Would med schools do this for low GPA applicants?

[TheAppleJuice]

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So this is a hypothetical and I'm wondering if it exists. please don't call this a stupid question even if it is a stupid question lol

basically would the collective med schools in the US look at a low-gpa applicant that they might want to admit and purposely wait out the fall semester in silence, only to give an interview in the spring, with the goal of compelling the individual to make good grades in the fall i.e. scaring him into thinking he might have to be a re-applicant

perhaps a "textbook SDN" question, but I'm asking anyway 😛

 

[gyngyn]

Not mine.

 

[Lannister]

Doubt it. At the end of the day medical schools, like all universities, do not care about you (especially if you're not even a tuition-paying student). They are out to make money and build their reputation.

 

[gyngyn]

They are out to make money and build their reputation.

Risk aversion is way more penetrant than either of these.
We actually lose money on the medical students.

 

[ndafife]

The impact of 1 semester's worth of grades on your GPA is miniscule. Definitely not going to have a big enough impact to be worth waiting on from a school's perspective. For example, if you've done 100 credits of 3.0 work, 20 credits of a 4.0 is going to only bring you up to a 3.16.

Then from there schools really don't know enough about the individual classes you are taking to assign some level of benefit to them for you doing well.

 

[Lawpy]

Risk aversion is way more penetrant than either of these.
We actually lose money on the medical students.

Could you clarify the bold? Sources will also help.

 

[moggat]

I seem to remember reading at one point that it costs a million dollars to educate a medical student. This paper from 1997 suggests that the cost of instruction + resources per student is 1100-160,00$ a year. So a million over 4 years actually seems plausible.

On the cost of educating a medical student. - PubMed - NCBI
http://www.amsa.org/advocacy/action-committees/twp/tuition-faq/

 

[Lawpy]

I seem to remember reading at one point that it costs a million dollars to educate a medical student. This paper from 1997 suggests that the cost of instruction + resources per student is 1100-160,00$ a year. So a million over 4 years actually seems plausible.

On the cost of educating a medical student. - PubMed - NCBI
http://www.amsa.org/advocacy/action-committees/twp/tuition-faq/

It's costly to teach students sure (since it's an investment), but do schools actually lose money? I thought the costs of training students are covered by the revenues gathered elsewhere.

 

[gyngyn]

Could you clarify the bold? Sources will also help.

The time taken away from the clinical enterprise alone (when monetized), was several times more than the tuition collected. The PhD time was about a wash.
Our internal assessment has not been made public but is consistent with published findings.
I'm not at a place where I can access them right now, but I can get the references when I get out of the hospital.

 

[Lannister]

Risk aversion is way more penetrant than either of these.
We actually lose money on the medical students.

Yeah I guess when I said making money I was thinking more of med schools that are part of larger universities.
But I mean isn't risk aversion basically a way of protecting their reputation?

 

[Lawpy]

The time taken away from the clinical enterprise alone (when monetized), was several times more than the tuition collected. The PhD time was about a wash.
Our internal assessment has not been made public but is consistent with published findings.
I'm not at a place where I can access them right now, but I can get the references when I get out of the hospital.

What about revenues gathered from other sources? Do they cover the costs of teaching students/training residents?

Tuition alone is probably insufficient but I'm struggling to understand how schools/programs operate at net losses.

 

[Lannister]

I seem to remember reading at one point that it costs a million dollars to educate a medical student.

Well that makes me feel a little bit better about my $90,000 of debt.

 

[gyngyn]

What about revenues gathered from other sources? Do they cover the costs of teaching students/training residents?

Tuition alone is probably insufficient but I'm struggling to understand how schools/programs operate at net losses.

As a whole, we stay solvent because of indirects and clinical revenue (and underpaying the clinicians!) as far as I can tell.
We definitely lose money on the students, though.

 

[Lawpy]

As a whole, we stay solvent because of indirects and clinical revenue (and underpaying the clinicians!) as far as I can tell.
We definitely lose money on the students, though.

Ok i think i got it. So losing money on students basically means the cost of teaching is more than the tuition paid by students? That'd make sense.

 

[gyngyn]

Yeah I guess when I said making money I was thinking more of med schools that are part of larger universities.
But I mean isn't risk aversion basically a way of protecting their reputation?

Until you have seen a medical student fail, you have not seen a heartbroken community.

