Premed Q&A – Maximizing Gap Years, Residency Merger and More

Introduction

Dr. Ryan Gray: The Premed Years is part of the Med Ed Media network at www.MedEdMedia.com.

This is The Premed Years, session number 203.

Hello and welcome to the two-time Academy of Podcasters Award nominated podcast, The Premed Years, where we believe that collaboration, not competition, is key to your premed success. I am your host Dr. Ryan Gray, and in this podcast we share with you stories, encouragement, and information that you need to know to help guide you on your path to becoming a physician.

Now I am recently back from the UC Davis pre-health conference which was an awesome conference, and the week before that I was at the AMSA Premed Fest in Tampa, Florida. So I will have a recording or a podcast in the next week or two from clips that I received while I was there talking to premed students about what they wanted to do with their life and why. I thought it was a great- lots of great conversations and I’ll put those all together in a podcast episode.

This episode though is going to be a lot of question and answers. I, as you might know, get a lot of emails and questions from students about different things that they have on their mind, different questions that they have on their mind. And so most of the time their answers- the answers to their questions are useful for everybody, and so I like to gather these questions and release a question and answer podcast every now and then.

If you have questions, you can ask them either in our Facebook group which you can get over at www.MedicalSchoolHQ.net/group. You can email me, Ryan@medicalschoolhq.net. Or you can- if you’re a nontraditional student, even if you’re a traditional student, you can go over to our www.OldPremeds.org forum and ask over there. Again the forum over there is not like Student Doctor Network. It’s an awesome collaborative environment of amazing nontraditional students. So you can check that out, again that’s www.OldPremeds.org.

Maximizing Gap Year Time

So this first one I want to dig into is one that is talking about what this person should be doing over her next year, and she is saying, ‘I’m always fishing for advice here but I’m out of school-‘ here meaning the Facebook group, this came out of the Facebook group. But she’s out of school and lacking an advisor or mentor which is why she comes into the Facebook group and asks awesome questions. So if you don’t have an advisor or mentor, again www.MedicalSchoolHQ.net/group will take you right to the Facebook group.

Says, ‘I could take a full time job at a hospital as a child life assistant, or I could continue working from home doing my cake business, which I’m currently collaborating with the local hospice to provide monthly no-cost cakes to area patients. The thing is, I want to do what makes me look more appealing as an applicant. The perks of working as a child life assistant are obviously being able to get direct patient interaction. My cake business isn’t healthcare related but it shows leadership and my community involvement is really a passion of mine. In theory I could try to maintain both but I’d like to prioritize one right now. Any opinions on this?’

So I’m going to- before I answer this I’m going to read another question because the answer is about the same. This next one came in through email and it says, ‘I have a question for you regarding gap years. I originally planned on going to PT school and used my gap year after undergrad to work in a physical therapy clinic as an aid in order to clock in the requisite hours to apply to school. However, the more I worked in the clinic, the more I realized that physical therapy was not the path for me. I took cadaver dissection as an undergraduate and ever since then I’ve been addicted to seeing, touching and feeling muscles, nerves and vessels, and I found that physical therapy really didn’t satisfy that desire of mine. I’ve been shadowing a surgeon lately and I am finding that surgery is the perfect blend of my passions. However, I have not taken the MCAT and need to prepare and study for it so that I can apply to medical schools this cycle. Additionally, I am getting married this fall and can’t afford to be unemployed for an entire year while I am applying to medical school. Research is a financially tempting option, but labs usually don’t want to hire an RA who can only commit to working for a year. Besides, I much prefer patient interaction to the lab bench. I have a year of hospital volunteering under my belt, as well as a year working as a physical therapy aid in an out-patient clinic. I would love to work in a hospital but I’m not sure what positions I am qualified for. And I’m not sure if lobotomy or medical assisting is worth the extra time and money it costs to get a certification. I feel lost as how to spend the next year other than continuing to shadow and prepare for and take the MCAT. What do you think? How can I maximize the next year?’

