What makes the difference?

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Spot on as usual, Grapo.


GrapesofRath said:
I think the much bigger point to make here is that half the applicants don't have stats that aren't within the MD ball park but many of them just aren't as knowledgeable of the process as they ideally should be. It's not uncommon at all to see people on the WAMC thread applying with decent stats and limited/no volunteering experience or clinical exposure. These instantly can destroy the best applications; imagine what they can do to your generic 3.6/30 applicant. And keep in mind these people at least post on SDN and have some perspective about getting feedback on their chances; there are many who listen to their clueless pre-med advisors a couple friends with anecdotes and go ahead and start applying. Hell there are people who actually go about applying to medical school without investing in MSAR; that's the height of stupidity right there.

And the much bigger issue you'll see is people come up with poor lists of schools. Many borderline applicants don't apply to enough schools. And far more don't apply to well chosen lists of schools. Even on SDN you see ALL TIME time your 3.65/31 applicant with a list of 15 schools and only half of them being realisitc. There are roughly 25 lower tier MD schools that a borderline applicant can apply to and be competitive for in theory regardless of state. Many of these borderlne applicants are applying to less than 10 of them. So to me that's where when you hear someone like Goro say "Deans of Admissions I've talked to have said half the people applying have no idea what they are doing" really refer to. This to me is one of the biggest reasons why many people don't get into medical school. It's not that half the applicant pool has a 27 and under on the MCAT. The table I always refer to when I talk about the general lack of awareness of a number of people who apply is the one below.

https://www.aamc.org/download/321442/data/factstable1.pdf

Name a state school that takes at least 80% IS. I can almost gurantee the majority of applicants applying there will be OOS. This is just basic ignorance and not doing appropriate research on schools and medical school admission; nothing more. Take it even a step further. Look at schools like Arkansas: 6/7 applications are from OOS for a school that takes 85% of its class IS(and interviews a similar proportion). This is not uncommon at all. Hell, even schools like FSU takes 98% of its class IS and yet over half their apps are OOS. UC Davis probably laughs all the way to the bank at the 1500+ applications they get OOS a year when not a single one of them will matriculate. There alot of applicants who simply just throw money down the toilet with unrealistic schools and don't have as many realistic schools on their list as they should.

So no I don't think the majority of applicants have major flaws with their stats. Its just that there are so many borderline applicants who just don't have good knowledge on what is best for their application, be it ignoring the idea of getting clinical exposure or volunteering experience to not applying to realistic schools or enough schools(the average applicant applies to around 14 schools and if we assume maybe 5 or so of those schools are unrealistic that leaves 9 realistic schools when in reality there are around 25 lower tier OOS schools that borderline applicants regardless of state can in many cases have a shot at being competitive at). That to me is a major reason why the statistics for borderline applicants not getting in isn't higher. It's hard to quantify how much better the success rate would be if applicants were more aware and knowledgeable about the process, but I certainly think it would help significantly.
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ThucydidesLazar said:
You weren't there. And he was insulting me. You realize Lucian and Lincoln were both self-taught lawyers, right? I don't suppose I have tripped some of the old conditioning from a former profession, have I? You don't know me and you are not qualified to say what I do or do not know.
Incidentally, if professional knowledge were all that were required to win cases, why, when I look on my state records, do I see such large amounts being donated by the big law firms to the campaigns of judges?
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b/c this is Murica
C.R.E.A.M.
 
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Temporary Superman said:
They do test for that actually, it's called an interview. It isn't foolproof, but it does keep out at least some of the people who have the stats, but shouldn't be practicing medicine.
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A lot? Okay, I can grant that. But, do they have anything that tests who is most vulnerable to compassion burnout, etc?
It seems to me that a lot more--psychological testing, if you will--needs to be done. I very much appreciate the person who says that they are doing this out of an emotional altruism, and effusively want to help people. If this industry were a little more logical, that might work fine. But what happens to all of that idealism when a person is continually deprived of sleep for years of their life? As--Guderian? or was it Manstein?--said, your empathy tends to wear out a bit during prolonged periods of crisis. So, that sort of empathy is great, don't get me wrong, but if I were selecting, I would look for more. As an example, I actually think that what some admissions people refer to as "the Victim" applicant is a good choice, because of the theory of empathy based upon previous experience.
I don't know, it just seems to me like the interview process could be doing more.
 