 

[MCATISEZ]

This is funny. Honestly I don't think any school cares that much about you. They will view your application in its entirety and decide among the applicant pool if/when they find it worth interviewing in (all in light of what options they have).

 

[Lannister]

Until you have seen a medical student fail, you have not seen a heartbroken community.

I mean I totally agree. The med school administration really cares about us and does everything it can to see us succeed. But at the same time, the med school administration is not the same as the university administration. And this probably isn't true of all universities but the university I went to for undergrad did not give a crap about us. If your interests did not align with the interests of the school, they would gladly screw you over to protect themselves.
But I guess that's irrelevant since OPs question was about med schools.

 

[Goro]

So this is a hypothetical and I'm wondering if it exists. please don't call this a stupid question even if it is a stupid question lol

basically would the collective med schools in the US look at a low-gpa applicant that they might want to admit and purposely wait out the fall semester in silence, only to give an interview in the spring, with the goal of compelling the individual to make good grades in the fall i.e. scaring him into thinking he might have to be a re-applicant

perhaps a "textbook SDN" question, but I'm asking anyway 😛

Not at mine.

Risk aversion is way more penetrant than either of these.
We actually lose money on the medical students.

Any decent academe department can pull in more money from indirects on R21s and R01s than can be gotten from the tuition of an entire med school class.

 

[Lifeblood_20]

No this would almost surely never happen.
Looking at this and grasping at a possibility of hope in not hearing is some design by the school to give you a chance is not going to happen. Any applicant who thinks this is real should take a cold shower followed by standing in front of the mirror and slap themselves until this idea passes.

I loled so hard for I literally just took a cold shower followed by slapping myself multiple times for a mosquito.
But yeah to the original question, probably the answer is no.

 

[Prometheus123]

So this is a hypothetical and I'm wondering if it exists. please don't call this a stupid question even if it is a stupid question lol

basically would the collective med schools in the US look at a low-gpa applicant that they might want to admit and purposely wait out the fall semester in silence, only to give an interview in the spring, with the goal of compelling the individual to make good grades in the fall i.e. scaring him into thinking he might have to be a re-applicant

perhaps a "textbook SDN" question, but I'm asking anyway 😛

Realistically, we should all be planning on being reapplicants. Push yourself to get good grades this fall with that in mind, and for the sake of doing whatever you do with excellence.

 

[P0ke]

Not at mine.

Risk aversion is way more penetrant than either of these.
We actually lose money on the medical students.

Any decent academe department can pull in more money from indirects on R21s and R01s than can be gotten from the tuition of an entire med school class.

Don't med schools get a lot of money as donations from alumni as well? My school president said they want us to match into competitive specialties so we make more money and have more to donate back to the school. So an acceptance today may show an ROI in 10-20 years.

We also have an ever-expanding SMP packing the first year lecture halls, with a very small % of them actually matriculating into the MD program, so maybe my school is more focused on the bottom-line than others.

 

[Prometheus123]

Absolutely, every applicant should be continuing to enhance their record from the moment they submit an application so they are in a stronger position if they need to reapply and will be in a position to do so on the next cycle. Else they may make the huge mistake of reapplying too soon without improved application

Do you have any gut metrics of what constitutes significant improvement you'd be willing to share?

EDIT: Please feel free to direct me to the search box if this has already been answered many times before.

 

[FlowRate]

The time taken away from the clinical enterprise alone (when monetized), was several times more than the tuition collected. The PhD time was about a wash.
Our internal assessment has not been made public but is consistent with published findings.
I'm not at a place where I can access them right now, but I can get the references when I get out of the hospital.

I totally believe you, but I'd like to see those references if you have them somewhat readily available.

 

[gyngyn]

I totally believe you, but I'd like to see those references if you have them somewhat readily available.

The papers in post #7 are a good start until I can get out of here!

 

[Turkishking]

Not at mine.

Risk aversion is way more penetrant than either of these.
We actually lose money on the medical students.

Any decent academe department can pull in more money from indirects on R21s and R01s than can be gotten from the tuition of an entire med school class.

What are R21s and R01s?

 

[Goro]

Don't med schools get a lot of money as donations from alumni as well? My school president said they want us to match into competitive specialties so we make more money and have more to donate back to the school. So an acceptance today may show an ROI in 10-20 years.

We also have an ever-expanding SMP packing the first year lecture halls, with a very small % of them actually matriculating into the MD program, so maybe my school is more focused on the bottom-line than others.

