Signet’s own Scott L. shares some valuable insight about his medical school experience.

Tell us a little bit about your own experience applying to medical school.

I followed the “standard” timetable of applying direct from college, without a gap year. (At the time, taking time off between college and medical school was still considered unusual; things have changed considerably since then.) I was applying MD/PhD, which affected some of my decisions, although not my overall timetable.

I took the MCAT in April of my junior year and lined up letters of recommendation that spring. My letters were from the head of the lab where I was working on my thesis, another P.I. (principal investigator) in whose lab I had worked the summer between freshman and sophomore years, two professors, and the teacher in the classroom where I was volunteering. I submitted my AMCAS application in June and spent most of that summer filling out secondary applications.

I applied to 19 schools and got interviews at 16 of them, so my fall semester of senior year was very busy! I got five acceptances, but only one (Washington University in St. Louis, where I ultimately went) was among my top choices. A few schools accepted me into the MD or PhD program only, but turned me down for the joint program, and the rest rejected me. I’m happy with how things turned out, but in retrospect, I probably should have applied to a few more schools. Applying to medical school (especially MD/PhD) is really competitive, and nothing is guaranteed, no matter how strong your application is.

How do you generally advise students go about preparing for the MCAT?

Practice, practice, practice! Unlike the GMAT or LSAT, the MCAT is not primarily an aptitude test; rather, it tests your mastery of a specific body of knowledge. However, many, if not most, of the questions are based on data interpretation rather than straightforward recall. The AAMC, which develops and administers the MCAT, regularly releases old examinations, and these are by far the best guide to what the actual MCAT will be like. (The practice exams in commercial prep books are a fairly reliable guide to content, but generally fail to capture the “feel” of the questions on the MCAT, in particular the balance of recall vs. data interpretation.) I advise students to start by taking one or more practice exams—ideally the actual released MCAT exams—to identify their areas of weakness as specifically as possible, then work on shoring up knowledge in those areas. As the exam gets closer, focus on taking exams under as close to actual testing conditions as possible. The MCAT is an all-day exam, and stamina will become an issue. Learning your circadian rhythm, and finding out how your brain and body respond under prolonged stress, will help you maximize your performance.

To take or not to take a prep course is a controversial question, and the answer depends very much on individual circumstances. If you haven’t learned the core material tested on the MCAT, no prep course can make up for that. But prep courses can help with study strategies, and can help you pinpoint your areas of weakness and focus your studying accordingly. They also force you to set aside time to study, which may be important if you are taking a full load of courses or dealing with other distractions at the same time you are trying to prepare.

Finally, one thing that is often overlooked, but critical: Register for your test date and site as early as possible to maximize your chance of getting your first choice. Desirable test dates (e.g. January and April-May) and location (any site near a college) fill quickly, and MCAT test day will be stressful enough without having to worry about getting to the testing site on time.

What do you recommend students consider in order to determine how many schools to apply to?

In general, most students should apply to about 25-35 schools. Students with weaker applications will want to apply to considerably more to maximize their chances of admission. (I can’t imagine a reason to apply to considerably less.) The major considerations in deciding how many schools to apply to should be:

Overall strength of application: This should be the overriding consideration. If you have a very strong application, you can afford to stick to the low end of the range and apply to around 25 schools. If your application is on the weaker side, you will probably want to apply to closer to 40 schools, possibly including D.O. schools as well as allopathic (M.D.) schools. Either way, most schools you apply to should be a good fit in terms of average GPA and MCAT scores, and overall profile (i.e., the school’s orientation towards research vs. primary care should match your application). No more than 25% of the schools you apply to should be “reach” schools.

State of residence: State schools are often—but not always!—the “safety” schools for residents of that state. They are also often the best bargain if you are eligible for in-state tuition. However, some states have many state schools (Texas, California), others have only one (Massachusetts), and others have none. (Students from a state with no state medical school may be eligible for preferential admission and in-state tuition in a neighboring state.) The number of state schools, and how competitive they are, may significantly impact the total number of schools students choose to apply to.

Geographic considerations: If you have a very strong desire to attend medical school in a certain region—for example, if you have a spouse whose job is not mobile or are caring for an elderly relative—then you will want to apply to all of the schools in that region (even ones that you might not otherwise apply to) at the expense of other schools that might be a good fit, but are ruled out due to distance.

Financial considerations: Applying to medical school is expensive, and each additional school you apply to adds to the cost of your application. There’s no point in throwing money away by applying to a school that you would be unlikely to attend even if accepted. However, not applying to a school that would be a good fit just to save money could reduce your overall chance of getting into medical school. Financial assistance is available for applicants who can demonstrate financial need, but you do need to apply in advance.

Once they’ve been accepted to med school, how should students get themselves prepared to actually begin classes?

For students coming to medical school directly from college, particularly science majors, the content covered in first-year medical school courses will not be that far a reach from the material covered as an undergraduate (although the volume and pace will probably be faster). For non-science majors or students who have spent significant time away from school, it’s probably worthwhile to review cell biology and biochemistry, and perhaps a little bit of organic chemistry (particularly properties of functional groups, and basic substitution reactions, which are relevant to pharmacology). Your school may have recommended resources available for this.

It’s important to review the curriculum at the school you will be attending. Medical schools today are much more diverse in their format and curriculum than they were just a few years ago. A few are still traditional (lecture-based), but many have adopted a case-based or problem-based curriculum, and/or shifted to active learning, with core content delivered outside of class and class time spent working on problems in small groups (the so-called “flipped classroom”). If you will be facing an unfamiliar learning format, it’s probably worthwhile to read up on how best to succeed in that format and possibly solicit advice from current or former students.

Finally, many schools offer pre-matriculation programs organized around specific interests: wilderness medicine, social justice, etc. These can be a great way to find out more about the school and the city, and meet some of your soon-to-be-classmates. Most MD/PhD programs will offer you the opportunity to do your first research rotation the summer before you start classes, which will allow you to move in early and spend the summer acclimating to your new home, as well as getting one of your research rotations out of the way.

What’s something you wished you had known about medical school that you want to share with readers?

I wish I’d known to focus less on classes and grades, and more on the experience. In the pre-clinical phase of medical school (the first year and a half to two years, depending on the school) you have a lot of details thrown at you. Some details are important, others not so much, and some will be wrong by the time you enter practice. It’s the big-picture stuff—how to evaluate clinical information to generate and prioritize a differential diagnosis, how to establish rapport with patients, etc.—that is essential to becoming a good doctor. Also, medical school curricula include a lot of planned repetition. Although you will have a massive amount of material thrown at you in a short time, the information that is truly critical to taking care of patients will be repeated multiple times, in different contexts, both in class and on the wards (clinical clerkships) in the later years of medical school. It’s OK if you don’t pick up every detail on the first pass.

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