Thursday, 28 July 2011

Introduction to Extracurriculars - Workin' for Free, by Danielle

So you’ve got the GPA, the MCAT and the reference letters and you think you are ready to apply to medical school? This is like having unprotected sex, you’re missing something very important. There is one more step and this hoop is not as simple as just studying for a summer for a test. This step involves years of loyalty and commitment. Most medical schools now require their students to demonstrate “non-academic criteria” and each school has their own little special way of describing it. Dalhousie calls it “any outstanding achievement or breadth in terms of life experience is given consideration.” Toronto says “the admissions process identifies the best possible candidates for medical school through assessing each applicant's overall achievements, including those in academic and non-academic areas. It is understood that academic excellence is necessary, but not sufficient, to ensure success as a physician.” And UBC describes it the best by saying “motivation, social concern and responsibility, creativity, scientific and intellectual curiosity, attitude toward continuing learning, maturity, integrity, and realistic self-appraisal, are just a few examples of important non-academic qualities.”

You get the point; extracurriculars, volunteer work and employment are necessary and Jeff will address how you can choose them but I want to tell you how they can actually help your application. Here is a little secret; everyone who applies to medical school is smart, has a good enough GPA, did well on the MCAT and has met some people that will write a letter for them. So then how can you differentiate yourself from all those losers? You can have kick ass EC’s, volunteering and employment!

I hope you are still reading and are not hiding in your basement fearing rejection because you did not cure AIDS, or build a school for children in Cambodia. I am going to tell you another little secret; it is not necessarily what your activities are but how you present them on your application. I am not telling you to lie but I am telling you to take a closer look at those seemingly insignificant activities and reconsider what they have done for you. Use who you are and what you have done to your advantage. Talk about that soccer coaching that you did for your little sister, or that lame karate that you taught for a long time (no offense to actual practitioners of this well respected craft, just Jeff). 

Ok so you are a little bit of a loner and do not have too many activities at this point. It is not the end of the world you can still jump on the activity bandwagon, and for the love of God do not volunteer at the hospital because that is what all the cool kids are doing. Pick something that you actually enjoy because the admissions committees will see your transparency. When you do pick something stick to it and expand upon it. The admissions committees will want to see commitment and reliability.

To sum up what I have said here and what medical schools want is that they want a human that is the spawn of a genetics experiment where Albert Einstein and Mother Theresa had a baby and then that baby married Neil Armstrong and they had a kid and now that child is ok enough to be a doctor. When medical school applications seem overwhelming, like it sure does a lot of the time; break it into tiny pieces and tackle one at a time. There are worse things in life to get into, so there is no need to cry yourself to sleep at night.

- Danielle

Introduction to Extracurriculars - Just for the Fun of It, by Jeff

Believe it or not I am going to keep this post shorter than Danielle’s (for once), while feeding your prepubescent premed mind with the fundamental information it needs. In the meantime, think of this post like a box of All-Bran Buds cereal – the initial taste in your mouth will be something similar to horse-feed; but after several hours of digestion, your bowels (and mind) will thank you.

Now, if you take anything from this post, in addition to the importance of dietary fiber, remember this: Do what you enjoy, and enjoy what you do. It’s that simple.

There is no secret to achieving a high score on the “non-academic” or “activities” section of your medical school application. Contrary to what Danielle says, not everyone who applies to medical school is smart, has an adequate GPA and does well on the MCAT. How do I know this? I’m one of those individuals. While I’d like to think I’m “smart,” my GPA and MCAT suggest otherwise. But what I do have is an extracurricular resume that is fourth to curing cancer… but not third or second to. Finding the cure for cancer and AIDS, along with instituting world peace, probably dominate the forefront of extracurricular supremacy.

In short, pursuing interests outside of work (and school) act as outlets which aid in continued healthy mental and physical development. This fosters fresh perspectives throughout your schooling and career, resulting in an enthusiastic work environment. As such, when it comes to choosing what to do with your spare time; pursue your interests, seek out new endeavours, and do whatever stokes that fire breathing within. After that, success is …almost… a cakewalk.

Having said that, I am not going to tell you what you should specifically do for extracurriculars; because as Peter Griffin once said: “What might be right for you may not be right for some. You take the good, you take the bad, you take them both and there you have…” all that I have to say!

- Jeff

Thursday, 21 July 2011

How to Study for the MCAT...

...Step 1: Don't be like Jeff.

I always tell people that ask me “What do I  need to do to get into medical school”,  that you just need to jump through a few hoops. Some of those hoops are big and easy to jump through but some of those are tiny, flaming and covered in Chlamydia. The MCAT, in most people’s minds, is more of the latter. I taught an MCAT prep course for 3 years and through my own writing of the test and teaching others I have come across a lot of advice. A lot of it is crap but I will give you what I think works. 

