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Subject: Medical Education FAQ [1/2] (misc.education.medical FAQ) [v2.6]

This article was archived around: 07 Sep 2003 08:48:52 GMT

All FAQs in Directory: medicine/education-faq
All FAQs posted in: misc.education.medical, sci.med, soc.college.admissions, soc.college.grad
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Archive-name: medicine/education-faq/part1 Misc-education-medical-archive-name: faq/part1 Posting-Frequency: 14 days Last-modified: 2002/7/17 Version: 2.6 URL: http://www.memfaq.com/ Maintainer: Eric P. Wilkinson, M.D. <eric@wilkinson.com>
Welcome to the misc.education.medical Frequently Asked Questions list (FAQ), also known as the Medical Education FAQ. This article answers questions commonly asked on the misc.education.medical newsgroup, which discusses medical education (MD and DO training issues). It is crossposted to several groups with readers interested in medical education. This document should always be available on the World Wide Web at: <http://www.memfaq.com/> or through the hypertext FAQ archives at: <http://www.faqs.org/faqs/> The FAQ should also be available via anonymous FTP at: <ftp://rtfm.mit.edu/pub/usenet/misc.education.medical/> and is posted regularly to the following Usenet newsgroups: misc.education.medical soc.college.grad soc.college.admissions sci.med news.answers sci.answers soc.answers misc.answers Comments about the FAQ itself are invited and can be sent to me at <eric@wilkinson.com>. Suggestions for improvement and corrections of inaccurate information are especially welcome. If you have a question that is not answered in this FAQ article, try asking it on misc.education.medical. IMPORTANT NOTE If you are looking for answers to questions about medical conditions or procedures, the proper newsgroups to read and post to are the sci.med.* groups. If you are seeking medical advice, consult a licensed physician. The newsgroup misc.education.medical is for discussions of medical education only. ACKNOWLEDGMENTS This article is not the work of one; many individuals have contributed to this FAQ. Special thanks go to James Bright, who maintained the "version 1" FAQ from the early days of the newsgroup in 1994 until July 1998, and Sandeep Dave, who created the newsgroup in June 1994 and compiled the first FAQ answers. Contributors to the current FAQ include: Natalie Belle; Tim Cramm; Scott Goodman; Chris Kahn; Ryan Maves; Kris McCoy; Greg Nee; John Nguyen; Dave Russo; Eric Wilkinson; and Timothy Wu. DISCLAIMER This article is provided as is without any express or implied warranties. While every effort has been taken to ensure the accuracy of the information contained in this article, the maintainer and contributors assume no responsibility for errors or omissions, or for damages resulting from the use of the information contained herein. ------------------------------ Subject: 0. Contents 1) The Journey to Medical School -- Before Applying 1.1) What is an MD? 1.2) What is a DO? 1.3) What are the prerequisites for medical school? 1.4) What is the MSAR? 1.5) State school or Ivy League for undergrad? 1.6) Which major should I choose? 1.7) Is admission to medical school competitive? 1.8) Do I have to do research? 1.9) Do I have to have clinical experience? 1.10) How old is too old? 1.11) How high does my GPA need to be? 1.12) I completed college without finishing the pre-med requirements, and I want to apply to medical school. What do I do now? 1.13) What are some good sources of information about medical school and medicine? 2) The MCAT 2.1) What is the MCAT? 2.2) How important is the MCAT in the admission process? 2.3) What material is on the MCAT? 2.4) When should I start studying for the MCAT? 2.5) How should I study for the MCAT? 2.6) Should I take a review course? 2.7) Can you tell me about Stanley Kaplan vs. Princeton Review? 2.8) Are there any other options for review courses? 2.9) When should I take the MCAT? 2.10) Does it matter whether I take the MCAT in April or August? 2.11) What is a good MCAT score? 2.12) Are different sections of the MCAT more or less important than other sections? 2.13) My MCAT score was not stellar. Is it advisable to take the MCAT twice? Three times? 2.14) Should I go ahead and apply with my current MCAT score, or should I wait until I take the test again? 2.15) How do medical schools interpret multiple MCAT attempts? 2.16) I heard that you can take the MCAT as "practice" but not have your score count. I could use the practice; is this a good idea? 2.17) Can I decide not to release my MCAT scores and then later decide to release them after I have seen my score? 3) Applying to Medical School 3.1) What is the timeline for admissions? 3.2) Where can I find a list of medical schools? 3.3) What is AMCAS/AACOMAS? 3.4) How many schools should I apply to? 3.5) Which schools should I apply to? 3.5a) What are good sources to help me choose? 3.6) How expensive is it to apply? 3.6a) Is there any way to make the application process cheaper? 3.7) Should I apply to DO schools? 3.8) What is a secondary/supplementary? 3.9) What is an MD/PhD program? 3.9a) What are the different sources of funding for MD/PhD programs? 3.10) Should I enroll in a combined BS/MD program? 3.11) What are combined MD/MPH and DO/MPH programs? 3.12) Can you tell me about combined MD/MBA programs? 3.13) Can you tell me about combined MD/JD programs? 3.14) What are PAs? 3.15) Should I consider going to a foreign school? 4) The Interview Process 4.1) How can I prepare for my interview? 4.2) What should I wear to the interview? 4.3) Should I bring anything to the interview? 4.4) What will I be asked? 4.5) "Why do you want to be a doctor?" 4.6) What questions should I ask? 4.7) Should I do anything after the interview? 4.8) What does "waitlisted" mean? What does "hold" mean? 4.9) What if I don't get accepted? 4.10) How should I choose what school to go to? 4.11) What should I do during the summer before medical school? 5) Medical School Curricula 5.1) How long is medical school? 5.2) What classes are there in medical school? 5.3) How are students graded/evaluated in medical school? 5.4) What are "rotations"? 5.5) What are the "must have" textbooks? 5.6) What is PBL? 5.7) Is there any free time in medical school? 5.8) What is the USMLE? 5.9) What is a good USMLE score? 