Medical School Admissions, Blackjack, and the Art of Checking Boxes

[Planes2Doc]

The box-checker. What does it mean to you? If you're an SDN member, I'm assuming that if someone calls you a box-checker, you take it as an insult. Looking at past threads and even current ones, I see that some people take offense to being called this, and also insult people who they deem to be one. I see ADCOM members saying that they don't want to admit box-checkers. But given the fact that ECs in medical school admissions have become a huge arms race, it's kind of hard to deny that just about every applicant is a box-checker!

I've been inspired to write a long essay regarding the topic of box-checking after being inspired by a few recent posters. I know this is long, but I hope that you find the time to read it and get something out of it. I've decided to compare it to playing Blackjack in the casino, and will continue to use this as a recurring theme. Also, I've enclosed a poll which I hope you could answer honestly after reading.

*The EC Arms Race & ADCOM Perspective*

Every single person applying to medical school is required to take the prerequisite classes and the MCAT. That's a given. There's no way around it. But are there any factors that can influence a medical school's decision besides academics? Unless you've been living under a rock, you'd know that medical schools "require" you have to have certain things done. You pretty much need shadowing and some form of volunteering in order to get in. Even though these are not official requirements, it's pretty well-known that you need to have these things on your application in order to get admitted. Technically, all you need is shadowing and volunteering (making sure you have "clinical experience"). That's it. But, pre-meds, especially on this site, tend to go above and beyond doing many different activities. These include research, clinical volunteering, non-clinical volunteering, entry-level clinical jobs, non-clinical jobs, mission trips, starting non-profits, sports, and a variety of other things to woo the ADCOM members. On SDN, people tend to use the term "beefing up" when talking about their ECs.

And this is where the "check-box" in the title comes into play. You have applicants checking off each of these activities in order to make sure that they have a strong application. So far everything seems Kosher, right?

Well then things get a little weird. ADCOMs apparently don't like box-checkers. Say what? Yeah, you heard me, they don't like box-checkers! How does this make any sense? Do they not realize that a majority of applicants are doing activities that they would not have otherwise been doing solely for the purpose of getting into medical school? Apparently not. This is quite troubling. This ultimately requires pre-meds to plan their activities strategically to make their box-checking not seem like box-checking. This also perpetuates the anti-box-checking mentality here on SDN, which is confusing since the more "competitive" applicants just have a more elaborate cookie cutter shape than other applicants. Everyone is still following the same schematic. Now let me explain why I have a problem with this whole thing...

*Playing Blackjack by the House Rules*

Are you familiar with card counting in Blackjack? It's a legal advantage method that people use to gain an advantage over the casino when playing Blackjack. It's done entirely within one's head when they are utilizing legal methods. Despite them not using any cheating devices or committing an actual crime, casinos highly frown upon this practice. They can and will kick you out and permanently ban you from ever entering the casino again. Casinos welcome you to play all the Blackjack you want as long as you're playing by their arbitrary house rules. So despite you wagering your own hard-earned money, you're supposed to leave your brain at home when playing so that you do not have any advantages, thus playing according to the house rules.

So what does card counting have to do with medical school admissions? I think that ADCOMs remind me of a casino. When it comes to ECs, they put out a set of arbitrary house rules. So what exactly are ADCOMs saying? This: You are expected to do ECs, but you can NOT do them solely using the filter of getting into medical school.

So what does this mean exactly? It means that ADCOMs want you to do things that you're supposedly passionate about, but if you do things solely as check-list items to get into medical school, then they will reject you. I mean you obviously have people who aren't pre-med lining up in droves to perform free labor at hospitals across the country, right?

ADCOMs expect applicants to make a whole lot of sacrifices in order to get into medical school. If you thought that getting good grades and a high MCAT were hard enough, now imagine having to devote the rest of your free time doing things ADCOMS want you to do... err... I mean that you're passionate about. Just like casinos expect you to play with your own money and abide by their rules, ADCOMs also want you to play with your entire future at stake, also abiding by their rules. If you make things look like you're just checking boxes, then you're out! You might have to waste another year (think about the loss of income for one year) building up your ECs further even if you have competitive stats. That's why it's very important to make yourself look genuine, and the things you do to make yourself look genuine are quite baffling.

And before moving on to the next section, I would like to say that in all the time I've been on SDN, I have never heard of any pre-meds asking how they can help more people, they only ask how they can help themselves.

*Making Your Box-Checking Not Look Like Box-Checking*

1. Longevity - There's two ways which you can go about this. If you are starting college and know you're going to be a pre-med, it's best to start your activities freshman year, or sophomore year at latest. When ADCOMs see longevity in the activities, they will somehow think that you were doing them because of genuine passion instead of doing them solely to get into medical school. I guess that starting a bunch of stuff the moment you become pre-med isn't suspicious at all. You also want to make sure that you are volunteering at the time you submit your AMCAS and or AACOMAS. That's the one activity you do NOT want to quit before applying. In fact, even though you can technically quit the moment you submit your primary application, it's best to continue doing it until you have an acceptance. Then you can drop volunteering if you seriously dislike it. Other things like shadowing and clubs can be treated like more obvious check-list items, and ADCOMs are okay with it.

2. Showing passion - We all know that the more typical pre-medesque activities can really suck, particularly hospital volunteering where the staff are all too familiar with the pre-med agenda. But of course you're not going to go to an interview saying your activities suck. It's important to find some good things from each of them to share in your personal statement and at interviews. Even the crappiest of activities can have their good moments. Just make sure you don't go in there with nothing to talk about.

3. Become Mother Teresa - Your best bet to having "strong ECs" is to become what I call the "ZERO to Mother Teresa" applicant. This is the type of person who picks up a huge laundry-list of activities immediately after becoming pre-med. So pretty much, they have never volunteered a day in their life before starting college, but then suddenly they are doing a bunch of activities, and make those elderly volunteers in the hospital look like selfish bastards! I'm surprised that ADCOMs haven't caught onto this. On the contrary, ADCOMs love love love these applicants. You can't call them a dreaded box-checker as long as they started their activities early and continue doing them for a long time.

*Making Your Box-Checking Painfully Obvious*

1. Lack of longevity - There are pre-meds who pick up an activity like volunteering and then ask how many hours they have to do. Generally, you see that magical 100-150 hours floating around. They might do this early on, let's say as a freshman and finish sophomore year once getting into that hour range. The activity gets dropped long before submitting the primary application. ADCOMs can smell a box-checker from a thousand miles away when this happens! DO NOT DO THIS! If you want to do a minimal commitment and still come off as not box-checking, then make sure your 100-150 hours lead you into the primary application, and the activity is thus listed as "current." With such low hours, this means you'll likely be volunteering a few months at a time, and not going through the whole year like most people on SDN do. My suggestion is to bite the bullet, and rack up more hours. This will make you more competitive for schools that are also focused on community service.

2. Starting activities too close to the primary application - It's probably fine to join a club or do some small activities/gigs close to submitting your AMCAS (I'd say within a year). But as for your mainstay ECs, like volunteering and shadowing, those should not be done within a year of applying assuming you're a traditional student. This will come off as box-checking to ADCOMs, since you left these things until the last minute to do them. Unless you decided late to become pre-med or are non-traditional, starting late will bite you. This happened to me when I wasn't pre-med. I wanted to become an investment banker, and sadly I never heard of things like wallstreetoasis.com nor cared to research the things I needed to do. This didn't end well with me. As for medical school admissions, unless you have stellar scores and perhaps long-term research, you'll likely need to do a gap year "beefing up" those good ole' ECs. Now I know what you're thinking, but do not do the next thing on this list either.

3. Doing an obscene number of hours in a short time period - If you volunteered for 40+ hours per week in a summer and racked up more hours than someone who volunteered for four years straight, how would that look? I mean you'd have the same or even more hours, right? Well, ADCOMs will see this as a case of obvious box-checking. They like to see a long-term spread of hours versus doing them all at the same time. Even if you happened to start activities too close to the primary application, it might be a better idea to just take the gap year and do lower consistent hours. This would also be incredibly difficult to do during the regular school year. So remember, racking up 500 hours over four years looks a whole lot better than racking up 500 hours in one summer.

