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Duke Medical School’s Curriculum and Admissions [Show Summary]
Dr. Linton Yee, Associate Dean for Admissions at Duke University School of Medicine, shares with us the unique curriculum of the program and the thought process behind it. He also fills us in on what applicants should consider as they fill out their Duke Medical secondary applications, which will make it more likely to be invited for an interview.
Interview with Dr. Linton Yee [Show Notes]
Our guest today, Dr. Linton Yee, earned his bachelors and MD at the University of Hawaii. He then did his residency in pediatrics at Harbor UCLA Medical Center and a Fellowship in Pediatric Emergency medicine at Children’s Hospital in Los Angeles. From 1996 to 2007 he practiced and taught pediatric emergency medicine in Hawaii and California before taking a position at Duke University as an associate professor in the Department of Pediatrics, Division of Emergency Medicine and as a pediatric emergency room physician. He is also Duke Medical’s new Associate Dean for Admissions, having been appointed to the post in May.
Dr. Yee, can you give an overview of the Duke Medical’s highly distinctive curriculum? [2:15]
The curriculum is a little different than the vast majority of US-based medical schools in that you do the basic sciences in the first year, a clinical year in the second year, a research or advanced degree in your third year, and the last year is the same as most schools, with rotations and other preparations for graduation. The curriculum has been different than most schools for the last 40 years, with the goal to produce leaders in medicine. We believe research works hand in hand with the advancement of clinical medicine.
How does Duke Medical condense what many schools take 18 months or more to teach into one year? [3:42]
You have to be efficient in how you are presenting material and make it relevant to how students are learning. We put our students in the clinical realm really early, seeing patients even in the first few weeks of school. A lot of it is integrating material, taking fairly complex ideas and clinical scenarios that go back to basic science in order to see relevance to the basic realm. One example I always talk to students about is shock. The definition of shock is inadequate profusion at the cellular level. If you look at that definition, how are you going to treat it? You have to reverse the profusion, so you need flow, so your carrier would be fluid, you need delivery of oxygen, and an energy source. To maximize oxygen, you need a pump to circulate what is carrying oxygen and fluids, and you need to maintain pump stability. You learn a lot of this stuff in basic biology in junior high school. You have a complex clinical scenario that you actually knew how to treat way back when, you just didn’t know how to integrate it.
Can you give me a few examples of how students spend their 3rd year at Duke Medical? [11:52]
The goal of the third year is to choose their own direction. Most of their academic life to this point has been pre-determined, so allowing them to choose is key in determining their thought process and ability to think critically and objectively about things. Some examples are we have a scholarship to Singapore to do infectious disease research. A lot of students do work in Tanzania as well. People have gone to Geneva to the World Health Organization, or gone to the London School of Economics for a masters there, and people go all over the place for research opportunities – it is pretty much an open book. We have people do MBAs, Divinity degrees, or an MPH. Not too many people go the JD route but every now and then we do have a student that does that.
Let’s turn to medical school admission, your secondary application is one of the more thorough and demanding secondary applications. This year, old questions 5 & 6 were removed and Duke added several – from what I can see ( 1,2,7, 8 and 9). What are you trying to learn with these changes? [15:09]
Every year we change the questions because the needs of the exec committee change or evolve over the course of time. No year is going to have the same questions. The one we dropped this year was qualities, and the one we added was access to healthcare. The one we modified was the research question. We had previously asked what applicants’ roles were with regard to research, so we needed clarification on what they were doing with their research – were they involved in hypothesis development or just an observer? With the current question we wanted to look at thought process as people apply the learning from their research to what they want to do in the future. For the question we added with access to healthcare we are looking at the physician/patient relationship and how it has evolved, medical ethics, and what they will face in their careers. The humbling essay and failure essay are some of the more key ones, as well as the “Tell us who you are” one. We learn so much from their life experiences, how they think, how they’ve matured, and how they will be looking at taking care of people. We want people who care for other people, and a lot can be gained from these essays. We know they are tough, though!
Duke had 7030 applications and winnowed that down to 751 (>10%) interviews for 116 spots in your 2017 incoming class per MSAR. You interviewed in-state, out-of-state, and international applicants. Other than stats, what separates those invited to interview from those not invited? [20:24]
We are fortunate in that we are not a state institution so we can look at people from everywhere. What separates those invited vs those not invited goes back to the essay questions – people who have a certain level of maturity, a certain level of compassion, people who have been kind, who really understand what it will be like to take care of people for the rest of their lives. You have to have the innate ability to care for people – you either have that or you don’t. It is not something you can force, so we are looking for people who have already shown they are compassionate and kind and are ready to dedicate their lives to caring for others. Of course clinical experience and strong letters of recommendation are important, but the key is really the essays.
