Episode 37: Love Thy Parents: The Application Process (Part 1/4)

Your parents have questions. We have answers. Love Thy Parents is a series dedicated to all the fathers and mothers out there. Applying to medical school can be confusing for applicants themselves; how do you think parents must feel?

In Part 1, we tackle the application itself: the timeline, the most basic resources, finances, and tips for parents of applicants to keep in mind.

In future parts, we’ll cover financial aid from the parental perspective, common myths, and what to expect when a son or daughter starts medical school.

If you have questions for us, please send them to pritzkerquestions@gmail.com. Or, call (773) 336-2POD and leave us a message.

[Music: “The Area” used with permission from Eliot Lipp. “Shiggidy” used with permission from Greg Spero and GMG.]

Episode 37 Transcript

Ben Ferguson: Hey everybody, this is Episode 37 of the Pritzker Podcast. We are joined by Joni Krapec. Hello, Joni.

Joni Krapec: Hello Ben, how are you?

BF: Good. We decided to do an episode specifically for parents. We realized that throughout this process sometimes applicants don’t know what they’re doing and in that case parents really don’t know what applicants are doing. And sometimes they have a lot of questions about financial aid issues, about the timeline issue, about just how to apply overall, so we figured it might be useful for students and their parents to do a show specifically for those parents and answer some questions and maybe bust some myths about this process.

So we’re going to do this in three parts. This is going to be the first part, and Joni has joined us to talk a little bit about the application timeline and really the application itself. So Joni, we’ve gotten some feedback from a lot of folks on studentdoctor.net, over email, over Twitter, and I think far away the biggest question that people have is about the application timeline or really just the overall application process. So can you explain just in kind of lay terms to parents of applicants how the application works and when all the parts fit together?

JK: Sure, so basically the entire process can be up to, oh geez, about 14 to 18 months, so we’ll kind of break it down slowly, and just for the sake of ease of communication, I will use the example of somebody that’s applying in order to go to medical school immediately following their college career. And that is by no means an endorsement or a suggestion, which we’ll talk about the myth-buster episode, that you have to do it that way. I’m just saying for ease of understanding, that will be the easiest way to explain it.

And so what typically happens is if, for example, your student is currently a junior in college, they will begin the application process for medical school starting in the spring of this year. If the student has a health professions advisory committee at their college or university, typically they need to start working with that committee beginning in January or February of this year. And the reason for that is that many of those committees will write a letter of recommendation on behalf of your student, and so there are certain paperwork, responses to essay questions, an interview process that is typically pretty standard within those committees. So the student should be on the look out for emails announcing those meetings and orientation sessions and things like that. Typically, those will start happening in January or February for your student. And that it is good to know that if you have this committee available, you absolutely should work through it. If you try to not use the committee because you don’t think they know you very well or because you’re just not very impressed with your premed advisor or whatever it might be, it signals to the medical schools that you’re may be trying to hide something. So definitely go through the committee process.

If your school does not have a committee process, that’s perfectly okay. In the spring is when you will start working with faculty members to identify people that you would want to ask for letters of recommendation. Typically, three letters of recommendation are required. Depending on the size of your campus, think about how many premed students are there and how many faculty members may be asked from a hundred premeds in that year to write a letter of recommendation for them, you want to be one of the first ones to go through that pipeline. So it would be good to start thinking and to start asking those faculty members in kind of early winter of this year if you’re trying to go to medical school directly following college.

So that’s some of the groundwork. And certainly then also during your spring semester, the student should be thinking about the MCAT and when they’re going to be taking the MCAT. They should also be thinking about starting to research medical schools and determining which medical schools they wish to apply to. The application itself for medical school will kick off the first week of June and that is through the AMCAS application which stands for American Medical College Application Service. So, that application is a general common application that would be sent to every single medical school. On that application is where the student will put all of their grades, all of the courses that they’ve taken, they will write a personal statement, they will also list all of their experiences. So the first day on which that can be submitted is typically the first week of June, and then AMCAS itself, as a application service, will go through each and every application in order to verify what is listed on that application. So applicants will send their transcripts straight to AMCAS and AMCAS just sits down and double checks that everything you entered on the application is reflected in your transcript. So that process can take two to three weeks at the earliest part of the year. As they get more and more applications rolling in, that verification can take longer and longer, so that could severely delay your application.

