Monday, July 25, 2016

New College of Human Medicine Prerequisite Models Offer A Variety of Pathway Options

It doesn't take a philosophy major to understand that change is constant. Some changes are serious and life-altering; others, not so much.

In the world of science, new discoveries and knowledge add foundational context from which the future of medicine must learn to incorporate and adapt.  Higher education communities have raised concerns about whether or not premedical curricula have kept up with these changes; what seemed to work yesterday may not be what works tomorrow.

Many medical experts agree that an undergraduate education should not be geared towards only getting students into medical school; instead, these years should be dedicated to creativity within an intellectually stimulating liberal arts education.

Congruent with this mindset is the concept that prerequisites (or for that matter any scripted course of undergraduate study) should not be so overwhelming that the applicant seems pressured to emphasize (major in) science in lieu of other academically rigorous disciplines, especially those within divisions of humanities and social sciences.

Approximately three years ago, the College of Human Medicine (CHM) put together a committee of premedical experts to review our legacy prerequisites.  One thing that came out of committee discussion is that there is no “one size fits all” in the world of preparatory premedical coursework that sufficiently meets the needs of all medical schools and its applicants.

Flexibility in the curriculum, though, did come forth as a key concept in trying to meet the many types of qualified applicants that exist in today’s changing world. This coincides with schools, including our own, taking a more holistic approach to reviewing applicants once they apply to medical school.

Starting with the 2016-17 application cycle, a new set of course prerequisite models will be implemented.

The New Prerequisites 

In order to meet the needs of as many applicants (both traditional and nontraditional) and undergraduate institutions, CHM embraced a flexible approach in providing various options (or pathways) to meeting premedical course requirements as follows:

OPTION A: MCAT-Influenced Preparation Model

This model follows a historically traditional pathway of prerequisites that should prepare students for both the MCAT exam and an entry-level undergraduate medical curriculum:

  • Biology with lab (1 year)
  • General Chemistry with lab (1 year)
  • Organic Chemistry with lab (1 year)
  • Introductory Physics with lab (1 year)
  • College Algebra or Statistics (1 semester)
  • Biochemistry (1 semester)
  • Social science coursework: Anthropology, Economics, History, Political Science, Psychology, or Sociology (1 semester)
  • Upper level (defined as 300-400 level, junior-senior level coursework, and coursework that maps as upper-level by MSU transfer criteria) Biological sciences (1 semester); examples include coursework in (but not limited to):
      • Anatomy
      • Advanced Cell Biology
      • Embryology
      • Genetics
      • Immunology
      • Microbiology
      • Molecular Biology
      • Neuroscience
      • Physiology
      • Zoology
A grade of C (2.0 on 4-point scale) or higher must be achieved in order to meet prerequisite standards.

OPTION B: End-point Coursework Model

This option describes what courses need to be taken, but not the path to achieve the end point. Undergraduate institutions work with their students to help decide acceptable pathways to these end-point courses that may include (but are not limited to) traditional course requirements, condensed courses, novel curriculums, AP credit, and online course work.  A number of strongly recommended, but not required, courses are included in this option.

Any applicant selecting this option must document the required end-point courses that have been taken/planned as well as the list of pathway courses taken/planned that led to that end-point.  Applicants will also indicate which courses in the recommended areas have been taken and which ones are planned.

The following courses are required:
  1. Biological sciences: 1 semester of upper-level Biology; see option A for examples    
  2. Biochemistry: 1 semester
  3. Introductory Physics: 2nd semester
A grade of C (2.0 on 4-point scale) or higher must be achieved in order to meet prerequisite standards.

Additional coursework in traditional liberal arts divisions (science, humanities, and social sciences) outside Biology, Chemistry, and Physics is strongly recommended by the Committee on Admissions. Examples include coursework in (but not limited to):

  • Anthropology
  • Art
  • Classics
  • Computer Science
  • Economics
  • English
  • Foreign Language
  • Math
  • Music
  • Philosophy
  • Political Science
  • Psychology
  • Religious Studies
  • Sociology
  • Theater

OPTION C: Course Competency Maps Model

Applicants eligible for this admissions criteria option are limited to those enrolled at institutions with departments that have constructed course-competency maps which have been submitted to the College of Human Medicine and approved by the Committee on Admissions.

The current model for this option is derived from premedical competencies described in the 2010 Howard Hughes Medical Institute -Association of American Medical Colleges report, Scientific Foundations for Future Physicians.

To qualify for admission, an applicant must complete any combination of courses whose combined content has been mapped by its faculty to cover the 37 learning objectives from this report, which emphasize the following eight entry-level medical student competencies (See pages 22-35 for a description of all 37 prematriculation learning objectives).

  • E1-Apply quantitative reasoning and appropriate mathematics to describe or explain phenomena in the natural world.
  • E2-Demonstrate understanding of the process of scientific inquiry, and explain how scientific knowledge is discovered and validated.
  • E3-Demonstrate knowledge of basic physical principles and their applications to the understanding of living systems.
  • E4-Demonstrate knowledge of basic principles of chemistry and some of their applications to the understanding of living systems.
  • E5-Demonstrate knowledge of how biomolecules contribute to the structure and function of cells.
  • E6-Apply understanding of principles of how molecular and cell assemblies, organs, and organisms develop structure and carry out function.
  • E7-Explain how organisms sense and control their internal environment and how they respond to external change.
  • E8-Demonstrate an understanding of how the organizing principle of evolution by natural selection explains the diversity of life on earth.
A grade of C (2.0 on 4-point scale) must be achieved in all courses being used to demonstrate competencies in order to meet prerequisite standards.

