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Ask the Dean: Premed Questions Answered

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

12 Premed Questions Answered: Application Turnoffs, Imposter Syndrome, & More

Today, we delve into topics related to clinical experience, postbac programs, what premeds should know about the U.S. healthcare system, how to get over imposter syndrome as a premed, and the 3 biggest turnoffs in a med school application!

We also talk about the importance of avoiding typos in essays this week.  We recommend Grammarly, a proofreading tool with free and low-cost options.  

Ask the Dean is the first media project from my new company Mappd. Joining me today, as always, are Mappd co-founder Rachel Grubbs and Dr. Scott Wright, our VP of Academic Advising. More than 1,400 students are using it to track their progress to medical school. If this is something you're interested in, check it all out for a free two-week trial. Also, check out Mappd.tv.

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

[04:05] “Real” Clinical Experience 

Q: Is caregiving in a nursing home "real" clinical experience?

A: While not all clinical experience is the same, it can be valuable depending on the students themselves and how they talk about that in their application or in the interview. A caregiver experience can be more valuable to that student than a student who has scribed for a year and doesn't have a clue what's going on and doesn't care. So it's all about how you talk about it, what it means to you, and the depth you decide to go into on your application.

"Not all clinical experience is the same."

It's not the "what," but it's the "so what" that's super applicable. It's ideal that you broaden your experience to other types of clinical experience. But if that's not possible, or if you don't want to because you really enjoy the nursing home then you create that value and you go with it. Talk about that in your application – why you enjoy it, why it's valuable to you, and what you've learned out of it – and then go with that. But the idea that experience X is always better than Y is not always the case. 

Students often want to experience the cool things from the get-go. And there are students who get frustrated with their clinical experience or with volunteering because they're doing mundane things. But you have to be able to create your own definition of what matters. If you find yourself stuck in that mundane thing, whether you're just filing or answering a phone or whatever, keep it up and work hard. 

Show that you're committed to doing what you're doing because opportunities will arise if you’re able to show you're there for the long haul.


[10:06] Experience at a Free Clinic 

Q:​ Is helping at a free clinic a valuable clinical experience?

A: A free clinic reaches out to those who need health care. They need it because they don't have insurance, or they don't have any other possibility for health care. 

Students who go through this experience are able to do something that really shows healthcare at a very fundamental level where it reaches people who needed the most. Therefore, this is a great clinical experience. Again, create the meaning of it as you do it. 

[11:29] Lack of In-Person Experience

Q: What can I do about lacking in-person shadowing due to COVID?

A: Medical schools are going to recognize that and they're dealing with COVID, just like everybody else is. Do what you can do. Continue shadowing and volunteering and just do what you can. And whatever clinical experience you have before that – put it out there. 

“Medical schools are going to be responsive to that and they're going to understand that's the way things are right now.”

Moreover, you shouldn't be taking a gap year just for the reason there's a possibility that in-person shadowing is going to be back for the next application cycle. That being said, medical schools are going to look at you within the context of everything else that's going on.

[15:35] Discussing Health Care Policies

Q: What should premeds know about healthcare policy issues?

A: Healthcare is one of the biggest topics, regardless of what side your own on. And so you need to understand the issues and the potential solutions being talked about on both ends of the spectrum. That's why you need to vote.  

“Whatever happens in the future, in terms of policies, it's going to affect you in a direct way.”

Look at the issues surrounding healthcare in America, and look at it from both perspectives. Evaluate the issues and how you feel about the topics. Make an opinion of your own about what that means as this could easily come up in an interview.

It could come up in a variety of ways. It will affect all of us as we need health care. But it will also affect you in terms of your future in the healthcare field. How you practice medicine in the future is going to be affected by these policy issues. 

[20:01] Premeds as Standardized Patients

Q: Is being a standardized patient a good experience as a premed?

A: Virtually every medical school uses standardized patients. A standardized patient is basically an actor who portrays a series of symptoms. Some standardized patients get on to get a history taken from them. So it's all verbal, but there are standardized patients who actually get physical examinations, as well. 

The best way to see patient care from a patient's point of view is to actually be the patient, which we all are. But being a standardized patient is a forced scenario. As an actor, you are given strict guidelines on what to say if they ask this type of question, and you respond accordingly so your symptoms don't deviate. So your specific interaction is very fixed. Obviously, you are interacting with a student who is learning how to communicate with you. 

While it's not really a good way to see the healthcare system, it's a good way to have some fun interaction with the medical students. 

At the end of the day, it doesn't teach you about health care or medicine. It doesn't really teach you anything, other than it's cool to be in a medical school or wherever you are. Then on the other side, students will learn how to communicate as a health care provider. And that's huge. 

And so, maybe that'll give you a little bit of a headstart once you are going through this course. But you wouldn't want to lean on it to try to sell it as anything super fancy to help you get into medical school because it’s not clinical experience.

[25:11] The Value of Being a Real Patient

Q: Is going through surgery or health issues as a patient good for your app?

A: Either major surgeries or health care issues of your own or you have a close family member, these are very common scenarios that are covered in applications. 

In The Premed Playbook: Guide to the Medical School Personal Statement, I talked about the seed. And for a lot of students, personal illness injury is a seed because that's the first time they've been exposed to healthcare, being in and around health care. Where students fall flat is the "what" versus the "so what."

