The Road to Medical School
Dr. David Frank
Chemistry Department
CSU Fresno
McLane 159 (278-2273; email is better)
davidf@csufresno.edu
11th Annual UC Davis Pre-Medical & Pre-Health
Professions National Conference: “Passion for Life,
Education, Service, and YOUR Future in
Healthcare”
Saturday & Sunday
October 12-13, 2013
8:00am-6:00pm
University of California at Davis, Pavilion
For Bundle (Bus, Food, Lodging) contact Cristian
Sarabia
cristiansinaloa@mail.fresnostate.edu
Malpractice Insurance
•Cost depends on the state & location
•Internal Medicine: $6K - $11K/year
•OB/GYN: $55K/year (2009)
•General Surgeons: $28K - $55K/year
•Physician Assistant: $2K –$6K/year
Financing Physician Education
•The median education debt for indebted medical
school graduates in 2012 was $170,000, and 86
percent of graduates report having education debt
•Debt: Public: $160K, Private: $190K
•Cost: Public: $197K, Private: $275K
•Scholarships (4 yr): Public: $14K, Private: $30K
•Remember you need a good credit score to qualify
for many loans.
Academic Medicine, Jan. 2013: Study shows that recent
medical school graduates with the median amount of
education debt ($160K-$170K) can enter primary care,
raise a family, live in an expensive urban area, and
repay their debt within 10 years without incurring
additional debt. However, heavily indebted primary
care graduates (who owe $250K+) must plan
repayment and lifestyle choices carefully and
strategically. The article includes debt repayment
models across a variety of scenarios and specialties. It
suggests that education debt need not play a
determining role in specialty choice and illustrates the
capacity of physicians to repay their education debt.
The Path to Becoming a Physician
• Bachelor Degree
– Possibly Post-bac work to shore up soft GPA
• Medical School - 4 years
• Residency - Minimum of 3 years (1st year
often called internship)
• Optional: Fellowships for further
specialization
Have A Plan
Diploma
• Academics - Required Courses,
Bachelor’s Degree
• Extracurricular Activities
(including medical experience)
• MCAT
• Research
• Letters of Recommendation
• Finances for the Application
Process
www.csufresno.edu/premed
www.fresnostate.edu/premed
What Should I Major In?
1. Whatever interests you the most, BUT...
2. English, philosophy, history, music majors, etc. may take
longer to graduate to get all of the pre-reqs, cannot get
grants for units outside of their major, and the science GPA
is vulnerable.
3. Advantages of Biology or Chemistry major
• Premed prereqs are part of the degree requirements
-grants & scholarships can only cover units of MAJOR
• Science (BCMP) GPA is buffered by taking more
science classes
• Better preparation for first year of med school
• Higher priority at getting into impacted first year Chem
1A/1B and Biol 1A/1B.
Undergraduate Academic Preparation
• 1 year of General Chemistry (1A and 1B), even if you
have AP credit. NOT 3A/3B
• 1 year of Organic Chemistry with lab 128 A
& 129A, then 128B and 129B)
• 1 year of General Biology with lab (Biol 1A and 1B),
even if you have AP credit. NOT Biol 10
• 1 year of physics with lab (Phys 2A/B; Does not have
to be physics for physics majors).
• Math 75 and Math 101 (Statistical Methods; 4 units)
AP Credit
• In general we advise pre-med students to take
general chemistry and biology at Fresno State (not
a community college) even if they have AP credit
for these courses.
• However, you can check with the medical schools
in which you are interested to find out about their
policy on AP courses.
• The medical school might allow an upper division
course in the particular discipline to fulfill the
requirement.
