Boromir’s right about taking the MCAT. Which is why we recommend taking your time scanning the reviews posted on Amazon.com and the Student Doctor Network to decide which MCAT prep books are best for you. I’ve written my own reviews of the MCAT prep materials by Examkrackers and the Berkeley Review.

How do I know what the best MCAT prep books are for me?

Each line of books has unique strengths and weaknesses (i.e. depth of review, cost, emphasis on content vs. practice, similarity to the actual MCAT, etc.). It’s not a one-size-fits-all purchase pre-med students are making here. And that’s why we put this list together: you deserve to go into the MCAT with confidence that your books helped, not hurt, your score.

For some pre-meds, there’s a lot of value in picking and choosing from different MCAT prep companies, depending on where your weak spots are and how much time you have to prepare. That’s what I did. I was especially weak in verbal, so, although I went with the TBR full set, I also sprang for the Examkrackers 101 Verbal Passages and the Kaplan Verbal Review. And I’m glad I did, because in a month’s time, I went from getting consistent 8′s to consistent 12′s on practice verbal CBTs, and ended up with a 12 on the real thing.

FYI, when you click on the links below, it’ll open a separate window on Amazon.com. Nothing shady or spammy.

KAPLAN

Kaplan MCAT Practice Tests, 6th edition, $23 used
Kaplan MCAT Comprehensive Review with CD-ROM, 1088 pages — $9 used
MCAT General Chemistry Review, 320 pages — $20 used
MCAT Organic Chemistry Review, 320 pages — $21 used
MCAT Physics Review, 576 pages — $20 used
MCAT Verbal Reasoning and Writing Review, 344 pages — $15 used
Kaplan MCAT 45: Advanced Prep for Advanced Students
Kaplan MCAT in a Box

THE BERKELEY REVIEW

(I’ll share a pre-med trade secret here. The Berkeley Review materials are the toughest MCAT prep materials to get your hands on. What? I can only get them by mail order? What century is this again? You can try Amazon, but they’re hard to find there…took me two weeks to get my books from TBR.)

EXAMKRACKERS

Examkrackers MCAT Complete Study Package (5 books) — $90 used
Examkrackers MCAT101 Passages in MCAT Verbal Reasoning — $24 used
Examkrackers: 1001 Questions in MCAT in Physics— $18 used
Examkrackers 1001 Questions in MCAT Chemistry— $18 used
Examkrackers: 1001 Questions in MCAT Organic Chemistry— $18 used
Examkrackers 1001 Questions in MCAT Biology Questions — $18 used
Examkrackers MCAT Audio Osmosis with Jordan and Jon, $169 used
Examkrackers MCAT Biology-$18 used
Examkrackers MCAT Chemistry-$18 used
Examkrackers: MCAT Organic Chemistry-$18 used
Verbal Reasoning & Mathematical Techniques (Examkrackers MCAT)-$12 used
examkrackers 16 Mini-MCATs (Examkrackers MCAT Manuals) $16 used

PRINCETON REVIEW

MCAT Workout— $10 used
MCAT Biology Review— $17 used
MCAT Elite 45— $19 used
Cracking the MCAT, ’11-12 Edition, 1080 p — $1 used
MCAT Physics and Math Review, 512 pages — $18 used
MCAT Verbal Reasoning & Writing Review-$11 used
MCAT Physics and Math Review-$17 used
MCAT General Chemistry Review-$14 used
MCAT Organic Chemistry Review-$17 used
Hyperlearning Mcat Science Workbook (2009 Edition)$48

NOVA

The MCAT Physics Book— $28 used
The MCAT Chemistry Book— $28 used
The MCAT Biology Book — $28 used

BARRON’S

Barron’s MCAT with CD-ROM-$26 used
Barron’s MCAT Flash Cards-$12 used

STUDENT DOCTOR NETWORK

The Official Student Doctor Network MCAT Pearls (paperback) $180 used
The Student Doctor Network What Every Doctor Should Know… But Was Never Taught in Medical School $85 used

THE GOLD STANDARD

The Gold Standard MCAT with Online Practice MCAT Tests- $45 used
The Gold Standard new MCAT CBT Deck of Flashcards, 2011 Ed.$10 used
The Silver Bullet: Real MCATs Explained w/ Verbal Reasoning Prep- $12 used
The Gold Standard MCAT Prep on 16 DVDs-$200 used
Gold Standard MCAT Prep Kit w/ EK and AAMC Test, 2010-2011-$320 used

IVYHALL REVIEW

MCAT Verbal: The Complete Comprehension Program, 416 pages — $99

MCGRAW-HILL

The New MCAT with CD-Rom, 1st Edition, 1,120 pages — $65

You might also want to check out my recent post, “What’s a good GPA/MCAT combination for acceptance into med school—3.7/32?” The point of this post is that having good stats (GPA/MCAT), while not decisive in and of itself, is pretty critical. And I stand behind that. But while med schools love good numbers, they’re also looking for a packagedeal: an applicant who’s well-rounded, with stellar references, a “balanced” MCAT score, good EC’s, and a successful personal interview. And it doesn’t hurt to have some kind of unique attribute, honor or experience that helps you stand out from the crowd.

Is there a designated GPA I can’t fall below?

