The Cost

I have said from the beginning that one wouldn’t do this if they didn’t love it. If you didn’t, no amount of money would be worth the work. For the most part, I still believe that. I have met physicians that I thought must live in agony because they couldn’t possibly like what they do, but they are rare. So let’s take a look at what a career in medicine might cost. This is a very conservative survey.

Tuition
Baylor College of Medicine
Texas resident $24,000/yr
Non-resident $37,000

University of Texas Medical Schools
Texas resident $20,000/yr
Non-resident $34,000

University of Kansas Medical College
Kansas resident $37,000/yr
Non-resident $66,000

AT Still School of Osteopathic Medicine, Kirksville
Missouri resident $51,000/yr
Non-resident $51,000

University of Florida College of Medicine
Fl resident $33,000/yr
Non-resident $45,000

Applications usually run $50-200.

Fees (and there are always fees) are all over the place.

Books, supplies.  $5,000-10,000.

Room and board.  This is kind of relative.  You’d have to have room and board regardless of what you were doing so it isn’t really a medical school expense.

Lost wages.  $225,000

Testing. $1,300 for the US Medical Licensing exam.  Schools vary as to testing through out the 4 years.

Loan debt service. A $300,000 loan at 5.25% for 30 years would require $1,657/month payments and $596,380 total repaid in 360 payments.

So, using middle of the road numbers from above, your looking at it costing you $522,300 to go to medical school.  And, I’ve not mentioned the loss of a life.  You know what I mean; missed holidays, weddings, vacations, time not spent with kids, hobbies not explored, lost or missed love.

So, what do you think? Worth it?

Uncle Dave

Acknowledgements
This post was prompted by discussions with Rae of sunshine.

Weary

Is Medical School Worth It Financially? Retrieved 9/14/18. https://www.bestmedicaldegrees.com/is-medical-school-worth-it-financially/

Kaplan: What is the Real Cost of Medical School? Retrieved 9/14/18
https://www.kaptest.com/study/mcat/whats-the-real-cost-of-medical-school/

https://www.amortization-calc.com/student-loan-calculator/

The Test, MCAT (rev-1)

I took the phase 4 MCAT in about 1977, so I do not have much experience with the most recent iteration. But it is interesting to look at the history and evolution of the test and what the AAMC feels is important to emphasize in the testing program. It is interesting to note from the last graph (Medical School Acceptance vs. MCAT ) presented in this citation (at the time I looked) which reveals that you don’t have to have the top score on the MCAT to get accepted into medical school. While much fewer do, some of those accepted are low scorers.

And for full disclosure, I have never applied for, tested for or been accepted at any other type of professional school. Still, I think that the same principals apply.

Despite multiple choice tests (MCT) being a standard by 1930, essay and fill-in-the-blank tests were still common in the 1970s. The changes in education that occurred about this time were that teaching changed from teaching the subject to teaching the test. The major thing I’ve noticed in these changes is that there are people that can ace MCTs and those that struggle with them, despite the knowledge level of the test taker. This paper is focused on the later, those that struggle.

So, I will suggest how to prepare for the test.

See one, do one, teach one.  Somewhere along the way, I was taught that there are 5 ways to learn new material. We can hear it, see it, teach (speak) it, write it, and experience it. Yes, having brain surgery just to learn how seems a little drastic so by experience it, I mean practice the test.

Read the material, in the textbook, the lecture’s slides, your notes, other’s notes and everything you can get your hands on. Write notes in class and, repeatedly after class until you take the test for the last time. Organize your notes into outlines; one-time lump categories and the next time split the categories, repeatedly alternating. Use pen and paper and not just a keyboard. Use your notes to teach the material, to others, your dog or your cat. Form study groups and take turns teaching each other the same material. You get to repeatedly write, say and hear the material many times.  You get another’s view in addition to the repetition.  Find the best test taker in your class and get them to join your study group.

Experiencing the material. Collect every sample/practice question you can get your hands on. The AAMC has sample packets that it sells and there are several commercial firms that provide practice questions.  Some of the commercial firms require you to take their whole test preparation course to get the sample questions. I recommend taking a test prep course, but if you can’t, ask others who have taken the courses if they will share their material. You still might have to pay but it should be less than the whole course.

The pro’s and con’s of multiple choice standardized tests can be argued forever, but MCTs are here right now. Learn how to take them.