5.10) What is AOA? 6) Paying for Medical School 6.1) How expensive is medical school? 6.2) How can I pay for medical school? 6.3) Can you tell me about Armed Forces scholarships? 6.4) Can you tell me about Public Health Service scholarships? 6.5) Can I really borrow more than $10K/yr in Unsubsidized Stafford Loans? 7) Residency and Beyond 7.1) What are the different medical specialties? 7.2) What is a residency? 7.2a) What is an internship? 7.2b) What is a "preliminary" year? A "categorical" year? 7.3) What is the Match? 7.4) What is the NRMP? 7.5) Are there specialties that don't use the NRMP? 7.6) What is a fellowship? 7.7) How many hours do interns/residents work? 7.7a) Aren't there limits on this? 7.8) What does "board certified" mean? 7.9) What does FACP/FACS/FACOG/etc. mean? 7.10) What is an IMG/FMG? 7.11) What is the ECFMG? The CSA? 7.12) What is CME? ------------------------------ Subject: 1. The Journey to Medical School -- Before Applying 1.1) What is an MD? An MD, or Doctor of Medicine, most simply is a person who has graduated from a medical school. An MD can have many and varying roles in the community. First, an MD is a caregiver, a person turned to by members of the community in times of physical, psychological or emotional weakness. MDs treat not only the body but also the mind and the spirit, often delving into the emotional, psychological or social reasons behind a physical illness. MDs treat people in inpatient settings, in the operating room, outpatient clinics, and in emergency room visits. Not all MDs, though, deal with patients in such a direct manner. Pathologists deal with diseased tissues taken from the patient as well as clinical laboratory and blood bank settings. Radiologists deal with images of the patient produced and enhanced by various imaging technologies. Some MDs choose to concentrate their efforts solely on research, developing new equipment, vaccines, drugs, or discovering the underlying causes of disease. MDs can devote their time to teaching, both in a classroom setting (in a medical school, for example) and in the community (teaching preventive methods to community members, teaching CPR or first aid, or administering vaccines). Becoming an MD opens up to you a vast number of possibilities for using your medical training. MDs serve the community in many more ways than just seeing patients, prescribing drugs, or performing surgery. If you say to yourself, "I'm not a people person, so I'd make a lousy doctor," keep in mind that there are ways to use your interest in medicine to benefit the community without seeing patients on a day-to-day basis. 1.2) What is a DO? Doctors of Osteopathic Medicine (DOs) are the legal and professional equivalents of Doctors of Medicine (MDs). They are licensed to practice medicine in all 50 states and use all conventionally accepted therapeutic modalities such as surgery, radiology, and drugs. They are eligible to enroll in all federal programs, managed care and insurance plans, serve as commissioned medical officers in all branches of armed services, and serve as public health officers, coroners, insurance examiners, and team physicians. In other words, they practice complete medicine and surgery. Only DOs and MDs can do this. DOs represent about 5% of the country's physicians and provide care for approximately 10% of the patients. This is because higher proportions of osteopathic medical graduates enter into primary care residencies after graduation compared to their MD counterparts. Andrew Taylor Still, MD founded osteopathic medicine in the late 1800's in response to what he thought was poor medical practice at that time. He based osteopathic medicine on the following principles: 1) The structure of the body and its functions work together, inter-dependently. 2) The body systems have built-in repair processes which are self-regulating and self-healing in the face of disease. 3) The circulatory system provides the integrating functions for the rest of the body. 4) The musculoskeletal system contributes more to a person's health than only providing framework and support. 5) While disease may be manifested in specific parts of the body; other parts may contribute to a restoration or a correction of the disease. The preparation and training of DOs is nearly identical to the training of MDs. Admission prerequisites and curricula are very similar. DOs can sit for the MD boards if they are interested in pursuing a MD residency after graduation. The primary difference in their education is that DO students complete an additional 200-300 hours of training in osteopathic manipulative medicine (OMM). OMM is a modality used primarily to treat musculoskeletal problems and overlaps in its scope with physical therapy and manual medicine techniques. Also, DO schools place more emphasis on producing primary care physicians than do some MD schools. This means that during their clinical years, students at DO schools spend more time rotating through primary care specialties such as family medicine, pediatrics, obstetrics and gynecology, internal medicine, and psychiatry. Nevertheless, specialty training isn't out of the question for DOs. Many DOs seek and obtain residencies in surgical and non-surgical specialties. For more information, see the American Association of Colleges of Osteopathic Medicine at <http://www.aacom.org>. 1.3) What are the prerequisites for medical school? All medical schools require a baccalaureate (BA, AB, BS, or equivalent) degree, with rare exceptions. The usual course prerequisites for both MD and DO schools are: 1 year of Biology or Zoology (with lab) 1 year of Inorganic Chemistry (with lab) 1 year of Organic Chemistry (with lab) 1 year of Physics (with lab) Some schools require english, humanities, calculus, or biochemistry as well. Check the book "Medical School Admission Requirements" (cf 1.4) for each school's particular requirements. The one year of Physics need not be calculus-based, although many colleges offer only the calculus-based class. There is disagreement over whether prerequisites may be taken at community or junior colleges. To be sure, contact the individual schools to which you plan to apply. Many students finish their undergraduate degrees without completing the medical school prerequisites. Some of these students choose to take the courses at their local public college or university, while others enroll in more formal "post-baccalaureate" programs, where the classes are taken full-time over approximately a year. 1.4) What is the MSAR? The book "Medical School Admission Requirements," or "MSAR," is often considered the premedical student's "bible." Published by the Association of American Medical Colleges (AAMC), it contains information on premedical requirements for each of the MD schools in the US and Canada, as well as information and statistics about admissions, financial aid, and minority student issues. Many questions not answered in this FAQ will be answered in the MSAR. It is revised each April, so make sure you get the most recent edition. You should definitely get this book if you are considering medical school. You can buy a copy at your local college bookstore, from an online bookstore, or direct from the AAMC at: <http://www.aamc.org/publications/resources.htm>. 