Studying for the MCAT kind of runs like a bad drug commercial with 1 benefit and 57 side effects including things like anal leakage or a decrease in the size of your testes . The most important side effect happens to be favourable; the fact that it is required for almost every medical school in Canada and the US and if you do well you are one more hoop closer to getting into medical school.  
Now let’s talk about the unfavourable ones:
  1. Let’s start with when you should take the test. Regardless of when this ‘MCAT drug’ is taken it will take away your summer. I recommend taking it after your second year so that all that organic chemistry you just took can go to use before it is drank away.
  2. Any relationships you have or are trying to have will probably cease to exist as you start to look less like yourself and more like your Exam crackers 1001 verbal passages book.
  3. Any job you have, you will probably wish you didn’t have. A few weeks into studying or after you take a diagnostic and realize you can’t critically think about verbal (Jeff for example who for the life of him can’t pull off anything above a 7) all you will want to do is study.
  4. I do recommend taking a prep course (any one really) if you have problems with the idea of ‘individual study time’. These classes not only offer  teachers who are highly attractive, witty, and wonderful people…sorry I am talking about the other instructors … but they also offer a lot of strategy which cannot be taught through a book. The side effect of these classes is that the people in them will become more like your family and the memory of your own family will begin to die away.
  5. All of the studying that you are doing is useless if you don’t actually practice any full length MCATS. Writing full tests is really the best way to improve. I have seen too many students focus strictly on content, forgetting that it is only 1/3 of the actual test. Your familiarity with the tests after all this practicing will be so bad that you see those review screens in your head when you go to bed at night.
In all honesty though and seriously for once, it is not the worst thing in the world to have to write the test. Just write it  get it over with and do well because having to be like Jeff and write it again sucks a whole lot more then just doing it well once.

...Step 2: Be like me,

Why Medical Schools use the MCAT...

...and how is medicine like hardcore pornography?

Another exam! …Don’t like it? I heard McDonalds is hiring.

The academic world is full of exams, and the MCAT is the first of many exams throughout one’s medical training.  Furthermore, (written) tests such as the MCAT are very objective measure; and therefore, we assume they are a fair way to assess applicants.

Like any test – if you do well, you wish medical schools placed greater weight on your MCAT scores; and if you did not do so well, you think… what the hell do I.C.E. tables and a short story on abstract art have to do with real-world medical practice anyway?

The jury is in:
You don’t have to look very far on PubMed for publications praising the predictive value of the MCAT. Without going into too much detail, your MCAT score is a predictor of your performance throughout medical school, both in Canada and the US1,2.

Well this is simple right? High MCAT score equates to a successful medical career, and vice versa. Wrong!

To paraphrase one study2:
  • The writing sample and physical sciences sections carry no predictive value of med school performance.
  • Biological sciences and verbal reasoning scores positively correlate with MCCE part 1 scores.
  • Only verbal reasoning scores positively correlate with MCCE part 2 scores.
(The Medical Council of Canada Exams (MCCE) parts 1 and 2 are taken after completion of a medical degree; part 1 tests declarative knowledge & part 2 tests clinical reasoning.)
Now you know why many schools not only use the MCAT; but why many only look at verbal reasoning or verbal reasoning and biological sciences.

However, if you look at the actual numbers in this study2, the positive correlation and regression coefficients (albeit significant), describing the relationship between verbal reasoning and the MCCE parts 1 or 2 test scores, are not very convincing. Thus, the explained variance is not very satisfying either.

…But what do I know? I’m still wondering why I had to learn I.C.E. tables and answer questions on a short story about abstract art…

If divers are finding fish in sunken shipwrecks, does that mean fish are sinking ships?
As I indicated above, a high MCAT score does not necessarily mean you will be a good doctor (and vice versa). Clearly there are other factors which can be attributed to one’s success. For starters, the MCAT does not measure diligence, motivation and communication skills1.

Wait. Let’s back up here…
…What is a “good doctor?”
…Are the top academic medical students usually successful doctors?
…Are the bottom medical students less successful doctors?
…What are the cause and effect relationships between the MCAT, GPA, diverse extracurriculars and achievements throughout medical school and a medical career?

Herein lies the problem; what is a good or successful physician? I think the US Supreme Court answered this best when taking a stance on pornography: we know it when we see it, but any definition lacks concise parameters and is too subjective.

Long story short, the MCAT is a reputable achievement and aptitude test; albeit, it’s far from the end all to be all.  So, while we’re left with an imperfect system, I’m glad it’s an ever evolving system.


1. Prideaux D, Roberts C, Eva K, et al. Assessment for selection for the health care professions and specialty training: Consensus statement and recommendations from the Ottawa 2010 Conference. Medical Teacher, 2011, 33:215-23.
2. Donnon T, and Violato C. Does the Medical College Admission Test predict clinical reasoning skills? A longitudinal study employing the Medical Council of Canada clinical reasoning examination. Academic Medicine 2005, 80(10):S14-6.

Tuesday, 12 July 2011

It's A Snowy Hell...

