The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Thursday, May 17, 2007

Medical School Applications

Although it feels like it's been decades away for me, applying to medical school is an experience that is fairly fresh in my mind. I consider myself an expert when it comes to medical school applications. Why? Not just because I went through the process three times, but because each time I further refined my application until it was exactly what the medical schools were looking for. Then, I sat on applications committees. I read applications and personal letters. I interviewed applicants. And after all that I can honestly say that if I knew then what I know now, it would have saved me time, money, and possibly a degree or two.

Since I have frequently been asked for advice on the topic, I'm giving it here. Free of charge. But my experiences are with the Canadian system and I've been around the block enough times to know that the U.S. system is a whole different ball game, so my American readers are out of luck.

Now this is just my advice based on my experiences, and if you think that following this advice guarantees you a spot then you're too stupid to be a doctor anyway. Just don't sue me.

Dr. Couz's Guide to Canadian Medical School Admissions

Step 1: Go to School

This is easier than it sounds. Go to university. Any university. Honest. Not only will the fact that you went to Nipissing instead of Queens not be held against you, it might actually make you more interesting than the typical med school candidate. Trust me-- when you see 30 medical hopefuls who are all majoring in immunology at U of T, they start to blend together. In fact, if you're the kind of person who learns better in smaller classes or when you're living at home, it's probably in your best interest to forgo the 'big name' schools, where you can be assured that you will be one of a thousand students in your first year biology class.

This doesn't mean that if you're going to U of T you're at a disadvantage in any way-- particularly if you thrive in the city, don't mind that you have no idea what your professor looks like cause you can't see her from the 102nd row, and think that going there makes you better than other people (PSA: it doesn't). It just isn't necessary if medical school is your goal.

Step 2: Study Something.

Again, it doesn't matter what. Study something you like. Now I'm sure that some of you are now doubting my sanity and wondering how you can possibly get into medical school with a degree in music performance. Well you can. And here's your strategy. Make a list of all of the medical schools you're interested in. Even the long shots. Now go to each school's web site and look up their admission requirements. You'll probably find that the total list of pre-requisites is actually pretty short. A few biology classes, a biochem, the occasional physical science... most can be completed in first year (or in CEGEP, if you're in Quebec). The rest of your time at university is your own. Love working out? Study kinesiology. Want to learn languages? Pick one and take a course in it. Want to better train your dog? Become a psych major. It's a bonus if whatever you choose to study will actually lead to an interesting career if medicine doesn't work out, but these days very few bachelors degrees actually give you employment potential anyway.

Don't feel compelled to enroll in one of the uber-competitive "pre-med" courses popping up in more and more Canadian universities these days, thinly disguised as Life Sciences or Health Sciences. They're filled with scary people who will stop at nothing to claw their way to the top of the class. Friends who have survived these programs recall stories of lab sabotage and theft of reserve materials from the library required for assignments. All of my med school classmates who came from these types of programs say that they got into med school in spite of these programs, not because of them. But that brings me to my next point:

There is a caveat.

Step 2A: Pick a Major Where Good Grades are Attainable.

This is important. Because no matter how great a doctor you have the potential to be, you won't make it past the first cut without decent grades. Some programs (philosophy, for example) have a reputation for being nearly impossible to score A's. Don't pick these programs. Although you should study something that interests you, make sure that you can do well in it. The occasional B+ won't kill you, but in order to be competitive your GPA should convert to at LEAST 3.6 on the OMSAS scale.

Which leads nicely into...

Step 3: Get Good Grades.

Sorry, there's no way around this one. Unless you can prove that French is your first language (Ottawa has different requirements for their Francophone stream-- or at least they did when I applied) or you carry a band card (proving Native status, to those of you now confused) expect to need close to an A- average to even be considered.

But here's a secret-- at most medical schools, there is a grade cutoff. How high it is depends on the medical school, and some calculate a weighted GPA whereby each subsequent year of university is worth more than then one before. But once you reach the cutoff, that's it. You don't get bonus points for having 3.8 if the cutoff was 3.65. You're all on a level playing field after that. There is one medical school that used to rank people by GPA, but according to inside sources the differences between GPA rankings at the top of the scale are so minute that it was actually other factors that ended up deciding if someone got offered an interview. And that school is weird anyway. Heh.

Step 4: Write the MCAT

Some people think they can beat the system by only applying to those schools in Canada that no longer require the MCAT. Bad move. For starters, this limits your applying power. Second, rest assured that you're not the only one who thought of this brilliant plan. The schools that don't require the MCAT see many more applicants than the ones who do. And the MCAT is actually a pretty painless hurdle to jump as long as you prepare properly. I don't mean by paying $1500 to some Kaplan-like organization (although if you have the money and REALLY lack the motivation, this might be worthwhile) but simply by studying. The high yield stuff is the practice tests. Do as many of them as you can get your hands on, and make sure that you can do them in the allotted time (this is particularly challenging with the Verbal Reasoning section). The Canadian schools don't seem to be quite as in love with the MCAT as the U.S. schools are-- a combined score of 30 with at least an 8 in each section should put you in good shape for your applications.

Step 5: Do Your Homework

This step will save you a lot of time and effort. And unnecessary fees.

Canadian schools reward their own. Not their own students (so don't rush to go to Western for your undergrad simply because they have a medical school) but their own region. Some go so far as to publish different GPA cutoffs for residents and non-residents of their province. Some have gone so far as to allow lower GPA's in people who grew up in the city where that medical school is located. Thankfully, these schools all publish these fun facts. They are there on the web for anyone who takes the time to look.

