Lolita Wood-Hill has been working in the field of pre-med advising for over 25 years, so it’s safe to say she knows the ins and outs of the medical school application process better than most. In this podcast, Lolita gives advice on how to make yourself the most enticing applicant to medical school possible, starting as early as freshman year of college. She lays out a timeline of activities, including coursework, research, and clinical experience that are an essential medical school application plan. Lolita also shares the realities of the application process, and how to prepare for it from an academic and financial perspective.
How to Plan Your Pre-Med Application Process
Our guest today, Lolita Wood-Hill, started her pre-med advising career in the early 1990s working for AAMC’s Summer Health Professions Education Program , which had a different name then. She then worked as Deputy Director for Premedical Studies and Prehealth Advising at CCNY and Hunter College. She arrived at YU and assumed the role of Director for Prehealth Advisement in September 2010. In that role, Lolita provides academic and career guidance for all students interested in health profession careers.
Three and four years before planning to start med school, what’s a successful applicant’s timeline? [2:44]
First-year students need to understand about grades. The transition from high school to college can be tough, so it is important for them to find tutors, to find upperclassmen that can give them info on classes, and to make sure they know how to access money for books, for example. Freshmen struggle with this, and if that transition is really bumpy then all of a sudden the first year of college turns out to be a C in Bio, a C+ in Calculus, and you are climbing uphill.
First-year students need to think about how to transition to college successfully and also what they will need three years later – they will need letters of recommendation, so start looking at professors. Who do you like the most? Who do you have the best rapport with? And continue those relationships so in two-three years you can ask for a letter of recommendation. Also, think about your interests outside of the classroom – look at clubs (though in the first semester no one should join a club, people should be focused on their grades) and extracurricular activities to participate in. When you apply, you need to have a robust resume, which should start the second semester of your first year.
Second-year students need to start thinking about research by the end of their sophomore year, thinking about summer research, doing it with a faculty member (so figuring out who you want to do research with), and overall figuring out where the research opportunities are. Students often don’t think about things until they are upon them, but they need to really think about their plan as soon as they are in the door. You only have three years that you are going to show to a medical school in your application, so you need to make the most of them.
When do you recommend applicants start getting clinical exposure? [5:36]
That can start in freshman year. You can volunteer in a hospital ER, hospice, or nursing home. The summer you finish freshman year you could take an EMT course and work as an EMT a few hours a week. Schools want to see your interest in working with patients continuously. You want to show two-three different activities over the course of your years in college. You also want to make sure this is the right career path, which you can do with that exposure. And don’t give up on your dream if you find one clinical experience distasteful, explore the many options before switching.
What should students be doing the actual year they are applying? [7:47]
You should try to continue doing your regular activities. You will have to cut back a bit with test prep and interviews, of course. You don’t want to be in the middle of a research project that would make you have to turn down interview invitations. Your course load should be fairly light to accommodate the idea you will be running around to interviews, which will all be during the week. I like to see people continue their research, because if they take a year off, they can continue it and maybe get it published. Continuing anything clinical is also good, and you need to keep your grades up, too.
When should they submit the AMCAS or AACOMAS application? And what happens after it’s submitted [9:33]
When they’re ready. Seriously, though, it’s a hard question. I encourage students to really think about what else they’ve got going on when they are putting their medical school application together. It requires an enormous amount of time and energy. Ideally people should get applications in as early as possible. The application opens in May, and you can submit in June. So sometime between June-mid July is great, and then secondaries and MCAT scores should be coming right behind that. Schools have a finite number of interview spots, so in June, there may be 800 spots. By August they’ve used up half of those spots – then you are looking at 400 spots. Every month you delay your application, you lose the opportunity to be looked at carefully for a greater number of seats for interviewing. Students should also think about it in terms of the letters of recommendation, and availability of money for interviewing. If you are waiting for a tax refund check to come in, or you have a loan in September, and don’t have money to plan for travel, buying a suit, or fees for the applications, all of that needs to be thought about beforehand. Everything impacts whether you can complete it – the AMCAS application, MCAT scores, secondaries, and letters of recommendation all need to be in the pot before an application can be viewed.
