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T H E

FREE GUIDE
T O

MEDICAL
SCHOOL
ADMISSION

Written by medical students,


residents, & attendings

There's already enough stuff in your

way, access to good advice

shouldn't be.
Acknowledgments

We would like to dedicate this book to everyone who has been


told they can't do something and are out there excelling at it
anyway.

We want to thank several contributing authors who opted to


remain anonymous; we are grateful that you want to share your
expertise even without named credit.

Note to the Reader


Because the content here is based on these authors'
experiences, processes described and advice given is intended
for American MD programs. For the same reason that the
content is based on our experiences, we must recognize that
there is no guaranteed formula for anyone to get into medical
school.

However, we hope this guide will help demystify the logistics of


the pre-med and application process.

Have edits, typos, suggestions, further

questions, or comments?

Send them over to freemedschoolguide@gmail.com -


we would love to hear from you!

Cover design and ebook formatting done using Canva


by M. Grace Oliver, MD, and Briana Christophers.
Project Leader:
Roxana Daneshjou, MD PhD
Resident in Dermatology, Stanford School of
Medicine
@RoxanaDaneshjou
Authors:

Jennifer Caputo-Seidler, MD
Hospital Physician
@JenniferMCaputo
Briana Christophers
MD-PhD Student
@BriChristophers
Ruth Ann Crystal, MD
Obstetrician-Gynecologist, ACF Stanford School of Medicine
@CatchTheBaby
Rebecca Lin
MD Student
M. Grace Oliver, MD
Resident in Family Medicine, University of Kansas
@MGraceOliver
Tricia Rae Pendergrast
MD Student
@TRaePendergrast
Sara Beltrán Ponce, MD
Resident in Radiation Oncology, Medical College of Wisconsin
@SaraBelPon
Arghavan Salles, MD PhD
Bariatric & Foregut Surgeon, Washington University in St Louis
@Arghavan_Salles
Carina Seah, MSc
MD-PhD Student
@CarinaSeah
Joannie Yeh, MD
Pediatrician
@BetaMomma

All usernames indicated with an “@” are for Twitter


Table of Contents

Introduction
Why does this guide exist?................................................................................................7
When do you need to know you want to be a doctor?.........................................8
Finding a mentor.................................................................................................................10

Preparing to Apply
Soul-Searching & Reflections before Applying.......................................................16
Application timelines and cost ......................................................................................17
Taking a “gap” year.................................................................................................................17
Selecting schools....................................................................................................................25

MD Primary Application
Grade point average (GPA)................................................................................................27
MCAT..........................................................................................................................................28
Letters of recommendation..............................................................................................31
Extracurricular activities..................................................................................................32
Research experience............................................................................................................34
Personal statement......................,.......................................................................................37
MD-PhD Programs
What does it mean to be a “physician-scientist?”.................................................41
MD-PhD application process..........................................................................................43

MD Application Next Steps


Timeline....................................................................................................................................45
Communicating with schools: when, why & how...............................................46
Secondary applications.....................................................................................................48

Interviews
MD interviews........................................................................................................................52
Making the most of informal sessions......................................................................64
Interviewing on a budget..................................................................................................65

Making a Decision
Factors to consider in decision-making.....................................................................67
Second look...............................................................................................................................68
The Waitlist..............................................................................................................................70
Reapplying.................................................................................................................................72
Declaring & deposit...............................................................................................................75

Conclusion................................................................................................................................77
Appendix...................................................................................................................................79
Introduction
Why does this guide exist?

When do you need to know you want to be a doctor?

Finding a mentor
Why does this
guide exist?
The inspiration behind this guide is a tweet by
@RoxanaDaneshjou that said, “Any profession that requires
hours of free labor in order to even be qualified to enter a
training program (e.g. shadowing in medicine, doing unpaid
research) will have disparities in recruiting across socio-
economic statuses. Thank you for coming to my TED talk.”
Medicine clearly has disparities across racial groups and
socioeconomic groups; systemic prejudice and privileged social
structures play a role in these disparities. Applying to medical
school requires insider knowledge, connections and financial
resources, and this shuts out individuals who would have
otherwise been talented doctors. Our patients come from
diverse backgrounds; likewise, they deserve doctors from
diverse backgrounds that they can identify with.
There are many different routes to medical school, both
traditional and non-traditional. Many spectacular practicing
physicians have stories about someone telling them, “you’ll
never get into medical school” or “you’ll never be a doctor.”  If
you want to be a physician, you have to ignore them. As there
are many different paths to medical school, this guide does not
claim to cover all of them, but we hope to encourage you in
your pursuit of whatever path is best for you, and to give you
some ideas to close the gaps that privilege and structural
biases have put in your way.  The medical school admissions
process has been shown to disproportionately favor upper
class, cisgender, heterosexual white men. This guide was
designed to help anybody and everybody succeed anyway.

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When do you need
to know you want
to be a doctor?
Many personal statements start with a story about how “I
wanted to be a doctor since age 6 after event X.”  First of all,
please do not start your personal statement like that (more on
that in the personal statement section). You do not need to have
always known that you’ve wanted to be a doctor. However, you do
need to know why you want to be a doctor because it is a long
road paved with loans, sacrifice, and delayed gratification.
For some, the path to medical school began in childhood.
Depending on the type of program you want to pursue, you don’t
need to know until about two years prior to matricula-tion. An
exception to this is Direct Med Programs, or combined BS/MD
programs. These are generally applied to out of high school,
similar to a college application timeline. A benefit of these
programs is that you get to skip the MCAT and the arduous
application process, and you may even get to shorten the overall
education process by up to two years. Because of these appealing
benefits, these programs are extremely competitive. Further,
they may not be accessible if you didn’t happen to know you
wanted to be a physician in time, or if you didn’t know about
these programs. There aren’t very many, but as of the time of this
publication, a list can be found_______
here.
This is just one view of the application process. For the
majority of American physicians, applying to medical school
starts about two years before matriculation. For instance, if you
decide to apply so that you would begin medical school the fall
after you graduate from college, you must prepare starting your
junior year. Ideally, you would take your Medical College

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Admissions Test (MCAT) in your junior year to give yourself an
opportunity to take it a second time, if needed. Many students take the
MCAT (whether for the first time or retaking it) in the summer before
their senior year, though depending on the month and score return
timelines, you risk delaying the submission of your applications. In
general, delays in submitting are not advisable. The early bird gets the
seat in the rising class! During your junior year, you would meet with
your pre-med advisor if you have one, start asking around for letters of
recommendation, and put together your personal statement. If your
school does not have a pre-medical advisory committee--and even if it
does but you would not mind some extra advice--check out the Finding a
Mentor section of this guide. There are three major application services
for US medical schools: __________
AMCAS (allopathic or MD programs), ______________
AACOMAS
(osteopathic or DO programs), and the ____________
TMDSAS (Texas medical schools).
The exact date changes every year, but they all open the summer a year
prior to beginning of the medical school term you would be applying for.
 You would want to submit your application as early as possible--with
almost no exceptions, submit on the earliest possible date--, and then
senior year is spent going to interviews. Because of this process, I
recommend making a decision to attend medical school or not by the
end of your sophomore year of college (again, if you’re not planning to
take gap years, which is common and often beneficial for students).
Prior to the application process, you do need to make sure that you
have satisfied the prerequisites for medical school; this is why you need
to know so far in advance whether or not you want to attend medical
school. I always get asked “what is the best major” for medical school.
Honestly, it does not matter (note, a few admissions committees may
give you a little GPA leeway if you are majoring in a notoriously difficult
subject, such as chemical engineering). There is no major that will give a
“head start” once in medical school, and non-science majors often stand
out in the applicant pool because so many students accepted to medical
school were STEM majors in college. As long as you are able to complete
the prerequisites to apply to medical school, the best major is a subject
you a passionate about and can perform well in. A 4.0 GPA in an English
major is generally going to be better-received than a 2.0 in a Physics

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major. Prerequisites may vary between medical schools, but in general
(this example is taken from Johns Hopkins specifically): two semesters
(8 credit hours) of biology with lab, two semesters (8 credit hours) of
general chemistry with lab, two semesters of organic chemistry with lab
(8 credit hours), two semesters (8 credit hours) of physics (with lab),
calculus and/or statistics (varies by school), biochemistry (varies by
school), social science/humanities (varies by school). Additionally, a
certain amount of “upper level” biology courses of your choosing are
often required. Every medical school has a website documenting their
requirements, so check these in advance when organizing your class
schedule and prior to applying.
Another resource to spend some time on is this guide from the
_____________

Association of American Medical Colleges (AAMC) on understanding the


application process. There, you can find a wide variety of topics on
admission officers’ advice to pre-meds, from tips for international
applicants to feedback on social media activity.

Finding a mentor
By far one of the most important things you can do is to find
yourself a mentor (or, really, several). Mentors will give you free--and
hopefully good--advice.
Note that a pre-med advisor will give you advice but is not a mentor.
Additionally, most pre-med advisors have never actually applied to
medical school, are not physicians, and might not even give good advice.
That is not to say you shouldn’t work with your pre-med advisor--you
should, and usually have to in order to obtain a pre-medical advisory
committee letter that many medical schools require for application--but
other mentors are important. The pre-med advisor is most helpful for
fleshing out your application timeline and making sure you have the
application requirements (MCAT, letters of recommendation, course
prerequisites) completed. They often have resources for interview
preparation, professional closets, and application review as well. If your
pre-medical advisor does not, check if your college has a more general
career success center with these resources instead.

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At minimum, it is good to have two mentors: a more senior
physician (attending level) and a medical student or resident who has
been through the application process more recently. The process is
constantly evolving in small ways (such as how the MCAT is scored,
trends in which courses are required, etc.) so having a mentor who went
through the application cycle recently is key. The less experienced
mentor will also have a more empathetic approach to mentorship in
many cases since their own journey through this process was not long
ago. The more senior mentor is more likely to offer “large scale” advice
such as choosing a specialty, as well as to be able to help connect you
within your community to shadowing, research, or volunteer
opportunities.

If they’re so important, then how can one get a mentor?

First, make sure you have a CV or resume ready. We have an


example from Dr. Oliver’s pre-med CV in Appendix A. There are lots of
formats for CVs and resumes available online and in word processing
programs like Microsoft Word for free.
Next, if there is a medical school nearby, go on to their faculty list
online and start reading. Find someone whose research or scholarly
interests are similar to yours (it’s okay if you have no formal background
in that area, interest is enough!). If there is not a medical school nearby,
try checking out nearby hospitals and clinics, or #medtwitter
________________ on Twitter

to identify physicians you may want to contact. It is very common for


people at all levels of their career to offer to help if you need it, or to
answer any questions you may have. So if that happens, take advantage
of it! Some of these authors’ most fruitful career connections have been
made electronically. A new, free mentor matching service was recently
founded by author Tricia Rae Pendergrast. Mentors and mentees are
matched based on career field and personal interests. You can apply for
a mentor here.
______

The hardest part is putting yourself out there, and you will have to
work hard to make connections. But once you have them, the potential
benefits to your career and personal growth are endless! Write a short

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and unique email to the person of interest asking them to meet in
person or to speak on the phone. If you have a school/work email ending
in .edu, use that email rather than a generic email account, and
especially rather than that email address you made when you were 14
and doesn't resemble your name at all. You know the one... With a .edu
email address, and/or with an email address that is just some form of
your name, you will be more likely to catch the recipient's attention.
Most importantly: make sure it isn’t a generic email! Mention if you have
read any of their papers or scholarly work. Attach your resume. If you are
more interested in their clinical practice than their research, emphasize
that side. Authenticity is key for maximizing your success in this
process; no need to fake interest in anybody’s research. See Appendix B
for examples of first contact and follow-up emails.
Send two to three of these emails out at a time and wait. Many
people may be too busy to respond immediately, or perhaps ever, but do
not be disheartened! Keep sending emails. If you have not received a
response after a week, you could consider sending a follow-up email in
case the recipient just missed your first one. If your follow-up does not
receive a response within a week, move on. Persistence is important,
especially in this stage.