It depends on the school. Some will indeed reject you if either your GPA or MCAT scores fall below a certain threshold. What’s more common, however, is deriving a set “value” for your grades plus your MCAT. You can get into medical school with numbers a couple of points lower than the above combination (3.7/32), but it will only happen if the other parts of your application package and your interview outweigh the subpar numbers.

Just for fun, let’s look at a few schools. Here are some known for a strict adherence to statistical purity: Washington University, Ohio State, University of Virginia, University of Chicago and University of Michigan. A lot of these fall under “urban legends,” as they’re based on anecdotes rather than empirical data. I could name a whole host of other schools as well, but I don’t know if it would do you a lot of good.

That’s because no school is going to say they want you just because you sport a tantalizing GPA number. On the flip side, there are very few schools that would reject an applicant who’s stellar in every other category simply because his or her GPA falls short.

Broadly speaking, apply broadly

Let’s say your GPA is right on the line, yet you fall within the “prescribed” range of one of these medical schools. If they already have enough applicants that look just like you, you probably won’t be considered. Which is one reason to forget applying to schools you have no business applying to. And apply broadly to a range of schools. The odds are stacked against you getting into medical school, no matter who you are. While you can unstack those bricks with great stats and an impressive application package, another strategic way to increase your chances is by applying to a few less competitive schools.

How many schools to apply to?

A lot of pre-med students I’ve known set a limit of 10-15 schools to apply to, and then shoot pretty high, filling out their list with the elite schools they’re dying to attend. That’s a risky strategy, and one that may not pay off. Even if you’re an excellent candidate, ask yourself this question: “What happens if I don’t get a bite from any of the schools I apply to?” Because that’s reality for half of all applicants every year, and if it becomes a reality for you, you’ll have to (1) go back and strengthen your application; (2) apply again; (3) wait for at least a year for another chance; and perhaps (4) give up on your medical school dreams.

Don’t put yourself in that position. Cast a wide net when you apply! Submit 20 or more applications, and again, target a range of schools.

MCAT leverage

Here’s another fun fact: some schools will consider only your highest MCAT score, even if you take a more recent one and bomb it. That’s giving you a bit of leverage, and makes it easier to commit to a second time, knowing the risks won’t outweigh the benefits. Here are a few I’ve heard of: NSU, Campbell (opening in 2013), University of New England (D.O.), Kansas City University of Medicine and Biosciences, Lake Erie College of Osteopathic Medicine (biggest class of any U.S. med school), and Nova Southeastern University (D.O.). There are others, so if you have some M.D. schools you know fit this profile, let me know! I’m not trying to create an end-all and be-all list, but it’s always nice to know these flattering facts about schools where you may or may not want to apply.

No one wants to hear this, but there are applicants with a 4.0 GPA and 44 on the MCAT that don’t get accepted to medical school. So don’t let up on your GPA, and don’t assume it doesn’t matter, because it does. And will. There’s no getting around it!

You may want to check out these posts:

How do I pay for medical school? What can I do to reduce my debt?

What’s the best MCAT prep course—Princeton Review, Kaplan, Altius, Examkrackers, Berkeley Review…?

Does failure to match on Match Day mean I’m out of luck in the national residency Matching Program this year?

Can I still get into a residency program if I don’t go to a top-tier medical school?

“Golly. Kaplan or Princeton Review?”

In any given year, between 70 and 80% of MCAT takers enroll in a formal MCAT prep course. In this post, I review the courses offered by the two most popular test prep companies, Kaplan and The Princeton Review.

Decisions, decisions….

The words they use may be different, but every Kaplan and Princeton Review recruiter is going to try and convince you of  three things:

1. The MCAT is tricky and terrifying, so you need serious help to prepare
2. Medical schools care about your MCAT test score a ton, so you had better not screw this up
3. How absurdly high their companies’ instructors scored on the MCAT

You’ll notice that none of these tell you anything about why someone should choose one MCAT prep course company over another. They’re focused, instead, upon manipulating your fears about the MCAT and getting you to sign up right then and there. That doesn’t mean that either of the courses are bad by any means, but it does mean that ambitious pre-meds need to do some digging on their own (reading this page is a good place to start) to find out what distinguishes the MCAT prep giants from one another.

Now for…

The B A S I C S

The Princeton Review MCAT Prep Course

Reviews of The Princeton Review’s 3-month MCAT prep course are positive on the whole. I occasionally encounter students who complain that their instructors were weird or condescending, but that’s rare and it’s the risk (albeit small) you run when signing up for any prep course. Students tend to speak very positively about the number of class hours and the breadth of their study materials with The Princeton Review as well.

Class Time and Practice Tests

The main classroom TPR offer comes with 42 class sessions and 20 one-on-one office hours with an instructor, who is on hand to help you work on problem areas or questions you don’t understand. That comes out to about 105 hours total, which is more than any other MCAT prep course on the market offers. Instruction is offered by a team of certified instructors, all of whom are considered “subject experts.” Also included in the normal course are 19 full length practice exams, including the 8 official CBTs from AAMC. The rest are created by TPR. A typical semester-long course meets 3 days per week for 2 1/2 hours per class session.  The cost is $1,999-$2099, depending on the location.

