Ask the Dean: Premed Questions Answered

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

22 Premed Questions Answered: Extracurriculars, Gap Years, and More!

Today, we discuss a grab bag of topics ranging from activity hours, volunteering, and leadership activities, to doing postbac and taking gap years. Also, we clarify some concerns around applications getting into the trash for being in the “religious pile.”

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 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.

[2:37] Listing Activity Hours

Q: As a non-traditional applicant, I didn't count how many hours I spent in clubs and sports before I decided to pursue medicine. Some of these activities were years ago. How do I estimate hours for my application for these activities?

A: You answered your own question: you estimate hours. Just estimate the best you can and that's all you can do. You're not going to get called out, but don't exaggerate. 

“The number of hours needs to make sense, so go for a conservative estimate.”

[4:27] CNA’s Clinical Experience

Q: I'm a nontrad completing my bachelor's degree. I volunteer to sit with CPS children in the hospital as they physically recover, and I have been virtually shadowing. But It's been over six years since I've worked in health care as a CNA. I'm planning to get more clinical experience during the summer months. How will a med school admissions committee view me with my current experience? 

A: Don't submit your application until you've accumulated several hours of clinical experience, probably at least midway through the summer. Then in your application, indicate that you're going to continue with your clinical experience for the remainder of the summer.

“Saying you plan to get clinical experience during the summer won't be the same as having done it or started it.”

 [7:22] How to List an LDS Experience

Q: Out of high school, I lived in New Zealand for two years serving as a proselytizing missionary with the Church of Jesus Christ of Latter-day Saints. That incredible experience probably opened my eyes to how much better life is when you put other people instead of yourself as your life’s focus. My advisors told me to not mention it because it places my application on the "religious pile” which ends up in the garbage. And also because the LDS Church has the stigma of being conservative. What are your thoughts?

A: There is no religious or conservative pile that ends up in the garbage. We've had LDS students in the past who pursued missionary service. And their experience was incredibly impactful for their story. 

So, you have to tell your story and how it impacted you. But avoid using church jargon, such as proselytizing missionaries.

In telling your story, you have to recognize who your readers are. To say that you're on a service mission for a particular church might be a concern for non-religious members of medical school admissions committees. 

Your readers might not share your views and have no idea of what LDS is all about. Or they might think you will use your practice of medicine as a proselytizing effort. Hopefully, you won't. 

There's a trap you need to avoid and that is saying you want to be a physician because you love serving people. To the reader, that is not a convincing reason. Instead, be clear on what your intentions are and how your experiences tie up within the context of medicine. Expound on why you put other people as the focus of your life instead of yourself within the same context. 

“Your love to serve others doesn't mean that you should be a physician so be careful writing that in your application.”

[10:50] Quantifying Volunteer Work Hours

Q: But how do you quantify or count the hours for volunteer work such as missionary service? 

A: You could say that during the mission, you would go once a week for five hours to build houses, then work in a clinic for two days a week for eight to ten hours a day. You could then describe what you did during those hours. But it all depends on what the students are comfortable sharing and what they want to get across.

[16:14] Sending a DO Letter to an MD School

Q: I've shadowed a DO for a long time. I know he will write me a strong letter, along with my MD letter. Can you send a DO letter to an MD school?

A: You can send a DO letter to an MD school. But you can't replace an MD letter with a PA letter. A DO letter, however, is equivalent to an MD letter, even for allopathic MD schools.

[17:00] Taking Postbac in the Same Institution One will Apply to

Q: What are the pros and cons of taking postbac undergraduate classes at the same school you plan to apply to?

A: That would be fine. But you must have realistic expectations about how that's going to go. State schools usually have a preference for their undergraduate counterparts. For example, UC Riverside School of Medicine saves some seats for Riverside undergraduate students. Riverside does this to serve a specific population.

“It is better to find a school that really fits your needs.” 

[19:54] Leadership Activities

Q: Is leadership experience a necessary part of the application? Can I show leadership in my other activities that impacted me?

A: It's necessary. You can show leadership in a lot of different ways. But you have to think broadly about what leadership is all about. 

Think about skills that are related to leadership, and then talk about those skills that you've developed through these activities. 

Apart from pointing out activities that have made an impact, identify ones that have leadership opportunities. If you were a head scribe or scribe trainer, you can focus on the impact the role had on you as a leader. 

[22:45] Asking for a Letter of Recommendation

Q: I thought I wanted to be a PA, but now I'm fully committed to med school. I've only been out of undergrad for a year, but I lost contact with most of my school professors. How should I go about reconnecting with my professors without giving the impression that I need them just for a letter of recommendation? I've only been out of undergrad for a year. 

