ADMISSIONS

 1) The Journey to Medical School -- Before Applying
1.1) What is an MD?
1.2) What is a DO?
1.3) What are the prerequisites for medical school?
1.4) What is the MSAR?
1.5) State school or Ivy League for undergrad?
1.6) Which major should I choose?
1.7) Is admission to medical school competitive?
1.8) Do I have to do research?
1.9) Do I have to have clinical experience?
1.10) How old is too old?
1.11) How high does my GPA need to be?
1.12) I completed college without finishing the pre-med requirements, and I want to apply to medical school. What do I do now?
1.13) What are some good sources of information about medical school and medicine?

Subject: 1. The Journey to Medical School -- Before Applying

1.1) What is an MD?

An MD, or Doctor of Medicine, most simply is a person who has graduated from a medical school. An MD can have many and varying roles in the community. First, an MD is a caregiver, a person turned to by members of the community in times of physical, psychological or emotional weakness. MDs treat not only the body but also the mind and the spirit, often delving into the emotional, psychological or social reasons behind a physical illness. MDs treat people in inpatient settings, in the operating room, outpatient clinics, and in emergency room visits.

Not all MDs, though, deal with patients in such a direct manner. Pathologists deal with diseased tissues taken from the patient as well as clinical laboratory and blood bank settings. Radiologists deal with images of the patient produced and enhanced by various imaging technologies. Some MDs choose to concentrate their efforts solely on research, developing new equipment, vaccines, drugs, or discovering the underlying causes of disease. MDs can devote their time to teaching, both in a classroom setting (in a medical school, for example) and in the community (teaching preventive methods to community members, teaching CPR or first aid, or administering vaccines).

Becoming an MD opens up to you a vast number of possibilities for using your medical training. MDs serve the community in many more ways than just seeing patients, prescribing drugs, or performing surgery. If you say to yourself, "I'm not a people person, so I'd make a lousy doctor," keep in mind that there are ways to use your interest in medicine to benefit the community without seeing patients on a day-to-day basis.

1.2) What is a DO?

Doctors of Osteopathic Medicine (DOs) are the legal and professional equivalents of Doctors of Medicine (MDs). They are licensed to practice medicine in all 50 states and use all conventionally accepted therapeutic modalities such as surgery, radiology, and drugs. They are eligible to enroll in all federal programs, managed care and insurance plans, serve as commissioned medical officers in all branches of armed services, and serve as public health officers, coroners, insurance examiners, and team physicians. In other words, they practice complete medicine and surgery. Only DOs and MDs can do this.

DOs represent about 5% of the country's physicians and provide care for approximately 10% of the patients. This is because higher proportions of osteopathic medical graduates enter into primary care residencies after graduation compared to their MD counterparts.

Andrew Taylor Still, MD founded osteopathic medicine in the late 1800's in response to what he thought was poor medical practice at that time. He based osteopathic medicine on the following principles:

1) The structure of the body and its functions work together, inter-dependently.

2) The body systems have built-in repair processes which are self-regulating and self-healing in the face of disease.

3) The circulatory system provides the integrating functions for the rest of the body.

4) The musculoskeletal system contributes more to a person's health than only providing framework and support.

5) While disease may be manifested in specific parts of the body; other parts may contribute to a restoration or a correction of the disease.

The preparation and training of DOs is nearly identical to the training of MDs. Admission prerequisites and curricula are very similar. DOs can sit for the MD boards if they are interested in pursuing a MD residency after graduation.

The primary difference in their education is that DO students complete an additional 200-300 hours of training in osteopathic manipulative medicine (OMM). OMM is a modality used primarily to treat musculoskeletal problems and overlaps in its scope with Cardiology and manual medicine techniques. Also, DO schools place more emphasis on producing primary care physicians than do some MD schools. This means that during their clinical years, students at DO schools spend more time rotating through primary care specialties such as family medicine, pediatrics, obstetrics and gynecology, internal medicine, and psychiatry. Nevertheless, specialty training isn't out of the question for DOs. Many DOs seek and obtain residencies in surgical and non-surgical specialties.


1.3) What are the prerequisites for medical school?

All medical schools require a baccalaureate (BA, AB, BS, or equivalent) degree, with rare exceptions. The usual course prerequisites for both MD and DO schools are:

1 year of Biology or Zoology (with lab)
1 year of Inorganic Chemistry (with lab)
1 year of Organic Chemistry (with lab)
1 year of Physics (with lab)

Some schools require english, humanities, calculus, or biochemistry as well. Check the book "Medical School Admission Requirements" (cf1.4) for each school's particular requirements.

The one year of Physics need not be calculus-based, although many colleges offer only the calculus-based class.

There is disagreement over whether prerequisites may be taken at community or junior colleges. To be sure, contact the individual schools to which you plan to apply.

Many students finish their undergraduate degrees without completing the medical school prerequisites. Some of these students choose to take the courses at their local public college or university, while others enroll in more formal "post-baccalaureate" programs, where the classes are taken full-time over approximately a year.

