Medical Ethics

Medical ethics is a topic that is frequently addressed during the interview. They are a bit trickier to answer because oftentimes the situation presented sits in a gray area with no real "right" answer. Although you cannot prepare for every possible question of this category, familiarity with several types of scenarios will help train you to think through unfamiliar or difficult cases.

The following is link to scenarios that are well presented and should help you prepare for these types of questions:


Medical Ethics

How to ace the medical school interview

Interview season is coming up, so those looking for some quick tips should find this article useful. It will be a summary of suggestions based on my personal experiences interviewing at multiple medical schools as well as books and advice I have garnered from other resources. This is not a list of common interview questions; those you can find elsewhere on the web. What I present is a comprehensive overview to help guide you through your interview.

We are going to break down the interview into a few key parts:

0. The Prep
1. The Look
2. The Act
3. The Talk

0. The Prep
Preparation. This is the most important part of an interview. Not the first five minutes in, or the last five minutes out. Your interview begins even before you get in your car or plane. How so? The interview lasts typically 30 minutes to 1 hour, and the interview day usually consists of 1 to 2 separate interviews. When you are invited for an interview, they have already considered you to be an acceptable and interesting candidate. From now on your GPA, MCAT score, and essays are no longer in your hands, but the interview is still something that you very much can control. So spend some time, the more the better, looking over your application, reviewing common interview questions, looking over the school's website, and talking to other medical students at the school if possible. You should know your application inside out; there really is no excuse not to, and it is poor form if the interviewer knows your application better than yourself. Try to conduct a mock interview with a friend, relative, or professional and get feedback on where and how you can improve. Reciting answers in your head is a useful exercise, but it cannot replace being held on the spot and telling your story to another person. Some have also found it helpful to record themselves, which my reveal unknown tics or distracting habits.

Before getting on your flight or car, make sure you have all your essentials with you, including spare clothes and hygienic supplies. Gum in the pocket and Clear Eyes in the bag for the morning before you head out. Shoes polished, suit pressed, and be ready to look your absolute best on game day, leading us into the next part.

1. The Look
No matter what anyone tells you, you should expect to look your absolute best. When in doubt, go for conservative, clean, and professional. A simple black or navy suit with a white or light blue shirt goes a long way. Ties are an absolute must for guys, though a vest is usually overdoing it. Conceal any tattoos or inappropriate piercings. For those with longer trips, a lint roller can become very useful. It is probably best to leave all jewelry items at home save for a simple watch or wedding ring. Ditch the perfume/cologne. Do not forget to pack essentials such as lotion, deodorant, hair product, and comb. How you present yourself says a lot about you and it will definitely reflect on the interviewer. Whether you like it or not, appearances play a definite role in the impression you give and evaluation you receive. Recent studies have shown taller, charismatic, and fitter individuals to receive a significantly better result in receiving jobs, promotions, and raises.

2. The Act
This is what you do, what you say, what kind of facial expression you make, where you stand, how you move, all of it. It starts the moment you step onto the medical school campus. Do not count anyone out - try to give your best impression to everyone you meet, whether it is the janitor you see on your way in or the secretary taking down your name. Cheerful, excited, with a bit of nervous energy is expected, but do not overdo it either. You do not want to look like a weirdo who cannot grasp common decorum. Smile a lot, and remember that talking to fellow interviewers is okay! It will help engage your mind and even ease some tension.

3. The Talk
This is when you step into the interviewer's room and start you actual interview. It incorporates all of the above, so keep that in mind. "The Prep" should give you the knowledge base and confidence to properly answer questions. "The Look" should add to that confidence, and begin to project an image of yourself to the interviewer. "The Act" is a prologue to this final stage, the main performance. As trite as this may sound, the best advice here is to be yourself. Do not regurgitate memorized answers or try to mold yourself into someone that you are not. Giving unique, well-thought answers that demonstrate a clear passion for medicine is the best way to impress your interviewer. It is okay to express opinions that deviate slightly from the norm, but always be professional and do not appear too rigid in your thinking. Also remember that interviewers vary widely in how they approach the interview and what kind of questions they ask. There are some that are friendly and try to have more or less of a conversation, whereas others keep it strictly to a question-answer format. Do not be distracted by what the interviewer does or says; oftentimes they do this intentionally to throw you off. Focus on presenting yourself in the best light possible - in the end, this is all you can do. End the interview with a firm handshake and a smile.

For further tips, check out this book: The Medical School Interview: Secrets and a System for Success. Personally, I found a lot of helpful advice from this book while preparing for the interview.

