Pre-Med Requirements: Part I (Planning and Prep)

Diverse group of pre-med students walking together after organic chemistry class.

This is part one of a two-part series that goes into detail on how to be a pre-medical student and eventually apply to med school. More than just a list, this section is focused on informing the high school, early college and non-traditional student about what U.S. medical school requirements are and how to go about fulfilling them.

We’re going to skip whether or not you should become a doctor. Nor go into a discussion on what a doctor’s life is like; these questions are best discussed with healthcare professionals, friends, and family. Rather, this section will discuss majors, classes, GPA, extracurriculars, letters of recommendation, and of course, the all important MCAT.

Intro: Being Pre-Med

pre-med_student_7653Being pre-med is an extremely grueling road; in college, many of the pre-meds you encounter freshman year will no longer be pre-med by senior year. The infamous “weeder classes” such as organic chemistry, physics and biochemistry discourage many would-be doctors. So, be prepared for difficult classes, long hours in labs, discouraging words from professors, and competition from other pre-meds. Try not to get frustrated by any one grade in a class, or that your friend is taking harder classes than you. The most important thing is to stay focused. Perseverance is the only way to get through the pre-medical track.

The medical admissions process is a game. It’s you versus the other applicants in a contest to see who can distinguish him or herself from the others. Medical schools see too many great applications these days; they have many more qualified people than they have spots in their classes.

While med programs have been increasing resources and subsequently the number of seats available over the years, acceptance rates remain very low due to the growing number of applicants. For example, at Stanford Medical School, in 2013 they received just over 7,300 applications for 196 spots – a 2.7% acceptance rate. (Fourteen years prior the figures were 5,800 and 86, respectively – a 1.5% acceptance rate).

Basically, your job is to make sure you are qualified, and then make sure you distinguish yourself from your peers. Qualifying yourself should be the easy part. That’s done with grades and scores. Distinguishing yourself is what’s difficult.

Being premed is not something done on the side. It can be looked at as a major in itself. Unfortunately, many schools do not have “pre-medical” as an official major, so it is up to you to know what you should do and what classes to take to make the cut and then stand out.

Choosing an Undergrad School

The pre-med high school student should only be concerned with one thing: choosing a college. This is a hard choice for many students, but can be an especially hard decision for pre-meds that requires some additional research.

Acceptance Rates

In choosing a college, you should check into what that college’s record of acceptances into medical school is. You should investigate statistics such as how many pre-meds there are, and most importantly, what percentage of them are accepted to medical school. If the college only has had three pre-meds in the last three years, you can be pretty sure that pre-med advising at that school won’t be as good as a school which sees one-hundred in each class.

Acceptance rate is even more important. If only 20% of applicants get into a medical program from that college, then the college’s advising, reputation, curriculum, or student quality may be lacking. As a note, be aware that acceptance rates only reflect just that, acceptance. With a 20% acceptance rate, 80% of the premeds failed to get into any school. Of the 20% who were accepted at one or more schools, perhaps many were accepted to top tiers or the same place(s) you want to go. Statistics do not lie, but you may have to drill deeper to get more meaningful information.

Pre-Med Advising

While statistics may paint an overall picture of a college’s advising system, there is no better way than to investigate yourself. In the Ivy League colleges, advising usually comes in the form of pre-med tutors and committees who provide direct guidance and advice in curriculum as well as the actual application process. Most significantly, many of these committees provide a large cover recommendation or “committee packet” which summarizes the individual recommendation letters obtained from professors, TAs and other faculty.

At larger, public schools, such as UC Berkeley, there typically are no such advisory committees, and the pre-med may be on his or her own. This is due in part to state schools simply not having the one-on-one student resources that some private schools have. Whatever the case may be, it’s definitely worth your time and effort to do some asking around and find out exactly what kind of advisory structure exists at the college you wish to attend. If you find out the school of your choice has no such formal pre-medical advisement, your sparked interest and motivation may influence a professor to provide mentorship in this area.

Geographical Considerations and Residency

Some private medical schools and almost all public schools select their students based upon geography. Public med schools, especially, see little reason to spend the time and money to train doctors who are just going to leave the area and practice elsewhere after they graduate. For instance, at FSU College of Medicine in Tallahassee, FL almost 96% of matriculants in 2013 were Florida residents, and UC Davis in Sacramento, CA accepted 97% of their class from California residents.

