Med School Admission: Pitfalls and Myths

For half a dozen years after 1965 American medical schools were concerned by a slow ominously steady decline in the number of medical school applicants.

In 1962, however, this trend sharply reversed itself; and the number of men and women competing for one of the 8800 places available in the nation's approximately 90 accredited medical schools is expected to rise indefinitely, despite a slight sag in the applicant curve this year.

It is plainly a buyer's market for medical school admissions committees.

And because of the mystery of the process and the natural anxiety surrounding such a pivotal step in one's life, various myths, shibboleths, tutor's tales, halftruths and vast amounts of sage advice on how to finesse one's way through the medical school portals of one's choice circulate in dining halls, corridors, bachelor's corners at mixers, and any other places where premeds are apt to congregate.

Many of these bits of advice are patently false; others contain considerably more than a grain of truth. The following are a few of the more prevalent rumors and what students and officials at medical schools along the eastern seaboard had to say concerning them.

Organic Chemistry

Perhaps the greatest speculation concerns The Legend of Organic Chemistry. Much is said about how important a good grade in "organic" is, and horrible tales are told of grade-grubbing souls who audit lectures the year before they take the course and sabotage labs in the hopes of scrambling up the Almighty Curve over the bodies of fallen brethren.

Once upon a time before the revolution in molecular biology and while we were little more than undeveloped oogoniums rattling around some place, organic chemistry was indeed a most crucial subject for premeds. It reflected to a great extent the material that had to be mastered in medical schools. But since then, medical school curriculum has undergone fundamental transformations. Inertia is itself a fundamental element of any change, however, and it seems to have sustained over the years an overblown emphasis on organic chemistry, especially among undergraduates.

Admissions committees savor good grades in science, and there is no denying that an honor grade in organic chemistry leaves a pleasant taste in their mouths. (Although one doctor claims that "A" students in organic "worry" him, unfortunately he is an exception). These committees, however, are no more titillated by an honors performance in this subject than they are by similar success in any other moderately challenging science course.

Medical school officials patiently explain that the goal of today's medical education is to form an understanding of modern biochemistry, which more and more demands quantitative ability. Hence, emphasis shifting from formulas to mechanics.

Admissions people are impressed with a regal straight A in organic; but they are enchanted with a common B-plus in a stiff mathematics course; and they are orgastic over a vulgar C-minus in physical chemistry.

Indeed, it would be much more realistic to bestow to mathematics and "p-chem" all the attention now lavished on organic chemistry.

Some students seek to mitigate the trauma of organic chemistry by taking it in summer when it is supposedly easier. (It is not so, incidently, unless you thrive on two hours of class and six of lab every day). One can also spread the load, splitting lectures and laboratories, making it less difficult to receive an honor grade.

Medical schools do not mind such practices, but they do want to know why a student went about taking the course in this manner. The members of admissions committees are quite wise to the ways of the world, and patent attempts to build up med school brownie points are usually detected with an eye as jaundiced as it is sharp.

In recent years medical schools have been stressing the need for proficiency in the sciences. Some medical school rejects rationalize their fate, ascribing it to the fact that they were not science majors. All this helped perpetuate the myth that science majors have a considerable advantage in the competition.

Interestingly enough, one often hears the opposite contention. This theory rests on the idea that medical schools have recently become "enlightened" and that in this new area science majors are viewed with some disdain as lacking the breadth, warmth, and empathy of humanities concentrators.

In the first place, new medicines and methods of treatment require a high degree of scientific sophistication on the part of their users. One does not, of course, have to have majored in the sciences to have the necessary grasp of them.

But if a non-science concentrator who has taken the minimum of science requirements has a lacklustre record, sprinkled with a D or two, and a poor scientific Medical Aptitude Test score, he can hardly expect a school to have confidence in his ability to do science. Students in these straits should not be surprised by rejection notices.

This unhappy prognosis, however, might well be changed by a simple dose of preventative medicine: take more science--it will kill you or cure you.

Regarding less marginal non-science majors, suffice it to say that not a single non-science major at Harvard whose grades in science were on a C level, with evidence that he could do quantitative work on the level of Math 1 and Physics 1, failed to be offered a place in medical school last year.

Furthermore, concerning any statistics about the relative success of science and non-science majors, each case is scrutinized so exhaustively on its own merits that these figures have no effect on any individual decisions.

In short, the rumor that medical schools either downgrade non-science majors or are overawed by "Renaissance men" is absolutely false.

Caveat Wonk?

Comments often float around to the effect that "wonks" or "grinds" will "get theirs" when medical school application time rolls around.

Exactly what the term "wonk" signifies, of course varies with who uses the word; it can denote anything from all those who got a better grade on the last hour exam than the speaker to a bonafide anal compulsive bookworm. Generally speaking, the term applies to a sort of drab toiler of limited cosmic vision, whose main concern in life is his academic grade average.

It must be remembered that medical schools are faced with a large number of superior people. If all work and no play really does foster an aphasic dullness, students might do well to ponder the words of one medical school dean who remarked, "The unexciting person will definitely have a more difficult time getting admitted in the coming years." On the other hand, for those students at the other polar extreme, there is very little play in medical school. The moral, Neither an ant nor a grasshopper be.

