I found this article on the front page of the nytimes.com webpage: http://www.nytimes.com/2002/08/04/edlife/04COLLEGT.html Premeditations By GLENN C. ALTSCHULER An awful lot of the best and brightest 17-year-olds want to be doctors. Despite the constraints of H.M.O.'s and the costs of malpractice insurance, the letters M.D. continue to bring prestige and prosperity to the names that are attached to them. That's why in the nation's elite colleges of arts and sciences -- including the University of Chicago, Cornell University and the University of Virginia -- 20 to 30 percent of first-year students identify themselves as pre-med. Within four years, of course, their ranks will be depleted -- only 10 percent will apply to medical school. Some drift away when they discover a new interest or find that they don't have the fire in their belly for a career in medicine. Others get derailed by the rigorous pre-med requirements -- a year of biology, general chemistry, organic chemistry, physics and, for some medical schools, calculus. ''Stars in their high schools, they are unwilling to accept their first C's,'' says Jane Cary, director of health professions advising at Princeton -- or to persist when they can't beat the mean in organic chemistry, the ultimate pre-med weed-out course. Pre-meds have every reason to be grade-conscious. Even though applications have dropped significantly from their peak in 1996, admission to medical school remains extremely competitive. Moreover, if the job market for undergraduates continues to tighten, the number and quality of applicants to medical school will most likely increase. Last year, according to the Association of American Medical Colleges, 35,000 students vied for about 16,000 places, submitting applications to an average of 11.6 schools (a total of 400,000 applications). Successful candidates had a mean grade point average of 3.6. On the Medical College Admission Test, or MCAT, they scored about a point above the overall average in verbal reasoning, physical sciences and biological sciences. Academic and extracurricular choices during undergraduate years have a big effect on medical school admissions. But what are the right choices? Shakespeare? Why Not? Many pre-meds declare a major in biology or chemistry because they think that medical schools prefer applicants in those disciplines. They are wrong. Data collected by the association of medical colleges demonstrates that there is no meaningful correlation between a major and the likelihood of admission. Of the applicants to medical school in 2000, a letter of acceptance went to 44.9 percent of applicants majoring in the biological sciences, 50.9 percent in the physical sciences and 50.5 in nonscience subjects. ''In my years of medical school admissions work,'' says David Owen, health professions adviser at the University of Chicago, ''never once have I witnessed an applicant's major be influential in a decision for admission.'' Pre-med science courses are all the preparation that is needed for the science portions of the MCAT's -- science majors do not post higher scores than Shakespeare specialists. Medical schools encourage undergraduate students to major in subjects they like most and are best at. Interest in what is being learned enhances performance. Medical schools, Mr. Owen adds, favor applicants who can analyze moral, ethical and cultural issues with the same facility they bring to scientific problems. Experience Wanted: Clinical experience gained through voluntary or paid work is indispensable. Judy Jensvold, senior associate director of health careers at Cornell, calls it ''the unwritten requirement, on a par with taking biology.'' Admissions committees may doubt that a totally green applicant is committed to medicine or knows anything about it. For that matter, being around sick, injured, older and vulnerable people early on helps students judge whether they have the stomach for the profession -- before they invest huge amounts of time and money. Ralph E. Purdy, associate dean of admissions for the College of Medicine at the University of California at Irvine, will never forget a student who was admitted without clinical experience and nearly passed out the first time he saw blood drawn. Because so many applicants have carbon-copy high grade point averages and MCAT scores, committee members have the luxury of looking for a history of service activities, rather than a single experience, and for work that is substantive -- say, a clinic, nursing home, rescue squad or hospice. ''We want people who are activists, who can get good grades and also want to save the world,'' Dr. Purdy says. His model applicant: Mario San Bartolome, who was a candy striper in high school and who helped organize health clinics for migrant workers while in college. He secured 1 of the 92 places in Irvine's entering class in 1997. Unlike clinical work, research in the sciences is not essential for admission (except in an M.D./Ph.D. program). But most pre-meds do it. ''It seems to them to be one of the unwritten requirements,'' says Peter S. Van Houten, retired director of Graduate School Services at the University of California at Berkeley. Although medical schools are looking for students who have gone beyond basic course work to examine a subject in depth, admissions committees can readily distinguish between advanced work that arises out of genuine intellectual engagement and research just to pad the resume. ''Many do it without much interest,'' Dr. Van Houten says, ''and it likely is of little value to them.'' Test Prep: MCAT's are usually taken during the spring of junior year. Well-organized, disciplined students can prepare on their own with the manual and practice tests issued by the association of medical colleges (www.aamc.org). The aim is familiarity with the test format and types of questions. Pre-meds frequently ask me, as their adviser, about the utility of MCAT prep courses. Using a commercial course, I tell them, is like joining a health club. The money one pays can provide motivation to exercise. But many lockers assigned to health club members never get opened. What to Write: MCAT scores, grades and the application itself determine whether a student will be invited for an interview. In the personal essay, applicants should discuss and document in depth their interest in medicine, taking care to avoid trite and shallow formulations. ''The 'I've wanted to be a doctor since I was 6 years old' is meaningless,'' says Beth Bailey, director of admissions at the University of Virginia School of Medicine. As associate dean for admissions at Tulane University School of Medicine, Joseph Pisano has seen that, too. ''There is no M.D. wannabe gene,'' he says. His favorite line: ''My performance on the MCAT is not an accurate reflection of my ability because I do not test well.'' He recommends that essays be interesting ''and, I might even dare to say, entertaining.'' Interesting prose is difficult to define. Like most academics, I am engaged by essays that are rich in detail and unsettle ingrained expectations -- for example, arguing that MacMurphy of ''One Flew Over the Cuckoo's Nest'' was emotionally disturbed or explaining why a hospital staff was unsympathetic to a terminally ill patient. What to Say: To prepare for interviews, Dr. Pisano advises visiting the school's Web site and being ready to comment on current issues in medicine like stem cell research and therapeutic cloning. Medplaza, a consulting company for health sciences on the Internet, offers the ''Premed Advisor'' on its Web site (www.medplaza. com/premed) with sample interview questions and answers: ''Why do you want to be a doctor?'' ''Why did you apply to our school?'' ''Why should we choose you?'' The Association of American Medical Colleges lists ''31 Questions I Wish I Had Asked'' on its site: ''May I see a list of residency programs to which this school's recent graduates were accepted?'' ''Is someone available to assist students with budgeting and financial planning?'' The interview is a crucial factor -- an opportunity to explain and defend and to make a good impression. You don't have to look like a primary-care physician, but dress is important, says Dr. Pisano, who advises not to overdo fragrance and jewelry. Indeed, an advisee once asked me if she should remove the rings in her eyelids, nose and tongue for the interview. Sometimes, I replied, to ask a question is to answer it.