I think that several others above had mentioned that the parent University may glom on to that extra money; this is the case at our school. So, for example, the med school might be funding the drama school.

Stanford has an endowment of ~$800 million, the l last time I heard. My school has an endowment of some old books.

Don't know if the older DO schools have endowments like MD schools get.

 

[TelemarketingEnigma]

What are R21s and R01s?

R21s and R01s are types of research grant mechanisms. Indirects are the part of the grant that go towards funding the institution itself (electricity bills, janitors, infrastructure) rather than the investigator/specific research project

Types of Grant Programs | grants.nih.gov

 

[Prometheus123]

No metrics. Wholly dependent on original app to new app. This is where applicant have to use something they rarely put to work; their judgement. You need to identitfy your weakness and improve them

Haha, fair enough, thank you. In my judgment (or at least in the judgment of my "inner ADCOM", if you will), I need to rack up at least 100+ hours of non-clinical community service (through an organization, not just handing out food to homeless people from our car on holidays) and 50+ net shadowing hours. Another hundred or two hours of clinical experience wouldn't go amiss either. Ideally, I should also get some more formal research experience.

I could also stand to continue my all-As trend of improvement for some more quarters. If I do one more full course-load with all As, I'll reach a 3.3 cGPA. If I do another 3.5 quarters (the equivalent of another full year and the first month of summer) at all A level I could get to 3.4, although I couldn't quite get all the way to 3.4 in time for next cycle. If I do reach 3.4 before my 519 MCAT expires in March 2020, I've extrapolated from that chart that I'll have about a 63% chance of getting into at least one medical school in the US, at least based on historic MCAT and cGPA data.

While I fully understand the reasonableness of these expectations (in fact, what I wrote is lenient), please understand that I would strongly prefer to start my true career already. I'm turning 27 this year and my wife is turning 34. Not that that is unusual or matters, but you must understand I have a strong incentive to not want to have to tell my wife that I can't start medical school until 2019 at the earliest, when she's 36. However, I understand the system, and I accept it. Qué será, será, right?

 

[Prometheus123]

I think that several others above had mentioned that the parent University may glom on to that extra money; this is the case at our school. So, for example, the med school might be funding the drama school.

Stanford has an endowment of ~$800 million, the l last time I heard. My school has an endowment of some old books.

Don't know if the older DO schools have endowments like MD schools get.

Forgive me for asking, Goro-sab, but do you think the DO schools need a more aggressive centralized regulatory body like the MD schools have? I mean I totally understand the value of local autonomy, state's rights and all that, but sometimes it's beneficial to have a powerful centralized lobbying group, no? Although I'm not sure if that would affect this particular issue. But for instance, maybe it would be good to lobby for residency match committees to be blinded to which medical school applicants graduate from, no? That way, the decision would be based purely on merit as demonstrated in medical school, not whether the person happened to go to an MD or a DO school.

I realize this is sort of like debating how many angels can dance on the head of a pin. I decided a long time ago to stop trying to change deeply-entrenched systems and just go with the flow and do good from within. And yes, I am applying to multiple DO schools because life isn't fair, we do well with it anyway, and that's OK. But it's good to think about what an ideal world would look like, no?

 

[Goro]

Forgive me for asking, Goro-sab, but do you think the DO schools need a more aggressive centralized regulatory body like the MD schools have? I mean I totally understand the value of local autonomy, state's rights and all that, but sometimes it's beneficial to have a powerful centralized lobbying group, no? Although I'm not sure if that would affect this particular issue. But for instance, maybe it would be good to lobby for residency match committees to be blinded to which medical school applicants graduate from, no? That way, the decision would be based purely on merit as demonstrated in medical school, not whether the person happened to go to an MD or a DO school.

I realize this is sort of like debating how many angels can dance on the head of a pin. I decided a long time ago to stop trying to change deeply-entrenched systems and just go with the flow and do good from within. And yes, I am applying to multiple DO schools because life isn't fair, we do well with it anyway, and that's OK. But it's good to think about what an ideal world would look like, no?

What, like LCME? Absolutely. The low bar for clinical education hurts all DO students.

Mind you, LCME doesn't regulate how any med school can handle its money. If Columbia U says to Weill, "we need another $10 million from your budget to renovate Lawrence A. Wien Stadium", the med school will have little choice but to fork it over.

