According to the 2020 Matriculating Student Questionnaire, over 22% of entering students started medical school 3 or more years after college graduation. A primary concern of medical school admissions committees is the applicant’s ability to negotiate the intensive, fast-paced didactic work in the first year. You have to provide evidence of readiness for a rigorous academic environment. If you were a strong student at Princeton, one or two years away is highly unlikely to cause concern, especially if your glide year experiences include a significant critical thinking/science component. Many students take two glide years because they find amazing research opportunities that require a two-year commitment or take a one-year international fellowship but do not want to manage med school interviews while abroad: in these cases, you’re very likely to maintain an academic mindset.

If your GPA and/or MCAT score may be cause for concern with schools, it would be worthwhile to take some classes or retake the MCAT during your years off.

Beyond one or two glide years, we have still seen students accepted with no additional academic work. In this case, though, it may be helpful to take the MCAT closer to the time of application if you’ve taken multiple years off since that will provide a more timely gauge of your readiness than counting on a score that’s a few years old. You’ll also want letters of recommendation from recent experiences that speak to your readiness to jump into the academic setting.

Each medical school will evaluate academic readiness for their own curriculum: the MSAR provides data on age of students at matriculation, which may help you gauge which schools are friendlier toward “non-traditional” applicants. And every applicant is different—we are happy to provide guidance based on your specific situation.

Let’s start by rethinking the term “year off.” We like to think of a year (or two) between Princeton and medical school as time to do something you’ve always wanted to do, which will continue your growth, intellectually as well as socially and culturally, even if you’re not in a classroom. Hardly a “year off,” when you think about it! 

The two most common reasons people elect to take a "glide" year are: 1) They're ready for a break from the rigor of school and to refresh before beginning their medical education, or, 2) They want their senior year (or additional time) to work on their candidacy so that they are stronger applicants.  If you're in the first group, you have more freedom in choosing how to spend your time.  If you're in the second group, you need to be realistic, and work toward filling in gaps -- for instance, taking extra coursework in the sciences if your science grades are not competitive, or volunteering at a hospital or clinic of you have done very little since high school.  Here are some things that recent alumni are doing with their year. This should give you a sense of the broad range of things you might consider:

• Doing clinical research in endocrinology at Mass General
• Earning a masters of public health at Columbia
• Working for Africare, setting up HIV/AIDS youth centers in Zambia
• Developing the curriculum for a charter school in Brooklyn
• Assisting with research in pathology/immunology at WashU in St. Louis
• Researching in parasitology at the Univ of Colorado while volunteering in the ER
• Studying in the special masters postbac program at Georgetown
• Working at an AIDS hospice in Houston
• Volunteering at a health clinic in Spain
• Coordinating a literacy program in low-income areas of New York City
• Investigating breast cancer in clinical research at UCSF
• Pursuing Gates, Rhodes, Marshall, Fulbright, P55, Labouisse, ReachOut and Princeton In fellowships
• Teaching biology and coaching a sport at a New England prep school, and more! 

We have added some links to programs pursued by recent graduates to the Glide Year Opportunities page of our website as well as a Google Spreadsheet that captures hundreds of alums' glide year experiences.

As you know, there is no one way to prepare for, apply to, and get into medical school. Every year, quite a few alums who graduated years ago get in touch with our office for advice and support, and we love working with them! Advising is available to all alums. We can add you to our listservs and continue to meet with you. To be eligible for a committee letter of recommendation after you graduate, you must meet our eligibility criteria, which are outlined on the website.

As far as things to do before you leave, email us with your permanent email address if you’d like to remain on our alumni email list. You’ll receive Vitals and will thus be able to stay abreast of anything related to future application cycles. You might also want to ask for letters of recommendation for us to hold on file for you. We are happy to hold any letters in our files for six years beyond your date of graduation. You can learn more about the process of gathering letters of recommendation on the Letters of Recommendation page of our website.

GPA is just one of many factors that play into when to apply. Your first year GPA is at most one-third of your applicant GPA (since you’ll be taking at minimum 17 courses in your first two years and 10 in your junior year when you include junior independent work). The expectation is that your first year is a transition year, especially after the period of online pandemic learning, so try to be gentle with yourself around your performance. Try to focus on how to improve and demonstrate an upward academic trajectory moving forward. Watch our recent When to Apply panel recording and see “When to Apply” on our website for more information.

We’re having this conversation a lot right now—your thesis deadline, classes, and graduation have a fixed deadline, whereas the medical school application timeline is more flexible. Many jobs, especially in research, prefer a two-year commitment; the application process requires a significant financial investment, so a year of work can provide some financial cushion. And with the stress of recent events and mental health concerns, some students want more time to to manage everything. 
 