Extras

•  You get five Diagnostic Exams to assess your strengths and weaknesses in the five different MCAT subjects, plus a Reading Comprehension exam.
• A recent addition to the TPR classroom course is its new “Amplifire” online workbook, which integrates and complements the practice material you get with the TPR MCAT book set. More on this below.

Kaplan MCAT Prep Course

Kaplan’s MCAT prep course is probably the most popular choice for pre-med students, if only because of Kaplan’s name recognition in the test prep industry. It simply has more courses available in more cities than any other test prep provider. So, there’s actually a pretty good chance that Kaplan is your only option for a live MCAT prep course. Like TPR, reviews of Kaplan courses are positive as well, although I think certain types of pre-med students respond better to Kaplan than others.

Class Time and Practice Tests

Like TPR, Kaplan’s live MCAT prep course is typically spread over a semester with 2-3 hour class periods 2-3 days per week. In that time, you’ll have 54 classroom hours and 32 hours for practice test taking. Kaplan’s courses come with a “higher score guarantee” so you can repeat them at no additional cost within 2-3 months of your first attempt. Kaplan’s courses also come with 19 full-length practice exams: the 8 from AAMC and 11 of Kaplan’s own.

Extras

• When you sign up for the Kaplan course, you get access to QBank, Kaplan’s online practice question database. It has 11,000 practice questions for you to arrange to take on your own.
• Kaplan has several unique options and services, but they’re mostly sold separately. More on this below.

Comparing the two…

Practice Tests and Books

Both of these well-respected courses come with access to all 8 AAMC computer-based full-length MCAT tests. These are the best indication of what to expect on the actual MCAT. The remaining 11 tests as part of each course were created by Kaplan and Princeton Review, respectively. Students are almost unanimously in agreement that TPR’s MCAT practice material is better than what you get from Kaplan. That’s because Kaplan’s tests and passages are not particularly reflective of the actual MCAT question style. In my estimation, they over-emphasize memorization and calculation, and many of the reviews I’ve read by other students express similar feelings. TPR’s certainly aren’t the best on the market (I’ve written more about the various brands of MCAT CBTs and how to use them here), but they’re pretty well respected.

TPR is also known for having a better line of MCAT prep books. They’re more in-depth and they have more helpful review sections. I used a Kaplan book for about a week, until I realized the review questions at the end of each chapter were nowhere near as challenging or tricky as what I’d come across with the materials from Examkrackers and Berkeley Review. (If you’re thinking about supplementing your prep with either of these book brands, I’ve written reviews of both.)

Edge: Princeton Review

One-on-One Tutoring

The Princeton Review MCAT prep course comes with 20 hours of personalized tutoring; Kaplan’s doesn’t come with any. Granted, instructors are able to answer your questions in class, but if you’re looking for some real time-intensive help, you’ll have to buy an extra plan with Kaplan (MCAT Advantage Plus). Kaplan also sells tutoring hours separately, however, at roughly $185/hr. when you buy them in bulk. Yikes.

Edge: Princeton Review

Online Tools

Up until this year, Kaplan had an overwhelming upper hand on this, simply because TPR didn’t have anything to rival QBank. Even then, QBank was not thought of as being particularly helpful, since Kaplan’s practice material isn’t great, and QBank is just more of the same. But this year, the Princeton Review added its Amplifire online test prep software, which I have to say is very impressive. It’s very focused on illuminating your thought processes while you’re answering each MCAT question. If you want to see what I’m talking about, check out the video on TPR’s site. Pretty cool, if you ask me. That said, QBank has tons more to work with—11,000 questions compared to TPR’s 2,700—so if you’ve got lots of time to burn, Kaplan and QBank might be better. Also, the really glitzy stuff TPR offers isn’t nearly as time-efficient as Kaplan’s, so it’s probably not as good at preparing you for the break-neck pace of the real MCAT.

(Both companies also offer “Live Online” MCAT prep courses, where you attend real lectures on  your computer.)

Edge: It’s a tie. Kaplan for quantity. Princeton Review for quality. (Both are important.)

” yeah. just round to the nearest                                        integer and you’re fine, bro.”

The Classroom Experience

For whatever reason, Kaplan MCAT teachers are known for being better at helping students get the fundamentals down. TPR is known for going deeper in class and in their texts. Both courses are well-respected in the classroom, however, and neither is too advanced or too elementary for anyone. No matter which MCAT prep course you choose, you’ll be able to ask whatever questions you like during class, and study at your own pace outside of class.

Edge: Kaplan for beginners and non-traditional applicants. Princeton Review for science pros and purely classroom learners (more classroom hours and tutoring time).

Intangibles

Excuse me for using sports terminology to name this section. By intangibles, I mean extras and minutiae that don’t matter much, but are worth mentioning and may make a serious difference in certain circumstances. Kaplan is offered in more cities than Princeton Review, and since any course is better than no course, it’s probably worth taking MCAT prep from either company, even if it’s not perfectly form-fitted to your needs (if you can afford it). Kaplan also has an MCAT Advantage-On Demand course, which offers 24/7 access to classroom lectures online for the same fee as a normal live prep course. For people with irregular schedules, or who really need to see or hear something twice before it registers, this might be a good option.

