Medical Get Accepted to Dartmouth’s Geisel School of Medicine - podcast Episode 530

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

In this episode, Professor of Medicine and Medical Education and Associate Dean of Admissions at the Geisel School of Medicine at Dartmouth University explains the draw of the close-knit community at Dartmouth, why the school doesn’t send secondaries to applicants with an MCAT below 503, and how to ace Geisel’s secondary. [SHOW SUMMARY]​

Are you dreaming of becoming a doctor at an Ivy league medical school, one of the best in the country? Do you want to learn how to ace the admissions process at Dartmouth Geisel School of Medicine? Tune in to this episode of Admissions Straight Talk, where I interview Dr. Roshini Pinto-Powell, the Associate Dean for Admissions at Geisel, and get her insider tips on what makes a successful applicant.

An interview with Dr. Roshini Pinto-Powell, Associate Dean of Admissions at Geisel and Professor of Medicine. [Show Notes]​

Welcome to the 530th episode of Admissions Straight Talk. Thanks for joining me today. Are you ready to apply to a dream medical school? Are you competitive at your target programs? Accepted’s Med School Admissions quiz can give you a quick reality check. Complete the quiz, and you'll not only get an assessment, but tips on how to improve your qualifications and your chances of acceptance. Plus, it's all free.

Our guest today is Dr. Roshini Pinto-Powell. Dr. Pinto-Powell grew up and earned her bachelor's degree in chemistry in India. She earned her MD at the Ross School of Medicine. She did two fellowships in infectious disease and returned with her husband to Dartmouth where she actually focused on general internal medicine. She also found that she loved teaching, and today is a professor of medicine and a professor of medical education as well as co-director of On Doctoring at Dartmouth Geisel, Vice Chair of Clinical Affairs at Dartmouth Hitchcock Medical Center, . Aand most importantly for our conversation today, aAssociate dDean of aAdmissions at Geisel.

Dr. Pinto-Powell, welcome to Admissions Straight Talk. [2:08]​

Thank you.

Can you give us an overview of the MD program at Geisel, focusing on its more distinctive elements? [2:17]​

I think one of the things I'd start off by saying is that Geisel is a small school, relatively. We have 92 students, 90 MD students, two MD/ PhD students, and this is the largest we've ever been. We were a much smaller school, 65 students, until fairly recently, about a decade and a half to two decades ago, and then have grown to 92. I mentioned that because I think that's one of its distinctive elements. It's small enough that in some ways, I would say, we are the “Cheers” of schools where everybody knows your name and everybody's glad you came. And if you ask any of our students or staff or administrators, what is their favorite thing, they will say the sense of community, the sense of feeling like people know you. Our students don't graduate without personally knowing more than 10-15 faculty, have been to their homes, watched their dogs or animals and things like that. I think that makes it just a wonderful place to learn to be a doctor.

Sounds like a very close-knit community. [3:35]​

I believe so.

On the website, it mentioned several times that the medical school has a real determination to graduate what they called “the complete physician.” What does that mean, “the complete physician,” and does it tie into the community that you were just talking about? [3:41]​

It does. It absolutely does. I'm really glad you asked the question because that is our tagline. My silly joke usually is, well, I don't know any medical school in this country or any other that's trying to graduate the incomplete physician.

What we mean at Geisel when we talk about the complete physician is somebody who's totally grounded in the foundational science. I think that first point is really relevant and important today. I think we all know that most medical schools have a pass/fail pre-clinical curriculum to stimulate collegiality and openness to learning and being unafraid to be wrong. But now, USMLE Step 1 is pass/ fail. I feel, I worry a little bit about the sense of just having to pass, maybe not focusing, students, not focusing on the foundational science as its very core. Something that is very integral to the second part of being a complete physician. That –that is being a caring physician who really knows how to connect with patients, to take care of patients. But you can't do that effectively. You can't be the most empathic, wonderful physician and not know your stuff.

It doesn't matter. Exactly. I wouldn't say that you were a complete or a really good physician, frankly. So those two are foundational to me, really grounded in the sciences, really outstanding clinician. But then the third and fourth thing I think are very important at Geisel. Geisel's been the home of Dartmouth Atlas. I think many people will know about that. So I think the one thing we really want our students to go away with is somebody who understands the science of healthcare delivery. In 2023, I would really add somebody who understands implementation science. So I think about implementation science really as the adoption and integration of evidence-based healthcare. In order to take great care of a population, you have to really do this well. Because there are so many studies that show there's so many new things. Science is developing at this incredible speed, and the time it takes from knowledge, which is really effective evidenced-based to be really used in the care of patients, they say it's something like 17 years. That's absurd.