As you can see, residency in a particular state can be of paramount importance when it comes to getting into certain programs. Now, this doesn’t mean you have to attend an undergraduate institution in the same state as where you want to go to med school, but it may help to establish residency as an undergrad if you really want to end up studying medicine in the same state.

Furthermore, it’s important to know that attending college in a specific state does not automatically grant you residency. You must find out what the requirements are to establish state residency, and the requirements vary for each state.

In California, for example (where the UC system greatly favors California residents), you must have a California address and driver’s license, pay taxes in California for over one year, and be eligible to vote in the state.

So, if you’re really set on attending a particular medical program, first research its geographical and residential preferences. Check out AAMC’s record of in-state vs. out-of-state acceptances in 2014 (PDF) for more information.

The Pre-Med Funnel

student-funnelCollege is more than simply being pre-med. It is an experience unto itself, where students are away from their families perhaps for the first time, where they learn what it is to truly be a student, and where they gain independence. It is a time to go away and learn not only about class, but about life. So, with this view, please do not think of college as simply as a “pre-med funnel”. College is a time of growth and not just preparation for medical school.

While you do not want to totally disregard the fact that you are eventually going to school to become a doctor, don’t limit your choice of undergrad institutions just because one school has a slightly better record than another in terms of medical school acceptance rates. It deserves repeating – college is a time to grow; so pick the one you really think is the best fit for you. And once enrolled don’t forget to experience the present while looking forward to the future.

Standing Out in Undergrad

eccentric-studentAs will come up again and again, getting into medical school is all about being unique, and sticking out in the minds of interviewers and application reviewers. Choosing where to attend undergrad is also relevant to this idea of standing out.

Now, realize this: Even Harvard grads have difficulty getting into their top medical school choices because the competition is so stiff. Harvard has so many students with great GPAs and MCATs that medical schools could essentially fill their classes with pure Harvard grads.

But, of course, they don’t wish to do this. Diversity is the key to creating a good medical school class, so adcoms will choose those who stand out at Harvard, and then move on to others schools, and choose who stands out at those institutions.

The point is, many students who didn’t stand out at Harvard would have at other schools. By entering such a competitive academic institution, their GPAs were no longer at the top of the class, and their scores became lost in the crowd. Trying to stay afloat in the sea of top competition, some students get so frustrated that they drop premed altogether.

Don’t let this happen to you!

Many of these students would have been fine doctors, but they let frustration and competition limit their options. Sometimes it’s better to be a big fish in a small pond (less prestigious/competitive school) rather than a small fish in a big pond.

Choosing Your Major

library-study-timeChoosing a major is a difficult choice for any college student. Approximately 80% of students are said to change majors at least once during their college careers. For the non-premed student, the major is usually whatever they believe is easiest or most in line with their interests. But, for the premed student, the question most often asked is:

“Do I have to major in a science to go to medical school?”

The short answer is, “No!” Definitely DO NOT major in a science just because you think it will help you get into medical school. Some argue it’s actually harder to get in as a science major, simply because there are more science majors applying. Your choice of major should be based on pure interest and, ideally, passion.

Pick The Major You Love Most

Choose a major which best fits your interests. If you try to “fit” your interests into biochemistry while in fact they lie with art history, you will just be forcing yourself through the biochemistry curriculum, never explore your passion for art history, and have a miserable time with your studies. Truth is, medical school admission committee’s don’t care what major you are! They really don’t! But, they do care that you enjoy what you do, and most importantly, that you do it well. From your application and interview they can really tell if you are just doing something to get in, or if you are doing it because you love it.

Use Your Major to Stand Out

As mentioned above, majoring in something like biochemistry doesn’t necessarily pose an advantage simply because many biochem majors are premed, and competition is stiffer. Realize that if you choose such a major, then you may “stand out” less and risk being seen as just “another biochem premed.” Of course, if your passion is biochemistry, then major in it! Your passion will shine through and with it good grades and achievements.

