“Congratulations! After review of your application, our Medical School Admissions Committee would like to invite you for an interview.” These are the words that every medical school applicant hopes to read.

In an AAMC survey of medical schools, the interview was found to be the most important factor in the admissions process.

To prepare, applicants consider how to respond to anticipated questions. Why do you want to be a doctor? Why are you interested in our school? Why should we choose you? While these questions are challenging, my experience advising applicants has shown us that questions about current healthcare issues provoke the most anxiety.

PREPARE TO BE ASKED QUESTIONS ABOUT CURRENT HEALTHCARE ISSUES

  • What can be done about rising health costs?
  • How could you affect the health care system?
  • How do you see the field of medicine changing in the next ten years?
  • What do you think of the government’s involvement in health care?
  • What is your understanding of the Affordable Care Act?

Prepare to be asked these questions. As medical school admissions interviewers, we ask these questions. We know that our colleagues ask these ques- tions. “I think ALL students applying to medical school should be prepared for questions about the healthcare system and reform,” says Dr. Gregory Polites, Associate Professor of Emergency Medicine at the Washington University School of Medicine. “Now more than ever, it’s crucial that both students and physicians keep abreast of the changes that are occurring now and will occur in the future.”

UNDERSTAND THE IMPORTANCE OF THESE QUESTIONS

A review of medical school websites reveals the importance of these questions in the interview process:

  • “Specifically, the interviewers will try to determine…What do you know about the practice of medicine and issues in delivery of health care?”
  • “You may be asked to discuss a controversial issue or situations dealing with ethics or profes- sionalism in health care. Be aware of current issues and recent debates in the health field.”
  • Qualities searched for in an interview…Knowledge of health care systems and its current changes.”
  • “Given the critical nature of health care in our country I feel every prospective medical student should have at least a general understanding of the more salient parts of the national health care policy,” says Dr. Will Ross, Associate Dean for Diversity at the Washington University School of Medicine.
  • “I expect them to defend their rationale for why health care reform is moving well, flawed, or fine as is. I will then comment in my interview summary on whether the applicant has a pedestrian, mature, or sophisticated understanding of health care reform.’

UNDERSTAND WHAT THE INTERVIEWER IS SEEKING

Rest assured that your interviewer does not expect you to be well versed in the nuances of healthcare reform. With that being the case, what is the pur- pose of these questions? “This interaction tells the interviewers that the candidate has some awareness of the wider world and that she or he is cognizant of the changes in the health care system that may have complex implications for practitioners,” writes Dr. Carol Elam, Associate Dean for Admissions at the University of Kentucky College of Medicine. “Neither is the applicant expected to have exten- sive knowledge of the subject. Rather, this discussion gives the interviewer a chance to see that the candidate, in preparing for a career in medicine, is aware of the issues confronting the profession.”

With the changes that are occurring in our health care system, schools seek to identify students who have an interest in finding solutions to our nation’s health care problems. “Just as we learn to diagnose diseases and develop treatment plans for individual patients, we must also learn to diagnose and treat problems in the systems,” writes Dr. Paul Rockey, former Associate Dean for Clinical Affairs at the Southern Illinois University School of Medicine. “Too often our profession has left this task to administrators, regulators, and insurers. Medical care doesn’t end when we leave the patient’s bedside or exit the examining room.

BECOME WELL INFORMED OF HEALTHCARE ISSUES

If you’re feeling unprepared to handle these questions, take comfort in knowing that others feel the same. University of Michigan researchers surveyed more than 58,000 graduating U.S. medical students from 2003 – 2007. Nearly half of the students felt inadequately prepared in understanding the health care system, health economics, managed care, or managing a practice. In another survey of over 800 medical students in Minnesota, researchers sought to determine knowledge of the 2010 Affordable Care Act. Less than half reported understanding the law’s basic components.  To increase knowledge of health care issues, schools have incorporated coursework into their curricula. “Ten or 15 years ago, most schools did not have anything involving health care policy,” said Dr. Matthew Mintz, Associate Professor of Medicine at George Washington University in an interview with Slate. “Medicine was medicine and policy was policy and why would doctors want to learn anything about policy?” Today, most medical schools include health policy, business and/or delivery teaching along with traditional subjects like anatomy and pathology.

Medical students have also taken the initiative to develop resources to enhance understanding of complex issues in the health care system. One such text is the Health Care Handbook written by Elisabeth Askin and Nathan Moore, students at the Washington University School of Medicine. “We wanted to write a book that would be like giving people little floaties to help them learn to swim through the vast and confusing ocean that is health care,” said Elisabeth in an interview with the New York Times. Other recommended resources to help you become well informed include American Medical News, AMSA The New Physician, Virtual Mentor, KevinMD, and the New York Times Health Section.

With your interview invitation in hand, you are one step closer to your goal: medical school. Although developing an understanding of the health care system may seem daunting, now is the time to recognize current healthcare issues, identify gaps in your knowledge, and take steps to expand your understanding. It’s well worth the effort.

About the Author
Dr. Samir Desai is a faculty member at the Baylor College of Medicine where he serves on the medical school admissions committee. He is the author of 14 books that have sold over 150,000 copies, including TheMedical School Interview: Winning Strategies from Admissions Faculty and Success in Medical School: Insider Advice for the Preclinical Years. He provides mock interview consulting services to students at www.TheSuccessfulMatch.com. He can be reached at sdesai@md2b.net.

REFERENCES

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This article was published in the September/October 2013 issue of PreMedLife magazine.