"Hey, transcript office, thanks!" aka My tale of woe in medical school admissions

The BBQ Pit
1

"Hey you, working in the CU-Boulder transcript office!

Thanks!"

Damn it all. I will confess to a certain level of personal culpability here. When applying to medical schools, you have to go through this large, weird, and enormously expensive system called AMCAS. From when you take the MCAT (for $200) onwards, you basically submit a common application to AMCAS (for $160+ $30/school). Furthermore, you submit all of your transcripts to be verified by AMCAS as well. Technically, I could have started this process back in June, but the offices don’t even begin to look at applications until August, and after being turned down by the two schools that I applied to last year, I figured that I would put off my application trying to scrounge up more healthcare related experience and some letters of recommendation. I went through the comprehensive list of every private med school in the nation (public med school’s admissions practices are a whole separate pit thread), and whittled down my list to four candidates that I felt offered the best mixture of shools I wanted to attend, schools I could get into, and schools that I could afford to go interview at (the seeming impossibility of doing regional interviews like every fucking undergrad institution in the nation is yet another separate pit thread). All of these schools had application deadlines of November 1st. As I was finishing up my application in early October, some friends strongly encouraged me at to add Stanford and Emory to that list. I figured, what the hell. Both had good viewbooks on their website, it was October 13th, so I figured why the hell not, the application deadline for both schools was October 15th. I scrambled up the rest of my 10 page application, sent it in on the 14th, and bam, with the click of a mouse button, I’ve wasted another $60 in AMCAS application fees plus another $180 in actual secondary application fees to both Stanford and Emory, and I’ve moved up all of my deadlines by two weeks so that my transcripts are due to AMCAS by October 31st. I start a mad-dash to get all of my transcripts headed in to AMCAS from the twisted trail of carnage that I’ve left across various American undergrad institutions. I e-mail fax, phone, and smoke signal in transcript requests all across the nation. All save for my own lovely home transcript office, the CU-Boulder transcript office. When I step into their “garden level” dungeon which reeks like bad milk and “Xerox smell,” credit card in hand, I think to myself: “well, let’s see, I’ve got about 10 days to get this transcript into the hands of AMCAS in Washington DC. The free transcripts leave in four days, the mail should take about two days, leaving me with a two day margin of error. But, I’ve already spent $500 on this little Odyssey, so why not splurge? $5 for the next day? Small potatoes! I’ll go all out, $10 for the same day service from my biggest and most important transcript, CU Boulder!”

Everyone’s cool. By October 28th, all of my transcripts are in. I’m sitting pretty, waiting for AMCAS to say, “nope, he didn’t just lie and pretend to have taken an underwater course in basket weaving when he really couldn’t close a lid on a pot in dry air,” and for schools to send out requests for secondary applications. Sitting pretty, of course, except for CU-Boulder. CU Boulder still hadn’t gotten to AMCAS, so I start to worry. Not panicking or throwing things, mind you, I’m just worried. I call down to the transcript office, ask for them to double check that the transcript had been sent, and they say, “yep, signed it out on the log, with AP scores!” What else is there to do but wait? And wait. And wait. Until the 31st. Still no CU Boulder transcript in Washington DC. Oh no, I’ll have to wait until 9:38 AM on the morning of November 1st when AMCAS’s stupid, chipper little e-mail automailer responds that CU Boulder’s transcript has alas arrived and all of my transcripts are finally in and, oh, by the way, you’ve missed deadlines for Stanford and Emory, but, “Thank you for using AMCAS and good luck with your admissions process!”

I call in to Emory and leave voicemails, pleading and begging for a deadline extension of one day. A nice woman from the admissions office calls me back, collects my AMCAS ID number, and says that she’ll see what she can do. So good, I think that Emory is going to be cool. Stanford’s website, even though it explicitly warns that, “No deadline extensions will be granted!” I decide to call in and see if they are willing to have any flexibility. Someone gives me a voicemail box, I leave a message. Later that day, I check my voicemail and some guy with a funny German accent starts screaming, “Vaat is zee matter wiz youze? Aysk us for zee zeedline extension again and zou vill be killed!” Actually, no, I haven’t heard back from Stanford and I’m beginning to trust their website.