If you find yourself interested in biochemistry just as much as you like English or philosophy or government, you may want to consider choosing to double major, or major in the non-science major. Again, getting into medical school today is all about “standing out.” For example, being one of the relatively few philosophy premeds amongst a science-heavy applicant pool may automatically pique the interest of admissions. However, you definitely shouldn’t choose something like philosophy if you don’t love it. Go with the major, whether science or non-science, that interests you most.

Premedical Curriculum

In general, medical schools require one full year each of the following:

  • English Composition/Writing
  • Statistics/Math
  • Biology (with lab)
  • Physics (with lab)
  • General chemistry (with lab)
  • Organic chemistry (with lab)

English/Writing is meant to show the medical school that you can express yourself, if you are science major. The remaining requirements are to show the medical school that you are able to do well in science classes if you are not a science major. Medicine is, after all, a science, so you should feel comfortable with these fundamental science requirements. Each school may have its own special requirements in addition to ones mentioned above, such as 1-2 semesters of biochemistry or upper-level bio coursework, so make sure you to contact the med schools you’re interested in well ahead of time to find out what they are.

Go Easy or Go Hard?

We’ve put together a table showing GPA statistics for students nationwide matriculating into medical schools for the 2014 entering class:

Program TypeMean GPAStandard Deviation (SD)Mean +/- SD
Allopathic (MD)3.690.253.44 - 3.94
Osteopathic (DO)3.430.353.08 - 3.78

This means that approximately 75% of the 2014 M.D. entering class had a GPA of between 3.44 and 3.94, and 65% of 2014 D.O. matriculants had a GPA between 3.08 and 3.78.

Now, here are a couple questions for you. Are you a strong proponent of challenging oneself? Have you always taken classes beyond your reach and struggled a bit, but in the end learned a lot more than you would have than taking easier classes? If you said yes, then you’ve probably experienced how your grades can sometimes suffer with very challenging coursework. But, if you had to do it all over again, you’d still do things the same way, right?

Well, realize this: medical schools would rather see great grades in easy classes than good grades in harder ones. That’s just how it is. Grades are used to determine GPA, and in turn, GPA is used heavily to weed out applicants. Aside from MCAT score, it is one of the only concrete rankings, and thusly carries a lot of weight. Adcoms have no idea what the difference between Physics 160 and Physics 1 is between two universities, or that Dr. Smith’s Orgo 1 class is terrifyingly impossible compared to Professor Jone’s relatively laid back Orgo 1 class at your college. However, they do know that an A is better than a B.

In reality, adcoms are not going to try and weigh if your B in calculus-based physics indicates a better student than another applicant’s A in algebra-based physics. What they’ll see is simply:

  • Your physics: B
  • Other applicant’s physics: A

And, that’s what they care about most: not the class, but the letter grade. In fact, on the AMCAS and AMCOMAS applications, your science GPA, non-science GPA, and overall GPA are given on the front; only upon closer review in the back can one actually see your classes. So, that’s the unfortunate reality of medical school admissions.

Don’t agree with it? We don’t blame you since learning and challenging oneself should be more important than getting slightly better grades, but it’s necessary to understand that you’re playing by a set of very superficial rules – at least when it comes to making the first cut.

For Science Majors

For those majoring in biology, chemistry, or biochemistry, the premedical requirements should for the most part already be integrated within your major requirements. Medical schools may be more forgiving if for some reason you didn’t take, say a second semester of biology, compared to an economics major that’s missing Bio II. Remember, the science requirements are meant to show that you’re able to tackle science without difficulty; by selecting a science major and earning a good GPA, you have already shown that to them.

For physics majors, because this field is more removed from biology or chemistry, you must still take the required classes even if you’ve taken more difficult courses such as physical chemistry. Same goes for engineering, astronomy, and computer science majors; you guys need to take all the premed classes no matter how difficult your respective majors.

For Non-Science Majors

For the non-science majors, you must show you’re capable of successfully completing the scientific work which will be presented to you in medical school. So, you must jump through all the hoops and take all the required classes. You should also take these classes as early as possible! The longer you wait, the longer you have to wait to take the MCAT, and that test is easier to take when you don’t have Senior thesis research or an internship project looming on the horizon. So get the science classes out of the way early, so you can get the MCAT out of the way and allow time for re-taking classes in the summer if needed. Studying for the MCAT while you are trying to write up the AMCAS or AMCOMAS primary wouldn’t be ideal.

