Introduction to Medicine
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!
Here are some places to start:
- HPA Exploring Careers webpage (especially Human Medicine)
- The Road to Becoming a Doctor (pdf) produced by the Association of American Medical College (AAMC) is a great resource from the organization that oversees medical education.
- AAMC Aspiring Docs, which includes 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). HPA has copies of these and many other books in our lending library!
- What I Learned in Medical School provides short pieces written by newer physicians
- The Pact chronicles the story of three African American men who grew up as friends in Newark and supported each other in their goal to become doctors
- Treatment Kind and Fair: Letters to a Young Doctor, written by a physician mother to her son as he begins medical school.
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.
Starting Premed "Late"
It's never too late! There are individuals in their 50s who start medical school.
If you only consider it during your junior or senior year, is it too late for you to be ready to start medical school right after graduation? Probably, both because there is preparation to do for the application process and because you really want to take your time exploring this new interest and being sure medicine is right for you -- which is something your premed peers have been considering for years and building up experience to help them make that commitment.
Give yourself time to gather information via shadowing, volunteer work, speaking with recent alums about what it's like in medical school, and making sure that medicine is the best next step. We can help you chart out a timeline based on your prior experiences, your coursework, and other aspects of the preparation process, but expect that it'll take at least one, more likely a couple of years between graduation and matriculation at medical school to prepare comprehensively and well.
Like any huge life decision that's going to require a lot of time, money, and emotional sacrifice, better to take the time at the outset to do your research and feel confident in your decision than to jump into something and regret it.
Absolutely! There is no one path to a career in the health professions and no finite timeline for achieving this goal. For some students, as soon as they discover their interest in a health profession they want to dive right into the courses. This, of course, is perfectly fine. But for those who want to continue with the academic path they’ve started, or who want the flexibility to explore courses that they might never have an opportunity to do outside of Princeton, a career changer postbac program might be a great option.
Career changer postbac programs are, as the name implies, for students who started in one discipline and are now changing careers to pursue a health profession. These one- to two-year programs will allow you to take the basic science prerequisite courses you need, and will also assist you with gaining invaluable clinical and/or research experience that will further enhance your application to health professional school. Most programs are open only to students who have taken few, if any, science courses. Additionally, programs aren't limited to premeds: many will accept students who are interested in dentistry, podiatric medicine, and veterinary medicine. Some programs will accept students who are interested in other health professions such as physical therapy and physician assistant.
If you think a postbac program might be right for you, sign in with your Princeton credentials to view our “Postbac Possibilities” recording on our info sessions webpage (under "Prehealth After Princeton") and schedule a meeting to speak with us about your goals. We are happy to help you plan a course of action that fits you!
In recent medical school admissions visits with Cornell Weill and Johns Hopkins Med, both emphasized the importance of academic excellence of readiness for the curriculum (as demonstrated via academic choices and performance, MCAT scores and letters of recommendations), as well as personal competencies.
The Association of American Medical Colleges identified a set of core 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.
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.
- Join a student organization focused on an 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 U Matter initiatives.
It’s going to just sound like a series of platitudes, but they’re looking for future professionals who are intellectually curious, who embrace lifelong learning, and who have already proven themselves as leaders. They tend to seek innovators and visionaries who have a strong sense of themselves and their values, and who have the vision and drive to constantly improve and grow while also demonstrating a commitment to caring for patients from all backgrounds with humanism and empathy. Most schools’ admissions websites include something about selection factors (e.g., NYU, Wash U, Cornell); if they do not state them directly, you can glean them from the school’s mission and how they present themselves through their online admissions information. The MSAR online publication also includes data for each medical school regarding the range of MCAT scores and GPAs for accepted applicants, as well as how many of their students participated in clinical volunteering, shadowing, research, community service, military service, and other experiences. You can subscribe to the website for an annual membership fee or access it on the HPA computers for free. As with all medical schools, use the AAMC Core Competencies as a backbone for preparation and seek to develop them through deep involvement in a curriculum and co-curricular activities that are meaningful to you, then be ready to help others understand the meaning that you found in your choices through the way that you present yourself as a future physician in your application and your interviews.