A long time. [6:27]​

It's a long time. So I think implementation science sort of pushes that forward. It says, "Here is evidence-based practice. Now, go forth and spread it around, take care of the individual patient as well as populations." I think that, and both by the way, from a practice point of view and as well as a policy point of view. Then the last thing I think a complete physician is somebody who is actually willing to both create and share knowledge in the form of whether it's research, outstanding clinical care, teaching, medical education, any and all of it I think is important.

Maybe even turning to another care provider who might have a certain specialty - physical therapist, for example, or psychologist. [7:03]​

Oh my goodness. Yes.

Would that be also part of the sharing? [7:09]​

Absolutely. Absolutely. Medicine is teamwork today. As Atul Gawande said a while ago, "It's no more the Lone Ranger or the cowboy sort of thing. It's a pit group." So, absolutely sharing with anybody and everybody. Then the last thing that I personally add to the complete physician, because I think it's really critical in today's world, is somebody who's a leader from within. Because to me, a leader is not somebody with titles. Titles truly are, Linda, a dime a dozen, but a leader to me, somebody who shows up authentically in every encounter, whether it's one-on-one with a patient or a colleague or a group or students or an institution, somebody who brings their integrity and the authenticity and really lead in any situation. We can always be leaders from within. So that to me, and I think Geisel does that, which is why I add that on to the four main pillars of what I see as a complete physician.

That's a wonderful answer. Thank you. Now, what is On Doctoring, which you are the director of, at Geisel? [8:12]​

Yeah. So all schools generally have a clinical skills communication, interpersonal skills course, basically teaching the art of doctoring. While I'm talking about evidence-based and I'm talking about the science and foundational science, which is critical, . Tthe second piece is that being a good clinician, being somebody who truly brings and the authentic self listens to the patient, understands things like shared decision making. , wWe don't make decisions for patients anymore. We partner with them trying to get them to really understand what the evidenced-based by sharing appropriately and appropriate words, not scaring them, but also not just saying, "Oh, do this." So our course at Dartmouth is called On Doctoring. It's been in existence for a long time. I've had the absolute honor and pleasure of running and directing the course for the last 15 years.

What I really love about it is that it's extremely robust. So our class of 92 students is broken up into groups of eight or 10, and they meet with two faculty for a group of eight or 10 every week for two hours. So it becomes a sort of homeroom. They really get close and then they learn the skills of doctoring, starting off obviously with how do you take a history, ask the different components of the history in a caring, empathic and open way, being non-judgmental, and then learning each and every portion of the physical exam skills. But in addition to that, Geisel, the On Doctoring course has a lot of these high level communication skills like breaking bad news. How do we do that?

When we say bad news, I think our mind immediately goes to cancer. But to be fair, somebody who is newly diagnosed with high blood pressure and needs to take a pill every day of their life, that can be terribly bad news. Or somebody who is a diabetic and you need to put them on insulin, that can be devastatingly bad. So, how do you empathically and in a caring way share this information, partner with the patient? We do a session on intimate partner violence, a huge societal issue. We have had a transgender medicine session for the last 10, 15 years long before it became a topic of national conversation. So we do a lot of those kinds of skills in On Doctoring.

What are some of the benefits and challenges of studying medicine in a rural setting like Dartmouth in Hanover? [10:49]​

I love that question because one of the things that I'm very, very insistent on is that we don't recruit people who really don't want to be here or who feel strongly that they wouldn't flourish here. Because as the dean of admissions, to me, it's not so much about admissions. It's really about retention and flourishing. We want our students to come here. Medical school is hard. I'm not going to pretend it's all roses. No. But we want somebody who wants to be here. Sometimes, clearly, I love it. I've been here for 28 years, but a rural place like this is not comfortable for everybody.

I personally think it's absolutely gorgeous. People come here for vacation. I feel like I don't need to go anywhere. I love the four seasons. Some people who have not experienced winter might feel it's hard. But I think once you wrap your mind around it and you understand the concept of layered clothing, which I didn't when I first came here, it had to grow on me. I think our students really learn to stretch themselves and try things that never would've before, like skiing or ice skating. I think that sort of stretch and growth is really important for us to become well run. We tell our patients to exercise and go outdoors and commune with nature. Here, it just allows us to do that.

