Applying to medical school is tough. Really tough. There are more qualified applicants than there are spots. The number of applicants is increasing every year (and subsequently, the number of qualified applicants) while the number of medical school spots isn’t keeping pace.

But if you want it bad enough, with a lot of hard work and a little bit of luck, you will get there. No matter how good an applicant you think you are, there is always room to be better, and ways to increase your chances of getting that medical school acceptance.

Feel that you’ve done everything you can? Looking for the next thing you could work on? Then this article is for you. I present to you: 10 things you can do right here right now to make yourself a better applicant to medical school.

1. Study
Whether it’s for tomorrow’s exam, the MCAT, or for a quiz five days from now, studying a bit more can’t hurt – it can only help. The truth is GPA and MCAT are the two most important factors for getting your foot into the door of a medical school, so academic excellence should be at the top of your list of priorities.

2. Review your application and identify areas of improvement
It’s always a good idea to review your progress as an applicant and find holes in a future medical school application. Are you very involved in your community but lacking direct leadership experience? Are you missing 1 or more of the 3 strong referees you need for letters? Are you overly-involved in the community but struggling in your university courses?

I am strong believer in self-reflection to figure out what your next steps should be. If you have extensive leadership experience, there’s no point joining the executive of another club (unless you really want to). Try something else and make yourself an even more well-rounded and interesting applicant. Not to mention trying new things will increase your skill set and often give you added perspective on life.

If you want to know what you need to work on as a medical school applicant, don’t ask me – I won’t know the answer. You need to spend time looking at your own progress and identifying what’s missing from your application.

3. Look up the latest information on medical school admissions
Admissions requirements can change from year to year. The MCAT cutoffs are the University of Western Ontario’s medical school change every year. In the last few years alone, McMaster added the Verbal Reasoning component of the MCAT to their admissions process and McGill University completely removed the need to take the MCAT.

Smart students are resourceful students. Keep up to date with the latest admissions information and don’t miss out on opportunities. I wonder how many potential future doctors didn’t apply to McGill this past year just because they didn’t realize they didn’t need the MCAT anymore.

4. Ask friends and family members to review your application
As the authors of our applications, we know exactly what our words and sentences mean, even if they aren’t necessarily written well. It’s always good to get a second (or third or fourth) pair of eyes to read over your essays and applications. From small things like spelling and grammar to large things like ideas and themes, it’s good to get someone else’s perspective – someone other than you is going to be evaluating your application, right? So it makes sense to see that your work is understandable to complete strangers.

5. Keep track of your activities and accomplishments
Even if you’re not applying to medical school for a year or two, I highly suggest keeping track of your accomplishments and activities, both academic and non-academic. It could be as simple as a list of these items or a professional resume, whatever you like, as long as it includes pertinent information such as dates, name of activity/accomplishment and brief description of activity/accomplishment.

I suggest this for a few reasons. 1.) It’s easy to forget all of the amazing work you accomplish over the years and you’re bound to forget something as time goes by. 2.) Having all of this prepared makes completing your medical school application a lot less of a pain (especially the 48-item OMSAS autobiographical sketch).

6. When you experience an event in your life that impacts your interest in medicine, take time to reflect and write it down
“Why medicine?” is the toughest question you’re going to have to answer when you write your essay, when you take part in interviews, and in fact, is a question you’re going to keep asking yourself even throughout medical school as you realize it doesn’t actually get easier. The reality is that the answer to this question is rarely going to be one obvious thing. For many of us, the answer to this question is going to be a myriad of reasons and experiences, and if you can keep track of any key revelations you go through, it will make answering this questions (and understanding yourself) easier as you go through the admissions process.

7. Read HealthyDebate.ca
I have been asked about my opinion on the Canadian health care system at both traditional and MMI medical school interviews. Clearly, having a basic understanding of how our health care system works and some key problems we are facing today would be useful for both your interviews and for practicing as a future physician.

In retrospect, I actually think it’s kind of funny that we are expected to answer questions like this. In my first two years of medical school, I have basically learned next to nothing of significance about our health care system, which I think is actually concerning, but I digress and that rant is for another day. I have spent my summer so far working on a project that has significantly increased my understanding and shaped my current perspective on our health care system. If I had to answer those interview questions all over again, questions like “what are the biggest problems facing health care today”, my answers would be extremely different.

In any case, a newly developed and excellent resource for learning about Canadian health care issues is HealthyDebate.ca and I highly encourage you to read their articles. I admit I am probably biased because I know some of their authors, but based on my conversations with them (who by the way have terrific credentials/qualifications), I am confident they are providing you with good information.

8. Work on your ECs
We all have unanswered volunteer emails, club events to organize, and 99 research papers to read for our lab work. Get off this blog and spend an extra 30 minutes today and take care of one of those things!

9. Plan ahead for the future
Getting into medical school is hard. It’s important to have a plan for both getting in and for what happens if you don’t get in at your next attempt. Think about how you are going to spend your summers, how you are going to spend your non-academic life during the school year, and what you might do if you graduate and do not get into medical school. If you are in your fourth year of undergrad, realize that grad schools have deadlines. If grad school is something you are thinking of, make sure you know those deadlines. The same goes for any other opportunities you are thinking of, even if it’s just for a summer – all opportunities have deadlines, keep track of them, and plan ahead.

