There are a lot of spectacular reasons to earn a masters degree. From personal academic enrichment to general career planning, all the way down to specific job requirements, graduate degrees are a viable path to expertise and growth. A masters degree is not, however, a requirement to practice medicine, nor even a recommendation. Despite this, they have become a begrudgingly common method for attempting to pad a GPA after a difficult admissions cycle in a US and Canadian medical school admissions process already placing too many barriers in front of qualified applicants. Today, we're going to look at this phenomenon, dig into some data, talk to our students, and offer some insight into why it may not be what it's cracked up to be and what other options may be out there for you.
Put Your Goals at the Center
First, it's worth re-emphasizing that if public health is your passion, or if you are driven by research opportunities, then obviously a relevant masters degree in a scientific field you choose to pursue prior to earning a medical degree is valid and worthwhile. Furthermore, in the US medical school application process, you are likely to stand out as someone pursuing a larger, more nuanced goal. What we are interrogating today are the chances of getting into medical school with a masters degree.
That's why today we want to look closely at the value, and potential consequences, of pursuing an advanced degree to boost a GPA or bolster a resume in an attempt to earn admission to a medical school, especially after already attempting one or more admissions cycles with US MD programs. The presumed benefit of earning a masters degree prior to applying to a US medical program is a greater chance of acceptance. Unfortunately, the reality is far more complicated than that. Above all else, your personal goals should dictate any higher education decision, as we said above, they should be at the center. That means if your goal is practicing medicine, diverting yourself to fit an arguably malfunctioning system might not be putting you and your goals at the center of your choices.
First, we need a baseline. What are the pre-reqs for med school? Most admission criteria across the US, Canada, and the Caribbean follow the same guidelines. You need an array of basic science course work that will prepare you for those first two years of labs and lectures in medical school, MCAT results, letters of recommendation, etc. And while a masters degree could theoretically provide that course work, for someone who didn't have it, it's a high-risk approach (as we'll get into), potentially negating the benefit of getting a masters before medical school.
While there are one year masters programs for medical school, typically called special masters programs with a linkage to medical schools, creating a potential strait track (and we'll get to them), first we want to address attempts to use additional education to boost a GPA and show an upward trend in academic skills and discipline.
Grad School GPA and Medical School
The common consensus is that undergraduate GPA is weighed significantly more heavily than graduate GPA, as far as its positive impact on admission. There is an exception to this weight, though, and unfortunately it's working against students. While good grades in a grad program have a blunted impact on your record in a positive direction, poor outcomes will be counted against you with the same rigor as a difficult undergraduate record. Put another way, from a GPA perspective, there are few of the benefits and more of the same consequences for struggling.
Med School Alumni Perspectives on Graduate Degrees
Current medical student Nancy Thomas embodies the complexities at play in both long term career planning and strategic attempts to enhance her admission file. She earned an MPH and an MS before coming to Trinity. She had this to say, "Both degrees were to enhance my application but the second, my MPH, was borne out of interest in the field with plans to use the knowledge later on during my practice. I’m glad I earned my MPH degree but in some ways, I regret the masters in medical science because of the time, the cost, and the uncertainty. Deciding to retake science courses at a local college would have saved me money as well as better prepared me for the MCAT. I met with the admission counselor at a medical college who basically agreed that my MCAT scores were the only thing weighing me down. If I knew of Trinity earlier, I would have definitely enrolled sooner, but still taken time off to earn my MPH."
This brings us to masters programs to get into medical school, often called "special masters programs." The best SMPs for medical school (sometimes tautologically called "SMP programs"). SMPs are a viable and valid approach, and almost an exception to this rule, as they're direct "feeders" into MD programs. However, they are a high stakes, high cost, high risk path. Grade minimums for promotion in this program are a hard 3.65 and climbing, and if you are not promoted you have a masters in medical science that will offer you no additional benefit in applying outside of that program's feeder school after you are done. We actually spoke with a Trinity alum and resident who tried this approach, Dr. Charelle Smith. Dr. Smith graduated Magna cum laude from her undergraduate program, but enrolled in a masters program to improve her odds with admission to US medical schools.
