The Shuffle

Medical school applicants cannot hold more than one acceptance past May 15. Before that magical date, you can sit tight, waffling back and forth, filling out pro/con charts, and otherwise hem-and-ha over which school is right for you. Once accepted applicants are forced to take a stand, the flood-gates open, so to speak, and there is pretty active movement happening on waitlists throughout the country. Schools suddenly find themselves with openings and there is a rapid shuffling to fill them. My husband was hoping that tomorrow might bring an acceptance for me from my state school. Considering that I withdrew my application from them a week ago, it is highly unlikely.

So why did I do it? I'll spill the beans. Out-of-State University of Awesomeness is a Texas school. Have I already sung the praises of Texas medical schools? Let me tell you, they are fantastic! You see, Texas is pretty darn picky with their out-of-staters. State law requires that at least 90% of students are Texas residents. Some admissions offices set that number at 95%. That said, many applicants don't bother to apply to Texas since (1) the chance of getting in is so low and (2) Texas has its own application system for its eight medical schools. [FYI: Baylor is a private school, but it does receive some state funds and shows a preference for Texan applicants. Baylor uses the national AMCAS application.] Though I wasn't a fan of sending transcripts and entering data into an entirely separate and time-consuming database (TMDSAS), I was very pleased with the entire application process. My state school interviews many, many, many more people than they intend to offer positions to. Roughly one-quarter of interviewees are offered admission. Some schools offer admission to about half of their interviewees. Texas schools tend to do a more thorough screening prior to interview. That means that some schools extend acceptances to nearly three-quarters of the applicants that they interview. Got multiple Texas interviews? There is a good chance you'll get in to at least one of them.

Texas does a Match Day for med school that is similar to residency matching. As an out-of-stater, I did not go through the match process, but found it fun to follow on applicant forums. Even without applying early decision, Texas residents (as a whole) were more likely to know where they would end up significantly earlier than the typical med school applicant. Out-of-state applicants are offered admission on a rolling basis. My acceptance came three weeks after interviewing at one school.

But I really haven't gotten to my favorite part. Texas is affordable! The tuition at Texas medical schools is some of the lowest in the nation. My in-state school has a rate of $35,000 per year. Out-of-state tuition at a Texas school is lower than that. Tuition for Texas residents ranges from about $15,000 to $18,000 per year. If you are awarded a competitive scholarship as a non-resident, you may qualify for in-state tuition during your first year. Unlike many states, you can establish residency during your first year and be reclassified. (That is, if you actually meet legal residency requirements.)It's pretty amazing. I am planning on a career in family medicine. The affordable tuition in Texas really makes it possible to pursue that path without feeling over-burdened with debt.

There are other reasons why I am ready to move to Texas. Lots of them. But the freedom of moving into a new career relatively late in life without much debt is one of the greatest feelings imaginable.

Year+ in Review

A med school application cycle is longer than most people realize. Here's what's mine has been like...

January 2012

• Apply to AAMC's fee assistance program to get a discount on the MCAT and AMCAS. (TIP: If you have kids, you must do this or else you are just wasting good money.)
• Write personal statement.

February 2012

• Approach professors about potential letters of recommendation. (TIP: If they don't recognize you, go else where.)
• Revise personal statement.

March 2012

• Sign up for the MCAT (TIP: Do it earlier. I was surprised by how many dates were no longer available)
• Put on five pounds. (Hey, when you are the one studying for the MCAT at 1:00 in the morning, you'll understand.)
• Revise personal statement.

April 2012

• Freak out over MCAT
• Revise personal statement. (No, this isn't hyperbole.)

May 2012

• Take the MCAT (Holy cow! I was not prepared. Revisit my posts from mid-2012.)
• Start AMCAS application.
• Start TMDSAS application.
• Fill out letter of recommendation cover forms and forward to letter writers.
• Pretend that the MCAT couldn't have possibly gone as bad as I thought.
• Revise personal statement.

June 2012

• Get my official score. (Heartbreak and sorrow.)
• Despair for a while.
• Start AACOMAS application.
• Order transcripts (from FIVE schools--can you say "non-traditional"?) to be sent to each application service.
• Sign up for September MCAT (TIP: Only do this once if at all possible.)
• Send reminders to letter writers.
• Revise personal statement.
• Write (and revise, revise, revise) extracurricular activities sections.

July 2012

• Find a letter writer to replace one of my letter writers.
• Send more reminders to professor to submit to the other application service. (TIP: If you get all of your letters sent to Interfolio, you will avoid some of this mess.)
• Find another letter writer to tentatively replace the writer you are now stalking.
• Take four full-length, five-hour practice tests.
• Submit AMCAS.
• Submit TMDSAS.
• Submit AACOMAS.

