Ask Dr. Gray: Premed Q&A: What Counts as an Upward Trend in Your GPA?

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Ask Dr. Gray: Premed Q&A: What Counts as an Upward Trend in Your GPA?

Session 79

Today’s caller had a mediocre GPA from her undergrad in business. Now, she’s on the premed path taking prereqs and her GPA is improving—but is it enough?

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[00:22] Natalie’s Question and Background

Natali is asking what is considered a significant upward trend? What is not? What are they really looking for? How much does the undergrad GPA matter at that pace?

Natalie majored in business and undergrad and got a 3.24 GPA. The one science class she took was microbiology online and she ended up getting an A. Overall GPA was a 3.24.

And right now, she’s a little more than halfway through the prereq science courses. She’s doing them at a community college as a DIY postbac program. So she’s sitting at a 3.8 right now.

She’s taking a summer class with a summer organic chemistry class and she has calculated her GPA to drop to 3.70. So from 3.24 to 3.70, she only has three classes left after this organic chemistry class.

And in those three classes, she calculated realistically that if she gets two A’s and a B, it would stick at a 3.7. This is a pretty strong upward trend.

[02:10] Dealing with Mediocre GPA

Her situation is great because her initial mediocre 3.2 GPA was non science. And so her science GPA is going to be solid 3.7. And that’s a solid science GPA. And then you also have this cumulative GPA, which, if you haven’t done, you can go to and it’ll give you the little graph and show you everything.

“Your cumulative GPA is going to be potentially flatline whatever those trends look like in your first undergrad if there were any big valleys or peaks or whatever.”Click To Tweet

But, say, you will go from a 3.2 and it’s pretty flat freshman, sophomore, junior senior, and then 3.7 for however many credits for your postbac, that’s going to look solid. The story may be that this student wasn’t super engaged early on, wasn’t potentially sure what she wanted to do. This student maybe knew what she wanted to do business but understood that grades really didn’t matter.

“There are so many stories that can be told from looking at a transcript.”Click To Tweet

The GPA is just one part of your application. So you’re fine as long as you’re doing everything else appropriately. 

[04:04] Make Sure Other Parts of the Application Look Good Too

Natalie has extracurriculars that I think are pretty strong and very unique extracurriculars. But she doesn’t know what categories to really put them in.

Then she’s taking the MCAT in four weeks (as of this recording). She really tried hard to do a lot of practice exams and study and she finally crossed the 500 on her last practice exam. So she has three solid weeks of absolutely nothing but MCAT studying. She’s aiming for 510.

Now as we’re recording this for AAMC, the latest report is 511 and for DO schools is around a 504. DO schools look and favor a lot of other factors much more than the MCAT. Activity wise, it’s great. So as we’re recording this, it’s mid July. She’s taking her MCAT in August.

Natalis is thinking of applying to a couple of the schools in the U.S. affiliated with schools in Israel. Basically, her husband is Israeli so that makes sense for them as he wants to move back.

[08:17] What is a Good GPA?

The average matriculants getting into and starting medical school is around a 3.7 for the AAMC. So Natalie is already right there.

“The science GPA and cumulative GPA are relatively close with cumulative GPA being just a little bit higher, just kind of on average.” Click To Tweet

What may be concerning to me is if Natalie dropped down and got a C in her last semester. If she’s stumbling into the finish line, that could potentially be a question for me. But her GPA is not a concern at this point.

[09:11] Applying Early

A mid-August MCAT date is just too late for the current cycle. So if I were you, I would not apply to medical school that cycle including the Israeli schools and take the MCAT if you are not getting the scores that you want within a couple weeks of your MCAT date before you can reschedule or cancel and kind of get some money back.

Then cancel or reschedule, push it out because if you’re not applying this cycle, then the MCAT isn’t really a rush. And so I’d rather you be prepared for the MCAT then take it because you “need” to take it right now. 

[10:41] Applying to Sackler

I did some mock interviews with a student who got into Sackler recently. He wanted to go to Israel and be there for a while. I have a very limited understanding, just from this one student, I was working with having some conversations with him.

