Revamp Medical School Admissions to Mimic Residency Application Process

[DermViser]

So it goes from extreme violence (which doesn't apply in places like Sinai) to non-compliance?! I don't follow you. There are plenty of docs at Columbia and Sinai that choose to serve those populations.

It's both. Areas of extreme poverty beget violence and crime. Is that a shock to you?

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[DermViser]

OK. I really wanted to change the topic but this motivated me to make a final point. Yes, I agree that elite, wealthy, highly specialized tertiary/quaternary academic medical centers in inner cities serve the poor and underserved. However, the jobs you're describing (attending positions at Columbia presby and Mount Sinai) are some of the most desirable jobs in the country. Do you really think that an ORM would be less likely to want to work at Columbia and live on the UES? Every attending at these places serves the underserved, they don't pick and choose their patients. When we're discussing serving the underserved, we're talking about moving to places other people don't want to move to like rural/impoverished areas or working at run down community hospitals in the middle of nowhere. The attending positions at top medical centers (which are actually geared towards those accomplished in research and not what we're discussing) aren't really relevant to boosts in med school admissions. Let's move on to point 3.

Yes, thank you. You made my point better than even I could.

 

[Cyberdyne 101]

It's both. Areas of extreme poverty beget violence and crime. Is that a shock to you?

How does that apply to East Harlem? And the Lower East Side? Those are the examples that I used.

 

[Cyberdyne 101]

OK. I really wanted to change the topic but this motivated me to make a final point. Yes, I agree that elite, wealthy, highly specialized tertiary/quaternary academic medical centers in inner cities serve the poor and underserved. However, the jobs you're describing (attending positions at Columbia presby and Mount Sinai) are some of the most desirable jobs in the country. Do you really think that an ORM would be less likely to want to work at Columbia and live on the UES? Every attending at these places serves the underserved, they don't pick and choose their patients. When we're discussing serving the underserved, we're talking about moving to places other people don't want to move to like rural/impoverished areas or working at run down community hospitals in the middle of nowhere. The attending positions at top medical centers (which are actually geared towards those accomplished in research and not what we're discussing) aren't really relevant to boosts in med school admissions. Let's move on to point 3.

You make an excellent point. All I was saying is that there are doctors that help underserved populations and are not in "harm's way." I was just providing examples of this in my area.

 

[Flashfan]

And here I was thinking that you were going to advocate ranking schools and getting a single match and it turned out to be yet another URM/SES discussion.

 

[Greenberg702]

Thanks fellas, let's hit some other points. I've already been accused of fostering affirmative action flame wars.

 

[Greenberg702]

And here I was thinking that you were going to advocate ranking schools and getting a single match and it turned out to be yet another URM/SES discussion.

This is actually a very interesting idea and I mentioned it in my post. The biggest hiccup that I can see is financial aid. Schools would have to issue awards before acceptances and merit aid (trying to lure applicants away from other schools) would be eliminated.

 

[Flashfan]

I think it would eliminate merit aid entirely, which may not be a horrible thing. Of course, there would probably be people that do not match simply because they aim too high, only ranking reach schools.

 

[Gauss44]

Hello fellow SDNers. I wanted to spark a discussion regarding an issue that I've been thinking extensively about since the beginning of last summer and that is the goals, nature of, and success of the current medical school admissions process. I ran several of these ideas and suggestions past the Dean for Medical Education at the school I'm currently doing research at and was surprised to receive positive feedback and genuine interest in some of these points. Was curious to hear what people (especially current and former applicants) thought.

It appears to me and many of my pre-med friends and acquaintances that the current system of med school admissions feels extremely contrived, with artificial hoops set-up for no discernible purpose than to please some bigwigs or administrators sitting on admissions committees. Schools are often extremely vague about what they're looking for. It seems that much of the process is "fake" and rewards mindless box-checking/conforming to certain requirements than really preparing oneself for a career in medicine. If we're really honest with ourselves, we would admit that this process has at least somewhat affected how we structure or schedules/ECs/summers and the thought of medical school is always looming in the back of our minds as we go through undergrad.

Applications for residency/post-graduate training differ significantly from those for medical school. As is well known, residency directors look at 1. USMLE Step I score (in order to have a standard for comparing all applicants) 2. Clerkship grades (are you a strong clinician? can you work with other residents/attendings?) 3. Letters of recommendation from physicians (very field dependent but writers are often from the specialty you're applying to) 4. Research (are you committed to academics/advancing the field? More so at top programs). They care very little about anything else. Some cool ECs and volunteering may be good talking points but they never make or break an application. People want to know a) Are you smart? b) Can you be a good physician with whom we can work with for the next 3-7 years? The whole process seems much more intuitive, almost like applying for any normal job.

Now, what if we can extend some of these principles in order to make medical school admissions look more like residency applications? I've heard of some people advocating for a match system in order to minimize waitlisting, which is an interesting but slightly different discussion. First, we must establish "the point" of the whole system. How can we find people who will make excellent physicians and advance the field we're so passionately about? I think the crucial questions that we must ask are 1) Are you a smart individual? Will you be able to successfully graduate from medical school and become licensed? 2) Are you interested in medicine?What makes you passionate about the field? 3) Are you somebody with whom people can work?
In order to better answer these questions, I'd like to propose the following modifications:

