You Didn't Get In, Now What?

This chapter covers the steps to follow for anyone who applied to medical school but was unsuccessful. We will guide you through recovering from that initial shock of rejection, the process of seeking feedback on your unsuccessful application, developing a plan to strengthen yourself as an applicant, and outline potential avenues you can take in the interim between application cycles.

Introduction

Opening that rejection email may feel like the end of the world. But it is not the end of the world, nor is it the end of your career!

Remember you are not alone – less than 20% of applicants to Canadian medical schools are accepted and less than 10% are accepted to Ontario medical schools (1). In fact, many medical students admit to having applied 2 to 3 times before being successful.

Do not panic! Instead, finish reading that rejection email, make sure you weren’t waitlisted (which by no means is a rejection) and once you are certain you will not be starting medical school in the fall, put your phone down and take a deep breath. Take a deep breath and go for a walk or do whatever you need to do to clear your head of that burning desire to go to medical school – at least temporarily that is. Rejection is emotionally and mentally exhausting, especially after dedicating so much of your time, energy, and money into applying. Thus it is crucial to your well-being to take a break from all things medical school-related. Take a day or two off from all things academic, spend time with family and friends, doing whatever it is you like to do for fun (see Chapter 12 for a more in-depth discussion on the importance of wellness during your pre-medical school journey). If you don’t have classes and can afford to take more time off to recuperate, consider taking a 1-2-week vacation to decompress. It is important you do not let this set back affect your academic performance if you are still in school at the time of receiving this disappointing news. Remember how hard you have worked over the years to maintain a strong GPA. Do not drop the ball now because a downward trend in your grades can negatively impact your future applications. Channel your disappointment into determination of getting accepted the next time you apply. Focus on your courses and finish your academic year on a strong note., This will ultimately strengthen your application for next time. In the following chapter we will highlight the steps you can take if you were unsuccessful in an application cycle to improve your candidacy for subsequent cycles. We will guide you through the immediate steps of evaluating your previous applications for weaknesses and planning on how you can improve on those shortcomings through various academic and non-academic endeavours.

Re-Evaluate your Application

One of the most critical things you must have is a PLAN. Specifically, it is important you have a rough timeline in mind of when you would like to reapply. Do you want to apply in the immediately next application cycle or are you willing to take a year or two off before reapplying? This timeline will help guide the pace at which you seek feedback and make the necessary changes to improve your application.

Taking the time to thoroughly evaluate your unsuccessful application is the first step to ensuring success in your next attempt. You are your biggest critic, so be the first to critically appraise your performance in the preceding application cycle. It will have likely been months since you last saw your application so you will have a chance to look at it with a fresh set of eyes. Begin by creating a list of what your strengths and weaknesses are as an applicant tailored to each individual school. Pay attention to your GPA, MCAT score, extracurriculars, your written statements, and letters of recommendation. Go back and review each school’s requirements , admissions statistics, mantra, and culture in order to better understand what they are looking for in prospective medical students/applicants.

A strong indicator of your performance in the previous application cycle, relative to the global pool of applicants at these schools, is whether you were rejected pre-interview or post-interview. Read through following two scenarios below to see which category of unsuccessful applicant you fall into:

• Did you receive one or multiple interviews but were either waitlisted or rejected? If yes, you are likely a competitive applicant on paper and need to work on your interviewing skills (see improving interview). Furthermore, consider your success rate for obtaining interview offers. How many of the schools that you applied to offered you an interview? If you applied to dozens of schools and only received 1 or 2 interviews, you may need to evaluate your pre-interview competitiveness as determined by your GPA, MCAT score, CASPer score, extra-curricular activities and written application. You should seek out external feedback for your written application. Being rejected post-interview can tug at your heartstrings but you should not be dejected as this is also the best-case scenario as this means you likely do not have to make extensive changes. With some improvements to your written application it is possible to receive more interview offers next time* (be weary that the application reviewers change from year to year and the variance of cohort applying may influence standards from year to year). Supplementing your improved written application with extensive interview preparation can make you feel more confident that you will receive an offer of admission.
• Were you waitlisted for an interview, but never received one? If yes, this likely means you have a competitive application but have some short comings that must be addressed. You should get external feedback on your application.
• *Random fact: McGill Faculty of Medicine has a pre-interview waitlist
• Did you not receive any interview offers? If yes, this means there are several minor or one or two major deficiencies in your application that need to be addressed. Your next step would be seeking external feedback for your application.

