Investing Your Money While in Medical School

So you’ve worked hard at your part-time job during undergrad – or maybe you’ve taken some time off to work at a “real job” – and now you have what seems like more money than you know what to do with. In reality, perhaps, it’s not much – but you’ve never had this kind of money before. So what to do with it? Invest it, you say? That’s an easy way to make a buck, right?

But how the heck do you do that?

Well, for starters, before you ever come close to purchasing your first mutual fund or opening up an IRA, stop. Stop and think about the big picture. You have successfully saved up a few grand. Perhaps you’ve worked really hard and have $15,000 or so and are feeling quite good about yourself. Or maybe you have even more.  That’s great. It really is an accomplishment, but that doesn’t mean it’s time to go find the best and brightest stock picks and start wheeling and dealing.

First, if you are about to start the medical school application process, you have a lot of costs ahead of you. Your AMCAS application, secondaries, a suit, airline tickets, taxis, food, hotels – all of these things cost money. Quite a chunk of change, actually. If you’ve made it through the process, awesome – but don’t forget you probably have to move to medical school. Moving is expensive. You’ll probably have to buy new furniture, put down a security deposit, and perhaps even your first month’s rent – all before your loan money arrives in your bank account. Once all that is taken care of, what if your car breaks down? What if you trip, fall, break your ankle, have terrible insurance, and get slammed with a huge medical bill? What if [insert unlikely but costly scenario here]? Obviously – hopefully – none of those things will happen. But it’s smart to be prepared. Which leads me to the first step you should take with your grand riches – allocate some of it to an emergency fund.

An emergency fund is for…umm…emergencies. You probably guessed that. But not the “Oh darn, I really need that cool new computer/car/video game/whatever” kind. More like the, “Oh darn, my car just gave up on life and now I need a new one” or “Oh darn, something bad happened and now I need to support myself from my savings for a few months.” It’s generally recommended that you have enough money in your emergency fund such that, if needed, you could support yourself for about 3-6 months. Once you build it up, you put it in your savings account (or higher-interest online savings account, such as Ally Bank, or perhaps put two-thirds of it in a CD ladder with reasonable early-withdrawal penalties) and leave it there until it’s needed. If Mr. Murphy strikes and finds you with your pants down (or at least without an adequate emergency fund), that could be financially catastrophic for you.

In addition to having a solid emergency fund that you can fall back on to cover unforeseen expenses, you should also have a handle on your budget. Live below your means. It’s often said that it’s best to live like a student now so you can live like a doctor later, instead of the opposite scenario. That doesn’t mean you will be eating Top Ramen for the majority of the next decade, but it does mean that you should be financially wise with your resources. Figure out your emergency fund, figure out how much you can spend each month to stretch your loan money for the year, factor in rent and utilities, figure out how to cut costs in certain areas if needed, and don’t spend more than your monthly allowance. It’s really not all that difficult to figure out. The hard part is sticking to it.

Ok, you say. I’ve done all that. I’ve got a great emergency fund, I’ve developed a picture-perfect budget spreadsheet in Excel, and I follow it to the letter. I’ve got money left over, and I still want to invest. Now what?

The first step is learning about the world of investing. I’ve posted before about some resources that you could read to learn a bit, but I’ve reposted some relevant links below for your convenience, and added a few new resources.

The White Coat Investor

This is a great resource for medical students and residents in particular, but also for anyone interested in investing. It is written by an emergency medicine physician, and has a lot of great info about all sorts of things. I would highly recommend reading all of the articles linked in his “First-Timers!” section from top to bottom.

The Motley Fool

What is the difference between a Roth IRA and a traditional IRA? What’s a 529? How do mutual funds work? The answers to these questions and more can be found here. I recommend reading at least through all of the articles under the tabs “How to Invest” and “Retirement” to get a general idea of what’s going on. One word of caution: This site offers a lot of great free content, but has to make money somehow. This often comes in the form of “hot stock tips” newsletters and what not. Ignore these.

