There’s a sense of excitement and anticipation that accompanies the hunt for one’s first job out of college. Finally, the knowledge you’ve amassed will be put to use. Finally, you’ll be taking control of your future and molding your career. Finally, you’ll enter the real world. Finally, you’ll be making money. I remember looking toward graduation hoping that it would be less scary if I knew where I’d be and what I’d be doing. After four years you are leaving what is familiar, and there’s no small amount of expectation. Your parents expect that you’ll immediately prove a worthwhile investment. Professors have staked a similar claim on you, and they watch you with an eye towards the underclassmen- knowing what you do will largely set precedents for your younger peers. Finally, you bring your own set of expectations to the table and students seem to naturally align themselves on three paths: the immediate career seekers, those looking for a stepping stone along a path to graduate school, and those who will test the waters more uncertainly without a firm sense of what they want to be “when they grow up.” I can only speak with the experience of being a member of the second group. I know members of the former group, mostly humanity majors, whose broad educational background prepared them for nothing or everything, depending on how you look at it. These people looked for jobs at places like monster.com or careerbuilders; they searched for employment that spoke to their innate skill set (communication abilities, fast learners, management types, etc.) and not any technical ability. For people who graduated but still weren’t sure what the future would hold (those walking the third path mentioned above), it was more important that they find a niche. Usually that niche would be a specific geography or a group of people to be with. I envied the confidence these people had in themselves, which assumed they would be able to find meaning anywhere so long as a few basic premises were met (roof over ones head, roommates for laughter and commiseration, etc.).

The people in the second group, like me, knew that the years between undergrad and graduate school were going to be pivotal. A diminishing minority of people jump straight from the frying pan to the fire, going immediately for the PhD, MD, MBA, and so on. The rest of us have a plan that starts ten years from now, “when I’m a _____ (insert profession) I want to be in ____ (insert location), specializing in ____.” So how do you make the most of the space between here and there, those key years that will really show that you have taken the “right” route?

First, acknowledge there is no one path to get where you are going. The road is fraught with exits, on ramps, detours, and traffic. Listen to everyone who tells you that there is as much significance in the journey as the destination. College years are for growing into your prototype, the alpha version of yourself. You are independent, an adult, but are fairly green. You are untested and immature. These aren’t negative attributes; they are a wonderful testament to the fact that no person emerges fully formed from either the womb or their education. During the time between graduation and graduate school there is space for evolution, time to explore what lies beyond the nest. More importantly, you are in the unique position to give your future a test-run. You are going to take, most probably, a bottom-of-the-ladder post in a place where other people are doing what you want to do. Don’t just assume you are “paying your dues;” use this opportunity to actually observe what is taking place around you. Explore your profession and find out which facets suit you and where your true potential lies. I know several people who were pre-med upon graduation and are now pursuing PhDs, and of course vice versa. For the next 1+ years you are not locked in to anything. Sure, you’ve always said you were going to be a ____, but now is the time to see if that is the right fit. The only person you are truly accountable to at this moment is yourself, and you owe it to yourself and your potential colleagues to make sure you are going to be the best professional you can be.

I spoke to a women a few months ago who is just now, that her three children are graduating college, pursuing nursing school. It will be her second career, having been a thriving business owner for multiple decades. It was, impressively, her children who inspired her. One daughter, who had been shockingly independent, fell in love and joined her fiancé in Germany. The daughter realized she could be happy regardless of her geography and it was allowing herself to meld her life with someone else’s and give up some autonomy that showed real growth. Another daughter decided to jump in with both feet and pursue marine biology in Australia. She had no idea what she would find on the other side of the world, but she was confident in her capacity as a scientist and she let that guide her. The final child is a son entering college. The mother knew it was hypocritical to say to her child he could pursue whatever he wanted when she herself had not become a nurse because it didn’t fulfill her parents’ bourgeois image. Despite starting essentially from scratch the woman is happier then she has been in years and is only sorry for the many patients over the years whose treatment she wasn’t a part of.

