The Road to Medical School

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The Road to Medical School

• Dr. David Frank
• Chemistry Department
• CSU Fresno
• McLane 159 (278-2273 email is better)
• davidf_at_csufresno.edu

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11th Annual UC Davis Pre-Medical Pre-Health
Professions National Conference Passion for
Life, Education, Service, and YOUR Future in
Healthcare Saturday Sunday October 12-13,
2013 800am-600pm University of California at
Davis, Pavilion For Bundle (Bus, Food, Lodging)
contact Cristian Sarabia cristiansinaloa_at_mail.fres
nostate.edu
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• Malpractice Insurance
• Cost depends on the state location
• Internal Medicine 6K - 11K/year
• OB/GYN 55K/year (2009)
• General Surgeons 28K - 55K/year
• Physician Assistant 2K 6K/year

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• Financing Physician Education
• The median education debt for indebted medical
  school graduates in 2012 was 170,000, and 86
  percent of graduates report having education debt
• Debt Public 160K, Private 190K
• Cost Public 197K, Private 275K
• Scholarships (4 yr) Public 14K, Private 30K
• Remember you need a good credit score to qualify
  for many loans.

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Academic Medicine, Jan. 2013 Study shows that
recent medical school graduates with the median
amount of education debt (160K-170K) can enter
primary care, raise a family, live in an
expensive urban area, and repay their debt within
10 years without incurring additional debt.
However, heavily indebted primary care graduates
(who owe 250K) must plan repayment and
lifestyle choices carefully and strategically.
The article includes debt repayment models across
a variety of scenarios and specialties. It
suggests that education debt need not play a
determining role in specialty choice and
illustrates the capacity of physicians to repay
their education debt.
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The Path to Becoming a Physician

• Bachelor Degree
• Possibly Post-bac work to shore up soft GPA
• Medical School - 4 years
• Residency - Minimum of 3 years (1st year often
  called internship)
• Optional Fellowships for further specialization

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Have A Plan

• Academics - Required Courses, Bachelors
  Degree
• Extracurricular Activities (including medical
  experience)
• MCAT
• Research
• Letters of Recommendation
• Finances for the Application
  Process

Diploma
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www.csufresno.edu/premed
www.fresnostate.edu/premed
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What Should I Major In?

• Whatever interests you the most, BUT...
• English, philosophy, history, music majors, etc.
  may take longer to graduate to get all of the
  pre-reqs, cannot get grants for units outside of
  their major, and the science GPA is vulnerable.
• Advantages of Biology or Chemistry major
• Premed prereqs are part of the degree
  requirements-grants scholarships can only
  cover units of MAJOR
• Science (BCMP) GPA is buffered by taking more
  science classes
• Better preparation for first year of med school
• Higher priority at getting into impacted first
  year Chem 1A/1B and Biol 1A/1B.

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Undergraduate Academic Preparation

• 1 year of General Chemistry (1A and 1B), even if
  you have AP credit. NOT 3A/3B
• 1 year of Organic Chemistry with lab 128 A
  129A, then 128B and 129B)
• 1 year of General Biology with lab (Biol 1A and
  1B), even if you have AP credit. NOT Biol 10
• 1 year of physics with lab (Phys 2A/B Does not
  have to be physics for physics majors).
• Math 75 and Math 101 (Statistical Methods 4
  units)

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AP Credit

• In general we advise pre-med students to take
  general chemistry and biology at Fresno State
  (not a community college) even if they have AP
  credit for these courses.
• However, you can check with the medical schools
  in which you are interested to find out about
  their policy on AP courses.
• The medical school might allow an upper division
  course in the particular discipline to fulfill
  the requirement.
• Hard to know early on which med schools you will
  choose to apply to

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Academics - Courses Required by Many Medical
Schools(and really important for the MCAT)

• 1 year of EnglishUpper division with lots of
  reading, critical thinking, and writing or
  Philosophy courses
• 1 year of Math (calculus, statistics, computer
  science)
• 1 semester of Biochemistry

