ATD 8: VITA, Healthcare Reform, Clinical Experience & More!

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ATD 8: VITA, Healthcare Reform, Clinical Experience & More!

Session 8

How diverse should your clinical experiences be? We talk about that today, as well as a host of other topics around AAMC’s VITA, how schools are using CASPer data, international shadowing, virtual shadowing, and more!

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.

[01:02] AAMC’s VITA

It’s disheartening how the AAMC is always looking for ways to ask for money. The University of Utah uses a one-way video screening as part of the secondary essay process.

It seems like it’s more work for the medical schools as they have to figure out how they want to incorporate this. They figure out their rubrics. They can’t control what questions are asked, right. So it’s just force-fed down their throat.

From a student’s perspective, this causes more anxiety because this is not the year to release this. It’s not replacing the interview. Most medical schools are going to do a virtual interview through Zoom or Skype or whatever platform they’re going to use. So it’s not replacing that. So it’s not helping with social distancing which is part of their reasoning. It’s adding this extra step that’s already during this stressful time.

It’s nice that it’s going to be free this year but they’re going to charge for next year. And it’s more work for the schools this year when their whole process and timeline is all screwed up already.

'It's just more hoops to jump through for students.'Click To Tweet

It’s more money. It’s going to add more bias to the process because they’re going to see you and everything about you. And there’s going to be some bias there because it’s human nature. Regardless of how many schools are going to use it, the downside is that it’s still going to be added cost and anxiety for the student.

[08:07] Reform in the U.S. Health Care System

Q: Do you believe the U.S. healthcare system will reform for the better after this pandemic exposed its long-standing disparities for disadvantaged communities and its mental slash physical burden on healthcare workers?

A: First, the U.S. healthcare system will not reform because of disparities. It that’s not what drives our country, unfortunately. The question is, will companies be hurt enough by people being out of work? Will employees be out of work affecting production (aka money-making) enough that it hurts the bottom line of companies? And would companies start fighting back based on our employee-based health care system?

'The administration paid a lot of money to bail out healthcare systems to keep them open. But they're going to be hurting. A lot of doctors' offices won't survive this.'Click To Tweet

But from a pandemic standpoint, and from a social justice standpoint, those who have empathy are starting to see the light. They’re seeing everything unfolding in front of them and they are voting. And the only way to really make a change is to vote for the people who you want in office.

[12:20] How Schools Are Using CASPer Data

Q: How do Deans utilize this information from CASPer when looking at applications?

A: In Texas, a third of the schools at this point are requiring CASPer and they’ve been requiring it for several years now but none of them are actually using it yet. They’re still studying how it can be used in their process.

The medical schools are doing a great job actually. Because they’re being very careful with how CASPer might be used, how it correlates with a variety of different things they’re interested in and what they know about, etc.

[14:38] Diversity of Experience List

Q: How diverse should my experience list be? I’ve been volunteering as a medical assistant in private practice since February and my premed advisor told me to stop that and find other experiences. I love volunteering as an MA and I want to continue my clinical experience.

A:  Well, you shouldn’t stop being a medical assistant if you’re really enjoying it and you’re really having a good experience with it. If you’re volunteering as a medical assistant at a pediatrician’s office, you may want to seek out volunteering as a medical assistant in a different type of setting to see what that would be the differences between a pediatric clinic and a urology clinic or the difference between a pediatric clinic and another type of clinic.

'If you're getting great experiences and you're enjoying it, then go for it.'Click To Tweet

From a social justice perspective, with everything going on in this world, it’s just highlighting the disparities more and more because there are students out there who don’t have access to this kind of stuff.

[17:56] International Shadowing

Q: I’ve shadowed a family friend in Argentina for about 80 or less. Is a letter of recommendation from a physician outside of the U.S. acceptable?

A: Yes, it would be acceptable. However, there’s a difference between something being acceptable and something being optimal. A letter from a doctor in Argentina would be great. But what you might want them to talk about are things relevant in the American healthcare system – in other words, contact with patients. 

So if you have a good relationship with this physician, they really want to write you this letter, and they’re very enthusiastic about it, then go for it. It sounds like a great letter. You’ve done a lot of work there and it shows a diversity of knowledge of health systems around the world. So, if the Argentinian physician really emphasizes the things that cross over well within the context of the American Medical healthcare system, then go for it.

Additionally, I would like to make two points here. First, saying that you got a letter from a family friend, as long as the admissions committee doesn’t know it’s a family friend writing about you, then the letters are going to be fine. Second, the University of Utah, for instance, has a clause on shadowing where they do not accept international shadowing. So you have to take a look at the school and see if they accept international shadowing or not.

[23:05] Virtual Shadowing

Q: What do you think of virtual shadowing during the pandemic?

A: Well, it’s better than nothing. Who knows, you may get some interesting experiences out of it. It’s not optimal, but nothing these days is optimal because of the Coronavirus.

Also, you don’t know what doors are going to open because of that. So if you have this virtual shadowing position, you may be exposed to a physician, to an administrator, or someone who’s going to open some doors for you as soon as this pandemic is over.

'You're going to have some doors open because of this experience. It may not help you in your medical school application. But you just never know.'Click To Tweet

[25:35] What Are the Minimum Cutoffs for Shadowing?

Q: What are the minimum cutoffs for shadowing?

A: Maybe you’re limited on the actual shadowing sort of hours, but that’s not what medical schools are looking for. They’re looking for the richness of experience.

