Today, we handle a grab bag of questions from our students covering topics on scores and stats and the relationship between work-life balance and burnout. We also talk about what makes a good clinical experience, as well as the different types of curricula you should think about when choosing schools.
Ask the Dean is the first media project from my new company Mappd. It’s a technology platform that’s going to help premeds understand the process of getting into medical school.
Joining me is Mappd co-founder Rachel Grubbs and Dr. Scott Wright, our VP of Academic Advising. He’s the former director of admissions at UT Southwestern and the former executive director of TMDSAS.
Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.
[04:55] Discrimination Against Age and Race
Q: How much of an impact does race play in admissions for medical school as a current Asian-American?
A: Sometimes, it can get overwhelming when looking at the stats for overall Asians compared to other races, and how much higher it is.
The federal law with regard to race and admissions is quite interesting. For example, there was a 16-year-old kid who applied to medical school and they denied him of an interview because he was too young to participate in a clinical environment.
There were a lot of issues related to that and all the legal counsels said that the federal anti-discrimination laws with regard to age are all about the upper end. There are some limits to what students and what schools can do on age.
With regard to race, it depends on the state. It depends on the school, on whether or not it’s a private school or public school, and how they’re going to deal with race in their admissions process.“All medical schools want a diverse medical school class.”Click To Tweet
There are tons of research that show the advantages of having diverse people in the class because this is advantageous to the clinical environment.
Race is an important quality in terms of that diversity factor. But diversity reaches a lot of different things, not just race. It also encompasses age, life experience, socioeconomic status, and a variety of other things that really go into this idea of diversity.
There are schools in states where that has been eliminated or are severely limited in terms of what public institutions can do. With regard to considering race, some schools cannot use it at all and essentially have a race-blind process.
To address the issue of this particular statement, yes. Asian Americans are not considered underrepresented minorities with regard to admission to medical school. Medical schools are looking for a variety of people.
But do not concentrate too much on comparing yourself within statistics. You have to make yourself the best applicant you can be. Whether you’re Asian-American or white, or you’re African American, or Hispanic or wherever you’re coming from in terms of race or ethnicity.
Medical schools don’t look at you for your race but they look at you as an individual. They want to see what you can bring to the table compared to the general pool of applicants and if you’re a good fit.
[13:34] Looking at Historical Data
When you look at the AAMC data or individual school data, they are not telling you your chances. They only present historical data of what happened.
You can’t tell your chances based on historical data because you don’t know the stories behind all of those numbers. You don’t know how many Asian-Americans didn’t get and what their applications look like. So it’s not useful at all to look at that historical data.“It's not about finding the most qualified student simply in terms of the metrics. It's really about finding the best student in terms of the overall picture.”Click To Tweet
It also goes back to having a variety of people in the class that benefits everyone in the class. Again, diversity is not only limited to race. But it covers all things like rural vs. urban, experiences, as well as a diversity of thought.
Qualification doesn’t only refer to numbers. It refers to personal qualities and interpersonal qualities. AAMC has particularly enunciated the core competencies that they’re looking for to make a good medical student, and ultimately, a good physician. And that’s the key!
[18:01] What is a Good Enough MCAT Score?
528 is obviously the best and you want all of those students. But again, it’s good enough academically. It’s good enough to get through medical school and through a curriculum. 520 is good enough. 510 is good enough. 505 is good enough. 498 is probably not good enough. It’s not a spectrum. It’s like a tripwire. As soon as you get over that tripwire, you’re good enough academically.
But then again, you may have a good enough MCAT score, but if you don’t have those personal skills, then still that’s no guarantee of getting into medical school.
[20:00] Work-Life Balance and Burn Out
Q: There’s a growing emphasis on burnout from the medical community at least a lot more than previous years. Do you believe this new awareness will actually result in action toward helping all physicians achieve a work-life balance?
A: Personally, I think work-life balance is a joke. It’s just that you have work and you have life and your family and you have other responsibilities, and you have to figure out how to live with all of it, especially as a physician. The problem is that being a physician never ends.'Work-life balance is a fantasy. The ultimate goal is figuring out how to integrate work into your life.'Click To Tweet
There is so much burnout because we have this focus on work-life balance that nobody is finding. And so they think they’re broken, and now they’re burnt out. I’m all about meditation and exercise and eating right and sleeping well. All of that stuff is good stuff, and that will definitely help. But chasing this dream of work-life balance is part of the problem.
At the end of the day, we just need to figure out how to balance the work we want to do, the income that we want, to have the life and lifestyle that we want to have, and make our life fit with that picture.
[22:48] Get Into Medicine for the Right Reason
We have too many people in healthcare, who became physicians because they wanted a stable job with good pay. And they didn’t become physicians to be there for the patients and to deal with all the patient’s needs and issues.
We had admissions processes 20-30 years ago, where we have physicians now practicing that really focused on the stats. So now you’re dealing with physicians who have seen healthcare change around them. They’ve seen reimbursement rates change and decrease dramatically while they’re out practicing. And now they’re seeing more patients, they have less time. They have less autonomy, and they don’t like that. And they’re getting burnt out because of that.
You have to go into medicine for the right reason, no matter what happens, no matter how pay is, no matter who your boss is. You’re taking care of the patients and you’re there for them.“We have too many physicians out there who are focused on the paycheck and on work-life balance so they get burnt out and they don't like medicine anymore.”Click To Tweet
Unfortunately, students have this unrealistic fascination with bigger houses, fast cars, boats, and all that stuff. And now all of a sudden, you’re working to maintain your lifestyle. So you end up getting burnt out and jaded because of that.
