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Show Summary
In this episode, Linda Abraham interviews Darrell Nabers, Assistant Dean for Admissions and Recruitment at Loyola University of Chicago, Stritch School of Medicine. They discuss the distinctive elements of the Loyola Stritch approach to medical education, the importance of faith and compassion in the application process, the impact of AI on medical education, and the timing of the medical school application process. Darrell emphasizes the importance of being ready and not comparing oneself to others in the application process. He also advises applicants to seek advice from reliable sources and to focus on their own journey rather than succumbing to the fear of missing out.
Show Notes
Welcome to the 580th episode of Admissions Straight Talk. Thanks for joining me. Are you ready to apply to your dream medical schools? Are you competitive at your target programs? Accepted’s med school admissions quiz can give you a quick reality check. Just go to accepted.com/medquiz, 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.
Our guest today, Darrell Nabers is a return guest. He’s the Assistant Dean for Admissions and Recruitment at Loyola University of Chicago, Stritch School of Medicine. Darrell earned his bachelor’s and master’s degrees from Whittier College and Golden Gate University, respectively. He then held various admissions positions from 2000 to 2005 before joining the University of Chicago’s admissions staff. There, he served in different roles until 2015. He joined Loyola College Stritch in 2015 as Director of Admissions and became Assistant Dean for Admissions and Recruitment in February 2019.
Darrell, welcome back to Admissions Straight Talk. [2:12]
Good to see you again, Linda. Thank you for having me back.
To start, can you give everybody an overview of the distinctive elements to the Loyola Stritch approach to medical education? [2:27]
Well, we’re one of four Jesuit medical schools in the country so I think that by virtue of that, there tends to be an understanding within the collective consideration of our institution about the path to medicine being similar to that of one who discerns their vocation very comprehensively. So within the scope of that discernment, we apply a lot of the same principles that might be applied in any kind of Jesuit environment, which is to obviously think of others first in supporting efforts that are more social justice oriented, being a global thinker, to be proactive and engaged when you sense or see a problem, that you don’t resist the urge to do something about it, that you are putting into motion perhaps an understanding of the situation, and then utilizing your resources to understand what needs to be done, and then pursuing a path to mitigate that which you see as an injustice or an inadequacy or an inefficiency.
And I believe that within the scope of that also is the added element of compassion for others, not just that you’re supporting the goals of others, that you’re helping others, but that you have a passion to do that and a passion to build equality among populations where that may not be the case. So if you apply that Jesuit ideal within the realm of education, which is where I’m pursuing my doctorate. I’m about a year away, but the thing that helped me affirm the sort of Jesuit pedagogy is taking classes myself, not in the medical school, but adjacent in another program because then I could understand the pedagogical link. I could understand reflection as a means to solve problems, I can then understand why principally we focus our efforts on underserved populations, because of the opportunity that exists to help a great number who are underserved, but also the potential to mitigate further consequences as a result of their being ignored. These are all essential elements of the Jesuit culture.
I would suggest that there is a culture in mind here when you are becoming a member of this community. And I further understood that when I went to Italy a couple of years ago for a class. I spent an entire summer there. It was really hot, but other than that, I learned a lot about the essential element of the Loyola name, the idea of St. Ignatius being a martyr and being a saint and being a part of this global culture, recognition of what means, his life being lived for others, his life being lived to teach others ethical responsibility, to teach others how to serve and provide compassion to others, how to solve problems reflectively, how to just think in an introspective way. And those things are still at play in many communities around the world. So for us to have an opportunity to build that environment within our learning environment and within our care environment, so right now we have students who are out there in the world working on missions in Bolivia and Belize and other parts of South America.
So that’s part of the culture of this space, and that’s an expectation that we have when we look at an application. We want to understand if a student is compelled by this environment, compelled by doing those things. And if they are, I think they’ll come out of this environment much better practitioners than if they had chosen to go to another institution.
What if one shares the very noble ideals that you just enunciated but isn’t of the Catholic faith or is of no faith? [7:05]
I think faith is a part of cultural identity for many, but it’s also something that many of us don’t recognize as being a part of our everyday life. But I think in essence, what is most important in this environment is to understand how people are compelled by faith. So before we got on the podcast, we were talking about our personal situations, personal stories. One of the things I didn’t mention in that instance was the decision was made to have care at a hospital that is Catholicly affiliated. And when I asked the question why, there’s always a spiritual element to that. There’s always a reason that’s important to the patient. And as a Catholic hospital that is very front-facing as a Catholic hospital, it represents Loyola. And remember what I said about Loyola being a global brand, a global brand that represents and means many things to many people.