A: That's part of your professors' job. And they do it for alumni all the time. Just contact them and ask how they are. Tell your professors how you're doing, then ask them to write a letter of recommendation. Don't contact them and make chitchat, only to ask for the letter in the end. That would be worse.

[23:59] Do Volunteering Hours during COVID Count as Clinical Experience? 

Q: Does volunteering at flu clinics and COVID testing sites where the responsibility is to check patients count as clinical experience? 

A: Yes. These clinical interactions include checking patients for vital signs and asking how they are feeling. But doing patient registration in the emergency department is not clinical, even if you're talking directly to the patients. Asking for personal details such as name, phone number and insurance number does not count as clinical experience.

“Interacting with patients in any clinical way counts as clinical experience. On the other hand, tasks performed in clinical areas don't necessarily count as clinical experience.”

[25:04] Will Past EFS Hinder GPA?

Q: I'm a nontrad, who had many W's and F's when I first set out to go to college in 2015. I ended up leaving school and not coming back for personal health-related issues. In December of 2020, I decided to go back to school at a new community college in my hometown and have maintained a 4.0. For the past two terms, I'm in the process of doing an academic renewal at my previous school, and I'm on track to enter a tag agreement with UC Davis for neurobiology physiology. Will my previous F’s hinder my GPA so much that it won't matter? 

A: Those grades apparently are on the college record, so they will go into the calculated GPA. Even if you go into an academic renewal program, AMCAS doesn't care about that. Everything will still be counted. So it will hinder you. 

What matters is how you're moving forward with what you are doing now. Making good grades at community college is a good start and making good grades at university to finish your program or degree is a necessity. You have little room for B's and no room for C'S or below. You've got to really do well.

[28:09] Can Clinical and Extracurricular Activities Become Outdated?

Q: At what point do clinical experiences or related extracurricular experiences become outdated? 

A: If you did clinical hours, say 10 years ago, and you haven't done anything since then, that's a problem. If you continue doing things throughout the recent past, then then you're good. Include all those activities on your application. 

“Clinical and related experiences are never outdated. What matters is whether you pursued anything afterward.”

None of these experiences go outdated because you talk about the story of your journey on your application. Something you did 10 years ago is still pertinent. What you do afterward will serve as a continuation. As a rule of thumb, though, what counts are your experiences after graduation from high school.

[30:21] Research, Clinical Experiences and Community Service

Q: What are med schools looking for in the following experiences: research, clinical experiences, and community service?

A: It's impossible to answer that question. It's like asking us to tell you everything you need to do to get into med school. We can't answer that. But certainly, research, clinical experiences, and community service are all important.

  • Clinical experience is important to reassure yourself that you want to be a physician – that you like being around patients. 
  • Shadowing is important for you to understand what the life of a physician is like. 
  • Research is important to show curiosity and inquisitiveness and to challenge the status quo. 
  • Community service is important as it is service above oneself.

“You need to formulate in your own mind that you know what you're getting yourself into.” 

[31:51] On 31 Credits of Postbac Coursework

Q: How do medical admissions review 31 credits of postbac coursework? Most are 300- to 400-level courses, but 10 credits are 200-level sciences from the beginning of postbac work.

A: If you're a second career person that has to get a bachelor, you need to take the sciences from scratch. Or if you're retaking classes that you did poorly in, you have to take certain lower-level courses such as general chemistry and general biology. What these courses depend on the mix of the 31 credits. 

It’s not to say that lower-level sciences are easy but medical schools like to focus on upper-level biological science classes to see how you can handle the rigors of it.

“The admissions committees want to focus on upper-level biological science classes to see what your performance will be in those rigorous science classroom courses.” 

[33:36] Letter of Intent vs. Letter of Interest

Q: What should go into a letter of intent versus a letter of interest? 

A: A letter of interest is a more general way of saying that you're interested in the school and that you would like to request an interview. But since you will be submitting an application, a letter of interest is unnecessary. 

“With so many applications to go through, the admissions committee won't find any meaning from a letter of interest.” 

A letter of intent, on the other hand, can address more specific situations. An example would be if you're on a waiting list at a medical school. You can send a letter of intent that says you intend to come if you're offered a place in class. 

Another good opportunity to send a letter of intent is after the interview, assuming it went well. Apart from signifying your intention to attend the school, you can expound on certain points that were raised during the interview.

[36:45] Academic Dishonesty and Personal Challenges Impact on Grades

Q: Would it be wise to address academic dishonesty and other challenges during my undergrad that may have impacted grades during some terms, such as sudden deaths, mental health issues, and divorce?

A: You have to mention academic dishonesty, but separately. 

Academic dishonesty falls under institutional action. While the challenges you faced as an undergrad can be addressed in the personal statement, an optional essay, or secondary essay. 

