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In 2018, the Association of American Medical Colleges received applications from 52,777 applicants for 21,622 open positions for medical schools across the United States, a rejection rate of nearly 60%. The American Association of Colleges of Osteopathic Medicine fared even worse, with 20,826 applicants fighting for 7,317 open spots. From a quick glance, it’s easy to see that getting accepted into medical school is a difficult proposition, not even taking into consideration that you are competing against individuals who already gained admission into prestigious universities and have spent the last 4 years honing their resume and application.

I am writing this to help out anyone who wants to take on the challenge of becoming a doctor. When I decided I wanted to go to medical school, I had no one to turn to, which resulted in a lot of wasted time and having to learn from trial and error. Growing up in the central valley of California, I never really met anyone that had gone to medical school (aside from my family doctor, with whom I never quite mustered up the courage to ask in between blood pressure tests and the awful hernia check). None of my relatives had ever to medical school, so needless to say I bumped around like a blind mouse, but even blind mice find cheese every once in a while.

I was fortunate that the university I attended, Brigham Young University (BYU), consistently ranks high nationally in dental and medical school applicants. I was able to rub shoulders with the kids of doctors and other types of high-earning professionals, take classes from professors who understood that many of their students were aiming for medical school, and work with a professional career center that has successfully advised hundreds of successful medical school applicants. Much of what I’ve learned has come from working with the counselors at BYU as well as friends and acquaintances I met in premed classes. Additionally, I was directed to online forums like reddit (/r/premed) and studentdoctor where I could ask granular questions and get answers from a wide variety of medical school applicants.

Eventually, I learned enough that I was able to start giving out advice on what to do to start preparing for applying to medical school. I successfully applied and began helping others informally on their own applications. After about a year of coffee chats and lunches, giving the same advice over and over again, I drafted an email I could send out to premed students looking for someone to show them where to start. This article is taken from that email and I hope it can help someone who was in a similar situation to me way back when I first started preparing to apply to medical school.

Before we begin, here are some caveats to the subsequent advice:

I’ve been asked to write about my experience by several persons at different points in their journey to medical school. Accordingly, I’m going to start as if you are an incoming freshman beginning your first semester at college. One of the most frustrating things about preparing for medical school was that most advice I received was too generic. I wanted someone who would tell me what are the specific experiences and achievements that make a medical school applicant competitive. I wanted a benchmark to verify if my progress toward medical school was adequate or if I needed to adjust my plans. For example, some medical school websites tell you to “shadow doctors”, but they don’t mention key details like how many hours or how many doctors you should shadow. So, my goal is to show you what I think is the best way to prepare, with the condition that this is my opinion based upon what I’ve learned. If you come to a point where you feel it would be better to do something different, then it certainly might be best to do so. In the end, I chose not to go to medical school, but rather decided to pursue a career in management consulting, though that part of my journey is a story for another post. However, I did spend three years preparing for medical school, place in the 98th percentile on the MCAT, received multiple interviews at top institutions in the US (including Michigan, UCLA, UT Southwestern and The Ohio State), and was accepted to one of these programs. Many will ask you to reconsider applying to medical school, largely because there are much easier ways to earn money for a living. There are door-to-door salespersons earning $100k in per summer with pest control and security system companies based out of Utah (such as Aptive environmental and Vivint). Both of my brothers are studying computer science and regularly field great offers with high-earning potential. The best piece of advice I have heard is, “If you can picture yourself doing anything, anything else, do that instead. But if you can’t, if nothing will give you the satisfaction that medicine can, it will be the best decision you’ll ever make.” There are other careers that you should consider in your own time that offer just as much fulfillment and purpose in health care and should not be ignored. This includes PA’s (Physician’s Assistants), CRNA’s (Certified Nurse Anesthetists), nursing in general, and PT’s (Physical Therapists). I was a tutor for an MCAT prep course, which you will see me advocate for later. I really believe the course helped me immensely and I am not receiving any sort of compensation to talk about it I just want to be completely transparent here. Anytime I say “The U medical school”, “U of U” or anything of the sort, I am referring to the University of Utah. They’re the only allopathic medical school here in the state of Utah, so we tend to refer to them a bit. They have a terrific premed website and their medical school is known for having very high standards for the kinds (and hours) of extracurricular activities they look for in applicants. I would bookmark their website: https://advising.utah.edu/preprofessional/pre-medical/index.php

Now onto what you really want to know.

