Perspectives On the Admissions Process

[SnowmanTheSWOMEN]

Hey all, since I have a lot of time on my hands now, I was doing some thinking and the topic of medical school admissions system came to mind. Different countries use different systems, and whether we agree with them or not, it has proven to work for (many of) those countries.

From where I come from, medical school entry is granted upon the student's ranking in a college entrance exam. Basically, graduating high school students who score very, very high on this exam (like, top 0.1%) get to go directly to medical school without having to go through undergrad, do the usual pre-med things, and complete interviews. The system seems to have worked out for the most part, but I do occasionally hear that doctors cultivated by such a system are regarded more or less as "robots" rather than empathetic caregivers.

I do have a bit of hindsight bias considering that I just prevailed through the Canadian admissions process. But personally, I have enjoyed this journey (albeit stressful) and would not trade this long experience for one sitting of an exam that dictates my entire career. My desire for medicine was consolidated by: going through undergrad, persevering through the MCAT, gaining diverse life experiences in the field of healthcare and more, maintaining good social networks that eventually lent it self to good LORs, writing essays that helped me to organize my thoughts and goals, and preparing for interviews which really taught me that a doctor is more than just a "mechanic for diseases".

So, what do other medical students think? If you could go back, would you be willing to go through the Canadian process again? I would also love to hear from international graduates who went through the direct entry route. I can definitely see the pros and cons of both systems. Personally, I prefer the Canadian process. 

 

 

 

[Snowmen]

I personally don't think that an exam alone is a good way to select applicants since an interview tells you a lot about someone, and especially MMI. On the flip side, I'd say that the need to absolutely select applicants with strong social skills perhaps is overblown. Sure, you need to weed out the ones that have no social skills whatsoever to the point of that being a personality problem. For the rest who are by definition average, I think empathy can actually be learned. This is all coming from someone who got in with average marks and a very high MMI score so hopefully I wont come across as biased.

This whole debate about empathy and what not reminds me of the other thread about medical students supposedly become less empathetic as they advance in their training. In fact, I do believe they become much more empathetic. The issue is that people are very quick to mistake sympathetic people with empathetic people. I would say that people actually tend to become less sympathetic and more empathetic which is a very significant distinction. Being sympathetic can cloud your judgement and is something that is a big disadvantage in medicine while truly being empathetic (ie: having an objective understanding of someone's emotions, experience and values) is not as flashy but is much more useful.

 

 

Also, I'd like you to change your username. Thank you.

[DrOtter]

hmmm I'm not too sure. I'm all for holistic assessment of applicants but this process is filled with subjectivity and lacking in transparency. Having gone through (successfully, thank GOD!) the admissions process both in Australia and Canada, I'm still on the fence about how I feel. In Australia, it was pretty much grades (either from high school or uni depending on the entry) + admissions test pre-interview, which I think offers some sense of control (vs. the seeming randomness of essays, ABS, and CASPer) and then candidates are selected using an interview. Canadians might say that this will disadvantage a lot of candidates who couldn't afford good schooling/test prep etc. but Australian schools also have different streams for rural/indigenous/low SES students that try to make up for that. The point is that applicants know with much higher certainty whether they'll get an interview or not. Another big difference in Australia is that people are asked to rank their schools to preference and they're only offered interview at the highest ranking in their list (provided that the school invites them, kinda like CaRMS, I guess). It reduces the number of interviews med schools have to do and waitlists (and the stress that comes with those) are non-existent in Australia.

With all of that said, I did enjoy the Canadian process in certain aspects - I got to tell my stories and my experiences, but it's still so arbitrary from the outside looking in! There are candidates out there who apply year after year with little to no change to their application with varying numbers of interviews and eventual acceptances. It's also so difficult for the applicant to know where they should put more work it. I really like how some Canadian schools like UBC, McGill, where they actually give out numerical scores of the file review to candidates they refuse - it gives the applicants a direction as to where they should improve. The fact that one can apply to and be considered for multiple school also means that schools get the same access to the amazing applicant pool (unlike the preference system in Aus).

TL;DR = holistic assessment in Canada is good. Lack of transparency is not.