August 2012

• Study for MCAT
• Get philosophical about where you are in life, what you've accomplished, and how you try to "live in the moment."
• Purchase "I'm a grown-up" suit. (Chocolate brown with turquoise top.)
• Preview secondary application essay prompts.

September 2012

• MCAT redoux.
• Start writing secondary applications.

October 2012

• Continue writing secondary applications.
• Get official MCAT score.
• Cry in relief.
• Get first interview invitation. Then second.
• Get first rejection.
• Get over it.

November 2012

• Buy the "right" purse. (Bright red.)
• Start interviewing.
• Freak out and apply to more schools. (TIP: Apply early so you don't do this! $170 down the drain.)

December 2012

• Keep interviewing.
• Send schools an "update." (TIP: You got to actually have something to update them with such as a new publication or a completed class.)
• Get in.
• Celebrate.
• Cancel interviews at "I'd rather go to accepted school than this one" schools.

January 2013

• Cancel another interview.
• Decline an invitation. (Oh, the table has turned and it feels so good!)
• Fail first biochemistry exam. (TIP: Don't!)

February 2013

• Start telling myself "I didn't want to there anyway" for the schools that have silently wait-listed me.
• Decline yet another invitation to interview.
• Join Facebook Group for Class of 2017 Totally Awesome University of MD Acceptance.
• Try to figure out my ambivalence over my state school (see Valentine).
• File federal tax return so that I can...
• File FAFSA. (Twice! One for me and one for Mini-Me. Looks like she'll get about a $700 Pell Grant.)

Premed Application Valentine Saga

Remember a time when you had a crush on a guy, and he didn't even give you the time of day? Maybe it was middle school or high school. I've kind of got that thing going on now. Kinda.

You see, my state school is one of those guys who thinks he's All That. God's gift to med students, if you will. Here's how our conversation has played out so far.

Me: Hey, you're kind of cute. Here's my number (application).

State School: Yeah. I know. You're not so bad yourself. (Read: fill out the secondary.)

Me: So you wanna go on a date (interview) or something?

State School: Sure. Why don't you come to my place. We can double. (He's keeping his options open.) How about lunch?

State School: By the way, don't call me. I'll call you. Maybe.

Time passes. A semester ends. Grades are posted.

Me: So, hey, what's up? I'm, you know, still here. And I haven't heard from you. And thought maybe you lost my number. Maybe you wanna go out again? (In other words, I sent an update with a list of courses I completed and my grades--4.0, of course.)

State School: Cool. ("Thank you for your update. It was added to your file.")

Me: Cool. (As in, "Where do you get off wait-listing 95% of the people you interview! Really?")

State School: <Silence>

Meanwhile, I decided to date another school. This one was out of state. Maybe he wasn't quite as cute as my state school, but he certainly wasn't as stuck up. Now I'm in some sort of New Order-esque "Bizarre Love Triangle."

Other School: Hey, Vieve, wanna go out?

Me: Whatever. I don't have anything else to do.

Other School:  Hey, Vieve, I'm really into you.

Me: Whatever.

Other School: I got you a present ("We are pleased to offer you a scholarship...")

Me: Wow. This is kinda serious.

State School: <Silence>

Other School: Wanna move in?

Here I am, crushing on this school that's student-body president while this down-to-earth, sweet-as-pie other school is looking at me with puppy dog eyes. Of course, giving in to his puppy dog eyes means that I'll be selling my house, packing up my family, and moving a thousand miles away. I find myself feeling a little resentful towards my state school. It's like he's just leading me on and toying with my heart by not giving me a "thank you for your application, but..." letter. Why? Why do you have to play hard to get? If  you are this hard to get a second date with, I'm wondering if you are really even my type. Really, what's a girl to do?

Retakes, Anyone?

With my second test scores yet-to-be-revealed, I can say with confidence that I'm glad I retook the MCAT. According to AAMC, you have about a 50/50 chance of improving your MCAT score with a retake. That's right, my friends, that means you could actually do worse. Before retaking it, be honest with yourself about your ability to raise that score.

It took me almost two weeks to make peace with my first MCAT score. Could I be content with it? Were there clear challenges I could overcome? If I didn't find time to study like I wanted to for the first test, would I really find more time before the second? How likely is my score to fall instead of improve?