So, this has gotten quite extensive, but to sum up, first, screw you CU Boulder transcript office. The requests that I faxed in later for free to other schools arrived before the request that I paid $10 for from you fuck-ups. I don’t know how hard this whole process is of, “print transcript, stamp transcript, place transcript in envelope, deposit envelope in mail in timely manner,” is for you, but apparently it’s too damn hard. Stop spending so much time looking at furnitureporn.com and start mailing transcripts! Additionally, screw this med school application process. That it’s long, excruciatingly boring, overly anal, and generally annoying, I expect. The fact that it costs, at a bare minimum, $1200 to apply to around five schools plus interview travel expenses is absolute bullshit. I have the means to apply to these schools, but what about the people that don’t? I sincerely doubt that this entire ridiculous interview process has the actual ability to separate out those, “special type of people,” that all of your websites talk about, so all that I think you really need is a set of grades, MCAT scores, description of experiences, personal statement, and maybe a regional interview to verify someone’s status as not being some creepy psychotic bastard hoping to enter med school to learn how to conduct experiments in human-cat brain transplants or else write pain killer prescriptions to strippers in exchange for sex. So, fuck the people that have permitted this to become an ungodly expensive process in the name of, “fairness,” while ignoring the fact that a number of otherwise qualified applicants have been priced right out of the market or into applying to a smaller number of schools.

Yeah, I think that’s it for now.

2

I feel for you, man. Thanks for a flashback-triggering post. :slight_smile:

Unfortunately, once you get into med school, it only gets worse. If someone could transcribe all the curses I hurled at the USMLE during those four years…well, I’d have a really long sheet of paper covered with small writing.

And let’s not even talk about the Board Exams…

(Sorry, just had to cheer you up a bit. Good luck!)

3

As a fellow reapplicant, I salute you.

However, I have to ask: how do you get $1200 out of four schools!? Holy crap, last year I listed 35 schools on my AMCAS application (only completed ~20) and my AMCAS fees didn’t even approach that much. Were you factoring in travel expenses and such?

In the meantime, take heart.

USC Keck, Loyola Chicago, and MN Twin Cities all developed issues in getting me their secondaries. With the latter two I managed to get extensions, since they don’t have a general deadline, rather, they give you something like 28 days to finish your secondary.

On top of that, consider that seeing as how this is your second go, this shows how committed you are to this career. This is my dream, and clearly it’s yours too. Let’s give 'em hell, aright? :cool:

4

Your post reminded me… I’ve paid my admission fees for our version of the MCAT but they haven’t gotten around to sending me out the registration forms.

So far, my fees total 1300 AUD, and I haven’t even applied yet.

Good Luck!

5

I’ve lurked on the boards for a while, but nothing ever came up that I felt I could really contribute to. However, $5000 and a year later, I think I known med school admissions. I’m currently on the other side of the table (just began interviewing the Class of 2010), which is interesting in its own right.

1)There is a Fee Assistance Program. Go to aamc.org, click on AMCAS and look for the link. If you qualify, they waive the $160 fee and give you 20 free primary applications. IMO, the people that get screwed over the most in this are the middle class, but that’s what second (or in my case, third) jobs are for.

2)Admissions are rolling. Yes, I know that the committee doesn’t start reviewing applications until August. However, there is no harm in getting stuff in early and lots of harm in getting it in late. If you are so desperate for health care experiences that you think two months will make a difference then list it as an in-progress activity on AMCAS. I did it, and it worked just fine. Heck, my essay discussed what we were planning on doing in the lab. This is no excuse for a delay. Moreover, there are 30 applicants per spot and many of them are all equally qualified. You don’t want to stand out for a negative reason.

