Hedging Your Bets for Medical School Admission

As an internal medicine resident physician at Harvard Medical School and Brigham and Women’s Hospital, both in Boston — and as a premed tutor at Harvard — Ahmed Mukhtar Ahmed, MD, understands well the stresses of applying to medical school. He also has a curious mind and wondered how much variability there was in course requirements and recommendations at US allopathic medical schools. So along with several colleagues, Ahmed set about to find that answer.

The result is the recent report “Premedical Course Requirements in US Medical Schools,” published in the Journal of the Association of American Medical Colleges (AAMC). What Ahmed and colleagues learned is that, of the 157 US medical schools, no two are alike when it comes to required or recommended coursework. With the average student applying to 19 schools, according to AAMC, that can make things challenging.

“It’s essentially a ‘hedge-your-bets’ approach,” said Ahmed. “It can create challenges for students on what to take, how many credits, and whether to consider pass/fail, online courses, or community college courses. It’s very complicated.”

This can create challenges for college advisors, too, said Ahmed.

“How do you give advice on what courses students should take, especially if they’re outside the typical majors for premed?” he asked. “Those courses aren’t trivial — they’re among the top criteria admissions officers use when considering who to offer a second interview, and ultimately, admission.”

The new study sheds light on an issue worthy of discussion, according to Ahmed. “We think there could be benefit in understanding what the floor is,” he said. “Ideally, this will ensure that premed students are equipped to be competent medical students.”

Navigating a Confusing Landscape

According to Tami Levin, director of Premed and Applicant Resources at the AAMC, the fact that medical schools all have their own requirements is by design.

Ahmed Mukhtar Ahmed, MD

Ideally, this will ensure that pre-med students are equipped to be competent medical students.

“We don’t dictate or prescribe requirements for any of our med schools,” she said. “Each is unique. We often tell applicants and advisors to pay attention to the mission of the schools to determine which look like a good fit.”

The AAMC provides an annually updated report (the Medical School Admission Requirements) on its website, which details the coursework required by all medical schools. The site includes a variety of tools for premed students, like worksheets to track coursework and plan for interviews, and twice each year, students can attend a virtual medical school fair.

“This allows students to speak directly to admissions officers across the United States and Canada,” said Levin. “There are also informational sessions on a variety of topics related to med school, the MCAT, and how to prepare for interviews.”

While there are no official, specific standards or guidelines to premed student course selection, Levin said there is generalized commonality. Courses such as upper-level biology, chemistry, and math all fall into that category, and on the medical school admission requirements site, students can also find information on how to best fulfill those classes. This can include specifics on what types of courses qualify, from AP classes to pass/fail, online or community college.

“We try to update our resources and have a variety of free or low-cost materials available with current information and policies available to premed students,” Levin said.

She added that all students should have access to good advisors and advisory materials. David Lenihan, CEO of Ponce Health Sciences University, both oversees a medical school and is a father to two sons just out of medical school. He agrees with Levin that there are certain courses that all premed students should aim to take, regardless of where they hope to attend med school.

“Classes like organic chemistry, physics, and biochemistry will provide you with a foundation that will make medical school easier, even if they’re not specifically required,” he said. “You’re going to enter med school and have all these difficult courses thrown at you at once. If you have a basic understanding of the Krebs cycle, for instance, you’ll be able to spend more time on physiology, if that’s where you’re struggling.”

Nikolas Grotewold, a medical school admissions expert at Inspira Advantage, said that in helping premed students, advisors must keep multiple factors in mind. “They must account for factors like foundational knowledge, course difficulty, and medical school prerequisites,” he said. “Additionally, they keep MCAT [medical college admission test] preparation in mind, recommending classes what will help them prepare for the test. In a nutshell, by collecting data from admissions teams and past students, advisors guide premed students toward a course schedule that would maximize their chances of success in med school, and a career after that.”

Premed students also strive for a high grade point average amid intense academic difficulty — but this can complicate the course selection process. This is where advisors can help students design a strategic course schedule, including challenging coursework, while also allowing students to present as top candidates.

“This is why each school has different advising recommendations, and each undergraduate school may structure their curriculum differently,” Grotewold added. “Moreover, advisors may know insider details about a handful of med schools, helping them recommend to students schools where they have their best shot at acceptance.”

Another way to go about it, according to Jillian Ivy, CEO and founder of Ivy League Essay, is to aim to match the requirements at the most competitive medical schools out there. “If you set the bar high for your premed courses, you’ll be qualified for any school,” she said. “All medical schools are competitive, and they want to see that you’re doing well in difficult courses as a baseline.”

While that is one approach, Lenihan likes to see students stand out in other ways, including communications skills. “All deans will tell you that students are brilliant in their test scores, but that many don’t have people skills for communicating with patients,” he said. “This is a priority that’s starting to pick up in the health sphere because it can impact patient outcomes.”

Jillian Ivy, CEO and founder of Ivy League Essay

All medical schools are competitive, and they want to see that you’re doing well in difficult courses as a baseline.

To improve those soft skills, Lenihan recommends taking public speaking courses so that you don’t come off overly nervous in a school interview. “If you’ve engaged in your interview — plus meet all that school’s requirements — that’s a huge plus,” he said. “Demonstrating an ability to focus is good, too. Playing a sport or taking courses like philosophy can boost your focus and teach you how to lose and pick yourself up. These skills can set you apart.”

One thing everyone can agree on is that tracking premed and applying to medical school is difficult. For his part, Ahmed said the takeaway from his study is recognition that the landscape is ill defined and confusing.

“We’re asking students to identify as premed, while also thinking about what schools they should apply to,” he said. “Students should work with their advisors on crafting a premed journey that will allow them to apply to as many schools as they’d like. But also recognize that worrying about a setback in one course is shortsighted — plenty of med schools might not even expect that course. Take it, even if it’s challenging, and you’ll still be a fine candidate.”