For example, a common secondary application question is to address any adversity or difficulties that you've experienced in your life, and how you faced those challenges. This is where you can bring up the significance of the sudden deaths, mental health issues, and divorce in your story.

But be careful in how you talk about those sensitive topics. You can briefly acknowledge why your grades went down in light of those difficult challenges. 

“To make the story resonate with the reader, you need to discuss how you overcome those challenges and what you've learned from the experience.”

[40:17] Creating Meaningful Connection with Online Professors

Q: One of my classes this semester is online and does not meet regularly nor does the professor have regular office hours. How can I develop a connection with the professor so I can ask for a letter of recommendation toward the end of the semester? Should I tell them now that I'm looking to get a letter of recommendation later? 

A: The whole point of a letter of recommendation is that the professor knows you, your personality, your strengths, and weaknesses, and can speak about who you are. With an online class where you're not meeting with the professor ever, getting that letter might not be possible. But if it’s not really necessary to get a letter from that particular professor, try to get letters from the other professors instead. 

[41:21] Listing Pet Therapy as Clinical Experience

Q: I was wondering if pet therapy is considered clinical experience. I was pre-vet most of college, and I've spent plenty of time at nursing homes taking baby goats, chickens, rabbits, dogs, and other therapeutic farm animals to patients while providing emotional support. 

A: The experience is clinical because you're dealing and interacting with patients in the nursing home, and seeing how they are doing. Taking farm animals and playing with the patients is no different from joining patients during the game night at the nursing home. Both activities provide emotional support. But not everyone would agree.

The question always comes down to what you are doing with the patients. And what you think about the experience and how you describe it are important. 

If an admissions committee member, in an interview, disagrees that your experience is clinical, then you have to be prepared to argue why you think otherwise.

“Experiences and how they are perceived are not black and white.”

This is the same with admissions committees whose members would have differing opinions at times. So for you to stand firm about your experience would certainly mean something to the committee members.

[45:53] Listing Research that Involves Clinical Experience

Q: My research involves clinical aspects. And I'm wondering if I can count this additional clinical experience: I interact with patients and gather data, but it is research. So I wanted to know if it could be both? Or should I just count it as research only?

A: Separate the items if necessary. If it is truly research, split it. If you're gathering data while hanging out with the patient, then that's probably more clinical.

Make sure you focus on the right aspects. Often, students will write something as clinical experience even if most of the tasks revolve around non-clinical aspects such as cleaning the room. 

“It's one thing to have a red flag in your application. It's another thing to have a red flag that you yourself pounded into the ground and unfurled.”

[48:03] Determining if Postbac Credits are Enough

Q: I'm over 200 units in undergrad in a positive trend for my postbac classes, both core science in upper-division. How do I know when it is enough, like for GPA cut-offs? 

A: Depending on your GPA, you can gather 45 hours of upper-level biological science or hard science classes, a level you have shown to be strong in. You just need to bite the bullet and apply.

Many schools use different kinds of cut-offs, and they look deeper into GPAs and the nuances of a GPA. So it's not all just straightforward overall GPA.

This is similar to what we're hoping to build into Mappd as we dig more into the students' ability. Still, the process will vary from school to school, committee to committee, year to year based on the applicant pool. 

[51:00] Deciding When to Take a Gap Year

Q: How do I decide whether or not to take a gap year?

A: You have to ask yourself whether you need to take a gap year. Some students just want it because they want to do something that they'll probably never have time for again in their life. There's a whole list of things that you can do in a gap year. But most importantly, don’t just take it because it looks good on an application because that’s not a reason to take a gap year.

“A gap year could be one of the best things that a student can do – for mental health reasons, for enjoyment reasons, for financial reasons.”

[52:05] Academic Fresh Start

Q: Academic Fresh Start: will my old GPA be calculated with my new GPA for AMCAS?

A: Yes. Academic Fresh Start only applies to schools in the state of Texas that are public institutions where you apply through TMDSAS.

[53:34] Categorising a RADx-UP Experience

Q: I serve on the board of ethics and equity for the RADx-UP study, a project to increase COVID-19 testing in nine Massachusetts communities and to better understand community thoughts on COVID-19 vaccines. 

Over the coming months, my responsibilities involved participating in shared decision-making across each aspect of the work, contributing to the development of the ethics in equity framework, reviewing additional materials on ethics-equity issues that arise. 

So with the ethics-equity issues that arise within the context of the RADx-UP implementation, I'm struggling on how to categorize this experience. Hoping you can give me some advice. 

A: You could go in a number of different directions. But it definitely is a leadership experience. It doesn't sound clinical, but you can also categorize it as research or community service. This sounds like an amazing opportunity that you're involved with, and you should talk about it anywhere you could in the application. 



Academic Fresh Start

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