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A Postbac Primer Carol Baffi-Dugan and Gale Lang This is
a modified version of an article that was originally INTRODUCTION One particularly noteworthy phenomenon in the medical school applicant pool over the past decade or so is the growth in the “non-traditional” population- those applicants over 23 years of age. With the GPEP report on medical education in the early 1980’s1 medical educators made a clear statement that they wanted students from many different majors and backgrounds. In addition, court enforcement of laws prohibiting age discrimination, and the decline in the traditional-aged applicant pool in the later eighties may also have encouraged the acceptance of this non-traditional group, as hinted by a US News and World article on March 22, 1993.2 Perhaps this gave hope to many college graduates who had thought that only undergraduate biology majors were successful in gaining admission to medical school. Perhaps there were other forces at work. Whatever the causes, the result was tremendous growth in interest from that segment of the population which had completed college with a non-science major and pursued other interests or careers before determining that medicine was their true calling. On the heels of this growth was the proliferation of programs designed to help those students meet their goals. The “non-traditional” group is comprised of this type of student but also the student over 23 who is reapplying after having been unsuccessful at gaining admission. As medical school admission became increasingly competitive throughout the nineties, this group grew as well. Students who had been rejected sought ways to make themselves competitive candidates in order to reapply. Other postbac programs developed to meet this growing need. Lastly, medical education has made concerted efforts in recent decades to increase the number of underrepresented minorities pursing the medical profession. Among the many activities and approaches that have been attempted by individual institutions, foundations, the federal government and the AAMC, was the development of programs to work with minority students after their college graduation to enhance their applications and make them competitive for admission. Some of these programs have been funded by a Health Careers Opportunity Program (HCOP) grant, others have not.
“Post baccalaureate” very simply means “after the bachelor’s
degree,” but the “postbac” population is far from simple.
Different students with different needs have resulted in a myriad of
types of programs. In the 1970’s
there were fewer than a handful of formal “Postbac Programs” designed for
the non-science college grad, known as the “career changer”.
Today there are dozens, perhaps one hundred different programs that are
listed under that rubric. How is
the pre-health advisor and the pre-health student to sort through this mix of
programs and find the right choice? The
intent of this article is to offer guidance in understanding and researching
various programs and suggest the questions that an advisor or student should
ask. TYPES OF POSTBACCALAUREATE PROGRAMS
The first important step is to understand that there are two types of
postbac programs- those designed for the career changer and those designed for
enhancement of an existing science record.
Most program literature will state clearly which population it serves.
Some serve both. A student
must understand what his/her needs are, and
an advisor might need to help the student reach that understanding.
If the student needs to enhance a weak record, there are programs that
offer undergraduate coursework and those that offer a master’s degree.
In addition there are programs which specifically target underrepresented
minority students. Once the student
knows which type of program s/he needs, then
the research can begin. The advisor
can provide resources for the student and guidance in how to use them.
