Boston College or University of Florida for pre-med?

Pre-Med & Medical School Pre-Med Topics
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@nrtlax33

The article you link includes US graduates of international medical schools (IMGs) in its discussion of med grads who failed to match. Caribbean medical grads face many issue w/r/t to the Match, already match at about half the rate of US MD or DO grads, and their situation is going to get worse as the number of US grads increase. The MO program is primarily aimed at US IMGs. (IMGs who have borrowed from the federal government to finance their education in the Caribbean, BTW, and who are now defaulting in huge numbers on their student loans…)

The 5.7% unmatched rate for US grads does not include the 3% who find a residency placement thru SOAP, or any candidate who matches off-cycle or at a non-NRMP residency program. (There are a few left.)

US grad candidates who don’t Match typically have serious flaws–failed STEP exams, failed rotations, failed pre-clinical coursework, professionalism issues, disciplinary issues, character/personality issues, drug/alcohol abuse problems, mental health issues… Other reasons are hubris (applying to specialties without having appropriate board scores/class rank research/LORs) and unrealistic geographic restrictions. (Only applying to neurosurgery programs in Montana/Idaho/Wyoming. [Hint–there aren’t any.] Only applying to CA residencies. )

Part of the issue with the Match and ERAS is that since the all-in policy was implement in 2015, the number of applications per student has ballooned, (Much like what’s happened with the common app.) Anxious applicants are now submitting more applications to more schools. For most low to moderately-competitive specialties, 15 well choose applications will typically yield 7-9 interviews, 7-9 ranks typical offer a 94% certainty of Matching. But anxious candidates are applying to 40-50, even 90 or 120 programs. Insane. Because RDs have no idea how many other interviews a candidate may have–and desirable candidates often may have15-30 interviews–this contributes to greater instability of yields and rank lists at residency programs. Where before an RD might interview and rank 25 students to fill10 slots, now they need to interview and rank 50 - 60 candidates to guarantee filling all 10 of their positions.

D2 mentioned that she was seeing the same candidates over and over again at her interviews this past cycle. Like so frequently she knew their history/background/interests and was friendly terms will most of them. It became like joke-- Bye! I’ll see next week at the Duke interview…

There’s talk at NRMP of placing a cap on the number of applications a candidate is allowed to submit, perhaps even a cap on the number of interviews each applicant is allowed to take. The hope is this will force candidates to be more realistic and selective about which programs they apply to and allow residency programs to be less disingenuous in their post-interview communications with candidates.


@gallentjill  

Internship is the term used for the first year of medical residency.  First year residents are called interns.

This is entirely different from pre-college or college internships which are a form of job shadowing or trial employment.
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The 6% number is pre SOAP so <6% of applicants graduate without at least an internship lined up. Of the 6% who don’t match, half could have been identified as being unlikely match due to red flags (failed classes, failed exams, professionalism issues, not applying broadly enough etc) so I don’t think that necessarily speaks to the “competitiveness of the process.” Once you get beyond SOAP, a decent chunk (the majority?) of those students will match the following year as reapplicants. After 2 failed matches i would move on but someone recently posted on SDN the story of their matching on the 3rd try.

American senior med students will not have issues finding a position for a very long time. The Caribbean grads and FMGs will feel the squeeze far sooner.

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@gallentjill

A competitive internship refers to either–

a residency in a competitive specialty (neurosurgery, orthopedics, urology, ENT, ophthalmology, radiation oncology) which are competitive because these require very high academic metrics for entry consideration and because there are significantly more applicants than there are training positions.

or–

a residency at a top ranked program within a particular specialty, particularly if it located in a desirable/prestigious location.

(for example, landing a pediatrics residency at Penn or Colorado or UWash is every bit as competitive as matching into orthopedic surgery.)

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@WayOutWestMom and @iwannabe_Brown : Thanks very much for the detail explanation.

@gallentjill The “internships” I was talking about are for college students. To give some ideas what I was talking about, here is an [random example](https://med.ucf.edu/biomed/undergraduate-programs/pre-health-information/internships/clinical-research-internships/) close to where you live.

