2013-2014 Washington University in St. Louis Application Thread

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The students made it sound like half the class was WLer's who got off (probably an exaggeration but means a good amount must). Since the same amount of initial acceptances were given out, I would assume it would be a similar number getting of the WL.

In my year at least it was no exaggeration. ~50 members of the 100 person MD class were off the wait list.


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In my year at least it was no exaggeration. ~50 members of the 100 person MD class were off the wait list.


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Crazy that only 50/250 would accept their spot at wustl.
 
Crazy that only 50/250 would accept their spot at wustl.
While WUSTL is an awesome school, this may not be so crazy after all. Considering the kind of students WUSTL accepts, most if not all of them will have acceptances to other top schools and/or full tuition merit scholarships etc. I think 2 things hurt WUSTL when it's compared to other top schools: 1) location (for most people, St. Louis is nowhere near as exciting as Boston, NYC, Chicago or some places in California); 2) its more traditional curriculum and grades in MS2 (while most top schools are p/f in preclinical years and are all innovative and stuff). Plus, WUSTL is one of the most expensive schools in the country, though cost of living is cheap and fin aid is decent.
In any case, as long as WUSTL fills its class with 120 or so strong students, there is no need to worry 🙂
 
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Any students/people who know the area have suggestions on what to check out on campus? I'm at wustl for other reasons and trying to explore. Unfortunately it's spring break so no med student classes to sit in on...
 
A couple quick ideas:

Forest park (including free art museum, history museum, science center, zoo, and lots of biking/running trails)

Euclid avenue just north of the medical center (has lots of shops and good restaurants)

Delmar loop (delmar blvd between skinker and big bend; fun street with lots of quirky shops and some good restaurants)


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Any students/people who know the area have suggestions on what to check out on campus? I'm at wustl for other reasons and trying to explore. Unfortunately it's spring break so no med student classes to sit in on...

MS3 and 4 peeps are on campus so it's not entirely deserted. I'd be happy to give you a tour if you like. PM me. I should be free after my final exam tomorrow AM. 🙂

Are you looking into housing or just checking out CWE? What would you like to come away with?
 
Thanks for all the ideas and the offer!

The main reason I don't think I'll be exploring the CWE or much of STL is the storm and my lack of transportation, but if it dies I'll definitely check out all I can!
 
A big thanks to Asperphys for showing me around today! Gave me the full tour! I really appreciated it!
 
A big thanks to Asperphys for showing me around today! Gave me the full tour! I really appreciated it!
You're welcome! It was my pleasure. Btw, congrats-- you have great schools to choose from. You wouldn't go wrong picking any of them. But it'll be our great honor if you do choose to join us next school year. Good luck!
 
You're welcome! It was my pleasure. Btw, congrats-- you have great schools to choose from. You wouldn't go wrong picking any of them. But it'll be our great honor if you do choose to join us next school year. Good luck!

I must say that you taking time out of your day like this (and of your own accord) reflects incredible well on the kind of student that goes to WashU. 😉
 
I must say that you taking time out of your day like this (and of your own accord) reflects incredible well on the kind of student that goes to WashU. 😉
Well, gee.. I hope so. 😉
I'm just doing what innumerable mentors (upperclassmen/alumni, residents and attendings) have done for me. I can't pay them back, so I'm paying it forward. Makes for a very collegial atmosphere anywhere. 🙂
 
Thanks!!
You're welcome! It was my pleasure. Btw, congrats-- you have great schools to choose from. You wouldn't go wrong picking any of them. But it'll be our great honor if you do choose to join us next school year. Good luck!
 
I have some questions to WUSTL students: what is the schedule like in the first 2 years? Is there any flexibility/ time to do things like research, shadowing etc? (I used to be pretty certain about my areas of interest, but now that I'm about to start medical school I'd like to explore different specialties to make sure I'm not missing anything, and I'd like to do that sooner rather than later.)

I also have some questions about the clinical years:
1. I know that BJH and SLC are awesome and all, but are there any other hospitals like county etc? In other words, how much of a hospital diversity there is? How much patient diversity? (How much student diversity? - haha, but diversity does mean a lot to me not only in terms of training but also because I would be more comfortable in a more diverse environment.)
2. How much responsibility do students have on the wards? How many students per team there usually are? (I understand that this is service dependent, but still.)
3. Are students comfortable doing their histories and physicals? Do they feel prerared to function as residents?
 
In St. Louis??? 😱
Cannot tell if sarcasm, but Yup. Apparently they are not very common, but lucky me. Tornado sirens woke me up at 5am and said take shelter, so we all went to the basement. Tonight we were out to dinner when the warnings came, but no sirens so we just sat there like it was nothing. Definitely a new experience.
 
