) but as I'm certain you know there is a significant pool of applicants who apply to the correct schools are qualified and still don't get hits. For this pool, the probability of acceptance at the schools they apply to is not zero. So the number of schools they apply to does indeed affect the overall probability of being accepted. And if this is true, then limiting applications via increased fees, will certainly increase the odds of acceptance for the select group where cost is not a concern and @chillaxbro 's comment above was correct.

 

[Gene Parmesan]

I think it's hilarious that interviewers will say things like "You're going to have choices, so talk to as many students as you can to decide where you'll fit in best" (I have one acceptance at a different school) and at another school my friend was told "You're a 10/10 applicant, I'm not sure why you didn't get interviewed last cycle" then he got waitlisted this cycle.

If an interviewer is impressed by an applicant, they should end by saying "You're great and I'd vote for you, but this process is stupid, so you'll probably be waitlisted. Best of luck!"

 

[aspirantmed]

Make it possible for a candidate to show how much he did all at once.

I, for one, believe that the most impressive thing about me is how much I accomplished at any one given time. The application process does NOT allow me to make that point ANYWHERE.

This is such a specific point that it could only really be asked (or answered) in an essay. And you have loads of those. Your personal statement, your secondaries, your update letters, your interview, etc.

 

[Planes2Doc]

I wonder if silent rejections give schools the option of interivewing someone very late in the season if they exhaust their waitlist and still have open seats. A rejection is forever but a silent rejection means you are still under consideration.... I don't know i any schools do this but it is a possibililty with some logic behind it.

This actually happened to me when I was looking for internships, and also my girlfriend with her current job. I was rejected by a financial firm, who two days later said I got the job because no one else ended up taking it. Sure I felt a little offended, but since I needed an internship, I would have taken it if I didn't already have one lined up. My girlfriend received her current teaching job after she was previously rejected from the same school district only weeks before. Apparently they were desperate according to her.

While there are plenty of applicants who will have the luxury of having many acceptances to choose from, others might not be so lucky. These pre-meds can get desperate to get into school. I don't think they would object to a reversed rejection. Beggars can't be choosers. I think most people would rather have reversed rejections, than being ignored with silent rejections.

This creates a different type of game where the bottleneck is at many schools rather than one. Since medical school is so competitive with uniform "requirements" already it would place greater pressure on applicants to drill really hard into 7 possibly arbitrary categories in order to maximize acceptance at a smaller number of schools rather than have a reasonable chance at a lot more schools. Admission pressure up, gamification constant.

More importantly, it reduces admission transparency which is exactly the opposite of what needs to happen.

This is a terrific point. More arbitrary "requirements" aren't going to help anything. I think that schools need to have some oversight over these activities. It's frustrating to know that an activity can mean the difference between rejection and admission, yet ADCOMs can't realistically tell the difference between someone who was a valued volunteer at their hospital versus one who signed in only to ditch their shifts (assuming both have "good" similar stories to tell).

 

[Xenoblade]

I think that it is so important to recruit people from different fields outside of the sciences (especially in the arts).

So many people are extremely dissatisfied with the health care in the states (doctors, patients, nurses, etc.). Yet what do adcoms do? Double down on what worked in the past, meaning seeking applicants with higher and higher metrics. But then they turn around and complain about a broken system that they had some part in creating (by not actively trying to change it and recruiting the same type of applicants for decades who are unable to think differently and to cause change). This is an exercise in insanity and futility that will continue the downward spiral in our health care system.

99% of us pre-meds all think and problem solve very similarly, regardless of external factors (that I dare not name lest people paint me in an unfavorable light). We need leaders who think differently because they are the ones who are able to see solutions that 99% of the current crop of pre-meds cannot see. Our health care system will continue to be in a state of decline without creative visionaries who can work with leaders to create sensible and practical solutions.

 

[Psai]

I would love to see application fees raised to something ridiculous like $500 with a generous "free" secondary to any 4 schools. I'd love to see applications to my school cut to 700 from 7,000. I'd love to interview everyone who applies and make offers to more than half of them (maybe even 90%). If everyone could be more mindful of where they direct their applications, and if you knew that the pool of applicants was relatively small meaning that you were likely to get an interview and if you knew that if you attended an interview your likelihood of getting admitted was greater than 50-50, then this whole process would be much more manageable.

A few comments on others' wish lists:

I love the idea of providing the MSAR bundled with the first MCAT. Might be "too late" for some people but it is a start.

The closed file application spares you a bias based on your grades, scores, and experiences that might introduce a bias such as involvement in a political or religious cause. It also measures how well you can develop a rapport with someone who is a relative stranger.

Depending on where you are located, it is possible to apply only to schools where you are within driving (or bus/Amtrak) distance as a way to save money. I recall some years ago that was the strategy of a former hairdresser in Philly (great location for this strategy) who ended up in New Haven.