But the one above is for credits and for local students. Imagine an internship like that without credits and the famous hospital is associated with a top medical school. The accepted interns (from many top schools) are working on several studies in clinical settings with a lot of patients. Only top candidates are accepted and it is very competitive. If the students only take some basic courses like bio/chem/etc., it would be impossible to even get an interview. Taking Physiology/Statistics/Orgo I etc. will be helpful if you can finish them all up during freshman year. Statistics is particularly useful for internships.

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There are several hundred summer internship/summer research fellowship programs for pre-med/biology/chemistry/ neuroscience/biophysics majors. They range in acceptance rates from 3% to around 40%. (Amgen & HHMI are 3-4%, NIH-Bethesda Campus Summer Fellows program is ~15%. Some less popular NSF summer fellowships are in the 30-40% range.) Some are even pay-to-play.

Some pre-meds get hot & bothered lusting for an acceptance to one of these programs, but guess what? The effect of having one of these internships or fellowships on one’s med school school application is minor. (MD/PhD might be a different story…) These programs are a grace note, not the main melody.

This simply isn’t true. Some summer internship programs are specifically designed for students attending colleges that offer only limited research or course choice opportunities. Many of the rest are looking not for specific coursework, but specific laboratory or other skills. (Why? because summer is short and it takes too long to teach a student skill Z from scratch and still have time for the student to complete a project. )

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@WayOutWestMom : I have several questions:

[quote]
These programs are a grace note, not the main melody. /quote So what is the main melody? What would you suggest that an incoming sophomore pre-med do for the summer? Nobody in our family is in the medicine field and we have no connections. My niece did a NIH-Bethesda summer research because my sister’s neighbor is leading a lab there. A large number of those positions are filled by connections. I think we should give credits to students who go out on their own and get accepted to internship positions. The Florida program I (randomly) mentioned earlier has prerequisites also. That is why it is so hard for a freshman student to compete. Most freshmen have not shown course rigors.

(2) My understanding is that clinical internships are more valuable than doing research in the labs which has no human interactions. Is that true? Of course, lab research is required but do you think clinical one is more valuable since medicine is actually about people?

(3)Some statistics (like MIT’s mentioned earlier) seem to suggest a gap year is not helping at all. ( MIT’s acceptance rates were 94 percent for undergraduates, 47 percent for graduate students, and 67 percent for alumni.) What do you think? We actually suggest our kid to take a gap year even if it is not needed. We know one kid from my child’s school got accepted to Harvard Med School this year without a gap year and we start to wonder if a gap year is actually harmful to top applicants.

Thank you very much.

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@iwannabe_Brown : I would appreciate very much if you could share your opinion too. :slight_smile: What would you look for on a application to distinguish applicants if hundreds of them look the same academically?

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Can we drop the use of “internship” to refer to summer programs? It’s confusing because it’s not the standard terminology use by most people when discussing pre-med activities.

  1. Summers are time for ECs–shadowing, clinical volunteering, community service–heck even working a service job to earn $$$. That’s what both mine did–worked service jobs. One as lifeguard & swim instructor with the community pool; one sold gas & Slurpees in Yellowstone. (D2 said she got way more comments/questions/discussions w/ adcomms about working in Yellowstone than she did about her Amgen Fellowship–and she applied to research intensive med schools.)

There is value for pre-meds in working an ordinary job because they learn valuable people skills–how to get along with co-workers and bosses, how to deal with difficult customers or irate parents, how to show up on time everyday and do stuff that doesn’t necessarily thrill them personally or intellectually, how to do what needs to be done even though “it’s not my job.” I’ve heard med school preceptors and RDs complain about med students/interns who have lousy basic work skills and “attitudes” because they’ve never had a actual job before med school/residency. (BTW, having an attitude or lousy work skills can get a young physician kicked out of residency. After being asked to resign or fired, chances of finding another program willing to offer them a position is just about nil.)