Other Classes

You must also do well in your other, non-premed classes. As stated before, adcoms want to see you consistently do well in whatever you choose to do. And, as before, they don’t know or even care what you actually take. Just do well in your classes. Remember, they are more concerned with grades and subsequent GPA than the actual classes themselves.

Postbacc and Non-Traditional Students

Students who pursue premed studies as undergraduates often design their college curricula and extracurricular activities to improve their chances of getting into medical school. An increasing number of graduates, however, many with well-established careers and no previous premed preparation, are returning to school to fulfill the requirements for a successful medical school application.

In recent years, medical school acceptance figures show a growing interest in these older, more experienced candidates – sometimes referred to as “non-traditional students”. Specifically catering to this group, there are well over one-hundred postbaccalaureate or “postbacc” premedical programs that prepare older students to enter the premed race. You can find a list of them (sortable by program focus, state and other factors) at the Association of American Medical Colleges’ Website at https://services.aamc.org/postbac/.

These programs not only supplement a student’s college record with the scientific course work required; most also provide clinical opportunities, MCAT tutoring and career counseling. Admission is based on undergraduate transcripts, recommendations and work experience and, in some cases, volunteer experience or employment in a health care-related field.

Some post-bacc premed programs even offer admission-linkage programs, which accelerate the admissions process by eliminating the usual lag, typically a year, between filing applications and starting medical training. Postbaccalaureate programs boast impressive lists of schools at which their alumni are accepted. So if your favorite medical TV show has you dreaming of wearing a lab coat, it’s not too late to apply.

The MCAT

The MCAT is a test administered by the American Association of Medical Colleges (AAMC), and it is the only true way medical schools can objectively rank candidates. While one may argue that a B at an Ivy League is “better” than an A from your local community college, no one can contest that a lower score is better than a higher score on the MCAT. So, take it seriously. We’re sure you are anyway, but just in case you didn’t realize the importance of the test, know that it deserves your utmost attention and effort.

2015 MCAT Redesign

April 2015 marks the beginning of a significantly restructured MCAT – both in terms of material, structure and scoring. The following table offers a quick comparison of the previous and new versions of the exam.

MCAT changes comparison chart.

Official AAMC MCAT Resources

Here’s a list of essential resources directly from the developers and administrators of the exam that provide all the information you need to know about the MCAT:

Plan on Taking the Test Only Once!

Although you’re allowed to take a crack at the MCAT up to 3 times and it’s not uncommon for people to take it twice, you should really treat it as a “one and done” type deal. Given that you’re completely prepared on test day, then ideally you should only be put in the position to take it again if your test was under abnormal conditions that affected your performance adversely, such as illness, an airshow overhead, or some masked gunman asking for all the exams (which actually happened!). There really is no point in stressing yourself out over another MCAT unless you think your score can significantly improve. And remember, if your score significantly goes down the second time, then you basically just invalidated your higher score.

The MCAT is NOT like the SAT. You are encouraged to take it only once. Unlike the SAT, where students are encouraged to take it twice or three times to validate their scores, medical schools only want you to take the MCAT once. It is not worth the time, stress, or money to retake the MCAT if it is to raise your score by only one or two points. The exception, of course, is if your score is uncompetitively low. Currently, it’s not known what a good or bad score on the new MCAT will be. The AAMC has to wait until the April and May 2015 administrations to receive examinees data and provide meaningful scoring information.

Extracurriculars

Simply getting straight As and an astronomical MCAT just doesn’t cut it any more – at least for top-tier medical schools. Over the years they have stressing more and more that applicants expand beyond simply doing the coursework and engage in extracurricular activities of significant endeavor.

Extracurriculars (ECs) are important for two reasons. First, medical schools want people who are complete, not simply outstanding in the classroom. It gives applicants a chance to show abilities such as compassion or empathy which cannot be demonstrated in class. And second, medical students and doctors are busy people; ECs show that you are able to manage your time wisely.

Some people interpret the extracurricular requirement to mean joining each and every premedical organization at their college, or working in a research lab, because they think that’s what medical schools “want to see.” Others just do what they want to do, be it swim on the varsity team or join a student organization.