1.5) State school or Ivy League for undergrad? In general, whether you attend a well-known school or a relatively invisible school is not important. What is important, however, is doing well at whichever school you decide to attend. One thing you may want to keep in mind is that doing well at a prominent institution goes a lot farther than doing well at a lesser-known state college. Choose what you are most comfortable with, not what you think the medical schools want to see. 1.6) Which major should I choose? According to the Association of American Medical Colleges, a premedical student may select any major he or she chooses, provided that he or she completes the prerequisites for medical study (cf 1.3). The most important thing is to select a major you enjoy, as this would allow you to master the subject. Medical school admissions committees want to see students who master their major fields of concentration in college, and many medical schools enjoy receiving applications from students who have studied areas outside of the sciences. Acceptance statistics broken down by major are provided in the MSAR (cf. 1.4). 1.7) Is admission to medical school competitive? Medical school admissions has always been competitive, as there are always more applicants than there are seats. In recent years, however, admissions has become even more competitive as the AAMC has logged a record increase in applications which hit a peak of approximately 45,000 applications during the 1995-1996 cycle, which represents a ratio of about 3 applicants for every medical school seat. Since then the number of applications filed has slowly declined. 1.8) Do I have to do research? Absolutely not, but doing research does help to demonstrate analytical skills in scientific investigation which are helpful for practicing physicians. There are many medical students who have never stepped inside a lab outside the prerequisite lab courses, but at the same time, many people feel that with increased competition for medical school seats, research experience is a much-needed notch on the applicant's belt. 1.9) Do I have to have clinical experience? Gaining clinical experience as a premedical student is rather important as it can show that your decision to want to go to medical school is well-rooted, and not coming out of left field. Gaining clinical experience, however, means different things to different people. Simply volunteering at your local hospital may not be sufficient, as these volunteer opportunities often have you do tasks very unrelated to medicine (e.g. filing, faxing, copying). Look for "Health Career Opportunity Programs," or other such internships designed for premedical students, so that your valuable premedical time is not wasted in a second-rate program. If your school has a "premedical internship" program, take advantage of it. 1.10) How old is too old? It may not be too late. Students in their 30s and 40s are admitted to many medical schools. Anecdotes about students in their 50s have been posted on misc.education.medical. When making your plans, keep in mind that the shortest amount of time from entering medical school until exiting the shortest residency (general internal medicine, general pediatrics, or family practice) is 7 years. 1.11) How high does my GPA need to be? Perhaps every premedical student has heard tales of the 3.9 GPA Phi Beta Kappa applicant getting into every medical school he or she applied to, and of the 2.5 GPA student applying to medical school without a prayer, but there is a little more to the GPA issue than just getting above a certain mark. GPAs will vary depending on the competitiveness of your school, so if you attend a world-renowned institution such as Harvard, your GPA will be calculated based on competition with an intense student body. If you attend Acme State University, where there is a major in bartending, your GPA will be calculated based on competition with a slightly less intense student body. Generally, however, a 2.3 at Harvard is still pretty bad and probably not as good as a 4.0 at Acme State, and we can guess that perhaps the Harvard student is not going to get into medical school. So what are the generalities we should look at when determining whether our GPAs are good enough for medical school? Some premedical advisors say that if your GPA is 3.3 at a good school, you have a 20% chance for admission. Others will say having a 3.5 to 3.6 is the requisite GPA, but if you keep it as high as you can, you should have no problem (so try to keep it above 3.3!). 1.12) I completed college without finishing the pre-med requirements, and I want to apply to medical school. What do I do now? There are a couple of options. You can enroll at a local college or university as a non-degree student and simply take the prerequisites. Additionally, you might consider enrolling in a formal post-baccalaureate pre-medical program offered by many of colleges and universities in response to an increasing number of students changing careers into medicine. A comprehensive list of "post-bacc" pre-med programs can be found at <http://www.aamc.org/students/considering/postbac.htm>. 