I Like You

It's an awkward thing to say in a relationship, and the same goes for expressing interest to medical schools (this is in response to a comment from November 28.) I have several thoughts on this issue.

- It's late enough (now) in the interview season that you are likely starting to have a sense for which medical schools will be your top choices. You see, at the beginning of interview season, when an applicant says, "I like you," I think to myself, "I don't believe you." How could you know?! There are too many fish in the sea. But by now, you've sewn some oats; expressing sincere interest means something. So, one potential thing is to overtly express interest when you send your thank you notes. Something like...

"I have nearly completed my interviews, and I anticipate that ___ with be one of my very top choices. I would be absolutely delighted to become a medical student at ___."

- That said, saying it in a thank you note is not enough. I HIGHLY recommend sending a letter of interest to your top choice. But, be cautious. You should not be sending multiple letters of interest. Your word means something. While the above comment could be sent in thank yous to, say, your top three choices, a letter of interest should be sent to just one. I would send it electronically so that it can easily be forwarded (if necessary) and so that it makes it into your electronic file. Be brief, personal, and sincere. Say why you think the school is a good fit (as opposed to just saying that it is a good fit).

Just yesterday, I was chatting with a current first year at my school who says that this time last year she knew my school was her first choice. She sent an email to one of her interviewers because she had been waitlisted, and he recommended that she write a letter to the admissions committee expressing her sincere interest in attending. Although a waitlist is a slightly different scenario, she was delighted to report she got in shortly thereafter. Admissions committees often look kindly upon these communications. You have nothing to lose, so go for it! If you message me, I will happily review yours.

What Not to Say

A gem from my interview with an applicant this week: It is not ok to use the term "douche-bag" in an interview, particularly when describing another individual.

Sunday Funny

One of my friends, an assistant to the Director of Admissions at a graduate school, recently shared with me this:

"[S]miley faces have their appropriate settings: text messages between friends, on a child's spelling test, and even from the greeter at Wal-mart. An example of an inappropriate setting might be, let's say, on a personal autobiography statement for your grad school application. Especially in lieu of appropriate sentence endings (i.e. a period)."

There are plenty of qualified applicants out there, and the folks who read applications are pretty much searching for a reason not to read further.  Try not to give them one, or at least not one so obvious :)

Don't Blow It

Simple enough advice, but tremendously challenging for many applicants: don't blow the interview.

My school's Admissions Committee met again this week, and I was surprised that applicants' "numbers" (GPA, MCAT score) and overall qualifications came up only twice during a whole evening of discussion.  Instead, what dominated the dialogue was the interview content. 

Highlights:

• One applicant was described as "lacking depth."  He was apparently unable to elaborate upon some of the observations he made in his personal statement about differences between the US healthcare system and healthcare systems elsewhere.  
• Another applicant was marked down because the interviewer was unable to get him "off script."  Often, interviewers are truly trying to get to know you.  For example, when they ask what you do for fun, it's not a trick; they really want to know what you enjoy.  This is not an opportunity to say something about how much you love sports because they have taught you about working in teams and developing as a leader.  It's enough that you love sports.  Save the additional details for when you're asked a more appropriate question.
• One applicant was described as "weird."  There are plenty of extremely normal smart folks out there.  Being a bit unique is nice; being gross is not.
• Finally, an applicant was described as arrogant.  This is a big problem.  Every future doctor is proud of their achievements, but a little humility goes a long way.  It's not too much to ask you to be humble for 30 straight minutes.

Remember:

• Everything in your application is fair game.  If you are unable to expand upon your coursework, activities, or topics you discussed in your application materials, read up.
• Regardless of how much you've rehearsed, try to ad lib a bit.  This will become even more challenging as the interview season continues.  Relax.  Chat.
• Don't be "that guy."  For example, if you lived and bathed in a park during part of undergraduate, you might just keep this to yourself.  Really.
• Be poised and confident.  Don't be cocky.  Often it's not what you say, it's how you say it.

Comment Follow Up - Thinking of Thanking

Last week, I emphasized the importance of thanking interviewers, and I received a Comment today that I feel merits further discussion.  Don't loose sleep over this issue, but here are my thoughts:

Writing thank you notes will not get you into medical school, and choosing not to write them will not keep you out.  Writing thank yous isn't about good karma, or paying it forward, or hoping for more points on your interviewers' evaluations.  It's simply the right thing to do. 

For one thing, you will be a student at one of the schools at which you're interviewing in less than a year (!!).  While you may never see your interviewers from the other schools again, your interviewers from the school you will attend are likely to be lecturers, attendings, and even mentors in your very near future.  Thanking them is the courteous and professional thing to do.  Some of these interviewers may one day be your colleagues.