It is vital to get outsider opinions once you have completed self-evaluating your application. The first stop for external feedback on your application should be the schools you applied to. Remember that different schools have different admissions requirements and as such they have different criteria for how they score applications. You can try to directly call or email the admissions department of the schools you applied to and ask for feedback. However, schools have differing policies on post-application feedback. It is important to become familiar with whatever system is in place at each school. The only Canadian medical schools that provide specific feedback and scores (both pre and post-interview) to rejected applicants are University of British Columbia, Calgary, Alberta, McGill and Dalhousie. Usually, the pre-interview score is based on MCAT score, CASPer score, GPA, research, extracurricular activities, and personal essays. As such, your pre-interview score can be very informative telling you where you fall statistically compared to other applicants in your cycle, indicating which components of your application need improvement. If you had an interview and were unsuccessful, a post-interview score indicates how your interview skills compared to other applicants and should determine how much effort you put into interview preparation for future cycles. Most schools, however, do not provide a pre-interview score or any specific feedback with your rejection email. It is still worth personally reaching out to the registrars or representatives of admissions committees of the schools you were hopeful for to see what exactly they are looking for in a strong candidate. While some may not be able to give individualized feedback, a representative can provide insight into the admission process and even help you come up with a plan for reapplying. It may seem annoying and unfair that you do not know what was “wrong” with your application but this new knowledge can help you highlight your strengths and transform weaknesses into strengths. Moreover, some schools also provide sample high quality essays that you can use to compare your responses to and determine if you are a strong applicant who merely needs to work on developing your written responses.

Sometimes it may feel like there is no clear reason why you were rejected. If this is the case, try to consult mentors, classmates, friends, successful applicants, and analyze you applications on your own to find weaknesses and areas for improvement. Be open to criticism and try not to internalize it. Try to understand that the feedback may sting but it is there to help you improve. These individuals can provide excellent feedback as they likely know you and your accomplishments well and can tell whether your application reflected your best-self. Also consider emailing medical student groups at the university to see if they have any mentorship opportunities (see resources for mentorship for more suggestions for who to seek feedback from). An unsuccessful application cycle can sometimes also be attributed to the number of programs you applied to - the more broadly you apply the more likely you are to receive an interview. Keep in mind the greater time and money required when applying to more schools (refer to Chapter X for finances).

At the end of your re-evaluation and feedback seeking process, compile everything you learnt about your previous application and determine the sources of weakness. Use the following checklist:

• Were my metrics (GPA, MCAT) strong? Compare your GPA and MCAT scores to the minimum cut-offs and previous years admissions statistics. Falling below the cut-offs or not having a competitive GPA and MCAT scores are the most common reasons why applicants are rejected pre-interview. If you identify either as being the contributing factor to your rejection, then there are solutions. For ways to improve your GPA, you can refer to the sections below on completing a fifth year or pursuing graduate studies. For improving your MCAT score (See section on Re-taking the MCAT.
• Did my application demonstrate the attributes the schools were looking for? (Also consider the CanMEDS roles): Each school has a specific set of mandates and values and your application should reflect that. For example, is the school’s primary focus on rural medicine? If so, how would you fit in? Is the school more concerned about scholarship and academia? Have I demonstrated how I am best adapted to their program? Have I demonstrated what I can bring to the table as a future physician? A lack in any of these areas would indicate you may need to spend more time on adding experiences to your application. Sometimes, it’s not even about drastically updating your application; rather, it may be something as simple as rewording statements. Reflect on your activities, referees/reference letters, and other sections of the application to determine how they can best demonstrate the qualities/attributes, skills and experiences admissions committees are looking for. Refer to Chapter 6 for specific guidelines on submitting an exceptional application.
• Did I forget to submit a part of my application or get a reference letter from someone that is not allowed to write one? It is not uncommon for applicants to forget to submit an important document by the school’s listed deadline. Having a transcript arrive after a deadline could potentially cause a school to consider your application incomplete, thereby rejecting it. Moreover, consider who wrote your reference letters. It is also not uncommon for strong applicants to be rejected because their reference letter was written by someone who could have a conflict of interest. Examples include friends and family members, particularly with the same last name as your own. Be cognizant of this in your next application cycle.