1.13) What are some good sources of information about medical school and medicine? RECOMMENDED AUTHORS OF BOOKS ABOUT MEDICINE Lewis Thomas, MD Sherwin Nuland, MD David Hilfiker, MD Perri Klass, MD Oliver Sacks, MD Robert Marion, MD David Ewing Duncan BOOKS ABOUT MEDICAL SCHOOL ADMISSIONS There are many books on this subject (too many to list), and quality varies widely. For an exhaustive list, try doing a search on "medical school" at an online bookstore. DOCUMENTARY The PBS television show NOVA aired a documentary about the training of seven medical students at Harvard Medical School, following them from anatomy lab through residency. Highly recommended. "MD: The Making of a Doctor" may be ordered from WGBH-Boston, item #WG2207, by calling 1-800-255-9424. It costs $19.95. An update on the "Making of a Doctor" physicians was recently completed, called "Survivor MD." It is a 3-hour special and can be ordered from WGBH at the number above for $29.95. WEB "Official" sites on the World Wide Web (many of these are referenced at other points in the FAQ): Association of American Medical Colleges (AAMC) <http://www.aamc.org> Liaison Committee on Medical Education (LCME) <http://www.lcme.org> National Board of Medical Examiners <http://www.nbme.org> Federation of State Medical Boards <http://www.fsmb.org> United States Medical Licensing Examination (USMLE) <http://www.usmle.org> American Association of Colleges of Osteopathic Medicine (AACOM) <http://www.aacom.org> American Medical Association (AMA) <http://www.ama-assn.org> USENET The Usenet newsgroup for discussing medical school and medical education is misc.education.medical. Medicine is discussed in the sci.med.* hierarchy of newsgroups. ------------------------------ Subject: 2. The MCAT 2.1) What is the MCAT? The Medical College Admissions Test, or MCAT, is the standardized admissions test required by nearly all U.S. medical schools (some combined BS/MD programs that accept students directly from high school do not require the MCAT). The test consists of four sections: Verbal Reasoning (scored 1-15), Physicial Sciences (scored 1-15), Biological Sciences (scored 1-15), and an essay section (scored J-T, with T being the highest). The test takes one long Saturday to complete and is offered twice a year, usually in mid April and in late August. Official information about the MCAT, including registration information, may be obtained online from the Association of American Medical Colleges (AAMC), at <http://www.aamc.org/students/mcat/start.htm>. 2.2) How important is the MCAT in the admission process? The MCAT is very important. A high MCAT score by itself will not get you into medical school, but a low MCAT score may keep you out. Unfortunately, an otherwise qualified applicant may not even be granted an interview if his or her MCAT scores are not high enough. Once an interview is granted, each applicant is evaluated individually in determining acceptance or rejection. In most cases the MCAT still is just as important as other parts of the application in making the final decision. 2.3) What material is on the MCAT? The official MCAT registration materials include a syllabus that spells out the subject matter tested in detail. Below is a summary: * The verbal reasoning test is virtually identical to similar tests found on other standardized exams (such as LSAT, GRE, or even SAT), except it typically contains two or three science-oriented passages. * The essay section consists of two timed half-hour essays. In each essay you are asked to interpret an open-ended ambiguous statement. * The physical sciences test covers inorganic chemistry and physics. One full year (two semesters) each of inorganic chemistry and physics sufficiently covers all the tested material. * The biological sciences test covers a variety of biology topics (about 50% of test) and organic chemistry (about 50% of test). One full year of organic chemistry plus lab is sufficient to cover the organic chemistry material on the MCAT. 2.4) When should I start studying for the MCAT? Nearly all students require at least two months of regular review to cover all the necessary material. Many students require longer. However, preparation really begins as soon as you start college--by doing your best in your undergraduate science courses and reading broadly to prepare for the verbal reasoning section. You can then spend the final 2 or 3 months reviewing and solidifying the information you have already learned. It is unlikely that you will learn and understand a lot of new material in the final months leading up to the MCAT. 2.5) How should I study for the MCAT? Basically, whatever study methods have served you well in the past should also help you prepare for the MCAT. For example, if you read your textbooks heavily in class, then review your textbooks. If you used study sheets or notecards in your classes, then review those. A few other tips: * It is important to be quite disciplined and to make the time necessary for review. Most pre-medical students find they don't have the time for MCAT review unless they make a concerted effort to make the time. * For more structured review, consider buying a review book (such as the Kaplan MCAT Comprehensive Review with CDROM, edited by Rochelle Rothstein) or taking a review course (see below) * No matter what you do, take lots of timed practice tests. Practice MCAT tests are available directly from the AAMC, in any book store, or through review courses. 2.6) Should I take a review course? That depends. If you are overwhelmed by the thought of MCAT review, and if you like structure and learn well in a classroom environment, then a review course is not a bad idea. When used properly, review courses are an expensive, effective way to prepare for the MCAT. They offer structured, comprehensive review, teacher-student interaction, numerous practice tests and test- taking strategies, and comprehensive, well-written review materials. However, do not enroll in a review course just for the materials. Equally good materials (such as the Kaplan Comprehensive Review, cf. 2.5) may be purchased in the bookstore for a whole lot less money. 