Dual Degree Options
According to the 2020 AAMC Graduating Student Questionnaire, over the past five years, between 90 and 91 percent of MD students were pursuing the MD only; last year, about 3% were pursuing the MD/PhD, 2% an MD/MPH, 1% an MD/MBA, and a little more than 1% were pursuing another dual degree option. This doesn't take into account students who completed another degree prior to starting medical school.
Dear HPA: I know that I want both an MD and an MPH, but I don't know if I do a joint program what the applications are like. I will be applying to medical school next summer, I think. Do I have to fill out separate applications? How does it work? Thanks.
When you apply to medical school, you will complete the online AMCAS application and will be given the option of choosing joint degree programs at your schools. Once you've checked the joint "MD/MPH" boxes for the schools you've chosen, you have alerted the medical schools of your desire to apply to their Schools of Public Health. However, they have separate application processes. The medical school admissions websites should outline the procedures that you will follow. Most Schools of Public Health now use a centralized application service kind of like AMCAS, called SOPHAS, but some ask you to complete their own individualized application. Generally, you will want three letters of recommendation; these can be written by the same individuals who recommend you for medical school but they should be revised to talk about public health and your interest in the MPH; these letters go to SOPHAS or to the individual schools on their own, without coming into our office. Most MPH programs accept your MCAT as the required standardized test. Note that many of our applicants opt to apply to the MPH during their first or second year of medical school, using their early med school years to get a better sense of what dual degree, if any, is best suited to their interests, and whether they'd prefer to pursue the MPH at their medical school or at another school.
Use the Medical School Admissions Requirements publication during your application year to explore dual degree programs. Before then, you can use the list compiled by the Association of American Medical Colleges. For a few more related links, go to our Public Health section on the HPA site under "Other Health Professions."
About 10-15% of our applicants in a given year apply MD/PhD; Princeton gives you a better taste of what it might be like to carry out independent research at the doctoral level than most colleges and universities, and many students develop a passion for inquiry within their discipline. That said, some of the students most passionate about their research also choose to apply MD only with plans to incorporate research into their four years in medical school. Students applying MD/PhD complete the same “common application” as MD applicants (the AMCAS), but some of the details are a little different:
- Essays: MD/PhD candidates write two additional essays: one about their rationale for pursuing the dual degree and the other detailing their research experiences.
- Standardized tests: most programs will only require the MCAT, but a few may ask for a GRE score – be sure to check your prospective schools’ requirements.
- School Selection: your research interests will come into play as you decide where to apply. Some of our applicants choose to apply to some schools MD only and some schools MD/PhD, depending on what a given medical school offers.
- Letters of recommendation: some programs will ask for letters from each of your significant research experiences.
- Interviews: most interviews will be over two days while MD only interviews are one day. You’ll meet with potential research mentors as part of the MD/PhD interview process.
Statistically speaking, the acceptance rate for MD/PhD candidates is not too different from MD only candidates. In 2017, there were 1,858 applicants and 646 matriculants, so about 35% of students who applied eventually matriculated into an MD/PhD program, and we can assume (based on our experience with our own applicants) that a number of students who were not accepted MD/PhD joined MD only programs. MCAT and GPA metrics for MD/PhD were a touch higher than for MD only applicants nationally, and we’ve seen the same for our Princeton applicants, but we’ve also seen success for students from a range of academic metrics,. The commitment to research, as demonstrated through experience and supported by letters of recommendation, can make a significant impact on the success of an MD/PhD candidate. You can find more specifics in our Explore Careers: Physician Scientist page on the HPA website. This FAQ is particularly useful.