Equally important is the advisor’s role in encouraging the student to
ask the right questions and do a realistic self-assessment before making any
hasty decisions. As with all pre-health advising, there are personal choices
that a student must make for him/herself. CAREER CHANGER PROGRAMS As mentioned above, career changer programs are those designed for students who have taken few, if any, science courses and seek an institution that will allow them to do so. There is a vast array of institutions to accommodate such a student, but the ways in which they do so vary tremendously. They tend to fall into three groups. Formal, structured and selective programs are perhaps the most visible of the postbac programs. They are well-organized and clearly defined. Their literature outlines their offerings and gives them a distinctive image. There is some structure to the way students proceed through the program, and there is a selection process that is fairly rigorous, including an application, letters of recommendation, and often an interview. Only a percentage of those who apply are admitted and, in turn, the success rate of those students applying to medical or other health professions schools is high. Often there are linkages to certain medical schools offering the student an early conditional acceptance and the opportunity to avoid the “glide,” or application, year. There are also formal programs that are far less structured and not very selective. These programs are also clearly defined and have literature explaining who they are. But they have less structure to the way students begin and end their studies; they may not actually have a “list” of students in the program. Typically these programs have a more open admission policy and many more students studying than the more selective programs. The attrition rate may be much higher in these programs, but they offer opportunity to those students who may have been closed out by the smaller, more selective programs. Their success rate may also be lower than the more selective programs. Lastly, there are programs in the loosest sense of the word. Many colleges and universities have tapped into the adult market by offering continuing education options or second degree opportunities to students seeking courses beyond the original bachelor’s degree. These “programs” rarely have specific literature about postbac premed study, or a structure in which students work, or a selection process. There are many factors that students will use in determining which program is best suited to them, and many students will seriously consider and even apply to numerous programs before making their choice. What sorts of questions might a student ask in researching programs? Some of the more practical questions might be: · Where is the program located? · Can I study full-time, part-time or either, depending on my needs? · Is this a public or private institution? What is the tuition? · Are the classes held in the evening or during the day? Can I keep my job? Programs often involve far more than just taking courses. Questions about services offered are important: • Will I receive individual advising from a pre-health advisor? How accessible is that person? • Will I be guaranteed a space in the classes and labs I need to take? • Will I receive a composite letter of evaluation from the institution? • Is there financial aid available? • Are there linkages to medical schools or other health professions schools? • Is there assistance in finding a health-related internship or job? • Is there academic assistance, such as tutoring, available? Is it free? • Is there a community of students of which I will be a part? • Is there programming- lectures, workshops on applying, etc? Once a student has all this information about each program
being investigated, s/he can begin to determine which factors are important.
Of course, this will vary for each student.
Geographic location may be the primary concern because a student needs to
stay with a spouse, or live at home with parents.
Cost may be the major determinant and/or the opportunity to keep a
current job while taking classes. Services
may be of the highest priority because a student wants more than merely a place
to take classes. Notice that the
list above does not mention acceptance rate.
Pre-health advisors realize, through personal experience at their own
schools, that students put undue emphasis on that factor and often overlook far
more important factors. Also
acceptance rates are affected by many things.
Just as with undergraduates, postbac students who do very well in their
courses and their MCATs tend to do well gaining admission to medical schools.
Those who don’t do well, don’t.
As with everything else, advisors can only guide, raise the important
questions and encourage careful thought. ENHANCEMENT PROGRAMS While students who need to enhance an existing science record in order to become more competitive candidates have many options, planning for this can be complicated. Before deciding whether or not to do this and planning how to do this, the student must consider carefully the existing record and ask some difficult questions. This is a time when the help of a supportive, but probing, advisor can be crucial. Advising students about pursuing further science work is most productive when the student is open and honest about the previous record and what contributed to it. Candid self-assessment, with the advisor’s help, is essential. Encouraging a student to consider what weaknesses must be addressed and why s/he believes things will be different in postbac work can result in the student either continuing on in science or exploring other career goals. Why are you not a competitive candidate? Why have you not been successful in science coursework to date? What will change if you undertake further courses? Why do you think you can do better on the MCAT? The chances for success in postbac work are best when a student can be reasonably confident that s/he can do better in science, when there is reason to believe that with an additional year or so of work, the record will improve. The classic “late bloomer” who began to do good work late in college, or the student who started out well but had a “sophomore slump,” or the student whose record is erratic- these students often find postbac work an effective way to solidify the record and demonstrate consistent good work. The student without an upward trend in the sciences, whose work did not get better as s/he became a more seasoned student may find that postbac work