“Nontraditional.” What does that even mean? It implies that there is a “traditional” medical school applicant, which is probably accurate. The vision we have in our minds is that they have come straight from undergrad with some form of premedical-related science degree. Maybe we imagine other similarities they have in terms of race, gender, and socioeconomic status. Why this is important to deconstruct is that the essence of nontraditional can mean many different things, but one common root vision — diversity. Whether it’s demographic, psychographic, or cognitive diversity, all one must do is throw a stone at a medical school website to find this term on almost every landing page. And while there is an allure to being in the new nontraditional group, there is also risk. A major theme nontraditional applicants will have to repeatedly address on the interview trail is essentially, “How do we know you’re really dedicated to medicine? And can you handle the rigors of it? And what will you bring to make our educational environment (and ultimately) medicine better for it?” I hope to help you explore those questions to find your own answers by way of my Q&A with U.S. News & World Report recently on this very topic:
If a medical school applicant is older than is typical among aspiring physicians, what advice would you give him or her?
Your “nontraditional” background is an asset, not a liability. You have had more time to cultivate your interests, demonstrate competence, and often have a stronger “sense of self” and real world resilience. If you have come to know deeply that medicine is your calling, you should absolutely pursue it. Ask yourself, what is unique about my journey/perspective that directly relates to how I plan to move medicine/health care forward. Being able to articulate this uniqueness with “show rather than tell” examples, while simultaneously demonstrating your commitment to medicine, will make you a very compelling candidate. Nontraditional students sometimes feel self-conscious that they are perceived as less competitive than those who have been on one track since the beginning. But life, medicine, and self-identity are rarely linear and so it is important to see yourself not as a “train switching tracks” but rather a “train gaining speed/momentum,” as one of my mentors put it so eloquently.
If this person has been out of college for a while (or even if they haven’t), what advice do you have for how they should prepare for the MCAT exam?
- Learning the content: The best thing is to try to make sure you have taken as many of the prerequisite science classes as possible that the MCAT will test (Physics, Chemistry, Biology, Psychology, Sociology). If you haven’t completed them all before the exam, like I had not, there are a plethora of resources to identify the highest yield subjects and teach yourself. The best resource for this is AAMC’s own MCAT prep material and sample tests.
- Studying the content: Studying comes after learning, but not all study methods are created equal. It can be easy to watch YouTube videos on what worked for this person, but that can consume a lot of time trying different things with low outcomes. A pivotal turning point for me in my studying, and something that has saved me in medical school, was learning my own learning styles and then preparing with strategies most effective for my learning styles. There are free online assessments you can take or resources many colleges/junior college counselors can offer.
- Preparing for the marathon: the MCAT is about 8 hours long so knowing the content is not good enough, you need to build the mental endurance to be able to recall under a time-pressured environment for a sustained amount of time. It’s critical to take practice MCAT exams, ideally written by the real MCAT writers (by AAMC), and see how long you can test before your mind “hits a wall.” Note what helps you regroup and keep going (like taking a quick stretch or deep breaths) and what is maybe hurting your physical endurance (perhaps a caffeine crash). This should be your own personal reflection that you keep tinkering with until you have optimized your body and mind for the endurance of the day and execute with as little “new inputs” as possible.
- Reflect/grow: critical to getting better is auditing your own thinking. After each practice exam you should go question by question and ask, “if I got this right, what led me to the right answer?” and “if I got this wrong, what led me to the wrong answer?” You will start to see your blind spots that need attention and also your natural intuitions. I still do this in medical school and learn new things about how I absorb different types of content one way vs another. I turned this into a list of about 50 things I could mentally reference when I was stuck on a question. You will likely have moments when you get a less-than-amazing practice score and that can feel consuming, so it’s important to have, what I call, a “Bounce-back Strategy” when your mood tanks, which it will. Maybe you watch your favorite TEDTalk on Gratitude and go for a swim. Perhaps you buy yourself flowers and write a thank you letter to someone who has always supported you. Having a plan for the storm will help it pass sooner. A negative mindset is like infertile soil, it’s not very fruitful conditions for learning long-term, in my experience.
How can they fulfill medical school prerequisites if they did not already do so during Undergrad?