– Hard to know early on which med schools you will
choose to apply to…
Academics - Courses Required by
Many Medical Schools
(and really important for the MCAT)
• 1 year of English
Upper division with lots of
reading, critical thinking, and
writing; or Philosophy courses
• 1 year of Math (calculus,
statistics, computer science)
• 1 semester of Biochemistry
Academics – Other Courses
• Physiology (Comparative or Human; can
help with the MCAT)
• Genetics (can help with the MCAT)
• Human Anatomy (just before entering; can
help with first year med school)
• Cell Biology & Molecular Biology (can help
with first year med school)
Academics – Other Courses
Because the the MCAT in 2015 will change, we strongly
advise students who may take this exam to take…
• One or two semesters in introductory psychology
-PSYCH 10. Introduction to Psychology (3 units)
-PSYCH 40T. Topics in Research Design and Statistics
• One or two semesters in introductory sociology
-SOC 1 or 1S. Principles of Sociology (3-3 units)
-SOC 3. Critical Thinking about Society (3 units)
• Introductory Biochemistry: Chem 150
Before applying, make sure that
you have fulfilled the course
requirements for the medical
schools to which you intend to
apply.
Academics Count
• Aim for a minimum 3.6 GPA, for BOTH
your overall GPA as well as your BCMP
(Biology, chemistry, math and physics)
GPAs.
• For allopathic medical schools, the GPA is
calculated based on all courses taken, even
those for which you applied for grade
substitution.
www.aamc.org/msar
Stanford =
Upper Division Biology
Statistics
Irvine =
Nationwide: 20,518 seats and 46,454 appicants: 44%
Schools with multiple CSUF accepytances 20112013
32 other schools have
accepted one CSUF
student in this 3 year
period.
2013 Data
# of Applicants
26:48% - 20518: 44%
GPA
MCAT
2013 Data
44 CSUF students applied, 20 were admitted to at
least 1 school: 45% acceptance rate.
Highest MCAT with acceptance: 39R
Lowest MCAT with acceptance: 23Q
Highest GPA: 4.0
Lowest GPA: 3.57
What is Osteopathic Medicine?
• Critical physician workforce shortage. By 2020, the gap between our
physician supply and demand = 50,000 to 100,000+.
• > 4,200 new osteopathic physicians/yr enter the workforce.
• > 63,000 fully licensed osteopathic physicians practice the entire
scope of modern medicine, bringing a patient-centered, holistic,
hands-on approach to diagnosing and treating illness and injury.
• > 20% of US medical students -> osteopathic physicians.
• DOs can try for any specialty, prescribe drugs, perform surgeries,
and practice medicine anywhere in US.
• Osteopathic manipulative techniques to diagnose and treat patients.
• Osteopathic physicians work in partnership with patients to help
them achieve a high level of wellness by focusing on health education,
injury prevention, and disease prevention.
Osteopathic Medical Colleges
AACOM.ORG
There are currently 29 colleges of
osteopathic medicine, offering
instruction at 37 locations in 28 states.
Twenty-three of the COMs are private;
six are public.
Western University of Health Sciences
College of Osteopathic Medicine of
the Pacific (Pomona, CA)
Candidates for admission must have a
minimum science GPA of 3.30, a
minimum overall GPA of 3.30, and a
minimum average MCAT score of 27.
What is a Physician Assistant?
A physician assistant (PA) is a medical professional who works as part
of a team with a doctor. A PA is a graduate of an accredited PA
educational program who is nationally certified and state-licensed to
practice medicine with the supervision of a physician.
What can PAs do?
PAs perform physical examinations, diagnose and treat illnesses, order
and interpret lab tests, perform procedures, assist in surgery, provide
patient education and counseling and make rounds in hospitals and
nursing homes. All 50 states and the District of Columbia allow PAs to
practice and prescribe medications.
Prereqs for Physician Assistant Program - Tuoro
8 semester/12 quarter units (including labs) in each of the following
categories:
Biological Sciences (may be comprised of general biology,
genetics, immunology, embryology, etc.)
Chemistry (may be comprised of inorganic, organic,
biochemistry)
4 semester/5 quarter units (including labs) of the following:
Human Anatomy (must be completed within 5 years of
expected year of matriculation)
Human Physiology (must be completed within 5 years of
expected year of matriculation)
Microbiology
Statistics (3 semester/5 quarter units)
All pre-requisite courses must be completed with a “C” or
better
Clinical Experience - Tuoro
Candidates must have obtained a minimum of 500 hours of health
care/clinical experience, either as a volunteer or in a paid
position. Competitive candidates, however, will have obtained
1,000 or greater healthcare hours.