Additionally, writing thank you notes is also about creating allies who can help you with your decision making process.  Come spring, you may be making some difficult decisions, and it's nice to have established rapport with some of the very people who can help clarify questions for you. 

Finally, it's just nice.  People like nice people, and it's nice to be a nice person.  This season, I have received multiple thank you notes, and on every occasion except one, I had already completed my evaluation of the applicant by the time the thank you arrived.  But, the fact that they wrote notes to thank me for my time was very meaningful and makes me think highly of applicants I had already decided I really liked.

Certainly, if you have been told not to thank your interviewers (maybe Stanford does this?), it would be inappropriate to do so.  (As an aside, learning to properly follow instructions, even silly ones, is an important part of the medical school process.  Earlier this year, I had a Residency Program Director tell me that applicants who did not follow the instructions to list prior education in reverse chronological order were not invited for interview regardless of how qualified they were!)  However, it's hard for me to imagine a school specifically instructing you not to thank someone.  Do you really want to go to that school?  And, if your thank you note borders on coercion, I suggest you tone down the language. 

I love reader Comments.  Keep commenting.

Action

Institutional Action, that is.

I recently reviewed the application of a young man who answered "Yes" to the question regarding "Institutional Action" on his AMCAS application.  Although he could not have known at the time, his application and letters of recommendation actually include no mention of his infraction.  However, I feel he did the right thing by being forthcoming because the consequences would have been significant if a letter or institutional endorsement had mentioned his infraction and he had not.  Moreover, I was impressed by his response because he 1) explained the scenario (he had an unopened alcoholic beverage in hand and falsely reported his name and age), 2) took full responsibility for his actions, and 3) demonstrated personal growth as a result (not only did he perform required community service, but he continued to volunteer at the same place for the remainder of undergrad).

Impressive.

Danke Schoen

I really cannot emphasize enough how much Thank You notes after interviews matter. Previously, I've mentioned Thank Yous here and here. I have actually been quite surprised how few Thank You notes I have received this season. Perhaps this is in part due to the fact that I'm a student conducting interviews, but given that I have equal weight on the committee as my more senior colleagues, I think this is a mistake.

Although I'm editing to ensure anonymity (both for me and the applicant), I received a Thank You note via email this evening very similar to the one below, and it blew me away. I found the applicant to be appropriately gracious while continuing to sell herself as an applicant and also mentioning specific details of things we discussed during the interview. Kudos to this applicant! I thought she was terrific when I interviewed her, and this just confirms what I already knew.

Dear ______,

Thank you so much for the opportunity to interview at *** Medical School on Tuesday. I was really impressed by ***'s top-notch facilities; I was especially amazed that ***. I was also impressed with the innovative PBL curriculum, which seems to be an excellent match with my experience working in small groups as an undergraduate and in my current job. I loved the location and would love to be in *** near my family during medical school.

Thank you again for taking the time out of your busy schedule to meet with me. *** is on the top of my list of medical schools. I really appreciate your consideration for entrance into the Class of 2016. Good luck with your residency interviews!

Sincerely,
_____

I Prefer Multiple Mini Snickers

I had every intention of blogging soon after my first interview, but between the hectic nature of traveling (always! right?), packing for a brief trip home, attending my high school's Homecoming, and studying for the USMLE Step II CS (tomorrow!), it's been a bit of a crazy week.  The interview went really well and reminded me of the medical school interview process, although the lunch was much better. 

Interestingly, my first interview day had two primary components: a traditional interview and multiple mini interviews (MMI).  You may have read about MMI's here (or some naysayers critiques here).  In general, the format uses ethical conundrums, patient vignettes, or real-life challenges to assess how the applicant will respond after taking a brief time to ponder the scenario.  I enjoyed the contrast between the two formats and felt as though the MMI enabled me to paint a more complete composite picture of myself as an applicant.

Has anyone experienced the MMI format yet during interviews?  Please comment and tell me what you thought, your advice for other people, the strengths and weakness of the experience, etc.

What Goes Around Comes Around

After two weeks of conducting medical school admissions interviews, I will be sitting on the other side of the desk tomorrow.  It's my first residency interview!  From the applicants I have interviewed thus far, I have learned a tremendous amount about body language, humility, and poise, and I'm looking forward (albeit a little bit anxiously) to tomorrow's opportunity to practice what I preach.  I hope this experience will make me an empathetic interviewer and also give me the opportunity to self-assess my own strengths and weaknesses as an interviewee so that I can regroup for my next interviews in October.  Updates to come.

Theme and Variations

My school's Admissions Committee convened for the first time this week, and what an interesting experience!  I am pleased to say that my gut feeling about the applicants I interviewed was nearly identical to that of the other committee members who interviewed the same applicants.  That's not to say the process is perfect (it's not!), but it's reassuring to know that my advice to you is on target.