1. MCAT + GPA: These should be very heavily favored a la Step I.
2. Eliminate ridiculous cut-offs that some committees have in terms of box checking. A personal anecdote: My SO who is on the committee of a top 5 med school at my undergrad told me that a 3.9+ from Princeton with good research, no red flags, worked through college to support themselves, and who spent 2 years in Colombia streamlining healthcare delivery systems got dinged because of insufficient shadowing. "How do we know he's really interested in medicine, they asked." These kinds of attitudes from members who aren't even physicians (see point 4) are ridiculous and archaic. There should be no cutoffs for clinical experience/shadowing, volunteering, or other requirements. The resume padding that occurs among pre-meds is wildly rampant (I myself am guilty of this) and really isn't productive for anybody or makes a good use of students' time. I've seen posts on SDN that boast getting 100000 hours of hospital volunteering just to one-up somebody else.
3. Make requirements for letters of recommendation more flexible. In a college environment, interacting with professors (particularly science professors) is fairly difficult without some major outside involvement like performing research with your science professor or having him/her as an adviser for your student organization. When applying this cycle, I felt that the people who really knew best were NOT my science professors who lectured from power-point slides but were physicians who I shadowed, my PIs, and EC/student org advisers. Personally, I think this point needs to be discussed/addressed. I chose to present an abstract (on a topic I was not remotely interested in) with one of my science profs in order to better get to know them for a rec letter. This "playing the game" shouldn't be necessary.
4. Make admissions committees MD only (except for screeners). I personally believe that you should not be permitted to assess students' suitability to pursue a degree which you yourself do not possess. Some of the administrators/PhDs on these committees have no idea what real medicine is like (I'm not claiming I do either) and have no idea how out of touch this process is with the reality of pre-medical preparation. Some of them genuinely believe that people who spend a couple hours a week tutoring or going on 2 week trips to Guatemala (never to be seen again) are somehow more compassionate than those who don't.
5. Repeal MMI interviewing in favor of traditional interviews. The whole notion that setting up a bunch of contrived scenarios is somehow better than speaking with and getting to know an actual person is ridiculous. REAL patient interactions occur in the traditional fashion. Residency interviews occur in the same 1 v 1 way. You need to learn how to present your thoughts/ideas/story in a cogent manner to any person who is sitting in front of you. That is real life and nobody will be asking you what you would do if you crashed into a BMW in the parking lot. The most natural solution to this in my view would be to have residency application style "speed-dating" interviews with multiple people.
6. Convert affirmative action utilizing race into an affirmative action system that takes into account socioeconomic status. The latter method would incorporate indigent individuals of ALL races. At several of my interviews/second looks, the vast majority of URM students were super rich and attended private schools. There is absolutely no way that they were more disadvantaged than an Asian or Caucasian growing up in coal country or more likely to serve URM groups in the future. They all admitted to wanting to pursue derm/plastics and open up private practices. Obviously, this is highly controversial and anecdotal but an affirmative action system utilizing socioeconomic status intuitively seems more fair and may better differentiate those who are more likely to practice in underserved areas. Asking individuals who checked the URM box additional questions regarding their ties to certain groups during interviews can also help address this.

Full disclosure: I was very fortunate to be successful this past cycle. This does not, however, mean that I support all of the aspects of medical school admissions or believe that there should not be serious changes to the system. I'd love to hear what other people think.

Thanks for taking it upon yourself to write all of this. I agree that the admissions process needs to be fixed. Here are some of my ideas:

1. Take your list here, "1) Are you a smart individual? Will you be able to successfully graduate from medical school and become licensed? 2) Are you interested in medicine?What makes you passionate about the field? 3) Are you somebody with whom people can work?" And turn that list into an optional essay section of the application with only a suggested word limit. Encourage applicants to ONLY answer these questions if they have something critical to say that's not on their application elsewhere. This gives unusual applicants a chance to explain themselves.

2. I 100% agree with your part about letters of recommendation.

3. I agree with most of your part about cut offs. Some shadowing should be required IMO, so the applicant knows what some doctors do.

4. I disagree that the ADCOMs should be ALL MDs. I think MDs could use the help of trained psychologists and professional corporate interviewers for input about applicants that might otherwise go undetected.

5. Regarding affirmative action, I believe that it should continue to ensure that entire racial and ethnic categories of people are NOT wholly excluded from the profession. It should also include socioeconomic status. I believe that doing so would help many things and many people. One thing it would help is the sense of bitterness, injustice, and fury among some poor disadvantaged White and Asian individuals and communities. The problem of racism is often fueled by this sort of resentment of the system. I believe that little fixes here and there could potentially go a long way to help that part of that problem too.

 

[Greenberg702]

I think it would eliminate merit aid entirely, which may not be a horrible thing. Of course, there would probably be people that do not match simply because they aim too high, only ranking reach schools.

Probably but I think that most people would rank all of the schools they got interviews at. Personally, I feel like merit aid can be a useful tool for schools to strengthen their student bodies. It acts as a sort of salary cap for med school recruitment. Otherwise, like in baseball, the Yankees will always be the best and the Pirates will suck.

 

[Greenberg702]

Thanks for taking it upon yourself to write all of this. I agree that the admissions process needs to be fixed. Here are some of my ideas:

1. Take your list here, "1) Are you a smart individual? Will you be able to successfully graduate from medical school and become licensed? 2) Are you interested in medicine?What makes you passionate about the field? 3) Are you somebody with whom people can work?" And turn that list into an optional essay section of the application with only a suggested word limit. Encourage applicants to ONLY answer these questions if they have something critical to say that's not on their application elsewhere. This gives unusual applicants a chance to explain themselves.

2. I 100% agree with your part about letters of recommendation.

3. I agree with most of your part about cut offs. Some shadowing should be required IMO, so the applicant knows what some doctors do.

4. I disagree that the ADCOMs should be ALL MDs. I think MDs could use the help of trained psychologists and professional corporate interviewers for input about applicants that might otherwise go undetected.

5. Regarding affirmative action, I believe that it should continue to ensure that entire racial and ethnic categories of people are NOT wholly excluded from the profession. It should also include socioeconomic status. I believe that doing so would help many things and many people. One thing it would help is the sense of bitterness, injustice, and fury among some poor disadvantaged White and Asian individuals and communities. The problem of racism is often fueled by this sort of resentment of the system. I believe that little fixes here and there could potentially go a long way to help that part of that problem too.

Let's avoid #5 at the moment.

For 2. do you agree with the new requirements in my above post?

For 3. perhaps schools can establish some guideline below which there will be a penalty but above which no additional benefits will be garnered. For example, schools can require 25 hours of shadowing and 25 hours of volunteering in a healthcare setting.

For 4. perhaps exceptions can be made for the interview process. Although I have very strong views for an all-MD panel making final decisions. See some of my previous posts.

 

[Cyberdyne 101]

Let's avoid #5 at the moment.

For 2. do you agree with the new requirements in my above post?

For 3. perhaps schools can establish some guideline below which there will be a penalty but above which no additional benefits will be garnered. For example, schools can require 25 hours of shadowing and 25 hours of volunteering in a healthcare setting.

For 4. perhaps exceptions can be made for the interview process. Although I have very strong views for an all-MD panel making final decisions. See some of my previous posts.