I will say that if you think of and can encourage your son or daughter nothing else other than this next sentence: Apply as early as possible. So they want to be as close to that June 1 date as possible because medical schools, as soon as we start receiving applications, we start making interview offers, and the later somebody applies, the fewer interview slots are left for them to take. So, once the AMCAS goes in all of the medical schools receive it that your student has indicated that they wish to apply to, then the medical schools may send a secondary application. This is the application that is specific to that school. Some medical schools will only send secondaries to those students that they feel are competitive for their school. There are also schools that send a secondary to anybody who applies. We fall into that second category. So we send a secondary to anybody that applies and we wait to get that secondary back before we assess the application.

BF: And if I could just add here, too, that some schools send an automatic secondary to everybody and the secondary itself consists of just sending a check.

JK: Yes.

BF: And that’s perfectly normal as well.

JK: Absolutely, and from a small little financial standpoint, it’s important to note that the AMCAS application will charge a fee for every medical school that you are applying to, then each medical school that sends you a secondary will also charge you a fee. So it will start adding up and we will can talk more about that. Yeah.

BF: Sure, maybe we’ll have a dedicated section about the finances of applying.

JK: Exactly. The secondary applications, like Ben said, they could just be send us a check and fill out this form. I think the still-reigning champion for a number of questions on a secondary is 12, I think. So they can be very time-intensive and those take quite a bit of effort, the questions that are asked are individual to each medical school. So they do require a lot of work and a lot of preparation. So then the student sends those back in. Hopefully, at some point in all of these, the letters of recommendation have arrived as well that you’ve asked for early in the spring semester and then once your application is complete the medical schools can begin assessing those applications for interview.

I do not know of any medical school that does not require an interview as a part of the application process. So you should expect that any school that you’re invited to, you will have to interview, you can’t just get accepted off the basis of your application. So those interviews can start typically the last week of August and run all the way through, I think, the latest one that I’ve heard off at a school is in April.

BF: Wow.

JK: So it can be a very long and very intensive applications process and those interviews can stretch on for quite some period of time. By and large, I would say that if you are on the early side of applying, you have a better shot of condensing those interviews into only taking up the fall semester of your senior year. So you’ll go through and do those interviews. The first day on which a medical school can give any admission decision is October 15th of the application year. So we’re currently in the midst of our interview season for those applicants who would be coming to medical school in 2011. The first day that we can let any of them know that they’ve been accepted is October 15th. Those acceptances, though, can come also for months after that. There are some schools that have rolling admission, meaning they start to make acceptance offers as October 15th hits, and they continue to make acceptances on a fairly regular basis throughout the rest of the year.

There are some schools that have a non-rolling admission, which basically means that they will make all of their acceptances on one date. Typically, that date is in February or March, depending on the school. Just to reiterate, it is still important to apply early even if your son or daughter is only applying to non-rolling schools. The reason for that is that they are interviewing beginning in August or September. So when you’re applying to medical school you’re applying for an interview. Whether or not the admission is rolling or non-rolling isn’t really going to matter if you never make it in to interview to begin with. So still apply early regardless.

So then medical schools by March 15th of any given year need to have offered as many acceptances as they have seats in their school. So for example we have 88 seats; by March 15th we need to have made at least 88 offers of admission. And then the applicants themselves have until May 15th to make one decision on medical school. So if your son or daughter is fortunate enough to be accepted at three schools, you can only hold one acceptance on May 15th. If you are waitlisted at schools, you can continue to hold those spots, but you can only hold one outright acceptance as of May 15th. Once May 15th hits, then some of the real fun begins, which is now each medical school has a good idea of who will be coming to their school and they may have spots to fill. Then they start making offers off of their waitlist and asking people to join their class.

As you can imagine, this will create a ripple effect around the country. So if I make an offer to somebody that’s currently accepted at medical school A and they’re on my waitlist but I make them an offer and they decided they’re going to come to Pritzker, now medical school A has a spot that they need to fill. So they’ll go take somebody else and now medical school B has a spot that they need to fill. So throughout the summer months, this chaos will continue. And typically, it could go on until early August. Now we’re talking about August of 2012 if you’re taking about a current junior to medical school. If you’re talking about somebody that is a senior right now or is currently interviewing, it can go until August of 2011 before every medical school has their class filled.

BF: So I guess that would be the end of the summer after their senior year, really.

JK: Exactly.

BF: Okay.

JK: So that’s how we wind up with this process lasting about 14 to 18 months if you’re starting to work with your premed advisory committee or with your faculty to write letters of recommendation in January of your junior year and you may still be getting acceptance offers August following graduation.