So these two questions are very similar, asking about maximizing time. The first one specifically mentioned the- how it would look- appealing as an applicant, how the medical schools would look at her application as an applicant based on what she’s doing. The second question I read doesn’t specifically mention it, but it’s probably at the heart of the question, is what is going to make me a better applicant? And the answer to these is both the same; don’t do what you think medical schools want you to do. Don’t do what you think is going to make you a better applicant. Yes you need to- as an applicant you need to have good grades, you need to have a good MCAT score, you need to have clinical experiences, you need to have some shadowing. Outside of those things, an admissions committee is not going to go, ‘Oh look this person volunteered in the hospital or worked in the hospital doing this job for a year, that’s awesome, let’s accept her or him.’ You need to do what obviously fits into your life as far as pay, you need to be able to afford to live. So if you need to work and receive a paycheck, you need to prioritize that, that comes first and then you fit in everything else besides- around that. Figure out what that one priority is. If it’s working to pay your bills and put a roof over your head, then prioritize that. Do not look at anything along this path whether you’re in high school, or in college, or you’re a nontraditional student looking at getting back into school; don’t think about anything and go, ‘I wonder if medical schools will like this. I wonder if this will make me a good applicant. I wonder if schools will think I am a better applicant if I just do X, Y, Z.’ That’s not what you should be thinking about. You should be thinking about what fits your needs- again we talked about it, if you need to pay bills, you need to pay bills. So what fits your needs, what fits your schedule, and what do you like to do? If you think that you need research because it’s going to look good to medical schools but you don’t like research, then don’t do research. Just don’t, you don’t need to. It’s not a requirement to apply to medical school. At least not all of them. There are some funky schools that have some weird requirements, but look up the schools that you’re interested in applying to and find out if that’s one of the schools. But go through this process and figure out what you like to do. What fits into your schedule? What fits into your needs, and go and do that. Don’t try to do something that you think is going to make you stand out as an applicant. Period, end of story.

Sending MCAT Scores to AACOMAS

Alright, next question says, ‘Hello. I am applying to MD and DO schools and I’m having trouble figuring out how to send my official MCAT scores to AACOMAS through AMCAS. Does anyone have any advice on how to do so?’ So this came into the Facebook group and I thought it was an interesting question; a lot of people were able to help this person but I figured I’d talk about it here because maybe you’re applying to both MD and Do schools, so the MD school you apply through AMCAS, and the DO schools you apply through AACOMAS. And the MCAT score is housed in the AAMC website which runs AMCAS. And so it’s very easy when you’re submitting your MD applications for AMCAS to pull your MCAT score because it’s all the same people running both things. But AACOMAS is run by AACOM for the DO schools, and so they’re not affiliated with the AAMC. Is there enough letters and alphabet here? The alphabet soup episode. And so the Texas Medical and Dental School Application Service also is not affiliated with the AAMC. And so what you need to do- not through AMCAS but through the AAMC, you log into the AAMC website and you send your transcripts to these non-AMCAS applications, these non-AAMC application services. You can do that, or you can request official transcripts of your MCAT score and have them mailed to the different services, but they can be sent electronically. So little interesting question there. It’s the first time I’ve actually seen it pop up so I thought I’d answer it here on the podcast.

Replacing Research Time

Alright we have another one here that says, ‘I am a premed student getting a Bachelor’s degree in Anthropology, a minor in Biology, and staying steady on the premed track all within three years total. With my extracurricular involvement including being in a fraternity, intramural football and soccer, and various philanthropies throughout the year, I’m having trouble finding time to do research of any kind that fits my schedule. What I was considering to do to replace the time that a premed student would spend on research with in-hospital volunteering and shadowing. The number I have in mind for how many hours total- or how many total hours I want to allocate to spending in-hospital is 500 hours over the next one to two years. The question I have is do you think this is a sufficient amount of time to spend gaining experience in a hospital setting to make up for the research I am not able to do, or do you think I should get more? I think I could possibly get 750 to 1,000 total hours in that one to two years, but I was wondering what someone who has been through the process thought. Thank you for your assistance, and advice is greatly appreciated.’

So this is another one of those questions, like those first two questions, about somebody who is trying to figure out the checklist. There is this secret checklist that admissions committee members must have that say, ‘Oh this person has 750 hours in a hospital, that means we should invite them for an interview.’ And it’s just not the case. 500 hours is a lot of time. 750 to 1,000 hours is a ton of time. And the fact that you think you are trying to make up for not having research by doing more volunteering, it doesn’t work like that. Again you don’t need to have research experience. If you’re not interested in research, don’t do it. If you think you are interested in research, go find some research opportunities. If you have time for 500 hours working in a hospital, you have time to go get 10 or 15 or 20 hours of experience doing research. You don’t need hundreds, upon hundreds, upon hundreds of hours of these experiences. You need quality- not quantity, you need quality experiences that are going to show you and prove to you that you want to be a physician. Period, end of story. All of these experiences that ‘admissions committees want you to have’ are only there because we want to make sure that you understand what life is like as a physician, and you understand what you’re getting yourself into. So we want you to shadow because that will give you some idea of what a physician does day in and day out. We want you to get clinical experience because we want to make sure that you really love- I don’t know if anybody really loves it, but you are okay with being around sick people, and smelly people, and smelly fluids, and other body excrements, and other things. That takes a special person to be okay with that, and so that’s why those are ‘requirements.’ Even though they really aren’t, we just need to make sure that you know what you’re getting yourself into and that you’re okay with it. There is this aspect of giving, and community service, and so extracurriculars come into play. We want to make sure that you’re okay sacrificing your time for others, because going through medical school and residency and even working as a physician, it’s not a 9:00 to 5:00 job for most people. There’s a lot of work that can be done outside of a hospital or clinic environment. Allison works at home most nights during the week doing patient emails, and checking labs, and other things that she needs to do that she can’t get done during the day. And so you need to have a service before self attitude so that you can be okay with that, and you know again what you’re getting yourself into.