LOL

 

[Cyberdyne 101]

Thanks for bringing up this topic, btw.

 

[Cyberdyne 101]

#3 is tough with lower limits in terms of volunteering. A lot of hospitals require a year commitment with at least 4 hrs a week, which is about 200 hrs.

 

[Mad Jack]

Residency interviews don't need the BS filter because you've already been through it. I like the current admission system, personally.

 

[Gauss44]

Let's avoid #5 at the moment.

For 2. do you agree with the new requirements in my above post?

For 3. perhaps schools can establish some guideline below which there will be a penalty but above which no additional benefits will be garnered. For example, schools can require 25 hours of shadowing and 25 hours of volunteering in a healthcare setting.

For 4. perhaps exceptions can be made for the interview process. Although I have very strong views for an all-MD panel making final decisions. See some of my previous posts.

I agree with eliminating cut offs (except for a little bit of shadowing), and I like your recommendation about making LoRs more flexible. I also think what you mentioned about #3 is fine. In general, I like the idea of having less box checking and less rigidity. To be clear, less rigidity, to me, does NOT mean going easy on people. It means letting people be themselves, and judging them based on what's truly important - not all the other fluff. All MDs making the FINAL decision sounds fine to me. I still strongly believe they should get input from psychologists and professional corporate interviewers though. Anyone who's familiar with the level of insight those professionals can provide will likely agree with me on that. Everyone is on good behavior on interview day regardless of true character. Some people get nervous for interviews but are otherwise strong candidates. Some people are harder to read and don't express themselves well. Those are just a few examples of where the non-MD experts come in handy.

 

[Greenberg702]

I agree with eliminating cut offs (except for a little bit of shadowing), and I like your recommendation about making LoRs more flexible. I also think what you mentioned about #3 is fine. In general, I like the idea of having less box checking and less rigidity. To be clear, less rigidity, to me, does NOT mean going easy on people. It means letting people be themselves, and judging them based on what's truly important - not all the other fluff. All MDs making the FINAL decision sounds fine to me. I still strongly believe they should get input from psychologists and professional corporate interviewers though. Anyone who's familiar with the level of insight those professionals can provide will likely agree with me on that. Everyone is on good behavior on interview day regardless of true character. Some people get nervous for interviews but are otherwise strong candidates. Some people are harder to read and don't express themselves well. Those are just a few examples of where the non-MD experts come in handy.

For letters, how about:

1. Letter from ANY professor who knows you well (some people advocate removing this requirement altogether).
2. Letter from a preceptor of a nonclinical EC who has worked with you in some capacity (perhaps to organize fundraisers, start organizations, etc.)
3. Letter from a research PI or a physician from a clinical EC (like hospital volunteering/shadowing).
4. An additional letter of your choice

I feel like requiring #2 could be useful in many circumstances.

I agree regarding standards, they should definitely remain very high. I'd have to ponder the logistics of having psychologists present at interviews. Seems slightly over the top.

 

[Cyberdyne 101]

I definitely agree with more LOR flexibility. I understand the pros of a committee letter, but it's not always the best option for many qualified applicants.

 

[Gauss44]

For letters, how about:

1. Letter from ANY professor who knows you well (some people advocate removing this requirement altogether).
2. Letter from a preceptor of a nonclinical EC who has worked with you in some capacity (perhaps to organize fundraisers, start organizations, etc.)
3. Letter from a research PI or a physician from a clinical EC (like hospital volunteering/shadowing).
4. An additional letter of your choice

I feel like requiring #2 could be useful in many circumstances.

I agree regarding standards, they should definitely remain very high. I'd have to ponder the logistics of having psychologists present at interviews. Seems slightly over the top.

The main purpose of including a psychologist would be to get clarity on any number of situations: They could help select a diverse class of introverts, extroverts, nervous interviewees with potential, typical and unusual personalities, and make sure that the class is likely to work well together. A group of all MDs might NOT be capable or comfortable selecting such a diverse group. They might only select a very narrow non-psychologically diverse group that they feel most comfortable with. In my person opinion, the medical profession should be diverse so that everyone practically will feel comfortable with some doctor out there. And so that the medical profession doesn't unintentionally become bias against some patients. I also think a psychologist would be helpful in selecting or deselecting applicants from rough backgrounds, who've been involved in activism, who have a criminal record, or who seem a little odd somehow (perhaps only due to nervousness, or passion, or culture, subculture, or something else). Some MDs might enjoy hearing a psychologist's thoughts. What's in it for the MD's and psychologists? Networking, ensuring a quality next generation of physicians, and learning from one another. I'm sure some MD's and psychologists (and professional corporate interviewers) would enjoy doing this.

I think your letter requirements sound fine. I think the purpose of the science professor and/or committee letters is partially that there's some kind of code or traditional wording that rates candidates. However, I agree that a science professor usually isn't in a very good position to make those judgments.

 

[Gauss44]

I would include LGBT in affirmative action as well. LGB&T have specific medical needs, have faced a history of discrimination in healthcare, and would do well to have their kind represented.

 

[Spinach Dip]

a 3.9+ from Princeton with good research, no red flags, worked through college to support themselves, and who spent 2 years in Colombia streamlining healthcare delivery systems got dinged because of insufficient shadowing. "How do we know he's really interested in medicine, they asked."

Honestly, at this point, I could find a reason to reject ANY applicant. Try these ones next time you sit on the admissions board:
-"How do we know he's interested in medicine?"
-"But his ECs shows a lack of altruism."
-"Lack of research..."
-"Lack of leadership..."
-"Won't bring any diversity to our program..."
-"Won't fit in with the rest of the student body..."



Schools have gotten so deep into looking "at the whole applicant" (and made the process so subjective as a result) that they can literally decide to give an interview invite (or not) for any reason whatsoever.

 

[basketcase0a0]

that's why I say it's very harsh. Just out of curiosity do you remember your FL verbal scores on practice tests? My practice FL VR scores were nonsensical even with additional practice and when I looked at many other's I saw much of the same. On one legit mcat I got an 11 in VR and the next I got a 7 and I literally did nothing different, while in the science sections when I studied more, my scores reflected that with improvements. With the science sections studying more and more resources and doing more problems can really help, but with verbal it's diff. Also, there are a wide range of passage times. Social sciences and science articles are essential to know and do well in for medicine, but if you miss one humanities passage, which use to assess doctors is debatable that can drop you a huge number of points.

