Deep Dive into Penn Perelman School of Medicine: An Interview with Dr. Neha Vapiwala, Dean for Admissions [Episode 455]

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How to Get Accepted to the Perelman School of Medicine [Show Summary]

Dr. Neha Vapiwala, Dean of Admissions for Perelman School of Medicine at the University of Pennsylvania, the first medical school in the United States, explores the values the school instills in its community while reflecting on the new wave of interest in medical careers that has developed over the course of the past two years.

Interview with Dr. Neha Vapiwala, Dean of Admissions at PSOM [Show Notes]

Welcome to the 455th episode of Admissions Straight Talk. Thanks for tuning in. Are you ready to apply to your dream medical schools? Are you competitive at your target programs? Accepted’s Med School Admissions Calculator can give you a quick reality check. Just go to accepted.com/medquiz, complete your quiz, and you will not only get an assessment, but also tips on how to improve your chances of acceptance. Plus, it’s all free.

Professor and Vice Chair of Education in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania, Dr. Neha Vapiwala is also the Dean of Admissions at Penn’s Perelman School of Medicine. She earned her Bachelor’s in biology and Hispanic studies from Johns Hopkins and her MD from the University of Pennsylvania.

Dr. Vapiwala, welcome to Admissions Straight Talk.

Could you start by giving an overview of the Perelman School of Medicine’s curriculum? [2:00]

Absolutely. I really appreciate the opportunity to speak to listeners today about our idea of medical school education here at the Perelman School of Medicine. We think of it as learning for life, so really establishing the foundation of medical education, but recognizing it goes and extends well beyond our students’ time with us and working to establish the best practices and the foundation for a lifetime of learning, which I think all of us in the healthcare field understand. It’s a very humbling and constant reminder of how much there is yet to know.

We start in the summer of the first year of medical school with the core principles, what we refer to as Module One. It’s all of the basic sciences. This is a pass/fail block. The idea is really for all of our learners, all of our students who may or may not have been science majors in undergraduate, who may or may not have done a post-baccalaureate year, it’s bringing everyone onto that same page as far as our basic sciences.

After that first six-month period, we launch into Module Two, which is a full calendar year. It runs from January of the first year into December of the second year and teaches what’s called Integrative Systems and Disease. It’s taking all of those foundational basic science elements, and it’s saying, “Okay, how does this apply to the human body? How do we think about the cardiovascular system, the pulmonary system, renal, and so on and so forth?” It goes through all of these disease site, organ-based modules with this idea that you’re learning about the normal function of the human body, the physiology, and then learning to identify the pathology, both in terms of what you see under the microscope and what you see in the human patient, in front of you in the exam room, and really integrating all of it so that the learning in the classroom is given immediate clinical impact and context.

These basic science and then disease site-based modules are, of course, integral, but concurrent with all of this, we have Module Three which is running from that first day of medical school through December of the second year. It’s called Technology and Practice of Medicine. Of course, students are learning the science, but there are also so many other aspects of healthcare: the business of healthcare, the innovation, the role of information technology and artificial intelligence and everything in-between to really help understand and give some depth to a lot of what we’re learning in the classroom. This is meant to enhance the core curriculum.

Then the January of the second year, after finishing that first year-and-a-half, we move right into core clerkships. This early entry into the clinic was introduced at the Perelman School of Medicine over 20 years ago and was unheard of at the time. Now, of course, we have other colleagues at other schools who offer this. Again, this is something that was really designed way back when with the idea that until students really get into the clerkships and are in the hospital, the outpatient and inpatient setting, working alongside teams, all of these principles and foundational sciences don’t really feel as relevant as they do when you get in there and roll up your sleeves and start working. That entire calendar year, January of year two through December of year three, is performing all of the core clerkships.

That leaves also on the back end a year-and-a-half in a traditional four-year curriculum. I’ll point out that many of our students do extend beyond four years for additional degrees, taking advantage of our university offerings. In many other graduate schools, they might choose to pursue a certificate. They may take a year out for scientific research or other types of entrepreneurial or other pursuits. They might even be combined degree students seeking a PhD. If you just think of the traditional four-year curriculum, there’s a whole year-and-a-half for electives, for research, for a scholarly pursuit requirement that we have in which a three-month period is spent in a dedicated course of research with mentorship and with deliverables.