10. Start completing your application
The earlier you start your application, the less work you have later on, and the more time you have to fix any bugs and fill any holes. Inevitably you’re going to find yourself stressing out the night before your medical school applications are due and telling yourself “I wish I started earlier”. Well, earlier is now, so get cracking!

Any more tips to add to the list? Let us know!

Related posts:

1. Is there a “perfect” medical specialty?
2. Stanford Admissions Video – Medicine, Business, Education and Law

In recent days, Canadian medical schools have begun spreading joy (through interview invites) and crushing dreams (through rejections) among students everywhere. Great for those invited to interviews, but feelings of disappointment, sadness, and sometimes anger for those who received bad news. As we all know, it’s never fun to be rejected for anything.

When you receive a rejection, many thoughts can go through your head, like: What did I do wrong? Was I not good enough? Boy, they really screwed up!

While some of these thoughts can end up leading to something positive (e.g. you work harder for next year’s application cycle), some of them can be quite destructive (e.g. you blame the medical school admissions process solely and spread a lot of negativity).

In perusing the Canadian premed forums this past week, it’s quite clear that all kinds of thoughts formed in response to rejections. In reacting to rejections, I think it helps to stand back and take an objective look at the medical school admissions process.

What happens every year around interview invite time is that students who hear back from medical schools post their “stats” and a status update for their application. For those unfamiliar with I’m talking about, here’s an example:

Rejected!
4th year applicant
3.91 GPA
PS12/VR14/BS10/WSQ
EC’s: 2 summers of research, started a club, lots of leadership positions, volunteered at a hospital every week
Application: Strong essay and reference letters

There are lots of good applicants with really good “stats” who get rejected from medical schools every year – stellar GPA, strong MCAT, lots of extracurriculars and leadership experience, etc. In their mind, they have put together a pretty darn good application and are shocked when they don’t get an interview – especially when they see other students with similar or even lower “stats” moving on in the admissions process. So what’s going on?

The easy way out would be to blame the admissions committee and say they screwed up. I see this a few times every year and unfortunately this is an unhealthy attitude. It suggests a sense of “entitlement” to the applicant when the reality is that there isn’t one. Understand this: the admissions committee can do whatever the heck they want. It is their process. Their goal isn’t to get you into medical school. Their goal is to create a medical school class that they and the medical school are happy with.

What do we really know about the process? Really, a whole lot of nothing

We are told some things about the medical school admissions process, but not a whole lot. We know that GPA matters more at UofT than it does at Western, for example, but there are many things we still don’t know. How is GPA scored? How much of a difference does it make if I’m a graduate student, 4th year student, or 3rd year student?

The same goes for other parts of the application. Sure we might be told that a school looks at our essay, reference letters, and autobiographical sketch – but in what way? Is the essay worth the most or the least? Are reference letters worth something or are they just a flag?

The truth is that as an outside applicant, you really have no idea. You might be an outstanding candidate, but if personal statements are your weakness, and you so happen to apply to a medical school where personal statements are, unknowingly to you, worth the most, then you might just not make it – unfortunately, you won’t know this. Which is why your goal should be to put forward the best application you can in all aspects.

Subjectivity in the process

Unless a computer does everything, there will always be subjectivity in the admissions process. Human beings read your applications and will have their own subjective interpretations of you as an applicant. It’s the reality, and we just have to deal with it. Maybe if you’re lucky you will have an evaluator who identifies with the same issues you speak passionately about, and maybe if you’re unlucky you will have someone who completely disagrees with your point of view.

Realize that there is only so much you can do as an applicant. All you can do is put your best foot forward, and hope things work out.

Is the process fair? It depends on how you look at it. If you look at it theoretically, it’s fair in the sense that everyone has an equal chance of getting lucky or unlucky. You just have to hope you’re on the right side of the coin when your application gets read. That’s not to say that the admissions process is completely based on luck (it’s not), but let’s face it, everyone needs a bit of luck sometimes to do well.

Being honest with the quality of your application

When people post “stats” like the example above, I often read things like “strong essay, good reference letters, stellar EC’s” – however, realize this is just your opinion and not necessarily a reflection of that of the admissions committee. What you might think is a strong essay might not hit any of the points the admissions committee is looking for. Just because you had a strong relationship with your referee doesn’t mean that they know how to write reference letters well (just like with essay writing, reference letter writing is a skill). And just because you had medical students and medical professors give you a thumbs up on your essay still doesn’t mean your essay is good enough to get in – the only people who decide that are the people who are assigned to read your essay and mark it. I am sure there are medical students who got in with their essays being the weakest part of their application, and medical professors who are now quite far removed from the current admissions process. And even if these are medical students and professors involved in the process, well unless they are the actual people reading your application for marking, then their subjective interpretation is only worth so much.

The admissions committee knows exactly what they are looking for in applicants. They might not agree with your perspective, but this is the reality.

My advice is to reflect on your application experience and work towards making your application better for the next cycle. Many people apply more than once before getting in, have a healthy attitude, and don’t give up!

Related posts:

1. 10 Things You Can Do Today to Improve Your Medical School Application
2. A is for Attitude – maintaining a positive attitude even when everything goes bad
3. Is there a “perfect” medical specialty?

