The way I see it

  1. Be a nice person.
  2. Acknowledge your imperfections.
  3. Use your talents.
  4. Tell the truth or wire your mouth shut. Lying is like carrying an extra 100 lbs around.
  5. Collaboration often yields a considerably worse product than what you could produce on your own. Choose carefully when and with whom you collaborate.
  6. Distinguish between your logic, your instinct, and your emotions. Recognize that the three are equally fallible.
  7. Only count on the present moment.

Is Medicine a Calling?

I think this question is funny, yet legitimate. The notion of “calling” can be hokey, like those evangelical tv stations showing every person with a motor deficit being “healed” in front of the congregation. I haven’t met, heard of, or read about anyone who went into medicine as a result of some direct communication with any deity. So medicine is not that kind of calling.

Medicine is a calling, in the vocational sense. The proof of this is how many doctors dislike their jobs. A consistent 50% of physicians polled would not recommend a career in medicine – get one of these people talking and they will admit that they chose medicine for the wrong reasons, and that they did not know what medicine is actually like. Many say, “I wish someone had told me how hard it is.” You must be right for medicine, and medicine must be right for you.

If you are not right for medicine, it will crush you with its bureaucracy, long hours, and high liability. Then, just for fun you will get splattered with some stool, vomit, and choice purulent bodily fluids. You will be colonized by MRSA and C. Diff, and you will not think this is funny.

On the other hand, you may have the raw materials of a fine doctor, but medicine may not be a good fit for you.  If you don’t actually like medicine, how could you be happy practicing it? As I’ve said, there are already enough doctors who do not enjoy their jobs.

So, you ask, “Is medicine my calling? How do I know if I should be a doctor?” You need to start by getting to know what medicine is actually like (on a side note, do not even consider applying to medical school until you know what medicine is like…med schools will sniff you out immediately). You need to spend a lot of time around sick people and see how it makes you feel. You need to spend enough time observing doctors to understand how repetitive their job is, and ask yourself if that would wear you down. Once you know what medicine is all about, be honest with yourself about whether or not you love it.  Ask yourself two questions. “Is medicine a good fit for me? Am I a good fit for medicine?”

How to get accepted to medical school

As I mentioned in a previous post about post baccalaureate premedical programs, I had a chance to meet with a dean of admissions for a medical school in Chicago. He gave me some invaluable advice regarding what makes for a competitive med school applicant.

There are 5 things to which medical school admissions committees pay very close attention.

1. Academics:

What is your GPA, and what are your MCAT scores? If you don’t meet their minimum, they won’t give you a look. Most schools don’t advertise or divulge what their minimum GPA/MCAT requirements are, and some don’t have formal minimums (but have informal minimums that are established when they don’t strongly consider applicants below a certain threshold). If you meet or exceed their minimum scores, they will look at the rest of the factors.

2. Demographics:

Where are you from, and where did you go to school? What is unique about you? What can you contribute to the student body that others could not contribute? Non traditional students have the built-in diversity of “life experience” that sets them apart from the majority of applicants.

3. Service activities:

This is not service just for the sake of having it on your resume. This is service that reveals one of your passions. If you say that you are passionate about autism, do you have service that backs that claim? If you are passionate about helping the poor, what actions have you taken that demonstrate this? This is the “actions speak louder than words” part of your application. You can say that you care about people, but what have you done to prove it?

4. Exposure to medicine:

Have you shadowed a doctor? Have you shadowed multiple doctors? Have you spent time in the hospital as a patient? Have you spoken with doctors about the sacrifices involved in medicine (long hours, sleep deprivation during residency, compromise on your family life)? Have you educated yourself about different specialties? You need to be able to answer “yes” to most of these questions and still know that you want to be a doctor. In other words, prove that you know what you are getting yourself into, and prove that you are still passionate about doing it in light of the sacrifices required.