2.7) Can you tell me about Stanley Kaplan vs. Princeton Review? Stanley Kaplan <http://www.kaplan.com> and Princeton Review <http://www.review.com> are the two largest standardized test review companies in the United States. Opinions differ as to which company offers a better review course for the MCAT. Traditionally, the Kaplan course focused more on detail and offered more review materials, while the Princeton Review course focused more on "the big picture" and offered more student-teacher interaction. However, Kaplan has recently decreased its class-size, and Princeton Review recently increased the amount and detail-level of materials offered. Today the two courses really are more similar than they are different. The biggest factor in determining the quality of either course is the quality of its teacher. If you want to take a review course, it helps to ask around locally to see which courses have a better reputation in the local area. 2.8) Are there any other options for review courses? Yes. Many colleges offer structured review courses for the MCAT. Ask your local pre-med advisor for details. Also, if you happen to live in California, MCAT review courses offered by the Berkeley Review <http://www.berkeley-review.com> have an excellent reputation. 2.9) When should I take the MCAT? You should take the MCAT at least one year prior to the date you wish to begin medical school. However, do not take the test until you have completed the necessary pre-requisite courses: one year each of biology, inorganic chemistry, organic chemistry, and physics. Many students take the April MCAT while they are concurrently taking prerequisite courses (usually Physics II, Organic Chemistry II, and/or an advanced biology course). This is not a bad strategy: virtually all of the material tested on the MCAT will already be covered by the time April rolls around -- and the material should be fresh in your mind, since you have just learned it. 2.10) Does it matter whether I take the MCAT in April or August? If you are prepared for the exam, it's probably best to take it in April. Taking the test earlier allows you to complete your application early in the season--and the earlier you submit your application, the better. Also, If you are applying under an early decision program, you *must* take the April MCAT of that year (or any time prior) so that test scores are available in time for early interviews. Of course, there is also an advantage to taking it in August: it allows you more time to study. You can take the exam in August and still apply for the same application season, but you'll be running a tight time-schedule. Keep in mind that it takes approximately 8 weeks for scores to get back to the schools. 2.11) What is a good MCAT score? Traditionally a good score is "double digits" (10 or better) on each test, and a score of at least "N" on the essay. You can get into medical school with lower scores, depending on the rest of your application and on the medical school. For your state medical school, a total score of 27 or higher, with no individual score less than 8, is probably sufficient. It is important to have a well balanced MCAT score, with no individual score markedly lower than the rest of the test. For example, a score of 8,8,8 (total 24) is generally considered superior to a score of 10,10,5 (total 25). 2.12) Are different sections of the MCAT more or less important than other sections? Yes. The essay section is less important than the other sections. Your essay score is impressive if it is extremely high (S or T) and is detrimental if it is extremely low (J or K). However, any score in between has little or no impact on your application. Be sure to demonstrate your writing abilities to medical schools by composing a well-written personal statement essay. 2.13) My MCAT score was not stellar. Is it advisable to take the MCAT twice? three times? Yes--as long as you improve your score! Taking the MCAT multiple times is only helpful if a significant score improvement is reflected in each attempt. However, it is preferrable to study as hard as possible and be prepared so that you do an excellent job on your first attempt. Who wants to take this test multiple times, anyway? 2.14) Should I go ahead and apply with my current MCAT score, or should I wait until I take the test again? If you received greater than 27 on your first attempt, it is advisable to apply with your current score and not take the test again. If you received less than 24, you should probably take the test again, prepare harder next time, and try to improve your score. The range of 24-27 is a grey zone: whether to take the test again depends on the rest of your application and on where you are applying. Note that these are just guidelines. You must consider your own individual situation to arrive at a final decision. Also note: if you take the MCAT in April and are dissatisfied with your scores, you can go ahead an apply anyway and still retake the test in August for the same application year. It's better to submit your application early than to submit it in the fall. 2.15) How do medical schools interpret multiple MCAT attempts? Medical schools consider them favorably, as long as you improve your score. Most medical schools will consider the highest overall MCAT score in evaluating your final application. 2.16) I heard that you can take the MCAT as "practice" but not have your score count. I could use the practice; is this a good idea? No. At the end of the exam, you must decide whether or not to release your scores. It is almost always advisable to have your scores released. The only good reason not to release scores is if you know you did poorly by some fluke; for example, if you filled in all the bubbles incorrectly. Deciding not to release your scores on a whim is not advisable. 2.17) Can I decide not to release my MCAT scores and then later decide to release them after I have seen my score? Yes, however, medical schools will be informed that you originally did not release your scores and later decided to release them. This allowance is actually a new rule recently instituted by the AAMC. Because the rule is new, it is unclear how medical schools will view an MCAT score that was originally not released. Common sense says that medical schools will not view this favorably, and that it is not a good idea to exercise this option. ------------------------------ Subject: 3. Applying to Medical School 3.1) What is the timeline for admissions? AMCAS (cf 3.3) begins accepting applications on June 1. After receiving your application and school transcripts, you will receive a Transmittal Notification from AMCAS, which means that schools have been sent your central application. After evaluating your application, schools can choose to have you continue the process by completing a supplementary application (cf 3.8) and after further evaluation, an interview (cf Section 4). Some schools are on a "rolling admissions" system where applicants can hear about an admissions decision fairly soon after interviewing. Other schools wait until late in the season to send decision letters. More information can be found in the MSAR (cf 1.4), the AMCAS application materials, and school admissions brochures. 