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"You have some warped view of what it means to be a doctor, a lawyer etc"
Oh? But I suppose I understand you fairly well. Law2Doc, your viewpoint of the world is quite feudal. Compounds have a physiological effect independent of a knowledge of what this is or the mechanism. As such, the Romans knew lead pipes were bad, even though they didn't understand why or the mechanism. You'll recall from your medical history that much of medicine originally arose in antiquity from observing what effect things like diet seemed to have on people. They didn't understand why this happened, but they were able to develop rather complex systems, particularly the Indians of the subcontinent. One performs the function of a healer by healing. There is nothing else that is, in real life, actually required. The difference is when people like you start adopting a superior attitude and putting everyone else down. If a person, in an unregulated system of infinite access and unlimited resources, followed the same treatment outline in, for example, a Merck manual, he would have the same exact effects upon a patient as one who was a doctor and did the same exact thing. It is a matter of laborer specialization. The reason one goes to a surgeon is because they have more finely developed psychomotor skills and one assumes (sometimes incorrectly) that there will be no malpractice. The value of a specialized diagnostician is an assumed speed and faculty in recognizing the significance of an affliction. If it is rare, and they run a clinic on the model of factory medicine, that assumed use largely disappears and then private investigation takes over as a possibly better route. The value of the doctor also consists in the fact that he has barred anyone else from being able to dispense medicine. That, in theory, cuts down on negative reactions, but when you consider the fact that various foods (Earl Gray Tea, grapefruit, etc) have medicinal effects, that logic fails a bit. Not to mention that everyone is allowed to drink alcohol (I don't), which can be potentially very dangerous. And everyone rides around in these vehicles that are multiple tons and capable of going easily 60 mph, thus generating a lot of momentum. If everyone really is as stupid as some narratives presume, why don't they create a mandatory profession of drivers? There are certainly enough people who die from car accidents.
 
I am reminded of Sir William Osler, one of the four founders of Johns Hopkins Hospital. "To see patients without reading books is like going to sea without a chart; to read books without seeing patients is to never go to sea at all."

What do adcoms want? We don't want everyone to have the same activities although we want to see some evidence that you've been around sick/injured people and have tested your interest in making the care of such people your career. We like to see that you have a concern for those in need and are willing to freely spend time in service to those in need. We are looking for people who are curious and who have an interest in the natural world and so have pursued some activities that further our collective knowledge of the world. We want people who enjoy working as members of a team and who are comfortable as leaders and as followers. We look for people who would be interesting to talk with because they have had some life experience -- they've been an athlete, a musician, or a game show contestant, worked as a carpenter for a summer, or lived in an monastery for a year. There are thousands of variations if you think about doing what interests you rather than approaching things as a checklist.
 
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after me and a friend explained the 'Murican admissions process to a foreign MD, she said "wow, it's like they expect applicants to be experienced physicians already"
 
Oh_Gee said:
after me and a friend explained the 'Murican admissions process to a foreign MD, she said "wow, it's like they expect applicants to be experienced physicians already"
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Being an experienced physician and having personality traits/integrity aren't mutually exclusive. I'd argue that people should have an idea of what they are getting into.
 
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FutureHopeful? said:
Being an experienced physician and having personality traits/integrity aren't mutually exclusive. I'd argue that people should have an idea of what they are getting into.
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i think she was just surprised because in her country, (Sweden i think) they just take a test during high school to get in and that's it
 
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LizzyM said:
We look for people who would be interesting to talk with because they have had some life experience -- they've been an athlete, a musician, or a game show contestant, worked as a carpenter for a summer, or lived in an monastery for a year.
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Hey! Maybe trying to make some money and have some fun as a carpenters assistant last summer wasn't a waste of time after all...
 
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LizzyM said:
I am reminded of Sir William Osler, one of the four founders of Johns Hopkins Hospital. "To see patients without reading books is like going to sea without a chart; to read books without seeing patients is to never go to sea at all."