MCTs give you the question and the answer. You just have to choose which of the 2-5 choices offered is the right one.  They are intentionally designed to have at least one of the choices very close to being the correct answer, but not as close as the correct answer.  Most who struggle miss a question because they rationalize the next closest answer into being the correct answer or miss read the question.  Practice will help overcome these faults, to some degree.

Go to the Association of American Medical Colleges web site and read what the current test tests.

Here is a site that offers free assistance studying, flashcards and practice tests. Check it out, it may help.

Khan academy

Low cost packages
Next step

From Amazon Prime

Your Uncle Dave.

Weary

History
https://en.wikipedia.org/wiki/Medical_College_Admission_Test

Multiple choice testing
https://www.edutopia.org/blog/dark-history-of-multiple-choice-ainissa-ramirez

The cons of MCT
https://www.theguardian.com/commentisfree/2013/nov/12/schools-standardized-testing-fail-students

AAMC site
https://students-residents.aamc.org/applying-medical-school/taking-mcat-exam/about-mcat-exam/

The Personal Statement

Unless your institution provides specific questions to answer that you are limited to answering (how boring), here is your chance to shine and let your guard down, just a little bit. There is some latitude allowed in the personal statement that might not be as well accepted in a personal interview or other aspects of the application. Some applicants feel that they want their statement to be a guide for the interview to follow. The chances of that happening are slim, but it does allow you to say what you might not get a chance to say in the interview or elsewhere in the application.

Traditionally, the personal statement would elaborate on why you want to go to medical school, or this medical school (or whatever kind of school), what your strengths are and why you are more qualified to be here than the applicant sitting beside you. Things like that. But that is all factually listed in other portions of the application. Furthermore, you can’t be qualified to be a doctor until you go to medical school, that’s why you want to go to medical school, so you can’t just illustrate how great you are at medicine. As opposed to a vocational applicant, who would be expected to be professionally competent to be considered for a position. If you search the web for examples of personal statements, you will find too many to read and almost all of them will be of little use as a guide for the applicant to a professional school.

So, you start your statement with, “I’m good at science and want to help people.” Yeah right. You and the other 75,000 medical school aspirants in the US this year. But, what makes you different, special or the applicant that will just wow the admissions committee?

You write a statement that espouses the uniqueness that you feel you have to offer, the unusual life experiences you’ve had, the problems you’ve overcome, etc. Then take a break for a day or so and go back and read the statement with the view that every other applicant wrote the same thing. Now try to think of ways to say the same thing with an emphasis on trying to be different or approach the same qualities from a different approach.  Try to think like the reader, ask yourself what the writer is trying to say.  If you are having trouble being detached (really, do it anyway), have someone else critique the statement for you.

This is a personal statement, so be personable. You are unique and have had unique experiences. Share the personal aspects of yourself and your life that make up that uniqueness. The uniqueness does not have to be medical or science oriented. Every doctor has a life outside medicine, so there is no reason you shouldn’t have one, also.  Talk to other applicants and ask what they plan to write, then don’t write about that, whatever it is.

Rather than give you a bunch of examples of fictitious personal statements, let me ask you to consider the different types of personal statements you might use.

Historical; How have you arrived at where you are now? What was the defining moment or event that convinced you to become a doctor? Was it a person, an event or a series of events, a tragedy or even a personal experience that influenced you?

Goal oriented; You want/will go to medical school, regardless of whether this particular interview is successful or not. You have that burning desire, the drive that can only be satisfied by going to medical school. When, where or how did your desire begin? What do you plan to accomplish by being a doctor?  What will you do if you don’t get accepted from this interview?  What will you do if you don’t get accepted this year?

Problem-oriented; Did you start from a less than spectacular beginning? What was the turning point? Was it poor grades, finances, lack of family support, poverty or some other obstacle? Are you motivated by knowing that you will not continue on the path you’ve been on up until now?

Achievements; Maybe you’ve published papers, worked on research teams in college, invented a device or done something that you feel the admissions committee needs to know about and will be impressed by.  Maybe you have a prior professional career to talk about, prior military experience or Peace Corps experience.  Maybe you surfed the Great Barrier Reef or climbed Mount Kilimanjaro.  Whatever it was, let them know in as exciting and riveting way as you can.

Fiction with a point; Remember your creative writing class. Say you have a muse and are a gifted writer. One of the following genres might carry a message that accurately reflects you or your journey (in any of the above categories) through fiction. A fable is a fiction using non-human characters or inanimate objects that speak and act in human ways to present a moral point. A parable is the same as a fable except excludes non-human and inanimate objects, using only humans. An allegory uses a metaphor to deliver a less than obvious broader picture about worldly issues than the storyline would imply. This may be the riskiest form of personal statement, but I bet it will be one the most unique.

