Sick blogging about medical school admissions

The last three weeks have been rough – fatigue, spaciness, lymph nodes the size of golf balls – so pardon any over-exuberant reactions to the notion that medical school is going to be sissified.

The New York school is introducing a flexible admissions program for half its incoming students, who will be able to skip the Medical College Admission Test, forgo traditional premed requirements, and be accepted in their sophomore year in college, as long as they maintain a 3.5 grade-point average through their senior year.

Proficiency in Mandarin or Spanish will be big pluses as the school seeks well-rounded students who can communicate with an ethnically diverse mix of patients. Traditional prerequisites like organic chemistry and physics will be replaced with courses like health-care policy and ethics, as well as clinical experience. Admitted students will also be encouraged to wait a year or two after college before enrolling at Mount Sinai, to work or pursue their academic interests.

Pray tell, if a student has never taken orgo, physics, biology, or the MCAT, how on earth would you know if the person can make it through medical school?  While the traditional medical school track may not be a perfect measure of who can succeed at medical school, this system does not even attempt to make such an assessment.  Maintaining a 3.5 GPA often encourages students to take easy, grade-inflated classes, which is the exact opposite of what future medical students should be doing.  By abandoning a strong pre-entrance screening process, Mount Sinai is leaving itself the choice of either flunking out substandard students, or passing those students and setting them loose upon the world to practice medicine.

Mount Sinai is also doing a disservice to medical school students who pass its classes but cannot pass the Boards.  The value of pre-admissions screening is that the rate-limiting step happens before students have invested years of their lives and hundreds of thousands of dollars into schooling that will not be of any use to them.  There is a reason why weed-out courses exist at the undergraduate level: they turn students off a futile track sooner rather than later, enabling them to get degrees in other subjects and move on with their lives.  (Would you rather drop a biology degree senior year, with little hope of getting a BS or BA in four years, or freshman year, when you could switch over to psychology? Would you rather your dreams of being a board-certified doctor be crushed during senior year when you don’t get into medical school, or after medical school and residency?)

Moreover, if the goal is to have physicians who will work with immigrant, low-income, and minority groups, it is very inefficient to accept Spanish speakers and hope that they will do the type of medicine you want them to do; you have little guarantee that they will not become dermatologists who administer Botox to wealthy suburbanites.  We would be better off teaching Spanish or Mandarin to the best physicians  who want to work with immigrant groups, rather than teaching medicine to the best Spanish or Mandarin speakers with no demonstrated ability to master difficult science courses.

I will admit to being irked by the notion that non-native English speakers are better served by having a doctor with whom they feel comfortable, rather than a doctor who absolutely rocks at medicine.  I am also irked that this is happening at precisely the time in which we need doctors to have a better understanding of science; medicine is far more technical and advanced now that it was even thirty years ago.

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13 Comments

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13 responses to “Sick blogging about medical school admissions

  1. Pingback: MSHQ 016 : Interview with Mount Sinai - All About FlexMed | Medical School HQ: Pre Med, Med Student or Resident - the most up-to-date, unbiased, and factual information to make your path to becoming a physician as easy as possible

  2. HuMed student

    Dear Massachusetts-based Lawyer,

    As a HuMed student, I can assure you that my friends and I who will soon matriculate to Mt Sinai do not “take easy, grade-inflated classes” to maintain a 3.5 GPA — as you are well-aware, I am sure, getting into med school through the traditional route normally requires a much higher GPA, which means students in the traditional track are more likely, than we, to be focused on boosting GPAs. From our perspective, we already got into medical school and so we wish to make the most out of our liberal arts education — that is, to learn the most, rather than being more focused on easy-A classes. I would encourage you to meet these HuMed students and see for yourself.

    A reading suggestion, if I may, which I hope will fundamentally emend your view: the article from the journal “Academic Medicine” which the deans of medical education at Mt Sinai co-authored back in 2010. These physician-deans concluded that “students without the traditional premedical preparation performed at a level equivalent to their premedical classmates.” You can inspect all the data at: http://journals.lww.com/academicmedicine/Fulltext/2010/08000/Challenging_Traditional_Premedical_Requirements_as.26.aspx

    Enjoy.