I have no idea what you are getting at in the bold. ACGME is a totally separate body from LCME. The former regulates residencies; the latter MD schools.

 

[Prometheus123]

What, like LCME? Absolutely. The low bar for clinical education hurts all DO students.

Mind you, LCME doesn't regulate how any med school can handle its money. If Columbia U says to Weill, "we need another $10 million from your budget to renovate Lawrence A. Wien Stadium", the med school will have little choice but to fork it over.

I have no idea what you are getting at in the bold. ACGME is a totally separate body from LCME. The former regulates residencies; the latter MD schools.

Once again, you have gone beyond my understanding. Thank you for your perspective. I will read a bit about all those institutions and get back to you once I even fully understand what you're saying (after writing at least 3 more secondaries and seeing the apartments we have to see today).

Note to self: Never try to work, volunteer, have a month long family reunion, move at the height of the busy season in one of the most competitive real estate markets in the country, and apply to med school at the same time again. It is not ideal.

 

[CyrilFiggis]

Note to self: Never try to work, volunteer, have a month long family reunion, move at the height of the busy season in one of the most competitive real estate markets in the country, and apply to med school at the same time again. It is not ideal.

Don't comment on things you have only marginal working knowledge of... a little bit of knowledge is more dangerous than none at all.

While I fully understand the reasonableness of these expectations (in fact, what I wrote is lenient), please understand that I would strongly prefer to start my true career already. I'm turning 27 this year and my wife is turning 34. Not that that is unusual or matters, but you must understand I have a strong incentive to not want to have to tell my wife that I can't start medical school until 2019 at the earliest, when she's 36. However, I understand the system, and I accept it. Qué será, será, right?

It's only your "true career" if you get in. I think your wife would be more frustrated if you rushed back in and failed completely.

 

[Prometheus123]

Don't comment on things you have only marginal working knowledge of... a little bit of knowledge is more dangerous than none at all.

True. I'm sorry if I spoke out of turn. I was just asking about the DO regulatory situation because this whole industry is sort of fascinating, and it's a nice break to think about that instead of apartment hunting or secondaries. The advice I gave the OP is just a paraphrase of standard advice from ADCOM members, especially Gonnif and Goro.

It's only your "true career" if you get in. I think your wife would be more frustrated if you rushed back in and failed completely.

That's true too, I suppose, although I'm not sure what you mean by "rush[ing] back in and fail[ing] completely". I think I'll get in somewhere eventually. If not this cycle, I'll apply next cycle. If I don't get in again, I'll apply the cycle after that.

If I don't get into a US school by my third attempt, I'll apply to the two Caribbean schools that do accept US federal financial aid. Yes, I realize that means we'll have to go into even more debt than the average US med school graduate, the education will be low-quality, the administration will be purely driven the profit motive, I may have to basically self-teach myself certain subjects, and I'll have to score 250+ on Step 1 to even have a shot at residency, but c'est la vie. I know I can score above average on standardized tests, I just have to put the time in. Also, my wife thinks she could get a job teaching Step 1 prep there, which would help offset our debt.

If I get rejected from SGU and Ross for some reason, then we'll just move back to Bombay and I'll go to med school there. Sounds sort of miserable, but entrance there is based purely on your entrance exam score (the Indian equivalent of the MCAT), so I know with enough time I can get in there.

Ultimately, as my wife likes to point out, once you're licensed, no one cares where you went to medical school or whether you have an MD, DO, or MBBS, people just care about where you did your residency and whether you're good at your job.

In other words, there's always a plan B.

 

[Goro]

Ultimately, as my wife likes to point out, once you're licensed, no one cares where you went to medical school or whether you have an MD, DO, or MBBS, people just care about where you did your residency and whether you're good at your job.

In other words, there's always a plan B.

Residencies care.

 

[Prometheus123]

Residencies care.

Yeah...sigh...that is a crucial detail. Do you think a really high Step 1 score and significant research experience can be enough to overcome that? My sense from looking at FMG match data is that 250 seems to be the point of reasonable chances for most branches.

 

[Lawpy]

Ultimately, as my wife likes to point out, once you're licensed, no one cares where you went to medical school or whether you have an MD, DO, or MBBS, people just care about where you did your residency and whether you're good at your job.

This is misleading because matching into competitive residencies/fellowships at top academic medical centers depends partly on where you went to medical school. Training in MGH would be awesome but it's practically inaccessible to DO/IMG and super competitive for US MD.