Structured summer programs for pre-meds are offer by many schools. (I know UC-Davis has one. D2’s BFF did it one summer, but it was in addition to other activities that summer. In the BFF’s case she was a translator for a medical outreach/education program for undocumented immigrants.) While I think the programs like the one you linked may give students a small window into a medicine as career, because they are pre-packaged and readily available they are less valued by adcomms because it’s not a student-originated activity. (As in the student went out and found or created the activity.) BTW, the consensus is that a program’s clinical hours can’t be listed separately on AMCAS as a clinical or research experience because they’re part of the class requirement.

We have no doctors in the family and had no medical connections when D1 started on her journey. You really don’t need connections to find shadowing & clinical volunteering opportunities. You make your own connections and opportunities. It takes persistence, creativity, initiative, and a willingness to jump through a lot of hoops. And these are exactly the traits adcomms are looking for when evaluating applicants.

  1. basic lab vs clinical research. Both have value. It depends on a student’s interests, opportunities and the depth/significance of their involvement. (Collating, but not analyzing, patient response questionnaires is clinical research. but it provides no patient contact nor much valuable in the way of learning.) Overall, I would not say one type of research is more valuable than he other.

As a bottom line, all med school applicants are expected to have significant clinical exposure through volunteer work or paid employment. (not class work.) Students who plan to apply to MD/PhD programs or to research intensive medical schools need to develop a significant basic research portfolio as well.

  1. MIT’s data (assuming you looked at the same archived data I did) is about 5-8 years out date. Plus it’s just MIT–which has its own unique culture, one that doesn’t particularly look favorably at medicine as a career choice.** Today the norm is to take a gap year (or two or three). More than 60% of last year’s matriculating students had been out of college for 1 or more year before matriculation.

https://www.aamc.org/download/485324/data/msq2017report.pdf

** Medical school is referred to as “trade school” and is often considered a fallback option for people who can’t get accepted into a PhD program in the physical sciences/comp sci/engineering. Medicine is for the people who can’t hack doing “real science” for a living.

As in: Hey, I heard you’re going to be a plumber[doctor]? What happened? Couldn’t get accepted to grad school? (I’ve heard this kind of talk first hand, and much, much worse…)


You asked what's the melody?

It's different for every individual who journeys toward medical school. It's the central theme of their application. It's "I want to be a doctor because....."

D1 and D2 both went to med school. Were their journeys the same? Heck no.  Not even close. Different kids, different interests, different ECs, different GPAs and MCATs, different career goals. But both developed a wide ranging portfolio of clinical experience, research, employment, volunteer service, hobbies, etc  that all supported their interest in medicine, while at the same time portrayed them as interesting, well-rounded and vibrant individuals. Someone you wouldn't mind sitting with at lunch every day while they're on your service, and  someone you'd trust to treat your elderly and mildly demented mother.
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@nrtlax33 I think MIT’s applying sideways blog also applies to medical school with the only difference being that you have to look like a future physician, whereas for college the options are more varied.

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@WayOutWestMom : Thanks so much for taking the time to answer my questions. We did not know the term “internship” has been used for the first year of medical residency. Although the official name for the program is indeed called an internship, I will use “summer programs” to refer to future summer activities. The program is not associated with a college. The PIs are associated with a top medical school. Participants have to work with patients directly. Currently they are still at shadowing stage. But they are expected to work independently soon.

Actually my child was also looking at the Amgen Scholars program in the spring. Since Amgen Scholars program’s eligibility requirement specifically says that applicants must be sophomores or above, we have to look elsewhere. I know Amgen Scholars program is extremely competitive. If you don’t mind me asking, did your D2 have prior research experience before being accepted into the program? Could you share the application experience? Thanks again.

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Strength of applicants may matter. There may be self selection of applicants, with weaker ones doing gap years more often.

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Sent you a PM.

