"the whole process is a crapshoot"

[Quix]

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To paraphrase Einstein, "Adcoms do not play dice."

That being said, there *are* strong parallels with statistical mechanics, in that given a few known variables, you can make some probabilistic predictions and explain trends.

That being said, I freely admit that I don't fully get the admissions process. In my case, my biggest liability was (and is) my QPA: 3.29 post-bacc (ignoring graduate QPA of 3.85). My MCAT is above par (32T - 11 PS, 11 VR, 10 BS). I have several years of clinical experience from policy-level decisions to patient personal care. I have had patients die beneath my hands as part of the code team and as a result of the recommendations I gave as part of an ethics consult team. I'm the PI for two studies in critical care medicine. I've trained doctors by delivering psychiatric Grand Rounds. I've written sections of a textbook on critical care nephrology on gene polymorphisms, metabolic disorders, and renal dysfunction, as well as sections of a reference book in critical care on acidoses and alkaloses. I've given presentations on a broad spectrum of issues, including pain management, informed consent, ethics and technology, and transplants for recidivist drug abusers. Etc., etc.

I didn't apply to the top 25; I applied to all six MD programs in PA (I'm in state) and Pritzker. I got one interview, and was waitlisted. I know my faculty interviewer gave me a strong recommendation (he told me so as we see each other every week), and I'm generally not this boastful (I tend to be more self-depricating), so I don't think I came across as an arrogant bastard.

But I wasn't what any of them were looking for during that cycle; I don't think that this necessarily translates into a crapshoot, but it sure supports a lot of uncertainty and indeterminism.

 

[Khanal007]

1. Only interview a small % more than you are willing to accept. I think that if you have to spend all that money on travel and lodgings, and take all that time off from school or work, you should have something like a 80% chance of acceptance. Lets face it...the interview plays a very small part in the decision making. One interview I flew all the way across country for was conducted by another med student! At another school that I was interviewed at, the professor told me I was the best person he had interviewed all year and that he would make a personal pull for me...waitlisted and later rejected. The interview helps them weed out a few of the really offensive, creepy people that really would be misfits, but otherwise, everyone is on their best behavior.

2. No more rolling admissions. I think there should be one date by which all of your stuff is due. People should not get an advantage for getting their stuff in a few weeks earlier. Some people have to work or travel over the summer and they can't turn over 25 secondaries in 48 hours. Other people have professors who take extra time on letters of rec. All applicants should be compared against one another at the same time, and all decisions should be made by a single date.

3. Do away with secondary essays. I understand they need to collect secondary fees to pay for their new research facilities...but come on! I already told you everything you need to know in my PS...those dumb essays are just redundant. Don't they realize that people just recycle them from multiple schools whenever they can?

just my opinion

I agree wholeheartedly, well said. I had a professor take 4 months (asked him late may, submitted letter in late september...he had a family emergency in vietnam and had to fly back for the whole summer). Things like that are unavoidable for the applicant. Secondary essays are a total bitch, I have NO idea how people who do 10+ secondaries kept up their motivation. I think I had 3 or 4 actual secondaries to do and wanted to kill myself after.

 

[rales]

"it is not random if you know what the ADCOMs want to "round out" their class."

I disagree. Even if you knew the exact stated goals of the ADCOMs, there would still be some unpredictability to each decision. For example, much as we would like to believe that a 34 is better than a 33 and not as good as a 35, there really isn't all that much difference here. A few questions either way can shift the scores by that much. Similar for GPA - a 3.5 is just about the same as a 3.6 or even a 3.7 (or a 3.4). The other differences between applicants can often wash out numerical differences.

Worse, the percieved strength of your application at a particular ADCOM depends not only on who has read your application, but when and in what context. What applications did they read just before yours? Is yours near the top or the bottom of the stack of applications they have to read that day? What else is going on in their lives at the moment? All of this feeds into the decision process. That said, most ADCOM members are well aware of this and try hard to mitigate it but humans are humans. Your application could be accepted one week and rejected the next, by the same ADCOM member for completely intangible reasons - and it will always be this way because the complete applicant can't easily be classified/ranked in a meaningful, algorithmic way.

That said, there are statistical trends - good GPAs tend to do better than bad ones, etc., but this does not mean that individual decisions are predictable. Nor does it mean that the ADCOMS are being discriminatory/inconsistent/incorrect. Let's face it - we're all bright, we're all qualified, we're all are capable of being doctors, and there are too many of us for the available slots. The decisions will often come down to small, subjective differences. Some of us will be admitted where we expect, for the reasons we expect. Some will be surprised by an admission, and some will be surprised by a rejection.

-r

 

[postbacker]

"it is not random if you know what the ADCOMs want to "round out" their class."

I disagree. Even if you knew the exact stated goals of the ADCOMs, there would still be some unpredictability to each decision. For example, much as we would like to believe that a 34 is better than a 33 and not as good as a 35, there really isn't all that much difference here. A few questions either way can shift the scores by that much. Similar for GPA - a 3.5 is just about the same as a 3.6 or even a 3.7 (or a 3.4). The other differences between applicants can often wash out numerical differences.

Worse, the percieved strength of your application at a particular ADCOM depends not only on who has read your application, but when and in what context. What applications did they read just before yours? Is yours near the top or the bottom of the stack of applications they have to read that day? What else is going on in their lives at the moment? All of this feeds into the decision process. That said, most ADCOM members are well aware of this and try hard to mitigate it but humans are humans. Your application could be accepted one week and rejected the next, by the same ADCOM member for completely intangible reasons - and it will always be this way because the complete applicant can't easily be classified/ranked in a meaningful, algorithmic way.