simply offers the opportunity for “more of the same,” likely producing the same admissions results. Once the student decides to continue on in the sciences, in the hope and expectation that credentials can be improved, then the choice about programs arises. The student needs to ask the same questions raised in the previous section of this article, plus there are others to consider: • Do I want a formal program, or informal? • Do I want to stay on for another year at my alma mater or start fresh at another school? • Do I want to study full-time or part-time? • Will I need financial aid, and if so, is it available, and for how long? There are further questions to consider: • If I need to improve on the MCAT, how will I accomplish that? • Are commercial preparatory courses available nearby? • Are there support services available to me? • Should I take courses at the undergraduate level or take graduate courses? • Is graduate work in public health an option for me? The student with premedical preparation from undergraduate school may have choices about advising: • Will I continue to work with my undergraduate advisor? • Or will there be advising at the postbac program? •
Who will provide letters of evaluation -
the postbac program or the degree- granting school? Graduate vs. Undergraduate Work The decision between further undergraduate work or graduate work can hinge on several factors. If the student has completed a major in the sciences and feels s/he has exhausted the range of further undergraduate courses, then graduate work may appeal. The converse is true- the student with only a few courses beyond the requirements may be well served by more undergraduate courses, which will be included in the undergraduate science grade point average. The student must be realistic about his/her long-term career goals. Clarity of purpose will help in making the decision between further undergraduate work and graduate work and the decision between traditional graduate work and the “special master’s” programs. Good conversations with the undergraduate pre-health advisor and the postbac advisor can help the student understand the options, which will help decision-making. Here again the advisor can help by posing tough questions: • If you do not ultimately gain admission to medical school after completing this degree, what are your alternate career goals? • Is this a graduate degree that will be useful to you in that career? • Do you want to gain research experience? • Do you want an academic career in science? In addition to the traditional master’s degrees in the biomedical sciences, there are several “Special Master’s” programs, offering MS degrees in the medical sciences. These graduate programs generally target students whose career goal is medicine, rather than an academic career. These are offered by medical schools and usually comprise a combination of medical school courses and advanced/graduate science courses. The courses may be those traditionally offered in the first year of medical school, however, advanced standing or transfer credit to medical school is not usually earned. Students who go on to medical school complete a full four-year medical school curriculum. The programs are highly structured and the work is rigorous, with the intent of modeling a year in medical school. The programs seek students whose academic credentials are close to those of accepted medical students. Many students in these programs may have interviewed at medical school in the previous cycle, but they were not ultimately admitted. Good performance in these programs can be a useful predictor of success in medical school. For this reason they can be attractive to the student who will say, “I know I can do the work; they just need to give me a chance to prove it.”
Admission to the medical school granting the MS is not guaranteed,
although admission to that school often results from good work there.
With these special master’s programs and all other enhancement
programs, the hard truth is that mediocre or poor performance at this level
effectively puts medical school admission out of range for that student. FOR THE UNDERREPRESENTED MINORITY STUDENT Underrepresented minority students (defined by the AAMC prior to 2003 as Blacks, Mexican Americans, Native Americans and mainland Puerto Ricans) may find any of these types of postbaccalaureate premed programs appropriate for them. These students should ask the same questions outlined above. However, there are other programs specifically designed for minority students that should be investigated. These all fall under the heading of enhancement programs, designed to support minority students and increase the numbers of them who apply successfully to medical school. Websites that list postbac programs sometimes note which ones specifically target minority students. Publications such as Getting into Medical School, A Planning Guide for Minority Students, by Edward James and Karen Hamilton,3 list programs as well. While every program will be interested in receiving applications from minority students, it is important to know which ones have that as their particular mission. Usually such programs offer greater financial support, including stipends and travel expenses. Often there are mentoring, research opportunities, study skills and MCAT prep included. If a program is designated as HCOP (Health Careers Opportunity Program), it is supported by a federal grant to offer a program targeted to minority students. Usually such programs are located at medical schools. Other medical schools may fund their own programs for select minority students to whom they have denied admission but whom they want to assist in improving their application and reapplying. All of these are typically small, well-designed programs that offer tremendous support to their students and have note-worthy success.
REFERENCES 1.
The General and Professional Education of the Physician. Carol Baffi-Dugan is the health professions advisor at Tufts University and directs the Tufts Postbaccalaureate Program. Gale Lang is the former Assistant Dean of the College of General Studies and Director of the Postbaccalaureate Program and Special Science Program at the University of Pennsylvania. Carol and Gale initiated and coordinated, along with their colleagues Jodi Domsky, Bryn Mawr and Jodi Olson, Scripps College, a Postbaccalaureate Programs Pre-Conference at the 1998 NAAHP National Meeting in Crystal City, which was attended by 75 advisors. Interest and questions at that pre-conference prompted this article. |