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If you want to know how much of BU medical school’s recent $100 million gift it intends to use for scholarships, or what happens to applications to ensure a genuinely holistic process, or what its associate dean of admissions wants to see in students read on! In this interview, Dr. Kristen Goodell, associate Dean of Admissions at Boston University’s Chobanian and Avedisian School of Medicine answers all these questions and more.

Welcome to the 541st episode of Admissions Straight Talk. Are you ready to apply to your dream medical schools? Are you competitive at your target programs? Accepted’s Med School Admissions Quiz can give you a quick reality check. Complete the quiz, and you’ll not only get an assessment, but tips on how to improve your chances of acceptance. Plus, it’s all free. 

DON’T MISS Linda Abraham’s 2021 interview with Dr. Kristen Goodall: All About BU School of Medicine, a Social Justice-Minded Med School [Episode 405].
Click here for a full transcript!

Today’s guest, Dr. Kristen Goodell, associate Dean of Admissions at BU’s Chobanian and Avedisian School of Medicine, earned her bachelor’s degree at Colby College and her MD at the Columbia University College of Physicians and Surgeons. She completed her residency in family medicine at Tufts and has been a practicing physician ever since 2007. In addition, from 2012 to 2017, Dr. Goodell served as a Director for Innovation in Medical Education at the Harvard Medical School Center for Primary Care. In 2017, she was appointed Assistant Dean of Admissions at the Boston University School of Medicine and became Associate Dean in 2018. 

Dr. Goodell, welcome back to Admissions Straight Talk. [1:57]

Thank you so much. I’m happy to be here.

Can you give an overview of Boston University’s Chobanian and Avedisian School of Medicine program focusing on its more distinctive elements? [2:03]

Sure. So the most important thing to know about BU School of Medicine is that we are a social justice medical school, and you see our social justice focus come through in many different ways. It is woven into the curriculum quite explicitly. You see it in what our students do with their free time. You see it in the particular areas of expertise of our faculty, and of course it’s in the patients that we serve at our primary hospital, which is really on the same campus with the medical school.

Now I normally ask what’s new and I will ask what’s new, but the obvious thing that’s new is the school’s name. So why don’t we start with that; then you can tell me what else is new in addition to the name. [2:44]

Sure. So last year we got a new name for our medical school along with a hundred million dollar gift.

That’s a big gift. [3:00]

Right. And it was a wonderful gift and in my mind, perhaps the most exciting thing about that is that $50 million of it, so half of the gift was specifically earmarked for financial aid. Ever since I have been here, we’ve been really focusing on increasing the amount of scholarship aid that we have available to give students, and the maximum scholarship award has almost doubled just since I’ve been here. It’s gone from $30,000 to $55,000 per year, and that’s just only for scholarships and it’s need based. And so that increase has been really remarkable, but now we know that it’s going to increase even more. So I think that is amazing. As a private school, we know that our tuition is high. As a school that is in Boston, we know that living expenses here are high. So anything that we can do to offset the cost I think is really good, obviously for our students and makes us a more accessible institution.

Do you think you’re going to get to a point where you can make it a free medical education? [3:57]

There are intermediate goals before we get to completely free, we would love to be able to meet the full demonstrated financial need of our students. I think that’s a sooner goal than making it free completely. And I think I feel comfortable with that. I feel good about giving resources to the people that need them the most.

What percentage of the student body is currently getting some of that scholarship money? [4:22]

That’s a good question. I don’t know the answer to that. Probably a little bit less than half.

All right, great. I just thought of it. So what else is new? That’s pretty big. [4:33]

No, we actually also have another really big thing since we last spoke, which is that we have really reorganized our curriculum. So we have moved completely away from lectures and towards a flipped classroom team-based learning format for the first two years, for the pre clerkship phase. And we had already redesigned the doctoring course, which is the clinical skills course, and that has been great and that gets tweaked every year based on feedback, but basically stays the same. But now our big foundational basic science work is all done in the format of small group discussions, problem solving, workshops, labs. It’s very hands-on. And this means some important things. It means that first of all, attendance is required, but it also means that when you come to class, you’re never just sitting and listening. You’re always discussing problems or discussing cases with the eight team members at your table or your table is debating what’s the correct answer with another table and trying to figure out why or you’re interacting with the faculty as they put questions on the board and invite you to answer using a clicker to make sure that people have understood the foundational knowledge.

So it’s really exciting. Basically the way the curriculum happens is that instead of coming to lecture and having the content delivered to you by a professor that’s standing there, which frankly, that’s what we were doing before, that’s also the way it was when I went to medical school in a year that started with 19. So one might think that we could have updated, that we should update things since then. 

Now the content is delivered to students in the form of these self-learning guides, and they are online, and it has some reading materials, some videos, some animations, a lot of questions, like test questions. And some of the questions are study questions that are meant to be discussed with your classmates. So describe the process by which the three germinal cell layers, or whatever, reform to make the thorax or something like that. And some of the questions are more board style, multiple choice questions to make sure that you’re understanding the information in the way that it’ll eventually be presented on an exam and later on a board exam. So students have these self-learning guides, you have lots of time on your own to review those before you go to class. And then when you go to class, you have all these different formats that I talked about with some big group interactive sessions and some small group problem solving, and then some labs and some hands-on workshops and things like that.

You learn the material on your own and you apply it in class? [7:19]

Yes. Yep, that’s right. And it’s great. This is the second year that we have been doing it, and the students really like it. Lots of medical schools have made this change and it’s often very rocky, and I feel as though ours has not been rocky. Sure, we get feedback about it and we’re collecting and tweaking things. We’ve made some small changes, but generally people feel satisfied with it. Even the students themselves are able to realize that they have a really good depth of understanding. When faculty go and sit in these classrooms and listen to the types of questions that students ask, they’re three clicks more advanced than students were ever asking before. They just are asking much more interesting, thoughtful, deep questions instead of, I don’t understand why this thing belongs to this category instead of this one. It’s just much more in depth and thoughtful. And that’s good because that’s what medicine is. We don’t need to memorize stuff. We can look up stuff. If it’s just facts, we can look them up. But what we really need is for people who can think and solve problems and really understand how things work.

I would assume that it’s probably one of the goals or one of the ways you’re going to test it. But I would assume that the scores on the step two should go up. Clinical skills. [8:38]

Hopefully. It’s too soon to tell because, so the first class that’s had the new curriculum is just starting their second year, so they still have nine months before they take step one.

I noticed on the medical school’s website that you have 40 plus outpatient sites where students learn and practice their clinical skills in addition to in the classroom. How does this wealth of opportunity and the program’s location in Boston influence the educational experience of medical students at BUSM? And also that would be part of your focus on social justice. [8:56]

Yeah, it impacts students in a lot of different ways. One of the important and social justice related impacts is that we are affiliated with the largest network of community health centers in Massachusetts. So many of these outpatient sites are our own community health centers that exist in the different neighborhoods in Boston. Often they have a particular patient population that tends to go there. So for example, east Boston community health center is almost entirely Spanish-speaking patients. Really all of the doctors speak Spanish who work there. So that’s one really interesting thing. There are others that focus on other populations of patients. There’s Dorchester House and Codman Square, both of them have very large African-American populations. So we’re really glad that students have opportunities to work in those health centers for a number of different reasons. One is because you should have experience taking care of populations that are from a background different from you.

And also because these health centers are incredibly robust primary care sites that have many different kinds of services to support health that go far beyond what you might see either in a community office or in a hospital-based practice. So for example, the community health centers often have dental services at them. Some of them have food pantries. Many of them have integrated behavioral health. And these are just wonderful things for students to learn about, partly because you get to see a much broader scope of the things that are needed to help keep people healthy. And that’s good for all doctors to know also, because we really want people to be thinking about healthcare in that way. Those things should be our job also. So I think it’s a good influence in that way. So that’s one way that the health centers in particular are great and support our social justice mission.