*The Different Types of Pre-med Box-Checkers & Corresponding Blackjack Players*

Here's a list of different types of box-checkers. Hopefully this will be helpful in maximizing your application to medical school.

1. The Clueless Box-Checker = Clueless Blackjack Player

This is the person who says they want to go to medical school, but do not do research into the required things. They will likely never visit SDN, and thus I'm assuming that probably none of you are clueless. The clueless box-checker might meet with a pre-med advisor, and just do some shadowing and hospital volunteering with the minimal level of commitment. This will immediately look like box-checking to the ADCOMs. I'm also guessing that most of these people will probably never end up making it to the MCAT. I'm actually curious as to how many of them end up applying to medical school. This is equivalent to a Blackjack player that knows the basic rules (do not go over 21), but does not know basic strategy.

2. The Authentic Box-Checker = Blackjack Spectator

THIS IS THE APPLICANT EVERY ADCOM DREAMS ABOUT. In other words, this is the genuinely altruistic person who is going into medicine for all the right reasons. These people were likely involved with volunteering and other activities since they were children. Thus, they would only need to add shadowing and clinical volunteering (or clinical paid-work) solely for the required clinical experience. So in essence, since this applicant is already heavily-involved in ECs, they aren't really box-checking since they are filling out a known requirement because they have no other choice. The ZERO to Mother Teresa fakers put on a huge dog and pony show to come off as these types of applicants, and I'm guessing that ADCOMs have no choice but to buy it. But seeing how many bleeding heart applicants who are dying to help the underserved suddenly start gunning for high-paying lifestyle specialties in medical school, it's obvious that most people are faking it. In my entire lifetime, I can count on one hand the number of people I know who are genuinely altruistic. I'd like to note that NONE of them are from my medical school class. It's a very rare trait. ADCOMs really want it, and the applicants know they do. That's how box-checking got started. I'm assuming that probably less than 1000 applicants a year are genuinely altruistic. I'm just making up this number, I don't really know, but I'm assuming it's very low. This is equivalent to a person spectating on a Blackjack game. They don't need to play because they aren't a true player.

3. The Informed Box-Checker = Basic Strategy Blackjack Player

This is the applicant who either has a good pre-med advisor, or knows the basic things they need to do to be competitive for medical school. They will likely do the minimum required in terms of ECs, but will probably do enough to be competitive. I'm guessing that they will do shadowing, clinical volunteering, possibly non-clinical volunteering, and possibly research. They will probably go over the magical 100-150 hours for volunteering, or at least time it so that it's a current activity while filling out the primary application. They may or may not access SDN. I'm guessing that this makes up the majority of pre-med applicants. I'm sure that there are many competent pre-med advisors (mine was) contrary to what people on SDN says. This is equivalent to a Blackjack player who knows basic strategy and not lose all of their money when they visit the casino.

4. The Strategic Box-Checker = Advanced Strategy Blackjack Player

This is the applicant who is what I consider to be ZERO to Mother Teresa. They are likely SDN members, or are at least very well versed with the medical school admissions process. They will sign up for a large number of ECs which will be started early in the process, often at the same time. They do not have any previous significant volunteering or other ECs before becoming pre-med. They know how to time their activities, and that the most prominent activities need to be continued even after submitting the primary application. Typically, when it comes to things like hospital volunteering, they will consider busy meaningful gigs as the best. As long as these activities are started early in the process, ADCOMs will fall head over heels for these applicants. If these [same] activities are started close to applying, then ADCOMs will hate on the applicant calling them a disingenuous box-checker. It's funny how the timing of the same activities can present completely different applicants. This makes up the majority of people on SDN, which is clearly evident in the pre-allopathic forum as well as WAMC. This is equivalent to a skilled Blackjack player who is familiar with advanced strategy, yet still plays within the house rules since they aren't counting cards.

5. The Honest Advantage Box-Checker = Card Counting Blackjack Player

This is the applicant who likes to play outside the house rules. Just like the ZERO to Mother Teresa applicant, they will start early and check off all the correct boxes. But there's a big difference in the activities they seek. For instance, while most people on SDN are looking for a "meaningful" clinical volunteering experience, this type of box-checker will look for the complete opposite. They will look for what most here would consider a "crappy" hospital volunteering experience. So what does that mean? This applicant is only looking to check a box, so regardless of what happens at the hospital, the box will be checked and the hours will be valid. This applicant can then exploit a crappy volunteer experience by spending most of the time studying or using it for recreation while on the job. They may also kill two birds with one stone and utilize their volunteer shift to do things like shadowing. This allows them to double-dip and count both the volunteer and shadowing hours at the same time! It also helps when 75% or more of the shift can be spent studying. I'm sure that they are respectful and do things when told to by the staff, but take advantage of the down-time to do additional things to help their application. Since hospital volunteering is like Vegas minus 99% of the fun, they will only tell ADCOMs the best of their experiences, and leave out the rest of it. These advantage box-checkers can also scope out other opportunities where they can list good-looking things on their application, yet spend a majority of that time doing things not for the organization, but for themselves. This is equivalent to a Blackjack player that utilizes card counting. It definitely breaks the house rules, but as long as they aren't obvious, no one will know.

6. The Dishonest Advantage Box-Checker = Card Counting & Hole Carding Blackjack Player

This is also an applicant that likes to play outside the house rules, and takes advantage of ECs in dishonest ways. For instance, this applicant will specifically look for a "crappy" clinical volunteering experience. After going for a few sessions, they will later on do something dishonest like checking in at the beginning of the shift, leaving and doing their own thing, then coming back to sign out at the end of the shift. They can also have a buddy sign them in and out on certain days, which would double their perceived commitment. Also, if they are friends with anyone who can vouch for an activity, they will use it to put on their application. Now, as long as they know what to say, they are safe from ADCOMs. Why? Because like I said, volunteering (and other ECs) are like Vegas minus 99% of the fun. What happens in Vegas stays in Vegas. Same with the ECs! Therefore, if ADCOMs decide to verify the applicant's hours, they will come back legitimate. This is equivalent to a Blackjack player that not only counts cards, but also uses hole carding techniques. This means they will do whatever is necessary (withholding illegal methods) to spot the hole card from the dealer, in order to gain an advantage.

7. The Gambling Box-Checker = Blackjack Player Utilizing Illegal Methods

This is the worst of the applicants. This is someone who is willing to take a huge risk and completely fabricate some or all of their ECs (and also dramatically embellish hours)! Now, we know that ADCOMs don't verify everyone's activities, and this is what these people are banking on. It's like playing Russian roulette. The payoff if they win is huge, but if they lose... Well... They will likely be blacklisted from every US MD and DO school. Therefore, these applicants are likely to lose everything if their bet doesn't pay off. It's very dumb to be this kind of applicant. Not because it's morally wrong, but because they will have to look over their shoulder for the rest of their lives. They can have their acceptance rescinded, expelled from medical school, or even have their medical degree revoked! It's not worth playing the game this way. There's simply too much to lose. This is equivalent to a Blackjack player that uses illegal methods to cheat, such as a camera or other type of device. If caught, they will be prosecuted to the fullest extent of the law.

*My Final Thoughts*

And there you have it... ADCOMs say they hate box-checkers, yet everyone that applies is a box-checker!

It kind of sucks that the medical school admissions process has become a huge dog and pony show in terms of ECs. Of course ADCOMs want those genuinely altruistic people, but as I've mentioned above, it's a very rare trait. Mother Teresa was a rare soul, but the fake "ZERO to Mother Teresa" applicants are all over SDN! I hope that you found this helpful as well as entertaining. I wish you all the best of luck in this tedious process. The reward at the end is definitely worth it. It's just that playing within the house rules can be a little difficult.

May the odds be forever in your favor.

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[Person0715]

What may start out as box checking may eventually turn into a real passion. For example, I only became involved in research early in my college career because I knew that research was necessary to be competitive for medical school. Despite that reason, I came to love doing research and I've become more involved in my research. Now, I've realized that I want to continue doing research, even during and maybe after medical school. I never would have realized this, however, had I not felt the need to "check boxes." Box-checking is not all bad. It gives us wandering pre-meds some direction, and if all works well, eventually we will start to truly care about what we're doing, rather than doing it for admissions.