In comparison I found the SAT critical reading to be far more objective and the same goes for the LSAT, if you did passages and practice resources you'd know what to expect. If the verbal section was reassessed and modified to be more in line with the science sections and practice improved your scores similarly many of my complaints about the mcat would dissipate.

My scores oscillated between 9-12, with a mild increasing trend, and I got a 12 on the real deal, but it's been a long time since I even really thought about my practice MCAT FL's so that's just the general impression of what I remember. I also scored my lowest in every section on the last practice test I took one week before my test day, so maybe I'm just weird. I don't necessarily think the section is unfair, but it's certainly the hardest of the three to prepare for in my opinion.

 

[hushcom]

1. MCAT + GPA: These should be very heavily favored a la Step I.

This is already the case, but pushing even further in that direction will not serve the system. We would only get closer to producing our own brand of gaofen dineng.

2. Eliminate ridiculous cut-offs that some committees have in terms of box checking. A personal anecdote: My SO who is on the committee of a top 5 med school at my undergrad told me that a 3.9+ from Princeton with good research, no red flags, worked through college to support themselves, and who spent 2 years in Colombia streamlining healthcare delivery systems got dinged because of insufficient shadowing. "How do we know he's really interested in medicine, they asked." These kinds of attitudes from members who aren't even physicians (see point 4) are ridiculous and archaic. There should be no cutoffs for clinical experience/shadowing, volunteering, or other requirements. The resume padding that occurs among pre-meds is wildly rampant (I myself am guilty of this) and really isn't productive for anybody or makes a good use of students' time. I've seen posts on SDN that boast getting 100000 hours of hospital volunteering just to one-up somebody else.

Cutoffs affect screening, not the subsequent, more thorough review of applications that survive. Your Princeton boy suffered not because of some cutoff, but because the pool is filled with people who possess similar credentials, and admissions committees need to parse them. Should another Ivy Leaguer with a 3.9+, good research, no red flags, some hardship, some professional experience, and better clinical exposure not be looked at a bit more favorably? The box checking has been fueled not by the institutions but by the applicants, who incrementally one-up each other year after year.

3. Make requirements for letters of recommendation more flexible. In a college environment, interacting with professors (particularly science professors) is fairly difficult without some major outside involvement like performing research with your science professor or having him/her as an adviser for your student organization. When applying this cycle, I felt that the people who really knew best were NOT my science professors who lectured from power-point slides but were physicians who I shadowed, my PIs, and EC/student org advisers. Personally, I think this point needs to be discussed/addressed. I chose to present an abstract (on a topic I was not remotely interested in) with one of my science profs in order to better get to know them for a rec letter. This "playing the game" shouldn't be necessary.

I routinely review LORs from PIs, EC/student organization advisers, physicians shadowed, etc., so I am not sure what the problem is. Yes, it can be challenging to forge relationships with faculty, but that part of "the game" is also an opportunity to display initiative, persistence, and interpersonal skills.

4. Make admissions committees MD only (except for screeners). I personally believe that you should not be permitted to assess students' suitability to pursue a degree which you yourself do not possess. Some of the administrators/PhDs on these committees have no idea what real medicine is like (I'm not claiming I do either) and have no idea how out of touch this process is with the reality of pre-medical preparation. Some of them genuinely believe that people who spend a couple hours a week tutoring or going on 2 week trips to Guatemala (never to be seen again) are somehow more compassionate than those who don't.

Speaking only from my own experience, some of the most experienced and perceptive members of my committee are PhDs, and a couple of the least trustworthy are MDs. Having gone through medical school does not grant one a magical ability to choose future physicians, so the blanket proposal above is just silly.

6. Convert affirmative action utilizing race into an affirmative action system that takes into account socioeconomic status. The latter method would incorporate indigent individuals of ALL races. At several of my interviews/second looks, the vast majority of URM students were super rich and attended private schools. There is absolutely no way that they were more disadvantaged than an Asian or Caucasian growing up in coal country or more likely to serve URM groups in the future. They all admitted to wanting to pursue derm/plastics and open up private practices. Obviously, this is highly controversial and anecdotal but an affirmative action system utilizing socioeconomic status intuitively seems more fair and may better differentiate those who are more likely to practice in underserved areas. Asking individuals who checked the URM box additional questions regarding their ties to certain groups during interviews can also help address this.

This sounds very reasonable until you discover how difficult it is to accurately assess socioeconomic status. Just ask the people in the financial aid office. AMCAS has adopted a SES indicator, but it is based on a formula that examines the educational attainment and professions of the applicant's parents. While better than nothing, I am sure you can see the flaws in this model.

 

[V5RED]

All of them are good except for 1 which is horrible and a huge portion of what's wrong with the process. By making a number such as the mcat THE factor that makes you a doctor you indadvertedly screw over a lot of great future doctors, regardless of "statistical relevance" (if you ask me someone should release the full set of data that correlated the mcat and step 1 because even in a statistical context, data can be interpreted in many diff ways. Let more people see all the data and make their own decisions). Elevated Standardized test scores importance also screws over a lot of people from non-trad backgrounds and diverse circumstances, if anything most of the time they're better off used as a way to indicate one's socioeconomic background (can you pay for 9 bajillion resources and expensive $350/hr private tutoring or upteen thousand prep course? this is considering the fact that many people don't know about sdn)

If anything med school admissions should be like college admissions as colleges take the highest standardized test scores in each section. Applicants should be given the benefit of the doubt, instead of held to superfluous competition-induced admissions standards regarding standardized tests.

The MCAT is the only "put up or shut up" aspect of medical school application. You can game your GPA, you can easily get away with fudging shadowing and volunteer hours(which even if not fudged, can be done by any fully functioning human), you can brown nose enough for good letters, etc. The MCAT forces you to show what you have, and you can't use any smokescreens to pretend you are more competitive than you really are.

The SAT is a joke. The test is super easy, and combining subsections takes away all credibility from a score you claim you earned. All you have to do is focus on one section at a time and you can pretend you got a 2400 when you never really scored above 2000. It is just another thing you can game for admission to college. I love that the MCAT not only cannot be effed with like this, but also that multiple attempts are all shown to schools you apply to. A 36 that was earned in one shot is far, far, superior to someone who mushed together a bunch of 29s and pretended he really has a 36.