The Bogleheads' Wiki and The Bogleheads' Forum

Don’t be thrown off by the strange-sounding name – this wiki and the associated forum are one of the one of the best resources online for learning about investing and finance. Spend some time here – it will serve you well in the future. If you have any questions, ask away in the “Help with Personal Investments” subforum – you can get answers within minutes from many wise individuals, including those who have authored some of the most common-sense investment books available today.

Morningstar.com’s Investing Classroom

If you really want to learn the nitty-gritty details about stocks, mutual funds, bonds, etc., this is the place to go. It takes some time – I’m still not done yet – but going through their free classes is an excellent way to learn some of the finer points of investing.

In addition to the above websites, I recommend getting your hands on some quality books.

The Bogleheads’ Guide to Investing

This is an excellent starter book that outlines a basic philosophy of investing that I believe will serve any reader who is in it for the long haul very well. I highly recommend getting your hands on a copy of this book and reading it. Once you are done here, you might want to grab a copy of their next book…

The Bogleheads’ Guide to Retirement Planning

This excellent work details the various nuances of planning for retirement, including the various kinds of vehicles you can use to stock away tax-advantaged cash. Honestly, if you read the above links you’ll probably get a pretty good handle on most of the basics, but you might want to consider adding this one to your collection at some point. That said, I do highly recommend their Guide to Investing. 

Some general main points of the sources above are summarized below:

Avoid Individual Stocks

You are not an expert stock-picker, and the market is smarter than you are. You can’t beat it consistently. No one does. But if you try to time the market, you will underperform it. And you will likely do that fairly consistently.

If You Can’t Beat ‘Em, Join ‘Em

Why limit yourself to a few poorly-chosen stocks? Why not just buy them all? This is where index funds come in. These are mutual funds that attempt to replicate a market index, such as the S&P 500 – a fund that is composed of stocks of many of the larger companies in the U.S. You can take that even further and buy an index fund such as the Vanguard Total Stock Market Index Fund, an index fund that essentially covers the entire spectrum of the domestic market – big companies, small companies, and everything in between. If you buy this fund, you are essentially buying over 3500 different stocks. Try doing that on your own. Round out your portfolio with funds like the Vanguard Total International Stock Index Fund and the Vanguard Total Bond Market Index Fund. Do that, and you’ll essentially own the entire market.

The beauty of low cost index funds is that, over time, you will get at least market returns. Actively managed funds (mutual funds that are essentially run by a single manager or group of managers) try to beat the market by buying and selling certain funds according to where he/she/they think the market is going. Which might sound good in theory. But in reality, in any given year, actively managed funds underperform the market over two-thirds of the time. Of course, that means that one-third of actively managed funds are beating the market. That’s great, but those funds are changing every year, and there’s no way to know who will be the next winners – or losers. Investing is not a game of winning and losing, though – it’s a game of not losing. By getting at least market returns, you are guaranteed to not lose.

Determine Your Asset Allocation

Your asset allocation (AA) is essentially how much of your money you put in different areas of the market. For example, you will have to decide how much money you will invest in, say a Total Stock Market index fund versus a Total Bond Market Index Fund. A good general rule of thumb here is that your 110 minus your age equals your equity (or stock) allocation. So, a 30 year old investor might invest 80% of his money set aside for investing into stocks via index funds and the remaining 20% in fixed-income securities, perhaps via a Total Bond Market index fund. It’s generally recommended to have at least some type of fixed income allocation. Over time, this acts as a hedge against market downturns and can even increase your overall returns as stocks might go one direction and bonds in another in varying market environments.

An easy way to choose and maintain your asset allocation while also investing your money wisely (especially if you could care less and would rather have a hands-off approach) is to simply buy a Target Retirement fund, such as the ones that Vanguard offers here, or a LifeStrategy Fund, which can be found here. These funds invest in all of the funds I mentioned above, thereby allowing to you cover the entire market in one fell swoop that you never have to think about again, if you don’t want to.

Invest for the Long Term

Investing your money in the market comes with a certain degree of risk – namely, at certain times, you might actually lose money. But the general trend of the market is up, and if you keep your head on straight and don’t sell your investments in a panic (thereby locking in your losses), you will, over time, regain your lost money and then some. All that takes time, though. Don’t invest any money in the stock market that you will need in the next 7-10 years. Short-term goals are better suited to CDs and high-interest (relatively speaking…) savings accounts.