3)Four schools? Are you nuts? I applied to 18. Yes, it’s expensive. But look at it this way, unless you are a superstar (which you might be, if you are only applying to four programs), you are going to accumulate significant debt. 150k+ if you are looking at private schools. 5k is a drop in the bucket. If you keep on reapplying, you are just going to have to pay those AMCAS fees over and over again. In the long run, you will be able to pay it off. Doctors aren’t making what they once were, but let’s face it. How many poor doctors have you met?

If you are worrying about interviewing expenses, try contacting the school and seeing if they have any students that would be willing to host you for the evening. Even if they don’t organize an official program, there might be someone willing to do it.

I hope everything works out for you, and if you have any questions, please let me know. I really don’t mind taking a break from Cell Biology, strange as that may sound.

6

Well, thank you all for your replies and support, it certainly seems like the Dope has a healthy population of people with familiarity with this process.

Pazu, yeah, I’ve heard from second year’s that if I liked AMCAS, I’m going to just love USMLE. What is it, $1,200 per year for each exam?

Khan, yeah, let’s hope that this year goes better for both of us. I’ve heard that reapplication isn’t any sort of strike against you. Maybe it’s a lie, but I’m confident that given enough time and patience, some admissions committe is bound to screw up and I’ll be there to sprint past the barriers. Good luck.

Big Red, snort, $1200 AUS? Wow, and you haven’t even applied yet? It sounds like you Austraulians have it even worse than us.

incidental, thank you for your advice, although I fall into that category of middle classers that are far from eligible for ye’ old fee waiver. I’ll definitely be doing this process earlier (July/August) next year if, god forbid, there is a next year. The reason that I’ve only chosen to apply to four schools (last year it was two) is because I really, really want to go to my state medical school, both due to its reputation and financial reasons. I applied last year as a sophmore and made it to within a few spots of their list and I’m a junior this year, so in a way I kind of have the leisure to go through another admissions cycle, although I really doubt that I would come back to CU Boulder for another year; I would rather try to work as an EMT or trauma tech. I’ve just run out of classes that I want to take and it certainly isn’t my MCAT or GPA which is holding me back from any of my schools, it’s health related experience.

If I can ask you for some more rather direct advice, I come from a background of nearly 3 years of extensive ride-along experience, 5 years of mountain search and rescue, and 2 summers of moderate (5-7 hours a week) volunteering in the ER. Again, it’s not exactly, “I want to be a doctor because my dad was,” or, “George Clooney was so hot on ER!” but it certainly needs to be improved. Given the three months or so until the peak of interviewin’ season, what type of experience do you think would be the most valuable to a typical admissions committe in this short period of time?

If that isn’t a realistic question, just say so, but do you think that you have any advice to offer in that department?

Finally, don’t take this personally, but I do take issue with calling $5,000 a, “drop in the bucket.” I understand that it’s only 3-4% of a total debt load from med school, but 3-4% is a lot, and I feel that it should be possible to do the process for well under $1000. It’s attitudes like this that are a part of why healthcare costs in our nation are enormous, and although we’d love to practice medicine in a vacuum, we have to understand that people’s ability to pay for medicine has a major impact on the quality of care received in our current system, and we need to be conscious of trying to save money in providing care. I think that more cost-consciousness on the part of health care professionals could do a lot to imrove the overall care and health of the people that we serve.

Thanks,
threemae

7

I think it sounds like you have plenty of experience. That’s far more than most people. At this point, it’s mostly the presentation of your experiences that will make a difference. I had about three summers of volunteering, a few lab experiences and a shadowing experience (and some college stuff, but those are the healthcare related experiences). If you present it well and personably, you should be set. Before I submitted my AMCAS, I sat down with a fellow (who had served on an admissions committee) and had her read my essay. She basically scrapped half of it, gave me a few basic guidelines and told me to rewrite it. Presentation counts for a lot.