BF: Gosh. You really started with the start of junior year kind of looking into this process, but really the process starts a little bit earlier than that in terms of taking care of some of the prerequisite classes, volunteerism, doing research, having leadership activities on your resume. When is it normal for people to start those things, at the start of junior year or kind of earlier than that as well?

JK: I would definitely say earlier than that. One of the things that medical school admission committees look for, obviously a career in medicine is a long career. You have four years of medical school, three years of residency training at least, and then potentially longer than that if you’re subspecializing. So what we look for is, does this person commit to something? Do they have evidence of longevity and a commitment to something long term? So really, what I usually recommend and when I used to be premed advisor, what I would recommend to my students was, you know, during your freshmen fall semester, get your legs under you academically because you never want to put yourself in a GPA hole, so make sure that you’re kind of stable with your academics. Start thinking about those things that you might like to add to your plate: the extracurricular activities or the research or the volunteer programs, whatever that might be. And then as you move in the second semester of freshmen year, start doing some of that experimenting and see what you really find to be most interesting.

Then typically, by sophomore year, I usually recommended to my applicants that they had a couple of activities that were mostly important to them that they would then be continuing throughout their collegiate career, gaining leadership positions with, things along those lines. We can generally tell pretty easily if somebody just started everything junior year and we kind of can recognize it as that, “Oh shoot, I’m applying to medical schools here. I better go do some clinical volunteering or I better go try out some research.” We can kind of see when it’s a like a scrambled hasty approach. It’s definitely much more important to start this early in your collegiate career.

BF: Joni, we talked a little bit about some of the costs involved with the primary AMCAS application as well as the secondary application. Are there other costs associated with the application process, and really how much can people expect to spend on this entire process when it’s all said and done?

JK: Okay. If you are–

BF: Sorry that’s a big question but–

JK: No, that’s okay and I was just going to say if you’re a parent listening to this, grab on to something. What typically happens is it is most common for applicants to medical school to average about 15 medical schools they’re applying to. Anywhere from 15 to 20 is pretty normal. So then you multiply all of the secondaries that come with that. Generally speaking, just playing the odds, not saying anything about one specific person, just kind of knowing how many applications medical schools get compared to how many interviews they’re able to offer, you could probably assume that each student would gain anywhere from five to seven interview invitations. You will have some that get an interview everywhere they have applied, you may have some that get no interviews. But roughly speaking, you can assume about half will get interviews.

So you’ve already paid application fees for the AMCAS application. You’ve paid individual secondary fees. Now you need to start thinking about interview fees. So along with an interview fee, obviously we don’t charge you anything to come interview, but you have to get here. So whether that’s a car ride, a train, or a plane, you need to pay for that. You need to pay for lodging. So as a random tip, if the medical school offers you the opportunity to stay with current medical students for free, always a good idea to take up that opportunity. You will also then, of course, have meals and things like that while you’re gone that you need to pay for. And you have your wardrobe to consider. So broadly speaking, when you’re applying to medical school you need to go to those interviews in a suit. Most people will probably get one or two suits just in case something happens to one they have a backup one to use. It may also be the case that the person needs some kind of dress overcoat or something like that that they could wear over a suit as opposed to like a Columbia ski jacket being worn over a suit.

So those expenses can definitely add up. I don’t think it’s out of question that the entire application process, again depending on how many schools people apply to, where they apply, so how many flights might be involved, and the overall number of interviews that they are offered, the whole process could be anywhere from $2500 to $4000. So it can definitely add up, and we certainly encourage students to not charge all of that to Uncle Visa or Aunt Mastercard, but instead to think about starting to save for that early on.

BF: Okay. I think it’s not uncommon for applicants to medical school to have physician parents of their own. And those physician parents might have gone through this process, you know, 20, 30, even 40 years ago sometimes. Can you kind of speculate or maybe speak to how this process might have changed since they themselves went through that application process?

JK: Yeah, and most of this information is going to come from some of the faculty that are on our admissions committee sharing their experiences with going to medical school. I would say kind of the biggest change or changes has been, number one, the number of medical schools that people apply to. Many of the faculty in our committee, you know, they applied to four or five schools, and that was it. And now the competition has just gotten so much greater that most students apply to triple that number.