Stats are very different where you need to meet a threshold. But if you frame it from an experience perspective, it’s about having enough experience to know that this is what you want to do. So that’s how you want to frame it.

The clinical experience is for you to prove that this is what you want. You’re not one of the 60% of physicians who are burned out of your career because you went into it thinking it was something different.

Consistency is another thing to shoot for. If you can get five hours a month, maybe it’s one day a month or one weekend morning a month where you can shadow for a little bit. Over time, that adds up to a lot. But if you’re in a situation where you have to work and you don’t have time and you have kids, all of that stuff gets taken into account.

“It's really not the total hours but the consistency to show you're interested.”Click To Tweet

[30:06] Taking a Gap Year

Q: Is less clinical experience in online labs or in prereqs enough reason to take a gap year?

A: Everybody’s classes are online labs. Everything is in such a chaotic state right now, including clinical experiences, volunteering being cut off, shadowing being cut off, and everything else. You’re not going to be the only person out there who’s affected in that way. But it shouldn’t necessarily force you into a gap year.

“You're not any different than anybody else in the cycle.”Click To Tweet

[31:27] Online Classes

Q: Which online classes should I take?

A: Ultimately, it’s about learning. It’s about whether you’re doing it online, or whether you’re doing any class or hybrid method or whatever. It’s all about learning. And if you learn the material, and you do well in the class, and you prepare well in those classes that are relevant to the MCAT then that is that’s the key.

'It's about learning. It's not about where you took them, or whatever medical schools are going to be very forgiving for the next couple of years on this issue of online education.'Click To Tweet

[34:33] Getting In-Person Shadowing Experiences at This Time of Pandemic

Q: When would be an appropriate time to ask physicians about shadowing, and how would you recommend we even go about it considering the current situation?

A: If you’re okay with those risks right now, then go for it. Because there are some physicians who allow students to shadow at this time. And if they don’t allow right now, tell them that you’d love to be considered once they open up and taking shadows again.

Don’t let your own considerations prevent you from getting some great experiences that are out there.

“Don’t tell yourself no. Let the physicians tell you no. Go ahead and ask whether you can shadow them and why you want to shadow them.”Click To Tweet

[37:40] Retaking Classes

Q: Is it worth it to retake classes you got a C plus in if you are already passed in your series. , I got a C plus in Gen Chem series, but A’s in Organic Chem 1 and 2 and Biochem. It just really hurt my GPA.

A: The math is all the same. At the end of the day, extra classes are just math. You’re adding credit hours and you’re adding GPA. So you’ve already proven that your foundational knowledge is fine as you got A’s in Organic Chem 1 and 2 in Biochem. And for some reason, your brain just didn’t work with gen chem, which is very common, strangely.

Students like to think micro of the med schools. That they’re not going to be accepted because they got a C plus in gen chem 1 and 2.

“Medical schools are looking at that holistically. They're looking at your trends.”Click To Tweet

Instead, it would be much better to take upper-level science classes that you’re interested in. Take those that are really going to be much more relevant to preparing you for what you’re going to face, particularly in that first six to eight weeks of med school than Gen Chem.

[41:00] How Career-Changing Nontrads Can Boost Their Application

Q: What can seasoned career-changing nontrads do to be considered a desired applicant?

A: Whether you’re seasoned or not, whether you’re a nontrad or not, it’s the same for everybody. You want to have good experiences and a good academic track record.

Now, if because you’re an older applicant, and in your past experiences in school they were poor, then you’re obviously building a new framework for a medical school to look at you, academically speaking. In this case, have a good number of hours of coursework to say this is who you are as a student now as opposed to back when you were younger.

'Show that you have the cognitive ability and you're doing well on the MCAT. You want to get a lot of good experience in medicine through shadowing and/or clinical experiences.'Click To Tweet

This is not a question is about your age because medical schools just want to see the same thing. The key for a career-changer especially is why do you want to do this now? Why do you want to make this change? What led that decision making processes to unfold? Your story has to make sense to the admissions committees.

The whole point of this application process is not to be the best GPA student. It’s not to be the student with the best MCAT score. It’s not to be the student with the most hours. It’s to be the student who can explain why they want to go through this process. Because you might be coming out on the other end with hundreds of thousand dollars worth of debt, with bags under your eyes.

Why would you want to put yourself through that when there are other careers out there where you can be happier and make more money and do all this other stuff? 

[47:41] How Texas Schools Are Receptive to Out-of-State Applicants

Q: How receptive are Texas schools to out-of-state applicants?

A: It doesn’t matter what state you’re coming from. But based on the state law, the way you risk losing your state funding is if you have more than 10% out-of-state students in your class. So the medical schools are going to be very cautious about that. If you looked at in-state residents getting into medical schools versus out-of-state residents getting into medical schools, with very similar GPA, the big difference is in the MCAT score.

“For non-Texas residents, the average for MCAT scores is going to be considerably higher and that's the differentiator.”Click To Tweet

Moreover, there are medical schools in Texas who try to figure out if you have some connection to Texas. It’s not going to make you a Texas resident. But it may mean that they feel better about having you in the class as a non-resident because your grandparents live in Texas or they lived here when you were five and six years old.

That being said, the far majority of students want to apply to Texas schools because tuition is so much cheaper. It is the wrong reason to apply to school. But it happens.



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