Show Summary
Welcome to the 600th episode of Admissions Straight Talk! In this milestone episode, host Linda Abraham sits down with Dr. Michelle Schmude, Vice Provost for Enrollment Management and Professor of Medical Education at Geisinger Commonwealth School of Medicine, to explore the innovative and comprehensive Total Health Curriculum.
Dr. Schmude shares how this evidence-based program prepares medical students for the complexities of 21st-century healthcare through early clinical experiences, team-based learning, and a focus on systems-based and humanistic medicine.
Listeners will also learn about exciting updates at Geisinger, including the evolution to Geisinger College of Health Sciences and its impact on healthcare education, as well as details on the Abigail Geisinger Scholars Program, which allows students to graduate debt-free in exchange for service in underserved areas.
Show Notes
Welcome to the 600th episode of Admissions Straight Talk. Thanks for tuning in. Do you know how to get accepted to medical school? Accepted’s free guide, Med School Admissions, What You Need to Know to Get Accepted can tell you exactly what you need to do.
Today’s guest, Dr. Michelle Schmude, has spent her career in higher education administration and med school admissions. After earning her BA in history and business, she went on to earn an MBAand then a doctorate in education from Wilkes University Since 1996 she has worked in admissions first asDdean of Full-time Admissions at Point Park University Then at King’s College and since 2015 at Geisinger Commonwealth School of Medicine, where she is now Vice Provost for Enrollment Management and Professor of Medical Education.
Dr. Schmude, welcome back to Admission Straight Talk.
Thank you so much, Linda. I’m really excited to be back again to chat with you about Geisinger College of Health Sciences and our School of Medicine.
You were telling me before we got online, there’s a lot going on. But let’s start with something basic. Can you give an overview of the Geisinger Med School program focusing on its more distinctive elements?
Absolutely. And that’s a great question. And I’m really excited to talk about our total health curriculum which debuted a few years ago. And I would say that there are definitely a few key elements that I think make us unique in terms of our medical education. And the first area I’d like to talk about is the science of learning. And so the total health curriculum uses an evidence-based active learning approach to medical education that has been demonstrated to improve learning and that’s so important for the success of our students.
Second of all, we utilize a clinical presentation model which relies on decades of educational evidence and ensures basic science and other content receive necessary emphasis in the clinical context. We also expose our students to early clinical experiences. And so they’re placed in the primary care setting in their second semester as part of the longitudinal clinical experience. And then our students are placed into their core clerkship rotations in January of their second year when they transition to phase two of the curriculum, and we’ll talk more about our phases in a little bit.
It’s really our team-based approach to teaching and learning so clinicians and scientists work in interdisciplinary teams to create and implement our curriculum, which enhances the learning environment, provides clinical perspective, and connects our students early with Geisinger Clinical Faculty who are their role models and advisors for residency and specialty selection. Really, really important. Another area is our systems-based learning, which immerses our students into a highly effective health system for clinical learning experiences, steeped in health system science, all to prepare our students to function in the 21st century practice environment. Additionally, I love to talk about this one too, is research and scholarship because our students engage in a lot of research activities that ultimately result in a lot of scholarship opportunities for them to speak at national presentations, to be published.
And so there really are a lot of opportunities for our students to engage in clinical research, in bench research, and also medical education. They do this through our summer research immersion program and through our medical research honors program. You can also find some of their research in our journal called the Scholarly Research in Progress that is known as SCRIP.
We also have a career pathways program, which is a four-year, required longitudinal curriculum that embodies our mission, vision and values and lives within our personal and professional development theme, which we’ll talk a little bit about later when we discuss our themes. And then last but not least, which is vital to our mission is service learning. And so service has always been an integral part to the education here at Geisinger College of Health Sciences and our School of Medicine. And the total health curriculum builds on this tradition by creating a more interconnected structure for immersion that collaboratively advances the work of our local service agencies.
That was a great answer. Very thorough. Thank you. All right, we’ll get to the total health curriculum in a minute, as you said.
Can you discuss what’s new at Geisinger? We have had the pleasure of having you on AST before. So what’s been happening in the last couple of years?
Sure. So I’d like to point out three things. So first would be our establishment and our evolution from Geisinger Commonwealth School of Medicine to Geisinger College of Health Sciences.