 

[Goro]

Yeah...sigh...that is a crucial detail. Do you think a really high Step 1 score and significant research experience can be enough to overcome that? My sense from looking at FMG match data is that 250 seems to be the point of reasonable chances for most branches.

Those FMGs you're referring to come from some of the best med schools in the world.

Don't go Carib or India. If you want to be a doctor in the US, go to a US med school.

 

[Prometheus123]

Those FMGs you're referring to come from some of the best med schools in the world.

Don't go Carib or India. If you want to be a doctor in the US, go to a US med school.

I will certainly continue to do everything in my power to make that happen. Carib and India are plans D and E, which I fervently hope I'll never have to deal with. Plan B is just do better next cycle, and plan C is do even better the cycle after that.

That's an interesting point about which schools the FMGs come from, I hadn't thought of that.

 

[Prometheus123]

This is misleading because matching into competitive residencies/fellowships at top academic medical centers depends partly on where you went to medical school. Training in MGH would be awesome but it's practically inaccessible to DO/IMG and super competitive for US MD.

That's true, and thanks for pointing that out. For what it's worth though, I don't really need to get into a competitive residency. I just need a good education and a license. I don't know which speciality I'll choose yet, I need to spend more time shadowing all the different specialists before I can really tell which one will be best for me. That being said though, I know for sure I won't go into derm, ENT, or any surgical branch. I have immense respect for all those branches (my wife's residency in India and fellowship in the US were in ENT with a focus on ENT surgery and laryngology), but I'm much more of an internal medicine kind of guy. I'll probably wind up doing internal medicine for residency and then a fellowship in in immunology, endocrinology, or gastroenterology. Isn't internal medicine low to medium competitive, relatively speaking?

 

[CyrilFiggis]

That's true, and thanks for pointing that out. For what it's worth though, I don't really need to get into a competitive residency. I just need a good education and a license. I don't know which speciality I'll choose yet, I need to spend more time shadowing all the different specialists before I can really tell which one will be best for me. That being said though, I know for sure I won't go into derm, ENT, or any surgical branch. I have immense respect for all those branches (my wife's residency in India and fellowship in the US were in ENT with a focus on ENT surgery and laryngology), but I'm much more of an internal medicine kind of guy. I'll probably wind up doing internal medicine for residency and then a fellowship in in immunology, endocrinology, or gastroenterology. Isn't internal medicine low to medium competitive, relatively speaking?

You don't need more time shadowing. You'll learn what you like once you're on the wards 3rd year actually using your brain rather than just your eyes. IM is the largest residency block with roughly 7,300 spots, but that doesn't mean it's not competitive. The average IM resident ranked at least 14+ programs and has a STEP 1 score of 230+

 

[Med Ed]

You don't need more time shadowing. You'll learn what you like once you're on the wards 3rd year actually using your brain rather than just your eyes. IM is the largest residency block with roughly 7,300 spots, but that doesn't mean it's not competitive. The average IM resident ranked at least 14+ programs and has a STEP 1 score of 230+

On the whole, IM is not competitive.
Only 45% of categorical spots were filled by US seniors in 2017.
In 2016 a total of 3,051 US seniors matched in IM. Only 62 did not.
126 US seniors applied with a Step 1 score of 200 or lower. Of those only 19 did not match.
The mean Step 1 score is ~229.

Like every field, there are some extremely competitive programs in IM, but pretty much anyone who can graduate in 4 years without a felony or psychotic break can land spot somewhere.

 

[Lannister]

You don't need more time shadowing. You'll learn what you like once you're on the wards 3rd year actually using your brain rather than just your eyes. IM is the largest residency block with roughly 7,300 spots, but that doesn't mean it's not competitive. The average IM resident ranked at least 14+ programs and has a STEP 1 score of 230+

Yeah but to be fair, residency isn't like applying to med school. An average applicant applying to med school has a good chance of not being accepted. But an average applicant applying to residency is almost certainly going to match somewhere.

 

[Ad2b]

I seem to remember reading at one point that it costs a million dollars to educate a medical student.

Late to this party:

I worked in finance for a very large, academic health center that had the consolidated: vet, nursing, pharm, med and mph programs under it's hood. My whole job was making sure we could balance the books between research, patients, and med school students (lol). Oh, and figure out the bond funding the building of the new ambulatory care clinic for patients who didn't want to drive into the large, scary health complex.