[HongHongHong]

@DrOtter how competitive are admissions for Australian schools for local residents? I recall seeing some Australian schools advertising in UBC's student union building: it seemed a much more sure bet for admission if you ignored the $80K/yr tuition

 

Overall, I'm glad Canada isn't entry into medical school straight after high school. I didn't know I wanted to pursue this path out of high school, my grades definitely weren't strong enough, and I've heard about people who go into it so early and regret it due to how stressful it is. Personally I'm also biased against people with the doctor dream from a young age due to parental influence. My parents did that to me for another career path and it nearly sunk my grades in university as well.

[DrOtter]

1 hour ago, HongHongHong said:

@DrOtter how competitive are admissions for Australian schools for local residents? I recall seeing some Australian schools advertising in UBC's student union building: it seemed a much more sure bet for admission if you ignored the $80K/yr tuition

 

Overall, I'm glad Canada isn't entry into medical school straight after high school. I didn't know I wanted to pursue this path out of high school, my grades definitely weren't strong enough, and I've heard about people who go into it so early and regret it due to how stressful it is. Personally I'm also biased against people with the doctor dream from a young age due to parental influence. My parents did that to me for another career path and it nearly sunk my grades in university as well.

Australian schools are comparably competitive to Canadian for local students. Most people (without some sort of special pathways like rural/indigenous) get in with a 3.8+ GPA and at least an 80th percentile on the GAMSAT, higher for higher ranked schools. They're just competitive in slightly different fronts than in Canada, since they care less about non-academic pre-interview.

I do agree though that entry straight after high school is very soon. You're signing up for an incredible journey at a very young age. With that said though, in countries where this model exists, specialisation is usually less straightforward: e.g. In UK and Aus, medical graduates don't match into residencies right away. They instead "rotate" through different departments as interns for a few years before applying for training programs, usually 2 years for Family med, but this could be longer for more competitive specialties (EM, surg, derm) and a lot of people end up being hospitalists with no specialisation and very low salary (nothing compared to the consultants). I remember meeting a 40yo hospitalist who was still trying to get into an EM program... 

[hiheyhi]

@HeyMrSnowman This is the same system as where I am from as well (I'm assuming the Middle East?  ). I remember when I lived back home, those exams were very stressful. I had cousins that were aiming for Medicine, but ended up getting scores that put them in Engineering instead, a profession that they weren't passionate about but had to go with it anyways. I also think these scores are published publicly with your first and last name, and I hated that when I was in grade school, it always gave me anxiety . I personally don't like that system because it is a very one-way path. You either get it or you don't. I'm not that familiar with how it is now, but I am not sure if it gives mature individuals the opportunity to switch careers into medicine. I have the impression that it is a one-shot kind of deal and it's a bit unheard of for a 30 yo to make the switch. But I could be wrong because I'm not that familiar with how it is now (at least from where I'm from).

I do wish that Canadian schools were more transparent and a bit more forgiving for mature applicants.

In terms of transparency, I love how UBC and McGill provide scores if you get rejected, that way you have closure and know what you can work on. I also love when you kind of know the pre-interview evaluation because you can always try to improve one aspect if you don't receive an interview. This process is difficult and you need to be resilient and continue to improve yourself over and over again but what I personally find hard is that how can you improve yourself if you don't know why you got an interview in the first place or why you were unsuccessful after you interviewed. I'll give an example: last year I applied to Ottawa with the same exact application and the only thing that changed is my Casper (which I don't know how I did on it). I never got an interview last year but this year I did and I am so grateful for it. However, because I was unsuccessful this year, I am feeling a bit hopeless with being lucky enough to get an interview next year because I have no idea what their pre-interview evaluation is. I feel like it was just luck this year and it makes me feel so uneasy because am I going to be lucky again next year? (for reference, my wGPA for UO is not competitive for English stream)

In terms of forgiveness, I am mostly discussing mature applicants as myself. I found it very difficult for me to improve my GPA for schools like Mac and Toronto because 8-9 years ago, my first 2 years of university were terrible and no matter how many courses / extra years I did, my cGPA will never be on-par or nearly as competitive. Even if I do 3 more new degrees, Toronto will never take my wGPA because of a missing 0.5 credit in 1st year when I was 17. I'm lucky that my final 2-3 years are competitive for UWO, Queens and UO, but it would still be nice to have the chance to start fresh, especially for those who either had a rough UG or a career change. For example, I love that Calgary drops your earliest year after 10 years, etc or that Western allows you to do a special year after your degree. 