And that was established in the fall of 2022. And within the Geisinger College of Health Sciences, we have three schools, our School of Medicine, our School of Graduate Education, and our School of Nursing. So that’s update number one. Update number two would be we have a new chief executive officer of Geisinger, and his name is Dr. Terry Gilliland who began a few months ago, and we’re very, very excited about his appointment to this important position. And then last but not least, we are the first member of Risant Health, which is a nonprofit charitable organization created by Kaiser Foundation Hospitals with a transformative vision to improve the health of millions of people.
By increasing access to value-based care and coverage, Rise and Health will raise the bar for care that is based on better health outcomes. And again, Geisinger is the first member of Risen Health, and we are very excited about that opportunity.
That’s a lot going on in the last two years, that’s for sure.
We’ve been a little busy.
A couple of times you mentioned the total health curriculum and it has three fees phases. Can you review that please?
Sure. So, the total health curriculum is built on the science of learning and utilizes an evidence-based approach to trained skilled compassionate and competent physicians who provide individualized care and promote health in the communities they serve. Besides offering a fully integrated and immersive educational experience in basic clinical and health system science, the curriculum emphasizes six longitudinal themes that compose the systems, society, and humanism in Medicine IV. So we liken our total health curriculum to a tree, similar to the tree of knowledge that forms our current seal.
And we have three phases. So the first phase is the principle of medical science and practice. And this is our foundational piece of our curriculum that is rooted in basic clinical and health system sciences. Phase two is our core clinical immersion phase. This is the trunk of the tree and is a solid body of clinical experiences that begins early and grows in complexity and meaning, providing firm support to the branches. And then phase three is our career differentiation and exploration. And during this phase, and it is the final phase, students progress in the development of advanced clinical skills and training that suits their individual interests and ultimately career goals.
I can kind of envision the tree. I saw it online. I didn’t print it out, but now I can make perfect sense. I love the tree, and I love what it represents and how it relates to our three phases within our curriculum. It’s a lovely concept. You were saying tree of knowledge. I was actually thinking tree of life, but it can go either way. It’s interchangeable, right?
Absolutely. I think in terms of the curriculum, knowledge fits better, but that’s kind of what I was thinking of.
But you also mentioned the six themes in the curriculum.
Can you go over what they are again and then how are they manifest in the Geisinger experience?
Sure. So the six themes compose systems, society and humanism and medicine. And I’ll list those for you. So we have community immersion, which I talked about before, which is fundamental to the mission of our institution. Health systems, citizenship, which I think we can all agree that we want better healthcare for all citizens. Our personal and professional development theme, which I’m a faculty member in, and we really look to this theme to grow our students in terms of their emotional intelligence, being compassionate and caring future physicians and ethical in their decision-making. I mean, that’s embodied throughout our total curriculum but our personal and professional development theme definitely does advance emotional intelligence, leadership, so on and so forth. Population health, which we know that social determinants of health play a part of one seeking health care. And so really important for our students to understand population health.
Primary care, we know that we need to see our primary care physicians in order to really have good health. And if we need to seek any type of specialty care. So primary care is extremely important to our institution. And we’ll talk a little bit more about that in terms of our Abigail Geisinger Scholars Program and how primary care specialties in psychiatry interact in that respective program. And then last but not least, social justice and health, health equity, providing equitable healthcare for all.
Can you give an example perhaps of how one or more of these themes are manifest in the curriculum? How is social justice manifest in the curriculum?
Sure. So it’s a longitudinal theme, and we have various topics that work together and those topics are embedded in our clinical as well as our basic science and health systems science classes. So it’s a longitudinal theme that if we’re doing a case presentation, it might then overlap in terms of the theme of social justice and health equity. It could possibly be personal and professional development. And so it all depends on what the session topic is and how the theme is woven throughout. They can also interlace, they can interact in multiple ways.
It’s not like you have your social justice class, you have your personal, you know, they, and don’t make sense.
That absolutely is the case. And, I’ll use the word case again, because we do a case for our students and all of the themes are present within the case, along with basic clinical as well as health system science. And so it’s really an integrated approach to teaching and learning.
And you mentioned the Abigail Geisinger Scholars Program. It is very, I think, important to highlight that even though we’ve discussed it in the past, I want to discuss it again.
How can applicants, medical students, attend Geisinger Medical School and graduate debt free?
