Hi Polymer,
I know this post is a bit old now, but I've been thinking about what you've said. It's definitely informed what I'm looking for and my plans. I guess I have two things I've been thinking about that I'm not sure how I can square with your advice and I'm wondering what your input is.
firstly, when I've looked at MSAR, the amount of accepted students who have paid clinical experience at all kinds of schools across the board is always around or under half. For some schools I've seen even lower. Do you think students who have paid experience are probably in the upper half of the school's view of these students?
Secondly, and this is admittedly more anecdotal, but I know that EMS work is very popular for clinical experience and it seems like most schools like it or at least don't have a problem with it. I definitely see the value in this type of work, but it also doesn't necessarily have much physician interactions, or longitudinal interactions, etc etc. Do you think students who go this route and get accepted probably have some kind of other qualifier (hundred+ hour(s) of shadowing, some other physician interaction)
Again, your thoughts were very much appreciated. I'm just not sure how to square these two things and I see how thoughtful you are about all of this. And congratulations on starting MS1!
I should preface by saying this is my opinion and from my perspective as an applicant. There are also professionals here who have been in charge/are in charge of selecting students who could offer more information about what they see from their perspective.
I didn't think MSAR data was particularly helpful in applying to medical school beyond cross-checking requirements and seeing what schools choose to publish about their programs.
You have to understand first that, because selection beyond some arbitrary objective threshold must inherently be subjective, any applicant data that is scraped from AMCAS has pretty limited utility to you.
We can't drill down on any specific population-level number to an individual matriculant and say definitively why someone was accepted, and we cannot know the specific details across all of the rejected profiles that specific school had to choose from in selecting this one applicant over all the others. We really don't know what happens in the room, how applicants are narrowed and compared. And even if we did, we would run into the same problem for every comparison case.
So, when you say less than half of the matriculants across many schools have clinical employment, I'm skeptical. The uniformity of that number across many schools would almost seem to imply that schools would have some stake in building classes on that singular basis, which doesn't make sense on any level.
My explanation of the statistic you're presenting is that you're probably looking at a highly underestimated number. It doesn't tell us how many of those matriculants had unpaid clinical experiences, and how many had special circumstances that blended categories (say, a CRC with highly clinical duties who listed the experience as research but compelled that particular school to accept that experience as meeting clinical competency). I would not approach this under the impression that having clinical employment will carry your application.
As an aside, part of the reason I suggest clinical employment is because it is very difficult to convince some healthcare institution to allow you to put your hands on a patient and perform any medical task of consequence without being fully credentialed to work there and licensed (to the degree that your state requires licensure) to perform that specific task. An extreme example, but can you imagine someone volunteering as a "doctor" with zero relevant experience or education? I understand that MA work is not physician work, but a court of law will see it as similar in kind.
I agree with Moko that EMTs typically enjoy scheduling flexibility you might not get as a clinic MA, for example. I generally don't recommend it (for now) because MAs don't need to be licensed in many states, and time is money and money is money—and EMT licensure costs you both, only to get to medical school and have that license become immediately redundant after BLS training. Of course that is only the case for me and my situation, others might have different life circumstances with different considerations, which is totally OK.
To add nuance to your estimation of EMTs, what you're saying is mostly true—however, pre-hospital work tends to be more procedural and acute than the cases you see as a clinic MA. So, you might not be making the claim that you enjoy seeing sweet ol' Jane Doe every other Friday for her infusion as an EMT, but you might talk about keeping her calm during recurrent episodes of altered mental status on transport calls from her nursing home to the hospital, and how much you wish you could see what happens once you drop her there and deliver a careful report to a nurse who thanks you and whisks her away.
To give you an idea of the "other qualifiers" you are referring to, it wouldn't be coming out of shadowing. To give you an idea of the crowd at the doctoring small group I was in yesterday, here's a little profile on them, with some minor changes for privacy:
- Person 1 is a Fulbright scholar and had an excessive amount of research experience, even in my eyes
- Person 2 was a US Air Force officer for many years and trained at West Point
- Person 3 was an inpatient hospital dietitian of many years at a famous hospital system
- Person 4 transported nukes in the Navy
- Person 5 was a recurring beauty pageant winner throughout their teens and twenties and held just about every prestigious scholastic/research fellowship their state offered
- Person 6 was a staff bioinformatician for a major public university
- Person 7 just went to the best school you can think of and was successful there
...and I'm Person 8.
To be clear, this isn't a list to make you feel bad. This is just a short list of their most characteristic role. Everyone did research, everyone had extensive clinical experience, everyone did the volunteering, and advocacy, and leadership, and so on. Bear in mind that we are a combined group of almost 200... I don't think I just happened to get all the superstars. From what I can tell, virtually all of my classmates have something really interesting about them that is just not easy to accomplish casually.
So... do not read ~60% of matriculants have paid clinical employment and think that the other 40% must be a group of slackers. It's fair to say that there are less selective schools out there with shorter barriers to entry... but I would prefer, in a game theory sense, to overshoot rather than undershoot. That's just me and my risk tolerance. Many people would be satisfied going to a community program in their backyard with a very average application and moving forward by the skin of their teeth.
However, at a certain level of competitiveness, in this process, everyone "checks all the boxes." The game becomes more about what unique skills you bring to the table. We are all working together to become physicians, but we are all bringing our own flavor and approach to it.
Once you're in, you can see it. It's a very rewarding and humbling experience to work with these people. Each of them bring their own specific knowledge to a situation and talking cases out with them have led to very interesting conversations.
...it's almost like they selected us on purpose!
Hope this helps. Apologies for another long ramble. (And thank you! Having a blast.)