There are many different options on what to do following rejection from medical school. Firstly, you should decide if you want to apply again and when. Take time to reflect on whether medicine is even the right career for you. Would you be satisfied with other healthcare professions? (see Chapter 1) Although students sometimes feel obliged to follow a medical career path because it is what their family expects of the, you will ultimately live your own life and have to endure all of the challenges associated with a career in medicine. You do not owe anyone when choosing a career path. Ultimately, the decision to reapply and continue on the path to becoming a physician is based on your personal life goals, what makes you happiest, and the extent of improvements you think your application requires to be competitive. When you choose to apply can also be based on where you are in your education and career. If you applied out third year and were unsuccessful, your next steps are pretty straightforward – finish your undergraduate degree. Use the time between third and fourth year to begin self-reflection and work on any weaknesses you identify in your initial application (see re-evaluate your application). If you are in your final year of undergraduate studies and were rejected, you have many more options in terms of what your next steps are. It is important to be realistic with yourself in terms of what you can accomplish between subsequent application cycles. If your application has some moderate weaknesses, such as in your interview skills, MCAT score, research or life experiences, it is reasonable to accomplish these tasks in several months before the next application deadline.

Most students will retake the MCAT, take extra courses, engage in research, travel or take the time to invest in themselves in another way. However, if during your review of your previous application you identify large gaps, such as low GPA, extensive deficiencies in extracurricular activities, it is likely that you may need to invest more time into making improvements. Not everyone will reapply the following cycle and some people may even take 3 or 4 years off to invest in other passions and life goals. The options are endless as to what you do during this time to improve your application . Whatever you choose to do, have a plan and timeline in mind. Having a plan can help to make sure you are staying on track with whatever goals you have set between application cycles. The next few pages highlight both short-term and long-term avenues medical students pursued following rejection letters.

RETURNING TO SCHOOL

Graduate Studies

Graduate studies have recently become a popular option for students who have completed an undergraduate degree and want to continue formal education between application cycles. Pursuing graduate school is a multipurpose alternative plan for undergraduate students unable to gain acceptance into medical school after previous attempts who have decided on embarking on a medical career late into their undergraduate degree. This route allows you to strengthen your medical school application for future cycles in many ways, while simultaneously providing you with alternative careers and employment opportunities if you choose not to apply to medical school again or are unsuccessful after reapplying. Moreover, many medical students will complete masters and/or PhD studies during their residencies to pursue academic jobs or for career advancement. Thus, pursuing graduate studies before medical school can allow you to develop these skills much earlier in your training. Although there is no wrong option for graduate studies, it would be useful for you to sit down and consider what your long-term goals are if you get accepted after an additional degree. For instance, if you are passionate about working in an academic hospital as a doctor, it could be useful to work towards a master’s degree in epidemiology or clinical research. Alternatively, if you are interested in administration, you could pursue an MBA/MPH/MHA as there is an increasing trend of physicians working towards these degrees during their training.

There are several streams of graduate studies, which vary in duration, expectation, and the type of work produced at the end. Generally, graduate programs fall into two streams, research-based and course-based, also called thesis-based and non-thesis, respectively. Depending on the medical school, a course-based and researcher-based master’s can be evaluated differently. Some schools do not categorize those with a course-based Masters in the graduate student pool of applicants, therefore the advantage is provided to those with a thesis-based graduate degree. As such, in some cases a research based Masters may be more favourable to your medical school application - the decision ultimately comes down to which schools you want to apply to and your individual preferences and interests. It is best to choose something you are passionate about and which you could talk about in an interview. Interviewers often love to ask why you chose a particular path, such as completing a PhD, prior to applying to medical school. Some graduate programs can help add to your overall GPA with certain schools, while others with a lesser emphasis on coursework may not have a major impact on your GPA. One benefit of engaging in higher-level academia, in addition to enhancing your knowledge, is the plethora of networking opportunities and ability to establish connections with individuals who may be helpful throughout your medical school journey. These can be referees for future applications or mentors who can provide insight into making difficult decisions. Earning a master’s or a PhD can also open alternative career doors in the medical field. It is important that the decision to pursue a graduate degree is driven by interest and not just a desire to “boost your application”. A lack of genuine passion for academia can be readily evident if brought up during the interview process and is often frowned upon.