Cannot tell if sarcasm, but Yup. Apparently they are not very common, but lucky me. Tornado sirens woke me up at 5am and said take shelter, so we all went to the basement. Tonight we were out to dinner when the warnings came, but no sirens so we just sat there like it was nothing. Definitely a new experience.

During my 1st year of medical school here, I was picking up my in-laws at the airport in my brand new car that I had gotten from my parents as a college graduation present. There was a tornado, and my car got totaled.
 
I have some questions to WUSTL students: what is the schedule like in the first 2 years? Is there any flexibility/ time to do things like research, shadowing etc? (I used to be pretty certain about my areas of interest, but now that I'm about to start medical school I'd like to explore different specialties to make sure I'm not missing anything, and I'd like to do that sooner rather than later.)
There is plenty of flexibility in the first 2 years and both shadowing and research are ENCOURAGED. If you wanna shadow, you can arrange it through Dr. Polites and his POM I team. You will get an introduction to the clinical team and they will take care of you. I've seen a number of 1st years do this when I was in my 3rd year. Also, ALL the lectures are filmed and posted online. You also get the ppt files. What I found as a 2nd year is that I learn better by reading the materials first, watching the lectures and pausing them if I didn't understand stuff, look them up or write down my questions for the profs, and then continue. Obviously, if you're not tied down to the classroom/lecture schedule, you can shadow or do research at your convenience.

I also have some questions about the clinical years:
1. I know that BJH and SLC are awesome and all, but are there any other hospitals like county etc? In other words, how much of a hospital diversity there is? How much patient diversity? (How much student diversity? - haha, but diversity does mean a lot to me not only in terms of training but also because I would be more comfortable in a more diverse environment.)
2. How much responsibility do students have on the wards? How many students per team there usually are? (I understand that this is service dependent, but still.)
3. Are students comfortable doing their histories and physicals? Do they feel prerared to function as residents?

1.) There is diversity in the patient population in St. Louis, but nowhere near what you'd find in LA or NYC. Still, there were plenty of times I had to do interviews via a Nepalese, Vietnamese, Spanish etc translator. There is diversity in the student body as well-- but I thought the mix was typical for most med schools. As for hospitals, I personally rotated through both underserved and posh hospitals because I had the option to do so. I still think of time I spent in the Grace Hill (indigent) clinics as some of the most educational I had in the 2 clinical years I had.

2.) The amount of responsibility you have on the wards is scaled to your ability. Sub-interns (4th years) are expected to carry their own patients and report to the chief/fellow. 3rd years are partnered with residents (1:1), so they carry some of the resident's patients and not get overwhelmed. At minimum, the 3rd year writes daily progress notes, pre-rounds on their patients and presents the patients on rounds. If you're a stellar 3rd year, you will be treated like a 4th year, and will be expected to put in orders (after checking with the resident of course), write or dictate the H&P and discharge summaries, etc. There are typically two 3rd year students per surgical, medicine, neurology, and psychiatry team, and three students on OB-Gyn and Peds teams.

3.) Students are comfortable doing history and physical exams after their 1st year. They refine their ability to do their assessment and devise plans as 2nd to 3rd year student. And yes, we are prepared to function as residents when we graduate. As 4th years, you will be required to take the Capstone course (aka intern bootcamp) where you will be trained to deal with acute scenarios, deal with overnight call and pages, learn to hand-off your patients properly and all other skills that will help you NOT kill anyone as an intern.
 
Cannot tell if sarcasm, but Yup. Apparently they are not very common, but lucky me. Tornado sirens woke me up at 5am and said take shelter, so we all went to the basement. Tonight we were out to dinner when the warnings came, but no sirens so we just sat there like it was nothing. Definitely a new experience.
Then an important question is-- do they have basement in every building/apartment complex? I just googled what to do when a tornado hits... So St Louis has heavy snow and bad tornados. How often does bad/extreme weather hit the city? Any impacts on regular life? I just realize I need to take location and weather into consideration...
 
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Are you ever going to tell us what your beef is with this place? You're quoting a post from a while ago for the sole reason of putting down washu.

"A while ago" = 2 days ago? Ok, if you say so. It's a statement of fact. If only 50 out of the 250 accepted, did in fact matriculate, the rest must have had better options. It's not "crazy" at all.
 
Th convo had clearly moved on.
"A while ago" = 2 days ago? Ok, if you say so. It's a statement of fact. If only 50 out of the 250 accepted, did in fact matriculate, the rest must have had better options. It's not "crazy" at all.
 
