Ask Dr. Gray: Premed Q&A: When Should You Say “No” as a Premed

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Session 89

Today’s premed is considering a gap year. She’s only a sophomore! We talk about how important it is to be selective with extracurriculars and how to say no!

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[00:22] Question from Victoria

“I am an upcoming sophomore. I am not American. So I don’t know how I would be considered applying to medical school. Right now, I’m struggling with everything that goes out of college. So I’m doing research. I’m getting my EMT. I volunteer in the ER. I’m the president of the premed class. I’m the secretary of the chemistry club. I’m doing counseling for high school students that want to go into pre-health professions. And I’m shadowing trauma surgeons. But I don’t know if I should slow down and take a gap year or just continue doing everything and sleeping last.”

[01:43] Don’t Sacrifice Your Grades

Victoria is afraid of just rushing everything and not being able to get a good MCAT score. So she wants to be able to really study and focus. But she has so many things right now that if she continues on this pace, she probably won’t be able to sit down and stop and just take the MCAT. Or she would have to just stop everything she’s doing. That’s her concern.

The question is how are you handling everything with your class load with all the extracurriculars that you’re doing? How are you personally handling all of that? What does that look like from a mental health perspective, from a physical health perspective, and from a grade perspective?

To get into medical school, you need good grades and you need a good MCAT score and you need to be doing a lot of these things that you’re doing as well. But you don’t want to sacrifice too much to try to do everything all at once.

“You don't want to sacrifice too much to try to do everything all at once.”Click To Tweet

Victoria says her GPA is 3.5 as of now as a sophomore. It’s not great. And she’s taking organic chemistry and physics altogether.

[03:08] Learning How to Say No

She basically has a lot on her plate because she really didn’t know how to say no to most of her offers. You absolutely do not need to be doing all of it. At this point in time, you should be doing some of it. And at this point in the game where you have a 3.5, you have lots of room to move up and go down.

“There are always going to be good opportunities. But to be successful, you're going to have to say no.”Click To Tweet

So try to cut out as much as possible. Just maintain your foot in the door with some medicine, maybe some leadership positions. Try to cut down the stuff that really doesn’t bring you a ton of joy and that you’re just doing because you think it’s going to look good. Really focus on your grades and your overall mental and physical well being.

[05:22] Reasons for Taking a Gap Year

Victoria is in her sophomore year of college and there’s no need for discussion of a gap year at this point.

Gap years are for students who need to take a gap year because they want to take their MCAT while they’re not taking classes. It’s for students who need to work on their clinical experiences and their activities because they didn’t do enough.

Or maybe they entered this premed world later in the game and they’re trying to make up for the lost time. They’re getting the clinical experience, the shadowing, etc, that they need to prove to themselves that this is what they want.

It’s for students who are super burnt out of school and want to take a little bit of break from school but also still maintain some foot in the door for medicine. 

[06:42] A Gap Year is Something Personal

Victoria doesn’t really want to take a gap year because she doesn’t want a year to set her behind. She says she just wants to be there in the hospital and practice medicine as soon as she can. But a gap year is just really another year. It’s not wrong to want to do that. Most students actually just want to get this over with and just go out and be a doctor and live the dream.

“Gap years are just super personal and super unique.“Click To Tweet

Some people look at gap years as something that must be how you get into medical school. But correlation doesn’t equal causation. You don’t know why they were taking gap years. You don’t know why they potentially thought they needed to take gap years and what they were trying to improve in the application.

You can’t look at those students and go, they took gap years therefore you should take a gap here.

Again, a gap year should be very super personal to you. If your application is strong right away, go ahead and apply. If you are getting burnt out or you want more time to study for the MCAT or you need to strengthen your application in one way or another then gap years are fine.

[09:21] Do You Need to Shadow a Specific Specialty Only?

One of Victoria’s premed advisors told her to focus on one field as soon as she got into college because that’s what medical schools want to see. They want to see that you want to be a specific doctor. So if you want to go into emergency medicine, then just shadow emergency doctors.

And at that moment, her research is about trauma and she shadowed trauma surgeons, which is what she wants to do with her life. But at the same time, she really wanted to get the experience of looking into other fields and stuff.

Well, that premed advisor was definitely wrong. Not surprisingly, medical schools don’t care if you know 100% that you want to be a psychiatrist or a trauma surgeon or pediatrician.

According to the last data that I saw from the AAMC is that 75% of students change their minds in medical school. Or they come in wanting to be a trauma surgeon, and they change their minds and go on to get into another field.

So the premed advisor is mistaken in that way. It’s not bad to only shadow trauma surgeon. If that’s what you’ve been exposed to, if that’s what you love and you really enjoy it, then go for it. You don’t need to test out every specialty or test out multiple specialties. You don’t have to.

“The goal in this process of applying to medical school is to show why you want to be a doctor, not why you want to be a trauma surgeon.”Click To Tweet

[11:54] Choosing Between DO vs MD and Overcoming the Bias

Victoria heard that the residency program of the hospital she’s shadowing at is only accepting MDs in their program. And you’re going to find those types of people. But that’s what it is. It’s a very old school mentality that MDs are better than DOs.

The negative bias is actually becoming less and less, basically. But it’s usually the older population that is giving that advice. As those people retire and die off and get out of academic medicine, those sorts of biases are going away. So you can be a trauma surgeon as a DO 100%.

“You can go to every program in this country and be respected and treated the same way as a DO.”Click To Tweet

And that sort of bias and treatment, whether it’s DO versus MD or Ivy League med school versus state university med school, you’re always going to find those perceptions of people out there.

Everyone is making judgments and forming their own opinions and you can’t do anything about that. At the end of the day, go to the medical school that’s going to fit you the best. Go to where you feel the best fit, the best culture, and where you feel the happiest. Because at the end of the day, that’s what’s going to make you a successful medical student.

Moreover, board scores are a big part of where you can go into residency. So be the best you and don’t worry about MD versus DO because plenty of doors will be open for you no matter what you are.

Listen to Episode 28 of the Specialty Stories where I had Dr. Nii Darko. He’s a DO trauma surgeon at that time who went to an MD residency program. So if one person can do it, anyone can do it.

You have to make the connections and form the relationship just like for any residency program. Prove that you are a worthy physician and that you’re going to be an amazing resident. MD or DO, it doesn’t matter.

“Whether MD or DO, show that that you're going to be a good fit at that residency program.” Click To Tweet


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Specialty Stories Session 28: What is Trauma Surgery? Dr. Darko Shares His Story


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