 

[La Presse]

This thread has been a long time coming. You're like a broken record with the "premeds are Mother Teresa until matriculation" and "the system is broken" spiel.

I am a strategic box-checker, however.

 

[IlDestriero]

I check boxes with the best of them.
[√] [√] [√]
#winning

 

[Planes2Doc]

This thread has been a long time coming. You're like a broken record with "premeds are Mother Teresa until matriculation" and "the system is broken" spiel.

I am a strategic box-checker, however.

I like to answer threads which involve ECs. These usually come from short-lived/throwaway accounts. I usually list the same points and try to be as helpful as possible in them. That's why I probably sound like a broken record to you.

My last thread regarding ECs was posted on August 29, 2013, so it's been a while since I've posted anything of my own!

Anyway, I feel like I'm in the minority opinion on this site when it comes to ECs. A lot of people on this site make the pre-med journey out to be this magical happy exciting journey where personal growth is the most important thing. On the contrary, I see it as a means to an end. Continuing with the gambling theme, pre-meds are required to make great sacrifices in order to pursue the end goal of medical school. A good majority put all of their eggs in one basket, where they pick up a science major, and then revolve all of their ECs around medical school admissions. This is all wonderful when these pre-meds become medical students, but we're forgetting about the people that don't make it.

The ones who put all of their eggs in one basket don't have the easiest time moving on to other things if they fail to make it to medical school. I personally know a few who didn't make it. One of my friends got a job in a doctor's office to get clinical experience. She didn't make it to medical school. After graduation, she's still working in this doctor's office. She's underemployed considering that she went to a fairly prestigious first tier university. Another friend I made during my post-bacc spent a little too much time doing EMT work. Now he's doing research, and has been trying to get into medical school over the past few years. There's other people too, and their stories aren't pretty. People make a huge gamble when they decide to play the game. There are a lot of issues with it, and I feel it's making things worse, not better. I think it's a fun discussion to have with pre-meds. Also, if I'm able to sway pre-meds in the right direction with their activities, then maybe they won't end up like the people I mentioned?

Because who is the more successful medical student? The medical student who did simple clinical volunteering and shadowing or the ZERO to Mother Teresa medical student who spent all of their time in college doing things for medical school purposes? Unless their purpose was to help the most number of people, I'd have to say the first one, because they actually did what they were passionate about. It's an important discussion.

 

[Lya]

I like to answer threads which involve ECs. These usually come from short-lived/throwaway accounts. I usually list the same points and try to be as helpful as possible in them. That's why I probably sound like a broken record to you.

My last thread regarding ECs was posted on August 29, 2013, so it's been a while since I've posted anything of my own!

Anyway, I feel like I'm in the minority opinion on this site when it comes to ECs. A lot of people on this site make the pre-med journey out to be this magical happy exciting journey where personal growth is the most important thing. On the contrary, I see it as a means to an end. Continuing with the gambling theme, pre-meds are required to make great sacrifices in order to pursue the end goal of medical school. A good majority put all of their eggs in one basket, where they pick up a science major, and then revolve all of their ECs around medical school admissions. This is all wonderful when these pre-meds become medical students, but we're forgetting about the people that don't make it.

The ones who put all of their eggs in one basket don't have the easiest time moving on to other things if they fail to make it to medical school. I personally know a few who didn't make it. One of my friends got a job in a doctor's office to get clinical experience. She didn't make it to medical school. After graduation, she's still working in this doctor's office. She's underemployed considering that she went to a fairly prestigious first tier university. Another friend I made during my post-bacc spent a little too much time doing EMT work. Now he's doing research, and has been trying to get into medical school over the past few years. There's other people too, and their stories aren't pretty. People make a huge gamble when they decide to play the game. There are a lot of issues with it, and I feel it's making things worse, not better. I think it's a fun discussion to have with pre-meds. Also, if I'm able to sway pre-meds in the right direction with their activities, then maybe they won't end up like the people I mentioned?

Because who is the more successful medical student? The medical student who did simple clinical volunteering and shadowing or the ZERO to Mother Teresa medical student who spent all of their time in college doing things for medical school purposes? Unless their purpose was to help the most number of people, I'd have to say the first one, because they actually did what they were passionate about. It's an important discussion.

The interview article with Dr. Hunt in the front page of SDN also said that the college life should be simply more than taking pre-reqs and doing medical-related activities, and I think many pre-meds will agree. Some of their most meaningful activities are not always medically related, which in my opinion is good news.

 

[Planes2Doc]

The interview article with Dr. Hunt in the front page of SDN also said that the college life should be simply more than taking pre-reqs and doing medical-related activities, and I think many pre-meds will agree. Some of their most meaningful activities are not always medically related, which in my opinion is good news.

Yeah I agree with that, though with the pressure of trying to get into medical school, it's easy to be pushed into considering everything's value toward your application.

I like that he said you should study things other than pre-med. I think this is a double-edged sword though. I struggled a lot during my first year of medical school because I had a minimal science background. But on the contrary, if I didn't make it to medical school, I would have had a great background to fall on. I also believe I'm more savvy with the business side of things than certain pre-meds. But there's much to learn, and anyone from any major can make it to medical school.

 

[Atom612]

Non-trad student here. I started volunteering at my hospital in the fall of 2012, and only managed to go once a week with my school schedule. I've also done some minor research and shadowed some. I stopped volunteering earlier this year in January after I graduated from my university in December. My mom has cancer and is having a real rough go of it recently. I figured that since moving out of state and being away for the next 4 years at medical school is a big possibility, I would try to spend as much time with her and the rest of my family before I leave. Did I screw myself?

 

[mrh125]

How could you apply this box checking to secondary statements where you have to dig information about their school and sell yourself to their schools? It's another high stakes game and when you have to exhaustively apply to 40+ schools and some schools have pretty generic stuff, but potentially high expectations how does one check those boxes? I think strategic box checking hits the nail on the head. Btw this is a nice social experiment about who will actually check "dishonest boxchecker" even if they were. I doubt anyone will lol.

 

[Mt Kilimanjaro]

Where are the studies linking undergraduate activities (or any other qualitative metric) to anything once one becomes a practicing physician? (If anyone knows of any, I'm seriously curious.)

I'd prefer medical schools create more structured (shadowing+volunteering+career education) programs that harness the pre-med energy while also actually educating them about the career.

 

[mrh125]

Where are the studies linking undergraduate activities (or any other qualitative metric) to anything once one becomes a practicing physician? (If anyone knows of any, I'm seriously curious.)

I'd prefer medical schools create more structured (shadowing+volunteering+career education) programs that harness the pre-med energy while also actually educating them about the career.

I doubt there are any. It's just based off of a bunch of assumptions that probably don't hold well in any case and gimmicks such as doing a ton of stuff makes you well-rounded (it's a big buzzword), as well as another way to throw applicants in the discard pile. Plenty of people in the past with very few or zero ECs did fine in med school, and went on to become damn good doctors. Also, if you want a definitive example of why a lot of ECs and having to box check is irrelevant to future success look at how college admissions have changed over the past 10-20 years. high school kids are expected to do way more ECs to get into college now, when really they should just be given more time to enjoy their lives in all honesty, and people without all sorts of ECs still have done and will continue to do a damn fine job in college and professional work.

Even quantitative measures like the mcat breakdown (the highest correlation any section has with the step 1 is in the bio section and that's an r=.53) in practice honestly.

 

[AndyQC]

I doubt there are any. It's just based off of a bunch of assumptions that probably don't hold well in any case and gimmicks such as doing a ton of stuff makes you well-rounded (it's a big buzzword), as well as another way to throw applicants in the discard pile. Plenty of people in the past with very few or zero ECs did fine in med school, and went on to become damn good doctors. Also, if you want a definitive example of why a lot of ECs and having to box check is irrelevant to future success look at how college admissions have changed over the past 10-20 years. high school kids are expected to do way more ECs to get into college now, when really they should just be given more time to enjoy their lives in all honesty, and people without all sorts of ECs still have done and will continue to do a damn fine job in college and professional work.

Even quantitative measures like the mcat breakdown (the highest correlation any section has with the step 1 is in the bio section and that's an r=.53) in practice honestly.

How would you propose that medical schools select students for their incoming class? Do they just accept applicants with the highest MCAT scores and GPAs? I've always wondered if that would be a wise approach.