The other thing is more general. We also have students, obviously all students do some rotations at Boston Medical Center, which is a big academic medical center. But we also have affiliations with some community hospitals. And that’s important too because not all doctors work in a giant academic medical center. And so we really want people to understand the whole scope of healthcare and not simply this is what we do in this big fancy hospital. And the other thing is that it’s always good to, when you are mostly or solely in one hospital, there are practices that hospitals do not because they’re best practice necessarily, but because they’re habit or it’s the way that the hospital has always done it. And this really even gets to, well, we always treat atrial fibrillation in using this particular protocol. And the hospital across town might use a different protocol. And so the actual fact is that neither one of those is known to be better. But if you only ever go to one hospital, you assume that that is the correct way and then you’re missing information. So it’s good to be able to see how healthcare is practiced, how medicine is practiced in a variety of different settings so that you can just understand the different way things are done. It helps build your toolbox for your own practice.

And the point you made about the big academic medical center, the big academic medical center might have resources that the smaller community hospital just doesn’t have. So how do you treat the sick patient who ends up in your hospital and you don’t have the super-duper whatever it is? [12:28]

Yeah. And also it’s so clear that in a big academic medical center, your typical patient is just much sicker, they’re more complicated, they have more things going on. It’s a bigger deal, it’s more life-threatening. But also that’s not most of medicine. There’s this really famous image from the New England Journal of Medicine that was published a long time ago, maybe in 1989, and then they redid it in the early aughts and it was like, wasn’t the sociology of healthcare. I can’t remember what they called it. But basically you start with 1000 patients, 800 of them experience symptoms, 600 of them think about going to see somebody about it, and then it goes on and it basically is, they show boxes, a big box of 1000 people and then on down, down, down, and less than one out of 1000 ends up hospitalized in an academic medical center. And yet that is where most medical training takes place. That does not make a lot of sense. You have a whole bunch of people being trained to do something that is not actually what their job is going to be. So it’s really important to have experiences in other settings so that you can get a better sense of how to do the actual job that you might have someday.

Can you touch on PISCEs, if I’m pronouncing it correctly? [13:47]

Yep. So PISCEs is the name of our new basic science curriculum that I was describing before, and I talked a little bit about the theory behind it. Some other things to mention about it are a little bit more nuts and bolts. So it is team taught. So in any given module, there are a small handful of faculty members that are running the show. It’s pass-fail is another really important thing to know about it. And they’re also learning progress assessments (LPAs). We used to call those exams, but now they’re called LPAs, and they happen every other week, which is good. The idea is that basically we’re basically trying to reduce the stress so it doesn’t feel to people like you’ve got this big giant exam. In fact, what you have is a lot of assessments over time. Another thing that we’ve changed, speaking of assessment, is that if you don’t pass an LPA the first time, you are allowed to just retake it and it doesn’t go on your transcript or anything else.

And that is because the goal, and really this was really built into the new curriculum, the goal is to get everybody to master the material. The goal is not to try to identify, okay, who’s really amazing and who’s on rocks. That’s not what we’re trying to do. What we’re trying to do is no, no, we want everyone to get to amazing. So fine. If it means you need to take it again, let’s do that. So yeah, so those are some other things about PISCEs, but it basically, it’s just the name given to the new course.

I wrote down it stands for Principles Integrating Science, Clinical Medicine and Equity. That’s the acronym, but it’s easier to say “Pisces”. I also noticed in preparing for the call that research is another important focus at Boston University School of Medicine. How important is it for applicants to have done research before applying to the school? [15:20]

Yeah, it’s not at all required, and we have people that come here that haven’t done research, but I would say that the majority of our applicants and the majority of our matriculates have done some research. We are a big research school, but what I would say is the reason that’s most important is because we really need people to be intellectually curious and we want everyone to be the kind of person that loves to learn and just wants to keep learning for their whole life. And so having done research is really evidence of that. And if there’s not research, then we want other evidence that you are the kind of person that likes to learn and tries to learn as much as you can all the time and is capable of doing so independently. And that’s really because that’s what medicine is. And the other thing about us being a big research school is it’s not so much that we are trying to churn out PhD researchers, but I will say that a thing that we do turn out a lot of that we feel very proud of is we have a lot of people that go into academic medicine.

And if you’re going to be in academic medicine, that means, okay, you’re going to work in a big academic medical center, you’ll be doing some research, you’ll be engaging with the scholarship, you’ll be furthering the discipline. So it’s not that we’re trying to identify the next great Nobel Prize winner, it’s more that we are trying to cultivate the type of intellectual curiosity and skill and interest that will help our graduates contribute to the practice of medicine in that way with that academic intellectual focus.

Now let’s turn to the application itself. What does a holistic approach to medical school admissions mean at BU? [17:19]

Yeah, so this is a great question. Everybody says that they do holistic review and then you’re like, what does that really mean? So I think that one of the clearest ways to describe it is just actually to describe our process, which I don’t think I did last time we talked because I’ve started some more and I’ve realized I think it’s kind of silly that medical schools don’t just tell the process. So this is what we do. First of all, a human reads every single application. Last year we had 10,600 and some applications and a human reads every single one. And I’m not even kidding. It’s really true. So the applications are reviewed and we use a structured rubric to make sure that each application is evaluated, that we’re looking for the same things in each application. And those things include things like research experience, clinical experience, your distance traveled, your mission fit, how well you fit with our mission.

So we look at a bunch of different things for each application… So there’s a special team of reviewers that does the initial reviews. All these people are part of the admissions committee. It’s about 12 or 13 people. So we all use this structured rubric. We read the applications, we evaluate them with each of those different metrics, and then we give a score to each of those different metrics. And then we tell the reviewers, do a big bunch of reviews like 20 or 50, and then at the end of that 20 or 50 go back and about the top 20, well, yes, your top 20%, you should designate those for interview. The next 20% we hang on to in case we have more time, time for more interviews because we never know actually how many people we’re going to get. And then the bottom 60%, we say, sorry, it doesn’t really look like you’re going to be competitive in our pool.

Then you get invited for an interview and a different person who is not the person that reviewed your application will be your interviewer. That person reviews the application with a slightly different focus.

But that interviewer is also a member of the admissions committee. [19:23]

Also a member of the admissions committee, also a faculty member, and they review the whole entire application. We don’t blind it. Some people feel as though holistic review is better accomplished if you blind the interviewers or certain committee members to certain aspects of the application. I actually think that makes it not holistic because then you are no longer looking at the whole entire application. To me, you’re trying to figure what you’re trying to figure out when you’re looking at academic metrics is how well-prepared is this person to do well in medical school? And so to do that, you need to understand the whole entire application.

Anyway, so the interviewer then reviews the whole application, conducts the interview, which is a semi-structured, very conversational interview. Takes about 45 minutes, and then they write up a report. The interview report gets appended to the application. And then we have two selection meetings, one in November and one in February. And the selection meetings, the whole committee comes together. We break up into teams of four or five. Each team gets a stack of applications. Again, these are not applications that you reviewed or interviewed, and then they go and they discuss each one of the applications and make a recommendation about whether to accept, reject or wait list. So that’s how we do our process.

And a couple of points to highlight there is that, again, you actually, I said a human reads every application, but actually by the time you get to the stage of having a decision made, you’ve often had four or five person hours of attention on your application between all these different people bringing a lot of people into the decision-making process. And the analysis really helps to mitigate bias. The particular type of bias it helps get away from is what would be positive bias for some people. For example, I went to Colby College and I was a coxswain on the crew team. So if I read an application from somebody that happens to come from Colby College, I’m naturally inclined to be like, oh, awesome. Yay, go team. But that’s not fair. Just because we happen to go to the same college that doesn’t make any sense, doesn’t make them better.