Kaplan also has a variety of courses and tools you can purchase apart from its full-length MCAT courses. It sells tutoring hours (as I mentioned above); subject-centered courses called Organic Edge, Physics Edge, and Verbal Edge; and an Online Science Review, which is an online set of tutorials designed to help you get a good grasp of the core pre-med sciences. There’s also a new option called MCAT AdvantagePlus that comes with added perks like one-on-one mentoring and small group sessions. These variations cost anywhere in the ballpark of $199 to $4,399, depending on what you need. So if you can’t afford a full-length course, but could use some outside help, it might be a good idea to purchase something smaller that focuses on your weak areas. You can see a full list of Kaplan’s MCAT prep courses here.

Edge: Kaplan

You should go with the Kaplan MCAT course if you…

…need lots of basic review (you had trouble with pre-med classes or it’s been a while since you took them) and aren’t interested in a rigorous classroom experience. Kaplan teachers are known for being better at helping students get the fundamentals down.

…you don’t care about extra tools or you don’t have time for them. You’re signing up primarily for the classroom experience and want an MCAT prep leader to provide you with it.

…live too far from either course’s prep center and have irregular study hours so that you’d benefit from the On-Demand option.

…you really don’t think you need to take a full course, but could use some heavy review of Organic, Physics, or Verbal. Kaplan offers these courses more cheaply than the full course, and also allows you to purchase access to QBank without enrolling in a full-length course.

If any of these  circumstances describe yours, you should head to Kaplan to check out their online and live course options up-close. That will give you a better feel of whether or not it’s right for you.

You should go with The Princeton Review MCAT course if you…

…don’t want to spend cash on materials beyond what you spend on the course. TPR gives you better MCAT books and MCAT practice tests, so you’re less likely to need to supplement with other books (although I would recommend it anyway).

…have the content down pretty well. TPR is known for going deeper in class and in their texts, and it offers better tools for you to refine your MCAT-reflexes.

…think you could really use some one-on-one tutoring and can’t afford to spend what Kaplan charges for it.

If one of those describes where you’re at, I suggest you surf around TPR’s site to see how their courses work or you can click here to look at TPR books on Amazon.

ONE CAVEAT: Because every Kaplan and TPR testing center can be slightly different depending on who’s running it, it wouldn’t hurt to put an ear to the ground, and see what you can find out from people who’ve enrolled at them. I’ve come across a number of students who recommend going with better instructors, rather than going with a specific MCAT prep company. Unless you hear specific things—good or bad—about local teachers, pick the program that fits you best. Hope that helps!

*If your options are limited due to finances or geography, you might want to ask yourself whether you need to enroll in a live MCAT prep course in the first place. Plenty of people do fine without buying prep courses. It just means you’ll have a little steeper learning curve and you’ll have to work extra hard to keep whatever schedule you decide to set for yourself.

I’m reminded of that old Jimmy Buffet song here—you know the one…”It’s 5:00 somewhere.” So my first, best answer is, “3.5/29 is competitive somewhere!” In fact, if you’ve read my post, “What’s considered a good MCAT score?“ it underscores the fact that a 29 on the MCAT is good enough to get you into some (lower-tier) schools. If you hit 30-32 with a GPA of 3.5 or higher, it’s probably going to get you into a lot of middle-tier schools. Then, when you land a 34-35 on the MCAT, you won’t have to sing that Jimmy Buffet song anymore, because you’ll be competitive anywhere!

My  answer isn’t based on empirical data, because you can find that on a lot of medical school websites. For starters, you can check out the 10th and 90th percentile MCAT scores  in the Medical School Admission Requirements (MSAR) 2011-2012. I’m just offering parameters and pointers for where your GPA/MCAT numbers should be, from my own personal perspective. But in my opinion it’s a mistake giving two little numbers too much power over your psyche! Obviously you need good-looking numbers to seduce adcom committees into inviting you to “the dance,” but I’ve seen some pretty well-endowed students (numbers-wise) smacked down with rejection, while others with badly pocked scores somehow squeaked through. Since this game of predictions is not an exact science, I’ll throw out every bit of wisdom I can….and then recommend that you take it with a grain of salt.

MD vs. DO

Let’s start with the MD/DO difference. Actual data from 2011 and 2012 shows that for a DO program, the average numbers for GPA/MCAT matriculants are 3.48/26.5, while MD candidates have to ramp it up a bit: 3.68/31.2. So if those are averages, then they likely correspond to middle- or lower-tier schools. If you’re targeting top-tier programs, your numbers will have to be higher. That would tend to bear out the number at the top of this post—3.7/32—as a pretty solid combination.

What about GPA?

Let’s just say in most cases, a 3.6 won’t keep you out of any school. And yes, I mean Ivy League contenders. But that 3.6 GPA needs to be paired with a good MCAT number, great extracurriculars (EC) and a stellar personal statement. In my opinion, great ECs will give you more of an advantage than another couple of GPA points. If you’re at 3.6 or 3.7, be happy and build on your ECs. If you’re at 3.5, it could be a negative factor, depending on where you apply.

A balanced MCAT

Adcom committees will consider your overall MCAT score, and also your score on the three test sections. They’re looking for a balanced score that shows preparation in all areas. Even a 32 might not cut it if it’s unbalanced. A 7/12/13 may yield the same final number as a 10/11/11, but the latter is more likely to get you in.

