Medical School For International Students and More Q&A

Introduction

Dr. Ryan Gray: The Premed Years, session number 211.

Hello and welcome to the two-time Academy 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 welcome to The Premed Years if this is the first time joining me here, thank you for taking the time to do that. And if this is not your first time here, thank you for coming back and putting up with me, or whatever you want to say. But anyway, alright today I have a lot of- not a lot, I have a few questions that came in. One in a voicemail, and a couple that came in on Facebook, and a couple more that came in through email. If you ever have questions you can go to www.MedicalSchoolHQ.net, there’s a feedback box on that site that you can fill out. You can leave us a voicemail feedback or just shoot me an email, Ryan@medicalschoolhq.net. Let’s go ahead and jump in and listen to the first voicemail that came in.

Hello my name is Joslyn and I am an international student studying premed in Louisiana. I’ve heard that it is harder for international students to be accepted into American medical colleges. Exactly how true is this, and if you can, could you suggest me a few schools that I’m most likely to be accepted into? It would be most helpful. Thank you so much.

Medical School for International Students

So one thing to know, as an international student, if you are here in the states and you are going to an undergrad university here in the states, as an international student you are still considered an international student when you apply to medical school even though you did your undergrad here. If you’re here on a visa, you’re considered an international student. Seems to make sense, right? When you apply to medical school as an international student, it is very hard for you to get into a US school as an international student. There are a couple reasons for that. Number one, we have a lot of US applicants applying to US schools, so why not take our own students? So that seems to be the obvious reason. Medical schools want to train people that are going to stay here, and work here, especially public universities it’s a big consideration. Public schools are getting funded by their states to train students to hopefully stay in the state and work.

International Students Financing Medical School

One of the biggest things that comes up with international students is financing medical school. As an international student you do not have access to government loans like all the other students that are here in the US going to medical school. In case you haven’t heard, medical school is expensive and the majority of students take out loans from the government to pay for medical school, and as an international student you don’t have access to that money. So medical schools are very shy about accepting students who don’t have the means to pay for medical school. So a couple things. A lot of medical schools will ask for a really, really big deposit if they do accept you as an international student. They want to make sure that you have the cash to pay for it. So unfortunately what that does, is it limits students that don’t have the family support to actually foot a medical school tuition.

There are medical schools that have big endowments, think about the Ivy League schools, a lot of those obviously private institutions, they have lots of money to spend on students. And so they might have the ability to loan you money to pay for school, you have to pay it back. Or you may possibly get a scholarship. But those are the three ways to fund school, is you’re footing the bill or your parents are footing the bill, a family member. You’re taking out a loan directly from the school if they have the funds to do that. Or you’re getting some sort of scholarship, or some sort of combination of all of those.

The other big consideration that schools have to think about, worry about- and I was at the AMSA Premed Fest January of 2016, two Premed Fests ago, and there was an international student talking to an admissions committee member from one of the- I think it was a DO school, and the admissions committee member straight out said, “We don’t like taking international students because after you graduate from medical school, there’s no guarantee that you’ll be able to get a visa to work as a resident.” And medical schools don’t want to risk you going to school and leaving school and not being able to work. That looks bad on them because they’re training somebody who’s not going on to do post-graduate education, which for medical school, for medicine you need to be able to practice medicine. So you can’t graduate and just go work, you need to actually go do some internship residency to actually work. So it’s important to keep in mind.

So those are really the big things to keep in mind. So the question is as an international student where should you go? And how should you figure this stuff out? And the two big resources, the MSAR- get a subscription to the MSAR. The MSAR tells you the data on applicants to each of the medical schools, and matriculants to each of the medical schools. Some of them break down the people that they’ve interviewed so you can see international applicants, international interviews, and international matriculants to each of the medical schools, and you can get an idea of what medical schools are international friendly, so that’s important to do. Do your research. The College Information Book from the osteopathic colleges has not that detailed of information, but it has a list of schools that do accept international students with links to each of those schools, with most of them being specific pages on that school’s website that talks about international applicants. So it’s important to keep in mind when you’re doing that.

Getting Involved with Healthcare Policy

So that’s what I wanted to talk about to begin with. This next question was about healthcare policy, and working as a physician, and getting involved in healthcare policy. And as a physician, you can do whatever you want. You can see patients part of the time and go run a business part of the time, you can do research part of the time, and that includes getting involved in policy. And obviously it would help to be involved in policy in areas where there’s a lot of- there are a lot of policy makers to get involved, whether you’re in the DC area, or you’re near the state capital of whatever state that you live in so that you can be involved, because that’s where the lobbying and everything happens is in those areas. But if you don’t live in those areas and you don’t want to move to those areas, you don’t have to, you can obviously get involved- we have this cool thing called the Internet so you can get involved from anywhere, wherever you live. So those are some things to think about. You can do whatever you want as a physician, that’s the cool thing.