As a patient, I want a doctor that is exceptionally bright, competent, and has strong communication skills. Is academic achievement alone indicative of a student's ability to develop these three qualities? Or would it be preferable to choose a candidate that is "well-rounded" on paper and has spent hundreds of hours volunteering or working in healthcare? It's difficult to say.

As you pointed out, doctors that underwent training twenty years ago were expected to engage in much fewer ECs than applicants of today. Are they any less competent than newly minted attendings?

What about the attrition rate? One of the reasons that pre-meds are expected to have clinical experience is to demonstrate that they understand what it means to work in healthcare. If that's true, then one would expect that the attrition rate back in 1980 would be much higher than it is today. Is that the case? I don't know, but I would be curious to see the numbers if they're available.

In any case, it's an interesting topic. Personally, I never minded volunteering, but I was fortunate to have found something that I enjoyed doing. I know plenty of students who have been stuck doing scut work for years on end and don't benefit from the experience. I completely understand their frustration with the system and I agree that there is probably a better way of doing things.

 

[LostinLift]

Because who is the more successful medical student? The medical student who did simple clinical volunteering and shadowing or the ZERO to Mother Teresa medical student who spent all of their time in college doing things for medical school purposes? Unless their purpose was to help the most number of people, I'd have to say the first one, because they actually did what they were passionate about. It's an important discussion.

Neither. The honest and dishonest advantage because they will maximize their time. But how do you define a successful medical student?

 

[mrh125]

How would you propose that medical schools select students for their incoming class? Do they just accept applicants with the highest MCAT scores and GPAs? I've always wondered if that would be a wise approach.

As a patient, I want a doctor that is exceptionally bright, competent, and has strong communication skills. Is academic achievement alone indicative of a student's ability to develop these three qualities? Or would it be preferable to choose a candidate that is "well-rounded" on paper and has spent hundreds of hours volunteering or working in healthcare? It's difficult to say.

As you pointed out, doctors that underwent training twenty years ago were expected to engage in much fewer ECs than applicants of today. Are they any less competent than newly minted attendings?

What about the attrition rate? One of the reasons that pre-meds are expected to have clinical experience is to demonstrate that they understand what it means to work in healthcare. If that's true, then one would expect that the attrition rate back in 1980 would be much higher than it is today. Is that the case? I don't know, but it would be interesting to see the numbers if they're available.

In any case, it's an interesting topic. Personally, I never minded volunteering, but I was fortunate to have found something that I enjoyed doing. I know plenty of students who have been stuck doing scut work for years on end and don't benefit from the experience. I completely understand their frustration with the system and I agree wholeheartedly that there is probably a better way of doing things.

I hate the idea of using just gpa and mcat, especially since the correlation between mcat scores with medical school success rate (bio sci has the highest with r=.53) is pretty poor. It's also gotten to the point where you have to have really high mcat scores due to competition when really you can probably do fine with in medical school with more than a few points less than the median of a 33 (LizzyM said a 24 or above is indicates so). There needs to be subjectivity and selection for doctors that actually have social skills and sympathy of more than a tin can robot and alternative ways for one to prove themselves because good test skills and rapid recall don't mean compassionate caring doctor regardless of how much the AAMCS hypes up the new mcat to do that imo. I like URMs just because it adds a layer of subjectivity to the process even though it's not exactly balanced and one look at mdapplicants just confirms that unfortunately (I have major respect for anyone who has had to actually overcome adversity due to their upbringing and background because I have as well and even if I didn't have adversity, everyone should recognize and respect adversity). I'd like ECs if you weren't penalized for doing like one or two things you are passionate about instead of box checking and running on burnout due to them, the mcat, and GPA demands placed on you at once and if it's not necessarily explicitly medical you shouldn't be penalized for it. For example, when I learned something I really liked tutoring and helping others understand it so they can succeed and see things from different views, even though that's not explicitly medically related it can easily complement you as a doctor when you have to explain stuff to patients. You should be given a chance to let your passion really show through if you want and having it, but not expected to do a ton of ridiculous things for a huge number of hours. Competition kills this though. If one person does a bajillion hours over a lot of activities that raises the bar for everyone and that sucks in this regard. Also, who can really blame the people who jam hundreds of hours into a few weeks and toil to get those hours they need at the last moment? How does treating volunteering like a full time job make it worth any less merit when you have the time? College on its own is pretty demanding, where do you get the time to be a normal person your age? I myself was blind-sided the day I graduated with the amount of volunteering I'd need to do to get into medical school and well that was pretty damn dreadful. I got them done and more, but scribing 8 hours a day and commuting 3 hours is pretty damn intense. I enjoyed it but at the same time it really fizzled me out.

As for clinical experience correlating with attrition rate that's a great question. It's debatable how much clinical experience may prepare one for understanding healthcare and I'm the kind of person who longed for hands on knowledge my entire undergraduate career. There are so many intricacies and nuances that a doctor does that you don't really pickup until you are actually in the situation and rotations provide a way better context. It's kind of like being expected to be prepared to have clearly tangible reasons when you're applying to 40 medical schools and just want to get into one and ADCOMs tell you all the neat stuff about their school during the interview. Would going to each and every school and know them or having clinical experience that shapes your interest in medicine be helpful or kind of cool? For sure it would, but being expected to go excessively far in terms of hours and reasons for each school becomes a chore. I'd love a class in undergrad that gives you more of an insight into medicine with hands on clinical experience and teaches you about healthcare and what doctors do though.

I wish there were ways to demonstrate you're still a good candidate regardless of a less competitive mcat score or not being strapped down with ECs. It's just hard to find out a way how or a reasonable solution. With personal statements there's a huge degree of similarity between a large majority of them and for secondaries it's not any better, especially if schools don't prescreen and still apply rigid gpa and mcat cutoffs even when the subjective information is right in front of them (secondaries and PS). Is that wrong and could you blame them if you had 15,000 applicants in front of you? Probably not and even then excelling at secondaries/more subjective tests is just more box checking with buzzwords like diversity, multiculturalism, passion.

For almost everything in this process there's just as many flaws as merits. I just want a way for people to achieve their goals and give people the benefit of the doubt instead of holding them back no matter what issues they face. I know what it's like to struggle and have a bunch of nasty assumptions thrown at me and be held back and I don't want anyone to be if they have a goal, genuine passion, and can prove they can do their job well. One great ER doctor I had one time was from a caribbean med school because he didn't do well in undergrad and he still managed to become a great doctor and do what he wanted regardless of those limitations. So should everyone else to a reasonable extent.

 

[ciestar]

I really don't know if I fall into any of those categories..
All of my ECs were done out of pure interest and I didn't even have med school in mind when I started any of them.

Once I decided on the med school path, I started shadowing. That's basically the only thing. But with gap year 3 looming, I'm thinking of starting other things just to make use of my time when I'm not working.

No idea where i fall with my story.

 

[Spinach Dip]

And there you have it... ADCOMs say they hate box-checkers, yet everyone that applies is a box-checker!

OMG!?! REALLY?!?



Take it from someone who knows (me!), not checking one or two of those boxes can be the difference between acceptance and pre-interview rejection.

So, yes. Go check boxes with the best of em. Maybe you'll get into med school before you're 30.

 

[mrh125]

OMG!?! REALLY?!?



Take it from someone who knows (me!), not checking one or two of those boxes can be the difference between acceptance and pre-interview rejection.

So, yes. Go check boxes with the best of em. Maybe you'll get into med school before you're 30.

You're right and you have every right to be pissed off as hell about it. I was almost in your situation minus the kickass mcat score. How many secondaries did you have to slog through during the previous cycle? God, putting all this effort into secondaries and PS to get rejected most be one of the must infuriating disheartening situations ever.

 

[Aerus]

I would have done all my EC's even if I wasn't premed, except maybe hospital volunteering, since that seems sort of random if you're not premed and with all the paperwork, immunity tests, and training, I probably wouldn't have had the patience doing it if I wasn't premed. But I do enjoy it.

All my other EC's, I definitely would still be doing them if I wasn't premed. Why do people think that community service and altruism doesn't exist without some ulterior motive?

 

[touchpause13]

A lot of good points were raised by OP. I think it's really just a function of how competitive the process has become.

