Perspective on Applying to Medical School as a Third Year Applicant

Credit Flickr: TzofiaIntroduction: this post was co-written with one of my long time readers, Spencer, who recently applied to medical school as a third year applicant. He is applying again this year as a fourth year applicant. I have added in some of my own commentary to his hope, and I hope you find this perspective useful.
 

Spencer: I am currently finishing my BSc. at an Ontario university. The schools I applied to last year were McMaster, University of Toronto, Queens, and uOttawa (english). I was fortunate enough to receive interview invites for U of T and uOttawa. When I applied last year, my OMSAS GPA was 3.96 and my MCAT score was 33 (PS:11 VR:10 BS: 12).

Are third year applicants disadvantaged when applying to med school?

The short answer is maybe. I say this because there are implicit disadvantages that come with being younger and less experienced. However, most schools do not have official restrictions on undergraduate applicants. In Canada, there are medical schools that will accept applicants after having completed two or three years of post secondary education. There are only a few schools – Western University, MUN (Memorial), Dalhousie, Manitoba, Montreal, McGill, NOSM – that absolutely require a four-year bachelor degree.

Medaholic: The majority of accepted medical school applicants will have completed a bachelor degree. Certainly, getting in to medical school before finishing a degree is no easy task and you will be in the minority.

How applying earlier affects your GPA

The way your GPA is calculated as a third year applicants can leave you at a disadvantage. For example, at the University of Toronto, third year applicants do not qualify for a bonus weighting formula that eliminates your lowest marks.

Similarly, Queens‘ GPA grading system considers the two most recent years in their calculation, which can help applicants who did not do as well during their freshman and sophomore year. These special GPA calculations can make the difference in admissions, especially if an applicant only has a few bad grades that are dragging down their GPA. I have a friend who applied this year without success because of a C in first year calculus that moved his GPA below whats needed for an interview. However, now as a fourth year undergraduate, he will be a competitive applicant for the schools with the adjusted grade weightings.

Medaholic: Most schools will preferentially – through bonus grading mechanisms – give better GPAs to applicants with degrees.

Lack of extracurricular activities

I think another big disadvantages of being a third year applicant are fewer life experiences in general. This manifests itself in a number of ways throughout the admissions process.

First, it is challenging to have meaningful activities with longevity and impact in the first few years of post secondary when compared to graduate students and older applicants. As a result, your autobiographical sketch may not be as impressive as other applicants competing for the same spots. In addition, writing the personal essay prompts may be easier when you have more activities to draw examples from.

There are some schools that do take measures to level the playing field. For example, the University of Ottawa only uses the top three entries in each of the ABS categories that were completed during your undergraduate tenure and McMaster does not include the ABS in their official pre or post interview score.

Interview Process

Similarly, in medical school interviews, you may be asked about any area of your application such as leadership, teamwork, volunteering, etc. During some of my interviews, I was asked to give examples of times that I displayed certain traits. In my case, there were occasions where I had to examples from high school. This is often fine for most situations – a lot of applicants accomplished interesting things before university. However, I cannot help but think that an interviewer may often interpret a high school experience inferior to one in a more professional setting, eg. leadership for high school hockey vs. leadership in a laboratory or hospital setting.

It is worth mentioning that some third year applicants do manage to build a comparable résumé to those older applicants. Personally, I know of people who were able to fill every entry in the autobiographical sketch by the time they applied in third year but that is the exception, and it can be challenging to do so.

Medaholic: Having been on the admissions committee before, I find the interviews are quite fair for third year applicants. Interviews help assess maturity and composure, and although they are often correlated with age, I have found that often not the case. I have interviewed grad students who were definitely not ready for medical school, and I’ve interviewed a few young applicants who would make a great fit.

How should I prepare to apply during third year?

A friend of mine, who was accepted to four Ontario medical schools after third year, made a post on premed101 that explores this in great depth:

It is important to take advantage of any opportunities in extracurriculars activities, volunteering, and research early on. However, third year applicants have a very small pool of grades that make up their GPA. Medaholic has talked about this in previous posts- grades are what gets your foot in the door. Take the time to ensure that your grades will not suffer because it can ruin your chances in a lot of circumstances . You need to find your balance between school and extracurriculars.

Medaholic: One consistent trend among successful second and third year applicants, is they have perfect or near-perfect GPAs. They maximize their grades and MCAT to make up for deficiencies in their extracurriculars. This will usually help them get to their interview stage, where their performance on it will be the key determining factor.

Should I apply in my third year?

If you have a chance of being competitive at any school and can afford it financially, I strongly advise applying. Each school has different requirements, exceptions, and cut-offs so it is tough to give the exact stats that one should possess to consider applying. It is difficult to get an acceptance, regardless of age/experience/GPA/MCAT, because there are so many components to the admissions process. You have to be able to put yourself out there and give the admissions process a try.

