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Applying to medical school? How does your character stack up?

Outstanding MCAT scores and GPAs still count, but these days, proof of one’s compassion weighs heavily for admission

As a St. Olaf College student, Matt Majerus spent a good deal of time not only conducting research in biology and biochemistry but also hanging out at a nearby long-term care facility, volunteering his time and getting to know the residents.

He fondly recalls two avid gin players—and the strategy one employed to win: “She cheated!” he says, laughing.

A few years before, Majerus had lost his own grandmother to cancer. “No physician ever sat down with my family,” he says, to explain what she was facing. Ultimately, this Minnesota farm boy and science scholar realized that, as a doctor, “I could make a difference.”

Dilangani Boralessa—friends call her Dana—grew up in Sri Lanka, where, beginning at age 10 she accompanied family members who visited rural medical camps to provide basic health care.

“As I got older, I realized that I liked medicine and being able to interact with patients, usually people from medically underserved areas or people who couldn’t afford private health care,” she says.

Majerus, a first-year medical student, and Boralessa, a second-year student, reflect the new direction the University of Minnesota Medical School is taking in recruitment and education.

As a teenager growing up in Sri Lanka, Dana Boralessa accompanied family members on rural medical visits that fostered her interest in providing health care to underserved patients. (Photo: Richard Anderson)

As one would expect, their GPAs and MCAT scores are stellar—but it was their compassion, empathy, and personal commitment to caring for others that gave them a leg up on the competition.

And the process is competitive: Of the 3,212 applicants for the 2008-09 school year—the largest number in 20 years—just 281 students made the cut for the entering class of 170 on the Medical School’s Twin Cities campus. Of 1,413 applicants to the school’s Duluth campus, 83 were accepted and 60 enrolled.

Today, such personal traits not only provide the tipping point for admission; they’re also valued and honed throughout medical school. That will become even more ingrained as the Medical School adopts MED 2010, a new University-designed approach to medical education that promotes competency-driven learning and a flexible program more tailored to individual students.

“Medical schools nationwide recognize that patient care needs to change,” says Paul White, J.D., associate dean of admissions at the University of Minnesota Medical School. “Because patient care is placing much more emphasis on working collaboratively with other doctors, nurses, technicians, even social workers, at Minnesota we want to attract medical students who have demonstrated their commitment to patient care through prior contributions, especially clinical exposure.

“Also, our population has changed, with more individuals coming to this region from different countries and cultures,” White continues. “It’s important that our students be tolerant and respectful of these differences.”

Leaders at the Medical School’s Duluth campus, where the mission is to train family practice doctors to work in rural and Native American communities, share that philosophy.

“We’ve always looked for these essential qualities in our applicants,” says Lillian Repesh, Ph.D., associate dean for student affairs and admissions on the Medical School’s Duluth campus. “But now these qualities are front and center, so applicants, the community, our stakeholders, and our faculty know their significance. Science aptitude is very important, but these core values are even more important.”

Recruiting students

White and Repesh were among a group of Medical School administrators involved in revamping the admissions process in 2007. The task force quickly discovered a few surprises: Compared with 18 other medical schools with similar missions, the University of Minnesota Medical School demanded the greatest number of prerequisites.

“That could be a barrier to certain applicants who come from disadvantaged backgrounds or who have taken atypical pathways to medical school,” says Repesh.

In addition, surveyed applicants told the Medical School that the process was arduous, communication inconsistent, and the wait for a decision too long.

“We wanted to make the application process more user-friendly, more of a recruiting process rather than a weeding-out process,” explains Medical School Dean Deborah Powell, M.D.

In response, the task force honed the prerequisites: AP credits are no longer accepted; instead, higher-level courses or specific areas of study are encouraged. Now required are a course each in biology and chemistry, four in the life sciences, and at least one upper-level humanities or social sciences course. Courses in biochemistry, ethics, genetics, psychology, statistics, humanities, and social and behavioral sciences are recommended, as well as a foreign language, independent-learning coursework, and seminars involving small-group discussions.

Says Powell: “The revised prerequisites speak much more about the individual and the values that the Medical School holds, and they suggest courses and experiences that will satisfy or demonstrate those characteristics.”

