How to Get Into Medical School: The Ultimate Guide (2024)
/Everything you need to know to get into medical school, whether you’re a student, recent grad, or non-traditional applicant, including a step-by-step guide to get into your dream program
LEARN HOW TO GET INTO MEDICAL SCHOOL
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Part 1: Introduction
Getting into medical school and becoming a physician is a dream for many—and with good reason.
Beyond being a highly respected and lucrative profession, medicine uniquely allows you to combine your love for science with your desire to help people directly. While the latter—wanting to help people—is clichéd, it’s true and necessary if you want to be fulfilled as a doctor. You wouldn’t be interested in so many years of training if you were simply motivated by earning potential or prestige. For instance, you could achieve the former faster as a software engineer.
As a reader of this article, you probably fall into one of four categories:
You’re a high school or college student who is considering medicine as one of several career options
You’re a premed student or recent college grad who surely wants to become a physician
You graduated from college years ago and are considering a career change
You’re a parent who wants to learn more about how your child can become a doctor
Regardless of which category you fall into, you’re in the right place. After helping thousands of students get accepted to med school for nearly 20 years—and answering every imaginable question about how to get into medical school—I decided to write a guide that covers all medical school requirements, from various degree programs and extracurricular activities to MCAT prep, admissions essays, and interviews.
Reading this guide thoroughly will help you approach medical school admissions the right way, whether you’re a high schooler, college junior, nontraditional applicant, or anything in between. It will also help you avoid applying bad advice on premed forums or the opinions of misinformed people so you can maximize your odds of getting into med school in the shortest amount of time possible.
This guide focuses on getting into U.S. medical schools—allopathic (MD) and osteopathic (DO). That said, the majority of advice also applies to Canadian medical schools and Caribbean medical schools, the latter being a consideration for students with low grades or test scores. On the other hand, international medical schools fall outside the scope of this article.
Paths to medical school
Historically, the most traditional path involves completing a four-year college degree and applying to medical school during the summer between your junior and senior year of college. If successful, you would enroll in medical school a few months after graduation. This path is also known as “going straight through.”
However, the average age of matriculation into medical school is 24, which means that most students take at least one gap year before enrolling. Gap years are typically used to supplement or bolster your application, whether you need to complete outstanding prerequisite courses, boost a low or so-so GPA, or deepen your involvement in various extracurricular activities, like research. While taking a gap year is not required, it is helpful for students who are not ready to go straight through.
In addition, some people take over two years—sometimes way more than two years—to enroll in medical school. While there is no agreed-upon definition, nontraditional applicants are typically those who are over 24 years old. They may be career changers or individuals who focused on personal responsibilities (e.g., raising children) before returning to school.
On the other end of the spectrum, high-achieving high schoolers who are certain about wanting to become a physician have the option to apply to direct medical programs, otherwise known as BA/MD or BS/MD programs. (More recently, BS/DO programs have begun to attract students interested in osteopathic medicine. We’ll cover osteopathic medical schools in a moment.) Direct medical programs allow students to complete their undergraduate and medical degree in 6 to 8 years—7 years is most common—depending on the program. Moreover, these combined programs offer “conditional acceptance” to medical school, meaning you have to maintain a minimum GPA and achieve a minimum MCAT score to secure your position.
Finally, a small number of medical schools offer early assurance programs to college students who have exhibited an extraordinary level of achievement and promise during their first year or two of undergrad. Accepted students are not required to take the dreaded Medical College Admission Test (MCAT)—the standardized test for medical school—and can focus on their studies, research, clinical experiences, and so on.
While most medical students receive a single degree—MD or DO—a subset of students complete dual degrees, such as an MD/PhD, MD/MPH, or MD/MBA. Typically, these admissions processes require that you separately get admitted to the two programs. However, if you get rejected from the “other” program, you will still be considered for the medical program.
Types of medical schools
U.S. medical schools are mainly divided into allopathic and osteopathic programs. The former confers the widely-recognized MD degree, whereas the latter offers the less-recognized DO degree.
Historically, the osteopathic model has focused on holistic medicine, which is sometimes thought of as “treating the whole person.” Criticism of osteopathy has largely focused on the use of therapeutic techniques that are not necessarily evidence-based (i.e., research-supported).
Over the years, MD and DO programs have come to be more similar. Allopathic physicians consider disease prevention, mental health, and systemic factors more than ever, and osteopathic physicians focus on delivering evidence-based care. Moreover, many are involved in cutting-edge research.
While MD and DO physicians can practice the same specialties, their residencies have long been separated. This changed in 2020, when residency programs for the two merged. However, some applicants, parents, and DO students are concerned about having to compete against highly regarded MD students for the same positions, especially when it comes to entering highly competitive specialties.
There are two main reasons for MD programs being more coveted:
The MD degree is generally more widely recognized.
MD programs tend to admit higher-achieving students. In other words, it is typically easier to get into a DO program than an MD program. Therefore, most students prefer to attend an MD program and see DO programs as Plan B.
In truth, DO students who do well in medical school and ace their board exams can go on to have careers that are just as successful and impactful as their MD counterparts. However, the prestige issue is hard for many med school hopefuls to shake off, so the DO vs. MD debate rages on.
(Recommended reading: MD vs. DO: The Biggest Differences (And Which is Better))
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Part 2: What medical schools look for
I often tell students, “Medical school admissions is hard, but it’s not complicated.”
My point is that while there is little mystery regarding what it takes to get into medical school, pulling it off can be difficult. As an analogy, it’s one thing to understand how to dunk a basketball on a 10-foot rim—grab the ball, jump and extend your arm high enough to get the ball over the hoop, and dunk—but an entirely different thing to do it.
