On Tuesday, we hinted that we had something say about the United States and Canadian application systems and the challenges they had for most applicants. Well, today's the day. We're going to cover something that's long been an elephant in the room for medical schools across the hemisphere.
Getting into US and Canadian medical schools is a numbers game. And the rules don't add up.
What follows is going to be a hard read for some people. Stick with it, though. There's a brilliant silver lining to this cloud.
In 2016, 53,000 students applied to medical school. They had an average GPA of 3.55 and an average MCAT of 502. Of those 53,000, only 21,000 (under 40% of them), actually made it. For students actually at that middle of the applicant bell curve with that 3.55 GPA and a 502 MCAT, only 27% percent of them were admitted.
According to the Association of American Medical Colleges (AAMC), the threshold where the most (75%) applicants were offered admission is at an MCAT score of 511 with a concurrent GPA of 3.79 and higher. Keep in mind, that's not a 75% chance at your top school, that's a 75% chance at all.
Those odds drop precipitously from there, too. At that same MCAT score, every 0.2 reduction in GPA results in a 10% reduction in chance of acceptance. Similarly, at that same GPA (3.79), likelihood of acceptance drops by 10% at a 508, an additional 15% at 503, 20% more at 501, and so on.
The prospects get uglier as both scores decline. Of students with a 506 MCAT and a 3.69 GPA, still well above the average of applicants, only 41% were offered admission to US medical programs.
What about the other 32,000 applicants? Were they going to be bad doctors?
No. Emphatically, no.
The system itself is broken, specifically in its reliance on MCAT and GPA for first round rejections in an industry that has wholly embraced the recruiting stance of a "holistic review process." Applicant message boards and forums around the web are jaded and cynical as a result.
Each year, there are literally thousands of qualified premed students out there facing a barrier they can't clear because an admissions committee is not looking at the bigger picture of what they bring to the program and the profession of medicine. Trinity School of Medicine is specifically here for them. US and Canadian medical schools setting the numerical admission bar so high don't even give these students a chance to interview, to give context to their lives. It's one of the reasons we interview students so early in the admissions process. We want to know why a students' grades and scores are what they are.
Did someone put themselves through school? That matters when considering academic performance. It shows a special sort of dedication to a goal that matters more than a fraction of a GPA point. We firmly believe that students who overcome obstacles on their path to medicine, financial difficulty, raising a family, dealing with health issues, changing careers to follow a dream, etc. tend to perform very well as both medical students and physicians.
Gating on GPA and MCAT so early in the admissions process is an enormous problem. Even the AAMC has intimated that the MCAT is over-emphasized at this phase. The organization's president, Dr. Darrell Kirch, said it himself, "The MCAT doesn't predict how good a doctor you'll be. I can point to many very successful medical students when I was a dean who had scores below that, and those [with scores] above that who struggled for various reasons."
It's not fair to students, it's not good for medicine, and it's certainly not helping the physician shortage. It's ultimately about what you achieve in medical school that counts, and the denial of the very opportunity is a major bottleneck.
Winning the numbers game.
First, it's important to define winning. If winning is admission to a US or Canadian medical school with stats that don't line up to those outlined by the AAMC, it's nearly impossible. Remember, at their highest level, only 75% of students still made it across that specific finish line.
This doesn't stop people from trying, and more power to them. Common application enrichment tactics like additional healthcare experience, graduate school, even volunteer research assistantships are common approaches. Applicants still run a very good chance of that additional effort not even making it through the first GPA/MCAT hurdle that halted their progress in the first place. How many times should you retake the MCAT? How much can you expect to improve your GPA after graduation? While we do applaud anyone who seeks to enrich themselves and better prepare for a career in medicine, it's still playing the exact same numbers game for years at a time.
However, if you define winning as attending an accredited medical school and securing a residency, there are other paths and, obviously, Trinity is one of them. A good one, in fact.
The reality is Trinity School of Medicine exists to serve those qualified applicants that go overlooked by the numbers game. Earlier, when we mentioned the language of a holistic admissions process and how students don't believe it anymore? Nearly every applicant at Trinity that meets our pre-requisites earns an admission interview. We use it to make final decisions, sure, but it's also a critical part of giving context to a student's life.
Picture left: From rejection to chief resident. All it took was a chance.
An interview-first approach makes a student's work ethic, drive, volunteer experience, and passion for medicine an undeniable reality for our admissions committee. It's a critical element of our own admission cycle, one that, as I said on Tuesday, operates continuously.
More often than not, Trinity graduates look back on their efforts to earn admission in the US or Canada and decided it wasn't worth it. Graduate Dr. Drew Clare didn't mince words at all, saying, "I would have gone to Trinity a year earlier, because staying up here and doing a year of grad school was a huge waste of time and money, I could have been doing what I wanted to do all along." It took graduating for him to realize it himself, but winning isn't about admission. It's about earning your MD and practicing medicine.
We can't force anyone to do anything, though. All we can do is show them the door, they have to walk through it and recognize that they can succeed based on their potential rather than feel limited based on their past. Trinity School of Medicine students, many of whom faced rejection at the hands of US and Canadian schools, make the most of their medical school opportunity and perform within 4% of the US average in the UMSLE Step-1 exam. Often times, as you'll see in a minute, they are top performers across the board.
What does that tell you about where the bottleneck really is? And who is it actually serving? It's not the students and it's not a country in need of qualified physicians.
We've talked about it at great length on our blog and to students at graduate fairs across the US and Canada, but the reality is students thrive at Trinity. Those called out students above in the 250-260 range on the USMLE Step-1 exam (the NRMP's #1 criteria for residence matching) scored 21, 23, and 25 on the MCAT. In the current scoring system, that's the equivalent of earning a 490, 493, and 499.
These students stood not chance of a US admission in the current system, but when it came time to take the first medical licensing exam in the United States, they scored in the 98th percentile, high enough to match into prestigious, top choice specialties.
Trinity students go on and succeed after graduating. While we offer an exceptional opportunity with our curriculum, our Step-1 prep and our clinical training, the real takeaway here is this: the 32,000 that go overlooked each year are not necessarily ill-equipped to become physicians. It takes a deeper look. These are often very good students that had a difficult situation in undergrad. And after they're given a shot, they go prove themselves to be excellent doctors. They're not even being given that chance in the US and Canada. It's a numbers game, and a bad one at that. We're not saying people shouldn't play at all. But remember this:
Winning isn't getting into a US or Canadian medical school. No matter how you slice it, that's only the beginning.
Winning is becoming a doctor. And with Trinity, the wait is over and the opportunity has arrived. Don't put your future on hold to wait on a maybe.