February 25, 2014

The Gap Year for Pre-Meds

The gap year is often used by premeds to bulk up their application: study for the MCAT, retake the MCAT, raise the GPA or finish prerequisites. In addition, it could be used as a time of reflection. Is med school really for me? I feel like a lot of premeds start college with a self-ultimatum of getting accepted into medical school and when they're finally done with undergrad, they realize that they want something different. Maybe the past 4 years of science was enough and they are tired of science, or the motivation to becoming a doctor is no longer there, or they are simply not willing to work that hard and dive into a career that they are not really sure about, but considered it because others are doing it.


In my situation, all of the above applied. I was sure of wanting to go to medical school until I did not get accepted into medical school. Reflection was good. I had lost perspective after graduating with a degree in biology, which is pretty much worthless (literally) unless I did apply to some graduate or professional program. Of note, I was not interested in becoming a grade school teacher.

During my interviews, I was often asked about what I did with my year off after graduation. I personally think that there is nothing wrong with just "relaxing", however, my time is perceived to be more meaningful if I could hold a conservation with an interviewer regarding this topic for more than 2 minutes. For those in a similar situation, please consider the following.

Food for thought:

  • Graduate Degree
Of course, I would not suggest applying and obtaining a graduate degree just to make your application "look better" because you will probably be miserable going through it, however, for those interested in dual degrees (MD/MPH, MD/MS, MD/MBA), now may be a good time to start. Besides MD/PhD which tacks on an additional 3 years to a regular MD or DO degree, an MPH, MS and MBA degree takes less time. Every school has a different routine they follow, but the latter dual degree options usually adds 1-2 years to your undergraduate medical education. Since you have a gap year, why not start? I would, however, do heavy checking before starting to make sure where ever you decide to apply to medical school will accept transfer credits. Also beware that most schools require the GRE as an entrances criteria versus the MCAT, choose wisely.

  • Continue Your Edumacation 
First of all, the start of a medical career is the start of a journey that will always involve learning. I believe that you would be doing yourself a disservice to go to medical school if you think learning is a boring, non-gratifying chore. Thus, taking classes out of enjoyment during your off year can only boost your GPA (hopefully) and make your application look better. There are those who've already taken all the pre-med requirements and already have a pristine GPA so this may not be the best route.

As for me, my GPA was already a 3.9 at the time of graduation, however, I majored in biology and did not get the chance to take any social science classes. At my community college, I took intro to psychology and intro to sociology. I have to say that I really enjoyed the study of human behavior. It is such a refreshing contrast from cells, tissues and action potentials. The topics studied popped my "medicine is purely science" bubble. I realized that people are just as susceptible to mental illnesses as to physiologic diseases. The human brain is the most powerful organ and is also potentially the most dangerous one. It is capable of changing who we are and what we will become.

  • Healthcare Job / Clinical Experience
In the 21st century, the idea of wanting to be a doctor is not sufficient to gain acceptance to medical school. Applicants with a perfect GPA and a solid MCAT score may not always, by default, get an interview invite. Not only does working in a healthcare setting look "good" on your application, it will hopefully, affirm or rule out medicine as a career.

Considering that a majority of premeds are in school, finding a job in this setting can be difficult. It's unlikely that you'll be certified to work as a medical assistant, technician, or EMT/EMS. In the recent years, the position of a medical scribe has really picked up pace. The job description of a scribe includes documenting for the physician or other healthcare providers such as a nurse practitioner or physician assistant. Instead of having the physician do the chart, the responsibility is transitioned to the scribe so that it can be done real-time.  In addition to documenting the history and physical, scribes also take part in documenting medical decision making, adding in differentials, final diagnoses along with the treatment plan. Traditionally, scribes are most often utilized in emergency rooms because of high patient volume. However, with the mandate that all physician offices need to convert to Electronic Health Record by 2015, scribes are not going away anytime soon despite the tightening restrictions set out by The Joint Commission.

Currently, there are 2 main routes to this job: getting hired through a scribe company such as ScribeAmerica and PhysAssist Scribes, or obtaining employment by a physician directly. With reference to pay, scribes employed directed by a physician tend to make more than those employed by a scribe company. Most scribe companies have their own required training program that newly hired scribes must successfully complete before working solo in the hospital.

The advantages of scribing are endless. There isn't a better job to introduce you to medicine. Since the scribe goes everywhere the physician goes, you will get to see all the spectacular not-so-glamorous side of medicine. This job is so much better than shadowing a physician because you are actually part of the work flow and it makes you feel somewhat useful.

I first started working as a scribe during my junior year in college. I was employed through a scribe company and worked for huge ER physician group. I traveled amongst 4 different ERs depending on my schedule. Despite the odd hours ranging from 9-12 hour shifts and long nights (graveyards), I loved my time in the ER. I felt like a sponge every time I go to work. I get to see physician-patient interactions, medical decision making, and think that I'm helping out in some minuscule way. I did work for a level II trauma center so there was ample opportunity to see traumatic injuries from high falls, motor vehicle accidents, motorcycle accidents, auto vs pedestrian, infections, gun shot wounds, myocardial infarctions (heart attack) and strokes.

Bottom line. I believe this type of job looks good on paper and is even more impressive when you can make it applicable to your interview. Of course, if scribing is not a viable option, I would still opt in for shadowing. Just imagine this question looming over your head, "how do you know you want to go to medical school, spend the next 8 years studying and eventually become a doctor if you have not been part of a clinic or hospital microcosm?"


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