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Postbaccalaureate Options
for the by Gerald Soslau, Ph.D., Yolanda Pressley, and Laura Mangano This article
was published in the Advisor, INTRODUCTION The ratio of college
students who seriously consider medicine as a vocation versus the number who
actually become doctors is probably higher than for any other profession.
Of course, many typical applicants are very successful in gaining
admission to one, or more than one, medical school in the United States.
However, we have found that many premedical students who ultimately
succeed at matriculating into medical school do so only after many missteps,
some of their own making and some due to limited counseling.
Our personal experiences over a combined 40 years indicate that these
students who have remained true to their commitment to a life in medicine tend
to be altruistic students whose personalities seem most appropriate for a career
in medicine. But many of these
students struggle with being accepted into medical school.
How do we, as premedical advisors, best serve these qualified students to
help them achieve their career goals?
A significant number of students have taken postbaccalaureate course work
before entering medical school, whether it was continued coursework to
strengthen their application to medical school or premedical courses taken for
the first time, as is indicated by the AAMC 2004 Matriculating Student
Questionnaire (1). In fact, nearly 15% of the matriculating class of 2004 was 26
years or older (2). These “nontraditional applicants” often needed
postbaccalaureate work due to the competitiveness of the medical school
applicant pool, explorations of other career paths, time off for volunteering,
or other health care experiences. Students
who apply often not aware of, or are unsure about, entering a postbaccalaureate
or graduate school program. These
students need help in assessing which, if any, type of program best fits their
individual needs. They also need to
reevaluate their overall credentials and realistically identify weak areas in
order to apply to a program that will help them reach their goals. TYPES OF POSTBAC PROGRAMS In
general, premedical postbaccalaureate programs fall into two categories:
enhancement and career-changer programs. Enhancement
programs give students an opportunity to improve their weak academic record
and/or strengthen their knowledge in more advanced scientific coursework.
Most programs offer either undergraduate or graduate coursework, a
combination of both, or the opportunity to receive a master’s degree.
With a review of the student’s undergraduate academic performance, the
MCAT score(s), and healthcare experience, health professions advisors can help
students make more informed choices about choosing which program is right for
the individual. Career-changer
programs are typically designed for students who have either taken minimal or no
science courses. Students have a
variety of choices ranging from the highly structured programs, more liberal
loosely structured, and lastly the self-study or continued education option.
All of these programs allow for students with little or no science
background to complete most or all of the prerequisites required to sit for the
MCAT and apply for admission to medical school.
Career-changer programs include individuals straight out of college to
those who have long-time established careers. Occasionally,
advisors encounter students who strongly favor the sciences but are undecided on
their career path with regard to practicing medicine versus conducting
scientific research. These students
may do well to enroll in a thesis-based Master’s of Science program in a
discipline of personal interest, i.e. biochemistry, physiology, neuroscience,
etc. While in the program, if they
discover that research is definitely appropriate for them, they could decide to
continue on for a Ph.D. or join the workforce with their M.S. degree.
However, during this time, if they decide that they would prefer clinical
medicine, they could make application to medical schools while completing the
M.S. degree. Hopefully along
the way, they participated in significant community and clinical volunteer or
work-related activities, attained strong academic grades from the master’s
program and have been successful in taking the MCAT.
Students applying to medical schools from a graduate program should be
aware that acceptance to a medical school is usually contingent upon the
completion of their graduate degree. This
is sometimes problematic for the applicant since research results and thesis
writing may not follow the anticipated time course.
In this case, it may be best to wait until the research is completed
before applying to medical schools. WHO CAN BENEFIT FROM AN ENHANCEMENT PROGRAM? For
those students right out of college who have already decided that medical school
is their primary goal, but whose credentials would preclude their being
positively considered for acceptance, enhancement postbaccalaureate premedical
programs could possibly help them become more competitive candidates.
As previously stated, the first step is for the student to realistically
assess his/her weaknesses. Potential
weaknesses may include: lack of
clinical exposure; MCAT scores with any section below a 9; science and overall
GPAs below a 3.30. Additionally,
personal illness or other issues during the undergraduate career could skew
one’s acceptable GPA for medical school acceptance.
Clearly, any of these weaknesses raise the bar for application to medical
schools. Even though admission
allowances may be made for disadvantaged students applying with slightly lower
academic credentials, their successful application to medical schools is difficult
to achieve. In
our experience, underqualified applicants to medical school often have not
sought, or have ignored, advice from health professions advisors.
These less academically qualified students have applied to medical
schools only to have been denied acceptance.
If these students had met with their advisors, they may have been
counseled to not apply to medical schools but rather attempt first to strengthen
their credentials. After being denied admittance to a medical school however, if
the student remains committed to his/her goal, s/he can select a
postbaccalaureate program best suited to his/her needs and weaknesses, hopefully
with guidance from a trusted advisor. There should also be a very realistic
evaluation of the student’s potential to improve credentials.
Together, both advisor and student should be able to select appropriate
program(s) that will help the student rectify any shortcomings.
