SMPs, Post Bacs , and MPHs oh my!

Categories Medical Education, Medical School, Pre-Med
Special Masters Program, MPH, Oh my!

Medical school is notoriously difficult to get into. In fact, the American Association of Medical Colleges posts that only ~39.2% of applicants gained admission in the 2015 application cycle. This number is shocking in and of itself, but in reality these statistics can be much more ominous depending on a number of factors.

For example, the state that you live in has a huge impact on your chances. Texas has its own medical school system which tends to show a strong preference for in-state residents, leading to a higher acceptance rate for a native Texan than would be expected from other areas. Other states do not have a medical school (such as Alaska, Wyoming, Delaware and others), and applicants from these regions can have a more difficult time gaining acceptance. Don't even get me started on the California schools. Despite giving some preference to Californians, the number of west coast pre-meds dwarfs the number of available medical school seats. This forces most California applicants (us included) to leave their home state.

Other non-academic factors are also very important when looking at your chances of getting into medical school including race, socioeconomic status, etc. While not unique to medical school, these factors undeniably affect each and every applicant and it is important to be aware of. For example, an Asian applicant with an average MCAT score has an 11.9% of acceptance, while the same student would have a 54.7% chance if she were an African American. Note that we're just trying to point out that your ethnic background is a factor in your application, and are not debating whether this policy is right or wrong.

Regardless of the reason, 6 out of every 10 applicants are left in a situation where they are (understandably) stressed, confused, and unsure of the future. A multitude of options exist and each route can be both expensive and time consuming. Even worse, these routes do not guarantee that students achieve their ultimate goal: receiving a medical school acceptance letter. We are going to break down each of these options and provide our own reflection from the insight we have accumulated over the years.


Situation #1: I was not a science student during my undergraduate years and now I want to be a Doctor.

In many ways, good for you! You earned a degree in something you enjoyed (or thought you would at the time), but now you are ready to enter the medical field. You are focused and determined to do what it takes to apply for and attend medical school. But- how do you get started?

This really depends on what exactly you majored in, and if you have taken any of the medical school prerequisites. Some majors, like Engineering or Math, may already include some of the required courses like Calculus or Chemistry. Additionally, some students with non-science majors who knew they wanted to apply to medical school sometimes are able to sneak the pre-requisites into their schedule. If this is you, congratulations! All you need to do is finish up any required classes and apply

With only a few classes to take, many applicants take classes at the same institution that they received their undergraduate degree. It seems like a no-brainer: You already know the campus, likely know the area well (or still live nearby), and may even know which professors are the best for you to succeed. The major downside is that it can be difficult to schedule classes without spreading them out over several years. At my undergrad, Organic Chemistry II was only offered in the spring, which would have forced me to wait over 6 months to finish my last pre-req.

However, if you’re like me and majored in Literature with very few science requirements, you may graduate with very few of the pre-reqs done. Don’t panic! There are structured programs that will help you complete these classes in a timely manner. It’s easy! You go to: https://apps.aamc.org/postbac/#/index. You apply. You attend a program with academic support, mentors, application advice, and plenty of opportunities to do research/volunteer/etc. If you are a good test taker (i.e. Grades!!! MCAT!!!) this helps even more, as you will be well prepared to apply once you have finished. Several classmates of mine pursued this option and got into medical school no sweat.

The major con to this option is the cost. Although these programs make it relatively easy to schedule your classes, you often pay a price for the convenience. However, the federal government is currently happy to provide graduate loans for students in these programs and the cost is manageable. The costs of attendance should not be a barrier to commit to these programs full time, which will be required for most to truly excel. If you apply yourself and succeed, the cost is generally worth the investment.


Situation #2: I did my pre-medical requirements but I didn’t get straight A’s (or study efficiently.. or had family/health issues… or I had too much fun in college…) and now I want to be a Doctor.

If you have already been through an application cycle or invested in a college degree, you know how this feels. You overestimated your chances as an applicant or underestimated the competitiveness of the medical school application process. You are now left with a bruised ego, an unfilled dream, thousands of dollars in debt with a pile of rejection emails in your inbox. So, what now?
One option that is the very attractive “special master's program” (SMP). These are programs offered by many medical schools, which allow you to take graduate level courses (often with current first year medical students). If you succeed, you may gain favor and acceptance into that medical school. You read stories of students successes, see them as tour guides on the interview trail, and maybe even have a friend of a friend who is now a Doctor with a very motivating personal story to tell. But how do these programs really work?

The specifics of these programs vary. At my medical school, ~100 special masters students were placed on a straight curve against one another and the top half were offered guaranteed acceptance for the next year. It sounds great, simply study your butt off and make sure you are in the top half and viola! You’re now in medical school. However, the unfortunate reality is that the bottom half of every master’s class spent thousands of dollars and did not get in. Thus, everyone who enters is desperate, leading to these programs being plagued with cheating, “gunning”, and creating a ruthless dog eat dog world. (On a topic for another article I believe this dynamic contaminants the environment of medical school in general).

