Med School Application Process

My daughter's a senior in high school. She's already decided on the school she wants to attend. She applied online, paid $30, sent her transcript in, and designated the school on her ACT. This process was moderately stressful for her. Her acceptance envelope came in the mail the next week.

Lots of people tend to think that applying to medical school is just like applying to undergraduate school. When they say to me, "Where are you applying?" I don't think that they are really expecting me to list off all 21 schools that have received a primary and secondary application from me. In July, a few people asked if I was applying for this fall. No, med school isn't quite as "open-enrollment" as the local community college. Here is a brief run-down of the application process.

The MCAT is the greatest obstacle you must overcome on your way to medical school. The colleges classes requisite to taking the MCAT include biology, general chemistry, organic chemistry, and physics. Having taken a physiology course was very helpful for me. Starting in 2015, the MCAT will also include biochemistry as well as social science (psychology) questions. After taking these courses, you need to buckle-down and work through some good study guides. Doing well in these classes is no guarantee that you will do well on the MCAT. It takes devoted study time to review the concepts and work on timing. One of my biggest challenges was working on my "testing stamina." The exam is five hours long. Prep-time for the exam should be around three to four months. Ideally, the MCAT should be taken before May of your application year (the calendar year before you wish to start).

There are three main application systems for medical school. One is for the allopathic (MD-granting) medical schools in the US, another is for the osteopathic (DO-granting) medical schools, and the third is for the eight Texas schools (7 MD, 1 DO). Texas used to be its own country, so it isn't such a surprise that it has its own med school application process. You can create your log-in to these sites in May. You will use these sites as electronic receptacles for a slew of data.

May is a great time to begin requesting letters of recommendation. If you do not have a letter-writing committee at your school, you will need to collect a minimum of three letters from professors. Two of these professors must be from science departments and the third should be from your major if you did not major in science. I had a letter from my physiology professor as well as my organic chemistry professor. For my third professor, I request a letter from my thesis chair for my master's degree (public health).  Many schools have additional, school-specific letter requirements. For instance, some may want a supervisor or someone who can attest to your professional work (if you are currently employed full-time). One school that I applied to wanted a research reference. My thesis advisor was able to address their concerns. Many DO programs request letters from physicians you have either shadowed or work with. All of these letters can be managed on-line so that your writers only need to upload their documents to a single website (or three websites at most). Your accounts with AMCAS (MD) and TMDSAS (Texas) include letter delivery. The DO site, AACOMAS, is run by Interfolio, and Interfolio collects an additional fee for each "packet" of lettes you send out to schools. Managing letters is a nuisance, but the electronic format makes it easier. One of my writers submitted to AMCAS, but not TMDSAS. That left me in the awkward situation of sending lots of reminders. If I had the letter just sent to Interfolio, I could have had only one address to send it to.

In May, you will also want to start ordering copies of your transcripts. You will need your own copy of your transcript--whether official or not--as each application system requires you to manually enter your classes, credit hours, and grades, and then assign each class to a system-specified category. Having finished a bachelor's degree a while back meant that I took quite a few "postbacc" classes. I also had my graduate school courses to enter. I wish I could say that this was the most time consuming part of the application process, but it wasn't. It was tedious and slow, but the narrative writing took me much, much, much more time.

Ah, yes. The narratives. You will write like you are enrolled in an intensive freshman composition class during this process! The most important document is your personal statement. Admission to medical school is riding on it. All three systems require a personal essay on what motivated you to apply to medical school. The essay is limited to 3,800-4,500 characters including spaces. (The character limit is different for each of the three systems.) I did about eight drafts of mine before I felt happy with it. Yes, eight. Most revisions were deciding which elements to trim out.  Additional narratives are allowed for each of the 10-15 extracurricular activities you list. These are about 300 characters each. Much of what you write in one system can be saved as a plain text document and used in another system.

With the best of intentions, it was not until early July that I had all of my electronic applications ready to submit. Letters, transcripts, and writing took a fair chunk of my not-so-free time.

After submitting your application, a few schools will automatically send "secondary" applications. Secondaries generally (but no always) entail any where from two to five additional essays. Rarely can you "recycle" an entire essay, though you may find enough overlap to do a quick revision to tailor the essay to the school's prompt. Secondaries often cost $50-$100 a piece. If you apply for financial assistance, many schools in the AMCAS system waive the secondary fee.

The "complete" application consists of your primary, your letters of evaluation, and your secondary. The admissions committee at the school will begin reviewing your file in the order in which it was complete. Most schools don't begin the review process until July or August. Interview season begins in either September or October, depending on the school.

You are only considered for an interview after your secondary application is received by a school. The complete application usually takes about a month to be reviewed. Sometimes you might hear back from a school in less than a month, but most people do not get interview that quickly. Of course, an interview is not the only possible outcome. In fact, an interview is not the probable outcome. After schools review your complete application, they may reject you or put you on hold. "Hold" is kind of like being wait-listed to interview.  Interviews are always face-to-face. The interview day includes an orientation to the program and a campus tour. Interviews are offered on a rolling basis. Some schools will schedule your interview within a couple of weeks of inviting you, and others may schedule your interview date as far as two months later. Texas schools finish interviewing in December. Most other schools continue to interview for real spots (not just the wait-list) through January or even later. It's pretty nerve-wracking waiting for interview invitations.

It's estimated that about half of interviewees get accepted. For me, that means that five is the magic number. Five interviews roughly translates into 1- (50% x 50% x 50% x 50% x 50%) = 96.875% chance of getting in somewhere. Of course, each schools acceptance rate of interviewees varies dramatically. "Acceptance" rate data is rarely released. In-state versus out-of-state status may translate into slower acceptance times for out-of-staters. Don't be surprised if you don't hear back for a month or more. You might even find yourself on the wait-list until all in-state positions are filled. Again, this varies from school to school.

Once an offer for admissions is extended, you must respond with a deposit to hold your spot. You may hold more than one spot until May 15. Both you, and the schools, must decide who they want by that date. Many people will hold more than one acceptance up to that point, and so there is quite a bit of wait-list shuffling that happens. Schools routinely admit more students than they have space for, knowing that many applicants will wait until this deadline to decide. For instance, Mayo Medical School has only 40 students per class, yet they admit about 70 students knowing that just over half will matriculate. What does this mean? It means your odds for acceptance just might be better than they appear based on out-of-state matriculants.

So far this lengthy process has taken us from May (actually before than for MCAT prep) of one year to May of the next. If you don't already have an acceptance in hand, you might just get a surprise offer in June. Yes, that really does happen. Remember, that is just two weeks after the wait-list shuffle really begins. If you haven't already, it is time to pack up and move. Most schools begin orientation to medicine in early August, though some start in July.