Now what?

So how do you buy these funds? I won’t go into too much detail here about the different ways you can invest (e.g. via Roth IRA, Traditional IRA, 401(k), 403(b), taxable accounts, etc. – that’s what the above resources are for!) except to say that, for someone just entering medical school, the best investment option (if indeed it is appropriate to invest in the first place) is probably via a Roth IRA. Think of a Roth IRA (or any of the vehicles mentioned above) as a bucket in which you hold various types of investments, such as stocks, bonds, etc. A Roth IRA is not an investment in of itself. Each different bucket has different benefits. In this case, you contribute to a Roth IRA with post-tax money, but all of the money you earn within that “bucket” will be available to you in retirement tax-free. Additionally, the money that you contributed can be withdrawn without penalty, which may prove helpful in a time of extreme need.

The catch, of course, is that you need earned income to be able to qualify for contributions to a Roth IRA. That means that if you haven’t earned at least as much money as you plan you contribute in the past tax year, you are out of luck. But don’t let that stop you. Spend time now pouring over the resources above and learning about all of this now. Becoming familiar with sound investing principles now will pay off in a huge way later. Good luck to you in your journey, and feel free to post any questions you might have in the comments section below.

How to Get into Medical School: Part 3

In the most recent post in this series (which can be found here), I talked about writing your personal statement, getting LORs, and creating your AMCAS application. In this last part of the series, we’ll discuss the rest of this *cough* fun *cough* process.

Secondaries (or, Giving Away Your Savings)

Secondaries are medical schools’ way of holding you upside down on the playground and shaking your milk money out of your pockets.  Secondary applications are medical schools’ way of getting to know you a little bit better as an applicant by asking questions that they, as a school, care about. It essentially amounts to more essay writing, and oftentimes many of the essays you write will be interchangeable among schools. The catch (there’s always a catch) is that you have to pay to submit them. In fact, most schools won’t even review your application until you do. And then, they might just reject you outright anyway within a period of time that makes it highly unlikely that a real person even read them (I’m not bitter at all….). Some schools don’t have secondaries…but they often still make you pay. Just because they can. They can run anywhere from around $25-$125 a pop, so plan ahead financially for these.

The key here is just staying on top of them. It’s not a bad idea to create a list of schools you’ve applied to, which ones have sent you secondaries, which secondaries you’ve returned, etc. You can update this later with interview invites, acceptances, waitlists, withdrawals, etc.  If you can find last year’s secondaries (like on the school-specific threads on SDN), then if you have time it usually pays off to pre-write them. They generally don’t change too much, but even if they do, you can often re-use the prewritten ones for other schools. Regardless, try to have them submitted within about two weeks of receiving them. Again, spend some time on these and try to have other people review them, if possible.

Interviewing

After a ton of writing, wringing your hands, and nervously checking your email, you’ve finally got your first interview. First off, congrats! Somebody wants to get to know you a little more. Once you’ve made it to this stage (generally, anyway), your odds of getting accepted by that school can go up quite a bit. But now you’ve got a whole host of problems to worry about.

First off, what to wear? I’m no fashion expert, by any means, so I’ll defer this topic to any one of the threads that pop up on SDN this time of the year regarding interview attire. I will say this, however: be fairly conservative. Now is not the time to express yourself via fashion – let your application do the talking. Unless you really know what you are doing (and you probably don’t), your goal is to not stand out in a crowd, at least in terms of fashion. Usually, it just ends up being a bad thing. Stand out in your interview and in your application – not your fashion choices. For guys, this means buying a suit. Charcoal is recommended, and some people like navy blue. Black can be done, but seems to generally be recommended against. Wear appropriate dress socks, and get some nice (but again, not loud) shoes. Women….you’re on your own. Sorry. Again, the threads over on SDN, as well as countless interview attire articles online, are likely to be of more service to you here. Just play it safe, watch your necklines/hemlines and perfume (it’s ok to smell nice, but don’t be overpowering), do some research, and you’ll be fine. Regardless of your gender, DO NOT wear jeans. That should be a given, but, sadly, that doesn’t always seem to be the case.