 

[Goro]

Here's the deal: As touchpause as correctly pointed out, this is a seriously competitive process. Look at, say U IA. They interviewed 297 IS and 375 OOS people (total 672) for 152 slots. And that's out of >3500 apps. My own school gets ~5000 apps for the same number of seats.

Based upon what my own school gets, I'd estimate about 50% of those apps were from people who have no business applying to barber school, much less a medical school. But of the people who alone interviewed, ALL were competitive for a seat at Carver/U IA.

So how on earth are Adcoms going to figure out who to accept, much less who to invite?

You kids can bitch about box checking all you want, but something beyond numbers is needed to net an II, because all of the GPA and MCAT numbers are pretty much the same.

So if you don't want to spend >100 hrs in a hospital pushing someone's granny in a wheel chair, and you don't want to follow an ER doc around, and you don't want to help feed shut-ins or the homeless, or read to children, how are you going to make yourself a better candidate than the other 3.8/33 guy/gal who is the avg matriculant at Carver????? Note: 1st authors in Cell or Nobel Peace Prize winners are rare, so don't compare yourself to them as what you need to do. OK, maybe for Harvard, but one can be down to earth in this process for everywhere else.

I think the key is not to box check, but to avoid having a cookie cutter app.

 

[user12]

im really glad I read this. I agree with pretty much everything the OP wrote. I've been thinking about it basically the same way. in comedy, as well as im sure many other businesses where one has to work to move up... they call putting in all the time doing activities you don't necessarily WANT to do as "paying your dues." I hate to say it, but that is pretty much what you're doing (most people anyway) to get accepted to med school... paying dues. before I really became familiar with the application process, I thought solid grades and mcats with a little clinical exposure were fine. but now i know that stuff like shadowing 2 or more doctors, clinical volunteering, non-clinical volunteering, getting the big hours in... everyone has to do it and it's not optional if you want a reasonable shot at acceptance. I personally think it's stupid as hell. but now having paid my dues, I get angry if someone gets accepted WITHOUT doing all that work. and a lot of it comes down to luck too, I don't think that's been mentioned yet. some committees just pick and choose what stuff they'll overlook for certain applicants and what stuff they'll make a big deal about. it gets me even more angry when they reject an applicant who has stellar grades and mcats and cant overlook the fact that they dont have an enormous number of long term service hours. but then they go and accept a student with a TERRIBLE mcat or a low gpa who has the ECs. It's like... if they can let something like the mcat score slide in favor of other features, they should certainly be forgiving of the student with the mcats and grades (which most premed advisors claim come FIRST) who for whatever reason slightly lacks in their number of checked boxes.

I'm a little bitter about the whole process, but those are my thoughts.

 

[Planes2Doc]

Non-trad student here. I started volunteering at my hospital in the fall of 2012, and only managed to go once a week with my school schedule. I've also done some minor research and shadowed some. I stopped volunteering earlier this year in January after I graduated from my university in December. My mom has cancer and is having a real rough go of it recently. I figured that since moving out of state and being away for the next 4 years at medical school is a big possibility, I would try to spend as much time with her and the rest of my family before I leave. Did I screw myself?

I'm sorry to hear about your mother. This is a really tough thing to go through. I can't imagine how hard it is for you. You should explain this to ADCOMs, and I'm hoping they'll be understanding of it. I'm not an ADCOM though, so I can't comment on it. I wish you the best of luck though, and I hope that your mom has a speedy recovery.

But how do you define a successful medical student?

In terms of pre-med to medical student, I'd say that the most successful medical student (first day of M1) is the one that spent their undergrad or time before medical school doing things they were passionate about. Therefore, between two applicants who were solely doing activities to pad their applications, I'd say the one that did the least number of activities/hours. At the end of the day, they will both be sitting in the same lecture hall (before they stop going to class of course, hehe), and their ECs (other than research) from undergrad will have no bearing on residency.

Once everyone as equal on the first day of M1, then I'd say the most successful medical students are the ones who will end up getting into the most competitive or desired residencies. But that's a whole different discussion.

I hate the idea of using just gpa and mcat, especially since the correlation between mcat scores with medical school success rate (bio sci has the highest with r=.53) is pretty poor. It's also gotten to the point where you have to have really high mcat scores due to competition when really you can probably do fine with in medical school with more than a few points less than the median of a 33 (LizzyM said a 24 or above is indicates so). There needs to be subjectivity and selection for doctors that actually have social skills and sympathy of more than a tin can robot and alternative ways for one to prove themselves because good test skills and rapid recall don't mean compassionate caring doctor regardless of how much the AAMCS hypes up the new mcat to do that imo. I like URMs just because it adds a layer of subjectivity to the process even though it's not exactly balanced and one look at mdapplicants just confirms that unfortunately (I have major respect for anyone who has had to actually overcome adversity due to their upbringing and background because I have as well and even if I didn't have adversity, everyone should recognize and respect adversity). I'd like ECs if you weren't penalized for doing like one or two things you are passionate about instead of box checking and running on burnout due to them, the mcat, and GPA demands placed on you at once and if it's not necessarily explicitly medical you shouldn't be penalized for it. For example, when I learned something I really liked tutoring and helping others understand it so they can succeed and see things from different views, even though that's not explicitly medically related it can easily complement you as a doctor when you have to explain stuff to patients. You should be given a chance to let your passion really show through if you want and having it, but not expected to do a ton of ridiculous things for a huge number of hours. Competition kills this though. If one person does a bajillion hours over a lot of activities that raises the bar for everyone and that sucks in this regard. Also, who can really blame the people who jam hundreds of hours into a few weeks and toil to get those hours they need at the last moment? How does treating volunteering like a full time job make it worth any less merit when you have the time? College on its own is pretty demanding, where do you get the time to be a normal person your age? I myself was blind-sided the day I graduated with the amount of volunteering I'd need to do to get into medical school and well that was pretty damn dreadful. I got them done and more, but scribing 8 hours a day and commuting 3 hours is pretty damn intense. I enjoyed it but at the same time it really fizzled me out.

As for clinical experience correlating with attrition rate that's a great question. It's debatable how much clinical experience may prepare one for understanding healthcare and I'm the kind of person who longed for hands on knowledge my entire undergraduate career. There are so many intricacies and nuances that a doctor does that you don't really pickup until you are actually in the situation and rotations provide a way better context. It's kind of like being expected to be prepared to have clearly tangible reasons when you're applying to 40 medical schools and just want to get into one and ADCOMs tell you all the neat stuff about their school during the interview. Would going to each and every school and know them or having clinical experience that shapes your interest in medicine be helpful or kind of cool? For sure it would, but being expected to go excessively far in terms of hours and reasons for each school becomes a chore. I'd love a class in undergrad that gives you more of an insight into medicine with hands on clinical experience and teaches you about healthcare and what doctors do though.

I wish there were ways to demonstrate you're still a good candidate regardless of a less competitive mcat score or not being strapped down with ECs. It's just hard to find out a way how or a reasonable solution. With personal statements there's a huge degree of similarity between a large majority of them and for secondaries it's not any better, especially if schools don't prescreen and still apply rigid gpa and mcat cutoffs even when the subjective information is right in front of them (secondaries and PS). Is that wrong and could you blame them if you had 15,000 applicants in front of you? Probably not and even then excelling at secondaries/more subjective tests is just more box checking with buzzwords like diversity, multiculturalism, passion.

For almost everything in this process there's just as many flaws as merits. I just want a way for people to achieve their goals and give people the benefit of the doubt instead of holding them back no matter what issues they face. I know what it's like to struggle and have a bunch of nasty assumptions thrown at me and be held back and I don't want anyone to be if they have a goal, genuine passion, and can prove they can do their job well. One great ER doctor I had one time was from a caribbean med school because he didn't do well in undergrad and he still managed to become a great doctor and do what he wanted regardless of those limitations. So should everyone else to a reasonable extent.

This is great. Thanks for taking the time to put it together.

Why do people think that community service and altruism doesn't exist without some ulterior motive?