This section attempts to clear up some of the myths, and explain some of the realities of what medical schools want to see on your extracurricular sheet.

Desires (What you want to do)

In considering which extracurriculars to do, medical school really shouldn’t take a part in the decision. If you are interested in something, then do it! If you love to play in the marching band or moonlight as an electronic DJ, then do it. If you love writing for a magazine, then do that.

Just like choosing a major, medical schools would rather see you do something you love than do something because it will supposedly “look good” on your application. If you are doing something just for your application, then think again. Your time is wasted if you list ten activities on your application only to have nothing meaningful to say about them.

Furthermore, when you get to an interview, and the interviewer asks, “Tell me about so-and-so” and you have nothing constructive to say, it doesn’t look very good. So don’t do things you don’t really want to do. If you have a passion for something, then go for it.

If it’s just to put in down on your primary application, then skip it. Adcoms can see right through that kind of superficial extracurricular effort.

The only concern regarding your ECs, which is a significant one, is that you shouldn’t participate if you will significantly adversely affect your GPA.

Example: Varsity Sports

If you’ve ever played on a varsity team, then you know the demanding schedule involved. You often wake up early to train, and practice five or six times a week for two hours each. During the season, you may travel up to half of the weekends. With all of this, the time commitment can reach upwards of 30 hours a week! This means you will have no time for anything else, and little time for lengthy study sessions.

Remember that extracurriculars are secondary to grades and MCAT. You do not want to be sacrificing your grades for your sport. Make sure your priorities are straight. Getting to medical school is tough enough already; don’t make it harder by lowering your GPA.

Pre-med student that plays soccer.Preparing to become a doctor involves being prepared to make the necessary sacrifices to do so. Sports will only be the first of many such sacrifices. You may be able to be pre-med and on a varsity team in college, but there is no way you can successfully compete in a scheduled amateur (not recreational) or professional sport in medical school, much less in residency.

The prospect of giving up something which has been such a part of your life is frightening, but realize that you will be taking on a whole new challenge as a physician. It will be time to move on sooner or later, and by playing sports in college, you may be jeopardizing your future as a doctor. These are discouraging words, but realize that college-level sports or any other such time-intensive activity may adversely affect your grades and subsequently lessen your chances of getting in to medical school.

Now, if you decide that sports are important enough for you to play throughout college, then make sure you can handle the workload. Stay focused on the ultimate goal, and evaluate your situation once in a while to make sure your long-term goal of medical school is not being jeopardized. If you realize one day that your grades are terrible because you have no time or because you are constantly exhausted from practice, maybe it’s time to call it quits.

Remember, do you want to be a pro athlete or a doctor? You’re going to have to give one up.

Sure there are some students who made it through four years of varsity and went straight on to medical school without a hitch. But, these are unique cases. They were very committed both to their sports, and to being premed. In any case, think twice before playing sports. Make sure it’s not going to cost your grades and your future as a physician.

Realities (What you should do)

home-health-volunteerThere really is only one thing that’s absolutely necessary as a premed extracurricular and should be made a top priority:

GET CLINICAL EXPERIENCE!

You need to be able to answer questions like, “Do you know what it’s like to be a doctor? How do you react to sick people? To dying?”

It is vital to have first hand experience with people requiring health care, so that you may answer these difficult questions intelligibly.

This does not necessarily mean you have to work in a hospital or even being a volunteer. But, you definitely have to get some kind of exposure to clinical medicine, either by shadowing a doctor, observing in the OR, visiting with elderly or handicapped persons, or other such contact.

You must prove to the admissions committee that you know what it is like to work with the sick, aged, and infirm. If you don’t get some exposure, then you’ll be stuck when an interviewer says, “How do you know you want to be a doctor when you’ve never been in a position to see what one does?”

Myths (What you don’t have to do)

Having experience working in a science laboratory or hospital IS NOT required to get into med school. While it can help more or less depending on where you apply, don’t believe the hype when you hear that one or more of these is NEEDED to get in.

Myth 1. The Lab

lab-assistantMany science majors, especially those in biochem, chem, and bio, believe that you must work in a lab as an extracurricular for medical school.

This is not true!

Work in the lab only if you want to (or have to for your thesis requirement). It’s quite common for pre-meds to work in lab at their school that it may not even be much of a distinguishing characteristic on your application.