On the one glide year timeline, your senior year is your final preparation year and you’ll prepare your application, ask for letters, do school research, take MCAT. Then your glide year will also present many tasks: writing secondaries, sending updates to show your continued interest in schools, staying productive so that you have something to say in those updates, managing interviews, feeling the stress of the unknown.

If you take two years, the first year becomes your preparation/preapplication year. You can take the MCAT, develop additional relationships for letters of rec, gain clinical experience, and just be an adult in the world. Application prep for HPA and our committee letter would begin late fall/early spring, but you will have a lot more time to manage it without coursework.

If there are weaker areas that you’d like to address, with two glide years, you can focus on them in the first year and know that you’ve addressed them prior to applying. Experience/grades on your initial application when you take two glide years are more compelling than a promise that you will gain experience / take classes if you take one glide year.

This is not to say that it's impossible to prepare a strong application sooner--our current applicant pool is about 20% direct entry (including sophomore early assurance applicants), 30% one glide year, and 50% two or more glide years (this graph shows the trends over the 2016-2020 application cycles). Consider your own personal situation, your goals, and what is best for you. We're happy to talk through it with you!

Think about how you can prioritize activities that lean into your narrative or prioritize skills that you want to further develop, whether that’s through your job or not. If your “why medicine” includes dedication to mentorship, maybe you can do some volunteer college application coaching with students at an underserved high school in your area. If you loved your thesis research and hope to continue in research in med school and beyond, maybe there’s a way to keep working with the lab virtually for a few hours a week. If you wish you had learned more about health disparities, put together your own “syllabus” using course readings or suggestions from GHP friends and work through it independently over your glide year (even better, establish a zoom reading group with prehealth peers in other locations).

There may also be clinically relevant glide year opportunities close to home. Look at local hospital Human Resources pages for entry level jobs you might be able to train for quickly: some include medical scribes, certified nursing assistants, home health aides, patient care technicians – depending on the level of need, some jobs may include on the job training. Check with local private practices, as well, which may be more open to training their assistants. If you aren’t local to Princeton, ask friends who attend colleges in or near your hometown to check their Career Services office’s Handshake or equivalent for healthcare opportunities since postings can be regional rather than national.

And there is always hospital or hospice volunteering – the requirements for adult volunteers are often more flexible than they are for college students. Keeping a foot in clinical care during your glide year doesn’t have to be fancier than that. You just want to show that you’re committed to patients’ needs and learning how to meet them at whatever level you can.

First, you should prioritize filling any potential gaps in your candidacy. Beyond that, you should look for something that’s meaningful for you that will let you grow personally and professionally. Here are a few of the more unique opportunities our students have pursued, all of which they found ways to tie back to their future in healthcare:

• Fulbright Fellow: teaching English in rural Czechia
• Client Advocate for a public defender's office + volunteer dental assistant at Healthcare for the Homeless
• Patient Advocate in underserved clinics in Philadelphia through AmeriCorps
• Ski patrol officer for a ski resort in Wyoming
• Recruiter for Xenon Health, a physician-led anesthesia services company
• Field therapy mentor at Elements Wilderness Therapy in Utah
• STEM curriculum developer for a school in Rwanda as a Princeton in Africa fellow
• Brewery trainee at Anheuser-Busch followed by a graduate program + clinical volunteering

Find a full list on our Glide Year Opportunities webpage.

If you’re interested in those types of positions, then yes, but many of the positions of more interest to our prehealth students (research, clinical, service) tend to come available later in the year.

Timing for some opportunities popular with our applicants:

• postgraduate fellowships coordinated through the OIP - Fellowship Advising (varying deadlines, September through January)
• Princeton in Africa/Asia/Latin America (deadlines in November)
• P55 Fellowships (application due December/January)
• NIH Postbac IRTA (varying deadlines).

Other early tasks to attend to:

• update your resume
• read through the Glide Year Opportunities portion of our website
• let people in your network (family, friends, internship supervisors, faculty mentors, physicians) know that you’ll be looking for a position in the coming year so that they might also be on the lookout for opportunities that will fit your interests.

Research jobs come available year-round, but we’ve seen many positions specifically seeking glide year students in November through February. You can page through our postgrad job board to get a sense of past opportunities. We already have a couple of jobs posted for this year, which are also in Vitals. Princeton AlumniCorps P55 Fellowships (deadlines in the fall semester) have been available at Thomas Jefferson University Hospital, Massachusetts General Hospital, and the UCSF Breast Care Center in recent years. The NIH Postbac Intramural Research Training Award. (varying deadlines) is another popular option. See the Career Development Center FAQs, including their recruiting timeline, for more about other industries.