It's funny because residency applications are going in the opposite direction with more of an emphasis on that test scores and extracurriculars than ever before. Also I've heard of urology applicants applying to 40 places even with a 250 on Step 1.

About the anatomy lab, I think it still has an important place because it's a real welcome to medical school. It might sound silly but I felt a kind of reverence as I started to open a body with my classmates. It's the whole feeling of jesus christ there's a dead person right there and I'm cutting her open. It makes you wonder why someone would donate their body so that a bunch of dumb, young kids can learn a thing or two about the human body. After you spend hundreds of hours with your hands inside of a cadaver, it takes a lot more to faze you. I don't mind doing histology labs online and I thought cleaning fat was a huge waste of time but I think we would lose a lot if we didn't have cadaver dissections in medical school.

 

[LizzyM]

While there are plenty of applicants who will have the luxury of having many acceptances to choose from, others might not be so lucky. These pre-meds can get desperate to get into school. I don't think they would object to a reversed rejection. Beggars can't be choosers. I think most people would rather have reversed rejections, than being ignored with silent rejections.

No reversed rejections,please! There would be no end to the phone calls and petitions from applicants, alumni, faculty, etc to reverse a decision not to admit an applicant.

 

[Redpancreas]

More seats + residency slots would be ideal.

Tons of well qualified and driven individuals don't get to be physicians because of the BS system we have.

Also, more docs will drive salaries down and will do something to decrease the cost of medicine.

Throwing away Fee For Service is what I anticipate will make the greatest effect on decreasing costs for medicine and will lower the salaries of many crony physicians. There's no need to further drive physician salaries down by taking more applicants into medical school. I still think they ought to be an elite group and between DO schools and all the new schools opening up, there is really no need for more medical schools seats to be available. The amount required to get into ANY ONE US school is not really THAT high. What I will admit though, is that for students with limited funds, the process is quite difficult and we are definitely losing some of those driven individuals who don't have the $$$ to pay for MCAT classes, unlimited application cycles, DO schools (same quality but are often more expensive), and SMPs. Add that to familial support and encouragement and there's really no excuse for those financially well-off applicants (with exception to students from a couple of difficult states). Quite frankly (I know this sounds entitled so before I say it I acknowledge there are hundreds of thousands of students who have achieved way than me, given what I have), but I see a lot of people admitted into medical school that cheated on all their tests through college, spent their whole weekends partying, and then somehow ended up in a medical school.


Anyways, what I think we need is to just increase the incentives for going into primary care by increasing their wages, thus lowering what each specialty will need to do which will naturally lower their wages.

 

[Goro]

Sounds like what my school does!

I wonder if silent rejections give schools the option of interivewing someone very late in the season if they exhaust their waitlist and still have open seats. A rejection is forever but a silent rejection means you are still under consideration.... I don't know i any schools do this but it is a possibililty with some logic behind it.

 

[ThisCouldBeYou]

I love the idea of limiting applicant to pick only 4 schools. Wouldn't that be a frenzy to get into certain schools? Alas, that's not the American way.

I've been wondering this: why is Early Decision designed to have the odds stacked against you? I mean, you can't apply anywhere else and by the time you find out if you're accepted, you've practically missed getting into any med school that cycle. Why would anyone choose ED?

 

[Pacna]

Throwing away Fee For Service is what I anticipate will make the greatest effect on decreasing costs for medicine and will lower the salaries of many crony physicians. There's no need to further drive physician salaries down by taking more applicants into medical school. I still think they ought to be an elite group and between DO schools and all the new schools opening up, there is really no need for more medical schools seats to be available. The amount required to get into ANY ONE US school is not really THAT high. What I will admit though, is that for students with limited funds, the process is quite difficult and we are definitely losing some of those driven individuals who don't have the $$$ to pay for MCAT classes, unlimited application cycles, DO schools (same quality but are often more expensive), and SMPs. Add that to familial support and encouragement and there's really no excuse for those financially well-off applicants (with exception to students from a couple of difficult states). Quite frankly (I know this sounds entitled so before I say it I acknowledge there are hundreds of thousands of students who have achieved way than me, given what I have), but I see a lot of people admitted into medical school that cheated on all their tests through college, spent their whole weekends partying, and then somehow ended up in a medical school.


Anyways, what I think we need is to just increase the incentives for going into primary care by increasing their wages, thus lowering what each specialty will need to do which will naturally lower their wages.

You can't just raise wages. I know you're reading economic texts; you should be aware of this.

I agree that 30+ MCAT scores and 3.5+ GPAs are really not THAT hard to get, but only about 40% of applicants get in. Flooding the market with more people willing to do all specialties will force competition and drive prices down.