Each med school student, on average, cost the university about $600,000 from MS1 - graduation. Of that $600,000 the med student only paid about $175,000 leaving the university to cover the difference.

That difference is the "Debt to society" that the adcom of that particular school uses to evaluate someone like me who is 53 and may only have 15 years of service left in me after residency (if I am ever accepted).

The triangulated way the 3 areas had to provide funds for the med school was an interesting little sociological experiment the AAMC should consider putting on the MCAT. Obviously, the vets don't want to pay for nurses, med doesn't want to pay for anything, mph just want to sing cumbayah around the camp fire with s'mores (nothing wrong with anything in that phrase)... and the administration who took care of all that?

Well, that was also interesting. Researchers had to spend a great deal of time putting grants together, teaching and seeing patients; but the time spent teaching students was time taken away from research and grant writing and/or patients. Patients = RVUs and income.

The point being: that $600,000 is not only the true P&L it also includes the indirect costs to as gyngyn said... loss of revenue from patient visits (or increase in denials of claims by insurance companies)...

If I get rejected from SGU and Ross for some reason, then we'll just move back to Bombay and I'll go to med school there.

Ultimately, once you're licensed, no one cares where you went to medical school.

My current client is a large clinic... with some MDs who graduated from India and that region. They are number crunchers; could not pass the USMLE Step 2 or 3 and now are out of cycle to ever take them (or so I was told - don't know how that works).

Be careful in presuming that clinics/hospitals don't care where you graduated from; they do and they care about those scores. If schools don't teach, scores don't reach.

P.S. AUC > Ross or SGU; just saying 🙂 but I won't do any of them anyway

 

[MareNostrummm]

Like every field, there are some extremely competitive programs in IM, but pretty much anyone who can graduate in 4 years without a felony or psychotic break can land spot somewhere.

How common is a psychotic break among med students? (Or at least manifestation of underlying mental illness)

 

[precisiongraphic]

How common is a psychotic break among med students? (Or at least manifestation of underlying mental illness)

I don't know but this brings up a memory from just a few years ago when one of my children started school at UNCCH and the director of student health gave a talk and said "We'll be there for your student when they have their first psychotic break." And I groaned and said to myself, please let that not happen. Sheesh.

 

[MareNostrummm]

I don't know but this brings up a memory from just a few years ago when one of my children started school at UNCCH and the director of student health gave a talk and said "We'll be there for your student when they have their first psychotic break." And I groaned and said to myself, please let that not happen. Sheesh.

Geez... way to downplay a serious event.

 

[Prometheus123]

On the whole, IM is not competitive.
Only 45% of categorical spots were filled by US seniors in 2017.
In 2016 a total of 3,051 US seniors matched in IM. Only 62 did not.
126 US seniors applied with a Step 1 score of 200 or lower. Of those only 19 did not match.
The mean Step 1 score is ~229.

Like every field, there are some extremely competitive programs in IM, but pretty much anyone who can graduate in 4 years without a felony or psychotic break can land spot somewhere.

Then I'll consider myself fortunate. Thanks for the info. So I've got several theoretically viable backup plans. That puts my mind at ease.

229 is not an exceptionally challenging target (just the regular level of soul-crushing challenging that Step 1 is for US seniors). I definitely want to try to get more than 230 anyway, just because it's a once in a lifetime learning opportunity. I mean, that's the foundation.

I admit I still have a lingering interest in psychiatry. However, I think psychiatry as a residency is not a good fit for me because while I'm very interested in treating underlying organic causes of mental illnesses, I'm not particularly interested in prescribing most psychiatric medications. I'm interested in evidence-based therapuetic approaches that aren't currently in use by most psychiatrists. Don't worry, I won't go into that. Anyway. Most of the tools I want the most are taught in various subspecialities of IM.

I'm also just an internal medicine person by personality I think. I like solving mysteries.

If I could make up my own fellowship, it would be immunometabolism, the intersection of sterile inflammation and metabolic dysregulation. That might change as I experience more.

Again, thanks for the info!

 

[Prometheus123]

Late to this party:

I worked in finance for a very large, academic health center that had the consolidated: vet, nursing, pharm, med and mph programs under it's hood. My whole job was making sure we could balance the books between research, patients, and med school students (lol). Oh, and figure out the bond funding the building of the new ambulatory care clinic for patients who didn't want to drive into the large, scary health complex.