So thanks so much for this question. This program is near and dear to my heart. The cost of medical school continues to rise, and students are drowning in debt. And so a few reasons why we established the Abigail Geisinger Scholars Program first and foremost is to address medical student debt and provide opportunity for them to graduate from medical school with us covering their tuition and fees and providing them with a $2,000 a month monthly stipend. So first and foremost, reduce medical student debt.
The second piece is to repopulate our physician shortage in Northeastern and North Central Pennsylvania. So particularly the counties we serve in one of, so a student can pursue a specialty in one of five areas. And they are family medicine, internal medicine, pediatrics, psychiatry, and medicine pediatrics. And again, those specialties directly relate to our primary care phase.
You were mentioning just a minute ago how important primary care is to really all populations.
Absolutely. And so with this program, if we provide four years of funding to a student for their four years of medical school, so if we cover their tuition and fees and provide them with a $2,000 a month stipend throughout their four years. They will then attend residency in one of the specialties I mentioned, and then immediately post residency, they will come back to Geisinger as a physician and begin to practice in their respective specialty for four years. So if we provide them with four years of funding, they will give us four years of service immediately post residency.
But they can pursue their residency anywhere they want, right?
Absolutely.
Let’s turn to the Geisinger application. What is the Geisinger secondary like?
So the Geisinger secondary application, first and foremost, there’the first question is “Are you interested in the Abigail Geisinger Scholars Program?” So we talked about that. So this was really a nice segue into this next question. We have a couple of other ones, but they’re really focused on getting at mission alignment and whether or not the students are mission aligned in terms of their writing. So it’s really meant to better understand the student and how they align with the mission, vision and values of our medical school.
The themes of, I shouldn’t say the theme, the Geisinger values, as I read on the site, were kindness, excellence, safety, learning, innovation. They seem to play a role in the Geisinger secondaries, as you just said. Any suggestions for how applicants can answer those questions without just spitting back the themes? Because I think that’s sometimes a trap that medical school applicants fall into where they quote your website back to you and that doesn’t really do you any good.
And I agree. I see that a lot. OK. I would appreciate a little bit of a diverse perspective from an applicant. And when I say that, I mean, don’t just regurgitate what’s on the website.
But really think about how you as an applicant embody those values and link those to your experiences and your attributes so that you can demonstrate mission alignment with our respective institutions. And that’s really what the secondary can do for a student is give them the opportunity to demonstrate that they are mission aligned.
I frequently say that the primary application is about one’s fitness to be a physician and the secondary applications are about fit with the individual schools. So I couldn’t agree more. You just said that in connection with Geisinger very, very beautifully.
What do you think of applicants using chatGPT or other AI options in writing their essays?
Well, chatGPT and AI is here and we want people to use chatGPT and other AI options for the common good. However, we still believe that a personal statement should be that and it should be written personally by you, not chatGPT or AI. And so I really highly encourage applicants and we require that for our applicants to write their own personal statement as well as their comments and their narrative comments for a secondary to be their own personal work.
And yeah, it doesn’t come out quite the same if they don’t also… it’s just not as personal.
Sometimes it’s very vanilla. And you, the last thing you want to do is be vanilla, right? You want to, you want to add some sprinkles, right? Because those sprinkles represent how you align with the mission. And individuality.
Now Geisinger recommends but does not require the AAMC professional readiness exam or the Preview. What does the PREview give you that you don’t get from the rest of the application?
Wow. Another great question. I’m so glad you asked this. AAMC actually asked us to partner with them to become a pilot school in 2021 for the PREview exam and so we’ve been a PREview school in terms of highly recommending applicants submit the preview exam or assessment, whatever you want to call it, to us. And we believe that that gives the students another opportunity to show us another dimension of who they are as an applicant.
And I say this because the PREview exam assesses competencies for entering medical school, right? And so, and many of these competencies are emotional intelligence. And what better way to demonstrate that is through the AAMC’s exam. So we know we want future physicians when we select them to have an IQ that they can accomplish in medical school and be really great physicians, right? But we also want emotionally intelligent physicians who are kind, caring, and compassionate, who have excellent social skills, who are culturally competent and culturally humble, who are ethical and moral and those are some of the competencies assessed in the preview exam. And so I would really encourage applicants if they want to demonstrate those other competencies to consider the exam. I know it’s an additional cost and again, it might not be for everyone and that’s why we make it, we don’t make it required, we prefer it. What I will say is if, anyone who’s listening to this wants to learn more about this research. I, along with some colleagues, have a paper in academic medicine. It is called Evaluating a Situational Judgment Test for Use in Medical School Admissions: Two Years of AAMC Preview Exam Administration Data.