It's in your backyard. [12:37]​

Yes, it's in our backyard. I think it's close enough to cities like Boston and New York. So for instance, we have a Dartmouth coach that in two hours and 15 minutes or two and a half hours, you can be in Boston. In five hours, no driving, you can study in the coach and in five hours you'll be in New York City. So I think we're close enough, but I do want to say that I don't want students or candidates to think they have to like the outdoors to come here. No, Dartmouth College. So yeah, we have this absolutely wonderful Hood Museum. We have the arts that come here, musicians that come here from all over the world. So we do have other things. You don't have to be an outdoorsy person.

Lastly, I'll just say one thing because I think it's actually critically important. I always tell students sometimes it's really important, we don't realize how regional the practice of medicine is. I do say for people in the Midwest or across the country, it's almost important sometimes to come to a different coast to learn medicine and then go back to where you live or where home is for your residency or your final practice. People are often surprised. That's what the Dartmouth Atlas showed, how regional variations are.

Really? [14:00]​

Oh, my goodness. It's fascinating. I'd love for you to Google it and look after our conversation.

Okay. I think I will. [14:07]​

I hope our candidates who listen to this do that. I think it's a peaceful place to stay four years, I tell my students, four years, no distractions. This is another reason, I'll be honest. I think they form such a tight-knit community. Our students say, every class thinks that they're the best class. It's somewhat hilarious to me. I have to promise everyone, "Yes, yours is the best," but I tell the next class. But I'm glad that they feel that way.

I'm glad. I think part of it is this bonding. There's not a whole lot of other distractions, so they really get to know each other well. They have house parties all the time. Those that don't, some run or bike together, but others cook with each other and really get tight. Anyway, clearly I love this place and I could wax lyrical on and on.

I mentioned I visited Dartmouth many years ago, and I remember talking with ... At that point, it was the admissions officer of Tuck that I was speaking with, and she said that, "Nobody locks their doors." Now, I don't know if that's still true. This was about 20 years ago. [15:00]​

It's true.

It's still true. [15:13]​

Doors or cars. We don't. I don't have a front door key. I'm being honest.

Let's turn to the application. Does Geisel screen before sending out secondaries, and are you planning to make any changes to your secondary application this year? [15:28]​

No change to the secondary application this year.

The only screen, and this is on our website, is that when we looked at years and years of data, we realized that we had never really admitted or very, very few, I can count on the fingers of one hand, somebody with an MCAT score of less than 503. But we have, we believe, a really rigorous curriculum. We thought it was fair to put that on our website so that everybody can see that. That we did not – Because as you know, most secondary applications cost, – and we did not want to take money under false pretenses. But other than that, once you clear that bar, 503, there is no screening. We don't screen forever. We really do a holistic review.

So you tell people that you don't admit people below 503? [16:36]​

It's on our website. We're, I think probably the only school that does it. I can't say that because I haven't looked at 157 school websites, but I'm pretty confident that most people don't use the screening, but don't really put it as transparently.

I think I've seen websites say that “we haven't admitted somebody less than this” or “that we do screen based on MCAT”. Some do say it, but it's pretty unusual.​

One of the interesting aspects of Geisel secondary is that three of the four required questions have no word limit. That is very unusual on secondary applications. Have you ever gotten the Great American novel in response to your questions or have you found that that policy burns you? Or do you find that it's a good way to assess judgment among your applicants? [16:55]​

All of the above. We've never had a problem. Nobody has written a novel yet.

Maybe their memoirs? [17:37]​

No. It's interesting. I know we didn't have a word limit, but it never struck me as something until you just mentioned it, because that has never been an issue.

Most schools have a word limit. Some schools don't and I actually think that it's a case where applicants really have the opportunity to show judgment when they don't have a word limit. [17:52]​

That is true.

Both good and bad. [18:10]​


What do you hope to glean from the secondary that you don't get from the primary? [18:11]​

Secondary is a couple of things, right? We want to know what they're doing that year. Lots of people take gap years or are planning things, especially during Covid. There was a lot of, "We're going to do this," but we realized a lot of people didn't follow through. So I think that just allows them to tell us, what are they doing in the moment? I think the other secondary, we just give them an opportunity to tell them anything that they feel strongly about that they haven't had a chance to mention in the rest of the application. So that is also, again, an interesting thing to see what folks write in there. I think one that is a really important one is giving us an example of when they felt like the other, and I think that's a really important one. We have gotten some really interesting responses on that.