• I know I could be content with my scores. If I get the same scores on the retake, I'll be OK with that. It just means I'll most likely need to change the name from "MD at 43" to something that doesn't quite rhyme. ("DO at forty-fo"?)
• I was able to identify clear challenges for me to overcome. I realized that the actual test was the first time I sat through the complete exam, including the writing. None of my practice exams were the mock tests I intended them to be. It was hard finding a place to sequester myself for 5 hours, but I did it. I even packed myself a little cooler bag of snacks and kept my potty breaks to the allotted time.
• I realized that I wouldn't magically find extra study time, so I made it, and I was pretty ferocious about it, too. "Sorry, honey, I want to help you," I said to my teen-ager who wanted to practice driving, "but I feel like I already failed the MCAT once and don't want to do that again. Go ask Dad." My kids came around, and became my cheerleaders.
• My verbal score is likely to be lower the second time around. But you know what? That's only because 12 is pretty dang high and if it fell to a 10, that would still be really solid. I had to take that risk in order to bring up my biology score from a 7. (And I'm fairly certain I bottomed out on the 7. Hopefully, I could only go up from there.)

If you really have your heart set on an MD program instead of a DO program, you will definitely want to retake the MCAT if you didn't score at least an 8 in each section. Not all eights are created equal; an 8 in biological sciences will actually put you at a lower percentile than an 8 in physical sciences, and there are a few schools who will look at you with a 7 in physical sciences. But even with an 8 in each section, a total score of 24 is not competitive for the vast majority of MD programs.

As nerve-wracking as it seems, you've got to be OK with that bit of reality. If you are scoring outside of a competitive range on your practice exams and on your initial MCAT, I don't know if it is worth putting yourself through the wringer to try to bump up your score by a couple of points. Apply for the MD schools that you like, but be sure to hit the osteopathic medicine programs early. I know that there are people who don't get into an MD program and so they spend a year trying to strengthen their applications by focusing on MCAT prep. The MCAT is just one piece of the puzzle. If it is the only place where you are weak, why wait another year?

Watching my future insanity play out...

Holy smack! How many schools does a person need to apply to?

A friend is applying this cycle. She's a late applicant. (No, I didn't say "old" applicant.) She took her MCAT in September and just got her personal statement finished last month. Just yesterday she confessed that she was thinking of sending applications off to "a couple more schools--just to be safe." Oh, I forgot to mention that she has already sent her application to 22 schools. Twenty-two schools! As an "older" applicant (mid-twenties) her rationale is that she must do everything she can to secure her spot this year, as time is money.

With the wisdom that comes with age, I kindly suggested that she might say to herself,  "I've done my research and I know that these five schools are well-within my grasp," take a couple of deep breaths, and just chill. Her response was, "Yeah, but I think that there are a couple more schools that I could have applied to that don't have their deadline until next week." I just smile. "If it makes you sleep better, then do it."

Is that what I have to look forward to? Second-guessing, trying to maximize every possible chance I've got to get in? Hmm. Probably. I'm taking steps to avoid finding myself in that same up-against-the-wall scenario my friend is in.

Here's my game plan:

First (and kind of duh), I'm applying early. I've got my personal statement in the works and I'm scheduled to take the MCAT in April. That leaves me with May to enter transcript data, shepherd my letters of recommendations in, and fill in all those time-consuming, irritating parts of the AMCAS application.

Second, I'm including a few DO schools in my application. It seems like some individuals view DO programs as an after-thought. ("Oh, no, I didn't get in to the MD programs I thought I was a shoo-in for...quick, scramble, hit up the DO schools before their deadlines.") DO program usually have later deadlines than MD programs. I really believe that the fresher the reviewer's eyes are when he or she looks over my application, the better odds I have.

Finally, I'm prepping myself for the inevitable. I know that next fall will take me to the brink of insanity as I wait to hear back from the schools I pick. Knowing what's on the horizon, I'm working on a coping strategy that includes staying away from Student Doctor Network next fall (I love the site, but I know when I'm in the midst of my craziness I don't need to be seeking advice from other crazies), training for a few races (at least one half-marathon and maybe an early-spring marathon), and getting a message before each interview.

So stick around and see what happens Fall 2012. Hopefully I won't be telling myself that two dozen applications really isn't that many.

Drafting My Personal Statement

I recently met an MD/PhD student who offered to assist me with crafting my personal statement. What a relief! I've gotten my first draft to her (and she's already given me feedback). I have a few other people who said that they were willing to review it (2 MD clinical professors, 1 MD not associated with the university, 1 second-year student). So much is riding on this single essay--it's a bit frightening. My plan is to go through a few rounds of revision with a single reviewer before sharing it with others.