Another area that has changed or is different is kind of the overall preparation and how much a student needs to do in order to show themselves as having had a good experience throughout college or beyond college if they’re applying as a non-traditional student. You know, there were faculty in our committee who said, “I never shadowed a doctor. I just thought I would be a good doctor. So, you know, I did a couple of things and, yeah, that was fine.” Those stakes are definitely much higher, and I think the thing that’s always important to know is that, when we look at an application, we’re not simply saying, does this person have what it takes to be a doctor? Broadly speaking, all of them do. I would say probably, of the applications we receive, 80 to 85 percent will be fantastic physicians, but what then comes into play is, which are the most competitive? Which are the people that stand out the most in this application process? So the application is not simply a yes-no decision by the medical school based on the applicant and the applicant alone; it’s more, of the 4,000 applications that we receive, who are the 600 that rise to the top is being the most competitive? So that would be another change.

And I think really the final change is looking at the overall academic standards. Even in the six years that I’ve been here, I’ve seen our GPA, our average GPA, go from being about 3.5 for an accepted student, now we’re up to a 3.8. The MCAT score when I first started a few years ago was about a 32 to a 33 for the average; now we’re up to a 36 is the average. So–

BF: This is out of 45 points total?

JK: Exactly, thank you. And so that, you know, every year it just gets tougher and tougher and tougher and so we hear the faculty physicians on our admissions committee say, “Oh, my gosh, I never would have gotten in if I had the same credentials now that I had back then.” And so it’s just that the competition and the intellect of the students has just continued to grow each year.

BF: Sure, so it stands to reason that students might be a little bit more stressed than their predecessors were or their parents were about things like their GPA or their MCAT exam or doing enough research and stuff like that that didn’t necessarily matter even just a few years ago–or matter as much, I guess.

JK: Right.

BF: So, Joni, you mentioned earlier that you actually have been a premed advisor. Do you have any advice, in addition to the stuff that we’ve already talked about, that parents might want to keep in mind or might not know about this process that they probably should be familiar with as their son or daughter applies to medical school?

JK: Sure. I think the biggest piece of advice and probably the one that is the hardest to try to follow is to definitely support your son or daughter in not only helping them to see where their successes are, but also not to dismiss when they might feel stressed, or as though something that happened would blow their chances, or that they in your mind might be getting overwhelmingly stressed about something. It’s important to at least validate that concern. I think as parents, a lot of times, we look at our son or daughter, especially if they’ve already been successful up to this point and just think, “Of course, you do amazing, you’ve never wanted something and failed at it, so of course this will be easy for you and you will be able to do this.”

BF: “And how could anybody not love you as much as I do?”

JK: Exactly. Exactly. You know, “you’re the cutest and the smartest and the most loving and wonderful person ever.”

BF: “Yeah, you’ll be fine!”

JK: “You’ll be fine!” And I think by and large most of them will, but when your son or daughter is having a bad day, when they’re stressed about something, when they start to think, you know, I don’t know if I’m going to succeed at this, it’s important to recognize that that concern is valid on their side. And although you will still build them up, it’s definitely just important to not blow off their concern in saying, “You know what, you’re just getting yourself wound up. You have nothing to worry about.” I think it’s important to just kind of acknowledge that this is a stressful process, this is a competitive process, and it definitely takes an emotional toll on the applicants. So that’s just something to kind of keep in the back of your mind.

A couple of the questions that I think parents often have either the most lack of knowledge about or not really sure what to do about, one is certainly in thinking about the courses that students need to take. You do not have to have one major over another. Students can major in whatever they choose, but they do have prerequisite courses that every medical school expects, and so those need to be taken. So if your son or daughter is freaking out because they have to take organic chemistry, the appropriate response is not, “Well, I’m sure you’ll be fine if you don’t take it.” No, they won’t. They have to take organic chemistry. So that’s something to just kind of keep in mind that there are prerequisite courses that, broadly speaking, are a year of biology, chemistry, physics, and organic chemistry, all with lab. So they’ll have to work that in.

One thing that students also get concerned with and may ask for your help with is in taking an MCAT preparation course and whether or not that is needed. I would say, and this was the same advice that I would give to students, if the student themself can stay disciplined with studying for the MCAT, you can buy practice exams straight from the AAMC, the American Association of Medical Colleges, which administers the MCAT. You can also buy any series of practice books from local stores or from Amazon, whatever. So if the person is disciplined, no, they don’t need to take a course in order to do well on the MCAT. If your son or daughter happens to be a procrastinator or if they happened to be somebody who might come up with any other excuse possible to not have to study for this exam, which is a bit of a bear, then it might be worthwhile to take an MCAT preparation course or if you know that your student, based on ACT or SAT preparation really benefits from that structure or has test-taking anxiety or something along those lines, then it may be important to take an MCAT preparation course. There are some universities that offer those courses themselves, so it’s not something that the student needs to pay a lot for. If they go through a test prep company it can be–I think the latest tuitions that I’ve heard are anywhere from $1,600 to $2,000 for a course. So just something to keep in mind.