That is a brief overview of the four years. I want to mention that throughout the entire medical school curriculum is our Professionalism and Humanism course that is considered Module Six. It’s also pass/fail and designed to really give context and breadth and depth to what is being taught in the traditional medical school environment. This is sitting down and taking time and pausing and thinking about some of the particularly challenging, ethical, moral, personal, emotional, psychological aspects of what it is to be a medical professional and what it is to have humanity in everything that we do.

Again, the vast majority of all these modules are pass/fail, except for the clerkship year, and we have a lot of unscheduled individual time. We have throughout all of this, learning teams that really help you to understand what it is to be a team member, whether you’re a leader or a listener, learning both roles, and really thinking about that final year-and-a-half to individualize and flex the curriculum depending on your interests. Hopefully, that gave all of our listeners a nice overview of the program.

In terms of that last year-and-a-half, do most of the Perelman students use it to pursue scholarly research? Do they use it to get the certificate? Or do they use it to pursue other clerkships? [8:08]

Actually, I would say all of the above. We do have quite a few who engage in research and decide they want to do even more time and take that year out, dedicated usually to research in a basic science lab, but not by any means limited to that. A lot of our folks choose to do clinical research, public health pursuits, global oncology, certainly not in the current pandemic times, which have obviously limited travel, but historically, that’s been how their time is used. Almost half of our students regularly pursue additional certificates and/or master’s degrees, and in some years, actually, more than half. In the case of the certificates, that doesn’t even extend your time beyond the four years. The additional master’s degree might typically add on one year of training, so five years, typically

Is graduating earlier an option? [9:21]

That is not an option just based on the way the curriculum is designed and also in order to meet all of the LCME requirements and other aspects. That has not been currently a feature of our curriculum.

What do you think listeners don’t realize about the Perelman School. What are some myths about the Perelman School that you would like to dispel? [9:39]

I appreciate this opportunity because I think a key aspect is the perception that some may have that our students who are in our environments are hyper-competitive. I can understand why that might be felt to be the case, given some of the metrics and the academic characteristics of the students whom we admit. But having said that, the curricular structure and ultimately the admissions process and its holistic nature actually lends itself to a very diverse population and a truly collaborative environment. I want to give a lot of that credit, of course, to our faculty, our staff, our students, and of course, their personalities and their general proclivity for an environment that is actually meant to build each other up rather than stepping on someone to get ahead. I think that is, honestly, at the heart of our ethos. Also, the learning teams, which literally on day zero, you arrive for orientation, and you are thrown in, so to speak, and introduced to your learning team. We also have the house system, which is basically four houses, and each student is assigned to one of the four, regardless of whether they are a four-year MD student or an MD/PhD applicant, whatever it is, everyone joins a house and it creates a sense of community within the community. It creates a sense of supporting each other across the years, so first years mingle with seniors and everything in-between. There are faculty mentors who support these learning teams and the house system and there’s everything from social events to, of course, the foundational learning that our students are here for. All of this is to say, even though it could be a hyper-competitive environment just by being medical school, we strive through all of these programs and through our personalities and through our tone and our tenor from the top down to create an environment that is nothing short of supportive and embracing and inclusive.

The other thing I would mention is that we’re located in an urban setting which is a very rare find, I think, of having practically all of the health system buildings. We have the Perelman Center for Advanced Medicine, which is the largest outpatient care center in our health system, a brand new state-of-the-art hospital that just opened two months ago, the Children’s Hospital of Philadelphia, which is a top-ranked pediatric hospital, all of our major research buildings, and then our main campus with a top graduate school at Wharton and a top nursing school, our communications school, our bioengineering, our law school – all of these are within walking distance, or perhaps a short bike ride away. To be able to have that in geographic reach and proximity, and then, of course, the diversity of the population of students, faculty, and the community that we serve, I think, is something that maybe not all of our listeners appreciate, so it’s a nice thing to be able to highlight, and I think a rather rare thing as well.

Do students consistently work with the same learning team throughout medical school? [13:11]

Excellent question. Several learning teams comprise a house, so there is continuity in terms of day zero. As I said, at orientation, you’re in this learning team. You do work with them throughout Modules One, Two, and Three, and then that Professionalism and Humanism, which is Module Six, and runs the entire gamut of your medical school training.