In summary, I wish the process was more transparent so you can truly try and improve on your application and a bit more forgiving so again, you can actually make improvements, changes, etc. 

But one thing that I do like about the Canadian system is the ABS, Western's ABS/essays, Toronto's essays, etc. I know they can be subjective, but I do think it is great that you're able to tell your story. It gives you the chance to shine when your other scores, like GPA, might not be as competitive. It gives you a tiny voice to explain yourself, your path and who you are through alllll these numbers and I think that is important in any application process, not just medical school.

[HongHongHong]

5 hours ago, DrOtter said:

Australian schools are comparably competitive to Canadian for local students.

That's hella competitive! Why are they taking international students (at what was advertised to me as a lower barrier)? 

[DrOtter]

1 hour ago, HongHongHong said:

That's hella competitive! Why are they taking international students (at what was advertised to me as a lower barrier)? 

Australian schools can charge internationals more (~100k/year). Same with Canadian schools here haha. 

Plus while Aussie students are guaranteed an internship after graduation, only the good internationals are retained while most go somewhere else or back home to practice. 

[bearded frog]

Yeah, some schools primarily serve international students for profit.

[ShadesofCyan]

I think this is such an interesting discussion. I was talking to a friend today about how odd it is that Medical School in Canada is considered an undergraduate program. I don't really understand why they are not requiring a degree before you enter medical school. I know some Canadian schools do require a 4 year degree but many do not. I think life experience and those extra couple of years can really help people become better physicians in the long run. It wonder if it is challenging for the very young students to really connect with their patients.

That being said medicine is such a long journey and for those who want to have a family it gets very complicated. I guess I can see both sides.

I just think the competitiveness in Canada is ridiculous and it seems like there are way too many qualified candidates for the amount of spots each year. This may be an unpopular opinion but I wish they would put the degree requirement back for all of the Canadian Medical Schools. I just think this would reduce the number of applicants and make things a slightly more even playing field. What do you think?

[Galaxsci]

20 hours ago, ShadesofCyan said:

I think this is such an interesting discussion. I was talking to a friend today about how odd it is that Medical School in Canada is considered an undergraduate program. I don't really understand why they are not requiring a degree before you enter medical school. I know some Canadian schools do require a 4 year degree but many do not. I think life experience and those extra couple of years can really help people become better physicians in the long run. It wonder if it is challenging for the very young students to really connect with their patients.

That being said medicine is such a long journey and for those who want to have a family it gets very complicated. I guess I can see both sides.

I just think the competitiveness in Canada is ridiculous and it seems like there are way too many qualified candidates for the amount of spots each year. This may be an unpopular opinion but I wish they would put the degree requirement back for all of the Canadian Medical Schools. I just think this would reduce the number of applicants and make things a slightly more even playing field.

Speaking as one of those "young" students, in the vast majority of cases, the age difference is irrelevant. The maturity difference between the average 21 year old (no UG degree) and 22 year old (UG degree) aside (which I would argue is negligible), it was very difficult to guess which students in my class were 21 and came straight from 3rd year and which ones were 23+ and had completed a master's degree or more. Of course, students entering in their late 20s or 30s were noticeably more mature on average and at a different stage of life, but I didn't notice any difference between any of the groups of students in their early 20s and it didn't seem as though people in my class noted much of a difference either. 

[ShadesofCyan]

@Galaxsci that makes a lot of sense. Thanks for your perspective. Age definitely doesn't always equal maturity and you are so right that an extra year in undergrad probably doesn't make a significant difference. I know I really appreciated the critical thinking skills and depth that some of my 4th year classes had but I'm sure that wasn't everyone's experience.