Over the past year and a bit, I’ve gotten a lot of questions about the medical school admissions process. As you can imagine, a lot of students have the same questions. I figured it would make a lot more sense to just compile these common questions and my answers for everyone to see. Overtime, as we get more questions and write more answers, we will keep adding to the list. Enjoy!

• General
• Undergrad
• MCAT
• Extra-Curriculars / Non-Academic Experiences
• Reference Letters

General

Could you give a general timeline of how the med admissions process went for you?

It’s a pretty basic process, but keep in mind that this won’t be the same for everyone, and there’s no “correct” way.

Summer after 1st year – took MCAT prep course during May to July, then MCAT in August

August to Sept of 3rd year – apply to Ontario medical schools through OMSAS (Google this if you want to learn more, this is the online application service)

January to February of 3rd year – hear back about possible interviews (and rejections)

Late Feb. to Early April of 3rd year – interviews

May 15 of 3rd year – first round offers from medical schools (as well as waitlist and rejections)

What courses would best prepare me for medical school?

The best courses to prepare someone for medical school are anatomy and physiology (and maybe a few other ones, like immunology, genetics, biochemistry, etc.). That being said, these are NOT prerequisite courses for med school. I’m just saying that these types of courses are most relevant to the type of information covered in medical school.

Undergrad

Do students from universities like York stand just as much chance of getting into medical school as a student from UofT with similar GPA and MCAT scores? Do you know of any other York peers that were accepted to medical school?

Which university and program you attend in undergrad does not matter at all in the medical school admissions process. There are at least 5 students in my UofT med school class from York undergrad and I have many friends from York at other med schools. Medical school classes are full of students from many undergraduate programs and universities.

Why does York have fewer students in med school than say UofT? Honestly, I think it’s a combination that York has fewer medical school applicants in the first place, and from my experience, it seems that most students who go into university serious about medical school end up at more popular undergrad schools for science like UofT, Queen’s, etc.

Does it matter what program I take?

As long as you take any necessary prerequisite courses for specific medical schools, you should be fine. Sure, it’s a lot easier for a health sciences major to explain that they have prepared themselves for medicine than a music major. That doesn’t mean a music major has no shot – it just means that when you write your application and go to your interview, you need to make sure you have a good explanation for how your undergrad experience will contribute to your medical training.

What courses do I need to take?

Some medical schools have a few prerequisite courses. You should spend some time researching the medical schools you are interested in to find out what you might need to take. For a quick glance at Ontario medical schools, check out page 14 of this document.

Should I take a full English course?

It depends on which med schools you would consider applying to in the future. If you only plan on applying to Ontario schools, then there’s no need to take english. However, I know some schools in Western Canada (e.g. U of Alberta) require English, and I believe a lot of American med schools also require a year of english. That being said, if you do want to take english, you don’t have to take it this year, particularly if you think it will be one of your lower marks (as a lot of science students might believe). So instead of taking english earlier, you can take it the year you apply so that the mark won’t show up on your application if you’re worried about it being a bit low compared to your other courses.

What happens if I’m in a 4-year undergraduate degree but get into medical school after 3 years? Do I just stop doing my university degree and start med school?

Yup, you just leave your undergrad program and start medical school. However, at some undergraduate institutions, you can apply for a 3-year degree if you have achieved enough credits. For example, I was in the 4-year Biomedical Sciences program at York. After getting into med school, my science counsellor found out I had enough credits to graduate with a 3-year Bsc (general science) and I got a degree.

What elective courses did you take in university?

In general, I took a few economics, one psych, and a lot of philosophy. I took two economics courses over 1st and 2nd year because I knew I could do well in them, and I wanted to get as good a GPA as possible since I was planning on applying to med schools in 3rd year. In 2nd and 3rd year I took a lot of philosophy courses because I was really interested in those topics. I didn’t pick them for marks (getting an A+ in an essay based course is pretty tough), but I thought I would do okay in them too.

Should I just go to a university program that is “easier” to get marks in?

It depends on what’s most important to. A lot of factors come into play: location, other opportunities (e.g. research), campus life, etc. It really depends on how you balance your priorities and interests. Some people care about getting a higher GPA less than others, some people care more.

MCAT

When should I take the MCAT?

I wrote a whole article about when you should take the MCAT, but here’s a short answer. My general advice is to plan to study and take the MCAT after having taken your science courses like 1st year physics, biology, and chemistry, as well as 2nd year organic chem. Which is why I would suggest taking it after 2nd year, or even after 1st year if you think you can figure out organic chemistry without having taken the course. Taking it after 3rd year is okay too, but you have to keep in mind that a lot of the science material won’t be fresh in your mind anymore, and you will have more review to do.

Should I take physics in university to prepare for the MCAT?

I would say that in terms of the physics material you need to know for the MCAT, it is basically high school physics plus a bit more – however, this doesn’t mean the difficulty of the questions are the same. All I’m talking about is the type of material covered.

The advice I always give when people ask me this is to pick up a MCAT prep book, go over the physics material, and see if you can understand it on your own. If you can, then don’t take 1st year physics (unless you want to, or think you will do well in it). However, if you have trouble with the MCAT physics in your own, it may be worth taking a physics course.

What courses should I take to prepare for the MCAT?