I believe close to 90% of medical school applicants have some sort of community service. Compare that to the rest of society. The number is significantly lower: http://www.bls.gov/news.release/volun.nr0.htm

I find it hard to believe that pre-meds are somehow morally superior beings compared to the rest of society. Well actually, the reason that a lot of popular pre-med ECs tend to suck so much is because of the horrible reputations that pre-meds get. I was treated like garbage when I volunteered in the hospital as a pre-med. I'm currently volunteering at a hospice a couple of hours a week as a medical student, and I'm treated with so much respect. It's because pre-meds go into these activities with a piss poor attitude, because they are essentially being forced to do things they don't want to do, and it definitely shows.

When I see young people volunteering, I always think that there's an ulterior motive. What about those elderly volunteers in the hospital? Not so much.

I think the key is not to box check, but to avoid having a cookie cutter app.

Everyone is a cookie cutter to some degree. Like I said, there are people who would be heavily involved in such activities regardless of being pre-med or not, but they are pretty rare. It's great when you can scoop them up, but I'm assuming the majority of the student body was probably different levels of cookie cutters. Some are better at coming off as genuine than others.

im really glad I read this. I agree with pretty much everything the OP wrote. I've been thinking about it basically the same way. in comedy, as well as im sure many other businesses where one has to work to move up... they call putting in all the time doing activities you don't necessarily WANT to do as "paying your dues." I hate to say it, but that is pretty much what you're doing (most people anyway) to get accepted to med school... paying dues. before I really became familiar with the application process, I thought solid grades and mcats with a little clinical exposure were fine. but now i know that stuff like shadowing 2 or more doctors, clinical volunteering, non-clinical volunteering, getting the big hours in... everyone has to do it and it's not optional if you want a reasonable shot at acceptance. I personally think it's stupid as hell. but now having paid my dues, I get angry if someone gets accepted WITHOUT doing all that work. and a lot of it comes down to luck too, I don't think that's been mentioned yet. some committees just pick and choose what stuff they'll overlook for certain applicants and what stuff they'll make a big deal about. it gets me even more angry when they reject an applicant who has stellar grades and mcats and cant overlook the fact that they dont have an enormous number of long term service hours. but then they go and accept a student with a TERRIBLE mcat or a low gpa who has the ECs. It's like... if they can let something like the mcat score slide in favor of other features, they should certainly be forgiving of the student with the mcats and grades (which most premed advisors claim come FIRST) who for whatever reason slightly lacks in their number of checked boxes.

I'm a little bitter about the whole process, but those are my thoughts.

I always made myself upset when I compared myself to people who did less to get to where I am now. Once you make it though, just be glad you're there, and leave the rest of the stuff behind. People forget about pre-med pretty quick once they are facing the rigors of medical school!

 

[Euxox]

Well written post, Planes2Doc.

This whole theme of appearances beyond substance seems to be have extended itself far beyond admissions. It's almost become a part of the culture of academia. Grad students looking to defend their theses, post-docs/residents/fellows looking to land a faculty position, professors looking to get tenure -- they are all increasingly under pressure to show their worth in a quasi-quantifiable way. Sadly, it seems that this has degraded into some function along the lines of (number of papers published) * (number of talks given) * (dollars of grant money received). The demands at every stage have become so unreasonably that the only way to perform is to create a the illusion of a good publication record:

http://chronicle.com/article/We-Must-Stop-the-Avalanche-of/65890/
http://www.scidev.net/global/capaci...-publication-rate-hides-drop-in-quality-.html

It's gotten so bad that now you have Peter Higgs saying in his Nobel acceptance speech that that he would never be able to get a faculty position in today's academic system:

http://www.theguardian.com/science/2013/dec/06/peter-higgs-boson-academic-system

But in the end, it's just a function of having more people competing than there were twenty or thirty years ago.

 

[Donald Kimball]

I agree to a large extent, but I honestly think a lot more people outright lie about and fabricate their ECs.

 

[Planes2Doc]

I agree to a large extent, but I honestly think a lot more people outright lie about and fabricate their ECs.

Yeah it's a shame that they do that. Sometimes they don't necessarily fabricate the EC, but just embellish the hell out of the hours! This makes things harder for the rest of people, since it drives up the number of hours that people think they need to be competitive. Back in the day it was probably around 100 hours or so, now you have people nearing 1000. If ADCOMs implemented oversight over ECs, I think that we would see hours come down to more reasonable levels, and people would be happier since the liars could no longer ruin things for everyone else.

 

[Euxox]

Back in the day it was probably around 100 hours or so, now you have people nearing 1000. If ADCOMs implemented oversight over ECs, I think that we would see hours come down to more reasonable levels

I don't know if that is the result of embellishment as much as strategic/informed box checking. I'm an admitted strategic box checker (although I don't plan on going from Mother Teresa back to zero after I start med school) and this is what my volunteering hours looked like:

4 hours/week * 30 weeks/year * 3 years = 360 hours

Now add in the time I put in over the summers:
15 hours/week * 10 weeks/year * 3 years = 450 hours

That's 810 hours of work without any embellishment. Embellishment is definitely widespread, but my hunch is that most people who embellish only up their hours by 10 - 20%, which really isn't enough to make a difference. There are those who over-report hours by 100% or more, but considering the risk involved, I would guess that it's probably only a small fraction of all applicants.

 

[Spinach Dip]

I agree to a large extent, but I honestly think a lot more people outright lie about and fabricate their ECs.

Sometimes you don't even need to lie. A little exaggeration might do. Say, for example, that 2 applicants do 200 hours in the local soup kitchen. Adcoms won't be able to tell the difference between the guy who broke his back bussing tables and cleaning the dishes and the guy who spent 199 of those hours texting his girlfriend about how much he hates being around homeless people.

Hypothetically an adcom would be able to tell the difference between the lying and the honest applicants, but I have noticed that those who make the greatest exaggerations about their achievements tend to also be the best liars.



As I stated in my Culture of Lies thread, I would like to see a shift away from things which can be exaggerated/falsified, and a greater focus on things which cannot be fabricated. The list I posted back then (and which is by no means perfect) was:

--speaking foreign languages
--playing instruments
--employment
--peer-reviewed research
--poster presentations
--double majors
--minors
--advanced degrees (MS, PhD, etc)



For the life of me, I can't understand why adcoms have little-to-no appreciation for things which require years of effort to complete (such as a masters, a double-major, or becoming fluent in a second language), yet will gladly reject someone who hasn't volunteered for 100 hours in the local ER (stocking shelves, fetching water, or whatever it is that volunteers do these days...)

 

[Planes2Doc]

I don't know if that is the result of embellishment as much as it is strategic/informed box checking. I'm an admitted strategic box checker (although I don't plan on going from Mother Teresa back to zero after I start med school) and this is what my volunteering hours looked like:

4 hours/week * 30 weeks/year * 3 years = 360 hours

Now add in the time I put in over the summers:
15 hours/week * 10 weeks/year * 3 years = 450 hours

That's 810 hours of work without any embellishment. Embellishment is definitely widespread, but my hunch is that most people who embellish only up their hours by 10 - 20%, which really isn't enough to make a difference. There are those who over-report hours by 100% or more, but considering the risk involved, I would guess that it's probably only a small fraction of all applicants.

That's a good point. And yeah, I was surprised with the number of hours I was able to accumulate from once-weekly hospital volunteering as a non-traditional student. I did it over a long commitment, and was somewhere between 300-400 hours when I applied. I'm guessing that a lot of pre-meds will end up embellishing hours by 10-20% like you said, and not consider it to be a big deal. But look at it this way, if you're putting in three hundred hours in a crappy volunteer gig, and embellish by 10%, you get 30 extra hours that never happened. In reality, these hours are absolute torture! I'm not sure how much pre-meds push the embellishing envelope, but these 10-20% add up to quite a bit. I'm curious to see what an ADCOM has to say about applicants that are caught embellishing. Where do you draw the line? Is it ethical with someone who volunteered 297 hours to write 300? What about the applicant who volunteered for 277 hours and writes 300? When is it right, and when is it wrong?

I honestly hope that people who embellish hours by 100%+ or completely fabricate things are in the minority, but I don't know. People don't usually flaunt these things openly, since it can come back to haunt them in any point. Now if medical schools did verification checks randomly each year regardless of how legitimate or illegitimate things look, then future applicants will be spooked into lying. I think that these small embellishments are pushing things farther than we might assume.