Below are some of the themes that consistently emerged when interviewers discussed interviewees who did not receive the highest marks.

The applicant:

• spoke at a volume that was too loud or soft to comfortably hear.
• was disorganized in the way he or she spoke about experiences well known to him or her.
• was unable to recapitulate concepts that had been eloquently described in the written application.
• passed blame to someone else for low grades in courses, missed opportunities, etc.

In the end, my first Admissions Committee meeting was far more contentious than I expected.  But, the above themes consistently led to applicants receiving less favorable reviews that they likely would have preferred.  Take home points:

• Speak at a comfortable volume.  Ask the interviewer if you're unsure.
• Be organized in your discussions, and in particular, be able to fluently discuss your application.  (An applicant I interviewed had incredible leadership experiences listed in her application, but when I asked her to describe a time when she had demonstrated leadership, she could not think of an example.)
• Don't ever lay blame in an interview, even if it's true.  Past circumstances are a superb way to demonstrate personal growth.

Sunday Funny

This is Why We Knock

Once in medical school, you will learn all sorts of reasons why doctors knock on patients' doors before entering their rooms in the hospital, although certainly common courtesy seems the most compelling to me.

Last week, I knocked my a patient's door (a mid-40's female) before entering her room, and when I did not hear a response, I wondered, "Could something be wrong?" I knocked again, paused to listen for a response, and then entered. And there she was, lying in her hospital bed with her hospital-issued gown wide open in the front, no sign of undergarments anywhere, and her boyfriend lying in the bed right next to her!

That is why we knock. Loudly.

The (Body) Linguist

Unfortunately, I am decidedly less enthusiastic about the candidate I interviewed yesterday compared with the young man from Tuesday. After pretty much devouring her written application, I was eager for our conversation but left with a sour taste in my mouth. However, I am going to withhold most details for now because my Admissions Committee meets next week, and I want to determine whether my evaluation of the applicant is similar to that of other Committee members.

For now, my thoughts on body language.

The applicant from Tuesday had some of the best body language I have ever observed. He made excellent eye contact throughout the interview, resisting the temptation to look at the floor or to the windows for inspiration during difficult questions. Similarly, when I responded to his questions, he continued to maintain eye contact and appear sincerely engaged. His hands were folded in his lab or on the armrest of the chair for the entire interview except for his firm, reassuring handshakes at both the beginning and ends of the interview. All of this is worth taking note of and attempting to emulate, although certainly a difficult task. In a similar way, the applicant from Thursday had very appropriate body language when she was speaking. She used her hands somewhat more while talking, but I found this to be tasteful and acceptable because it was appropriate in context. However, during the time when I answered her questions, she became extraordinarily fidgety. It was as if she thought I would be so wrapped up in my own responses that I might not notice her ongoing presence in the room. She fluffed her hair (fairly dramatically), adjusted her glasses, straightened her skirt, etc. It was so distracting! Given her sincerity, I am positive she did not mean to be disrespectful, but I was struck by the suggestion that things she said were important and things I said were simply an obligatory part of the interview.

Be cautious. Body language is too important to put on autopilot. Think about your actions and how they appear. If need be, practice answering questions in front of a mirror or with someone you trust. Become aware of your tendencies. As my grandmother said to my (occasionally bickering) siblings and I siting in the back of her car, "Be still."

The Conversationalist

"Interview" is really a misnomer for the conversation that occurs between an applicant and Admissions Committee member. Interview seems to imply that one person is asking the questions, really grilling the other person, while the applicant spitfires rehearsed, trite, and long-winded answers. An interview does not at all describe what transpired between me and the first applicant with whom I spoke today. (Yes, I was scheduled for my first "interview" on Thursday, but a physician interviewer canceled, and I was recruited to take his place.)

Have a conversation with your interviewer. In fact, having a conversation is precisely what my Dean of Admissions instructed interviewers to do - to coax a conversation out of the applicant, to assess the genuineness and spontaneity of his or her answers, and to discern whether the applicant responds to the interviewer's facial expressions and body language, particularly when explaining potentially challenging topics such as research endeavors.

Today's applicant did a fantastic job embodying the conversationalist approach to interviews. I was impressed by his consistent eye contact, lack of fidgeting, and natural intuition regarding my level of interest in the things he described. In truth, the young man I interviewed today was far from the most outstanding applicant with whom I will speak this season, but his poise, sincerity, and articulateness were more than enough to impress me. "Two thumbs up."