Do you have a recommended number of schools that students should apply to? [12:18]
15-20. Never go over 20 or 22 schools. I have students who have applied to 40 schools. If the first 15 aren’t interested in you, the next 15 won’t be, either, and you look desperate. Eventually schools will see you applied to all these schools – they do have access to that information. You don’t want to give a school the impression that you are throwing hope out in the wind, you want to look confident.
What about lining up recommenders? Who should they be? How can applicants help them without being a pain? [13:37]
Try to find one faculty member every semester that you connect with – they are the ones you should be asking for letters of recommendation. You can ask for the letters at any time. You can set up an Interfolio account so they can submit on your behalf, or go to your pre-med advisor and the letters can be held for you. Most schools have a letter-holding service so I would start there.
You want to have at least three letters from science people – two faculty in science and one lab instructor is ideal. Three is a minimum. Make sure you also get letters from people you do research work with and who can see competencies that med schools are looking for – leadership, volunteerism, empathy, and maybe a personal letter from someone who can share a personal struggle of yours and resilience. I’d say a maximum of seven-eight letters, but three in the sciences you really want to see, talking about lab skills, ability to think critically, write critically, work as part of a team, and leadership in the classroom.
What about gap years? [16:07]
Schools really value that extra year of experience, not in school, doing something you personally are passionate about. It’s an opportunity to have personal growth, and work on competencies that med schools really value. That is hard to showcase while you are still in school. It also takes pressure off, and you can ensure MCAT scores are reflective of effort you put into the test as opposed to not having enough time. It also gives you a chance to earn money. Med school is expensive, so having a year to work to pay for a suit, travel, can be really benefit.
What about the costs associated not only with attending medical school, but the application process? [18:52]
The AMCAS application itself is $190, and then it is $38 for each college. So if you do 10 colleges, you are at $380. Secondaries are about $100 each, so the process itself is expensive. Test prep companies are charging $2500-$3000, private tutors are maybe $1000, but the overall cost of applying to medical school is probably going to be $5000-$6000. With interviews you need money to travel, spend the night, clothes to wear, and it’s a real problem if you haven’t thought about it and made a plan. Scholarships don’t cover these types of expenses, and loans have to be budgeted a year in advance.
Once you commit to a school you have an initial deposit, which is typically just $100 for MD schools, but for osteopathic schools could be $2000. Then schools will want an additional $5000. Where is the money going to come from? It’s not the time to go to financial aid – there are no more loans or scholarship money, and parents may be cash poor after tax season. Then there are moving costs, first and last rent for security deposit, and you have to think about what you need for books, stethoscope, your first kit – all of this must be in place before your first day. But no money comes through until you are sitting in that seat. You need to prepare your finances. If you take a gap year, once you are out of school you need to start repayment, otherwise you need to put in a formal request asking for forebearance for a year
What’s the big difference between the primary and secondary applications? [25:12]
Secondary applications should help schools get additional information that you couldn’t put into a primary. If you are going to do research in the summer you are applying, save it for your secondary application. You don’t want to leave anything blank. Either use it to further enhance your application, or explain things that you struggled with or where your grades faltered.
You don’t want to repeat from the primary, you want to delve much more deeply. The primary is about fit as a physician, while the secondary is more about fit with the school. Students should be looking at vision and mission statements of every school – do they match up with things you’ve done and can you show that match in your application.
You mentioned the challenges faced by under-represented minorities in healthcare admissions. Can you provide the most common challenges and how to overcome them? [27:21]
The biggest challenge is that there are no family members who have gone through the process before – so they don’t have support from someone who understands what needs to be done, or the sacrifices that need to be made to be a competitive applicant to med school. Sometimes it means taking out loans when family members are against debt. With a disadvantaged background you are typically going to school with people of the same background as you. When you go to college that changes, and can be difficult to overcome. It is easy to get discouraged – “Everyone else can do it but me,” but really it’s just that you probably didn’t have the opportunities that other students had in their schooling to that point.