How can I study for the MCAT?

The MCAT is one of the most important parts of an application to medical school. Given its importance and the busy schedule of a pre-medical student, it is equally critical that an applicant use the most efficient method of study for the MCAT using only the best materials available. One popular resource that is widely recommended by those who have taken and performed high on the MCAT is the Examkrackers Complete MCAT Study Package. There are 5 books in the package, each covering one of Physics, Biology, Chemistry, Organic Chemistry, and Verbal. The books are written in an user-friendly format, with full color illustrations and layout that is reliable and easy to understand.

Many other MCAT review books cover similar material, yet they are much more dense and often cover a lot more material than is necessary to score well. This author has reviewed a majority of the popular MCAT review books out there; the Examkrackers books offer the most complete, comprehensive, yet concise review of the MCAT. Many people have used these books to score competitvely and gain admission to top medical schools.

If you want to study efficiently and score your best, be sure to supplement these books with practice tests. These can be obtained directly from the AAMC at e-MCAT, which lets you take practice tests that very closely simulate the actual exam.

What does my MCAT score mean?

This question is also commonly phrased as, "What is a good MCAT score?"

According to the AAMC [1], the mean score (from a possible 45) was 25.1 for all 2011 administrations. The standard deviation was 6.4 for the same year. Below you can see a graph that depicts the score distribution versus the percentage of test takers achieving that score. Note that the scores below is a total sum of three individual scores representing the whole of the test. For this post, the writing sample will not be discussed as it usually has only minimal or circumstantial bearing on admissions.

From the table below, we can see where each score stands. For a score of 25, this puts the applicant in the 43.7-49.7th percentile of all test takers. The score is scaled such that very few test takers are able to achieve the upper range of scores: a score of 30 is in the 73.9-79.1th percentile, a 35 in the 93.9-95.8th percentile, and a 40 in the 99.6-99.8th percentile. The percentile rank assigned for each score has slight variations from year to year, but for the most part they change very little due to the way the MCAT is scaled.

Scaled Score	Percentile	Scaled Score	Percentile	Scaled Score	Percentile
45	99.9–99.9	30	73.9–79.1	15	6.3–8.1
44	99.9–99.9	29	68.1–73.8	14	4.8–6.2
43	99.9–99.9	28	62.2–68.0	13	3.6–4.7
42	99.9–99.9	27	55.9–62.1	12	2.6–3.5
41	99.9–99.9	26	49.8–55.8	11	1.9–2.5
40	99.6–99.8	25	43.7–49.7	10	1.2–1.8
39	99.2–99.5	24	38.0–43.6	9	0.8–1.1
38	98.5–99.1	23	32.6–37.9	8	0.5–0.7
37	97.4–98.4	22	27.7–32.5	7	0.3–0.4
36	95.9–97.3	21	23.1–27.6	6	0.2–0.2
35	93.9–95.8	20	19.2–23.0	5	0.0–0.1
34	91.2–93.8	19	15.8–19.1	4	0.0–0.0
33	88.0–91.1	18	12.8–15.7	3	0.0–0.0
32	83.9–87.9	17	10.2–12.7
31	79.2–83.8	16	8.2–10.1

So what kind of MCAT score should you aim for? This is highly dependent on your individual application, GPA, and the schools you are applying to. You can read a previous discussion on acceptance rates given a certain GPA and MCAT score here at How important is the MCAT?  Still, we can assess general admissions trends from data provided by the AAMC [2]. For 2011, medical school applicants had a mean test score of 28.2, with a standard deviation of 5.5. However, the mean score for matriculants was 31.1, with a standard deviation of 4.4. Thus students accepted to at least one medical school had an average MCAT score of 31, representative of being in the 79.2-83.8th percentile of all test takers. This figure is mostly unchanged year to year, though a small increase has been noted in more recent years. Generally, admissions committee members at most medical schools consider a score of 30 or above to be competitive. A score of 35 and above is considered to be in the competitive range for the highest ranked schools.

1. Percentages of MCAT Examinees Achieving Scaled Score Levels and Associated Percentile Rank Ranges by Area of Assessment
2. MCAT Scores and GPAs for Applicants and Matriculants to U.S. Medical Schools by Race and Ethnicity, 2011

What are the top ranked medical schools?