I wish I had something more helpful to tell you. I’m not sure that there are any good experiences that you can do in a couple of months. If you do end up reapplying, try finding a doc who will do a clinical research project with you. It doesn’t have to be too elaborate, but see if you can tie some shadowing in with it. A lot of academic centers have programs for this kind of thing, but they may be off the beaten path. I’m afraid I’m on the East Coast though and I’m guessing you are in CO, so I don’t really have any specific programs to pass along.

[Quote]

Finally, don’t take this personally, but I do take issue with calling $5,000 a, “drop in the bucket.” I understand that it’s only 3-4% of a total debt load from med school, but 3-4% is a lot, and I feel that it should be possible to do the process for well under $1000. It’s attitudes like this that are a part of why healthcare costs in our nation are enormous, and although we’d love to practice medicine in a vacuum, we have to understand that people’s ability to pay for medicine has a major impact on the quality of care received in our current system, and we need to be conscious of trying to save money in providing care. I think that more cost-consciousness on the part of health care professionals could do a lot to imrove the overall care and health of the people that we serve.
/QUOTE]

I’m not quite sure how medical school expenses are at all tied into rising healthcare costs. Typically a medical school is associated with a series of hospitals, but I don’t think that tution has anything to do with spending on the clinical side of things. I believe you were trying to make a point about stuff like unnecessary testing and imaging. While I totally agree that it is a problem, I don’t think medical school admissions are related to clinical medicine at all.

I think you do need to be realistic about the costs associated with medical school though. It’s expensive. Really, really expensive. Everything is expensive, the equipment, the books, the tests…it never ends. I’m doing my best to minimize costs, but I certainly don’t regret spending that much money on applications. I’m in a program I’m happy with, with (mostly) good people and a nice city. Was it my first choice coming in? Not really. But I didn’t really know that until I visited a lot of schools and knew enough to compare programs. Schools that look good on paper can be a totally different story when you actually get there.

Also, applications are just very, very unpredictable. A lot of it really is luck. It was more important to me that I get in somewhere than to save a few bucks. So, I applied to maximize my chances, knowing that my savings account was going to take a hit. But that’s what my savings account was for - I earmarked the money for applications and that’s what it went to.

Admission costs basically come down to supply and demand. With 30+ applicants per seat, medical schools have the upper hand and of course they are going to take advantage of it. If you look at the “less competitive” (ha!) medical schools, you can see that their secondary fees can be double that of other schools. But they will also have application pools 40-50% larger than schools where the pool self-selects. They charge more money because applicants will pay it.

Medicine sucks sometimes. The hours suck, the people can be difficult and there’s a lot of pressure. You need to be committed if you are going to go through this. If an application fee is enough to dissuade you from applying, maybe it’s for the best. I hope that isn’t too harsh - I completely understand why you would want to stay in your home state (heck, I did it. Huzzah for public schools). Have you considered applying Early Decision? You sound like a very strong candidate and if you are that determined to go to that school, applying Early Decision might tip the scales in your favor.

8

Not quite, at least not yet. Step 3 was only $625 for me last year, and it’s two days, so Steps 1 and 2 shouldn’t be more than $4-500 each. The new clinical Step 2 (the most ridiculous thing I’ve heard of in a while) is about $1000, and usually requires some travel.

(Wait until you get out of residency; I spent about $1000 to get my license to practice, $400 for my DEA#, $1000 on the internal medicine boards, and more other random amounts to random people than I care to think about.)

I haven’t done all that much admissions work, but just from knowing my class and a few others, I’d say that you have considerably more medical experience than the average applicant. I would not worry about this anymore. When I have done this sort of thing, the thing that turns me off the quickest is the appearance of having done a bunch of stuff just to appeal to a med school admissions committee, and anything you squeeze in now is going to come off like that.

I have to echo this. It sucks, but there isn’t much you can do about it. Once you’re in, borrow what they’ll let you borrow; most people I know who tried to get by for a few grand less ended up with nothing but headaches and a pile of credit card debt.