3.2) Where can I find a list of medical schools? The MSAR (cf 1.4) has a list of all of the medical schools in the US and Canada accredited by the Liaison Committee on Medical Education (LCME) <http://www.lcme.org>. On the Internet, you can find this same list at <http://www.aamc.org/meded/medschls/start.htm>. 3.3) What is AMCAS/AACOMAS? AMCAS, the American Medical College Application Service, is a centralized program which works much like the "Common Application" that you may have seen in high school (for applying to college). Run by the Association of American Medical Colleges (AAMC), it consists of a form you fill out like an application, which is sent to AMCAS, processed, and then distributed to those medical schools you wish to apply. In the past several years a computer-based version, AMCAS-E, has been developed. See the AMCAS web page at <http://www.aamc.org/students/amcas/start.htm>. AACOMAS, the American Association of Colleges of Osteopathic Medicine Application Service, is a similar service for osteopathic medical programs run by the AACOM <http://www.aacom.org>. 3.4) How many schools should I apply to? Depends. If you're 4.0 and 40+ on the MCAT, then probably you could apply to only one or two and get away with it. There are stories of people who applied to 50 or 60 schools and didn't get into any. Most people apply to around 10, more if they feel their folder is a little weak, less if they think they've got a pretty solid record. 3.5) Which schools should I apply to? Your best bet is to think about where you'd like to go to school and apply there. Remember: Wherever you go, not only will you be spending the next 4 years there, but also the odds are pretty good that you will do your residency there as well. So don't pick someplace you'd never want to live. Always apply to your state school, if you have one; most (if not all) state schools give preference to people who are state residents, and every little bit of help counts. You should have 2-3 schools that are a real stretch--places you don't think you could get in to but places you'd love to go. Try to find 1-2 places that you think you have an excellent shot at; your state school usually goes here. And in the middle, 6 (or more) places that you think you'd be competitive at. Finally, don't discount D.O. schools (cf 3.7). 3.5a) What are good sources to help me choose? Your primary source should be your college's pre-medical advisor. Make an appointment with him/her early on--sophomore or junior year would be best. Make sure he/she pulls your transcripts, etc. before you show up. The two of you can talk about your strong and weak points, what you could do to boost your chances, and which schools you should apply to. Also keep in mind that most pre-medical advisors send a letter along with your applications, so getting to know him/her will help get a more accurate letter for your file. The Internet is a good source. Most medical schools have web sites that give lots of information, application requirements, etc. In addition, post any questions, concerns, fears, or despairs to the misc.education.medical Usenet group. It's populated by lots of grizzled veterans who have been through this process (sometimes more than once) and can help you avoid the pitfalls. Another essential source is the MSAR (cf 1.4). 3.6) How expensive is it to apply? The AMCAS fee is about $45 for the first school, and $25 for each additional school. When your AMCAS is processed, most schools will request "supplementary" information, and filing this will cost an additional $60-$125. The AACOMAS fee is practically the same, and the cost for filing supplementary materials at osteopathic medical schools is also anywhere from $60 to $125. Add in costs for the MCAT, flying to schools for interviews, hotels, and other expenses, and the total application cost can rise into the thousands of dollars depending on how many schools you apply to. 3.6a) Is there any way to make the application process cheaper? You can request from AMCAS a fee waiver, which covers the cost of AMCAS filing and supplementary filing fees for up to 10 medical schools. Fee waivers are based on financial need, and many schools will waive their supplementary application fee (cf 3.6) if you have an AMCAS fee waiver. The MCAT also offers a fee waiver program. 3.7) Should I apply to DO schools? Osteopathic medical schools have a reputation for "looking past the numbers" in their admissions process. Consequently, the average accepted MCAT scores and GPA are a bit lower at DO schools. If you're an academically borderline candidate, but have a competitive application overall, your chances for admission might be higher at DO schools. Because most DO schools emphasize primary care medicine, they look very closely at an applicant's motivation for pursuing medicine and prior life experience. The average age of matriculation tends to be higher at DO schools than MD schools. Students who want to practice an osteopathic approach to patient care are especially sought after; this means demonstrating an interest in hands-on medicine and a commitment to a holistic understanding of patient care issues, especially time spent with a DO. There are two important points to consider if you're thinking of applying to DO schools. First, DOs are minority physicians in the profession of medicine. If you are uncomfortable being different, think that you'll always have to prove something because you're not an MD, or are likely to become frustrated having to explain what a DO is to new patients, then DO schools might not be right for you. Second, you might have a harder time competing for some of the "brand-name" MD residencies. Many competitive MD residencies don't regard the additional training DO students receive as applicable to their particular area of medicine, and with keen competition for slots among MD applicants, they feel obliged to take their own