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What’s new at Washington University School of Medicine? [Show Summary]
Dr. Valerie Ratts, Associate Dean for Admissions at Washington University School of Medicine, shares what’s new in the program, including the Gateway Curriculum and the virtual interview experience.
Interview with Dr. Valerie Ratts, Associate Dean for Admissions at Washington University School of Medicine [Show Notes]
Welcome to the 485th episode of Admissions Straight Talk. Thanks for joining me today. 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 will not only get an assessment, but also tips on how to improve your chances of acceptance. Plus, it’s all free.
Today’s guest, Dr. Valerie Ratts, earned her MD at Johns Hopkins, where she also did her residency in obstetrics and gynecology as well as a fellowship in reproductive endocrinology. She joined the Washington University faculty in 1994 and currently serves as Associate Dean for Admissions and a Professor of Obstetrics and Gynecology at Washington University School of Medicine.
Can you give us an overview of the WashU School of Medicine program focusing on its more distinctive elements? [1:52]
Well, actually, our curriculum has changed since I last spoke to you. We’re very excited about it. It’s called the Gateway Curriculum. We’re reimagining how we should best be educating medical students for the future and we deliver that in three phases.
In phase one, we concentrate on the fundamentals and foundational modules in medicine. But we’re integrating it the entire time. When you’re getting basic science courses, we’re integrating clinical problems, social sciences, health equity, and justice. All of those things come up during phase one. We also have clinical immersions during that period where students go into the clinical spaces for three weeks at three times during phase one. They’ll go to inpatient, outpatient, and peri-procedural spaces. The goal is not to be the physician. Yes, you get some clinical skills. Yes, you see how the different units work. But the goal is to get a perspective of how all the other healthcare providers in that space, including social workers, nurses, and pharmacists, work together. We think that medical students, at that point in their education, haven’t quite learned all the bad habits that physicians get. They have a very unique perspective. We have small group sessions where the medical students will meet with other medical students and their professors to talk about the things that they observed in those spaces, good and bad. The thought is that when they become the physician down the road, they can reflect upon that period of time, and it will hopefully make them better doctors in the future. That’s one of the things that we’re doing in phase one, getting them very quickly into the clinical spaces and using that unique perspective that an early medical student has.
Then we have phase two. This is the gateway to clinical medicine. This is when students rotate through the six big specialties in medicine, OB/GYN, medicine, surgery, neurology, pediatrics, and psychiatry. All medical schools require you to rotate through these clinical services. You’re basically trying on all the hats to learn what type of medicine you really enjoy. What we do uniquely in this phase of the curriculum is we have the clerkship start with bookends. In the beginning, we review foundational modules and science that we first taught in phase one that is applicable to the clerkship that you’re going to be engaged in. We are reviewing that medicine to help you remember it, understand it, and to better apply it. This is this helical learning that we’ve integrated into our curriculum, and it seems to work really well. Then the students go, and they engage for a period of about six weeks. At the end of that clerkship, they have a one-week period of time called ART for assessment and review. Phase two is working out really well. Students are very excited about it. They’re learning medicine and seeing it applied.
You’re a little over halfway through the four years of medical school when you finish phase two, and then you go into phase three. This is called the gateway to specialization. By this point, you have the foundational knowledge. You’ve tried on all the hats. You have an idea of what you’re going to be interested in. We use the remainder of phase three to do activities to help you prepare for residency. Yes, there are a few required activities. There’s an internal medicine sub-internship, and there are some advanced clinical rotations that you get to choose from. You really get to choose what you want to do. If you were thinking about going into surgery, maybe you’d do an advanced clinical rotation or two in surgery, but you might also consider doing anesthesiology. In addition, during phase three, there’s ample time to do elective work. This is where we anticipate our students doing most of their research. They’re doing research in the area of medicine that they’re going to go into. They’ll do research when they go off into their residency interviews and they’ll be able to talk about their research. The physicians who are interviewing them will be very interested in their topics, and they’ll be very knowledgeable. It really enhances our students as they prepare for the next step.
Could you give us an idea of how long each phase is? [8:19]
Phase one is about 16 months. That’s where you do the seven foundational modules and the three, three-week rotations, as well as a one-month period of time for what’s called Explore.
Phase two is 12 months. And then, the remainder period of time is spent in phase three.
We’re piling in a lot. We’ve always been a very flexible medical school in terms of how we educate our students. We have very bright, motivated, and enthusiastic medical students. Our job is to give them the resources, the experiences, the exposures, and the knowledge so that they can go on and do what they want to do in medicine. That’s what we’re trying to do with this new Gateway Curriculum.
