Question for SBMB doctors about med school

Factual Questions
1

I was torn about where to put this – I think there are factual answers, but it could also be dependent upon opinion… Mods, feel free to move it, if you think it needs to be elsewhere.

So, Straight Dope Docs – I have an 18 year old daughter who is a senior in high school and considering premed in college, with an eye towards an MD someday. She is a good student (4.1 GPA this year) and a bright girl with a genuine interest in medicine. But there are a few questions we have.

First of all, she is disabled (possibly sparking her interest in medicine in the first place). Doe has Cerebral Palsy and walks with crutches. Actually, one crutch most of the time, but she can’t stand at all independently. Her diagnosis is spastic diplegia with most of the involvement in her legs, but she does have some fine-motor and range-of-motion problems as well. I assume undergraduate school wouldn’t be a problem for her (I guess most of that would be classroom work?), but what about med school and residency? She is leaning towards research as a profession rather than patient care, but hasn’t definately made up her mind.

Secondly – math. We have heard that strong math skills are a neccesity for pre-med and med school. Math is not, and never has been, her strongest subject. She is in pre-calculus this year and doing fairly well (she had a ‘B’ on her last interim report), but she struggles with it. There may even be some visual-perceptual learning disabilites at play – although she’s never been formally diagnosed with such, it has come up as a possibilty several times. Anyway, at some point, we suspect she will reach her ‘level’ with math. How important is very advanced math, really, to a doctor?

If she does major in pre-med and then decides that med-school is too difficult, or simply not for her, where will that place her? Are there things other than med school and residency that can be ‘done’ with a pre-med degree? She would stiill plan on going on to grad school and majoring in a science of some sort, and she would still want to work in medical research in some capacity. Would a pre-med degree allow her to get a Master’s or/and PhD in Anatomy, say, or Physiology. Or would she be better off getting her undergrad in something else (Anatomy? Biology?) and trying for med-school with that, if she decides to go that route?

2

Being diabled would likely exclude her from certain medical specialties, but should not in itself be a big barrier to medical school. I think many admissions committee would look upon such a student quite favourably if well qualified in other areas.

Medical school is all about the pre-requisites. You need everything they say – excellent grades, good MCAT scores, a broad range of suitable experiences, enthusiastic recommendations. In practice, few doctors use (or understand) math much beyond the high school level. I do not use my advanced university mathematics on the job at all, although did use some advanced math doing certain medical research slanted toweards this sort of thing. In short, math is not much of a barrier, once you have gotten into med school, but you need to do reasonably well in all prerequisite courses. Doctors need to be good at “easy math” – do simple multiplications (such as drug doses) accurately, have a good handle on the difference between grams and micrograms, understand basic statistics, be able to plug numbers into basic formulae – stuff that should be straightforward by high school.

“Pre-med” degrees are rare in Canada, so can’t comment. You don’t need to be an MD to do good research, having a back-up plan is mandatory in case you don’t get in – so don’t put your eggs in one basket. Do some volunteer work, take the prerequisites, seriously question if this is really what you want, and why.

3

Some of my best friends are doctors, so what I tell you is complete hearsay.

First of all, I think you’re jumping the gun a bit. Of my doctor friends, half (well, 2) didn’t decide to go to med school until junior year college. Let me clarify: they were pre-med, but they either had avg scores (MCAT or grades), or were disillusioned with med when they were volunteering/internship. Anyway, the decision really is out of your daughter’s hands until she takes the MCAT. If she doesn’t have a good MCAT score, going into med school will be extremely difficult, the only real viable option is going abroad. Good grades are expected too, but the MCAT can be very key. (As an aside, there is some debate that your daughter’s condition may actually improve her chances of getting into good schools, but I’ll leave that for GD).

Once in med school, she will be precluded from certain specialties. She just won’t be able to hack it physically, particularly surgery. On preview, I see that Dr. Paprika does a better job explaining the options. I’ll just add that if she doesn’t go to med school, she can always work in research for a university or in a lab at a university or at large pharmaceutical company.

4

High school graduation is much too early to be stressing about this stuff, Jess. Let her be pre-med; if she gets weeded out, like most entering pre-med frosh do, she’ll have plenty of other options which she can explore in her last two or three years of college.

–Cliffy

5

IMHO…IAAD… etc etc

Your daughter should not let her disability keep her from anything she wants to do academically. Although as Dr_Paprika states, she will be limited in her choice of specialty. Likely nothing procedure oriented like surgery, Ob/Gyn, ER, etc.

High end math is not necessarily required for the practice of medicine, but it is often required for admission to medical school and/or premed-science undergrad degrees. The medical schools I applied to required at least one semester of calculus.

Lastly and most opinioned… Pre-med degrees are silly. Get a degree in something you’re interested in even if it’s not medically related as long as she takes the prerequisites (biology, chemistry, physics, organic chemistry, english, math, and maybe statistics). In my undergrad degree (Psychology within the College of Liberal Arts) I took all the pre-requisits as ‘electives’ which gave me a minor in biology.

USCDiver, MD

6

Also, pre-med is not at all a necessary major with which to enter med school.

I have many friends in med school at the moment, and most of them had science-related degrees (bio, chem, etc), but weren’t pre-med majors. Your daughter might consider that even if she really wants to be a doctor, a pre-med undergrad major is by no means a requirement, assuming she does a little bit of research and figures out what things she does need to have under her belt before applying to med school.

