The End of the Beginning

Source: rkramer62

Source: rkramer62

I started medaholic eight years ago to document my transition into a doctor. It’s been a crazy adventure, but I made it. I’m now a fully licensed doctor in internal medicine.

I’m a much different person now than when I started this journey. Back then, I was fresh out from undergrad, young and optimistic. When I entered medical school, I didn’t know what to expect. Looking back now, medical school was challenging but also fun and filled with happy memories. I made some lifelong friends, some of them, now family.

Residency is when you actually become a doctor. Medical school gives you the tools and prepares you, but residency is when you get to practice and treat patients. You get to live and breathe patient care. You hone your craft and learn to heal people, and most of the time, it has nothing to do with knowledge.

I don’t know what’s to become of medaholic. I have some time to figure it out. I’ve been trying to write something for the last year but all I have is a bunch of saved drafts. I might update some old posts so they remain relevant. But I’m not that interested in MCAT or medical school admissions anymore. My interests have shifted and what used to be an obsession is now an afterthought.

I’ll still reply to emails – that’s one of the highlights, hearing from readers and their successes.

Finally, thanks to everyone who has supported me and have left thoughtful comments and emails. It’s been a pleasure meeting so many people and knowing that I may have helped in some way.

Here’s to the end of my training and to the beginning of being a doctor.

Be kind, for everyone you meet is fighting a hard battle.

Not much time to update these days, but found this excellent blog post that needed to be shared.

Too many times I’ve seen patients turfed from service to service. In the lounges, emergency doctors are ridiculed and colleagues bad-mouthed. Everyone thinks their specialty is the only service that actually looks after patients. This has to stop and everyone needs to be part of it.

I was on call the other night and teaching a soon to be senior-resident, how to survive in her next year. My best advice to her was to “be nice to everyone, not just the patients.”

Things You Need to Know about the 2015 New MCAT?

For the first time in recent history, the MCAT is being overhauled. The most recent change was in 2013 when the writing section was removed and according to the AAMC, there will be many more changes in 2015. The new MCAT will be implemented for the first time this year. In this post, I will breakdown the changes that are coming and what it means for you and the medical school admissions process. You can also access the AAMC webpage for a more indepth explanation of changes.

Here are some of the things you need to know about the new MCAT

Length of Test:

The time allotted for the new MCAT is approximately double that of the old MCAT, and will be 6 hours and 15 minutes.

New Sections:

The Verbal Reasoning, Physical Sciences, and Biological Sciences sections will be replaced with 4 new sections:

  1. Biological and Biochemical Foundations of Living Systems
  2. Chemical and Physical Foundations of Biological Systems
  3. Psychological, Social, and Biological Foundations of Behavior
  4. Critical Analysis and Reasoning Skills (CARS)

Eacch section will have 59 questions with the exception of CARS which will have 53

According to the information released by AAMC, the new questions will integrate two new skills: (1) Research Design and (2) Graphical Analysis & Data Interpretation. This signifies a shift in the type of intelligence the MCAT is seeking, as these skills are critical for potential students to be effective researchers and users of the research literature.

Additionally, the titles of the new categories implies that the focus of the scientific questions is to relate it back to medically related systems. Being able to apply textbook knowledge to living systems and human interaction is essential for the practice of medicine, and the new MCAT is striving to evaluate this skill.

A New Scoring Scale

The 1-15 scale in each category and a final score of 45 or less has been left out of the new MCAT. According information provided by the AAMC, the new scoring system will be as followed: “Total scores for the new exam will be centered at 500. Total scores will range from 472 to 528. Individual section scores will be centered at 125. Section scores will range from 118 to 132.”

Changes in the content tested

All of the traditional sciences such as biology, chemistry, and physics will continue to be examined. However, the new MCAT will have proportionally less physics, organic chemistry, and general chemistry as they will now comprise 25%, 15%, and 33% of the Chemical and Physical Foundations of Biological Systems section respectively.

The Psychological, Social, and Biological Foundations of Behavior section introduces Psychology and Sociology into the MCAT topics. These two subject areas play a major role in many aspects of health care (E.g. physician-patient relationship) so it is no surprise that the MCAT would take this opportunity to add these subject areas. Additionally, the Biological and Biochemical Foundations of Living Systems section adds biochemistry to the MCAT. That section is approximately 25% biochemistry questions.

The CARS section will be similar to the previous Verbal Reasoning category. However, there will be no passages on natural sciences and will only have passages about humanities and social sciences.

How will they phase out old MCAT scores & introduce the new scores in the admissions process?

I (Spencer) wrote my MCAT during the summer of 2013. As an applicant this year, I am in the final cohort of applicants with the preexisting MCAT. Starting next year, there will be overlap between applicants who have written the old MCAT and those who have completed the new one.

Everybody who plans to apply for medical school over the next few years has been anxiously awaiting for each individual school to release their statement about how admissions committees will handle the transition into the 2015 MCAT.

This document has been released by AAMC which contains information about how medical schools across North America will handle this situation. Unfortunately, most Canadian schools did not enter their policy when this data was compiled.

The University of Calgary and University of Alberta announced they would only accept the 2015 MCAT starting with the next cycle. Most other schools that have now released their policy on the matter will be accepting both of the old and the new MCAT during the next application cycle. These schools include University of Toronto, Memorial, and Dalhousie. UBC has also stated that they will accept old MCAT scores until the 2016/2017 cycle. Other schools have still not released an official policy on the matter.

Should I write the new MCAT even though my old scores are still valid?

This really depends on your situation and which medical schools you want to apply to.

The change of focus of the MCAT might make it favorable for you to rewrite with the new MCAT. If you are strong in psychology and sociology, the new section which incorporates those two fields might end up being beneficial to your score and your overall application. The same thing applies to the reduction of focus towards sciences such as physics which poses a problem for many applicants.

Obviously, if the University of Calgary is your top choice then you should write the new MCAT to become eligible. For the most part, it appears that the majority of schools will accept both scores for the next cycle. However, it isn’t clear what the medical schools will accept in the application cycle for the 2016/2017 year and beyond. The fact of the matter is that the 2015 MCAT is here to stay and  will be the only accepted score in the near future.

This post was written by Spencer, a guest poster, who has written about his experience applying to medical school in 2013-2014. Only minimal editorial changes have been made by medaholic.

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.