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In this episode, the founder and former Director of San Francisco State University Postbac Programs and Accepted consultant since 2015 explains why the fastest way to medical school is slowly and carefully, and explores the advantages and disadvantages of applying to med school from a postbac program. [SHOW SUMMARY]​

Are you in a postbac program or specialized masters program? Are you wondering what are the nuances of applying to medical school from a postbac program? You’re in luck, because that’s the topic of today’s episode – along with a healthy dose of excellent med school admissions advice for any med school applicant.

An interview with Dr. Barry S. Rothman, PhD, Emeritus Professor of Biology, founder of SFSU Postbac Programs, and Accepted consultant for 8 years. [Show Notes]​

Welcome to the 526th episode of Admission Straight Talk. Are you ready to apply to your dream medical schools? 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 chances of acceptance. Plus it’s all free.

Our guest today, Dr. Barry Rothman, is the former health professions advisor and director of San Francisco State University’s pre-health profession certificate program which serves pre-med, pre-dental, pre-nursing, and other pre-healthcare students who are preparing themselves to apply to graduate programs in healthcare. This episode focuses on medical school applications, but since 2015, Dr. Rothman has helped Accepted’s clients in all aspects of the application process to medical school and specifically those both applying to postbac programs and applying from postbac programs.

Dr. Rothman, welcome to Admission Straight Talk. [1:54]​

Great, Linda, good to be here and good to have been part of the Accepted family for now eight years.

Glad to have you as part of the Accepted family. How did you get involved in postbac programs and helping applicants from postbac programs apply successfully to medical school? [2:04]​

Wow, what a story. At San Francisco State, I’ve had three careers. Started out very research oriented, leading a postdoctoral fellowship at UC San Francisco, and then transitioning to SF State as a new faculty member and conducting lab research in a lab at SF State. Which I was quite successful at, but it didn’t really make me super happy, and I decided to stop doing research and start teaching. I had quite a lot of experience teaching already, and so that made me happier. And then around 20 years into my time at SF State, my dean approached me and said, “How’d you like to be the health professions advisor?” And I thought, sure, it’ll be an easy thing, no big deal.

And so I naively said yes, and it took over my life. I just loved doing it. I loved working with the students. I actually had been teaching a molecular medicine class, so I was interested in medicine anyhow, and I just took it from there. The students were wonderful to deal with. We created a program that required a lot of political maneuvering through the academic senate, and after a whole year of processing we had a postbac program, a newly formed from zero postbac program.

What are the different kinds of postbac programs, and whom are they for? [3:50]​

Sure. Well, actually there’s a bunch of different kinds. First of all, you can do a do-it-yourself postbac program, or you can enter a structured postbac program. So in do-it-yourself, you figure out the classes you take. You could take them at one or more universities as long as it’s a four-year university, and you need some kind of advising. And Accepted can provide that kind of advising for a do-it-yourself postbac program. As you might guess, a DIY postbac program is less expensive than a structured program. Structured programs as you might guess offer structure, and so there’s a bunch of people who are running the program, there’s faculty who participate in the program, and there’s usually fellow pre-meds. Those are mainly the population that are in these structured programs. So that’s one big division, do-it-yourself versus structured.

There’s other postbac programs that focus on disadvantaged students and/or minority students versus a broad population. So that’s another way of dividing postbac programs. Also, some postbac programs have linkage programs where you can immediately get into a medical school that has a linkage. You’re not guaranteed that, but it’s an advantage to have that. Some postbac programs don’t have linkage programs. Some postbac programs are at medical schools, some aren’t. Some are very expensive, some are less expensive. Some offer financial aid as an undergraduate. Some offer financial aid as a graduate student, and graduate financial aid is actually better. During undergraduate times you’re eating into the lifetime maximum that you’re allowed to have for federal loans. And so you may have used all that money up by the time you get to a postbac program.

So having undergrad financial aid is both less in terms of the absolute amount, and perhaps zero if you’ve used up your undergraduate financial aid allocation for federal money. Graduate financial aid is better, it’s a whole new pot of money. Of course, do-it-yourself postbac programs don’t have financial aid, but the total cost might be less anyhow because of the lower tuition. So there are many ways of dividing postbac programs. I think I’ve given you the main ones.

The two other divisions that I thought of would be postbac programs for academic enhancers and postbac programs for career changers. [6:31]​

Yes, that’s right. That’s right. Thank you for reminding me of that. So career changers are people who are starting out taking the academics for medical school. They haven’t had any. So they may have been an international relations major or journalism major, et cetera, et cetera, and they have decided after being an undergrad that, gee, I want to become a physician. Many career changers are children of physicians who want to prove that they are making their decision independently of their parents. And so they often go into areas very different from medicine and often do quite well, but then they decide, gee, being a physician maybe isn’t such a bad idea and maybe I’ve proven my independence. And so then they’ll go into a postbac program. So they’re called career changers and their curriculum is mostly prereqs for medical school, although they do need to take a few upper division electives as well.