Working in consulting (healthcare-related) or the pharmaceutical industry for a year or two before matriculating at a medical school is an acceptable thing to do, but only when all other aspects of your candidacy for medical school are in place. We often recommend that one spends time 'off' strengthening any weak spots (academic, clinical, research) in one's application. To be honest, reactions to the type of experience you're describing are somewhat mixed among medical schools, but generally speaking it will not hurt you as long as you continue doing something involving patient care, even if it's simply volunteering a few hours per week at your local hospital or community health clinic. If you're interested in an MBA, your path makes some sense, and it could be argued that all MD's could use some background in industries and professions next door to medicine, such as health insurance, health policy, and pharm. Just make sure you spend a little time doing something patient-centered if at all possible—patients are what it’s all about, when all is said and done!

The Center for Career Development has a great guide to help you think through your job search and decision. Think about your priorities—What do you want to accomplish in the coming year? What do you need from a job setting? From a supervisor?—and jot down the pros and cons, what makes you excited about the job and the doubts that you have. Writing things out may help you think about the situation more objectively. We often recommend chatting with someone else who has been in the role before, but if there isn’t anyone preceding you, this can get more complicated. You could see if there’s another postgrad in a collaborator’s lab who you could contact for their perspective on the department more broadly. Keep in mind that just because you saw a listing on our website, it doesn’t mean we necessarily endorse it—a lot of folks reach out to us to post their positions and we don’t do any specific “vetting” or “recommending” of what’s listed, so we’d definitely encourage you to do your due diligence to learn as much as you can before accepting an offer. We’re happy to meet with you to talk about the offer and how to communicate with employers (and career advisers at Career Development can do the same).

Here are a few options based on the focus you might be looking for:

• For a closer view of how physicians interact one-on-one with patients, as a medical scribe through a company like ScribeAmerica or directly through a hospital (like RWJ) or other care facility, you'd be in the room during patient visits, taking notes so the doctor can focus on the patient.
• To demonstrate your commitment to the health needs of underserved individuals and communities, National Health Corps places you in a high-need community with compensation that will cover your basic needs.
• If you want an active, intimate patient care experience, as a Certified Nurse Assistant you provide bedside care, often in assisted living or similar care facilities or in hospitals.
• If you're interested in a particular specialty, Medical Assistants are often hired in dermatology, dentistry, and other private practice settings. 
• Other jobs our alums have taken include: patient navigator, EMT, clinical research coordinator, ophthalmic technician, genetic counseling assistant . . . check out our List of Sample Glide Year Opportunities for more inspiration! And if you aren't in a clinical job, you can always seek clinical volunteering and shadowing in your free time.

In addition to your job, it will also help to shadow, read healthcare news, watch documentaries, listen to podcasts and attend talks by health professionals, and otherwise find ways to immerse yourself in healthcare to complement the job. You will also want to do a lot of self-reflection, journaling, and otherwise thinking about how your narrative is taking shape so that by June when you submit your application, you have a personalized, evidence-based “why medicine” that convinces others that you know what you’re getting yourself into.

Of course it’s possible! In fact, in recent years, premed 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 afterward; 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. Work with HPA and your fellowship adviser concurrently--fellowships advisers are happy to meet with students individually and hold info sessions for interested students. The Fellowships office is located in the Office of International Programs.

It’s never too early, especially if you’ve already developed an interest in something that you’d like to cultivate! Starting to plan as a sophomore may lead to different summer internships, course choices, relationships with mentors, and other experiences that will help you develop and hone that interest, and ultimately help you be a stronger fellowship candidate. For instance, you’ll be a stronger candidate for some of the prestigious UK fellowships if you’ve participated in abroad experiences before applying, and this summer may be a great time to look into the IIP opportunities. There is a Fellowships adviser who works specifically with first-year and sophomore students and he’d be happy to talk with you about your interests and provide some suggestions moving forward. The Fellowships Pre-Advising form, which you fill out before your first meeting, will also help you reflect on your interests (and make your meeting with the advisers more fruitful). Don’t let the form intimidate you, though! As a younger student, they won’t expect your answers to be too in-depth yet. If you’d like to work through the form with an HPA adviser, we’re happy to meet with you to talk about it. And as a sophomore, be sure to keep an eye out for information about the Dale summer awards – they’re only open to sophomores and they provide funding to pursue an area of personal interest.

There are a few things to consider when it comes to postbac programs. First, there are competitive admissions processes, so there's no guarantee that you'll get into your top choice program. Many of the strong programs are away from major metropolitan areas, so you might have to rebuild your social network and family -- if it's important to you to have support nearby, you'll have to quickly try to seek a new network when you arrive. But time and cost are probably the most significant factors. Postbac programs are intense and science-heavy, so if you find out in your first semester that you need to slow down and take the courses at a less intense pace, that may change your timeline to completion, and many students are concerned about the amount of time it'll take to move through the course work, then to medical school and residency. Cost should not be overlooked -- postbac programs are expensive, and there is little grant aid available, so doing a postbac will likely mean taking out loans.

