Only the nearly perfect need apply

With medical schools rejecting the vast majority of their applicants, what's an aspiring Hippocrates to do?


Jennifer King
January 15, 1999 2:15PM (UTC)

What is perfection? Don't ask a philosophy student -- ask a pre-med.

A philosophy student will ramble on about God, Plato, subjectivity and a bunch of other metaphysical hooey. Pre-meds are concise: a 4.0 grade-point average and a 45 score on the Medical College Admissions Test. And every day that pre-meds spend applying to medical schools, these two numbers stand in evidence of how far they fall from the ideal.

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Lest this sounds like dragging out the Sturm und Drang for those who neither have the brain power nor the patience to become doctors, consider the following statistics. Though approximately one out of every three applicants eventually finds a spot at one of the nation's 125 allopathic (that is, traditional) medical schools, acceptance rates at the majority of the nation's schools are well below 10 percent. For top-flight schools like UCLA, Johns Hopkins and Harvard, the rate often drops below 5 percent. Applicants to med school are generally a self-selecting bunch; pre-med majors tend to be those competitive, alpha pupils who map out their futures early and know they'll need good grades to get there. For this reason, medical schools generally get to pick and choose between highly qualified students, and those who do gain acceptance have an average of 30 on the MCAT (about the 75th percentile) and a science GPA near 3.6, as opposed to an average MCAT score of 27 and science GPA of 3.3 for all applicants. For most students, the prognosis is so poor that pre-meds must prepare for the worst.

Ariela Gutierrez has dreamed of becoming a doctor since high school, she studied biology in college and got an above-average MCAT score. But after facing rejection from 14 medical schools last year, she began to rethink her career.

"It was the numbers," mourns Gutierrez, 24, now a graduate student in public health at the University of California-Berkeley. "You could be the greatest, well-rounded person and it just doesn't matter."

A pre-med's GPA and MCAT score must be at least average (around 3.5 GPA
and higher than 25 combined score on the MCAT) to make the first cut. Otherwise, you're dead on arrival unless you have some unusual claim to fame (like Stanford pre-med student Chelsea Clinton) or some compelling or original scientific research to your credit.

"It's a mind-numbing process," agrees Greg Chronowski, M.D., a recent
graduate of Jefferson Medical College in Philadelphia, who worked for a year as a student admissions coordinator at Jefferson and authored one of the most popular pre-med sites on the Web. Chrononet at times receives more than 1,000 hits a day.

Chronowski, who had a 29 MCAT score but a GPA below 3.0, beat incredible odds to get into school. "The irony is that I did extremely well once I reached medical school," says Chronowski, who graduated from Jefferson in the top third of his class.

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Though widely recognized as legitimate, osteopathic medicine maintains
a low profile compared to traditional allopathic medicine. The medical
training that doctors of osteopathy (D.O.s) receive is almost identical
to that of M.D.s, but with a twist. While M.D.s are trained to focus on
the specific symptoms that cause disease, D.O.s are taught to conceptualize disease holistically by examining a variety of factors, including diet and mental state. Osteopathy is also known for its use of musculo-skeletal manipulative treatment, a form of physical therapy resembling chiropractic manipulation that has traditionally garnered accusations of quackery from some M.D.s.

Among many pre-meds there is a widespread perception that osteopathic
schools are second-rate. Young didn't bother applying to an osteopathic school because he believes "the quality of education isn't as high as what you would receive in an allopathic school." Though the average GPA and MCAT scores are lower than at allopathic schools, osteopathic schools are only slightly less competitive. With more than 50,000 applications filed last year for approximately 2,500 spots, the acceptance rate hovers at about 10 percent.

Ali Tehrani, a student at the University of Health Sciences, an
osteopathic medical school in Kansas City, Mo., who tutored pre-med students for the MCAT with Hyperlearning, is familiar with such attitudes. "I had one of my MCAT students complaining about not getting in the first couple times he'd applied [to allopathic medical school]," he said. When Tehrani asked the student why he didn't try applying to osteopathic schools, "He said, 'No -- I want to go to medical school.'"

"I have no regrets," says Tehrani, who applied to both osteopathic and
allopathic schools, "because the curriculum is a carbon copy of M.D. schools. I want to practice orthopedic surgery, which as a D.O. is to your advantage [since] a lot of people on the orthopedic surgery national board are D.O.s."