What percentage of students do research in their third year? [28:46]
It varies year by year, but I would say the vast majority do research – I would guess at least half to two-thirds do research. It all depends on their career trajectory. People going into tougher sub-specialties need something to be competitive, whereas someone who wants to go into hospital administration might go for an MPH, MBA, or Economics degree.
Should applicants to Duke have research exposure in their background? [29:59]
I would say the vast majority of people applying this year have some sort of research experience, whether as part of their thesis or graduation requirements. Ideally it is nice to know why you are doing research and to understand the role research has in promoting medicine because chance favors the prepared mind, so you need to recognize the nuances.
How does Duke evaluate multiple MCAT scores? [31:22]
You are capped at four MCATS for us, and we take the highest one. Hopefully there is a trend upward. If there is continued less than optimal performance that becomes somewhat worrisome unless there is some justification for it. Usually we will take the highest one the applicant has.
How does graduate education and grades fit into your evaluation of a candidate? Let’s say the applicant’s grades as an undergrad were less than stellar and then they got motivated and did a graduate program in public health with a strong science curriculum or an MS in epidemiology or another relevant masters degree and they did very well. How does the masters GPA or postbac program fit into your evaluation? [32:50]
We are always looking for an upward trajectory. If they didn’t do well as an undergrad but excelled as a graduate student we may not pay much attention to the undergrad grades unless there is something really significant of concern. Normally people mature as they progress along. We would tend to focus more on the graduate part. We pay attention more to the current situation. Also if applicants take gap years they can have some interesting or relevant experience they bring to the table as well. We think very highly of people who do things like Teach for America, Americorps, or the Peace Corps, for example.
What can someone invited to interview at Duke Medical expect? [37:19]
Our interview day is broken down into multiple mini interviews taking place over roughly two hours. When the day starts there is a brief introduction and history behind Duke and why we do things the way we do, and after that we talk about financial aid and leadership. We have breakfast and lunch as well as a tour, and then a brief closing. The night prior we have a get together that is fairly informal, with our students and our applicants. They meet at a coffee shop or an ice cream parlor. In the past people didn’t get a good perspective on what Durham was like or get enough time with students, so we highlight some of the good things about Durham and also allow for the informal meeting with students.
What are some of the more common ways that applicants blow their primary and secondary applications or their interview? And for the applications, I’m not talking about low grades and MCAT. [43:12]
A lot of that again goes back to their clinical experiences or essays. If many of their essays are “I” focused or a reiteration of their AMCAS experiences it doesn’t tell us anything more about them. People do mess up a lot with essays. We want to know more about you, not a rehash of what is in the AMCAS experience list. Tell us something different about you that will provide value to us in conjunction to analyzing how you will care for others in the future. For the MMI, sometimes people are nervous or rude, and that is where people tend to bomb that. The vast majority of people can pass the interview (only about 10% don’t), but with stress sometimes people aren’t pleasant or something like that.
This interview is scheduled to air in mid-August. Would you advise an applicant who has not submitted his or her primary application by mid-August for whatever reason to still apply this cycle or to wait until June of next year? [45:31]
I think that all depends on where they are in the scheme of things. Right now we already have 4,330 applications and we opened the portal about 20 days ago. Already 1,100 people have completed their secondaries, so that is quite a bit for this early. So it tends to be the early bird gets the worm. People need to act quickly and get their application in early. The longer you wait the more interview spots will be gone.
And on a forward-looking note, what advice would you give to med school applicants planning to apply to Duke in 2019 for a 2020 matriculation? [49:04]
I think they need to broaden their horizons and get as much clinical contact as possible. I recommend people look at hospice, as you can be often a much more active participant as well as see the ambiguity of medicine, since you can’t operate or really intervene, so it is a different sort of thought process. Another thing is to consider being a scribe, since you gather the vocabulary and thought process of a physician in each scenario. Do stuff for the community they are involved with. Try to make a positive impact on peoples’ lives.
You have been involved in admissions at Duke for several years, first as vice chair and chair of the School of Medicine’s Admissions Committee, then as co-associate dean of admissions and since May as associate dean for admissions for the Duke University School of Medicine. What are your plans for admissions at Duke School of Medicine? [51:15]
I think our goals will be continue to produce leaders in medicine. We need to also diversify in terms of what our school population is like. Half of the US will be a minority, and we want to improve our outreach in every area. The advantage we have as a private school is we can look at all the different states to spread Duke’s message and expand our influence.
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