Ask the Dean: Premed Questions Answered

Dr. Scott Wright and Dr. Ryan Gray answer our Mappd Members' Questions

Applying to Med School With a Disability, Activities, & More!

Today, we tackle questions around disability, clinical activities, credit hours, and blank transcripts!

Ask the Dean is the first media project from my new company Mappd. It's a technology platform that's going to help premeds understand the process of getting into medical school. 

Joining me, as always,  are Mappd co-founder Rachel Grubbs and Dr. Scott Wright, our VP of Academic Advising. He's the former director of admissions at UT Southwestern and the former executive director of TMDSAS. 

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[00:34] PTSD as Part of Your Story

Q: I have a question regarding disability. I am a nontrad, 36 years old, I'm a veteran of the Iraq war and spent 10 years after that working as a firefighter paramedic. I was recently retired because of PTSD. I still want to serve people. But I am concerned that medical schools will think my PTSD symptoms will prevent me from completing the training. I watched Dr. Gray's podcast which suggested that I only mentioned it if it is part of my story. But the thing is, I really want to serve the veterans.

A: There are applicable federal laws that dictate what can and can't be done with regard to disability and discriminating against an applicant because of disability. However, you can request accommodations based on your disability. And the school can decide whether it's willing to or can offer similar accommodations. 

However, it's a bit concerning that you had to leave your work as a paramedic firefighter because of PTSD. And the stress of medical school is going to be intense.

“If you can't work as a firefighter paramedic because of PTSD, then is that going to mean there's going to be problems in any career potentially?”

Personally, I had the privilege of taking care of firefighters while I was in the Air Force. And there were a couple of times where I had to go to a firefighter and tell them they can't do their job anymore. And it's definitely a unique situation. 

Things that would be disqualifying for a firefighter would usually not conflict with being a physician. And so my assumption is, maybe they were retired, not because they couldn't handle the job, but because their physician probably said they have PTSD. And maybe their symptoms aren't the best. 

And the biggest question that it comes down to whether we're looking at pilots, or firefighters would be is there any risk of sudden incapacitation? Or if there's something triggering in a firefighting situation and you want to run away and hide which is what PTSD may do to some people. Obviously, you can't do that if you're the person holding the hose and all of the rest of the team is relying on you. 

[05:19] Firefighting Setting vs. Clinical Setting

Working in a hospital setting, maybe seeing a patient coming in with bad trauma, like gunshot wound or motor vehicle accident, are some triggers as well. And so the student will have to be okay with that. 

But again, there's a little bit less of the risk of sudden incapacitation. Usually, that's not going to harm everyone else around you in that situation. And so there's a little bit more flexibility with that. 

“In a firefighting situation, you don't know what's going to happen around you. Whereas when you're in the hospital, a lot of it is routine stuff.”

When we look at the fields of medicine that might be less or more appropriate for someone experiencing PTSD, it depends on what those triggers are in an individual. If it's someone who suffered years of abuse from a parent, maybe being a psychiatrist, hearing other people's stories of abuse may not be the best for them. So that's going to be completely individual.

This student sent a follow-up response stating that they got cleared by their psychologist to pursue a career as a physician. But they won't allow them to work as a first responder because their symptoms affect them more when they're on-duty than when they're off-duty. 

This particular student is obviously triggered more by seeing the situations they're in. And in a firefighting situation or in a first responder situation, there are lots of lights and lots of sounds and lots of chaos, that aren't going to be there in more of a clinic setting. 

Going back to the original question of whether you should make it part of your story, I would include it if it makes you you. It's actually an interesting conversation for the interviewer to really understand.

[08:26] Stuttering as a Disability?

Q: Would you suggest disclosing stuttering as a disability on applications? 

A: In my experience, Scott never had anybody with a stuttering issue. Stuttering is obviously going to come up in an interview. And there are two sides to this. 

The stutter could offer a great deal of empathy to patients who also have disabilities or who are struggling with incapacitation, whether it's physical or mental or whatever. 

On the other hand, the medical school is going to be concerned with how the patient is going to be able to understand the doctor. If the stuttering is so severe and the patient is going to have difficulty understanding what the doctor is saying then that can be a problem. 

The same thing occurs when you have medical school applicants who have very severe foreign accents where it makes it very difficult to understand what they're saying. 

But in terms of bringing that up in the application, again, this is relative to what is your story. Talk about it in your secondary where you're asked about that. If you're connected with that story well enough, you've got to tell it.

“If your stuttering is a huge part of your story and why you want to help people or whatever, then you have to talk about it.”

[12:14] Quitting Your Job to Apply to Medical Schools

Q: I've been a respiratory therapist for about nine years. And I've been contemplating quitting so I can focus on applying next cycle MCAT, essays, interview prep, etc. I love my job. So I'm really on the fence. I also don't know if ad coms will frown on quitting this far out from the application cycle. Any thoughts?

