Try a Residency Bootcamp

I was recently speaking to a medical student with excellent foresight, who was asking me what he could do to prepare himself for residency. I suggested reviewing the basics – perhaps by perusing a favorite clinic handbook – of how to work up common chief complaints like chest pain, shortness of breath, abdominal pain, back pain, among others. It was timely, then, that I read an article about Transition to Residency classes offered at the majority of medical schools. These intensive courses help medical students refresh their knowledge about clinical approaches, so they can hit the ground running when internship starts. 

If a Transition to Residency class is robust and offered at your institution, I would recommend taking it.

Also, when thinking about preparing for residency, I advised the student to consider ways to make life as smooth as possible: When I was in training, I splurged to pay for a laundry service. I never missed the money; instead of spending my downtime at a laundromat or an apartment complex laundry room, I was able to sleep a little more. 

Of course, I had to be frugal during residency, as many others do, but doing one or two things that can make your life better can pay dividends.

Check Out the AAMC Virtual Medical School Fair

The AAMC (Association of American Medical Colleges) will be holding a live informational medical school fair this Wednesday, April 10 through Friday, April 12. There will be sessions on financial issues like loans, budgeting, and scholarships and some advice from current medical students and admissions officers. Registering also affords you 15% off a one- or two-year subscription to the Medical School Admissions Requirements (MSAR®) website.

You can register here. I offer individually-tailored, one-on-one assistance, but there's no downside to hearing more general tips from the AAMC itself.

Major Changes are Needed to Head Off a Worsening Physician Shortage

 The AAMC recently published a report estimating that the United States will face a physician shortage of up to 86,000 doctors by 2036.  

A variety of issues are contributing to the problem, including the lack of adequate residency slots. A bipartisan bill called the Resident Physician Shortage Reduction Act of 2023 (H.R. 2389/S. 1302) has promise but has yet to progress through Congress. The legislation would gradually increase the number of Medicare-supported residency slots by 14,000 over the course of seven years.

Other issues are at play, including an aging American population, one that requires more healthcare. Additionally, doctors who are 65 and older make up 20% of the physician workforce, and those between age 55 and 64 constitute 22%, meaning that many doctors are reaching retirement age. 

A cohort also left clinical medicine during and after the pandemic, and, in a related issue, burnout is very high for those who stayed. A whopping 49% of doctors surveyed through the annual Medscape questionnaire reported being burned out.

The opaque medical school admissions process and the very high cost of medical school are also barriers.

Anecdotally, I hear of many family members who wait weeks or even months to see a physician. Most of those people live in urban areas; the problem is significantly worse in rural locations. Becoming a physician is a noble endeavor, but without structural support, many talented students will pursue other fields. We can't blame them.

My Five Year Anniversary with the White Coat Investor Podcast

Looking for a podcast episode for today's drive to work? Check out my take on entrepreneurship, creating autonomy and flexibility, and balancing clinical practice with raising a family on the White Coat Investor (WCI) podcast. The interview initially ran in March 2019, but the content is still highly relevant for those considering alternatives or enhancements to clinical careers.

For those of you who aren't familiar with WCI, it's a website/blog/podcast founded by James Dahle MD, an emergency physician whose interest in personal finance and the FIRE (financial independence - retire early) movement sparked a slew of devotees. Check out my podcast episode here (where you can also read the full transcript) or listen on your favorite podcast app. 

Leverage the MSAR for Your Benefit

The Medical School Admission Requirements database (MSAR) is an online resource that allows users to search, sort and compare information about U.S. and Canadian medical schools. (I hate to date myself, but when I was applying, the MSAR was a hard copy book.) The annual MSAR usually comes out this month or next; if you're applying to medical school, I'd recommend purchasing the 2024 version when it's here because it provides so much information about institutions and their admissions statistics. The MSAR allows you to compare schools by median MCAT scores, AMCAS GPAs, and other criteria. (Of course, how institutions utilize the MCAT score is variable, which contributes to the shameful opaqueness of the medical school admissions process.)

You should use the MSAR to help determine which schools are in your range and which are "reach" schools. While it's fine to have a lot of "reach" schools (if you can afford it), it's critical to ensure you are applying wisely to schools that match your numbers. The advantage of the MSAR is that you can make evidence-based decisions. I've found some applicants have eye-opening experiences when they thoroughly review schools' statistics and either realize that their numbers are low and that they should apply accordingly or, happily, that they have numbers that match with top schools. Either way, reviewing the data is critical to good decision making.

