Restarting Your Journey to Medical School

There is a common misconception amongst students that medical schools only care about grades and MCAT^® exam scores. However, being a good doctor requires so much more than just academic success. Physicians must also demonstrate a host of other professional skills, many of which are cultivated outside of the classroom. Curious what’s on the list? (Yes, there is an actual list.) Learn more about the premed competencies for entering medical students here.

The good news is that, while some students cultivate these skills before or during their undergraduate education, the majority of students develop these characteristics post-graduation. Many students who engage in volunteer work or other professional experiences after graduation acquire a host of skills and competencies that are transferrable to a healthcare profession. Usually, students who take one or more gap years find it much easier to demonstrate the core competencies through their application. They also often find interviewing easier, as they have experience interviewing and advocating for themselves in a professional setting. Lastly, the work ethic, focus, and tenacity required to keep a job post-college generally translates well to success in premedical school education, medical school, and beyond. In summary, taking one or more years can lead to valuable experiences and personal growth that strengthen an applicant's candidacy.

For more guidance, check out the following stories of students who successfully matriculated to medical school after pursuing different careers or taking time off:

• When Michael Foster initially applied to medical school during his senior year of college, he didn’t receive any acceptances. As a result, Michael spent two unplanned gap years shadowing, volunteering, and teaching mathematics part-time before his second successful application cycle.
   
• Hadin Foster started his career working at several startup companies as an engineer. Then, after receiving a diagnosis for a painful condition he’d been living with for years, he was inspired to pursue becoming a physician.
   
• Shira Lanyi performed as a professional ballet dancer for a decade before earning her bachelor’s degree in biology and subsequently applying to medical school.

An older student who has recently decided to pursue medicine can create a strong application that can easily compete with students who’ve wanted to pursue medicine since birth. Why? Because being of service to others and developing an awareness of the field is not something that requires 10 years of experience (usually). Most of the premed competencies are professional skills that one can cultivate in a variety of jobs and industries. Furthermore, applicants who change careers typically become very competitive candidates due to the maturity, professionalism, and unique perspectives they would bring to an incoming medical school class. For more information about leveraging skills from a different career field, access our presentation “Career Changers — Medical School Student Profiles.”

And, if you’re coming from another role in health care, all the better. Hopefully you’ve realized that the core competencies for entering medical school students are not that different from the expectations in your own field, and you’re likely to have medically relevant and/or service experience that informs your knowledge of the field and decision to pursue medicine. For inspiration and advice, you can access dozens of stories on the AAMC’s website featuring medical students who’ve previously worked in other fields — from nursing to engineering to digital marketing and more.  

Remember there isn’t one flavor of premed. The holistic review methodology used by most admissions committees allows students to gain necessary competencies while also maintaining their individualistic perspective on how they can serve others through medicine.

Schools vary widely in what they consider “too old,” so getting a good answer to this question involves checking the websites of each individual school or looking to see how they’ve answered this question in their Medical School Admission Requirements^TM (MSAR^®) profile. (Search under “Selection Factors,” “Oldest date prerequisite coursework can be completed” — You can also check the latest date coursework can be completed in this section.) Although you may not know exactly where you’ll be applying, start with a few medical schools in your area to get a sense of their requirements. Any coursework that is too old will need to be retaken.

You may notice that the schools who have the most relaxed requirements for what is too old may also be the most selective. As a result, excluding all the schools that will require retaking courses could mean you’re making your application strategy unintentionally high risk. Be careful that you don’t make the process hard just to avoid retaking coursework. Also, note that schools that are more lenient on the age of coursework may review your MCAT scores more closely. Since the MCAT exam typically (but not always) ages out between three to five years, it offers a convenient way for schools to know how much you remember without requiring you to retake classes. (You can see the oldest and latest dates in each MSAR profile or in the MSAR Reports.) Using the MCAT exam in this way may or may not be an advantage to you.

Even if a school’s policy doesn’t require you to retake a class, you might consider doing so anyway. Students often fixate on getting into medical school, but remember, you also want to be successful during medical school, and you want to give your future patients the best care possible. The former may not require retaking classes, but what about the latter two? Regardless of what schools require, consider realistically how well you know that content and how easily you’ll be able to access that knowledge in medical school. Although it’s not the only option, retaking courses is an obvious path to reacquainting yourself with long-forgotten content you’ll need later.