First create a list of the courses you need based on the schools you want to apply to (it will be on their website). For most schools the science prereqs will be: 1 yr Physics, 1 yr Biology, 1 yr Inorganic Chemistry, 1 yr Organic Chemistry. A small minority will require additionally Biochemistry and/or Genetics. Many schools will allow you to apply as long as these courses are planned for completion before matriculation. The Chemistry is sequential, which means if you have neither course that puts you at least two years out so factor this into your timing as probably the “Critical Path.” Then you need to find these courses. Some people find a postbaccalaureate program that will hit all these requirements. If you work full-time like I did though and can’t enroll in a full-time postbac program, you can “collect” these classes from colleges in your area. Depending on your location, you may have an undergraduate institution close by that will allow you to enroll as some type of “lifelong learner” to take the courses there without formal degree plans from their institution. Another option, and what I did, is to find the courses scattered around different junior colleges in the area. This was the only way for me to meet the requirements by taking them around my full-time work schedule (early in the morning, late at night, on weekends). Some people worry that will “look bad” but when asked on the interview trail why I had so many student IDs (?!) it was a source of pride for me to explain that if I had to manage multiple schedules, travel hundreds of miles at odd hours to take these courses to pursue my medical dreams than that was exactly what I was going to do. I think most schools ended up seeing it as proof of commitment.
Where can they find assistance and guidance during the medical school application process?
First, the AAMC is the absolute best resource and starting place to create a list of critical deliverables (Primary Application: Undergrad transcripts, MCAT, Personal Statement, Extracurricular activities, Letters of Recommendation) and due dates (Primary Application, Secondary Application, MCAT/CASPR, Interview timeframes, and Commit dates).
Second, having a pre-health advisor and mentors is KEY for maximizing your responses. If you don’t have a pre-health advisor like I didn’t, you can request one from NAAHP (email@example.com) and get matched with an advisor who has volunteered to help nontraditional students. My Advisor Gina Camello at USC was critical for helping me wrap my head around the process, requirements, and refining my personal statement through many, many drafts (Thank you, Gina!). Other mentors who were critical came from my involvement with The American Medical Women’s Association. So many physicians who have charted this path before me have been so generous with their time and wisdom on how to be successful in getting into medical school and beyond.
What should they keep in mind about the medical school application timeline?
It seems like a long time but there is much to do and gather. The best thing you can do is get organized and know what needs to be completed by when and give yourself lots of buffer time. Things like getting official transcripts sent can take much longer than you anticipate. If you’re going to ask for letters of recommendations from specific individuals, give them enough time and information to be successful in helping you. I studied for the MCAT for 8 months. It took 6 months of drafts before my personal statement was succinct enough to be worthy of application, and I had considered myself a prolific writer before this. A high quality application takes a lot of time and introspection so make sure you get highly organized and give yourself enough time to complete things because there’s no shortage of stories of people who dropped out of the application process because it was coming down to the wire for submitting items, and the pressure was too much.
What can they do to highlight the ways in which their life experiences make them strong candidates for medical schools?
I think it’s important to find out what about your life experience is unique, what’s your “differentiator,” and how does that apply to what your vision is for your future medical career. Admissions teams highlight repeatedly that applicants who really know themselves on this level and can “show don’t tell” stand out as the most serious candidates. “Show don’t tell” means have specific life stories/examples ready that can back up the points you want to illustrate. Anyone can say “yes, I am resilient,” but having a real-world scenario where you proved that will be taken much more seriously. If you are a nontraditional candidate, by linear time definition alone, you may have an advantage in likely having had more opportunities to attain these skills and stories.
What should they consider when deciding whether medical school would be worthwhile, and how should time, family and financial commitments play into their evaluation of whether the medical career path is a viable option for them?
There’s a common quote in medicine that if you can see yourself being happy doing anything else, you should do that instead. I completely agree. Medical school is hard: mentally, physically, emotionally. But there is a Nietsche quote that, “He who has a why […] can bear almost any how.” And I think this is true for medicine. Your “why” has to be so strong to be able to keep you going through a profession like this that requires so much from you. For a while I had this dream, but thought I was “too late” or “too old now.” I was reminded that [paraphrasing] time passes anyway, you may as well be doing what you love [Earl Nightingale], and I knew that at the end of my life if I didn’t try I would deeply regret it because I know I have something very important to contribute to medicine. I also was held back for a while thinking that committing to medicine would mean sacrificing family and going into financial debt. However so many mentors (especially through AMWA) reinforced that many successful physicians also have rich family lives. My calling for medicine had grown so loud that when I was finally ready to apply I was willing to give up any amount of time, family, or money to see this through. As it turns out, you don’t have to be this extreme. I’ve learned that life is a great balancing act and with the right strategies, planning, and preparation you can have all the things!