Pros and Cons of Pursuing Graduate Studies to Strengthen Your Medical School Application

Pros

• Professional connections
• Professional development
• Allows you to continue education
• Gain experience in project design and management, academic writing and potentially teaching
• Enhance resume
• A chance to invest in healthcare in a different way
• Can open doors to alternative career paths

Cons

• Time consuming
• Expensive - consider programs with stipends
• Long term commitment - it is frowned upon to leave graduate school early on acceptance to medical school

Applying to Other Postgraduate Programs

If you are not interested in applying for graduate studies, there are a wide range of programs you can apply to. Some of these postgraduate programs are variable in length and can often lead to specific careers. For example, Pharmaceutical Regulatory Affairs and Quality Operation is a 1-year post-grad program that focuses on the understanding of the regulatory compliances in Canada. It often includes a paid internship that can help propel your career in that field. Careers working in the private pharmaceutical industry or even with Health Canada are common employment sites. Another program is clinical research certification that helps with the conduct and principles of clinical research and design, something that can help further your interest in medicine.

You can also consider applying to other health professional programs such as nursing, pharmacy, physiotherapy, physician assistant, dentistry, etc. These programs have many similarities to medicine and can lead to fulfilling careers and can potentially suit your goals and aspirations You could also always re-apply to medicine after additional training and provide a diversity of knowledge to the incoming medical school class. Keep in mind some of these other programs have specific requirements and may need you to plan ahead to ensure you have the necessary pre-requisite courses, and/or additional exams (e.g. Dental Aptitude Test).

Pros and Cons to post-graduate programs or other professional schools

Pros

• Wide range of program choices
• Allows you to continue education without doing graduate studies
• Develop knowledge/skills geared towards a specific career that will lead to employment
• Can often complement training in medicine

Cons

• Academic rigour varies and can affect your GPA
• May be difficult to do other projects (e.g. volunteering, research, etc.)
• Long term commitment - it is frowned upon to leave other professional schools early on acceptance to medical school Course requirements to apply to these programs may require you to plan ahead to ensure you can start at the end of your undergrad.
• Many of these programs are costly

Continuing Undergraduate Studies

If you were planning to graduate, you may consider adding a 5th year as a special student. Alternatively, you can complete another undergraduate program. This may allow you the flexibility to redo certain courses to potentially improve your GPA and provide you with time to consider adding additional courses to apply more broadly. Although continuing undergraduate studies is not a popular choice in general, it is one that is available to you if you feel you are not ready to graduate. This 5th year can also provide you with time to reflect on your current and future goals.

Pros and Cons for continuing undergraduate studies

Pros

• Chance to improve GPA
• Redo specific courses
• Help study for the MCAT
• Chance to take courses for interest and possibly parallel plan for other programs
• Developing other non academic skills and activities
• Get involved in school activities
• Complete prerequisites courses missing previously (e.g. English course to apply to UBC)
• Some schools may only look at last 2 or 3 years of undergrad marks

Cons

• Possible that GPA is not improved (it is a risk)
• A 5th year can be costly and it is not as great for future jobs/employment
• GPA calculation is variably dependent on institutional policy

TAKING TIME OFF

While some students feel like taking a year off to travel or volunteer is needed after going through many years of school, others may still feel pressured to be highly productive during this time making this seem like a mere pseudo-escape. In any case, taking a year off to travel or volunteer is a great way to embark on some deep self-reflection, personal growth and relax. That said, your decisions on whether to travel, work or volunteer, and on where to do so should be well-planned. If there is an intention to reapply to medical school, it may be a good idea to set internal deadlines for decisions that you will need to make.

• “When are the deadlines for applications the year I finish my time off?”
• “When are interviews and will I be able to make them” “How long am I giving myself to decide on whether I want to re-apply for medical school or continue on my new path?” “Will I have to work to balance the cost of traveling with medical school application fees?”

Thinking about these questions ahead of time will reduce last-minute stress. A reasonable timeline is to try to plan out gap year travel or volunteer by March of your senior year, that way you can also weigh your options of travelling/volunteering with research and applying to graduate programs, which typically have deadlines around this period of time.

Taking a Year off to Travel

Don’t feel pressured to be caught in the “rat race” of being extremely productive 100% of the time to get into medical school. Sometimes a break is necessary, particularly before starting the arduous path of becoming a licensed physician once accepted into medical school. Self-care is important. To this end, many medical students themselves travel throughout the year to recharge their batteries before going back into their studies, research, shadowing, and extracurriculars. Travelling as a pre-medical student allows you to develop stories and life experiences packed with lessons about other cultures, yourself, and not repeating certain mistakes in the future. The AAMC has a blog post about travelling during one’s year off. Although travelling can be fun, it is strongly advised that you think about how much time you want to be travelling and weigh it against other activities like volunteering, working to make money, or performing research.

Pros and cons of taking a year to travel

Pros

• Cater to your mental health
• Provides the opportunity to do some reflection that might help your application
• Experience new cultures, personal development, etc.

