Pre-Medicine (eBook)

1 The 30,000-Foot View

Ray Funahashi and Joel Thomas

Whether you’re already committed to or still contemplating a career in medicine, understanding the birds-eye view to becoming a physician is paramount.

You might be surprised to learn that applying to medical school requires years of preparatory work from required courses and grades to volunteering, shadowing, and extracurricular activities. There are also many unwritten rules, like working with the “pre-medical committee/advisors/office” at your college and carefully timing your application.

Feeling overwhelmed? Don’t worry! We’ll explain all of these things step-by-step so that you will feel well-prepared and poised for success. Below, we outline the basic pathways to medical school and becoming a physician. We will describe each step in more detail in the subsequent chapters, so focus on understanding the big picture for now. You’ve got this.

How do you become a physician in the United States? Let’s get started!

1.1 Step 1. Get a Bachelor’s Degree

All medical schools in the United States require you to have a bachelor’s degree (B.S. or B.A.) from an accredited college or university (they require you complete 90 credits before you apply, and that you will complete your bachelor’s before enrollment). The degree can be in any major. Yes, whether you are a biology major or a philosophy major, it doesn’t directly affect your chances of getting into medical school.

Additionally, some applicants take additional time to pursue another degree, work, or do research after finishing their bachelor’s to become more competitive applicants. More on this later.

On the other hand, if you're in high school and committed to becoming a physician (and have thoroughly explored that commitment), then you can apply to Guaranteed Admissions Programs to secure a spot in medical school at the time you enter college. More on this in Chapter 7, Guaranteed Admission Programs and Early Assurance Programs.

1.1.1 Complete Required Classes

In addition to receiving a bachelor’s degree, completing certain classes in the sciences, humanities, and mathematics is a prerequisite to applying to medical school. These classes can be—and often are—done while working toward a bachelor’s degree. The usual length of time for this step is 1.5 to 2 years if doing this in the context of an ongoing bachelor’s degree, and 1 year if completing a post-baccalaureate pre-medical program. In general, it takes most people 4 years if they need to complete a bachelor’s degree, although students in some Guaranteed Admission Programs can save up to 2 years off the process and complete their undergraduate studies in 2 years instead of the usual 4.

You might be surprised to note that you’re not required to complete any “medical” courses as an undergraduate, (e.g., anatomy, physiology, microbiology, and immunology). This is because all medical students will cover these subjects in the first 2 years of medical school, but in extreme detail and focus on clinical applications. The undergraduate years are instead designed to develop your general scientific thinking to develop a scaffold for clinical decision-making and application of science in medicine.

If you didn’t complete these required classes, you have options to complete them by taking them through a pre-medical post-baccalaureate (post-bac) program (see Chapter 16, Gap Years, Employment, Graduate Degrees, and Post-Baccalaureate Fellowships).

You should have a good — ideally great (close to 4.0) — GPA, especially in your science classes (more in Chapter 10, Obtaining a Solid GPA).

1.1.2 Engage in “Recommended” (Essentially Required) Activities

Most medical schools want to see that applicants have the following:

Clinical Exposure

How do you know if you want to become a physician if you have never been exposed to medicine from a career perspective? Medical schools expect applicants to have either (ideally both) shadowed a physician in person or worked/volunteered in a setting where they worked with patients and/or physicians. In case you were wondering, being a patient yourself doesn’t fulfill this expectation.

Volunteering and Service

Medicine is a field where you are caring for others. Accordingly, medical schools expect applicants to demonstrate this through volunteering over a significant period of time. Volunteering should be longitudinal and personally meaningful.

For example, an applicant who volunteers for several years at his/her local food shelter and communicates personal meaning from the experience demonstrates a more compelling commitment to service than an applicant who volunteers to clean the local park for a week and can’t articulate any transformative insight after doing so. Medicine is a 24/7 vocation, and showing you can commit to something matters.

Research Experience

The practice of clinical medicine actively evolves through scientific discovery, and many medical schools are also academic research institutions. Most—if not all—value students who have demonstrated critical thinking using the scientific method. In addition, as a doctor you will be a lifelong learner. This means that you will have to be able to consistently appraise and critique the latest research when making day-to-day clinical decisions. The research you get involved in doesn’t have to be medical—it can be in any academic field from philosophy to theoretical mathematics.

Schools don’t necessarily expect you to become a researcher or conduct research once you are in medical school, but they still value those who at least have had the experience.1

1.2 Step 2. Take the Medical College Admissions Test (MCAT)

MCAT stands for Medical College Admissions Test, and it is a standardized computer-based exam that tests critical thinking and comprehension across physical sciences (physics and chemistry), biological sciences (biology and organic chemistry), psychology and sociology, and verbal reasoning. This is the “big test” that you may have heard other pre-meds talk about. Taking this test is a prerequisite to applying to medical school, and doing well is essentially a requirement for acceptance into medical schools.

Your MCAT score is one of the most important factors in your application’s competitiveness besides your GPA because medical schools will have a soft (and sometimes hard) cutoff on reviewing applications based on the MCAT score. That means some schools will have automatic cutoff scores that will preclude certain applicants from having their applications even be seen by reviewers.

Generally, this test requires you to have a strong grasp on the scientific concepts central to the required coursework we have discussed. Your college classes should cover the majority of what you need to know, but you will most likely need to buy a MCAT review book or review materials to make sure you can focus efficiently on the right content. Some people choose to enroll in preparation classes, which are generally very expensive.

Basically, the MCAT questions give you information or evidence in a written passage or graph/table form. Sometimes this information will be baffling on purpose. You will need to understand how to identify the relationship between the new information given and scientific concepts you already know.

When you take this exam is up to you, but most people finish their science classes first and then dedicate weeks to months of study time to prepare to take the exam prior to June of the year before starting medical school. For traditional applicants, this would be around the end of their junior year of their undergraduate degree.

The timing of when to take this exam will vary based on your situation, especially if you are not applying to medical school straight out of college. Those applicants that have already graduated—or plan on taking time off but have not taken the test—will have to find a time that makes sense for them and when they want to apply.

The exam is graded with a numerical score that will permanently remain on your record. Generally, most medical schools will accept MCAT scores from the last 2 to 3 years. However, some schools may accept older scores. Schools also vary on how they determine the time cutoffs. Some schools count the time backward from the date of expected matriculation, while others count the time backward from time of...