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Medical School, for Non-Traditional Students

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The MCAT

Bloom's Taxonomy of Educational Objectives, Handbook I: The Cognitive Domain is the basis for standardized testing. It is out of print but available in libraries. If you're going to take the MCAT, you should read these: Appendix I to Bloom's Taxonomy and my notes on Bloom's Taxonomy sites (Excel). Have you ever wondered where they get those reading sections for the MCAT? Read the articles in Arts & Letters Daily and tune your car radio to NPR.

AMCAS

This is the first application, the nationwide application where you'll deposit insane amounts of personal information for all the medical schools to use. Hey, at least you only have to do it once. Apply early. Like May. Even if you're not taking the MCAT until August. I don't care if you'd rather wait to see how you did, get the damn application in. NOW.

If you're applying to Texas schools, you also have to fill out the TMDSAS application.

Odds and Secondaries

What are the odds of getting into medical school? Odds and chances are slightly different but for the purpose of medical school applicants,  "What are my chances of getting into medical school?" is essentially the same question. Well, let's say you're a Virginia resident and you get two interviews: University of North Dakota and Eastern Virginia Medical School. According to US News and World Reports Ultimate Guide to Medical Schools UND accepted about 30% of out-of-state students invited for an interview in 2003, while EVMS accepted about 50% of in-state residents. Without knowing anything else you're best guess is that the odds you'll get into medical school are exactly complementary to the odds of being rejected by both schools. In the figure, the odds of total rejection is represented by the white area. (1 − (1 − 0.3)(1 − 0.5)) × 100% = 65% chance of acceptance. 65% of the figure is some color of gray; the remaining 35% represents the probability of total rejection.

Let's say you get a third interview, this one at UVA, which accepts 70% of in-state interviewees. (1 − (1 − 0.3)(1 − 0.5)(1 −0.7)) × 100 = 89.5%: you now have an A− chance of acceptance. Spatially this could be represented by a cube, but what shape would you use for a fourth interview? The illustration only works to a point, but the math works no matter how many schools you consider.

A bit more formally, for any school there is an acceptance quotient: Q = (acceptances sent out) ÷ (number of applications received). For any given student applying to some schools 1 thru n, the student's goal is getting at least one acceptance, and applying to more schools, mathematically, can't possibly hurt in the closed case (neglecting social engineering, time spent on applications, etc), so the chance of acceptance, C_a, approaches 1 with every new application in the following fashion:

Ca = (1 − (1 − Q₁)(1 − Q₂)(1 − Q₃)...(1 − Q_n)) × 100
...
[if you want to calculate your odds, use this equation]

Let's do another example. How many schools do you have to apply to to garuntee you get in? 20? Well, there's about a 6% chance of getting into any private or out-of-state school; that means there's a 94% chance of rejection.

(1 − 0.94²⁰) × 100%=71%
...
[The power notation is just a little shorthand useful for this sorts of estimates]

Wow, that's a lot of secondaries at $30 per application plus an average submission fee of about $70. You're talking $2000 for a low C chance of acceptance. Figure the average state school accepts about 30% of in-state applicants, and the average state has three state schools. That's about a 66% chance of acceptance. So, if you apply to twenty private and out-of-state schools and all your in-state schools, you've got a 90% chance of getting into medical school. You also just spent $2300. Of course, since admissions are rolling you improve your odds if you submit early. My guess is you probably pass through average and start hurting your odds if you haven't submited all you're secondaries by 1 October. That's the major stuff. If you haven't done the math and the schedule, don't worry about the next paragraph.

There are any number of minor factors that you may want to keep in mind. Apply to a couple top notch schools because the schools know what other schools you applied to and they may take that as a measure of your self-esteem (a doctor at Georgetown told me this). Write letters to your favorite or most-likely-to-get-into schools. This takes time, so make 'em count. Write the letters weekly. This worked for me and has since worked for my wife in the job search world.  Filter what you hear from other medical school applicants. Y'all are cut-throat (more so than actual medical students) and are generally on the outside looking in. Know your enemy: find your current school's admissions committee and see if they'll let you sit in on a review session. Read up on admissions from the admissions perspective. Try to find a book or two on being an interviewer (having interviewed people for jobs, I can assure you it can be stressful).

Apply to a spread of schools. Here's where I would have applied in 2006 as a Texas resident ($120 to input data in AMCAS, plus $30 per school, $35 per Texas school, unkown for New England Osteopathic):

Secondaries are rather individual. They generally require one additional essay or five to ten short paragraph responses to school-specific questions.

[Edit 20 August 2006] What you've just read are solutions to the simplest problems of frequency probability. You will need to understand this stuff as a doctor, because you're patients will ask "Doc, what are my odds?" Except instead of buying your way into populations by paying for more applications, you will have to filter studies for your patient's demographics to find as many studies as possible in the literature that include people like him. Then you'll do the same math to figure out their specific odds of various outcomes as best you can. Your professors may call this Bayesian probability, but it's really frequency probability because we're dealing in real measurements of defined populations. Bayesian work is mainly theoritical.

If you think it's hard to get into medical school, you're right. The acceptance rate for business school is about twice the rate for medical school. Harvard Business School, like Dartmouth and Wharton, admitted 13% of it's applicants last year. Most private medical schools admitted 6% of their applicants. State schools admit an even smaller percentage of out-of-state applicants. Here's more on the not so competitive B-school route. More to follow (including law school comparisons).

Interviews

I Got Into Medical School, Now What?

Well, you can read my ongoing thoughts about how to learn in medical school in my blog's archives of medical education.