All Posts Tagged With: "med school"
Rejects ‘r us
One student’s story about not getting into his dream program
Microscopes. Lab coats. Dead bodies. What’s not to love? Yes, I’m talking about the perfect pre-med program—in this case, health sciences at McMaster University.
In my last year of high school, when filling out university applications, health sciences at McMaster seemed like a perfect fit. I knew that after my undergraduate degree, I wanted to study medicine, and McMaster’s program has all the prerequisites built in. It gives students lab experience, and it’s focused on biology, my favourite subject area.
The more I read about the program, the more I wanted in. Health sciences at McMaster was my first-choice program. But I knew the odds. A minimum 90 per cent average is required for consideration, but in order to be competitive you need to be in the low 90s at the very least.
Med schools across Canada claim they’ll consider any undergraduate degree—meaning, it doesn’t matter if you have a degree in biology, anthropology, engineering or drama. It’s your GPA that really counts. Most med schools still have prerequisite courses, like organic chemistry, microbiology and physics. You can apply to med school with a music degree, but you still need to have all of those mandatory courses. The beauty of McMaster’s health sciences: after completing the program, you have all the necessary prerequisites to apply to any med school across Canada.
Oh, there’s also the fact that Mac students get to experiment with cadavers. Seriously.
A 90+ average isn’t the only thing you need to get in. There’s also the mandatory supplementary application—essays and personal questions, including a few, well, odd ones. One asks, “What’s one extracurricular activity that’s important to your sense of self and why?” There’s only one thing worse than a meandering, open-ended, self-exploration kind of question like that. And that’s question No. 2: “What is the one question that shouldn’t be asked and why?” (I knew instinctively not to write, “Have you accepted Jesus Christ as your personal Lord and Saviour?”)
Unlike with real estate, when it comes to choosing a university, location isn’t the most important criteria. Sure, it matters. But when I decided health sciences at McMaster was my first-choice program, it wasn’t because it had the most convenient location. After all, I live within 15 minutes of the University of Waterloo and Wilfrid Laurier. But health sciences at McMaster was still number one. It was meant to be.
Demand growing for cadavers in med schools
“If you make mistakes, that’s fine. Your patient’s not going to complain.”
Colour-coded denim cloths cover the row upon row of black body bags atop cold metal tables. Blue means a body that eventually will go into a common grave. Tan, the family wants those remains back for burial, eventually.
These are bodies donated to science, awaiting one of the most sensitive rites in becoming a doctor. Before first-year medical students lay their hands on the living, they learn anatomy from the dead. Week after week, for six months, teams of students will file into in a laboratory at Georgetown University to slowly take apart “their” body.
First goes the skin on the back, peeled away from the yellow globs of fat that made up what in life someone may have called love handles. They lay bare the spinal cord and marvel at how its lower roots resemble the tail of a horse.
Carefully probing a lump inside one chest, a team unearths what at first looks like a metal button — a port through which this man once received chemotherapy. The room quiets as students unwrap the protective covering over each hand. One torso, they quickly learn, looks pretty much like another. But a hand is unique, somehow more intimate, as they hold it with their own blue-gloved hands. Many of the women’s nails still bear polish. One year, shockingly, students found a wedding ring.
“You will be working with somebody’s grandmother, father or wife,” Dr. Carlos Suarez-Quian tells his 200 students before they unzip those body bags for the first time. They’re beginning a balancing act: How to steel their emotions so they can help people, without losing their compassion. Dissecting cadavers is an evolving tradition. No, sophisticated simulators and the plastic-infused organs of museum exhibits can’t replace seeing and touching and lifting real bodies. In fact, demand is growing for whole-body donations.
What’s changing is how they’re used. Nearly one-third of medical schools have begun integrating nuts-and-bolts anatomy with clinical training spaced throughout their first year. That means Georgetown students dissect the heart, for example, the same week they begin learning how to tell the “lub-DUB” of a healthy heartbeat from the “lub-SHOOP” of a blocked valve.
“There’s a very big difference between talking about chromosomes and having your knife in fat,” says student Sarah Buchman of Bethesda, Md., as she eases through fat that, yes, looks like the squishy goo encountered on raw chicken.
Let’s all play doctor
Do you have what it takes to get through the Multiple Mini Interview?
In the late 1990s, medical faculty at McMaster University in Hamilton were growing increasingly frustrated with the interviews used to evaluate medical school applicants. Even the most conscientious interviewers, it seemed, were biased, and there was often no correlation between the interview process and the subsequent performance of students. “The way we were admitting students was approaching being unethical,” explains Jack Rosenfeld, a professor emeritus in pathology and molecular medicine at McMaster. “The interview process was letting in people who should not have gotten in and excluding people who should have.”