Applying to medical school involves a well-rounded application, involving several parts: the MCAT, your college GPA, and extracurricular activities that demonstrate your ability to excel as a physician (community/volunteer service, leadership experiences, research experience, physician shadowing, patient exposure, and actual extracurricular activities).

The MCAT

The Medical College Admissions Test. This, more than any other single indicator, will determine where you can go. Think of this test as the SAT of the medical world. Hearts are lifted or shattered by this test (for proof, check out: http://www.reddit.com/r/premed/comments/2wm3be/i_got_my_last_rejection_letter_today/ ).

To learn more about what is on the MCAT Test, check out: https://www.aamc.org/students/services/343550/mcat2015.html

The test is scored out of a maximum 528 points, with each of the four sections (Physical Science, Critical Analysis (the old Verbal Reasoning), Biological Science, and Social Science) having a possible score of 118–132 points. For reference, see https://www.aamc.org/students/applying/mcat/scores/.

One more clarification I have to make about what would be a sufficient score to get into medical schools is that there are two types of doctors, and thus two types of schools for doctors, MD (Allopathic Doctors) and DO (Doctors of Osteopathy):

MD (Allopathic) schools are the ones that usually come to mind when you think of medical school: Harvard, UCLA, Stanford, USC, UC Irvine, etc. Pretty much any public medical school is allopathic, and most private schools are as well.

schools are the ones that usually come to mind when you think of medical school: Harvard, UCLA, Stanford, USC, UC Irvine, etc. Pretty much any public medical school is allopathic, and most private schools are as well. DO (Osteopathic) schools are much less well-known, and the only ones in California are Touro University — California and Western University of Health Sciences College of Osteopathic Medicine of the Pacific (say that 5 times fast).

The first thing to know about being a DO is that they have every right and privilege that MD’s do. In practicing medicine, there is no stigma associated with being a DO nor should there be. There apparently was a very bad stigma associated with them starting in the 60’s but that has largely disappeared. Nevertheless, there still appears to be some disadvantages to going to a DO school:

They are usually private and as a result generally cost more (I believe the only public DO school is Michigan State University) Statistically it is harder for a DO to get into competitive residencies (further training after medical school that all doctors do). For example residencies like surgery are harder to get into than the primary care specialties, like family practice). Why it’s harder for them, I don’t know. There is a big test in medical school known as the USMLE Step exams that are the big measuring stick for doctors applying to residencies, so whether it’s DO schools not preparing their students as well as MD schools, or if the students they attract are just less able, stats show DO students get into competitive medical schools much less than MD students. In correlation, the average MCAT score of an accepted DO student is usually less than an accepted applicant of an MD school. For a full history of the DO vs. MD, check out: http://medicalschoolhq.net/the-difference-between-m-d-and-d-o/, or just google MD vs. DO or something to that effect.

With all that out of the way, you really need to aim for a 508 or above to be a competitive applicant for an MD school. From this link on the AAMC website, you will see that correlates to about a 76th percentile score for the whole test. Note that a score of 508 is a rough threshold for thinking, “OK, I can apply to some MD schools and maybe get in to a couple.” I had friends with scores between 504 and 512 and their lives were hell while applying. Many ended up on waitlists for medical schools and not all were accepted where they wanted to go. It seems as though the 515–517 range (so 90th percentile) is where you can start feeling really comfortable about your odds.

For DO schools, I’m not as familiar with what scores would be adequate, but I would say anything between a 499 and a 508 is comfortably in the DO school range (anywhere from 48th percentile to 80th percentile. When you apply to medical school, you will generally apply across a broad spectrum of schools since no matter where you score, you never know what can happen (unless you get around 525+, then you can take your pick). Even with my score being at the 98th percentile, I still applied to one DO school and to at least one of each of the “tiers” of medical schools.