Getting into medical school is so hard, in fact, that over 60% of applicants fail to matriculate into all MD programs they apply to. In other words, most applicants don’t get in anywhere. Therefore, there is little room for error with the admissions process and it’s important that you achieve at the highest levels you’re able, with regard to academics and extracurriculars.
While it’s important to know medical school requirements (e.g., which specific classes to take), it’s also critical to understand why medical school admissions committees (adcoms) expect you to complete certain coursework, achieve at a certain level, and participate in various extracurricular activities: to demonstrate your commitment to medicine, including the lifelong pursuit of academic knowledge, passion for promoting health, and desire to serve people.
Without this understanding, you may adopt a “checklist mentality” and, rather than develop a clear “it factor” (more on this later), fail to stand out due to completing academic and extracurricular requirements at a surface level.
The Association of American Medical Colleges (AAMC) provides an official list of core competencies, as follows:
Interpersonal competencies:
Service orientation
Social skills
Cultural competence
Teamwork
Oral communication
Intrapersonal competencies:
Ethical responsibility to self and others
Reliability and dependability
Resilience and adaptability
Capacity for improvement
Thinking and reasoning competencies:
Critical thinking
Quantitative reasoning
Scientific inquiry
Written communication
Science competencies:
Living systems
Human behavior
This is an overwhelming list, but you need not worry. Core competencies are not separate medical school requirements, but can rather be demonstrated through the academics and extracurricular activities you will have to pursue anyway.
To make things more digestible, medical school admissions factors fall into the following categories:
Academics (i.e., “stats”): GPA and MCAT score
Extracurricular activities: Shadowing, patient exposure, community service/volunteering, research
Qualities: Leadership, compassion, thoughtfulness, interpersonal skills
Personal factors: Ethnocultural, socioeconomic, and regional background
Academics
Your stats—GPA and MCAT score—collectively represent your level of academic achievement and fitness for medical school. While GPA is perhaps the single most important variable for med school admissions, different grading practices and prestige across schools affect its interpretation. Because there is no GPA conversion table, we don’t know that a 3.7 GPA at Vanderbilt is the same as a 3.8 GPA at, say, Penn State.
That said, your undergrad does matter for med school—that is, medical schools indeed consider the strength and prestige of your institution—so a 3.6 GPA from UC Berkeley is valued more than a 3.6 GPA from UC Riverside.
To further complicate things, adcoms consider your overall GPA and science GPA, the latter comprising your biology, chemistry, physics, and math (BCPM) courses. Most students will have a slightly higher overall GPA than a science GPA, reinforcing the widely held belief that humanities courses are easier to do well in than science courses.
Medical schools use the MCAT, a difficult standardized exam, to address these GPA-related variabilities. The MCAT is composed of four sections—roughly Biology, Chemistry/Physics, Psychology/Sociology, and CARS (reading comprehension)—that make up an eight-hour testing day. It is graded on a 472–528 scale, with 500 corresponding to the 50th percentile score. To do well, you’ll want to study hard anywhere between two and four months and focus just as much on test strategy as you do test content.
I often get asked, “What MCAT score do I need to get into medical school?” or “What MCAT score should I aim for?” The answer depends on where you’re trying to get into, your GPA, and your other extracurricular achievements. The more prestigious the med schools you want to get into, the higher your MCAT score will need to be. The higher your GPA, the more it will buffer your MCAT score. Similarly, stronger extracurricular achievements, like multiple research publications, will assuage adcom concerns about your MCAT score.
Extracurricular activities
Adcoms review applications from many students with a high GPA and MCAT score, and it’s incredibly difficult to discern from stats alone who the top applicants really are.
In addition, medicine transcends scientific knowledge and achievement. In other words, it’s not just about your ability to do well in science classes or on exams. Therefore, medical school adcoms rely on your extracurricular activities to understand how you spend your time outside the classroom, your efforts to get involved in the medical field, what you’re passionate about, your commitment to service, and your leadership potential.
Obtaining shadowing experience is typically the first clinical step for premed students. Shadowing a doctor is a mostly hands-off experience where you will observe a physician’s daily activities. Your goal will be to shadow 2–4 physicians—for 50–100 hours total—across multiple specialties and medical contexts (e.g., inpatient vs. community clinic) to show adcoms that you know what a doctor does.
Clinical experience is a broad term that encompasses the following:
Patient exposure: Hands-on work with patients, like working as an emergency medical technician (EMT)
Clinical volunteering: Any paid or unpaid work in a clinical setting. Clinical volunteering may count as patient exposure (e.g., providing care to patients in hospice) or more general service (e.g., volunteering at a hospital’s information desk).
While it’s important to get involved with service opportunities, there is no substitute for true, hands-on patient exposure.
(Note: Working as a clinical scribe falls somewhere between shadowing and patient exposure. Scribing is more active than shadowing, but does not provide the same direct patient experience as other activities.)
Community service/volunteering is another foundational extracurricular category. Your service could be medically relevant, but it does not have to be. For instance, leading after-school math programs for students from low-income backgrounds, developing community gardens in urban food deserts, or organizing large beach clean ups or other environmental initiatives are all meaningful activities. Since medicine is viewed as a career of service, adcoms want to see evidence that you share their mentality.
Finally, conducting scientific research is more or less required by noteworthy medical schools as a demonstration of your scientific literacy and ability to contribute knowledge to the field. You can work in a basic science lab or get involved in clinical research. Moreover, you can work in a wet lab or dry lab, as well as conduct biological experiments or focus on data science in a cognitive psychology lab. More important than the specific lab chosen is your longstanding commitment and, ideally, your publication record.