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Academics Other Courses

• Physiology (Comparative or Human can help
  with the MCAT)
• Genetics (can help with the MCAT)
• Human Anatomy (just before entering can help
  with first year med school)
• Cell Biology Molecular Biology (can help with
  first year med school)

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Academics Other Courses
Because the the MCAT in 2015 will change, we
strongly advise students who may take this exam
to take One or two semesters in introductory
psychology -PSYCH 10. Introduction to
Psychology (3 units) -PSYCH 40T. Topics in
Research Design and Statistics One or two
semesters in introductory sociology -SOC 1
or 1S. Principles of Sociology (3-3 units)
-SOC 3. Critical Thinking about Society (3
units) Introductory Biochemistry Chem 150
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Before applying, make sure that you have
fulfilled the course requirements for the medical
schools to which you intend to apply.
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Academics Count

• Aim for a minimum 3.6 GPA, for BOTH your overall
  GPA as well as your BCMP (Biology, chemistry,
  math and physics) GPAs.
• For allopathic medical schools, the GPA is
  calculated based on all courses taken, even those
  for which you applied for grade substitution.

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www.aamc.org/msar
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Stanford Irvine
Upper Division Biology
Statistics
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Nationwide 20,518 seats and 46,454 appicants 44
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Schools with multiple CSUF accepytances 2011-2013
32 other schools have accepted one CSUF student
in this 3 year period.
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2013 Data
of Applicants
2648 - 20518 44
GPA
MCAT
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2013 Data 44 CSUF students applied, 20 were
admitted to at least 1 school 45 acceptance
rate. Highest MCAT with acceptance 39R Lowest
MCAT with acceptance 23Q Highest GPA 4.0 Lowest
GPA 3.57
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What is Osteopathic Medicine? Critical
physician workforce shortage. By 2020, the gap
between our physician supply and demand 50,000
to 100,000. gt 4,200 new osteopathic
physicians/yr enter the workforce. gt 63,000
fully licensed osteopathic physicians practice
the entire scope of modern medicine, bringing a
patient-centered, holistic, hands-on approach to
diagnosing and treating illness and injury. gt
20 of US medical students -gt osteopathic
physicians. DOs can try for any specialty,
prescribe drugs, perform surgeries, and practice
medicine anywhere in US. Osteopathic
manipulative techniques to diagnose and treat
patients. Osteopathic physicians work in
partnership with patients to help them achieve a
high level of wellness by focusing on health
education, injury prevention, and disease
prevention.
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Osteopathic Medical Colleges AACOM.ORG
There are currently 29 colleges of osteopathic
medicine, offering instruction at 37 locations in
28 states. Twenty-three of the COMs are private
six are public.
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What is a Physician Assistant? A physician
assistant (PA) is a medical professional who
works as part of a team with a doctor. A PA is a
graduate of an accredited PA educational program
who is nationally certified and state-licensed to
practice medicine with the supervision of a
physician.   What can PAs do?   PAs perform
physical examinations, diagnose and treat
illnesses, order and interpret lab tests, perform
procedures, assist in surgery, provide patient
education and counseling and make rounds in
hospitals and nursing homes. All 50 states and
the District of Columbia allow PAs to practice
and prescribe medications.
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Prereqs for Physician Assistant Program - Tuoro
8 semester/12 quarter units (including labs) in
each of the following categories Biological
Sciences (may be comprised of general biology,
genetics, immunology, embryology, etc.)
Chemistry (may be comprised of inorganic,
organic, biochemistry) 4 semester/5 quarter units
(including labs) of the following Human Anatomy
(must be completed within 5 years of expected
year of matriculation) Human Physiology (must be
completed within 5 years of expected year of
matriculation) Microbiology Statistics (3
semester/5 quarter units) All pre-requisite
courses must be completed with a C or better
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Clinical Experience - Tuoro
Candidates must have obtained a minimum of 500
hours of health care/clinical experience, either
as a volunteer or in a paid position. 
Competitive candidates, however, will have
obtained 1,000 or greater healthcare
hours. Evaluation Criteria for Clinical
Experience Total number of hours Setting Specific
duties performed and/or skills acquired Descriptio
n of the duties Patient population served Level
of supervision Time frame of the experience    
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Prereqs for Physician Assistant Program - SJVC
 General Chemistry (with lab)  General
Microbiology (with lab)  Human Physiology (with
lab)  Human Anatomy (with lab)  Public Speaking
or Oral Communication  Intro to Sociology or
Cultural Anthropology  Reading and
Composition  General Psychology  College
algebra or higher 2,000 hours of direct patient
care experience is also required for admission
(paid and volunteer hours are acceptable). Hours
accrued as a student in a training program cannot
be used towards this total.
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• Some Pros for a PA Career
• Requirements for admission to PA school easier
  than med school
• PA school is only 2 years need not acquire huge
  student debt.
• You can easily switch specialties without lengthy
  schooling residencies
• Work fewer hours and time off is really off(?)
• Malpractice insurance less costly 2K 6K/year