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I would be absolutely stunned if this weren’t true. I’m not sure what defines the “grad school” group in this case, but I would imagine that the weakest applicants at the end of junior year are the ones who will do some sort of master’s (i.e. become grad students) for GPA repair beyond senior year vs. the next tier up of applicants who will be doing gap years with jobs because senior year is enough GPA repair and/or because they just need to boost the EC portion. Being a reapplicant is definitely the worst so only the strongest applicants should be applying at the end of junior year.

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In general, premed students need to do at least one standard deviation better than their peers to achieve a GPA competitive for medical school. The standing of the student in his/her class tends not to change during the time the student is in college. There are exceptions definitely. However, they are in the minority. Boston College is a peer of Hamilton College. This Hamilton professor’s [blog[/url] explains the meaning of “grading on a curve”. BC’s 208 med school applicant number last year seems a bit low as a percentage of the class size of about 2300. It is really not difficult for BC’s premeds to find out if it is worth to “keep going and going and going” like Energizer Bunny. Even at school like Brown where one’s success is not predicated on someone else’s failure, there is curving at the final grades for lower level courses. A school’s “ranking” is not a guaranteed reflection of the quality of the undergraduate experience. In fact, some very “highly ranked” schools are known to be exactly the opposite. Trying to look at rankings such as [url=<a href=“https://www.usnews.com/best-colleges/rankings/national-universities/undergraduate-teaching%5DBest”>https://www.usnews.com/best-colleges/rankings/national-universities/undergraduate-teaching]Best Undergraduate Teaching](Do you really want that grade "curved"?) or [Best Professors](https://www.niche.com/colleges/search/best-college-professors/) would probably give someone a much reliable indicator of one’s potential undergraduate experience.

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Given that you are being graded based on your peers in that particular class that semester I would actually bet a students’ standing in their classes changes semester to semester and is far from fixed.

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I have kept this very old [PDF file](https://mailman.stanford.edu/pipermail/hotterthanhadelees/attachments/20081001/adb009a4/attachment.pdf) from Stanford – PRE-MED MYTHS: GETTING INTO MEDICAL SCHOOL.

First of all, this is important

Regarding research … Here is one of the most important THINGS TO DO IF
YOU WANT TO BE PRE-MED

For bench research, here is the comment

It looks like although both bench research and clinical research are important, clinical experience is more pertinent to the medicine. BTW, I have heard enough kids here saying that they want to be a doctor because they want to find a cure for something. That is mostly the job of the pharmaceutical industry. (Obviously clinical trial, etc. connects with medical field)

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@nrtlax33

Let me clarify: When I said that both clinical and bench research have value I meant intrinsic value as a learning experience in that both require the application of the scientific method to a process of discovery.

Clinical research ≠ clinical experience

I never said that research (any type) and clinical experience are the same thing nor did I say that research of any type is more important than clinical experience. It’s not

Annual surveys of adcomms always report that adcomms rank clinical experience (whether it’s volunteer or paid employment) as being of the “highest importance” when reviewing med school applicants. Research (clinical or basic laboratory) is ranked as being of “moderate importance”.

According the MSQ, ~15% of matriculants report having ZERO research experience of any kind.

When a student is deciding what kind of research experience they want to pursue–that’s an entirely personal decision. Clinical vs basic science or even the research field itself is only of minor importance. The important take away from any kind of research experience is a deeper understanding of the scientific method in action and the shortcomings and pitfalls of of the research process.

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@WayOutWestMom : I thought that clinical research = clinical experience + research so participants get both at the same time. I heard shadowing for two weeks (80 hours) is already more than enough. Although high school volunteering hours don’t count, if a student already has more than two hundred hours of hospital volunteering experience before college, what else clinical opportunities are more valuable than clinical research? (other than EMT … everyone is doing EMT these days)

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“If you can smell the patient, it’s a clinical experience”
-LizzyM

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Ah, but AMCAS forces you to choose. You can only attach 1 descriptive label to each activity. So you can list an activity as clinical experience or you can list it as research, but not both.

Not all clinical research involves direct patient contact.