(Note: Competitive MD/PhD applicants participate in research for years, and often work in multiple labs. If you’re interested in MD/PhD programs, you will be expected to submit letters of recommendation from all PIs you worked with.)
While it’s important to shadow, work with patients, volunteer, and conduct research, the best applicants are those who develop a specialty or “it factor” in one, perhaps two extracurricular activities.
Top medical schools especially want to admit students who are “world class” (i.e., the best of the best) at something. For instance, some of the students I worked with who got into top-10 schools demonstrated a research specialty by publishing three first-authored papers in peer-reviewed journals. Yet, others founded science teaching initiatives for elementary students in low-income schools.
The point is that one extracurricular category is not inherently better than the other. This should be liberating. Instead of looking around to see what your peers are doing and attempting to mimic their achievements, consider how you want to spend your time, where your passions lie, and what type of impact you want to make in your community or the medical field.
To stand out, you must be memorable, and you’re much more likely to be remembered for being great at one thing vs. pretty good at a bunch of things. And even if you are pretty good at a bunch of things, you’ll still want to be great at one thing.
To use another basketball analogy: Stephen “Steph” Curry of the Golden State Warriors is a perennial NBA All Star, widely recognized as one of the best players who ever lived. And while he’s incredible in a number of ways on a basketball court, he is credited for revolutionizing basketball mostly for his unprecedented three-point shooting ability. Countless articles have been written about how no one in NBA history has shot three pointers as well as Steph Curry, and from such incredible distances.
Your goal is to be the Steph Curry—relative to your peers—of your chosen area, no matter how niche. For instance, you can be the Steph Curry of publishing autism fMRI research or the Steph Curry of opening soup kitchens. Fortunately, even if you get 80-90% of the way to Steph Curry status, you’ll be ahead of 99% of the applicant pool.
Sound difficult? It’s supposed to be. At the same time, it’s doable. If your aim is to get into a top med school like Stanford or Johns Hopkins, you have to be a top applicant. And there’s no better way to separate yourself from the other academic high achievers than through an extracurricular specialty.
(Recommended reading: How to Choose the Right Extracurricular Activities for Medical School)
Qualities
Medical schools aren’t looking to admit applicants who have simply checked all the right boxes with regard to academics and activities. Rather, they want to admit students who have demonstrated certain qualities during their premed years, such as compassion (e.g., patient exposure, community services) and desire for knowledge (e.g., research, honors thesis).
Many students mistakenly think that leadership is its own extracurricular category. They then pursue activities that require a significant time investment but that are not impressive. You can demonstrate leadership through any experience, whether leading an organization you started or taking on increasing responsibilities in your research lab.
Personal factors
Doctors serve diverse people—individuals from high-income and low-income backgrounds, ethnic majority and ethnic minority groups, patients from urban and rural areas, religious and non-religious individuals, and so on.
To be treated well, the diverse human race requires a diverse physician workforce. Therefore, medical schools look to recruit individuals from various backgrounds to their programs. While personal factors like your ethnicity, sexual orientation, and familial income are outside your control, you can demonstrate an appreciation for and commitment to serving diverse people through your coursework and extracurricular activities.
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Part 3: Medical school applications
Your academic and extracurricular paths will eventually converge on your medical school applications, which are divided into three phases:
Primary applications
Secondary applications
Interviews
Some people will say that your primary application, which includes your personal statement, is more important than your secondary applications. Others will say the exact opposite. While some medical schools indeed weigh one more than the other, you should apply your maximum effort towards all of your application materials. You’re putting in a lot of work into your premed journey; don’t slack off as you near the finish line.
In addition, it’s imperative that you begin working on your applications early. Not only is there a significant amount of work to complete, but applying late can hurt your chances, as medical schools practice rolling admissions, meaning that they invite students for interviews—and accept them—on a rolling basis. Therefore, the earlier you submit, the fewer people you’ll be competing against for more spots. Conversely, the later you submit your applications, the greater the competition for fewer spots.
You should begin working on your medical school applications months before the submission dates open in May. There is a significant amount of work to complete, and starting later will compromise your ability to submit applications early.
(Recommended reading: The Ideal Medical School Application Timeline)
Primary applications
Your primary applications, otherwise known as “primaries”, are the centralized application systems that will send your demographic information, transcript(s), MCAT score(s), letters of recommendation, expanded resume, and personal statement to individual medical schools.
There are three main primary applications:
Fortunately, each application will require you to more or less submit the same materials, with a few exceptions.
Entering demographic information is relatively straightforward. Medical schools want to know your age, gender, state of residence, family income, etc. Next, you’ll be asked to enter all of your academic information: your college courses and grades, as well as your MCAT attempts and scores. (Note: Your official transcripts and MCAT scores will have to separately be sent to each application system’s physical address.) You will also be asked to indicate who will submit your medical school letters of recommendation.
Next, you’ll be asked to complete the AMCAS Work and Activities section, which is essentially a long-form resume. You’ll list your extracurricular activities and awards, hours devoted to each, along with a short description. Moreover, you will be asked to further discuss a few of your most meaningful activities.
If you’re applying through AACOMAS or TMDSAS, these application systems also have Work and Activities sections called ‘Experiences’ and ‘Personal Biography and Activities,’ respectively. Both are quite similar to the AMCAS Work and Activities section but neither limits the number of examples you can add. However, AACOMAS limits your descriptions to 600 characters while TMDSAS limits them to 500.
Next comes your medical school personal statement, a 1.5-page narrative essay that describes your personal path to and reflections on medicine. Your personal statement is your single most important application essay and will likely take up more time—and stress you out—than any other piece of your primary applications.
