As a psychology major, I was somewhat removed from the “premed” culture of my undergraduate institution. I had only taken a few biology classes as a undergrad (the rest of my science prereqs were done in a formal postbac program). However, in my introductory biology classes, I witnessed many premeds suffering from the classic symptoms of this syndrome. It was a truly frightening sight. There were premeds who saw every exam as a potential recipe for disaster, the tipping point that would forever ruin their chances of getting into a top medical school or even any medical school. This fear of a less-than-stellar grade drove them to spend long hours at the library. It’s hard to forget the lab partner who cried after every science test, panicking at the thought of having failed, only to find out the following week that she had gotten one of the highest scores in the class. Yet her genuine bouts of anxiety continued. I had even asked whether she would consider taking time between college and medical school to destress a bit, but she told me that if she were to do that, she would never actually go to medical school. She did go on to medical school, but I often wonder if she went on to become a happier or more relaxed person.

There were other premeds whose symptoms included monopolizing the 400-person biology classes, their hands raised high to ask a panoply of questions carefully designed to impress the teachers with their superior intellect or to ask what information being presented would actually be tested. Although some premeds were less afflicted than others, few emerged psychologically unscathed. The intensity and competitiveness drove many smart and talented people away from the career path, many of whom would have made wonderful doctors. 

Now please feel free to take the following insights and advice with a grain (or boulder) of salt, as it is only one person’s experience. Although I don’t claim to speak for all premeds or admissions committees, my very humble opinion is that the “premed syndrome” often hurts premeds in the application process by having them focus only on the most basic criteria of medical school admission to the exclusion of other factors. Premeds became far too obsessed with maintaining a 4.0 GPA or getting a 36+ on the MCAT or getting lots of research or clinical experience or going to a brand-name undergraduate institution. It’s not to say that those factors aren’t important: numbers do matter, it is critical to have clinical experience, research experience can help, and undergrad reputation probably helps in some slight way (I’m not sure, as I didn’t go to an Ivy League school or anything like that, so there’s no basis for comparison). But many people take that to mean that they need to focus on these factors to the exclusion of everything else; they focus on getting the highest numbers, the most research, the most clinical experience, the most impressive undergraduate pedigree, and so on.  However, I believe that going through your undergrad with the idea of fulfilling a checklist of predetermined criteria is a less useful and ultimately less successful approach to the admissions process, because to some extent, the admissions process is more about what makes you different in relation to everyone else. That means you need to present yourself as a candidate outside of the typical cookie-cutter premed mold. I’ll elaborate further.

My firm belief is that the main goal in this somewhat capricious admissions process should be to stand out as a unique individual who can significantly contribute to a school’s student body beyond the numbers. Of course, it is very possible to do this through one of the typical premed criteria mentioned above. That is, if your clinical experience was unique or demonstrated initiative and a passion for a particular cause, that’s one way to stand out. However, if your clinical experience consists of shadowing or volunteering in a hospital (which is very easy for most premeds to do), then it probably won’t do a whole lot for your application. The fact that you have clinical experience will let the admissions committees know that you’re aware of what a career in medicine is like, but volunteer work at a hospital won’t really impress the committee all that much or tell them who you are as an individual. Of course, any clinical experience is better than none, as the lack of clinical experience will suggest that you don’t really know what you’re getting yourself into by choosing medicine as a career. But if your clinical experience is typical of most premeds, then make sure you focus on quality rather than quantity. It’s not going to really matter if you have 100 hours vs. 250 hours. Just make sure you’ve gained some understanding of what medicine is really like, and then use the extra time to focus on something else that you’re passionate about. Similarly, if your research experience led to presentations and publications in a field you’re very interested in, that can help you shine. But if it mostly consisted of washing glassware or carrying out tasks for the graduate students or postdocs, that doesn’t really do much for your application, and it’s probably best to move on to something else.

