Do you ever have these moments where you want to fix everything? I mean, fix the things that could potentially be fixable if you and like a whole, whole, whole bunch of people galvanized to make it better?
Yeah. Like that.
I have feelings like that a lot. Sometimes it's a really big and nebulous thing. Other times, it's more concrete and smallish. That is, until I really start to flesh it out. So then I'm just sort of left with this problem that I think I may have some ideas to help with solving. But simultaneously this tiny undercurrent of angst because I'm not.
Sigh. This sounds rambly, doesn't it? Like, I'm sure someone is like, "She goes a bunch of weeks without blogging and this is what she posts?" Or maybe that's too self-important a position to take. Perhaps you, too, are busy and don't fully give a shit whether or not I blog every day or every month but still think this sounds cryptic and tangential.
Okay. Fair enough. I guess I'll give an example of my latest "thing" that I'm thinking about (in terms of problems that need solutions.) And since you already can see that I'm feeling rambly, I advise you to read at your own risk of utter confusion.
Okay. So check it: 1991 was the year I applied to medical school. I drove to Auburn, Alabama from Tuskegee, Alabama and took the MCAT on my 21st birthday. I remember that part well because on my way home, I stopped at the State Store and bought a pint of some kind of alcoholic beverage. Not so much because I wanted to get drunk, but more because I could buy a pint of something--using my legit state-issued over-twenty-one identification, that is. Anyways. Luckily, I did pretty well on it on that first go (the MCAT, not the pint of liquor.) That fall, I began hammering out my med school applications for what I hoped would be my future career.
Now. 1991 was a hell of a lot different than 2016. See, back then, you literally "hammered" out applications--on a typewriter. Sure did. I typed my applications out and mailed them via snail mail. Yes. Via the United States Postal Service. Some human received my envelope, tore it open with a letter opener, and read it. They looked at my picture and read my personal statement. My letters were skimmed and my meaningful participation in student leadership was noted. And all of that was coupled with my academic performance and MCAT scores for a more complete picture of my potential as a medical student at their institution.
I got plenty of interviews. And though I was a good candidate in terms of merit, I wasn't necessarily out-of-this-world academically. But coupled with my total package of service and leadership? I was a very attractive potential med student--if I do say so myself.
But this? This is totally, totally different than the way things are now. Now? Everything is electronically-based. Applications are just a few clicks away and one universal form goes everywhere. That means it's easier to to apply to more schools. And for the schools, it means way more applicants from way more places.
Now that? That part isn't really a big deal and is probably a good thing mostly. But what is tricky is that now that it's computer based coupled with more volume, that human-being-looking-at-the-real-you component is removed. Or, at least, super diminished. That is, unless you jump the first objective academic merits hurdle--then, and only then, will your chances of getting your stuff looked at become highest. Which makes it MUCH harder to get into medical school (or any super competitive school without a slam dunk GPA, MCAT and, just maybe, alma mater.
Oh--and let me clarify something on the alma mater part: A 3.9 GPA from anywhere? You're golden. A 3.5 is more complicated. That said, that 3.5 GPA will be looked at differently if it is from Princeton or Harvard. I mean, it just will. Does it mean you have to go to an Ivy League school to get into medical school? Definitely not. And would I trade my HBCU undergraduate experience for anything in the whole world? No way. But it's probably fair to say that certain schools might get a person more wiggle room than others in the numbers game.
Okay. So here's why I'm talking about this: There's not a month that goes by that I don't receive an email, in box message or call from a friend, a family member, a friend of a family member or even just some acquaintance-of-an-acquaintance asking me to speak with someone who is applying to medical school. Now. If they are young? Like a freshman or even a first semester sophomore? It's great. Really, it is. But usually, that isn't who the person is.
Often it's someone who is a college senior or who has already graduated. Maybe they look like me, but not always. But what does seem to be very common is that there is this critical information that they needed long before the call was made to me that they never received. And that information is simple:
This ain't 1991.
It breaks my heart to hear someone say their GPA from non-sexy state university or teeny-tiny-college-that-we've-heard-of but-the-admissions-committee-hasn't was "pretty good" and that they "could've done better on the MCAT." So I ask, of course, what "pretty good" means. That's when I learn that usually that's anything from a 3.0 to a 3.4 cumulative grade point average. Which, I know, I know, to a lot of folks reading this sounds great. And to me, I'd agree that this would sound totally great--were this 1991.