So you’ve picked out your attire. Now what? Well, you’ve got to get there. This is where it can get really expensive (as if buying a new suit wasn’t enough…). Drive if you can, but oftentimes you’ll need to fly. Shop around, try and find good deals, and lump your interviews together if you can to reduce the number of trips you’ll need to make. Take advantage of student hosts – it’s cheaper than a hotel and often a great way to really get some great info about the school (just be sure to maybe take them to dinner, or at least leave behind a nice card). Get a decent travel bag, preferably something you can carry on to the plane. Avoid checking a bag if you can. Get travel-sized toiletries. And use the public transportation systems when possible – avoid taxis and rental cars, as these can get really expensive really fast. Get a travel folder to carry your itinerary and any lodging plans, boarding passes, or public transportation info in.

With regards to preparing for the interview: Know your application by heart. Come up with a good answer to the questions, “Tell me about yourself,” “Why do you want to be a doctor?” “What are your greatest strengths/weaknesses?” (think of at least three for each category),  “Why this school?”  and “Do you have any questions for me?” Don’t memorize a rote answer, but remember some high points that you’ll hit when you address each question. If you do all of that, you’ll probably be fine. It’s also a good idea to peruse the interview questions section for each specific school on SDN.

At the end of the day, just remember that your interviewer is your friend. It’s his or her job to present you to the admissions committee and sell you to them. While the questions might seem difficult or your interviewer might seem mean, s/he is just trying to get to know you. So give him/her something to sell. S/he’s on your side.

Aaaand the Waiting….

 Once you’ve finished your interview, you’ve pretty much done all that you can. So relax. More than likely, it’ll be a few weeks before the school can even get back you with a decision. Hopefully, they’ll give you a timeframe. If not, you’ll probably be constantly checking your email and mailbox (Ok, let’s be honest…you’ll be doing that anyway). But seriously…relax. You’ve done what you can.

If all goes well, sometime in the fall or spring after your interview, you’ll get a notification of acceptance. Congrats! You’ve made it. You’re going to be a doctor. If you are put on a waitlist, don’t give up hope – consider sending in occasional updates with new information about activities, why you love the school and would be a good fit, updated transcripts, etc. If you’re rejected, write it off and move on. There are more interviews to come. Hopefully. If not, consider what you can do to buff up your application for next year.

Springtime Glory

Hopefully, once spring rolls around, you’re sitting on at least one (maybe more?) acceptance. By May 15^th, you have to withdraw from all but one school. By that time, schools should have sent you financial aid packages, which will assist you in making your final decision. My only recommendation here is, when at all possible, go with the cheapest one. Cheap school is good school. The “prestige” of the school (unless it’s literally a top 10 school, or whatever, and your goal is definitely something in academics) really doesn’t matter. You can do well wherever you go – your school’s name won’t give you a free ride. And money may not be able to buy happiness, but the quicker you can pay back your loans, the quicker you’ll be financially free – and freedom is pretty darn good.

The summer before school starts is generally pretty much up to you. You can work, relax, travel, etc. Do NOT prestudy for school. You won’t be able to study efficiently, and more than likely you’ll regret it later. It’s tempting, I know, but don’t do it. If you absolutely must do something, then start thinking about HOW you’ll study. Will you read books? Make outlines? Use flashcards? Group study? Solo study? Some combination of the above? For example: I, for one, am considering using the spaced-repitition flashcard program Anki to retain material – not as a primary learning tool, mind you, but something to help me remember the bits of info I need AFTER I already understand them from reading a textbook, listening to lecture, etc.  I’ll probably post more about this later. You can read more about it here and here (I highly recommend these sources if you’re interested in Anki). I also plan on using OneNote to take notes during school. So I’ve spent some time familiarizing myself with these programs.