first. There are DO specialty residencies in everything ranging from aerospace medicine to otolaryngology, but these residencies tend to be concentrated in the eastern and mid-western United States. Some students find the geographic limitations of these residencies unattractive. In short, some students have compared the kind of medical education DO schools offer to the kind of undergraduate education that smaller liberal arts colleges offer. Both stress generalist skills and training. Like the smaller undergraduate colleges, the research programs at DO schools tend to be smaller. Consequently, the basic science faculty is usually more professionally involved in medical education than research. However, it is difficult to make accurate generalizations because there is much variety in curricular programs offered by both MD and DO schools. There are primary care oriented MD schools and research oriented DO schools. The most prudent advice is to look at the curriculum and educational focus of each medical school on a case by case basis. 3.8) What is a secondary/supplementary? Secondary (also called supplementary) applications come in a variety of forms and typically are utilized only by schools using the AMCAS application (MD programs), or schools using the AACOMAS application (DO programs) rather than their own application. Depending on the school, they may request no more than a check and signature to complete processing of your application, or they may ask you to provide additional information such as SAT scores and respond to several essay questions. A number of schools "screen" applicants prior to sending secondary applications. This means that based on information (essay, biographical data, MCAT scores and GPA) provided by the applicant's AMCAS or AACOMAS application, the school decides whether or not to send a secondary application to the applicant. Screening of applications at the secondary stage is not done by all schools; many schools have all applicants complete all application materials and then decide who to interview based on information contained in the primary and secondary applications. Information on application fees and whether a school uses secondary applications may be found in the MSAR (cf. 1.4). 3.9) What is an MD/PhD program? Students that are enrolled in combined MD/PhD programs pursue the MD and the PhD degrees concurrently. Students can select from a number of fields in which to complete the PhD. Although this field is typically a biomedical science (e.g., biochemistry, immunology), students in the past have combined their medical studies with research in engineering and the humanities. Combined programs typically require 7-9 years to complete. The first two years are typically spent on the basic science portion of the M.D. curriculum. The next three to five years are spent on full time PhD work. The final two years of the combined program are spent on the clinical portion of the MD curriculum. MD/PhD programs are eclectic by nature, however, and the course of study can be very individualized. Combined MD/PhD programs were initiated to train a cadre of academic medical scientists who could make fundamental scientific discoveries and then translate these discoveries into tools and knowledge that could be used at the bedside. It is important to note that "doing it all", from the lab bench to the patient bedside, is extremely difficult. Both caring for patients and running a research program are full time jobs in and of themselves! Most MD/PhDs focus on either lab research or patient care to stay abreast of their fields and to remain competitive with their peers. With that caveat, however, MD/PhD training has some benefits. Some good reasons to pursue an MD/PhD - You want to focus on clinical research and practice, but would like rigorous research training - You want to focus on research, but want the perspective provided by clinical training Bad reasons to pursue an MD/PhD - You want extra letters after your name - You want to save money (in the long run, you probably won't!) Ultimately, the decision to pursue an MD/PhD is a personal one. Think about the career goals you envision for yourself and whether they can be achieved with a single degree. Consider talking with MD/PhDs who have careers similar to that which you envision for yourself. Information on programs may be found at <http://www.aamc.org/research/dbr/mdphd/programs.htm>. 3.9a) What are the different sources of funding for MD/PhD programs? 1. Medical Scientist Training Program (at official NIH MSTP schools) 2. Other NIH funds (e.g., Human Genome Training Grant) 3. School-Specific Funds (e.g., Franklin's scholars program at UPenn) 4. Funds from special interest groups (e.g., funds for the study of alcoholism) 5. Howard Hughes Medical Institute Funds 3.10) Should I enroll in a combined BS/MD program? BS/MD programs, or, more appropriately, college/MD programs, allow a high school student to apply to both college and medical school during the college application process. If accepted, the student is assured a place in a medical school class, assuming she performs at an acceptable level. While many of these programs only allow specific majors, some will allow any major, including those which award the BA. Thirty-six of these programs currently exist all across the United States, in sixteen states and the District of Columbia. Program length generally varies from six to eight years, although the University of Wisconsin-Madison does allow extension to nine years. Admissions guidelines vary widely. Some schools specifically state entrance requirements (e.g., the University of Medicine and Dentistry at New Jersey (Newark) expects that their applicants will be in the top five to ten percent of their class with a minimum combined SAT of 1400). Most schools require program students to take the MCAT during their junior year of college. Many require particular SAT II/Achievement tests, particularly those in chemistry and mathmatics. In essence, these programs are appropriate for the student who has already explored the field of medicine and is positive that it is appropriate for him. While admissions criteria vary widely, they all insist that the student be academically superior. As not all programs allow students to leave once they have matriculated into the program, the student must be sure that medicine is the right choice; those with any doubts are advised to consult their college or guidance counselor and consider applying to medical school "normally" in college if they then decide it is the correct choice. For more current information about combined college/MD programs, browse the Association of American Medical Colleges' web site at <http://www.aamc.org/students/applying/programs/collegemd.htm>. Students may also wish to read the AAMC's guide for high school students considering medical careers at <http://www.aamc.org/students/start.htm>. 