So I don't believe my community is underserved...

[moemoekyun]

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So I'm just about to submit AMCAS (procrastination hard), and I saw that on the print pdf view of my AMCAS, my county has a (U). I later learned it means my county is underserved, but I never saw it like that. I "know" serveral docs, and the hospital system I'm involved with (shadowing/volunteer) seems to be doing well. The ER I volunteer at now is dead (not busy), and I even got a healthcare scholarship after hs.
So my question is, what makes a place "underserved", even with hospitals and doctors in the area. Granted, my city has a drug problem (a meth house near my hs was busted a week ago or so), and my family's income is less than $25000 (didn't go to doc outside of shots), but it felt like the services were there. On the other hand, I don't know everything.
Next, should I put down I feel my area is underserved? I've asked about disadvantage status here before, and the discussion prompted me to say I'm not disadvantaged, so how would I put down the underserved thing. This is literally the last thing I need to put down before I can hit that submit button. Thank you.

 

[deleted407021]

You probably aren't getting the whole picture. There could very well be some spacial inequality in neighborhoods other than your own or even right around your home, but you haven't the background to be able to see it. That rating has to do with several variables such as PCP concentration, income levels across the area, percent of population over 65, etc. So it would be easy to perhaps not really see why your area earned the label.

I'm guessing these are the criteria being used.


As to your app...I don't know. I apply next year.

 

[nwts]

I think it's all based on what you think. Since the AMCAS labeled it as underserved, it clearly wouldn't be completely ridiculous for you to think it is. However, it seems like you're saying that you don't think it is. If you don't think it is, you probably shouldn't check the box. If you check the box, you need to be prepared to be asked about it in interviews. From what you described, you might have trouble speaking about your county's issue of being medically underserved because you don't really see it as being underserved. If you think more and realize that you actually do understand why your county has been designated as underserved, go ahead and check the box if you'd like. If you still don't really know why it's considered underserved, you may be setting yourself up to answer a question poorly in an interview.

 

[moemoekyun]

I think it's all based on what you think. Since the AMCAS labeled it as underserved, it clearly wouldn't be completely ridiculous for you to think it is. However, it seems like you're saying that you don't think it is. If you don't think it is, you probably shouldn't check the box. If you check the box, you need to be prepared to be asked about it in interviews. From what you described, you might have trouble speaking about your county's issue of being medically underserved because you don't really see it as being underserved. If you think more and realize that you actually do understand why your county has been designated as underserved, go ahead and check the box if you'd like. If you still don't really know why it's considered underserved, you may be setting yourself up to answer a question poorly in an interview.

I was planning to say I don't think it's underserved, and hoped that this is a tiny thing that does nothing, but I was thinking what about what you said. I should be aware of this thing to discuss it. Anyways, I'm shadowing tomorrow, so hopefully I can ask the doc what he thinks.

 

[moemoekyun]

AMCAS is well known to have a broad definition of "underserved." Even large cities with prominent hospitals and medical schools are often labeled. If you don't feel your area was underserved, identifying it as such does no good.

I see. I was thinking of leaving it as not underserved. Now I have something to talk with my healthcare people about tomorrow.

 

[moemoekyun]

As I understand it, the issue is partly due to AMCAS looking at counties as wholes rather than being specific. E.g. my city is not underserved; however, outside the city (which has a decent size medical system, relatively speaking) is mostly rural. AMCAS designated the county underserved. In short, it's not wrong, but it's not exactly right either. Just lacking specificity.

Oh, that's a good point. The hospital system is sorta centralized in the middle half of my county, and the north quarter is like 100% minorities (nice old buildings, just no hospital) and the south is redneck/farming (again, no hospitals). I know they don't have many schools in either area, and probably no PCPs. Ok, I have a better idea now. Thanks!

 

[nwts]

I was planning to say I don't think it's underserved, and hoped that this is a tiny thing that does nothing, but I was thinking what about what you said. I should be aware of this thing to discuss it. Anyways, I'm shadowing tomorrow, so hopefully I can ask the doc what he thinks.