You can write your personal statement on any topic. Many students mistakenly believe that some topics are better than others, but that’s not the case. I’ve seen great essays written about pretty much every topic, and I’ve seen poor essays written about those same topics. Therefore, how you write your personal statement and every other essay is at least as important as what you write about. Just make sure that your essay highlights why you want to be a doctor and the qualities that will make you an asset to the medical community.
The final step before submitting your primaries is to choose the list of schools that you’d like your applications to be sent to. Ideally, your school list will include a number of schools whose average stats are lower than yours (undershoots), about the same as yours (targets), and slightly higher than yours (reaches). Target schools should comprise the single largest category.
(Note: TMDSAS will ask you to submit two additional essays—Personal Characteristics Essay and Optional Essay. The Optional Essay should be treated as a required essay. You can find examples of each in our TMDSAS: The Ultimate Guide)
Secondary applications
Shortly after your primary application(s) is verified, it will be sent to every school you indicated. Save for a few medical schools that automatically filter applications that don’t meet certain GPA and MCAT cutoffs, you will receive a secondary application, otherwise known as a supplemental application, from every school you applied to.
Most secondary applications comprise a number of school-specific essay prompts with varying character or word limits. The three most common prompts are those generally pertaining to diversity, a challenge you’ve experienced, and why you want to attend the specific school.
Given rolling admissions, you should submit your secondary applications within two weeks of receiving them. If you begin working on your applications early, you can pre-write many of your secondaries by viewing previous years’ secondary prompts, since they change little from year to year.
(Recommended reading: Medical School Secondary Essays: The Complete Guide (Examples Included))
Looking for secondary essay examples? Click below to access sample secondary essays for every prompt required by every MD and DO program in the United States and Canada. 1500+ essays and counting.
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Medical school interviews
Anywhere from a few days to a few months after you submit your secondary applications, you may receive invitations for in-person medical school interviews. The earlier you receive interview invitations, the better the omen.
There are two main types of interviews: traditional and multiple mini interview (MMI). The former, as the name suggests, will involve you answering typical interview questions, such as, “Tell me about yourself,” “What is your biggest weakness?,” or “Why do you want to be a physician?” MMI interviews, on the other hand, will require you to visit various interview stations, where you will be asked how you would behave if presented with a certain ethical dilemma, communicate with an actor playing the role of patient, work with a teammate to solve a problem, and so on.
Years ago, medical school interviews tended to be much more stressful than they are today. You are unlikely to encounter uncomfortable personal questions or “put on the spot.” Rather, medical school adcoms are hoping to get to know you interpersonally and to confirm their positive reaction to your application.
It’s important to practice your interview skills with experienced interviewers. Instead of focusing on rare questions like, “How do you feel about Obamacare?,” you should practice more common questions, such as, “Why do you want to attend our program?” and focus just as much on how you come across in your answers as you do on the content of your answers. Remember: if they simply want to know the content of your answers, adcoms could’ve just asked you to write more essays.
(Recommended reading: How to Ace Your Medical School Interviews)
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Waiting
Waiting—for interview invitations or for admissions decisions—is the most stressful part of the application process for most students.
During this time, you should do what you can to take your mind off the admissions process. You should also consider sending update letters—letters of interest or letters of intent—to schools when you have meaningful updates to share, and also to express your continued interest in their program. If a school explicitly requests that you not communicate with them after submitting secondaries or interviewing, honor their request.
Admissions decisions
Some time after submitting your secondary applications or interviews, you will receive one of the following admissions decisions from medical schools:
Accepted
Rejected
Waitlisted
While acceptances and rejections are fairly straightforward, navigating wait lists is more tricky. Some schools will invite you to send letters of continued interest, whether others will let you know that you will not need to send in anything. In the latter case, consider sending an update letter, unless expressly told not to.
If you are accepted to multiple medical schools, you will have to accept one of your offers by May 15 and turn down the others. If you receive additional acceptance past May 15, you’ll have two weeks to decide whether you want to keep your accepted offer or turn it down in favor of the new one.
Financial aid
Unlike with undergrad, few medical schools offer financial aid in the form of grants or scholarships. And the schools that do offer scholarships tend to give them to one of the highest achieving students they admitted and that they want to recruit
Unless you can afford to pay for medical school out-of-pocket, you will have to finance your school through loans or external scholarships, fellowships, or employment.
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Part 4: A four-year guide to getting into medical school
How this guide is organized
This section is separated into four parts that correspond to the traditional four-year college path, assuming that you will apply straight through. However, it is meant to be applied flexibly.
For instance, if you’re a college sophomore and realize that you didn’t complete one of my freshman-year recommendations, it doesn’t mean you should skip over those. Rather, you should work hard to “catch up” by completing tasks you may have missed. Conversely, if you’ve completed a recommended task ahead of time, you don’t have to repeat it. In addition, if you intend to take one or more gap years, you can space out various tasks.
In addition, each year has a theme to guide your approach to academics and extracurricular activities. Therefore, you should never be over-focused on one or the other. Remember that maintaining strong stats is critical, so never take on too much coursework or too many extracurricular commitments that they compromise your grades. At the same time, you don’t want to be seen simply as an academic high achiever.
At first, you’ll want to cast a relatively wide net. Over time, your interest will become more clear. As you decide which area(s) to pursue deeply, your “it factor(s)” will naturally develop. Think of your medical school admissions journey as a funnel, where your focus gets narrower over time.
Freshman year: Healthy foundations and breadth
The first year of your undergraduate career will speed by much more quickly than you think. In addition, you will receive seemingly endless opinions on your many questions about how to navigate your premed years. Here are the most common ones:
Which specific courses should you take? Should you take more general education courses (GEs) or more prerequisite courses? How many of each?