Another way to meet people is in person by finding events that may


have potential mentors in attendance. Once again, if you are near a
medical school, try to look up a list of open research seminars and talks.
Attend ones that are of interest to you. At the end, go up and introduce
yourself to the speaker. If you are shy, you can use this script: “Hi my
name is X and I am studying Y at Z school. I really enjoyed your talk and am
interested in the work you do. I know you’re busy, but if you have time I would
love to meet with you and learn about your career path.” Worst case scenario
is they say no, and nothing has been lost. Several of these authors have
successfully used this method ourselves, finding mentors and obtaining
positions in research labs.

A third way to locate mentorship opportunities is through


contacting medical school admissions offices at a school or schools that

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you are interest in. Most of these offices have strong relationships with a
group of students who regularly volunteer as tour guides, overnight
hosts, or interviewers, and they are happy to connect you with someone
who can serve as a mentor through the process to answer questions.
These people can also be a connection to more senior level mentors or to
research opportunities, especially if you are located in the same city and
can meet to discuss interests that you might share. Further, interacting
with students or recent graduates of nearby schools can help you decide
if you would be interested in attending that program.

Let’s say you get a meeting. What happens next?

Make a plan for your meeting. First, do background research on the


individual--reading their papers, familiarizing myself with their career
roles (are they clinical? Research? Administrative?). You can make an
outline of what you want to discuss, including a short list of questions to
make sure you ask. You want to be organized so you don’t waste anyone’s
time, but at the same time, you want things to flow naturally.
The hardest part of the meeting may be the opening. Here is a script
you could use: "Thank you for agreeing to meet with me. I’m an X (student?
Post-bacc?) studying Y. I wanted to meet with you because Z." Reasons may
be, “because I’m really interested in your work in (enter relevant work),”
“because I am really interested in your clinical area,” or something else
entirely. It’s ok to be honest, and if nothing else you can just say “because I
am applying to medical school and I was hoping to get some advice.”
If the meeting goes well, ask if they would mind meeting with you
again in the future. If it goes really well, consider saying, “I am hoping to
find mentors to help guide me in pursuit of my goals (which you’ve hopefully
discussed). Would you consider being one of my mentors?”
The ideal way to really harness a mentorship is to have specific
goals: either short-term things you hope to accomplish with your
mentor’s help, or general roles you want your mentor to have in your
career. These don’t have to all come from your own brain; you can
brainstorm them with your mentor, or with a pre-med advisor. For
example: a goal can be to diversify your clinical experience, and a general

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role for a mentor could be to read, advise, and assist with grant
applications. These specific goals should also include how often and in
what way you will be communicating with your mentor--will you email
monthly? Meet in person quarterly? Have a plan at the start so that you
both have realistic expectations for the relationship, and also so that
you don’t accidentally lose touch.
Another form of mentorship that is helpful to learn how to
cultivate in your career is sponsorship, which is more direct inclusion of
the recipient in career-advancing opportunities rather than advice.
Author Dr. Oliver co-wrote an article series here
____ describing the hows
and whys of sponsorship.

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Preparing
to Apply
Soul-searching and reflections before applying
Application timelines and cost
Taking a “gap” year
Selecting schools
Soul-searching and
reflections before
applying
What is your story?
The application process is your opportunity to share with schools
why you want to be a physician, why you will be an asset to their
program, what you envision yourself doing, and how you have prepared
yourself for this path. You have a few opportunities to give them
insight into your life: the personal statement, your extracurricular
activities list, your secondary application essays, the interview, and
communications after you interview. Be intentional about what you
are trying to communicate to the admissions committee at each point
in the process, and try not to be redundant where possible (i.e. don’t use
the same anecdote from your personal statement in a secondary essay--
tell them something new!)
When figuring out what you are trying to share, it is good to spend
time reflecting well in advance of applying. Keep a notebook/sticky
note/document on your phone or computer with a list of impactful
experiences, anecdotes, specific events, projects, and interests so that
you won’t forget them later. Start keeping a journal of answers to some
example interview questions, like those found online (e.g. 1, 2, and 3).
Take a look at the AAMC core competencies and write out examples of
moments when you have illustrated growth in each competency and
how you might grow in some of them throughout medical school.
It is important to have several people read your essays--both in
medicine and outside of it--to give you some thoughts on how you are
presenting yourself on paper.

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Application Timeline
and Costs
Use the Student Doctor Network medical school application ______ cost
calculator
_____________ to estimate how much the application process will cost,

including MCAT test preparation and interview travel. Take it now to


familiarize yourself with some of the fees, and then come back to it when
you are more certain of the services you will utilize and schools you are
interested in. Furthermore, get familiar with the____________________________
AAMC fee assistance
program to see if you qualify. At some point, however, debt will be
accumulated with medical school tuition, so you will have to consider
how much debt and risk you are willing to take on and how early.
Also, be informed about being in control of your finances and
having a financial plan early on; part of that plan is having debt. There
are many resources online for managing debt after medical school, but it
is important to at least know in advance of applying that this is a very
expensive path to take. However, part of our goal in creating this guide is
to make the application process more accessible and successful for
people from all backgrounds. 

Taking a ”gap” year


The Decision
The decision to take a gap year (or years) can be made anytime
during your undergraduate career. When deciding if a gap year is right
for you, consider your desire to combine pre-medical prerequisites with
your college experience, your finances, and readiness for medical school.
Scenarios where a gap year is appropriate include, (1) you do not feel like
you can balance a full course-load and studying for the MCAT at the
same time, (2) you did not do extensive clinical or basic science research
in your undergraduate career and want to apply to a medical school that
emphasizes scholarly work, (3) you want to take a year and chill out

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before being in school for the rest of your life, and you go to work at a
museum as a tour guide, (4) you need the extra year to create a financial
plan to pay for the costs during the application process, (5) you have
family obligations (marriage, pregnancy, kids, parents) that require your
attention at the present time. These reasons are varied, and all are valid.

Post-baccalaureate Programs
For those students who do not want to combine pre-medical
prerequisite classes with their college career, a post-baccalaureate (AKA
post-bacc) program may be an option. Post-bacc programs are comprised
of prerequisite classes for medical school, and are open to all manner of
pre-health students. These programs are offered at numerous
undergraduate universities, are often scheduled around traditional work
hours, and generally offer financial aid. Some programs are specifically
designed for career-changers, and students from economically or
educationally disadvantaged backgrounds and other post-bacc programs
are designed for students from groups that are often underrepresented
in medicine. Post-bacc programs often last between one and two years. If
you complete too many of your pre-medical prerequisites during your
traditional college years, you will not be eligible for post-bacc programs.
Beware of Master’s-level or other programs that appear similar to
post-bacc programs, but do not include pre-medical prerequisites.
Specifically ask if participants in the program qualify for federal
financial aid (FAFSA). Please note that masters programs do not count
towards your undergraduate or science GPAs as calculated by the
AMCAS. Admissions committees recognize that there are many
programs that exist solely to boost applicants’ GPAs. When considering
different post-baccalaureate programs, prospective students should
evaluate the following:
The length of the program (varies, usually from one to two years)
Whether the post-bacc program has affiliations or agreements
with certain medical school programs
Cost of the program, availability of financial aid
Costs of application fees, security deposits, textbooks, etc.
Location and relocation costs
Percentage of graduates who matriculate in medical school

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The AAMC has a list of the post-baccalaureate pre-medical school
programs ______
here.

Master’s Degree Programs


If you’ve already completed all of your pre-requisite classes, but like
the idea of continuing to learn more and stay in this academic setting,
this may be a great option. This can also be helpful if you feel that your
undergraduate GPA is a weak point in your application and want to show
that you are capable of performing well in higher level courses. Earning
your Master’s degree can also allow you to pursue a different interest and
provide a unique perspective in your medical training, something that
can add to the diversity of a medical school class and should be
highlighted in the interview. Examples of programs that previous
applicants have completed and noted by the participants to be helpful
include public health, social work, nursing, biology, literature, statistics,
population health, global health, psychology, and sociology. That does
not in any way limit you to pursuing those degrees, but they are simply
examples of the academic pursuits of current students that have added
to their ability to publish papers, understand social determinants of
health, or add a more humanistic perspective to the basic sciences.

Non-Academic Gap Year


Activities
Gap years are an opportunity to demonstrate your growth to
medical schools. These years should be filled with something
meaningful, whatever “meaningful” means to you. If you are passionate
about clinical research, go work in a lab. If you are passionate about
teaching yoga to children, teach yoga for a year. Ensure your gap year
activities align with your personal statement, and the way you plan to
talk about your interests during your interviews. For example: “I taught
yoga for a year, am passionate about prevention and nutrition, and would like
to work in medical education to improve the way doctors learn about
nutrition.”

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Research
Many applicants between their undergraduate and medical school
years opt for research. Research experience is highly valued by
admissions committees, and may provide valuable letters of
recommendation, poster presentations, and authorship in academic
manuscripts. If your intention is to apply to an allopathic medical
school that emphasizes research in their curriculum, it is in your best
interest to be involved in clinical research or basic science research
outside of the lab classes required by medical schools. If your intention
is to apply to an allopathic or osteopathic medical school that does not
emphasize research, then clinical research is not as essential to be
competitive in your application. Know yourself and the values you are
seeking in your future medical school. If you aren’t certain if you value
research for our career and your main value is “getting in,” that’s fine--
research will not be a detriment to your application to any medical
school. However, these authors acknowledge the difficulty of
incorporating research into a gap year given that many positions are
unpaid. Seek positions at your nearest university, medical school, or
academic hospital to find paid research positions, or consider applying
to paid research internships through national organizations and
academic hospitals.
Finding the right research lab
Research positions tend to fill quickly. Begin your search for a
research position at least two and as many as six months before you are
ready to graduate your senior year if you know you plan to take a
research gap year. While your search may start on the jobs website for an
academic institution, you need to quickly move to direct contact with
someone in the lab. Most lab websites will provide extensive details
about current and/or past research. Write a cover letter email that
expresses interest in a position contributing to their current research.
 Include a full CV if requested,, but if you are limited to the one-page
resume, tailor it to represent your utility to the lab based on previous
experience. Paid lab experience takes precedence over unpaid, and
experience in similar research areas takes precedence over research in

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other subject areas. However, do not be discouraged if you don’t have
extensive experience already in similar paid positions. Highlight any
research you have, as well as leadership and organizational experience
that has prepared you to do this work. Everybody has to start
somewhere.