Edit: you can't buy an MCAT score. You can get very good second hand materials and teach yourself everything you need to know. No ridiculously expensive tutor or classes will take a lazy or low aptitude student and earn him a 45

 

[Gauss44]

Stake in outcome

I might also suggest comparing the responses here to responses from medical students about this same topic. My reason is that I think there may or may not be more of a perceived "stake" in the outcome of this for some premeds. In other words, there may be a tendency for some to argue for a system that would favor the stats of the person responding.

 

[Gauss44]

Opinion of ADCOMs for other forms of graduate school

I think there is also an opportunity here to learn from similar processes: If one were so ambitious, one could compare the medical school admissions process to the admissions process for other forms of graduate school like business school, law school, etc. This could be accomplished by meeting with ADCOMs from other fields and asking how they screen applicants and why? What sort of an entering class do they want, and how do they screen for that?

I believe that both a strength and weakness of the medical profession is a tendency to be objective/robotic, and an outside perspective may or may not be helpful. (Objectivity suggests non-bias, a good thing in general. Being robotic suggests blindly adhering to an overly simplistic formula, which I think is part of the problem we're trying to address.)

 

[mrh125]

The MCAT is the only "put up or shut up" aspect of medical school application. You can game your GPA, you can easily get away with fudging shadowing and volunteer hours(which even if not fudged, can be done by any fully functioning human), you can brown nose enough for good letters, etc. The MCAT forces you to show what you have, and you can't use any smokescreens to pretend you are more competitive than you really are.

The SAT is a joke. The test is super easy, and combining subsections takes away all credibility from a score you claim you earned. All you have to do is focus on one section at a time and you can pretend you got a 2400 when you never really scored above 2000. It is just another thing you can game for admission to college. I love that the MCAT not only cannot be effed with like this, but also that multiple attempts are all shown to schools you apply to. A 36 that was earned in one shot is far, far, superior to someone who mushed together a bunch of 29s and pretended he really has a 36.

Edit: you can't buy an MCAT score. You can get very good second hand materials and teach yourself everything you need to know. No ridiculously expensive tutor or classes will take a lazy or low aptitude student and earn him a 45

if it only it actually worked that way as a no bs indicator, instead of a flawed indicator of competition, how well you can do on a breadth slot machine examine, and handle the flawed VR. you can buy resources and expensive prep courses that give you a leg up if you dont have access to sdn. it's a great socioeconomic status indicator.

the score replacement on the SAT actually gives people the benefit of the doubt instead of screming them over needlessly and subjecting them to more retakes, so what if it's an easy exam? if it's so damn easy the avg score wouldnt be like 1500. admissions should be about emphasizing a candidate's strength instead of finding ways to screw them over and whittle them out in cheap ways like the mcat does.

Also, if it's such a great indicator where's your 38+ mcat score?

 

[Gauss44]

GPA/MCAT

I might suggest making this requirement more flexible as well. I am all for merit scholarships and I think that process should remain unchanged. However, for admissions purposes, I believe that making every single (LizzyM) point count becomes detrimental past a certain point. (No offense to LizzyM. It's not her fault.)

One of many ways this could be changed:
Maybe a 3.7 GPA plus a certain amount or type of achievement outside of school could = 4.0 AND
Anything between a 3.5 and 3.7 GPA plus more accomplishments outside of school could = (something)

The point here, is to let premeds demonstrate their abilities in a number of ways. The option of essentially "4.0 plus 40 MCAT = success" could be one door left open, but we could open other doors as well so that premeds aren't so "boxed in" in terms how they are allowed to spend their undergraduate years.

 

[V5RED]

if it only it actually worked that way as a no bs indicator, instead of a flawed indicator of competition, how well you can do on a breadth slot machine examine, and handle the flawed VR. you can buy resources and expensive prep courses that give you a leg up if you dont have access to sdn. it's a great socioeconomic status indicator.

the score replacement on the SAT actually gives people the benefit of the doubt instead of ******* them over needlessly and subjecting them to more retakes, so what if it's an easy exam? if it's so damn easy the avg score wouldnt be like 1500. admissions should be about emphasizing a candidate's strength instead of finding ways to **** them over and whittle them out in cheap ways like the mcat does.

Also, if it's such a great indicator where's your 38+ mcat score?

You love that catch phrase. Woo hoo a test is based on a large body of knowledge and you are randomly tested on a small sample of it. That was many of my classes in undergrad. I am sorry you went somewhere where they only taught you exactly what was going to be on every test and nothing more.

You see it as a massively flawed indicator because it is easier to say that the test is unfair than to lay the blame for your scores on your preparation and aptitude. You even push aside blame for your preparation by saying that you can't prepare for the test since you aren't a millionaire. For a few hundred dollars you can get plenty of used prep materials, and compared to the cost of applying, prep for the MCAT is a drop in the bucket.

My score is irrelevant to my point. At the time I took the test, my preparedness and aptitude were probably lower than those who scored 36+, and higher than those who, like yourself, scored below 35.

 

[mrh125]

You love that catch phrase. Woo hoo a test is based on a large body of knowledge and you are randomly tested on a small sample of it. That was many of my classes in undergrad. I am sorry you went somewhere where they only taught you exactly what was going to be on every test and nothing more.

You see it as a massively flawed indicator because it is easier to say that the test is unfair than to lay the blame for your scores on your preparation and aptitude. You even push aside blame for your preparation by saying that you can't prepare for the test since you aren't a millionaire. For a few hundred dollars you can get plenty of used prep materials, and compared to the cost of applying, prep for the MCAT is a drop in the bucket.

My score is irrelevant to my point. At the time I took the test, my preparedness and aptitude were probably lower than those who scored 36+, and higher than those who, like yourself, scored below 35.

nah, actually i dont, nice straw man though. the verbal reasoning scaling is flawed and unforgiving, not to mention it's questionable whether it actually assesses anything. I used every resource and spent 8 hrs+ a day studying, so your generalization about prep is as full of holes as swiss. referring to the costs as a drop in the bucket (are you seriously referring to thousands of dollars in prep as a drop in the bucket?) just shows your socioeconomic disconnect.