Then an important question is-- do they have basement in every building/apartment complex? I just googled what to do when a tornado hits... So St Louis has heavy snow and bad tornados. How often does bad/extreme weather hit the city? Any impacts on regular life? I just realize I need to take location and weather into consideration...

I agree, it's a serious consideration. But in truth, extreme weather rarely hits Stl. In my 8 years here, this is only the 2nd time I've worried about tornadoes. Winters (except this year) are usually mild. I used to brag to my family in New York that we have snow only 3-4 times every winter with a max snowfall of 6 inches. For a Midwestern city, it's way milder than Chicago for instance.

The weather impact isn't big on a regular basis. They have a saying here that if you didn't like the weather in Stl, just wait 5 minutes. Because it changes fast. But tornadoes, hail storms and such things have happened. And they can damage cars, much like what yuiness experienced.

I have not surveyed the apartments in CWE, but the ones I've lived in have basements. In my current apartment, we don't, so if I have to, I'm hiding in the inner closet of my walk-in closet. 😀
 
Um, no. Not when you have better options.
Everyone has their own preferences. For me, washU sits on top despite having some options others would prefer. I can see how massive amounts of aid could sway me, but it is very, very unlikely in my scenario so I believe washU will stay my number 1.
 
what is the schedule like in the first 2 years? Is there any flexibility/ time to do things like research, shadowing etc?

The first year is 719 hours over 38 weeks. The second year is 618 hours over 36 weeks. The hours are majority lecture, a minority mix of lab, small group, team-based learning, and clinical or standardized patient sessions.

Asperphys covered shadowing. I would extend the answer to say that there is flexibility to do research, but it is not especially encouraged outside the summer. However, few first years actually do research during the school year, including MD/PhDs unless it's half a rotation when the year is winding down. MD students looking for research projects during the first year will not find overt barriers either but can expect some resistance or difficulty. Research is not a required part of the curriculum. As such, there is not built-in protected time, mentorship, or progress checks outside of what you find out of your own initiative with some guidance from the office of medical student research. Additionally, because faculty here are not used to having hoards of med students look for academic-year part-time projects, there will be few such projects readily available. Some faculty might readily take you on, others won't be really sure what to let you do, others will straight out suggest that you focus on doing well in your classes (especially second year, which is graded and demands being treated as more-than-full-time job)** and consider working for them during the first-year summer or a 5th year program. Again, it depends on your initiative. There are students who successfully balance life and a part-time research project during the school year that publishes and gets good enough grades for AOA, but they can be counted on one hand. (Unless there are a lot of quiet gunners out there, but I doubt it.) If you think you can do it, as many incoming first years do, I encourage your initiative, but don't be surprised if you find yourself overwhelmed about half a year or a year in. A significant minority of second years partake in research mostly as a continuation of their summer activities with the mindset of 'wrapping up' the project and getting it out of the way so that they can focus on getting good grades and/or studying for the boards. This kind of scenario is true at most schools, except, again, those that require research as part of the curriculum and have the structure to ensure progress during the school year. There is also elective time to do research during 4th year, with the caveat that you're limited to a maximum of 12 weeks of research time.

That said, ~80% of students participate in research during the summer after first year, with the rest doing either something abroad that may or may not be "research" or a primary care preceptorship somewhere else in the country. By graduation, 90% of students will have participated in a research project with a faculty member. The vast majority (90%) of students are satisfied with the research environment and think that the administration is supportive of research. More than half of students graduate with authorship on a primary research article (exclusive of reviews and case reports). The caveat is that these figures include graduates of the largest MSTP program in the country, making up 20-25/year, in addition to another dozen or so that do a 5th year for research, out of a class of 120-125.

**Many years ago, a dean for curriculum wrote that what defines WashU is that it "emphasizes the belief that scholarly pursuits are primary and are necessary preconditions for other important goals of medicine--for example, the delivery of health care and the development of the individual." (emphases mine)

I know that BJH and SLC are awesome and all, but are there any other hospitals like county etc? In other words, how much of a hospital diversity there is? How much patient diversity? (How much student diversity? - haha, but diversity does mean a lot to me not only in terms of training but also because I would be more comfortable in a more diverse environment.)

Hospital setting/diversity: WashU/BJH/SLC provides 40% of the uninsured specialty encounters in the metro area. It is the only non-profit hospital left in the city of St. Louis. Here are the demographics of St. Louis. It's 50% black, 44% white, and relatively segregated, with WashU sitting around the apex of where poor meets rich, black meets white, geographically speaking. That said, St. Louis has the biggest Bosnian population in the country, making it the third most common language spoken (1%, after Spanish at 3%). In addition to BJH, you can rotate at the VA, where the patient population is essentially all old men. You can also do an ambulatory care rotation with a community physician within a hour radius (if suburban or rural is what you want).