What should it mean? [8:22]
Well, again, all the things that I described, the life of St. Ignatius. And principally, if you go to an Ignatian high school or, I know many students that have gone to parochial schools or secondary schools where there’s been an affiliation with Ignatius or Jesuits. I mean, they’re all the same. Jesuits and Ignatian spirituality are all the same element, but they’ve learned certain principles in those environments and they gravitate to them throughout their lives.
But ultimately, when a patient is sick, they gravitate towards things that are important to them. And so that becomes the element of our experience. When we have patients here, they’re drawn here in many cases by their faith, by their understanding and recognition of Loyola as being a place where they will be treated with compassion and care. So that’s very important. And that example I provided to you before the call, that’s the reason why the decision was made, because of the care model, the way that the patients were treated, the way that the staff cared for the patients.
I’ve had relatives at various Catholic institutions. I don’t know if they’re affiliated with Jesuits or not, but they were definitely Catholic, and the care was excellent. [9:35]
Right. So I think there’s an element of understanding that. So if you are Muslim, faith is obviously important to you. So it shouldn’t be a surprise that a patient is drawn to an environment because of their faith. It’s that faith and that understanding and recognition of the importance of faith that compels, I think, us to see that student potentially as a good fit for this environment. So it really doesn’t have to do with the religion that you practice, but I think it is important to have an understanding of the importance of faith to others.
Obviously because of AMCAS and all the other restrictions, we don’t question candidates about their religious backgrounds. If they want to tell us that information, they’re free to do that, but we’re not going to make any discerning considerations about their application because of that. But when you provide a candidate with the platform to just speak about faith, even when you, you’re not making it a direct request like, we’re just telling them what does our mission mean to them, you get a lot of really detailed and historical longitudinal perspectives about not just themselves, but their family, and the connections their families have had to that faith element. And in many cases, that’s inspired them to move towards medicine.
So I think it has a lot of importance to a lot of people. Everyone doesn’t express faith the same way or recognize it in the same way, but I think if you do recognize it and you do understand it, you will also understand how it can compel others, and I think that’s primarily the benefit of having an environment like this, because we bring students from all sorts of religious backgrounds. When things are happening in the world and there’s contention and discord, our students come together and embrace the idea that they’re serving a higher power by virtue of being here and learning, and that their faith is helping to inspire that.
I had my doubts coming from a very heavy research institution coming to a Catholic institution, and whether or not I would feel comfortable. I’ve always felt comfortable here. I’m not Catholic. Those questions that I get about Catholic faith, I’m not really sure what that might mean. When we have mass, I often don’t know when to stand up or sit down, but it’s the feeling I get being in that environment and seeing people who are passionate about their faith. I feel like that helps me at times, because I’m very spiritual and I recognize that faith is important to me. I just really haven’t put a name to it like many people have.
Going in a completely different direction from faith, from ancient faith, let’s talk about AI. How is AI affecting medical education at Stritch, if at all? [12:30]
Well, right now, I think it’s just a very comprehensive conversation about the utility of it. I think there are obviously some concerns. The initial part of it were the concerns. In my realm, in admissions, the red flags have been flying for a couple of years about candidates using AI to write their applications, to write their essays. Do we have a mechanism to prevent that from happening? So there have been discussions about that. At the end of the day, being disingenuous, it’s very easy to spot, and that’s definitely something that would rate a person down in our process, if not completely out.
So I mean, obviously again, as a student currently, I recognize that some of my classmates might be using AI to stimulate some response to a prompt or stimulate some response to a question at a greater level that needs to have more detail to substantiate whatever assertion is being made. But in the world of the pre-med, if it’s the goal to address a question and to be as compelling as possible, AI serves that purpose, but is it your experience? And I think that-
Well, it can rarely go into the depth that you need. [14:10]
Exactly. And so I think that that’s the cautionary consideration in terms of admissions, and medical education as a whole, there’s probably many different ways that this could benefit. I mean, I think of simulation all the time. We have an ophthalmology lab, a VR lab, and I feel like if I were to speculate that that is a form of AI, I mean, it wasn’t presented to me as such, but when I put the goggles on and I’m in this immersive environment and I see a big eyeball in front of me and I’m able to twist it and turn it and go inside of it with my hands, to me, that seems like artificial intelligence. It may or may not be, but it’s certainly an amazing learning tool. And if I were to be an ophthalmologist, I would bend over backwards to have that as part of my training environment.
So I think that there will be, if there aren’t already applications of it, especially in the clinical training environment because I think that’s where it’s really essential, because if you can just consider in training how many different cases are you going to be able to see before you graduate? With AI, you could literally see any case you wanted. And if you’re programming, we use mannequins in our simulation lab. If you can program a mannequin to do anything that’s possible for a human to do, then that’s a great tool for training.