Start Your Engines

For the most part, I applied to be on my school's admissions committee because of my interest in medical education. Ultimately, I hope to conduct research and teach medical students and residents at a large, academic institution, and as a result, most of my extracurricular activities in medical school have related to medical education in some way - curriculum development task forces, institutional accreditation committees, teaching and tutoring, etc. A year on the admissions committee seemed very consistent with my endeavors and sounded like a fun and educational way to give back to my school. Nonetheless, a portion of my motivation for joining the admissions committee was my desire to get a insider's look at the admissions process. Along with the other student committee members, I met with my school's Dean of Admissions yesterday to discuss the beginning of interview season. I have to tell you, I am absolutely giddy with excitement about the whole process getting underway.

Of course, I cannot share with you the specific rubrics we use to assess applicants or the voting procedures themselves. But, what I can do is continue to provide nuggets of information that will hopefully demystify the process and help you in your pursuit of the right school. Most importantly, what I learned at the meeting yesterday is that there is no "formula" for the perfect applicant. MCAT scores, GPAs, research, extracurriculars, and many other components are intimately interweaved and make each applicant very different. As my Dean of Admissions explained, every applicant we interview is qualified to attend our institution. In fact, about 1,000 of the applicants who don't get interviews are also qualified. Interviews go a long way toward distinguishing candidates, and ultimately the committee's gestalt coupled with some good luck leads to the creation of another diverse and immensely talented group of future physicians.

Stay tuned in. I'm conducting my first applicant interview on Thursday, and I can't wait to share with you what I learn about the process so that I can continue to provide with you honest and reliable advice.

Policy Prep

The state of American health care. This is a topic that terrified me when I was in your shoes four years ago (Fall 2007 - the 2008 election was just a year away, and "the health care debate" was all the rage). Even now, after almost four years of studying the health care system, reading about it, attending lectures, and observing as patients and physicians alike navigate though it, I admit to being confused. It is nearly impossible to master this ever-changing system, and luckily no interviewer is going to expect that of you.

That said, some interviewers will be more eager than others to talk shop. It simply can't hurt to have a few comments to contribute. The best way to do this is to keep up with current events. I recommend making a point to spend about 10 minutes each day reading about health care policy in the national paper of your choice. For me, that's the New York Times (click the Health link), but the Wall Street Journal also has great relevant pieces, as do other papers and news outlets with which I'm less familiar. Having an "issue" oriented approach to preparing rather than trying to learn the nitty-gritty of the health care system will prove much more fruitful (and much more fun). While you're at it, you may find interesting articles unrelated to policy but very relevant to the topics discussed on the interview trail. Here and here are two of my recent favorites.

In the Neighborhood

Many applicants apply to schools in "geographic clusters" - for example, every school in Chicago, New York, or northern California. If you don't live near your geographic clusters, then it is certainly ideal to avoid traveling back and forth multiple times. Sometimes, a brief email to the admissions office can alleviate your travel woes.  A sample:

Dear ___,  

I recently learned I will be in Boston on September 22 for an interview at another institution. Would it be at all possible to accommodate me for an interview at Tufts during the same week? I am very interested in interviewing at Tufts, and I am hoping to minimize travel as much as possible. Thanks for helping me with this matter.

Warmest regards, 

Sam Student

Additional suggestions:

• If you know the name of the person who receives correspondence for the admissions office of interest, include it; otherwise "Dear Admissions Committee" is sufficient.
• Do not share the name of the other school. You will appear either pretentious or desperate, neither of which is desirable.
• Be succinct and kind. The administrative assistants who work in the admissions offices are the people who can make things happen for you! 
• Finally, recognize this is a long shot. Some schools can and will accomodate you and others won't, but it is absolutely worth a shot.

Date Me? Errr, Update Me.

As I have previously mentioned, at almost every interview you will be asked, “Do you have any updates you would like the Admissions Committee to know about?” (previously discussed here and here).

The answer to this question is YES even if you suspect the answer may be no. Undoubtedly, you have done something between when you submitted your AMCAS and your interview! Whatever this is, you want to make it sound as good as possible.

If you have major accomplishments, publications, job changes, or leadership positions to report, then your job is easy. Practice succinctly articulating these updates. Additionally, prepare a document to leave with your interviewer. This can be a letter to the Admissions Committee, an updated CV/resume, or a bulleted list of updates. If an article was published, bring a copy. The point isn’t the format – it’s that you’re leaving a hardcopy of your update with the interviewer rather than relying on his or her memory to report these updates to the Committee. Your additions will likely become part of your applicant file. Moreover, a hardcopy of your update goes a long way toward making you look prepared, enthusiastic, and thoughtful. Bring several copies to your interview, as you will often have multiple interviews.

If you don’t have any major changes to your application, then the task may be a little more difficult. For starters, you don’t need an update letter or document – don’t highlight things that aren’t important. Instead, think of one thing you can genuinely explain to the interviewer – a new class that is engaging, a new task at your job, a new experience of some kind. Simply demonstrate that you are remaining engaged as your conquer the application and interview process.