Student diversity: Most students feel that the school makes a good effort to recruit diverse students. That said, WashU is among the 40% of med schools around the country where 'diversity' in its students and faculty has been identified by the accreditation body as an "area of transition." I give you some data (attached) so you can judge for yourself. This is reported by deans to US News and World Report. Beware that different schools might define questions/categories differently. URM = underrepresented in medicine. Non-trad = non-traditional. Social/human = social sciences + humanities majors.
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Do they feel prerared to function as residents?

On a scale of 1=strongly disagree to 5=strongly agree, the average answer at WashU to something similar to this question is similar to the national average (4.2) upon graduation.
 
Whats the status on Merit scholarships at this point in the cycle? Are most of them yet to be given or the other way around?
 
That said, ~80% of students participate in research during the summer after first year, with the rest doing either something abroad that may or may not be "research" or a primary care preceptorship somewhere else in the country. By graduation, 90% of students will have participated in a research project with a faculty member. The vast majority (90%) of students are satisfied with the research environment and think that the administration is supportive of research. More than half of students graduate with authorship on a primary research article (exclusive of reviews and case reports). The caveat is that these figures include graduates of the largest MSTP program in the country, making up 20-25/year, in addition to another dozen or so that do a 5th year for research, out of a class of 120-125.

Student diversity: Most students feel that the school makes a good effort to recruit diverse students. That said, WashU is among the 40% of med schools around the country where 'diversity' in its students and faculty has been identified by the accreditation body as an "area of transition." I give you some data (attached) so you can judge for yourself. This is reported by deans to US News and World Report. Beware that different schools might define questions/categories differently. URM = underrepresented in medicine. Non-trad = non-traditional. Social/human = social sciences + humanities majors.
View attachment 180050

2 things:

  • What is a primary care preceptorship somewhere else in the country? Does that mean WashU sets you up with alumns to work with in other parts of the country?
  • The URM percentage is pretty pitiful, even compared to WashU's peers. Do you know if WashU is doing anything or what it is doing to change this?
 
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Do we get an email/notification of waitlist? I interviewed ~3 months ago and have heard nada.
 
2 things:

  • What is a primary care preceptorship somewhere else in the country? Does that mean WashU sets you up with alumns to work with in other parts of the country?

This is a little unclear to me too. I'll leave it to @chronicidal to explain this. We do give students the option of doing a primary care rotation during the medicine clerkship. Students are put up in hotels in various towns in MO or IL so they can shadow physicians there. They could be alums or former trainees (residents/fellows). But I'm not sure if that's what he is referring to.

  • The URM percentage is pretty pitiful, even compared to WashU's peers. Do you know if WashU is doing anything or what it is doing to change this?
Yeah. It's a bit sad. No clue why we have trouble drawing URMs here. I chalked it up to them not liking STL (attendings included). But better informed people than I are looking into this. We have a Dean of Diversity for the med school, and even have several administrators whose job is to specifically recruit URMs to the MSTP. The atmosphere is one welcoming of anyone regardless of background so I personally am mystified by this.
 
This is a little unclear to me too. I'll leave it to @chronicidal to explain this. We do give students the option of doing a primary care rotation during the medicine clerkship. Students are put up in hotels in various towns in MO or IL so they can shadow physicians there. They could be alums or former trainees (residents/fellows). But I'm not sure if that's what he is referring to.

Primary care summer preceptorships are students working for the summer with alumni who are doing primary care anywhere. http://bulletinoftheschoolofmedicin...Pages/Primary-Care-Summer-Preceptorships.aspx

WashU is not traditionally considered strong in primary care. However, the school is making it a priority to become stronger in this area, short of buying out community physicians' practices like Penn did some years back, which lost money. This year, a new director of primary care and ambulatory medicine was appointed, who will be overseeing and strengthening the exposures to primary/ambulatory care throughout the four-year curriculum. The department of medicine has a relatively new primary care track/pathway for its residents. The small group of WUSM students who want to go into primary care have done very well and, I speculate, are on a probable trajectory towards some kind of policy leadership. This year, 4 of the 17 AOA members graduating (including two former class presidents) matched into internal medicine-primary care track residencies (at MGH, BWH, and UCSFx2). Last year, 1 AOA member matched into IM-primary at BWH and the class president matched to family medicine at UCSF.
 
