The Basics of Medicine
Question: Hi HPA: I’m the first person in my family to attend college, I’m good at science and my family thinks I should consider being a doctor. Of course, I have my own doctor, but sometimes I feel like the only student who doesn’t know anything about becoming a doctor, even really basic information. Can you recommend something I can read or do to get a basic foundation?
Answer: We’re so glad that you asked this question, and rest assured, even your friends who may have doctors in the family might not know some of the basics—things change in medical training and preparation over time, so how things were when their parents or grandparents became doctors may have changed. Additionally, here at HPA, we tend to focus more on how to get to medical school in our presentations and materials than on what happens once you’re there. Please don’t hesitate to come in and ask your questions—as simple or even “silly” as they seem to you, we are happy to answer them. We meet with a number of students who are the first in their families to go to college, who may not have as much access to this kind of information — getting to know individual students and their backgrounds, and provide guidance and advice is a very satisfying part of our job as HPA advisers!
We will also create a “career of the month” about medicine some time soon, to cover some of these basics. For more immediate information: one good overview is The Road to Becoming a Doctor (links to a pdf), produced by the Association of American Medical College (AAMC). Another great resource from the AAMC is the Aspiring Docs portion of their website, which includes Basics FAQs (we especially like their blog written by current med students and materials about deciding whether medicine is right for you, working with your adviser, and finding a mentor). For slightly longer, personal accounts, a few books come to mind (with amazon.com links): What I Learned in Medical School provides short pieces written by newer physicians, The Pact, which chronicles the story of three African American men who grew up as friends in inner city Newark and supported each other in their goal to become doctors, and Treatment Kind and Fair: Letters to a Young Doctor, written by a physician mother to her son as he begins medical school. HPA has copies of these and many other books in our lending library! ♦
The Cost of Applying to Med School
Question: I was talking to a senior who said I should start saving my money for med school applications now. What’s the average that a student spends on applying?
Answer: There are many costs associated with applications, but few are set – most will vary depending on the student. The MCAT costs $300, but preparation can range from a few hundred to a few thousand depending on your preparation method. Your primary (common) application will cost $160 to process for the first school, and $37 for each additional school. The average student applies to about 20 schools, so that’s about $850 for your primary application. You will receive secondary applications from most if not all of your schools, and those range from $0 to $100+ depending on the school; you’ll likely spend around $1500 on secondaries. So, that’s in the neighborhood of $2600+MCAT prep for applications and MCAT. You’re responsible for your interviews – professional clothes, travel, lodging – depending on the proximity of the interviews, this cost will vary widely.
This is one of the many reasons we advise students not to apply until they feel competitive enough to gain acceptance to medical school. We have seen more than one student worried about the strength of their candidacy, who tried to apply to 50+ schools, hoping someone would take a chance on them. The cost for 50 applications will likely end up around $7000, money that would be better spent on taking some postbac courses to improve academic metrics, or supplement income to allow an applicant to accrue more volunteer hours, or otherwise be used to bringing the candidacy to a more competitive level before applying.
There are ways to help mitigate the expenses along the way. Students from low-income backgrounds can apply to the AAMC Fee Assistance Program, which reduces some application costs. Shopping consignment, outlets, and discount stores can reduce clothing costs (suits are most often on sale in January and July, as seasons change). Keeping your school list local can reduce interview travel costs. Saving up frequent flyer miles or credit card award points could help. Many medical schools have volunteer students who will host you during your interview visit so that you don’t have to stay in a hotel. ♦
Question: I'm thinking about the AAMC personal competencies and want to do more to improve my cultural competence. I'm applying for IIP, but what other ideas do you have?