Extracurriculars

Extracurriculars can be extraterrestrial! If you have a 3.6 and great ECs, it could bring you more adcom love than a 3.7 with mediocre ECs. Depending on your school, there’s a bottom line GPA that’s acceptable, and once you reach that, your time and attention is best invested in improving your ECs, rather than worrying about an extra tenth of a point in your GPA.

Mistakes to avoid

Here are some don’ts, with some links to my posts on the subject: Don’t apply late. Don’t let your science GPA lag behind your cumulative GPA more than .2, don’t submit a mediocre personal statement, don’t apply to too few schools or to only top-tier programs, don’t mess around when choosing who writes your letters of recommendation, don’t walk into an interview unprepared, and don’t send in sloppy secondary applications. Any one or more of these items—done right—can be the key to unlocking the door to your chosen school, as long as you have the minimal numbers.

“Ding” factors

Here are a few other things that can “ding” you….undergrad grades that trend lower during your upper level classes, taking easy classes for science electives, or major classes taken at a community college. Avoid at all costs!

So finally, I’m going to stick with the 3.7/32 combination, with probably a 75% chance of at least one acceptance. But there’s a lot of anecdotal evidence that with lower numbers on both fronts (a 3.6/30) you could still get through with great ECs, LORs, and an excellent personal interview!

Trending up…

If you want my opinion, this post has an expiration date on it. All the trends show that grades and MCAT scores are going up. I don’t know if that’s a reflection of a better class of students, or a more competitive playing field, but if the magic numbers in 2013 are 3.7/32, they will be a point or so higher in 2015.

Here are some related posts:

What’s the best MCAT prep course—Princeton Review, Kaplan, Altius, Examkrackers, Berkeley Review…???

What exactly is in the AMCAS primary and secondary applications?

Where can I find a list of the best MCAT prep books in 2013?

When should I take the MCAT, what’s the cost?

Can I still get into a residency program if I don’t go to a top-tier medical school?

Without further adieu…

I weigh in on the question: Kaplan or Princeton Review for MCAT prep?

My review of Altius MCAT prep.

My review of the Berkeley Review and Examkrackers MCAT prep courses.

Check out the Student Doctor Network online forums to see what other students have said.

Other posts you might find helpful:

“Do I need to take an MCAT prep course?” and “Where can I find a comprehensive list of MCAT prep materials?”

This is a hotly debated topic in student circles, and even among the people in the know. Some answer with an emphatic “yes!” while others point to a long list of factors in the residency selection process such as Step 1 scores, your chosen specialty, your school’s reputation for putting out good doctors, and even personal connections.

Considerations for a medical residency match

There’s no way around it. Your choice of school and its ranking are factors that play into your ability to snag the best residency. There is an argument that a top-tier school will guarantee you a good spot. However, if you rely on that factor alone, you’re likely to end up with a residency match that’s less than you bargained for. So what matters most?

Step 1 Scores

Your scores on Step 1 testing (“the Boards”), taken at the end of the 2nd year of medical school after your basic science classes are finished, are a significant “omen” in predicting your success in landing a good residency. It’s a first look at your ability to show a command of the basic science curriculum and understand its relationship to medicinal practice. Whether you simply “pass” the test, or excel, has real implications for your future. Since it’s the only standardized measure that applies to all applicants, it lays down a helpful marker. A score of 188 means you passed the test, while the national mean is 225.

Your School

A top-tier school carries weight. That’s assuming that your school is known for churning out good doctors. That’s usually the case, but not a given. Your school’s reputation in this area will be critical, and traditional wisdom can come back to bite you here. PD’s are looking for the best residents for their program, period. So how do they gauge a good fit? Based on past residents, of course! If your school has provided good residents in the past, that’s a plug in your favor. On the other hand, if your school’s sent up a couple of residents that disappointed, then you could pay a price for that. These are factors beyond your control.

Is there a possibility that an Ivy League education could play against an ideal medical residency placement? Yep. Some PDs will assume students from certain schools come with a sense of entitlement, and refuse applications from those schools. But all things being equal, I’d say top-tier status for your school is a net plus.

Competitive specialties?

School choice increases as a factor with more competitive specialties and prestigious hospitals. If there are two applicants, all things being equal, vying for a highly competitive spot at a prestigious hospital, and the hospital’s had no negative experiences with the residents from either of the schools the applicants hail from, I’d give a hair to the student from the top- or medium-tier school over a lower-tier one.

That said, I’d recommend some serious research before you decide your first, second and third choice schools for residencies. It’s common for students to request more well-known schools, and completely gloss over some top notch schools known for their expertise in certain specialties. Yes, Harvard and Johns Hopkins have top-rated EM programs, but schools like Chapel Hill and University of Colorado have comparable rankings. And sometimes your education at these non-elite schools will come at half the cost! Don’t discount a school you haven’t heard of. There are some gems out there that are considered major players in your chosen specialty! Find out where they are.

Networking

This is more important than you think. If you have a friend of a friend of a friend with a contact at the hospital where you want a residency, it can elevate your prospects above and beyond where they might otherwise be. Also, PD’s at different programs are in contact, and do talk. They can push an applicant into a program, in spite of disappointing Step 1 scores or a less than stellar medical school program. It doesn’t hurt to talk to your friends-of-friends, your contacts at other schools, a colleague’s contacts at the hospital of your choice. We’ve all heard of students from lower-tier programs whose mentors worked the phones with their colleagues to place the student in a stellar residence. It happens!