How can they explain to admissions officers why they decided to enter medical school later, and what can they do to illustrate the career journey that brought them to this point?
There are many jobs that “help people” so that is not enough of a reason for any Admissions Office to feel confident about a candidate, so you should be able to articulate specifically why a “physician” vs. other roles. This is why it’s important to spend some volunteer time shadowing or on medical missions so you can really be sure this life is for you. A good format to answer “why medicine” in conversation or your personal statement that I was exposed to is to break it down into: 1. When your interest was piqued about medicine; 2. Further development of that interest; 3. Final commitment point. When you apply later in life, Admissions teams want to make sure you’ve given this tremendous thought and that your diverse life experiences have informed the natural culmination to this decision.
How can they get relevant recommendation letters if it’s been a while since college?
First, applicants should know what the requirements are from different schools because some will want science professors, some will want non-science, etc. These are key to know and identify as early as possible, especially if you will need to (re)build these relationships. If you have spent a majority of your time in a professional career or other venture, you should absolutely consider getting letters from people in these spheres. I had letters that covered career, volunteer work, science instructors, and long-time mentors. If you have been out of school for a while and your letters are as diverse as your experience, that’s okay! I would also try to identify people who can speak to a range of your attributes that you’d like to demonstrate. Maybe your director at work can speak to your innovative qualities, your volunteer manager can reflect on your ability to execute, your science teacher can reflect (beyond your science aptitude) on your teamwork with classmates, etc.
What types of nontraditional medical school applicants tend to be especially competitive?
In my humble opinion from observing the process, what is competitive to one school is a liability for another. What that means is that certain schools want to be known for certain values and have curriculum, opportunities, and faculty to represent those interests. The most important thing is fit, not to win them all. For example, with my technology background and vision for the future of tech/med intersection, not all medical schools valued or had support for that direction and that’s okay. For me, good “fit” meant being at an institution that valued diversity, inclusion, and pioneering new health technology (which is exactly what I found at the University of Michigan). Other schools may have seen my background and thought “what can we offer someone who is passionate about tech if we don’t really invest in that for our students or faculty?” A great way to know if a school is going to want to invest in you and the uniqueness you bring is to do research on the projects their faculty are involved in because I think it shows what the institution values. If your dreams are surgical and a majority of their projects are mostly around Primary Care, no matter how eloquently you describe being inspired by the graceful gesticulations of Reconstructive Surgery, it may not be a match. The other positive tip about researching projects at the institution is that perhaps you find a lab/team you want to work with if accepted and when at that interview can speak more concretely about that school and your plans. That shows Admissions that you will hit the ground running if admitted and have done research about their school that makes them feel that their institution is really special to you and not just a “copy, paste, change name, someone please accept me.” You are going to spend the next 4+ years at this institution so it is very important that you have done enough research about the school to know that you actually want to go and could be successful/contribute there.
What kinds of premed life experiences are especially attractive to medical schools?
Again, sort of depends on the school and what they value. Forward-thinking, tech-inclined schools will be excited about your passion for and experience with new technology or methods. Rural schools may be more impressed with your experience on topics that affect their patient populations more severely like health care access or perhaps substance abuse. It can be a good idea to see what kinds of things the school gets research funding for because that may tell you what traits they care most about. As a general blanket statement, most schools will highlight research, diversity, and service. I think ultimately, though, the premed life experience that ends up being most attractive are ones that are: unique (so you will have a different perspective to share), altruistic (so you are internally, mission driven), and authentic (which shows you are introspective and resilient).
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Michelle Benedict is a first-year medical student at University of Michigan Medical School and is currently the Director of Research & Development for the American Medical Women’s Association. Prior to matriculation, she was a Sr. Engineering Project Manager in Applied Machine Learning at Apple in California. She can be followed on Instagram at @michellledesiree.