Is a Postbac Program Right for You?

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Understanding postbac programs, and how they can help YOU apply to medical school successfully [Show summary]

Accepted consultant Dr. Barry Rothman offers an overview of postbac programs to help prospective med school applicants discern if the postbac experience is the next best step for them, along with tips for postbac applicants.

How postbac programs help applicants apply at their best [Show notes]

Are you applying to medical school but concerned about your undergraduate record? Or, did the medical bug bite you when it was too late to take the med school prerequisites? Then you either are or should be considering a postbac program.

Our guest today is Dr. Barry Rothman, Accepted consultant. Dr. Rothman has been on the show several times. The first time was way back in 2013, before he joined Accepted. At the time, he was serving at San Francisco State University as a professor of biology, director of postbac programs, director of the SFSU health professionals advising committee, director of the pre-health professions certificate program, and director of the SFSU/University of Pacific Dental postbac program. He has since left SFSU and is now a much-loved consultant at Accepted.

How and when did you get involved in postbac programs? [2:11]

Around 2005. I was a professor at San Francisco State, and my Dean approached me and said, “We need a new health professions advisor.” I thought, “I like working with students and I’m interested in molecular medicine. This sounds good. I get three units of release time, and it should be easy.” Well, it was a lot more work, and I loved it. I really fell in love with the area and especially the students, working with them closely, helping them find their way into the health profession. At the time, there was an informal postbac program that all the CSU campuses had, but there were no services. You could just take classes with undergrads.

What services did you feel were lacking? [3:03]

Mostly advising, letter writing. There was no organization. It was just free-floating. The postbacs who came to SF State could take classes, but that was it. Nobody took care of them. A group of them approached me and said, “We would be willing to pay extra money if we could get some advising.” I said, “Okay, let’s put our heads together.” We wrote up a proposal, and my dean got on board. I had to take it to our Academic Senate, which was a learning experience in itself, having to learn how to navigate the political waters at San Francisco State, which are pretty calm, not turbulent, but still, I had to learn how to present my program to the Academic Senate and convince them that this was a good thing to do. It turned out great. Amazingly, it was in black ink from the very beginning.

I’m not directing the program anymore, but now the program’s into its 14th or 15th cohort. It’s been quite successful. It was formulated on the idea of cooperation, although many health professions situations can have a competitive component to them. We really wanted to select people who wanted to be team players, and that has been very successful. A lot of folks don’t want to be in a heavy competitive situation and want to be in a situation where people pull together and support each other.

Let’s dive into the different kinds of postbac programs that exist, focusing on MD and DO postbac programs. Can you give us an overview? [4:34]

The two main divisions are career changer and academic enhancer. A career changer is somebody who hasn’t taken any, or perhaps one or two, of the prerequisites for medical school. They are, in essence, changing their career from whatever they were doing before to a medical track. An academic enhancer is somebody who has completed most or all of the medical school pre-reqs, and probably some electives, but hasn’t done as well as they wanted to do to be. They need to enhance their academic record by taking additional, usually upper-division biology electives. Those are the two different areas.

There are many more academic enhancers than career changers, and not surprisingly, there are many more academic enhancer programs than career changer programs. Our program at San Francisco State actually catered to both. The career changers would be taking classes that the academic enhancers wouldn’t, but at the end of the career changers’ time, which was usually two years, they would take a few electives, and there they would overlap with some of the academic enhancers. The academic enhancers would take a diet of lots and lots of upper-division bio electives, such as neuroscience, immunology, endocrinology, etc.

Are there also other differences? Some programs award a degree, and some programs don’t award a degree. There are informal and formal postbac programs as well. Can you explore some of those distinctions? [6:09]

A formal program is structured. It has somebody running it and hopefully paying attention to what’s going on. Sometimes they have to hire their own faculty. Our program was a formal, structured program. I hired all of our faculty, and our classes were actually more separate from all the undergraduate classes. Some postbac programs will throw you in with the undergrads. Some will have separate classes. They can both be formal programs.

An informal postbac program is the way things were before I started my program at San Francisco State. People take classes where they can get in with the undergraduates. If there’s room in a class and the school is prepared to do this, you can take a class with the undergraduates. The problem with that is there is no financial aid. You have to pay out of pocket for this. The good part is, compared to a formal program, it’s less expensive all around. The formal programs will either confer a certificate, which was the case in my program, or they can confer a degree. Many programs now confer master’s degrees because they actually have more robust financial aid. If you’re an undergraduate, there’s a limit that the feds will put on the amount of loans you can get (somewhere around $70,000, lifetime). When you become a graduate student, then it’s a whole new pot of money. So, a lot of postbac programs have gone on to become master’s programs that will then allow you to find a better source of loans. For somebody whose money is really tight, an informal postbac program (or what you might call a “do it yourself” or, DIY postbac program) is really a good way to go.

