Active Learn and Admissions at UVM’s Larner College of Medicine

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All About UVM’s Larner School of Medicine [Show Summary]

The University of Vermont’s Larner School of Medicine’s new Associate Dean for Admissions, Leila Amiri, shares the hallmarks of the program, including its active learning curriculum and mission centered around respect, kindness, and cultural humility.

Interview with Dr. Leila Amiri, Associate Dean for Admissions at UVM Larner School of Medicine [Show Notes]

Welcome to the 494th episode of Admissions Straight Talk. Thanks for joining me. Are you ready to apply to your dream medical schools? Are you competitive at your target programs? Accepted’s medical school admissions quiz can give you a quick reality check. Just go to accepted.com/medquiz and complete the quiz, and you’ll not only get an assessment but also tips on how to improve your chances of acceptance. Plus, it’s all free.

Dr. Leila Amiri, UVM Larner’s new, as of June 2022, Associate Dean for Admissions, comes to Larner from the University of Illinois College of Medicine, where she was Associate Dean for Admissions and Recruitment. Previously, she was Director of Admissions and Financial Aid for the University of Chicago Pritzker School of Medicine. She holds a Ph.D. from North Central University and an MA and BS degree from the University of South Florida. Amiri is a member of the Association of American Colleges Advancing Holistic Review and Alignment Working Group, National Chair of the AAMC BA/MD Affiliate Group and National Chair for the Committee on AAMC Professional Development Initiative. Dr. Amiri was also a guest last year in her previous role, and it’s a pleasure to have her back on Admissions Straight Talk.

Can you give us an overview of UVM Larner’s College of Medicine’s program focusing on its more distinctive elements? [2:12]

I’ll be happy to. At Larner College of Medicine, we have a big history of training medical students. We’re actually celebrating our bicentennial, so the class that’s meeting for 2023 will be the 200th class that we’ve seated. We’ve come a long way in terms of the educational model. We’re most known for our active learning model. Students are really at the center of our learning model and its active, student-centered learning all based on educational pedagogy and adult learning principles. There’s a lot of community engagement with our students here and at our clinical sites which are in Vermont and in Connecticut.

What does active learning mean in practical terms? [3:11]

When you look at educational philosophy and pedagogy, adult learners need to really be invested in what they’re learning. Not only do they need to be invested in what they’re learning, but they also have to find meaning and value in it. They have to be at the center of constructing the information.

There’s very little lecturing that happens here for our students. There’s time that they spend on their own before they come to class. Think of a flipped classroom model. They spend a lot of time on their own looking at basic information and then when they join us in the classroom setting, there’s a lot of group activity, engaging with their peers, and working through problems.

It’s not completely problem-based learning, but there’s problem-based learning, case-based learning, and team-based learning. We have all of these different models where students are not sitting there just as recipients of information, but really they’re constructing the information with each other as they’re going through the different phases of their learning.

They’re getting cases, they’re getting problems, and they’re working in teams. When you think about the way these things look, they become progressively more complex and progressively more sophisticated in terms of the case that they’re engaging with. For example, they might not receive all of the information that they need, which is typical in a clinical setting. They will get a patient scenario and there’ll be some gaps in that knowledge. They’ll have to identify what those gaps in the knowledge are. They’ll have to figure out a way to find it. The students are really working through the information that they would need to have in order to solve the problem that’s in front of them. That problem is typically a clinical case that they’ve engaged with.

How does Larner’s location in Vermont influence the education? Is there more of a focus on rural or wilderness medicine at Larner? [5:24]

We are the only medical school in the state, so we have a commitment and an obligation to our community here in the entirety of Vermont to provide care. Everyone in the state looks to us for their healthcare. That’s part number one.

Part number two is there are ample opportunities for rural health, wilderness medicine, and global health as well. Our Connecticut campus has a really robust global health program with opportunities for students to visit and learn from healthcare providers in different parts of the world to help us understand how to take care of individuals better.