Teeter-Totter

What a week! The Northeast survived an earthquake, and now we’re facing a hurricane. As for personal triumphs, in addition to finishing my residency application, I took my final medical school clerkship “shelf” exam.

The balancing act of strengths versus weaknesses and preparing for interviews

I have mixed feelings about “preparing” for interviews. I think it’s healthy to have a balance between rehearsed answers and organic spontaneity. Interviewers will see right through trite or overly-rehearsed responses to their questions, so use some restraint as you prepare. That said, there are a few questions you simply must be ready to answer.

• What are your strengths and weaknesses?
• Do you have any updates you would like the Admissions Committee to know about? (briefly mentioned here; more details to come)
• Do you have any questions for me (the interviewer)?

The “strengths and weaknesses” question is a toughie. It’s easy to come up with glowing strengths but much harder to assess your own weaknesses. Moreover, you do not want your weaknesses to appear so weak that they case doubt of the quality of you as an applicant. A few things to consider:

• Be humble. Interviews are like a marketing campaign. Yes, you want to shed positive light on yourself. However, if your strengths are significantly stronger than your weaknesses are weak, it will appear as though you think very highly of yourself or are unable to self-assess and discover weaknesses (an important part of being a physician!).

• Use anecdotes. Actions speak louder than words, so be ready to support your strengths and weaknesses with an example. If a strength is “leadership,” have a **very brief** story prepared regarding a time when you demonstrated leadership.

• Put a positive spin on weakness. For example, if your weakness is that you find it challenging to delegate tasks to others, then be prepared to discuss how you’re working on this. You might say, “As I have taken on more leadership responsibility in ___ group, I have recognized how challenging it is to delegate tasks to others. I have been actively working with the group to assess individuals’ strengths as well as their interests in order to appropriately delegate the tasks we need to accomplish, and I feel like I have really grown this year in my ability to do so.” Ta-da! You practically demonstrated a strength.

Certainly, if a mock interview is available to you, go for it! And, if you have the luxury of scheduling a “safety school” interview first, that’s also nice, although most applicants won’t be so lucky.

Fast Forward

It may sound premature to think about residency when you’re not even in medical school yet, but I have a quick tip, and you will thank me later.

Save, save, and resave your medical school application materials. AMCAS information, personal statement, Secondaries – all of it. This will come in very handy when you are applying to residency and trying to remember which action verbs you used to describe the organizations with which you were involved in college! The past employment history will also come in handy. Moreover, you will likely never be a better writer than you are now, and you will be amazed at how many nicely written sentences you may want to pluck right out of your personal statement for medical school and drop into your residency application.

If you’re not already familiar, dropbox.com is a great place to store things like this given that the computer you’re using now will probably not be the one you’re using 4-5+ years from now.

(And of course, saving your materials is also a good idea in the short-term in case you are a re-applicant in the future.)

Sunday Funny

This comic, featured in the New York Times a few weeks back, appropriately captures how I feel about sending personal statements, abstract drafts - even everyday emails - to professors, mentors, and advisors. Given my advice to send your personal statement to your advisor or mentor, I thought you might appreciate that you're not the only one who agonizes over every word.

Happy Sunday.

Phone a Friend

Well folks, to say I feel your pain is probably an understatement. Applying to residency is exhausting and excruciating.
 
But, my application is finished! Letters of recommendation – mailed; transcripts – submitted; USMLE scores – sent; personal statement – written, rewritten, edited, trashed, written again, and finalized.
 
It will take me another week or so to dig out from the “life” things I have been putting off. However, I have missed blogging, and I have received tremendous feedback from readers about the blog, so I wanted to say, “Howdy, I’ve missed you!”
 
One of the biggest lessons I learned in the final week of obsessing over my application is the significance of another set of eyes. Allowing other people to read your application – personal statement, Secondaries, activities lists, whatever – may make you feel extremely vulnerable, and admittedly, it’s scary. But, it’s one of the single best things you can do to improve the quality of your work.
 
Don’t go nuts. I think it’s important to select only a handful of people with certain purposes in mind. If too many people make suggestions and edit, you will lose your voice. Here are my suggestions:  

• One person with a quasi-medical or health background who can confirm that you’re saying things about medicine that make sense. We all understand that “medicine” is another language, so using it properly is important.
  

• A person who knows you really, really well and can bring out your accomplishments, strengths, etc. and also enhance your ability to use important anecdotes about personal experiences.

• Someone with a gift for the English language. Proofread, proofread, proofread. This person can make sure you aren’t missing something just because you’ve read your whole application 10,000 times.

Of course, you’ll have to make adjustments if you don’t know people who meet these categories. Also, it can’t help to have your advisor take a look if you have that kind of relationship.