Answer: Traveling abroad can certainly be beneficial in stretching your comfort zone, helping you gain independence and insight on those different from yourself. In the wake of the election, there are many communities much closer to home whose members are feeling vulnerable, and many of them will be your future patients. A culturally sensitive, empathetic physician who listens carefully and respectfully, and who is knowledgeable about the concerns of those communities -- refugees, immigrants, individuals experiencing homelessness, people of color, people who are LGBTQI+, people with disabilities, and many others -- can make a significant difference in the health and overall wellbeing of individuals and society. Here are a few ideas closer to home:
- Attend events and educational opportunities hosted by the Fields Center, LGBT Center, and Women's Center
- Join the Minority Association of Prehealth Students (and come out and support Arts vs Disease, their signature event, this Sunday).
- Join a student organization focused on a culture or identity different from your own or a student organization focused on a culture other than your own
- Take spring classes like Race and Medicine; Gender and Illness Experience in the US; Social and Economic Determinants of Health (or if you don’t have room in your schedule, then read some works from their reading lists)
- Engage directly with communities in Pace Center initiatives like Petey Greene Prisoner Assistance; Breakout trips; ESL El Centro; Community House
- Read up on topics like trans health; immigrant health care; health care and homelessness; minority health; refugee health care
- Volunteer at a Federally Qualified Health Center or a Community Health Center this summer
- Learn about social inequality as it is presented for the MCAT through the Khan Academy video lessons
- Contribute to creating a respectful Princeton community through these U Matter initiatives: http://umatter.princeton.edu/respect-matters/tools/creating-respectful-community
What “pre-health things” can I do during Fall Break while I have some free time?
Good question! There are always things that you could do with a few free hours:
- Borrow a book from the HPA library to read, and get some insight about being a doctor, applying to medical school, or learning about other health careers. We lend books for two-week periods. A list of titles we have is available on our website.
- Contact some alumni physicians near your home by searching by location in the Tigernet Directory and LinkedIn using Career Services’ Networking Tips for best results. See if they are available to shadow, or just take them out to coffee and learn about their experiences as physicians.
- Surf through some websites for medical schools in your home state (links to each of them are available here).
- Start looking into summer internship and other summer experiences. We have a list of clinical opportunities and research opportunities in which past Princeton students have participated. Other good places to look include the AAMC list of Summer Undergrad Research Programs at med schools; Career Services, and in Vitals.
- The most important thing is to take some time to just relax! The second half of the fall can feel even faster and more stressful than the first, so come back refreshed and ready to work. ♦
Question: Hi HPA – I finally have some time to breathe during fall break. Is there something I can do that’s productive for my pre-health plans?
Answer: This is a great time to take stock of where are you and what to do next, and that’s going to be different for every student.
Freshmen – consider how midterms went, get caught up in classes if you need to, think about your study skills and time management, read through some of the McGraw Study Strategy Tip Sheets for ideas on how to improve, reach out to some physicians you know and do some shadowing.
Sophomores – start looking at summer opportunities including IIP international internships, clinical opportunities and research internships, apply for Princeternships if you want an in-depth short-term shadowing experience, come by HPA and borrow a library book or two to read up on medicine over the break.
Pre-Applicants – familiarize yourself with the health professions school application process on our website, start to consider letters of recommendation, touch base with friends who are currently applying and talk to them about the process, or friends who have recently started medical school and see if they’ll take you on a tour of their school or let you sit in on a class with them. If you need to keep raising your GPA before applying, look into post-bac record enhancer options and start working on your application materials.
Fellowships & Medical School
Question: I am a current sophomore pre-med. I’ve heard of fellowships like the Fulbright and the Rhodes that involve a year of study abroad, and they sound like very cool options. However, a couple of people have told me that these fellowships are somehow incompatible with med school, and I was wondering if this is true. Is it possible to do a program like these after college but before entering med school?