Primary care summer preceptorships are students working for the summer with alumni who are doing primary care anywhere. http://bulletinoftheschoolofmedicin...Pages/Primary-Care-Summer-Preceptorships.aspx

WashU is not traditionally considered strong in primary care. However, the school is making it a priority to become stronger in this area, short of buying out community physicians' practices like Penn did some years back, which lost money. This year, a new director of primary care and ambulatory medicine was appointed, who will be overseeing and strengthening the exposures to primary/ambulatory care throughout the four-year curriculum. The department of medicine has a relatively new primary care track/pathway for its residents. The small group of WUSM students who want to go into primary care have done very well and, I speculate, are on a probable trajectory towards some kind of policy leadership. This year, 4 of the 17 AOA members graduating (including two former class presidents) matched into internal medicine-primary care track residencies (at MGH, BWH, and UCSFx2). Last year, 1 AOA member matched into IM-primary at BWH and the class president matched to family medicine at UCSF.

To be fair, Internal Medicine-primary care track residencies, have been found to be quite huge failures, when it comes to actually graduating primary care physicians: http://newsatjama.jama.com/2012/12/...are-reluctant-to-pursue-primary-care-careers/

WashU's strength is not in primary care medicine, and it would be quite weird if it was, based on the things that WashU's medical school invests in. Students who are paying WashU level tuition would be pissed (rightfully so), if their school wasn't gearing their students towards becoming specialists, unlike if they were paying state school level tuition. "Strengthening the exposures to primary/ambulatory care throughout the four-year curriculum" usually equates to more work that med students don't want to do but have to do.

That being said, the sudden primary care medicine may be due to 1) vocal student interest (although the minority, but maybe quite loud at badgering the administration) or 2) changing reimbursement models: ACOs, etc. in which primary care is being brought to the forefront.
 
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The first year is 719 hours over 38 weeks. The second year is 618 hours over 36 weeks. The hours are majority lecture, a minority mix of lab, small group, team-based learning, and clinical or standardized patient sessions.

Asperphys covered shadowing. I would extend the answer to say that there is flexibility to do research, but it is not especially encouraged outside the summer. However, few first years actually do research during the school year, including MD/PhDs unless it's half a rotation when the year is winding down. MD students looking for research projects during the first year will not find overt barriers either but can expect some resistance or difficulty. Research is not a required part of the curriculum. As such, there is not built-in protected time, mentorship, or progress checks outside of what you find out of your own initiative with some guidance from the office of medical student research. Additionally, because faculty here are not used to having hoards of med students look for academic-year part-time projects, there will be few such projects readily available. Some faculty might readily take you on, others won't be really sure what to let you do, others will straight out suggest that you focus on doing well in your classes (especially second year, which is graded and demands being treated as more-than-full-time job)** and consider working for them during the first-year summer or a 5th year program. Again, it depends on your initiative. There are students who successfully balance life and a part-time research project during the school year that publishes and gets good enough grades for AOA, but they can be counted on one hand. (Unless there are a lot of quiet gunners out there, but I doubt it.) If you think you can do it, as many incoming first years do, I encourage your initiative, but don't be surprised if you find yourself overwhelmed about half a year or a year in. A significant minority of second years partake in research mostly as a continuation of their summer activities with the mindset of 'wrapping up' the project and getting it out of the way so that they can focus on getting good grades and/or studying for the boards. This kind of scenario is true at most schools, except, again, those that require research as part of the curriculum and have the structure to ensure progress during the school year. There is also elective time to do research during 4th year, with the caveat that you're limited to a maximum of 12 weeks of research time.

That said, ~80% of students participate in research during the summer after first year, with the rest doing either something abroad that may or may not be "research" or a primary care preceptorship somewhere else in the country. By graduation, 90% of students will have participated in a research project with a faculty member. The vast majority (90%) of students are satisfied with the research environment and think that the administration is supportive of research. More than half of students graduate with authorship on a primary research article (exclusive of reviews and case reports). The caveat is that these figures include graduates of the largest MSTP program in the country, making up 20-25/year, in addition to another dozen or so that do a 5th year for research, out of a class of 120-125.

**Many years ago, a dean for curriculum wrote that what defines WashU is that it "emphasizes the belief that scholarly pursuits are primary and are necessary preconditions for other important goals of medicine--for example, the delivery of health care and the development of the individual." (emphases mine)



Hospital setting/diversity: WashU/BJH/SLC provides 40% of the uninsured specialty encounters in the metro area. It is the only non-profit hospital left in the city of St. Louis. Here are the demographics of St. Louis. It's 50% black, 44% white, and relatively segregated, with WashU sitting around the apex of where poor meets rich, black meets white, geographically speaking. That said, St. Louis has the biggest Bosnian population in the country, making it the third most common language spoken (1%, after Spanish at 3%). In addition to BJH, you can rotate at the VA, where the patient population is essentially all old men. You can also do an ambulatory care rotation with a community physician within a hour radius (if suburban or rural is what you want).