What do adcoms want? We don't want everyone to have the same activities although we want to see some evidence that you've been around sick/injured people and have tested your interest in making the care of such people your career. We like to see that you have a concern for those in need and are willing to freely spend time in service to those in need. We are looking for people who are curious and who have an interest in the natural world and so have pursued some activities that further our collective knowledge of the world. We want people who enjoy working as members of a team and who are comfortable as leaders and as followers. We look for people who would be interesting to talk with because they have had some life experience -- they've been an athlete, a musician, or a game show contestant, worked as a carpenter for a summer, or lived in an monastery for a year. There are thousands of variations if you think about doing what interests you rather than approaching things as a checklist.
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Hmm. Very interesting. I agree with your quote, incidentally. I always believe that practical experience is very useful. You need to get in there and do it. I sometimes find I learn even quicker through doing than just by reading. And you can learn just as well by experiencing failures as by finally experiencing that success. Then again, as Frederick the Great said, "A mule after ten years on campaign would not be the better strategist for it." Then there is the issue of diminishing returns. But that is the same for books as for experience. As I was saying, I definitely agree with the quote. I would think this would be particularly true in fields like Emergency Medicine and Surgery, and less so in fields that require less that ingrained, reflexive judgment which actual experience helps develop.

About the other thing: it is interesting, because, in my two most recent acceptances, my varied activities and areas of learning, reflected in my "activities", led me to be viewed as a "well-rounded applicant". But previous to that, looking at essentially the same thing, an interviewer had remarked that I was "all over the place". That, obviously was not true, and I pointed out how all of these areas of study generally supported one another. But, it is really funny, because it is almost impossible to entirely protect against the very real factor of the intrinsic personality of the adcom you are interviewing with.
 
Oh_Gee said:
after me and a friend explained the 'Murican admissions process to a foreign MD, she said "wow, it's like they expect applicants to be experienced physicians already"
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The great thing about college applicants, including to medical school, is that they provide the economy with a large pool of free labor. Not saying the clinical experience isn't valuable, and charity is good for the soul and all that, but it is true.
 
ThucydidesLazar said:
About the other thing: it is interesting, because, in my two most recent acceptances, my varied activities and areas of learning, reflected in my "activities", led me to be viewed as a "well-rounded applicant". But previous to that, looking at essentially the same thing, an interviewer had remarked that I was "all over the place". That, obviously was not true, and I pointed out how all of these areas of study generally supported one another. But, it is really funny, because it is almost impossible to entirely protect against the very real factor of the intrinsic personality of the adcom you are interviewing with.
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Your posts definitely support the notion that you are "all over the place". It can be very hard to follow your thought.

Also, quoting Nazis is generally frowned upon in the admissions process, even if they have something meaningful to say.
 
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Zen Arcade said:
Hey! Maybe trying to make some money and have some fun as a carpenters assistant last summer wasn't a waste of time after all...
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I've always thought it might be fun to see an applicant take an essentially blank activities sheet and transform it into something deep by talking about his Zen meditation and his asceticism.

Just for a laugh, and hopefully LizzyM doesn't mind occasional levity, what do you think your reaction would be if you saw an "activities" sheet that was full of activities that involved things like meditation, clinical exposure that involved the person sitting in the waiting room of a clinic for entire days, or watching people entering and exiting the hospital for hours, etc? I suppose the "research" component would be lacking, but otherwise, it occurs to me that, if this were written well, some people might take this person to be an incredibly deep human being. But it would be an application that consisted almost entirely of non-verifiable activities and eloquent expositions of essentially nothingness.

Assume the GPA and MCAT are present and acceptable. Others can feel free to comment as well on what their reaction would be.
 
Doug Underhill said:
Your posts definitely support the notion that you are "all over the place". It can be very hard to follow your thought.

Also, quoting Nazis is generally frowned upon in the admissions process, even if they have something meaningful to say.
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Then the admissions process is full of bigots. Manstein is recommended reading for anyone interested in the military or WWII. He was a general, not a politician, and he has an interesting ability to analyze situations.
 