Create a four-year plan that works backwards from key landmarks (e.g., graduation, applying to medical school, taking the MCAT). Then, fit in your coursework accordingly (e.g., “If I want to take the MCAT during the summer after my second year, I’ll need to complete XYZ before then.”). Do your best to create balanced schedules. You don’t want to be taking three science courses one quarter (a rather heavy load) and then three GE courses the next (a rather light load).
What extracurriculars should you participate in?
You have a considerable amount of time to decide how to commit your limited bandwidth. The goal during your first year is to expose yourself to as many opportunities as possible, noting programs that you would like to contribute significantly to and can see yourself growing within. We’ll discuss this further below.
What’s shadowing and when should I get started with that?
Shadowing is a passive activity where you observe the daily practice of medicine. In other words, you follow a physician throughout their workday to get a better sense of the type of work doctors do so you can decide whether medicine is the right career for you. While you don’t need to shadow right away, you should check this box—really the only activity you may treat as a checklist item—relatively early so you can move on to more hands-on clinical opportunities. You’ll need to amass about 50–100 hours by the time you apply to medical school and you can do so quickly during your winter/summer breaks.
Am I already behind on research?
No! If you insist, you could begin searching faculty pages in departments of interest (e.g., neuroscience, molecular biology) to get a sense of the work being done on your campus. If you’re eager to get started with research right away, reach out to a few professors and ask about available opportunities to work as a research assistant.
How important is my major and which is the best to get into medical school?
Students often ask about which major will give them the best chances of acceptance into medical school. While many premeds already have an interest in science and are happy to major in biology or chemistry, neither of these is necessarily going to grant you an advantage on your application.
When it comes to your major, take your freshman year to explore your options and figure out what you’re passionate about. As long as you keep your GPA up, excel in your prerequisites, and get the necessary extracurricular hours, you’ll have an excellent chance of entry regardless of your major. Remember, it’s much easier to do well studying something you’re excited about rather than toughing it out in a subject that doesn’t much interest you.
Now, take a deep breath. We’ve answered these questions for the sake of assuaging freshman jitters. Over time, you’ll complete everything necessary, so do your best to find a trusted advisor and avoid overwhelm, rather than rely on premed hearsay or online forums that are filled with misinformation.
College’s novelty tends to produce two camps of students. The first comprises those who feel the pressure to jump into every opportunity that comes their way. These students feel like they may “miss out” or that they’re not taking their pre-medical aspirations seriously enough. This approach is largely borne out of two errors:
Following the herd of other premed students who are getting involved in certain activities
Fundamental misunderstandings of what it takes to get into medical school.
Unfortunately, joining too many clubs and pursuing too many opportunities you’re not completely passionate about leads to shallow, unmemorable work in all of your commitments.
The second group of students are those who do not take advantage of the freedom that college offers. They’ll focus on their coursework and return to their dorm promptly after, choosing to pass on activities fairs and introductory club meetings. These students won’t understand the breadth of experiences available on a college campus.
Which of these two approaches is “right?”
The truth is that your first year means relatively little in the grand context of your medical school candidacy. It’s built as a transition year to help you acquaint to a new space surrounded by new people and new freedoms. Therefore, the theme for your freshman year is to build healthy foundations and explore the breadth of experiences available to you.
(Note: There is one exception to my point about your first year meaning relatively little: your GPA. A common saying that circulates the premed community is: “Pain is temporary, GPA is forever.” Above all else at this point in your pre-medical journey—including shadowing, research, clinical experience—is your GPA, so protect it. As your units rise, it becomes increasingly difficult to budge it. Be on the right side of this so you can have the opportunity to relax during your later years, because while a B or C early on can compromise your GPA, a slightly lower grade later will make little difference.)
Here are a few key points to consider when developing a strong, lasting foundation:
Build healthy habits. Eating healthy, working out often, and sleeping consistently are too often overlooked by students. If you neglect your health, you’ll likely burn out when coursework intensifies and extracurricular commitments start piling up. Therefore, treat healthy habits as a cornerstone for your success as a premed student.
Optimize your studying. Experiment with location, temperature, music, etc. Your study space will become your holy space for the next couple of years. Treat it as such. As with the previous point, many students will neglect this. But while pure intellect may get you through freshman year, your courses will get tougher and your commitments will take more of your free time. You should therefore study effectively when you have the opportunity to do so.
Struggle, then seek help. Take pride in your ability. Push yourself to solve problems and learn to ask for help only once you can answer: "What specific step am I stuck on?" The premed journey will require you to be self-sufficient in many areas of your life, including academics. Many students fall into the trap of depending entirely on office hours and study guides created by students from prior years. Learn to push yourself because there are fewer such resources as you move forward in your academic journey.
In addition, it’s important to get a sense of your available opportunities. Survey the choices that your campus offers you through engaging in small, bite-sized extracurricular experiences. Become acquainted with a few clubs and programs and note which experiences interest you so can return and possibly commit to them.
Moreover, don’t feel the need to exclusively engage in medically-related experiences. Since admissions committees look for attractive qualities, such as the ability to work in teams, interpersonal skills or the capacity to lead can be developed through a hospital volunteering program as much as through an a capella team.
Lastly, take advantage of your first college summer, as it will be your most free one. While a popular option is to get ahead of your coursework by taking summer classes, consider a variety of experiences, such as:
Studying abroad to complete prerequisite courses (e.g., study physics in Hong Kong). Often, these programs allow you to complete entire prerequisite series (e.g., Physics ABC) in 8 weeks, as compared to the traditional 3 quarters/2 semesters/30 weeks at your university. In addition, you can enjoy time abroad!