How does the focus on active learning influence admissions? [6:20]

Right now in our current admissions model, we have an MMI interview process, so there are standard MMI questions that you would see. We also have a team-based learning station where the team-based activity requires individuals who pretty much don’t know each other to work together as a team over the course of 20 to 25 minutes to solve a problem that’s really designed to be so hard that it’s not solvable, but the intent is to get them involved with looking for information that’s not available to them for what we’ve provided. They have permission to go online to take advantage of other resources that they have to solve this problem and to work with each other to figure out what this is. We assess students on their curiosity and their openness to finding other sources, and obviously in working with each other because that’s what we’re expecting of them when they show up on the first day.

As we’re evaluating students during the screening process, we look at their grades just to make sure that they can handle science and to see what their educational stamina looks like. In addition to that, we look at the breadth, depth, and scope of the types of classes that they’ve taken. How curious is this individual in their educational curriculum? Is what they’ve taken the basics that you would take for a micro-degree, or are there other interests that emerge that would suggest that they have a curiosity that goes beyond, for example, their interest in science or their interest in being a healthcare provider?

Those are some of the ways that we tap into students’ preparedness and readiness for active learning. I’ll give a preview to your audience and say that we will be changing the secondary next year so there will be questions in there that relate to students’ openness and their understanding of active learning and how it fits with what they’re interested in learning.

Do you like to see that people have worked in teams, whether it be in sports or the arts or something else? [8:35]

We do like to see that, and I can say that every other med school where I’ve been likes to see it too. This is my fifth stop now. Right now, we don’t specifically have a question on that, but that is something that we look for in the application. It’s not something that’s graded in our screening process currently, but it does come up during admissions committee discussions.

Does UVM screen secondaries before sending them out? [9:17]

We don’t. We release secondaries to every student who puts us on their AMCAS application. My recommendation would be to take a peek at our average metrics and really decide if it seems like this is going to be a good option for you or not.

What do you hope to glean from the secondary, especially next year that you don’t get from the primary? [9:47]

If it’s okay with you, I’ll share with you what’s in the secondary now because I’m not sure I’ll remove what we have.

Right now, we ask students to share with us an experience that they’ve had with someone that’s different from them and what they learned from that. Our model is one of inclusivity and cultural humility so it’s really important for us to know that the individuals we invite to be part of our community have had opportunities to engage with others.

It can be a person who’s in a different ethnic or racial group. It could be in a person who’s from a different part of the country. It could be a person who speaks a different language. We’re not looking for anything in particular, just someone who is different than the individuals you generally engage with.

Reflection is most important to us. The experience itself isn’t that important, it’s what the individual has taken away from it. We want to know about challenges that an individual may have faced during their life and for them to share a little bit about that with us as well. What we’re hoping to see is really reflection, resiliency, and how individuals learn and recover from obstacles that they may have dealt with.

What is a common mistake that applicants make in approaching the primary and secondary applications? [11:22]

I think a common mistake that I’ve seen over the years that I’ve done this kind of work is that the applicant doesn’t treat the personal comments as personal comments. It becomes a space for them to revisit experiences and tell us why they’re a good choice to be a physician and recount their degree, research, and volunteer experience. That’s just a waste of 5,300 characters because it doesn’t give us any additional information. We’ve already read that in the experiences section.

The challenge with the personal comments is that some schools don’t read them, and some schools read them very thoroughly. I think applicants need to think about the school that reads it thoroughly. If the school isn’t going to look at it, that’s fine. I mean, it doesn’t hurt your application in any way if they ignore that. Where it hurts is if a school looks at it and if they haven’t done a good job there.

It’s important to help schools understand something about you. I know, generally, students feel they need to explain why they want to pursue medicine, and it could be that or why you’ve done all the things that you’ve done. Collectively, there should be understanding that a person has from having volunteered and having done the research, and having had leadership in all of those things.