Or maybe somebody was on the rowing team at a different school. [21:35]

Yeah. That’s the kind of thing, it really shouldn’t influence your factor. But some of those things are going to happen some of the time, but that’s why we have a bunch of different people involved.

The other factor would be if somebody reads your application in the morning as opposed to in the afternoon and they’re tired. [21:50]

Yes, exactly. Or they’re tired or whatever. They’re in a bad mood. So that’s why having a bunch of different people involved with the process, and this happens occasionally that the selection team will say, this interviewer seems like they don’t seem as impressed with the candidate that we are. That seems funny. So that’s how the decisions get made. That’s what we mean by holistic. Again, everybody looks at that whole application throughout. It’s because we really believe that context matters, and we believe that the whole application matters. If you have a lot of strength in one area and you’re less strong in the other area, well maybe we decide that’s okay. We think that your strengths outweigh your weaknesses, relatively speaking.

I assume that most candidates are not strong across all metrics. [22:35]

Right. It’s more likely that people would be mediocre across all metrics. And actually those are probably the people that I feel the most bad for because I think they were just trying to follow instructions and do all the right things. And they did, but makes them not stand out that much.

They’re checking the box. 

I’m going to have to add that to my questions, what’s the process at your school for admissions? It’s a great answer. [22:58]

I feel as though I am very comfortable with our process. I think it’s a good process, and it’s perfectly fair for people to say, why on earth do you do that? But then I should be able to defend it and say, well, this is why we do it.

And it does also contribute to a more complete picture of every candidate from people with multiple perspectives. What do you hope to glean from the secondary that you don’t get from the primary? [23:25]

That’s a great question. So we have a couple of extra questions on the secondary that really help us understand who individual applicants are and what they bring to the table. And in fact, when I’m doing my initial application reviews, that’s actually one of the first places that I look.

Yeah, because we have, for example, a question that I can’t remember how it’s worded from the applicant’s side. We refer to it as our educational history question, but basically we say, if there’s anything else about your education that you’d like to tell us that you feel had an impact on you, please tell us here. And that is really helpful because sometimes somebody says, well, I… I’m trying to think of a good example.

I got sick, there was a family issue. [24:27]

Yeah. My parents were in the military and I attended or whatever. For some reason, family instability or my parents were in the military. And so I moved and I attended six different elementary schools in five years. And then people usually say something positive. So I learned how to make friends and get along with people, but it’s just helpful to get a sense of how things were. Or sometimes people will tell us about an interruption in their educational experience, not COVID. We have a separate question for that. Sometimes people use that space to tell us if they had a dip in their college grades, for example. And they’ll say, well, this was the semester that I was diagnosed with Lupus or whatever, I don’t know, depression, something like that. So that is really helpful to be able to put those things in context. And a really great example of that is students who did one of the special programs where they, for sort of academically talented students in underperforming high schools where they then get a mentorship and a big giant scholarship to go to some elite college.

Those students often take a little while to get their footing in college. And so they may have a lower overall GPA and an upward trajectory, or they may have problems with certain type of class. People use that space to explain what was happening. Then It’s so helpful for the context for us to understand. Oh, I see. Okay. The problem here is not, they can’t do chemistry. The problem is they were totally unprepared for college level chemistry because they did not have adequate high school preparation or a top-notch high school preparation or whatever it is. So that is really helpful. This is actually why we send every single applicant to a secondary application. It’s because we want that information before we simply look at somebody’s grades and say, nah, this isn’t going to be good enough. You know what I mean?

So we have all of those. And then we also have a question that asks specifically about our school, and we essentially say we take care of a mostly underserved and extraordinarily diverse population. What in your background or experiences motivates you to care for that population? While it is true that all applicants say what they think we want to hear, it’s also true that some people have had a lot of significant personal experiences that motivate them and some people have not. It’s very clear if people tell us about it, if they tell us about it, then we’re kind of like, okay, we’re taking it seriously.

It’s about context and fit to really boil it down. [26:56]

Yeah. To boil it down and fit is probably the best way to say it of all. Yeah, context and fit. That’s where we get that information.

Are you at all concerned about the impact of ChatGPT on the essay component of the application process? And how do you think AI will affect medical education. But with your flipped classroom, you’re kind of not giving students the opportunity to abuse AI, but in terms of the application process. [27:07]

Yeah, they use it. The faculty will use it. They’ll be like, quick, somebody ChatGPT this and see what we get. We’ll talk about it. So yeah, I am very concerned about ChatGPT and AI just in general. In fact, I have developed this terrible icebreaker question where I ask students what they think is going to be our ultimate demise. Is it going to be climate change or AI? So far, the students are really coming down on the side of climate change. But anyway. So yeah, I am worried about people using ChatGPT for their essays. What I understand from what I’ve read from various sources, including essays that are written by students, is that everybody is using it. They’re not so likely to cut and paste, but they are likely to get ideas from. And I think that bums me out because we really actually need people who can think for themselves. And I’m not crazy about having computers doing their thinking.

What a shocking revelation. [28:28]

Yeah. But I think that that part is probably here to stay and it probably is just going to be a change in how we humans live in the world, is that we get ideas from something else. So I think interestingly, the semi-structured faculty conversational interview becomes more and more important because that’s where we have a chance to talk to people and find out, what do you mean by that? Give me an example. Can you tell me about a time when…. That’s when we have a chance to do that on the fly and ChatGPT is not going to help you out there. So I think that’s going to be a little bit of an offset. And I think that students’ own personal experiences, I think so ChatGPT not this year, maybe in future years, but is not yet at the point where you can just put in your resume and your activities list and have it write a personalized essay.

It will write drivel. [29:26]

A very boring template, and then you have to figure out what to say about it. So yeah, I think I certainly do not hope for more sterility in essays, but the smart people will figure out a way to overcome it. I don’t know.

I completely agree that if an applicant uses ChatGPT to write their first draft, they’re probably using it the wrong way. And I haven’t tried this. I have played with it a little bit just to see what it could do. And I’m wondering if you were to draft something and say, edit this for me, please. That I think… [29:39]

Yeah, that I don’t know. Certainly it can do editing, but the problem is the editing will make it more sterile and worse of what it needs to be. The problem with ChatGPT is that it can write a passable and very boring essay about whatever topic you tell it to. And so the problem is that, one of the things I think is that you have to make it… There still is a little bit of imperative to make it stand out. I’ve been telling students for, I don’t know, I’ve been telling applicants for a decade, do not try to stand out in your essays. But I guess now I would be like, maybe try and stand out a little bit, but please not by writing me poetry. Don’t, just don’t.

Don’t do that. No. No imitations, poetry, anything. No.

What advice do you have for applicants, especially those who come from underrepresented backgrounds in medicine as they write their essays? Given both BU’s commitment to diversity and the recent Supreme Court decision. [30:40]

So applicants can and should tell schools all about themselves and their background. We are trying to figure out who you are and what you bring to the table. And so I think applicants should be as absolutely as open as they are comfortable being. And that is very clear. The Supreme Court, this is a free speech thing, applicants can tell us whatever they want. It’s up to us to follow the rules. And we are maintaining our commitment to diversity and are still trying to, and we know that it benefits the learning environment to have people with all different perspectives that are having a discussion. And so we are really committed to doing that still. So what we’re doing is we’re looking at the application and trying to figure out, okay, what’s different about this person’s perspective? I just had a great, I was teaching right before I did this, and had a great example. A student who, we were talking about depression, and in fact, there were two students in the group who had spent significant time in other countries as they were growing up. And they were chiming in with how depression is really viewed differently in their countries and how they were understood that it was really hard for people, but they wondered… We had this really lively and engaged discussion about, is there a point at which you’re being too accommodating? This is a discussion in my classroom.