Before your interview, prepare answers to the following


questions/topics:
Why you want to go into medicine
Why the research of that lab/primary investigator (PI) specifically
interests you
How you plan to balance studying for the MCAT/post-bacc
program/etc with this job
Social determinants of health
Communicating complicated topics (like research studies) at a 6-
8th grade reading level
How your previous experiences (even those not directly research-
related) have prepared you to do this job well

At your interview, make sure to get answers to the following


questions:
How would they describe the culture of this lab?
Are there any upcoming major changes to the structure of the
lab or the project you’d be working on?
What level of interaction would there be between the PI, other
research assistants, and you?
Who would be training you in your lab duties?
Are employees in this position able to receive authorship on
published manuscripts?
How many posters are employees in this position given
authorship on, in a given year?
Would you be able to receive a letter of recommendation from
the PI in time for your medical school application?
Would you be able attend conferences with the lab team?

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Following your interview, send thank-you notes or emails to
everyone you met with. For examples of how to write such notes, see
Post-interview correspondence subsection.
Note additionally that there are special research programs you can
consider applying to, such as at the NIH:
https://www.training.nih.gov/programs

Clinical Experience
While “clinical experience” is mentioned as something to highlight
in your application on most medical school websites, it can take many
forms. The reason many programs value these types of experiences is
because it shows you have actually been exposed to medicine and
understand something about the career you intend to pursue. Having
clinical experience lends credibility to your application and your
description of why you want to pursue medicine. It is far more
important to be able to speak about healthcare in a realistic way than to
have spent any particular number of hours doing any specific activity.
Clinical experience may include a personal experience in the hospital,
shadowing, supporting a loved one during a chronic illness,
volunteering, or prospective research recruitment in clinical spaces.
Volunteering, work, and research in a clinical setting is often preferable
to passive shadowing because they demonstrate additional qualities
such as service, academic rigor, and work ethic.
Shadowing
Shadowing is the most common form of clinical experience, but it
is almost always unpaid, so it is inaccessible for some applicants. For
those who do want shadowing experiences, the most difficult step is
getting in contact with a physician who will allow you to shadow them,
especially if you will be the first physician in your family and don’t
personally know physicians already. If you are currently working in an
academic research institution, this process will likely be much easier.
Just start emailing attendings (seriously, it's a teaching institution, so
they're used to it) to ask if you could set up a time to shadow them,
because you are interested in their specialty and/or attending medical
school. If you have met someone in an area you're interested in already,
consider starting there. Otherwise, you can just cold email and you will
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still likely get results. If you haven’t heard back in a week, send a brief
follow-up email in case they just hadn’t seen your original email. If no
response again, move on. Keep in mind that you will need to work
around their schedule, not yours, which is a big part of why shadowing is
often inaccessible to applicants. When you have an opportunity to
shadow, dress professionally and have a clear plan before arriving for
how long you will be shadowing. Ask as many questions as you can, for
your own benefit and to make it clear that you are interested in the field.
Physicians you shadow can connect you with physicians in other
specialties, research opportunities, mentorship, and even letters of
recommendation.
Volunteering
Service is an essential component of medical education across all
institutions, and is a highly-revered value among physicians. Therefore,
applicants are expected to demonstrate a history and personal
prioritization of service before applying to medical school. Many
applicants feel pressure to participate in several organizations in order
to lengthen their CV. Fight this urge. The adage “quality over quantity”
applies very well here. Stronger commitment over more time to fewer
organizations will serve you--and likely, your community--better than
limited involvement with every service project you could find.
Unfortunately, by definition these opportunities will also be unpaid,
and so difficult to fit into a schedule of anyone needing to work.
However, it is very important that you find a way to include
volunteering in your application, so consider it an opportunity to help
causes that are important to you, and to explore areas of interest that
may later inform your medical specialty. But most important of all is
that you serve causes that you are passionate about. It doesn’t even
matter if it is strictly related to medicine--eg Dr. Oliver spent time in
high school and college knitting baby caps and booties for a local
hospital and women’s shelter--as long as you are passionate about it.
This authenticity is important for the group you serve, for your
enjoyment of the task, as well as for the medical school admissions
committees. Below are some organizations that our authors have direct
volunteering experience with during a gap year.

23
Crisis Text Line. Crisis Text Line is a global not-for-profit
organization providing free crisis intervention via SMS message. The
organization's services are available 24 hours a day every day. Crisis
Text Line volunteers work remotely from their homes using a laptop
computer. Crisis Counselors commit to 200 total hours of
volunteering (no time frame), serving a recommended 4 hours per
week to meet this requirement. Before you begin as a counselor,
you’ll complete a training period to give you all of the expertise you
need to successfully and empathetically navigate crisis intervention.
All new crisis counselors undergo a 30 hour training, where they
learn reflective listening, collaborative problem solving, and crisis
management. Crisis Counselors highlight their intervention training
on their medical school applications. If counselors volunteer for
more than one year, they can request a letter of recommendation.
Learn more ____
here.
Americorps. Americorps offers opportunities working in healthcare
settings, in rural communities, and in schools. Programs accept
applications on a rolling basis throughout your senior year of
undergraduate classes, and the interview process can be done over
the phone. Beware that these programs are paid with a stipend that
is liveable, but not generous, so it will be difficult if you plan to only
use this stipend to pay for interview expenses (which will run you
anywhere between $2,000-8,000).
AmeriCorps City Year places students in underperforming
schools where they serve as mentors and tutors. The program
occurs during a school year instead of a calendar year, which
allows for a summer off before medical school. City Year
participants are allowed 10 days off per year, which can be
used for interviews.

24
Selecting Schools
Applicants on average apply to 15-20 medical schools. If you are a
highly competitive applicant you may be able to apply to fewer and still
maintain a good chance of acceptance. Pre-med advisors and mentors
will be able to guide you in how many schools to apply to based on your
specific application, but expect to apply to about 15.
An important consideration in deciding which medical schools to
apply to is state residency. State schools accept a majority of their
classes from in-state candidates which gives you an advantage in the
application process. State schools also have lower tuition for in-state
residents.
This also ties in to consideration of where you want to live. Don’t
discount proximity to family and friends. Medical school is stressful as
is, and being far from your social support network may be difficult.
Next you should consider your competitiveness as an applicant to
your schools of interest. You should review the median GPA and MCAT
scores of matriculated students at the schools you are considering and
see how you compare to them. A reliable source for this information is
the Medical School Admission Requirements website which provides a
comprehensive listing of U.S. and Canadian medical schools with each
school’s profile showing specific admissions requirements along with
their applicant and accepted student data.
Cost should also be a factor in deciding where to apply. As stated
above, in-state tuition will provide significant cost savings over out-of-
state or private schools. DO schools also tend to be significantly more
costly. Also consider availability of financial aid and scholarships. Some
people may try to dissuade you from considering cost at the application
stage (“you’ll be a doctor, you’ll pay it off!”) but student loan debt is a
significant burden on physicians that may affect you future lifestyle,
specialty choice, and job choice, so you should at least think about it.
Some other factors to consider in choosing which schools to apply
to: How do you learn best? Lecture format versus small group learning?
Do you want strong research opportunities? Are you interested in a focus
on primary care?
25
Primary
Application
Grade Point Average (GPA)
MCAT
Letters of Recommendation
Extracurricular Activities
Personal Statement
Grade Point
Average (GPA)
Your GPA is an important part of your application. Given the
sheer volume of applications medical schools receive, GPA and
MCAT scores often serve as an initial screening tool for admissions
committees to narrow down the applicant pool. For medical school
applications the GPA is further broken down into overall, science,
and non-science GPAs. The average GPAs for medical school
matriculants in 2017–2018 was a 3.71 overall, a 3.64 science, and a
3.79 non-science, per the AAMC. None of this is to say that a below-
average GPA will be prohibitive to medical school acceptance. While
some schools may utilize a hard cut-off in reviewing applications,
most schools will view your GPA in the context of your GPA trends,
the level of difficulty of your areas of study, and your MCAT score.
For example, a below-average GPA freshman year with steady
improvement thereafter shows personal growth and commitment
to improvement. GPA is also viewed in the context of your overall
application, including your ties to the area (ie in-state versus out-of-
state for public schools), letters of recommendation and offered
commitment to special programs such as rural medicine.
To put overall GPA in concrete numbers as of the timing of this
publication in 2019, per the AAMC, a GPA above 3.8 is excellent. A
GPA between 3.5 and 3.8 is considered "competitive," that is an asset
on your application. A GPA between 3.0 and 3.5 will likely require a
demonstration of an upward trend over time, as well as an
otherwise strong application. Basically: if you bombed freshman
year general chemistry but improved your grades since then, don't
lose hope! However, an application including a GPA below 3.0 will
be difficult to get past medical school admissions committees. If
this is your situation, consider an academic gap year to raise your
GPA.

27
Figure 1. Grade Point Average (GPA) according to AAMC

MCAT Exam
MCAT Basics
The MCAT is a multiple choice, computer-based exam. It consists
of four sections: Biological and Biochemical Foundations of Living
Systems, Chemical and Physical Foundations of Biological Systems,
Psychological, Social, and Biological Foundations of Behavior, Critical
Analysis and Reasoning Skills.
It is scored out of 528 (132 per section). For applicants of the 2018-
2019 cycle, the average MCAT score was 505.6. For matriculants
(students who were ultimately accepted to medical school), the
average was higher at 511.2. Source for this info and other trends for
medical school applicants here.
  While the MCAT does test your knowledge of facts and
information, it is especially a test of how well you can read and process
information. Much of the questions have to do with reading charts and
figures. These authors found that a good way to practice for this is
reading scientific literature and interpreting figures. This is absolutely
a necessary skill that is often not covered completely in MCAT prep

28
books, and there are many YouTube videos and articles teaching how
to do this online.

Registering for the MCAT


The MCAT is only offered from January through September.
Registration costs $315. If you are a low-income student, you can apply
for the Fee Assistance Program which reduces the fee to $125. Note that
the Fee assistance program also includes other benefits that help reduce
the cost of application fees.
Make sure to register for the MCAT early. You can register up to six
months in advance. This allows you to book a testing center close to
where you live, and avoid having to travel out of the way on test day.

MCAT Prep Courses


There are variety of courses, tutors, and book series that exist for
medical school applicants, but they are by no means necessary for your
success on the MCAT. The cost is prohibitive to many students, but
there are high-quality, affordable materials out there. Contact your pre-
medical advisors, your local library, students at your college who have
already taken the MCAT, or your school’s career success center to see if
anyone has test prep books available to borrow, or even for sale at a
reduced price. Khan Academy has also made a series of free videos
covering relevant tested material in partnership with the AAMC.

What to expect on test day


Most tests are held at private testing centers, so your experience at
any testing center will be different. To be sure of what to expect, you can
call the center ahead of time and ask about their procedures and setup,
and/or speak to any classmates or friends who tested there recently.
Most testing centers will have lockers for you to place your
belongings (including your cell phone switched off, any snacks or lunch,
water, etc). You won’t be able to drink water or snack while in the exam
room.
The testing room will have rows of desktop computers where you
will take the test. There will always be a surface given for you to write
scratch work on. Sometimes it is a pencil and scratch paper, and other
29
times it may be an erasable whiteboard and marker. Many centers also
provide noise-cancellation headphones at every station.
Every time you enter the testing room, you will have to show
government-issued ID like a driver’s license and provide a signature.
Proctors may use a metal detector to scan you prior to entrance, and
check your pockets. Test-takers wearing their hair in certain styles such
as large buns or dreadlocks may also have their hair patted.
Depending on your test location, proctors may be strict about
sitting at your test station upright with both feet placed on the floor.
Consider  practicing sitting this way during all of your MCAT practice to
get into the habit and avoid any potential interruptions during your
exam by persnickety proctors.

