Premedical Studies in The US
Applying to medical school as an international student in the US can be daunting. Here are some resources that may be helpful in your journey.
A webinar for International medical students applying to medical school in the US
The process of applying to US medical school
This article is meant to demystify med school applications for people completely new to the process, or people looking for more resources.
Disclaimer: This is an article on applying to medical school as an international student studying in the United States. It was written by Patoungana (PTU) Public Health and Medicine Editor and Harvard Medical School student Emmanuel Magara (Now a Breast imaging radiologist), and PTU Editor-in-Chief, Alison Erlwanger. They have an entire series on applying to medical school that has plenty of helpful information andmaking yourselt a more successful candidate, that can be found on Patoungana.
What is the difference between a US medical degree and most foreign medical degrees?
Most foreign medical degrees are bachelor’s level qualifications: MBChB or MBBS. US medical degrees on the other hand are post-graduate/doctorate level qualifications – meaning you need a bachelor’s degree as a prerequisite.
There are two types of US medical degrees – the Doctorate in Medicine (MD), and the Doctor of Osteopathic Medicine (DO). The trainings are virtually the same and both allow you to be fully qualified physicians, but the DO focuses more on osteopathic manipulative medicine which has a distinct philosophy and approach to healthcare. We will focus more on the MD qualification as it is the most common.
Can international students study medicine in the US?
Short answer: Yes, it’s possible for US and Canadian college international students to get accepted into medical school.
According to 2014 American Medical College Application Services (AMCAS) data, among the 1,901 international students who applied to MD granting medical schools, 409 were accepted and 300 matriculated, roughly 1 in 5 applicants. Competition is stiff, but it is possible.
International students do also face unique financing challenges because a lot of funding options are exclusively for US citizens. This can be a source of apprehension for applicants, but again, it is possible (we will return to the issue of funding in a future article).
Please note, if you are an international student studying at a non-US college, it becomes complicated and highly unlikely to be accepted. This is because US medical schools require the prerequisite courses to have been taken at US, Canadian and sometimes UK colleges.
What does the medical school application process entail?
We will go over the typical medical school application process in this and upcoming articles, but it is important to know the school-specific requirements in case there are discrepancies. You can do this by checking out the website of your target medical schools, or for $25/year you can sign up for the AAMC Medical School Admissions review database (MSAR) which provides information on each school’s admissions process, selection criteria, cost, and financial aid packages, as well as stats on past successful applicants GPA and MCAT scores.
Medical school applications generally have 3 steps, the primary application, secondary application, and interviews.
Step 1: Primary application
Much like the college common application form, primary medical school applications are submitted through a single portal called the AMCAS application for the MD and the AACOMAS application for the DO (some schools may also have supplementary primary application requirements).
The application requirements include:
- Transcript(s)
- Medical College Admissions Test (MCAT) scores
- Information on extracurricular activities
- A personal statement
- Letters of recommendation
The application opens each cycle in May and you may begin to submit applications in June. Final deadlines are dependent on individual schools. Regardless of the deadlines, it is highly recommended that you be prepared to submit your application in June because many medical schools will review applications on a rolling basis. This means that the longer you wait, the lower your chances of moving forward in the process. In 2016 the application will cost $160 for the first school, and $37 for each subsequent school. Unfortunately there is no AMCAS application fee waiver for F1 or J1 visa holders, but if you are a US citizen, permanent resident or under refugee/asylum status you may be eligible for a waiver, learn more here.
Step 2: Secondary Application
If a school decides to move you on to the next round after reviewing your application, they may invite you to submit a secondary school-specific application. Again, complete and submit this as soon as possible (aim for 2-7 days) because they may be reviewed on a rolling basis.
Step 3: Interviews
After the secondary application successful candidates will move on to the final stage which is an interview. Most, but not all schools will require the interview, and for many schools it will be an in-person interview. It is recommended that you select the earliest interview date offered (sensing a trend here yet?) Be prepared for the associated costs of travel and accommodation.
Note: As with college applications, some medical schools have an Early Decision Program (EDP) with an August 1st deadline. You may only apply for one EDP school, and if the school extends an offer are obligated to accept. Learn more about EDP here.