You succeed by finding a mentor who will help you through the challenges – explaining what is going on, and helping you to see things in a different way. You need exposure to museums, music, how people perceive the world who have money and don’t know about the issues you have dealt with. It is important to find mentors to give encouragement. Students should not take on a load of courses just because that is what everyone is doing. If you did not have AP Bio in high school, you should not be taking Biology and Chemistry your first semester in college, I don’t care what your advisor tells you – it’s wrong, for you. It might not be wrong for everybody, but it’s wrong for you. Make sure you take courses that work in a schedule that fits your lifestyle, particularly if you do have to work 20 hours a week, or are a single parent, or are the only one in your family who speaks English and you have to manage that stuff. You need to let your advisors know the struggles you are facing, so advisors can send you to appropriate places to get support. Support is key.
What is the most common mistake medical school applicants make? [31:22]
They don’t make enough effort to work outside of their comfort zone. I work at a school with all Orthodox Jewish guys. They are great guys, but what I have to stay on them about is getting out of their bubble, because the bubble is there and you have to be able to work with people who aren’t in the bubble or even know a bubble exists. You need to work with communities very different from your own to show you are not a one trick pony, have lots of exposure to diversity, and are willing and ready to work with the diverse populations that hospitals will have. You also have to show maturity and independence. When you go to an interview and are asked, “What has challenged you the most in college?” and you say, “I spent a summer in Cleveland doing research and had to wash my own clothes” – yes, I’ve had a student say that – that is not a good thing.
The other thing is applying late in the season. Medical schools are very concerned about students who apply in September, because in their mind it means you have not yet gained the skill of time management, which is crucial in med school. They are wondering what you’ve been up to the last three months – sometimes it does have to do with money, which we talked about earlier. If that’s the case you might want to think of pushing off, since realistically you don’t have the money to go through the entire process.
Students also need to look at their grades carefully. The fact that you have a 3.6 might not be the strength it might seem. Schools are looking whether or not you transitioned well. If you got a B+ in Bio 1 and an A in Bio 2, that’s great. Now you go to Chemistry and you get a B+ in Chem 1, and an A in Chem 2. The successful transition is important. Patterns in grades are what med schools want – either a straight A student, or showing an upward trajectory. If you have up and down grades, then the 3.6 starts to not look so good – admissions officers do review grades with this type of precision.
What would you have liked me to ask you? [36:37]
If students have taken any time out to figure out whether or not they are ready for the process. I have my students do a self-assessment a year before they are ready to apply. Have you talked to people about letters? Have you met with your advisor enough times? Have you dug down into your grades? What are you thinking about with regard to your family? Are you emotionally ready? Ask someone else to help you assess whether you are ready, too. There is no harm in taking the gap year and it may well give you more opportunities. This process is not for the faint of heart.
Another thing is for people who did ok with their grades, and ok with their MCAT scores, but are not competitive for MD or DO school in the US. In that case, they can possibly go to a Caribbean school, one of the three American programs in Israel, or try Canadian programs (they don’t look at the MCAT as heavily). So look at your alternatives. If you need to, take an extra year, fix what’s broken, and then apply.
If someone does have grades that aren’t going to enable acceptance to med school, do you recommend a post-bac program, or a science-oriented masters? [45:24]
It depends on what the GPA looks like in the sciences. Masters program in the sciences is my preference because if you still can’t gain admission to med school, at least you have another degree. If you don’t do any better in a post-bac program, you still only have an undergrad degree. I prefer masters programs connected to medical schools because those are really for students just below the threshold, so they are using that as a recruitment tool. If you can’t afford a post-bac, go to a local college and take a bunch of science courses. 20-24 credits as a post-bac is the recommendation if you are doing undergrad work. Do not repeat classes unless you got lower than a C, and make sure to take higher level courses. If you did poorly in chemistry take a quantitative analysis course, which is usually a souped-up general chemistry course. Take advanced statistics if you like math. Take additional bio classes, molecular biology, try to take all the courses from one school.