Going on a medical mission to Vietnam/India/Tanzania, etc. These opportunities are great if you’re interested in healthcare institutions outside of America, all the while enjoying a summer in a different country.
Freshman year will be over sooner than you think. Although there’s a lot to consider, the main takeaways are:
Protect your GPA. It is very difficult to budge it as you progress through your undergraduate years and accumulate units.
Transition into the college environment to the best of your ability. These healthy foundations will carry forward into the next three years. Neglect this, and you won’t be able to handle things when the pace of your coursework and extracurricular activities increase.
Prioritize breadth over depth when it comes to extracurricular activities. Survey your entire campus’ landscape and when you’ve come to the point where you’re settled academically, you can begin to funnel your additional time into extracurriculars you’re truly interested in.
Take advantage of the summer after your freshman year! It is an important time to get ahead of the pack and, when planned right, can also involve memorable experiences studying abroad or serving underserved communities in developing countries.
Sophomore year: Academic refinement and exploration
During your second year, the academic and extracurricular pace will pick up considerably. Professors will assume that you’ve transitioned to college and that you can now excel despite the rigor of university coursework. In addition, if you’re considering matriculating into medical school right after graduation, you must apply in May/June of your third year.
With just under two years until you submit your application, MCAT, letters of recommendation and extracurricular involvement should be moving towards the forefront of your mind. Due to these considerations, the theme for your second year should be academic refinement and exploration of activities that will make you more than just your GPA and MCAT score.
Think about when to take the MCAT. It’s an incredibly difficult exam and should be treated seriously. If you’re looking to apply straight through, a popular option is to study full time during the summer after your second year. This strategy will give you protected time away from coursework and extracurriculars so you can focus entirely on getting the best score you can. Note that the alternative to studying during the summer is to study during the school year. With that approach, you’ll have to juggle MCAT study time with your university coursework, which is often a recipe for disappointment.
Review your four-year plan and ensure that your coursework in the upcoming years matches your timeline for taking the MCAT and applying. Pay particular attention to whether you will have completed the majority of your prerequisite courses for the MCAT before you begin to study for the exam. Remember, the MCAT consists of:
(Note: The MCAT also includes reading comprehension and analysis, but those skills are not directly associated with certain prerequisite courses.)
By the time you enter a dedicated study period for the MCAT, you should have completed most of these series in their entireties, except for the associated lab courses (e.g., General Chemistry Lab won’t be important for the MCAT). It will help if you have taken introductory psychology and sociology coursework, but if you can’t fit all these subjects into your schedule, self-studying psychology and sociology would be manageable. In contrast, you should ideally complete all of your chemistry, physics, and biology coursework beforehand.
More generally, continue to refine your learning style and protect your GPA by excelling in your classes. The learning habits you develop as an underclassman will carry with you throughout your undergraduate years and far into medical school. Continuing to study inefficiently (e.g., with your phone’s notifications on or in loud, distracting environments) will eventually catch up to you as coursework becomes more difficult.
(Note: It’s completely normal for you to not have found your groove with your coursework just yet. Rather than panic about a B here or there, the correct course of action is to double down and focus entirely on your academic success. On the other hand, it would be a mistake to continue adding onto your plate. Slow down and take your medical school admissions journey one step at a time. Once your healthy academic habits are in place, you can take the training wheels off.
Too often, students spread themselves thin every which way, hoping that their extracurricular involvement will be enough to “cover” their lower academic stats. Remember, with so many applicants, many of whom have strong stats and extracurriculars, admissions committees need quick ways to filter applicants. Don’t let your low GPA be the reason you don’t get a second look. Your numbers are most important and your extracurriculars, the differentiating factor.
Think of it this way: your GPA and MCAT scores are the cake and your extracurriculars are the frosting. Without the cake, your frosting may be nice, but insubstantial.)
Extracurricular-wise, it’s time to get more involved . Because you’ve had a year to survey the extracurricular landscape and found things that interest you, you should have no problem with diving headfirst into them and doing your best to contribute however you can. Whether giving your best efforts when serving patients at a community health fair, answering questions during a club presentation, or interacting with guest speakers at a panel, make sure that you make your time spent in these activities well worth it. Prioritize serving the mission and members of every organization over your personal interests. Too often, premeds join clubs simply in search of leadership positions.
Consider exploring clinical experiences to get a better sense of what working in patient care is like and what medical contexts you’d like to practice within. A general rule of thumb is that if you are interacting with patients, that experience is clinical. Here are some examples of programs to consider on your own college campus:
Join the hospital volunteering program and get a sense of what life is like as a nurse, physician, or patient. Pay attention to how you feel when serving people in their times of poor health and whether you see yourself working in this context throughout your professional career.
Serve as a volunteer in a free community health clinic. Get a sense of working with patients from different socioeconomic backgrounds and what medicine looks like “in the field.”
Create a program to coach patients with chronic illness on losing weight and maintaining weight loss. This unique clinical experience would broaden your perspective on patient care.
Also, seeking out research experiences not only to improve your candidacy for medical school, but also to get a sense of whether you’d like to pursue academic medicine in the future. To make headway on a research project, you should dedicate anywhere from 10–20 hours a week to the lab. That said, remember not to push your schedule if you’re not yet at the point where you can handle it. Here are some ways to get involved with research:
Attend lunch seminars hosted by your college’s science departments (e.g., psychiatry, biochemistry). Get a sense of the type of work that’s being done on campus and reach out to faculty members via email if you’re interested in supporting them. Be persistent. Often, faculty members see your email but, for whatever reason—they saw your email right before lunch or while leaving lecture—did not or could not respond. Don’t take it personally and continue to follow up if you’re genuinely interested.