Sackler really doesn’t want you to stay in Israel. They want to train students, and then come back to the states and spread the Sackler name and go, “Hey, this is awesome. I’m practicing here in the U.S. and I went to Israel.”“If you don’t have a strong message that says you’re going to come back to the states and practice and be a good alumnus, then there are some potential issues there.” 

But the biggest thing is that you’re an IMG and that’s just automatically based on how our residency system is set up. It automatically puts you at a disadvantage.

As long as you know the risks of what you’re doing, and you’re okay with those risks, then go for it. 

The other question potentially comes up is what are you interested in doing? If you’re interested in something that’s just not competitive, like family practice or internal medicine, go for it as an international medical graduate. You do well on the boards. You’re a US citizen. You will probably be okay.

If you’re interested in a super competitive specialty like dermatology, orthopedics, neurosurgery, getting into those specialties is hard no matter who you are, and then even harder as an IMG.

The assumption from the program director standpoint is that you weren’t good enough to get into a U.S. medical school. You just don’t want to put that stigma on yourself.

Nevertheless, there are amazing physicians who come from those places, it doesn’t mean you’re not going to be a good doctor. It just means it puts you at a disadvantage to start this process coming back to the States.

[13:53] Competitiveness Based on the Location of the Program

When you look at the least or less competitive specialties, then it’s like, as an IMG, do you want to be in New York City? Do you want to be in LA? Do you want to be in the Bay Area? Do you want to be in Boston? Even though it’s internal medicine, it’s still going to be super competitive because of the location of the program.

And so if you are interested in internal medicine to follow on with a fellowship. Then the next question is where in the country do you want to do your training? And if you’re okay being in the Midwest, if you’re okay, being in the south, if you’re okay with some of the lower competitive areas, you’ll probably be fine.

Natalie wants that if she would go to med school there, she would do residency in the U.S. even if she ended up moving back to Israel after she needs to do the residency in the U.S. Now she questions if she can practice in Israel if she does residency in the states or if she does residency in the U.S. can she practice in Israel.

“We have a very elitist medical system here that says we want people trained in the states to take care of our people in the States.”Click To Tweet

I personally don’t know the Israeli medical system well enough to say that they will accept a U.S. trained physician. Or is it just us because we have a very good training system here?

I’m not saying that our medical system is the best in the world because it’s not. But we have a great training set up here. 

For our residency slots, we are projected to have a big physician shortage. So there could be a time, and there have been in the past, where people who are trained outside of the states are granted a license because we just need them.

[17:05] Taking the MCAT

Natalie talks about taking seven full-lengths in three weeks. In this case, I advise that she just pushes back her test day because it’s just a ton.

“The biggest benefit of a full length is not taking the full length, it's reviewing it.”Click To Tweet

In an ideal timeline, you have for each test one day to take it, two days to review, and then probably two to three days of content review based on the test review. And so now you’re at five or six days. It’s almost a week for each test.

That’s where students go wrong with their test prep is they go cram seven tests in three weeks. And they think they’re going to be good because they took seven full lengths. They just look at that total number without actually looking at what they did.

Setting yourself up for success is knowing that if you’re not going to apply this cycle, you don’t have to take the MCAT in August. It’s going to cost you a little bit of money to reschedule it. But I’d rather you reschedule it, then try to cram all of this test prep in before the MCAT. Then you potentially go in burned out because you’re cramming it all in. So there are just so many reasons not to take it and almost no reasons to take it in August.

[22:45] Reviewing Full-length Tests

If it is a content issue where you keep missing all the same questions because you don’t know this material, etc. then more tests aren’t going to help. More tests are just going to show you that you need to do more content review.

You don’t need to take 10, 11, o2 12 full length exams. Around 5 to 7 full length exams for the majority of students is going to be plenty. But Natalie is still at a score where she’d want to improve and so more full lengths potentially will help you improve. This will give you an understanding of the test and how it’s written and how to think through the process.

Everyone should be shooting for a 528 but I really don’t play that game. If you can get a 510 awesome, if you can get a 513 amazing. 

“A higher MCAT score is only going to help you. Too low to apply with is less than 500.”Click To Tweet


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