When you’re on the clerkships and when you’re on a given elective and when you’re doing your scholarly pursuit, or perhaps you’re doing a specialized certificate or master’s, then you’re not necessarily seeing your learning teams as much, you’re in different teams. The idea is that there will still be opportunities where your learning team comes back together because of the Professionalism and Humanism course, because of connections that you formed, and because quite often, there are bonds that are formed with these classmates that are life-lasting. There is that common thread of your learning team throughout. New team dynamics are absolutely thrown into the mix when you’re in the clerkships. The whole point is taking what you’ve learned from being a team member and studying how to be on a team. I mean, it is in itself a discipline, and then applying that when you’re thrown into various teams in the clerkships is fundamental to the learning.

Do you think the abundance of pass/fail courses contributes to the collaborative environment at Perelman? [15:00]

I would like to think that the pass/fail environment certainly contributes and helps, but even before, when we were not pass/fail for the majority of these modules, we did, I think due to the nature of the team-building, the camaraderie-building, the emphasis on focus on life outside of medical school and the unscheduled individual time, really understand what it is to be a member of a larger society outside of medical school, including the other graduate schools. That lent itself to already having that collaborative environment, but I do believe the students would tell you that the pass/fail nature absolutely further supports that.

What COVID adaptations or changes do you think will continue beyond the pandemic? [15:55]

We’ve been very fortunate to be able to maintain, outside of the immediate period in spring of 2020 when the entire world was uncertain, we’ve been able to really maintain the curriculum as much as possible to its original intent and have our clerkship students participate in patient care as they need to.

I think some of the things that may stay with us and one that will be interesting to see is if admissions numbers continue to be up nationwide. There’s this concept of the “Fauci Effect” and a general interest and reinvigoration of what it is to be a healthcare provider. I think a lot of young folks have been inspired by the examples that they’ve seen. I think certainly for me, it’s so heartening, and it’s one of the few pluses that we’ve seen come out of this is that perhaps more people are called to action. I don’t just mean medicine as a physician, but other branches of medicine, nursing, etcetera. Perhaps, hopefully, that will last.

I think the use of virtual classrooms and more flexible teaching within the classrooms, and of course, virtual interactions like this, particularly for teams that perhaps can’t meet for periods of time, but can still maintain connections, I think is hopefully something that will last.

What remains to be seen, Linda, and I don’t know where it’s headed, it’s certainly too soon for us to say is what the role of interviews for student selection in a virtual format will be moving forward. There are obviously pluses and minuses, as with every technology, and certainly, making it more accessible and more affordable for applicants is a wonderful thing, but denying them the opportunity to be on a given campus and to have that interaction with the community here, I think, is a major loss, so that I think is very much TBD.

Does Perelman screen before sending out secondaries, or are they automatic? [18:18]

We do not screen the secondary applications, so anyone who is verified as an eligible candidate through the AMCAS system is sent the link to our secondary application.

Penn’s secondary application is one of the more thorough and demanding secondary applications. What are you trying to glean from this very comprehensive secondary? [18:40]

Our secondary, as with most secondaries, it’s intended to cover ground that’s not in the general primary application. It’s really trying to help our committee, which is dedicated to the holistic student selection process, to get to know the candidates on a more personal level on aspects that the candidate would like to highlight. Particularly with COVID, we have added a couple of areas in which candidates can share with us to the extent that they wish and feel comfortable how the pandemic has impacted them, impacted loved ones, perhaps might explain some areas in their application that are not as strong as they would like them to be, so it’s providing that opportunity.

We all also want to understand their motivation for medicine beyond Perelman. I think it’s now more incumbent than ever to help these young folks. By the same token that I just said, it’s very heartening and wonderful to see this huge influx of more applications nationwide to medicine. I think we also owe it to these applicants to make sure that they know what they’re signing up for and that they can articulate what that motivation for a long-term successful career in medicine looks like for them and what it is that they envision. I think being able to share that with the committee so we can understand what these decisions are based on and where these applicants see themselves fitting into the medical school community is an additional opportunity for these applicants to highlight themselves.

The last thing I would mention is that all of our applicants, regardless of their own personal, racial, ethnic, socioeconomic, sexual identity background, are asked to speak to how they would contribute to our environment of equity and inclusion and what their own personal background and/or personal ethos will contribute to that environment and how they see themselves contributing. We all play a role in creating that, no matter who we are.

What are some of the more common mistakes you see applicants make in approaching that thorough secondary? [21:15]

As you are well aware, anyone applying in medical school tends to be of a certain personality, and I’m sure they’ve double, triple, quadruple-checked their application, so I’m pleased to say the majority of the time, we really don’t find any errors. They’re really kind of flawless and extremely thoughtful applications that we receive. On rare occasions, we may find answers that were meant for another school and somebody might have had a cut/paste error, or perhaps the hours that they say that they did in a certain activity might not be clear if that is concordant with something shown somewhere else. But as I say, thankfully, those are rather rare.