It's interesting to see the things that resonate or that sit with folks that they want to share with us. So I particularly love that one. Of all, everybody on our committee has found that particular essay very, very important because we do, we at Geisel, and most schools do, so I'm not going to say it's just Geisel. We do value diversity in all its forms, and we know that sometimes people feel othered in so many different ways. So that's a question we really like. Then the last question is about tell us why, particularly, Geisel? It's always nice to hear some nuggets that you might, sometimes it's clear that folks are simply reading the website, but to me, that's good. Reading the website.

That's a good start. [20:05]​

It's a perfectly good start.

Maybe they'll start quoting this interview. [20:08]​

There you go. People have, sometimes. But I think looking at our website or being interested enough in a particular subject that they've found faculty who are doing things or something on our website in terms of a service learning project that really intrigues them. I think lots comes out in that, that I think we find valuable.

How do you think AI will affect medical education? That's question number one. Question number two, which is closely related, are you concerned about the impact of ChatGPT on the essay component of the application process? [20:36]​

I'll answer that one first. I'm not worried at all.

Okay, great. [20:56]​

So even before ChatGPT, Linda, let us not pretend that there have not been cases of others writing the essay. How is that different, whether it's artificial intelligence or your parent or a hired company? So I'm not so worried about this. What I think, and I'll give our listeners a tip here, a big tip.

Your portfolio, your file has to have synchrony. Your personal statement can't be so different from the rest.

That's right. Or from the emails you send. [21:32]​

Or from the emails you send, or frankly, when you do arrive for your interview. So I'm not worried about ChatGPT, I think that is a little bit of hand wringing in my opinion. I'm not laying awake at night thinking about that candidates are using ChatGPT to write their essay. I think AI is already here, it's here in medicine. It's in healthcare. We use it. What I think is fascinating, so at Dartmouth, we have an incredible associate professor, Dr. Saeed Hassanpour who actually is an expert in AI. We are working together with some students. He's doing a lot of incredible work - separate. But we are actually looking at how do we train our students in the big concepts of artificial intelligence, because it's here already. I think everybody needs to know its limitations, its possibilities. Then a few of our students possibly will do that. Number four, I talked about sort of create and share new knowledge. They might be leaders in AI, and so they need to know a little bit more in depth about coding and things like that. But the use of big data and medicine, it's here. It's here.

If you talk about it, obviously data is a foundation of science. [22:59]​

It's a foundation of science. We've been collecting so much data over the last decade and a half, two decades. So now, the key is, how do you mine that effectively in order to improve healthcare? Yeah.

Agree with you that it's here. [23:20]​

I think Dartmouth will be on the cutting edge in that, in my opinion.

I noticed that Geisel does not require a situational judgment test, which seems to be increasingly popular at medical schools. May I ask why is that? [23:25]​

I would say a couple of reasons. Unlike a lot of schools, we still have two 30 minute interviews. I think there's an ample opportunity to get a sense of somebody's situational judgment during those two 30 minute interviews, more than a standardized test that's delivered to me as a result.

That's a good answer. Succinct and to the point. [23:58]​

That doesn't mean, I think, for schools that are using it, and we have talked to a lot of schools, so to be fair, we looked at those.

We just didn't think right now we needed to change anything in our process since from our perspective, it's working well. We get great students.

You mentioned interviews a minute ago. Will interviews be in person or virtual this cycle? What can interviewees expect if lucky enough to be invited to interview? [24:21]​

Interviews are going to be virtual. So when the walls shut down and we have to pivot, we had two interview days left that were fully organized. So there was about 50 candidates that we had invited, and we felt that in no way could we disappoint them. In no way could we just say, "Sorry, that's it." So we literally turned on a dime within a week and set up to virtual interviews. But what we also did, this is the Dartmouth way, we're all about studying things and doing continuous quality improvement. So we studied those two days and we studied it from many perspectives. We studied it from the satisfaction, whether the faculty ... Not faculty, because we also have staff interviewers. Whether the interviewers were able to connect with the candidates, whether the candidates felt they were heard, seen and listened to. We also studied whether there was any difference in the rate of admission for those two groups offered admission compared to the rest of the year.