Whatever you write, edit, proofread, fact check, spell check and grammar check it many times, especially after any revision. If you use online or computer software based programs to do this, use more than one. They don’t all agree. If you use a real person to bounce the statement off of, use more than one. They don’t all agree. Not everybody likes the same book.

Do not, I repeat, do not plagiarize.  You might think that the readers couldn’t possibly have read what you’ve stolen, but at least one will have seen it. That does not mean that you can not repeat what others have said. It means that if you do, you must give appropriate credit. Go back to your English writing class notes or a writer’s handbook to do it correctly.

Use of a ghostwriter is questionable. Make sure that they can actually write better than you. If you seek the assistance of someone else, you should still do all of the writing and be involved in the editing. If you are not involved, you will be less familiar with the “voice” of the statement and may be caught trying to explain something you are clueless about. The statement should reflect your vocabulary, your intellect and your passion. Not those of someone else. By all means, though, get help if you are not a good writer.

Your Uncle Dave.

Weary

The language

Watch your mouth.  What you say and how you say it (as well as any written documents you submit) will greatly affect your interview and ultimately your application.  Like other aspects of the application, being conservative will offend fewer interviewers than not.  Consider differences between yourself and the interviewer in age, race, culture, training, region and religion.

Consider the term constructive criticism.  It implies that the critique has positive aspects and that any negative aspects are combined with alternatives to the negative and that it is presented in a manner that tends to not offend or be purely antagonistic.  Now develop that concept into a philosophy and apply it to your answer technique for the interview.  Consider how you will answer each question.  Do you answer it with a statement or a question.  The later may be appropriate in certain situations.  Your answer may be inclusive or exclusive,  in other words by answering the question or not.  For instance, you feel the question  is too personal but you are not sure of the intent of the interviewer, you may answer with vagueness or avoid the subject altogether.  You are being exclusive.  But, be knowledgeable or be quiet.  If you don’t know the answer or are unsure, be quiet.  Being quiet does not mean not answering, it means don’t try to bluff your way through something you don’t know.  It will show.  This is where answering with a question  may show your interest or at least inquisitiveness.  Remember, nobody is perfect and you don’t know nor are expected to know everything.

Avoid slang.  All your friends and family know what you mean because you’ve indoctrinated them but not everyone may be familiar with what you mean by a certain slang word.  In medicine, abbreviations are strongly discouraged or outright prohibited in some institutions because of  potential misinterpretation and resulting errors.  The same argument can be applied to slang words, abbreviations and colloquialisms in your interview.

If it’s listed on The Urban Dictionary don’t say it or write it.  For instance, “That sucks” is a common and almost universally used slang that usually means that the subject that sucks is unpleasant. To a large number of people, it’s origin from the sexual act is prominent in it’s meaning and origin.  They view it as crude and offensive.  Other commonly used slang words of dubious origin include dumb ass, screwed, tits, boob, dick, nuts and many more.  Using substitute words does not hide the offensive word.  For instance, when one says “effing” this, “fricking” that or “that F word”, the meaning is obvious.  Sure you are not actually saying the word “fucking” but the listener is hearing it.  The same applies to dang, darn, damn and God damn.  If it is not already obvious, this isn’t a good time to show your mastery of cussing.

Don’t use mill-speak; hundo p, sorry not sorry, perf, its me, tbh.*  Try to train yourself to communicate without using them.  Your interview is not a social media outlet where these forms of communication are expected.  Having someone else listen to you talk for a brief time can be helpful pointing out when and how often you use these fillers and slang.  They are often used subconsciously and you may need help in training yourself to be free of them.

OMG, seriously, really, totally, um, uh, well, you know, so, like and other nonsensical words are distracting, annoying and don’t communicate anything to the interviewer.  Technically they are called filler words or discourse particles. They are used to buy time while you think, are used to cover nervousness or ingrained because of fad habit.  The two most critical times they are used are at the beginning of an answer or at a point of change in the topic or idea of the answer.  One recent famous politician used the phrase “you know” 142 times in a 20 minute speech.  Pause, think and then answer.  If you feel your pause will be too long, a phrase (yes,it is a filler but it imparts intent) such as, “Let me think just a second before I answer,” will help the interviewer understand the pause.