This is a great option if you have one school that stands head and shoulders above the rest. It’s how I did it, and it saved me an awful lot of hassle and expense.

9

Well a lot of that is a prep course for the test. 10% of entrants who don’t take the prep course get a good enough mark. 70% of people who do take the prep course get a good enough mark.
I don’t have the time to take it twice, they’re shifting the GPA up the year after I will be applying.

10

Yeah the USMLE Step 2 CK (Clinical Knowledge) was IIRC $450. The USMLE Step 2 CS (Clinical Skills) was IIRC $975, and luckily it is offered here in Houston. Unfortunately, my medical school requires a CS-like test “in preparation” and “to assess our clincial skills”, and that costs another $700.

Luckily (luckily, luckily), the AAMC’s system for residency application is cheap. My medical school transcript office handled the uploads of the Dean’s Letter, the transcript, the 5 letters of recommendation, and my photo for free. It is like $8/program to send out your CV and files. The NRMP (Match Program) registration is another $60 or so. No secondary applications, except when applying to specific tracks like research tracks (which I am doing in a few places). It blew my socks off that the computerized system managed to find and transmit my USMLE Step I score (done in 1999 before a PhD) with nary a hitch, as well. So far (knock on plastic keyboard), the system has been flawless.

Of course, this doesn’t factor in airfare, hotels, suits, and all of the associated sundries associated with residency interviews.

Give me an email if one of your schools is Baylor College of Medicine and you’re coming down here. I’ll show you around…

11

There is one thing I’ve learned about large institutions: when you get an answer you do not like, keep asking until you get a different answer. Go somewhere else, try a different method, use a different angle. But persistence might pay off.

It seems incredibly odd to me that AMCAS doesn’t go by a postmark deadline, not an “in the door” deadline. That’s how undergrad institutions work with applications and enrollment deposits. It’s how the IRS handles tax returns. I know credit card companies and utilities operate under a different system, but in my experience higher ed institutions (and auxiliary agencies) operate in a diffrent manner. The thing is, people have no control over the mail or the speed of processing the mail. They only have control over when they get things put INTO the mail.

You met that deadline by a large margin, so it seems unusually punitive to me that they would refuse to honor a transcript whose mailing date was clearly over a week before the deadline.

Are you absolutely positive it was CU-Boulder’s error? Have you asked AMCAS to tell you what the date is (on the official stamp affixed by the registrar)? That will tell you whether or not they honored their policy of “next day.” processing that you asked for. If they did, then you’re pissed at the wrong people. If it’s truly their fault, they owe you an apology, and I’d ask them to enter into your appeal to Emory backing up your allegation that you did all you could to meet your deadline and it wasn’t your doing. If it’s not their fault, then it’s the postal service, and I think you have a strong case here that both you and CU-Boulder did all the things right and you were unaccountably screwed by a postal delay that no one could have anticipated. You’re not going to get the postal service to back you up, but all that AMCAS/Emory needs to do is look at the postmark.

12

Just about everyone in the med school admissions process has received by deadlines rather than postmark deadlines. Not just AMCAS deadlines but also the the invidual schools with their secondary apps. Between that policy and my tendency to procrastinate I spent a lot of money on priority mail to ensure that my apps would get places on time.

13

Wow, I find that remarkable. (I mean, I don’t doubt you, I just think it’s a surprising policy). I do a lot of work with (undergrad) admissions here, and we try to be conscientious about this and go by postmarks so the kid from, say, Alaska doesn’t end up being screwed. Or doesn’t have to spend money on guaranteed arrival, like Fed Ex.

It’s not like a person screwed by the mail incurs a late fee; it’s a pretty big lost opportunity. It could cost someone their chance to to be considered for admission, or their place in the freshman class. I understand why admissions committees wouldn’t want to have mail straggling in after they’d like to begin the evaluation process, but it seems a lot more fair to go by postmark.