Medaholic: If you think there’s a remote possibility that you could get accepted, I say go for it. If you have top grades and a strong MCAT, you should definitely go through the experience. Best case scenario is you get accepted, worse case scenario is that you’ll have gone through the process once and be more prepared for it the second time. If your chances are slim, ie you have a 3.0 GPA and a 27 MCAT, I would suggest saving your money and only applying if you have a real shot.

Lessons Learned

Applying this year, I feel much more comfortable and confident with the process. I knew to start my personal essays earlier, I tackled my CASPer preparation in a different way, and I made minor adjustments by troubleshooting the previous cycle. Working with a system like OMSAS is much easier the second time around. I now feel like I am a professional at shortening a description of an extensive activity to a mere 150 characters.Having done medical school interviews now, I feel like I have a better idea of what to expect this time around. Overall, it was a valuable experience.

This all only applies if you are 100% sure that medicine is the field for you. If you have any reservation about pursuing medical school, I suggest taking at least the extra year to reflect and explore all of your options. It is a stressful and expensive process and I advise putting a lot of thought into whether or not medicine is what you actually want before you go through the admissions cycle. An extra year of undergraduate studies can give you time to shadow a physician or explore other options.

Do Third Years Ever Get Accepted?

There are not many published statistics from Canadian medical schools about the number of third years accepted each year but many do receive offers. I did not end up being accepted but numerous people with similar backgrounds and grades were successful applicants. It might be an uphill battle as a third year but it is by no means impossible.

Things could have easily gone a different way for me. Since I was waitlisted at U of T and “good” waitlisted at U of O, it felt like I had just missed the cut. This was a tough to swallow since I felt that I had invested all my faculties to gain an acceptance, yet I was not successful. However, the benefit of being a third year applicant is that if things do not work out, nothing changes. You go back to school and you can apply again immediately. The next cycle, you will have a better application and greater experience under your belt. I have thoroughly enjoyed my fourth year so far and I feel that my current studies, research, volunteering, and extracurriculars will serve me well in my future career.

Medaholic: I probably have a better knowledge about accepted third year applicants having gone through medical school and residency and being involved in admissions. Second and third years get accepted all the time. I would say at the schools where they can be accepted, they make up about 10-15% of the class. The ones who do get admission tend to be strong applicants who would have gained acceptance in their fourth year regardless. They are often quite driven and have had a plan from day one of university. For example, looking at the University of Alberta entering statistics,  2/3 year applicants had on average a 3.96 GPA, ~35 MCAT vs 4 year applicants who had 3.9 GPA, 33 MCAT.

Medaholic’s Final Take

I can relate to Spencer’s post. I applied and was accepted into medical school as an early applicant. A lot of times, my undergrad schedule was not in alignment with other pre-meds. I took a lot of prerequisite courses such as stats and organic chemistry a year earlier and I wrote my MCAT the summer after my first year.

I found when I applied, I also lacked in volunteer and extracurricular experiences. I think I was able to beat the odds and be interviewed because of a strong GPA and MCAT and a solid interview. There was probably also a lot luck. I also wasn’t accepted to medical school the first time I applied. I had experiences applying to combined B.Sc/MD programs during highschool. Although I was rejected from those programs, I think the application process was valuable to positioning myself for future success.

Overall, if you know for sure that you want to do medicine, and can financially and realistically apply earlier, it’s worth a shot. It’s a bonus if you do get in, and you may save yourself some time and money since medical education is so long already. I’m in my seventh year of “medical training” and there’s at least two more years to go before I can practice independently. I can confidently say I didn’t regret applying earlier. I certainly don’t think I missed out on anything in undergrad.

Please post questions for Spencer of myself in the comments below. We will try to answer them to the best of our knowledge.

Figure 1 App Review

Figure 1 IconIt’s been a long time since I reviewed an app, but the one that I have been meaning to for the last year has been called Figure 1. (Free)

To sum it up succinctly, it’s Instagram for medical doctorsCreated by Dr. Joshua Landy, a critical care doctor, it’s a mobile platform that allows medical images to be shared for educational purposes. It has recently received $4M in Series A funding led by Union Square Ventures, and there are constantly new features coming out that are promising.

At the heart of it, Figure 1 lets health care professionals do something they have been already doing better, share medical photos. From interesting xrays and ECGs to strange rashes and sometimes gory pathology, Figure 1 is also a community where people can comment and teach around these images.

It also addresses the concerns of patient privacy, by letting users de-identify images with black markers and boxes before they are uploaded. There’s also a built-in feature where you can ask for patient consent before uploading.