Sunday Funny

I'm taking a brief hiatus from my blog this week to finish up my own residency applications, but I want to leave you with an amazing distraction for when you're procrastinating and hiding from your Secondaries.  This photo brought back so many memories from my obstetrics and gynecology clerkship, and the remaining non-medical photos will keep you laughing in pain for hours.

Enjoy!

Couch Surfing

Continuing from yesterday, more cost saving strategies:

Where to Stay

If you want to stay in hotels while traveling for interviews and have the means to do so, that’s fantastic.  For most applicants, however, such an endeavor is prohibitive.

--Their Network

Most schools will help you to find a current student with whom to stay on the night preceding your interview.  Some schools widely advertise this opportunity in their interview invitations and confirmations.  However, most schools will help you find housing if you just ask.  The trick is knowing to ask!  If you don’t find information about housing opportunities in the interview materials, I suggest calling the Admissions Office and simply asking.   

Although it may sound awkward to stay in the same room as a complete stranger, this is an incredible “insider” view into the lives of medical students at each institution, and you will find the information you gather by observing and chatting with your host (and often his or her friends) to be extraordinarily beneficial when you begin to decide where to attend.

--Your Network

If you strike out with the Admissions Office, look at your network!  Search Facebook for friends in the city to which you’ll be traveling.  Ask your parents whether they have friends in the neighborhood (you’ll be shocked to find how willing people are to support your endeavor to become a physician).  Finally, consider contacting your alma mater to see whether alums who might be willing to host you attend the school you’ll be visiting.

--Say Thank You

A sincere, handwritten note is a “must.”  Keep blank cards with you so that you can jot down a few brief thoughts before rushing out the door en route to your interview.  If you’re feeling particularly generous, you can never go wrong leaving a small gift card ($5-$10 for Starbucks, Dunkin, etc.) or an item from your home state (a small container of maple syrup if you’re from Vermont, for example).  But regardless, leave a Thank You note!

Full Disclosure: "Couch surfing" the night before your interview is a little risky.  You want a good night of sleep and a shower!

"Carpooling"

Between your AMCAS fee, Secondaries, and perhaps a new suit purchase, you are already feeling the financial pressure of applying to medical school.  And, for most applicants, interviews have not even started!

Even the most savvy applicants will likely find interviews to be an expensive endeavor.  That said, there are definitely a few ways to cut back. 

When Traveling

Transportation expenses add up quickly.  Frequently, you will find no way to avoid an expensive flight, and you simply have to eat those costs. Of course, shop around for your tickets, and buy early when you can.

The expense that is often more difficult to predict and surprisingly expensive is transportation to and from the airport, train station, etc. and medical school.  When I was interviewing, I often arrived at my destination on the night before interview day.  Usually, this meant I wasn’t too pressured for time which enabled me to avoid cabs and take advantage of public transportation, which is a slower option in most US cities.  Use websites like hopstop.com to plan your route.   

Following the interview, you may be more pressured for time because of flight, train, or bus departure times.  Don’t hesitate to coordinate over lunch with your fellow interviewees.  Many of the applicants will be headed where you’re headed, and the Admissions office is often happy to call or hail a cab for you.  Be sure to bring cash so everyone can split fairly.  I did this at almost every interview and loved the combination of efficiency and savings!

The Walls Can Talk

Many Admissions Committees are reviewing applications and starting to send out interview invitations.  You may be wondering what to expect on an interview day. 

Although every school’s interview day will proceed a little differently, the general ingredients are

• 1-2 interviews,
• an information session regarding the school, facilities, curriculum, and “special highlights” such as dual degree programs, study abroad opportunities, and research highlights,
• a tour of the educational facilities, hospital, and housing, if applicable,
• and a lunch (varies tremendously in quality and variety!) with current students.

Applicants frequently make the mistake of being on their best behavior during the interview(s) and then relaxing somewhat for the rest of the day.  This is a mistake.  You are being evaluated throughout the entire day.  Although particularly pleasant interactions with administrative assistants, students, etc., are unlikely to significantly enhance you chance at acceptance, missteps will almost certainly ruin your opportunity.  In fact, my medical school sends an email to current students each year reminding them that offensive remarks, disrespectful behavior, or anything else that detracts from an interviewee's application should be noted and reported to the Admissions Committee.  Do not say or do anything you would not do in the presence of your interviewer.  That said, relax and try to have fun.  Medical schools want to accept fun individuals who will deal with the pressures of medicine in stride. 

Sunday Funny

I was on call yesterday, and during my review of systems with a patient, he explained his recent struggles with incontinence:

"I had been having some trouble with my urination. Incontinence, I think. I kept finding yellow stains in my white underwear, and I was pretty concerned. But I switched to black underwear a couple of weeks ago, and it doesn't seem to be a problem anymore."