Medical schools tend to be wary of accepting any student who has not taken any BCPM coursework within the past two years (as of the summer in which you submit your application). To avoid an educational gap, it is strategic to re-enroll in a single postbaccalaureate academic term, taking 9-plus credit hours of relevant BCPM courses in that term. Upper-division courses are preferred. Aim to earn As and Bs in each of those courses, with a term GPA of 3.5+. With this approach, you not only will demonstrate to the medical schools that your academic skills are still sharp but also will set yourself up to request a current academic letter of recommendation from a BCPM faculty member.

Here are some guidelines to consider when deciding whether or not to repeat any premedical prerequisites:

How much time will have elapsed between your MCAT test date and the relevant coursework?
If it has been less than eight years and you earned an A or B in the course, check out an MCAT prep subject review book to gauge how well you remember the material. If you feel confident that you can excel on MCAT questions on these topics, you may decide not to repeat the course. If not, you may need to consider retaking this course.

If you earned a C-plus or below in the course, it likely indicates you haven’t completely mastered the material. In general, we advise premedical students to repeat any such course that will be tested on the MCAT exam. This is especially important if a given course is foundational to success in additional courses to come. For instance, if a student earns a C-plus or below in General Chemistry 1, it is advised to repeat that course and fully master it before moving on to General Chemistry 2, both of which are foundational to Biochemistry, and all of which are tested on the MCAT exam.

If your MCAT test date occurs eight or more years after you originally took courses that will be tested on the exam, then it’s in your best interest to repeat the course. This will better prepare you to earn a competitive MCAT score. Some advisors report a trend in which students who opt not to repeat these older courses tend to earn noncompetitive scores on the relevant section(s) of the MCAT.

Postbaccalaureate programs are designed for students who either need to complete some or all of the prerequisites and/or who need additional coursework to demonstrate that they have developed the academic skills needed for success in medical school. There are three broad categories of formal postbaccalaureate programs:

• Career-changer programs
  These are typically designed for high-performing students who didn’t take the science prerequisites during college and need to take most or all of the prerequisites. (Typical GPAs for admitted students is 3.5-plus.)
   
• Academic record-enhancer programs
  These programs are offered at both the undergraduate and graduate level. They’re designed for students who have already completed most or all of the science prerequisites but whose grades are not quite strong enough to make them competitive applicants. (The typical GPA range of admitted students is 3.0 to 3.4.)
   
  • An undergraduate-level program might be right for you if: 
    • You are seeking to improve your cumulative undergraduate GPA and your biology, chemistry, physics and math (BCPM) GPA, and/or
    • You haven't yet completed some of the prerequisite courses, and/or
    • You would like to repeat some of the prerequisite courses you took earlier so you can be well-prepared for the MCAT. 
       
  • A graduate-level program might be right for you if:
    • You already completed all of the prerequisite courses within the past few years, earning A's and B's in each of them. 
    • You are excited to move on to graduate-level science courses. 

If you are planning to apply for federal student loans, be aware that financial aid may be more limited for undergraduate-level postbaccalaureate coursework than for a graduate-level program.  

• Fully individualized programs
  There are many postbaccalaureate students who do not fall into the two categories listed above. Some have a history of strong grades and have completed some but not all of the prerequisites, so they are only seeking to finish up the last few courses. Others have undergraduate GPAs below 3.0 (with or without prerequisite coursework completed), so they may not be considered a strong candidate for academic record-enhancer programs.
  
  Prospective students who fall into this third category should look for a school that offers prehealth advising to postbaccalaureate students who need a fully individualized coursework plan.

Although not an exhaustive list, the AAMC has a free postbaccalaureate database where you can search by criteria such as program focus, degree offered, location, and more. You can also compare admission requirements, program structure, the type of degree or certificate granted, the length of enrollment, types of applicants accepted (e.g., Deferred Action for Childhood Arrivals [DACA] recipient, international, or out of state), and more. To read about two recent students’ experiences with postbaccalaureate programs, check out the AAMC’s fact sheet What It’s Like to Enroll in a PostBacc Program.