The other thing that we’ve added to the curriculum is called Explore. It’s this concept that there are four big areas in medicine. You pick your specialty, but then there’s also your passion in medicine. The passions that we think we do really well in are research, education, advocacy, and inquiry innovation. These aren’t pathways. You’re not slotted into a pathway, these are areas that you can develop in terms of passions. Our students typically will do many times more than one passion. Medicine is just exploding forward, and we have to keep up with the change. And that’s one of the things in the Gateway Curriculum we’ve really emphasized. We can’t teach you absolutely everything you’re going to need to know right here and now.
Can you talk about the advising and coaching element to WashU’s medical program? [11:34]
Yes. Thanks for asking about it. That is one of the things that we added to the curriculum that we’re truly very excited about. Our coaching program is such that when our medical students step onto campus on the first day of medical school, they are assigned a faculty coach. This faculty coach is someone who has been educated and trained to know exactly what issues first-year medical students will encounter. Everybody who goes to medical school encounters a few bumps in the road. That’s just the way medical school is. One of the things that we have to do is we have to help train you on how to navigate those sorts of issues. So you’re assigned a coach and a small group of other medical students is also assigned to that coach. You get together at regular intervals to address some of the issues going on in medical school. Whether it’s just in phase one, when you’re learning all this material, or in phase two, when you begin to encounter some difficult problems that might arise. We’re here to help our physicians grow emotionally to handle the rigors of medicine. This program has been very helpful. That coach stays with that medical student for the entire four years of medical school.
At our medical school, typically as students enter into the clinical phase and begin to pick what area of medicine they like or enjoy, the other mentors in that specialty start to come out. This is a friendly place. It’s extremely collaborative because we know that’s how we have to do medicine. It takes many minds together to solve problems. That’s the environment we have created here. It starts with our Dean, the top of the medical school, and just infiltrates through the entire medical school curriculum. I think our students feel it too. That’s a really important part of our medical school.
What is the WashU secondary like, and does WashU screen secondaries before they send them out? [14:27]
We typically send out a secondary application to all applicants who complete their AMCAS application.
For our secondary, we’re collecting a little bit more demographic information and some interests that the students might have so that we can help send them back information that will be helpful to them. When you’re picking a medical school, you’re looking for the school where you fit too. You look at us, we look at you, and you’re trying to find that fit, because when you find the fit, you’re going to flourish. That’s something we recognize and we try very hard to give lots of information about our school.
The secondary also has a few essays on it. There are standard essays like “Tell me about a time when you’ve failed or been unsuccessful.” I think that tells a lot about an individual and how they handle difficulties. That resilience and grit component is something that we truly look for. The second essay asks, “Is there anything that you haven’t told us about you that you think is important?” We want to make sure we give applicants plenty of space to tell us about them.
What do you think is a common mistake in approaching the medical school application, be it the primary or the secondary? [16:13]
I think that the application is about why one wants to go into medicine. What are the activities that have been most meaningful to you? That’s really important. I think the one common mistake people make in their personal essay is just rehashing all of the things they’ve done. You don’t need to do that. Be a little more creative in that personal commentary than just rehashing the activities. I have all of your experiences because you told me about them. What is the motivation?
It’s okay to tell me about the first time you decided you wanted to be a doctor. I think those are interesting stories. That motivation for medicine is key. If you’ve done other things, tell me why you persisted. People who apply to medical school are incredibly talented. They could do a lot of different things. Sometimes you see students doing all sorts of different things and you’re like, “Why are you going to med school?” Making sure that comes across is incredibly important.
At WashU, this sense of wanting to help people is important to us. Doctors take care of people in very difficult times. Applicants need to understand that. That’s a really important part of the story. And then creativity is a great thing to share. I love people that have done things outside of medicine.
Don’t think that everything you have to put on that application is all about medicine. Tell me if you’re an artist or you’re a writer or you’ve done some unusual activity. Those unique experiences are great. Our medical school class is not that big, it’s 120 students. We’re always looking to create a class of individuals who have unique experiences so that when we bring the class together, individuals grow from interacting with each other. That’s a very important thing to consider.
I’m hearing two things, and I’m wondering if they are complimentary or in conflict. On one hand, you’re saying you want people with diverse experiences, but you also say that if they have a bunch of different experiences, then why medicine? Can you reconcile that for me? [19:45]
I think that having lots of different experiences allows you to be a complete person. As a complete person, you are applying that knowledge set and that desire to help others by going into medicine. You’re right. You’re getting right at the thing that we’re looking for. We’re looking for individuals that have done these different things, but at the end of the day, in those essays, in that application, it should be very clear cut that medicine is how they’re going to apply themselves and that they have a passion for it.
There are different areas in medicine too. There are people who do great research. That’s pretty creative. You have to be creative and look at things in different ways to do research and inquiry innovation. Even education takes creativity. Maybe there are some better ways that we should be teaching these concepts. It applies to advocacy, too. Just because we’ve always done it one way, doesn’t mean there can’t be a better way. Maybe we need that creativity there to help us do it in a better way. That’s what I’m always looking for too.