 

The Medical School Admissions Process is Totally Broken - From Start to End

The medical school admissions process is cruel. I recently told that to a strong applicant who was "ghosted" by five institutions this cycle. Poor or absent communication is only one of the problems. The lack of clarity about selection criteria causes confusion, and expensive supplementary applications that generate money for schools are sometimes exploitative.

Check out my Doximity op-ed piece "The Medical School Admissions Process is Falling Short," and feel free to leave a comment on the site about your experiences and opinions.

One Billion Dollars

I was super impressed with the news that Albert Einstein College of Medicine Professor Ruth Gottesman is donating $1 billion to her institution to make tuition free for all medical students going forward.

In 2019 NYU made medical school tuition free. Subsequently, the demand to go to their institution skyrocketed, as did their matriculants' median MCAT and AMCAS GPAs. According to the most recently published MSAR, NYU's median total and BCPM GPAs were both 3.96, and their median MCAT was 522. A similar phenomenon will occur with Albert Einstein School of Medicine.

The tremendously generous donation by Professor Gottesman allows earnest individuals interested in caring for our communities to become physicians without excessive debt. Of note, Albert Einstein offered to rename their school to include "Gottesman," but the professor declined, a choice which adds to her stature in my mind.

No One Wants to be your Second Choice for the High School Prom

Imagine you're back in high school, planning to ask out a fellow classmate to the prom. You approach your potential date, "Would you be interested in going with me to the dance? You're my second choice."

Not very compelling...The same is true for letters of interest or, really, any outreach to medical schools or residency programs: Over the years, I've edited many letters in which applicants mention that an institution is "one of my top" picks.

Avoid that type of language. Instead you can say something like "I would be thrilled to be at your institution," or "I am confident I can make a positive contribution." In other words, you can stay honest while not shooting yourself in the foot.

Let me know if you need assistance with a letter of interest.

This Has Been a Weird Cycle

I founded Insider Medical Admissions in early 2007, and, looking back, I'm struck by the fact that this is one of the longest medical school admissions cycles I remember. What I mean by that is I have applicants who were admitted to medical school in early fall, and, simultaneously, there are some who are still being invited for interviews at top schools, scheduled for this month and early March.

I've seen late invitations in the past, but they were few and far between. This year, it seems almost routine to be interviewing into the late winter.

If you're facing an interview this month or next, check out a couple of articles I wrote for Student Doctor Network years ago that have survived the test of time: One is about how to skillfully manage difficult interview questions and the other will teach you how to transform your candidacy's liabilities into assets. 

I'm still offering mock interviews this cycle, so contact me for help.

  

How Sesame Street Can Help You Write a Good Medical School Personal Statement

I learned an interesting fact years ago: When small children don't understand something, they will simply tune it out and start to engage in another activity. That's why great shows like Sesame Street use professionals to make sure their content is precisely age-appropriate. Children - and adults - don't like being confused, and you can’t blame them.

In their personal statements, some medical school candidates make the mistake of referring to an accomplishment without explaining it. This is understandable since we are all intimately familiar with what we've done. The problem is that the vast majority of application readers are way too busy to do independent research or go back and forth checking an applicant’s supporting documents if she writes something that isn’t crystal clear.

I remember a talented candidate I advised who showcased an award she had won. She listed the name, but didn’t explain what it was. When I asked her, she told me the award was an academic honor given to only the top 1% of students out of several thousand. I was impressed! And, I asked her to rewrite the section so that her admissions readers would give her the credit she deserved for that extraordinary accomplishment. Because the medical school admissions process is so competitive, what you fail to adequately explain counts against you.

On a related topic, don’t expect a reader to understand something in your essay because it’s explained in your AMCAS activities. Different faculty members will approach the application in different ways, so – to get “full credit” for your accomplishments - you need to assume that your reader is seeing your essay first, independent of your AMCAS activities. Ensure your personal statement can stand alone and doesn't rely on your AMCAS Activities section for clarification.

Contact me for help with your written materials. I have read thousands of essays, and I personally review every document sent to me.