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• Some Cons to a PA Career
• If you have a leadership personality and would
  prefer to give orders rather than take them, PA
  may not be right for you.
• PA salaries are capped and less than a doctors.
• Less status as a PA than as a doctor.

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The Old MCAT (Before 2015)

• Three Multiple choice parts
• Verbal Comprehension
• Physical Sciences
• Biological Sciences
• Writing Sample is gone in 2013
• Be sure that you have completed all the
  coursework required
• Take practice exams. Scores on these will
  determine whether you are ready to take the real
  one. These are available for only 35 each, after
  the first free one, from AAMC.

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The New MCAT (Begins 2015)

• Natural Sciences concepts in biology, general
  and organic chemistry, biochemistry, and physics
• Psychological, Social and Biological Foundations
  of Behavior Concepts of introductory psychology
  and sociology, and introductory biology concepts
  that relate to mental processes and behavior.

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The New MCAT (Begins 2015)

• Critical Analysis and Reasoning Skills be able
  to analyze, evaluate, and apply information
  provided by passages from a wide range of social
  sciences and humanities disciplines.
• Does not test specific knowledge
• Does test the skills in analysis and reasoning
  that you need for medical school
• may prompt you to read broadly as you prepare
• Along with many others, passages about ethics
  and philosophy, cross-cultural studies and
  population health are included.

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The New MCAT (Begins 2015)
https//www.aamc.org/students/applying/mcat/mcat20
15/
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MCAT Timing

• The best timing is to take the MCAT in the
  spring of the calendar year prior to the year
  you plan to enter. (For most this will be April
  of their junior year.) However, do not take the
  MCAT before you are ready. APPLY EARLY, SEATS
  SELL OUT.
• The MCAT is now offered on-line on 24 different
  days during the year. The exam is now a 7 hour
  test. There is a test site in Fresno. Register
  early to be sure you get the date and site you
  want.
• Go to the AAMC website for information and
  registration.

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MCAT Preparation

• While taking chemistry, biology and physics,
  remember you are preparing for the MCAT.
• Check the AAMC website and consult The Official
  Guide to the MCAT Exam available from AAMC
• For MCAT2015, visit
• https//www.aamc.org/students/applying/mcat/mc
  at2015/
• Remember to schedule in preparation time before
  taking the MCAT. Consider the Kaplan prep course
  (2000).
• Dont ever take the MCAT for practice its
  expensive (270). Plan to take it only once.

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MCAT Preparation
Change your high school study habits Rote
memorization doesnt work so well for the MCAT.
You need to develop conceptual thinking
skills. Start making notes from your text as
well as lectures. Organize the material by
topic. Look for logical connections between
all of the facts, don't just memorize
isolated facts. Read and review notes for
understanding. This all takes TIME (2-3
hours of study for each hour in
class) Recommend Engl 101, 102, 103 for
reading comprehension critical thinking
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What Do I Do In The Summer?