And I know that we have a simulation lab and I know that we do those things. The mannequins we use tend to be directed by, they’re not autonomous, they’re directed by someone, so someone has to pull the levers to flip the switches behind the glass to make it bleed or to have the baby come out, whatever. But I think at some point that technology will progress. That mannequin will probably be five times the cost, but it probably would reduce the need to have the person behind the glass because now the AI functions autonomously, and now this isn’t for all intents and purposes, a patient.
Let’s look at the application. You have a pretty extensive secondary, from what I recall, looking at it before. Is it going to change? [16:29]
Yes. We’ve just applied a change. We’ve got to get it programmed in. Actually, more than one change. The one change I’m most proud of, if we can make it happen. So if it doesn’t, I guess having it out there, you throw on a podcast, not great, but I’m trying to implement some sort of sound file so that candidates can actually tell us their name. They speak it into the system and then provide a pronunciation for us, a phonetic pronunciation using a standard that we provide. So that actually would be one of the questions, one of the new questions.
That’s a fairly easy one to answer. [17:18]
Yeah, it’s pretty easy. I don’t necessarily think that’s taxing, but it’s essential. Once it’s set up, it’s going to be great for us because now we’re making connections with students and we’re not embarrassing ourselves by trying to say names that we don’t understand or making the candidate feel bad when they visit us. And again, I think if we’re able to maintain that file and the candidate comes into the medical school, now we can share that with faculty so now everyone knows who that person is. And obviously there’s touch points that are really important, I think that’s definitely one of them. The other questions that we utilize, again, we’ve modified them because what we look at in one cycle, we get a sense for a question’s response and how the patterns of response go. And we might think to ourselves, well, they’re addressing the question, but can they take it a little further?
And if they did take it a little further, would this address questions to us about the candidates in general? And I would say that most of those questions tend to be questions of behavior. What kind of behavior does this predict? Or what type of response did this particular situation engender for this person? And what kind of change did it make to their original path? We are always trying to get candidates to extend their opportunities to dialogue, and that is another essential element of the Jesuit model. It is to reflect and to provide a pretty consistent baseline of understanding and evidence to support the assertions that a person makes. And so the prompts that we set up are in many cases designed to do that. Some of them are more structured to help us understand what they understand about our mission or what they know about the Jesuit environment.
So just like you mentioned in your question, that’s a big mystery to some people. So just trying to understand where they’re coming from. Did they accidentally apply to us or did they really intend to, right? And then once we get beyond that, again, it’s really trying to understand behaviors. And I can say absolutely 100% that behaviors are predictive and they often don’t change. So if a candidate has evidence of a behavior and that behavior is not, let’s say, trending up in the right direction, it’s going to be hard for us to see any way for that to change without the candidate expressing that they have remediated the behavior or that they have done things tangibly to put them on a different path.
They’ve accepted the gift of change. [20:24]
Exactly. Or sought the advice they need to make the change possible. So that’s where we’re really going with the mandatory secondary questions. We have mandatory secondary questions, and then there are some that are not mandatory because they don’t apply to everyone.
So you are anticipating some changes to the secondary to help applicants dig a little deeper and gain a better understanding.One of the things I noticed on your website is that it conveniently provides a lot of data about the average number of research hours, paid clinical experience. I think the first one was 1,545 hours of research experience, 1,498 hours of paid clinical experience, 599 hours of clinical service, and non-medically based service was 548 hours, and this is per admitted student in the M1 class. You’re one of the first schools that I’ve seen do this, which I think is actually really helpful to students. [20:41]
Yeah, I mean that’s an average. I think in some ways it might be more anxiety inducing than anything else, but here’s what I’ve often shared, is that this is an average of all the candidates who are matriculating into our program. So within the construct of any of these hours, you’re talking about paid clinical hours, that’s a pretty high number.
When I think about how to articulate this to a candidate, I’m really telling them three things. Out of 170 individuals, this is an average of the hours that they have utilized for this experience, which means that if you were looking at this as a spread of hours, if we’re looking at this longitudinally or putting all of these on a graph, there’s going to be probably 15 that have exceeded the maximum number of hours. So let’s say, 10,000 hours or more. There might be 15 individuals.
Right. I see there’s a bell curve. [22:33]
Correct. But that curve may be a little bit more slanted, it may not be exactly a perfect bell. So what we’re saying is that on the one hand, there are some candidates out there that are exceeding the hours that normally would be bringing down the average, and there’s a reason for that though. The reason that that’s happening, and the reason there are more than there have been in the past is because candidates are taking more time to build on their experiences before they apply. This doesn’t necessarily mean that you have to do that, but this is a trend.
It’s indicative of a trend. So if a curious candidate were to ask more questions about this, which does happen a lot, then I simply tell them, thinking about this from perspective of average age, when I started here, the average age of our first year class was 23, now it’s 25.