Answer: Of course it’s possible! In fact, in recent years, pre-med students have been awarded the Rhodes, Sachs, Fulbright, Gates Cambridge, Dale, Labouisse, ReachOut, Churchill, and Whitaker fellowships, not to mention numerous P55, and Princeton in Latin America, Asia, and Africa Fellowships. If you’re fortunate enough to find such support for studying at Oxford, Cambridge or another location abroad, then we would advise you to take such an opportunity and make the most of it. It can get tricky in terms of determining when to apply to med school. You always want to apply when you have the richest qualifications and also when it is logistically possible to write applications and attend interviews in a timely manner. In some cases this may be before/during your fellowship year, in other cases it may be after, but the details can be worked out with proper planning and good advising. We have alumni who are awarded postgraduate fellowships and scholarships every year, heading off to med school afterwards; one of them even spearheaded an effort to write a guide for med school applicants considering fellowships abroad, which we are happy to share with you. Make sure you come talk to us, and make sure you let your fellowship adviser know of your intention to apply to med school. Currently, Dr. Deirdre Moloney and Ms. Hanna Lee advise students individually and hold many info sessions for interested students. The Fellowships office is located in the Office of International Programs at 36 University Place, just upstairs from HPA. ♦
Graduate and Professions School Fairs
Question: I know today is the Graduate and Professional School Fair, but I don’t even know if I want to go to graduate or medical school. If I go, what should I say to school representatives?
Answer: It’s great practice to attend graduate school and job fairs before it “counts.” It helps to have developed a one minute introduction that you can give of yourself (name, concentration, class year, where you’re from, one or two interesting things about you), and then have a couple of questions you want to ask. Some examples: “Do you have suggestions on how to spend the summer as a freshman – it can be hard to find internships without more experience,” or “What advice do you have about how to decide if medicine is right for me?” or “What have Princeton students liked about your school?” You should also be prepared to answer some questions about yourself and your interests. If you’re shy or anxious about attending, try to recruit an outgoing friend or two and find strength in numbers! It’s also okay to just go and check it out without engaging with the reps – at least you’ll know what a fair is like for future reference! ♦
Journaling as a Pre-Health Student
Question: Hi HPA – I’ve been told by a lot of people that reflecting on my premed activities and experiences as I have them may be helpful when I apply to medical school, but I’ve never really been good at writing in a journal or being reflective. Do you have any advice?
Answer: When you apply to medical school, the expectation will be that you’ve done some “soul searching” to understand why you’re pursuing a career full of sacrifice and challenge, and you’ll have to articulate how you came to the decision to become a doctor to others. Practicing this means of communication before you reach the application stage can be helpful, and journaling is a way to capture your thought process as your understanding of and motivation for medicine evolves with your experience. Journaling isn’t a natural skill for many people, so don’t worry if you have trouble getting started!
Here are a few ideas as you get started:
1. Read others’ reflections for inspiration – jot down ideas based on their writing. Aspiring Docs Diaries is a good place to start – these blog entries are written by current premeds, med students, and residents: AspiringDocsDiaries.org
2. Identify experiences or influences—special events, service projects, shadowing experiences, conversations, books—that inform, inspire, or challenge you. Record significant details about these moments, and then describe your impressions, feelings, and thoughts.
3. Use a format that helps you – some people prefer to type, some to handwrite, some to dictate into their phone as an audio journal. Some people blog online because they’re inspired by having an online audience, some want to keep their thoughts private, some do a mix of both. Doodling and illustration are also encouraged!
4. Over the summer, HPA will post “pre-health ponderings” on our Facebook page. These questions make good journal prompts. You can view last summer’s posts on the Premed Pondering section of our Facebook page.
International Students and Medical School
Question: Dear HPA – I have heard that it’s harder for international students to get into medical school. Is this true? If so, why?