And then I think the third thing really is, if something does go haywire, if your student starts off in college, high school was a breeze, they didn’t really have to study, their first semester of college they get straight B’s, a lot of times the kind of immediate response is, “Oh, my gosh, I’m completely sunk. No medical school is going to take me. I have to be perfect.” You don’t have to be perfect in order to be a successful applicant to medical school, but it is important that he or she is able to rebound from that experience and to keep improving their grades as every semester goes on. Certainly, academics are important when it comes to the overall process of applying to medical school. And I think, too, it might be important to talk about kind of non-academic behaviors. You know, if a person gets caught for underage drinking, if they have noise violations in their dorm, if they have 37 speeding tickets, those kinds of things could come back up, and it’s not to say that any of one of those things in isolation might prevent somebody for being accepted to medical school, but if one of these things kind of occurs, it might be a good idea to have a conversation about, you know, you’re trying to enter a profession that relies on incredible maturity, relies on responsibility, relies on discretion and sensitivity to patient issues, and you need to make sure that you’re behaving in that way in all aspects of your life.

BF: Cool. Anything else. I’ve got a list of things that I like to just briefly mention at the end but do you have any other advice for folks?

JK: I think that’s–that’s about it.

BF: Okay. We did mention the MSAR, the Medical School Admissions Requirements book that’s put out by the AAMC every year, and that really should be, as we mentioned before on the podcast, and I think earlier in this very episode, that really should be the bible for medical students in terms of figuring out information about individual schools and comparing across schools. But really, I think for parents it can really be a bible of sorts as well, just to figure out application fees and other information about individual schools. So if you want to find out more about that, I think it’s on Amazon, it’s maybe $25, and the official website is aamc.org/msar. So go and look that up if you’re interested in that.

Also, I think an interesting thing for parents to do might be to visit some of the actual premed sites and the most popular one is called http://studentdoctor.net. I think I mentioned it earlier in the episode but the URL is studentdoctor.net, and they have a number of forums on their site that medical students can use to ask questions of other premedical students. And one person actually mentioned that his father is actually a lurker on studentdoctor.net as well just to get a sense of what, you know, what concerns premedical applicants, I think. So that might be a good place for parents who have more questions to go and kind of read up about this whole process.

And then I think my final piece of advice for parents, which was also posted on studentdoctor.net, and I think it’s a good piece of advice for all family members of premedical applicants to consider, is to keep in mind that they are premedical applicants. They are applicants to medical school, they have not done it yet, they have not been trained to diagnose diseases or to give any medical care or advice or anything. And I think often times, once you put the moniker on yourself as a student that you’re applying to medical school, then people might just assume that you, you know, know even something about medicine.

And they’ll start to ask you about freckles on their arm, or headaches, or random pains and stuff like that, and I think it’s good to may be start to involve them in that process if you have something that you’re curious about, if you do have a headache or you do have a bump on your arm or something, but keep in mind that they’re not physicians, so you should definitely go to your own physician and keep in mind that your physician has done it before and the applicant has not. And so don’t expect necessarily that they’ll know anything special about this process because they just haven’t done it before. So that’s my final advice.

JK: That is an excellent advice, Ben.

BF: Cool. Well, thank you very much, Joni. It was very nice to have you on the podcast, and I would encourage anybody listening who is applying to medical school to send this to your parents, send them the link, send them the audio file. As I said before, this is going to be a multi-part episode. This one was concerning specifically admissions and application issues. Coming up, we’ll talk more about financial aid issues that are associated with being a medical student. Another one we’ll do–really we’ll touch on like big myths that parents often have in the application process and in the medical school process. And then, Joni, I think we might want to do one about what it’s really like to be a medical student: what the lifestyle is. how your life might change going from being a college student to being kind of a preclinical medical student and even a clinical medical student, because obviously your lifestyle it was a little bit different during those times. So we can tack that one on the end and make it a four-part series. So hopefully this first part has been useful for you guys.

Do be sure to send it to your parents, and do be sure to email us any follow up questions that we might not have covered because we’re happy to answer any questions that we can for parents and applicants alike. So thanks for listening and take care!