3.11) What are combined MD/MPH and DO/MPH programs? MPH stands for Masters in Public Health. Public health is an interdisciplinary science of disease prevention. Physicians who work in public health are called preventive medicine specialists. The MPH is the professional degree for those interested in a career in public health or preventive medicine; MPH degree programs usually require approximately 50 additional semester hours of coursework in areas such as biostatistics, epidemiology, health behavior, and health economics. Many programs offer opportunities for specialization in areas such as toxicology, environmental health, epidemiology, and health administration. It is not uncommon for medical schools to offer dual degree programs for medical students seeking public health training. This may add an additional year or two onto medical school. Usually students in dual degree program complete the first two years of medical school and then proceed to their MPH work before finishing the last two years, though some break up school between the third and fourth years. Some programs allow students to take MPH classes in addition to their medical school classes to shorten the length of the program. For more information, see the web sites for the American College of Preventive Medicine <http://www.acpm.org> and the American Public Health Association <http://www.apha.org>. 3.12) Can you tell me about combined MD/MBA programs? Ten schools offer the combined MD/MBA program. They are: UCLA, U. of Chicago-Pritzker, U. of Illinois at Urbana-Champaign, Dartmouth, Wake Forest, Case Western, Allegheny, Jefferson, U of Pennsylvania, and Vanderbilt. This list of schools, with direct links to them, can be found at <http://www.aamc.org/students/applying/programs/mdmba.htm>. Many programs run as two years of medical school, one year of graduate (MBA) school, then a return to medical school for the final two years of medical curriculum and completion of MBA material, for a total of five years. However, there are variances in application processes and program details. For example, UCLA opens its program only to third-year UCLA medical students, who then take a year off for the MBA program and complete the MBA program during the fourth year of medical school. Application procedures vary by school, so your best bet is to contact the admissions department directly and ask for information on the program. 3.13) Can you tell me about combined MD/JD programs? Seven schools offer the combined MD/JD program. They are: Yale, U. of Illinois at Urbana-Champaign, U. of Chicago-Pritzker, Southern Illinois U., Duke, Penn, and West Virgina U. This list of schools, with direct links to them, can be found at <http://www.aamc.org/students/applying/programs/mdjd.htm>. Program details are highly variable. One common method of integrating the two programs is to have the student complete two years of medical school, two years of law school, then complete law school during the final two years of medical school for a total of six years. Applications are generally accepted both from first-time applicants and current students from each individual program; however, as always, the best information about a particular school can be obtained by contacting the school's admissions office. 3.14) What are PAs? Physician assistants, or PAs, provide medical care under the supervision of licensed physicians. For information regarding the PA profession and educational programs, see the web page of the American Academy of Physician Assistants (AAPA) at <http://www.aapa.org>. Another resource is the Usenet newsgroup alt.med.phys-assts. 3.15) Should I consider going to a foreign school? Attending a foreign medical school is a tricky situation. On the one hand, you have the opportunity of attending medical school and graduating with a M.D. degree, but on the other hand, your opportunities for practice in the U.S. are severely limited. Because of legislation, International Medical Graduates (IMGs)--students who obtain their M.D. outside the U.S.--are being scapegoated for the country's oversupply of physicians and their acceptance into U.S. residency training programs is being scaled back. This means that the IMG who does enter the US for residency training generally must score very high on the USMLE and the new Clinical Skills Assessment (CSA) examination, which is only administered to IMGs (cf 7.10, 7.11). The education may or may not be inferior, depending on the foreign school you wish to attend, but whatever the case, attending a foreign school is going to be expensive. Student aid from the U.S. may not be so easy to come by, and you may have to spend more time in school because of the difference in curricula. Take, for example, the system of medical education in Australia versus the United States. In the US, students go through four years of undergraduate college to earn a Bachelors degree and then go on for another four years in medical school for the medical degree. In Australia, students go into a medical program as high school graduates and earn a Bachelors in Medicine and a Bachelors in Surgery in six years. This means that a US college graduate who wishes to attend medical school in Australia will have to spend an additional two years because of the medical curriculum in Australia, which translates into higher costs. Think about your decision to apply to a foreign medical school carefully. Not all are reputable, and boasting a World Health Organization (WHO) listing is not at all impressive. Not all foreign medical schools offer a solid medical education, which of course does not preclude those that do. Speak to your premedical advisor and, if possible, any students at the schools that you consider. ------------------------------ [end of Part 1]