 

[Planes2Doc]

Sometimes you don't even need to lie. A little exaggeration might do. Say, for example, that 2 applicants do 200 hours in the local soup kitchen. Adcoms won't be able to tell the difference between the guy who broke his back bussing tables and cleaning the dishes and the guy who spent 199 of those hours texting his girlfriend about how much he hates being around homeless people.

Hypothetically an adcom would be able to tell the difference between the lying and the honest applicants, but I have noticed that those who make the greatest exaggerations about their achievements tend to also be the best liars.



As I stated in my Culture of Lies thread, I would like to see a shift away from things which can be exaggerated/falsified, and a greater focus on things which cannot be fabricated. The list I posted back then (and which is by no means perfect) was:

--speaking foreign languages
--playing instruments
--employment
--peer-reviewed research
--poster presentations
--double majors
--minors
--advanced degrees (MS, PhD, etc)



For the life of me, I can't understand why adcoms have little-to-no appreciation for things which require years of effort to complete (such as a masters, a double-major, or becoming fluent in a second language), yet will gladly reject someone who hasn't volunteered for 100 hours in the local ER (stocking shelves, fetching water, or whatever it is that volunteers do these days...)

Amen! Especially the bolded part. As I always say like a broken record, volunteering is like Vegas minus 99% of the fun. What happens in Vegas stays in Vegas, and the same goes with volunteering and other ECs. I have proposed implementing a standardized grading system, which would help eliminate abuse. I'm sure ADCOMs do a great job eliminating applicants who are clearly bad liars, but the skilled ones will definitely get away with it. But it's hard to have such significant oversight over something that's not an actual requirement. After all, you technically don't need anything except the MCAT and your prerequisite classes to get into medical school. Large changes would need to be made. Perhaps changing "volunteering" to "community service" would be a start.

 

[Euxox]

I would like to see a shift away from things which can be exaggerated/falsified, and a greater focus on things which cannot be fabricated.

I like the general idea, but beyond the numbers (GPA + MCAT) I really don't think there are many qualifications that can't be fabricated but are still useful yardsticks of achievement.

--speaking foreign languages

So should native speakers be given a boost over people who learned the language in a classroom (and aren't as fluent)? That doesn't really seem fair. If not, how do you know that a native speaker isn't just throwing in a grammar mistake and a mispronunciation here and there to convince you that he's not a native speaker?

--playing instruments

How would you check this though? Hold the interview in a room with a piano/trumpet/french bassoon?

--peer-reviewed research
--poster presentations

So much of this depends on luck. I know people who graduated from top five PhD programs that were not published as undergrads. They had outstanding resumes otherwise, but just had bad luck when it came to timing of paper submissions and such.

--double majors
--minors

The problem here is that at college A, a minor in economics could be five notoriously easy courses, while at college B it is ten GPA killers plus a research project. So I don't think it would be fair to compare double majors and minors across colleges, just as it wouldn't be fair to compare GPAs across colleges without the standardizing factor of the MCAT.

Looking at employment and advanced degrees is slightly better, IMO, but then this would turn into a competition of how many gap years you could fit in before applying. The line between trads and non-trads would get very blurry when premed gunners start applying with two Master's degrees and three years of work experience.

 

[Spinach Dip]

Looking at employment and advanced degrees is slightly better, IMO, but then this would turn into a competition of how many gap years you could fit in before applying. The line between trads and non-trads would get very blurry when premed gunners start applying with two Master's degrees and three years of work experience.

If a gunner is willing to put 5-7 years in after undergrad (depending on if the masters programs are 1 or 2 years), they deserve a spot in med school.

If it gets to the point of everyone having a masters, hundreds of hours of bench research, and speaks 2-3 languages, I think that would be a better world than the one we live in now.

 

[Euxox]

If it gets to the point of everyone having a masters, hundreds of hours of bench research, and speaks 2-3 languages, I think that would be a better world than the one we live in now.

I agree with this entirely.

If a gunner is willing to put 5-7 years in after undergrad (depending on if the masters programs are 1 or 2 years), they deserve a spot in med school.

My point here was that if a few rich-kid gunners can afford to do 4+ gap years, they slowly start to raise the bar for everyone. Ten years later, having a Master's before medical school is no longer unusual; it is now fairly average. This makes medical school less attainable for those who can't afford to spend a few years on higher education and/or working low paying jobs just to build a resume.

 

[hotrodsduo]

OMG!?! REALLY?!?



Take it from someone who knows (me!), not checking one or two of those boxes can be the difference between acceptance and pre-interview rejection.

So, yes. Go check boxes with the best of em. Maybe you'll get into med school before you're 30.

Do you mind if I asked which "boxes" you may have "missed"? I am curious if you might have changed anything in retrospect.

 

[Mornhavon]

.

 

[Spinach Dip]

That's complete bulls***.
Medical training takes too long in the first place. Why do we waste years in undergrad studying things completely unrelated to medicine? It's a joke.

You seriously want to make it so people have to go further into debt, spending 100's of thousands on pointless degrees so they can start school in their 30's?
None of that has anything to do with producing physicians, which would actually be good for society.

And you're also forcing girls to choose between medicine and children, if they can't have a stable life until they are well into their 30's.

I merely said it would be better than what we have now, not that it would be ideal or perfect. I'm certainly not insisting that everyone needs a masters, but that it should be valued as an accomplishment which stands above the typical fresh-out-of-undergrad-applicant.

One thing you'd have to think about (and which would vary widely between adcoms) is how many LizzyM points is an MS worth? What about a second language? Do you get bonus points for being fluent over conversational? Is Spanish worth more than Lithuanian?

The horse and pony show to get into med school is ridiculous. You'd be better off letting high school kids take an IQ test, and then have a lottery for the top such and such % of scorers. Any cynical douchebag can manipulate the system and rack up EC's....just read SDN...it isn't exactly a collection of sweethearts.

Agreed.

That's why I think that basing admissions on someone's ACTUAL ACHIEVEMENTS is a step in the right direction.

 

[olivia_k]

Oh my... you people are so jaded.

I feel like interviewers could easily gauge your level of commitment to a volunteer activity during an interview. I mean, how are you going to talk about an issue with any level of depth if all you did was "sit around and text your girlfriend?"

 

[Mornhavon]

.

 

[Spinach Dip]

Oh my... you people are so jaded.

I feel like interviewers could easily gauge your level of commitment to a volunteer activity during an interview. I mean, how are you going to talk about an issue with any level of depth if all you did was "sit around and text your girlfriend?"

If person X gets into an interview and is asked "so what did you do in that soup kitchen?" They would never respond "I goofed off and did nothing." No. They'll make up some great tale about how it was their calling to help the homeless, and they remember this one old vet who lost his arm in Vietnam and always sat at the same table and had 2 bowls of soup...etc.

The problem with placing a value on things which can be falsified is that it gives an unfair advantage to people willing and able to falsify them.

But is an MS an achievement? What have you achieved? I mean, sure if you make some cool discovery or contribute in some way, sure, but going to class and taking tests? meh. The only positive side I can see to it is that it gives people a chance for redemption if they screwed up their gpa earlier...one and done testing in other countries is unfair and shuts out late bloomers.

By that argument, is a job an achievement? I mean, sure you showed up on time and performed well enough to not get fired, etc.

As I said, it would be better than current metrics (some vague definition of 'we want to see altruism'), but its not perfect.

 

[NickNaylor]

@Spinach Dip

Agree with you, but it also requires some skill in presenting yourself in a positive light. That in and of itself isn't dishonest, but it's an incredibly valuable thing to learn how to do. As I'm beginning to work on ERAS, it's all about finding a way to present the things that you might take for granted or consider relatively minor in a way that makes them commendable or, at the very least, interesting.

Applying to medical school is exactly the same way. Falsifying info is never a good idea, but you do have the advantage of filtering the experience to your liking. Volunteering at a soup kitchen in and of itself is nothing to write home about, but if you can find a way to talk about it in a meaningful and interesting way, then your goal is accomplished. That's really the key. Pre-meds don't have to do the most amazing activities ever in order to get into medical school, even a good one. They just have to talk about those activities intelligently and demonstrate that they've put some thought into why they did those things.