So don't waste your time. Apply smart. If the University of Toronto requires at least 8 in each section of the MCAT and you only got a 7 in Physical Sciences, don't waste your time or money applying there. If Dalhousie only accepts 3 non-Maritime students for their class of 125 every year, unless you're REALLY an outstanding applicant focus on schools in your own province. And be sure to check what they consider a 'resident'. Even if you did your undergrad at UBC, they don't consider you a resident of BC unless you went to high school there. At least that was the rule when I applied. Since training people from the area doesn't ensure they'll stay in the area, I think the whole residency restriction thing is stupid anyway. But I don't make the rules.

Step 6: Get Some Letters

Letters of recommendation are really a lot less important than people think. Everyone has good ones. The ones that stand out aren't the ones by people with big names-- they're the ones by people who clearly know you well and can comment on some aspect of your work/personality/life. And don't forget to ask people BEFORE they write the letter if they will be giving you a positive recommendation. This seems obvious, right? Not so much. I know more than one grad student who found out later that their primary thesis supervisor gave them a crappy letter because he thought that his favorite grad student would be 'wasted' in medicine and would better serve the world locked in a lab for the rest of his life. Nice, eh?

I also know of an applicant who managed to get a letter of recommendation from the founder of the medical school he was applying to. Apparently, the guy was his great-uncle or something. The application committee was not sufficiently impressed to invite the applicant for an interview. So really, just get good letters from people who know you. Don't stress about the number of letters after the person's name or the fact that they aren't 'medical'.

That's it for this installment. Following these simple steps should get your foot in the door-- and by that, I mean an interview invitation. The next installment in this series will be on acing the interview.

For starters, if you must throw up in the middle of your interview, there is actually a way to make it work in your favour. I am not kidding. But I'll save that story for next time.


Blogger Midwife with a Knife said...

Great advice. Most of it also applies in various different forms to american schools.

And remember, the application process sucks, so try to make it suck as little as possible.

9:07 AM

Blogger Xavier Emmanuelle said...

Great advice. Although, not all health science programs are so cut-throat. The health science students at the University of Ottawa are actually very nice to each other, and while there is a little bit of competition they work together so that everyone can do well, rather than trying to sabotage each other. I've heard that the Queens program is terrible for that, in that the students will sneak into the lab and mess up each other's projects and stuff.
The uOttawa program is actually a great program if you're genuinely interested in medicine, as most of your classes are directly based on skills and knowledge that will be useful in clinical practice, as opposed to doing a bio major or something where your classes are interesting, but you have to take a lot of classes (ie geology, plant stuff, etc.) not directly related to medicine.
Sorry, er, I got a little long winded there. I just don't want people to be deterred from doing a health science program because of the mean spirited competitiveness when some programs are filled with friendly, supportive people. :)

12:32 PM

Blogger A girl said...

I have to add one more thing. After you ask your referees for a letter, make sure you check whether they completed it before the deadline. I had an experience when one of my references misplaced my letter. Likely, I caught him on the last day. If I didn't bother to check, I would probably have to reapply. So, ask, don't be shy.

12:52 AM

Blogger medstudentitis said...

Having interviewed applicants this year for my medical school I have to say, this is all great advice, plus: if you get an interview, please prepare. You ARE going to be asked why you want to be a doctor and you're going to be asked to reflect on your life experiences, so be prepared.

9:37 PM

Anonymous patientanonymous said...

This was fun to read. People said I should go to medical school but I thanked them first and then promptly followed up by telling they were deluded.

Can't wait to hear how throwing up during an interview can work in your favour, however.

7:09 PM

Blogger TheBrummell said...

Thanks for putting this together.

The next time an undergrad asks me about med school (or, worse, whines that they deserve a higher mark because they're pre-med), I'll point them here.

I'm also looking forward to seeing how barfing during an interview can be turned to the applicant's advantage.

My two bits unsolicited advice: don't annoy your biology TA by asking for special treatment because you're "pre-med". Having made the decision to apply for medical school at some point in the future is not an excuse for slacking off on an apparently unimportant assignment in a third-year genetics course. See the point above about getting good grades, regardless of subject. Whining about admissions requirements you'll face in two years does not count as "getting good grades".

6:58 PM

Blogger Richard said...

As someone who went through the whole rigamole of med school applications twice (and came in from engineering), one word of advice:

"PRE-MED" is not a program. It is not a degree. Don't go around bragging to your friends that you're in Pre-Med. It means nothing and just makes you sound like an ignorant jackass.

9:01 PM

Blogger Vitum Medicinus said...

This strangely looks somewhat like a condensed strategy guide to the game that is medical school applications!

Ask me when I get to residency if anybody actually wins.

4:22 AM

Anonymous Anonymous said...

thanks for sharing your advice, as a very confused but hopefuly and determined undergrad (and in canada!) that will be applying to med within the next few years, i really appreciate it!

11:24 PM

Anonymous Anonymous said...

lol....right on

I actually graduated from UofT in...immunology, and I say without hesitation that with what I know now, I would have studied something I really liked, like linguistics or sociology, two of the "extra" courses I absolutely fell in love with.

3:38 PM

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Anonymous Anonymous said...

Hi all! I was just wondering how you convert the Canadian prerequisites to British ones?? I'm currently studying at a British Uni and wishing to study Medicine in Canada. Cheers in advance!

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