Answer: It is statistically more difficult for international students to be accepted into medical school, and once a student is accepted, there are also financial considerations that can create a barrier. According to AAMC statistics , in 2014, of the 1,160 MD applicants whose legal residence was outside of the US, 130 matriculated to medical school, for a matriculation rate of about 11% (vs. 41% for all applicants). There are some US medical schools that do not accept international students and some that limit international acceptances to Canadian citizens. Once an international student is admitted, the financial aid options at many schools are more limited than they are for US citizens. Over the past four years, we have had about 10 international students who matriculated to medical school, so it certainly isn’t impossible, but it is important to have a realistic understanding of the obstacles that international students may face. Please refer to the International Students section of the HPA website for more information, or come in to meet with an advisor to discuss your plans. ♦
Medical School Visits
Question: I know that HPA and Premed Society host visits from admissions reps from medical schools. I’m only a freshman—should I go to these? It seems intimidating to think about the application process to medical school this early.
Answer: Like many things, it wouldn’t hurt to try going to one, and see how you actually react by attending. Some students get inspired and motivated by going to these talks, but it’s true that some find it stressful. We do try to choose admissions representatives who are accessible to students and interested in helping you out, and sometimes seeing them in a smaller group setting can make the idea of interacting with them less intimidating when it comes time to apply. Many of the admissions speakers are also willing to communicate directly with students who have come to information sessions, which can be a nice connection if a specific question comes up and you want a second opinion beyond HPA’s about an aspect of your candidacy. That said, it’s absolutely fine to wait awhile before you start coming to these information sessions—we will continue to offer a few every semester, so you’ll be able to catch some when you’re ready! We do hope that juniors and seniors who are closer to the application process choose to attend at least a couple of these info sessions, since it can help them get into the mindset of applying, and help them see how schools highlight certain aspects of what they offer to students (e.g., location, curriculum, patient care opportunities, global health offerings), and use that information to decide where to apply and how to craft their application materials for schools of particular interest. ♦
National Health Service Corps
Question: I’m interested in becoming a physician who practices in an underserved area. I've heard that I can get assistance with paying for med school if I am headed in this direction. How would this work? Thanks HPA.
Answer: You’re probably talking about the National Health Service Corps (NHSC). The NHSC was established in 1972, in order to provide primary health care programs to underserved populations, in what they call "health professional shortage areas" (HPSA) as designated by the Department of Health and Human Services. They have a loan repayment program for med school. According to their website, the NHSC loan repayment program (LRP) recruits fully trained health professionals who agree to provide primary health services in NHSC community sites. In return, the NHSC LRP assists clinicians in their repayment of qualifying educational loans that are still owed. The NHSC is seeking clinicians who demonstrate the characteristics for and interest in serving the Nation’s medically underserved populations and remaining in HPSAs beyond their service commitment. It is important to remember that service to medically underserved populations is the primary purpose of the NHSC LRP and not the repayment of educational loans. For medical and dental students oriented toward this type of service, there are also scholarships, residency opportunities, and "ambassadorships" available in conjunction with the NHSC. We encourage you to explore these opportunities in more detail at http://nhsc.hrsa.gov/. Of course, making a commitment to the Corps should only be done after a great deal of research, consideration, and soul-searching. ♦
Paying for Medical School
Question: Dear HPA: I keep hearing about how expensive med school is. I know of at least one pre-med who has decided to do something other than medicine since he doesn’t feel like he can afford med school. I’m on financial aid here. Do med schools have financial aid? Is the cost really that bad? I hope to work part-time while in school to help pay for it.
Answer: The average allopathic medical student graduates with over $175,000 of debt. So yes, as a raw number, it does look “bad”—that amount of debt (plus the interest that accrues on top of it) can be scary. You need to know as much as possible about the financial commitment you’re making and the options available to you. The first thing you should do is read the Financing Health Professional School handout in full. We’ve included information about online resources, service repayment programs (like the National Health Service Corps), and other sources of funding. Generally speaking, medical students take out loans to pay for medical school—not grants or scholarships. These loans are most often federal loans, and their interest rate is relatively low. As an aspiring physician, you are considered a “good risk” by the government, someone who will be able to repay loans and still live comfortably as long as careful budgeting is in place. Also, make sure that you seek out the Financial Aid personnel at the medical school you attend. Cultivate a true advising relationship with these people, if possible, as the financial climate in this country is ever-changing and by the time you’re a first-year med student there may be new financial options—and those options may change over the course of your four years in med school. It is not too soon, during your med school interviews, to ask about the Financial Aid office, learn who these people are, and get a feel for what type of interaction they have with current students. We try to host a Financing workshop every spring semester as well, so keep an eye on our events in Vitals for that event! Ultimately, though, if you're truly committed to becoming a physician, a medical education is an excellent financial investment and worthwhile from a lifelong financial perspective. ♦
Question: I couldn’t make it to the recent medical school visits. Did they talk about what they’re looking for in applicants?