If you are considering the option of completing additional coursework at the graduate level to improve your academic credentials before applying to medical school, you can choose between Special Master’s programs that are designed for premedical students and traditional, research-based master’s programs in a BCPM discipline.

Considerations regarding Special Master's programs:

• These programs typically are one year in length 
• Most provide dedicated prehealth advising services. Some also offer an MCAT preparation course. 
• Your peer group will be fellow premedical students. 

• The Special Master’s degree does not serve as a “fallback plan,” as it is not recognized within academia or industry to be equivalent to a traditional, research-based master’s degree.

• The total out-of-pocket cost of a Special Master’s program tends to be higher than that of a traditional, research-based master’s program.

Considerations regarding traditional master's programs:

• These programs are typically two to three years in duration. A premedical student in such a program would submit their application to medical school in the summer prior to starting their final year in graduate school.
• These programs typically require the GRE (general test and perhaps subject test) and prior research experience.
• Some master’s programs are well- funded. For instance, it is fairly common for students to receive a tuition discount and to receive a paycheck for working as a part-time graduate teaching assistant or research assistant for the duration of the program.
• Medical schools value the experience you gain from designing, conducting, and defending a master’s research project. This type of experience not only develops your ability to grapple with tricky intellectual challenges but also prepares you to be a more critical evaluator of other research studies.
• Medical schools also value the competencies you would develop from serving as a graduate teaching assistant, as these positions require interpersonal leadership and mentoring skills as well as the ability to help people understand complicated science concepts.

For more assistance on how to decide if a traditional master's program or a Special Master’s program is right for you, be sure to discuss your plans with a prehealth advisor.

Start by assuming you can access resources at your undergraduate institution until you are explicitly told otherwise. Depending on the school, you should reach out to a prehealth advising office, a preprofessional advising office, or individuals within departments who will be able to help you. A good place to start is simply googling your school name and “premed” or similar. You can also ask your previous academic advisor whom to speak with.

If your undergraduate institution is not able to help, don’t despair. In the absence of other sources of advising (like a postbaccalaureate program or someone in your graduate institution if you pursued other degrees), the National Association of Advisors for the Health Professions (NAAHP) offers a free Find an Advisor service, which connects students who do not have advising support to volunteers who will help you. These volunteers are NAAHP members who advise for a living at academic institutions across the country, so you can be assured that the information you're getting is high quality and can be trusted.

If you’ve already applied to medical school but were not accepted, carefully review your application to try to determine which aspect(s) need further development. If your academic history is already strong, then you should consider other area(s) that need further development, which may include:

• Participating in hands-on patient care experience in clinical settings.
• Working in nonclinical, interpersonal service jobs or volunteer roles. Particularly valuable activities in this category are those that allow you to be of service to those in historically marginalized populations and positions that allow you to develop your interpersonal leadership and teamwork skills.
• Gaining formal research experience if you’re considering applying to research-focused schools.
• Strengthening your MCAT score.

You may be able to get a committee letter or letter packet through your undergraduate prehealth advising office or a postbaccalaureate program if or when you are enrolled in one. If you can’t, don’t despair. Medical schools recognize that not all students have access to committee letters, and students get into medical school all the time without a committee letter or letter packet. In this case, you should pursue individual letters of recommendation. What kind of letters you need will depend on the schools you apply to. Check their school’s websites or MSAR profile (under Admissions, see “Guidance on preferred letter writers) to understand their requirements and ask admissions representatives if you have questions about those requirements.

Most schools will accept three to five letters of recommendation. A common assortment of LOEs is a letter written by:

• A BCPM faculty member who taught you in class within the past two years.
• Another faculty member who taught you in class. (Some schools require this to be another BCPM professor; others are open to nonscience professors.)
• A supervisor from a long-term work or volunteer activity. (If you have been in the workforce, include a letter from one of your work supervisors.)

Letters 4 and 5 are truly optional. Consider including them under the following conditions:

• If you’ve been working in a clinical setting, include a letter written by a clinician who can provide examples of your approach to your work in that setting.
• If you’ve been heavily involved in research, you may want to include a letter written by your research mentor.
• If another faculty member or supervisor knows you well and can speak to any of the core competencies that will not be addressed by the other letter authors.