The second one is oftentimes really strong candidates get lost in the stories. It’s story after story of things that they’ve experienced in the clinical setting, and there’s none of themselves in it. It’s all about Mr. Jones and Mrs. Smith and the little girl whose hand they held, which is all really sweet and touching, but at the end of the day we don’t know anything more about them other than these experiences that they’ve had. Personal comments are going to be really important. That’s a mistake that we often see when the personal statement doesn’t add anything to their application.

I think in the experiences section, applicants often shortchange themselves by not telling us what they got from the experience. What did you take away? Think about what you got from that experience.

I don’t think the little bits and pieces of work here and there help either. You know, listing 20 hours here or 15 hours there just to fill up the 15 boxes doesn’t help the application. I think if there’s an individual who’s had opportunities that have been short in duration, somehow they should collect those and have a volunteering category that comes up to 125 hours. You can say, “I worked at these five different places, and collectively, this is what I took away from that,” because the little bits and pieces are not really a good look for the primary application.

On secondaries, the big mistake is applicants don’t answer the question that’s being asked. Generally, what the secondary is asking for is reflection. It might be different things. A common one is, “How are you going to add to the diversity of our program?” or “What was a challenging experience?” or “Who are the people that you’ve engaged with?” and they’ll say, “I engaged with other students in my class that were from another country that’s halfway across the globe, and it was so much fun engaging with them,” and that’s all they’ll say.

It’s not an issue of who did you interact with, but what was your takeaway? Not giving the takeaway or putting a lot of cliches in there hurts the application a lot more. I invite applicants to be very thoughtful about the tone of their statements. I know that this is a personal statement, and we’re asking you to talk about yourself.

At the end of the day, we’re looking for a service-oriented person. While we know you overcame obstacles and while you did your best and became captain of the soccer team, at the end of the day, bring it back to others that you were serving and that you were in service to. Those are some of the things that I have seen over the five institutions where I’ve worked. It’s been the same, and I’ve been at very different types of places. Those have been things that have ruffled some feathers on the admissions committees.

Your answer was fantastic. I think the key point is if applicants are not thinking deeply about their experiences, then they’re wasting their time to a certain extent, and your time as well. [16:28]

Oh, absolutely. We often hear from students about underage drinking or being caught with marijuana. What did you learn from that? Oftentimes we’ll hear, “Well, I wasn’t the one drinking.” Or students will share very traumatic things that have happened to them, and they don’t help us understand how they’ve overcome it. You’re exactly right, it is being superficial about things.

Remember that we don’t have the privilege of sitting across the table from them when we’re reading the application. We can’t ask follow-up questions. We have MMIs so even if I wanted to, I couldn’t even invite them for an interview because it’s an MMI, and that’s not one of the stations.

Just treat it as though this is your one shot at being able to explain what’s going on. A bunch of people who are sitting there in judgment of you are going to read this and make a decision so it has to be as clear as possible.

What is the virtual interview day like at Larner? [18:03]

We ask students to join us around 11:30 EST and we spend the first almost hour giving a little bit of information about the program. We talk a little bit about our resources, the active learning modules, some of the modalities, and some of the contexts where learning will happen for them. We also cover the institution and our two different campuses.

Then we jump into the interview. So there’ll be MMI questions, and then students will come back, we’ll debrief on the MMI, then we’ll go into the team-based activity. Then we have a student panel, and we invite our applicants to submit their questions to us ahead of time so that our student panelists will be prepared for their questions. We take questions live as well. Then we wrap the day up with a little bit more mechanics of the medical school deadlines and what we do with updates and things like that. It’s a little bit of a long day only because we have the over-hour MMI and then the 30 minutes of the team-based activity.

How do you view letters of intent and update letters at any time during the process or correspondence from applicants as well as the wait list? [19:27]

I will share what our model has been historically and I will share what my perspective is and what the future will be.