Also, spend some time doing things you won’t have much time to do later. Hang out with loved ones and friends. Read some books. Watch some TV. Relax. For example, I’m really interested in personal finance, investing, retirement planning, and have been thinking a lot about paying off loans and whatnot down the road. I figure it’s better to know these things ahead of time so that I can get the jump on them as soon as I am able – and some things, like personal finance, are just things you should know anyway. If you want, spend some time perusing the Boglehead’sWiki and over at White Coat Investor’s blog for more information.

So that’s it. Sorry about the written vomit. Good luck on your path to medical school, and I hope what you read here proves helpful to you in your journey.

How to Get into Medical School: Part 2

In the first post of this series (which can be found here), I rambled on about some of the basics of your medical school application, such as volunteering, research, the MCAT, and your GPA. Now, we’ll talk about the next phase of the application process – and all of the stress that comes with it. Lucky you.

Your Personal Statement

Ah, the personal statement. Your opportunity to communicate to admissions committees across the country why in the world you would want to be a doctor, and why you would be a good candidate for admission to their school. This portion of the application is perhaps the most frustrating, if only because you need to communicate so much while only being given about 5,300 characters (including spaces. Yay...).  That’s a little over a page to sell yourself.

There are countless articles online about writing your personal statement, and ideally, you’ll have a writing service at your school and other knowledgeable individuals who can help you fine tune it. My primary piece of advice is START EARLY. While some people can hammer out a workable product in a relatively short amount of time, this is not something you want to rush. Plan on this taking a few months to write, review, rewrite, rinse, and repeat – about one bazillion times. Keep a journal about meaningful experiences while you are volunteering or working in a clinical position or shadowing. You can tie these stories into your statement later. As with all other parts of your app, and perhaps more so, have lots of trusted people review this before you submit. Ideally, you want this done at least a few weeks before you can even submit your application, because in the weeks leading up to submission you’ll have plenty of other stuff to worry about.

For those who are interested, you can read my personal statement here. 

Obtaining Letters of Recommendation

This part of your application can perhaps be the most awkward, but it is nevertheless important, if only to play the application game well. Letters of recommendation (or LORs, as the cool pre-meds call them) are essentially a venue through which admissions committees can obtain a perspective of you as a person that is different from that which is presented in your application. Therefore, you only want to ask individuals who can paint a very strong positive picture of you. Ideally, you’ll find writers who can honestly say, using real-life examples, that you are not just a good applicant, but a great one.

You typically need at least three letters – two from science professors and one from a non-science professor (think history, English, etc.). If you’ve done research in a lab, many schools will require one from your PI. If you are employed, consider getting one from your boss. I was a scribe who worked closely with a few doctors, and was able to get a few from them. Each school might vary a bit in their requirements, so be sure to check out their website for more information. Don’t get any more than six – that’s just annoying.

Writing letters takes time. So ask your writers well in advance of when your application is due – generally, about three months of notice is a good rule of thumb. When you ask them, be sure to bring along a little packet with your resume, a draft of your personal statement, a letter with instructions on how they should submit their letter (more on this in a bit), a due date, and perhaps what medical schools are looking for, and maybe a sample of your academic work. All of this should be in a clean-looking, professional folder. Ask your potential writer if they would be willing to write a strong letter of recommendation for medical school. If they hesitate, or give any response other than a confident positive answer, walk away – politely. You do not want a wishy-washy letter. After they have said yes and you’ve given them a packet, make sure they know how to contact you (this should be in the packet) and let them be for a bit. About half way through their three months, shoot them an email thanking them for their willingness to help you and reminding them about the upcoming due date. Send similar emails a week or two out from the due date if you haven’t heard from them, but don’t be annoying.

Typically, you aren’t supposed to see the letters – or, at the very least, you are supposed to waive your right to see them. Some writers may opt to give you a copy, and that’s fine. But they don’t have to. So how do you collect them? Perhaps one of the easier ways to do this is use a letter storage service, such as Interfolio. This site will allow you, for a small fee, to store your letters electronically and then send them safely to AMCAS. Your letter writers can submit directly to Interfolio via snail mail or by scanning them in. Give them a choice – usually, the former is easier. Just be sure to include a pre-addressed manila envelope with postage in your packet.

So, in summary – ask early, ask only people who can write strong letters, give them a packet, and check on them once and a while. Make it as easy for them as possible.