[28:33] Tailoring Application for MD/Ph.D. Programs
Q: How can one tailor our application for these MD/Ph.D. programs?
A: One of the key things for the MDPhD programs is to talk about what you did in the lab as an undergraduate, or what you did on your summer research project. Did you have a clear understanding of what you were doing?
There are a lot of students who participate in research activities who never ever get the big picture. They know the mechanical things they were doing, but they never really got it in terms of what was the effort all about. How does one connect to the other thing, and what is the big picture of all this?
When you talk about your research, particularly when you’re applying to MD/Ph.D. programs, you have to talk about not just the mechanical aspects of research, but what was it really all about?'What you were doing mechanically is fine, but you've got to move into the bigger picture of what this was all about.'Click To Tweet
[32:06] Nursing as a Good Clinical Experience
Q: Is being a nurse a good clinical experience?
A: Nurses sometimes get it better than the doctors get it. And this depends a little bit on the type of nursing you’re doing. So what sort of things are you doing?
But in general, as a nurse, you already know what’s going on. Oftentimes, too, nurses have a frustration that they don’t get more credit than they do. Because sometimes they deserve a lot more credit in terms of their understanding of the patients.
The nurses are on the frontline while the doctors are in there for 10 minutes every day. When he or she comes by, the nurses are the ones caring for these patients, particularly in the hospital. So these are the people who really get to know these patients. They know what their stories are and what their complaints are. These are the people that really make a difference. So yes, being a nurse is a great clinical experience.
Now, the follow-up question that always comes from this is does a nurse still need to shadow? And my answer is a resounding yes. Shadowing is to understand a little bit more of the doctor’s world outside of the small amount of interaction that you have with them.
[35:35] The Pros and Cons of the Different Curriculums
Q: What are the pros and cons of the different curriculums medical school use?
A: When I went to medical school, I didn’t really understand all of the differences between curriculums. And at that time, 15 years ago or so, there probably wasn’t as much diversity in the curricula as there is now.“Too many students focus on stats for picking medical schools. But the curriculum is a big one.” Click To Tweet
I went to New York Medical College that had a very traditional curriculum. You would study all of the subjects independently from each other. So you’d be studying histology separately from anatomy, and from physiology, and so on.
But there’s also the systems-based curriculum. You’re going to learn the cardiovascular system within the cardiovascular system block. So you’re going to learn anatomy, physiology, pathophysiology, pharmacology, and everything you need to know about the cardiovascular system. You’re going to learn it all together because that’s how the body works – all together. Personally, I think I would have done much better with that.
A flipped classroom is becoming more and more popular. It’s not really a standalone curriculum, but it’s just a learning style that schools are using where you do all of your learning at home. So, learn the material on your own and schools are going to spend classroom time not going over PowerPoints but actually discussing further in-depth. They’re answering questions based on what you’ve already learned.
Problem-based learning is something that University of Colorado School of Medicine uses a lot. It’s a group of six to eight students, usually a small group. Then they use vignettes that the school creates so that students can figure things out. There’s a problem. Usually, it’s a clinical vignette of this patient presenting with XYZ. And then you go through questions. What’s the first thing you want to think about? What’s the next thing you want to think about? And it’s just going through this whole process.
Scott adds that as an applicant, you have to ask yourself what is your learning style. How do you learn best? Are you an independent learner? Or do you learn better in groups?
Students really have to investigate on their own how do they really learn best and how they need to find a school that seems to match with that.
Medical schools are not as typical anymore that they require attendance. In fact, they’re already streaming those classes. They’re storing them on servers. So you can just watch them whenever you need to listen to the lectures while you’re exercising. You can also double the speed of the lecture. Students are hearing it faster. They could stop it and back up if they knew something they had missed or that they wanted to concentrate on or whatever.“There are a lot of different methods for students to be able to handle the curriculum in medical school these days.”Click To Tweet
At the end of the day, you have to know your own style. Clearly investigate what the curricular structures are at the schools you’re looking at or that you’ve interviewed. And that’s the key to finding a school that matches you and fits you.
[41:53] Khan Academy Test Prep Materials
It shocked the whole premed world when the Khan Academy announced that they were going to pull out all their test prep materials. Initially, it was until September 2020. Then they further extended that through the whole year.
Then the AAMC said they’re going to pull this information into their paid products. So there are still a lot of questions out there. Unfortunately, the way AAMC is handling all the issues going on right now is not that great. Anyway, the good news is that the MCAT prep for Khan is staying up until September 2021.
[47:15] Flipped Classrooms
Q: Is the flipped classroom mostly learning from textbooks or videos?
A: This depends on the resources from the school and the technology. Fifty years ago, students had to go to Harvard to hear from the brightest minds in the field of psychology because that’s where these professors taught. But now you go on YouTube, and you can see all of their lectures. Material-wise, we’re in a time right now where however you learn, there are materials out there for you to learn from.“The notion of the flipped classroom is not as much about the resources that you're using to learn the information. It is about where and when you're learning the information.”Click To Tweet
The notion of flipping that is important. It’s flipping that you’re not learning it in the classroom. You’re learning it at home. And then you’re using it in the classroom to better understand it.
[50:29] Letters from Podiatrists
Q: If you’re on the admissions committee and you have a letter of recommendation from a podiatrist. What does that look like?
A: It’s going to vary depending on the individuals on the committee. Some of them would be patient-centered. The podiatrist is working with the patient. The student is watching or interacting with the patient. So there’s going to be others who are going to say it’s totally different or whatever. So it’s basically a hit or miss.'If you want to be really careful and safe and you want a letter from a physician, don't get a podiatrist.'Click To Tweet