Cons

• May be giving up time that could be spent on other areas of personal growth
• May be a lost opportunity to reduce some financial burden before medical school

Taking a Year off to Volunteer Outside Canada

Service is a great way to facilitate personal growth. Many students decide to volunteer during their year off. It is very important to decide on how much time you will want to spend volunteering versus balancing your gap year with other activities. Volunteering abroad may lead to an opportunity to be a part of something you have always had at the back of your mind during undergraduate studies, or even lead something new altogether. It could also allow you to gain a new insight into various issues in other communities and ways in which you can work with others, particularly in solidarity with community members, to help those in need. This newfound knowledge can be critical to you if you are passionate about global health or global surgery and would like to make this a part of your medical training and/or practice. Some pros and cons for volunteering are listed below.

Although volunteering can be a good way to boost your application, a common misconception is that it is a necessary requisite for medical school, but this is not the case. It is not fair to those you are serving if you are not passionate about volunteering for them or if you are merely using them as a stepping-stone so it is important to recognize this.

*Note that travelling to a location where you can volunteer with the actual intent of vacationing or adding to one’s resume is known as voluntourism. This type of volunteering for personal gain is not the best reflection of service, and there are many documented cases of communities that have been inadvertently harmed by individuals coming into their living spaces, that disrupt their way of life without fully giving them the tools to recover and grow. It is important to plan your volunteering experiences with this in mind so that you not only grow yourself but also leave a lasting, positive, and sustainable impact on these communities.

EMPLOYMENT

Working is another great way to keep you busy all while exploring different careers. Working can be related to medicine such as research which may allow you to further develop those skills all while remaining in the academic world. At the same time, working in a non-medical field can provide you with not only new stories and skills but also help you stand out and build strong rapport with your interviewers. That being said, regardless of what the job is, working gives you the option to explore without committing to an additional degree such as doing a master’s or PhD. A list of pros and cons have been listed.

Pros and Cons to employment

Pros

• Earn a living
• Save money to reapply or repay loans from undergraduate studies, and thus reduce financial burden before medical school
• Explore different career options
• Take a break from academia and avoid burnout
• Depending on workload, may give you time to work on applications
• Allows you the time explore options if you do wish to return to academia (parallel plan
• reapplying to medicine AND other programs)
• Build new skills and overall work experience
• Develop contacts and mentors
• No studying during off work hours (hopefully!)
• May be able to take classes to improve GPA without committing to another degree
• Make yourself stand out and build strong rapport with your interviewers

Cons

• Hard to gage how schools interpret this
• May be difficult to readjust to academic life when you do return
• Workload may be heavy and difficult to schedule time for other activities (e.g. volunteering or research)
• Does not add to your academic repertoire
• Not always easy to find a job

Working in Research

Working in research allows one to develop a lot of great skills similar to that of a graduate program. If you are on the fence about doing a master’s, taking time to work in the field is a great option before you make the commitment. Often, many jobs in research recruit during the summer months, particularly hospital-based research positions. A benefit of working in research is that it allows you to get a better understanding of the conduct of research from ethics board approval to recruiting patients to writing manuscripts. It can be fulfilling to be able to see projects run their course. If you work at a hospital, there is access to mentorship, attending grand rounds, professional development and networking with other like-minded people. The skills and development gained in a research position is high and very translatable to medicine.

Working in a non-med related industry

Any current medical student that has worked in a non-med industry will tell you that the skills and experiences that they have gained are indispensable. The value of a non-medical job depends on what you make out of your position. Working in a non-med industry won’t necessarily harm your application as there are many medical students who have worked in the whole range of construction, security, flying planes, and retail before beginning their medical journey. In each of these positions there are traits that you gain that can be looked at favorably by whoever is reviewing your application. For some people, their job is in fact a part of their personal story. It is important to embrace this and reflect on if your decision to work in a non-med industry plays into your development as a doctor. At the same time, working in a non-medical industry can be rather unique to interviewers who typically only see students specializing in research and volunteering. If presented correctly during your interview, the interviewer can be more likely to connect with you, remember you, and vouch for you during the acceptance selection process.