For example, if a student has been a C/C+ student throughout their
college career and admits to having worked to their full capacity, then
postbaccalaureate coursework may not be of help to them.
Additionally,
some students elect to use AP credits in lieu of several of their intro-level
science courses. All too often they
then achieve mediocre grades in the more advanced science courses taken in their
first-year of college because they were not truly prepared to handle the work
and/or compete with upperclassmen. Generally,
students are better served to take all of their premedical science courses once
in college, independent of what courses they took in high school.
Repeating these courses in a college setting will firmly establish a
foundation of knowledge in the discipline, allow them to establish strong
academic credentials from the outset and allow them to mature into the college
lifestyle while growing academically. However,
if a student, or his/her parent, insists on transferring in AP credits and then
performs poorly at the onset, yet manages to improve their grades in upper-level
science courses during their junior and senior years of college, it may be
reasonable for them to seek out appropriate premedical postbaccalaureate
programs to help compensate for their initial shortcomings.
If
a student’s grades suffered due to illness, family issues, sports activities,
outside work schedules, or other legitimate reasons, they too could consider
post-baccalaureate coursework. Once
accepted into a postbaccalaureate program, these students need to focus solely
on their academics rather than extracurricular activities.
These students may do better in a lengthier post-baccalaureate program in
order to rectify four years of poor academic performance. Furthermore, students
with lower MCAT scores (i.e. in the range of 18, 6’s on all sections, to a 26)
along with solid or weak GPAs, need programs that address multiple weaknesses.
SPECIFIC TYPES OF POSTBACCALAUREATE PROGRAMS The
scenarios below describe the varied needs of different groups of students and
the types of programs that might best address those needs. Information about
many programs can be found at the Syracuse University website, hpap.syr.edu/LISTPB.HTM
or on the AAMC website at services.aamc.org/postbac. 1)
A student who graduated from college with a cumulative undergraduate GPA
under a 2.50 with less than a 27
total MCAT score would benefit by demonstrating the ability to perform well in upper-level
science courses at the undergraduate level before considering graduate work
and then applying to medical schools. The
reason we state this is, from our experience, most medical schools will not
accept candidates into their programs with an undergraduate GPA far below a
3.00. In order to demonstrate their
intellectual capacity, the student would be well-advised to take a minimum of
three courses per semester for a full-year at a strong four-year institution.
The student would do well to perform at a minimum 3.50 GPA level and
re-take the MCAT after this one year. If
successful, it may be possible to realistically move on to a graduate program to
further advance their qualifications or it may be appropriate to apply to
medical school directly after increasing their GPA and MCAT score. 2)
A student with a cumulative undergraduate GPA performance above a 2.50
but below a 2.70, with a total MCAT score above a 27 total, may benefit by
taking graduate courses in any strong four-year institution. Based upon personal experiences with graduate admissions,
these students are more likely to be accepted into a graduate bioscience program
rather than gaining admittance into a special master’s type post-baccalaureate
program. These students may want to
seek out programs leading to either a thesis-based or non-thesis based
master’s degree. The courses must
be scientifically rigorous and the student should probably achieve a graduate
GPA around a 3.50 to be a successful applicant to medical school.
Non-bioscience based programs, including most public health programs
resulting in a master’s degree, would more than likely not enhance the
student’s credentials for medical school.(3)
3)
A student with a cumulative undergraduate GPA around the 3.00 and a total
MCAT score less than a 27 could benefit from a strong science based program,
as above, along with an MCAT review program.
One such program offered at Drexel University College of Medicine is the
Medical Science Preparatory (MSP) program.
Students in the one-year MSP certificate program take four graduate
biological science courses, a laboratory techniques course, a community
dimensions course with a community service component and two undergraduate
advanced review courses in physics and chemistry (covering general chemistry and
organic chemistry topics). Students
also take a graduate student-driven MCAT review course plus six full-length mock
MCAT exams throughout the year. Students
in the MSP program have successfully improved their MCAT scores an average of
5-6 points over the past five years with many students scoring above a 30.
Students who achieve a graduate GPA of 3.00 or better and MCAT scores
above a 26 are automatically granted acceptance into the optional second year of
the program where they enroll in actual medical school courses and work towards
their non-thesis Master’s of Biological Science (M.B.S.) degree.
The benefit of this type of program is that students are given the
opportunity to increase their undergraduate GPA, take graduate coursework, and
improve their MCAT score. Students
applying to medical school from this program have been very successful in
gaining acceptance into U.S. medical schools and have even gained multiple
acceptances while completing the second year of the program. 4)
Students with cumulative undergraduate GPAs above 3.0 and MCAT scores
above a 26 could consider a special master’s postbaccalaureate-type
graduate program where they take actual medical school courses and are
graded in relation to the University’s own medical school class.
This allows the student a chance to prove their capacity to do well in a
rigorous medical school program. A
true special master’s post-baccalaureate program is one where the student
takes the exact same medical school course at the same time as the medical
school student. They have the same professors and they take the same lectures.