Historically, our model has been to invite individuals to submit updates if they wanted to, but that was not communicated back to the admissions committee. I feel that if a student has an update, we should hear it if they think it’s important enough for it to be shared with us, particularly if they’re wait-listed.

Telling me, “I’ve continued to volunteer where I was, and I continue to enjoy helping the elderly at this nursing home,” isn’t a substantive update. It’s a continuation of what was happening. But if there is a new role, a publication, a grant, or new courses that an individual has taken, if there’s something new that’s substantially different than what we had seen, I invite our candidates and our applicants to submit it to us. This year, I’ll ensure that they do get back to the admissions committee. Starting next year, we’ll have a formal process where it can be added to their application and it’ll be available for the committee to review.

There’s this meme out there that says if you don’t have an interview invitation by Thanksgiving, you’re not going to get one. When does Larner stop sending out interview invitations? [20:58]

My interviews will end at the end of February, maybe the first week in March. I would say if you haven’t heard by February, it’s probably unlikely that an interview will be offered from our institution. But Thanksgiving is really early. It has to be proportional to the primary and secondary application deadline. Right now, I’m sitting on over 8,000 applications and we haven’t screened them all. We’re not going to interview until we’ve had an opportunity to screen a large proportion of those applications. Everyone has a fair chance of being seen, and we’re certainly not going to close out the interview invitations before our primary and secondary deadlines.

How would you suggest applicants prepare for their interview? [22:03]

Because we’re solely an MMI interview, what I would say is there’s really not much preparation that a student can do for the MMI. Really, the MMI is designed to pick up on soft skills and how you are as a person, how much empathy you have, what type of team player you are, if you have strong communication skills. There’s really no way to prepare for that. It’s just a matter of being comfortable and confident knowing that this school would not have invited you for an interview if they were not seriously considered as a person they really wanted to join. I would say the fact that you are given an interview is not a test run. Half of the day is designed to recruit you.

I actually call our interview day “recruitment day” because we’ve done the screening. We know that we want this individual here with us. The activities of the day are meant to recruit and to make sure that applicants can engage well. If we have a team-based activity, for example, and the person is talking over everyone or being disrespectful to their teammates, it really doesn’t matter how fantastic the application was. We’re seeing how they are in a team setting. That would be a reason to, for example, not extend an acceptance to that individual because that’s how they’re going to be when they show up.

For the MMIs, there are no right or wrong answers. Be comfortable with your opinions. Give them as they are. I guess it’s easy for me to say because I’m not the one applying for acceptance to med school, but it’s okay if who you are as a person doesn’t fit well with that school because it’s too much energy to try to maintain yourself as you are, as a person at a place that doesn’t accept you as who you are.

For schools that have one-on-one interviews, I’d say do your homework and see what they have available to you. If they don’t have an MD/MPH, don’t ask about it because they don’t have one, that’s a red flag that you are not prepared. Have some good questions. Have some real questions. It’s okay if it’s on their website. You can say, “I saw active learning all over your website. What does that really look like?” Really be interested in what they have to offer and be interested in the person that’s interviewing you as well.

What’s the role of the CASPer in evaluating applicants to UVM Larner? [24:51]

For us, CASPer gives an additional value of a person. We’ll look at those things that the committee has determined are important for them to have in terms of experiences. We want students to have a reasonable CASPer. If it’s a -2.75, they’re on the wrong end of that continuum. We’re looking for CASPer scores that would suggest that the person is empathetic, a good team player, has cultural humility, and those soft skills that we’re looking for. It’s not a make or break for the application, but it is something that we look at if a person has a really low CASPer score. We’ve seen that. They come into our interview process and they don’t do well on the team-based activity so generally, we will not extend an invitation.

What makes an applicant jump off the page for you in a positive sense? [26:17]

It’s an individual who’s self-aware. If they had some hiccups along the way, they address them head on and they help us understand what happened.