While working in lab is a significant and rewarding EC that shows commitment to science, it is by no means required. Though, if you have and are asked about it during an interview, be enthusiastic, even if you disliked the experience. You definitely don’t want them to think you worked in lab just to put it down on your app and for the recommendation letter.

Myth 2. The Hospital

cna-nurseAs was stated above, getting some clinical experience is essential, but specifically working in a hospital is not. Hospitals are another place dominated by premeds, and just like the lab, you’ll look like everyone else.

Furthermore, hospitals will often only allow volunteers to transport patients, answer phones, or do clerical work such as filing papers. This is hardly a clinical experience.

It is much more rewarding (and exciting) to find other clinical opportunities such as at hospices, rehabilitation clinics, private practices, or nursing homes where you may have more opportunities for patient as well as physician interaction. Be creative in getting your clinical experience!

Recommendation Letters

Letters of recommendation (LORs) are another key component to the application. Although this is part of the application process, which is covered in Part II, we are going over it here since it’s during the prep phase that you cultivate relationships with the people who’ll be recommending you. By the time you get ready to apply all you can do is ask for them (if not already prepared) and send them off.

LORs are a way to show the admissions committees that other people respect your abilities and your work. It is also a forum to give testimony of certain skills and traits which cannot be shown on the MCAT or your transcript, such as your desire to help people or ability to persevere through struggle. Applicants may submit anywhere from three to eight letters, although five or six is the norm. This section will cover how to “cultivate” letters of recommendation, the recommendation portfolio, whom to ask, and how to ask.

Establishing Relationships

The rule to remember about letters of recommendation is that you want them to be personal. The longer and better you know someone, the more eloquent and personal the LOR will be. Ideally, you want to have a good relationship with a professor, physician, or someone else highly respected who can truly attest to your abilities. One way this is done is in the lab, where mentors are called upon to attest to the scientific capabilities of a student. But, this is not the only place to establish such a relationship.

If you are volunteering in a hospital, nurses or doctors you meet may be able to attest to your abilities. If you are on an athletic team, a sports coach is a good person to ask for a letter. The point is, you want your recommenders to know you well, and not just superficially. The worst recommendation to get is one from a big name professor which basically states:

Dear Sir/Madam,

John Medbound was a student in my class of 600 students. He received an A for his fine performance. His TA states that he was a great student.

Sincerely,

Arthur Nobleman, PhD
Professor of Everything, UMass Amherst

Essentially, this recommendation states nothing. The admissions committee already saw on your transcript what you received for a letter grade. Although no letter of recommendation would ever be so short, there is nothing further the professor can truly say, because he never knew the student.

The Recommendation Portfolio

So, what kind of recs should you get? The key here is diversity. Your letters should reflect you as a whole person. Just as medical schools want to see a complete, well-rounded applicant, they also want to see a well-rounded recommendation portfolio. You don’t need five letters saying that you’re a genius in science. Two are probably enough. You also don’t need five letters saying you write like Thoreau. Ideally you should have letters which cover these aspects:

  • Your communication ability, especially if you are a science major
  • Your scientific prowess, especially if you are a non-science major
  • Your ability to care for others (this is your clinical experience letter)
  • Anything else you spent time doing (sports, music, writing, jobs)

Anything you spend time doing, you should be able to get a LOR for. This is something that should be on your mind early on. If you worked in lab, you absolutely should get a letter from your mentor. If you worked with a volunteer program providing food to the homeless, get a letter from your supervisor.

If you don’t get a letter for something you’ve been spending a lot of time on, adcoms may notice, and that is not good! They will wonder why you didn’t get a letter, and assume that you didn’t think it was valuable or important enough, or that you didn’t do a good enough job to merit a recommendation!

If you play a varsity sport, definitely get a letter here. These letters are often the best because they show that you can manage your time, and that you are a team player, or succeed in effort where you might lack in ability. The best letters from a coach usually go something like this:

Although never the star of the team, Jane made up in heart what she lacked in ability. Her leadership and effort on and off the field led her teammates to choose Jane as team captain…

Med schools love that kind of letter, and surely some of you fit into that category. They love to see someone overcome adversity and persevere.