Is there a point at which you’re being too accommodating that you’re making it too easy. At some point people just need to push themselves a little bit to get up, have a routine, go to work, et cetera and it would actually be better for them. So we were having this very lively discussion that the reason it was a good discussion was because we had people who had grown up in two other different countries who were able to really speak to their personal experiences and what they personally saw and how it changed what they thought about this particular medical topic. You have to have it.

Diversity. [32:59]

Yeah. So that’s exactly, we know that that is helpful. We want to maintain that. We are continuing to look for applicants who will bring a different lens to their study of medicine.

How does the Casper assist in your evaluation process? You described the process, but you didn’t touch on that, so is that a part of it? [33:12]

Yeah, it’s on the application. I would say at this point, it’s a very minor factor. We have found in our analysis that Casper scores, they correlate with our ultimate decision about whether or not to admit. They correlate with interview scores, but the correlation is pretty small and it’s not determinative. So I think we’ve found, okay, this could be useful information. We’re in the process of doing research to see if Casper predicts medical student performance. So far the research that’s come out about that has shown that maybe it does a little bit. There’s a trend towards it predicting performance, but it’s not a slam dunk. That’s my take home message about Casper. So I think we’re still in the information gathering and research process, and we’ll see what we see and if it turns out to be helpful, we will use it. We’ll emphasize it more, and if it does not, then we will probably not use it.

What is a common mistake that applicants make in approaching the primary and or secondary application? [34:16]

Probably the most common mistake is what we’ve touched on before, which is having a checkbox mentality. Oh, okay. They said I should do research. Okay, so all right, let me find a research lab that I can work in for this year, and then, okay, maybe I’ll see if I can get a paper out of that and then, okay, good, that’s done. And then they move on to the next thing. That’s probably the most common mistake that I see. I think that it’s really important for applicants to go ahead and do the thing that they love and are excited about the most. I think another common mistake is I really want applicants to listen to advice. I really do. But I think sometimes you can get caught up in what other people think is a good idea as opposed to what you love and want to do the most. And I think you’re always going to do better If you’re doing the things that you love and are excited about. It means when you talk about it and write about it, you will seem excited about it and enthusiastic about it. You’ll perform better when you actually do those things, have bigger impacts. So do the things that you love and then find your profession to suit those things as opposed to deciding on an ultimate goal and then trying to backfill with the appropriate stuff.

Right, don’t shoehorn yourself into a particular mold.

What makes for a great interview? You don’t have many interviews. It’s just one interview. One roughly 45-minute interview. [35:32]

Right, exactly. Interestingly, Casper and MMI scores correlate really well. So I’ve thought many times about whether or not we should switch to an MMI, and I don’t think so. There’s not a lot of evidence to say that it produces a better medical school class or more diverse. I think people feel as though it may be more objective, but again, there’s not evidence to say that it’s better for any reason. And plus we have the Casper score and that correlates. So I’m thinking, well, I think we got that information. So anyway, so what makes for a good interview is an interview that’s like a conversation. We have, again, as I said, it’s a semi-structured interview. So we tell our interviewers, ask a question from this category, from that category. These are very big categories, by the way.

Start off with a softball question. So what made you decide to go to Princeton? Or whatever, or so I’ve never been to Wyoming. What’s it like there? Something easy. And then we ask some questions about motivation. Whatever. There are a bunch of different things that we ask, but the thing that makes the interview good is when people are actually just talking to you. So yes, answer the question, but I think for me, a really dull interview is one where people have an answer and they give it, and then they stop and sit back and wait for me to ask the next question. Those are boring for me. And then another one that I don’t like is when people have in their minds prepared, oh, I need to make sure that I get across these points on my application. And sometimes we can tell that you’re doing that. Sometimes we can even see that people are looking at their other computer. It’s not great. I try to always ask everybody at the end, is there anything else that we didn’t talk about? I want to make sure that you got a chance to say everything you wanted to say. So I try to always ask that question at the end so that people will have a chance to get all their points across.

They should know that upfront. [37:49]

I know. I actually should. That’s a good idea. I should let people know that.

You heard it here. [37:55]

No, that’s really good. I actually never thought of doing that, but I’m totally going to do it now. Yeah.

Now that I think about it, I’m going to tell the other interviewers, please do that. Make sure you always ask that.

Great. [38:07]

I can just tell all the applicants that.

I’ll have to do more of it. [38:10]

When I do my overview sessions, I can tell all the applicants just FYI. You don’t need to read bullet points. I promise you’ll get a chance to say all the things you want.

I’m going to give you that opportunity at the end. Just answer my questions in the interim. [38:20]

Yeah, exactly.

When does BU typically stop sending out interview invitations? And after you answer my question, I’ll tell you why I always ask this question. [38:26]

Yeah. End of January, beginning of February, we extended our interview season last year. So we historically had stopped at the end of January, and then last year I wanted to do some more interviews, and so we extended it a bit. So then we were sending out invitations later. This year we’re planning to have our last interview day be February 16th. So I think we’ll be done sending invitations by end of January. But when I say end of January, I mean January 31st, we have, since they’re virtual, if we have a cancellation, we’ll reach out to somebody.

The reason I asked this question, I probably asked it last time we spoke too. But the reason I asked this question is because there’s this meme out there that if you don’t have an interview invitation by Thanksgiving, you’re toast. You’re not going to get an interview invitation. And I have asked this question of every single medical school admissions director that I’ve spoken with or dean, they all give later dates. [39:07]

Yeah. Totally.

This thing is still out there. [39:30]

It’s wrong. I don’t know.

So I just keep asking and I keep getting the answers that show it’s wrong. How do you view prerequisites taken at a community college? Do you care? [39:36]

It totally depends on the situation. See, again, it’s the whole context. If you are attending Boston University and you decide to take physics at community college in the summer instead of at BU, that is not impressive to me. If you went to De Anza Community College in California and then you transferred to one of the UCs, that’s how you went to college because that’s how you were told to go to college. So it just totally depends on the situation, I think. If you are at a four-year university where the prerequisites are, you should take them there. But if you’re not, then good for you for figuring out how to get an education.

Right and at a very low cost. How do you view shadowing and virtual shadowing? [40:21]

I am not that impressed.

We really do want people to have some clinical experience.

Sure. [40:35]

But the reason that we want people to have clinical experience is because we want people to know what they’re getting into. And the more hands-on you can be with clinical experience, the better off you are. Because what you really want to do is to test it for yourself and figure out whether you like it or not, or what are the parts that you really like and what are the parts that you do not want to do. Every year there are people that come to medical school and they start doing their third year rotations and they walk out of surgery and they go, if I never see the inside of another operating room, that would be perfectly fine with me. Now, that’s actually fine because that’s a relatively narrow thing. But on the other hand, if you start medical school-

They deal with sick people. [41:26]

Yeah. Then we got a problem. So the closer you can get to having actual responsibility and contact with as much of the typical medical system that you can, the better off you are. Shadowing, I think, you can learn from shadowing, but I think the learning possibilities are rather limited because all you’re doing is just watching. So it has to be a very unusually excellent shadowing experience to be more than that. And often when people do have on their applications that they list a lot of shadowing, it often turns out that they were doing more than shadowing. They may have signed up and asked to shadow this person, but then over time they become more like a little assistant to the doctor. And that’s great. But just shadowing by itself is, I think of limited utility. It’s fine to do it a little bit to sort of check it out. I think it’s cool. It’s always cool to see an operation. If you’ve never seen an operation or see a baby born, yeah, do that. Great. If you can do it, it’s cool. But hundreds of hours not necessary. Dozens of hours not necessary. And virtual shadowing I think is not really worth it.