That’s a big difference. [23:33]
So over the course of, I’ve been here eight, nine years, that gradually has increased. And I was even suggested if you were to focus on the past five years, that increase would be the same. In other words, that increase has really been within the last five years. So we could say there’s an effect based on the pandemic and the delay that the pandemic caused for many to get clinical experiences, but what it also means is that students were not ready to apply or they took their time in applying and they gave themselves more time to dive into these experiences, which are very important to discern for oneself if medicine is the right vocation for you. A lot of candidates are going through this really quickly, and this is starting to build more now, I think there’s an adverse to the trend now. I’ve met a lot of candidates in this cycle who are applying as rising seniors. And it’s against the advice of their advisors.
So it’s a reversal of the trend? [24:38]
Correct. And this is indicative of what happens a lot in this process is that trends come and go. At some point, this trend where people are taking more time will probably abate. We’ll probably see the class start to become more aligned with this one or two year pattern, and it is pretty typical, but I think it also speaks to the idea of what many candidates are experiencing is going out into the social media environment and trying to figure things out, and what they’re going to see, the majority of them are going to see students really anxious about getting things going and not taking that extra time.
And sometimes their parents. [25:23]
Right. Yeah, there’s that factor as well. But I think when you combine the parent factor with the crowdsourcing factor and often the lack of advising, that’s typically what you get. I mean, there’ve been plenty of students that I’ve seen who have advising and are not listening to the advice, but there are even more that have no advising and are just playing it by ear or using crowdsourcing as the best way to approach this situation. But you’re absolutely right about parents, that does come up a lot. The statement is always like, “My parents don’t understand why I would take time off.”
They shouldn’t be thinking of it as taking time off. They should be working, they should be pursuing their goals. [26:06]
Or just regirding oneself for the next phase of this process. There’s nothing wrong with collecting oneself and putting everything in the right place and a proper perspective to move forward in an application process. So timing is everything in this experience, and some people are just not ready because they may not have had the formative experiences that others have had, but they may disregard that if they’re looking at a post on Reddit or they may disregard that if they’re to a person that they met who is actively engaged in applying to medical school, who is maybe a lot more certain about that opportunity. And again, I think thinking about yourself in terms of your readiness, far more important. The MCAT is one indicator that tends to be an outlier in that respect because I think a lot of candidates really push themselves to take the MCAT when they’re not ready, and they may get a score back that may not be indicative of the best work they can do, but they still continue to apply.
And if you’re not successful after that first attempt with that MCAT, then you really got to rethink, is this the right timing? And just maybe putting a patch on that isn’t really going to help, just taking the MCAT again may not necessarily help. It may be a sign that you might need a little bit more time, and there’s nothing wrong with that. I keep telling people, and I really share the story about me going through my doctorate now because I’m in my early fifties. It’s not medical school, but I did a lot of things before I decided to do this, and I’m pretty certain this is what I want to do. So it can take a little bit of time to be certain about those things, but it doesn’t have to happen while you’re in undergrad.
It doesn’t have to be this automatic switch that you convert to, because it is a much more challenging environment. It’s a much more demanding environment. It takes into account the fact that you’ve already made the decision about going into this vocation, and now you’re ready to do the work to get there. But I’ve seen a lot of medical students at some point in my career who rethink that and they say to themselves, “I didn’t really think that it would be this hard and I don’t know if I want to do this anymore,” and the majority of those people had parents that were pushing them.
But to me that’s not a surprise given the population of pre-meds. Now, a lot of them are still one parent physician, two parents physician, half the poll perhaps. I don’t know if it’s that many, but it seems like that many. And often it’s the case we’re really trying to figure out, is this really their decision or is this something that they feel is a legacy that they have to continue? And so it does take a little bit more introspection to get an answer to that question.
I interviewed somebody several years ago whose father wanted him to become a physician. And largely because his father wanted him to, he didn’t want to. And then, the father unfortunately passed away suddenly while he was in college, and he still didn’t want to be a physician, but somehow I think he became an EMT. Anyway, he ultimately decided to become a physician and was very happy he did, but it had to be his decision. And I think that’s what sometimes children of physicians struggle with.
I had two thoughts come to mind as you were speaking. One is that the applicants or the students who are in college are really determined to get through the college and go straight into medical school, and they want to do the clinical volunteering and they want to do the community service volunteering, and they want to get some research in and they want to take the MCAT after their junior year, and they want to get good grades. Well, all the time demands of those first four items don’t support and help you get really good grades.