A: Generally, admissions committees are not going to be concerned about you quitting your job to prepare for going to medical school. Because preparing for an application involves a significant amount of studying for the MCAT, writing essays, interview prep, etc.

The MCAT study can be a big time constraint, particularly depending on how long it's been since you've been in contact with some of that subject matter. 

Additionally, do not count on some of the classes you took for your respiratory therapy degree for prerequisites. If they're nine years away, then you're going to have to retake some stuff. 

There are also some students who have taken anatomy and physiology in their nursing program. Or they took microbiology in their medical technology program which are courses embedded in these allied health programs. They are not going to count toward the prerequisites. So be careful about that with regard to the coursework.

But going back to the question, quitting your job wouldn't be a concern for medical schools. Focus on a lot of that consistency as well. So just because you're quitting being a respiratory therapist doesn't mean you can't get some clinical experience of shadowing once a month.

[15:33] Is Blank Transcript a Red Flag?

Q: I have a question regarding a potential red flag. First semester, freshman year, I had to transfer out the first few weeks of school before the Add/Drop period due to unforeseen extenuating circumstances. I transferred to a school closer to home. All went well on the transfer and grade-wise. ECs, etc. Through my circumstances, the transcript from the first school is completely blank because I left before the Add/Drop. Is this a red flag to have a blank transcript? How should I explain this on my application? 

A: There's not even going to be a class on the transcript at that point. And you are going to have to submit the blank transcript, but none of the courses will go into the course register. 

Apparently, your reason was significant enough to leave school before you really even got started and go closer to home. So you may need to go into that story. It may not be in your personal statement. And you could explain this in a secondary or an optional essay or something like that. That being said, it's not a red flag. 

"If it doesn't show up on the transcript, it's not going to count as a credit."

[19:49] Virtual Shadowing

Q: UT Southwestern is starting a virtual physician shadowing program in October. Do you think TMDSAS schools would be willing to accept this experience as clinical shadowing?

A: Yes, because it's the medical school doing it. And if your question is whether another school in Texas accepts it, the answer is yes again. 

Especially during these COVID times, medical schools, in general, are going to recognize this is a necessity at this point. They are going to accept that just like they would any other kind of virtual shadowing program.

UT Southwestern’s program comes with a nominal fee. We're also doing eShadowing which is FREE. We're working on automating certificate granting and making sure students are actually attending the session for a specific amount of time. And they're doing the quiz and passing the quiz, making sure all that information marries up to actually offer credit for that. 

“There are several virtually shadowing opportunities out there right now and definitely everybody should get some.”

[22:29] Clinical Opportunities

Q: Do you have any suggestions for gaining clinical experience right now during the pandemic? It seems a lot of opportunities have been canceled and frozen since COVID. 

A: Clinical opportunities are going to be something completely different. And medical schools are going to recognize the severe limitations on this type of activity right now and they’re not going to hold it against you. 

Now, if you're a senior or you've been on the premed track for three or four years, and you're just now getting in the ballgame, in terms of clinical experience, then medical schools might question why only now. So it depends on your story and the progression of things. But generally speaking, they're not going to hold it against you.

Going back to the question of finding those opportunities, you can do the crisis hotlines or virtual scribing where you can do some virtual buddy for hospice or nursing homes. 

“Just get out there and be creative. And don't worry if it's going to count or if it's good enough.”

Over the long term, this is where Mappd really comes in handy. You're going to be able to track yourself through those experiences and where the feedback that Mappd is going to be giving you. It's going to say that you're two years into this, and you have no experience yet. So this is a red flag. Not only will Mappd keep track of those, but it will also give you some feedback.

[26:13] Counting Credit Hours

Q: As an exchange student, nine credit hours per semester was full time. So almost two years worth of class comes under one year, according to the year classification. Is that normal? Is that how I put in my courses?

A: You're just going to have to count by credit hours. The way the AMCAS manual currently words it is if you have a fairly traditional education, then don't worry about a cut off at a certain number. Just plan to change roughly every three quarters, roughly every two semesters. 

Then it says if you have nontraditional, if you have stops and starts, if you have transfers, if you have lots of community colleges, then you should designate by credit hour. But even there, it gives a little bit of a range, which is slightly different than the one on TMDSAS. It's like zero to 30 or 35. And then 30 or 35 to 65. So there's still a little bit of designation.

Students obsess about this a little bit more than they should. This is self-reported and the admissions committees are probably not concerned about this. So they're saying it's not black and white. It's gray, and they're giving you some boundaries. You are encouraged to make a judgment call. 

"Students have the flexibility to adjust things and if there are too many things they're adjusting, they're just going to send it back to you with a note to fix it yourself."

Processors see hundreds and thousands of applications. They're used to what is a normal amount of sort of variation. And if it gets too much, they're going to pop it back to you for you to fix some stuff.




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