How to prepare for the MCAT

First, start taking the classes suggested by your target medical schools and do well in these classes. The nice thing about the classes that medical schools require you to take is that they align pretty well with the classes which you need to take to prepare for the MCAT. I will talk more on classes down in section #2 and near the end of this post I will show you the timeline my school presents for getting ready for the MCAT/medical school.

Once you take those classes (and dominate them!) you have a choice. You can either:

Study on your own using study materials (e.g. Exam Krackers or Princeton Review) Buy an MCAT prep course like Kaplan, Altius, or Next Step. Alternatively, your university may offer some sort of specialized prep course.

I took the Altius prep course for my MCAT preparations and I highly recommend their course. Looking back, I definitely could have learned the material on my own, given enough time and experience. The problem is that most students don’t have these luxuries. All of the reputable test prep programs start at around $2,000 and, in my mind, you need to look at that as an investment into your training to become a physician. Everyone with whom I have spoken who has done a prep course has said it has been money well spent. I’ve seen too many cases where people try to self-study, do poorly on the MCAT, and then delay their application until the following year so they can improve their MCAT score. Rather than take that risk, I say approach this test with a healthy amount of respect and invest in a program that can assist with getting a good score the first time.

College Courses/GPA

The second most important factor is your GPA, which serves as a measuring stick to see if you can handle the curriculum in medical school (which I have heard is equivalent to taking 25 concurrent credits of hardcore science ). This is going to be the best indicator of whether you can handle medical school or not. Odds are, if you can’t get rocking grades in chemistry, organic chemistry, anatomy, physiology, etc., it’s a good sign that you should look towards other careers. That isn’t to say you can’t have one bad grade, I got a B- in my second semester of organic chemistry, but you need to aim for at least a 3.7 cumulative GPA and 3.5 GPA in science courses. Other thoughts:

Medical school admissions committees will look at both your GPA in science courses as well as your total GPA

There is no one “medical school” major, you just need to complete the prerequisites for medical school. That being said, I chose to do Exercise Science for my degree because it overlaps with the prerequisites for medical school so I didn’t have to take so many extra classes. The down side of this major is that many other students do it as well, so you don’t stand out as much as a music major would, for example.

Each medical school has their own special list of classes they require you to take (Stanford doesn’t have any requirements at all). Each year the AAMC publishes a database entitled the, “Medical School Admission Requirements” (MSAR). It costs about $30 for a year of access and reviews every allopathic (MD) medical school. I highly recommend this book so you can get an idea of each school’s required classes.

BYU did a great job of getting students on track for the MCAT and below is a general outline they have for students. From what I’ve seen, most universities have this same general format for pre-med required classes:

Year 1 — Semester 1:

General Chemistry 1

General Biology 1 (this may be more than a semester at some universities)

Psychology 1 / Sociology 1

Year 1 — Semester 2:

General Chemistry 2

General Chemistry Lab

Microbiology (With Lab)

Year 2 — Semester 1:

Organic Chemistry 1

Genetics (Note that I did not take this course, I would argue that what genetics you need to know for the MCAT does not warrant a full semester)

Year 2 — Semester 2:

Organic Chemistry 2

Lab for Organic Chemistry

Physics 1

Physics 1 Lab

Year 3 — Semester 1:

Physics 2

Physics 2 Lab

Biochemistry

Year 3 — Semester 2:

Human Physiology (note, aside from doing an MCAT prep course, taking this class the semester before my exam was one of the best decisions of my life. Take your human physiology class right before you do the MCAT).

you do the MCAT). MCAT Prep Course

Between Year 3/4: Take the MCAT

Year 4:

Finish Bachelors, do medical school interviews

Note that the above plan is geared toward the MCAT. Medical schools will require other work besides what I have listed, such as classes like Statistics and English. Additionally, many California schools also strongly recommend Spanish. If you have an idea of where you would like to go to medical school, consult the MSAR, identify that school’s prerequisites, and use those prerequisites as a guide for choosing your classes.