Is my score good enough?


You should receive your score around four weeks after taking the test.
Make sure to save a copy of your official score report; you will be asked for
it even after you finish medical school.
Your MCAT score is only one of a multitude of factors being assessed.
Keep in mind that it is only one part of your application. Even the best
schools admit students with a large range of MCAT scores. There is a
growing body of work demonstrating the inaccuracies of trying to identify
quality future physicians with this exam, particularly when those future
physicians come from underprivileged and/or underrepresented
backgrounds.
If you want to compare your score to that of current students at
schools you wish to apply to, many schools will list the MCAT scores of
their previous incoming class. For example, the 2017 incoming class at
UCLA had the following MCAT statistics (Source):
25th percentile - 505 (the average score for all people
applying to medical school in 2018-2019)
50th percentile - 514
75th percentile - 518
See how wide a range this is?

30
Letters of
Recommendation
The specific requirements for letters of recommendation vary
between medical schools. Generally two or three letters are required,
with at least one from a science professor and one from a non-science
professor. Many DO programs require a letter from an osteopathic
physician. If your college or university has pre-med advisors or a pre-
med advisory committee, you will typically need a letter from them as
well. Some schools offer to write a committee letter on behalf of your
application; this letter is typically written by the pre-med advisor(s) as a
way to compile a highlight reel of who you are as an applicant
(academics and otherwise) and provides quotes from the other letters of
recommendation in your packet. For more details about the committee
letter process and advice, see here. Depending on the requirements for
the medical schools you are applying to, letters may also be obtained
from research directors, physicians you’ve shadowed, faculty advisors for
extracurricular activities, or volunteer coordinators.
When seeking letters of recommendation it is important to ask
early. Professors and physicians are busy--often with requests for letters
from other applicants too--and if given a short deadline they may be
unable to accommodate your request for a letter. You should make the
request for a letter of recommendation at least one month before it is
due to be submitted; ideally two months if possible. You should ask for
letters from professors who know you well (from active class
participation, small group settings, or office hours) as you want the
writer to be able to highlight your unique qualities and skills. Generic
letters of recommendation will not help your application. It is best to
ask for the letter of recommendation in person. If an in-person ask isn’t
possible, email is an acceptable alternative. When asking for a letter of
recommendation, also request to meet with the writer to review your
application and requirements for the letter. Bring a copy of your CV and
be prepared to discuss why you want to go to medical school, what

31
makes you a good applicant, and which features of your application or
experience with this letter writer you’d like to be highlighted. You may
also want to follow-up after your meeting and provide the letter writer
confirmation of the due date and any  supplemental information that
might be helpful to them as they are writing: e.g. your finished personal
statement, a short statement about your future career goals, a list of
examples they can include about projects/course papers, and the list of
AAMC Core Competencies. An example of a helpful guide for your letter
writer can be found in the Appendix.
Specifically ask the professor after your conversation if they feel
they can write you a strong positive letter of recommendation (rarely,
there have been cases of strong negative letters). If they say no or seem
uncertain, you’d rather hear no at this point than to have a poor letter of
recommendation included with your application. Thank them for their
honesty, and find someone who can say “yes.” Specifically ask the person
after your conversation if they feel that they can write you a strong
positive letter of recommendation. Rarely, there have been cases of
strong but negative letters. If they say "no" or seem uncertain, you'd
rather hear that at this point than to have a poor letter of
recommendation included in your application. Thank them for their
honesty, and then go find someone who can say "yes."
In your application to medical school, it is advisable to waive your
right to read the letters of recommendation. The medical schools to
which you apply can see whether you've waived this right or not, and
will put more weight onto letters that are confidential. It is a red flag if
the letter is not confidential, because the question arises if you perhaps
unduly influenced the content of the letter.

32
Extracurricular
Activities
In addition to the personal statement, the extracurricular activities
portion of the application is an area which allows you to share your
experiences and paint a picture of who you are and what qualities you
possess that will make you an excellent medical student, and ultimately
physician.
You want to include significant experiences that highlight your
accomplishments or that had an impact on you. Don’t include high
school activities unless you have continued to engage in that activity in
college. One pitfall in extracurricular activities is treating them as a
checklist of “must haves” for your application. Quality of extracurricular
activities is far more important than quantity. You want to show
consistent participation and, when applicable, leadership roles.
You do need to have some clinical experiences among your
extracurriculars. These can be shadowing, volunteering, community
outreach, or research. Admissions committees want to see that you’ve
explored the field of medicine and are committed to it, and having
actually spent time in clinical settings lends credibility to your pursuit of
medicine. By no means do you need to have experience in all these areas
to have a strong application. An ongoing volunteer or research
experience throughout two years is going to be looked at more favorably
than a dozen one-off shadowing or volunteer experiences.
Any non-medical volunteering, club participation, jobs, or hobbies
that you are passionate about and deeply involved in should be included
as well and can help make your application stand out. These activities
can demonstrate your commitment, initiative, altruism, and time
management skills--all of which are important qualities in future
physicians. The extracurricular activities section is one interviewers love
to ask about. You should be prepared to elaborate about any experience
you list on the application and how they make you a strong candidate for
medical school. This is another reason it is important to choose carefully

33
what you include. It is easy for interviewers to see your enthusiasm
about experiences and projects you truly care about, but if an activity is
listed that you were only peripherally involved with, that will come
across poorly in an interview.
In addition to your personal statement, this section tells the
interviewers about your interests and passions both in medicine and in
other areas. This can also be an opportunity to include unique hobbies.
which can help show committees that you aren’t just working to do what
you think looks good, but rather that you have actually enjoyed your pre-
medical experiences. Examples may include community choirs, violin
playing, being a super fan of your school’s sports teams, etc. Making your
extracurriculars personal can help you stand out and will provide great
topics of conversation in interviews.

Research
Experience
Most schools will expect you to have some research experience, but
research experience is not required for most medical schools. Note,
however, that some schools value research more highly than others and
most schools will at least expect that you have tried it. One indication of
whether a school values research highly is if a required research project
is present in their medical school curriculum, which is usually available
on the school’s website. It may also explicitly state that the program is
seeking applicants with research experience and skills. It is important
that you participate in research if you are interested in it and if you are
willing to commit the time to understand your project and be able to
speak about it. Research can be clinical or laboratory-based, and ideally is
based on your own interests. Note that if you are applying MD-PhD, it is
expected that you have extensive research experience, as it would be if
you were applying to obtain your PhD.

34
Research during school
year
Many schools have programs within their departments to support
students who are interested in doing research. Seek these programs out
first. However, if you are lucky enough to be neighboring a medical
school, you can also seek to get a position in one of the labs there.  
Many funds for undergraduate research assistantships will require
you to already have a mentor in a specific lab. To find one,  look up
laboratories at your school in departments you are interested in. It is
appropriate to cold-email multiple investigators letting them know of
your desire to work in their lab and ask if you may meet. Be sure to
include a resume or CV with your email. Tips for a first-contact email are
in the “Finding a Mentor” section.
It is very important to meet with the PI of a lab before joining it, and
many times, you will be working with a post-doctoral or graduate student
in the lab. It is extremely important to meet them first. What is much
more important than the topic of research you are participating in is the
mentor you are working with. A good mentor will help you learn about
research, give you independence, and give you more opportunities to be
on manuscripts and presentations, which are valued highly by medical
schools. Many students make the mistake of doing research “to check a
box” without developing an understanding the project they are working
on or the methods they are performing. Be sure you understand what you
are doing in the lab. This is why it is important to have a supportive
mentor who can teach you about the project.
Another option for research is clinical. If you already shadow a
physician at an academic institution, it is highly likely that they
participate in some sort of clinical research. This generally involves chart
reviews and data collection and analysis. If this is something you are
more interested in, absolutely ask if you can be involved.
Many times, undergraduate research jobs are unpaid. This is not feasible
for many students, so many schools have grants and funding
opportunities. If you cannot immediately find such opportunities, email
the Academic Fellowships or Research Fellowships department at your

35
school. It is also perfectly acceptable to let your mentors know that you
would like to be compensated. Many schools also allow you to
participate in research for class credit, if this is of interest to you. Look
for classes that involve “Directed Research,” or ask your academic
advisor which areas you can obtain research credit that will contribute
towards your degree and protect time in your schedule for research.

Summer Opportunities
Summer research can be within your institution and or outside of it.
Some programs you could consider applying to include:
Programs via local academic hospitals
Amgen Scholars program
_________________________________

UT Southwestern Summer Undergraduate Research


_____________________________________________________________________

Fellowship
______________

NIH sponsored programs


__________________________________

Research fellowships post-


graduation
Your program, national research organizations, and nearby
universities and/or academic medical centers each have their own
unique sets of research positions and fellowships. Check carefully
wherever is conveniently located to you to see what opportunities await.

36
Personal Statement
On the primary application you are given space to elaborate on your
personal statement (currently called the Personal Comments section on
the AMCAS) to the admissions committee. This is your opportunity to
tell your story, so don’t be afraid to be personal--this is about you! You
have 5,300 characters (including spaces and some limited formatting) to
communicate your motivations and show off how awesome you are.

Topics
The AAMC notes that this is a chance to answer questions like
“Why have you selected the field of medicine? What motivates you to
learn more about medicine? What do you want medical schools to know
about you that hasn’t been disclosed in other sections of the
application? “This is not the time to give a summary of your resume;
that’s what the other sections are for. “In addition, you may wish to
include information such as: unique hardships, challenges, or obstacles
that may have influenced your educational pursuits and comments on
significant fluctuations in your academic record that are not explained
elsewhere in your application.”
Many applicants find it helpful to anchor their personal comments
around a salient experience, narrative, or theme and describe life events
that have prepared them to be a future physician. Remember that the
personal comment is fair game during interviews, so be ready to  talk
openly about the topic(s) you choose to include. If you don’t have any
heroic stories about medicine, don’t worry, you don’t have to. Some
applicants try so hard to have a “cool story to tell” that they blow things
out of proportion and seem disingenuous. Honesty and personality are
key here, not dramatic narratives worthy of an episode of Grey’s Anatomy.

37
Writing Tips
Don’t write it all at once; give yourself time to think through all
the topics you could write about, and don’t procrastinate
starting
Write about your passions: what makes you unique? Where do
you see yourself in your future career? How have your
experiences informed who you are and prepared you to be a
doctor?
Make a few different drafts: you may have to try different
strategies to write about the same topic--use anecdotes, try
different examples
Trust your gut: ultimately this is what you want to say about
yourself, so stay true to that
It’s ok to write about something emotional: it can be a good idea
to be vulnerable and show how this plays into your desire to
become a physician. Tread carefully between telling your
authentic story and seeming melodramatic, or implying
anything problematic.
Be careful with what an anecdote might communicate about
you, and that it isn’t overly cliche. It’s awesome that the kind
emergency medicine doctor who helped your grandma after she
fell made you first interested in medicine, but unfortunately
things like that have become so common that admissions
committee members joke about that type of story. Further, be
wary of making a narrative sound more impressive than it
actually was. If you spend ⅔ of your personal statement talking
about how impactful it was to work with blind orphans in
Guatemala, it would be concerning for the admissions
committee to then see you were only there for a three-day
mission trip because you likely didn’t actually do very much in
such a short time and it makes it seem that you’re really having
to stretch the truth to sound interested in medicine.