So if you say, I’m not going to put that kind of pressure on myself. If I start medical school a year or two years after I graduate college, I’ll be able to take advantage of my college experience in a much richer way. I’ll be able to get the experience I want. I’ll be able to confirm that medicine is the right path for me, which is your point, and I’ll just be more ready and be a better candidate. And I think that’s something that’s frequently lost on those who just say, “I want to get going,” or whose parents are pushing them. [29:09]
And again, I think that’s part of the advising structure, maybe the absence of it. In some cases, a lot of large undergraduate institutions just don’t have the bandwidth to support every student’s application process, so then they’re forced to form these groups on campus. I’m not going to name the school, but I interviewed quite a few of these candidates and I was told… Because I recognize they don’t have the advising structure, but I was told that this is a process that has been happening for quite some time to form these groups on campus to support students’ efforts to apply to medical school, to give them the opportunity to compel or link to clinical experiences and opportunities.
So now you have students essentially doing the work that a lot of advising teams would do, which is to engage physicians into shadowing opportunities for students or observational opportunities. And then if you’re proactive, which many of these students are, that leads to additional opportunities once they get that chance. But that’s what’s happening, students are really supporting one another, and that I think builds momentum. So I don’t think that having momentum is a bad thing. I think it’s a good thing. But I think the reality is you have to really know personally where you are compared to everyone else, and then just let everyone else do their thing, and just independently focus on whether or not, like you said, you’re ready to do all of those things, that all of those considerations are balanced, that you have an application that works for you because you have taken an MCAT that you want to forward on, because you consider the courses you’ve taken you know that the courses you’ve taken have prepared you well.
Sometimes I see applications and I’m like, and you don’t see either one of those things, but the candidate is not really being honest with themselves about what they see, or even more importantly, what that predicts in medical school. So that’s the thing I’m always trying to help them understand, the predictive nature of what they’re telling me or showing me or showing the committee is really what determines the impression the committee has. No matter what you say or try to tell, not show, but tell, is not going to mitigate what is seen in the trending or what’s seen in the transcript or what’s seen in the outcomes. Because I believe everyone will do what they have to succeed but at the same time, can you do that without delay? Can you do that while progressing in a very academically rigorous environment? Can you do that in an environment that’s going to demand of you your time and your efforts, and very quickly move forward rather than taking the time you might need to rethink things that are happening?
So that’s the thing about medical school, the pace is just unrelenting. And it’s constantly moving on to the next course or moving on to the next level and passing through the benchmarks without delay. So when a candidate shows me a transcript says that they’re ready to go into medical school and they’ve taken the MCAT six times, I say to myself, well, does this predict that you’re going to take the boards, the step one, six times? Because you can’t do that.
At some point you have to really understand how you can maintain success in the standardized testing environment without having to do it that many times. Think about all the costs, think about all the effort, think about all the anxiety, think about all the delay. All those things compounds and build that anxiety, and that’s the thing that really makes medical school hard. And when you start to see your peers advance and you’re still in the same classification, that’s another indication you’re not ready. But at that point, you don’t really have a choice, you’ve got to make it work. And I can tell that many students at that point are thinking to themselves, “I wish I’d taken more time.”
For sure. Just going back to those stats I cited about the paid clinical experience and the clinical service numbers. If I were just to look at those stats, I might assume that Stritch values paid clinical experience as much or more than volunteer clinical experience. Are those numbers just a reflection of the trend that we were talking about or does it reflect Stritch’s values? In other words, if you just volunteer, is that somehow worse than if you get a job? [35:07]
No, it’s a reflection of the trend. I mean, there are far fewer experiences coded as “volunteer.”
And certainly far fewer hours, particularly in the clinical arena because, again, this is the thing that most candidates are most compelled with when it comes to clinical experiences. It’s not necessarily the service part of it, it’s the application and the execution and whether or not it’s going to resound to the committee. Am I going to be licensed? Am I going to be certified? Am I going to have a level of progression within this clinical realm and it demonstrates that I’m ready to see patients or to have that experience of seeing patients? I think that ultimately, service unfortunately has been consigned to this sideline of, well, it’s just inherent in what I do.
If I’m going to get up and go to work and see patients, that’s service. And in my opinion, it also suggests that within the pre-med culture, there has been a redirect from service to clinical because of the challenge of getting clinical experiences underfoot, and especially when you think about that four years of undergrad. So the thing that I would say, if you’re doing four years of undergrad knowing you’re doing a gap year, what we tend to see is more service. We see more service in that four-year construct because they’re of the mind that I can wait until I’m done with undergrad to really focus on this clinical experience. I’m going to pivot to do scribing, I’m going to pivot to go on to clinical research.