In addition, the task force made changes that will result in quicker admissions decisions and improved communication with applicants.

Medical School associate deans Paul White, J.D., and Kathleen Watson, M.D., say new admissions standards reward such qualities as compassion, tolerance, and resilience. (Photo: Scott Streble)

Identifying key qualities

The process was further sharpened as the admissions task force focused on determining the essential and desired qualities of the ideal Medical School student.

“Every 10 years or so, it’s good to look at the prereqs,” says White, “but we needed to look at student qualities, too. We needed to streamline, simplify, and improve the selection process.”

The task force identified four primary qualities it was looking for in applicants: a commitment to improving the human condition, professional conduct, outstanding interpersonal skills, and dedication to lifelong learning.

“We’ve always recruited wonderful students and wonderful doctors,” says Kathleen Watson, M.D., associate dean for students and student learning. “What we hope to see now is more explicit evidence of these qualities—such as compassion, curiosity, tolerance, teamwork, scientific aptitude, resilience—as our students go through medical school.”

Meanwhile, it’s the Medical School’s job “to provide the learning opportunities and experiences that help students to become great physicians,” Watson says. “We are also preparing to cultivate these great qualities and allow their expression by demonstrating and communicating their value.”

White credits better-defined criteria with making the process faster and more efficient: The admissions committee spent 3,340 hours reviewing applicants for 2008-09, compared with 5,600 hours the previous year; and, according to surveys, students received responses sooner and communication improved.

And, despite the new focus on personal attributes, the MCAT scores and GPAs of this year’s entering class (49 percent of whom are women and 21 percent multicultural) are the highest ever.

MED 2010: Graduating lifelong learners

Traditionally, obtaining an M.D. degree has required a standard four years. For students entering in 2010 and later, the Medical School will be awarding medical degrees based on MED 2010, an initiative that tailors education to the individual student. To graduate, students must achieve these seven faculty-identified competencies—but they will be allowed to take more or less than four years to do it:

  • medical knowledge
  • clinical skills and patient care
  • systems of health care
  • professionalism
  • continual improvement of care through reflective practice
  • interpersonal and communication skills
  • scientific and clinical inquiry

Medical School leaders say they have adopted this new approach for three important reasons: First, technology and educational theory are advancing swiftly; the Medical School wants to be at the forefront. Second, health-care needs and delivery have changed and continue to evolve. And third, according to MED 2010 materials, “Our medical students deserve the most flexible and up-to-date education possible to develop a strong foundation as they become lifelong learners in their medical careers.”

Associate dean Lillian Repesh, Ph.D. (left), talks with Mae Bixby, a first-year medical student on the Duluth campus, about what to expect on a tour of six rural communities. (Photo: Dan Schlies)

The Medical School’s Flexible M.D. program—the first to be offered by a public medical school—helps lay the foundation for MED 2010. Begun in 2005, the program allows students to complete their medical degrees over three and one-half to six years, yet pay tuition for only 11 semesters. Students work with an educational enrichment committee to design their plans, which may include pursuing research, participating in health-care projects abroad, working in a clinic for an underserved population, or cultivating health-care policy changes.

MED 2010 will institute other changes, too: Throughout medical school, students will maintain an electronic portfolio that will allow them to demonstrate what they’ve learned in new ways. For example, rather than report on the number of babies delivered during an ob/gyn rotation, a student will be asked to write about what he or she observed, what was surprising, and what lessons he or she gained from the experience.

“We’re making our belief in the personal values that much more overt,” Powell says. “Students’ ability to communicate well with diverse groups of patients is paramount. You may know the facts and be able to hang the facts together well, but if you can’t build rapport so that patients trust you, what good is it?

“Ultimately,” she says, “patients are the ones who are going to take the meds or not, follow the nutrition and exercise program you’ve recommended or not, and make the lifestyle choices you’ve prescribed or not.”

For now, first-year med students are getting a feel for their new lives. As he prepared for classes to start this fall, Majerus summed up his philosophy: “Personally, I don’t really know what I’m in for. I just want to keep my eye on what all the studying is ultimately for—helping other human beings.”

By Karin Miller

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