Ask the Dean: Premed Questions Answered

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

Disadvantages, Shadowing Abroad, and Diversity as an Applicant

How do you write a good disadvantaged essay? Will medical schools look differently at nontrad students and URM status? How do you talk about your learning disability in your essay? Does working around a theme or narrative help? All these and more on today’s episode!

Here on Ask the Dean, we answer your questions. 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. Once again, joining me today is Dr. Scott Wright, the VP of Academic Advising at Mappd and Rachel Grubbs.

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

[03:27] How to Answer the Disadvantage Essay or the TMDSAS Optional Essay

The TMDSAS application doesn't have a specific disadvantaged essay, but they have an optional essay. There are three primary essays in TMDSAS. 

There's the personal statement, the primary application essay. There's an essay for Meaningful Experiences, which is pretty broad. It says that if there's something else that you really haven't had a chance to tell us somewhere else in your application, tell us that. Then there's an essay on disadvantage, on diversity in the classroom, and how you would add diversity to the educational experience. 

Additionally, there is a section where they want to know about disadvantage. Just like AMCAS, they have a variety of questions that try to get to this issue of disadvantage. They ask things like:

Are you getting a Pell Grant? How many kids were in your family? What's the value of your home? What's the zip code where you went to most of your life? What's the income of your family? And a variety of things like that. 

What you don't want to do as an applicant is you don't want to stretch it too far. You have the opportunity in these sections of the application to really talk about your growing up and your experiences over the course of your life. And what they're really trying to figure out is whether there are things that have been in your background that have provided barriers to you that should be taken into consideration in the application process. And so if you start writing about some stuff that is kind of a stretch, they're going to know that. So just be straightforward and honest. 

“There are a lot of applicants who really haven't had any disadvantage in their background so don't try to create something that's really not there.”

[06:46] How to Talk About Learning Disabilities in a Positive Way

There are a whole lot of areas where you could really cover dyslexia. It could be in the Meaningful Experiences section. It could also be in the personal statement. It basically depends on how it impacted your life and how that affected you. 

A disadvantage essay is a place where it would fit in really well too. As with everything else, it's not the time to whine about getting poor grades because of that. But it's an opportunity for you to say what you've learned from the experience and what you've overcome. Talk about what you've learned about yourself, about your colleagues, your peers, your professors, etc. You want to go to the value of that experience. 

“There will be students that are diagnosed for the first time with learning disabilities in medical school.”

Some students have learned how to cope so well and learn these strategies to overcome things. Interestingly, many students get diagnosed once they get to medical school. And it’s probably because it can be overwhelming and the amount of information just doesn't allow the student to really overcome those deficiencies.

[11:03] Shadowing Abroad

One specific school, University of Utah, specifically says they do not count shadowing abroad as shadowing hours. 

“Medical schools are looking for students who understand what the American healthcare system is.”

It's fine if you shadowed or did some volunteering in France during the summer or whatever. The French system is going to be a radically different system than what we have in the United States. It can augment it, but it doesn't replace it. 

Getting those types of experiences in other countries can be an amazing experience. But you have to be very careful with that. 

There have been some guidelines that have come out probably within the last 5 to 10 years about what you should be able to do. There are some really significant ethical problems with students who went abroad and had to chance to suture a patient or other procedures they really shouldn't be performing. And medical schools are very concerned about that. 

If you start talking about that in your essay or in the application, that can be a big huge problem. It's a red flag that goes up. Sometimes, third world countries are begging for health care providers. So you go down there on some mission trip or something. And all of a sudden, the doctors there ask you to do those things. So just be super careful about that.

You are a student who isn't certified to do that and just because it's a third world country, and the patients aren't going to say no, doesn't cut it. Sure, it's super exciting and it might be the first time you get to do something like that. But just say no. And if you talk about it, it's going to be an issue. 

Again, shadowing abroad is not going to replace experience in the American healthcare system. Now, if you're an EMT, then obviously you're certified and you're trained. You know what you're doing so that's a whole different topic.

[15:53] Looking Over Nontrad Applications

It's pretty quick to spot nontraditional student. Their ages are clearly different. Maybe they're at their 30's or 40;s. 

Another thing that can often indicate that is they've been to lots of different institutions. Maybe they've been to five or six different colleges at different places around the country. Or maybe they were in the military. So it's almost always pretty clear right off the bat when the student doesn't fall within the traditional timeline.

"It's not something that is a disadvantage to an applicant to be nontraditional."

Again, medical schools are trying to figure you out as a person. Are you going to fit with the institution? Are you going to fit into healthcare in general?

Medical schools see the value of nontraditional students. Because they bring a level of maturity and a level of experience in the classroom, which is a great asset to the class and to the institution.