So I’m going to enjoy, like you said, my undergraduate experience. I’m going to be of service to others. I’m going to do local leadership here, I’m going to do service over here. I’m going to do mission trips, those types of things. But once they leave medical or leave undergrad, those service engagements start to diminish because they’re more focused on either remediation of grades, doing a post-bacc or graduate program, or focusing on a longitudinal work-oriented clinical experience, because that’s how they build up that experience. So service becomes minimized in that setting. So we’re seeing that really hitting the post-baccs much harder in terms of limited service. So that’s why that construct across all 170 candidates has a value that is significantly less in terms of the average.
Does Loyola Stritch require shadowing? [38:18]
I think it’s a practical thing to do for all candidates. I wouldn’t say that it’s the most significant thing you can do. As I mentioned, I think that you really have to find an opportunity to engage in a patient-oriented experience, whether that’s scribing, which is not really hands-on. It’s obviously, again, a lot of observation, but there’s so much work and so much interaction with the clinical care team in that position that it does satisfy our considerations for whether or not the candidate is knowledgeable about medicine, knowledgeable about work, and a care team has really seen the environment firsthand and not through someone else’s perspective.
So I think that shadowing is reasonable if you’re trying to just assert whether or not this is the right location or the right experience that you want to pursue, but I think once you’ve made that decision, you really have to pivot into something that’s a little bit more tangible in terms of your time and effort to really make the case that you’ve tested your assertion and that you are in fact focused on this vocation. And again, it doesn’t necessarily have to be that I want to be this type of physician, but that this is the type of environment of training that is suitable for me.
This podcast should air on June 11th. If someone hasn’t submitted their primary by June 11th, or let’s say even in June, are they doomed? [39:50]
Oh, no. I just got off the phone with a young woman. She was so adamant about this thing, and then when I really pressed her to tell me where she got it from, she said it was a student. I was like, “You can’t listen to students.” You can, but you can’t. If I need financial advice, I’m not going to ask a student. That’s my advice. Treat application to medical school like financial advice, okay? Ask a professional. So no, I don’t think it’s late because we don’t actually pull the download in until July.
So I think that’s important for candidates out there to understand. AMCAS will compel you to submit your application in May. Once the primary application is given to them, then it’s verified. So that verification could take two weeks, it could take six weeks. That’s what really determines when your application goes to the medical schools. If the medical schools are ready to receive that application when it comes to them, then you receive a secondary application. So for us, we don’t actually start looking at those in our system until late June. So the earliest that we would send a supplemental application to anyone is, I think, the second week of July. So I would say that that would not be late. Now, if you were to say August or September, again, thinking about verification being six weeks, maybe four weeks, now that application isn’t getting to the medical school until September or October, and then you’re getting the secondary. Remember, it’s not complete until you finish the secondary. So all that time that’s elapsing is really now happening in an active cycle where you have interviews and all that’s happening. So I would say, if you’re preparing your application while active interviews are going on, then yeah, that’s too late.
Per our last conversation, Stritch is open to updates. What events are you interested in learning more about once the applicants have submitted their primary and secondary applications? How much is too much in terms of quantity? And what is insignificant in terms of quality? [42:08]
Well, this is one way I know that people are listening to your podcasts because I mentioned this, was it like three years ago I did your podcast? Ever since then, we’ve started to see updates from applicants increase. Remember what I told you at that point was that we don’t tell applicants about the update process, we only tell them once they interview. And then once they’ve interviewed, we help them focus on three types of updates. But we’ve been seeing those types of updates coming to us from the primary point, so they’re obviously listening to your podcasts and getting that advice. We always suggest three of the types of updates that are most effective are an academic update. So this is for those, remember I said there’s a large trend now applying into your senior year. So you may have coursework that has not been part of your process of discernment and that verification. When you submit your AMCAS application, they’re going to want to know what your predicted courses are.
So if you’re submitting your application and you’ve started those courses and you haven’t received an interview yet, a good thing to do might be to just let the school know, hey, these are my first semester or this is my first trimester outcomes, or these are the classes that I’m taking, or these are the classes I’ve changed, or I just started taking this class and this is what’s happened, this has been great. Academic updates can not only assert that the individual is interested, but provide some context to what may have been seen in the transcript or changes that may have been made. So academic, absolutely professional. Absolutely. This is even more pronounced because we’re seeing a lot more candidates anticipating hours of experiences rather than having them completed. And so if you’re anticipating the majority of your hours in a clinical experience that hasn’t really started at the time of your application, then that’s a great opportunity for you to provide updates, and we call those professional updates.
So I’ve been in this position as a scribe for a month. I coded this in my AMCAS guest application as anticipating X number of hours. Those hours have increased, decreased. I’m working with a different physician, and I wrote about in my application, because I’m doing such a great job working for the internal medicine person I’m scribing for. I had this patient encounter, this was great. Those updates, again, help us understand interest, but also provide context to what we’re seeing in the application. And then, the third is personal update.