38
Editing
Find some people in your life who know you to get some eyes on
your draft. Emphasize what you want them to focus on, because some
people will be better at telling you if your draft sounds like you, and
others are better at editing for spelling/grammar/flow. It is ok to go
through several drafts! You want to show the best of yourself, and it is
very difficult to do that in one try. Write something, and then give
yourself a few days without looking at the draft before you go yourself
and read it again with fresh eyes. You may also want to keep sentences
or anecdotes that you decide to not use for your personal statement in a
separate document because it might be better for your secondaries, or
for interviews.

39
MD-PhD
Programs
What does it mean to be a “physician-scientist?"
MD-PhD application process
What does it mean
to be a ”physician-
scientist?”
A physician-scientist is someone who bridges the worlds of
academic research and clinical practice; their research could be in
the basic sciences, translational applications, clinical
trials/research, medical device design, epidemiology, or other fields
like public health or history of medicine. After training, one’s career
might be 100% research or 100% clinical practice or somewhere in
between.
One way to train as a physician-scientist is to join a medical
scientist training program (MSTP). These are programs that operate
under a training grant (T32) from NIGMS/National Institute of
Health to support students. The recognized MSTPs are listed ______
here.
There are also MD-PhD programs that are not funded by the
NIGMS. However, training through an MSTP or MD-PhD Program
is not the only way to be a physician-scientist, as you can do
research in medical school, join a research track residency (some of
which will allow you to simultaneously get a PhD), and/or to
participate in research as a fellow and attending.

41
Some thoughts on attending MD/PhD programs:

Figure 2: Benefits and Challenges of Pursuing MD-PhD programs


Note: not all of these points are benefits or challenges for everyone, or for
every program

The most important thing to consider when deciding if to pursue an


MD-PhD: What matters to you? For more advice and things to
consider, consult these articles by Skip Brass, MD, PhD and Aimee
Payne, MD, PhD: Perspective: Three Crucial Questions When Applying
________________________________________________________________________

to MD-PhD Programs, Finding


_____________________________ Nirvana: Paths to Becoming a
_________________________________________________

Physician-Scientist, Is an MD/PhD program right for me? Advice on


________________________________________________________________________________
becoming a physician–scientist.
__________________________________________

42
MD-PhD
Application Process
Primary Application
For the primary application you will be required to submit the
usual personal statement and two additional essays for MD-PhD
programs. One essay focuses on why you want to be a physician-
scientist (3,000 characters), while the other gives space (10,000
characters) for you to elaborate on your significant research
experience(s). Use these essays as opportunities to highlight how you
have prepared for a career in research and what you envision for
yourself down the line. For more information, refer to the AMCAS
guide to applying to MD-PhD programs.
___________________________________________________

Interviews
Interviews for MD-PhD programs can vary widely: MD-PhD
interview day can be completely separate from MD day (each lasts one
day) or you can participate in an integrated interview day (both MD and
MD-PhD components in one or two days). Be sure to pay attention to
the format listed on the program’s website or in their communications
to you. The MD-PhD interviews can take the form as informational
interviews with faculty, an interview with someone on the admissions
committee or program director, a group interview with a subset or full
admissions committee present. The MD interview may also vary in
makeup. Interview days are long and taxing - be sure to dress
comfortably, prepare, and enjoy yourself! See the the section starting
page 62 for more details.
Please note that many programs will ask about your ideal goals for
how you plan to split your research and clinical time. 50-50 is not a
viable answer. MD-PhD programs often want to hear that you want to
do 70% research, 30% clinical (even though in reality, that is not what
happens with the majority of their graduates).

43
Application
Next Steps
Timeline
Communicating with schools: when, why & how
Secondary applications
Timeline

Figure 3: a Brief Overview of the AMCAS Application Timeline

As you will most likely be submitting applications to many


schools, it is important to stay organized and on top of your deadlines.
One way to do this is to create a spreadsheet of your schools and their
associated materials and deadlines. Using the "filter" tool in Microsoft
Excel, you can organize your schools by deadline and prioritize by
which is due first.

45
Here is an example of an Excel spreadsheet to organize schools from
Carina Seah:

The number one mistake that students make is not sending their
applications in a timely manner.  Your primary application materials
should be ready before the submission date opens. We strongly
recommend you submit everything the day the primary application
opens, or at least within the first two weeks of the application opening.
Once interview invitation slots are filled, they’re filled, and you don’t
want to not get one just because your application was too late for them
to see how great you are.

Communicating
with Schools: When,
Why, & How
We can divide communication with programs into two phases
with different expectations: pre-interview and post-interview. This
section will focus on pre-interview communications; post-interview
will be discussed later on.
The name of the game with medical school applications is “the
sooner the better.” Things come up, but try your best to stay on top of
your applications and travel arrangements to avoid any emergencies.
When calling, check normal office hours. When emailing, be
cognizant of any upcoming holidays that might disrupt a timely
answer. Typical etiquette is (for non-time sensitive matters, for which
calling is best): if you haven't heard back in a week, re-send the email.

46
The admissions staff exists not only to select the next M1 class
from among applicants, but also to help people become applicants. If
you have an admissions-related question that you can’t find the answer
to on the school’s website or in any emails or documents they have sent
you as part of your application, reach on out. If the question isn’t
admissions-related, it can wait until interview day.

Special note: some students, upon hearing that secondary


applications for a program they’ve applied to have been sent out to
some people but not yet to them, opt to contact the program to
reiterate their strong interest. If you haven’t heard from them anyway,
then perhaps you have nothing to lose and an interview to gain by
reaching out.

Assume that everyone you interact with at a program could


impact your admission decision. The person answering your phone call
deserves your respect and good manners as much as the admissions
director themselves, so act accordingly. For non-urgent matters, just
send an email so staff can answer it when it is most convenient, or refer
the question to someone else if necessary. Double check for typos, the
correct spelling/title/salutation of the person you are contacting, and
that your question is clear. For urgent or complicated matters, call so
that it can be worked out more efficiently.

47
Secondary Essays
Content & Strategy
What is a "secondary"?
A secondary application is a second application that is offered by
schools that have decided to evaluate your candidacy further. Note that
these vary across schools--some will just ask for some clarifying
information, while many will expect several additional short essays. It
can be daunting to complete these, because they typically come around
the same time and require quite a bit of writing; but there are ways for
you to prepare yourself in advance for success!
Work smarter, not harder: try to group the essays into “themes”
(example of failure, example of teamwork, diversity/working with
someone different than you, why are you interested in this school)
and then be strategic in identifying where there is overlap between
applications. One way is to write the shortest essay about a
particular topic first, and then use this as a starting point for
drafting longer versions for applications that allow you more
characters/words.
Picking what to write about: In advance, come up with a list of
anecdotes or topics that you can write about for your own
experiences (this will also be useful for interviews). You don’t want
to be redundant with your personal statement because this is an
opportunity to show something new about yourself.
Be creative:  Look around for some inspiration for examples of traits
that you may not have thought of initially. Check the________________
AAMC Core
Competencies,
___________________ ask your mom, ask someone who worked with you
_
on that volunteer project you did. With the amount of work most
pre-meds have done before applying, it’s easy for things to blur
together!

48
Stick to the limit: Keep the word/character limit in mind as you
are writing so that you don’t have to spend a lot of time cutting
out words just to get back under the limit. Use the limit as a
way of determining how much detail you can go into and what
information you should prioritize.
Consider pre-writing your essays: you can find the prompts for
some schools online which can make it easier to start planning
what you might be writing about. Start brainstorming, writing
outlines, finding overlap between applications and then start
writing! Remember there is often a lag between submitting
your primary and receiving a secondary application so use this
time efficiently. Even if the topic ends up not being the same to
a previous year, you can probably still end up using what you
wrote for another school’s application or for interviews.
Submission Timeline
Secondary applications can be sent at any point after your submit
your primary application. If you apply by the priority deadline (usually
in June) do not expect to get a secondary application until July. If you
apply later, then the secondary can arrive any time after that. Some
schools will wait until other parts of your application are in before
sending a secondary while others send requests almost immediately
through an automated screening process. For this reason, it is very
important to be checking your email consistently and to check your
spam folder. Some people recommend submitting a secondary
application within two weeks of receiving the email; this is not a hard
rule but it gives you a sense for how quickly you may have to turn these
around. That being said, do not rush through these applications! It is
more important to spend time and make sure you have edited
appropriately.

49
Other considerations:
There is a cost associated with secondary applications, so you
will have to plan accordingly (some schools do offer fee waivers
in specific circumstances)
Typically you will be copying and pasting your essay into an
answer box, so double check your formatting and spacing
Check each school’s application website for details about when
they send out secondary applications and when their final
application deadlines are
Stay organized--this will help you set goals and priorities to
stay on track. Try using a spreadsheet to track your status for
each school:
School Name
Primary Submitted
Secondary Received
Secondary Topics and limits
Secondary drafted
Secondary submitted
Interview Offer
Follow-up Correspondence
Outcome

50
Interviews
Interview Day
Making the most of informal sessions
Interviewing on a budget
Interview Day
MD Interviews
Traditional Interview
Many schools still use the traditional interview format. In this
format, candidates sit with admissions team members and speak about
their experiences and goals in a small setting. The person interviewing
you could be a practicing physician, a professor, a researcher, or a
medical student. The traditional interview typically lasts a 30 minutes
to 1 hour.
    The content of these interviews can vary significantly, but be
prepared to tell your story: why do you want to be a doctor? What
inspires you? What future do you envision for yourself? Some may ask
about challenges in healthcare. They do not expect you to have an
MPH, but they may expect that you have some thoughts on challenges
such as caring for un- or under-insured patients, diminishing
reimbursements to physicians, the burnout epidemic, etc. Still others
ask questions such as these, or some other unexpected question to see
how you react to things you weren’t able to prepare your “script” for.
You should be able to talk about what specialty you might be thinking
about, if there is one. No one expects you to stick to that, but it shows
you have at least thought about it. If you have done research, be
prepared to talk about it succinctly and coherently. If you cannot, that
will be a red flag suggesting you weren’t actually really involved in the
work. Some interviewers will ask questions about life, and may ask
about your biggest personal challenges and successes. Do not shy away
from talking about important, meaningful experiences you have had; a
superficial response may be read as you having lack of insight or
maturity. Even if you made a huge mistake or encountered a major
obstacle in your path, showing how you overcame that and learned
from it shows your ability to manage adversity and can impress the
interviewer. In many cases, the interviewers are the ones you represent
who you are as a person to the admissions committee. You want to give

52
that person the tools he or she needs to be an advocate for you.
    Some schools use blinded interviews, in which case the
interviewer may know nothing about you besides what you tell them
during the interview. Even when schools do not use blinded reviewers,
sometimes interviewers have not had a chance to fully review your file.
That means you need to be able to summarize your whole application
in a very brief statement. If you think through that in advance, you
won’t be stunned when the person gives you the dreaded “Tell me
about yourself.” A great response to that question includes some
personal information, such as where you grew up and where you live
now, as well as what you consider to be the most important, relevant
details of your application. The latter might be any organizations you
have worked with, meaningful work you have done, impact you have
made on others, etc.
    In addition to knowing the ins and outs of your application, be
prepared to speak about the things that make you unique outside of
academics and the experiences listed in AMCAS. Interviewers often
want to get to know you as a person, not just as a future medical
student. What are your hobbies? What do you do with family and
friends? How do you relieve stress? How do you plan to keep
participating in these activities as a medical student? This shows time
management and maturity, as well as makes you a more personable
applicant. We so often forget that we are a whole person, not a robot
boxed into the world of medicine, and it’s some interviewers’ top
priority to get to the root of who you are.
Most interviewers will give you an opportunity to ask questions.
Be prepared for this, and reserve questions for later in the day. These
questions show that you have thought about the school and any
opportunities or challenges you foresee there. If you know who your
interviewers are in advance, you can use this opportunity to ask
questions about their ideas or careers. If you can look up the
interviewers in advance and prepare 2-3 questions for each, you will be
able to fill the time and also show interest.