Extracurricular Activities

On the application for allopathic medical schools, you are given 15 individual spaces in which you get to include any and all extracurricular activities you would like the admissions committees to see. To help organize what types of things they want to see, extracurricular activities (ECs) can be further broken down into the following categories:

Community/Volunteer Service

The University of Utah premed website states, “The medical profession is strongly oriented to service in the community. Applicants should demonstrate a commitment to the community by involving themselves in service and volunteer activities.”

From what I’ve seen, medical schools are looking for a certain length of time. Pick 1–3 organizations and volunteer with them on a regular basis, the longer the better. We’re talking multiple year commitments here. Just pick a couple of organizations during your first semester and go from there. The idea is to stay long enough in an organization to eventually become a leader in one them (which will come in handy for the next section). They do not have to be academically rigorous, difficult, or related to anything medicine or science!

Here are some examples of service I’ve seen:

Organizing and running a charitable marathon

Teaching 6th graders basic anatomy and health courses

Volunteering at an Emergency Room

Volunteering as a wrestling coach

Have fun with this, do something you like and can really dive into. Anything from scouting to Special Olympics will work, and the more impact you can have within an organization, the better! According to the University of Utah pre-med page, the average applicant devotes 48 hours during each of the 4 years prior to entering medical school. Aim to volunteer 2–4 hours a week during your time in college and you’ll be in a great position. This may sound a little excessive, but this will help in our next section.

Some websites (student doctor network, /r/premed) infer that you should split this into Clinical (hospital/medical setting) and Non-clinical volunteer work. I wouldn’t worry about this at the beginning, find something you enjoy and just get started.

Leadership

Referring to the University of Utah premed website again, “Leadership is defined as a position of responsibility for others, with a purpose to guide or direct others. Dedication, determination, ability to make decisions and a willingness to contribute to the welfare of others are indicators of one’s ability to succeed in medicine. Individuals with these characteristics readily accept positions of leadership and are an asset to their community and profession. Leadership capacity can be demonstrated in a variety of ways. Positions in employment, church, community and school organizations including coaching, tutoring and mentoring will satisfy this requirement.”

The average applicant has 3 different leadership experiences each lasting 3 months during the 4 years prior to matriculation.

Here are some examples of leadership activities:

Officer in the Premed club

President of a club rugby team

Manager for a charitable race

Church/Religious callings that required directing and leading other volunteers

Military service

One of the interesting aspects of this is that many leadership opportunities for medical school applicants arise out of the volunteer experiences that they began towards the start of college. It makes sense that when you volunteer somewhere on a regular basis for 3–4 years, the odds are good that you’ll be placed in a leadership position. Two of my three leadership experiences began because I was looking to volunteer for an organization and stayed with them for a couple years or more. As a result, my recommendation would be to not look explicitly for leadership experiences, but rather seek out volunteering opportunities and employment early on and stick with them over the course of your undergraduate degree. Over time, these will evolve into leadership experiences and you can then supplement your application in the later part of your college experience with other volunteer opportunities.

Research

The U recommends getting at least 48 hours in. At BYU, getting into research comes by getting to know your professors and expressing interest in working for their labs (and almost every professor here does research). In some cases, this may be for class credit. In my case, I was paid $10/hr. for my research. Ideally, you become so involved that the professor adds you as an author on the research publication. This was probably a weak point on my application, as I did not have a publication credit on my resume, but nonetheless, I still worked in a lab. Research is one area of your application that is going to be sensitive to the quality/prestige of your undergraduate university. Lower-tier universities tend to have less funding for dedicated research, which translates to fewer opportunities to assist professors in their research. If you end up going to a state school where the professors do not have as much funding for research, it can be more competitive. As someone who went to community college before getting into my undergrad, I had to wait until my junior year to get any research experience whatsoever.