Academic enhancers, and there’s vastly more academic enhancers than career changers. Academic enhancers, as you might guess from the name, need to improve their academic record. Many undergraduates start out having difficulty in their coursework and science majors and math majors in particular have difficulty early on. And so their academic records improve, but perhaps if not enough, if it’s still not strong enough by the time you graduate, then you might want to go into an academic enhancer postbac program. Also, academic enhancer programs are good for first time applicants and they can be particularly good for re-applicants as a way to show that you have made some serious steps in terms of improving your record.

What about specialized master’s programs? When you finish a postbac program, you don’t get an additional degree, you’ll get a transcript. [8:47]​

Well, some postbac programs actually could give you a master’s degree.

There’s a blur between special master’s and postbac, but the, I guess, super special master’s programs are created to help people get into medical school. That’s their job. And for some applicants, especially applicants who are not disadvantaged and haven’t had a lot of barriers, the medical school application process can be extremely competitive. And this might be their last way of showing themselves to be an unusual applicant or a better applicant. So special masters programs are quite pricey, often around $50,000 a year. So that’s a huge amount of debt in addition to medical school tuition.

And undergrad. [9:59]​

Oh yes. And then the undergrad tuition as well, yes.

And postbac programs that do not confer a master’s, what is the typical cost for them? And I’m not talking about the structured postbac programs. [10:05]​

Right. The one that I ran cost about $600 a unit, and so our students taking 12 units would pay $7,200, something like that in a semester. So maybe $14,000 a year or something like that. That’s a lot less than $50,000.

And many postbac programs have some kind of loans available. They rarely have scholarships, but they do have loans, federal loans available. And for some people who can’t qualify for federal loans, you can get a bank loan. And even though federal loans sound really wonderful, they have very high interest rates such as 7 or 8%.

Higher than banks, or the banks are more? [11:00]​

I think the banks might be a little bit more, but it’s not like the federal loans are a real bargain. They can be quite pricey in terms of interest.

And it does add up. [11:13]​

Yes, it does. And then there’s subsidized loans and unsubsidized loans. So a subsidized loan lets you defer the interest payments until you’re in a position to actually make some money. Whereas unsubsidized loans, you’re paying interest from the get-go.

That would really add up for sure. [11:33]​

Yes, yes.

Before we talk about the nuances of applying from postbac programs, what qualifications do all successful applicants to medical school need? [11:37]​

So first of all, you need strong academic preparation. You need to have a good academic record. And if it had some problems early on that’s fine, but you have to show that you’ve repaired it. And I think what most med schools want to see is at least two consecutive years of very high GPA in the sciences. You need strong MCAT scores. MCAT is a national exam, it compares everybody, so it’s one way that med schools can compare everybody that’s independent of grade point average. And third, you need considerable clinical and social justice experience. You need to know what you’re getting into and you need to show that you actually care about the health of our society. Medical schools are organs of social change, and they really put a lot of emphasis in choosing people who want to see changes occur, changes for the better. In terms of the application, the application needs to be consistent.

Your biographical information, even though it might seem trivial, you need to make sure that all the little pieces of it fit together. For example, if you say that your family had very little income and then you put that they paid for 100% of your tuition, it might sound a little strange. How could they do that if they were making $14,000 a year? So you want to make sure that the biographical part is well written and internally consistent. You need to have thoughtfully written experiences and a personal statement, and really well-written and covering areas that medical schools want to know about. You need to have supportive, well-chosen letters, and you need to choose appropriate schools given your statistics.

That’s a fantastic overview. What about research? [13:45]​

Research is good and some med schools are much more research oriented, but many aren’t. And I would say research is not absolutely required.

More of a nice to have? [14:02]​

It’s nice to have, but to do it just because you’re checking off a box would probably make you miserable doing it that way. I know I’ve done many, many years of research, it can be very tedious and so you really need to be interested in it to do it. So I would say do research if you’re interested in it. If you’re not and you’re just checking a box, maybe don’t do it.

That’s pretty clear. [14:30]​

So there’s two kinds of research and maybe one kind is more appealing than the other. Two broad areas, one is wet lab research where you actually do experiments with solutions in biological materials or chemical materials or perhaps physical materials. And the other is data-oriented research, where you crunch numbers and everything’s done on a computer. So they’re very different, and one kind appeals to some people and the other kind to other people.