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Tehrani passed on his only opportunity for pursuing an M.D. at St.
George's University Medical School in Grenada. Foreign medical schools,
most notably the slew of schools located in the Caribbean, are popular
with American pre-meds due to higher acceptance rates and warm tropical
beaches. "A lot of people I know chose St. George's as opposed to a D.O.
school because they want to have M.D. after their name," says Tehrani.
"But I don't think that really matters."

Foreign medical schools present their own complications. Besides
academically inferior reputations and poorer access to clinical resources, especially at Caribbean schools, many foreign educated students find it difficult to obtain a residency in the United States after graduation, an integral step to becoming a doctor.

"It's becoming increasingly difficult for foreign medical graduates to get residency spots," says Chronowski. "I think a D.O. would match far better at any [residency] program."

Advertisement:

Gutierrez, who considered applying to foreign schools, agrees. "I
didn't want to take the risk. It's four years, it's still grueling, and
then you come back and find you might not get a job."

Some students flatly dispute this view. "You can either be a doctor or
an osteopath," says Casey Dellabarca, a 27-year-old medical
student at Trinity College in Dublin. "Going to a foreign country to study at one of their top universities is more appealing than studying osteopathy."

Dellabarca chose Trinity after applying to 20 U.S. medical schools
unsuccessfully for two years. When he finally applied internationally he
chose schools in both Ireland and Australia, shunning the Caribbean. "I
hear that student morale is always low," says Dellabarca. "I just
couldn't see myself going down there."

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For those not interested in studying osteopathy or gambling on foreign
medical schools, some find becoming a physician assistant is preferable to not practicing medicine at all.

P.A.s are board certified and usually possess a certificate or master's degree from a P.A. program. Doug Jacobs, a P.A. at the cardiovascular surgery unit of Stanford Medical Center, applied to medical school twice without success in the early 1970s. Now, at age 48, he wields much the same power as physicians, including writing prescriptions and playing an active role in the operating room.

"It's almost like being a permanent resident," says Chronowski. "A lot
of the floorwork that would normally be done by a physician is now being
farmed out to [P.A.s]."

Yet many former pre-meds cringe at the thought of being subordinate to
a physician, when with a bit more luck, they could have been the one giving the orders. Despite Jacobs' high level of responsibility, the attending physician
has the ultimate decision-making power. "Given a choice," he concedes, "I'd
rather be the physician. But this is an awfully good second choice."

Advertisement:

Perfect or not, Justin Young -- still trying to keep hope alive -- remains committed to medicine. "If I don't get in this time," Young says, "the next time I'll apply to some foreign schools."

Young's dilemma raises the question: Are current med school admission
standards fair? Or are we losing scores of potentially good doctors by
placing too much emphasis on MCAT scores and GPAs? No one could argue
convincingly that medical schools should lower their standards. After all,
when it's you under the knife, chances are you'd prefer to be operated on
by someone who got an A in biology rather than a C. At the same
time, it's important to recognize that good grades and
high MCAT scores aren't the only factors in determining what makes a good
doctor.

"It's very frustrating," says Chronowski, "to applicants out there like
myself who will probably make superb physicians, probably better physicians
than a lot of people who are accepted. But the process is still based on
objective criteria." The reality is that until the number of applicants
decreases
substantially, and the admissions game becomes less quantitative, nothing
will change. And in the meantime, osteopathic and foreign medical schools,
as well as other allied health professions, will continue to profit by
gaining students who couldn't be measured by simply a set of numbers.

Though widely recognized as legitimate, osteopathic medicine maintains
a low profile compared to traditional allopathic medicine. The medical
training that doctors of osteopathy (D.O.s) receive is almost identical
to that of M.D.s, but with a twist. While M.D.s are trained to focus on
the specific symptoms that cause disease, D.O.s are taught to conceptualize disease holistically by examining a variety of factors, including diet and mental state. Osteopathy is also known for its use of musculo-skeletal manipulative treatment, a form of physical therapy resembling chiropractic manipulation that has traditionally garnered accusations of quackery from some M.D.s.

Advertisement:

Among many pre-meds there is a widespread perception that osteopathic
schools are second-rate. Young didn't bother applying to an osteopathic school because he believes "the quality of education isn't as high as what you would receive in an allopathic school." Though the average GPA and MCAT scores are lower than at allopathic schools, osteopathic schools are only slightly less competitive. With more than 50,000 applications filed last year for approximately 2,500 spots, the acceptance rate hovers at about 10 percent.