Reach out to your upperclassman friends that are doing research in a field you’re interested in or to ask whether they recommend working in certain labs. Upperclassmen often know about research openings and a recommendation from these already-vetted students can help you obtain a position more easily. Spring quarter/semester is the best time to search for and obtain research positions as many of the seniors in the lab will be looking to transition out of their position after graduation.
Join established research pipelines. Some undergraduate institutions, like UCLA, have dedicated biomedical research minors and others have programs that promote research opportunities to certain student populations (e.g., first-generation, underrepresented). Apply to these programs only if you are relatively certain you want to incorporate research into your undergraduate career as these programs tend to be selective and rigorous. On the flip side, they offer excellent mentorship and, often, funding for your scholarly pursuits.
Apply to undergraduate research programs. Many schools offer summer undergraduate research programs that will pair you with a faculty member to assist with their research or grant you a stipend to pursue your own project. Either way, you’ll receive guidance and be able to tout your research credentials on your medical school applications. It’s also a great way to network with others involved in research and learn about other potential opportunities.
As sophomore year comes to a close, you’ll have completed half of your undergraduate years! The first two years are a period of significant growth and the following two years will be more exciting as a result. The main takeaway for second year include:
Don’t bite off more than you can chew. A strong GPA and MCAT score is critical for consideration from top medical schools. Therefore, don’t fall into the trap of leveraging your extracurricular experiences to attempt to compensate for subpar academic metrics.
Think about the MCAT and your overall application timeline. Ensure that your four-year-plan matches what you hope to accomplish by the time dedicated study for the MCAT rolls around.
If you’re academically comfortable, start shifting into a depth over breadth mindset when it comes to extracurriculars. Pour your time into things that truly matter to you and serve your clubs’ missions and members before expecting anything for yourself. In other words, don’t get involved in a club because you think, “It’ll look great for medical school.” This dangerous “checklist mentality” will hurt you when it comes time to write your medical school applications. You’ll have little of substance to communicate. The leadership positions, accolades, publications, and presentations will come if you provide value up front.
Explore clinical experiences. These are any activities that involve patient care and give you a better sense of what it means to serve patients in their time of need. Clinical work will develop your interpersonal skills and an understanding of what working with the sick and their families is truly like.
Explore research experiences, particularly in the spring as seniors look to transition out of their positions. Research will give you a better sense of whether you want to incorporate academic pursuits into your career. If you don’t, that’s perfectly fine, but medical schools want to see that you’ve worked to understand the science that goes hand-in-hand with the medical profession.
Junior year: Optimize your time and elevate your responsibilities
If you’re applying straight through, your third year will be your application year. At this point, you’ll probably feel like time is flying by. With one year remaining to boost your application, your goal should be to optimize your time and elevate your responsibilities. By now, you’ll need to have a firm grasp on your academics and funnel the rest of your time to differentiate your application from the rest of the pack.
Naturally, the content of your coursework will get more difficult as you enter upper-division coursework. Despite this, the habits that you’ve developed will pay dividends. Getting great grades in these non-weeder courses should be relatively straightforward now: put in effective study time in an environment optimized for your learning.
As a reminder, if you find yourself struggling academically, lessen your other commitments to improve your stats. You’re going to need competitive stats to be seriously considered among the thousands of applications that medical schools receive each year.
At the same, there is little difference between, say, a 3.85 and a 3.88 GPA. You’ll find that your courses now matter much less in moving the needle of your GPA. Therefore, you should be more strategic with your time and not chase diminishing returns. A 98% in a class is viewed the same as a 94% and getting those 4 percentage points may take valuable hours away from other ventures, like working on a research publication. Therefore, do the most you can academically with the least amount of work.
By protecting your time, you can focus more on extracurriculars than ever. Your achievements outside the classroom will help brand you as more than a student with great stats. If you’ve focused on serving the missions of your extracurricular opportunities, you’ll soon be taking on larger responsibilities. Per the Stephen Curry analogy earlier, look for ways to stand out. Here are some ways to elevate your responsibilities and be seen as a superstar applicant:
Take on a leadership role and use your experience as a member to identify ways to improve an organization! For example, you may have served as a volunteer at a community health fair for recent immigrants from Latin American countries and noticed that this population would benefit considerably from having point-of-care glucose and cholesterol screenings. You reach out to neighboring schools of pharmacy and nursing and bring out a team of healthcare providers that can now offer that service.
Lead your own independent research project. For instance, your larger research question may be: “What are the underlying mechanisms of stroke recovery?” You propose a smaller experiment that analyzes a mouse’s motor behavior before and after a stroke through a machine-learning algorithm. Whenever possible, disseminate your work through poster presentations and publications. This will give you facetime with experts in the field who can offer valuable feedback and push your research career forward.
Scale your positions to build out a team of members that can perform your role more extensively. Perhaps you are a health coach who helps patients achieve and maintain weight loss to reduce their chronic disease risk. You could recruit a dozen other health coaches, train them to be just as effective as you are, and then spend your time recruiting patients who can be served by the team you’ve just built out.
Often, your professors will be engaged in their own research and may need some assistance with their projects. This will not only win you points in an individual class but allow you to show initiative while taking on more responsibility and strengthening a relationship. What’s more, a glowing letter of recommendation never hurts!
On the admissions front, your primary applications will open for submission in May or June, which will come much faster than you think. While specific application details are outside the scope of this resource, here are some guiding questions:
Are you comfortable with your GPA and MCAT score?