No. There’s lots of options that you can do at this point. And do you care if it’s in a hospital setting or in a hospice or an old age home or pediatric clinic? [42:35]

Yeah, no, it doesn’t matter. Out of those things, you really get something different out of those opportunities. And I think what we really want to know is what you learned from it and also how engaged you are in it. It’s also possible to sign up to volunteer in a hospital and go to the emergency room or go to the kid’s playroom and not really do much of anything while you’re there.

We had a very ill child at one time, and he was in the clinic playroom, and there was a young man there sitting watching the video on the wall. He didn’t interact with any of the children, not our son, not anybody else. And I knew what he was doing. And at one point, somebody, the head nurse came in and looked at him and rolled her eyes and said, can you please take this to the lab? But it was such a waste, such a waste. 

Now what would you like me to ask you? I want to give you an opportunity to talk about anything you want to say to listeners like in the interview, you want to know? [43:12]

Yeah. You probably even put this in the list of questions and I forgot.

I did. [44:00]

The only other thing that I would mention is a thing that is really excellent about BU that it doesn’t always come up is the collegiality of the institution. And that’s true almost at all of the different levels. I report to the dean of the medical school and also I call her Karen, and I just go to her office if I need something. And colleagues in different departments get along well with each other and cooperate. And there’s just not a ton of hierarchy. And I think that attitude really filters to the students as well. And so it just makes a more pleasant and more positive and more productive atmosphere. The other thing I would say about PISCEs in this new curriculum is that has really encouraged student and faculty connection and trust because you’re in there engaging with each other for hours every day.

And so the students know because they can see that the faculty are doing their very best to make a great class for them. So the students can tell because they might be mystified about something or annoyed with something and the faculty can pick up on that. And then the next day, the faculty came in and they were like, okay. Yesterday was a little bit rocky. I could tell people were really confused about this, but I went home and I found these other resources and I just wanted to show them to you and make sure we take the time to get everybody’s questions sorted out before we move on. I’ve watched this happen, and so then the students are thinking, oh, okay, well, all right, so this is really hard, but I can tell they’re trying to do the best they can and that it just makes the environment so positive because the students know that the faculty are doing their best.

The faculty know that the students are doing their best. And so it really helps with this mutual positive regard that allows everybody to learn better and work better. You’re not going to do your very best to make an educational product if you think that the students hate you and don’t like it anyway. And the students similarly, are not going to do their very best to learn and learn in this new way if you think the faculty don’t really care and they’re just trying to whatever, do it the easiest way they can.

Or trying to trip you up. Trying to blow you out. [46:23]

So I think that just general collegial connected environment really helps a lot. The other thing that I would say is I think that, I really believe that the reason our environment feels like that, the reason our culture here at the school is like that is because of the patients we take care of. Faculty famously will fight over office size or who gets to present first at this committee meeting or who gets to do this or who’s going to move where. Honestly, we just have bigger fish to fry. We are trying to take care of people that don’t have a place to live. It makes it really hard to be petty.

There’s the old perspective. [47:13]

Yeah. Come on, how lucky.

I met with a patient today who had all these such difficult life events happen to her recently, and she was also working in a healthcare setting as a front desk person. And I walked out of that room thinking, why does she have that job and I have my job? She’s competent, she’s working hard, she’s managing her family, she’s doing everything she can, working super hard and putting in her all. So why does she have that job and I have my job? And it makes me think a bunch of things, but one of them is, I better do a good job at my job. I’m lucky to have this particular one. I better make good. I don’t know. So I think we have so much of that perspective all the time. I feel like it makes the faculty here, the doctors here, the administrators here, be more inclined to work on the big problems at hand and less inclined to, I don’t know, quibble about, well, so-and-so gets free parking. I don’t know.

We had somebody on staff who was just incredibly upbeat, always appreciative, thankful, up the kazoos, and she was going through a really rough time. But always upbeat and appreciative and you could ask why, but mostly it makes you, I think, a little bit more appreciative for what you have, whether it’s your job or your office or your house, or people say, be a little bit less petty. [48:22]

Right.

Hopefully less petty. [48:57]

It’s like you have this look, hey, let’s keep our eye on the ball folks.

What’s really and truly important. [49:03]

Yeah, exactly.

I also think we’re just about out of time, and I want to thank you again for joining me and sharing your expertise and your insight. This has been a fantastic interview and a fantastic episode. Where can listeners learn more about Boston University’s Chobanian and Avedisian School of Medicine? [49:05]

They can visit our website, but also you can just Google Boston University School of Medicine.

Relevant Links:

• Are You Ready? Med School Admissions Quiz
• Boston University School of Medicine Secondary Application Essay Tips
• Boston University Chobanian & Avedisian School of Medicine 

Related Shows:

• Get Accepted to Dartmouth’s Geisel School of Medicine – podcast Episode 530
• How To Get Accepted To Johns Hopkins School of Medicine – podcast Episode 533
• What Med School Applicants Must Know About Johns Hopkins – podcast Episode 392
• Active Learn and Admissions at UVM’s Larner College of Medicine – podcast Episode 494
• Get Accepted to the Michigan State’s MD Program – podcast Episode 522

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All About BU School of Medicine, a Social Justice-Minded Med School [Episode 405]

Looking to apply to a social justice-focused medical school? Find out if BUSM is a good fit for you. [Show summary]

Dr. Kristen Goodell, Associate Dean of Admissions at Boston University School of Medicine, explores student life at BUSM and its social justice-focused approach to medical education, as well as her advice to applicants on navigating its competitive admissions process.

Who gets accepted to BUSM? [Show notes]

Do you have your eye on BU’s medical school? Would you love to attend that program but are a little nervous about the fact that it gets 80 applications for every available seat? Have no fear: BUSM’s Associate Dean of Admissions is today’s guest on Admissions Straight Talk.

Dr. Kristen Goodell is Associate Dean of Admissions at Boston University School of Medicine. She earned her bachelor’s degree at Colby College and her MD at the Columbia University College of Physicians and Surgeons. She completed her residency in family medicine at Tufts and has been a practicing physician ever since 2007. In addition, from 2012 to 2017, Dr. Goodell served as a Director for Innovation in Medical Education at the Harvard Medical School Center for Primary Care. In 2017, she was appointed Assistant Dean of Admissions at BUSM and became Associate Dean in 2018.

Can you start by giving us an overview of the BU School of Medicine program, focusing on its more distinctive elements? [2:27]

The most important take-home message to know about BU School of Medicine is that we are a social justice medical school. You see that come out in a number of different ways. You see it in the types of things that we focus on in our curriculum. You see it in the patients that we take care of in our primary academic hospital. And you even see it in the energy and the vibe that we bring to our work. A big place that you see that is in the extra things that our students do in addition to studying for their classes. I could say more specific things about that; I have about one million stories to illustrate the fact that we’re a social justice medical school.

We’re not the only social justice medical school in the United States. There are a few schools that I know of that I would characterize as existing to take care of an underserved population, often a specific underserved population. We are one of those schools. It certainly differentiates us from the other schools in the northeast. A thing that is really interesting about our medical school is that this powerful social justice driver happens in the context of a major research university. We’re not a community school that’s focused on delivering care to one specific community, although we do take care of our patients in our neighborhood. But we are a big academic medical center along with a major research university. What that means is that you see a lot of our areas of expertise and some of our coolest innovations are all focused around the idea of social justice.

One example is that we’re the primary investigative site for a large multicenter trial that is looking to see what happens if you screen every single patient for social determinants of health. Every patient in any of our primary care clinics is asked about their access to food, is asked about their housing situation, if they have transportation for appointments, if they need employment support, all kinds of stuff. We’re doing this big study to see, if we know about those things, would we be able to address them? And then later on, does that impact the patient’s health? It seems like it should be obvious, right? Of course, doctors should hopefully know if their patients don’t have food or a place to live. Except the thing is, in medicine, we often don’t know that because we don’t ask because in medicine we don’t screen for things we can’t treat. But at Boston Medical Center, which is BU School of Medicine’s primary teaching hospital, we’ve developed all of these supports and ways to try to address those issues for patients. We can do this rigorous research where we see, okay, does it really make a difference? We know we care, but can we show that it actually impacts people’s health? That’s an example of how you see that social justice mission in the context of this big research medical school.