Ali Tehrani, a student at the University of Health Sciences, an
osteopathic medical school in Kansas City, Mo., who tutored pre-med students for the MCAT with Hyperlearning, is familiar with such attitudes. "I had one of my MCAT students complaining about not getting in the first couple times he'd applied [to allopathic medical school]," he said. When Tehrani asked the student why he didn't try applying to osteopathic schools, "He said, 'No -- I want to go to medical school.'"

"I have no regrets," says Tehrani, who applied to both osteopathic and
allopathic schools, "because the curriculum is a carbon copy of M.D. schools. I want to practice orthopedic surgery, which as a D.O. is to your advantage [since] a lot of people on the orthopedic surgery national board are D.O.s."

Tehrani passed on his only opportunity for pursuing an M.D. at St.
George's University Medical School in Grenada. Foreign medical schools,
most notably the slew of schools located in the Caribbean, are popular
with American pre-meds due to higher acceptance rates and warm tropical
beaches. "A lot of people I know chose St. George's as opposed to a D.O.
school because they want to have M.D. after their name," says Tehrani.
"But I don't think that really matters."

Advertisement:

Foreign medical schools present their own complications. Besides
academically inferior reputations and poorer access to clinical resources, especially at Caribbean schools, many foreign educated students find it difficult to obtain a residency in the United States after graduation, an integral step to becoming a doctor.

"It's becoming increasingly difficult for foreign medical graduates to get residency spots," says Chronowski. "I think a D.O. would match far better at any [residency] program."

Gutierrez, who considered applying to foreign schools, agrees. "I
didn't want to take the risk. It's four years, it's still grueling, and
then you come back and find you might not get a job."

Some students flatly dispute this view. "You can either be a doctor or
an osteopath," says Casey Dellabarca, a 27-year-old medical
student at Trinity College in Dublin. "Going to a foreign country to study at one of their top universities is more appealing than studying osteopathy."

Advertisement:

Dellabarca chose Trinity after applying to 20 U.S. medical schools
unsuccessfully for two years. When he finally applied internationally he
chose schools in both Ireland and Australia, shunning the Caribbean. "I
hear that student morale is always low," says Dellabarca. "I just
couldn't see myself going down there."

For those not interested in studying osteopathy or gambling on foreign
medical schools, some find becoming a physician assistant is preferable to not practicing medicine at all.

P.A.s are board certified and usually possess a certificate or master's degree from a P.A. program. Doug Jacobs, a P.A. at the cardiovascular surgery unit of Stanford Medical Center, applied to medical school twice without success in the early 1970s. Now, at age 48, he wields much the same power as physicians, including writing prescriptions and playing an active role in the operating room.

"It's almost like being a permanent resident," says Chronowski. "A lot
of the floorwork that would normally be done by a physician is now being
farmed out to [P.A.s]."

Yet many former pre-meds cringe at the thought of being subordinate to
a physician, when with a bit more luck, they could have been the one giving the orders. Despite Jacobs' high level of responsibility, the attending physician
has the ultimate decision-making power. "Given a choice," he concedes, "I'd
rather be the physician. But this is an awfully good second choice."

Perfect or not, Justin Young -- still trying to keep hope alive -- remains committed to medicine. "If I don't get in this time," Young says, "the next time I'll apply to some foreign schools."

Young's dilemma raises the question: Are current med school admission
standards fair? Or are we losing scores of potentially good doctors by
placing too much emphasis on MCAT scores and GPAs? No one could argue
convincingly that medical schools should lower their standards. After all,
when it's you under the knife, chances are you'd prefer to be operated on
by someone who got an A in biology rather than a C. At the same
time, it's important to recognize that good grades and
high MCAT scores aren't the only factors in determining what makes a good
doctor.

"It's very frustrating," says Chronowski, "to applicants out there like
myself who will probably make superb physicians, probably better physicians
than a lot of people who are accepted. But the process is still based on
objective criteria." The reality is that until the number of applicants
decreases
substantially, and the admissions game becomes less quantitative, nothing
will change. And in the meantime, osteopathic and foreign medical schools,
as well as other allied health professions, will continue to profit by
gaining students who couldn't be measured by simply a set of numbers.


Jennifer King

Jennifer King is a freelance writer living in Oakland, Calif.

MORE FROM Jennifer King

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