I'll tell you what the mcat is great at: giving lazy admissions and students who do well on it an easy copout and lazy way of evaluating others. if you score lower than expected they'll basically tell you a conceited, disconnected version of "get good", instead of recognizing its inadequacies. It's lazy as hell and a total copout to say that, instead of being more holistic. A student can still succeed in hard classes on do less than expected on the mcat. also a 29 is better than 78% of test takers and considered low, that's ridic. the scoring you need is needlessly inflated by competition as well.

The mcat is a test that a certain kind of people succeed on, and it less to do with undergrad pre than you expect. most people aren't taking joke elective science classes at easy schools.

 

[Gauss44]

if it only it actually worked that way as a no bs indicator, instead of a flawed indicator of competition, how well you can do on a breadth slot machine examine, and handle the flawed VR. you can buy resources and expensive prep courses that give you a leg up if you dont have access to sdn. it's a great socioeconomic status indicator.

the score replacement on the SAT actually gives people the benefit of the doubt instead of screming them over needlessly and subjecting them to more retakes, so what if it's an easy exam? if it's so damn easy the avg score wouldnt be like 1500. admissions should be about emphasizing a candidate's strength instead of finding ways to screw them over and whittle them out in cheap ways like the mcat does.

Also, if it's such a great indicator where's your 38+ mcat score?

My response to the whole "BS" concern is that once an applicant is accepted to a medical school, their application should go through a verification process. If there is a problem with truthfulness, the applicant should be notified and given a chance to explain. If the applicant is found unambigously guilty of blatantly lying, he or she should be banned from medical school for life. The scare factor involved here should discourage fraud.

Of course, there will always be ambiguity, and in those cases applicants shouldn't be "banned" or disciplined, but they might not be accepted if they cannot verify and prove that enough of their accomplishments did, in fact, happen. They could be given a chance to generate evidence, and if they do NOT come up with a satisfactory amount, they might need to reapply next year with more concrete accomplishments.

In the meantime, I think it's sad how often premeds quickly assume and pre-judge one another as being dishonest.

 

[lobo.solo]

****-hole = areas of extreme poverty, violence, etc.

My point is the URMs I know don't want to practice there anymore than the ORMs do, bc they realize what bad places they are to work: no resources, etc.

Honestly, anecdotes mean ****. Show me some data or article that support this.

It's always the same **** on SDN. There is many reasons why adcoms want a diverse medical class. This serves a greater purpose...a better service to society. Look it up! is not that hard to find evidence of this. I found this in 5 seconds http://bhpr.hrsa.gov/healthworkforce/reports/diversityreviewevidence.pdf
Read the first 3 pages and conclusion.

You know, I get it!! objectively, [some] URMs get in with lower numbers. This might seem unfair to applicants...
However, depriving society from the positive aspects of having diverse health care professionals is way worse IMO.

 

[V5RED]

nah, actually i dont, nice straw man though. the verbal reasoning scaling is flawed and unforgiving, not to mention it's questionable whether it actually assesses anything. I used every resource and spent 8 hrs+ a day studying, so your generalization about prep is as full of holes as swiss. referring to the costs as a drop in the bucket (are you seriously referring to thousands of dollars in prep as a drop in the bucket?) just shows your socioeconomic disconnect.

I'll tell you what the mcat is great at: giving lazy admissions and students who do well on it an easy copout and lazy way of evaluating others. if you score lower than expected they'll basically tell you a conceited, disconnected version of "get good", instead of recognizing its inadequacies. It's lazy as hell and a total copout to say that, instead of being more holistic. A student can still succeed in hard classes on do less than expected on the mcat. also a 29 is better than 78% of test takers and considered low, that's ridic. the scoring you need is needlessly inflated by competition as well.

The mcat is a test that a certain kind of people succeed on, and it less to do with undergrad pre than you expect. most people aren't taking joke elective science classes at easy schools.

If you had access to all possible materials, spending thousands in the process, it looks like you lack aptitude. This assumes you used a reasonable study plan and were diligent about it.

I spent a hundreds on my prep, not thousands. I made half of it back when I sold my books.

A straw man is when someone puts up a weakened, illogical, version of your argument and knocks it down. Ie a straw man as opposed to a real man. I didn't do that. You, however, tend to use ad hominem when people disagree with you.

 

[Greenberg702]

Honestly, anecdotes mean ****. Show me some data or article that support this.

It's always the same **** on SDN. There is many reasons why adcoms want a diverse medical class. This serves a greater purpose...a better service to society. Look it up! is not that hard to find evidence of this. I found this in 5 seconds http://bhpr.hrsa.gov/healthworkforce/reports/diversityreviewevidence.pdf
Read the first 3 pages and conclusion.

You know, I get it!! objectively, [some] URMs get in with lower numbers. This might seem unfair to applicants...
However, depriving society from the positive aspects of having diverse health care professionals is way worse IMO.

All right. We get it. You're willing to sacrifice stats for racial diversity, we're not and there is no way anybody is going to convince anyone here. This is like debating the abortion issue.

 

[mrh125]

If you had access to all possible materials, spending thousands in the process, it looks like you lack aptitude. This assumes you used a reasonable study plan and were diligent about it.

I spent a hundreds on my prep, not thousands. I made half of it back when I sold my books.

A straw man is when someone puts up a weakened, illogical, version of your argument and knocks it down. Ie a straw man as opposed to a real man. I didn't do that. You, however, tend to use ad hominem when people disagree with you.

cool story bro you can use the word ad hominem. like i said before the mcat is often a way for lazy people to find an easy copout way of quantifying individuals. "you lack aptitude". More like you lack any of way seeing things besides generalizations that the mcat levels the playing field for and shows who really has aptitude it doesnt or that there's a linear relationship between study time and score as you seemed to reference earlier. the mcat cant level the playing field. it's the whole picture that shows who an applicant is and you cant divide mcat test takers into those with aptitude and study time and those who had easy college classes. With the mcat you're just getting a bunch of numbers that may or may not represent anything, especially in the case of VR where a single passage/few mistakes can drop you 4-5 points, that's not an a realistic assessment of anything, it's stupid and flawed. People are a lot more complicated than that and a standardized test hardly demonstrates what you are hoping to prove, especially at the values inflated by competition. LizzyM once said that anyone with a 21 or above is most likely qualified for med school. what you're trying to say about the mcat and its current scoring values as indicators is like trying to set the world economy by the Zimbabwe dollar. it's ridiculously inflated and hardly meaningful.

also, of course the sat would seem easy to you on your high horse. that just furthers your inability to understand any perspective aside from your own. all you see is study time and aptitude and basically "getting good" like you. the whole 30+ mcat scorers thread with those who have 35+s is a testament to individuals like yourself who use the same study techniques as others and tout their solutions as something that anyone can do. in reality, they're disconnected reality. the mcat is often times a barrier to great docs because people are too focused on scores instead of the whole applicant. if standardized tests were so useful and being a doctor and med school student was just about standardized tests (not denying they're important) you could just be replaced by watson or some test taking robot.