[20:55] Reviewing the URM Status in an Application

Scott explains that looking at the URM (underrepresented minority) status varies considerably by state. It also varies by whether the institution is public and private. There's a lot of different factors that go into how that might be considered by medical schools. So it really does depend on the institution. 

"All medical schools are wanting to diversify their classes. There's tons of research that show that a diverse class benefits everyone."

It's not just about the benefits in the class of diversity. It's also about the benefits to society. By having a diverse population of physicians to serve them. You can look at research across the board that suggests that minority patients are much more likely to be comfortable with minority physicians. It doesn't mean it has to be that way. But it means that this provides role models in the community. 

Some schools are going to look very significantly at the race when they're looking at applications. There are also going to be other schools that are going to be completely race-blind and will not know anything about it. 

Ultimately, there are a lot of different ways that institutions can provide diversity in their classes. But in terms of URM, it does vary pretty widely by state.

[24:44] Volunteering as a Spanish Translator and Scribing for Clinical Experience

Just a side note: translating refers to written, and interpreting refers to verbal. There are so many ways in which being a Spanish speaker can impact the healthcare environment.

In Texas, for example, there are so many in the population that do not speak English or that their English is so limited. And so with that in consideration, medical schools would really look very kindly on those types of experiences.

Scribing is amazing! It provides an enormous amount of understanding and information for the student doing it. The student gets to learn so much about diagnosis, and about the doctor-patient relationship. 

[29:38] Prereqs Timing Out and Collecting Science Credits from Postbac or Community College

“Prereqs do not time out. It's one of those long-standing myths in the premed world.”

What medical schools are looking for is recent coursework. If it's been 10 years that you've been in school, and then you're applying to med school with no experience in the classroom, that's not going to go well. They're going to really see that you're not in the study mode. 

So if you already have many prereqs, the problem is going to be the MCAT. If it's been 8 or 10 years since you've had general chemistry, then you're going to be doing a lot of review. Because you're not going to remember any of that. 

It's really an issue of the MCAT and your preparation for the MCAT. It's also your preparation for other classes.

For example, biochemistry builds off of the other chemistry courses. Many of the upper-level biological sciences courses build off of lower-level biological science courses. Again, it's the issue of preparing for upper-level stuff that you want to take and the preparation for the MCAT.

Having said that, you have to consider your own circumstances – finances, location, family support, etc. There are a lot of things that go into these decisions about where you're going to take the prereqs or where you're going to pick up this or that course, and things like that. 

The vast majority of community colleges do not offer upper-level biological science coursework. If you're doing upper-level coursework, you’re not going to be able to pick that at a community college. It means you're going to have to go to a four-year school in order to do that. 

Be careful about where you're choosing to do those courses. But don't feel like they're going to expire or something. 

[34:01] ESL Students and The Dreaded CARS Section

There's another myth in the premed world that if you get a 123 on the CARS section of the MCAT, then you're going to have to retake the MCAT even if you got a good overall MCAT score.

Non-native English speakers often struggle on the MCAT in general, not just on CARS. So if you're translating your head as you read, then you're going to be much slower and it's going to affect your score. 

So for non-native English speakers, speak English as much as possible and read as much as you can read. It doesn't necessarily have to be textbooks, but just read whatever stuff. 

Whether a non-native English speaker or not, Scott recommends getting a monthly subscription to The Atlantic. It's a great magazine with a lot of different stories. The New Yorker is another great magazine as well as some newspapers, such as The New York Times or The Wall Street Journal. They're written at a higher reading level that can really benefit students. 

[40:52] Having a Theme in Your Application

How important is having a narrative or theme to your application versus a random mix of activities?

Students try to get so fancy and have this theme of being adventurous or a go-getter. So you go pick all of the activities that match that and throw them into my application. But you don't want your application to feel contrived because it's going to be obvious. So don't contrive anything that's going to make you feel it's fake or not real. Show them who you are, not who you think they want you to.

"Establishing a narrative is going to come across as fake."

That being said, the quality of the personal statement is important. It's difficult to communicate who you are if you don't know who you are. So you have to have a sense of what you're trying to communicate to the reader. But you can't do that in a contrived way because that's going to turn the reader off or that they'll see through it.

[45:38] Talking About Academic Probation

Academic probation or suspension is not an automatic filter. Medical schools will look at what you've done to recover from that experience. And the same thing goes for criminal activity and substance use.

Medical schools look at when it occurred. They want to see if you've recovered and whether you've learned a lot and moved on.

“Having an alcohol violation when you're a senior is a lot different than when you're a freshman.” 

Do you understand what happened? What value did you get from the experience? Again, they're going to look at how you talk about it. So you shouldn't sound like you're whining or you're making excuses. Focus on the value you got from that experience and how you've recovered.



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