The interface is clean and simple. In the last year that I have been using this app, there has been tremendous growth and improvements. Over 100,000 health care professionals are in the community, and the interface has become better and better

ImageDiscussion

There’s also a feature where you can browse through a series of image. In this case a CT scan of the abdomen uploaded by penguinophile (who has many excellent radiology images) is posed as a question. The most interesting part is often the discussion that takes place and the educational experience of learning in a community.

Anatomical Specialty

You can also browse by anatomical location or specialty if there are areas that interest you.

User Profile

Finally, the community is what makes Figure 1 unique and having a platform for users to upload images interact is what really drives the app. Pictured here is my profile and some of the pictures I have collected over the years. As you can see, you can have your profile verified for credibility.

I look forward to the many coming features including customized feeds depending on specialties and users, and better notification systems.

Join me on Figure 1 – a free medical image library for healthcare professionals. To sign up, visit: http://download.figure1.com/twcc

N.B. – I am part of Figure 1’s beta testers, and have used a referral link in this post. 

How to Pack a Suit for CaRMS Part 2

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I’m on the interview trail for my MSM (Medicine Subspecialty Match) for CaRMS. I’m starting to realize… the interviews never end. You just get more specialized and specific with each one. Medical school, residency, fellowship…. then jobs… Nevertheless, I would like to think I got better at packing and travelling over the years, even though I do a lot less of it now. I stumbled upon a great tutorial from Business Insider on how to pack your garments and  keep everything pretty much wrinkle free. I was quite happy with the results. Three years ago, I wrote a post on various ways to pack a suit in a carry on. I think I’m going to use this method for the next little bit. To those who are also on CaRMs travels, good luck. For those who are about to begin (4th year medical students), enjoy the process!

The Shortlist – Respirology vs Critical Care

Lungs

I’ve been busy these last few months, and what’s currently pre-occupying me is applying for fellowships.

I remember putting together a shortlist of specialties that I wanted to do in 1st year, 2nd year, 3rd year medical school, as well as subspecialties of internal medicine in first and second year residency.

I finally narrowed it down to two specialties that I really enjoyed – respirology and critical care, but in the end, I only applied to respirology – also known as pulmonology for my American readers.

It wasn’t an easy decision to forgo critical care. In fact, if they had the combined respirology / critical care fellowships in Canada like they do in the USA, I would have done it in a heartbeat. When I was a third year medical student, I did an ICU elective that solidified my interest in internal medicine. I loved the complexity, the physiology, the need to integrate broad fields of knowledge to make a difference and save lives. It also helped that I was pretty good at doing procedures and became quite comfortable putting in chest tubes and central lines. It was life and death situations and being there for patients and families in poignant and life-changing moments.

Fast forward to residency and I found I still very much enjoyed critical care. I enjoyed carrying the code team pager and found resuscitation and leading a well run team to be exhilarating.  I was touched by the patients I encountered and the dedication their families had for them when they were critically ill. But I also realized that loving what you do is not everything there is to a career. For everything that you invest time in, you must also consider what you may be sacrificing. My decision was also helped out with the fact that I liked respirology just as much.

On the surface, respirology and critical care share many common attributes. The airway and oxygenation physiology is a key subject in both. There are procedures in both specialties and a good breadth of practice in both, with perhaps critical care requiring a wider base of knowledge. But when you start practicing, you realize the day-to-day is intrinsically different.

In respirology, you see a wide breadth of ages and acuity of illnesses. You may see a young man with a new diagnosis of mild asthma, and in the same day see a patient with pulmonary fibrosis who is pre-transplant and waiting for lungs. You get to talk to patients and get to know them, and follow and treat them for years. It’s a good mix of clinics, procedures and inpatient consultations. And you can have a fulfilling career that won’t involve you being in-hospital call and answering pages overnight.

I ended up talking to fellows and staff physicians in both specialties. I even talked to staff that practiced both respirology and critical care. The reality these days is it’s hard to practice both, especially since critical care has matured into its own specialty rightfully so. There really is too much to know to be good at both. Most respirologists who work in the ICU have given up their respirology practice.

Furthermore, I talked to fellows who were on their second fellowship or in the middle of their PhD. The job situation is a lot tighter in critical care, as you need to find a unit to be tied to, and it has to be big enough to be financially feasible. Many told me, “if you like any other specialty as much, you should go do that instead.”

It’s these combination of factors that have made me apply solely to respirology. I am happy with my choice. I do have moments where I wish I could go work in the ICU from time to time. But I don’t think I’ll mind having my evenings and most of my weekends free from work. I’ve been told I could pursue a critical care fellowship afterwards, but would I want to do more training after being a trainee for over a decade?

So that is my shortlist for now. Just respirology. I hope I get accepted to my program of choice. If so, tune in for the next edition of the shortlist: respirology subspecialties.

Photocredit : lisabuddka (CC)