53
Here are some common interview questions you will want to
prepare for:
What has been the biggest challenge you have faced so far?
Tell me about yourself.
What are you most proud of?
Why do you want to be a doctor?
What do you think is the biggest challenge facing physicians
today?
Tell me about your research/clinical exposure/other broad
categories of activities.
What is your biggest strength?
What is your biggest weakness?
Tell me about a time when you made a mistake.
Where do you see yourself in 10 years?
How would your friends describe you?
Have you ever disagreed with other people you are working
with? If so, how did you resolve the disagreement?
How will you manage your interests outside of medicine
with a career in medicine?
Are you interested in doing research?
What questions do you have about our institution?
Why would you want to leave (wherever you currently
live)?
If your best friend described you in three words, what
would they be?
You’ve shadowed a number of physicians. What are traits
you saw in these physicians that you would like to emulate
in your future career? What are things you saw that you
wouldn’t want to do?

54
Some interviewers may ask inappropriate--indeed, illegal--
questions about your plans to have a family. You do not need to answer
those questions, and you may want to consider whether you want to go
to a school where people ask those questions. How you handle the
question will depend on your comfort, but you can always say
something like, “I intend to focus on learning as much as I possibly can
during medical school,” or, “I am committed to being the best physician
I can possibly be.”
Multiple Mini Interviews (MMI)

The MMI is an interview format consisting of more short


interviews in replace of a traditional interview format. Applicants
typically rotate between eight to ten rooms. In front of each room, there
is a prompt that will explain what is inside the room and what you are
expected to do.
You will often have two minutes outside the room to read the
prompt and gather your thoughts. Some schools allow you to take notes
on given scratch paper during this time. At other schools, you may not
take notes.
Upon entering the room, there will be a member of the admissions
process. This could be an admissions officer or faculty member, but at
some schools, this is a former patient or a member of the community.
You will have approximately eight minutes inside the room to discuss
the prompt or complete the activity.
The MMI has been adopted by many schools for the following reasons:
It allows candidates to be evaluated by a larger number of
people, reducing the chance of an interview resting on
whether you happen to click with your interviewer
It allows schools to choose scenarios that they care most
about. For example, a school that highly values research
might ask you to discuss what kind of evidence a doctor
might need to adopt a practice, and a school that values
advocacy and policy may ask you to evaluate current
governmental healthcare policies.
It can decrease the role bias plays in selection.

55
Possible Rooms
Keep in mind that different programs have different types of
interviews, and that not every MMI will use all or any of these room
types.

1. Ethical scenario

Sample question: A patient comes to you with a terminal disease


wishing to only pursue alternative medical treatments. How would you
counsel the patient?

Here, the admissions committee is looking to see how well you can
think on your feet to consider an ethical issue and approach it from
multiple angles. It is important to understand that there are MANY
answers you can give, and oftentimes there is no "right" answer,
because the point isn’t to see if you know the “right” answer.They want
to see that you understand the complexity of issues and can
communicate these intricacies well.

In most MMI rooms, there will be one admissions member sitting


across from you. At some schools, the admissions member is instructed
not to respond to you and not to speak back. At other schools, the
admissions member will actively ask you questions and continue the
conversation. A good tip is to ASK beforehand. At every school, there
will be a quick explanation session as to how the MMI works. This is a
good time to ask if you should expect the admissions member to ask
you questions or if you should prepare to spend the time answering the
question yourself unprompted.

In the time allocated for you to read the prompt, take your time to read
it. Two minutes should be more than enough time to go over it slowly
and gather your thoughts. First, figure out if anything is unclear. If you
are confused about the wording of something or feel like you need
additional information, you should absolutely ask the admissions
committee member inside the room. Some questions you might want 

56
to ask for this sample question are as follows: “Has the patient already
been fully educated about the current standard of care?” or “Does the patient
have any religious or cultural beliefs that are informing their desires?” Not
only will this help clarify the situation for you, it also shows you have
put some thought into the specific information you would need to
approach this question as a doctor.

Next, center your thoughts around a general idea. Here, your idea might
be “I will ensure the patient has been adequately educated, or try to educate
the patient to my best ability, and after this, the ultimate choice is up to
them.” Now, gather examples or reasons you believe this. Compelling
examples can be drawn from experiences you have had or articles you
have read. One example here may be, “While I was shadowing, we had to
spend a lot of time educating patients about things they had read on the
internet. I found what was most effective to navigate these discussions was to
be non-confrontational, never treat the patient like you knew better than
them, and always approach it from the perspective of wanting the best
outcome for the patient.” Bringing your personal thoughts and
experiences makes for a much more compelling discussion.

2. Group Teamwork Activity

Sample scenario: You are paired with another student. You are given a
simple picture to draw and the other student will have a blank sheet
and a pen. You will sit on opposite sides of the room and cannot look at
each other, but may verbally communicate with each other. You must
explain the picture so that your partner successfully draws it on their
sheet of paper. You will have five minutes to complete the drawing and
three minutes to evaluate your communication with members of the
admissions committee.

The purpose of this room is to evaluate how well you work in a team,
how you think on your feet, and how effective a communicator you are.
Keep in mind that you can be either the “giver,” giving instructions in
this room, or the “receiver,” who receives and must follow the 

57
instructions. The committee is looking for candidates who are
thoughtful and clear, and can also take into consideration what the
other person needs to be successful. Remember that the goal is NOT to
finish the puzzle. It is better to do a good job slowly and effectively
communicating your way through than to panic and feel like you will
not get done. Oftentimes, the puzzles are not solvable in five minutes,
because again, the point is not to finish the puzzle, but rather to see
how you approach it.

Some tips for this room are to think about being as clear as you possibly
can. What information does the other person need? Make sure you are
constantly checking in with the other person and clarifying. For
example, if you are the giver, asking something like, “Can you describe
what you have in front of you?” helps give you an idea of where to begin.
As the receiver, saying, “Just to clarify, that’s a straight line towards the
right, so now I have a square?” helps explain to the giver where you are at.
Providing the big picture is also a good idea, such as “We are going to be
drawing a rabbit,” or “Next, we will be drawing the ears.”

The last three minutes of the room will be spent talking about your
communication and reflecting on what you could have done better. Try
to think of something you think you did well, something you could have
improved on, and then compliment your partner on one thing they did
well and suggest one thing they could have improved on. This can be
specific, ie, “When we drew the wheel, I think you could have been more clear
about how big it should have been,” or general, like, “I appreciated how you
gave me the big picture before starting each new task.”

3. Actor

Sample Scenario: You are a rotating medical student. On your last


rotation, the attending used a racial slur that you felt was
inappropriate. You want to address this with him. He is in the room.

58
This room aims to test your communication skills. Inside the room will
be an actor who will play the role indicated in the scenario. You should
expect the actor to respond to what you say. Think about how you
would approach this situation in real life. Put yourself into the scenario
and pretend that the actor is a real person.

Here, the admissions committee is looking to see how you approach a


challenging social scenario. Remember that here, listening is just as
important as what you say. In fact, what the actor says will give you
insight as to how to respond. Don’t spend too much time on small talk,
and get right into the issue, then take cues from the actor as to how to
respond.

One tip is to use as much collaborative language as possible. Rather


than accusatory second-person language (ie, instead of “you”-focused
statements, try to use “we”). So for the example above, saying something
like “We value inclusivity and diversity, and I believe that we can do a better
job using more inclusive language.” It might be helpful to focus on "I"
statements. eg: "When you said <insert statement>, I felt <insert feeling>.
This concerns me because xyz."

Another good example for how to tackle an actor scenario is provided


here.
________

4. Rest Station

Most MMIs will have a rest station where you can use the bathroom
and grab a drink of water. Use this time to relax and mentally prepare
for the next station! Once each station has ended, let it be over. Don’t
carry worries about what you should’ve done differently into the next
room.

59
5. Traditional Interview
Some schools will have a traditional interview built into the MMI
rotations. This could be just for one rotation, or take up a double
rotation slot (which would be an 18-minute interview). This is
conducted like a regular traditional interview where you are expected
to go over your experiences and your goals with a member of the
admissions team.

6. Writing Prompt
Some schools may also include a writing station. This will include a
prompt at a   computer, and the same time alloted for the speaking
interviews. There is not the time to go back and change your mind, so
choose an idea and run with it!
General Tips
Always introduce yourself! There is no need to rush straight
into answering the question.
You don't need to use up the whole time if you are satisfied
with your answer; you won't be penalized for that. Sometimes,
a shorter but more thoughtful answer is better than a
rambling, long answer.
Before leaving the room, thank the interviewer for their time,
the same way you would at the end of a traditional interview.
At some schools, you are permitted to bring a watch inside,
which may help you structure your two minutes of
brainstorming. Or, it may stress you out! Try it both ways to
see how you feel about it. Keep in mind, though, that some
schools do NOT permit watches.

60
How to Prepare
The first thing you should do is go over some practice questions. Some
resources for this are below. Take some time and go over them. It may
help to write out a list:
1. Things you should consider or questions you have after reading the
scenario
2. The main point you want to get across
3. Personal experiences/anecdotes that will help support your answer
to the question
4. Other evidence you can use to help support your answer
5. Other perspectives on the issue
6. After you’ve done this for a few questions, try it out verbally. Can you
structure a coherent discussion on this without writing anything
down?
7. Make sure you try this out with a timer. It helps to feel how long two
minutes of brainstorming is, and how long eight minutes of talking is.

MMI Practice Questions

100 MMI practice questions from an Academic Consulting company


____________________________________

10 MMI sample _
questions
________________________________

MMI practice questions from a Canadian Medical school


______________________________

The University _
of Minnesota’s MMI presentation given during the
interview is ____________________________
available online here. It provides an example of how the
MMI works at this school, including how the rotations are set up, with
sample questions.