View the average GPA and MCAT scores of matriculants at every medical school and see whether your stats are in the ballpark range of schools you’d like to attend. If your stats are below what MD programs expect and you need to boost your GPA, consider enrolling in a post-bacc, Special Master’s, or extension program. If you need to improve your score, consider retaking the MCAT and studying more effectively than you previously did.·
Do you have sufficient shadowing hours and clinical experience to demonstrate an understanding of what medicine entails?
In other words, can you effectively verbalize why you want to be a physician? Do you have clinical experiences that can support your reasons?
Have you secured strong letters of recommendation?
These letters serve as a third-party perspective into you as a student and as a person. Strong letters of recommendation can make the difference between receiving an interview invitation early vs. waiting a long time, so consider the relationship you have with your letter writers and the picture they would paint of you. If it’s been a while since you were in touch with various professors or other references, use your third year to solidify relationships.
Do you need a mental break before medical school?
Medical school is four years long and nearly continuous, meaning you’ll get few breaks. Therefore, consider whether you want to commit to another four years of rigorous schooling right after undergrad.
Are you proud of extracurricular activities and can speak passionately about them?
If you can’t, perhaps you would benefit from another year or two of focused work. You’ll have much more time to devote to extracurriculars during gap years because you no longer need to dedicate so much time to your coursework.
Are you still committed to going to medical school straight through?
If so, you’ll want to get started on your applications early, ideally during the fall of your third year, and no later than the winter. Otherwise, you will risk submitting your applications late or rushing and submitting subpar materials.
The summer after your third year will be largely devoted to completing outstanding application essays and preparing for interviews. This is time can be extremely stressful, as nearly every medical school will you ask you to complete a supplemental application with a few additional essays. If your medical school list contains, say, 30 schools, you’re looking at upwards of 80 additional pieces of writing beyond your primary applications!
Whereas some essays may be repurposed, others will require original writing. Do your best not to have too many outside commitments. Even if you have a full-time job, try to schedule a few weeks of protected time to work on your application.
Should you have free time after submitting your primary applications, you should pre-write your secondaries. While you can view every prompt in our medical school secondary essay prompts database, note that they may change from year to year, although most remain the same.
When you receive a certain secondary, do your best to return it within two weeks. If you got started on your applications early, this should not be an issue. Rolling admissions truly comes into play here because once a secondary is submitted along with your letters of recommendation, your application will be considered complete and ready for evaluation. Submitting early means you’ll be competing against fewer applicants for more spots.
Senior year: Enjoy the interview trail and relax
Your fourth year may feel like you’re on a roller coaster. With secondaries (hopefully) out of the way, this year will likely be an intensely uncomfortable waiting game. You’ll have to wait to receive interview invitations, perform well on interview day and then wait some more. If you receive numerous invitations, you’ll accumulate more flight miles and credit card points than you ever could have imagined.
You’ll also be triggered by every email notification, anxiously wondering whether it’s an interview invite, an acceptance, or an unfortunate waitlist placement or rejection. Do your best to not let this period consume you. Mute your notifications when you can, schedule time away from technology, and lean on your support network to manage difficult emotions. It’s an exciting time, but you should still enjoy your senior year. Therefore, the theme for your fourth year is to enjoy the interview trail and relax to the best of your ability.
If you’re fortunate to make it through the primary and secondary screens and receive interview invitations, congratulations! You’re nearing the light at the end of the tunnel and you deserve it. On your interview day, remember to:
Enjoy interview days. You will visit new places and meet new people who may be your colleagues going forward. Often, medical school candidates end up meeting again on the interview trail and on second-look weekends. You’re in this together and may end up being great friends while you navigate your education and careers together.
Medical schools are as interested in you as you are interested in them. They were impressed enough with your application to give you a second look in person. Remember that interview spots are coveted, and it is therefore in schools’ best interest to invite only people they are genuinely interested in. Be yourself and show schools that what they read about you genuinely reflects who you are in person. There are no trick questions; schools just want to get to know you.
Read up on impostor syndrome and don’t psych yourself out. The admissions process is rigorous, and you deserve your interview invitations after three years of hard work. Stay out of your head and resist being your own worst enemy.
When you’re not interviewing, you’ll maintain your status as a full-time student and complete coursework for your degree. Whereas your goal during previous years was to protect your GPA, your mentality this year—assuming you’ve done well and won’t be applying during a future admissions cycle—should be to maintain it. Therefore, prioritize enjoying your senior year.
Now, that doesn’t mean you should coast, but it does mean that a 4.0 is neither necessary nor helpful. Since you’ve already applied, your fourth-year grades will not be considered during the application process. However, you must send a final official transcript after you are accepted, so don’t put yourself in a position where you have to explain why your 3.85 GPA suddenly became a 3.65 in a single year.
Most importantly, relax and reflect. You’ve worked hard and grown over the better part of four years. There won’t be many opportunities to do so during med school or residency as you study for exam after exam or push projects to completion. Consider traveling during the latter part of your fourth year and during summer, pursue other interests, and celebrate.
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About the Author
Dr. Shirag Shemmassian is the Founder of Shemmassian Academic Consulting and one of the world's foremost experts on medical school admissions. For nearly 20 years, he and his team have helped thousands of students get into medical school using his exclusive approach.
THERE'S NO REASON TO STRUGGLE THROUGH THE MED SCHOOL ADMISSIONS PROCESS ALONE, ESPECIALLY WITH SO MUCH ON THE LINE. SCHEDULE YOUR COMPLIMENTARY CONSULTATION TO ENSURE YOU LEAVE NOTHING TO CHANCE.