Another way in which quality matters more than quantity is in your list of extracurriculars. ”More” activities are not better than “fewer.” The purpose should be to show your devotion to a particular cause, project, or activity rather than to overwhelm adcoms with a litany of extracurriculars. For example, don’t volunteer 2-3 weeks in a developing country just to have it pad the extracurricular section of the AMCAS. It’s not really all that impressive, and since it costs money to volunteer overseas for such a short period of time, it just suggests that you had the money to do what few others can. Of course, you should do it if you want to and are eager to do it, but just not with the idea that it will blow away adcoms. The truth is, although those 2-3 weeks can certainly influence you towards international health or global inequities, it is not really enough time to show any sort of steady commitment or devotion to those issues, especially if there is no other indication of it on your application in terms of classes or research projects. But if you devote anywhere from a few months to a year or more overseas, or if you routinely go on short mission trips abroad, that is far more impressive and will set you apart from other applicants.

Numbers are a more complicated matter. You do need to prove yourself intellectually capable, and many schools have certain thresholds. However, at the other end of the numbers spectrum, higher is not necessarily better, especially if it means that you spend all of your time studying for classes and the MCAT and doing only the bare minimum with everything else. There is a common saying about this process: high numbers alone won’t get you into medical school, but low ones can keep you out. That means you do need to do reasonably well, but rather than being obsessed with a perfect 4.0 GPA, it’s fine to let it drop a little (though not too much) in favor of devoting time to something you’re interested in. Of course, there are some incredible superhumans out there who can have it all (the GPA, the MCAT, stellar experiences, and a great personality) while making it look effortless. Maybe they’ve been blessed with the natural intelligence to do extremely well on tests without devoting all of their time to studying. But for most of us mortals, juggling multiple responsibilities inevitably means that certain sacrifices must be made. Please don’t feel that you need to be perfect numbers-wise at the expense of everything else, including your social life and your passions.

I honestly believe that admissions committees find it incredibly refreshing to see applicants who have not devoted all of their life to getting into medical school. That means you don’t have to be a biology or biochemistry major if you really enjoy the arts or humanities instead. Being a literature or theater major is perfectly okay, and it will probably fascinate adcoms and get you interviews. As long as you can do well in your premed classes and the MCAT, and you have the requisite clinical experience, you should feel free to do what you’re passionate about. Also, if you have a certain talent or passion that means a great deal to you personally, by all means indulge. At virtually all of my medical school interviews, interviewers kept asking me enthusiastic questions about my theater experiences. Medical schools would love to hear about the fact that you play the guitar and have performed your songs at local coffeehouses, or that you’re part of a comedy troupe, or that you spent a year in Africa working with AIDS orphans, or that you’ve spent a lot of time as a competitive swimmer, or that you used to be a photojournalist in your first career. Those are unique facets of your personality and life experiences that will help the adcoms see you as an individual rather than a cookie-cutter premed. They will be more easily convinced that you would be a wonderful asset to their school.

Brief notes on personal statement: a well-written, creative personal statement can do wonders for you. Show, don’t tell. Don’t feel that everything in your PS needs to be focused solely on medicine. Let it shine a light on other areas of your life that have shaped who you are. Don’t make the mistake of turning the PS into a longer version of your resume by trying to cram in all of your accomplishments. The LORs and extracurriculars section of the AMCAS will give you the space to include everything. Use the PS to focus on the events that have been milestones or turning points in your path to medicine. 

Finally, learn to act with integrity and kindness towards others and to accept circumstances in your life gracefully. Of course, it is supremely important to behave well towards your professors and your advisors, since they will be the ones writing your recommendation letters. It might seem obvious from the onset. Yet I’ve seen numerous premeds argue with their professors over their grades or complain to their advisor about things that their advisor had no control over. Remember that a sense of entitlement or a superiority complex is never appealing. Not only will it affect the quality of your LORs, but those qualities can very easily be rooted out during medical school interviews. 

This post is probably about the extent of my “advice-giving” about the process, as I don’t think I have much more to offer. However, my next post will be about how applying to medical schools is a lot like dating. Seriously. Eventually I’ll move on to other aspects of my life, like the fact that I’m currently trying to get a staged reading of a play I really love off the ground, and how hard it is to both produce and direct at the same time. But I’m trying to get the whole medical school thing out of my system first.