We found there was no difference. We found that the candidates actually were quite comfortable with virtual interviews. Candidates are younger, they are used to things like FaceTime and all of this stuff. Our interviewers, for those two interview days, just were worried that they had not connected. But the candidates didn't notice that. The candidates, when we surveyed the candidates, they said, "We felt they connected well," so it was just a worry because they had done the rest of them in person. So they were worried about that. Then we spent that summer looking at the results and then training our faculty and doing it. We'd been virtual ever since. Let's be fair, when you think about the cost to these candidates in terms of money, time, travel, the carbon footprint, you name it, I can't see going back. I can't see going back.

Do you encourage applicants to visit at some point in time just to get a sense of Dartmouth? [26:53]​

Sure, yes. Yes, absolutely. Especially if they're offered admission. We have open houses for sure that they can come way before the second look day. That is correct.

Makes sense. Now, what makes for a great interview? What is the interview day? Is there a chance to meet with students virtually? Is there, obviously, you said two, one-on-one interviews, what can they expect and what makes a great interview at Dartmouth? [27:10]​

I just spent the first half telling you how wonderful our students are. Truly they are, right? So, if you ask young people today, you ask our candidates, people who really connect with and recruit candidates is our students. So we have the candidates meet with our students before the interview in a process we call Geisel Conversations. So, our interview days are on Thursday. The candidates get invited to meet with our students. These are student volunteers. There is no coaching, as I told you, we never want to recruit people under false pretenses and nobody in the admissions team is present for these interviews. These are not monitored. It's simply the current students with the candidates. We try very hard to have a preclinical student and a clinical student so that they can ask any range of questions. So they meet with the candidate, the candidates meet with our students on Tuesday, and then they come to our interview on Thursday, our interview starts at 10 o'clock to allow for the three-hour difference so that the people on the West coast, you for instance, wouldn't. Would really-

Be able to get up at a reasonable hour. [28:46]​

Yes, seven o'clock. Exactly. We have a lovely informational session. So at Geisel, we have an incredible admissions team. My admissions team is small but mighty. Our candidates absolutely love the team because they're so personable, so welcoming, so warm. So they are met by our admissions team and myself. In the morning, I do a little bit of a welcome. I talk to them about important things. Medicine needs to be a kinder, gentle place. It simply has to change. So when I talk to them, I talk to them about stuff like that, that it's a small community and they might see each other at other interviews. So really trying to get to know each other and making this a really fun-filled day, I think is what we go for. So our director, Aileen Panitz, and our assistant director, Alicia Kehn, do a little informational session.

We use a short PowerPoint, but they just talk through, what is Geisel other than what you've seen on the website, tell candidates a little bit of what they can expect about the curriculum, what they can expect about the extracurricular activities and things. They then have informational sessions with financial aid because we feel like that is an important component of going to medical school and that people want to know more about that. They meet with our diversity inclusion and community engagement team because they run a lot of our extracurricular and scholars programs. So we want the candidates to hear more about that. Then they have a little bit of a break and they do a little exercise called a group exercise. But I won't go into that very much because I think it truly ruins it.

Is that to assess teamwork skills? [30:43]​

Yeah, it's about them being them seriously, being your authentic self, bringing your authentic self, which I talked to them about from the beginning. Then we do our two half an hour interviews and we end close with a closing session where I try to answer any questions that have not been answered yet and just wish them well. It's a long season. My heart goes out to them.

Yeah, it's a long process. [31:13]​

Yeah. That's our day.

What is a common mistake that you see applicants make in approaching the primary or the secondary application? Going back a little bit here. [31:17]​

I don't know that I would say that I've seen mistakes, so to speak. But I would say the thing I would offer is when talking about their most memorable experiences, in addition to a little bit of a description, to really, basically, we want to know how did that experience change them? How did that make them think differently, see something differently? That gives me a little bit of a window into who they are. The description of the event itself is less important, I think. The personal statement, again, some people repeat a lot of their experiences, and I would say, try to keep every section telling us something different. The more about you, the more we know about you, the more we'll get to like you or more we will want to meet you. So try to not be repetitive in a lot of those. I don't see any major pitfalls or errors. I think ... Yeah.