And you can find that in Academic Medicine. And yeah, I’m really proud of that. And it’ll give applicants and again, anyone listening and viewing a better idea of the research behind it.
Thank you for sharing that. So you’re actually using, you’re not at this point in time, you’re not just recommending the test so that AAMC can have data, you’re actually using it in the evaluation process.
Absolutely, we’re using it as a plus factor. Just like, you know, we subscribe to a holistic admission process, which means we look at academic metrics, we look at experiences, we look at attributes, and we look at competencies. And so students have options of how they demonstrate that, right?
If you and I were both applicants, I would be a betting person if I said that we wouldn’t have the exact same experiences or attributes or the exact same classes. And that’s the same with the PREview exam. And that’s why we leave it up to the student to say whether they want to take it and have it as part of their application materials. So we give the student the option.
So we’ve talked about a couple of mistakes that applicants make. Spitting back the website was one that we mentioned. I would say relying on AI without any input is a big mistake. What are the mistakes you commonly see applicants make?
Yeah, one of them is really underestimating the value of the experiences section, not providing enough context in there and in each section or each entry and also understanding how experiences the personal statement you’re writing in the secondary. It really has to come together to present this integrated perspective of who you are as an applicant. So realizing that each piece of the application is important and really understanding how they integrate together because you want them to be integrated and not stand alone because then I don’t understand who you are as an applicant as opposed to a packet that’s integrated. Does that make sense?
Yes. The metaphor I usually use is a jigsaw puzzle.
Yes. Great.
Pieces fit together. They also don’t duplicate. People have so many experiences, they shouldn’t be just focusing on one.
Exactly. And the experiences, maybe you want to say like a sentence about it in your personal statement, but that should be with using it in concert with your themes and also supporting other areas in the personal statement.
They should integrate and complement.
Exactly. And it enhances.
I’ve many times used the metaphor, your application is like a jigsaw puzzle, things need to fit together and not overlap or duplicate. So I think that’s certainly a mistake that I’ve frequently seen also. Now I know that Geisinger has an MMI interview. What is it like?
So there’s a reason why we utilize a multiple mini interview and the science behind it is that it reduces interviewer bias. And so we have found that as well. And so we deployed the use of the multiple mini interview in 2021, the same year that we decided to be a pilot school for the AAMC preview exam. So that was a real busy year.
But the MMI really assesses the competencies for entering medical students. So I told you that the preview exam was preferred. And so it wasn’t required. But students do have to participate in the MMI if you are offered the interview and want to be considered for admission. And so we have six stations that evaluate some of those competencies.
It’s all virtual, right?
It is our MMI platform. We do it virtually. And then we do offer recruitment days for our students who have been invited to interview. And so we’re really trying to separate out the assessment of a student, which is the MMI and the recruitment of a student with recruitment activities during our recruitment days.
Now I saw online that you finish interviews usually by the end of February. When do you stop sending out interview invitations? I’m asking this question all the time because the silence can be deafening and students wonder, I toast now? Because I haven’t gotten an interview invitation.
Sure. So great question. So this year we’re actually expanding our class. So for a number of years now we’ve been at 115 new medical students, and this year we’ll go to 126. And so we will be interviewing a little bit later than we have in the past. So we’ll go a little later into March. And so we will be finished up with interview invitations probably mid February to the third week of February.
You’ve emphasized the importance of primary care and clinical medicine. You’ve also emphasized the importance of research in the curriculum at Geisinger. Do you want students you admit to have both research experience and clinical exposure?
So that is an interesting question. I would actually replace research experience with community service experience. I will tell you yet that yes, they need to have community service and clinical exposure and why, right? So we want students to have clinical exposure so they…
They can appreciate the role of the patient, the physician, members of the interprofessional healthcare team and how a hospital system works, right? From the community service perspective, that’s who we are as an institution. That is vital to the mission of the institution is to recruit students who are actively engaged in service and part of their community. And I will also mention that work within a healthcare organization and being a provider, you are in service of others. And so having community service and clinical exposure is absolutely aligned with the mission, vision, and values of our institution.
We would love for our students to have research experience as well. And I talked to you a little bit about the research opportunities within the curriculum. And so there are a lot of opportunities that we do offer students during their time here at our institution to engage in research experiences.