Early and consistent clinical exposure throughout the four years of medical school is a critical element in the BUSM curriculum. Are students still having that exposure despite COVID? [5:30]

They are now. The students’ clinical experiences took a hit in the springtime of 2020. That was when COVID really just slammed into the United States, and medical schools all across the country felt that they had to help pull medical students out of their clinical rotations for their own safety. But what we were able to do was really not to stop most experiences, at least not the core curricular experiences. We rearranged them. For example, our first year students typically in their spring semester have what we call the longitudinal preceptorship, where they go with a physician and they see patients in their office. In that setting, they practice their interviewing and physical diagnosis skills. They practice it with patients that are there for their care. So they have to be efficient and be goal directed, and all that stuff. But that normally happens in March and April and May. What we had to do was move that from the first year of spring to the second year fall. Our first year students didn’t get to do it last spring, but by summertime, things had settled down, and by the fall, we said okay, we have to bring these students back.

The school asked all the preceptors that normally do it in the spring, “Hey, can you take students? And furthermore, can you take extra students? Because we need to make sure that everybody is getting their experiences.” It required some flexibility on everyone’s part. First of all, the students had to wait longer, which is not what we want. I took extra students in my clinic. I’m happy to have them, but some of the time I see patients in the evening and Saturdays. So I’m happy to have students, but they’re going to have to come on evenings and Saturdays. So they did, and they were happy to do that. There was a little bit of rearranging. But we did pretty well without reducing the core curricular elements that happen in the clinical setting. And by August, everybody was back in clinic in the regular way. All the students were. Now, students are vaccinated along with health care workers. The vast majority of our students signed right up and said, “Yes, I’ll take it.”

Can you describe BUSM’s extracurricular enrichment activities? [7:57]

We have a series of structured courses that students can take. They’re entirely optional. A couple that I can think of that are very popular include the medical language courses. We offer medical Spanish at several different levels. Those are largely facilitated by students because about 80% of our students speak another language in addition to English. Many of our students come in speaking Spanish, so they’ll help their peers. We offer one for beginners, and then we offer another one for students maybe who have studied some Spanish but are not so sure about using it in the medical setting. We also have a course in Haitian Creole that’s taught by one of our faculty who herself is Haitian, so she leads that course.

In addition, a really cool course is our advocacy curriculum. It also has a lot of student leadership. As a first-year student, you’re a participant in the course. It’s one evening a week. Each session, you have a speaker that comes in to talk about something. I was invited a couple of years ago, because I had testified before Congress in favor of some primary care funding. They wanted to know, “Can you come and tell us about what it’s like if you get to do that?” They’ll have a speaker come in, and then they spend some time on a skills training thing, like how to write a letter to the editor, or how to set up an appointment with your congressional representatives, something like that.

Along with that, the students get into small groups, and they do some kind of a project, a year-long project. Sometimes, the project is a bite-sized one-year project. For example, the year that I was there, a group of students were working to bring dental services to one of our community health centers. Some of our community health centers have dentists and some don’t. They spent a year getting donations of equipment, finding people that would volunteer to staff the clinic, making sure they had all the appropriate permissions in place. And then there’s always a group of students working on some form of single payer healthcare. That one keeps going year after year, but they’ll set a goal for the year, like, “We want the Massachusetts Medical Society to address this particular amendment,” or something like that. That’s one of the examples of these kinds of extracurricular, really structured activities.

We also have an enormous number of entirely student-run groups. The most popular thing that our students do with their time is to participate in some service learning activity. There are about 17 or 18 different student-led service groups, a huge spectrum of what you can do. One of the longest running ones is called the Outreach Van, which is an actual van that students take to different parts of the city. They bring clothes, and they bring food and try to identify people that need to get to medical care.

There’s another one, this is one of my favorites: Our neonatologist, one of their innovations is that they have figured out a better way to treat neonatal abstinence syndrome, which is what babies have when they’re born to addicted mothers. Normally, those babies go to the NICU. In the NICU, they’re in a little plastic isolette, and they get a lot of medications to help ease them through the physical withdrawal. But what our neonatologist figured out is that you can dramatically reduce the amount of medications the babies get, but you can’t leave them in a little plastic isolette. You can decrease the medications, but you have to snuggle them. One of our service activities that students can sign up for is to get trained in the NICU, go into the NICU and snuggle the babies, which I’m just about to sign up for myself, because it sounds amazing to me. I’ll do it.

There are a whole bunch of different projects they do. And because they’re student run, students can come in and start a new group. Sometimes, over time, the need for one will fade. 

A lot of people ask, do you have a student-run free clinic that students can work in? And the answer to that is no, because we have a free academic medical center. Massachusetts passed a law five years before the Affordable Care Act that said everybody has to have insurance, and we hugely expanded Medicaid. So 98% of the population of Massachusetts is insured. But you’ve still got to take care of the other two percent, and they come to either our hospital system or there’s Baystate in Springfield, which is a couple hours away. We don’t need a free clinic because we are a free clinic. It doesn’t matter if they qualify for insurance. It doesn’t matter if they don’t have any money. Either we will get them signed up if they qualify, or if they don’t, we just take care of them. That includes all their medications, all their testing, all their visits, all their whatever.

Given BU’s focus on serving the underserved, do you feel that the MCAT helps or hinders that mission? Any plans to go MCAT-optional? [13:07]

I don’t have plans to go MCAT optional because I believe that more information about candidates is better. Hopefully the most important question that we’re trying to answer with any application is, who are you? And what do you bring to the table? That’s really the big picture question that we’re trying to figure out about every single applicant. But more specifically, one question is, the most important one of all is, are you going to be able to manage the curriculum? How the MCAT helps us is it allows us to understand students’ performance, particularly in institutions that we’re not as familiar with.

For example, you’re in California, right? I had, before a couple of years ago, never heard of Cal State Fullerton, never heard of that place. I don’t know where it is. I don’t know what kind of education it offers. I don’t know if it has small 50-person classes or 500-person classes. I don’t know if anyone can go there. But what I do know is that a lot of people who are smart and ambitious will go to that college because that’s what’s available to them. It’s inexpensive. Maybe they can live at home; they may have home responsibilities, they need to take care of things at home, or they have to help the younger siblings, whatever. That doesn’t make them less smart or good doctors. It just means that’s what they did. If I have the MCAT, then I can help understand the answer to the question, are they going to be able to succeed in medical school? I don’t have any plans to get rid of that because I don’t particularly want to fall into the trap of relying on your school’s fanciness.

The other thing that’s part of our social justice mission is to recruit as diverse of a class as possible. The important thing with the MCAT is really how you use it. The most important thing is not to have strict cut-offs. Because if you cut people off, then you’re definitely going to cut some people out. A test is not everything. That’s why we don’t have any cut-offs. We try to, as I said, understand everybody in context. If you use the MCAT as evidence of somebody’s academic ability or predictive ability in terms of success in medical school, that’s what it’s intended for. If you’re using it as a sign of medical school quality, or quality of the student body, or rankings factors, there’s a problem.

Yes, there is a huge problem with that. The real problem is that people can just fudge it. Most medical schools have way more applicants than they can accept. If you’re trying to game the rankings system, then fine, just take the people with the highest MCAT scores and ignore the rest. But is that really what is going to make good doctors? No.