Evaluation Criteria for Clinical Experience
Total number of hours
Setting
Specific duties performed and/or skills acquired
Description of the duties
Patient population served
Level of supervision
Time frame of the experience
Prereqs for Physician Assistant Program - SJVC
• General Chemistry (with lab)
• General Microbiology (with lab)
• Human Physiology (with lab)
• Human Anatomy (with lab)
• Public Speaking or Oral Communication
• Intro to Sociology or Cultural Anthropology
• Reading and Composition
• General Psychology
• College algebra or higher*
2,000 hours of direct patient care experience is also required for
admission (paid and volunteer hours are acceptable). Hours accrued
as a student in a training program cannot be used towards this total.
Some “Pros” for a PA Career
•Requirements for admission to PA school easier
than med school
•PA school is only 2 years: need not acquire huge
student debt.
•You can easily switch specialties without lengthy
schooling & residencies
•Work fewer hours and time off is really “off”(?)
•Malpractice insurance less costly: $2K – 6K/year
Some “Cons” to a PA Career
•If you have a “leadership” personality and
would prefer to give orders rather than take
them, PA may not be right for you.
•PA salaries are capped and less than a doctor’s.
•Less status as a PA than as a doctor.
The “Old” MCAT (Before 2015)
• Three Multiple choice parts:
–
–
–
–
Verbal Comprehension
Physical Sciences
Biological Sciences
Writing Sample is gone in 2013
• Be sure that you have completed all the
coursework required
• Take practice exams. Scores on these
will determine whether you are ready to
take the real one. These are available for
only $35 each, after the first free one,
from AAMC.
The “New” MCAT (Begins 2015)
• Natural Sciences: concepts in biology,
general and organic chemistry, biochemistry,
and physics
• Psychological, Social and Biological
Foundations of Behavior: Concepts of
introductory psychology and sociology, and
introductory biology concepts that relate to
mental processes and behavior.
The “New” MCAT (Begins 2015)
• Critical Analysis and Reasoning Skills: be able to
analyze, evaluate, and apply information provided
by passages from a wide range of social sciences
and humanities disciplines.
– Does not test specific knowledge
– Does test the skills in analysis and reasoning that
you need for medical school
– may prompt you to read broadly as you prepare
– Along with many others, passages about
ethics and philosophy, cross-cultural studies
and population health are included.
The “New” MCAT (Begins 2015)
https://www.aamc.org/students/applying/mcat/mcat2015/
MCAT Timing
• The best timing is to take the MCAT in the spring* of
the calendar year prior to the year you plan to enter.
(For most this will be April of their junior year.)
However, do not take the MCAT before you are
ready. *APPLY EARLY, SEATS SELL OUT.
• The MCAT is now offered on-line on 24 different
days during the year. The exam is now a 7 hour test;.
There is a test site in Fresno. Register early to be sure
you get the date and site you want.
• Go to the AAMC website for information and
registration.
MCAT Preparation
• While taking chemistry, biology and physics, remember
you are preparing for the MCAT.
• Check the AAMC website and consult The Official Guide
to the MCAT Exam available from AAMC
• For MCAT2015, visit
https://www.aamc.org/students/applying/mcat/mcat2015/
• Remember to schedule in preparation time before taking
the MCAT. Consider the Kaplan prep course ($2000).
• Don’t ever take the MCAT for practice: it’s expensive
($270). Plan to take it only once.
MCAT Preparation
Change your high school study habits:
• Rote memorization doesn’t work so well for the MCAT.
• You need to develop conceptual thinking skills.
• Start making notes from your text as well as lectures.
• Organize the material by topic.
• Look for logical connections between all of the facts,
don't just memorize isolated facts.
• Read and review notes for understanding.