They also take the same exams and quizzes and are graded in relation to the
medical school performance. A variety of programs listed as special master’s
programs exist, however, when comparing programs know that some of these
programs offer courses taken in the evening taught by medical school professors
and are not graded in relation to the medical school class. The
Interdepartmental Medical Science (IMS) program offered at Drexel University
College of Medicine is one example of a true special master’s program. The
program offers a non-thesis master’s degree for students wishing to apply to
health professional schools. The
advantage to a special master’s program over other non-thesis master’s
programs in a specific bioscience discipline is that they offer the student an
opportunity to self- assess their commitment and continued desire to work at a
level required to excel in medical school.
This program also allows medical school admissions officers to more
accurately predict the student’s ability to perform in a rigorous medical
school curriculum than for students coming from other graduate bioscience
programs. A
benefit of the Drexel University IMS program is that after successful completion
of the first year, students are awarded a certificate of program completion. If
a student wishes to continue postbaccalaureate studies, depending upon one’s
academic credentials from the first year, s/he may elect to return for a second
year to earn the master’s degree. When
comparing the Drexel University special master’s program to other special
master’s programs, another benefit is that a student may only need to finance
one year of tuition rather than the equivalent of two. Students
who had a strong upward trend in the GPA during their undergraduate academic
career may apply to medical school in the summer preceding the start of a
special master’s program. Under
these circumstances, the medical school will have six months of potentially
strong postbaccalaureate coursework to add to the evaluation of the student’s
credentials, assuming the student applied the previous year.
This may or may not be in the best interest of the applicant.
Therefore, the applicant should seek advice from the health professions
advisor before embarking upon such a costly process. If
before matriculating into the special master’s program, the student was right
at the cusp of medical school acceptance (perhaps on a medical school wait
list), this six months added coursework may be sufficient to gain acceptance to
medical school. Again, the student
can garner much from the advice from an advisor who has had several years
experience with the program in which they are enrolled. For
many students with weaker credentials, medical schools are looking for more
coursework than one semester provides. These
students should not apply at the onset of their post-baccalaureate program, but
instead apply following completion of the first year.
The IMS program offers counseling to incoming students in order to assess
which option is most beneficial. A
program with a second year affords many of these students the opportunity to
take additional coursework to further improve their credentials.
Drexel University offers the students in the IMS program the opportunity
to enter a second year and earn a Master’s of Medical Science (MMS) degree.
During the MMS year students are permitted to take a second year medical
school course along with other graduate coursework. 5)
Special programs for the disadvantaged student exist:
The AAMC’s 1991 “Project 3000 by 2000” initiated to admit 3000
underrepresented minority (URM’s) students into medical schools by the year
2000 never reached its goal. Although
URM’s account for about 25% of the U.S. population, they account for less than
8% of practicing physicians (3). This
minimal number of URM practicing physicians negatively impacts on health care
delivery in our country. In order
to address this imbalance, numerous Nationwide programs have been developed that
assist disadvantaged students in gaining acceptance to medical school such as
the Drexel Pathway to Medical School (DPMS) program offered by Drexel University
College of Medicine. These students
are self-described as disadvantaged applicants using the AAMC criteria.
DPMS students typically matriculate into the program with a cumulative
undergraduate GPA around a 3.00 and total MCAT score around a 20. Some
medical schools offer summer programs which expose students to a limited science
tutorial program in which they must attain a certain level of proficiency before
they either can be considered for acceptance to their school. Other schools
accept students but require a summer enrichment program to facilitate the
student’s transition into their medical school.
In some instances student performance may dictate that they be placed in
a decelerated program (first year of medical school taken over a two-year
period). The
DPMS program melds aspects of all of the above to help promising disadvantaged
students. These students are
accepted conditionally into our medical school.
They participate in a six week summer enrichment program followed by
one-year of medical school and graduate school courses along with a one-year
MCAT review program. If these
students earn a minimum 3.00 GPA in their course work and attain a minimum of 23
on the MCAT (with a minimum of 8’s in the biological and physical science
sections and 7 in the verbal reasoning section) they retain their seat in the
medical school class. Virtually all
similar types of programs for disadvantaged students are small, competitive and
intensely student oriented. CONCLUSION When
presented with complex scenarios relating to a student they believe can overcome
their prior obstacles and would make a truly caring clinician, health
professions advisors should consider contacting premedical postbaccalaureate
program directors for direction. It
should be clear that advising of premedical students is an extremely complex
process. The health professions
advisor must be able to accommodate the needs of individual students who present
a broad spectrum of academic strengths and weaknesses. Often there exists more than one solution to meet the needs
of the student. Arriving at a
singular solution depends upon a cooperative activity between the advisor and
the student. Ultimately there is a
great deal of satisfaction in seeing these late-blooming, worthwhile students
finally achieve their goals. 1.
www.aamc.org/data/msq/allschoolsreports/msq2004.pdf 2.
www.aamc.org/data/msq//allschools/msq2004.pdf 3.
Personal conversations with medical school admissions officers 4.
Strayhorn G. (2000) A pre-admission program for underrepresented minority
and disadvantaged students: application, acceptance, graduation rates, and
timeliness of graduating from medical school.
Academic Medicine, 75: 355-361. |