Student diversity: Most students feel that the school makes a good effort to recruit diverse students. That said, WashU is among the 40% of med schools around the country where 'diversity' in its students and faculty has been identified by the accreditation body as an "area of transition." I give you some data (attached) so you can judge for yourself. This is reported by deans to US News and World Report. Beware that different schools might define questions/categories differently. URM = underrepresented in medicine. Non-trad = non-traditional. Social/human = social sciences + humanities majors.
View attachment 180050



On a scale of 1=strongly disagree to 5=strongly agree, the average answer at WashU to something similar to this question is similar to the national average (4.2) upon graduation.
I have to admit, a couple of things in your wonderfully thorough and thought out response give me a pause: lower student diversity and less flexibility/time to do research compared to the other schools I'm considering. And these two aspects (student diversity and flexibility/time to do productive research) are very important for me, which is why I appreciate your response even more 🙂

Regarding research, I was a little surprised by your response given the research reputation of WashU and the fact that it seems to select students with strong research experience.
So, I understand - I mean, of course I can't *really* understand it until I start medical school myself - I understand that you have to learn a ton of stuff in preclinical years (in clinical, too, but that's another story) and that there is not much time left for anything other than studying; my guess is, this must be true for pretty much all medical schools. Yet, there are schools that not only encourage student research at pretty much any time (probably not in MS3 though) but have some dedicated research time. I should clarify that by research I mean not only basic science, but also clinical, epidemiological etc. research, i.e. research that still takes time for data collection and analysis, paper reading and writing etc. but doesn't require spending hours in the lab. While I have a lot of basic science research experience, lately I've been more interested in clinical research, which is what I'm likely to do while in medical school and beyond. One summer doesn't seem to be adequate to complete a meaningful research project and get a decent publication out of it even if you actually write the manuscript etc. during the next year.
Which brings me to my question: it seems like competitive residencies (residencies in competitive specialties and top academic residencies even in less competitive specialties like IM) now pretty much require some solid research. And WashU graduates match to competitive residencies - how? Mostly based on Step scores and grades? (Recommendations? WashU reputation?) Or do a lot of students take a research year to strengthen their residency applications? I know that a large part of WashU's class are MSTP students who obviously have substantial research experience, but this doesn't account for most of the class.
 
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That being said, the sudden primary care medicine may be due to 1) vocal student interest (although the minority, but maybe quite loud at badgering the administration) or 2) changing reimbursement models: ACOs, etc. in which primary care is being brought to the forefront.

Very likely this. But if they're gonna make primary care a requirement, I am glad I don't have to go through it. 😀
 
Tangentially related rant: I don't understand why top medical schools get so much heat from the media etc. for graduating so few primary care docs; that's not what they're for! Plenty of schools can prepare students for primary care training, but not so many have resources to prepare for specialty training and academic medicine. Harvard doesn't graduate many primary care docs? - seriously, who cares, it's not its mission.
 
Very likely this. But if they're gonna make primary care a requirement, I am glad I don't have to go through it. 😀

The very vocal minority who clamor for "more primary care" I've found usually to be:

1) from rural areas in which they know everyone in town and thus value the ability to establish chronic, long term relationships, where specialists are very scarce and PCPs are doing everything.

2) URMs from disadvantaged circumstances who want to give back to their disadvantaged communities (although to be fair, many of them want to leave these areas and live in nice gated communities ASAP)

3) the AMSA type (many of them rich liberals and thus devoid from actual reality and economics: http://news.yahoo.com/biggest-medical-student-group-leader-cheerleads-obamacare-while-052234883.html) who have no qualms on standing on their soapbox and lecturing to others. Hence their wanting to mandate that EVERYONE do it by forcing it in the curriculum.

Expecting medical students with high GPAs (including high science GPAs) and high MCAT scores to embrace primary care (with no intent to subspecialize) is ludicrous. I agree, the faster you can get out of med school, and esp. avoid those in #3 -- screwing up the medical school curriculum for the rest of students, the better.
 
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Tangentially related rant: I don't understand why top medical schools get so much heat from the media etc. for graduating so few primary care docs; that's not what they're for! Plenty of schools can prepare students for primary care training, but not so many have resources to prepare for specialty training and academic medicine. Harvard doesn't graduate many primary care docs? - seriously, who cares, it's not its mission.

Bc it's relatively easy to demonize those "greedy", "selfish" specialists vs. your "saintly", "pious" primary care physician.

Look at the New York Times and the specialty doctors they've attacked in their hit pieces: GI docs, Dermatologists, Radiologists, Emergency Medicine docs.

The ranking of medical schools by "social mission" written of course by "health policy" experts:
It's essentially the research rankings turned upside down. They obviously left out Harvard as then people would know their study really is FOS.