What is the virtual interview day like at WashU? [21:59]
It’s been a very interesting experience going virtual. Like many other medical schools across this country, we’ve had to think outside the box. I think that we’ve learned that it’s actually a pretty good way to do interviews. It breaks down financial barriers to interviewing at medical schools. We knew that was a problem we just didn’t know how to solve, and I guess in some ways, COVID solved it for us.
We do our interviews on Zoom. We have two interviews with faculty members. One is the longer interview where the faculty member knows a little bit about you. They’ve read through your entire application, and they’ll have a conversation to learn the applicant’s motivation for medical school. Then there’s an interview that’s much shorter, maybe 20 to 25 minutes, which we call the closed file interview. That interview is with a faculty member, but that faculty member knows nothing but your name and personal pronouns. It’s getting to know an applicant through a different lens. Communication is really key, because that’s what physicians have to do. That’s our job. Those are the two interviews that we do.
We have a tour that’s typically with a senior medical student. On this Zoom tour, there are little pins on a map and students go to different pins virtually. They open up and there are slideshows and videos to show different things. It’s like you’re walking around the campus. There’s more than one applicant with that senior medical student so there’s a conversation going on in real-time. You can also see other medical students who are doing the same thing as you as an applicant. That works out really well. By having a senior medical student do it, they also give their perspectives.
We have a conversation with the financial aid office because we know that affording medical school is a tall order. We have a very robust scholarship program here so we talk to the applicants about that.
Then we have a conversation with admissions leadership where we review the curriculum. We review how their day went and we open it up to any questions they might have. This is all a Zoom call webinar and there are multiple applicants on that webinar.
The other thing that we add is we have Why WashU Wednesday Webinars every Wednesday evening. That’s where we feature students from different years: phase one, phase two, and phase three students. We feature students in different portions of Explore. We feature community engagement, our health, equity, and justice threads within our program. We feature the medical school campus. We feature the city of St. Louis. There’s a lot that happens in St. Louis and our medical students really enjoy receiving their education in this city. We share what it’s like to live in St. Louis. We try to give lots of information through those webinars.
The stats from matriculating students at WashU are way up there: 521 median MCAT score and 3.93 median GPA. Obviously, WashU is very selective. What makes applicants jump off the page for you? [27:43]
I’d like to say that we have students here who are very academically accomplished in terms of their metrics, but the range is quite wide. I always like to point that out. We use the AAMC sort of directions of EAM (Experiences, Attributes, and Metrics). We do a holistic review process where we’re combining the experiences, attributes, and metrics and looking at the students to figure out who will best align with our medical school and contribute to the physician workforce in the future. We’re trying to educate academic physicians who will go out and do research, do inquiry innovation, educate, and be advocates in their communities.
That’s what we’re looking for. There is no formula. We take English majors who have done unbelievable things in terms of writing. Or people who have done volunteer work. We have amazing scientists who have already written papers and have done unbelievable research. There are people who have done some unique things in their careers, whether they were an athlete or did a leadership activity. We’re looking for those individuals who will bring those unique experiences to our medical school. There isn’t just one type of student. We want someone who can communicate very well. I always say the job of physicians is to take complex scientific information and distill it down and present it to a patient so that they can understand and ultimately make the decision that’s right for them.
That is a very important skill set we’re looking for. We’re looking for people who are doers. They’ve done something. They’ve accomplished a task. I think if you’ve accomplished something in the past, you’ll probably be able to accomplish something in the future. The final thing that I’m always looking for is grit and resilience. That determination factor. Maybe something was tough in one’s life. It’s okay. Show me how you overcame that. We really love those stories.
What makes for a great interview? [31:10]
I think in interviews, I always think it’s good to have your “Tell me about yourself” answer prepared. Every medical school will ask you that question. Be prepared for it. You don’t want it to go on and on and on. Make it about 60 seconds. Think about what the most important things are about you that you can share in 60 seconds. Frame yourself for the interviewer to start the interview process. Looking prepared is a good way to start.
I think that it’s very important in the interview process, whatever medical school you’re at, to let the interviewer know that you’ve done your homework. You’ve gone to their website. You’ve read about that medical school. You’ve looked and found what you think are the unique aspects of that medical school and its philosophies. You know that stuff. That’s really important in the interview.
How do you view letters of intent or updates at any time during the process or correspondence from wait-listed applicants? [32:28]
At WashU, we try to keep the communication open. To be honest, letters of intent and communication early in the application cycle are not necessarily or particularly helpful. In our application cycle from July to maybe January or February, we’re just trying to get through the applications and understand what the applicant pool looks like. Then as we get into the end of January, February, and March, that’s when we’re beginning to select the individuals we think will best align and fit the medical school. If you truly are interested in a medical school, I think a letter or email saying why is helpful. We keep that line of communication open. It’s the same process for the waitlist. We listen to students as they’re navigating this process.