Answer: On a big picture level, both Cornell Weill and Johns Hopkins Med emphasized the importance of academic excellence (as evidenced by grades, MCAT scores and letters of recommendations) along with personal competencies. The Association of American Medical Colleges identified a key set of competencies – observable behaviors that combine knowledge, skills, values and attitudes – that they desire in entering medical students. The competencies include: service orientation, social and interpersonal skills, cultural competence, teamwork, integrity and ethics, reliability and dependability, resilience and adaptability, capacity for improvement, and written and oral communication skills. If you’re applying this year, take some time to think about how you have developed and demonstrated these competencies, and find ways to comment on them in your materials (they may come across in activities list entries and the personal statement, but most significantly in secondary essay responses). If it is earlier in your “premed career,” actively develop/improve in these competency areas – meet with an HPA adviser if you would like to brainstorm ways that you might do so. Read this AAMC report for more insight on the relative importance of different academic, experiential, and demographic and personal attribute data that admissions officers use when making interview invitations and offers of acceptance. ♦
Premed Alphabet Soup
Question: Hi HPA – I heard a senior talking about calculating their BCPM and reading up on the ACA before doing their PAI and AMCAS. As a freshman, should I know what all of these things are? It felt like they were speaking another language.
Answer: The world of medicine and med school admissions can seem intimidating because of these “insider” terms, so we’re glad that you asked! BCPM stands for Biology/Chemistry/Physics/Math. Your BCPM or science GPA is evaluated separately from your overall GPA in the medical school admissions process, so it’s one of the numbers you should know before you decide to apply (read more about Science GPA here). The ACA is formally called the Patient Protection and Affordable Care Act, but it’s often shortened to Affordable Care Act, ACA, or “Obamacare.” Familiarity with the current state of the US health care system will help you know what you’re “getting yourself into” as a future physician. The PAI is the Pre-Application Interview. All Princeton applicants interview with one of the advisers as part of their preparation for application. The AMCAS, or American Medical College Application Service is the “common application” for most allopathic medical school (MD) programs (read the basics of the application process here). ♦
Question: I’ve registered for the AAMC Virtual Fair and look forward to networking with med school admissions representatives. I’ve never formatted my resume specifically for med school purposes – do you have suggestions?
Answer: Career Services has comprehensive resources to help with resume preparation on their website: http://careerservices.princeton.edu/undergraduate-students/resumes-letters-online-profiles/resumes - be sure to check out the Resume Guide, which includes a sample premed resume. A few premed specifics we would add:
· One page is best; if you’ve completed a second degree or been working for a few years, then you could go to two, but especially in the Virtual Fair environment, something short and easy to digest will be more effective.
· For your resume sections, consider focusing on clinical experience; service; leadership experience; research; awards and achievements; and skills.
· As you write your descriptions of activities, try to incorporate the personal competencies that medical schools value in entering students
· Include at least a couple of items that aren’t strictly medical (e.g., interesting skill, second language, unusual co-curricular, part-time job) -- show your well-roundedness and give your reader something unique to take note of.
Question: I’m a sophomore and I’m starting to feel the pressure of med school applications. I just want to know if I’m on the right track with my classes, choices of activities, and summer plans. Should I meet with an adviser to discuss this? Where else can I find information?