But, it ain't. Nope.
See now? Now with it all computer based, the easy clicks that you used to apply with less difficulty are also happening on the admissions end. A few mouse clicks helps medical schools easily filter out the "pretty goods" from the academically exceptional ones. GPA under 3.5? Click. MCAT under 505? Click. So the fact that you were SGA president or a volunteer at the Humane Society or a dancer with the Alvin Ailey Dance theater before college? Sorry about that. Thanks to your academic numbers, I'll never see it. Or your lovely headshot that your mom helped you narrow down and select.
So yeah. I find myself hearing these earnest young people and feeling like a damn dream killer. I listen and make a few suggestions but deep down what I really want to say is, "You need to go back to your freshman year and start over. You need to be pressed to get a great GPA from day one, especially if you went to a school that isn't the first ones people roll off of their tongues when listing the very top-tiered institutions of higher learning."
That brings me to this solution. The solution would be for a bunch of doctors to go to colleges--particularly some of our smaller ones --- and talk to freshman from the very start. We need to show up and give that speech that Debbie Allen gave the kids at the Performing Arts High School during their first days.
"You want to go to med school? Well med school costs. And right here is where you start paying. In sweat."
And honestly? I'm not even joking. That message needs to reach aspiring doctors waaaaaay before they cross into their junior or senior year of college. The caveat, of course, is if you already were knocking it out of the park all along. Then there isn't such an urgency.
But what's messed up is that a 3.4 GPA is really not bad at all, man. It isn't. But for medical school? It pretty much sucks. Unless, of course, you know someone somewhere who can help open a few doors or you have your sights set on less competitive schools. But remember--even those schools now have more applicants in their pool due to the click-click-click culture, remember? And a lot of folks are hungry, man. Hungry to get into medical school and now they are clicking the schools that in the past they didn't.
So yeah. Asking can you shadow a doctor in their office or in the hospital? Totally cool if you're in high school or you're an already high achieving college student. But for the person who hasn't been so serious all along? Don't bother. Following me or any other doctor around won't do much more than frustrate everyone.
Man. I feel so horrible for saying all of this. But it's true. Someone needs to yell it, scream it, tell it--it's true. And see, we need to either figure out how to re-humanize the application process or get the word out to everyone that there is no goof-off margin any more in college for those who wish to go to medical school. Additionally, even if you didn't goof off, unless you go hard from the very start academically, no one will ever get a chance to see your great qualities beyond that. It's jacked up but it's true.
So anyone with a kid starting college or who just got there that wants to go to professional school? Here's my PSA: Go hard from day ONE. Make connections. You must be exceptional in person and on paper. Or at least make enough meaningful connections with people who can advocate for you enough to get your application in front of someone who'll actually read it should it fall below the bar. But remember that, even with connections and prayers, being "just above average" academically could get you shut out of what you aspire to do.
And you know what? You won't even be able to take it personally. Because it won't be personal. In fact, it won't be personal at all. Nope.
Oh--and before someone says it--yes, I know that there is a story of someone somewhere after 1991 who overcame all of this and got into the very best med school in the whole world and did great. Just like someone somewhere dropped a quarter into a slot machine and won a million dollars. Just consider this some pragmatic real talk. And the earlier it reaches the right people, the better.
Yeah. I need to get this message out man. Because it ain't 1991 anymore. No ma'am and no sir.
Thanks for letting me ramble on this. I mean it. Oh, and sorry for the buzz kill.
Honestly? I write this blog to share the human aspects of medicine + teaching + work/life balance with others and myself -- and to honor the public hospital and her patients--but never at the expense of patient privacy or dignity.
Thanks for stopping by! :)
"One writes out of one thing only--one's own experience. Everything depends of how relentlessly one forces from this experience the last drop, sweet or bitter, it can possibly give."
~ James Baldwin (1924 - 1987)
"Do it for the story." ~ Antoinette Nguyen, MD, MPH
Details, names, time frames, etc. are always changed to protect anonymity. This may or may not be an amalgamation of true,quasi-true, or completely fictional events. But the lessons? They are always real and never, ever fictional. Got that?