• This all takes TIME (2-3 hours of study for each hour
in class)
• Recommend Engl 101, 102, 103 for reading
comprehension & critical thinking
What Do I Do In The Summer?
• There are lots of summer opportunities for
students interested in being physicians.
Check the internet, the AAMC and the
aspiringdocs & our websites.
• Applications are due between January and
March and are extensive. Look into
programs early.
Extracurricular Activities
•
•
•
•
Medical Experience
Leadership
Volunteer Service
Research
Keep Good Notes
• Keep track of your extracurricular activities
and the hours you devote.
• You might want to keep a journal of clinical
experience to record your experiences and
maturation: its good material for that
personal statement.
Letters Of Reference
• Two science faculty, one non-science faculty, and
one or two others
• Remember while taking courses that you are going
to need letters of recommendation.
• Doing research with a professor helps him/her get
to know you and write a more credible letter.
• Have the letters on file the spring semester before
you apply (April/May of junior year).
Letters Of Reference
• Most med schools use the AMCAS letter
distribution service. They only accept letters from
AMCAS.
• You must provide each letter writer with your
AMCAS Letter ID found on your AMCAS Letter
Request Form, as well as your AAMC ID#.
Letters Of Reference
• Instruct the letter writer to either send your letter to
AMCAS directly, or to Ms. El-Bendary in the
Information Center (S1-136). In either case, the letter
must be accompanied with your AMCAS Letter
Request Form, as well as your AAMC ID#.
• We shall send your letters to AMCAS on your
instruction. If all are being sent to the same schools,
they can be sent as a packet with the same Letter ID #.
• Advantages of our service: we keep copies of your
letters which may be needed for scholarship
applications, for non-AMCAS schools, and for
AACOM applications.
The Application Process
• Primary Application - takes
time!
– transcripts from all
college-level schools
– personal statement
– record of extracurricular
activities
– names of letter of
recommendation writers
for those medical schools
that use the AMCAS
service for collecting
letters of recommendation
• Secondary Applications
– more essays
– request letters of
recommendation be sent
to AMCAS, the MD
application service*.
(Letters to AMCAS can
be sent after the primary
application is
submitted.)
*unless school is not
using the AMCAS letter
distribution service.
Institution 1
Secondary Application
What is your interest in XYZ School of Medicine?
Insitution 2
Describe your motivation to become a physician.
What do you see as the most significant issue the medical
profession will face in the next 40 years?
What personal benefits have you gained from your major
extracurricular activity?
What personal benefits have you gained from your
research/teaching experience?
Given the opportunity to share dinner conversation with one
person (deceased or alive) who has made a significant contribution
to science, medicine or human service, identify the individual you
would select and why?
Institution 3
•Please explain your reasons for applying to XYZ School of
Medicine. We understand that you are probably applying to several
medical schools. We are interested in why you have placed XYZ
School of Medicine on your list of schools. (max character limit
1500)
•Please describe any unique characteristics you have that will
contribute to the diversity and bring educational benefits to the
entering class. (max character limit 1500)
•If you are not in a degree-seeking program, please indicate what
you will be doing from the time you complete this application to
the start of medical school.
The Interview
• Choose medical schools carefully. Know
what they offer and what you offer them.
Review your application and their catalog
and mission statement. Talk to medical
students. Find out about hospital
affiliations, curriculum, student support.
• If possible, engage in a mock interview.
The Interview
• Your experience in medicine. You need to explain
your experiences that have helped you to
understand the reality of a medical career.
• You have the longevity, discipline, motivation,
and resiliency to succeed in medical school. How
can you convey the evidence of these traits?
• You have thought about, and to some degree
understand, the current and future state of
medicine.
• How can you convey to the interviewer that you
are “one of them.”
Planning for Necessary Expenses
• All professions have application expenses.
• Med school application: ~$4000 to $8000 (+)
– MCAT review class: $2000
– # schools you apply to & where you interview.
– AMCAS Application: $160 first school, $32 each
additional school (UC Berkeley avg: 20 – 25 schools)
– Secondary applications: $70 to $100 each in CA
• AMCAS has a Fee Assistance Program.
aamc.org/fap
• Don’t short-change yourself on the application
process.
