How to Adeptly Complete the AMCAS Other Impactful Experiences Section

Last year the Association of American Medical Colleges (AAMC) gutted the AMCAS Disadvantaged Status section, replacing it with the Other Impactful Experiences, which allows for a broader approach to challenges that can adversely affect an applicant's life and candidacy. 

In other words, when you're considering the Other Impactful Experiences essay, consider financial barriers, but also issues like learning disabilities, immigration experiences, caregiving roles, etc. Here is some guidance from the AAMC.

Emotional PPE

Back in February, I showcased the sobering results of the Medscape Physician Depression and Burnout Report 2024: Of those doctors surveyed, 53% reported burnout and 23% depression. And those disturbingly high statistics had increased from the previous year. 

I recently listened to a Stanford Medcast Episode interview of Ariel Brown PhD called "Physician Distress Miniseries – Emotional Health Support for Health Care Workers." (You can get CME credit for listening to the podcast and completing the quiz afterward.) According to the session, each year in the United States, one in 10 physicians think about or attempt suicide and around 400 die by suicide. 

At the start of the pandemic, Dr. Brown started a nonprofit with Massachusetts General Hospital Anesthesia Program Director Dr. Daniel Saddawi-Koefka, called The Emotional PPE Project. The organization provides free and confidential psychological counseling for healthcare workers. Here is the website.

Applying to Residency this Cycle? Don't Forget the New AAMC Fee Assistance Program for Residency Applicants

Here's a quick reminder that the Association of American Medical Colleges (AAMC) is expanding its Fee Assistance Program (FAP) to residency applicants this year.

The good news is that if you were previously approved for the AAMC FAP, you will automatically get a 60% discount on your residency application for this ERAS season.

The bad news is that current medical students are not eligible to apply for the FAP even if they now have financial challenges that they did not have prior to medical school or if they qualified before medical school but declined to apply for the FAP benefits.

The AAMC says they are going to survey "the student affairs community" to understand "if and how" they can further expand the FAP for residency applicants.

Here is more information with some frequently asked questions.

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.