How to Choose Between Acceptances

Another question that came in was actually from a student that I’ve been working with this past application cycle, and she has the unfortunate predicament of needing to choose between three acceptances so far. She’s hoping for a fourth one at her top choice. But between the three choices that she has, she’s wondering how to choose between those. So she sent me an email and she said the first school is well-established, has a good reputation, but she can’t picture herself living in the city that it is in, and the class sizes are too large. The second one is in a state closer to where she’s from and where she wants to be, it’s near a good city that she thinks she would like to be around. And the third one is a lot closer to where she is, it’s in her state, and she loved the interview, and she was comfortable interacting with everybody there but she’s worried because it’s a newer school, and she’s worried about how that’s going to affect her residency applications, and whether or not program directors are going to view her going to a new school as unfavorable. So she is worried that she’s going to make a choice that is going to hurt her in the long run, and so she wanted my advice.

And so my advice, and if you’re in this situation where you’re lucky enough to have multiple acceptances, and a couple of the students that I’ve been working with this year are lucky enough to be in that situation; you need to go to the medical school that is going to give you the best ability to be who you want to be. So for this student, she knows she doesn’t want to be in a large class. So that automatically for me would rule out that first school even though it’s well-established and has a good reputation. If you can’t see yourself living in the city that it’s in, and you can’t see yourself being one of a couple hundred people, then don’t go there no matter how ‘good’ the reputation is of the school. If you’re unhappy there, your grades may suffer, your self-esteem- not self-esteem but your just general happiness will suffer, and you might not do well and then there goes your residency chances as well. Or at least getting a good residency. So don’t go to that first one if you can’t see yourself going there.

The second one she mentioned, she said it was close enough to where she’s from and is in a near enough good- it’s near enough a good city that’s diverse that she likes, she didn’t really have anything else good to say about it though. It was just that it was smaller class sizes and in a better city area that she would like.

And the third one she wrote the most about, but also had the biggest negative of being the newest school. She loved interacting with everybody, she had a great interview day- she actually said she loved her interview day there, and she loved the one-on-one time with the faculty and the community. She answered her own question in her email to me. You can’t choose the medical school based on what you think is going to be a determining factor for a residency program director. What he or she determines to be the criteria they use to select their residents, you have no control over. What you have control over is understanding who you are, knowing what is going to make you happy, and choosing to follow that direction. Everything else is a waste of time to think about because you have no control over it. So go to the school that is going to make you the happiest, that is in a location that you like, that the community is great, and you can see yourself going there and be happy there.

Alright the next thing I want to talk about is not necessarily something that has come up in a question form, but more when I’ve been doing mock interviews with students, things that come up time and time again, and I finally have been writing some of these down as ideas to talk to you about. And so one of those things is when you’re talking about your strengths and your weaknesses in your interviews, don’t take a question like, ‘What is your biggest strength or your greatest strength?’ Don’t say something that is your strength and then turn around and say, ‘It’s actually my weakness too.’ I had a student do that the other day and it just feels very forced and contrived, and it’s unnecessary. The question is, ‘What’s your greatest strength?’ Not ‘What is your greatest strength that also could be your weakness?’ If that was the question, which I doubt it ever will be, then sure go ahead and turn it into a weakness. But your job is to talk about your strength, tell a story about what that strength looks like, and move onto the next question. Same thing for, ‘What’s your biggest weakness?’ Don’t talk about your weakness and then try to turn it around into a strength. Your job is not to talk about a weakness and turn it into a strength. Your job is to talk about a weakness, tell me a story about what that weakness looks like, and then tell me how you are working on fixing that weakness so that moving forward it’s not a problem.

Gifts for Admissions Committee Members?

Another question that came in recently is whether or not you should be sending gifts to the admissions committee members that interview you. And I think you need to think about what is the norm in this world, and the norm is no gift. A thank you letter, a thank you note is basically required and is considered definitely the norm, but a gift should not be sent. It could hurt your application. They could see it as a bribe and so you definitely don’t want to send any sort of gift to the school that is interviewing you, after your interview day.

I had an interesting email come in from a member of the Hangout, which if you’re not in the Hangout please go be part of the Facebook Hangout, www.MedicalSchoolHQ.net/group. And the email is about an update letter basically. The school that this student wants to go to hasn’t accepted her, hasn’t invited her for an interview, hasn’t rejected her either. She hasn’t heard anything from the school. She’s done a lot of shadowing with a lot of the members of the admissions committee making connections, two of the letters of recommendation that she got were from the admissions committee members. And so she thought that it would have been easier to get in there, but because of some bad grades they said that it might be a little bit harder. And so she has an acceptance to medical school which is great, not the one that she really, really wants to go to, and she’s wondering what she could do to move forward and see what happens. She sent this letter of interest and has heard nothing back, and she wants to know moving forward what she should do contacting the school. And so I would have loved- I followed up with her, she didn’t mention to the school with her update letter that she had already received an acceptance. If you receive an acceptance, I think it’s appropriate to let that school know in your update letter that you have an acceptance, but they are still your number one choice. There’s this weird thing with humans that we always want something that we can’t get. And once a student is accepted, there’s this weird kind of draw, this psychology of ‘well she was already accepted somewhere else, I guess she is a good enough student to be accepted, maybe we’re missing something, let’s talk to her and invite her for an interview.’ There’s a lot of that stuff going on, so it doesn’t hurt to let them know that you have an acceptance, but don’t send an update letter just to say, ‘Hey I was accepted.’ If you haven’t sent an update letter yet, or a letter of interest, and you have a lot of stuff that you want to inform the school about and, ‘Oh by the way, I also have an acceptance from another school,’ great. Do that. But don’t go and bug the admissions committee member just to let them know that you have an acceptance. Be grateful for that acceptance, but if the school that you truly think that you’re meant to be at is not reciprocating that love, be patient and hopefully it will come. As we’re recording this it’s the beginning of December, there’s still time, schools are still interviewing people through February, sometimes into March. So take your time, be patient. Until you get that rejection letter, they haven’t said no.