Item
Cost
MCAT Test
$270
MCAT Preparation
$2,000
Initial AMCAS
Application
Each additional school
(24 is average) @ $32
$160
Secondary Application
(20 @ $100)
$2000
Travel Costs to
Interviews
Total
$3000
$768
$8158
Stanford
463
interviewed,
86 accepted.
Rush:
399/130
(19%/33%)
Resources: Getting Started
• Premedical Web Site
• Advising
• Informational Sessions, Conferences on and
off campus (i.e., UC Davis conference)
• HCOP (Health Careers Opportunity Program,
targets students from educationally or
economically disadvantaged backgrounds.)
• AEW (Academic Excellence Workshops,
NSCI 40T, LSAMP program)
More Resources
• Student Clubs: Fresno State Premed Club (only premeds),
AMSA Chapter (anyone interested in a health profession),
Tri Beta Biology Club
• Natural Science class: The Art and Practice of Medicine
(NSCI 1; spring class)
• Academic Research Associate Program at Community
Regional Trauma and Burn Center headed by Dr. Greg
Hendey and administered by Brandy Snowden. (NSCI 110)
• Research Opportunities-during the year and in the summer
• Conferences Given by Medical Schools for Premed Students
Yet More Resources
• Scribe Program at St. Agnes Hospital headed by
Dr. David Claypool
• Other scribe programs via CEP America at
Community, Clovis, and Madera.
• WorService to Collect and Send Out Letters of
Reference. (You must open a file with me and
sign a form to either waive or not waive your
right to see your letters of reference.)
Plan B
Postbaccalaureate Programs: academic
record-enhancement, career changing,
underrepresented groups, economically or
educationally disadvantaged groups..
• CSU Fullerton
• CSU East Bay
• Charles Drew University
• Mills College
• San Diego State University
• San Francisco State University
• Scripps College
• UC Berkeley Extension
• University of Southern California
UC Postbaccalaureate
Consortium
http://meded-postbac.ucsd.edu/
Helps educationally and
economically disadvantaged
students get into medical school.
Must be committed to practicing
in underserved communities of
California.
Post-bac nationwide:
http://services.aamc.org/postbac/
Plan B
Caribbean Medical Schools
There are three medical schools in the Caribbean that stand out:
St. George’s University in Grenada, West Indies, Ross
University in the Commonwealth of Dominica, and American
University of Antigua. Students admitted to St. George’s have
an average GPA of 3.34, and an average MCAT of 28. At Ross,
the average GPA is 3.4, with a range of 2.7 - 4, but for early
admission they require at least an overall GPA of 3.0 and a
science GPA (BCPM) of 3.25, with an MCAT score of at least
24.
Also: UAG School of Medicine in Guadalajara, Mexico
Plan B
Options
1. Medical Doctor
6. Optometrist
2. Podiatrist
7. Physician Assistant
3. Dentist
8. Nurse
4. Pharmacist
9. Ph.D.
5. Veterinarian
10. Clinical Lab
Technician
Excellent Books
• Medical School Admission Requirements
• The Official Guide to the MCAT Exam
• Complications: A Surgeon’s Notes on an
Imperfect Science by Atul Gawande, M.D.
• Better: A Surgeon’s Notes on Performance by
Atul Gawande, M.D.
• The Checklist Manifesto, by Atul Gawande, M.D.
• Advising Information:
www.csufresno.edu/premed
www.aspiringdocs.org
Useful Web Sites
• General Information:
 www.aamc.org/meded/start.htm
 www.aacom.org
 www.amsa.org
• Interviews:
 www.studentdoctor.net/interview/index.asp
• Scholarships:
 www.fastweb.monster.com
• Summer Opportunities:
 www.cmu.edu/hpp/intern.html
 www.swarthmore.edu/Admin/health_sciences/
summer_opportunities.html
 www.aamc.org/members/great/summerlinks.htm
ENJOY THE PROCESS!