When should you I start preparing for medical school?
The short answer – now.
Most people, the ones you are competing against, start preparing their medical school applications very very early. Like freshman year early. This is because preparing to apply for medical school is more than putting together the ACMAS application, it is often years of carefully curated experiences and achievements to reflect the intellectual ability, personal drive, grit, passion, and emotional intelligence to thrive as a physician. This means taking deliberate steps from the more obvious, like required tests and grades, to more subtle and individualized, like seeking out opportunities to serve and lead.
How do I prepare for medical school?
So now that we have established that preparing for medical school begins way before the primary application, let’s talk about how to prepare in terms of the qualities that make for a strong medical school application. The AAMC has defined 15 Core Competencies that are critical to incoming students which fall into 4 main buckets: Interpersonal, Intrapersonal, Thinking and Reasoning, and Science. Read through the list and consider how your experiences, inside the classroom and out, are helping you build these competencies.
We will not be going over these 15 competencies. Since this series is to help you prepare, we will focus on process over results. We will be going over 5 qualities, and their associated milestones and experiences, that can help you build most, if not all, of these 15 competencies. These are the qualities that you should strive to develop in the months and years prior to your application and make sure to reflect in your application.
- Academic excellence and preparedness
- Strong reputation
- Leadership and service
- Scholarship and research
- Integrity and professionalism
Academic excellence and preparedness
Medical school is academically rigorous and challenging. It requires a constant drive to learn and overcome challenges. You need to demonstrate that you have the intellectual stamina and discipline to succeed by excelling academically in college-level coursework. We will go over the typical academic requirements, but remember that there may be differences between schools and to always look for any differences in your target institutions for the final verdict.
Regardless of your major, build a strong GPA
The majority of medical school applicants major in the sciences (51% in 2012), but the rest major in a diversity of disciplines from the Social Sciences, Humanities, or Arts and can be equally competitive applicants. So major in something that interests and challenges you, don’t feel compelled to stick with the sciences if you have other interests. Your main goal should be to succeed and excel in all the courses that you take. Remember, the higher your GPA the more attractive you are as a candidate.
Also remember that you may change your mind organically as time goes on and you learn about alternative career paths, or medical school may not work out because you do not find a school that is a good fit. It’s fine if you switch paths and find another career which gives you fulfillment. So choose your major with a plan B and C in mind. What else might you be interested in doing other than being a doctor? You can hedge your bets with a major that would allow you to pursue alternative options.
Take all the pre-med requirements, the earlier the better
To ensure that applicants enter medical school with the necessary scientific background, regardless of their major, most schools will require that applicants fulfill a standard list of ‘pre-med requirements’. There is a movement towards competency-based evaluation in some schools, but chances are you will need to complete standard pre-med requirements to be eligible for all of your targets. It is very helpful to know all pre-med requirements as early as your freshman year to plan your study accordingly.
Typical pre-med requirements are:
- General Biology or Zoology with lab (2 semesters)
- General Chemistry with lab (2 semesters)
- Organic Chemistry with lab (1 semester)
- General Physics with lab (2 semesters)
- Biochemistry (1 semester, lab optional)
- English (2 semesters)
It’s still possible, although very challenging, to take the necessary courses in your later years of college. Some people even realize after college that they would like to go to medical school and take evening classes while working full-time, or enroll in post-baccalaureate pre-medical programs. Needless to say, the longer you wait the more challenging (and costly) fulfilling those courses can become.
[Looking for a post-bac program in your area? Check out this useful database from AAMC]
The most important thing to do for a healthy transcript is to perform well in pre-med classes especially since these may be the only ones that are similar between you are other applicants. The above required courses can be completed at most US or Canadian universities. Community college credit is also acceptable in most cases.
Score competitively in the MCAT
Another metric that will be used to determine your academic potential while leveling the playing field across majors is the Medical College Admissions Test (MCAT). You need to score high on this standardized test to stand a better chance of being accepted.