OPTION D: Novel Curricular Tracks Model

Applicants eligible for this admissions criteria option are limited to those enrolled at institutions that have devised novel premedical curricula that have been submitted to the College of Human Medicine and approved by the Committee on Admissions.

For institutions interested in developing novel curriculum for its students, it is strongly advised that the basis of this curriculum be grounded in the liberal arts divisions of science, social science, and humanities.  The institution should provide commentary that explains how this novel curriculum integrates learning objectives which they believe provide competencies for entry-level medical students.

A grade of C (2.0 on 4-point scale) must be achieved in the novel curriculum coursework in order to meet prerequisite standards.



If you are thinking about a future career in medicine, develop a good relationship with your academic and/or pre-health advisor at your school.  Share with them the content of this blog and our website as early in your undergraduate studies as possible such that together you can determine which of these prerequisite course options are available at your school and will best serve your intellectual needs and special interests. 

Joel Maurer, MD, FACOG, is Assistant Dean for Admissions in the College of Human Medicine and Associate Professor in the Department of Obstetrics, Gynecology and Reproductive Biology at Michigan State University.

Tuesday, July 12, 2016

Letters of Evaluation: The Basics

Letters of evaluation are an important part of the ACMAS application and thus, the med school admissions process. Per the Association of American Medical Colleges (AAMC), "A recommendation letter or letter of evaluation is a letter in which the author assesses the qualities, characteristics, and capabilities of the person being recommended/evaluated."

Admissions committees can learn a lot about an applicant beyond their metrics. Effective letters offer professional perspectives on an applicant's many diverse attributes and personal qualities. Truth is, the majority of medical school applicants from year to year have competitive grades and scores, so letters give insight into each individual's unique strengths and experiences.

In addition, letters of evaluation can highlight one's commitment to medicine through their service, research, and academic pursuits. Also helpful is the fact that other health professionals, academics, and/or mentors can vouch for those interests and capabilities.

So who are the people that you should consider to be your letter writers?
Think of who can best contribute to your application. The writers should be able to speak in depth about you, meaning someone who you've been engaged with for a consistent amount of time. In general, some ideas may include:

-Professors and other academic faculty (science and non-science)
-Research advisor
-Pre-med committees
-Employment Supervisors
-Volunteer Coordinators
-Health Professionals

There are certainly other possibilities but the key here is that they know you and your abilities well. The credentials of your writers are a factor, but should not take precedence over how well they can provide an accurate assessment of your suitability for medical school. Identify those who can best describe your strengths.

You'll need several writers.

Typically, medical schools will require a certain number of letters, which varies from school to school. The MSU College of Human Medicine (CHM) requires three letters with a maximum of five. Most schools will allow the same range, but some can allow up to six or more.

Along this line, schools may have additional guidelines to follow. For instance, the CHM Office of Admissions requests that one letter be from a basic science or medical science professor who can critically evaluate your academic potential, maturity, strengths and weaknesses, and the difficulty of coursework, if applicable. You can find more guidelines and information on our website's Letters of Evaluation page. There are also AAMC Letter of Evaluation guidelines that potential letter writers should review.

Potential traditional medical school applicants should start thinking about who can fill these roles towards your final year or two. Non-traditional applicants or those with extenuating circumstances who are prevented a letter from a basic science or medical science professor may be made an exception, if they can fulfill certain requirements and guidelines.

If you have taken time off between college and medical school, applicants to the MSU College of Human Medicine should also send a letter of evaluation from a person who can comment about experiences during that period.

Letters of evaluation must be submitted through the AMCAS Letters Service for all medical schools participating in the service. Instructions for submitting letters to AMCAS are provided within the AMCAS application. Unsolicited letters sent directly to CHM outside of the AMCAS Letters Service will not be reviewed and, instead, discarded. Once your letters are received by AMCAS, they will be sent to your designated schools.

There are three types of letters that can be submitted:
  • An individual letter is just that, written by and representing one author.
  • A committee letter can be provided by a pre-health committee or advisor to represent your undergraduate institution’s overall evaluation of you. Some schools have pre-health or pre-med committees, but others may not. With that said, some medical schools may require a committee letter from those applicants whose undergraduate institutions have a pre-health or pre-med committee.
  • A letter packet is a set of letters that can be compiled by several different options, including your institution or institution's career center.  In contrast to a committee letter, a letter packet does not include a single evaluative letter.

Something to note is that you should not add a separate entry for an individual letter if you have already included that letter within either a committee letter or packet. Also, committee letters and letter packets each count as one entry, though there will be separate notes from different sources.

Are you considering a dual-degree program? Applicants must submit letters as requested by these specific programs. Be sure to do your research.

There's a ton of additional information out there on letters, including this solid piece from Student Doctor Network. Brush up on how to acquire letter writers and be sure to pay attention to deadlines. On the other end, be courteous and give your letter writers a good amount of notice ahead of time. Obtaining solid letters requires time and planning.

Lastly, don't forget to thank your writers!

All in all, letters help fill in the gaps. Along with the personal statement, letters of evaluation can go a long way into making your application stand out.