So anything of a personal nature that might need to be availed to us, and this runs the gamut, I think, particularly for students who are applying with statuses that are a bit challenging. So we’ve had a lot of refugees and asylees applying to us over the past couple of years. We’ve also seen a lot more undocumented students who are not able to receive DACA status applying into the pool and asking for a remedy like, how do I keep my application active? So many of them are using adjustment of status, many of them are using asylee refugee. Many of them are using temporary protected status within their applications where they are describing their citizenship.
And we allow those applications to come through and we review them, but it’s always important in those particular cases to provide updates. So a personal update in that instance would be, this is my process towards adjusting my status, or any update that would refer back to the citizenship status that is working towards a goal of permanent residency or whatever the case may be in terms of the outcome. So I think those are really important, but we see a lot of… To provide a letter of intent before you are interviewed, I think is a little bit presumptive. I would certainly wait until you’ve applied to a school before you intend to matriculate, because it doesn’t really ring true if you’re going to do an-
Well, you already applied, that’s your intent. [46:57]
But I mean, if you’re writing a letter of intent, you’re essentially saying, I’m going to your medical school if given an offer. And at the application phase, what does that say? Does that say we’re your only choice? Or maybe you’ve just given everyone a letter of intent?
We don’t really know what that means. So on the other side of that, if you interview with us and you provide a letter of intent, well, guess what you provide? You provide a lot of detail as to why. This is what I experienced on the interview day. This is what I experienced in my research. This is the feeling I got when I was in person on that interview day. Those are things that resonate with the committee and are, I think, more believable.
So a personal update can really just be anything that the candidate feels they need to share.
We’ve covered a lot here. What advice do you have for applicants interested in applying to Loyola Stritch? Not so much this cycle because I think you’ve given a lot of outstanding advice for that, but they’re looking to 2025 or 2026. What would you recommend to them? [48:08]
Well, we see them all the time. As part of recruitment, we have an ASPIRE program with an applicant bootcamp workshop series involved. So we’re looking at candidates who are two years away. Here’s what we basically are trying to help them understand. We’re trying to help them understand, first of all, think about your rationale for wanting to go to medical school, really understand why you want to do this. I mean, obviously, the more you think about that why, the easier it is to share with others. And if you’re sharing it with others who are clinicians, who are educators, they’re going to support your efforts, especially if you’re a good person who is actively engaged in the work that you’re doing, is someone that is service-oriented. Again, this tends to be in that four-year wheelhouse of undergrad, so service is definitely tied to that discernment.
We also talk to them about really the timing of the application, when to determine if you’re ready, but not to force the idea of readiness. One of the presentations that I put together is it just describes all the different things that go into this process, all the different variables of consideration in a committee process. So if you’re laying that out like a map and you’re saying to yourself, I’ve really done a lot of this but not a lot of this, you really got to think about balance, you really got to think about putting it all together.
Obviously, I think in undergrad, you just have to do the things that you’re interested in. I’ve talked to music majors, I’ve talked to athletes, students that actually thought they were going to become athletes or become musicians, and then I think it’s good. I think it’s good that they’ve had the opportunity to really think about another profession, another vocation, another passion that have. But when they come back into this realm and decide that they’re going into medical school or that they want to do medicine, they really have to think more about helping the committee understand why have you made this decision and how are you determined not to change your mind again?
Because now you’ve got an investment of time and money and a process where we give you a seat and you choose not to take it to the fullest extent. Now we’ve missed out on giving someone else that chance. And that’s our goal, is to provide the workforce with physicians. So we want to be sure that you are sure that this is what you want to do. So if they’ve got more time, then really it’s about timing and helping them articulate their motivation, providing them with the resources and tools to do that. We talk about reflective practice a lot in this program. We give them frameworks of reflection. You can apply a framework of reflection to pretty much any part of the application that is contextual. And if you use that consistently, then guess what? The application makes a lot of sense. When you meet that person in an interview, you’re like, “Oh, this is exactly who I thought I was meeting, not someone completely different,” thanks to AI.
So I think having more time, as I said earlier, to really know this is what you want to do and to find the opportunities to involve yourself in a clinical experience, that is paramount because you’re starting to build your network. Those individuals that are helping and guiding you are not lost. They’re going to be part of a collected network over time. These are people that are going to be part of your support team. So you’re starting to build that, and you got to build that really before you get into medical school. It’s not the kind of thing you just start on day one in medical school to build. So those are things we try to really encourage, to get a running start at this process versus a cold start.
Sounds good. Thank you, great advice. What would you have liked me to ask you that I haven’t asked? [52:36]
Well, I think one question. I’m always thinking about what candidates are thinking is about common mistakes.