Being a poor standardized test taker doesnt show a lack of aptitude or study techniques and good mcat score doesn't show the opposite, especially considering the whole breadth slot machine.

 

[Greenberg702]

nah, actually i dont, nice straw man though. the verbal reasoning scaling is flawed and unforgiving, not to mention it's questionable whether it actually assesses anything. I used every resource and spent 8 hrs+ a day studying, so your generalization about prep is as full of holes as swiss. referring to the costs as a drop in the bucket (are you seriously referring to thousands of dollars in prep as a drop in the bucket?) just shows your socioeconomic disconnect.

I'll tell you what the mcat is great at: giving lazy admissions and students who do well on it an easy copout and lazy way of evaluating others. if you score lower than expected they'll basically tell you a conceited, disconnected version of "get good", instead of recognizing its inadequacies. It's lazy as hell and a total copout to say that, instead of being more holistic. A student can still succeed in hard classes on do less than expected on the mcat. also a 29 is better than 78% of test takers and considered low, that's ridic. the scoring you need is needlessly inflated by competition as well.

The mcat is a test that a certain kind of people succeed on, and it less to do with undergrad pre than you expect. most people aren't taking joke elective science classes at easy schools.

There is a really good thread in the MCAT forum about this titled intelligence and the MCAT. I happen to agree with the poster who said that doing well on the MCAT shows something good about you. However, doing poorly on it does not necessarily mean you're unintelligent. I still believe that anyone can hit 35+ with proper study/academic background.

 

[mrh125]

There is a really good thread in the MCAT forum about this titled intelligence and the MCAT. I happen to agree with the poster who said that doing well on the MCAT shows something good about you. However, doing poorly on it does not necessarily mean you're unintelligent. I still believe that anyone can hit 35+ with proper study/academic background.

I'll agree with half of what you say and i'm glad you recognize that doing poorly may not show much. the part that bugs me about the 35+ part is that there are so many variables (the mcat pulls non-representative questions, the verbal reasoning scale is flawed for starters). i'd say that a prepared person could hit a 25+ and that fits statistical data (mean = 25). there's diminishing returns in improvement trends often times. the breadth slot machine business is troublesome too. anyone can succeed on the "right test". getting it is a whole other matter

 

[Greenberg702]

I'll agree with half of what you say and i'm glad you recognize that doing poorly may not show much. the part that bugs me about the 35+ part is that there are so many variables (the mcat pulls non-representative questions, the verbal reasoning scale is flawed for starters). i'd say that a prepared person could hit a 25+ and that fits statistical data (mean = 25). there's diminishing returns in improvement trends often times. the breadth slot machine business is troublesome too. anyone can succeed on the "right test". getting it is a whole other matter

You have to understand what abolishing the MCAT would mean. The prestige of your undergraduate institution would fill that void. Students with 4.0s at state schools would be screwed because nobody can be sure if their grades are high because of the lack of rigor or because they're actually smart. 3.5s at Ivies would be given the benefit of the doubt. The same sort of system existed before the SAT became widespread. Students at elite private schools were "fed" to Ivies because of their school name and lack of standardized metrics.

 

[lobo.solo]

Not me, schools are... because it makes sense given the added benefits to society... did you even read the article?

All right. We get it. You're willing to sacrifice stats for racial diversity, we're not and there is no way anybody is going to convince anyone here. This is like debating the abortion issue.

 

[Cyberdyne 101]

cool story bro you can use the word ad hominem. like i said before the mcat is often a way for lazy people to find an easy copout way of quantifying individuals. "you lack aptitude". More like you lack any of way seeing things besides generalizations that the mcat levels the playing field for and shows who really has aptitude it doesnt or that there's a linear relationship between study time and score as you seemed to reference earlier. the mcat cant level the playing field. it's the whole picture that shows who an applicant is and you cant divide mcat test takers into those with aptitude and study time and those who had easy college classes. With the mcat you're just getting a bunch of numbers that may or may not represent anything, especially in the case of VR where a single passage/few mistakes can drop you 4-5 points, that's not an a realistic assessment of anything, it's stupid and flawed. People are a lot more complicated than that and a standardized test hardly demonstrates what you are hoping to prove, especially at the values inflated by competition. LizzyM once said that anyone with a 21 or above is most likely qualified for med school. what you're trying to say about the mcat and its current scoring values as indicators is like trying to set the world economy by the Zimbabwe dollar. it's ridiculously inflated and hardly meaningful.

also, of course the sat would seem easy to you on your high horse. that just furthers your inability to understand any perspective aside from your own. all you see is study time and aptitude and basically "getting good" like you. the whole 30+ mcat scorers thread with those who have 35+s is a testament to individuals like yourself who use the same study techniques as others and tout their solutions as something that anyone can do. in reality, they're disconnected reality. the mcat is often times a barrier to great docs because people are too focused on scores instead of the whole applicant. if standardized tests were so useful and being a doctor and med school student was just about standardized tests (not denying they're important) you could just be replaced by watson or some test taking robot.

Being a poor standardized test taker doesnt show a lack of aptitude or study techniques and good mcat score doesn't show the opposite, especially considering the whole breadth slot machine.

A lower MCAT score is not a "nail in the coffin" for someone seeking a medical career. I think you put too much emphasis on it and it only makes things more stressful.
n=1
But I know someone who got a relatively low score, went to DO school and landed a nice residency. And there are ppl at MD schools with less than stellar MCAT scores. I think you're overreaching by labeling it as a barrier to great doctors.

