Dr. Norma Wagoner is on the faculty at the University of Colorado School of Medicine talks with Dr. Ryan Gray, host of the Medical School HQ Podcast to discuss the medical school admissions process, the interview, and what committees are actually looking for.

Dr. Norma Wagoner is on the faculty at the University of Colorado School of Medicine. She has almost 30 years of experience in the admissions process. She graduate with a Ph.D. from Washington University School of Medicine and Anatomy and too her first job at Rush Medical College in Chicago. She has been the Dean of Admissions for multiple medical schools. She has a phenomenal breadth of knowledge about the application process, the interview process, and what medical schools are looking for on an application to get an interview and what the admissions committees are actually looking for during the interview process. Dr. Ryan Gray, host of the Medical School HQ Podcast had the chance to sit down and interview Dr. Wagoner for the nineteenth episode of the podcast.

On the admissions process and what admissions committee members look for in an application:

Committees are looking for candidates who have good critical thinking skills, they are excellent in quantitative reasoning, they like scientific inquiry. If an institution has a big research component or students are asked to do a mentored scholarly activity, you want them to have that capability. Communication skills. You want somebody who has got a knowledge of themselves and others; cultural competence in the last 4, or 5, or 7 years has become a really important aspect of what medical schools do. You want teamwork because that’s the direction medicine is heading. Obviously, ethical responsibilities, and you want people that can cope well and adapt and are reliable in what they have chosen to do. So, those are sort of a bunch of criteria that you put together. When I was the Dean of Admissions, we posted all the criteria we use online so applicants could see it. We handed out the interview form, because again, my goal always has been in demystifying this process. It’s challenging enough for students. They don’t need to be lacking in knowledge of what the school is trying to do coming into this process.

On whether “demystifying the process” helps the applicant before they come to an interview:

Of course as an anatomist, I always look to see whether the pupils are dilated and how cold the hands are and sweaty. So, that gives me an instant message about the confidence of the student. I always see it as my goal to make that student as comfortable as they can be and allow them to do their best. I feel that’s a role and a responsibility of faculty interviewers because this is a high-stakes process for them, they spent time and money and a lot of energy to get where they are. That’s just a goal I have but certainly you like to feel that the more information you give out, the more comfortable students feel.

On whether GPA is better at determining a good medical student or MCAT is better at determining a good medical student:

You used to look at predictors of success because that’s always been something that institutions are looking at. And the GPA, the undergraduate GPA, and aspects of the MCAT, although collectively they look at the combined number, gives indication of how well a student might do in the first two years and how they might do on Step 1. There is nothing that really predicts the third year. In the third year, the two areas that they know that they want information on are knowledge and professionalism, and those seem to be the factors that in the third year, if you’re passing information on to the residencies. If you can tell them about a student’s knowledge base, i.e., their critical thinking skills and all off the things that surround that and you can tell them about their professionalism, you are going to hit half of their competencies. And so that’s where they are seeing students who come with high values in those areas; they then can count on a greater degree of success. There isn’t anything in the grades and the MCATs that says, “This is the end-all, be-all, and this will tell you who is going to be a great physician.”

If you look at the applicant pool, for instance, the 2012 applicant pool, there were 45,266 applicants. Now, on average, students are going to submit about 14 applications and that’s been going up for the last several years. Now, when you have 14 applications from this number of total applicants, you are well over half a million applications in this process. But if you said, “Okay, how many people are actually matriculating to medical school?”, it’s just under 20,000 right now, but going to go up over the next couple of years with all the new medical schools. Right now in 2012 there are 137 medical schools. So, roughly 2.3 applications per position. So, medical schools have the responsibility to narrow that group.

Out of that 137, I think there are 54 medical schools that get between 5000 and 15,000 applications. So, how do you narrow that group of applications? Well, the initial weight goes to the grades and the MCATs, because that’s the only standard measure across the board for all applicants. Now, that’s where students wind up feeling that only the grades and the MCATs count.

Admissions is a competitive process. There are no two ways about it. When you have close to 19,000 students or close to 20,000 students entering medical school, that means roughly half of the pool is going to be interviewed and the other half won’t. And so you begin sort of looking at the highest grades and the highest MCATs and as you review the application in total, you try to pick – because you’re doing a holistic admissions process – you’re trying to invite those top students first because all the schools are going to go after those students, and then you work your way down the process. So, when I am counseling students, I always say to them, “Look, if you got a 3.4 and a 30 in your combined MCATs, you are not going to be the first off the block they’re going to invite to interview. You are probably looking at January or February in an application year.” So, you try to give them some assurance that there is opportunity out there, but there are certainly a lot of students with high GPAs and high MCATs. Now, one of the things we do know about the GPA is that there is tremendous grade inflation and that’s been going on across the board. So, it sort of shifted the weight in some respects to the MCAT.

Now, the MCAT does show success on those who can pass the step 1 and of course that’s a critical piece for students in being able to really get into residency anymore. I mean, that’s sort of the bottom line – they must pass that step 1 and they need to do it on the 1st time.

On discussing poor grades or a poor MCAT score on the personal statement:

Applicants should not do that because they may be coming to an interview where it isn’t an open interview and you are just disclosing information and if asked about a grade or an MCAT, you want to be able yourself to practice that in advance, you want to present that to somebody, you want them to hear what you say so that it doesn’t come off as complaining, whining, blaming, or any of the above. I always say to students that there are circumstances that prevail and you have to be forthright and honest and you give out that information, but I think writing about it in your application, unless it were something… for instance, let’s say there was a tragedy in the family, but you might write about the tragedy in the family, the impact on you as a person, and allow the reader to deduce what happened academically. And if it’s sort of a singular time in the application and the student winds up doing better at the end, again, if they have access to the application, they may ask it. I think you introduce in the personal statement those things that you definitely want somebody to talk to you about but it’s very tricky to write those, very tricky.

So, I always encourage students if there are circumstances that came up that enabled growth or change or challenges, it’s okay to write about those but leave the reviewer some opportunity to say “Oh, gee, that must have been terrible. There are things that must have happened during that time,” and you can say “Yes, it had a great impact on my grades,” or whatever. There are ways to bring it up but it’s subtle and it isn’t direct because writing about that is very tough.

This interview was originally posted on the Medical School HQ Podcast.