Indeed. I am probably the only Adcom in the US who knows who von Manstein was.



gonnif said:
Expecting admissions staff or faculty members who are heavily weighted towards biological and medical science to see the nuances of a quote attributed to a German WWII military officer without having the cultural bias or judgment that anything to do even tangentially with Nazis is an unrealistic expectation. Whether you like it or not, you must apply to medical school within the context of a process that suffers from variety of human behavior as anything does. That is the reality of the system. It, as with anything else, is imperfect and chance plays a large role in who reads your application, who interviews you, the group dynamics of an adcom during any cycle, and the wide varieties of applicants within a cycle.
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ThucydidesLazar said:
You weren't there. And he was insulting me. You realize Lucian and Lincoln were both self-taught lawyers, right? I don't suppose I have tripped some of the old conditioning from a former profession, have I? You don't know me and you are not qualified to say what I do or do not know.
Incidentally, if professional knowledge were all that were required to win cases, why, when I look on my state records, do I see such large amounts being donated by the big law firms to the campaigns of judges?
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I am curious, whats your status with medical school? Also, it sounds like you really like Law if you read so much on it so why not go to law school? Just curious...
 
wow there's so much I could add

one thing that people lose sight of, is that the US is a very diverse country
I won't go into all the studies that show that having a grasp of the socioeconomic/cultural determinants of health is crucially important
nor that patient care, in hard outcomes such as HA1C, has been shown to be affected by how much they like their physician, which, is also related to how much they perceive their physician likes them
interestingly, while studies have shown that people are not very good at being able to tell when they are being lied to, they are quite good at sensing someone's general "feeling" toward them

there are other studies that have shown that having about 1 PCP / 10,000 random ppl in the population would yield the best health outcomes
the average PCP will have around 2-3,000 people on their patient panel!!

as part of my admissions process, the decisions I have made in my life, such as activities to pursue, skills I have acquired, and what I chose to say on a variety of topics, was thrown at a number of random people
why shouldn't you face a random adcom and need to, in a short time, say 20 min, be able to hold an intelligent conversation where you hopefully will leave the impressiom as someone that trust can be placed in, someone who can talk about the weather/politics, and can envision you as a future leader and influencer of people? isn't that essentially a simulation of what the rest of your entire career will be?

people don't like this because it doesn't seem "fair," or "controllable," or "rational," or throw out a bunch of seemingly positive adjectives
like mating, there are a number of subconscious processes at work, and studies in game theory and the like have shown that there are both positive and negative elements to the way humans think along these other lines

could we try to educate adcoms to think past these cognitive biases rationally? maybe we would have some success, maybe we wouldn't
however we wouldn't necessarily be able to apply that education to all of the patients, families, ancillary staff, etc that a physician works with on a daily basis

at this point, all I've made a case for is the physician's need to be able to essentially "charm" a range of people, and owing to a diverse population we need a diverse force
I haven't gone into how we need different interests, skills, temperaments just to cover the different speciaties!

therefore, we cannot be cookie cutter about selection
and efforts to be more "rational" in selection I think are doomed to fail until man becomes a different beast to treat

TLDR
the rationality of the human beings you must treat/work with only goes so far, and you are essentially matched up with people almost at random as illness/death is a human universal
therefore, how humans "select" one another will likely never follow traditionally rational/formulaic paradigms, and I would argue, nor should it
 
OP

it's not enough to have "universal appeal" as I discuss, nor to to be a "special snowflake"

ironically what makes you special needs to have broad appeal

you might think quoting military commanders with tangential/direct (whatever) connections to the Nazi party makes you seem more "special," but let me tell you, not in the way that reflects well on you

it's not for the world to "learn to appreciate you" but for you to demonstrate that you appreciate it, even if it isn't "rational"
like dismissing the meaningful words of someone in the Nazi party
as a physician you must show deference for people's sensitivities
we must always adapt to our patients, not the other way around as there is no way to control *their* behavior, only our own

also, being an incredibly deep human being, while great, is not enough
 
I'd say a good amount are junk applications. These tend to be those blindly hopeful, i.e. a 502 3.1 applying to a school because they "fit their mission, did their UG there, really REALLY want to go there, and finally, they claim 'i know some1 wh0 got ad1tt3d with a 499 and 2.9, so I might have a chance'."

At the one school I'm thinking about they receive 6k applications, interview 1000.

I'd say those 1k are a great fit with respect to #s.

An additional 500 are superstars who are clearly using this school as a safety.

This brings us down to 4500. Assume 500 are students borderline, but not quite what the school wants, but sometimes takes (if mommy/daddy works at the hospital or if dad and the dean of admissions go to the same country club.

I'd say about 4k are too hopeful and unrealistic.

If you have the proper/competitive #s, good PS, good ECs, you'll be admitted at a school that you deserve, and at a school that deserves you.

Its important to have hope, but to also be realistic.
 
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