Beyond the Numbers

(Adapted from a presentation by Sylvia Robertson, Asst. Dean for Administration and Finance, Pritzker School of Medicine, Univ. of Chicago, at the Medical School Admission Seminar, November 1, 2003)

What do medical students wish they had known when they applied?

Partly, that admission to medical school is not all about the numbers (grades and MCAT scores). Medical schools do not want to accept students who will be a failure in medical school because they have not taken a rigorous science curriculum and are not capable of success in medical school. The numbers and grades can suggest whether the applicant has an adequate background and ability, but they are not the only important factors in choosing among applicants.

Applicants with a GPA of over 3.7 and MCAT scores of 11's are routinely rejected by medical schools--Why?

The schools are looking for more than numbers--in addition, they are looking for signs of inner strength and many other qualities. A physician should be a person who places a high value on humanism, self control, altruism, knowledge, skill, and duty, and who is willing to dedicate his/her life to service to others. The concept of duty includes taking responsibility for your own actions, being service oriented, and feeling an obligation to other people and a responsibility to society. Knowledge of science and medicine and personal ability contribute to skillfulness. Knowledge of cultural issues, acceptance of diversity in patients and colleagues, and ability to communication effectively with people whose backgrounds are not similar to one's own are valuable attributes for a physician. A well-rounded liberal education in a person who is emotionally, physically, and mentally healthy is likely to support these skills.

Questions applicants should ask themselves include:

  • Are you willing to make sacrifices for another person? If not, why not? If so, when? For whom?
  • Do people trust you? Why? Should they trust you with their lives? Who do you trust and why?
  • Are you comfortable with your usual role on a team? Is it leader, follower, facilitator, information source?
  • How do you respond to failure and loss? Have you helped other people through failure or loss?
  • Can you accept that you can't learn and control everything?
If not, the life of a physician may not be for you.

The Arnold P. Gold Foundation (a public foundation dedicated to humanism in medicine) held a national symposium in 1998 co-hosted with the University of Chicago to discuss the barriers to sustaining humanism in medical education imposed by the medical school admissions process. As part of this symposium, the participants proposed attributes desirable in physicians. Medical school applicants should demonstrate these nine attributes in both their applications and in their interviews.

  1. Integrity:
    • Do you take responsibility for your own actions?
    • Do you exhibit a concern for truth, right, fairness, opposition to injustice? Examples?
    • How do you handle mistakes?
    • Do you have the confidence of others?
    • What are your core values and beliefs?
    • How do you reach a right decision in an ethical situation?
  2. Respect for others:
    • How have you demonstrated your esteem for others?
    • How have you celebrated cultural differences?
    • Are you culturally competent?
    • Have you pushed your comfort zone by interacting with others from different backgrounds from your own?
    • Who do you describe as a "difficult" person or patient? (Your answer should not show disrespect or a lack of understanding of the difficulty of being a sick person.)
    • Avoid stereotypes, generalizations; avoid describing groups of people as "those" people.
  3. Empathy:
    • How well do you understand the needs and feelings of others?
    • Do you exhibit kindness, compassion and respect for others, on a daily basis?
    • Have you experienced diverse types of failure and loss? How have you dealt with failure and loss? Has it given you any insight into how others feel?
    • How have you dealt with someone who has different beliefs from yours?
    • Who has served as an empathetic resource for you? Describe the interaction and situation.
    • How will you meet the emotional and interpersonal demands of medical school?
  4. Common sense:
    • Do you reject simple solutions in favor of more complex ones? (Could you reject a treatment plan that is unrealistic in terms of the patient's lifestyle?)
    • Do you have unrealistic expectations of yourself and others?
    • Do you choose practical solutions that make sense rather than valuing superficial appearances? (Could you choose to wear boots to an interview on a rainy, muddy day?)
    • Do you have much common sense? Or not? Examples?
    • Do you value common sense?
    • How do you go about solving problems?
    • How do you set priorities? How do you choose the right thing to do first in a crisis?
  5. Maturity:
    • Are you demonstrating a lack of maturity by applying to medical school before you are ready and before you have taken sufficient coursework to be well prepared?
    • Does your personal statement show a lack of responsibility for your actions, by laying the blame for deficiencies on others?
    • Have you made a sustained committment to your extracurricular activities?
    • Do your high school experiences make up a more important part of your life and your personal statement than your more recent experiences?
    • How open are you to criticism? Can you learn from it? Does it make you defensive?
    • Are you in control of your moods and your anger?
    • Have you learned to focus your efforts and achieve your goals even if there are personal distractions complicating your life?
  6. Motivation:
    • Examine it!
    • Are you clear about your ability to sustain a committment to medicine? Can you put it into words, with examples from your experience?
    • Do you have a real passion for lifelong learning, especially about science?
    • Are you truly dedicated to service to others, no matter how hard or costly?
    • Are you dedicated to excellence in your profession?
    • Is there any other career path that appeals to you, even as a back-up plan?
    • Do you have a family? How are they involved in your decision? Will you have their emotional support?
    • Are you relying on motivation based on a decision made as a child? Have you reexamined such a decision as an adult?
  7. Inner strength:
    • Can you deal with happy, healthy patients? What about depressed, overstressed patients?
    • What about patients who are noncompliant--can't or won't do what you tell them to do?
    • What about terminally ill patients? What about an athlete who faces the loss of a leg?
    • How could you help a person who is out of control, exhibiting self-destructive behavior find a way to face their problems and deal with them effectively?
    • Do you know how to find the appropriate resources to help your patients?
    • How do you respond to challenges--to your knowledge, to your authority, to your self-esteem?
    • Do you require perfection of yourself and others? How do you react to a lack of perfection in yourself and others?
    • Are you calm under presssure? Or not? How do react in a crisis situation, and how do you react after one is over?
    • Do you withdraw into yourself or turn to others in a crisis? Who do you turn to, if you do? Why?
  8. Personal effectiveness:
    • How do you relate to others?
    • Do you have a sense of humor? Do others appreciate it?
    • Do you inspire confidence and trust in others?
    • Can you function as an effective leader?
    • What is your motivation for leadership? To obtain power? To achieve goals? To reach a concensus?
    • Do others find you a comfort in group settings? Are you supportive, reassuring? Do you smile?
  9. Dedication to service:
    • The demands, tasks, and rewards of being a physician require a committment to service.
    • Have you made such a committment to service others? How? Why?
    • What activities demonstrate that you can be a servant to others?
    • How do you see the impact of your committment on others?