• There are lots of summer opportunities for
  students interested in being physicians. Check
  the internet, the AAMC and the aspiringdocs our
  websites.
• Applications are due between January and March
  and are extensive. Look into programs early.

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Extracurricular Activities

• Medical Experience
• Leadership
• Volunteer Service
• Research

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Keep Good Notes

• Keep track of your extracurricular activities and
  the hours you devote.
• You might want to keep a journal of clinical
  experience to record your experiences and
  maturation its good material for that personal
  statement.

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Letters Of Reference

• Two science faculty, one non-science faculty, and
  one or two others
• Remember while taking courses that you are going
  to need letters of recommendation.
• Doing research with a professor helps him/her get
  to know you and write a more credible letter.
• Have the letters on file the spring semester
  before you apply (April/May of junior year).

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Letters Of Reference

• Most med schools use the AMCAS letter
  distribution service. They only accept letters
  from AMCAS.
• You must provide each letter writer with your
  AMCAS Letter ID found on your AMCAS Letter
  Request Form, as well as your AAMC ID.

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Letters Of Reference

• Instruct the letter writer to either send your
  letter to AMCAS directly, or to Ms. El-Bendary in
  the Information Center (S1-136). In either case,
  the letter must be accompanied with your AMCAS
  Letter Request Form, as well as your AAMC ID.
• We shall send your letters to AMCAS on your
  instruction. If all are being sent to the same
  schools, they can be sent as a packet with the
  same Letter ID .
• Advantages of our service we keep copies of your
  letters which may be needed for scholarship
  applications, for non-AMCAS schools, and for
  AACOM applications.

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The Application Process

• Primary Application - takes time!
• transcripts from all college-level schools
• personal statement
• record of extracurricular activities
• names of letter of recommendation writers for
  those medical schools that use the AMCAS service
  for collecting letters of recommendation

• Secondary Applications
• more essays
• request letters of recommendation be sent to
  AMCAS, the MD application service. (Letters to
  AMCAS can be sent after the primary application
  is submitted.)
• unless school is not using the AMCAS letter
  distribution service.

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Secondary Application
Institution 1 What is your interest in XYZ
School of Medicine? Insitution 2 Describe
your motivation to become a physician. What
do you see as the most significant issue the
medical profession will face in the next 40
years? What personal benefits have you gained
from your major extracurricular activity?
What personal benefits have you gained from your
research/teaching experience? Given the
opportunity to share dinner conversation with one
person (deceased or alive) who has made a
significant contribution to science, medicine or
human service, identify the individual you would
select and why?
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• Institution 3
• Please explain your reasons for applying to XYZ
  School of Medicine. We understand that you are
  probably applying to several medical schools. We
  are interested in why you have placed XYZ School
  of Medicine on your list of schools. (max
  character limit 1500)
• Please describe any unique characteristics you
  have that will contribute to the diversity and
  bring educational benefits to the entering class.
  (max character limit 1500)
• If you are not in a degree-seeking program,
  please indicate what you will be doing from the
  time you complete this application to the start
  of medical school.

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The Interview

• Choose medical schools carefully. Know what they
  offer and what you offer them. Review your
  application and their catalog and mission
  statement. Talk to medical students. Find out
  about hospital affiliations, curriculum, student
  support.
• If possible, engage in a mock interview.

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The Interview

• Your experience in medicine. You need to explain
  your experiences that have helped you to
  understand the reality of a medical career.
• You have the longevity, discipline, motivation,
  and resiliency to succeed in medical school. How
  can you convey the evidence of these traits?
• You have thought about, and to some degree
  understand, the current and future state of
  medicine.
• How can you convey to the interviewer that you
  are one of them.

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Planning for Necessary Expenses

• All professions have application expenses.
• Med school application 4000 to 8000 ()
• MCAT review class 2000
• schools you apply to where you interview.
• AMCAS Application 160 first school, 32 each
  additional school (UC Berkeley avg 20 25
  schools)
• Secondary applications 70 to 100 each in CA
• AMCAS has a Fee Assistance Program.
• aamc.org/fap
• Dont short-change yourself on the application
  process.