"My goal was mainly to increase my MCAT scores. My GPA was already great, but I had a lot of test taking anxiety, and back then, I wasn’t what you'd call amazing at applying my knowledge to a standardized testing format. I entered Drexel's post-baccalaureate program, an interesting approach that could transition either into medical school or move you into a masters in medical science program. I sat through a lot of classes I'd already taken before and done well in as a refresher, ready to go after the next application cycle.
Ultimately my performance didn't live up to my own standards, and the next step for that masters degree was going to involve a major financial investment and moving to another city. Neither of those were my ultimate goal. I wanted to go to medical school. I did improve my MCAT scores by quite a bit when I retook them (a 6 point jump on the old model), but I ultimately went home and resumed work as a teacher. It just wasn't worth it. Later, of course, I found Trinity and I'm now in my residency, so it worked out. Honestly, if I'd known about Trinity's pre-med [5 year] program back then, I would have gone directly into that and saved quite a bit of time and money."
Dr. Smith's comments take us to another complication in this approach. Finances, specifically the lifetime borrowing limit for student loans.
Grad School, Medical School, and Student Loans
For those who don't know, the lifetime borrowing limit is conceptually, a finite amount of loans available to someone to pursue their education. This limit is tiered depending on the type of school and how advanced the degree is. This is because higher education is a significant investment no matter the field or end goal, and traditionally, graduate school and professional school were parsed separately with their own limits.
However, due to changes in US federal loans, the lifetime borrowing limit is accrued in graduate school out of the same "bucket" as medical school, a $138,500 pool of available borrowing (keen eyes may notice that this is below the cost of many schools, this is why private borrowing is a reality of most medical educations these days, irrespective of their federal loan status). That $138,500 line in the sand cannot be breached with federal funds at all and can lead to additional difficulty in securing secondary private financing for medical students attending more expensive medical schools. In short, financially, earning a masters degree can actually jeopardize paying for the medical education students are trying to work their way into in the first place. It can and does leave students with the horror of running out of funds in the second or third year of a four year degree, unable to complete it. We mentioned the tremendous value of a masters degree a student is passionate about, but when it's a means to an end, it's worth asking: how is that degree going to feel if it becomes the final road block between you and your medical education?
Delaying Medical School with a Graduate Degree
Another element both Ms. Thomas and Dr. Smith mention, programs abroad in the Caribbean, especially those with a 5-year option like Trinity are a major time saver when your passion is medicine. Another Trinity graduate, Dr. Drew Clare, attending physician at Johns Hopkins, said something similar when we spoke to him when asked what he'd do differently:
"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. That is the one thing that I would have changed."
Finally, there's a career-wide impact that is difficult to notice but eye opening upon analysis of the data.
A masters degree is an investment in time and energy as well as money. Any decision to pursue an additional degree should be made seriously and not as a means to an end but as a part of the larger whole of who you are and where your career will take you. There's an often overlooked area where masters degrees come into the data evaluation game: The Match.
Of 2018's residency match pool, only 5% had non-PhD advanced degrees (including those who tried the path of an SMP/Special Masters program, and its documented 70% matriculation rate), and of that 5%, only 21% matched. That's damning any way you parse the data. First, that the impact of a masters degree is negligible because if it were more impactful, with 60% of all US MD applicants going rejected, you'd see more people with masters degrees in the match. With 5% of match applicants having masters degrees and only 21% of them actually matching, as opposed to Trinity's historic 86% average, the odds of becoming a physician are remarkably higher if students opt for a path at a school like Trinity. Possibly most telling of all, out of all of the questions asked of residency directors each year, the additional value of earning a masters degree to a practicing physician and as a residency candidate didn't even make the list.
Going directly to a medical program that will look at the big picture and evaluate your full potential and not eliminate you because of a bump in the academic road is a better financial investment, a better use of a students’ time, and gets you closer to your dream: becoming a physician.