I would say that you should take 1st year biology, chemistry, and physics, and 2nd year organic chemistry courses to prepare you for the MCAT. Physiology, biochemistry and genetics would also help.

How did you manage to participate in EC’s while studying for the MCAT?

I volunteered in a lab part time (2.5 days a week) one summer while taking a MCAT prep course and studying for the MCAT. I also spent the following summer doing research full time.

Personally, I highly suggest NOT committing to anything like a full time job while preparing for the MCAT if possible. A lot of people end up burning themselves out doing both at the same time, and as a result, some people don’t do as well as they can their first time on the MCAT and end up retaking the next summer. I’m sure there are some people who can handle full time commitments and preparing for the MCAT – if you’re one of those people, great, go for it. But it’s important to be realistic about how many things you can juggle. Don’t just burn yourself out because you think everyone else is volunteering, doing research, and preparing for the MCAT at the same time. The MCAT is an important test, and not a particularly fun one – you want to aim for taking it once and once only.

What MCAT score should I aim for?

The real answer is that you should try your best and get the best score possible for you. But if you really need a number to aim for, I would suggest aiming for something like a 11/11/11/R so that you are eligible at pretty much any Canadian medical school. It’s not fun when you miss the chance at an automatic interview at Western or Queen’s because of being one point short in a section.

I want to caution that each school uses the MCAT differently, and everyone should be aware of this when considering which schools to apply to. For a lot of students just starting to think about medical school, there seems to be some misconception that all medical schools are the same and perhaps have the same admissions process, when that really couldn’t be further from the truth. Each medical school has the same basic components (e.g. a combination of GPA, MCAT, application/essay, interview, etc.) but they all use and value these components differently, and may even administer them differently (e.g. some schools use the Multiple Mini Interview format while others have stuck to the traditional style interview).

Which MCAT prep course did you take and was it worth it?

I took the Princeton Review prep course. I would say that if you already have a background in science (e.g. you are a science major who is already taking 1st year physics, bio, chem, etc. in your program) then it’s not worth it. The prep books are pretty easy to follow if you’ve taken those courses before, so I think you’re just wasting a lot of time showing up to class to be taught stuff you could review on your own much more quickly. However, if you have never taken science before or haven’t reviewed it in many years, a prep course might be helpful. Prep courses also usually give you access to practice tests, which are useful.

What books would you suggest for studying for the MCAT?

If you’re going to study for the MCAT on your own and just get the books, I think Princeton has the best book for the Physical Sciences, Kaplan’s is probably better for Biological Sciences (Princeton is better if you want all the details, though I think that is unnecessary), Princeton has the best book for Writing Sample, and Exam Kracker’s has the best book for Verbal Reasoning.

Should I take an organic chemistry course before I do the MCAT?

As someone who didn’t take organic chemistry before doing the MCAT, I would personally suggest taking the course first. It’s possible to learn on your own if you’re willing to put in the effort and have good resources, friends, etc. who can help you. I personally didn’t get organic chem. while learning on my own for the MCAT, and I think I probably bombed most of the organic chem questions on the actual MCAT. I get the feeling if you take the organic chem course, you will breeze through the organic chem parts of the MCAT, so you should take advantage of that if possible.

Does it matter if I take the MCAT more than once?

For Canadian medical schools, no, I don’t believe it matters how many times you have taken the MCAT (most schools look at your best or most recent score). I think it might matter for some American schools, but I’m not sure.

Extra Curriculars / Non-Academic Experiences

What extra-curriculars (EC’s) did you do? What EC’s should I do?

The short answer is that I was involved in a lot of random things. I’ve been involved a lot with science promotion to youth, my church choir, volunteered with recreational therapy at a kid’s rehab centre, some band/symphony stuff. To be honest, I probably did less “EC’s” on a regular basis than many applicants, but I think I benefited from having being involved in my community for many years already and having diverse experiences.

I wrote an article previously analyzing how important non-academic things like ECs actually are to the medical school admissions process. Pretty much my conclusion was that it doesn’t matter as much as people think. This is because most medical schools rely on your GPA, MCAT score, and interview way more than the list of ECs/awards/experiences you give them. In fact, to my knowledge, schools like Western, McMaster, and Queen’s pretty much don’t really look at the list of ECs you give them. In general, it’s not so much that you have a stellar long list of ECs, but rather, their importance is that if in an interview (or application question) you are asked say “tell me about a time you had to be a leader”, you have a good example to talk about because of your ECs. That’s why quality of your ECs/experiences is way more important than volume.

I generally don’t like answering the “what ECs did you do” question because I think it might give the impression that you need to do X, Y, and Z to get into medical school, when that isn’t the case (at least not for Canadian medical schools). People get into medical school doing completely different things. Some people volunteered in a hospital and some people didn’t (I never did). Some people did research (I dabbled with this for two summers), other people didn’t and got in. There’s no magic formula.

The reasons why non-academic things like ECs, volunteering, hobbies, etc. are important to medical schools is because those experiences help you develop skills like communication, teamwork, patience, etc. that aren’t necessarily developed in the academic environment – all skills that a good doctor should have. It doesn’t matter so much how or where you developed those skills. What’s important is that you actually did develop them. So whether you were captain of your sports team or president of a club doesn’t matter as much as the fact that you can develop leadership, teamwork, and communication skills from both.