My own, less dramatic, experience becomes more poignant as I prepare to leave my job. During his call to my references my then future boss indicated I was “rough around the edges, but once she’d polished she’ll shine.” When my collegiate advisor told me this I felt slightly affronted. Hadn’t I spent the past four years at college becoming polished? Wasn’t I mature and refined? Yes, for a 21 year old I was. But now I realize I have become much more. Where I hid insecurity behind bravado I now have confidence. My theoretical knowledge now firmly rests on a solid foundation of experience. My employment and life experiences have given rise to a beta version who, begrudgingly, fulfills my employers predictions. I would, therefore, encourage the graduating class of 2007 to embrace the job-search process, whatever it might hold. Everyone will tell you that the coming months are full of promise and while I am loath to chime in with the chorus, I can’t help but agree. Congratulations, class of 2007, and best of luck!!!

Drum roll please….*

FACTS:

1. I left the MCAT feeling good. Not great, because the exam is too elusive to really gauge what your score will be, but confident it had gone rather well.

2. Two weeks later, as I attempted to return to normal life and was no longer spending all day everyday studying and searching for sources of caffeine, I was a little more iffy. As in, “if I didn’t do well, what do I do??”

3. Currently one waits 4.5 weeks before their score is released: approximately long enough to run every possible combination of scores that will make you love or hate yourself, confident in your application or confident you will be a fantastic animal trainer for Barnum and Bailey (“I think I’d look GREAT in the tiger-tamer outfit, don’t you?!”).

4. Scores for the April 7^th exam will be released on May 9^th (rumor has it at 7 am), and can be accessed at: https://services.aamc.org/mcatthx/

5. If you took the exam on a different date, this table lists the expected release date: http://www.aamc.org/students/mcat/datesdeadlines.pdf

This week I was planning to start a three part series on getting a job after college; unfortunately, with <40 hours until my MCAT score is released I found everything I wrote sounded hollow and contrived. Clearly, my mind is somewhere else. Mainly, it’s wondering if my practice test scores or the nightmare I had last weekend (where I scored a 21 and had a camera-pans-out-to-girl-in-the-rain-screaming “why!?!?!” moment) are better indicators of what I actually achieved.

I say achieved, as opposed to “received” “got” or “earned,” because with the MCAT there is very much a feeling of one controlling their own destiny by overcoming something. The pre-med student is walking the fine line between optimism and realism. Realistically one knows ~51% of first time applicants will not be admitted to medical school. Optimistically one aspires to standing out from the crowd enough to be in the lucky 49%. Realistically one appreciates that it’s safer to rely on hard work than luck. Do I have whatever it takes, whatever combination of factors the admissions committee is looking for? There are barrages of never ending questions a pre-med can ask.

For my money, it all comes down to faith: faith in oneself. The sort of faith that is a combination of effort, hope, and awe. You put the effort in, you hope it is enough, and you are awed that if you are successful you will be joining the ranks of people who hone their craft to help make a difference in the world. I’ve seen many people go through this process, and I can say there are parts of it that are discouraging, but at the end of the day it’s worth it.

* Figure property of the American Association of Medical Colleges.

FACTS:
1. I have wanted to be a doctor since my freshman year of college, almost six years ago.
2. I have wanted to be an oncologist since my grandmother died of small cell lung cancer my sophomore year, and my father passed away from non-small cell lung cancer 13 months later.
3. I have worked as a research assistant/technician for almost two years, have first authored publications and had my research presented at three conferences.
4. Next year I will complete a master’s degree in molecular medicine.
5. Despite facts 1-4, which indicate I am an ideal medical school candidate, I live in perpetual fear I will not get into medical school.
6. Every med-school applicant brings a different combination of things to the table that make them unique and no two applicants are really comparable, but they will be weighed and measured against one another. The MCAT is one thing all pre-medical students have in common.
7. This blog is an exploration of the course of applying to graduate school, attending graduate school, applying to medical school, and -hopefully- becoming a doctor.
8. Sometimes the best people to ask about a process are people in the middle of it: if there are ever ANY questions I might be able to answer I’m happy to help. Students can be fantastic resources for other students!

It’s no exaggeration to describe the process of becoming a doctor as hell. As they should, the medical community only wants people who will bring dignity and compassion to the field. We’re lucky to be living in a time when the medical mentality has shifted from being an “old boys club” to a community of empathetic, passionate care-givers. In the truest sense of the word, if you’re going to go to medical school you have to show the admissions committee you’re willing to “be all you can be” (to borrow a phrase from the military).