Creating Your AMCAS Application (or, Where Crap Starts to Get Real)

AMCAS (the American Medical College Application Service) provides a centralized application service for most U.S. MD schools (for a fee, of course). In the past, applicants had to obtain applications for each school they wanted to apply to, fill it out, and send in a hardcopy of their application to as many schools as they needed to. Now, thankfully, applicants can just fill out a universal online application that can then be sent to any participating schools (except most Texas schools – as might be expected, they do their own thing and use TMDSAS, a similar application service specific to the great nation of Texas).

The application itself can be found at the AMCAS website. Generally, it is made available to applicants in early May, but can’t actually be submitted until early June. I strongly recommend creating an account, opening the application, and beginning to fill it out as soon as you can. It’s a time-consuming process, and must be picture-perfect. Medical school admissions can, at times, be an arbitrary process, and you don’t want a poorly-written application filled with typos to be the thing that keeps you out of your dream school.

Before beginning the application, I highly recommend taking the time to read through the AMCAS Instruction Manual (which can be found on this page). It’ll save you time and possibly heartache later if you just do everything right the first time.

As far as general tips for filling out the application: start early. Spend some time reviewing your work/activities sections – these are like mini-personal statements for that activity. Some people prefer to write these in a bullet-point format, while others prefer a narrative format. I chose the latter, but that’s just me. Be sure to describe the activity, but don’t forget to mention how it affected you or guided to toward medicine or whatever. You can create fifteen work/activity sections, and pick a few of them (it was three, I think, when I applied) as your “Most Meaningful” – in other words, the activities that really changed you or drove you in this direction or taught you something important. You then get a little extra space to write about each activity. Don’t worry about trying to game the system (e.g. picking one research activity, one volunteering activity, and one leadership activity, or what have you) – just pick the three that were really the most important to your personal development. It’ll pay off later when your true passion for whatever the activity was comes through. Have people review your application. DO NOT miss typos – it’s just bad form. If you write your personal statement, work/activity descriptions, etc., in something like Microsoft Word, then be sure to paste it into a program like Notepad and then paste that into the AMCAS application – it avoids any potential formatting issues from directly importing Word’s rich-text into the comparatively low-tech application.

Ideally, if you started it early, you’ll have your application up and ready to go when it comes time to submit in June. Be sure that you and other people have reviewed it multiple times and that there are no errors. Once you submit it, it then goes to AMCAS for verification of your grades, classes, and whatnot. The earlier you submit, the less time this takes. If you submit in the first few days, this might just take a day or two. Any longer than that, it can take a few weeks – and your application will not be received by medical schools until after it is verified. So start it as soon as you can, stay on top of things, and submit early. 

And that wraps up this post. Next, we'll talk about secondaries, interviewing, financial aid, and the rest of the process.

How to Get into Medical School: Part 1

So you’ve decided you want to be a doctor. If this is truly how you want to spend the rest of your life—or at the very least, a significant chunk of it—then I congratulate you. You’ve chosen a noble path, though there are no guarantees as to how things will ultimately turn out. If the origin of your motivation is uncertain, or there is something else you really feel like it would be cool to try out, then perhaps it would be wise to attempt the thing that interests you most first. Medicine will always be here to come back to.

For some, deciding on medical school is a decision that is reached one day—maybe it is a sudden enlightenment, like getting struck by lightning (but perhaps somewhat less painful….or not, I suppose). For others, including myself, reaching this decision is more of a journey. Perhaps a person is headed in one direction, but along the way is exposed to medicine somehow. They don’t think much of it at the time, but perhaps repeated exposures leave them with a nagging feeling that there is something fulfilling to be had here. After a period of honest exploration, our hypothetical individual realizes that medicine—and in particular, becoming a physician—is the best fit for them. Of course, it’s generally not as clear cut. Life is messy.

Regardless of how you got to this point, you’re here now. So what’s next? Following are some of my random thoughts on important aspects of the application process. Take them with a grain of salt. Or two.