Afterschool jobs are another great place to get letters. Medical schools love to see someone who can handle school and supporting oneself financially. Get one from your boss or manager which says how great you are at leading the team, or being part of the team, or managing your time.

The TA or the Prof?

This was already covered previously, but I want to touch upon it once more. The key to any letter is for it to be personal. It is much better to hear a personal testimony of your abilities or qualities from a graduate student than a superficial letter by a big name professor. Letters such as the above example from Professor Nobleman are essentially non-letters and will be wasted in your portfolio. Don’t get one of those. If you want to get to know a professor better, sit down with him or her at lunch to talk about things. Email him or her. Go to office hours. This is part of the cultivation part, and might have to be done if you don’t have another one-on-one situation with a prof such as lab research. Don’t suck up, but express interest and impress. Get to know a prof. If you can’t, then get to know your TA, and get your TA, not the prof, to write you a letter.

How to Ask

When you ask for a medical school recommendation, you basically want to ask the person, “Do you feel comfortable writing me a STRONG letter of recommendation for medical school?” If he or she does, then great! You’ll get a smile, a “Sure thing!” and you’re all set. If not, then the vast majority of people will say, “Perhaps you should ask someone else.” If you state your request something like, “Can you write me a letter of recommendation?” more often then not you will get a positive reply, but you have no guarantee that it will be a good letter. Make sure you word your request such that there is no doubt that the letter will be strong.

Also, there is nothing wrong with asking your recommender to tailor the letter somewhat. You can let him or her know that you already have two people writing about your science, and that you’d like the focus to be on your personal qualities, or on your interpersonal communication ability. Of course, if you ask a sports coach or music teacher, it is pretty clear that he or she will write a letter accordingly, but it never hurts to make sure.

One Final Note

Generally you will be asked to give your recommender a waiver form. You will either waive your right to see the rec, or not. By all means, waive your right to see it. Many medical schools will not consider as heavily a rec which you have access to. The recommender may be compromised in writing it, because he or she knew you will read it. However, by waiving your right to see it, it does not mean that you cannot see it. Many professors will give you a copy if you ask. If you are too put off to ask, then you should find a way to get a look at it. One way is to ask for multiple copies for scholarships, and then read one. Sounds unethical, but you’re not going to change anything… just screen it out if it doesn’t help you. You have a right to know exactly what is in your application.

It’s important to know what your recommenders are saying about you. You spend days or weeks with your application and hundreds of dollars, possibly thousands, on it, why would you just blindly send something out without knowing what it says? There are stories of people getting to interviews and then being asked, “Your recommender says that you should not go to medical school. What do you think of that?” Aside from leaving you looking like a deer in headlights, your interviewers will think, “Geez. He’s supposed to get a good LOR, and the best he can do is get someone who writes that he shouldn’t be a doctor?”

Taking Time Off After Undergrad

More and more people are taking time off before medical school. Some take time off while in college. Others do it after college. More applicants these days are considered “non-traditional.” That is, they are not straight out of college, but have worked for a bit, or even been through law school or grad school.

Using Time Off to Your Advantage

First, if you are not sure you want to go to medical school, you should take time to figure it out. The last thing you want is the stress of the MCAT and the cost of applying only to find out that you truly dislike working with sick people.

Second, time off gives you time to beef up your application. The majority of people work in labs, take on research opportunities and/or take premed classes as post-bacc’s, but you can travel or do just about anything you can think of. Of course, the more medically-related, the better, so don’t just work retail for a year. Use the time off to ultimately make your application better.

And finally, time off allows you to distinguish yourself by being unique. Some of the best applicants are those who spent time abroad doing medically-related work. Some examples include going to Kenya to work in a hospital, working at an AIDS clinic in Thailand, and shadowing a surgeon in rural Brazil. Of course, all this requires money which not everyone has, but in today’s medical application race, often the best way to stand out is not just to volunteer in the nearest underserved area, but to volunteer in an underserved area in another country.

As previously mentioned, volunteering at all isn’t required, but the truth is traveling abroad is one of the best ways to get noticed and stand out. For example, if your particular experience piques the interest of an adcom to the point he or she wants to genuinely hear about your time serving people in another country, it could be the tipping point on your app that gets you the interview.