If the motivation for medicine is articulated yet the personal experience, and again, with the caveat that COVID has really waylayed many people’s plans for clinical shadowing, for hands-on research, for volunteer experiences, and giving back to their community, I recognize that they’ve been limited. But outside of pandemic times, in general, I think if you’re saying that you have this very strong desire to be in medicine, yet many aspects of your application don’t show that you’ve actually spent much time with a physician, shadowing a clinic, or working with patients in some capacity, that can be a little bit difficult to reconcile.

Another thing might be when you choose your most meaningful accomplishments and applicants all have the choice of their top three most meaningful if you pick something that isn’t otherwise clear from the standpoint of an Admissions Committee member looking at your application thinking, “Oh, that’s strange. They only spent very limited time doing this, yet they named it.” If you can’t articulate coherently or convincingly why that should be one of your top three, that could raise a few questions.

I think a little bit to what I was saying earlier, it’s sort of the equivalent of putting another school’s name. For me, it’s more if the answer to why specifically the Perelman School of Medicine, why Penn, is so generic that it could literally just be cut and pasted into virtually anything, it does disappoint a bit because you’d like to think that individuals could be more thoughtful about why they added us to their list. Is there something in particular that we offer that they’re hoping to take advantage of? That’s what we want to hear about and see that passion.

How do you view virtual shadowing? [25:14]

Virtual shadowing isn’t, unfortunately, going to ever parallel the real thing, but I think it does work for some settings where it’s primarily an outpatient ambulatory setting and patients are being seen for follow-up of a chronic condition, or perhaps a new diagnosis of something that will be a chronic condition through formats that are HIPAA-compliant, and of course, appropriate for patient-provider interaction, a medical student or an undergraduate interested in medicine with all the right clearances could listen in and participate. Of course, they’d be introduced to the patient, the patient would give consent, but they could learn a lot from this interaction between the provider and the patient and what kind of considerations go into care in this telemedicine care format. I think there’s still value to shadowing in that regard, but a lot of the procedural, hands-on type of stuff, you’re not going to be able to reproduce.

What process does an application go through at Perelman when it is verified by AMCAS and somebody submits a secondary? [26:33]

Once they’ve completed a secondary and their application is considered complete, they all undergo an administrative screening. The next step is screening by members of our Screening Faculty Committee. That can range anywhere from 12-16 faculty from Children’s Hospital of Philadelphia and the Perelman School of Medicine. These are individuals from various different academic departments within the medical school and they all take certain groups of schools so that from year to year, a given faculty member on our screening committee is accustomed to seeing, let’s say individuals from all California schools, for example, or this subgroup of schools. So they develop some familiarity with these undergraduate schools of training and they’re able to more comfortably navigate the transcripts, et cetera because they’ve seen them before.

Once that screening is complete, then I, as the Associate Dean of Admissions, review all of the screen scores, the comments, and determine who obtains an interview. Once the interview is complete – we do two interviews, one is by a faculty interviewer and another is by a student interviewer, one of our students, and it could be anywhere from a first-year student to somebody doing a year out or in their last year. We use all of our students who are interested in interviewing. Everyone, of course, undergoes interviewer training, etcetera.

After the two interviews and the scores are in, the applicants are all reviewed by the Committee on Admissions. The Committee on Admissions is comprised of a large group. It’s actually 25-ish faculty and 10 student members. Not all of the student members have votes. Only five of them have votes. The majority of the votes are standing faculty because that’s compliant with LCME rules on admissions. The Committee on Admissions decides either to advance the applicant to the Executive Committee, to recommend waitlist, or to essentially not advance them to the Executive Committee. The Executive Committee then meets regularly. That’s a much smaller group. I chair that committee. That’s a group of seven and we meet regularly to help build the class from the recommendations of the Committee on Admissions. Then we usually process the final decision about accept versus waitlist versus not accept in March of every year.

March is when people typically get answers from Perelman? [29:22]

That’s right.