I’ve had a lot of clients through Accepted whose hands I’ve held through the entire postbac process, and they’ve done very well. I would not suggest doing this all by yourself. It’s good to have an advisor somewhere who will guide you, and somebody to bounce ideas off of. It’s a big money-saver, and the good thing about advising is it goes a long way. What I can tell you in 20 minutes could be what you need to hear for the whole next semester. It’s very efficient financially.

Is there anybody who, in your opinion, should consider a formal postbac program? [9:01]

I think people who like structure and can afford it. It’s a really good way to go, especially a program where the directors are involved and it’s a good community, a robust community, where you can learn from fellow pre-meds. Most of the people in postbac programs are pre-meds so that would be preferred. But again, one can do quite well in an informal postbac program, as long as somebody’s guiding you and you do well in your classes.

The amount of support is really important. In our program, we had a learning specialist and a psychotherapist available because our students brought their own stress in, and they found it very valuable to have those resources. Not everybody needed those resources, but having that showed them that we really cared about them and wanted to support them in ways that maybe they weren’t supported as undergraduates.

If you’re going to shop around for a postbac program, see what kinds of extras they have. In our program, we had an MCAT colloquium where people could study together and pose MCAT questions to each other, but it wasn’t a standalone MCAT course. Those folks were taking a standalone MCAT course outside of the program and coming together to teach each other. I think that’s a really good way to get extra mileage out of a pricey MCAT program.

What advice do you have for academic enhancers, those considering a return to school and pursuing a career as a physician? Do they have to make up for low undergrad grades? How does that work? [11:00]

It depends on your undergrad GPA. What I’ve noticed is that med schools do not like seeing undergrad GPAs below around 2.6, and you really have to work hard for years to overcome that. Med schools are very cautious about somebody who didn’t do that well in undergrad. But if you’re at 2.7 and above, med schools will take you into account, but then you have to show that you really have changed something.

Many students didn’t have good study skills, they weren’t mature, or something was going on in their lives. You have to both explain what was going on and show that you can maintain a sustained high GPA, which means showing that you can do that for something like 40 semester units. It’s a lot, but it’s better to do that than to apply to med school prematurely and not get in. In fact, we have about an 80% success rate. The interesting part of it was that the 20%, the unsuccessful students, mostly were people who didn’t take our advice and applied prematurely. Med schools really like it if you think about what you’re doing and you take enough time to do it right the first time, rather than rushing prematurely, not getting in, and having to apply again some other time.

What advice do you have for career changers, those considering a postbac program to facilitate their career change? [12:44]

First of all, you need to have taken some science and math classes. We had an occasional applicant who had taken zero science and math classes. How are we going to judge your ability to prosper in science and math class if you haven’t taken any? You need to take some, and you need to have a track record of at least doing decently in that. If you haven’t, then go to a community college and take some intro or non-major biology, chemistry, and maybe math pre-calculus. Show that you have some aptitude for that, rather than wasting time applying and then not getting into a postbac program. Show them that you’re thinking about what you really need to convince them.

I don’t think I would jump into starting to apply to postbac programs this early. This cycle is really strange, and I think things are moving a little more slowly. There will be something like 20% more applicants this year. I think the schools are having trouble processing all of them, and I think the interview calendar will be pushed back a little bit. I think it’s premature to get too far into a postbac program, but it isn’t a bad idea to start thinking about it.

First of all, think about the weaknesses in your application. What do you think your weaknesses are? You can also hire one of us to do a review. It’s not very expensive, and we can do what’s called a rejection review, or you could call it a pre-rejection review or a maybe-rejection review. See what you need to shore up. Having this extra time, you could work on that. Maybe you don’t have enough clinical experience, which as you know is hard to get now that we’re in COVID. More experience, maybe. You need to show that you’re still academically active, and you need to take some courses, even if they’re online courses. It’s good to think strategically and think about what you could start to do now, rather than waiting till the end of the cycle when the time between then and the beginning of the next cycle is just a few months.

If, let’s say, it doesn’t work out, and you don’t get in, the wise re-applicant thinks about maybe spending an extra year to get things together rather than just jumping right back into the application cycle. If you are coming in with essentially the same application, you’re going to get the same result. It’s really good to put some time into fixing your application.

Once a student decides they want to go for a formal postbac program, what should they consider in choosing such a program? [16:08]

They should think about how good of a community the postbac program creates. There are some that are quite competitive just in terms of the everyday process. If you like that kind of atmosphere, then fine, but if you don’t, you may not prosper in that. How competitive or non-competitive is the vibe, and how engaged are the directors? Is somebody going to be paying attention to you? Or is it sink or swim?

Also, the quality of their committee letter. Some schools write cookie cutter committee letters. Others really go to some length to make it very personal and support you as an applicant.Those are some subtleties you may not think about. Of course, you can think about the success rate of the programs, but there’s no central compilation of the success rates of these programs, though you can ask and hope that they’re telling you what it really is.

