Q&A Session on LORs, MCAT, CASPer, Applications, and More!

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PMY 439: Q&A Session on LORs, MCAT, CASPer, Applications, and More!

Session 439

In this week’s IG Q&A, I answered many questions about DO Schools, International Applicants, extracurriculars, and so much more!

For more podcast resources to help you with your medical school journey and beyond, check out Meded Media.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[00:35] The MCAT Minute

Blueprint MCAT‘s live online course is now available with their amazing features and amazing instructors to help you score higher on the MCAT.

If you need the accountability to do well and get your prep done, go check out the new live online course from Blueprint MCAT over at blueprint mcat.com.

Now, how do you know you’re ready to take the MCAT? This is a hard question for everyone because no one ever feels prepared to take the MCAT. What you have to do is trust your preparation. Plan the work, work the plan.

Use Blueprint MCAT’s Study Planner Tool that you get for free to help organize your study plans. Select a date and put in when you want to take the test and when you want to take your full length exams. And let their magical algorithm tell you what you need to do every day. And because sometimes life happens, with a simple drag and drop interface, you can reschedule everything that you need to do.

'The fear and the anxiety around when to take the MCAT – that's really hard. So take it when you feel prepared. Don't rush it.'Click To Tweet

If you don’t feel you’ll be ready and if your preparation shows you won’t be ready, then sometimes the best answer is to delay the MCAT and delay applying to medical school.

[02:40] Submitting LORs

Q: When should I tell my LORs to have their letters? How do they submit?

A: There are a few things to think about. If you want to start having your letter writer submit their LORs right now, then you need to use a service like Interfolio. We’re hoping to have this kind of feature on Mappd hopefully soon as well. But if you want the letter writers to submit their LORs right now, before applications open up, you need to submit them through Interfolio. Or there are a few other third-party services that you could potentially use that interface with the application services.

If you don’t want to use Interfolio because it costs some money to transmit to the application services, you can check with your pre-health office. Sometimes your pre-health office will use services like Interfolio so they’ll have their own in-house service to handle LORs for you.

Wait until the application season opens up in the beginning of May. And then go through the application service. Fill out the LOR forms or requests and let the application service tell the letter writers to submit it to them.

And then the writers will then have to upload them directly to each of the application services you’re applying to. That means if you’re applying to all three services, then they will have to submit to each of those. Whereas with Interfolio, they only have to submit one and Interfolio will handle the rest for them.

[05:25] MCAT Score, Credit Hours, Research

Q: Why do you U.S. medical schools barely accept people when there is predicted to be a large shortage of doctors in the coming years?

A: The facilities only will hold a certain number of people. And residency spots only have a certain number of spots. We only have enough seats for people to train. So that is just the way it is.

Q: Should I still apply if I got a low MCAT score? 

A: It depends on what low is. If you have a 495, probably not. If you have a 505 and you think that’s low, that is actually a decent score. It’s not amazing. The average is about 511.4 for AMCAS. It’s close to that for TMDSAS, and a little bit lower for DO schools. It’s all relative.

DO stats are lower and there are good reasons for that. But it doesn’t mean DO schools are worse, therefore, you can do worse on your stats and still get in. Again, depending on the rest of your application, a 505 is potentially good enough.

Q: How do med schools look at the last 30 credits of undergraduate courses?

A: They look at it as if that’s your trend. Check out Application Renovation, where recently, this student had an amazing upward trend. The last 50 hours of his undergraduate coursework was a 4.0. His total science GPA was only a 3.35. And so, he had some issues, figured it out, and crushed it. So what’s very important is your story. What’s the story of those numbers? What does your trend look like? 

Q: I don’t like research. I don’t have a lot of research experience, but I have a lot of experience in a pharmaceutical company. Is that okay? 

A: Do what you want.

'Don't force yourself to do something that you don't enjoy just because you think it's required to get into medical school.'Click To Tweet

[10:49] GPA vs. MCAT, Activities, & Upper-Level Courses

Q: Can a high MCAT score outweigh poor GPA?

A: It’s a very common question. A good GPA doesn’t outweigh a bad MCAT score. A bad MCAT or good MCAT score doesn’t outweigh a low GPA. At the end of the day, medical schools have a rubric as to what is acceptable to them MCAT-wise and GPA-wise.

That being said, a higher MCAT score will always help you. A higher GPA will always help you.

Q: Do medical schools care if I do extracurriculars in college?

A: They do care. They want to see that you’re getting experiences for you. You need to do those for you to prove that you want to be a physician and to prove that you like to be around doctors and patients. And to show that you’re putting yourself out there.

Q: Tips for preparing for the MCAT 

A: Listen to The MCAT Podcast and The MCAT CARS Podcast. Also, get a copy of my new book, The Premed Playbook: Guide to the Medical School Application Process.

Q: How would you describe your experience with the Air Force scholarship looking into that? 