Does Perelman consider letters of intent or update letters, and if so, at what phase of the application process? [30:20]

We consider updates and letters of intent from applicants at any point in the process through the applicant portal, so they can use the document upload tool. That’s the best way to make sure that whatever they’re sending us gets placed in their file, where all committee members would be able to see them. I’ll just mention, we don’t cap the number of letters of recommendation although AMCAS limits it to a total of 10 through their letter writer system. If there are later unsolicited letters of recommendation that are sent along, they can be helpful because again, we have a holistic review process, so anything that’s sent and added to the file is fair game for consideration. An example might be, say, an applicant started a new role or had some new award or new honor at the beginning of the admissions cycle, but the supervisor or PI for that wasn’t quite ready to write that letter at that time. Maybe they want to write it later when they have more insight and more experience working with them and so there might be a delayed letter of recommendation and so if it’s sent to us and it’s official, we will include it in the file.

How do you look at candidates who have a criminal record or an academic infraction on their record? [31:50]

We recognize that there can be myriad circumstances that could lead to that, so as a committee, we will always review the circumstances and the details that are provided by the applicant. What was the infraction? How has the applicant learned from this experience and this error and what’s been done to remediate, if needed, that behavior or to prevent further infractions in the future? We’re looking for a sense of what went wrong and how we all can be reassured that it wouldn’t be a recurring issue.

How was Perelman’s application volume this year so far? [32:40]

From 2019 to 2020, we did have some growth. Then that pandemic year 2020 to 2021, that’s when we saw around a 20% increase and many schools were in that ballpark in terms of increase in applications. Compared to that major jump, again, we had been relatively stable the five years prior to the pandemic, so compared to the 2020-2021 jump of nearly 20%, this year, we’re still up compared to pre-pandemic time, but we are down from last year, so we’re more on the order of being up by 5-7% compared to our usual baseline, which is still a huge amount.

On a forward-looking note, what advice would you give to med school applicants planning to apply to Perelman in 2022, this summer, or even thinking ahead to the following year? [33:44]

First and foremost, we love hearing and knowing that these folks are out there with these aspirations and an interest in medicine. Making sure you have that local mentor/advisor or groups of mentors/advisors who are supporting you along the way is always critical. In terms of just some basic nitty-gritty, you definitely, if you can, want to try to get your applications in early. You want to, together with getting it in early, still, however, proofread everything, proofread it again and again, with a trusted source as well. Then I would encourage everyone to always make sure and review the MSAR. Make sure each school’s requirements for the application are clear. There can be some nuances and you wouldn’t want to make some silly oversight, so definitely, for every school you’re considering, check that you’ve met all the requirements for that particular school so you wouldn’t be left out on a technicality. That’s generally across the board.

As you think about where you’re applying and where you might ultimately interview or end up, you really want to think about where you want to be geographically, where you want to train, perhaps in a more urban or more rural environment. Would you prefer a larger or smaller medical school program, one that’s part of a huge university or one that’s not part of such a large university? What might work best for you in terms of a particular school that has a greater emphasis, say, in certain areas of research or certain clinical areas of excellence? Most schools do, of course, offer everything, but there might be certain aspects that that health system is known for, or their particular associated research enterprise is known for, and so just giving some thought to that. Not to the extent that it would rule schools in or out entirely on its own, but I think it’s the totality of all these considerations that one might consider as you’re going through the application process in the years to come.

Are there any questions you would’ve liked me to ask you? [36:03]

I think you hit on a lot of them and I tried to make some points along the way that I wanted to convey. Again, I’ll just say that while we are all living through our own incredible challenges right now with the pandemic and all of the aspects of our lives that it has impacted, there is something to be said about being engaged in patient care and being able to take care of people during these most vulnerable times that is continuously rewarding.

For those of you that are contemplating and seriously considering medical school applications, I commend you and I applaud you, and I encourage you all to try and find ways when you can, even during these times where the opportunities might be limited. Try and reach out to your advisors and people who may know somebody else within the network to see how you can get more involved, whether it is through virtual shadowing, whether it is through other community service experiences, whether it is through vaccination clinics, whatever it may be that allows you to keep busy and reengage in this commitment because it’s not just about, it looking good on the application, it’s about making sure that you are committed to this path and giving you that additional experience under your belt so that you can feel better equipped for the application process.

Thank you again. Dr. Vapiwala, I think we’re almost out of time. You’ve been very generous with your time, and this has been an absolute pleasure. Thank you so much for joining me today. Where can listeners learn more about Penn’s Perelman School of Medicine? [37:27]

Absolutely. Again, thank you for having me.

I encourage everyone to go to med.upenn.edu and look us up for any additional information or get in touch with us if you need something that you can’t find there.

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