The great news is that medical schools do not care if the research about medicine/life sciences. They are looking for students who are curious about the world and have demonstrated that curiosity. Find a research project that interests you, where you can find mentorship from the professor, and don’t worry about whether the research is something related to medicine. Find a lab that gives 5–10 hours of work per week and work there for a year or more.

Physician Shadowing

The goal for physician shadowing is:

Get a sense of whether you can see yourself doing the specialty you’re shadowing Develop a relationship with the doctor to the point that they would be able to write a strong letter of recommendation for you (more on this below)

This was a nightmare to do in Provo. Utah is not very populous and there are a ridiculous amount of pre-med students at BYU, so it’s really hard to find a doctor to shadow in Utah Valley. Another reason why shadowing is so hard in the Utah Valley is that many doctors have been turned off by rude/disrespectful students to the point where they refuse to let students shadow them.

As a note, when you shadow, here are a couple rules to follow:

Dress professionally

Be respectful

Be attentive and ask questions

Leave your phone in the car

Finding opportunities to shadow can vary:

Cold calling physicians

Finding contacts via your university’s pre-med club

The best option is using personal connections

This more than any other step will actually cement your desire to actually be a doctor, and it will help you figure out what kinds of medicine you like. For example, I have loved being in the ER, orthopedic surgery, and oral surgery, but I don’t think I would ever be an anesthesiologist. I highly recommend, before you do anything else on this list, that you get out and shadow. The U recommends shadowing for at least 24 hours. This is one number from the U of which I am actually wary of, as I ended up with closer to 50 hours per the advice from the BYU pre-professional advisement center.

Patient Exposure

This requirement is actually a bit unique to the U, so I’m not sure if all medical schools look for this kind of activity, but it’s just one more thing to add. Per the U website, “Patient exposure is defined as direct interaction with patients and hands-on involvement in the care of conscious people in a health care related environment, attending to their health maintenance, progression or end of life needs. It is important that the applicant be comfortable working with and around people who are ill, sick, injured or diseased. Direct patient exposure can be gained in a variety of ways e.g. volunteering or working in hospitals, emergency rooms, clinics or nursing care facilities, hospice or physical rehabilitation centers. Patient contact does not include indirect patient care such as housekeeping (cleaning operating or patient rooms) staffing the hospital information desk, or working in a pharmacy.”

The average amount of exposure is 48 hours, and note that the University of Utah Medical schools will not let physician shadowing nor caring for relatives count towards this requirement. Again, this is a unique requirement to the U medical school, but it does boost your application no matter where you apply.

A popular choice that checks off a lot of buckets is working as either an EMT, a phlebotomist, or as a CNA. Each requires some sort of certification that can be acquired from a night/weekend program and provides more than enough patient exposure. Due to the difficult job descriptions of being a CNA or a phlebotomist, becoming an EMT at BYU was way more popular. So much so that there were a surplus of EMT-certified students in the Utah Valley. As a result, it was extremely difficult to even volunteer as an EMT anywhere near BYU. Given that you only need 40–60 hours of exposure, you don’t need to go through all the trouble/expense of getting a certification and in my experience there are plenty of nursing homes that can use volunteers/paid staff.

Actual Extracurricular Activities

Although this is a checklist, make sure you don’t treat your application as a checklist. College should be a fun experience and you should use your application for medical school to push you into doing fun and challenging activities. The BYU pre-professional advisement office states: “Get involved! Sports, clubs, church, work, and hobbies can all demonstrate your ‘well-roundedness’. It is better to become deeply involved in a few activities than to be superficially involved in many. Anything that is outside the ‘norm’ is a plus on your application.”

I heard about a guy who wrote about doing demolition derbies on his personal statement. The idea here is to stick out, and how many admissions committees get to read about demolition derbies? My guess is not many, which meant this guy stuck out. I am restoring a wooden sailboat that my grandfather built (at which I’m failing miserably, but it did make for a great story). Try to find something fun that you can be passionate about. Often times these purely extracurricular activities will become talking points during your medical school interviews, so don’t fake any experiences or it could backfire. You don’t need to be a world-famous explorer to stand out here either, just be genuine and engaged about the activities you’re involved with.