Individual programs provide a lot of useful information, and researching them will show you the diversity of offerings: for example Penn(link is external), NYU(link is external), and U of Miami(link is external). The Association of MD/MBA Programs, run by program administrators provides a list of programs and additional resources. Lastly, you might search for Princeton alumni who hold both degrees, and talk to them about the advantages and disadvantages of their chosen path. See the Career Development "Connecting with Alumni" Resource Guide and HPA Networking Tips handout for suggestions on networking with alums.
There are a number of reasons we might suggest osteopathic (DO) medical schools. We are likely to suggest DO for students who we think would be a good fit for the philosophy of the profession, or whose interests and career goals align with those of other students we’ve seen find success in the DO profession. For example, if a student expresses interest in working primary care and preventative medicine in underserved communities, that may fit well with DO. If a student’s highest priority is attending medical school in a specific area of the country, adding DO schools to a school list opens up more options.
If by “good enough” metrics, you mean that there may be concern regarding the strength of an applicant’s MCAT or GPA, then yes, this can be a factor: in terms of straight statistics, DO programs often have lower average MCAT/GPA metrics for accepted applicants. But, we don’t think that this means DO programs are “worse” than MD programs, nor does it mean that you should treat it as a “fallback” option. A little more detail on osteopathic medicine: the field is experiencing rapid growth, with more than 25% of current medical students training as osteopathic physicians.
Similarities between DOs and MDs:
- Both complete a four-year medical education
- Both participate in the same residency match program and can participate in any specialty
- Both are found in private practice and hospitals all over the country, and can practice abroad
- DO schools employ a 'whole person' approach in their training, with an emphasis on the body as an integrated whole
- DO programs emphasize preventative medicine and the majority of students go into primary care, often in underserved areas
- DO training includes extra work in the musculoskeletal system and in manipulative treatment
Osteopathic medicine can be an attractive option for those who are interested in a holistic approach to medicine and also for those whose metrics may make them less likely to break through in the allopathic (MD) admission process. Any student interested in becoming a physician would do well to learn more about osteopathic medicine and see if it’s a good fit for them. You can learn more about osteopathic medicine and about Rowan University School of Osteopathic Medicine, the NJ DO school, from webinars on our HPA website.
The way that most premed students learn about different kinds of specialties is by shadowing physicians in those specialties and using the experience with someone in the field to think about their own fit for that field. Volunteering in a patient care setting will also provide some insight into a certain specialty; while you won’t necessarily spend a lot of time with doctors, you will get a sense of how the general environment and culture feels, for example, in an inpatient vs. outpatient setting. Rather than trying to learn about all 120+ specialties before medical school, focus on the kinds of interactions you might like to have with patients (some specialties focus on long term and continuous care, others with shorter interactions but perhaps more variety), what kind of work/life balance you seek, how much time you want available for non-clinical activities (e.g., research, policy), and whether you prefer work that’s more hands-on and procedural or more focused on reasoning and deduction. If you keep these factors in mind now, you’ll have more information to start narrowing down specialty choice once you get to medical school. Once you get to medical school, you’ll have an advisor who can help you think through your residency choices, just like at Princeton you have advisors to help you think through major choices. No need to absolutely decide until you’ve had much more exposure to medicine and much more time to think about other long-term life factors.
Of course, you can certainly read up and become more familiar with specialties beforehand if you’d like. The AAMC has a list of all of the specialties; the American Medical Association has blog posts about specialty choice, including specialty profiles; Wash U School of Medicine has some simplified specialty descriptions, and we have explored a few specialties in our HPA Careers of the Month.
And don’t forget, there are three human medical specialties that you “declare” before you begin professional school: dentistry, optometry, and podiatric medicine.
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 that 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 prehealth community. Aside from giving prehealth students another way to procrastinate (sorry about that), we agree that the videos are fascinating and perhaps even motivational. Of course, you're not required to be thinking about future medical specialties 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.