Love Letter

Conquering the “Why This School” essay may feel like writing a love letter to the Admissions Committee. It's tough, particularly because it is easy to become bogged down as you craft and adjust the essay for each school.

Be Brief. Most schools ask that you limit this response to about 200 words, and they’re serious. Keep yourself to two paragraphs. The first should focus on ONE (and only one) aspect of the school that makes it a good fit for you. You can tastefully tie in other points, but be judicious. The second paragraph is for special circumstances, discussed below.

Focus on You. Do not be fooled into thinking this is an essay about how fabulous the school is or how much you want to go there. Admissions Committees already know their school is terrific; do not waste words telling them (see “Be Brief”). At heart, this is an essay about you!

Don’t be a Broken Record. Secondaries are a place to tell Admissions Committee things they do not already know about you after having read your AMCAS. Try not to reiterate too many things you have already driven home elsewhere.

Demonstrate Commitment. Often, applications make applicants appear a little lost – a bit of community service here, some laboratory research there, a brief tutoring experience, etc. This essay is a place to demonstrate commitment, an attribute schools seek in applicants. For example, if you wrote for the school paper, you might explain, “During undergrad, I demonstrated my interest in journalism by taking relevant coursework, serving as a writer on the university paper, and ultimately being selected as Chief Editor. I look forward to attending ___ because of the unique opportunity to write for and help publish the medical student literary journal.” You get the point. 

Special Circumstances. The second paragraph is where you can mention that every person in your family has attended this medical school since before DaVinci, and you cannot imagine the shame of coming home for Thanksgiving if you do not get it. Not all special circumstances need to be “special.” You might mention your interest in practicing rural or urban medicine and thus wanting to train in that type of environment. My caution is to be careful about geography. Schools do not want to hear that you are interested in their program because you want to be in New York City, for example. Admissions Committees prefer to think that their curriculum and facilities are so wonderful that you would apply even if they were in Antarctica.

Say my Name. Everyone likes to hear his or her own name. Include each school's name in the essay. But, be sure to proofread and change the name before sending the "Harvard" essay to "Yale." I hear that's bad for business.

Put a Stamp on It

For applicants to the current cycle, letters of recommendation are a thing of the past, and Secondaries are the current focus, right? 

Maybe.

Have you sent Thank You notes to your letter writers?  If not, you should consider.

1.  Thanking your recommenders is the right thing to do.  Period.  Etiquette experts agree that writing a handwritten thank you note (yes, handwritten) is never inappropriate.

2.  It’s not just about the letter.  Even if you no longer anticipate frequent interactions with a writer of one of your letters (because you completed his or her course, are no longer working in his or her lab, or ended your commitment to the his or her volunteer organization, etc.), letter writers' names and contact information remain a very active part of your application.  Not infrequently, Admissions Committees call recommenders of applicants.  Whether it is because the Admissions Committee has further questions about you, is unsure whether to interview you, or is considering adding you to the waitlist, you want your writer to go to bat for you!  For this reason, you want them to know how much you appreciate the incredible effort they put into your letters.

3.  Did I mention it’s the right thing to do?  If you absolutely dread the thought of a handwritten note, then sending an email is better than nothing at all.  That said, imagine how much you will stand out when all your peers send emails and you send a old-fashioned note. 

Here’s a template to get you started.

Dear Dr./Professor Miller,

Thank you for taking the time to write a letter in support of my application to medical school.  I know that recommendation letters require significant time and finesse, and I truly appreciate your willingness to write on my behalf.  I anticipate that interviews will begin soon, and I will continue to update you on my progress and final plans.  Thank you again for your support.

Warmest regards,

Corey Medical Student

Wasn't that easy?

Extra, extra! Read all about me.

As time passes since you submitted your AMCAS, you may begin a new job, shadowing experience, or community endeavor; publish your research; change your planned coursework; win an award; or master a new hobby. You may find yourself wondering how to go about updating Admissions Committees.

At nearly every interview, you will be asked whether you have any updates for your file. If you email or send an update letter now rather than waiting for an interview, you risk having nothing to update at the interview. Updates are a key way to actively demonstrate to interviewers that you are remaining engaged despite the craziness of applying and interviewing for medical school. Moreover, you may find in a few weeks or months that you have an additional update, and you do not want to send multiple letters.

Here is my recommended time line. Wait until November or December. At that point, you will (hopefully) have been able to update some interviewers in person. Then, send an email to schools you have not heard from, express your interest in interviewing, and include any updates to your application. If updates occur after you have already interviewed, send an email to your interviewers as well as to the general email address for Admissions, include your updates, and also reiterate your interest. Finally, it's nice to have a printed copy of any updates to physically give to your interviewers so that the updates can be physically added to your file. If you only tell your interviewer, he or she may forget.