    • bridget

      I’m also a chemical engineer and know a thing or two about rigorous undergrad education and its benefits for professional school.

      But I suppose that you are going to inform me that your refusal to use my name or acknowledge my science degree is evidence of what a compassionate, awesome doctor you’re going to be.

    • bridget

      A more substantive reply:

      First, as I noted below, I am a chemical engineer and an attorney. Trust me when I say that I am well-versed in how a rigourous undergraduate education is both helpful and necessary for success in professional school. This is not me as a lawyer expressing a random opinion: this is me as a chemical engineer pointing out that a tough undergraduate programme is crucial to success afterward.

      Second, I presume that you are an undergraduate. If so, I forgive you your naivete and your assumptions that you are The Best Thing Ever. You’re young and you’re already admitted to medical school, but haven’t had medical school kick your butt yet.

      Did I say kick your butt? I know a physician who graduated in the top 5% of his (outstanding) college class – with a STEM degree, to boot – and who was dead in the middle of his class in medical school. That’s medical school for you: you’re going to be among the best of the best, all of whom are exquisitely prepared to succeed at the highest level in the toughest courses.

      Third, even the abstract of your own source undermines your claims:

      HuMed students were more likely to have lower United States Medical Licensing Examination Step 1 scores (221 ± 20 versus 227 ± 19, P = .0039) and to take a nonscholarly leave of absence (P = .0001). There was a trend among HuMed students toward residencies in primary care and psychiatry and away from surgical subspecialties and anesthesiology.

      OUCH! That’s a substantial difference and underscores one of the most important reasons for rigourous entrance requirements: so people can be able to be professionals at the end.

      Fourth, grow up. “I would encourage you to meet these HuMed students and see for yourself,” has to be the most immature thing ever written on this blog. This is not about justifying your existence as a person or your amazing, wonderful, passionate pursuit of knowledge about humanities; it’s about whether or not you are going to be able to handle medical school, pass your licensing requirements, and be a good physician.

    • FlexMed Student

      Bridget, you, just like the author, are missing the point of the HuMed/FlexMed vision. First of all, they’re not scrapping out the requirements, they’re changing (albeit reducing) them to fit a particular profile which represents a need for more diverse doctors in the healthcare system. So try to ponder over their vision a little. Secondly, like HuMed student said, you have to meet these students to get a fuller picture. No one gets admitted through this program unless they’re able to convince the admission committee beyond all possible doubt that they’re able to do science and excel in them (at least I had to), and to a slightly lesser extent, demonstrate a strong need/interest in an area in which they would otherwise not be able to pursue.
      I’ve been good at science for all my life and if after 2years of excelling in college level science you still need me to prove that to you, then there;s only one way to describe your system of evaluation: it’s complete rubbish.
      And that’s exactly what I think of the traditional pre-med track. It only serves to keep students super-stressed and constantly anxious. Ultimately, HuMed/FlexMed students will eventually enter med school with the same preparedness as traditional applicants, especially considering that they’ll both have undergraduate degrees, clinical exposure and basic science (yes, let me take the liberty to mention the basic science classes 6weeks before matriculation for FlexMed matriculants, which the author conveniently left out)

    • bridget

      If you think that being “good” at high school level science is indicative of your ability to succeed in medical school, with no need for intervening evaluation, then we simply cannot agree.

      I would suggest that you first attend medical school before pompously calling me immature and telling me that I have no clue what I’m talking about. I’ve earned a terminal, professional degree and an engineering degree, and am here to tell you that high school is nothing like graduate school.

      But you know more than me, don’t you? Because you’re not even legal to drink and you have the whole world figured out.

    • bridget

      Likewise, if you think that six weeks of science is the same as eight semesters of college science, you’re nuts.

      That would be like using middle school basketball ability and a quick boot camp to determine that you are ready for the pros.