Each med school student, on average, cost the university about $600,000 from MS1 - graduation. Of that $600,000 the med student only paid about $175,000 leaving the university to cover the difference.

That difference is the "Debt to society" that the adcom of that particular school uses to evaluate someone like me who is 53 and may only have 15 years of service left in me after residency (if I am ever accepted).

The triangulated way the 3 areas had to provide funds for the med school was an interesting little sociological experiment the AAMC should consider putting on the MCAT. Obviously, the vets don't want to pay for nurses, med doesn't want to pay for anything, mph just want to sing cumbayah around the camp fire with s'mores (nothing wrong with anything in that phrase)... and the administration who took care of all that?

Well, that was also interesting. Researchers had to spend a great deal of time putting grants together, teaching and seeing patients; but the time spent teaching students was time taken away from research and grant writing and/or patients. Patients = RVUs and income.

The point being: that $600,000 is not only the true P&L it also includes the indirect costs to as gyngyn said... loss of revenue from patient visits (or increase in denials of claims by insurance companies)...


My current client is a large clinic... with some MDs who graduated from India and that region. They are number crunchers; could not pass the USMLE Step 2 or 3 and now are out of cycle to ever take them (or so I was told - don't know how that works).

Be careful in presuming that clinics/hospitals don't care where you graduated from; they do and they care about those scores. If schools don't teach, scores don't reach.

P.S. AUC > Ross or SGU; just saying 🙂 but I won't do any of them anyway

This is very interesting and thank you for the info. It's eye-opening to learn the fuller extent of how much ADCOMs are investing in us.

I haven't taken any of these exams, so I don't know any of this from first hand experience. I think Step 2 CS and 2 CK are clinical skills and clinical knowledge, so that makes sense that your scores on those would be pretty dependent on the quality of your teachers. That's really sad that those particular IMGs got stuck. It's pretty common though from what I hear, usually for finanicial reasons.

I'm also 100% in agreement that we'd get an infinitely better education at US schools. Say what you like about the US, but we have great teachers. That's the main reason I want to get in here. No lecture video or textbook can ever replace the opportunity to ask experts questions directly when you need to.

That being said, I'm not sure if that addage applies to Step 1 as well as it sounds like it does to 2 CS and CK. Everything you really need to score well on Step 1 is available online as far as I can tell. It's incredibly expensive, but it's there. It's also available via torrent I hear, so it's accessible even to those who can't afford it. Some IMGs said online that they got insane scores like 250 and 260, including ones who went to low quality schools abroad. To do that, they said they deep learned everything in Uworld and Kaplan Qbank. I'm sure it takes a very long time, but apparently if you can do that, you can run the table on Step 1. Or so I'm told.

 

[Prometheus123]

You don't need more time shadowing. You'll learn what you like once you're on the wards 3rd year actually using your brain rather than just your eyes. IM is the largest residency block with roughly 7,300 spots, but that doesn't mean it's not competitive. The average IM resident ranked at least 14+ programs and has a STEP 1 score of 230+

That makes sense. Clerkships do sound fun, and for sure like a better learning experience than just passively observing. I have no doubt that getting 230 is a soul-crushing endeavor, but on the plus side, it does sound very doable.

 

[Prometheus123]

On the whole, IM is not competitive.
Only 45% of categorical spots were filled by US seniors in 2017.
In 2016 a total of 3,051 US seniors matched in IM. Only 62 did not.
126 US seniors applied with a Step 1 score of 200 or lower. Of those only 19 did not match.
The mean Step 1 score is ~229.

Like every field, there are some extremely competitive programs in IM, but pretty much anyone who can graduate in 4 years without a felony or psychotic break can land spot somewhere.

How common is a psychotic break among med students? (Or at least manifestation of underlying mental illness)

I don't know but this brings up a memory from just a few years ago when one of my children started school at UNCCH and the director of student health gave a talk and said "We'll be there for your student when they have their first psychotic break." And I groaned and said to myself, please let that not happen. Sheesh.

Correct me if I'm wrong, but I think @Goro mentioned recently that depression is the most common reason a few of his students don't finish. I'm curious whether "psychotic breaks" is being said literally or hyperbolically. Either way, chronic stress is clearly a serious threat, a public health calamity even, and its consequences need to be mitigated effectively, especially in ultra high-stress environments like medical schools.