But in terms of incoming students, research is more of a very nice to have, should I say? Whereas the clinical and the community service or the clinical exposure and community service really shows that alignment that you’re looking for to the core values. Am I interpreting you correctly?
So that is correct. However, I would like to say that as part of the mission, if you look, I like to call them our core pillars. Service, right? The other one is the ability to utilize evidence-based research. And having a background in research would help along with alignment there as well.
So I don’t want to say, you know, you don’t necessarily have to have it. What I will say is we do have a focus on community service and clinical exposure, but clearly having exposure in research does align with our mission in terms of the evidence-based research.
How do you evaluate multiple MCAT scores?
So we do look at all of them for context, but we will utilize the highest score. Highest total. Highest total. So we’re not going to separate subsections and do a super score like we’ll do with the SAT. No, we do not do that. But we do look at the individual sections. We look at the test, the number of times… to really, again, that’s holistic admission, right? It’s looking at the gestalt of the application materials. And so we look at it all, but we will utilize the highest score.
And per the MSAR, Geisinger last year received 5,254 verified applications, interviewed 823 applicants. And as you mentioned earlier, has a class of 115, which is going to grow to 126. How do you winnow it down? How do you go from 5,000, 5K to 823, which is the biggest cut, and then to 115?
Well, it’s a lot of work. I’m sure it is. But I think it’s important work. It really is, because the applicants deserve us looking at their materials, which we do. But I will tell you, again, it always goes back to mission alignment for us characterizing our, and so if you looked at our profile, you see approximately 65% of our students come from Pennsylvania. We have a very diverse class in terms of socioeconomic status, hailing from rural counties, students who have diverse racial backgrounds, and who are first generation in their family to go to college.
And so these are diverse backgrounds, they’re underserved populations, and we take pride in that. And so we are creating the diverse physician workforce of the future. And that’s really, really important to us. And so it does go back to mission alignment, and you can see the profile of our students and how that sort of shakes out in terms of the demographics.
How do you do view update letters either before interview, after the interview or from waitlisted applicants?
So great question. And we leave that up to the candidate to decide when is the best time for them to communicate with us. So we do, we allow students to give us two update letters if it…
You know, this year we’re closing in on 7,000 applications. So we allowed each applicant to give us two and they did. That would be 14,000 pieces of, or if we allowed more, that would be a lot. Not everyone takes us up on that opportunity, but we do say two is a nice number to give us some additional information that could help us in the discernment process of your candidacy for admission. So we encourage that. We do suggest to students to really think strategically about when is the right time to update us with meaningful and valuable information. Just saying, I’m continuing my interest. That’s great and we love that, but use it as an opportunity to tell us what have you done lately.
And I think you make the waitlist letter more valuable to the applicant by limiting it. You know, scarcity. There’s your MBA, your MBA coming through. Create scarcity. And give resources.
What would you have liked me to ask you?
Wow, that’s such a great question. I mean, I talked about Risant, we talked about our total health curriculum. You know, I love to talk about the Abigail Geisinger Scholars Program. I wove in, community service, which that was gonna be my piece on what I’d like to talk about more. I do really believe that this is the piece that I’d like to mention is the interaction between our students and our faculty, staff and administration in the building of a community and a community of practice. I think that that is something that’s unique here at Geisinger and special and does set us apart from other medical schools.
Now you actually, and I had meant to ask a follow-up question, so I’m going to ask it now.
You had mentioned that the students have relationships with the professors and that are they like assigned a mentor whom they see throughout the medical school experience? Does it change? How does that work?
Sure. So our medical students are assigned a faculty advisor, and they have mentors and coaches along the way. They have individuals within the clinical arena that serve as mentors and coaches.
And so it’s really an integrated approach to support for our students here at the institution. And then of course, when our students go out to their regional campuses, they have a regional campus team there to support them.
I want to thank you very much, Dr. Schmude. I think we’re almost out of time. Thank you so much for joining me and sharing your expertise.
Relevant Links:
- Geisinger Commonwealth School of Medicine
- Med School Admissions: What you Need to Know to Get Accepted
- Evaluating a Situational Judgment Test for Use in Medical School Admissions: Two Years of AAMC PREview Exam Administration Data
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- NYMC: How to Get In
- How to Write Essays That Will Get You Into Medical School
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