On Deciding to go to Medical School

I touched on this briefly already, but let me just reemphasize an important point: Within the realm of medicine, there are many career paths, most of which do not involve spending at least twelve years or so of your life in school. If you absolutely “know” and can articulate good reasons for wanting to become a doctor, more power to you. If not, before you plunge into a point of no return, explore a little bit. Take some classes that are not necessarily medicine-related—maybe that astronomy class you always thought would be interesting, but you never had time for. You want to be a doctor, after all. Try to talk to people in other fields, or at the very least, do some research on the internet. Though you obviously need to understand the limitations of other people’s input—particularly random internet strangers—on your own life, there are many helpful websites for all kinds of different careers that can help you get an “inside look.”

If you have done all this and are set on medical school, then I would strongly recommend taking time to research exactly what you are getting into. Research the medical education process; read books about medical school, residency and beyond; understand what it costs you to become a doctor (and not just financially); understand how this process will affect you and those you love; digest exactly how much debt you will be going into and the realities of paying that off (don’t just think, “I’ll be a doctor; it’ll be fine"); explore the current healthcare system and try to get an idea of how things are changing and how that will affect you in the future. The world of medicine is changing, and if you are going into school with unrealistic expectations regarding your future, your work, your life, your finances—you will be disappointed. Think long and hard about this decision before you do something stupid.

Creating Your Application

The formation of your medical school application begins before you even realized you wanted to become a doctor. The shaping influences in your life—your experiences, your family, your friends, your enemies, your jobs, your education, etc.—all played a role in even giving you this desire in the first place. But now that you know, now that you have joined the neurotic ranks of premedical students worldwide, the formation of your application needs to stop being a passive process and become an active one. On that note, there are certain components (listed below in no particular order) that will be helpful to have in your application.

Volunteering/Clinical Experience

Most schools will look for some type of volunteering or community service activity in your      application. Theoretically, this shows a dedication to service and a willingness to make personal sacrifices. Practically, this turns into just another box to check for most premedical students. But it doesn’t have to be that way. Volunteering just once a week for a few hours at your local hospital, community aid program, shelter, etc., can be an invaluable way to learn about the practice of medicine, interact with people who might be diametric opposites of you, and broaden your worldview. This can be an awesome experience, and it doesn’t have to be medical in nature, either.

I personally volunteered at a hospital, first at the information desk and then in the emergency department. As a volunteer, you are at the bottom of the totem pole. But, you can also wander the hospital without too many questions being asked. The experience is what you make it. The extent of your patient interaction might be handing out warm blankets and food trays, but you can hand out warm blankets and food trays like a champ. In the process, you—unlike the rest of the busy hospital staff—might have the opportunity to connect with patients on a more personal level. You are the closest thing to someone like them in a busy emergency room—everyone else is wearing scrubs, trauma scissors, and generally running around like busy ants whose ant hill is on fire. So don’t just write off the opportunity—make something of it. You can also make connections with the staff, who might let you help them out with some “cool” things every once in a while if they see that you are actually making an effort. That said, don’t just make an effort to get noticed. Make an effort for the sake of making an effort, and see what happens.

Briefly, let me also note that you don’t need thousands of hours. I think I had 130 hours total, and that was enough. I ended up stopping when I had to move, and getting too busy later to get involved in my new hometown, but I had a blast, and some pretty cool experiences to boot.

For those who choose to volunteer in a non-medical capacity, first let me say this: that’s awesome, and it will set you apart a bit in the application process. Do something you enjoy; don’t just volunteer at a hospital so that you can say you could. That said, though, you will have to get some clinical experience. This can be in the form of shadowing (start with your family doctor, or cold call offices in the area to start if you need to. But get some, even if you do hospital volunteering. If you are volunteering at a hospital, ask the doctors there) or in some type of clinical job. Personally, I worked as an emergency room scribe for about two years. I had a blast, learned a ton, made good connections, and got some good letters of recommendation on top of all that. I also worked as a patient transporter (our official title was “patient escort,” but I tried to not publicize that…) at a large hospital for about a year, which provided me with a lot of patient interaction and the chance to see how the hospital works together as a dynamic unit. Other people work as EMTs, phlebotomists, laboratory technicians, ED technicians, etc. You don’t absolutely have to work in a clinical capacity—extensive shadowing can suffice. But if you are able to, I would definitely recommend it.