What I tell students is that your application has to make sense. When I read the personal statement and you talk to me about taking care of underserved populations or that you’re interested in rural communities, everything that I see in your application is urban, it doesn’t make sense to me. A personal statement needs to be supported by the experience and activities that the individual has done. The letters have to be from people that know you and that know you well. One of the first changes that we had in our letters process was to give three academic or professional letters from people that know you. While you can’t say how great you are and why your being in the lab changed everything, your PI certainly can.

Together, those things help a person emerge. We’re looking to someone who shares our mission which is to be curious, excited about learning, have humility, and want to be part of the team. Those pieces all have to be together. We’re not shy about asking for things that we want. If there’s something that isn’t there, you can share it and the application.

When we ask about COVID-19, for example, don’t give the standard response. We’ve seen COVID-19 statements that have really been remarkable, that have really helped us understand what the individual has dealt with. We know that you couldn’t go into the lab and that you couldn’t volunteer. Many of the applicants have been very thoughtful during this process, or they’ve picked up a new skill or something like that. That’s a good way to mention those things

What role does connection to Vermont play in the evaluation process? [29:43]

It’s an important component for us. So much so that we invite our Vermont candidates all during the same days and they all go to the committee at the same time. We get less than one hundred applications from our state, somewhere between seventy-five to one hundred. We’re a low-population state of less than 700,000. The number of applicants that we get from Vermont is small. We interview as many as we possibly can and we make as many offers as we possibly can. We do lose out to neighboring states for a variety of reasons but we do ask about ties to Vermont. That’s part of the system that we have in place. For anyone who declares Vermont residency, we actually have to send that application over to the registrar’s office and they’ll approve it or not.

It’s not just based on the AMCAS application. In admissions, we take it at face value. If a student indicates that they’re a Vermont resident, we accept that. We ask in the secondary and if it’s a yes, then a box opens up and they’ll tell us what their relationship has been. Even having vacationed here for at least several months over the course of a year is enough for us to understand that the individual has an understanding of what life in Vermont might be like because it is very different than the urban communities that students might be living in.

How do you view prerequisites taken at a community college? [31:29]

We’re fine with them. I’m the product of a community college. The admissions committee doesn’t worry at all about community college courses. These are courses that students have taken, they’ve done fine and then they’ve moved on to other classes. We don’t even bother with it or say “These courses were taken at a community college.” We just want to be sure that the courses were taken.

How do you view shadowing and virtual shadowing? [32:01]

Shadowing is interesting. We had an admissions committee meeting yesterday, and we were talking a little bit about how shadowing is generally a passive experience. You follow a doctor around for a little bit of time and you get what you get from the experience really based on how much the physician engages the student. How often do they turn around and look at you and involve you in the discussion with the patient? That’s piece number one, that in and of itself it’s a rather passive experience. Number two, there’s a lot of privilege associated with that. Are you at a well-resourced institution that has a place or a connection that allows you to get the shadowing experience? Are you from a family of physicians that allows you to have that experience? Because of these things, we don’t put too much emphasis on shadowing. If a person has it, that’s great, but we don’t ding a candidate if they don’t have shadowing experience because we know it’s hard to come by, particularly if you’re at a small liberal arts college and there isn’t really much around you that you can participate in.

How we differentiate that from virtual shadowing really depends on what’s in the application. Some of those virtual shadowing experiences aren’t really virtual shadowing experiences. It’s a physician sitting there talking about what it was like when they got into med school 35 years ago and they talk a little bit about their daily experiences. If that’s what you had, it’s not really giving you what you should have had from the shadowing experience. If you participated in virtual shadowing and you got something out of it, let us know what that was because telemedicine is a reality.

If you’ve happened to have in-person shadowing and not, what’s the difference between that? I was listening to a podcast one day and the physician was talking about how she felt telemedicine was a disadvantage to her because she only sees the person’s face and not their gait or how they’re moving their hands. That’s a unique insight. What do you get from it and what do you not get from it? What are the benefits of it?