Regional saturation

If you’re living in a region where there are lots of top medical schools, and you’re thinking of attending a bottom- or middle-tier school, you’ll be up against stiff competition. So the region of the country where you plan to go to school plays in here too. You’d be advised to try to get into a top-tier or at least middle-tier school with a good reputation in your state/region if your area is flooded with top-tier schools. That’s not to say that a lesser school choice will deflate your chances, but you will need to come to the table with other pluses to increase your viability in getting a good residency match.

Other recommendations

From the National Resident Matching Program (NRMP) and AAMC’s “Charting Outcomes” 2011 report of which applicants matched their preferred specialty, here are some recommendations for getting a successful residency match:

—Rank all the programs you really want, without regard to your chances

—Include a mix of competitive and less competitive programs within your preferred specialty

—Include all of the programs where they have expressed an interest in you and you would accpet a position

—If you’re applying to a competitive specialty, also rank your most preferred programs in an alternate specialty

—Include all of your qualifications in your application

You can check out the latest medical residency match stats at the NRMP site.

Foreign Schools

Schools outside the U.S. have a decided disadvantage. For international medical graduates looking to be licensed to practice in the U.S., the preferred path is to complete a residency program at a U.S. hospital. International students must have an ECFMG (Educational Commission for Foreign Medical Graduates) certification to be considered. This certification relies on completion of USMLE Step 1, Step 2 Clinical Knowledge and Step 2 Clinical Skills, plus a diploma from a university registered in the International Medical Education Directory (IMED). This requirement for having a medical diploma creates a potential gap of at least six months between the time international graduates finish and the time they can begin residency. So needless to say, if you’re applying for a medical residency from a program outside the U.S., you will need to come with your best game.

How is a residency different from an internship?

The first year of a residency, or PostGraduate Year-1 (PGY-1) is called an internship. During that year, it’s typical to rotate through several specialties, working in a variety of medical settings. Besides patient care, you’ll also be learning through participation in prepared lectures and conferences. Following your internship, you’ll start getting much  more involved in your chosen specialty. After you’re done with your residency, you may decide to continue more work in a subspecialty, in what’s called a “fellowship.” You  might also decide to stay on an extra year after your official residency to become “chief resident,” overseeing other residents. If you’re looking to teach or take on an administrative or policy-making role later on in your career, this could be a very valuable experience.

How long is a residency?

Depending on your specialty, a typical residency is around three to five years long. If you’re going into primary care, plan on three years. For a surgical specialty, five. Not surprisingly, a neurosurgery residency is the longest, at seven years. Four years is probably the most common length of residency, for medical specialties like Anesthesiology, Dermatology, Neurology, OB/Gyn, Psychiatry, Pathology and Emergency Medicine. For help identifying available residencies and the process of residency matching, you can check out the AMA’s online database, named FREIDA for Fellowship and Residency Electronic Interactive Database Access. The National Resident Matching Program helps match available slots with the best applicants, after each applicant designates his/her preferred match(es).

The purpose of a residency is to give you the specialized training you’ll need to perform your specialty on your own. You’ll work under the supervision of the attending physician at the hospital or medical facility where you practice; that physician is ultimately responsible for all the patients you treat. You’ll do the same thing you would as a practicing doctor in your field: patient exams, orders for diagnostic tests and treatments, admitting orders and consulting with patients’ physicians.

How much are residents paid?

The salary a resident is paid isn’t meant as a reflection of his or her skills or training. It’s simply a “stipend,” if you will, to help pay the bills as he or she is fulfilling a residency. Remember, at this point, you won’t have a license to practice medicine, and as such, the hospital where you work can’t bill out for your work. But a typical salary during these years might be $40,000 to $50,000. Not enough to get that Maserati you have your eye on, so hold onto that thought a few years longer!

hint: no one is a "pre-med major"

Which pre-med major will give me the best chance at getting into medical school?

If you’re looking for a fast track to graduation, a degree in the sciences will likely allow you to count your pre-med classes towards your major requirements. If you choose a “non-traditional” major you’ll have to double up your course load—taking your major classes while also satisfying the pre-med requirements. Most medical schools don’t really care what you choose as your major as long as you take the required pre-med classes. It helps, though, if you like science and math!

Far more important than the major you choose is what you do to explore your interests and make serious academic accomplishments while you’re an undergraduate. Doing that won’t be easy if you’re stuck in a major you chose because you thought it would look good on an application. Plain and simple, you won’t be motivated to excel in it, you won’t eat, drink, and sleep it, it’ll be a means to end. And so, likely, in the end, you’ll have a lot less to show for your undergrad years.The same goes for those of you who’ve decided you want to be physicians, but have interests and passions in subjects other than the hard sciences.

Just like the folks who choose non-traditional majors to impress adcoms, if you choose a science major just because it seems like that’s what most premeds do, you’re going to find yourself bored and burned out with too many classes you don’t really love. And then, again, you’re not likely to really throw yourself into big projects or spend time outside of class expanding your mind.