Answer: Sophomore year can be especially challenging for pre-health students – rigor of classes often ramps up, you have to make some hard decisions (eating club vs not, major), you feel like your summer has to “count” compared to last year, you may be taking on leadership in organizations, and you’re still trying to figure out how to manage your time and academic expectations, but at the same time, you feel like you’re expected to know what you’re doing because you’ve been here for over a year now. We would be happy to meet and talk this through! Here’s some food for thought in the meantime:
· If you’re thinking of applying direct entry (starting med school the fall right after you graduate), this is the last summer when you can engage in activities that you’ll be able to draw from when you write your application. Your application will be submitted next June. Choose your summer plans accordingly, especially when it comes to direct interaction with patients – if you haven’t had any, prioritize that. There are many ways to gain clinical experience – you could do it as a full-time summer opportunity, or alongside another job/internship.
· Talking through your experiences with an HPA Peer Adviser will give you another perspective. They can talk about what they’ve done as pre-health students, which might make your appointment with an HPA adviser more productive. Feel free to email with any of them or set up a time to meet and talk.
· We will have a Sophomore Success Series of workshops starting after spring break – be sure to check them out – we’ll advertise them in Vitals! ♦
Question: Dear HPA: Tonight I was able to watch a live webcast where three doctors played a video of a Laparoscopic Sleeve Gastrectomy performed by the Vanderbilt Medical Center. The doctors pause the video and show slides giving information about the surgery; they also comment and answer questions (asked by people watching the live webcast). I went to the website that hosted the video and found hundreds of webcasts with videos of real surgeries which can be browsed by specialty, institution, condition, and procedure. I thought it was a really convenient way to look at an actual surgical procedure without having to go to a hospital. Students who think they want to be surgeons can go to the site, and I think it might really help them figure out if surgery would be for them. I’m not sure if you already know about it. Maybe HPA could refer students to it: www.orlive.com
Answer: It sounds like you’re practically a surgeon already! Seriously, given your enthusiasm for ORLive, we decided to send your note out this week to the pre-health community. Aside from giving pre-health students another way to procrastinate (sorry about that), we agree that the videos are fascinating and perhaps even motivational. However, please remember, you’re not expected to be thinking about your future medical specialty right now, as an undergraduate. Med school will bring you more than ample opportunity to choose your specialty. Still, for those curious about surgery, watching ORLive is definitely something to do when you’re taking a break! If nothing else, you’ll learn how you do at the sight of blood. ♦
The "Why Medicine" Answer
Question: I’m a freshman and I know that I’ll be ask to talk about why I want to be a doctor when I’m applying to internships and later to medical school, and I feel like my answer is the generic “I want to help people and I like science.” I know I want to do this for myself, but I know that’s not enough. How do I convince other people?
Answer: You’re not alone in feeling this way! When something has become part of your identity, as being premed is for some students, it’s hard to pull that out and question it and put words around it. For one, the more hands-on experience you get in and around medicine and caring for patients, the easier it will be to expand your answer. Think of an activity you’ve devoted a lot of time to – a sport, a musical instrument, a hobby – and think about why you like that. You’ll probably get at least some images coming to mind that you’ll draw from; as you volunteer at hospitals, shadow physicians, care for others through other activities, you’ll be able to draw from specific instances that inspired you or helped you see yourself in the profession more clearly. Asking physicians, medical students, even other premeds, why they’re pursuing medicine may also help: hearing what they have to say and (as importantly) how they say it could give you more of a framework for what it means for you. For some “why medicine” ideas, read some of the Inspiring Stories on the AAMC Aspiring Docs webpage. It can be a helpful exercise to start writing your own “why medicine” answers down in a journal or a blog every few months, or after meaningful experiences. This will give you early practice in putting ideas to words and you’ll be able to look back and see how your answer evolves as you mature. You can also use the “premed ponderings” that we’re posting to our HPA Facebook page as prompts to guide your thinking about your career in medicine.♦