7

I don’t have any med school advice to give, but I do know a wee bit about college degrees. You should think of “pre-med” as meaning “pre-requisites for medical school.” Students don’t major in pre-med; I’m not aware of any pre-med major in the country. Most colleges, however, will offer a pre-med program. That program consists of ensuring that students take all the pre-requisites they need for medical school. So your daughter can major in anything she likes – English, Art, Organizational Psychology, Biology – as long as she fulfills the entrance requirements for medical school.

Most students planning to go to medical school major in a science, mainly because there is a significant overlap in the requirements for a major in bio or chem and the requirements to get into med school. But for your daughter, that means that she’ll graduate from college with a degree in something other than pre-med, and you shouldn’t be concerned about her degree limiting her later. A science degree is great for getting into many fields: research, teaching, or (ahem) law, all of which are fine fields. Good luck to her.

8

I thought there were actual ‘pre-med’ degrees with foci in different areas, kind of like an education degree, with a focus in English, or math, or whatever. Guess I misunderstood that.

But yeah, Campion, you bring up another good point, which is that a degree of any sort will not close doors but open them, regardless of what the degree is in, and certainly a science-based degree will provide many oportunities.

9

I have a friend that majored in sociology in college. He was lazy and spent most of his days drinking. Basically one year in high school he looked at the requirements to get in to med school and realized he could major in whatever he wanted, he only had to have like six class (I think two biology, two chemistry and two math) courses to meet the prereqs for med school. He took and passed all of them and the rest of his classes were cupcake classes.

He graduated with like a 3.95 GPA, did really well on his MCAT and went off to med school and is now a general practitioner in a medium sized town. I have to say I was pretty surprised since he was lazy as sin, but he really buckled down when it came to his “prereq” courses and the rest of his course load was so easy (and he designed it as such) that he had no problem getting mostly As.

Anyways, if he can be a doctor, anyone can in my opinion.

10

My father’s a doctor, and the advice he gave to every high school senior thinking about medicine is: take Chemistry. As much as you possibly can. One of these seniors took him seriously (and is now Dad’s partner), and has thanked him ever since.

Be aware, however: once you get to Physical Chemistry, calculus is involved (my dad says that’s how he learned calculus - from his chemistry classes, instead of the other way 'round). I have no idea how much math is involved in med school, but she may be required to have a good knowledge of calculus in college.

11

At my university there’s a “Bachelor of Health Sciences” degree program, which is sort of a pre-med deal.

However, if she’s considering research, she would probably be further ahead doing a BSc in an area she enjoys. Then if she chooses to persue an MD, or a MSc or PhD she’ll be set up to do so.

I’ll also add that that the MCAT is pretty important, but I may be biased… :slight_smile:

12

Good luck to her.

She’ll find out whether she wants to do it, well before she actually gets anywhere near qualifying.

My maths skills are rubbish, but you don’t need more than the basics (area under a curve for pharmacology, statistics for evaluation of research data, simple arithmetic for drug doses and formulae).

Medicine is often a given as “the career” for gifted students. It’s not.
Better to think of it as a vocation which requires academic ability- it’s about having the personality for it more than anything else.

13

There’s little call for higher math skills for the great majority of MDs. A reasonable degree of computer literacy is more important. Familiarity with statistical analysis will be a help in a research career, but even there researchers often turn over their work to statistics geeks for analysis.
There are quite a few niches in medicine for someone with your daughter’s physical limitations, not limited to research. As for a major in college, I’d suggest picking a defined field like Biology or Chemistry if a possible research career is in the offing - but non-science majors do get into med school and do fine, if the prerequisites are satisfied.

Based on my own experience, I don’t think a lot of highfalutin knowledge of chemistry is at all essential for med school/doctoring success. Med-school level Biochemistry isn’t all that complicated, even if you forget most of what you learned in college organic chemistry. And most of Biochem can be safely forgotten as well.*
Krebs cycle? Can I park that out front??

14

Jess writes:

> She is a good student (4.1 GPA this year) and a bright girl with a genuine
> interest in medicine.

In what sense is she interested in medicine? Is she interested in studying medical science? Is she interested in becoming a doctor? What things about being a doctor is she interested in?

15

IANADoctor, but I was seriously considering becoming one for a long time. I’m gonna repeat a lot of what has already been said: don’t worry about a Pre-Med degree. (There are some out there, but I was told that they can actually be a hinderence for the admissions process into med school. My advisor was telling me the be as diverse as possible. Since I have the attention span of a… oh look, shiny… um any, I diversified, and have been thankful for it ever since. Chemistry is fantastic advice (it was my major), however, it is not necessarily a requirement. A friend of mine who became an MD was a drama major, fer pete’s sake. (Granted, he had to take a post-bach program to fulfill his requirements, but he still made it).)

If she is interested in science enough to consider research as a career, by all means encourage her to go Bio, Chem, etc. Usually, those programs are so similar, she won’t really have to choose one or the other until sophomore or even junior years, anyway. Even so, encourage her to think about a minor, or at least come close to one. Something outside of science that piques her interest. And lastly, (while you are looking for colleges), consider ones that have a society or club or program for future doctors. They generally can get a student into the good stuff - volunteering, observation, research, etc. That’s where your daughter can get a good feel for how much she truly enjoys medicine as a craft.

I also recommend a background in science because it will be very useful if she decides medicine really isn’t her thing. Pharmacy, pharmacology, research, teaching are all right around the corner with a science degree.

So, my advice boils down to: 1.) strongly consider a science major, 2.) think about a minor (in an unrelated field), and 3.) look for a future doctors program (or some such).

Good Luck to the both of you!
-Geek