I realize some applicants feel that they need to send updates now in order to increase odds of getting an interview. Rest assured that most updates are not so amazing that they would be reason enough to grant an interview to an applicant who would not otherwise have received one. Patience, patience.

Hidden Secrets

You have spent weeks, if not months, choosing exactly what you want Admissions Committees to know about you by selecting precise language and specific attributes to highlight in your AMCAS and Secondaries. You may have spent less time, however, contemplating what you don’t want Admissions Committees to know about you.

Now go ahead…Google yourself. According to careerbuilder.com, 35 percent of employment recruiters have come across compromising info that caused them not to hire a candidate. Like employment recruiters, Admissions Committees members are also likely to use Google and Facebook to dig up skeletons in your closet. Given that Admissions Committees frequently have medical student members, you are very likely to be searched for at some point during this process.

When you Google, look for text as well as images. Ask friends whose tagged images of you appear on Google to kindly detag you or remove the image; it will take weeks for a Google search to reflect this change. If you cannot bear the thought of deactivating your Facebook account completely (my recommendation for the duration of interview season), at least change your name or buff up your privacy settings.

Additional tips: Sign up for Google alerts, which informs you when your name comes up on a search. Socialmention.com and samepoint.com also allow you to search social networks, which Google may have missed.

Interview Bound

Once you’ve submitted your Secondaries, planning for interviews is the next step. For men and women alike, two items are essential: a professional suit and a leather binder. You have likely been brainstorming about your interview attire, but a leather binder may catch you by surprise.
 
A leather binder is perfect for carrying the essentials you will need on interview day. It is better than a briefcase, shoulder bag, or purse because it looks professional, is small and easily portable, and will allow you to keep important documents crisp and wrinkle free. Non-essential belongings can be left in the Admissions Office (the secretary will always be willing to store a suitcase and coat for the day), at your hotel’s front desk, or with the person with whom you stayed.
 
Here’s what belongs in your binder:

• Copies of your personal statement and application
• A curriculum vitae (CV) or resume that concisely reflects the information from your application
• A written application update, if applicable
• Materials from the Admissions office (maps, schedules, etc. distributed upon arrival)
• Cash, identification, boarding pass, metro card, etc.
• Blank Thank you notes
• Ink pen 

On the interview day, your binder will also be the place where you store the business cards you request from each interviewer.

I purchased my binder at my college’s bookstore for about $40, and it was one of the best investments I made during interview season. I recommend one with a zipper. Here’s an example from Amazon.

Forbidden Fruit

Among Secondary Application questions, the “ethical dilemma” is by far the most challenging. It is easy to feel overwhelmed by tackling this question, and many applicants struggle to choose a topic. My list of cautions is below.

1. Brevity is the soul of wit. Your response should not be long. Character or word limits are exactly that: limits. Do not interpret them as guidelines or suggestions about length. Admissions committees are simply assessing your ability to first identify an ethical dilemma and then behave appropriately in the face of it. The less you say, the less likely you are to dig a deep, deep hole.

2. Avoid “overshare.” Admissions committees do not want to know intimately personal details about you. This is a balancing act. If you depersonify the essay entirely, it becomes less interesting because it is no longer about you. That said, use care. Essay readers will be rightly skeptical if they find you positioning yourself smack-dab in the middle of a questionable situation. Similarly, avoid overtly controversial topics, particularly lifestyle decisions.

3. Do not be the hero. The essay does not need to be a story about your intervening in an unethical act. Enough said.

4. Do not attempt profundity. Your essay is not a philosophy dissertation. You do not need to be profound; you simply need to demonstrate good judgment.

5. Finally, do not choose academic dishonesty as your topic. This topic is so worn out that some schools will even forbid it in their instructions to the applicant. If they do not, assume they thought you would know better. Everyone has seen cheating, and studies show that most students themselves have probably done it at some time. If this is the only topic that comes to mind, it suggests to Admissions Committees that you may not be observant enough to identify the ethical dilemmas that occur daily in your life, and if you’re not observant, you won’t be a good physician. See Point 4. You do not need to be profound. It is better to choose a small, insignificant dilemma than to choose cheating, plagiarism, etc.

For inspiration, try reading a few entries from the collection of Ethicist columns from the New York Times Magazine. Times Magazine columnists also answer ethical questions on this free podcast: NYT: The Ethicist Podcast.

Then, re-read Point 5: do not plagiarize.

Go Forth and Excel

Although receiving and submitting Secondaries may seem stressful, interview season is likely to be even more hectic.  Now is the time to plan ahead to make interview season much easier: Create a spreadsheet.  

A well-made spreadsheet will streamline the process and help to make important details – like where you’ll be sleeping, and whether you’ve thanked your interviews – easily accessible and less forgettable.  You may prefer to put dates into the empty cells or simply check marks.  More on thanking your interviews in a future entry.