Whether we like to think so or not we judge each other. We judge each other on looks, successes and failures. We all pretend we don’t but deep down we are a competitive people and we all need to think of ourselves at some point. I am of course talking about any student who wants into medicine. One of the key points we all look at (don’t even lie to yourself because everyone does it) is what university someone went to. It seems like one of the most important decisions you will make; but I really don’t even think it matters.

I chose the University of Alberta; I tell everyone that I chose it because it’s an established school with an honours science program with lots of research opportunities. But really I just didn’t want to live with my mom and sister anymore and I wanted to go where my friends were. My mom restricted me to Alberta, this left me with few choices… So off I moved north into the snowy hell which is Edmonton. Fortunately it worked out alright for me. I had a few rough years while adjusting to class sizes of 1 trillion with profs that speak 17 words of English; but I came out of the school with great respect.

Would I have done it differently if I could? Why yes of course, but that holds true for most of my undergrad decisions. Firstly, many schools in Canada only count your cumulative GPA and do not take into account whether you had “hard courses” at a “tough marking” school with a “mean prof”. The will look at numbers and you can get numbers at any school in Canada. Secondly, if you want to expand your chances at getting into med it is always a good idea to have two provinces that consider you “in province”. I would recommend going to a province other then your own for school (not Ontario because that place is littered with med school wanna-b’s). A word of caution though, be careful what their requirements for residency are so that you don’t re-screw yourself. Alberta is a nice option to move to if you are not from here because you will be adding two medical schools that you are in-province for. Thirdly, pick somewhere where you can let yourself have a good time, because most schools now are not just counting grades, extracurricular and volunteer are becoming increasingly important.

So, the moral of my story- do not be tricked by fancy institutions and pretty buildings. Pick somewhere where you can do well and not kill yourself in the process.

- Danielle

...So Get Out While You Can!

Entering university after high school was a no-brainer as I have always had an affinity for school and learning. Committing to a full-time “job” has always seemed too stagnant, repetitious and boring to me. On the other hand, I realize this is an overly presumptuous attitude; but the reality is that I’m probably more afraid of growing up. Case in point – the day that I, or my liver, can no longer complete a “centurion” scares the hell out of me! (Huh! It looks like my library-hermit persona and deep knowledge of organ-transplantation will be useful after all.) 

I was born and raised in Edmonton, so attending the University of Alberta was a convenient and sensible option:
  • it’s close to established friends and family;
  • reasonably low cost of living in Edmonton (especially because I continued to live at home);
  • close to my established extracurriculars (skiing, hiking, mountain biking, karate, soccer etc.); and,
  • the Immunology and Infection (IMIN) program at the University of Alberta was of great interest to me before I entered University, and it continued to be throughout the course of the program. 

Having said that, stop sucking the proverbial teet like I have, and get out! GO AWAY! LEAVE HOME! Spread your wings from mommy and daddy and take flight! 

You should move for your undergraduate years for two reasons:
  1. for the experience; and,
  2. moving to another province will theoretically make you a more competitive candidate.

If you remember one thing from today, ignore Danielle’s post :) and remember this: “In business as in life – you don’t get what you deserve, you get what you negotiate.” (Dr. Chester Karrass.) With that in mind, getting into med school is a bit of a “game.”

I’m not saying you should do whatever it takes to gain an advantage; such motivations are counteractive and probably suggest you’re not the right fit to take on the “doctor roles” anyway. But what I am saying is that within your daily and life-long passions, if you can get a leg up, all the better.

Living in a different place would naturally force one to experience different outlets and learn from different peers, mentors and cultures. The point is, not only will a vast array of life-experiences aid your applications, but they will actually make you a better physician in the end. And in the meantime, assuming you moved to a different province …not just across the street (unless you live in Lloydminster)… you should get residency status in a second province. BONUS!

(I’ll second Danielle’s thoughts – now would be a goodtime to verify with each school on what their requirements are to be considered an in-province applicant.)

As Danielle also indicates, med schools can’t objectively assess the difficulty of the courses you took and the communication skills (or lack thereof) of your first year professors and TAs, among other dynamic variables. Maybe it’s unfortunate, but it’s also damn impossible! In light of that, do yourself a favour and set yourself up in courses or a program where you will most likely succeed in. That means:
  1. study a subject you enjoy;
  2. study with friends; and,
  3. don’t enroll in Psychology. Psychology is boring. The fact is, the only easy A out there is the A you receive in a course you enjoy studying for.

Last, for all intents and purposes, all Canadian universities are equal - sorry U of T. Although, I would be wary about colleges and newly accredited “universities.” Historically, course grades from these institutions may not have received the same subjective review on a med school application as a well-established university would have. I’m not poo-pooing these places, just double and triple check to see how your academic score (GPA/prereqs.) will be assessed; because I don’t know the answer to this. In fact, it would be a good idea to look into this no matter what university you enter and med school(s) you end up applying to.

- Jeff