Getting accepted into a medical school in the United States is no easy task. The hurdles in place ensure high caliber of applicants and matriculating students make simply getting accepted a task in and of itself. The mountain of expectations, requirements, and time required to pursue an advanced degree in medicine already eliminates many who would otherwise be capable doctors from pursuing these paths. Not to mention the immense financial implications that serve as barriers many who aspire to care for patients.
Particular difficulty faces our colleagues who are applying from outside of the United States. For example, the acceptance rate is roughly 10-15% for international applicants applying through the American Medical College Application Service. The seemingly impossible path towards becoming a physician is even more grueling for international students. Here, I have attempted to highlight some of these issues and how I have seen applicants overcome them.
1 | Differences in the Application
While the application for medical school itself is not different, there are sections that will make it known what your status is. Schools will separate candidates into U.S. and international graduates, with the latter group being further separated into those who graduated from an undergraduate program in the United States versus abroad. The application itself will delineate those differences and schools may have inherent biases one way or another.
2 | Finding a Mentor and Participating in Research
As with all things in medicine, mentorship is an invaluable tool. Finding someone to help guide you through the process will alleviate a lot of the stress. From observing my colleagues from overseas who have matriculated into schools in the United States, I have seen successful relationships formed with research and shadowing mentors. These relationships help two-fold, both in bolstering your list of experiences in the application and in providing you with someone who can help guide you through the process, granted they would have to have some knowledge of the system.
Ultimately, having additional research experience – peer-reviewed publications and abstract presentations are a huge plus – will be a powerful aspect of any application, and will certainly bolster an international applicant’s campaign. More and more, schools are looking for students who will produce academic publications, and international students who have research experience will certainly stand out amongst their peers.
3 | Grades and the MCAT
There is no doubt that medical school is becoming more and more competitive each year. Applicants boast incredibly high MCAT scores and GPA’s, and with the increase in applicant pool each year, higher percentiles are the norm. This is where international students can help level the playing field, because even some of the most stringent biases can be overcome by solid marks. Those reviewing applications may favor applicants from undergraduate schools in the United States but seeing an international candidate with high MCAT scores may provide the incentive to give an application a second look. With regards to GPA, the grades from most international schools may be entered into the AMCAS application, but without the normal methods of standardizing and verifying those scores – as would be done with an accredited US school – a GPA cannot be calculated. Thus, there will be heavy reliance on the standardized MCAT score.
Therefore, international candidates may want to consider completing pre-medical coursework at a U.S. institution. Showing that you can achieve good grades and maintain a high GPA at well-known and accredited schools in the States will help show that you are both capable of performing well in this system as well as demonstrate a commitment to matriculating and studying medicine in the United States. In fact, some schools require you to have completed all the actual pre-medical requirements in a US accredited school, making this almost a necessity for certain applicants.
4 | Citizenship and Visa Status
The first issue – citizenship – is often more of a financial concern. Most government programs require some proof of residency or citizenship to qualify. With the inherent expense of medical school in the US, international candidates must be prepared for addressing the bottom line, which will be an uncomfortably large bill. While many students rely on loans, many of the traditional options may not be available for entering the US on a student visa. In addition, make sure you do your research. Many schools traditionally will not accept international applicants and applying to them will be a waste of your time and money.
5 | Language Barriers
This goes without saying, but a mastery of the English language is a must. The rigors of the medical school curriculum are daunting for even the best students, US-based or international. The clinical lecture pattern for the first two years that most schools still adhere to are a whirlwind of information.
Thus, it is paramount that you demonstrate a level of understanding of the English language needed to succeed in this arena. This begins with the application. First and foremost, your personal statement should be immaculate, and edited until perfect. The application itself too must demonstrate a certain level of elevated polish. Bias and preference may lead reviewers to read an international candidate’s application packet under a metaphorical magnifying glass, eager to catch mistakes. Ensure that your application material is all up to the highest language standards.
6 | Interview Preparation
Next, significant time should be spent preparing for interviews. Instead of learning how to explain your international status, focus on the positive aspects of your experiences. International students bring with them a wealth of diversity. This includes diversity of culture, thought, language, and experiences. The study of medicine demands that students overcome barriers towards treating patients who may be different than themselves; having a diverse student body helps to start this process early on. I remember learning a great deal from a classmate in my anatomy lab group, who was able to sprinkle bits of his culture and experience into our session together. By the end of our year dissecting a body together, I felt I had a much stronger grasp of his African culture – his food, his family expectations, his marriage, etc. – than I had previously. This type of collaboration can be very positive, making overseas students an important part of every med school class. Practice selling how unique you are to interviewers.
That being said, ensure that you have rehearsed heavily for these interviews. US applicants spend time doing mock interviews and practicing answer questions with each other well in advance of interview season. International applicants should do the same, with extra emphasis on understanding American norms for body language, distance, and physical contact. A firm handshake and direct eye contact are a must to start any interview, and this may not be the norm for interactions between teacher and pupil in other areas of the world.
7 | Make Yourself the Best Applicant Possible
All the points above are designed for one purpose – to give you the best chance of matriculating as an international applicant. It is not a secret that the bar is much higher, and every effort should be made to bolster your application. Coming in prepared and having done the appropriate research will help prevent wasting both time and money. There is a lot to be gained by having a diverse medical school class, filled with students from around the world. Learn to sell your individuality and strengths, instead of explaining why you should be given a chance.