But surely not every program is like right? Other programs guarantee all their master’s students an interview, but often very few are actually accepted. Sometimes they take many students into the program. Sometimes they don’t. And most importantly: every year thousands of hopeful students are left an additional $20,000-$30,000+++ in debt… and again with nothing to show for it.
At this moment, a friend of mine is travelling across the country by himself moving home after failing the first few tests in one of these programs. He started a SMP like everyone else, full of energy and determination. Yet, despite his best efforts, he was not able to remain in top percentage of students. I imagine him driving alone with echoes from this highly competitive atmosphere and the incredible pressure feeling like a crippling headache on a fatigued mind.

Overall, these programs provide an amazing opportunity to show that you can survive the medical school curriculum and offer an alternative way to gain acceptance. Thousands of applicants get into medical school every year because of these SMPs. However, it’s important to be sure that you have fixed whatever study problems you had that led you to this route. It’s tough to honestly evaluate yourself, but it’s worth even delaying an additional year to prevent failure.


Situation #3: I did my pre-medical requirements but got some C’s and F’s/I am not a good test taker/I had too much fun in college and now I want to be a Doctor.

Caribbean medical schools vary greatly in quality and opportunity, and this option will be its own article in the near future. Most of the offshore medical schools have very low entry requirements and may be the only option for some applicants. If you’ve taken the MCAT more than twice and can’t seem to achieve a competitive score, this is the option for you. Be aware though, going to medical school in the Caribbean is a high-risk high reward proposition. This should be the last resort for almost all American applicants.
Regardless of all the negative stories and the disgruntled drop-outs, there’s no denying that thousands of Caribbean grads have become successful doctors. Several of the attendings that we regularly work with have gone this route, and they are all competent clinicians. In fact, over 2,500 US-IMGs (international medical graduates) matched last year

However, from encountering people on the interview trail, the Caribbean sounds like it is a very competitive and isolating environment where schools often accept >1000 students per class and the matriculation/match rates are purposefully vague. Be aware that if you have had difficulties with test taking or studying before now, make sure to fix these issues before starting on the island. These schools are notorious for not having many of the support systems in place that are usually included at most medical schools. You may find yourself three years into school, and hundreds of thousands of dollars in debt, but unable to finish your education. Despite the many difficulties, the students who make it through these programs are truly amazing and deserve their spots in US residencies many times over.

Stay tuned for a more in-depth look at the Caribbean route in the coming weeks.


Situation #4: I did my pre-medical requirements but have other interests/I am not quite ready for medical school/ My GPA and MCAT are good, but I feel that I need a small boost to my application.

This is my path, and so the one I can speak to most. I completed my undergraduate education with a literature degree (with my pre-med studies peppered throughout), a below average medical school GPA (~3.5) and a less than desirable MCAT score ( Instead, I remembered a physician speaking to our group of female pre-medical students about her experience attaining a Master of Public Health (MPH) degree. She described how the drive and passion she took from it helped her pursue and ultimately gain acceptance into medicine. As I read about the world of health policy and administration, epidemiology and utilization of healthcare, I and was instantly intrigued.

In addition the an MPH, there are other Masters-level degrees in biology or business that can also function this way. The key advantage that these degrees hold over an SMP, is that they can typically lead to successful careers that do not involve medical school. While the Special Master’s Program is virtually useless other than as a boost to your application, an MPH/MBA/MHA can all be applied to job advancement. In fact, I was able to turn my MPH into a full time research job at a large medical center.
I had applied and received an acceptance to an executive MPH at UCLA.The two year program was enjoyable, and I was able to work full time while learning about health care law, economics, healthcare systems and the newly passed Affordable Care Act. During this time I also retook the MCAT and was able to improve my previous score. Although it took me two application cycles, with my MPH, improved MCAT score and GPA, and a publication from my research job, I was ultimately successful in gaining acceptance to medical school.

When getting feedback as to why I was not accepted the first time, many programs told me that the MPH alone was not enough to overcome my less than competitive MCAT score and GPA. For this reason, many people advise that the MPH is a waste of time and should only be viewed as an extracurricular activity. In retrospect, I have mixed feelings. What the MPH did was provide me with connections a job and a greater perspective to the field which I would ultimately enter. In times where I would struggle, it grounded me as I had seen the bigger picture of the healthcare landscape and knew first hand what I was working towards. Additionally, I have been able to use the skills gained through the degree to create research opportunities throughout medical school.

 

 

Ultimately, there is no “right” or “wrong” choice among the list above, but there is making choices for the right and wrong reasons. Hopefully this article provided you with some more information so that fewer of us fall into this pattern in the future. Have any stories you would like to share? Or questions for us? Let us know in the comments!

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