I’ve got counselors who interact with candidates a lot more than I do, and they do reapplicant counseling. And they’re always talking about, first, where’s the information coming from? What’s building the information base for the candidate? And in many cases just like I mentioned earlier, it’s not fact-based. It’s a student. It’s a social media site. It’s something that was crowdsourced, something that’s not actually evidenced or factually based in an institution. And I had the experience earlier today of talking to an accepted candidate where I started hearing a lot of misinformation. So I think that’s the most common mistake, is really not getting the advice from the source. And I recognize a lot of medical schools are really hard to interact with. We tend not to be that way. I mean, we try really hard not to be that way. But of course, there’s probably someone out there listening that said, “I emailed D Nabers three months ago, and he never responded.”
Well, it’s probably because I didn’t see the email. But no, we try to be transparent, and I think that pre-meds have to, if they don’t have advising, they really have to find a mechanism of advice and resource that is tied to medicine, or more importantly, tied to medical school application that they can trust. I think the other mistake that they’re making, and this is a collective thing as well, is just in the anxiousness, the anxiety that my counselors are seeing, and a lot of it is because when they talk to candidates, candidates are really focusing on what everyone else is doing. So the perfect example is the candidate that is taking the MCAT this month to apply in the upcoming cycle. I always say, know what’s on your application. Know what’s every part of your application before you apply. And the question they’re getting is, “Well, should I apply and then take the MCAT?”
And ultimately, why would you do that? Because you don’t know what the MCAT result is, and now you’ve got an application you spent money on, it’s already out there. But when they dive into why the candidates are feeling that way or why they want to do that despite the fact that they should wait is that because they feel the anxiety, they feel the pressure, they feel the need to move things forward. So again, I would just, I say it a lot, but everyone that’s applying to medical school is young. And I know what AMCAS says, I think they said there was a 61-year old that applied.
I would even tell that person. That person probably did a lot of evidence, a lot of soul-searching to get to that point. They’re probably more ready than maybe someone at 22 or 23. So what is the principle here? Well, the principal thing is readiness and timeliness, and it can’t be on someone else’s schedule. It has to be on your schedule. So that’s what you really need to feel comfortable about if you get pressure from any source, whether it’s parents advising social media to throw an application out there, no it’s not ready, then you just got to use your own judgment and not do it. But you’ll know when you’re ready. You’ll absolutely know it. And trust me, that’s the best position to be in, because you have all the choices to make when that cycle is over, and it’s not that you’re settling for anything at the end.
A previous guest gave me the quote, “Comparison is the thief of joy.” And I just loved it. It was Mike Woodson who said it on a previous podcast. I’m sure you know him. And apparently, Teddy Roosevelt originally said it. I think it’s true, and I think for medical school applicants, if you’re looking at what your peers are doing more than what you should be doing, you’re in trouble. Whether it’s what your peers are doing or your cousin did, or your girlfriend or boyfriend, it may not be right for you. So you’ve got to figure out what’s right for you. [57:02]
I always say, less FOMO, more JOMO, right? FOMO being the fear of missing out, versus JOMO being the joy of missing out.
The joy of missing out is that you’re on the journey and you’re insulated in your cocoon. There’s much more positive joy in that than being on the FOMO train. And it’s not one of those things we can really vet, unfortunately. I mean, we’re doing our best, but I think, again, behaviors tend to predict that. How candidates write about their own personal stories and motivations helps us to understand that. And this is something I say at the White Coat Ceremony. I’m always talking about trying to mitigate FOMO and the fear of missing out and trying to suppress the social media.
You’re going to have your peers who graduated from high school. Yeah, they’re going to be getting married and having lives and you’re going to be a student, but there’s joy in that. There’s a great joy and possibility of what the outcome is for you, because you know what? You can still get married and you can still have children, you can still have that big house. But you’re going to be doing something that you love the rest of your life. There’s great joy in that. So try to find the joy in the experience, and I know it can be difficult if you don’t like standardized testing.
Who does? Nobody likes it. Nobody likes being tested or evaluated, period. [59:20]
It’s part of life. It’s definitely part of medical school.
Darrell, I want to thank you so much for joining me today. This has been delightful. I’ve really enjoyed connecting with you again and hearing your perspective. [59:35]
Relevant Links:
- Loyola Chicago Stritch School of Medicine
- Accepted’s Med School Acceptance Calculator
Related shows:
- Case Western Reserve University School of Medicine, podcast Episode 571
- Tulane Medical School: How to Get In, podcast Episode 569
- Start Medical School in 2025 How to Get Accepted This Year, podcast Episode 567
- What You Need to Know to Apply to Medical School, podcast Episode 561
- All You Need to Know about the New Frist College of Medicine, podcast Episode 558
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