Do you have any advice for premeds about to take the MCAT? [16:06]

My overall advice would be to believe what the AAMC is telling people. It’s pretty easy to think that they’re trying to make it as hard as they can and they’re trying to weed people out. The AAMC is not; they’re trying to make a fair and valid test. They really, really do want to make it so that people have equal access. When they give you an outline for the test, for example, and say, “Here’s what’s on it,” that really is what’s on it. Some of the best resources are to be found on their website.

In general, what people need to do is they need to plan about three to six months in advance of studying. People do better if they study consistently over three to six months. They do better than if they try to say, okay, I’m just going to take the month of July and study the whole thing. It doesn’t work as well to do that. When I say three to six months for most people, it should be about like a part-time job. People are usually spending between 10 and 20 hours a week on it. It’s a lot of work. It’s like a class. The best way to do it is take a practice test, identify your strengths and weaknesses, and study up on the weaknesses. It is more fun to study your strengths, but it will not help you that much. That’s the pattern that works out best: lots and lots of quizzing yourself. Testing yourself is what’s really good. Your ability to do well on that test, it shows mastery of the material, and it also shows your ability to set a big educational goal. Doing that consistent work like that, that’s what we’re looking for.

The BUSM secondary application is a thorough secondary application with three to six essays. What do you learn from the secondary that you don’t get from the primary? [17:46]

We ask specific questions on the secondary. We give everyone a secondary application. We don’t do an initial screening. The reason is because there’s information on that secondary that helps us understand who you are and what you bring to the table as an applicant. For example, several of our questions are not required. We have one question that basically says, tell us whatever you want about your educational history. If there’s something that didn’t come up in the rest of the application, use this space to tell us. Not everybody answers it; there are lots of people who’ve had a relatively typical pathway, and we get it. But on the other hand, people often use that space to tell us things that maybe they didn’t want to spend their whole personal statement talking about. Perhaps somebody had a difficult semester and it was because their parent became ill, and they had to go and take care of them. Or they themselves are struggling with depression and they needed to take some time to address it.

Some people say, “I didn’t get a chance to explain this but my parents were in the Foreign Service, so I’ve actually lived in six different countries. This really informs my view of medicine because I have an understanding of the different way people view things.” People tell us all kinds of different things. One recent really memorable applicant talked about his journey from community college to an Ivy League school to finish out his education. We asked those questions because we, again, are really trying to be able to put all of the data about you into context.

Then this year, we added another question which specifically relates to our mission. This is a question that we actually added at the suggestion of our students. Our students this summer said, “We really, really need to work on increasing the diversity of our incoming classes. We all say we’ve got the social justice mission, but we need to ask applicants about it directly.” We did; we added a question to our secondary that basically said, “This is what the hospital does. Why do you think you’ll be good at it? Why do you think you belong in this social justice community?” And we want to know that. I will tell you that I was actually a little bit skeptical because I thought, “Ah, applicants are just going to tell us what they think we want to hear. They’re going to read the website, and they’re going to figure it out.” But it turns out that there’s a big difference between somebody who has read the website and says, “Yes, that’s exactly what I believe too,” versus somebody who’s actually been living their lives like that the whole time. And you see that when you look at people’s experiences. It has to do with the way they write about it too. If they say, “Oh, this would be such a good experience for me to learn,” that’s a little bit different than, “I would so value the opportunity to give back to this community,” or, “My goal is to serve. The reason I want to be a doctor is because I grew up without these resources, or nobody spoke my language, and so I want to go back to my own community, and I think I can get well trained to do it.” 

How about the CASPer? What does that add to BUSM’s evaluation process? What does it add to your insight into an applicant? [21:07]

This is the first year that we’re actually using it in admissions decision making. We are in the process of analyzing how effectively CASPer helps us do our job. I don’t have hard data to share yet. The goal of CASPer is that it gives us information that otherwise is very difficult to get on the application but that almost everyone thinks is really important to be a good doctor. Most people believe that you need to have truly, truly exceptional communication skills, not just outstanding intelligence, but you also need to have outstanding communication skills. Most people believe that you need to have incredible empathy and that you need to be an excellent team player. But those things, it’s so hard to see them from the application. We look at the experiences to see if people have been inclined to work in teams before, but it’s hard to know if it’s really true or if it was just an accident that they were with a group of people.

It’s hard to pull that out of the rest of the application, and that’s what CASPer seeks to do. We hope that it is helping us get more information about each candidate. And frankly, I think that’s actually the stuff that’s really important. As I said, we have academic information with the GPA and the MCAT. I feel like we’ve got that covered. We know about your academic abilities.

Sometimes people’s grades dip because of depression or a mental health issue, but I know many applicants are reluctant to attribute a dip in grades to a mental health issue. How do you react to that? [22:40]

I agree that that is a difficult issue, because what you want is to put your best foot forward. And I think most people don’t think of that as being part of their best foot forward. I really do understand that it is difficult. And to be completely frank, I’ve seen people write things on applications that I think were a little bit too much. I think the key thing is to think about your audience and think about, again, what is the thing that they’re trying to assess? They’re trying to make sure that you are going to do well in medical school. Somebody who has wrestled with some mental health problems, grown a lot from it, developed an enormous amount of empathy, and there’s evidence that it’s really in the rearview mirror and it’s not to be a problem, then great, we’re good. That’s fine. People that seem to be in the midst of an ongoing struggle, I think I honestly would advise them to wait a little bit longer. Medical school is hard. We really are trying to support our students as much as we can. We believe in wellness. But the fact of the matter is, this is not a job for people that are trying to clock in and out at 9:00 and 5:00. It’s hard. You really want to be in a good place and feel like, “I am ready to jump right in there and pour my heart and soul into this thing.”

What is the interview day at BUSM like in the time of COVID? Is it a day, an experience, or an interview? [24:14]

First of all, we set up a special web page that’s part of our application portal that has a whole bunch of specific resources for students who are interviewing, which includes things like contact information for our current students who are admissions ambassadors. There’s this living FAQ document where interviewees can go in and put in a question, and then one of our students will answer it. It’s entirely done without my supervision. I asked the students to do it, but I don’t read it. You don’t have to worry about people trying to feed you the institutional line or whatever. There’s some things on there that are really just for interviewees.

Then, in addition, what we have in terms of the live stuff are three required things. You have one required faculty interview, you have one overview info session that I do, which is live, virtual, but it’s all real time and recorded. And then you also have a session with students. All of these are interactive. The session with me is interactive also, with lots of Q&A. With students, they start off with some introductory basic stuff, and then they go into breakout rooms, so then applicants have a chance to talk in just a small little group of students.

Those activities are all required, but we didn’t make people schedule it all in one day. That was a decision that I made when we were trying to plan out the season. And it mostly was because in the late summer, I was feeling just about maxed out on the amount of Zoom that I was doing. When I end up spending three hours or four hours in a row on Zoom, I just find them to be really tiring. I had a headache at the end. I didn’t think that would be appealing to applicants, so I thought, nope, let’s not do that. Let’s make these three things required, and we’re going to tell applicants to try and do them within a week of each other, and we’ll see if it works. The risk is the students won’t really remember that much, that all the stuff about BU will be a little diffuse, and that they won’t be able to remember it as well. But that was the experiment of this year.

Let’s say we get beyond COVID, and we can start traveling again. Will you return to in-person interviews? [26:37]

That is to be determined. I’m not trying to hedge; I really don’t know the answer. I am a massive extrovert, and I really like meeting people in-person, so I would vastly prefer to go back to our interview days, even though they’re hard to schedule and very demanding. I would prefer that. However, it is really expensive for applicants, especially if people are flying across the country and they’ve got to stay in a hotel. I think the evaluative part, which is the interview, that part actually goes pretty well over Zoom. I don’t know that much is lost. I think what’s lost in having a virtual day is getting to hang out at the school and just see what people act like and see how people seem to be with each other, and overhear little snippets of conversation and look at how everyone looks. I think that is the stuff that we lose.