Thank you, please, yes ma’am and yes sir are always appropriate.  Even if you can’t bring yourself to use them every time, a few occurrences dispersed in a conversation will go a long way toward showing respect.  When you show respect, the recipient feels good and is more likely to view you favorably. Isn’t that what the goal is, here?

When you speak, try to allow the other person to finish what they are saying or asking before you reply.  If you have to, nodding or shaking ones head instead of blurting out a response prematurely is preferable.  But if the interviewer sees that you have jumped to conclusions before they have formed their question, they may interrupt the question to ask why you are agreeing or disagreeing.  If you are astute enough to catch this, try to couch your response with something like, “Unless I have misunderstood what your are saying… .”

Speak with enough volume to be heard without being too loud.  If you notice the other person consistently asking you to repeat yourself, you probably aren’t speaking loud enough.  If they wince every time you speak, you might be too loud.

If you have any disabilities, hearing loss for instance, mention them at the beginning and that will help you communicate better.

Non-verbal language is just as important as what you actually say.  Making eye contact and avoiding distracting gestures (such as looking at your phone, watch or the clock on the wall or taking a call) will be observed and viewed positively. Slouching, leaning on a counter or table, rolling your eyes up, smirking, chewing gum or tobacco will not be viewed positively.

From your Uncle Dave.

*Translation;

hundo p means one is a hundred percent sure about something.
Sorry not sorry tells the listener that the person doesn’t care that the listener knows he doesn’t care.
perf is an abbreviation of perfect (which is being used as a slang in context).
It’s me is a abbreviation of “It’s not you, it’s me,” bringing the attention of the discourse to the most important subject.
tbh is an acronym of “to be honest,” which is generally interpreted that the speaker usually isn’t.

The Recommendation Letter

For almost any professional school, fellowship or job, an applicant will be asked to provide references.  Choose the individual(s) that you are going to ask with some thought.  There are things that you might overlook as obvious or irrelevant.  Consider the following.

Look for experience in both the field of concern and in writing recommendation letters for applicants.

Look for authority.  For instance, if you have a fellow in training versus a Nobel Prize recipient that are otherwise equal in consideration, choose the Nobel Prize recipient.

Know that your choice is respectful of you as an individual, your career choice and your choice of institution to which you are applying.

The individual should be knowledgeable of you, your talents, skills, character and any other trait that will indicate that they truly know you and are not using a boilerplate form for “just another” referral request.

When you approach the individual do not just ask for a recommendation. What you really want to know is whether or not the individual will give you a good recommendation.  You do not want to find out, after the fact, that they gave you something less.  I speak from experience that there are people that would do so and smile in your face and never let you know that they planned to trash you from the very beginning.  Sure, they might still do that, but at least, you will have done due diligence to see that they are honest.

A few years ago, I was applying for a new job and asked a coworker to write a recommendation letter.  I had worked with her for several years and thought she would write a good one.  Traditionally, recommendations are kept private and the applicant is not allowed to know what is being said about them.  In this situation, I found out that the recommendation was not a good one and was able to avoid using that individual in the future.

Despite the temptation, it is not appropriate to ask the person writing the recommendation to share it with you.  They can if they want but you should not ask them to.

Be prepared for the individual to ask you to write your own recommendation.  Be thoughtful and intellectually honest.  Put your best assets out there and forget your worst.  Or, at least, play them down to oblivion.  If you are asked to write your own recommendation, ask for advice.

Basically, you will want your recommendation letter to communicate to the institution what your best traits are that make you more desirable to them than any other candidate.  A recent online recommendation letter I filled out asked for ratings from Excellent to Poor in the following categories; Adaptability, Conflict Resolution, Empathy, Intellectual ability, Interpersonal Relations, Oral Communication, Reaction to criticism, Reliability, Self Awareness, Team Skills, Written Communication and Overall Evaluation.  Almost without fail the submitter will be asked to and should fill out a written letter.  This is in the form of  prose as opposed to a table or graph.  You don’t want to be too sterile,  include traits on the human side of things, such as hobbies, family and other interests.  You could (and should) prepare your own recommendation or a cheat sheet for whoever you plan to ask for a recommendation.  A cheat sheet should include, at least, your name, what position you are applying for, how long you’ve known or worked with the person being asked, the circumstances of the acquaintance, all attributes that you feel you project into the relationship and some personality traits in case the recommendation writer doesn’t know any.  Then, when the individual asks you to write your own recommendation, you could tell them that you have prepared one already and present it.  If they don’t, you can tell them you have a demographic sheet for their use as background information.

From your Uncle Dave.