1.4) What is the MSAR

The book "Medical School Admission Requirements," or "MSAR," is often considered the premedical student's "bible." Published by the Association of American Medical Colleges (AAMC), it contains information on premedical requirements for each of the MD schools in the US and Canada, as well as information and statistics about admissions, financial aid, and minority student issues. Many questions not answered in this FAQ will be answered in the MSAR. It is revised each April, so make sure you get the most recent edition. You should definitely get this book if you are considering medical school.

1.5) State school or Ivy League for undergrad?

In general, whether you attend a well-known school or a relatively invisible school is not important. What is important, however, is doing well at whichever school you decide to attend. One thing you may want to keep in mind is that doing well at a prominent institution goes a lot farther than doing well at a lesser-known state college. Choose what you are most comfortable with, not what you think the medical schools want to see.

1.6) Which major should I choose?

According to the Association of American Medical Colleges, a premedical student may select any major he or she chooses, provided that he or she completes the prerequisites for medical study (cf 1.3). The most important thing is to select a major you enjoy, as this would allow you to master the subject. Medical school admissions committees want to see students who master their major fields of concentration in college, and many medical schools enjoy receiving applications from students who have studied areas outside of the sciences. Acceptance statistics broken down by major are provided in the MSAR (cf. 1.4).

1.7) Is admission to medical school competitive?

Medical school admissions has always been competitive, as there are always more applicants than there are seats. In recent years, however, admissions has become even more competitive as the AAMC has logged a record increase in applications which hit a peak of approximately 45,000 applications during the 1995-1996 cycle, which represents a ratio of about 3 applicants for every medical school seat. Since then the number of applications filed has slowly declined.

1.8) Do I have to do research?

Absolutely not, but doing research does help to demonstrate analytical skills in scientific investigation which are helpful for practicing physicians. There are many medical students who have never stepped inside a lab outside the prerequisite lab courses, but at the same time, many people feel that with increased competition for medical school seats, research experience is a much-needed notch on the applicant's belt.

1.9) Do I have to have clinical experience?

Gaining clinical experience as a premedical student is rather important as it can show that your decision to want to go to medical school is well-rooted, and not coming out of left field. Gaining clinical experience, however, means different things to different people. Simply volunteering at your local hospital may not be sufficient, as these volunteer opportunities often have you do tasks very unrelated to medicine (e.g. filing, faxing, copying). Look for "Health Career Opportunity Programs," or other such internships designed for premedical students, so that your valuable premedical time is not wasted in a second-rate program. If your school has a "premedical internship" program, take advantage of it.

1.10) How old is too old?

It may not be too late. Students in their 30s and 40s are admitted to many medical schools. Anecdotes about students in their 50s have been posted on misc.education.medical. When making your plans, keep in mind that the shortest amount of time from entering medical school until exiting the shortest residency (general internal medicine, general pediatrics, or family practice) is 7 years.
1.11) How high does my GPA need to be?

Perhaps every premedical student has heard tales of the 3.9 GPA Phi Beta Kappa applicant getting into every medical school he or she applied to, and of the 2.5 GPA student applying to medical school without a prayer, but there is a little more to the GPA issue than just getting above a certain mark. GPAs will vary depending on the competitiveness of your school, so if you attend a world-renowned institution such as Harvard, your GPA will be calculated based on competition with an intense student body.

If you attend Acme State University, where there is a major in bartending, your GPA will be calculated based on competition with a slightly less intense student body. Generally, however, a 2.3 at Harvard is still pretty bad and probably not as good as a 4.0 at Acme State, and we can guess that perhaps the Harvard student is not going to get into medical school. So what are the generalities we should look at when determining whether our GPAs are good enough for medical school? Some premedical advisors say that if your GPA is 3.3 at a good school, you have a 20% chance for admission. Others will say having a 3.5 to 3.6 is the requisite GPA, but if you keep it as high as you can, you should have no problem (so try to keep it above 3.3!).

1.12) I completed college without finishing the pre-med requirements, and I want to apply to medical school. What do I do now?

There are a couple of options. You can enroll at a local college or university as a non-degree student and simply take the prerequisites. Additionally, you might consider enrolling in a formal post-baccalaureate pre-medical program offered by many of colleges and universities in response to an increasing number of students changing careers into medicine.

1.13) What are some good sources of information about medical school and medicine?

RECOMMENDED AUTHORS OF BOOKS ABOUT MEDICINE

Lewis Thomas, MD
Sherwin Nuland, MD
David Hilfiker, MD
Perri Klass, MD
Oliver Sacks, MD
Robert Marion, MD
David Ewing Duncan

BOOKS ABOUT MEDICAL SCHOOL ADMISSIONS

There are many books on this subject (too many to list), and quality varies widely. For an exhaustive list, try doing a search on "medical school" at an online bookstore.

Association of American Medical Colleges (AAMC)  http://www.aamc.org
Liaison Committee on Medical Education (LCME)  http://www.lcme.org http://www.lcme.org
National Board of Medical Examiners  http://www.nbme.org http://www.nbme.org
Federation of State Medical Boards  http://www.fsmb.org http://www.fsmb.org
United States Medical Licensing Examination (USMLE)
 http://www.usmle.org http://www.usmle.org 
American Association of Colleges of Osteopathic Medicine (AACOM)
 http://www.aacom.org
American Medical Association (AMA)  http://www.ama-assn.org http://www.ama-assn.org