A: There are actually a number of episodes that we’ve done about the HPSP Scholarship.

Q: Do you know clinical jobs that don’t require certification?

A: A lot of clinical jobs, unfortunately, require certification. Check your state because in Colorado, for instance, you don’t have to have a certificate to be a medical assistant. You can just get on the job training.

Q: As a nontrad, does taking upper level courses after my official postbac further display academic ability? I want to be as competitive as possible and the classes are at my dream medical school.

A: If you’re nontrad taking upper level courses after an official postbac, then that depends on how you did in your postbac. If you got a 4.0, then you don’t have to further show academic capability. At some point, it’s like you’re either good enough or you’re not. And so proving that you’re still good enough after you’ve already proven that you’re good enough would just be a waste of money.

Q: What would be a good amount of hours to volunteer to research for medical schools?

A: There’s no number, unfortunately, So just do what you can do.

[16:45] International Students

Q: Any tips for international students? 

A: There are lots of problems and complications that come from being an international student. The biggest one typically is finances. Because you’re not available for federal loans here in the U.S., medical schools will require either four years of tuition upfront or one year upfront. Or they would require a cosigner for private loans, or whatever that potentially looks like.

The second potential issue is where you did your undergrad. Medical schools want your undergrad done here in the States, or at least typically 90 hours. There are some variations in that. But continue to check that out.

Q: How to get into space medicine?

A: Aerospace medicine is typically what you need to look into through the military aerospace medicine residencies. When I was a flight surgeon in the Air Force, I got to go to a space center in Houston. We got trained by NASA on how to respond and what to do with the astronauts when they landed and everything else.

[21:11] Letters of Recommendation

Q: What should LOR writers include on the letter? How is it different for MD and DO?

A: Look at the requirements for different application services. Generally, it has to be on letterhead, has to be dated, and has to have a signature. And that’s really the core thing. If you go through the application services, each of the application services will email. Or you can print out a request form for the letter of recommendation, and it’ll have all the instructions on there.

Q: Is it a good idea to buy all the MCAT books to help familiarize myself with the material for the MCAT?

A: Science doesn’t change. For the most part, books are just being tweaked from year to year (i.e. different graphs, updated graphs, fixing typos, etc.)

“A very easy way to save some money on MCAT prep is to buy old books.”Click To Tweet

[22:19] Canadian Applicant & Choosing a DO School

Q: Canadians applying to U.S. medical schools?

A: You have to find the schools that are Canadian-friendly. Some schools will actually not consider you an international student. They would just consider you an out of state resident than not an international student, which obviously is a huge advantage compared to “international students.” So you just have to do some research and find out.

Q: How do we choose DO schools since there’s no MSAR for DO?

A:  The MSAR or the Medical School Application Requirements is for MD schools, but it isn’t how you should pick medical schools anyway.

“You shouldn't pick medical schools using the MSAR.”Click To Tweet

Every student does this wrong. They go to the MSAR to pick schools but that is not how you pick schools. Check out episode 437 where we talked about how to build your med school list. But to your point, there is an MSAR equivalent for DOs called the Choose DO Explorer.

[24:16] Activity List, Leave of Absence, Residency Abroad

Q: I did undergrad in four universities. I was in two clubs at each university. How should I put on AMCAS?

A: There are 15 spots for your activities on the AMCAS so you could do that or you could combine them.

Q: How do medical schools view a leave of absence in undergrad due to family illness but came back strong and 20 credits?

A: Medical schools understand that life happens. Some medical schools will ask in a secondary application – Did you have any breaks in your education? And so, you could tell them what it was. They’re only going to care about how you responded and what happened after that.

Q: Is it possible to do medical school in the U.S. and then do internship and residency out of the US? 

A: My guess is no because the educational system is different in other countries. The closest educational system to ours in terms of medical training is Canada. You go to college, you go to medical school, and you do your residency training. In most other countries, medical education is right out of high school. You don’t do college and you just go right into your medical school training. And so it’s a much longer process, and there are residency training spots.

[26:11] Retaking the MCAT and Neurodiversity

Q: How long should there be a gap between two MCATs?

A: As long as you need. Some students crushed their MCAT prep with 515 517, and did great on the AAMC practice exams. They go and take their real test, and they have a panic attack, and they get a 505. That student could immediately turn around, register for the next open test in three weeks, and go and crush it. They just need to manage their anxiety, but they have a high test score inside of them. They’ve already proven it to themselves that they can get a good score. And so that student can take the test immediately.

Another student may get a 494, which is equivalent to what they were getting on their practice tests. That student shouldn’t turn around and take another one in three weeks. That’ll just show medical schools that you don’t know how to really process challenges and think about the process. So don’t do that. Therefore, it’s going to be really dependent on your specific situation.