So Rosenfeld and his colleagues proposed a radical new system called the Multiple Mini Interview (MMI). Instead of rattling off prepared responses to typical interview questions, applicants would have to work through 10 to 12 eight-minute stations where they’d respond to carefully scripted actors, tackle ethical dilemmas or try to solve hands-on problems—all under the watchful eyes of a group of interviewers.
The MMI was a success: a 2004 study published in the journal Medical Education found that it succeeded in diluting the effects of interviewer bias and provided valuable insights into an applicant’s abilities. A 2007 follow-up study found significant correlations between MMI results and later performance on clinical clerkships and national licensing exams.
Now, five years after McMaster implemented the MMI—in the face of aggressive resistance from the health care establishment—12 of Canada’s 17 medical schools have adopted the practice. In fact, the MMI that McMaster pioneered has spread to universities in England, Australia and New Zealand.
How applicants are judged remains a closely guarded secret. Medical schools provide little information on how to prepare, and at most universities anyone taking the MMI is required to sign a confidentiality agreement. Med schools are serious about keeping the mystery in how the MMI works; one applicant who snuck into a training session for judges (specific questions were not discussed) was banned from applying for seven years.
Happily, Maclean’s is under no such restrictions. We spoke to medical school faculty, successful and unsuccessful applicants, and people who served as MMI judges to find out what happens during the interview process—and what kind of person med schools are looking for.
Next: How to prepare
Canada increasingly training its own doctors, finds report
When trained domestically, graduates are more likely to stay in the country
Canada is becoming more self-sufficient when it comes to its supply of doctors, a new report suggests.
Foreign-trained physicians practising in Canada make up a smaller proportion of the country’s doctors than they used to, says the report from the Canadian Institute for Health Information.
The number of internationally educated doctors grew between 1972 and the late 1980s, reaching a plateau of 13,500 that has held ever since.
Compared to the total physician workforce, however, there has been a decline, the report says: from a peak of 33.1 per cent in 1976 to 22.4 per cent in 2007.
The decline comes as physicians trained in the U.K. and Ireland in earlier decades age and retire, and as fewer new doctors who trained beyond Canadian borders begin practising here.
The percentage of foreign-trained doctors has dipped across all provinces and territories, though Newfoundland and Saskatchewan have the highest proportion and Prince Edward Island and Quebec the lowest.
“So what we’re seeing is that overall, Canada is training more people locally,” said Yvonne Rosehart, program lead in Health Human Resources at the institute’s Ottawa office.
Training physicians domestically is a good long-term strategy because graduates are more likely to stay in the country, she noted.
The report also says more than one-quarter – 27 per cent – of the country’s foreign-trained doctors actually grew up in Canada.
Doctors who were not raised in Canada and did not get their medical education here made up only 14 per cent (plus or minus 0.8 per cent) of the total number of doctors in Canada.
Regardless of national origin, doctors who studied abroad got their medical education from a wider array of countries than in the 1970s.
“We used to find that the majority of internationally trained physicians were from the U.K. and Ireland. Now, that’s not the case and they tend to be from more developing countries,” Rosehart said.
“We’re really seeing it go from OECD (Organization for Economic Co-operation and Development) or British-centric to more of a global recruitment.”
Hoping to get into med school?
Don’t be born in Ontario
For med school hopefuls, Ontario might seem like the perfect province to live in.
There are 17 med schools in the country. Six of those are in Ontario, more than any other province. But as I recently discovered, being born in Ontario is actually a huge handicap.
Most med schools prefer applicants from their own province. It makes sense: if you train local doctors, you produce local doctors. It’s not unusual to reserve 85 percent or even 90 percent of the available seats for in-province applicants. Most med schools even have higher entrance requirements for out-of-province applicants.
Everyone likes their own brand.
Except for Ontario. Not a single med school in Ontario reserves spots for Ontario applicants.
On the surface, the Northern Ontario School of Medicine and the Schulich School of Medicine & Dentistry at the University of Western Ontario might seem like exceptions to the rule. On it’s website, Northern says that it encourages applications from “students who are from Northern Ontario and/or students who have a strong interest in and aptitude for practicing medicine in northern urban, rural and remote communities.” Western Ontario gives special consideration to applicants from “rural/regional communities in Southwestern Ontario.”
But neither of these med schools actually reserve spots for in-province applicants. Not to mention, those “rural and remote” communities that Northern Ontario mentions could actually be anywhere across Canada.
McMaster’s policy is a bit more complicated. They don’t actually reserve med school spots for in-province applicants. Instead, they award 90 percent of interview positions for Ontario residents.
Yeah, I know. I had to read that twice, too.
It means that once you reach the interview stage, it doesn’t matter which province you’re from.
Even if McMaster offered a genuine advantage to in-province applicants, it wouldn’t make much of a difference anyway. With over 4500 applicants and a success rate of 4.9 per cent in 2006/2007, getting into McMaster is like winning the med school lottery.