 

[Patros]

Or have a progressive application cost.

School #1: $150 or whatever it is right now
School #2-10: $35
School #10-15: $50
School #15-20: $150
School #20-whatever: $350

edit: Better yet, if the goal is to reduce number of applications, then tie those amounts to a percentage of the applicant's income.

Seeing that the average applicant applies to around 14 schools, your model is just a minor annoyance and I don't think will change much for the vast majority of people who apply to 20 or less schools. I mean, at $50 each for schools 10-15, applying to 15 schools will just be about a $100 more expensive than the current model. I suggested something simpler with a flat rate for the first 6-7 applications and then a large fee for the next, but people were pretty up-in-arms about that being a bad idea (I'm assuming the same people who applied to >20 schools!).

But you're reinserting the "randomness" that I agreed with you was not an appropriate model. A college baseball team does not select students at random to play on the team. There is an implied fitness.

Yes exactly. And such a system would be relatively fair. I am willing to accept that there may be some cohort within the 45K applicant pool who are unfit(will always bat 0.000) but as I'm certain you know there is a significant pool of applicants who apply to the correct schools are qualified and still don't get hits. For this pool, the probability of acceptance at the schools they apply to is not zero. So the number of schools they apply to does indeed affect the overall probability of being accepted. And if this is true, then limiting applications via increased fees, will certainly increase the odds of acceptance for the select group where cost is not a concern and @chillaxbro 's comment above was correct.

Only on SDN do we combine game theory, probability, and a dash of evolutionary theory (fitness) to discuss matriculation statistics. I doubt there is a non-zero probability of me understanding what's going on!

 

[masaraksh]

I think that it is so important to recruit people from different fields outside of the sciences (especially in the arts).

So many people are extremely dissatisfied with the health care in the states (doctors, patients, nurses, etc.). Yet what do adcoms do? Double down on what worked in the past, meaning seeking applicants with higher and higher metrics. But then they turn around and complain about a broken system that they had some part in creating (by not actively trying to change it and recruiting the same type of applicants for decades who are unable to think differently and to cause change). This is an exercise in insanity and futility that will continue the downward spiral in our health care system.

99% of us pre-meds all think and problem solve very similarly, regardless of external factors (that I dare not name lest people paint me in an unfavorable light). We need leaders who think differently because they are the ones who are able to see solutions that 99% of the current crop of pre-meds cannot see. Our health care system will continue to be in a state of decline without creative visionaries who can work with leaders to create sensible and practical solutions.

 

[Lucca]

The application should immediately suggest tiers of schools that match the applicants stats and residency closely. Applying early and broadly is half the battle and if we really want to make medicine more diverse then we should stop making this like college admissions where your success is entirely dependant on how much information you have. If someone has a 3.8 and 36 they should know that they need to apply as early as possible to make the most of their great stats. If someone has a 3.5/30 they should know their options right from the start and not waste their time on Top 5 schools but also apply early and cast a wider net.

I don't think limiting schools will do anything except ruin people's chances. At a cap of four schools, a lot of students (especially younger ones) will "waste" a slot on Harvard/JHU when they don't have a chance and severely hurt their chances of being accepted anywhere. It makes it easier on the adcoms but, let's face it, this process should be biased towards the people who's hopes and dreams are on the line not on the commitee that says Yea or Nay. I know adcoms are usually doing their job out of the goodness of their heart and as volunteers, and I really appreciate how much they care about applicants since they were in our shoes once, but I think a tradeoff can be handled. If there has to he a cap, it should be closer to 15 schools

 

[T3ckFr3s]

As a waitlistee, I wish the May 15th deadline was pushed up to April 15th and that there was a cap to the number of acceptances you can hold on to (maybe 4 or 5?) It's just so hard to plan ahead when hope springs eternal until May 15th.

EDIT: Just remembered that gyngyn recently shared that there is an applicant out there that is currently holding 16 acceptances. Ridiculous.

 

[corndogger]

As a waitlistee, I wish the May 15th deadline was pushed up to April 15th and that there was a cap to the number of acceptances you can hold on to (maybe 4 or 5?) It's just so hard to plan ahead when hope springs eternal until May 15th.

I agree, I also wish the whole process was sped up by a couple of months. Have the applications open up in April and the acceptance deadline sometime in March. I think the extra couple of months would make a big difference in committing to alternate plans for those who aren't accepted. It would also be nice to have interviews start in June so there were less months that they interfered with classes.

