PHP: Final Exam
What did the old version of the MCAT measure?
Used as a standard to compare different applicants’ intellectual abilities and thus predict whether they would be successful in medical training
What does the new version of the MCAT measure?
Also provides more substantial information about the applicant’s ability to manage the issues they will encounter in medical school
What are the four sections on the MCAT?
Biological and biochemical foundations of living systems, chemical and physical foundations of biological systems, psychological social and biological foundations of behavior and critical analysis and reasoning skills
What classes are recommended to take before the MCAT?
Biology, chemistry (general and organic), biochemistry, physics, sociology and psychology
What classes are not necessary but very helpful to take before the MCAT?
How do you know you’re ready to take the MCAT?
When you are getting consistently acceptable scores on practice tests
When is the MCAT offered?
From January to September
When is the MCAT typically taken for the first time?
Spring of 3rd (junior) year
How many times can you take the MCAT?
As many times as you want, but more than 3 is not recommended
What MCAT score(s) do schools see?
All of your past scores
What MCAT score do you need to be competitive?
500 or better
What is the best way to study for the MCAT?
Take advantage of undergraduate course work
What common mistake do people make when studying for the MCAT?
Focusing too much on biology (it’s only 1/4)
What other skills are important for taking the MCAT?
Critical reasoning and reading skills
What is the best major for applying to medical school?
No specific major is considered “the best”
Why is it important to make a conscious effort to engage with professors you want to write a recommendation or evaluation letter?
So they know more about you than simply your grade in their course
Who are the best professors for writing a recommendation or evaluation letter?
Those in the science department
What are some good ways to connect with professors?
Research, office hours, asking insightful questions, do well on test, dress well and be genuine
Why do some schools have a secondary application?
It gives the admissions people more information specific to that school’s mission and programs as well as more demographic information
Who may letters of recommendation or evaluation be from?
Individual professors/academic mentors or put together by a pre-health office as a packet with a cover letter
What are some guidelines for an application photo?
Must be a conservative/professional photo and don’t crop others out of a photo, make sure it is a single shot
What should be included on an activities summary?
Only things after high school; list relevant activities such as health care exposure, community service, research, leadership role and employment
What questions should be answered in the personal statement (essay)?
Why medicine? What is your motivation?
What are the three application systems for medical school?
TMDSAS, AMCAS and AACOMAS
What is the TMDSAS?
Texas Medical and Dental School Application Service; the application for all public medical schools in Texas; the only Texas school that doesn’t use this is Baylor College of Medicine
What is the AMCAS?
American Medical College Application Service; the application for all MD programs outside of Texas; Baylor College of Medicine uses this
What is the AACOMAS?
American Association of Colleges of Osteopathic Medicine Application Service; used specifically for DOs
What is the medical school interview considered?
The last step in the application process
What is the typical format of a medical school interview?
A whole day; tour of the facility, student panel, presentation about the school and the interview itself
What is considered professional attire appropriate for a medical school interview?
Men: well fitted suit of simply colors like navy, black or grey and a tie; Women: well fitted (but not too tight) pant suit or skirt suit, no plunging necklines, plain colors as listed for men, professional closed toed shoes that are easy to walk in, simple hair make up and jewelry
What are the different formats for a medical school interview?
Panal interview (several people at once), one-on-one interview, multiple mini interview (several short separate interviews with different people about different topics/situations)
What are the three types of interviews for each of the three formats?
Closed file interview (the interviewer has limited information about the applicant; typically do not know GPA or MCAT score), blind interview (interviewer knows nothing about the applicant except maybe their undergraduate institution), open file interview (interviewer has all parts of the applicants’ application)
Who may an interview be conducted by?
PhD/MD/DO faculty, community physicians, administrators or medical students
What are residency applications submitted through?
ERAS (Electronic Residency Application Service)
What does the National Residency Match Program (NRMP) do?
Residency Directors submit their rank lists to them; the organization then matches based on applicant and director rankings
When is the national residency match day for MD students?
The third Friday of March
What do students do if they are not matched with any residency program?
SOAP (Supplemental Offer and Acceptance Program)
What programs do not participate in “match day” for residency?
Ophthalmology, neurology and military
What do DO programs use for residency?
When is Step 1 of USMLE or COMPLEX taken?
At the end of preclinical education
When is Step 2 of USMLE or COMPLEX taken?
During the 4th year
What is Step 2 of USMLE or COMPLEX composed of?
2 parts: clinical knowledge and clinical skills
How is clinical knowledge assessed?
Ability to apply medical knowledge and understanding of clinical science
How is clinical science assessed?
Mastery of clinical skills in a standardized patient setting
How is the medical school curriculum broken up?
2 parts: preclinical and clinical
How are the first 2 years or 18 months of medical school organized?