All that being said, I do highly suggest gaining some sort of experience in a health care environment, whether that be volunteering in a hospital, shadowing a doctor, etc. It’s not only important that you gain some insight into the field so you kind of know what you might be getting yourself into, but from the admissions committee point of view, how serious can a candidate be if they haven’t spent the time to learn what a doctor does?

How important is it to have consistency in EC’s between high school and university?

As for ECs, I would say that consistency is not that big of a deal – it’s pretty normal for many students to move to new cities for undergrad and start from scratch. I do think you should try and show some dedication to a few things, partially because the longer you do something, the better and more complete your experiences will probably be.

Do you need to do research to get into med school?

No, you don’t “have” to do research to get into medical school. Some people in medical school did research, some didn’t. It is by no means necessary. If you did do research, it’s another aspect of your life that the admissions committees might find interesting and you should definitely mention on your application. That being said, it is true that a lot of the doctors involved in the admissions process tend to be university-affiliated physicians who do research.

So why do people say some medical schools like research?

In terms of research, I believe research is valued by some medical schools because: 1.) doing research often means you have someone who can give you a letter of reference commenting on your academic skills, and 2.) many faculty and staff in medical school are academic physicians, meaning that they are doctors who do research. As you can imagine, like attracts like – doctors who like doing research themselves will like applicants who do research. No, as an undergrad you might not be doing medical research, but even doing any research shows you might be open to doing some sort of medical research later on.

How did you get a NSERC student award to do research with a professor?

For the NSERC, I think it depends on your university. At York, you had to find a professor willing to apply with you, and then you fill out an application form, and a committee at York selected the recipients from the list. From what I hear, GPA played a big role in the selection process at York. I have no idea how it’s done at other universities though.

How should I approach a professor about doing research with them?

I would first research potential supervisors and find ones whose work interests you. Then send them an email letting them know you’re interested in their work, let them know you’re interested in working for them, ask them if you could meet to discuss your interests, and attach your CV.

Do extra curriculars from high school matter?

ECs in high school are important for applying to certain university programs (i.e. those with supplementary applications). As for medical school, I think most medical schools allow you to put anything from 16 years old and on, but I would think that things happening earlier on in your life are given less weight. What you do now or what you’ve done recently provide a more accurate picture of who you are now as a person.

Reference Letters

Who did your reference letters come from? How did you choose them?

For a more complete answer, check out my article on reference letters.

In short, you should ask people who you know genuinely support you and want to help you get into medical school. It’s amazing how good a letter you can get from someone who genuinely wants to support you. A lot of people think that you need to get lucky to find someone who writes well, and while that’s true, the quality of your letter is significantly affected by being smart about who you ask. Don’t just ask a random professor you had a class with because you “need” an academic letter. If the letter isn’t going to be spectacular, then it’s not going to improve your application.

Personally, I got my three letters from my research professor, the director of the science charity I work with, and the head of the church choir I volunteered with. The big tie between all three, like I mentioned before, is that all three genuinely wanted to support me in my endeavours. I knew that my church choir director, for example, would not have had as fancy a “title” as perhaps someone else, but I knew she would write the best letter she possibly could – and that’s way more important than having some really famous person write you a short, generic letter.

The admissions committee knows you’re going to sell yourself the best you can in your essays and application. But if you can find 3 random people who will sell you just as well, that speaks volumes.

Related posts:

1. 10 Things You Can Do Today to Improve Your Medical School Application
2. Stanford Admissions Video – Medicine, Business, Education and Law
3. Is there a “perfect” medical specialty?

Today I got an email from a reader asking me for some advice on which referees he should ask to write his three letters for medical school admissions. If you haven’t read my first article on reference letters, I urge you to do so before reading this one. If you’re too lazy, the cliff notes of that article are that you should pick referees who know you very well and who you know genuinely want to support you in your quest to become a doctor. Simply put, unless your referee has known you for a long time, he will have nothing of substance to say about you. And unless your referee really wants you to become a doctor, then he has no reason to producing something with substance.

Of course, the question that remains is: “but what if my three strongest references are too similar”?

Why Diversity is Good

We have established that the strength of the letter is more important than who wrote it. It’s easy to see that what is written is significantly more important than who it is written by. For example, a one page letter written by your research supervisor is probably going to be better than one paragraph written by the dean of your faculty. However, one clear exception would be if your strongest possible letters would end up being too similar in content.

Reference letters can become redundant if they are focused on the same thing, and worse, they can leave out important information. For instance, if your three referees were all professors / researchers you worked with, chances are a lot of the same traits will be mentioned (e.g. intelligence, work ethic, problem solving, etc.). While these are most definitely traits necessary for a good physician and traits you want highlighted by your referees, you want to ensure that your reference letters hit on as many relevant traits as possible. You also want one or more of your referees to evaluate your abilities in compassion, empathy, etc. – traits less likely to be seen in a research environment, but commonly utilized in various community/volunteer experiences (which many of you are bound to have).

One quick way to think about this (at least for Ontario medical school applicants) is to check the OMSAS reference form and see what traits the referee is supposed to rate you on: intellectual capacity, initiative, leadership capabilities, maturity, cooperation, integrity, problem solving, fluency in spoken/written English, ability to communicate, ability to relate to others, ability for self-directed learning, and critical thinking ability.