That said, the benefits of the programs -- guidance through the curriculum, advising support and committee letter, a community of students in the same situation as you, guaranteed seats in the classes -- are a worthy investment. Be sure that you're pursuing activities during college that test out your interest in medicine and let you explore other career options so that you know that it'll be worth the time and financial investment (and so that the programs will be convinced that medicine is really right for you when you apply). In any case, if you aren't feeling drawn to medicine now and aren't doing well in the classes, taking a break and spending the summer really exploring your options may be a better plan than trying to slog through the classes, doing poorly, and wasting the opportunity to study what you're passionate about. Definitely come talk with us so that we can get a fuller picture of your specific situation and provide some insight for you.

We highlight some of postbac programs on the Career Changer Programs page of our website, so you can do more research there.

This is a common first-year concern—suddenly science is more rigorous, and other courses that you might have originally been taking just to fulfill requirements become the most interesting thing you’ve ever studied. College is a time of self-discovery; it’s important to be open to changes in your interests in light of new information that you’re encountering.

Try to spend this summer doing some soul searching and some general career exploration. Get into a medical setting if you haven’t done so before, shadow some physicians, read about careers in medicine. At the same time, talk with SPIA majors, read alum profiles of students who majored in SPIA, connect with alums through the Alumni Career Network who may be out in the non-profit or private sector, read some websites that focus on health policy. Keep gathering information, and see if that points you in one direction or another. Maybe you’ll decide to stick with sciences now, and maybe not. Don’t hesitate to talk through your thought process with an HPA advisor!

But, to answer your question, if you decide to take time off from being premed, but then feel the calling again later, you can always return to premed. In fact, some of the more compelling candidates we encounter are those who headed off in completely different directions for a while (theater, professional athletics, research) before settling on medicine. There are academic programs designed specifically for students who want to take the premed courses after graduation (post-baccalaureate) - we highlight some of them on the Postbaccalaureate Career Changer Programs page webpage of our website.

Finally, since you’re a first-year student, you might also consider the Mount Sinai FlexMed Program and Sidney Kimmel IDeA program, which allow college sophomores to apply and, if accepted, to ease the pre-requisites and application process to medical school.

There are many ways to complete the prerequisites after graduation.

Structured, formal postbac programs offer dedicated staff and  more services, which may include high-quality advising, access to a committee letter, guidance in the application process, linkages to professional schools, shadowing/volunteer opportunities, seminars, programming. They often have an established reputation with medical schools and provide a peer community. These services tend to come with a larger financial investment than other options.

On the other end of the spectrum, some alums take courses independently “a la carte” without going through a postbac program and reach their goals successfully. 

If you work well independently, can advocate for yourself, will seek out the information that you need to apply (which can include staying in touch with us at HPA), you may do fine taking classes on your own through a local college or university as a non-degree seeking or continuing education student. 

If you know that you’d prefer more support and infrastructure, going through a program that has a track record of success, the cost of the program may be a wise investment. Some alums work for a while to earn money to help finance their preferred program.

Many alums choose to take a year or two between graduation and postbac coursework: this gives you time to recharge after undergrad, earn some money, and make sure that it's really worth the time, money, and sacrifice that a medical career requires.

The most important aspect of your science preparation for medical school is that you do well in your classes and on your MCAT, and that you have strong letters of recommendation from your science faculty, so whatever postbac option you choose, focus on one that will bring you academic success and science faculty support via strong letters. 

We’re happy to talk with you based on your own situation about options from taking out loans, to working for a while before your postbac program, to taking classes independently. Different solutions are going to make more sense for different individuals.

There’s a lot more to being ready for medical school than the coursework that you have to take. Think about what it takes to be a good physician and look for activities that help to develop those characteristics in yourself. For some of you, you’ll be driven by the opportunity to be of service to society in a direct way, so developing your ability to communicate with people who are different than you and demonstrating your commitment to serving others may be your highest priority. For some, you’ll be interested in the intersections between other disciplines (e.g., humanities, tech/innovation, policy) and patient care, so you may focus there. For anyone considering medicine, spending time with patients and with health professionals is the most important activity to prioritize, since it’ll help you clarify your interest, provide role models and mentors in professions of interest, and provide proof to the postbac career changer programs where you may take your premed classes that you’ve gained motivation from concrete experience that will motivate you through the challenges of those courses.

If the last science courses you took were in 2021-22 and you plan to work from 2024 to 2026, then you wouldn't be returning to the classroom until around Fall 2026, which means five years will have elapsed. At that point, unless you feel very confident that you can jump back into advanced science courses immediately and do well, a postbac career changer program is likely the best bet.

A career changer program will let you rebuild your academic foundation in a structured setting. It was facilitate access to courses that you may not be able to register for without being enrolled in a program and offer personalized advising and other services. You can read more about postbac program options on our website. We're happy to discuss potential timelines and plans with you before you graduate and alums are also welcome to reach out for advising any time after graduation.