The MCAT is typically offered monthly (see the MCAT exam and score release dates on the AAMC website). There are test centers around the country (find the nearest test center to you). It costs $305 and registration deadlines are about a month before the exam (see list of registration deadlines for 2016). You may still be able to register 1-2 weeks before an exam, but would need to pay an additional $50 (see cancellation and reschedule fees). It takes a little over a month to receive results which can easily be included in your AMCAS application, but check to see whether your target institution is one of the few that needs the results mailed to them.
Take note that the MCAT underwent major changes in 2015 making it longer with more material covered, a new scoring system and different types of questions among other changes. So make sure that you have the most up to date information and materials.
So when is the best time to take the MCAT?
This all depends on your level of preparedness and when you want to apply for school. It’s recommended that you take the exam the calendar year prior to your applications (this would be Junior year if you plan on attending straight after college). You may decide to take the exam earlier or later depending on how many times you think you may need to re-attempt the exam to get a competitive score, or whether you would have covered all the material in time. The latest you should plan to take the MCAT is May 1st to get your results back in time to apply in June. Most schools will only consider MCAT scores that are not more than 2 or 3 years old. You can retake the MCAT up to 3 times within a year and seven times in your lifetime.
The MCAT has four sections:
- Biology and Biochemistry
- Chemical and Physical Foundations for Biological Systems
- Psychology, Social, and Biological Foundations of Behavior
- Critical Analysis and Reasoning Skills
According to the MCAT website, ‘All of the content on the new MCAT is covered in introductory courses at most colleges and universities, including introductory biology, general chemistry, organic chemistry, physics, and first-semester psychology, sociology, and biochemistry. Research methods and statistics concepts on the exam are used in introductory science labs as well as introductory psychology and sociology courses.’
Regardless of how well you perform in these classes, you will almost invariably need preparatory material from one of the many MCAT-prep companies. Depending on your budget, this could be in the form of MCAT prep books, online or in person classes, and/or one-on-one tutoring.
[Curious about what the acceptance rate has been in the past for people with your GPA and MCAT score? Check out AMCAS GPA and MCAT score tables broken down by race and ethnicity. But don’t forget that the MCAT and GPA are only part of your application]
Kaplan and Examkrackers are the most popular companies. But also be sure to check out free and cheaper MCAT prep options like Khan Academy and Dr Flowers, or get a refresher on the college courses through online learning sites like Coursera (check out Patoungana’s list of online learning sites). If you are able to pay over $1,000 for an actual class, Kaplan offers materials and in-house tutoring. This tends to be popular among pre-meds who like structure and consistent guidance. If you are able to work well independently you could buy material and study by yourself.
In addition to studying you will also need to take A LOT of practice tests to both know the material and to become a good test-taker, which is half the battle. You will need both theory and the ability to make educated guesses under the pressure of exam conditions. There are multiple free practice tests online which you could take right now to familiarize yourself to the outline and get your feet wet. It may even be helpful to just take one before you start studying to see where you stand and which areas to focus on, but don’t take the score of this pre-study practice test to seriously or let it freak you out, it is just to familiarize yourself with the set up.
Other Resources for International Students
1. Core competencies for entering med students
This is useful in demonstrating some of the competencies needed to demonstrate your competencies for entering into medical school. Can be used as a guideline when drafting personal statement, interviewing, etc. It can be found at the AAMC website.
2. List of external scholarships for international medical students
This is a list of scholarships for international medical students compiled by Simosenkosi Nkomboni who is going to be a medical student at Emory Medical School. The list can be found at her blog post.
3. Biomedical Science Careers Program
This is a good place to network and find postgraduate work positions or research opportunities. More information can be found on their website.
4. Internship opportunities in Zimbabwe to shadow or to do research
The Education Matters Zimbabwe Career Connect Internship Program, which began in 2016, is an experiential service learning program that matches Zimbabwean students studying in the U.S., Canada and with Ashesi University in Ghana, with Zimbabwean companies and non-governmental organizations during the student’s vacation period from university. The spectrum of available internship opportunities is broad and responsive to the interests of the selected student participants. More information can be found here.
5. Short list of some medical schools that accept international students
This list is by no means comprehansive but provides a starting point for medical schools that may consider international students.