You can reach out to anyone you prefer, including your professors from your undergraduate studies. When reviewing the specific letter requirements of each medical school, you’ll see that some require academic letters (science, nonscience, or type not specified). (It is not recommended to use high school teachers as your academic letter writers.)

As you consider the set of letters of recommendation that you will include in your application, be aware that medical schools are interested in hearing from a science faculty member who has taught you in class within the past two years, so that they can speak to your current level of intellectual engagement as a student.

When filling out the American Medical College Application Service^® (AMCAS^®) application, admissions committees will be most interested in your sustained, long-term activities within the two to three years leading up to application time. (Note: it’s not appropriate to list experiences that only occurred during high school.) Recent experiences tend to be considered more relevant than those that occurred many years ago.

The AMCAS application limits users to a total of 15 experience entries, so nontraditional applicants often need to be thoughtful about the experiences they choose to include or exclude. Generally speaking, it’s most important to list long-term experiences that (a) required a significant time commitment and (b) allowed you to develop the transferable skills that will help you be a successful medical student and clinician. (Learn more about premed competencies and how they can be developed in many different types of jobs, volunteer roles, leadership positions, and paid work.)

Finally, do not undervalue the experiences you’ve gained in your day-to-day work life! Many of the skills that you use in the workplace (e.g., communication skills, cultural awareness, resilience) are examples of the premed competencies. Although your experiences do not necessarily have an expiration date, their relevance should be made to fit the tenor of your application's overall narrative. It's not only about when or where you gained a given experience, but also about how you valued that experience, what you learned from it, and how it has contributed to your pre-professional growth and development.

Good time management skills are essential. A first step might be to make a full accounting of all the activities you currently engage in on a daily, weekly, and monthly basis. Evaluate the experiences and activities that you would like to explore to see if there are any time slots that are a natural fit for your existing work schedule. Having identified specific organizations you would like to engage with, consider contacting them to see if there is any flexibility with time slots when you could work or volunteer. Again, do not undervalue the experiences you have in your day-to-day job!

When planning your academic and activity schedules for each semester, a good guideline is to cap your weekly time commitment to 65 hours per week for all of your responsibilities combined. That said, be aware that 65 hours per week is a hefty time commitment! Most people find that they can keep up this pace (say, nine hours per day, every day each week, except during school breaks) for about one year while maintaining good grades and avoiding burnout.

Be intentional in designing your life during this time so you can optimize your ability to learn. Prioritize appropriate sleep, exercise, healthy food, rest, and time with the people you love. Set up your schedule so that you have the time you need to excel in your coursework while also having the time you need to recharge. Always, always, always prioritize your academics. Your top priority is to fully master your prerequisite courses and to demonstrate a consistent trend of academic success. By mastering your courses, you will boost your GPA while also preparing yourself to earn a competitive score on the MCAT exam.

Before enrolling in postbaccalaureate coursework, consider the total cost you will incur. Nontraditional students who return to school after spending time in the workforce will experience the opportunity cost of lost income while incurring additional education debt. Most postbaccalaureate students significantly reduce their work hours or take time away from paid work altogether. If possible, talk to a financial aid advisor at your school(s) of interest to get a sense of the types of aid available to postbaccalaureate students. Federal student loan rules will vary according to whether you’re enrolled in an undergraduate versus a graduate-level program, as well as whether you are in a degree-seeking or a nondegree-seeking program.

As you start researching the medical schools you may want to apply to, it may be helpful to learn more about the scholarship opportunities that are available at each school. Some medical schools offer a wide range of scholarship opportunities to their students throughout their four years of medical school, whereas others have more limited offerings. Many universities and medical schools will list organizations that provide scholarship funding on their financial aid webpages.

Having a sense of where you might apply for funding can be a great benefit in deciding which school you will attend once accepted into a program. Your list of researched funding opportunities will be useful after you matriculate into a medical school program. Even receiving partial funding to help offset the cost of tuition can be helpful.

For additional financial aid resources, visit the following:

• AAMC Financial Information, Resources, Services, and Tools (FIRST) website.
• “Money Management, Budgeting and Scholarships” (video).
• FIRST Fact Sheets.