So there are no number of hours that you can do, or need to do to make up for not doing something else in your application, and getting 500 to 1,000 hours of time in a hospital is crazy. This is a very- I hate to say it but it’s a very Student Doctor Network question. The amount of hours that get thrown around on Student Doctor Network are ridiculous. And so again, quality, not quantity. You don’t need to live in the hospital during your undergrad years to have a chance at getting into med school.

Residency Merger Information

Alright we have one more question here that we’ll get to, and it’s an interesting one. It says, ‘Is the merger- the MD and DO, so the ACGME and AOA merger, residency merger, going to make it harder for DO’s to match into specialties, and what can a strong DO student to do to qualify for more competitive careers post-merger?’

So let me give you a little background on this. Historically for MD students you would apply through ERAS, which is the Electronic Residency Application Service I think is what it stands for. You would apply to ‘allopathic’ or MD residency programs through that service as an MD student. Historically DO students could also apply to MD residency programs. DO students also can apply to DO residency programs, but MD students couldn’t apply to DO programs. And so there’s this huge divide in residency training, post-graduate training, where you’re either in an allopathic path or an osteopathic path, and it’s made things very complicated for a lot of people. And so both of the organizations that run the post-graduate education residency training, the AOA and the ACGME, have decided to merge, and I believe that merger is happening in the next three years; 2020 I think is the final time. And so it’s meant to make post-graduate training under one umbrella, one testing body supposedly, and MD and DO students can apply to any program out there. That’s the idea behind it. And so you would assume that MD and DO students are going to basically be on an even playing field, and the best student will get the residency spots that they want. And so it’s going to be just like anything else in life; you have good scores, you write good essays, you interview well, you’re going to get the spots that you want.

With that said, you’re still going to have some bias among MD program directors that maybe still think that DO students are students that couldn’t get into an MD school, and that’s really not the case anymore. And so there’s still going to be some bias out there possibly, maybe among some people. So it’s too early to tell what’s going to happen post-merger. If it’s going to be super competitive for DO’s to get these highly competitive specialties, or what’s going to happen, or if truly everybody’s on a level playing field, and they look at your board scores, and your grades in medical school, and everything else. So I think the moral of the story for this is don’t worry about it. Whatever happen will happen, you need to again focus on yourself, and this is where I talk a lot about- when I talk about collaboration not competition, you are your only- the only person that you’re competing against. And so when you are premed, when you’re a medical student, you are competing against yourself doing as best as you can do, and that will set you up for success in the future. Don’t worry about what the students to your left, the students to your right are doing. They’re going to do whatever they need to do to do the best that they can do, and everybody will be happy and sing Kumbaya hopefully.

Final Thoughts

Alright I think that is it for now. We covered a bunch of questions. Again if you have questions, email me Ryan@medicalschoolhq.net. I can’t always get to the questions right away. If you want to ask questions in our Facebook group, please do that. That’s www.MedicalSchoolHQ.net/group. And if you’re a nontraditional student check out www.OldPremeds.org which is an awesome forum for nontraditional premed students.

Alright I would love for you to do me one big favor. Go tell your friends about this. Too often over the last two weekends that I’ve been at conferences, I would be talking to somebody that’s part of a school premed club, and they listen to the show, love the show, and get a ton of great advice from it. And two minutes later I would talk to another person in that same premed club at the same school, and they haven’t heard of the podcast. So if this is like you, if you are listening to this now, and you are part of a premed club, and you haven’t told the rest of your premed club about the podcast, please do so. I would greatly appreciate it. And then once you do, let me know. Shoot me an email, Ryan@medicalschoolhq.net. I love hearing from you guys about anything that’s going on in your premed world, and especially when you share the podcast with your friends and classmates and fellow club mates if that’s what that’s called. Club members I guess is the right term.

So I think that’s all that I have for you. Again the next couple weeks I will be releasing the snippets of the students that I talked to at the two conferences that I went to. If you haven’t been to a conference- a premed conference, I highly recommend you take a look at what’s going on with AMSA, and what’s going on in your local areas. There are schools that put on smaller premed conferences compared to the 3,000 people that were at the UC Davis conference. So check out what’s going on in your area, and if there isn’t one, maybe think about putting one on, that might be good for you.

Alright I think that’s it finally. I hope you have a great week and remember collaboration, not competition. I’ll talk to you next week here at the Medical School Headquarters and The Premed Years Podcast.