Q: Do you think it’s harder for people with autism, ADHD, dyslexia, etc. to get accepted into medical schools? Or is it as challenging as with others, if it’s mentioned?

A: You need to make sure you’re getting proper treatment, proper care, proper therapy, whatever it is, for what you’re dealing with. And then make sure that you’re getting the support you need at each of the institutions.

Unfortunately, the AAMC is horrible with accommodations for the MCAT. They make you jump through so many hoops. They treat it like a medical procedure.

“The biggest challenge with neurodiversity is going to be making sure that you have the accommodations necessary to do well in your classes in undergrad.”Click To Tweet

So make sure you get the support necessary to do well in your classes, to do well on your tests, to do well on the MCAT. And then continuing that support in medical school as well.

Now, in terms of talking about it in your application, just know that there are personal biases and stigma that still exist out there.

These are human beings reading applications. And so as much as possible, don’t give them a reason to reject you. If you can talk about challenges you’ve had in schooling or whatever else without kind of calling yourself out, do that.

[31:16] DO vs. MD

Q: Should I apply to only DO schools or would that limit my chances? 

A: DOs markets themselves as this holistic philosophy but it’s a marketing gimmick that they have. Maybe they teach it a little bit earlier in medical school in terms of how to take care of patients a little bit more holistically.

The thing that I love about osteopathic medicine is the hands-on approach, being able to use your hands and fingers to feel what’s going on. I’m a huge believer in soft tissue manipulation, making sure that things are aligned and massage and popping and cracking and all that kind of fun stuff.

DO equals MD and MD equals DO. You can get trained on that kind of stuff as an MD if you want as well. 

“At the end of the day, go to a medical school that you think will help you be the best you possible.”Click To Tweet

[33:44] Out-of-State Applicant, Clinical Experience, and MCAT Prep Time, LORs

Q: What best tips do you have for those applying to Texas schools as an out of state applicant?

A: Have as high of an MCAT score as possible and as high of a GPA as possible, and a crap ton of clinical experience. Being an out-of-state applicant to Texas Medical Schools is really hard. And they have the ability because they are very limited in the number of seats to pick the best of the best of the best of the best. So do what you can do.

Q: What is the ideal length to study for the MCAT?

A: Three or four months but as long as you need.

Q: Does being a behavioral technician to autistic children count as clinical experience?

A: 1,000%.

Q: How much of a concern is it If only two out of four of my letter writers really know me personally?

A: That’s a big problem. Your letter writers should be able to speak about who you are as a person. They need to be able to write about who you are, your strengths and weaknesses, and personality and where you line up, core competencies and all that kind of fun stuff. So try to find people who know you know.

Q: When do you think we should take the CASPer?

A: As soon as possible. It’s going to be part of most schools’ secondary application process. So the sooner you can take it, the better, just to get it out of the way.

[37:15] Looking for Unique Extracurriculars

Q: What unique extracurriculars are out there? 

A: The unique part of all of this is who you are and how the experience impacted you and how you impacted the experience. That’s the unique part for everyone. And that’s why I harp on telling stories and narratives in your experiences, because that’s where the uniqueness comes out. If you just list job duties, you can’t be unique. Because everyone does the same thing in the same type of job.

'Narratives really help you explore the uniqueness of who you are.'Click To Tweet

Q: What do you recommend for extracurriculars in college that will give me great medical experiences? 

A: You need something that will put you around patients. You can volunteer in the ER or be a medical assistant. You can be a respiratory therapist, an anesthesia tech, an ER tech, an EMT, or a phlebotomist.

You should not be looking at all these different opportunities as is this going to help me? Is this going to look good on my application? Is this going to help me get into medical school? Is this going to help me stand out?

The question you should be asking yourself is, do I want to do this? Is this something that I feel I will grow from? And if you’re just doing it to stand out on an application, then don’t do it. Because that’s how it’s going to look and that’s how you’re going to treat it.

'Treat these experiences as life-altering experiences for you personally to grow as a human being not to check a box on an application.'Click To Tweet

[44:37] Out of State, Clinical Experience, and Listing the Hours on Your Activity List

Q: What public schools accept out of state?

A: A lot do, you just have to do your research.

Q: I worked as a physical therapy aide for many years at various locations and with different populations does that count as clinical exposure?

A: 1,000%

Q: How do we project the hours on AMCAS? I’m starting a scribe job in May but still want to apply early?

A: AMCAS specifically tells you to project out dates and hours. So date would go out to estimated med school start and then estimate hours. Some schools will say don’t do that. Some people will tell you put it as a separate line. I don’t recommend that either. Just do one block and estimate the hours.


Meded Media

The Premed Playbook: Guide to the Medical School Application Process

Follow us on IG @medicalschoolhq

Blueprint MCAT


Application Renovation

The MCAT Podcast

The MCAT CARS Podcast


HPSP Scholarship



Choose DO Explorer