5. Research experience:

Again, this is not a box to check off on your resume. You want to do research in a field that evokes one of your passions. Research is about the process of learning, and medicine is a career of life-long learning. Things are constantly changing and you need to be committed to keeping up. Doing academic research is one way to demonstrate your love of learning. You can get research experience as an undergraduate by asking one of your professors if you can serve as a research assistant, or by finding the closest research company or laboratory and asking to volunteer or observe. If you’ve done research, that is best but at a minimum you need to have exposure to it and understand the process.

Beyond these 5 things, you have your application with all of your essays, letters of recommendation, and if you’re lucky a few interviews. Essays and letters will not get you accepted if you don’t have the 5 things above. They are important because if you do have the 5 things above, bad essays and letters of rec. can still sink you. They need to be well written, and they should in no way contradict the statement you are making that you want to go to medical school, you are qualified to go to medical school, and they should accept you. You must be authentic while making this statement, and you must have a track record of action that backs it up.

Post baccalaureate premedical programs

I recently met with a dean of admissions for a medical school in Chicago. We approached questions like, “is a traditional post bacc program better than the do-it-yourself approach?” and the generalities of what makes med school applicant stand out. A second post will be dedicated to the second topic, how to get accepted to medical school.

Whether or not a post bacc program is “better” than a “do it yourself” approach depends on the circumstances of the student (whether or not he or she has already taken college-level science courses, time since graduation, aversion to extra debt vs. need for structure) and on the program itself (what is the reputation of the school in general, as well as the post bacc program? Does it have any affiliations with specific medical schools? Does the program also have relationships with PA and advanced nursing programs? The best ones do). In short, if you are debating between a post baccalaureate premedical program or taking the classes a la carte at a state school or community college, only you can answer that question. In general, I’ve never heard anyone recommend community colleges for med school prerequisites. People I have heard of taking this route ended up in medical school in the carribbean. And I’ve read that many people who go to medical school in the carribean have a harder time matching for residencies back in the U.S. It may be easier to start down the community college path, but it is harder to finish. There are much better, less frustrating options with better career outlook anyway.

My advice is do not cut corners and do not go low-budget. If the sticker price of medical school scares you that much, then you need to consider a master’s level program like generalist nursing, nurse practitioner, or physician’s assistant. NP’s and PA’s can earn around $100,000 a year (as opposed to family docs, pediatricians, or general practioners who average around $150K), with a debt that is usually half what doctors acrue (roughly $100K for nurses as compared with $200K or more for docs).

For nursing programs, community college is an acceptable way to get your prerequisites taken care of. In fact, my wife took biochemistry at a community college prior to starting a master of nursing program, while at the same time I was shelling out $30,000 per year for a post baccalaureate premed program.

Here is something to consider. At the medical school in Chicago where I met with the dean of admissions, they receive about 10,000 applications each year to fill 150 spots. This is a good medical school, but it is not top-ranked, and does not have the notoriety of medical schools like Harvard or Johns Hopkins. To get into the best schools, you have to be the most exceptional applicant. To get into a decent school, you still have to be in the top 1.5% of their applicant pool! And you do this not only by having the best grades and the highest MCAT score (see also: how to get into medical school). If you want to go to medical school, the question is far larger than “how/where do I take my prereqs?”

If you are not asking yourself (and others), “how do I make myself a stellar applicant?” then you are starting off on the wrong foot. You need to stand out in a good way, not in a cheap route/lowest common denominator way. You need to plan for your student loan debt, but not be paralyzed by it.

In summary, if you have a great state school/four year college nearby, and you are sure that you will be able to get enrolled in the classes you need, then I would consider that as an option for premed courses as it could save you some money. You will be on your own still when it comes to forging relationships with professors (which are needed for decent letters of recommendation), getting an internship, shadowing experiences, procuring study materials for the MCAT, and a few other odds and ends.

A distinct advantage of a post bacc premed program is the availability of internships, shadowing opportunities, MCAT prep, and letters of recommendation. If you get into the program, you are guaranteed to be able to take the courses that you need in the proper sequence. The structure will help almost any non-traditional student who has been out of college for over a year. All of this comes at a cost, as these programs typically run about $10K more per year compared with state schools.