If you just don't mark it as underserved, but make no mention anywhere on your application of your disagreement with the AMCAS's designation, you are unlikely to be asked about it in an interview. They aren't likely to ask you about a designation that the AMCAS made automatically and you made no mention of. I think the reason they ask in interviews is because if you designated your area as underserved, they'd like to know why you think so. They probably aren't as concerned with your opinion on why someone else considered it underserved. I think you really only need to be prepared to answer if you check the box, but it sounds like you're leaning toward not doing so.

 

[PreciousHamburgers]

My county also was designated under-served on AMCAS. While I always had health insurance, a pediatrician, and got regular check-ups, there is something to be said about growing up in a community with many people who do not have access to all of that.

 

[panda16]

I really had trouble with that question on AMCAS, and a phone call with them really didn't resolve anything. The county I live in is designated as (U), underserved, on AMCAS, like OP's.

My county is very, very large and incorporates a lot of different types of communities. For my childhood, I lived in an area that was very squarely middle class and was five minutes away from a decently sized hospital and a medical center with pediatrics, specialists, etc. So the immediate area I lived in was not underserved by any means.

However, and this is where the AMCAS was really dumb about this, I have since found out as I've gotten older that there are definitely people without access to care, especially after working four years at a free clinic for the uninsured in my hometown's urban areas. However, I never once experienced that healthcare discrepancy personally as a patient, yet it still existed and made a HUGE impact on my decision to become a physician as a student. I explained this to an AMCAS rep who just repeated the same thing on the AMCAS guide: "did you think that there was a shortage of doctors in the county you lived in," to which I said "yes, but I never experienced it personally and none of the members of my extended family did either," to which I could hear the shrugging of shoulders over the phone.

Going further, now I live in a rather rural area on the outskirts of the county, and I'm not too far from people who could be said to have lack of access to healthcare due to geographic location, just adding another layer to this question. The point is, I know that AMCAS imports HHS data about underserved communities and such, but the fact is that counties are seldom homogenous and I feel that the AMCAS question should reflect that, changing it to "do you feel that the area where you lived as a child was underserved?"

Also I don't really get the point of them asking the question in the first place if they've already designated which counties are underserved (U).

 

[nwts]

@panda16 I'm just grasping at straws here, but I wonder if the AMCAS designates in order to help adcoms decipher whether people are being truthful or not. Like maybe if an adcom is reading someone's statement and thinking: "Is that area actually disadvantaged? This seems kind of suspect," they'll use whether or not the AMCAS designated it as underserved to help them figure it out.

 

[panda16]

@panda16 I'm just grasping at straws here, but I wonder if the AMCAS designates in order to help adcoms decipher whether people are being truthful or not. Like maybe if an adcom is reading someone's statement and thinking: "Is that area actually disadvantaged? This seems kind of suspect," they'll use whether or not the AMCAS designated it as underserved to help them figure it out.

This is the best explanation to it that I've seen/along the lines of what I was thinking.

 

[Gandyy]

It makes it easy for us Midwesterners.

Everything is Underserved here.

 

[nwts]

It makes it easy for us Midwesterners.

Everything is Underserved here.

Oh my goodness, you're right! I had never bothered to look at it before, but the AMCAS actually did list both the county I live in and the county I was born in as medically underserved. I certainly didn't mark my county as underserved on the application because both the county I live in and the county I was born in are part of a large metropolitan area with tons of access to medical care. The county I live in has a decent-sized city with a bunch of smaller towns, so the smaller towns probably have to drive a little ways to get to the city I live in. Still, I am extremely surprised that both counties were marked as underserved. That's the Midwest for you, I guess.

 

[LizzyM]

NYC (as a county) is designated as underserved despite having 4 medical schools in Manhattan.

I have never heard a peep from any adcom about (U) and (R) designations. I'm not sure some of the members even knew why those letters were there or what they meant.