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Ranking by social mission: #1 - Morehouse, #2 - Meharry, #3 - Howard, which just happen to be URM schools, with minimal resources, and produce doctors who end up receiving disciplinary actions at a disproportionate rate: http://articles.courant.com/2003-06...cal-schools-disciplinary-actions-top-students funny how that somehow gets left out of the touchy-feely narrative.
 
I have to admit, a couple of things in your wonderfully thorough and thought out response give me a pause: lower student diversity and less flexibility/time to do research compared to the other schools I'm considering. And these two aspects (student diversity and flexibility/time to do productive research) are very important for me, which is why I appreciate your response even more 🙂
As tempting as it is for me to just overwhelm people's objections with my protestations of how much I love WashU, I realize that people have different values and it's important that you are raising these concerns now. Be sure to gauge for yourself the extent of student diversity at WashU when you visit for the 2nd look. If it is too monolithic for your taste, then based on your preferences, you will probably not be happy here, and by extension, not do as well as you would in other schools. The relatively low number of URMs did not scare me away because the rest isn't all Caucasian. There are plenty of "over-represented" minorities-- Asians (Southern, Eastern, Southeastern), Middle-eastern etc. In fact, there was more diversity at WashU than the college I attended in New York. But that's just me.

Regarding research, I was a little surprised by your response given the research reputation of WashU and the fact that it seems to select students with strong research experience.
So, I understand - I mean, of course I can't *really* understand it until I start medical school myself - I understand that you have to learn a ton of stuff in preclinical years (in clinical, too, but that's another story) and that there is not much time left for anything other than studying; my guess is, this must be true for pretty much all medical schools. Yet, there are schools that not only encourage student research at pretty much any time (probably not in MS3 though) but have some dedicated research time. I should clarify that by research I mean not only basic science, but also clinical, epidemiological etc. research, i.e. research that still takes time for data collection and analysis, paper reading and writing etc. but doesn't require spending hours in the lab. While I have a lot of basic science research experience, lately I've been more interested in clinical research, which is what I'm likely to do while in medical school and beyond. One summer doesn't seem to be adequate to complete a meaningful research project and get a decent publication out of it even if you actually write the manuscript etc. during the next year.
I'd encourage you to reread chronicidal's post, Amygdarya. Everything he wrote is so factually correct and dense, it's quite a feat to pack in that much information in such short a text. He didn't wanna mislead anyone into thinking that all WashU students find research projects by default. It does take initiative and an appropriate resume to get the faculty to invest time and resources on med students who are gonna do research with them. That said, there is no rigidity in the sense that you can only do research during the summer. For example, I managed to do two full lab rotations and got published during my first year (before summer) and had no trouble passing my classes. Anyone who gets into WashU and has the appropriate motivation surely can do that. If a summer is not enough, how many more extra months would suffice? If research is so important to you, wouldn't you rather take the extra year and publish multiple papers?

The beauty of the WashU curriculum IMHO is tremendous flexibility despite the traditional core. There is NO designated research time outside of the summer between 1st and 2nd year because some students will resent having that as a additional requirement as a 2nd year or clinical student, especially if they're more interested in policy-making etc. That said, you can choose to do research electives of up to 12 weeks as a 4th year. Now, if I could block off enough time to be in basic science labs and be productive as a first year (where it is P/F), one can easily do clinical research in that period as well. No one is preventing any of the students from doing this. As chronicidal pointed out, the only impediment is you-- can you find a PI and can you find a good project?

During 2nd year where is is important to really know the material, not only because it's graded but also because if you goof off, you will NOT do well on Step 1 (the most important screening tool for residency applications), you will be taking a great risk dividing your attention between studying for Step1/2nd year and your research. Or maybe your sanity because you will be giving up your leisure time. But even that is not impossible. Students who are AOA at WashU have done impressive things, even with the load of 2nd year-- like writing a book, or being politically active, or publishing clinical research.

Which brings me to my question: it seems like competitive residencies (residencies in competitive specialties and top academic residencies even in less competitive specialties like IM) now pretty much require some solid research. And WashU graduates match to competitive residencies - how? Mostly based on Step scores and grades? (Recommendations? WashU reputation?) Or do a lot of students take a research year to strengthen their residency applications? I know that a large part of WashU's class are MSTP students who obviously have substantial research experience, but this doesn't account for most of the class.

Solid research is NOT a substitute for fantastic Step 1 scores. You might have multiple Nature/Cell/Science papers and would still be ignored by competitive residencies if your Step 1 is below 220. That's why the emphasis is on learning the material well and not forcing people into multiple designated research periods.
WashU students match well because most do very well on Step1, and exhibited strong performance in the wards (as assessed by clerkship grades and LORs). This will not be different from how students from other schools match well.