 

[mrh125]

You have to understand what abolishing the MCAT would mean. The prestige of your undergraduate institution would fill that void. Students with 4.0s at state schools would be screwed because nobody can be sure if their grades are high because of the lack of rigor or because they're actually smart. 3.5s at Ivies would be given the benefit of the doubt. The same sort of system existed before the SAT became widespread. Students at elite private schools were "fed" to Ivies because of their school name and lack of standardized metrics.

Noted and you're 100% right about that. What about a fairer mcat? Less weight placed on verbal reasoning and the scoring system changed, and it's tightened so that questions within the question pool are representative of what you're expected to know. I'm mostly fine with the BS and PS because getting a 9 and above on those is reasonable

 

[Cyberdyne 101]

Noted and you're 100% right about that. What about a fairer mcat? Less weight placed on verbal reasoning and the scoring system changed, and it's tightened so that questions within the question pool are representative of what you're expected to know. I'm mostly fine with the BS and PS because getting a 9 and above on those is reasonable

And I agree that the VR section is flawed, but you definitely need a comprehensive standardized test for admissions.

 

[mrh125]

A lower MCAT score is not a "nail in the coffin" for someone seeking a medical career. I think you put too much emphasis on it and it only makes things more stressful.
n=1
But I know someone who got a relatively low score, went to DO school and landed a nice residency. And there are ppl at MD schools with less than stellar MCAT scores. I think you're overreaching by labeling it as a barrier to great doctors.

Great post. it is stressful though, imagine getting a 29 which is better than 79% of test takers and being told "that's not good enough", which often times happens on sdn and to be fair it is treated like a nail in the coffin and people under 30 are accused of going to "easy undergrad schools". It just bothers me that you can do everything you can and being cheap-shotted by something such as verbal reasoning and cause that to mess up your application or do reasonably well (a 29 isnt a bad score) and be told "that's not good enough, you lack aptitude, try harder." I want a fairer mcat and an admissions process where more weight is placed on the bigger picture. i'd like an admissions process where a strong unique PS or recommendation letter and high gpa is enough to get an interview to prove yourself. an admissions where a high 20s mcat cant sink you, nor can a super high mcat paint the picture that you're somehow better than most regardless of the rest of your app. Admissions should be subjective because we're all human and have our own strengths and weaknesses. I also wish standardized tests could show individual thought process, but that's asking for too much. somebody who is great at critically thinking and thinking differently could still do less than average but not be a worse doctor or med student.

Also on mcat retakes you can dip in one section such as VR but improve in the rest, yet because your overall score may be lower the improvement trend in more objective sections may not be noticed or considered by adcoms. that bugs me.

 

[mrh125]

And I agree that the VR section is flawed, but you definitely need a comprehensive standardized test for admissions.

for sure I agree 100%, but whether it should be like the mcat with it's VR is what I debate. I like the SAT in all honesty. I dont consider it a stupid or easy test. the passages weren't hard in critical reading and you could definitely pick it up as a skill through a lot of practice in the worst case scenario, the math was representative of what you were expected to know for the most part and could be practiced to do well in, and the grammar was annoying, but still totally do-able through pattern recognition and studying. Realistic if you study hard and have the right ability to think via aptitude, pattern recognition, hard work, or learning by association you should be able to do well. that's what I want a standardized test to be like.

 

[Cyberdyne 101]

Don't look at it as a cheap shot. Just keep calm and carry on. I understand that a sub-30 MCAT (especially from Cali) is stressful but you are not yet aware of its impact on this cycle. Here are 3 possible scenarios:
1. You get accepted into an MD program.
2. You go to DO school (if you applied DO) and are not accepted MD.
3. You regroup and put together a stronger app for a subsequent cycle.
(At least this is what I've seen from ppl with sub-30 MCAT scores).

You'll be fine regardless.

 

[mcloaf]

the breadth slot machine business is troublesome too

Just because you keep saying this doesn't make it true.

 

[mrh125]

Just because you keep saying this doesn't make it true.

according to you. how exactly is studying all the available resources and getting blindsided not to troublesome?

 

[mcloaf]

according to you. same would go for you and the opposite statement.

Your claim is that anyone can get a great MCAT score if they get lucky and get the right test, and also that the breadth of material is such that it cannot all be mastered by one person. I believe you're partially right on the first claim, someone with a subpar command of the material could get lucky on test day and have a falsely inflated score (though I wouldn't expect this variation to be more than a few points). How do you account for people with consistently high practice scores as well as a high score on the real thing? The simplest and most likely answer it seems to me is that they have a thorough understanding of all the material on the exam.

 

[Spinach Dip]

The MCAT is more important IMO because a) it is the only standardized thing all premeds must do and b) if you bomb it you can always take it again.

However, if you bomb the final in one of your sciences because of ___(your reason here)___, that D+ will tank your cGPA and your sGPA and there is no way to get that grade removed.

 

[basketcase0a0]

Your claim is that anyone can get a great MCAT score if they get lucky and get the right test, and also that the breadth of material is such that it cannot all be mastered by one person. I believe you're partially right on the first claim, someone with a subpar command of the material could get lucky on test day and have a falsely inflated score (though I wouldn't expect this variation to be more than a few points). How do you account for people with consistently high practice scores as well as a high score on the real thing? The simplest and most likely answer it seems to me is that they have a thorough understanding of all the material on the exam.

^This

The MCAT is not a perfect test. There's no such thing as a perfect test. But it isn't a slot machine and it isn't totally random. Some people are good at learning the test and figuring out what to look for in each passage, at learning the test rather than just rote memorization of raw material. Might someone get lucky and get a passage or two on topics they're familiar with and have that inflate their score a point or two? Absolutely. But I would be willing to bet that very few people score very low or very high on any section due to such randomness. And that is because the MCAT is a good general indicator of critical thinking abilities and academic aptitude. Why else would anyone bother with it at all?

Sidenote: I would also say that the breadth of the MCAT isn't actually that huge (with the new one I have no idea, but ignore that). Having just watched and helped my girlfriend prepare for and take the LSAT, that test is WAY more random than the MCAT is, and looking at her practice tests gave me an appreciation for how comparatively easy the MCAT is to study for.