What about clinical research? [15:01]​

Oh, yeah. Thank you. Clinical research of course would be great, and many students, especially postbacs can get jobs in medical schools or in universities where they’re helping to manage clinical trials. So here in San Francisco, we’re quite lucky that we have University of California San Francisco, we have Stanford nearby, and we have UC Berkeley nearby, not a med school, but the other two are med schools. And many undergraduates and postbacs can get jobs there. And for the med school, they’re a bargain because they can pay them modest amounts of money and they get highly skilled people who are running these clinical trials. So yes, thank you for reminding me. Clinical research is also another way to go.

What are the advantages of applying to medical school from a postbac program? [15:58]​

Well, I think most postbac programs have good reputations with the medical schools. And so in a way, if you get the postbac programs imprimatur, then the med schools think that, well, you’ve probably been carefully selected and chosen and maybe tuned up to be a better applicant. You’re in a program with other pre-meds, so the basis of comparison is a little different. They’re not comparing you to every undergraduate, they’re comparing you to a bunch of pre-meds.

Pre-med or to med students? [16:43]​

postbac programs.

Are postbac programs ever with first year med students? [16:48]​

Some are. So if you’re at a med school, obviously, in some postbac programs, you can take classes with med students. And then that’s a really good comparison because they’re actually comparing you to usually first year med students. So that’s a huge advantage.

What are the challenges of applying to medical school from postbac programs? What are the difficulties, disadvantages? [17:10]​

Well, some postbac programs can be rather competitive. When I designed my postbac program, since I was able to design it from zero, I wanted to emphasize cooperation, people getting along, and also having a broad population of students, both disadvantaged and highly resourced. So that was a real treat to do that, but some programs can be rather competitive and maybe not so good for you. As competitive as medical school is, at the end of the day medicine is a cooperative venture, and learning how to cooperate is a wonderful skill. And so I would put emphasis on that. And in fact, not only cooperate, but mutually support each other. I think that’s the way to go, and that’s the way I designed my program.

Would you say that having had that teamwork, exposure in a postbac program would definitely be an advantage both as a human being and as a medical school applicant? [18:11]​

Yes. And postbacs understand each other, understand the craziness of applying to medical school and can support each other when family members are wondering what happened to you? Why are you so crazy this year? And it can be very stressful, and it can leak out in unusual ways. Our postbac program actually went a long way to offer stress relief by having psychotherapists involved and also stress handling tools. And if your postbac program doesn’t offer that, it’s really a good time in your life to develop the ability to handle stress because you’re going to be entering a fairly stressful career.

Some postbac programs are two years, but aren’t most one year programs? Is that correct? [19:08]​

Yes. Yes. Career changers need two years. It’s crazy to do it in one year. I mean, it could be extremely stressful. I’ve seen some students do it though. They just dedicated themselves 110% to the whole academic endeavor.

I’ve quoted you often when you say the fastest way to medical school often is slowly. [19:32]​

Yes. Slowly and carefully. And I don’t say “often.”

Okay. Period. [19:41]​


All right, I’ll correct myself next time I quote you. [19:44]​

There’s no quick fix there. It’s such a labyrinthine process to get it right. You really need to think about it over a long period of time and also make sure it really fits who you are. Is this the career you want or is it just you want to be an overachiever and look cool? You want to make sure you’re actually choosing your career, any career, as long as it’s consistent with who you are as a person.

Should students count on, assuming they’re in a one-year postbac program (not the career changer programs), should they count on taking a gap year after their postbac program just because of the way the application cycle works? Academic enhancers, I assume would be probably critical. [20:14]​

Academic enhancers usually take a year.

But they need the grades from that year to apply so they almost have to count on a gap year, don’t they? [20:36]​

Right. It’s hard to avoid the gap year unless there’s a linkage program.

But some academic enhancers need more time. We had academic enhancers that took two years because their senior year academic record wasn’t so good. And again, med schools want to see a minimum of two years of strong GPA. And we even had a few people there for three years. It was fine.

That’s where they went part-time, wasn’t it? [21:09]​

Yes. Now, one thing I didn’t discuss was that some postbac programs allow you to be part-time and some absolutely insist you gotta be full-time, don’t get a job, you’re here full-time. In our program, we were flexible because we knew a lot of our students did not get adequate financial aid just through federal loans and so they had to work.

Makes sense. [21:31]​

And it was fine with us for them to be part-time. So they took longer.

So, yes, I’m a real proponent of gap years. It’s a wonderful time to further enhance your record, to get more clinical experience, to think about what you’re doing, develop your stress handling skills, and maybe even take some more coursework outside of the postbac program.