Now, that depends on how you talk about it and what you talk about in terms of the learning aspect of the experience. Admissions committees hear these stories a lot so you have to go deeper into why this is important to you. 

[28:05] Biggest Turnoffs in an Application

Q: What are the biggest turnoffs in an app from a reviewer's perspective?

A: One of them is when a student has flat-out mistakes in their application – misspelled words, bad grammatical errors, etc. – things that any applicant should be careful of. This is very frustrating for a reviewer to see because it's supposedly one of the most important things students have ever done and they screwed it up. But it inevitably happens. As soon as you click Submit, the typo pops out and there's nothing you can do about it. Unless it's just one instance, then maybe that’s fine.

And so, this tells the admissions committees that the student was not careful. They didn't put their full energy and their full focus into this process, they half-assed it throughout, and this is what you got. 

Another big turnoff is arrogance, which comes out in a lot of different ways. In an application, Scott explains they can hear the tone of some personal statements as if they were on the verge of a Nobel Prize. Or it’s when a student talks so negatively about the American healthcare system, or about doctors they've experienced, and that they want to be better than all the doctors they've ever experienced. 

And the tone of the personal statement may come across as you're single-handedly going to change the way the public views medicine. And that's just a big turnoff because you're dealing with a group of an admissions committee of at least half, if not more, clinicians. 

[33:08] SMPs vs. Postbacs

Q: What's the difference between an SMP and postbac? Which is better?

A: A postbac is anything after your bachelor's degree. It could be a formal postbac where you apply to a specific school or curriculum set up to take the courses. It could be a career-changer postbac where you haven't taken any science courses, and now you're switching careers because you want to go to medical school. Or you just graduated and you want to go to medical school after not taking any science courses. 

"All SMP's are postbacs , but not all postbacs are SMP's."

Then there's the academic enhancer program. Maybe you were premed or some other science major and you have lots of science courses under your belt. But you just need to improve your GPA. 

Or you just go back to community college and then try a do-it-yourself versus a special masters program, which is master-level coursework. Usually, it's a very specific curriculum that schools set up where they charge you a crap ton of money to do. And sometimes, they're connected with a medical school.

[35:22] Postbachelor’s Degree

Q: Does it count as a postbac if it's at the same school as your undergrad?

A: Yes, it's called a post-bachelor’s degree. But Scott doesn't really recommend doing a postbac at the same institution. He adds, sometimes it's beneficial to have a new start and get to a different institution and start over. The faculty don't really know you so there are no biases or expectations either way. But being in a totally different field at the same institution can change the dynamic as well.

"It can be beneficial to go to a different institution, but it's not necessarily bad to stay at the same institution."

[37:39] Intro to the U.S. Healthcare System

Q: Any book recommendations about the U.S. healthcare system?

Check out The Health Care Handbook written by medical students back in the day. Also, pick one of Atul Gawande's books as he has great perspectives on various topics and you get a bit of a window into the healthcare system. Another book every premed should read is called The Immortal Life of Henrietta Lacks by Rebecca Skloot. It gives you a window into the social, racial, ethnic issues, and medical ethics issues.

[40:58] Volunteer vs. Paid Clinical

Q: Do you need clinical volunteering if you have a lot of paid clinical work?

A: Clinical is clinical so don't worry about it. Having some sort of volunteer experience, whether it is clinical or not clinical, addresses something about your interest in caring for people when you're not necessarily getting any benefit out of it. So it's not going to be a big slam against you if you don't have that.

Some people just have to work and they just don't have a whole lot of opportunity or time to do school and work and everything. 

Medical school applicants or not, we should seek some volunteer efforts. We learn a lot from it about ourselves and about the plight of others in this country or in our society. Whether you're teaching kindergarteners how to read or helping at an art museum, this shows your interest in impacting the world around you. With that said, it's not a big slamming issue if you can't do that.

[42:46] Getting Over Imposter Syndrome

Q: How to get over imposter syndrome as a premed?

A: First, be sure to listen to Episode 269 of The Premed Years podcast where we had Danielle Jones talk about imposter syndrome. 

"Physiologically, fear and excitement are the same."

At its core, imposter syndrome is doubt and anxiety. It's your interpretation of your feelings that really makes a difference. So the first step is to trust yourself and reinterpret those feelings as excitement. 

The next step is to understand that Imposter syndrome never goes away – whether you're a premed, a medical student, a resident, and even an attending. So you have to consistently tell yourself positive affirmations and write a gratitude journal where you list things you're grateful for every day.

Then surround yourself with people who are going to affirm you as well – whether it's peers in your premed class, your friends and family members, or mentors. You need to surround yourself with people that are positive and who will help you see the best of you. Then cut the ones who are negative out of your life or spend less time with them. As Jim Rohn says, you are the average of the five people you're surrounding yourself with.

Also, check-in with the fact that rejection is normal – it's not personal. No does not mean anything about you. It just means you're not a fit, not right now. And everybody who's ever found a job they loved is probably going to tell you about all the rejections they had. So you just have to go through that process and be okay with rejection.

Links:

Mappd

Grammarly

Mappd.tv

The Premed Playbook: Guide to the Medical School Personal Statement

Atul Gawande's books

Immortal Life of Henrietta Lacks by Rebecca Skloot

Session 269: MamaDoctorJones on Imposter Syndrome in Medical School & Beyond


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