Research

Research is one of those things that isn’t necessarily required, but is nevertheless a worthwhile pursuit and very helpful to have. Honestly, some schools (Mayo, I’m looking at you…) won’t even really consider your application if you are researchless. Try to get involved with professors on your campus or local research groups in your area. If you can get some type of publication or presentation, that’s a plus. Whether you do clinical research or benchwork research, try to do something if you can.

I actually didn’t do research. When I had the opportunity to finally get involved, I was too busy with life, studying for the MCAT, school, work, planning a wedding, and on the verge of applying. If I hadn’t made it in this last cycle, I would be definitely getting involved now. It worked out fine for me, and I am very satisfied with how things turned out. But it would have been interesting to see, just for the sake of curiosity, how things would have turned out if I had had more research experience…

GPA

The bottom line here is simple: do well. You don’t need a 4.0, but you do need to demonstrate that you can handle the rigors of medical school. Most matriculating medical students have an average GPA of 3.5-3.7. Figure out study strategies that work for you (group study? solo study? notecards? rewriting notes? teaching your dog?) and do them. Your GPA is important, despite what some might try to tell you. This will distinguish your application, for better or for worse. You decide. As much as it is in your power, master the information presented to you—don’t cram—and show those classes who’s boss. Do particularly well in your core premedical prerequisites—biology, general chemistry, organic chemistry, physics, etc. Will a few Bs here and there destroy your application? No. Do people get in with abysmal GPAs? Yes. But you better have a darn good reason.

This is an important opportunity to show medical schools how well you can perform. Don’t waste it. 

MCAT

Remember how your GPA was an important opportunity to distinguish your application and show how good of a student you are? Well, this is the other opportunity. GPAs may be variable from institution to institution, but the MCAT is a standardized indicator of how well you will perform in medical school, and you will be judged by it.

The first thing you have to decide is when you will take it. I, and many people, elected to take mine in the spring of my junior year. This allowed me a little bit of time for a retake (albeit in exchange for a slightly later application) and allowed me to start medical school right away after undergrad. Some people take it later, perhaps later in their junior year or even in their senior year, so that they can have more time to study or take a “gap year” to do research, travel, work, play video games, etc. Whenever you take it, try to have your premedical prerequisites out of the way. Also, keep in mind that schools get picky about old MCAT scores—as a general rule, you want to apply within three years of taking the test.

Once you’ve decided when you will take it, you have to decide how you will study. If I had to guess, I would say that most people probably study on their own. There is a lot of information out there and a lot of resources you can purchase. This method allows for flexibility and works well if you are self-motivated and able to plan out a schedule and stick to it. One self-study method I have heard good things about is this plan devised by a fellow with the alias of SN2ed, posted on Student Doctor Network (a helpful site for tons of information from other—occasionally overly-neurotic—premeds).

Another option is to use a preparatory course. There are many out there—Kaplan, The Princeton Review, etc—and you can even just buy the materials and not use the course, if you want. I personally chose to use a prep course. I did this because, in the season of life when I took the MCAT, I was already busy with school, work, and getting married, and honestly just wanted someone to hand me the material I needed so that I could get straight to studying. I used a prep course called Altius, and thoroughly recommend it—with the caveat that your experience may be very different than mine. This course provided me with classroom session, a tutor, materials, practice AMCAS tests, and an entire academic year of preparation for this monster of a test. I ended up doing pretty well, and have no regrets.

Whichever option you choose, rock it like a champ. 

A Brief Note…

Allow me to pause here and note that your clinical experience/volunteer experience, GPA, and MCAT, and research experience form the cornerstones of your application. If you can excel in all areas, that’s awesome. If one area is lacking—for me, that was research—then you should try to compensate for that in the other areas.

That brings us to the end of Part 1. Next up, I’ll focus on creating your AMCAS application, gathering letters of recommendation, writing your personal statement, submitting secondaries, interviewing, traveling, and—hopefully—getting accepted.