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Item Cost
MCAT Test 270
MCAT Preparation 2,000
Initial AMCAS Application 160
Each additional school (24 is average) _at_ 32 768
Secondary Application (20 _at_ 100) 2000
Travel Costs to Interviews 3000
Total 8158
Stanford 463 interviewed, 86 accepted. Rush
399/130 (19/33)
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Resources Getting Started

• Premedical Web Site
• Advising
• Informational Sessions, Conferences on and off
  campus (i.e., UC Davis conference)
• HCOP (Health Careers Opportunity Program, targets
  students from educationally or economically
  disadvantaged backgrounds.)
• AEW (Academic Excellence Workshops, NSCI 40T,
  LSAMP program)

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More Resources

• Student Clubs Fresno State Premed Club (only
  premeds), AMSA Chapter (anyone interested in a
  health profession), Tri Beta Biology Club
• Natural Science class The Art and Practice of
  Medicine (NSCI 1 spring class)
• Academic Research Associate Program at Community
  Regional Trauma and Burn Center headed by Dr.
  Greg Hendey and administered by Brandy Snowden.
  (NSCI 110)
• Research Opportunities-during the year and in the
  summer
• Conferences Given by Medical Schools for Premed
  Students

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Yet More Resources

• Scribe Program at St. Agnes Hospital headed by
  Dr. David Claypool
• Other scribe programs via CEP America at
  Community, Clovis, and Madera.
• WorService to Collect and Send Out Letters of
  Reference. (You must open a file with me and
  sign a form to either waive or not waive your
  right to see your letters of reference.)

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Plan B
Postbaccalaureate Programs academic
record-enhancement, career changing,
underrepresented groups, economically or
educationally disadvantaged groups.. CSU
Fullerton CSU East Bay Charles Drew
University Mills College San Diego State
University San Francisco State University
Scripps College UC Berkeley Extension
University of Southern California
UC Postbaccalaureate Consortium http//meded-postb
ac.ucsd.edu/ Helps educationally and economically
disadvantaged students get into medical school.
Must be committed to practicing in underserved
communities of California. Post-bac
nationwide http//services.aamc.org/postbac/
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Plan B
Caribbean Medical Schools There are three
medical schools in the Caribbean that stand out
St. Georges University in Grenada, West Indies,
Ross University in the Commonwealth of Dominica,
and American University of Antigua.  Students
admitted to St. Georges have an average GPA of
3.34, and an average MCAT of 28. At Ross, the
average GPA is 3.4, with a range of 2.7 - 4, but
for early admission they require at least an
overall GPA of 3.0 and a science GPA (BCPM) of
3.25, with an MCAT score of at least 24. Also
UAG School of Medicine in Guadalajara, Mexico
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Plan B

• Options
• 1. Medical Doctor 6. Optometrist
• 2. Podiatrist 7. Physician
  Assistant
• 3. Dentist 8. Nurse
• 4. Pharmacist 9. Ph.D.
• 5. Veterinarian 10. Clinical Lab
  Technician

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Excellent Books

• Medical School Admission Requirements
• The Official Guide to the MCAT Exam
• Complications A Surgeons Notes on an
  Imperfect Science by Atul Gawande, M.D.
• Better A Surgeons Notes on Performance by
  Atul Gawande, M.D.
• The Checklist Manifesto, by Atul Gawande, M.D.

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Useful Web Sites

• Advising Information
• www.csufresno.edu/premed
• www.aspiringdocs.org

• General Information
• www.aamc.org/meded/start.htm
• www.aacom.org
• www.amsa.org

• Interviews
• www.studentdoctor.net/interview/index.asp
• Scholarships
• www.fastweb.monster.com

• Summer Opportunities
• www.cmu.edu/hpp/intern.html
• www.swarthmore.edu/Admin/health_sciences/
  summer_opportunities.html
• www.aamc.org/members/great/summerlinks.htm

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ENJOY THE PROCESS!