Knowing that you are being rated on these qualities, you want to select referees whose relationship/experience with you is diverse enough to achieve high ratings across all of these traits, even if those high ratings don’t necessarily come from the same referee. The point is to prove you are strong in all of these categories in some way or another, and it may be hard to do that if all of your referees are commenting on the same few traits. Two referees saying you are smart and one saying you are compassionate is way better than three referees saying you are just smart (That being said, it would be even better if all three said you were both smart and compassionate, so let’s aim for that when picking our referees!).

Long story short, physicians are multi-dimensional and therefore, you want your reference letters to reflect the same about you. It can be hard to do this unless your referees themselves come from diverse backgrounds and have different experiences with you.

So how should we go about obtaining diversity? The 2+1 Rule

To make it easier, let’s start by simply dividing up all possible referees into two groups: academic vs. non-academic. Academics would be individuals like course professors, research supervisors, etc – basically anyone who has seen you in an academic setting and can comment on you as a scholar and student. Non-academics would be individuals like volunteer supervisors, club facilitators, team coaches, etc. – anyone who has seen you in a non-academic, and more extra-curricular capacity.

We’ve established that if possible, we don’t want all three referees as academics, and nor do we want all three as non-academics. In that case, the only satisfactory solution is what I will now name as the 2+1 Rule of reference letters: you should aim for at least one academic and one non-academic reference letter, with the third letter being anything that you want (leading to 2 academic/1 non-academic or 2 non-academic/1 academic, and hence, the 2+1 Rule).

Personally, I had one academic (research supervisor) and two non-academic (two volunteer/community experience supervisors). While my research supervisor could most definitely account for my intellectual capacity, problem solving and critical thinking ability, there’s no way he would have been able to comment on my cooperation and ability to relate to others to the extent that my choir director was able to, and vice versa. But taken together, all three reference letters were able to create a complete picture of me, as a candidate with all of the traits sought for.

In the story I referenced at the beginning of the article, the student who emailed me listed all of his potential referees, and it was clear that he felt his strongest three letters would come from three academics. But once I saw that he had a volunteer supervisor who he had worked a fair bit of time with and whose strength of letter he predicted would be almost as good as the other three, in my mind, it was an easy decision to pick the two best academic letters and include the volunteer supervisor as the third, even though the three academic letters would each have been better in a vacuum. The key point here was deciding on which three letters work together best in combination, and that is best achieved using the 2+1 Rule as a foundation.

What if I can only find 3 strong references of the same type?

One caveat to the 2+1 rule is if you feel you lack a strong reference in either the academic or non-academic field – if this is you, it might be important to ask to what degree you are exploring both your academic and non-academic aspects of your life, and if there is something you should explore further. However, sometimes you may simply have to go with three academic or three non-academic referees – and that’s fine. There are most definitely medical students who had three academic or three non-academic referees.

That being said, I would ask your referees to comment on as many traits as possible, beyond what they normally would (e.g. if you have three academic references, ask them to comment on more than the usual academic-related traits). Bring up specific experiences of yours that you think they should keep in mind. For example, if you have three academic references, ask them if they know of your experiences beyond the academic setting. Have any of them see you do things in the academic setting that would demonstrate compassion or empathy, for instance?

Who writes your letter isn’t as important as the letters presenting you as well-rounded, complete candidate. As long as they can do that, I think it’s fine if your referees are all academic (or all non-academic).

To sum up, you want to pick referees who have known you the longest, who genuinely want to help you get into medical school, and who as a group, can positively comment on all of your different qualities.

Related posts:

1. 10 Things You Can Do Today to Improve Your Medical School Application
2. Is there a “perfect” medical specialty?
3. Stanford Admissions Video – Medicine, Business, Education and Law

If you applied to medical school this past year, you probably know where you’ll be this fall by now. Some of you may have been accepted into medical school and are excited for the journey that lies ahead. If so, congratulations, and best of luck as you start a brand new chapter in your life! Getting into medical school is an amazing accomplishment, but a lot of hard work and challenges still lie ahead. I’d suggest enjoying your summer as much as you can before the work really piles on =).

Others, however, may have fallen a bit short in the process and are now wondering what your next steps should be. If that’s you, then this article is for you. Before we go any further, you need to do something first.

Give Yourself a Pat on the Back

I know giving yourself a pat on the back won’t change the results of this past year, but fact is, you deserve it. Applying to medical school is hard, especially when you consider that you’ve really been “applying” since day one and not just when you started writing your application last fall. I’ll say it again: applying to medical school is hard. And tiring.

From filling out applications, to getting references letters, to doing interviews (not to mention staying on track of your school work, extra-curricular involvements, and your personal life) – the whole process is draining. And don’t delude yourself into thinking the process ends once you get into medical school. It keeps going because, well, you will have to compete for residency spots as well. Of course that is ways into the future, but it’s important to keep in mind that you’re still going to have to compete in the years that follow entering medical school. It is what it is.

So congratulate yourself for getting through this year. Even though you didn’t get in this year, going through the application process can only make you a better applicant for next year’s cycle. You will learn from your mistakes. Not only that, but you can build on last year’s application – a lot of the basic grunt work (for example, figuring out who your references will be, creating a list of all your achievements/experiences, etc.) is now done, and what happens now is more about improving than starting from scratch. That makes a huge difference.