When You Feel Stuck in a Rut

Another email that I got recently is from a student who is in a rut, or feels stuck. She says that she graduated undergrad, applied to medical school, didn’t get in, has taken a year off and is taking MCAT prep courses to take the MCAT again, and finds her motivation somewhat dissipating and is making her second guess what she wants to do. She’s surrounded by so many people who have changed paths and are now in PA school and nursing school. ‘Do you have any advice?’

So my advice to this student is to keep your head up first of all, to not worry about what the people around you are doing, and if those people are dragging you down maybe surround yourself with some other people. Just because they decided to change paths doesn’t mean that that is the normal thing to do, or that is what you should do. A physician is a physician, and somebody who wants to be a physician will not settle for being a PA or being a nurse or an NP. Those are amazing careers that do wonderful things, but they are not physicians. And I talk to nurses, and NPs, and PAs that go back and try to get into medical school because they’re not fulfilled with being a nurse practitioner or a PA. You have to always, always, always- and I talk about this specifically during MCAT studying, there’s something about the MCAT that gets people down. I wonder what it is that gets people down and depressed about what they’re doing, and the MCAT does that to you. It is a huge life suck, and it drains all of your energy. It’s so hard and especially having to re-take it, it’s very defeating. And when you’re in that position, you question why you’re doing it. It’s not abnormal. So you need to always, always, always keep in mind why you’re doing this. If you have one specific patient encounter that you remember as being this huge motivating factor and why you are applying to medical school, why you want to be a physician, keep that in mind. Always remember what your end goal is, keep remembering those stories, and those people that have had an impact on you, that have solidified in your mind why you want to be a physician. Because as you are studying for the MCAT, you’re going to run into this rut, and you’re going to get down, you’re going to feel stuck but you need to remember why you’re doing it to push through.

Best Undergrad Institutions

This next question might not be relevant to you if you’re already in college, but if you’re listening to this as a high school student, or maybe the parent of a high school student, I get questions every now and then about choosing an undergrad. And one parent recently emailed me and asked about how to figure out what undergrad institution will be best for their child. And my short answer was you never know what’s going to be best until you’re there, but the long answer is that you need to take that campus tour. A lot of kids and parents go on a little college campus tour, and go see what the campus is like, go feel what the vibe is like. It’s important to do, don’t just read stuff online but actually go there and see what it’s like. Take a tour. I think you need to understand who you are and what you want to get out of the school. I’ve talked about this a lot. Don’t go to a school just because it has a great reputation, and they sell themselves on being a great premed school, and having a high acceptance rate to medical school. A lot of those stats are not real stats because the admissions- the prehealth committees will a lot of times not include students who they won’t accept to write committee letters for. So they’ll say, ‘Your GPA isn’t good enough. Your MCAT score isn’t good enough. We’re not going to support you in your application to medical school.’ And so they don’t include that student in their stats, so it’s a very kind of shady system that some prehealth offices use. So you need to look at the schools for everything else besides their great reputation, their great name. You need to go for weather, location, how big the class sizes are. I’ve talked about a lot of this stuff before, but you really need to go to the schools, get a vibe and see what it’s all about to help you pick the school. There is no such thing as a great premed school. Just go to a school and do your best and you’ll be fine.

Final Thoughts

Alright as I said, I’d love for you to leave me some questions, Ryan@medicalschoolhq.net. Go join our Hangout, www.MedicalSchoolHQ.net/group. You can ask questions in there and I can take some of those questions and bring them into the podcast.

I mentioned it in the last episode that I did all about getting your applications started earlier. I am working with students starting for the 2017 application for acceptance into the class of 2018. Actually it would be the class of 2022, but starting in 2018. That sounds crazy, 2022. My coaching prices are going up in January, I’ve had a bunch of people already reach out to me and start working with me. Actually one person that reached out is not going to start working with me for another year, but obviously wants to jump in on the lower prices. So if you’re interested in working with me one-on-one to help you get ready for your applications, I would love to help you, www.MedicalSchoolHQ.net/coaching for that.

And one other thing, I mentioned it a couple weeks ago, I had an awesome session with the University of Houston Premed Club where I Skyped into their club meeting and answered questions and gave a little bit of a presentation about something- I forget what it was, about interviews I think, and I would love to do that for you and your school. Just reach out to me, Ryan@medicalschoolhq.net and we can try to set that up for you and your school.

Alright I hope you got a ton of great information out of the podcast today, and as always I hope you join us next week here at The Premed Years and Med Ed Media.