Be reflective. Let us know what you learned. That’s perfectly fine. We will not take away credit from anything that you’ve done unless it’s criminal, obviously, that’s a whole different story. But for anything that an applicant has done intentionally to inform themselves of something, there’s credit there because you’ve learned from it. Let us know what you learned.

If you were a premed student, traditional or otherwise, planning to apply in 2023 or 2024, what is one thing you would be doing to prepare yourself for medical school? [35:13]

I feel that higher ed has been dismissive of the trauma that our learners have faced because of the pandemic. There’s been trauma associated with that at different levels and it’s going to be different for every person. I would say building resiliency and flexibility and knowing that you have that and sharing that you can do that is really important.

We’re hearing a lot from our student affairs colleagues that students are less tolerant of change and flexibility. That’s an important thing for us to know that you’ve developed and that you’re aware of it. I think that’s going to be one important thing. That’s in all aspects of your life as a medical student. It might be that today you have to come in or you don’t come in, computers aren’t working, don’t panic about that. Don’t get agitated about those things. Be open to that.

I think the other piece will be the idea of being inclusive and accepting. As we continue to make medical education more accessible to different groups in our society, what does that mean? Begin to develop that type of learning portfolio that will allow you to take an education however it’s being delivered to you. Work on your humanism and your soft skills. Those are types of things that I would encourage students to think about and how you can communicate that with medical schools.

What would you have liked me to ask you? [37:48]

I would’ve liked you to ask me about our professionalism mission because we have a professionalism mission that I haven’t seen anywhere else.

Professionalism is this nebulous thing. For the people who are in the work environment, it’s one thing that a supervisor can ding a person on and they’ll never know what they mean if they say the person is not professional. What does that mean? When you think about the different generations that are involved in medical education, the people that are close to retirement, the people that are active right now, and then the young learners that are coming in, it’s always difficult to describe that.

I tell med students the day before orientation, “You’re just an accepted medical student. The day you start medical school, you become a member of this profession and are now obligated to all of the things that come with being a member of this profession, ways of being, cultural norms, ways of speaking, ways of conducting yourself, ways of presenting yourself.” What are those things?

When I interviewed at UVM and I had my one-on-one with the Dean, we all had a little card that described the professionalism mission on it. It’s based on the three tenets, which I’ve mentioned, respect, kindness, and cultural humility. Those are the ways that we as members of the Larner College of Medicine are expected to conduct ourselves in all interactions with each other and anyone that we come in contact with. I think we all know what that means. We know what it means to be treated with kindness so we know how to treat others with kindness. We know what it’s like to be treated with respect and what it means to treat others with respect. And cultural humility is the acceptance of our differences.

That’s how I’ve been received by everyone that I’ve come into contact with. I think that really sets the tone for applicants to know what the culture is. We tell students, “Go to the place that has a mission statement that’s in alignment with yours. Go to the place that has a culture that is aligned with the culture you’d like to be in.” And then their fair question is, “Well, What is that? I look at your mission statements and you’re all the same. Everyone wants to do research. Everyone wants to provide compassion to care and be excellent in leadership.” Our professionalism statement really defines that for us. If we get tense or if we’re unhappy, we remind ourselves how we’re supposed to conduct ourselves.

Dr. Natalie Feldman, our Director of Medical School Learning Environment, looks for instances where students feel that there has been mistreatment and they discuss that with her. She also created a portal for students to share accolades. We have under 500 medical students and she received almost 1,400 of them this past year. Over half of those were for our faculty, and the rest of it was for residents, fellows, other UVM hospitalists, and other individuals that they came in contact with. There were 1,400 instances, which is an average of three per person. I love to see these instances where our community exhibited respect, kindness, and cultural humility.

Where can listeners learn more about Larner College of Medicine at the University of Vermont? [42:44]

You can visit our website at med.uvm.edu. Not only can you see information about admissions, but really the medical center, the medical school, and a lot about our community engagement as well.

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