What does a typical postbac program application consist of? Is it as difficult as the MCATs plus secondaries, etc., or is it a little bit more simple? [17:39]

In the old days, each school had their own postbac application, but now we have PostbacCAS (postbac Central Application Service). CAS has become an industry, so there are CASs for optometry school, pharmacy school, vet school, etc., and they all end in “CAS,” like VMCAS for vet schools and PharmCAS for pharmacy school. Now there’s PostbacCAS. CASPAer, their CAS is in the beginning and not the end. Those are standardized.

It’s a good idea to centralize the application process because then you can apply to a number of programs using more or less the same application. They’ll have a personal statement that’s around 5,000 characters, they’ll have a place for experiences (very much like the medical school application process), and then each school will have its own supplemental questions. That’s maybe a little bit more like some of the other CASs. Those supplemental questions are starting to take over for the secondary applications, so that instead of getting a secondary, in some cases, it all goes in with the primary application. Not only do you apply through PostbacCAS, but then you look up the school that you’re applying to and find out what extra questions they have.

When you submit to that school, you have to submit your answers to those supplemental questions. I think the supplementals serve as secondaries, but it just all comes in at once instead of in two separate batches. You can submit the PostbacCAS, and then you can add on schools as you complete their supplementals. You don’t have to complete every school all the same time.

What should applicants emphasize in the personal statement for the postbac program? [19:48]

This seems obvious, but, “Why are you applying to the postbac program?” Admit why you are applying. Let’s say your academic record is not perfect, and you think that that’s important for getting into medical school. Say it. It’s really confusing that I have read applications to my postbac program where it wasn’t clear why in the world the person was applying. They didn’t want to admit that they had a tarnished GPA, or they didn’t have enough of this or that. It’s really good to show that you understand your situation, that you’ve thought about it, and these are the things you need to improve your application, and the program is a good fit for you. That’s one thing that’s important.

Another thing is adding personal information. Some personal statements can be laundry lists or repeats of resumes, and those don’t work very well because the personal part is missing. One of the things we like to see is, well, where is your heart? What really motivates you? Where are you coming from? Some personal information about your background, your values, why you’re doing this, that helps because that will make you different from the other applicants.

What are other common mistakes applicants have made in their postbac applications? [21:18]

There was the one about not having taken any science or math classes, so that’s a mistake. I think we covered the main mistakes. These postbac programs have interviews (now they’re online, but in the past, many of them are in person), and you need to be prepared for your interview. One of the things our program did was we had a waiting room where the students could hang out, and we encouraged them to talk to each other, and we were secretly watching them interact. One of the things that stood out was there were occasional applicants who would just sit in a corner and look at their cell phone. That move made us think, “I wonder how much of a team player that person is.” Think about your interview, take it seriously, and get some help with it because most of us don’t know how to interview. We’re not born with the interview gene. Think about your impression, even when you’re not in a formal interview. Even when you’re just schmoozing with somebody, you’re still, in a way, interviewing. You really need to treat people well and politely, which hopefully you would do anyhow. The interview is another important part, and that’s very disappointing if you get as far as an interview and you don’t interview well. That can be very disappointing.

Two other things. One is: Many schools are asking, what did you do during COVID, or what are you doing during this pandemic? They want to know, what have you been doing: sitting around watching Netflix, or are you actively involved in some way to help your community? Which you can do online, you don’t have to do it in person. That’s definitely one thing.

The other is, now every school is asking about diversity and how you relate to the diversity of their program. Most programs, including ours, want a diverse population. I think of medical schools and programs like postbac programs as organs of social change, and they’re making things change more than maybe other sectors of the population. They’re bringing people in who have not had a lot of opportunities. How do you relate to that? Whether you’re somebody from a disadvantaged or underrepresented background, or even if you’ve grown up with a lot of privilege, how have you dealt with that privilege, and how diverse of a population of people do you hang out with? Those are all really important, and that’s going to help you with med school applications as well.

What would you have liked me to ask you? [24:32]

You asked me the question I wanted you to ask me, which was, “What happens to the 20% who weren’t successful in the program?” I would like to expand on that a little bit. Families can be your support, and they can also be a pain. Sometimes families are well-intentioned and they pressure their adult children to apply prematurely, sometimes with tremendous guilt trips like, “Gee, cousin Charlie got into medical school. Why aren’t you in medical school now?” or, “You’re costing me a fortune.” You have to find ways to talk to your parents and calm them down a little bit. Maybe get some outside help in doing that, and don’t let that make you apply prematurely. If you apply prematurely, that’s one whole application cycle that’s gone. In the second cycle, many re-applicants get in, but the third cycle and the fourth cycle, no, those don’t work so well. The schools look at you much more cynically and much more carefully. You have two precious cycles to apply. Don’t waste one of them because you’re getting a lot of peer pressure or family pressure to do so.

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