Organ system blocks, topic/subject blocks or case based learning
What are the 6 main rotations in the second 2-2.5 years of medical school?
Family medicine, internal medicine, surgery, psychiatry, pediatrics and obstetrics and gynecology (others often included: emergency medicine, radiology, anesthesiology)
What is the traditional structure for clinical years?
Do the 6 clinical rotations consecutively and then do electives at the end
What follows each rotation?
A “shelf exam”
What are students expected to study during clinical rotations?
Review symptoms and treatment plans and research unknown diseases and treatments that come up
Who should write recommendation letters for applying for residency?
Faculty who know you particularly well, someone with specific ties to the program, only people who will highly recommend you
What is the dean’s letter?
MSPE (medical student performance evaluation), a compilation of the applicant’s clinical evaluations, used to compare the applicant to peers
What question should the personal statement for residency answer?
Why this specialty?
What is a curriculum vitae (CV)?
A running record of things the student has done
What is most importantly consider in residency admissions?
Rotations specific to residency applied for and step grades
What is allopathic medicine?
The system of medicine which treats diseases by the use of remedies which produce effects different from those produced by the diseases under treatment
What is osteopathic medicine?
The philosophy of holistic medicine focused on treating illnesses within the context of the whole cody; systems of the body were interrelated and impacted one another supporting the idea to treat lines within a broader context and to focus on preventative care
What do DOs learn that MDs do not?
Osteopathic Manipulative Medicine (OMM) — a set of manual manipulation techniques involving the musculoskeletal system
What matches both MD and Do programs for residency?
Single accreditation system for graduate medical education (GME)
What types of master’s degrees are commonly pursued with an MD?
Master of public health, master of science, master of science in clinical and translational science, master of business administration, master of science education for health care professionals, other masters
How many years does a Doctoral degree in Philosophy add to an MD?
3 to 6 years
How many years does a Doctoral degree of Jurisprudence add to an MD?
How many years does a master’s degree add to an MD?
1 to 2 years
What are the types of medical practices?
Hospital vs. clinic, private practice vs. non-private practice and academic vs. non-academic
Why is there a shortage of general practitioners?
Students look for something that they can fully know and feel comfortable practicing, negative perception or stereotype and misconception of primary care training, contrast in compensation between primary care and subspecialties
What is bench research in medicine?
Conducted in a controlled lab environment, academic fields of biology chemistry and biochemistry
What is translational research in medicine?
Biological or chemical processes are applied to a physiological/living system, plant animal cellular or human physiology, confined to a controlled laboratory setting using animals or plants
What is clinical research in medicine?
Discovering/measuring the effectiveness of new treatments drugs and protocols, conducted in a clinical or hospital setting, outcomes in patient care, ethical issues
What is research in public health?
Academic field, concerned with prevalence of disease overall health outcomes and the general health of a specific population
What are the types of residency programs?
Procedure/surgical, non-procedure/clinical or mixed
What do first year residents usually have?
Rotations within chosen speciality and some outside
What is expected during the second year of residency?
A resident will take on a leadership role
What may be some additional requirements in residency?
Research/lunch education sessions/journal club/presentations
What tests are taken during residency?
USMLE Step 3 or COMPLEX, in-service, jurisprudence, board exam
What is a fellowship program?
Traditionally a period of sub-specialty training that follows residency or another fellowship
How long are fellowship programs?
1, 2 or 3 years
What are the pros/cons of single or small group practice?
Autonomy, responsibilities of running the practice
What are the pros/cons of large group practice?
Professional practice administrator, financial stability, favorable terms with insurance, loss of autonomy
What are the pros/cons of hospitals?
Cannot employ physicians (Non-profit healthcare corporation)
What are pros/cons of academic medicine?
Lower income, opportunity to teach
How is employed physician compensation usually negotiated?
Based upon the RVU system
How are physicians reimbursed?
Based upon CPT (current procedural terminology) codes
What are Stark laws?
Intent to limit physician self-referral and outlaw many financial relationships between hospitals and physicians
What are the two major forms of managed care?
PPOs (preferred provider organizations) and HMOs (health maintenance organizations)
What are PPOs?
Preferred provider organizations are insurable products that combine physicians, hospitals and other providers to provide care at a discounted rate
What are HMOs?
Health maintenance organizations are insurance entities that typically have a “gatekeeper” primary care physician and drastically limit patient choice of physicians and hospitals, compensate physicians by either discounted fee for service or capitation
What does bundled payment mean?
All of the providers for an episode of care are paid a single lump sum and its is up to the providers to determine how the money will be split up
What is an ACO?
Accountable care organization, integrated health entities that provide care for a minimum of 5,000 Medicare patients and ultimately will be at risk for the financial aspects of their care
Why does the U.S. spend an enormous amount on healthcare?
Pharmaceutical industry, medical device manufactures (technology) and physician compensation