I say to medical student applicants, you start filling out your applications in April or May, and many times you don’t hear back until the following March or April. Sometimes the process really drags on through the beginning of the summer. That is not uncommon. It’s hard. Really be thoughtful about your emails and what you’re saying. I think that professionalism is key and important in being authentic.
Many of our applicants are doing activities as they’re applying to medical school. Those activities, especially during that point in their career or education, are often very important to their motivation in going to medical school. Those types of correspondence and emails are also helpful. We look at them and we place them in the file.
When do you stop sending out interview invitations? [35:58]
We typically stop sending out invitations around the end of January.
The reason I ask is because there’s this idea out there that if you don’t have an interview invitation by Thanksgiving, you’re toast. [36:13]
Not at WashU. That’s absolutely not true. I can guarantee it, as the Associate Dean for Admissions. We send out interview invites well after Thanksgiving. Absolutely.
How do you view applications from students who’ve taken some prerequisites at community college? [36:55]
We look at education and we look at competency. That’s even part of the Gateway Curriculum, which is all about meeting competency requirements. There are different categories of things that we’re looking for. The way we look at prerequisites is that you need to be competent in those areas because you need to have that knowledge to be successful in medical school. It’s not a way to keep you out of medical school. It’s a way to make sure that you will be successful and that you’ll hit the ground running. We take the stance that if you take those classes at a community college, that’s fine. We will take AP credit, especially if it’s been on a transcript and you document that. Even online courses, we will actually occasionally accept too.
Now, the caveat to that is that if you take those types of classes, we also expect you to do more rigorous classes in the areas of biology. You’ve been able to take those prerequisites, but you also need to show you’ve taken some advanced courses. Being able to do really fabulous in those advanced courses shows me your scholarship ability.
How important to WashU is shadowing, and how do you view virtual shadowing? [38:40]
I think shadowing is important because you have to be able to ask the question, “Have you ever seen a physician work?” And, “What do you like about being a doctor?” I think it’s hard to answer that question without having a little bit of real-life experience. Many times, shadowing shows the applicant that it’s not all perfect. Things don’t always go perfectly right and there are stresses. Those observations are very helpful to applicants as they apply to medical school.
I also think that you don’t always have to shadow a physician. You learn a lot from shadowing others within the healthcare space. There’s a lot of information to be gained and learned. The spaces in which physicians work take multiple people working together to solve complex medical issues and problems.
If somebody has a couple of years of EMT or scribing or medical assistant experience, do you still want to see shadowing? [40:48]
That, to me, is shadowing.
If you take the stance that you’re checking boxes when you’re doing the medical school application, that is not the right way to approach this process. Tell me about the experiences that you’ve had and why that motivates you to go into medicine. How are you going to change the world in medicine with those experiences?
As far as virtual shadowing goes, it depends on the experience. That’s part of the COVID thing and we recognize that COVID made it hard. So we’re going to understand that, but there were still opportunities to get experience. Maybe working on crisis hotlines and communicating with patients in that way. Being the EMT. Helping distribute vaccines. Being the person that navigates within the hospital or directs people where to go. You learn a lot in the healthcare space in that way too. There are a lot of different ways to get this experience.
Here’s a listener question that I thought was fantastic: You were once a medical student. If you were a premed student today, traditional or otherwise, planning to apply in 2023 or 2024, what is one thing you would be doing to prepare for medical school? [42:20]
One thing…That is such a hard question because the answer is you just can’t do one thing.
I think the most important thing is having experiences within the healthcare space like what we just talked about. You’ve got to understand the healthcare space and be able to say, “Yeah, I’ve seen it, and I know that it’s the right thing for me to do.” You have to show people that you care. You have to want to be around people and you have to show that too. Showing that you care about people and you want to help them is particularly important. There are different ways to show that. I would do that now.
It’s such a different world now than it was when I was going to medical school many moons ago. I wasn’t allowed to shadow when I was applying to medical school. I didn’t have anybody in medicine in my family. I worked in the hospital in the dietary department and I put food on trays, and there would be times when I would get to pass the trays to patients. I loved doing that. I loved taking this tray of food into a patient’s room, where I got to interact with them. I look for that in my applicants, that true desire to help others. Yeah, you have to be smart. Yeah, you have to be pretty good at science. That’s just part of it. But you have to show that sense and desire to help others.
What would you have liked me to ask you? [45:16]
You did a really good job. I don’t think there’s anything that you didn’t cover.
Where can listeners learn more about Washington University School of Medicine? [45:49]
Related links:
- Washington University School of Medicine
- Are You Ready? Med School Admissions Quiz
- Washington University School of Medicine (St. Louis) Secondary Application Essay Tips [2022 – 2023]
- Accepted’s Medical School Admissions Consulting
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