 

[Gandyy]

Oh my goodness, you're right! I had never bothered to look at it before, but the AMCAS actually did list both the county I live in and the county I was born in as medically underserved. I certainly didn't mark my county as underserved on the application because both the county I live in and the county I was born in are part of a large metropolitan area with tons of access to medical care. The county I live in has a decent-sized city with a bunch of smaller towns, so the smaller towns probably have to drive a little ways to get to the city I live in. Still, I am extremely surprised that both counties were marked as underserved. That's the Midwest for you, I guess.

Yea. The thing is if you came to my hometown, you wouldnt need a chart to tell you that. You would INSTANTLY know that its underserved.

The midwest is extremely underserved and most of the areas are Rural marked with a R in AMCAS.

Midwest public education is also worse than subpar. My high school was and still is 3 boxes+ 1 rectangle they call a gym that they spent more money on than the 3 boxes that matter.

 

[nwts]

Yea. The thing is if you came to my hometown, you wouldnt need a chart to tell you that. You would INSTANTLY know that its underserved.

The midwest is extremely underserved and most of the areas are Rural marked with a R in AMCAS.

Midwest public education is also worse than subpar. My high school was and still is 3 boxes+ 1 rectangle they call a gym that they spent more money on than the 3 boxes that matter.

I certainly didn't mean to imply that the Midwest in general isn't actually underserved. The vast majority of my state is underserved as most people have to drive at least 30 minutes to see any doctor at all, let alone go to a hospital. I just think it's very odd that my county and the county I was born in are both marked as underserved. The city I live in is one of the largest cities in the state, and it has multiple hospitals with lots of specialists. The city I was born in comprises the vast majority of the county I was born in, and it has a double digit number of full-size hospitals in it. I'm sure there is a good reason why both of these counties are marked as underserved, but I can't imagine trying to explain to an adcom why I feel that I come from an underserved area when I have easy access to over a dozen hospitals. Especially when my state probably has many counties that have one or zero hospitals in them.

 

[Gandyy]

I certainly didn't mean to imply that the Midwest in general isn't actually underserved. The vast majority of my state is underserved as most people have to drive at least 30 minutes to see any doctor at all, let alone go to a hospital. I just think it's very odd that my county and the county I was born in are both marked as underserved. The city I live in is one of the largest cities in the state, and it has multiple hospitals with lots of specialists. The city I was born in comprises the vast majority of the county I was born in, and it has a double digit number of full-size hospitals in it. I'm sure there is a good reason why both of these counties are marked as underserved, but I can't imagine trying to explain to an adcom why I feel that I come from an underserved area when I have easy access to over a dozen hospitals. Especially when my state probably has many counties that have one or zero hospitals in them.

Hmm oh I was just adding more to your statement.. Not disagreeing with you. I dont know why a city like that would be marked as Underserved.

But there are places in the Midwest (like my town) that are clearly lacking in almost component of a city and healthcare is no exception.

 

[moemoekyun]

I decided to leave the box blank and send. I told the doctors in the office I shadowed in this morning about that and were surprised to hear that fact. Actually had a small discussion over lunch before a CMA told us about her vacation to gayfest and that took over the conversation. The one I directly shadow used to be an adcom and told me he never considered that at all, saying the personal statements, good (story) and bad (General Hospital a major influence) was what he remembers looking over clearly. I think I'm just making a mountain out of an anthill here, as I've never seen/heard about this anywhere on SDN or my experiences.

 

[Lannister]

Oh wow I just realized that my county is classified as underserved as well! I'm from Cook county (Chicago) but I live on the super wealthy North Shore haha. So I'm guessing the U doesn't mean much.

 

[NorthOfBroad]

EDIT: Accidental double post.

 

[carpediem22]

The U definitely does not mean much. My home county in the Northeast is listed as underserved, when it is one of the richest counties in the entire country (note: I am not one of those rich families, sadly ahah). Very bizarre.