Still, we can’t start analyzing what you should do in preparation for applying again. There’s still one more important question to ask at this point.

Should I even apply to medical school again?

Just because you have applied once or twenty times already, doesn’t mean you have to apply again this year, or ever again. Before you consider how to improve your chances, you need to decide whether this is something you want to try for again.

Perhaps you have realized there is something else you want to pursue instead of medicine. Maybe your responsibilities in life are increasing and taking a chance on medical school is no longer an option (e.g. you have a growing family, and you need to start your career now). Maybe you think you’ve done all that you can and you won’t be able to do this again.

Whatever the case, take the time to think about whether you really want to apply again. As we have established, the application process is time consuming, draining, and hard.

If your answer is still yes, you want to apply, then keep reading.

GPA / MCAT

As I have written many times before, if you are applying to medical school, you should care about your GPA and MCAT scores the most. Your academics are what get your foot in the door. It doesn’t matter how good the rest of your application is – if your academics aren’t good enough, you have no shot.

You need to ask yourself if your GPA is preventing you from being eligible or competitive for certain medical schools. If not, can you do well enough with another year of undergraduate courses to give yourself a better chance at more schools? For instance, if you had a <3.70 GPA for your first three years of undergrad, but a >3.70 GPA for your last year, it may be worth doing a fifth year of undergraduate studies and hopefully be eligible for Western and Queen’s medical schools, which require two years with a GPA >3.70.

Similarly, is it worth re-taking your MCAT? If you know you’re capable of doing better, and it could open up doors to more schools, then maybe it’s worth retaking. For example, you have a 40M on your MCAT, and have not gotten into the few medical schools you’ve applied to the past few years. It might be worth taking the MCAT again to give yourself a shot at Western/Queen’s (which require a higher WS score), especially since having scored 40, it’s likely you will do more than well enough on the non-WS sections. On the other hand, if you struggled to get a 30P, then it might not be worth taking the risk of writing the MCAT again unless those schools you will apply to again only look at your best score, and not your most recent.

Volunteering, Extra-Curriculars, etc.

Do you have medically/health care related experiences? Do you have leadership experience? Do you have teamwork experience? If your answer is no to any of these, then I’d suggest starting to do something in those areas.

Medically/health care related experience like shadowing physicians, volunteering in a hospital, attending a conference for students interested in medicine, etc. demonstrate a real interest in medicine and show that you have some basic understanding. It shows you are at least somewhat serious about a career in medicine – that you’ve really though about it and taken the time to explore medicine.

Physicians often need to take on leadership roles, such as in a health care team. You want to have some sort of leadership experience, such as running a school club.

Of course, physicians aren’t always in charge, and are very often team players. If you haven’t yet, get involved in something where you have to work with others, such as a team sport, musical band, school club, etc.

If you want to be really safe, read the CanMEDS roles, and see if you have some sort of experience that demonstrates those qualities.

Reference Letters

It would also be a good idea to think about whether you got the best reference letters possible the last time around. Is there someone who would write you a stronger letter? Could you benefit from a bit more diversity (e.g. are all your referees academics? Are they all non academics? etc.)?

Remember, most importantly, you want a referee who wants you to get into medical school. If you don’t think they support you that much, I would suggest looking for an alternative referee if you can.

Essays

If your essay(s) were good enough to get an interview, then it is probably not worth changing completely.

But if you didn’t garner an interview, it is probably worth starting completely from scratch and coming up with new and improved angles to answer the question.

And don’t think it’s too early to start thinking about something as challenging as revising, or perhaps, re-writing your essay. A friend of mine asked me for advice on an essay that wasn’t successful in this past year’s cycle, just a few months ago. I am confident his hard work will pay off in the upcoming application cycle.

Have a Contingency Plan

I have to conclude by saying that no matter what, you need to be planning long term. Although you don’t have to stick to this plan, it’s good to think about your alternatives. If I don’t get in the next time, is that it for me? Should I apply again? Should I take a year off first?

These are all important questions you want to have at least some vague answer to so that you can form an outline for not just the coming year, but for the next few years to come.

Related posts:

1. 10 Things You Can Do Today to Improve Your Medical School Application
2. Is there a “perfect” medical specialty?
3. Stanford Admissions Video – Medicine, Business, Education and Law

Every medical school has a different philosophy when it comes to evaluating applicants. Some schools, like Queen’s and Western, look at your GPA and MCAT scores first, and pretty much guarantee you an interview if you meet certain cutoffs. Some schools, like the University of Toronto, look at your entire application package first before granting an interview: GPA, MCAT, personal essay, biographical sketch, and reference letters.

As with any medical school, you will get complaints about the process. Personally, I think it’s great that the medical schools have such different philosophies on admissions, so that many great candidates with different backgrounds are likely to get in somewhere. But when it gets more personal, and your application package isn’t as competitive at a certain school, it’s understandable for people to be a bit frustrated.

As an example, some applicants have voiced frustration with the fact that UofT’s medical school admissions places a greater weight on reference letters than some other schools. The most common argument is that there is a lot of variance involved with reference letters since it is out of the applicant’s control, in terms of how well the referees are able to write. So it is very possible that an applicant is fantastic, but his or her referee just lacks the skills, experience, and knowledge to put those ideas well onto paper.