I think you actually listed some really big ones. Repeating your activity section and your personal statement, it's a wasted opportunity. [32:25]​


Obviously, if something is a highly significant influential event, what did change as a result of it? If it had influence, what was the influence? So, I think those are fantastic tips, actually. [32:35]​

The last thing I'll say is again, this authenticity thing, right? Be you, everybody else has taken, so just be you. Don't augment the stories. Don't make them grander than they need to be. Just say it like it is.

Your website says that Geisel received approximately 7,000 applications for, as you said, at the beginning of the class, 92 spots. That's your biggest class ever. How do you winnow it down from 7,000 to 92, especially from completed applications? In other words, from the secondary to the interview? [33:04]​

With difficulty. Great difficulty.

That's a good answer. [33:25]​

No, it's really tough. So I do want to say this, I want candidates to hear this. As somebody who's been in medicine for 38 years and wakes up every morning, pinching myself, being so amazed that I get this opportunity to take care of patients and to teach in the way I do, I am thrilled that still incredible humans, our candidates, want to do medicine. It's not anymore the kind of thing, the way people used to think about it, that you could make a good salary. You do. But there are many other jobs now that have better salaries. The prestige. Yeah. I don't know about that anymore.

Again, it's not the whole cowboy thing. It's similar, the pit crew. So maybe slightly less prestigious, who knows? But I think our candidates want to do this, and that makes me delighted that they're still interested in the field of medicine, the profession of medicine. Because honestly, I think there's going to be a huge doctor shortage. I'm talking of good doctors who want to do those core four things that I talked about, who really want to invest the time and effort into this art because it is an art form.

I happen to have some elderly relatives, and there definitely is a doctor shortage and we have an aging population, it's going to get worse. [34:47]​

Yes, yes.

Thank you very much for that answer. Last year, I saw that Geisel stopped interviewing on March 14th. When does Geisel typically stop sending out interview invitations? Because there's this thing out there, which I've been fighting desperately, that if you don't have an interview invitation by Thanksgiving, you're toast. Every single admissions' director I've ever spoken with says, "That's absolute nonsense." [34:59]​

It is nonsense.

So, when do you stop sending out invitations? [35:22]​

Our process is a rolling process. Rolling admissions. So we continue to send out invitations.

Well into March? [35:34]​


Early March? [35:35]​


Okay. That's good to know. [35:36]​

Yes. Similarly, with the waitlist, that's another thing that people worry about. This is a long process, which is why I said I feel sorry for our candidates. It's a long year. It's a long year.

How do you feel about updates from candidates either invited to interview waitlisted? Do you not want them, or do you say, "If you have something relevant to say, I want to know about it?" [35:50]​

Absolutely. If you have something relevant to say, absolutely. We do not discourage them at all to send in updates.

How do you view prerequisites taken at a community college? [36:14]​

We are okay with those. As long as they meet our requirements, it's okay. Here's why, I want to be very clear about this. I think of all that we know today in our world of the issues of structural determinants of health and structural inequities. Lots of people, especially in California. So my son, our son went to University of California. So I do know that a lot of people in California, they actually go to community college and then transfer in their third year and graduate. So, I think that's okay.

Do you view shadowing as a must have, as a nice to have? And how would you compare in-person shadowing with virtual shadowing? [36:58]​

I think shadowing or clinical experiences, I'm going to call them broadly, more broadly, are critical.

May I interrupt? I'm sorry. Shadowing is when you accompany a doctor and you watch a doctor. Clinical experiences could be when you're actually doing something, you're volunteering, you're an EMT, you're prescribing. [37:14]​

I completely agree with the way you've categorized them, but we think about all of those as clinical.

Got it. Okay. [37:37]​

Definitely, if you're an EMT, definitely a nurse, a medical assistant or anything, pharmacy, you're doing a lot of healthcare anyway. So that's a lot of clinical work. But you may not have that opportunity if you're a full-time college student. Shadowing is all you can do. So we think about it on the umbrella of clinical, getting clinical experience. That is critical.

Oh, absolutely. [38:03]​

It's absolutely critical. During Covid, we completely understood the inability to do shadow or do clinical work in person. But I do think now that hopefully time has passed permanently, but maybe not, for the moment, I do think that's important. Virtual shadowing was a really incredible and innovative way of doing things. I think it's useful as an adjunct. For instance, if somebody has a kind of clinic that intrigues you and you don't have anything locally, and you're doing that in addition, but that cannot be your only clinical experience,

Would the same be true of even in-person shadowing? Would that be okay? Is your only clinical experience? [38:47]​

Yes. I think that's okay. Yeah. So in person shadowing, and I'm assuming this is backed up with other service things that are… I'm thinking about the current senior in taking a full course load. How much more can they do than that?