That said, there are statistical trends - good GPAs tend to do better than bad ones, etc., but this does not mean that individual decisions are predictable. Nor does it mean that the ADCOMS are being discriminatory/inconsistent/incorrect. Let's face it - we're all bright, we're all qualified, we all are capable of being doctors, and there are too many of us for the available slots. The decisions will often come down to small, subjective differences. Some of us will be admitted where we expect, for the reasons we expect. Some will be surprised by an admission, and some will be surprised by a rejection.

-r

I don't believe your bolded statement for a minute...even though the applicant pool for med school is highly self-selective and therefore fairly small, most of the unsuccessful applicants are shut out for good reasons that have little to do with subjective adcom judgments, the main reason being that they have not demonstrated sufficient ability to handle the rigorous science course load per their undergraduate track record...and while lots of these people do reapply and some of them make it on a second or third try, most of them never make it...

Med school admissions are highly competitive, but they are not as many contend a "crap shoot" of random outcomes due to "small, subjective differences."

 

[CCLCMer]

This whole process is crap. Trust me.

Ha ha, yeah, this process puts the "crap" into "crapshoot."

 

[rales]

I don't believe your bolded statement for a minute...even though the applicant pool for med school is highly self-selective and therefore fairly small, most of the unsuccessful applicants are shut out for good reasons that have little to do with subjective adcom judgments, the main reason being that they have not demonstrated sufficient ability to handle the rigorous science course load per their undergraduate track record...and while lots of these people do reapply and some of them make it on a second or third try, most of them never make it...

Ok, fair enough. A bit of hyperbole there. In any case, the majority of applicants that get through the initial screens and are invited for interviews are invited because the ADCOM thinks that they could be successful at that school. On paper, they're qualified. Even so, the majority of those interviewed will not be granted admission. Some rejections are relatively clear cut, but many/a majority of them are not. Most people interview pretty well, most are articulate, most have good reasons for attending medical school, most have good grades and good MCATs and good ECs - the choice between them often comes down to very subjective/intangible and probably irreproducible things. Two different ADCOMS with the same set of criteria and the same applicants are quite likely to arrive at very different admitted classes. There will be some overlap but I would not be the least surprised if the majority of the students differed between the two committees. As I said, there are more qualified applicants than available slots.

You're right - the process is not completely random. Considered as a population, there are strong predictors of admission somewhere but for a particular applicant at a particular school at a particular time of year it's often quite difficult to determine why that student was admitted, waitlisted or rejected - and there may not be any rigorous reason other than the fact that the committee had to make a decision and at that time they felt a particular way.

For the record, I've never been involved in an ADCOM, but I have spent many years on undergraduate, graduate and faculty selection committees...


-r

 

[ilovescrubs]

I completely agree with you rales, very well said. It is a nice change to read a post with both insight and encouragement. I actually read this and felt better about my chances (doesnt happen altogether too often on here!) So thanks for the insightful post and bringing your committee experience to those of us "waiting." 👍

 

[postbacker]

Ok, fair enough. A bit of hyperbole there. In any case, the majority of applicants that get through the initial screens and are invited for interviews are invited because the ADCOM thinks that they could be successful at that school. On paper, they're qualified. Even so, the majority of those interviewed will not be granted admission. Some rejections are relatively clear cut, but many/a majority of them are not. Most people interview pretty well, most are articulate, most have good reasons for attending medical school, most have good grades and good MCATs and good ECs - the choice between them often comes down to very subjective/intangible and probably irreproducible things. Two different ADCOMS with the same set of criteria and the same applicants are quite likely to arrive at very different admitted classes. There will be some overlap but I would not be the least surprised if the majority of the students differed between the two committees. As I said, there are more qualified applicants than available slots.

You're right - the process is not completely random. Considered as a population, there are strong predictors of admission somewhere but for a particular applicant at a particular school at a particular time of year it's often quite difficult to determine why that student was admitted, waitlisted or rejected - and there may not be any rigorous reason other than the fact that the committee had to make a decision and at that time they felt a particular way.

For the record, I've never been involved in an ADCOM, but I have spent many years on undergraduate, graduate and faculty selection committees...


-r

Again, I disagree strongly with the bolded portion of your statement...I think that the interview skills for many med school applicants, particularly the youngest trads, are marginal at best.

Schools interview far more applicants than slots because they also have to allow for the competitiveness factor - they have to manage their "yield" of acceptances to the number of offers of admission they must make to fill the available spots in the class, allowing for attrition for the admitted pool - thus they "over interview" and "over admit" every year, based on their yield experiences from previous years as people turn down offers.

Based on adcom comments on SDN, I believe the following: The interview is about assessing applicant fit and finding an overall comfort level with the applicant's personality - i.e, an adcom is answering the question "would I want to spend any amount of time with this person outside of this interview - is this person interesting - would this person be a positive addition to the class, etc?" - and the interview stage culls lots of people out on that basis alone.

But for applicants who "pass" the interview, the whole file is still in play - in other words, once you make it to the interview stage, it is not as if your MCAT and GPA and PS, etc., aren't still just as important - the playing field has not been levelled - you are still going to be judged on the whole of your application.

So you can get to the interview stage, think it went great, and still not get offered admission because other applicants who also "passed" the interview had better stats and a better application to begin with - not so much the tiny intangibles you seem to think are at play...