According to US News [1], the following lists the top 20 medical schools for 2012:

1. Harvard University
2. Johns Hopkins University
2. University of Pennsylvania (Perelman)
4. Stanford University
5.  University of California--San Francisco
6. Washington University in St. Louis
7. Yale University
8. Columbia University
9. Duke University
10. University of Chicago (Pritzker)
10. University of Washington
13. University of California--Los Angeles (Geffen)
14. Vanderbilt University
15. University of Pittsburgh
16. Cornell University (Weill)
16. University of California--San Diego
18. Mount Sinai School of Medicine
18. Northwestern University (Feinberg)
20. University of Texas Southwestern Medical Center

What can we take from this list? Let us first look at their methodology, or what factors they use to score the schools [2]. As of 2011, there were 126 medical schools fully accredited by the Liaison Committee on Medical Education; of these, 114 schools provided data needed to calculate rankings based on their model. 

Each school is given a score based on a weighted average of the following factors: peer assessment score (weighted by 0.20), assessment score by residency directors (0.20), research activity (0.30), total research activity (0.15), average research activity per faculty member (0.15), student selectivity (0.20), mean MCAT score (0.13), mean undergraduate GPA (0.06), acceptance rate (0.01), faculty resources (0.10). 

Indicators were standardized according to their means, which were then weighted, totaled, and rescaled so that the highest ranking school received a score of 100. Each school thereafter received their percentage of the highest score. Schools with equivalent scores are given the same rank as can be seen in the above list.

Thus we can see that research activity plays the largest role in determining rankings, with student selectivity and outside assessment scores following closely behind. So roughly, a school's ranking reflects the quality of the student body, the school's involvement in research, and the general reputation of the school by peers and residency directors.

Rankings are also important for residency admissions, networking opportunities, and finding a position in academic medicine later on. However, applicants should not neglect other factors that are commonly overlooked by ranking systems, such as quality of clinical training, academic resources, opportunities for students, the school's hospital network, and individual fit to the school's vision and philosophy. These factors may sometimes outweigh the benefits that may be conferred by a higher ranked school.

1. Best Medical Schools
2. Methodology: Medical Schools

How important is the MCAT?

A frequently asked question, many wonder how important the MCAT is and how much of an impact it has in medical school admissions. Next to GPA, the MCAT is often cited as one of the most important factors and most highly correlated with quantitatively measurable standards of success in medical school [1]. This is particularly appealing to medical school admissions committees, as it gives them an impartial method of evaluating applicants in addition to the undergraduate GPA, which is often highly variable and dependent on the undergraduate institution regardless of the applicant's individual potential.

The table below provided by AAMC (Association of American Medical Colleges) shows the percentage of applicants admitted into at least one medical school given a certain MCAT and undergraduate GPA [2]. For the sake of simplicity, we will regard this as a table of acceptance rates, or an applicant's chances for acceptance given a certain MCAT and GPA.



Given a GPA of 3.80-4.00, we can see that admissions success is highly dependent on the MCAT score. A score of 27-29 meets the requirement for having better than a 50% of admittance, and a score of 30-32 shows a significant improvement for acceptance, sitting at 82%. Scores higher than the 33-35 range show a modest improvement in acceptance rates. An MCAT score of 39-45 with a GPA of 3.80-4.00 shows the highest acceptance rate at 91%.

At a slightly lower GPA range of 3.60-3.79, a score of 33-35 corresponds to an 80% acceptance rate, and scores higher than this range show only minimal improvement.

One common question that arises is whether a high MCAT score can make up for a lower GPA. If we look at the 3.40-3.59 GPA range, which is below the average undergraduate GPA for matriculants, a modest score of 30-32 shows only a 56% acceptance rate. However, at the 39-45 range, the rate shoots up to a respectable 79%. Thus in short, disregarding other factors, a higher MCAT can in fact help an applicant's chances given a lower GPA.

The chart also shows a positive correlation between GPA and MCAT score. If we disregard this to simplify our analysis, we can break down acceptance rates by MCAT score. A score of 24-26 corresponds to a 25% acceptance rate, 27-29 to 43%, 30-32 to 62%, 33-35 to 73%, 36-38 to 81%, and 39-45 to 86%. It is also notable that greater still are the discrepancies of acceptance rates between GPA ranks, confirming that GPA is still a very important factor.

In conclusion, MCAT is very important for medical school admissions. A higher MCAT score can offset a lower GPA to a certain extent. At higher GPA ranks, MCAT scores higher than the 30-32 range for a GPA of 3.80-4.00 and MCAT scores higher than 33-35 show only modest to minimal improvement in acceptance rates.

1. Validity of the Medical College Admission Test for Predicting Medical School Performance
2. Using MCAT Data in Medical Student Selection