• Anecdote for working in a field outside of medicine:
• Mohamed Ahmed
• After completing my undergraduate degree, I decided to work in a warehouse as a production operator. During my time there, I realized the hard work that many labourers commit to - long shifts, cycling from day/night schedules, and all the effort that is put into their work. Effective communication was crucial to maintain high-throughput. My team comprised a majority of recent immigrants from all corners of the world. With that, I was able to learn countless lessons in cross-cultural communication, which became valuable during my application essays, interviews, and throughout medical school. Eventually I became a quality auditor, a higher leadership role that required diligence to detail and relaying key quality and safety information to various teams. Discussing the value of quality and safety for both the customer and business with production workers, managers, and others allowed me to learn how to better tailor my language and approach so that everyone could appreciate and benefit from my suggestions. Ultimately, this experience, which was not directly related to medicine, gave me a number of key experiences that really built upon my character and provided for meaningful anecdotes during my medical school applications!

• Anecdote for working in a med-related industry:
• Working in a med-related field is invaluable because you can earn money and gain clinical experience at the same time. I worked as a surgical assistant at an ophthalmology clinic for two years before reapplying to medical school. Before applying to this job, I looked into the position to ensure that it aligned with my interests and objectives. : It was really important for me to develop leadership skills and gain clinical exposure. I felt that this position would help me do that. I enjoyed my work because I could see how doctors managed their patients. In my application, I reflected on what I had observed in: the interactions between medical professionals and their patients. I considered both the limitations and strengths that I had been privy to in those interactions and in the doctor-patient relationship. While working there, I also often considered how I could improve that relationship both in my current role and even as a future physician.
• On the other hand, I was also able to gain insight into how patients really felt. : Dissatisfied patients did not always express themselves honestly to the doctor. Patients confided their fears in me, and that helped me better navigate my own role as a liaison between the patient and the doctor. It helped me figure out what I could do to help patients feel better, and how I could best support them in their relationship with the doctor.
• It was also critical for me to consider my employer’s priorities and goals. : While patient care was a priority, I also realized that some of the interests of the private clinic, included the delivery of services and products. Although these goals certainly influenced my experience, I also recognised that the stakeholders involved included patients and doctors, meaning that there was always more risk involved with mistakes or errors. II thus shouldered immense responsibility as a surgical assistant I tried to be aware of my own anxiety and feelings around these responsibilities When I needed help, I could rely on my coworkers and supervisor for support. All in all, working at an ophthalmology clinic was an invaluable experience. Because it was an important part of my life, it also ended up being a critical part of my application the second time around.

REAPPLYING

Use your rejection and the period between now and subsequent cycles as an opportunity to grow, improve, and learn. It would be futile and unproductive to submit the same application in the hopes of getting accepted in subsequent application cycles. While it may not seem like it at first, this is an opportunity to try new things, take on challenges, and learn more about yourself.

Consider applying more broadly (if you are financially able to do so) If you only applied to your home province, consider applying to other schools in Canada. While the decision to apply to more broadly is a personal one, it may improve your chances to consider all 17 Canadian medical schools. Each has their own requirements and often have more stringent requirements for out of province students. Applying more broadly does mean more costs to apply so be mindful that you truly meet the school’s requirements and consider the number of students they take outside of their home province. It would be beneficial to call the admissions office of the out-of-province schools to see what they consider a strong candidate. For instance, some schools will only consider your MCAT and GPA and provide interviews to students who ranked in the 99th MCAT percentile. If you did not score very strongly on your MCAT, and this is important for the school to which you are applying, it would not be in your best interest to blindly apply. However, if you are comparable to the pool of strong applicants at a school, then you should strongly consider applying. If you speak French, also consider applying to the French medical schools (which do not require the MCAT).

Re-taking the MCAT

There are a few things to consider when deciding whether to retake the MCAT. What are your objectives in retaking the MCAT? Do you have other commitments that might impair your ability to prepare adequately for a retake? While these are questions that you must consider critically, here are some other guidelines to help you with your decision:

Consider the limitations of retaking the MCAT. Some schools will only consider the most recent score, regardless of whether it’s higher or lower than your previous one(s). MCAT scores are also released on particular dates, meaning that you might not see your score until after you’ve submitted your application. What happens then if your score is not competitive, but you’ve already applied? Also consider how costly a retake might be. Not only are some prep courses expensive, but taking time off work to focus on studying may also not be financially feasible in your situation. Think critically about these things when deciding whether to retake the MCAT.