Right. Right. [39:14]​

If you're taking a gap year, that's totally different. If you are doing something else, yeah. But if you're going to a full-time school, there's only so much time in the day. The last time I checked.

168 hours in a week. [39:30]​

Thinking about that. That's the one thing I didn't call out. I want people to be authentic and honest on their hours and how they calculate it. Because I do look at some of those hours. Somebody says, they have 5,000 hours here and then 5,000 hours there. That is not enough time, especially if they're going to school. So, that doesn't jive.

Right. The math doesn't work. [39:54]​

The math does not work.

Good point. This is a listener question that I got a few months ago, and I like it. So I've asked it several times. "Now you were once a pre-med student, if you were a pre-med student today, traditional or otherwise, planning to apply in 2024, this cycle, or 2025, the following cycle," I realize it's 2023, but for matriculation in 2024-2025. "What is the one thing you would be doing to prepare yourself for medical school? What would you tell your younger self to do?" [39:57]​

Most people cover this, but I want them to really think about why they want to do medicine. That was relevant in my day, that's relevant today. Why do you really want to do this? Because everybody knows medical school is hard and everybody knows you come out with a lot of loans and everybody knows that it's not an easy path. So it has to be something you are willing to work towards. And if it's not your authentic need, but perhaps a parent pushing you to go, or perhaps this idealistic thing, "I'm good in science, so maybe this is a path for me."

"I want to help people." [41:12]​

I want a little more than that. Because there's a lot of healthcare professions you can go into.

I can tell you, when a client gives me that answer, "I want to help people." I said, "you know, when my sink is stockpped up, my plumber helps me too." [41:21]​


"So, why do you want to help people in this particular way?" [41:29]​

Right. So I want them to really deeply think about why medicine rather than ... In a way, I think this is even more relevant today, because the path seems accelerated. Everything is quicker. Quicker. We have them do a million things. We have them check a million boxes and they're running around checking those boxes being good.

Do you advise a gap year? [41:55]​

If needed? Yes. So, if somebody says to me, "There are some people who believe that you should want to be a doctor from the moment you're born and that means something." I don't. I think there are a lot of people that are great doctors who've been out, who've actually been working in other fields, and they just felt this deep call. They give up whatever they were doing,. Ssometimes went back, did a postbac, did some lots of service along the way and had this recognition about this is what I wanted to do. Love that. So yeah, if it takes a gap year to have that reckoning, then go ahead and do it.

What would you have liked me to ask you? [42:38]​

I don't know if you might have asked me, but I really want to say something. One is, again, I'm grateful that people are interested in this profession. I think in medicine today, I want people coming in, understanding it's going to be hard, but that they don't have to know everything. They don't have to be perfect. That nobody at the volume of knowledge that is churning out every day, there's nobody who knows everything. So it's perfectly okay to not know. That's why you're coming to medical school. I want people not to constantly compare themselves to each other feeling like imposters, which is very big in a lot of professions, definitely medicine. Because I feel that these things hinder learning. There's a very important thing in medicine that you have to be internally motivated to want to do this and do it well, and skill takes a long time. The other thing I think, we wanted yesterday, but this is science and art. It takes years. Even when they graduate from medical school, they're not going to be great physicians. That takes a lifetime.

Don’t get sick in July. Right? [44:03]​

Right. That's why I wanted to say that we think Geisel will get people there. Not only the foundational sciences are very strong. I think for decades, we have been really excellent in our clinical care. If you think about it, the first x-ray was at Dartmouth clinical.

Really? I didn't know that. [44:26]​

The first ICU in the country was at Dartmouth. I already talked about the Dartmouth Atlas. I think a lot of people know that the mRNA Covid vaccine went quicker to market because that happened with the scientist at Dartmouth. So, I think we could help people get to be that incredible complete physician if they want to be that, but they need to look inside deeply first.

That's a great way to end the interview. Thank you so much, Dr. Pinto-Powell, I think we're almost out of time. I want to thank you again so much for joining me and sharing your expertise and enthusiasm and authenticity. This has been just delightful. We're linking to the URL for Dartmouth Geisel. Where can listeners learn more about Dartmouth School of Medicine? [45:00]​

It is

This article was originally posted on

Members don't see this ad.