This Med School Admissions Dean Says “Dump the Checklist”!

Session 415

Dr. Sunny Nakae, author of Premed Prep: Advice From a Medical School Admissions Dean, shares wisdom from her years of experience in medical school admissions.

For more podcast resources to help you along your journey to medical school and beyond, check out Meded Media.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[02:54] His Medical School Journey

Sunny was never a premed. He started volunteering in middle school at a community hospital just thinking he wanted to go into medicine, and realized he didn’t like sick people or bodily fluids. So he majored in human development. He was interested in human interactions and relationships in undergrad and pursued a Master’s in Social Work. While doing that, he had a position at the University of Utah School of Medicine in Diversity and Community Outreach. He just got interested in working with premed students in diversity, equity and medicine. Eventually, he decided to pursue a doctorate in higher ed. She decided to get a PhD because she wants to be heard and since then, she has continued working with students at the University of Utah.

[04:30] Dump the Checklist Mentality

Being at a medical school and working in an outreach capacity, Sunny got to witness the different journeys of students from having the idea of wanting to do medicine all the way to being in medical school. And then following them in their careers. So this has given her a long perspective about what’s important at each of those phases.

She has seen students deeply unhappy in medicine, wondering why they chose it. Then it was really more about their parents pushing them into it or it was more about prestige of the career. It’s not a place that you want to just end up because it’s a very expensive pivot.

'Rather than asking people what they want to be, or what they want to do, ask them what problems they want to solve and who they want to work with.'Click To Tweet

Sunny has also worked with students who’ve just fallen in love with the idea of themselves in medicine and falling in love with this dream of being a doctor, rather than actually being a doctor. And despite years and years of struggle and continual feedback, they realize it’s not the best path. When your gifts and the world’s deepest needs find a good connection, there is a sense of ease and peace there. That’s not to say if there’s a bump in the road, it’s not meant to be right.

Therefore, there should be self-interrogation that takes place. Who are you and why do you want to do this? Being able to answer those questions clearly, and having that clear purpose unlocks all of the rest of the things towards being a successful applicant, and ultimately, being happy in the career that you’ve chosen.

Sunny’s book wants to convey this message that you have to stop focusing on what you have to do to get in. Everybody wants tips and tricks and edges and like this magic thing. But it’s different for every person. So the frame really should be who do you need to be to become ready to be someone’s doctor, and to know that this is the path you want to be on.

[08:56] What About Your Stats?

Sunny’s book has a chapter called Understanding the Graduate and Professional School Context where a very stereotypical kind of premed response is they feel so disgruntled and discouraged. Then she goes through the larger context for what that looks like from the school’s point of view. And the truth is that your GPA is not going to get you in. It can keep you out but they don’t look at the 518 and the 4.0 as your ticket.

'Taking care of patients every day, and the many roles that people have to fulfill as physicians are a lot more than test-taking and going to class.'Click To Tweet

It’s more than just showing up and going through the motions. There’s an element of investment that admissions committees look for in an application. And you just can’t fake the authenticity part.

[11:40] Why Students Struggle with the Checkbox Mindset

Students have had a very curated and formulaic winning combination for being successful up to this point. And medicine tends to attract the Type A students.

'It's hard for students to step out of the checklist mindset because there are so many requirements to meet.'Click To Tweet

You have to take biology and get good grades. That doesn’t necessarily translate into needing X number of hours in this area. So don’t approach your experiences like your coursework. Your experiences are for growth and development. Your courses are a lot like a checklist, because many schools have those prerequisites in order to be eligible to apply.

The medical schools want to see how much students are aware of what being a physician is. Therefore, they’re going to translate everything into how their experience has prepared them to be a physician in this way.

[13:50] The Meaningless Doughnut

Sunny calls this the meaningless doughnut. It’s the essays that say, there are many reasons why ‘I want to be a doctor,’ and then they explain all the things that they did to explore this. And then, in the end, they say, “I want to be a doctor so I did all these things.’ But there’s no “why.”