As Saturday, April 7th approaches I’ve reached a critical point in the application process: taking the MCAT. I have 6 years of being pre-med behind me, and now all that stands between me and the realization of my goals is a five hour test and the physical application I submit in June.

Unlike the undergraduate student applicant, who plans to go to medical school immediately after college, the mature applicant has no wiggle-room on the MCAT. All the other factors that affect your application are set in stone: GPA, volunteering, publications, work experience, medically related experience. The post-grad applicants I’ve talked to also tend to have a strong sense identity associated with being a doctor. Most have worked in a hospital or research facility for a year or more, and they have envisioned themselves as doctors for so long that it has gone beyond being their chosen career- it is part of who they are. So how does this sense of “I am a Dr” translate into the application process, can a test really determine how well you’ll do in medical school? The American Association of Medical Colleges believes it can, and that is all the motivation the average pre-med needs. As my father would have said, I am about to go there, do that, and get the t-shirt.

Frequently Asked Questions (FAQ)

• Is the MCAT important? Massively. It is the test to end all tests. Students preparing for the MCAT tend to have little sympathy for students preparing for other graduate school exams because the MCAT is -in a premed’s opinion- longer, harder, and more all encompassing. Students studying for other exams give up free time to study; students studying for the MCAT give (or feel like they give) up everything that isn’t necessary for basic survival.
• Is it the determining factor in my application? It depends on the applicant’s strengths and weaknesses- conventional wisdom indicates MCAT score is equally weighted with the GPA; however, if there is a discrepancy between GPA and MCAT then it’s rumored most schools defer to the MCAT score (why not, it’s standardized whereas grades can differ between institutions).
• How long should I study? MCAT preparatory classes throw out 200 hours as the amount of time needed to reach your MCAT-potential. Of course, this varies with individual applicants. Study for as long as it takes you to become comfortable with the test and happy with your practice test score.
• Should I take a prep class? That depends on your financial ability, time commitments, and ability to self-motivate. Your best tools to prepare for the MCAT are good study materials and lots of practice.
• Should I take the practice tests? YES. The MCAT is tricky due to extensive subject material and format. You can’t sprint the MCAT, it’s designed to be a marathon so the more practice tests you take the more comfortable you become with the test style. I recommend investing in AAMC generated practice tests. They are the most similar to the real MCAT, whereas practice tests generated by other bodies tend to be more difficult and your scores on non-AAMC practice tests are less indicative of your likely MCAT score.
• What’s a good MCAT score? Again, it varies with a person’s goals. An acquaintance of mine who wants to go to a highly selective school as an out-of-state resident is determined she’s going to get a 34. For her this is a practical goal because she has achieved that score on practice tests. For most of us, that would be a dream score. The MCAT is scored as a forced bell-curve, the mean is set at an 8. This means the majority of applicants will score around 25. In 2006 the average applicant, according to AAMC, had an MCAT score of 27.6 and the average matriculant (those who were accepted and started medical school that year) had a score of 30.4.
• I’m taking the exam very soon and I don’t feel prepared, what should I do? Acknowledge first and foremost that the MCAT is one of those exams you will probably never feel completely prepared for. The more you study, the more you feel as though you could do better with a liiiittle more time. When you are down to a time crunch cover the aspects of the exam that are a) most important, and b) your weakest areas.
• What are the most important subjects on the MCAT? No one can predict what will be on future MCAT exams, but the content doesn’t tend to vary much from exam to exam. Currently the most tested areas are as follows. Biology: genetics, cell biology, hormones, autonomic nervous system, immunology, the muscular/skeletal system, and germ layers. Organic chemistry: biochemistry, reaction mechanisms, stereochemistry and isomerization, bonding/hybridization/stability. General chemistry: atomic structure, periodic trends, gases, acids/bases, equilibrium, thermodynamics. Physics: electricity & magnetism, optics, toque, waves, fluid, energy, dynamics.
• Any advice? Breath. Tailor your studying to your learning patterns, don’t try and change your study habits while preparing for the exam. If you learn better with pressure, so be it. If you study best at libraries then go to the library. If you need to yell and scream and become addicted to caffeine, it might not be considered “healthy” but taking the MCAT is a survival-of-the-fittest exercise so whatever it takes to get you there (provided it’s safe, legal, and not harmful in the long term) is what it takes.
• Did you take your own advice? I plead the 5th.