In this article I want to analyze this common frustration, and then give my argument for why I think a medical school (or scholarship organization, summer program, etc.) might value reference letters.

Variance Exists Everywhere – Deal with It

I’m not going to deny that there is variance when it comes to reference letters. Considering the letters are supposed to be confidential, it’s quite possible that no matter how hard your referee tries, he/she could end up writing a letter that is relatively poor compared to the average, simply because he/she isn’t used to writing stuff like this. For sure, there is some skill involved in writing a strong reference letter, and it takes experience and knowledge to do that.

The problem with this complaint is that it’s essentially founded on the ideas of variance, chance, and luck. If you’re going to be upset with variance, then logically, you should be upset with the entire medical school application process.

For instance, it’s true that some applicants are naturally better writers than others. Should we throw out the personal essay too? Or, let’s analyze that fact that most applicants don’t get the same interviewers, which also leads to a lot of variance (as I’ve written extensively on before). Should we scrap the interview process too?

The fact is that most things in life, whether medical school related or not, consist of some things out of our control. Sometimes you just need to be lucky.

That being said, one question we can ask is whether a component of the admissions process has an unacceptably high amount of variance. While we can’t eliminate variance or chance, we should always try to reduce it whenever possible. And this is a question that needs to be asked for every component of the process.

Unfortunately, I don’t have the knowledge or experience to say whether there is too much variance in the use of reference letters. I would like to think that the admissions committees have seen enough reference letters over the years to recognize the type of variance involved, and adjust their selection process accordingly (and likewise with other aspects of their admissions process).

The Second Factor: How Strongly a Potential Referee is Likely to Support You

I’d imagine that most applicants have only been on one side of the reference letter process – that is, have had reference letters written for them but have never been in a position to write reference letters for others. As the founder of SMARTS, I have had to write my fair share of reference letters for some of our student volunteers over the past few years. By now having been on both sides of the fence, I’ve come to understand an extremely important concept that I don’t think many applicants realize about reference letters.

There are essentially two factors that affect the strength of your reference letter. The first factor is something we already know, and that is somewhat uncontrollable: the skills of the referee in writing a good reference letter. However, there is a second factor that most applicants don’t really realize, and I don’t think put enough thought into when choosing potential referees.

You see, many applicants just assume that anyone they could reasonably ask is going to write them the most fantastic reference letter. They assume that just because they asked for a fantastic letter, they are going to get one. The reality is that this is simply not the case. How good of a reference letter you can get also comes down to how strongly your referee feels about supporting you.

For example, when I’m asked to write reference letters for SMARTS student volunteers, I can honestly say that not all students get the same quality of letter from me. If you’re a student who I don’t work with on a personal basis, not only is it hard for me to fill up a letter with content and impossible for me to comment on your personal qualities, but I don’t have a strong enough personal connection with you to feel the urge to write you the best letter possible. The result is a letter that is much more formal and sparser in detail – I’d be lying if I wrote otherwise. In such a case, it would have made much more sense to ask a teacher or other supervisor who has seen your work in action, and can comment on personal qualities in a detailed fashion.

On the other hand, if you are a SMARTS student volunteer who I know personally and have seen in action on a regular basis, not only can I write much more detailed about you, but I end up writing a ridiculously fantastic letter. Why? Because of the personal connection we have developed, I personally want you to succeed and want to do anything possible to help.

So What Do Reference Letters tell Medical School Committees (or other judging committees)?

The importance of the reference letters is that they tell medical schools about how other people think about you, and how good of a physician they think you’d make. It’s easy for you to write a personal essay claiming to be a fantastic person – but of course they expect you to do that. And of course your opinion of yourself is going to be positively biased. You might say that you are a fantastic leader, communicator, and team player – but where is the proof? The closest thing to objective proof that the judges have are your referees.

Extremely strong reference letters show medical schools that there are actually people, other than yourself/your family, who genuinely believe you would make a great physician. If someone else can write a letter advocating for you so strongly, logic says there must be something really good about you. And unless they lack a ton of integrity (and are just making stuff up), referees are generally not going to write you absolutely fantastic letters unless they really believe you deserve one – I mean, do you really think that first year biology professor who only knows you from class really cares to write you an outstanding letter? I mean, why would he care whether you get into medical school or not? Why would he waste his time getting the letter “just right”? Furthermore, strong letters show that you can form meaningful personal relationships with other individuals.

I’d imagine that any referee would approach the letter writing process like I do. If they know you well, are impressed by you, and honestly desire to support you to the best of their ability, they will spend their time writing the best letter possible. But if they barely know you or aren’t particularly impressed by you, it’s a bit naive to expect a really strong letter.

So What Does this Mean for Picking My Referees?

In short, this means that you should pick referees who know you very well and who you know want to support you.

Don’t just pick someone because they have a really prestigious title. The person’s title makes up a few words, but what he/she writes makes up the entire page – which part do you think the judge is going to focus on and remember?

I know when I picked my medical school referees this year I followed those two exact criteria. I picked people who I knew for at least a few years, who I felt were impressed by me, and who I knew genuinely wanted to support me in my endeavours.

If you do that as well, I think you will be getting your best reference letters possible.

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