Letters of Recommendation

Letters of recommendation are letters written on your behalf by a number of people who will be able to attest to your ability to succeed as a medical professional. These will come from supervisors in organizations where you’ve volunteered or worked, professors from classes you’ve taken, and doctors whom you’ve shadowed.

For the most part, by the time you get to this point in your application, you’ll know what you’re doing already and won’t need my advice. Every university has their own specific requirements for letters of recommendation and it would be more beneficial if you researched each school’s requirements personally when the time came. From what I’ve seen, you will want at least 3 letters of recommendation from professors, two from science courses and one non science, one from a physician (probably from your shadowing experiences), and one from any of the “supervisors” you’ll end up knowing from some of the other activities in this list.

The reason I bring this up now is that you will want to ask professors who can really give you a strong recommendation and who know you personally. This is going to be a lot harder than you think when you walk into your classes and it has 300 students. The point is that once you start school, plan ahead, go into the professor’s office, talk to them regularly, and make sure they know who you are and that they can attest to you being a good student.

The best way to initiate this whole process is to go in at the start of the semester and say, “I really enjoy your class and how you teach. The subject matter fascinates me. I am preparing to go to medical school, and at the end of this semester I would really like to be able to ask you for a letter of recommendation. What would you suggest I do so that, come the end of this class, I can confidently come to you and ask you for a strong letter of recommendation?” This will:

Let you know right away if they even will write you a letter (you don’t want to kiss butt for a whole semester just to find this out, trust me) Make you stand out to him/her from the start Set an expectation from the start for the professor.

Once that is all done, participate! Be that annoying kid always raising your hand and asking questions, answer his/her questions, stick out, and develop a real (to the extent possible, let’s not scare the professor) relationship.

Conclusion

The challenge with creating a checklist like this is that there is a danger that one completes all the tasks without transforming themselves as part of the process. Medical schools look for these activities and achievements because they indicate that the applicant is a high quality individual who can handle the rigors of medicine and can demonstrate the selflessness and sacrifice to be a physician. One of my professors noted that despite BYU’s incredible average statistics for incoming freshmen, BYU alumni that place into top tier medical schools are very rare. He thought (and I agree at this point) that too many alumni ended up becoming “checklist” applicants. They would have the stellar resume, the high MCAT score, they shadowed physicians, and they volunteered as EMTs, everything you’d want to see on an application. But what they lacked was the story, that all-encompassing answer to question, “why medicine?”

When medical schools look at an application, they want to see a cohesive picture that connects all the parts of your application into a narrative that gives insight into your character and personality. In the end, any decent medical school application is going to have what I’ve describe above. You should view this checklist as necessary, but not sufficient to complete the medical school application. In order to stick out, your story will have to be genuine to you, and not something I can describe as part of a checklist or set of instructions. My advice on how to set out accomplishing this would be to use the experiences described above to explore the different aspects of medicine and take time to reflect on what you’ve enjoyed and what moves you.

Network with pre-meds and medical students, asking them why they chose medicine and what is their story. As you spend time listening to people and helping them, ideas and concepts will begin to resonate with you. Take the necessary time to ponder and grow as you undertake these experiences. There’s no shortcut to preparing for medical school and admission committees are very sensitive to disingenuous attempts at showing sincerity.

I’m sure this all seems overwhelming. The great thing about the pre-med journey is that it can be very enjoyable and it is overall a good map to a great undergraduate experience. I tell anyone going into college that if you go through college as if you want to go to medical school, by the time you graduate you’ll have a resume that can compete in any field. The process naturally pushes you to connect with organizations and become involved in multiple facets of your school, your community, and other organizations where you live. I found that although I did not end up choosing to go to medical school, I really appreciated the person I become as part of this process. If after reading this novel, you have any questions, please feel free to reach out to me at: premedkyle@gmail.com. Good luck!

Random Notes