Or in a different topic that just interests you. [21:57]​

Yes. Another topic that I think is really important for pre-meds is public health, and med schools really like seeing people who, well, if they have an MPH, that’s wonderful, but have taken some public health coursework. So you understand the social dimension of healthcare, not just the molecular and cellular part of it.

How is the postbac GPA calculated in the overall undergraduate GPA? I know graduate GPAs are viewed differently, they’re a little bit off the grid, but how about the postbac program GPA in the application? [22:21]​

So the MD and DO applications have this matrix of GPA calculations. And so on the rows they have freshman year, sophomore year, junior year and senior year. So they can see trends through undergraduate. And then a completely separate row is postbac, and another separate row is graduate. So if you’re in a master’s program, it would go into graduate. If you’re in a non master’s it would go into postbac. But every course you take after you graduate, whether you’re in a do-it-yourself or structured program, goes into that postbac bin.

As long as it’s not towards a master’s? [23:19]​

Right. And that bin is divided into three or four different areas. For MD it’s BCPM, biology, chemistry, physics and math. The other bin is all other, and then the third bin is total. So that’s an advantage because med schools can see directly how much you’ve improved as a postbac, and they see how many units too. So if you have five units as a postbac, even if it’s a 4.0, it’s not very impressive. If you have 40 units, oh, that looks good. 40 units of 3.95 BCPM GPA looks good. You’ve definitely repaired your academic record. For osteopathic schools, they have an extra bin or a couple extra bins. They have BCP, biology, chemistry, physics, they have total science, they have non-science, and then they have total. But it’s the same basic idea.

Can a high postbac GPA make up for so-so or less than desirable MCAT or are they just showing different things? [24:26]​

No, no, no.

There are three gates to get into medical school and they’re independent of each other. So there’s a lot of I think very confused thinking about, well, if I just do great in the MCAT, my not so good GPA doesn’t matter, or vice versa. And you have to do well in all three gates; which are your academic record, your MCAT score, and your experiences; clinical and social justice. You really need to be superb in all three. So don’t naively think that one will make up for the other.

I sometimes say that the test shows you have the head for the subject matter and the GPA shows you have the ability for sitting and studying and consistent performance. [25:15]​

And then the clinical experience maybe shows some of your heart.

Heart and that you know what you’re getting into. [25:36]​

Yes. And especially the social justice experience, I think it’s very important to… Well, it’s not just show it, it’s hopefully you actually feel it and you really want to better our society.

Any last words of advice for applicants both to postbac programs specifically or to medical school from postbac programs, either way, going into the postbac program or coming out of the postbac program? [25:57]​

Well, I’m going to repeat what you said, and then I said, which is the fastest way to medical school is slowly and carefully. It’s a labyrinthine process. It’s really worth thinking about. There’s no quick fix. Take your time and really do it well. If you do it really well the first time, your chances of getting in will be as high as possible. If you’re a re-applicant, figure out what were the weak parts of your application. Get some help if you need help. And don’t just reflexively reapply the next year. By the time you didn’t get in, you have like three months or four months to get your next application together. And how much change can you be making during that time? Unless you were making the changes from the very beginning of the previous application cycle, you’re not going to have enough time. Med schools really appreciate people being thoughtful and taking time. So taking an extra year in between applications is very impressive and gives you more time to improve.

And makes you that much more improved because you took that time. What do you wish I would’ve asked you? [27:20]​

I wish you would’ve asked me more about disadvantaged and minority applicants.

Consider it asked. [27:33]​

Yes. So again, med schools are organs of social change and they’re in a very powerful position. If you think about it, if you become a medical doctor and you come from a disadvantaged background, your socioeconomic situation will likely improve tremendously. And not only will that improve, but most likely your progeny and your grand progeny will also improve that way. So it has a huge multiplicative effect. And so med schools really pay attention to this, but as a disadvantaged applicant, you wonder what’s going on here? Are these people patronizing me? I mean, why are they making such a big deal out of disadvantages? And so I think it’s important to realize that making a big deal out of disadvantages is well-meant and well thought about. Although at times the programs don’t handle it so well because they don’t understand what it’s like being disadvantaged and maybe coming from a minority background.

So it’s really good to be in a supportive environment in a postbac program that really is supportive of people who are from disadvantaged and/or minority backgrounds. And also when you go to med school, you better find some compadres who are like you and support you and make things make sense. Because if you’re a disadvantaged applicant and you wind up in let’s say a med school that has 80% participants who are pretty well off, you might feel rather marginalized. And so it’s really important to find people to bond with who will make you feel safe at your university. And that might be faculty and most likely fellow students as well.

Thank you very much Dr. Rothman. I really appreciate your insight and input. [29:52]​

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