If you got a residency match on Match Day 2013, congrats! If it was the residency you were hoping for, double congrats! Especially if you’re in a competitive specialty like radiation oncology, orthopedics, urology, dermatology, plastic surgery, neurosurgery, ophthalmology or otolaryngology and snagged a match with your specialty, you’ve already beat the odds!

So how does the National Residency Match Program work?

So, let’s just review the process. You and thousands of other medical school seniors applied, then interviewed with the programs where you wanted to go, then—along with the schools—submitted secret rank-order lists to the National Resident Matching Program, and the NRMP computer generated thousands of matches. By participating in the process, you—along with the schools you applied to—agreed to accept whatever match the all-knowing computer generated.

You may not have gotten the exact match you wanted. If you did get a match, however, you are obligated to accept—as is the school. On the other hand, you may be one of hundreds who didn’t get a match. From all accounts, more students were turned away this year than ever, with more than 1,100 unmatched medical school grads! Last year there were 815 who didn’t get matched. Either way, these are pretty big numbers! For graduates of non-U.S. schools, the chances of not getting a match surge to around 50%!

What if I didn’t get matched?

By now the time has already passed for the Supplemental Offer and Acceptance Program (SOAP) for students who didn’t match on the first try. Those who weren’t matched by the NRMP computer were notified before Match Day and could still contact schools starting March 12 through the SOAP program, to compete for a limited number of openings. All of those matches were also finalized by Match Day. So now what? You have your medical degree, but it won’t do you any good without a residency to go along with it!!

It does seem twisted to go all the way through med school, with all that entails, and then graduate only to be told you can’t finish the process. And the reality is that there are plenty of students from international schools that are selected over those attending U.S. schools, so you can’t really game the process to create any level of certainty.

At this point, barring something incredible happening, you will probably have to wait a year to re-apply. During that time, I’d suggest doing three important things:

1. Reviewing your application and finding out where the holes are;

2. Working hard to fill those holes in the year ahead; and

3. Re-applying next year.

4. Oh, and keeping a watch on institutions where you’ve applied, where you have the best chances of getting in, and monitoring them in case something happens to create an opening. (I don’t want to give you too much hope here, but it definitely happens that a resident will drop out, or not show up, or not work out for some reason, and a spot opens up. Try to make a contact at the school or hospital, and check in regularly, and there’s at least a slim chance something could materialize. If you keep in constant contact, and you are considered a good applicant, you may be the first person they turn to.)

Failure to match doesn’t spell the end of your medical career

Missing the match the first time you try isn’t the end of your medical career! There are a thousand other students out there in  your same shoes. Here are some reasons why you may not have been selected, and some considerations for your next application:

1. Your USMLE Step 1 and Step 2 scores need to show you’ve got a handle on the material you studied during medical school (plus Step 3 if you attended a foreign school anywhere but the U.S. and Canada), and in the case of DOs, your scores on either the USMLE or the COMLEX exam.

2. Did you do well academically during medical school? If not, you won’t be pulled from the bottom of the barrel when there are plenty of applicants who sweat their guts out to make the grade.

3. Which medical school did you attend? Obviously, some of the more well-respected schools can give your application a boost. Which is to say, you need to bring lots to the table if you are attending a little-known school. On the bright side, a majority of students at little-known (even unknown) schools do get into residencies.

4. Did you attempt a “suicide match,” which means ranking only one program so as not to risk going anywhere but your first choice? This is obviously a bad strategy!

5. Are you trying for a competitive specialty (see the list above)? If so, your chances start out lower, unless every part of your application shines.

6. Did you attend a foreign medical school? This may affect your chances. The pass rate for students who attended a foreign medical school for their first time taking the USMLE is around 73%, while graduates of M.D. programs pass 94% of the time.

7. How did your interview go? Do you have good communications skills? This is a pretty critical factor in getting onto someone’s rank-order list.

How can I improve my chances of a residency match next year?

While you can improve on some of the factors on the above list, others are just what they are: a part of your overall package. It’s time to take action, and look closely at your clinical experience, your relationships, your academics and your test scores to see where you can improve. Here are some things to keep you busy until you can apply again, that should improve your chances of a match next year:

Review your application and find out where the holes are

Look yourself in the mirror. Take stock of where you are and where you’ve been. Do an honest assessment of why you think you didn’t match.

Look closely at your resume/CV. Have a mentor do the same. Figure out what’s missing, and where it can be improved.

If you got a low score on the USMLE, take it again, but if you do, you’d better be prepared to boost your score. The number of attempts you make and the score you get each time will show on your application.

Get some solid clinical experience while you wait.

Examine your experience in rotations. Are there things you could have done better? Can you go back and nurture some of the relationships made during those experiences?

Choose carefully who writes your letters of recommendation. Most important, you need to be able to demonstrate that you’re worthy of the kind of letter you want written.

Work hard to fill those holes in the year ahead

Set some clear-cut goals for the year ahead. Do this immediately. Be specific. Focus on your areas of greatest need.

Get a new-and-improved packet ready as soon as possible. (See recommendations above.) If something opens up somewhere, you will be ready to re-introduce your new, improved self.

Re-apply next year

Apply broadly, including schools/hospitals you didn’t consider the first time around.