Extracurriculars

Reflect on how you can better demonstrate and develop the attributes, skills and experiences that a competent physician should possess. Sometimes, rewriting and rewording your statements to better emphasise CanMEDS roles can greatly improve your application. Rather than stating or listing your tasks, for example, focus on how the activity helped you grow as a person and will ultimately contribute to your identity as a physician. Continue the activities, therefore, that are meaningful to you and your growth, since demonstrating long-term commitment is also an important aspect of your application. You may consider the way in which you are describing your extracurriculars in essays. For instance, rather than trying to list out the many accomplishments you may have achieved, it may be better for you to thoughtfully self-reflect on how the activity helped you grow as a person and ultimately as a future physician. For example, if you had the opportunity to work in an underprivileged community, you should not dedicate your essay on the accomplishment of spending three weeks to help build a well. Instead, you can focus on how the experience shaped you as a person. You want the admissions committee to see that you are self-reflecting. Thus, you could focus on your newfound appreciation for working long hours and working with your hands through building the well. Moreover, the experience allowed you to see the importance of teamwork and pre-planning to achieve a common goal. It also allowed you to become a part of this community coming together to build this well. Ultimately, you can integrate this to demonstrate that as a physician it will be critical to work well with others, plan well in advance, and sacrifice hundreds of hours all for the benefit of others.

There is no formula for an exceptional extracurricular profile. It is therefore useful to reflect on your own weaknesses, strengths and fears. In the past, you may have not focused on the activities and pursuits you were most passionate about for fear that they may have not been relevant to medical school. Any opportunity, however, to learn more about yourself, take on new challenges, grow and/or develop skills is relevant. When you genuinely enjoy doing something, it’s much easier to discuss it during interviews, in personal statements and essays!

Letters of Recommendation/Reference Letters

Were your letters of recommendation strong attest to who you are as a person? If you have any doubt that your referees are well-suited to speak highly of your character, consider replacing or changing them. To ask for a reference letter, consider: “Do you think you would be able to write a strong letter of reference for medical school?” Moreover, consider changing your referee(s) if you are now involved in an extracurricular activity that means a lot to you. Perhaps, you’ve developed a new and strong, professional relationship with a supervisor, manager or preceptor. Referees who work directly with you will be able to provide several instances that attest to your skills and character. Sometimes, it’s also helpful to select referees whose professional recommendation will have profound weight on your application. Individuals like preceptors, professors and doctors may be appropriate for this reason alone. On the other hand, you may not find it necessary to change your referees. That’s also completely fine, but it may be worth it to request that your referees update the previously submitted reference letters to reflect your new activities, new skills and new experiences. Refer to Chapter 6 for more specific guidelines on letters of recommendation.

Take your time! Don’t rush improving your application. It takes time to grow and learn more about yourself. You may need to skip an application cycle, so that you have enough time to work on your application. Rest assured - this is completely fine!

IMPROVING INTERVIEW

Reapplying after previously interviewing can be a daunting experience, but do not let that get to you! Having been previously selected for an interview, you have made it through the most challenging portion of the selection process. The medical schools in question already value your written application, and you may not have to adjust by much to remain competitive.

The next step of interviewing is a different ballgame. You need to be able to demonstrate your soft skills, personality, values and critical analysis skills in a rather short amount of time. Oftentimes the stress and anxiety of the interview can lead to poor performance where you could not represent yourself clearly, provide relevant experiences, articulate your thoughts clearly, and build rapport.

After having experienced the interviews in the past, the first step is to reflect on and re-evaluate your previous interview experiences. How did you feel before, during, and after the interviews? Did you feel you could improve on any of your answers? Were you able to answer your questions in time? Did you feel mental blocks? Really taking the time to reflect on questions like these and more, will help you isolate any areas of strength and weakness that you can work upon for your next application process! Also, it is good to compare your experiences with MD interviews to other interviews you have experienced in the past - good and bad - to get to know the interview style that works for you, and further tailor it to make you a more confident interviewer.

Next, the interview process is a very personable experience, and really explores your ability to communicate your thoughts, actions and values with your interviewers. With that said, having made it this far you have plenty of experiences that make you an awesome and interesting person - never forget that! In order to portray that awesome person to maximum effect you need to: A) Be yourself, and be true to your values and beliefs. And in order to that you need to B) Get to know yourself.