The question is, is there a way to do that in another way that’s more efficient? This could end up being totally wrong, but it could be good if we have our interview days and schedule the interview requirements similar to the way we do now. But then what we might do is something like have a series of visit days for accepted students. It won’t be just one big open house like in the past. We’ve had this giant open house and a big party and we have workshops, and we have a reception at the end with a band, which is awesome, by the way. We have a BMC band, which is really excellent. But instead of that, what we might do is have a series of 8:00 or 10:00, Mondays or Fridays, when people are invited to come to campus, and then they can spend the day with us, get a tour, have lunch with students, chit chat with faculty, maybe sit down in the class. We arrange some things like that to allow them to make a decision. 

I am really hoping that the AAMC surveys both schools and applicants to find out what they would like, because to some extent I want schools to play fair, and I want to be fair to applicants. I want it to be fair with schools too. We need to be aware of what everyone else is doing, and we really need to know what applicants think.

Do applicants miss the in-person experience? [29:10]

I think it’s both. We also need to be particularly attentive to some of the people we most care about recruiting, which is not necessarily people that have lots of money. When I was an applicant, I was living on my own, supporting myself, and I did not have a ton of family money or anything like that. I borrowed all the money for all of my school, but I still would have spent the money to travel to a school to go there. But I’m an extraordinary extrovert. I know I do much better in person, making an impression. So for me, it would have been worth it. But I don’t know that that’s the same for everybody, and I don’t want to disadvantage some people who are like, “I just can’t take time off from my two jobs and my family responsibilities.”

It’s something that everybody’s going to be grappling with in multiple fields. I actually prefer to see people in person. So I’m only seeing people in person right now. But I think for many things, telemedicine is perfectly adequate and really much more convenient for patients.

In 2019/20, BUSM received a total of 9,151 applications, yet it has 160 students who matriculated to its MD programs. Your site and this interview have both emphasized that every application is reviewed holistically. How do you winnow it down from 9,151 to 160? [30:28]

A human reads every single application. We have a team of people that review them. We have a set of criteria that we look at for every application. For every single application, how strong are the academics? How is the CASPer score? How focused is this person on service? There are a bunch of different criteria that we look at. We have a structured way that we review every application. we can’t do the whole pool at once and then do the invitations, so we do a chunk and then say, “Alright, of that 50, I’m going to pick the top 20%.” You take the top 20% and say, “Okay, those are the people we’re going to interview.”

Are you looking for anything differently today than you looked for two or five years ago when you first started at BU? Or maybe when you were at Harvard? [31:44]

Not because of the impact of the pandemic. The things we looked at at Harvard were a little different from the things we look at at BU, just because of the different missions of the schools. I actually really think that the things we’re looking at and the criteria are the same. I would say that this year, we’re more focused on mission fit, a little bit. We’ve always been pretty focused on mission fit, but I think now we’re emphasizing that more, really wanting to get people who share our goal of solving the biggest problems for the neediest people.

How do you view letters of intent or correspondence from waitlist applicants, or letters of intent? [32:30]

This year, as you no doubt know, everything was slowed down by a couple of weeks. There’s probably a lot of people still hanging out there wondering what the heck is going on, and it really is just because it’s taken us longer. We had a 27% increase in applications. Before the interview, they don’t make any difference at all for us. I don’t know what other schools are doing. We just review the application. For other letters of intent or updates, the later in the process you get, the more they matter. I used to joke with people: When you’re in person, I do want to know if you really are interested in BU. But if you go outside and, while you’re waiting for your Uber, you’re like, “Dear Dr. Goodell, BUSM is my favorite,” I’m going to be like, “You’re full of baloney, you haven’t even seen all the places yet. I don’t believe you.”

On the other hand, if people are more towards the end of the process, they have seen all their schools, and they feel really strongly about a school, then that becomes a little bit more important. But truly, the only time that makes a difference is if we’re your very first choice. Even then, the time when it makes the most difference of all is if you find yourself on the waitlist. If you’re on the waitlist, and you’re thinking, “Oh, I really wanted to go there. That is my number one school,” then sometimes that makes a difference.

You’re open to waitlist letters? You don’t throw them in the trash or anything like that? [34:06]

No, we don’t. I read them all, actually. Really every year, there are people who write and say, “This is my absolute choice.” The more honest and clear people can be, the better it is. People will say, “I have another plan. I have been accepted to another school. But if you let me in, I’m coming.” Especially if you’re like, “I am accepted somewhere else and will matriculate there on August 1st, but if you let me in first, I’m coming down.” Then I’m like, “Okay, I believe you.”

What advice would you give to med school applicants thinking ahead and planning to apply either in 2021 or 2022? [34:56]

The biggest question that applicants have is, “How can I get in?” And part of that is, “How can I make myself stand out?” And then a subsidiary of that question is, “Is it better for me to do this or this activity?” or, “How should I spend my time?” The most important thing is that you do what you are excited about, not what you think is going to look good. There’s a whole set of applications where people have met all of the criteria. When we read those applications, what we often write in our notes is, “This application has a checkbox feel,” which means, “They told me I have to do some community service.” That doesn’t play all that well.

But I also get it. I feel bad saying that because I understand, poor applicants, they’re just trying to follow the rules. I get it. It’s not that it’s a bad thing to do. But I think what is the most important is that you do the thing that is really exciting to you. Because most likely, there’s going to be some school that thinks that is amazing. Apply and go to one of those schools that thinks what you did is totally amazing.

As I said, we are not the only social justice medical school in the United States. We’re looking for people that we think are going to genuinely share our passion and enthusiasm. I think that’s really important. That can be for whatever the thing is. If your thing is serving the underserved, great. But if your thing is the business of medicine, so you worked for Deloitte for a couple of years, that’s good. Do that. I’m not sure that BU would be the best place for you. Do the thing that you’re excited about. Some school is going to like it, probably. That’s my advice. Do what you love.

One little subtlety: It’s okay to test something out and then decide it’s not really you. That’s fine. Then, if somebody asks you about it, you can say, “Oh, that wasn’t really me.” That actually happens. We see it happen with research sometimes. People will try to do some research, and their motivations were good, but then they found this bench work stuff is just not really where their heart is. There are multiple different ways to contribute. There are multiple different ways to do community service. 

What would you have liked me to ask you? [40:16]

I think it’s really important that people know that there is not one right path. The reason that we do this holistic review stuff, the reason that we have a human read every application, is because there are an infinite number of different pathways to have a successful career in medicine. We just don’t think it’s a one-size-fits-all enterprise. I want people to know that it’s okay to make mistakes, that it’s okay to change your mind about stuff.

You’re right, I finished my residency in family medicine, but I matched into general surgery and did that for three years and then switched. I totally changed. I don’t say I made a mistake. I regret it 0%; it just made me a better doctor. But on the other hand, that happened because the reasons I picked surgery were just wrong. “My mom will be extra proud if I’m a surgeon.” I was trying to make a decision in a way that I don’t make decisions. I was trying to check all the pros and not have any cons. That’s just not the way I actually do things. I want people to know that you can take all these different pathways and have it still be okay. There are really very few non-overcomeable mistakes.

That, and maintain academic integrity. Don’t cheat. That’s one of the hardest things to overcome that I can think of.

Where can listeners learn more about Boston University School of Medicine? [42:00]

Go to bumc.bu.edu/admissions. Or, if you Google BUSM admissions, that’s what comes up, and you’ve got all the information.

Related Links:

• Boston University School of Medicine website
• Med School Interviews During Covid-19, a Q&A with experts
• Get Accepted to Medical School in 2022, a free webinar
• Accepted’s Medical Admissions Consulting

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