Check out the match rates for different specialties, and if you’re open to choosing a new specialty, do it—it could greatly increase your chances the second time around.

Finally…

The good news is that with a changing health care system, and a greater demand for new physicians, there is legislation under consideration by Congress (the Resident Physician Shortage Reduction Act of 2013) that would push the numbers of physicians being trained up by 15,000 over the next five years. Presumably if that passes, it could benefit some of today’s unmatched grads. Its name suggests the urgency of the task ahead. However, the timeframe and specifics of the legislation won’t be known until its passage.

You may also want to check out these recent posts:

What exactly does a resident do, and what’s a typical resident’s salary?

Can I still get into a residency program if I don’t go to a top-tier medical school?

How do I pay for medical school? What can I do to reduce my debt?

How worried should I be about a W, FW, Drop, I or F on my undergrad transcripts (for medical school admissions?)

What matters most—GPA, undergrad school, or MCAT score?

Here’s what really matters: your GPA (3.6 or above), your science GPA (3.4 or above), your MCAT (31 or above), your extracurriculars (ECs), letters of recommendation, research opportunities and valuable shadowing experiences—oh, and of course, whether or not your mom or dad is a huge benefactor at your chosen school! (Kidding on that last one…but it doesn’t hurt!) The scores above trend pretty high, and are what you’d need to have top-notch prospects of acceptance to a top-tier school.

In my post on getting into competitive residencies, I point out the wildly diverging costs of a medical school education, essentially asking, “Is it worth it?” While there’s a correlation between med school choice and getting your top residency choice, there are lots of ways of compensating—and even beating—the “name brand” school advantage. This is the same story with your undergrad education. You can save a ton of money by attending a well respected (but lesser-known) university in your undergraduate years, and it shouldn’t diminish your chances of getting into a top-ranked program. The key is commitment, hard work and hitting the high notes below:

Undergrad GPA

If there is one vitally important statistic, it’s your GPA, so don’t let it lag. Since all medical students, no matter their undergraduate school of choice, have essentially the same pre-med requirements, you’ll be compared with “fellow” students from across the nation. A 3.5 GPA with a good MCAT score, ECs and LORs, could unlock the door to a top-tier school. But a 3.6 looks better! Keep in mind that if your school is one of those (like Brown or Harvard) that do a little “creative grade inflation” to give kids an easier entre to medical school, the adcoms know about it. If, on the other hand, you go to one of the schools known for grade deflation, you may get a small boost in consideration. Even a 4.0 GPA won’t score you a sure ticket to medical school, but it does help if the other parts of your application shine.

What about my MCAT score?

MCAT scores are similarly critical. An extremely good MCAT score can push you into the rarified air of top-tier consideration. For specifics on what’s considered mediocre and what’s exceptional, check out this post. And for a little advice on what counts for a good GPA/MCAT combo, check out this post: “What’s a good GPA/MCAT combination for acceptance into med school—3.7/32?” An MCAT score is never considered in isolation, so it won’t do the job alone. But it can definitely boost your chances, especially if you attend a lesser-known undergrad school.

Name brand or not?

The adcoms at Ivy League/top-tier schools have spoken on this subject, again and again. And their message is always the same: your undergrad school is NOT a critical deciding factor in med school acceptance. Whether you attend a private school, liberal arts college or state college (large or small), what matters most is whether you can do the classwork, plus land some good research opportunities, gain leadership experience and find health and medical settings where you can do some shadowing. These opportunities are pretty readily available in most college towns, except for exceptionally small ones.

Science/non-science major?

Again, this may shock you, but depending on the medical school(s) you’re applying to, as many as 25% to 30% of matriculants are non-science majors. Obviously, the core science classes are still a part of every pre-med’s curriculum, but you may even get some props for doing whatever it is that really floats your boat: English, History, Sociology, anyone? By studying what interests you most, you will gain added experience while likely getting better grades.

Are you well-rounded?

This isn’t a reference to your waist size, but to your experiences before and during college. Many medical schools count these experiences as equal to, or more important than the college from which you hail. So look around you. Are there clinics where you can volunteer? Do you have the time to join a club on campus? Are you a writer or astronomer or inventor on the side? A one-dimensional doctor is just that. And most medical schools are looking for students who will excel in much more than their science classes! And remember that you’ll be able to solicit letters of recommendation from people you meet in all disciplines and walks of life.

The inside game

Finally, you can’t ignore the obvious: by going to Harvard undergrad, you’ll have access to Harvard profs via the classes you take, and you’ll have the chance to prove your stuff. You’ll also be considered part of the “family.” If you’re targeting an Ivy League or top-tier school, and want only that one, then it can’t hurt to start there for undergrad, if you can get accepted. It’s just not a necessity! Keep in mind too, that should you decide to drop out of pre-med, and let’s say you’re shooting for business school or law school—a college with a good reputation will help you get there faster.

If you want some help choosing just the right non-Ivy League campus, check out the book with the cover featured above: Looking Beyond the Ivy League: Finding the College That’s Right For You.

Here are a few other posts to help you along the way, as you choose your undergrad school:

What makes a university good for pre-medical studies?

What are the basic pre-med courses I’m required to take?

What’s the best pre-med major?

I’m not sure I’m up for medical school. Are there other similar, shorter options?