It's best to think of one's competitiveness for residency in terms of a scale. If you're AOA at WashU and you have great Step 1 scores, any additional research you do is icing on the cake, and just proves that you are indeed a superstar. But even without publications, you will likely match into a competitive residency. If you're top 1/3 but not AOA, publications might help get you into the most competitive residencies. If you're in the middle third, you will still match well, but maybe not at MGH/BW/JHU/UCSF/(insert most famous residency program for each field here) etc. If you're in the bottom third, you are not guaranteed anything. If you still wanna go for a supercompetitive residency and you're only in the middle to lower third in class rank, then you better bone up your resume. This is when people take the extra year to do hardcore research because it could help.
 
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WashU's strength is not in primary care medicine, and it would be quite weird if it was, based on the things that WashU's medical school invests in. Students who are paying WashU level tuition would be pissed (rightfully so), if their school wasn't gearing their students towards becoming specialists, unlike if they were paying state school level tuition. "Strengthening the exposures to primary/ambulatory care throughout the four-year curriculum" usually equates to more work that med students don't want to do but have to do.

That being said, the sudden primary care medicine may be due to 1) vocal student interest (although the minority, but maybe quite loud at badgering the administration) or 2) changing reimbursement models: ACOs, etc. in which primary care is being brought to the forefront.

I agree it would be weird, and so do many faculty here. Yes the interest is probably driven by a vocal minority. I don't think they're badgering the administration, but a sizable minority of graduating WashU students do say on surveys that various primary care-geared curricular areas (e.g. care of ambulatory patients, long-term health care, continuity of care, community medicine) as "inadequate", and those numbers look bad compared to the national average.

It's best to think of one's competitiveness for residency in terms of a scale. If you're AOA at WashU and you have great Step 1 scores, any additional research you do is icing on the cake, and just proves that you are indeed a superstar. But even without publications, you will likely match into a competitive residency. If you're top 1/3 but not AOA, publications might help get you into the most competitive residencies. If you're in the middle third, you will still match well, but maybe not at MGH/BW/JHU/UCSF/(insert most famous residency program for each field here) etc. If you're in the bottom third, you are not guaranteed anything. If you still wanna go for a supercompetitive residency and you're only in the middle to lower third in class rank, then you better bone up your resume. This is when people take the extra year to do hardcore research because it could help.

This is consistent with my understanding based on looking at this year's match list and looking up whether people have pubs or are AOA.
 
Solid research is NOT a substitute for fantastic Step 1 scores. You might have multiple Nature/Cell/Science papers and would still be ignored by competitive residencies if your Step 1 is below 220. That's why the emphasis is on learning the material well and not forcing people into multiple designated research periods. WashU students match well because most do very well on Step1, and exhibited strong performance in the wards (as assessed by clerkship grades and LORs). This will not be different from how students from other schools match well.

It's best to think of one's competitiveness for residency in terms of a scale. If you're AOA at WashU and you have great Step 1 scores, any additional research you do is icing on the cake, and just proves that you are indeed a superstar. But even without publications, you will likely match into a competitive residency. If you're top 1/3 but not AOA, publications might help get you into the most competitive residencies. If you're in the middle third, you will still match well, but maybe not at MGH/BW/JHU/UCSF/(insert most famous residency program for each field here) etc. If you're in the bottom third, you are not guaranteed anything. If you still wanna go for a supercompetitive residency and you're only in the middle to lower third in class rank, then you better bone up your resume. This is when people take the extra year to do hardcore research because it could help.

Interesting that this is the case, bc your average WashU student in the middle 1/3 (and maybe even in the bottom 1/3 of the class), would quite easily have been in the top 1/3 or even AOA if they had attended a non-top 10 school or lower tier school. It just so happens that at WashU, you've already aggregated the best standardized exam takers (based on MCAT) and academically motivated students (based on GPA, from higher ranked schools), who presumably all are aiming/competing for Honors on rotations.

Being Top 1/3 or AOA at WashU (I'm assuming this is calculated based on # of Honors grades and Step 1 score) is a huge accomplishment due to the high caliber of the average student that attends WashU (there will always be outliers of course).
 
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Duplicate info
 
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I know I've heard around half the class last year came from the waitlist, but does anyone know the approximate number on the waitlist each year? Or the percentage that comes off?

Thanks
 
I know I've heard around half the class last year came from the waitlist, but does anyone know the approximate number on the waitlist each year? Or the percentage that comes off?

Thanks
I've heard its like half of the class, but there is a new dean of admissions, so things may be different.
 
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