“Telling physician readers or people who are evaluating your application about what you know about medicine is not enough.”Click To Tweet

The people evaluating your application already know about medicine because they’re in it. But if you can tell them about a meaningful encounter with the patient without preaching to them about the nuts and bolts of the profession, that grabs their attention. When you’re able to tell them something new, that’s what stands out in the process – more than the numbers.

Alternatively, things like serving your community just because it feels good are surface-level reflections that don’t grab anybody. You have to go deeper than that.

[18:23] The Power of Self-Discovery

The secret sauce is really growth. It’s challenging yourself. Journaling, reflecting, or just even having conversations with a group of peers, helps you find that meaning. It’s important to pay attention to surprise because that usually tells us maybe where our biases were before we went in.

“Discomfort is a huge flag that gives us insight into ourselves to reflect on our growth.”Click To Tweet

Reflect on what brings you joy, what brings you sorrow, as well as things that are still bothering you. What about that encounter that bothered you?

The beauty of this is that it’s a skill that you can bring with you into any path that you choose moving forward. It’s an iterative process of self-discovery if we can pay attention to those moments of joy, sorrow, discomfort, and surprise.

[19:52] The Biggest Mistake Students Are Making in Their Application

Sunny thinks that the biggest mistake students make in their application is they try to be everything to everybody. Applying to more schools doesn’t increase your odds.

Students who don’t really like research just go ahead and do research, just so they could put it on the application. But if that’s not what you like, and you’re not drawn to that, then why are you trying to fit into that mold? You’re probably not going to be that great of an applicant at an institution that’s championing research if you did it as a box-checking, or to meet eligibility for that school.

'You're not going to be everything to all schools.'Click To Tweet

Even if you’re a great applicant, some schools are probably going to say no to you, because you don’t fit what they’re looking for. Because there’s a whole array of missions and emphasis across the schools that exist out there.

[22:19] Looking at Fit When Choosing Schools

Unfortunately, students don’t think about what they want to do or what problems they want to solve. But you’re not just getting an education, you are starting a professional journey.

“You're joining a family of sorts when you choose a school, and that has identity implications.”Click To Tweet

So it’s good to know yourself, both your professional goals, yourself as a learner, and what interpersonal supports you might need.

If you have not left home before, don’t move 3,000 miles away to go to medical school by yourself. Ask yourself if you’re going to have these external support structures in place?

There’s a certain success formula that students should be thinking about how they get to where they are. So what do they need to recreate that in their medical school environment in order to be successful?

One of the ways that you can really understand what the school’s offering is to look at what their graduates go into. Look at which certain specialties those students at that school are matching. Are their dual degrees offered? What does the curriculum structure look like? When you look into schools, they will have curriculum maps overviews. So peruse them beyond just the admissions page and the admissions leaflet. Look at how the curriculum is delivered. What types of programs are offered? Connecting with current medical students who are at that school setting.

[26:32] Why Schools Are Scared to Put Out Statements About What They’re Looking For

There should be explicit messaging around what you consider to be plus factors or to talk about the kinds of patients that your institution is hoping to serve actively. And what sorts of backgrounds and experiences would make someone more prepared to serve that patient population.

You don’t necessarily have to be of that identity to gain experience or expertise in serving underserved communities. It’s really about the demonstrated experience. You just do it right and go there. Roll your sleeves up and get your hands dirty, and you really interrogate yourself.

[30:20] What Premed Advisors Should Be Like

Advisors and mentors should have this mentality of being a personal trainer, and not a talent scout. A personal trainer takes all comers, elite athletes, all the way to people who are just starting. They meet this person where they are and give them the tools to move forward in their health journey. And it’s the same thing for advisors.

'As an Admissions Dean, I don't need you to pick people for me. I need you to help people develop along whatever spectrum they're at.'Click To Tweet

The important things that your advisor may be able to do for you are nuances around classes, scheduling, and resources.