61
MD-PhD Interviews
Most MD-PhD interviews consist of a medical school interview
(which could be MMI or a traditional interview) with multiple
additional research interviews with researchers structured like a
traditional interview (as described above). The interviewer will likely
ask you to describe your research experience and ask in-depth
questions about your research. They will also ask you why you want an
MD-PhD, rather than just an MD or a PhD. One common question I
was asked that you should consider is that, as an MD-PhD, you are
splitting your time between two professions, yet have to compete with
individuals doing one or the other full time. What will you bring to the
table that is unique once you enter the field as a physician-scientist?

To prepare for this interview, here are some questions to consider:


What research do you do? How can you explain the gist of
it in an easy-to-understand, brief way?
How independent were you in working on this project?
Explain a time when your research/experiment failed.
What did you do next?
If you still had another two years to work on the same
project, what experiment(s) would you want to do next?
Explain to me how technique X that you used works.
What research topics are you excited about that you want
to learn more about?
Why do you want an MD-PhD as opposed to just an MD or
just a PhD? What unique perspective will you have?
If I say <<hypothetical situation X>>, what information
would you want to know or what experiment would you do
next to explore this further?
Be sure to be able to talk about your research comfortably and be
OK with not knowing the answer to a question. A good strategy if you
are caught off-guard by a question is to be honest, say “I am not sure,”
and then continue with information you do know related to their
question like "I know that xyz occurs in this context so perhaps something
similar would happen…" or “I would need to get background information into
62
xyz and that would help me answer your question because..." You don't have
to have all the answers but you should be able to talk about your
science and show that you can think on your feet.
This interview is also an opportunity to talk to Principal
Investigators (PIs) about their work, so be sure to look up their recent
papers/projects and have a few questions prepared about what they are
currently working on.  Background reading is a must with these
interviews. Some PIs will want to have a general conversation about
what they do, while others may have slides of data to show you.

Making the Most of


Informal Sessions
The informal sessions presented during interview day and/or the
evening before provide the main opportunity for you to ask questions of
current students. These can consist of student-led tours, lunches, pre-
interview dinners/socials, etc. For the most part, these students are
eager to help you with your decision, whether it be to attend their
school or not. Note that these questions are usually best-asked one-on-
one with a student, rather than with an administrator or faculty
member. Some sample questions you may want to ask:
What is your class schedule like? Is it lecture-based, group-
work, etc?
Are you able to stream classes from home or watch them later?
Is class attendance required?
How much clinical exposure do you have in M1-M2?
How prepared did you feel to take Step 1?
What has your experience been with finding mentors?
How competitive is your class with each other?
What kind of global opportunities exist for medical students?
How affordable is it to live here?
What is the diversity of the patient population you serve?
What are some activities you enjoy in this city?
How supportive are your faculty? Are they accessible?
What is your favorite thing about this program?
If you had to change one thing, what would it be?

63
This is also a great chance to see how these students interact with
each other and what the dynamics of their class are. Would you want to
be a part of a group of students who interact with each other in that
way? Oftentimes, a school attracts the same types of people each year,
and the interactions that you will have should you go there would be
quite similar.

Interviewing on a
Budget
Most schools will offer a program where you are able to spend the
night before the interview with a current medical student, usually a
first or second year. Not only is this a great way to save money, but it’s
also an opportunity to ask questions to someone who will not be
interviewing you and will have no stake in your acceptance. You’re able
to get the most honest feedback in this setting, and the students
volunteer to host, which means they’re usually very friendly.
If staying with a student at the program is unavailable, you have
lots of other options. AirBNBs are often going to be cheaper than a hotel
room, but be sure to carefully factor in how much farther you will need
to travel to get to your interview to avoid issues. Even cheaper than
rentals by owner are websites like _________________
CouchSurfer. Also see if you have any
friends or family in the area, even if you haven’t talked in a while!
If you are fortunate enough to have multiple interviews in a
similar geographic area, consider trying to schedule them close
together to save on travel costs. One trip to Chicago is probably cheaper
than three, even if it requires having to find more places to stay.
When booking your travel, weigh driving vs. flying. Is your car reliable
enough for a 10 hour drive? Is that preferable to a $250 plane ticket
cost, once you factor in gas money and time spent on travel? If you fly,
remember to check multiple websites to get a good price. Also consider
airports that are near-ish, if the price difference will be large. Plane
tickets tend to be cheapest about 52 days ahead of the date of travel,
and cheapest when purchased on a Tuesday or a Wednesday afternoon.

64
Post-Interview
Correspondence
The thank you note is a subtle, underappreciated art. It’s hard to
know how much it affects anything the admissions process, but
thanking people for their time is rarely a bad idea either way. Most of
the people you encounter during your interview will be volunteering
their time.
When crafting a cute and personalized thank you note or a quick
and eco-friendly thank you email, there are several opportunities to
take advantage of in addition to thanking those awesome people for
volunteering their time--and hopefully singing your praises to the
admissions committee. This is a way to stay salient in an interviewer’s
mind; they meet a lot of people, and probably interviewed several
people even just in the day they met you. It is also a way to reconnect
from afar by bringing up something positive from your interview: an
aspect of the program that impressed you (“it really stood out to me how
dedicated The Best Program Ever is to caring for underserved communities”),
a hobby you connected over (“I really enjoyed discussing unicycling with
you!”), or even an element of their career you admired (“your commitment
to slug attack reconstructive surgeries was so impressive”).
All of this shows you were (1) paying attention, (2) are nice, and maybe
even (3) are insightful. Plus, you thanked someone who gave their time
to you when they didn’t have to, so that’s all good. Keep it short and
sweet. If you don’t get a response (especially to a paper card), don’t take
it personally. Different programs have different policies about what
they are allowed to send to you in the way of post-interview
correspondence. Some may write even if you don’t reach out to offer
to answer any questions you still have, and whether or not you actually
had any more questions: come up with some if someone offers to
answer them. Positive interactions like that are important to utilize--
plus you’ll get to learn more about a program you’re presumably
interested in, which could help you decide if it’s the right one for you.

65
Making a
Decision
The Waitlist
Reapplying
Second Look
Factors to Consider
Declaring & Deposit
The Waitlist
After interviewing, it is possible that the admission committee
will vote to place you on a waitlist. This is not a rejection and many
candidates are accepted off of waitlists to various schools. You may
be accepted or rejected off of a waitlist any time up until August, but
most schools finalize their classes by July. The majority of waitlist
movement occurs starting May 1st, when accepted students must
narrow down their decisions to just one school. Keep in mind that
you must narrow down your accepted offers to one school by the
April 30th deadline but may remain on any waitlists. Once you
“commit to enroll” at a school, you must withdraw all waitlist offers
and may no longer be considered on a waitlist.
Different schools have different procedures for waitlisted
applicants. Some schools will not consider any updates and will ask
that you do not contact them. Other schools may ask for updates
monthly, or even biweekly. Regarding potentially moving from
“waitlisted” to “matriculated,” some schools have the list in a rank
order, and as spots in the rising class open they will be offered to the
waitlist in the order of that rank. Note, this rank has already been
made prior to any updates. Others will keep the waitlist as a pool to
select from each time as spots open up in the rising class, and so
application updates may play a pivotal role. If it is not clear what
the policy of a school is, do not hesitate to ask.

Application Updates
If a school asks for updates, you should send regular emails
reaffirming your interest in the school and updating the school about
any activities you are involved in. Important updates include, but are
not limited to: newly-accepted publications, awards or honors,
presentations, submitted abstracts, outreach events, employment. You
may spend a sentence or two thanking the school for their continued
consideration of your candidacy and confirming that you are still
interested in the school, then discuss any updates.

67
One common update many waitlisted students send is a Letter of
Intent. This should be sent only to the school where you would
matriculate if given an offer. In the letter, you should express your
intent to matriculate if given the opportunity, and provide reasons why
that is the one school you have chosen. You may choose to include any
updates to your application in this letter as well. The reason programs
might like this is because they want any extended admissions offers to
be accepted, so they know from this that if they were to send you one
that you would accept it.
Some schools also will allow additional letters of recommendation
to be submitted. This can be helpful especially if you have worked
closely with a new faculty member, physician, etc within the time since
you submitted your primary application. Follow the same guidelines
for letters of recommendation as described earlier in this guide.

Reapplying
For many people, reapplying is part of the path to medical school.
For some, reapplying multiple times is part of the path. As you can see
in this study from the AAMC, there are yearly fluctuations in the
number of first-time and repeat applicants but overall the trend is that
there are lots of them. Oftentimes, admission or rejection to medical
school comes down to the fact that there are more qualified applicants
than there are spots, and there may not always be a substantive reason
that you weren’t selected this year. Take the time you need to grieve,
then start forming your action plan.
An important note is that, barring any extreme personal
circumstances preventing you from attending this year, reapplying is
not a good option unless you received zero acceptances. Not only does it
go over very poorly with admissions committees to know you chose to
reapply rather than attend the medical school(s) you were accepted to,
we don’t recommend the added time, cost, and effort. All medical
schools in the US are accredited by the ACGME or the AOACOA and
will enable you to become a physician, and the differences in one
program versus another are not going to be great enough to be worth
declining an acceptance in favor of reapplying.
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Some medical school admissions officers will meet with you to
discuss your application following a rejection or the end of the
admissions cycle. Call each school you applied to and see if this is an
option, even if it’s just a discussion via phone or email. Express your
continued strong interest in attending this program, and that you
would like their input on your application so that you can improve for
the next cycle. Common concerns in rejected applicants may include:
poor interview, low MCAT score, low GPA (especially in the sciences),
and lack of clinical experience. Be prepared to accept criticism without
defensiveness, especially if you intend to reapply to this program.
However, it may have just been an issue of more applicants than they
could accept, and you may not get a clear answer about why you
specifically were rejected. Truly, there may not have been a clear reason.
In these cases, consider asking then what the weakest area of your
application was. It may not have been a dealbreaker, but it could give
you a direction for what to focus on between now and the next cycle. If
none of the medical schools you applied to will provide this
information (and even if they did), consider asking any friends or
classmates who are in medical school or recently graduated these same
questions. Also ask them to take a look at the list of programs you
applied to. Sometimes an unsuccessful admissions cycle was a matter
of applying to too few programs, or to programs that were too
competitive for your application. Not everybody can--or needs to--
attend the number one medical school in the country. Everyone who
graduates will still be a physician, and the reputation of the medical
school matters significantly less for residency and future jobs than the
reputation of undergraduate program did for medical school
applications. This is not the time for ego, it is the time for pragmatism.
When deciding what to do between now and the next admissions
cycle, take a look at the Taking a Gap Year section of this guide for tips
on areas to consider and how to get into them. Be realistic about what
you need to do to eat and be financially solvent between now and then,
and then fill in the remaining available time with targeted efforts to
improve the weakest areas of your application. Many people choose to
retake the MCAT or science courses before reapplying, but be realistic 

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about whether this extra time and expense is likely to result in an
improved score for you. Make sure you have a plan for what you will do
differently to ensure improvement. On the other hand, choosing to
spend time on clinical exposure or research experience is a guaranteed
improvement in these areas.