 

[NuttyEngDude]

I don't think limiting schools will do anything except ruin people's chances. At a cap of four schools, a lot of students (especially younger ones) will "waste" a slot on Harvard/JHU when they don't have a chance and severely hurt their chances of being accepted anywhere. It makes it easier on the adcoms but, let's face it, this process should be biased towards the people who's hopes and dreams are on the line not on the commitee that says Yea or Nay. I know adcoms are usually doing their job out of the goodness of their heart and as volunteers, and I really appreciate how much they care about applicants since they were in our shoes once, but I think a tradeoff can be handled. If there has to he a cap, it should be closer to 15 schools

I agree with this, and the point I was tying to make was if the price of applying is to go up, then allocate the money so that they can handle the volume and not for the purpose of restricting volume. If this means hiring more people (or products) rather than using all volunteers, then that is a good use of resources.

 

[zacharyw]

It certainly can be zero if you don't have the state residency in a state school that is strict in that regard or if you lack the language skills to be admitted to Puerto Rican schools, etc, etc.

If we were to rank by chance of admission, there are 100+ schools before anyone would get to the absolutely zero chance schools you speak of. No one is advocating an applicant to apply to all schools until they reach that point.

You'd agree that an applicant with average stats who is only applying to 1 school will have a much better chance of getting in if the applicant applied to 10 schools. So why isn't this true for someone applying to 20 schools that applying to 30 would also increase their chance, if they pick 30 schools that doesn't have stringent residency requirements. With 160-some med schools out there, it's not that hard to find 30 or even 4o schools where you have a shot.

 

[chillaxbro]

AMCAS verification shouldn't take 10 weeks

Hire more people to do it, they can afford it

 

[Redpancreas]

You can't just raise wages. I know you're reading economic texts; you should be aware of this.

I agree that 30+ MCAT scores and 3.5+ GPAs are really not THAT hard to get, but only about 40% of applicants get in. Flooding the market with more people willing to do all specialties will force competition and drive prices down.

I am but I never said we need to raise wages.

 

[Stabley17]

1. Make it so that decisions actually mean something about the applicant. Too often, both from my personal experience and learning about others', it seems like there is a hefty amount randomness and subjectivity in the current process. I don't feel like my acceptances mean more than "yeah, he fit the bill, let's flip a coin to see whether we should accept him or not" when there are so many others like myself that didn't get accepted. Similarly, it's hard to understand when someone you may believe to be equally deserving gets in and you don't. It also leads to situations where people get into their dream schools (awesome!) but then others that really should have gotten in somewhere, end up without any offers, even though there aren't substantive differences in achievements or capability.

There are many strong applicants applying to nearly all the same programs and so I would strongly support a system that either eliminated or reduced the number of applications. Whether it's by making the process similar to the match process, adopting the UK's UCAS limit to 5 schools, or even something like @LizzyM suggested, my hope would be that instead of having to decide between 20 "equal" applicants, schools may only have to make the decision between 5 of them, or perhaps none!

I could also support a mandate where a school's number of interview spots is limited by the size of it's incoming class/the number of acceptances it will offer. Have the number of interviews be somewhere around 250-300%. If I'm going to take additional time out of my life, travel, and then participate in what is, most of the time, a rather unpleasant experience of being judged, I ought to feel like I have a good chance of being accepted. The fact that a school may admit under 25% of the people the people they interview simply tells me that they have no clue what they are really looking for and seems quite unprofessional.

2. As someone who originally thought that MMI's were a great idea, I'm not so sure now. Yes the claims that they look for qualities that may not be easily ascertained otherwise and that they help to make the interview more fair through the use of raters, rather than a few interviewers who you may or may not get along with, are noble pursuits. Nonetheless, in practice I have come to see them as completely robbing the interview of all humanity. At the very least, they should be combined with a more traditional interview.

3. Shorten the whole process. Applying in June and potentially not knowing where you'll be over a full year later is ridiculous. Decrease AMCAS verification time and set a real interview season that ends by New Year's.

 

[Pacna]

I am but I never said we need to raise wages.

? Read the last line of your post.

 

[Redpancreas]

? Read the last line of your post.

Sorry. Your right. What I meant is that you can increase the medicare reimbursements for many things primary care physicians do. I'm sure there are other things that we can do to indirectly increase their wages but I am not saying that we need to pass legislation to increase their wages across the board.

 

[Pacna]

Sorry. Your right. What I meant is that you can increase the medicare reimbursements for many things primary care physicians do. I'm sure there are other things that we can do to indirectly increase their wages but I am not saying that we need to pass legislation to increase their wages across the board.

I see. I would maintain that any central manipulation like that is just going to tangle the web further.

I suggest a more natural approach. More docs benefits everyone except doctors' pocketbooks. However, ask a resident or 2. They could probably use another colleague.

 

[Laureatebarrel]

There should be one time fee only for application process. Also, standardized secondaries would be nice. Reduce MCAT scoring period and reduce emphasis on clinical volunteer.