    • FlexMed Student

      Maybe I don’t have life figured out yet, but your terminal professional degree (albeit a brilliant achievement) still does not give you the right to speak like you have all of life figured out. And again, I feel like I’ve been misread. So I’ll say again. I have excelled in science in BOTH HIGH SCHOOL and 2 years of college, and I have nothing more to prove, not to myself not to anyone. 6 weeks of science may not be as good as 8 semesters of science, but let me ask you, how many graduating seniors remember the non-major related science stuff they studied during their entire freshman year? Have you even tried to consider amount of unnecessary science packed into those 8 semesters? If 8 semester of science are a sufficient preparation, why are MCAT prep classes so popular? My point is, 6 weeks of med school-relevant science can be more effective than 8 semesters of stress, anxiety and competition.

      Given you’ve never been to med school yourself, how come you know so much about what it takes to succeed in med school and be a good doctor? Again what do I know, maybe your degree bestowed this knowledge upon you, or maybe it;s the fact that you’re legal and with alcohol comes all wisdom… why would you even try to bring that up?

    • bridget

      Did you actually ask a member of the general public why she cares about whether or not doctors are competent?

      Please rethink that one. If you need a hint, it’s because the licensing and training of doctors is for the good of the general public who puts their very LIVES into the hands of physicians.

      On a side note, please tell me that this is not indicative of what your bedside manner would be like – demeaning, hypersensitive, caring more about yourself than about the patient.

  3. FlexMed Student

    This author left out one fundamental point – most undergraduates who flunk out of the pre med track do so because of organic chemistry and the like, and that has nothing to do with whether or not a medical profession is for them. In terms of decision-making, will it not be more empowering to turn down a medical school rather than flunk out because u were unable to meet the requirements? And what was that about grade inflation? Do traditional applicants not inflate their grades too? Frankly you need to do more research before writing articles like this because I might still be an undergraduate but anyone can smell this kind of immaturity and unpreparedness from miles away (because it’s usually a survival strategy in the face of encroaching deadlines). Not to mention you accusing the school of “passing these students”… Wow, I’m gonna let that lie.

    • bridget

      If you are taking someone’s life into your hands, you have a lot to prove. Period, end of story.

      Stop taking it personally and ask yourself what kind of doctors you want to have. My guess is that you have never fallen seriously ill; otherwise, you would be on board with getting the best doctors possible, rather than making potential doctors happy.

  4. bridget

    Just for fun:

    “If 8 semester of science are a sufficient preparation, why are MCAT prep classes so popular? ”

    Because the MCAT is meant as a supplement to, and not a substitute for, rigorous college science courses. It enables a medical school to evaluate a student from Cornell against a student from East Podunk U: they are graded in the same scale.

    MCAT courses also teach people to take tests; a lot of test prep is leaning about the test, not the content. While MCAT courses are particularly content-heavy, they are meant as a refresher for what has already been learned, not a first run-through of it.

    As a final thought: the value of a class like organic chemistry is that it makes you work your butt off for a year straight. Most students at my alma mater studied orgo for three hours a night, every night, and then went into hibernation mode during tests. It’s a baby version of medical school.

    • PremedStudent

      Bridget,
      You have valid concerns about the program but there are a few things I’d like to point out. The program requires 1 year of chemistry, biology, and a semester of Physics, a course in Statistics, and then courses in Ethics and Health Policy. Students who apply are ending their sophomore year and many of them have already finished Organic Chemistry (year-long) with lab. In addition, all students who are accepted must go through a summer course program at Mt. Sinai that teaches you Cell Physiology, Biochemistry, Anatomy, and all other essential upper-level science.
      In addition, the program is extremely competitive. The type of students accepted have 3.8+ GPAs, majority of students are from Ivy league or top 30 schools, and have significant shadowing, research, and extracurricular resumes.
      Separate point: You seem convinced that students MUST go through this rigorous undergrad education to make it to medical school but that ignores the statistics that Australian, British, Indian, and other countries’ doctors outperform or at least are equal to ours and go straight to a medical school system after high school.
      http://www.washingtonpost.com/opinions/training-us-doctors-faster-by-cutting-out-college/2013/02/22/1c934da8-1255-11e2-be82-c3411b7680a9_story.html

      If you google this topic, there are a plethora of article about this.

      PS. I want to say that I fully respect your background as an engineer and attorney and I simply bring these points up to enrich the discussion.

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