Second Look
After you get your acceptance to a school, you may be invited to
return for a “second-look." It’s the chance for you to 1) learn more about
the school and speak with the students there, 2) meet some of your
future classmates (even meet potential future roommates if you’re
looking for them), 3) decide whether you can see yourself thriving in
this school if you are deciding between more than one school.
Second-look is informal and can be a lot of fun. There may be
social activities such as a dinner or reception the evening before that
allow for low-stress opportunities to interact with current students,
faculty, and other prospective students. Many schools will also offer
tours of the hospitals if they weren’t given on your interview day. They
also may highlight some faculty by providing sample lectures so you
can get an understanding about what a typical lecture period would be
like if you choose to attend their school in the fall.
If you haven’t already, make sure you’re part of the Facebook group
for your class. Not only is it the place for you to chat with your potential
future classmates, you’ll also be able to get some helpful updates from
clubs/events as well as ads for housing and textbooks from
upperclassmen. Oftentimes, there are also discussions about living
arrangements or spreadsheets for people looking for a roommate with
similar interests.
Quick note about the social activities: oftentimes, evening events
involve alcohol. It goes without saying that discretion is expected.
Sometimes administrators from the admissions committee stop by to
join the fun!

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When you get there: have fun! See if the current students seem
happy with their decision and ask them any questions you might have
about their experience so far. You’ll be in their shoes soon, and they will
provide honest opinions on the pros and cons of their school.
Bring your family or significant other if possible. It’s great of have a
second set of eyes and ears to help provide advice, especially from
someone who has your best interests at heart. They will also be given
separate sessions which provide additional information to share with
you to help guide your decision-making process.
Also consider taking time to explore the city if you’re not from the
area. Medical school should have some balance between academics
and your personal life, and you want to make sure you’re in an area
where you can thrive, not just as a student, but as a person.

What to Do Afterwards
Consider what you saw and how you might fit into that school. If
you have a list of must-haves, did the school check all of the boxes? If
no school does, weigh what’s most important to you and use that to
gauge your decision. If you are still unsure, you may even try reaching
out to the school and ask to sit in on a lecture or connect you with a
current student to chat further.
Ask advice from current students or friends who are going through
similar situations. Sometimes talking out loud can help in making
decisions.

Factors to Consider
Choosing a medical school is challenging. Each school you
interview with will have pros and cons that need to be weighed based
on your personal preferences. There are many important items to
consider including, but not limited, the ones below. These aren't
presented in any particular order of important; you need to decide
which things will affect your happiness the most, and then choose
accordingly!

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Mentorship Opportunities
Do students have access to mentors? Is this a formal program or
are students seeking out faculty on their own? Do current students feel
that faculty are approachable for mentor/mentee relationships?
Even if you’re not interested in or planning to complete research
during medical school, it’s still important to have mentors to help find
activities that suit your interests, plan for residency applications, and
offer advice throughout the process. Being at an institution where
students feel generally supported by the faculty is important for your
success as a student and can help build the platform for a successful
career in medicine.

Curriculum
Are lectures in the pre-clinical years available to watch from
home? What are the required rotations like? Do you have to participate
in rotations outside of the main campus? If yes, is there any
transportation provided or strong access to public transportation? Are
the pre-clinical years lecture-based or team-based?
Although the content of medical school curricula are very similar,
each school has some unique features regarding content delivery.
Knowing the way you learn best can help you determine what’s
important for you, especially in the pre-clinical years. If you have a
family or other personal commitments, make sure you understand if
there are requirements for away rotations that might pull you away
from those commitments.

Specialty Interests
If you have a specialty in mind prior to starting school, does the
school you’re applying to have a clinical program in that specialty? If
you're strongly considering a specialty, having a program at your
institution, or at least a strong department, is helpful for finding
mentors, pursuing research, and ensuring that you’re prepared for
residency in that field. It can be challenging to locate opportunities
without a home program, and it will create more stress and pressure for
you to prepare yourself for what is to come.
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Cost
What is the cost of tuition? Did you receive any financial aid or
scholarships through the school? What is the cost of living like in the
city?
Many students will take out loans that cover the entire cost of
tuition plus an additional loan for living expenses each year. Although
this is possible regardless of the total tuition burden, these loans accrue
interest during your schooling, residency, and beyond which makes
every dollar borrowed equate to several paid back in the long run. If a
school is not a great fit, don’t compromise based solely on tuition since
doctors who graduate from that school are still successfully paying
their loans, but if it’s a tough call between two institutions, this may be
an important factor.
Also consider the cost of living in a particular city. It may be more
challenging to meet your needs in a more expensive location. Ask
current students how they are managing on their budget and make
sure that you feel comfortable managing with something similar.

Location
Are there certain activities/hobbies that you need access to? Are
you hoping to stay close to family? Do you have a significant other who
needs to find a job in a certain sector?
Although it’s only four years, having an environment you enjoy
being in for medical school is so important. If you don’t enjoy life in the
big city, steer clear of those programs. If you need the hustle and bustle,
it’s appropriate to choose the school where you can find the best
balance between work and your personal life. Other location
considerations include weather, proximity to family and friends, the
needs of your family, diversity of the population, etc.

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Student Life
Are there extracurriculars that I’m interested in? Is the school
diverse? Do students spend time together outside of class? Are
students competitive with each other?
If you have specific interests such as health disparities, LGBTQ+
issues in medicine, global health, advocacy, etc., ensure that your
prospective school has opportunities for you to participate. Most
schools will have organizations for all major specialties, but they may
not have groups, mentors, or other students that focus on your other
interests. It’s also important to consider the diversity of the student
body, faculty, and community as a whole as well as how students
interact with each other. It’s important to be at a school where you are
comfortable with the learning environment and people around you.

Overall Vibe
How did you feel on the interview day? Do you feel like you would
be friends with the current students that you interacted with?
One of the most important, if not the most important, things to
consider is how the interview made you feel.  Medical school will be
your home for four years, and you want to be comfortable in the place
you choose. It’s like having a second family - where can you see yourself
building that? Schools have unique personalities, and it’s ideal if your
own matches.

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Declaring & Deposit
Once you have chosen a school, they will require that  you sign and
submit a form stating that you plan to enroll in their upcoming class.
Often, this will be accompanied by a small deposit (< $500) which will
hold your seat. Not every school with require this, so don’t be alarmed if
you’re not prompted to pay anything.
At this time, ensure that you also reach out to any other schools
that accepted you and inform them of your decision. Many other
students are hoping to get off of wait-lists, and you can pass those
opportunities on to others by declining an offer that wasn’t right for
you. The longer you delay declining offers, the longer other students are
waiting. Don’t rush into the decision, but be respectful of your peers
who may be on the waitlist when you have solidly chosen a school.

At this point: kick back, relax, and do whatever you love doing in
your spare time! You've finally made it.

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Conclusion
Our parting words
There are so many barriers to getting into medical school. We
don’t have the power to make every research opportunity out there
come with a living wage, or to level racial biases in MCAT scoring,
but we do have the power of experience. From incoming medical
students who just went through it themselves to attendings with
years of experience on admissions committees, this diverse set of
authors came together to bring the pre-medical community our
collected advice with the goal of making the medical school
admissions process more accessible to everyone, but especially to
people without the privilege of friends or family in medicine/robust
pre-medical advising/etc. We ourselves are a diverse set of women,
and we’re doing this because we care about seeing the future of
medicine become more diverse, because that’s how medicine gets
better for our patients.

We see your effort, and we’re proud of you.

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Appendix
A: CV Example
B: Example Emails for Seeking Mentors
C: Example Emails for Guiding Writers of
Letters of Recommendation
Appendix A
CV Example:

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Appendix B
Example Emails for
Seeking Mentors
First Contact
Dear Dr. Daneshjou,
My name is X and I am a student at Y College majoring in Z, and I am
interested in going to medical school. I’m emailing you because I am
fascinated by your work in studying (insert the subject of their work or
practice you are most interested in). I read your paper, “Title of paper”,
and I am excited about this field. I would love to meet with you to talk
about your work and get some advice. My resume is attached.
Looking forward to hearing from you,
X
Follow-Up
Dear Dr. Daneshjou,
My name is X, a student at Y College interested in going to medical
school. I’m emailing to follow up regarding my email from (insert date
of first email). I’d be very interested in speaking with you some time
regarding (insert their subject of clinical practice or scholarly work).
Looking forward to hearing from you,
X

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Appendix C
Example Emails Guiding
Letter of Recommendation
Writers: Carina Seah's real
emails
Dear ______,                       
Thank you for agreeing to write a letter of recommendation for me! I
have included as much information as possible below to perhaps
assist you in writing about me. Please feel free to use as much, or as
little of it, as you find useful. Also, please do not hesitate to contact me
for more information if needed.      
             
In my application I am hoping to convey myself as a self-motivated
student with a genuine passion for research and medicine, a sincere
ambition to improve the lives of others, and an innate capability for
creative problem solving, and I hope that your recommendation can
support that.              
         
Rationale for pursuing an MD/PhD:                   
I believe an MD/PhD will allow me to impact the greatest number of
people in the greatest capacity. I am frustrated with the lack of
urgency I have witnessed in translational academic research and
believe that witnessing and treating patients hands-on inspires this
urgency. At the same time, I believe that research has the ability to
impact a far wider patient population than just medicine alone.               
       

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Personally, what I view to be my attributes:               
I am ambitious and optimistic about my future impact.
I am self-motivated and work extremely hard
I joined the [ ] Lab in my freshman year and work almost every day,
spending over 15-20 hours a week in lab, and up to 40+
hours/coming in on weekends when necessary, in addition to
maintaining a full undergraduate course load and a concurrent
master’s degree. I will have received both degrees in 4 years, and
will likely be a coauthor on 3 published papers by the time I have
graduated.
I have attended [ ] conferences as well as the [] annual meeting,
where I presented a poster, and have a uniquely high level of
understanding of my work for an undergrad.
I genuinely love science and medicine.
In my spare time, I read scientific literature, I’m actively engaged
with scientists through twitter, I listen to the Science/Nature
podcast, etc.
I’m always the person in class asking questions, wanting to hear
more from the speaker, emailing my professors outside of class with
cool articles I’ve found, contacting speakers who have given guest
lectures to meet for coffee outside of class
I am passionate about science communication and science
awareness

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Your unique insight on me:                       
As my research mentor and supervisor, I think you have the most
unique insight as to who I am as a person and how I have grown as a
researcher in the years you have known me. I went from not knowing
how to pipet to understanding how to design experiments/test
hypotheses relatively quickly. I think you can speak to my ability to
critically evaluate experiments and come up with strategies to
troubleshoot or re-design experiments. I also hope that you can vouch
for the many hours I spend in lab despite the amount of class I have,
and how I genuinely enjoy being there. 
                      
I believe you can also speak to my curiosity–for example, me asking
you questions about topics I hear about in lectures that I attend, or
asking you why we pursue a specific experimental plan rather than
alternatives. I also think that you can speak to my love of science in
general, and how that has spurred personal projects to combine my
love of science and storytelling to spread information about research
to the general public. Additionally, I hope you can speak to my role as a
teammate, working together with [ ] and [ ], and how I interact with my
labmates, mentors, and peers.             
      
Finally, because you are a researcher, I hope you can speak to what you
believe my potential in the field is, and how you may be able to
imagine me contributing to research in the future. Bringing in my
contributions to the [ ] project, [ ] project, etc here would be very
valuable.

Once again, thank you so much! Please let me know if you have any
further questions. I am once again honored by your willingness to
write this letter for me.
Sincerely,
X

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