@Planes2Doc has a point in participating in these threads because the kind of person that comes to SDN wondering "what activities will maximize his chance of getting into medical school" will never ascend to that level of thinking. For that person, they fundamentally misunderstand the process and think it's all about accumulating as many experiences with as many hours as possible. What they don't see is that there are 200 people with similar experiences and 100 people with experiences more impressive than theirs. What will set them apart, instead, is their ability to come across in a mature and professional way in how they talk about those experiences on AMCAS and the interviews.

 

[Being]

I started volunteering before medical school was a thought in my head, and my clinical experience as an EMT->paramedic is actually what caused me to become interested in medicine: my ECs and life experiences led me to this path, rather than the other way around. My boxes were mostly checked when I printed out the application. Of course, now that I'm aware of the game, I will be checking more of them off...

 

[Chillbo Baggins]

I put authentic box-checker.

Everything on my app besides clinical volunteering and shadowing was because I wanted to do it and was passionate about it, including hundreds of community service hours. I didn't commit to pre-med until second semester of my junior year, so that's when I added in the other parts, because I knew I needed them. Did I necessarily want to do them? Not really. Did I find them to be useful aside from the app process? Yes.

 

[IlDestriero]

When I was chilling at the U, my pre med fraternity brother and I, when we were both President of the fraternity, created a number of leadership awards, academic scholarships, students athlete awards, etc. all legitimized by our alumni association with monetary awards. The president awarded them to senior members, many of whom were applying to professional school. As far as I know, they still exist.
Criminal or genius? Or criminal genius?
I would be happy to fund some now if I was asked.

 

[gettheleadout]

I hate the idea of using just gpa and mcat, especially since the correlation between mcat scores with medical school success rate (bio sci has the highest with r=.53) is pretty poor.

I don't know if anyone else has addressed this, but in the context of psychological testing (which both the MCAT and Step 1 are) the correlation coefficient of r = 0.53 is actually very strong. Don't make assumptions about the validity of the exam without background in the study of test design and use, in combination with your post history it makes you seem bitter about not performing well on the test.

 

[mrh125]

I don't know if anyone else has addressed this, but in the context of psychological testing (which both the MCAT and Step 1 are) the correlation coefficient of r = 0.53 is actually very strong. Don't make assumptions about the validity of the exam without background in the study of test design and use, in combination with your post history it makes you seem bitter about not performing well on the test.

It's hardly bitterness. Elaborate further on why .53 is so accurate and is a good fit. If I don't know the background explain it. Furthermore I could easily say given your post history and mcat score you're merely trying to justify backing an admission assessment that worked for you very well, which says very little about others.

 

[gettheleadout]

It's hardly bitterness. Elaborate further on why .53 is so accurate and is a good fit. If I don't know the background explain it. Furthermore I could easily say given your post history and mcat score you're merely trying to justify backing an admission assessment that worked for you very well, which says very little about others.

In the context of psychological testing, when evaluating criterion-related validity of a test (the MCAT) in relation to a criterion (Step 1) validity coefficients (correlation coefficients between the two scores) of r > 0.4 are considered to make the test very useful for predicting the criterion.

Read here for more background (PDF warning): http://www.sagepub.com/upm-data/36362_Chapter8.pdf

In contrast to your suggestion, I am acutely aware of the limitations of the MCAT from a statistical perspective. That said, I also recognize that in the context of predictive testing, the MCAT is also a strong tool (reliability of r = ~ 0.9 is excellent as well). A standardized test is necessary for measuring academic caliber across academic backgrounds, and while it shouldn't be the sole factor in evaluating applicants (and for all its faults) the MCAT has been rigorously evaluated and continually developed for many years.

 

[mrh125]

In the context of psychological testing, when evaluating criterion-related validity of a test (the MCAT) in relation to a criterion (Step 1) validity coefficients (correlation coefficients between the two scores) of r > 0.4 are considered to make the test very useful for predicting the criterion.

Read here for more background (PDF warning): http://www.sagepub.com/upm-data/36362_Chapter8.pdf

In contrast to your suggestion, I am acutely aware of the limitations of the MCAT from a statistical perspective. That said, I also recognize that in the context of predictive testing, the MCAT is also a strong tool (reliability of r = ~ 0.9 is excellent as well). A standardized test is necessary for measuring academic caliber across academic backgrounds, and while it shouldn't be the sole factor in evaluating applicants (and for all its faults) the MCAT has been rigorously evaluated and continually developed for many years.

Very good information thank you.

 

[Goro]

Speaking another language is valued. However, there's a difference in merely being smart, and showing evidence that you really are an altruistic person and who wants to dedicate your life to helping others.

And you're still not getting it, Spinach...there are literally 1000s of applicants out there who are basically clones of each other academically, applying for only 100-150 seats at any given medical school. My school alone gets >5000 apps. We know they're smart. So, in our seller's market, we have the luxury of weeding out the sociopaths, the pathologically entitled, the lazy or the perpetually clueless.

We also appreciate people with post-grad degrees, except some programs are better than others at telling us that an applicant can handle medical school. Poor performance in a post-bac is a big red flag.

For the life of me, I can't understand why adcoms have little-to-no appreciation for things which require years of effort to complete (such as a masters, a double-major, or becoming fluent in a second language), yet will gladly reject someone who hasn't volunteered for 100 hours in the local ER (stocking shelves, fetching water, or whatever it is that volunteers do these days...)

A) well, there's that little annoying thing called "competence" (not all gunners are equal, and not everyone does well in MS programs.) My school has some decent data that show a low B in our MS program = struggling in our medical school.

B) See my second para above. You're really still not getting it.

If a gunner is willing to put 5-7 years in after undergrad (depending on if the masters programs are 1 or 2 years), they deserve a spot in med school.

 

[Planes2Doc]

Oh my... you people are so jaded.

I feel like interviewers could easily gauge your level of commitment to a volunteer activity during an interview. I mean, how are you going to talk about an issue with any level of depth if all you did was "sit around and text your girlfriend?"

Not exactly. From my personal experience with hospital volunteering, close to 99% of my time was spent cleaning beds, restocking supplies, and aimlessly wandering around the emergency department. Over my few hundred hours, I still had some good patient contact moments, and maybe even a good day are two. These great experiences were definitely not enough to make this anything better than a crappy experience, but they were more than enough material that I needed for my personal statement and interviews. The same goes for most applicants.

Now imagine someone who started volunteering in the ED at the beginning of freshman year. They came for the first six four-hour shifts. In these 24 hours, they got all the patient contact stories they need for their personal statement and interviews. Now this applicant figures out that no one notices when they are there or not. They spend the next four years coming into sign in, leaving the hospital to go back home, then return only to sign out. By the time they apply to medical school, they will have accumulated enough hours to make them competitive for service-oriented schools. If the schools are suspicious and end up verifying the hours, it comes back as legitimate. Therefore, they will come off as being no different than an applicant who honestly volunteered through all of those hours.

Now assuming those stories from the first six shifts are real, an ADCOM won't realistically be able to tell the difference between an honest applicant, and a faker with legitimate hours to back them up. That's how the dishonest game the system and get into medical school. Unless they are stupid enough to brag about gaming the system, it's not possible to catch them.

 

[Annabell Lee]

I didn't realize volunteer work was something that helped you get into med school. (I've just decided to take pre-med)

I've been doing volunteer work since middle school (halfway houses, mission trips fixing houses, volunteer firefighter in high school) but haven't been doing much recently other than helping out at my local church and putting together food boxes on the holidays. As soon as I get a working vehicle I want to start volunteering at the halfway house again.

Are these things I should include in an application, even though they were before college? The only one I have any type of official verification for were my years as a volunteer firefighter, because they keep records of meeting attendance.

 

[gettheleadout]

I didn't realize volunteer work was something that helped you get into med school. (I've just decided to take pre-med)

I've been doing volunteer work since middle school (halfway houses, mission trips fixing houses, volunteer firefighter in high school) but haven't been doing much recently other than helping out at my local church and putting together food boxes on the holidays. As soon as I get a working vehicle I want to start volunteering at the halfway house again.

Are these things I should include in an application, even though they were before college? The only one I have any type of official verification for were my years as a volunteer firefighter, because they keep records of meeting attendance.

Consensus is that only activities that are continued through college should be included on the application (with some exceptions).