Shrink Shy?

Another much circulated tip is aimed at those interested in psychiatry. Such students, the word is, should not evince any interest in the subject within earshot of medical school walls because schools shy away from their kind on the general principle that "it takes one to know one." What to tell them, this tale continues, is that you are unsure but lean towards "research."

When asked about this rumor, most medical school officials asserted that this was not true at their particular institution, but several agreed that there was some substance to this claim of discrimination.,

There is a strange dualistic attitude psychiatry and psychiatrists on the part of certain persons, some M.D.'s included, which is reminiscent of the medieval outlook on Church and clergy. At no time was anticlericalism so rampant as in the Age of Faith. Analagously, some physicians have the greatest respect for psychiatry and would not hesitate to refer patients to psychiatrists; yet in their hearts they view psychiatrists with a certain mistrust and professional disdain.

Psychiatrists themselves, obviously, have interesting things to say about such colleagues, but the situation does exist.

In a more concrete realm than these sentiments, experience has shown many medical schools that some students with the avowed goal of psychiatry sometimes tend to downgrade their basic science courses. This is a genuine handicap, to a student, who must master the basics no matter what his specialty may be.

There is nothing sinister about an interest in the human mind, and students have little to fear about being frank about an interest in psychiatry, provided they demonstrate that psychiatry for them is an interest--not an obsession--and that their minds are open to knowledge not immediately concerned with this specialty.

Ex-Patients

There is another factor also: the attitude of medical schools towards applicants who have themselves had treatment. Many schools ask outright on their application forms. What effect this has on a student's chances varies with the school; but nowhere, certainly, does a record of psychiatric consultation help a candidate.

It is only common sense that their records are especially scoured. Also, such students are usually required to have a little chat with the medical school psychiatrist, and sometimes resentment is exhibited against what is considered to be an invasion of privacy. As a result suspicions are reinforced, and the medical schools shy away.

What line of action to take on this problem must be chosen by the student involved. However, the University Health Services emphasize that no psychiatric information is given out to any medical school, and students who feel they need help should have no qualms on this score. Rather, as one doctor put it, "It's those who haven't done anything about their problems who are the real dead ducks."

Students who have taken a leave of absence for a year or more because of personal problems should also be ready to explain their situation to medical schools.

Dr. Daniel H. Funkenstein, assistant professor of Psychiatry at Harvard Medical School, who has conducted much research on medical school admissions, has found that if such students return and do well academically, demonstrating their ability to do science, and if their recom- menders emphasize the "new man," they usually gain admission. For those who have taken all of their premedical requirements before they left, he recommends that at least one more science course be taken after returning to demonstrate ability in this area.

Financing School

One essential aspect of a medical education which some prospective students do not consider seriously enough is money.

"When you ask some of these fellows how they prospose to finance their education, they mumble blandly about 'scholarship' and 'loans,' or say they haven't really considered it yet, but they're confident that 'some way' will be found to meet the costs," one official complained. "We don't feel that this is the attitude of someone who has considered the problem in a mature fashion," he added.

There are multitudinous demands on medical school funds. For this reason the bulk of their scholarship aid is reserved for upperclassmen, so freshmen must find funds from some other resources.

Despite all the pitfalls outlined above and the stringent standards of American medical schools, Harvard graduates have been outstandingly successful in getting into medical school. An average 95 per cent of Harvard applicants per class are admitted.

Last year, however, something seemed to go awry. Although about 180 seniors secured a place in medical school, some 25 from the bumper premed crop were rejected.

Why Students Are Refused

Dr. Funkenstein has since interviewed these students and has formulated several reasons why some students are not admitted to medical schools.

One reason is the failure to apply to medical schools where students have a reasonable chance of acceptance. Admissions directors unanimously delight in saying that all medical schools in the United States are Grade A. Nevertheless, as any student knows, there is more than one way to get an A, and some schools are naturally more reknown than others.

Prestige schools are understandably a desirable goal. After all, prestige is but a measure of what the world has learned about an institution.

But for those interested in prestige, a much more important factor to a medical career is the hospital in which a doctor takes his residency. As a matter of fact, in order to advance in the academic branched of medicine, a doctor needs to have taken his residency in a University hospital. Anyone who does well in any medical school has reasonable hopes for such a residency. If a graduate has done poorly in a prestige school, he is not apt to gain such a residency.

Almost all Harvard premedical students want to go to Harvard, Columbia, or Cornell. Johns Hopkins, Yale, Penn, Western Reserve, and Rochester are strong second choices. With the burgeoning number of applicants, it is simply not possible for most premedical students to attend a medical school among their first choices. Today's snob might not get to be tomorrow's doctor.

The obvious course to take is to apply also to schools other than those with ten or more topnotch requests for one place. Many state schools, particularly in the Mid-West, Far West, Rocky Mountain Region, of the South, give preference to students in their states or areas. The geographical factor may be noted in the booklet Admission Requirements for American Medical Colleges.

A second reason for medical