To do so, reflecting on your past experiences is key. One common mistake applicants make is trying to give standardized answers to interview questions. As you practice with dozens of other applicants during the next application cycle you will begin to see that most students answer questions, like MMI and MPI stations, in a formulaic manner. Although this is important, and in some cases essential, it is equally vital to set yourself apart so that you develop rapport and your interviewer remembers you. Take, for example, the question of whether you would prescribe contraceptive medication to a 13-year old who is asking for it from you and pleading that you do not tell her parents. Although there may not be an age of consent in Ontario and you could spend time evaluating the pros and cons of providing the contraceptives, you should use this time to focus on how you can get the interviewer to get to know you during this station. You will learn about medical ethics and laws during medical school so show the interviewer who you are as a person. For instance, you can focus on the importance of family to you and how you would feel extremely uncomfortable with yourself by not telling the parents in this situation and building a barrier within this family dynamic. You can provide an anecdote about the importance of keeping a family together. Alternatively, you can emphasize the importance of advocating for women’s reproductive rights and any previous experience you have had with this field in the past. You can spend some time showing the interview why this topic is important to you, how you advocate for others, and who you are as a person and would be as a physician. While you remain the typical framework of answering MMI and MPI questions, you can use this approach to give the interviewer a sense of who you are as a person including your values, morals, and how you make a decision.

As an aside, doctors must make many difficult decisions and are not always right in the choices they make. It is better to outline a decision you will make, such as who you would save in a hypothetical trauma MMI station, compared to just outlining the two sides of the coin and saying that you would need more information to decide, ultimately not giving a solid answer. Many students continue to fall into this trap. Be aware of it and try to integrate a bit of who you are in your response while still answering which choice you will make, when applicable.

The table below highlights one method of exploring your experiences that you may have listed in your OMSAS application: Experience - E.g. OMSAS Entry #; Type of Experience

• Narrative: - What is the story of the situation?
• Skills Gained: How have I improved from this situation?
• Shortcomings/Failure: What were some aspects that could have improved on to improve this experience in the future?
• Conflicts: Were there any conflicts in this situation? How was it handled?

Undergoing a process like this is valuable in building your narrative and increasing your repertoire of experiences that can be used to improve the strength of your interviews. This has the effect of reducing mental block as well, and overall improving confidence when conducting your interviews!

Since the interview depends on effective communication - practice, practice, practice. Having previously interviewed, utilize your previous experiences to go over similar conditions with friends, family, or even by yourself. Other valuable resources in preparing for interviews include interview workshops hosted by University support groups, student councils, career support offices and privately by tutors (see Section 5. - Resources). Reviewing a list of common interview questions can be extremely helpful in not only practicing your ability to speak clearly, but it can also improve on your confidence by being more prepared. In practicing, it is really important to assess your ability to demonstrate that you listen, and be able to articulate a meaningful response.

This can be done with peers by having them provide feedback on certain aspects of your interview. Also, recording your practice interviews can be really valuable to allow you to self-critique your own interview. There are many times when you feel like you are doing a great job responding to questions only to listen back to, or watch, yourself sounding awkward, seeming uncomfortable, or having bad interview etiquette (touching your face too often, saying too many “umm” “uhh” “yeah”, rambling, not reading the room when the interviewer wants to move onto the next question). Remember that it is better to fail in practice and catch and correct your mistakes early than to be ignorant to them and continue making these errors during the real interview where every second counts.

Lastly, anxiety often is a big contributing factor to hindering interview performance. To start, it is okay to feel nervous, but it is important to address the cases of excessive anxiety that could prevent you from shining. Some important questions to ask yourself: Did you feel that anxiety affected your interview? What effect did it have on your ability to conduct/prepare for the interview? What are the root causes for your feelings of anxiety?

First and foremost, it is 100% critical to remember that you are an awesome individual with unique, interesting and valid experiences. Oftentimes a sense of inadequacy compared to peers can lead to self-doubt, and this leads many to try to portray themselves as a sort of “ideal applicant”. There is no one “ideal applicant” and interviewers can very quickly see through this facade as it does not reflect your personal beliefs and values. It may not seem obvious at first, but once you practice with others you will learn when students are trying to sound like an “ideal applicant” and when they are genuinely expressing themselves. Remember that you were chosen for an interview because you were deemed highly qualified!

Steps to bust anxiety:

• Control what you can - From the steps above, exploring your experiences and practicing interviews helps you to be better prepared and more confident for future interviews.
• Practice anxiety relieving techniques that work for you - some options include, taking a pause, breathing exercises, and so on. This can be practiced when conducting mock interviews.
• Practice self-compassion.
• Avoid caffeine before interviews.
• Do the power pose

RESOURCES FOR SUPPORT AND MENTORSHIP

Community of Support

Mentors in Graduate School

University Career Services

**Extra Resources**

• More

We came together to write this book in our attempt to break down some of the barriers to medical school. When hope this helps you on your journey and please pay it forward when you have the chance!