Medical School Offers of Admission

Medical school offers of admission are now out, and many lives have since changed. This post will be addressing the different outcomes, those who got rejections, those who got waitlisted and those with offers of admissions. If you do not want to read the whole post and only want the information that is pertinent to your situation then scroll down to the section that applies to you.

Rejection Letter

If being a doctor is your dream, then that rejection letter can be heartbreaking. What I can tell you is that if you were afforded an interview, you already have what it takes! You have the baseline statistics necessary; the schools saw something they want in your application, and you just need to sell yourself better next time. There is a lot of variation between interviews and a lot of confounding variables and situational factors that are out of your control and have nothing to do with you as an individual. Try not to take interview results to heart, but as I say in many of my previous posts and is a consistent theme from me in general, be reflexive. Think about your interview performance – how did you feel coming out of it? Was there something that went really well, was there something that did not go as well? An issue with interview performance is that it is more difficult to get objective advice on your performance compared to other aspects of your application. The people who interview you do not provide a score, so you can only guess how you did on the day. The best you can do is practice interviews with friends, counselors, or other individuals and hope that how you practice and how you interview on the real deal are similar enough, and hope their opinions are representative of how med interviewers judge you. If you were not afforded an offer, it is ok to be sad and feel down. I will not sit here and undermine what it means for you, but do not think it is over. There is no limit to the number of times you can apply and just because this year was not your year does not mean that you are unfit to be a doctor and next year will not be it. Many individuals in medical school applied multiple times to get in, it is not uncommon. Reflect on your experience, on where you could make improvements in your application and how you could improve your interview performance. Maybe you need to start practicing sooner, reflect on your experiences better, or improve your overall speech skills. Make a list of what you want to improve on, prepare some SMART goals for yourself and kill the next application cycle, do not let it keep you down. If this is your dream, then keep trucking away, soon enough you will make it.

Waitlisted

Now let us talk about those on waitlists. Waitlists for Ontario medical schools are strange. Most schools do not start releasing seats for their waitlist until after the acceptance deadline unfortunately, so for those who are waitlisted at their top choice school and provided an acceptance to another school have a tough choice to make. The first thing I would do is call the school you are waitlisted at and ask how their waitlist moves. If they roll out offers as seats vacate then I would advise waiting until the deadline to see if a spot opens up for you. Otherwise, you can risk a medical school admission for a possibility at your top choice school, but should you? In my “blunt” opinion, don’t be an idiot. I will address the issue of multiple acceptances and what to do, but if you applied to a medical school you should have the intention of going there, if you had no intention of going there then why would you apply? You have no idea where on the waitlist you are, you could be top or bottom or anywhere in-between, is it worth risking a medical school admission you were afforded for a CHANCE to get into a school you would prefer? The only situations I can think of against this advice is if you got into a school you have reasons you would not like to go to base on it being in a city that is incompatible with your life, if the program length is not ideal for you or you do not like the way they educate you, but if any of that was the case why did you even apply for this school to begin with? If your goal is to be a doctor, any Canadian medical school can help you get there, and you could risk it with your waitlist position, but if that is the case you need to assume you are not getting into medical school and hope that it works in your favor later.

If you are waitlisted without any admission, then my advice is to treat it as a rejection. You might be pleasantly surprised sometime in the summer but continue on with your life the same as a rejection. The only difference is since you were waitlisted you know that your interview performance just needs a touch more improvement, you are almost there! If you check statistics of the various medical schools, the waitlist does make good movement. Most schools have a waitlist movement of about 50-100 and the reason for this is that many times those individuals that get acceptances will get multiple acceptances, but they can only pick one school to go to. If an individual gets accepted to 3 schools for instance, once they accept their offer, 2 spots from the waitlist at the other schools they were accepted at open up. Your odds are not terrible, but it is still a good idea to treat it as a rejection for planning your immediate future.

Accepted

For those of you that got medical school acceptance letters I would like to take the time to congratulate you! You are about to join a great profession and I am very much looking forward to having you as a colleague and working with you in the future. Now that you got in, you probably have lots of questions, I know I did, so I will take this time to answer some common questions asked by individuals that got into medical school and provide some tips and information you may not know about. If you have more specific questions, feel free to contact me and I will aim to answer your specific questions.

First, I would like to address the case of multiple acceptances. If you have multiple acceptances, then I’d like to extend and even bigger congratulations. That means you not only impressed one, but multiple medical schools and the power is in your hands. You get to pick the school that you think is ideal for you and can address your needs the best. For the most part, any medical school in Canada is a good medical school and getting your MD from pretty much any Canadian medical school will be practically equal. The only differences you can get is in terms of how they teach you, the resources they have available for your use, the connections you can make from the program, and of course the city you live in. The name itself does have some weight, especially if you plan to go internationally, but in the grand scheme of things it is not all that important.

A huge difference in programs to begin with is 3-year and 4-year program differences. If you got accepted to multiple schools and there is a mix of 3- & 4-year programs, I think the first thing you should do is determine whether you would prefer a 3-year or 4-year program. There are pros and cons to both. To briefly cover, 4-year programs allow you greater time to learn before you start clerkship, they tend to give you time in the summer to build your resume or travel and enjoy your life. A 3-year program on the other hand has the advantage of saving time. You get into the workforce quicker; you also pay less in tuition and you tend to have more flexibility in terms of learning what interests you more. I always recommend 4-year programs for people like me who had no idea what specialty they were interested in, so they had more time to explore and learn a bit of everything before needing to commit. 3-year programs on the other hand are better for those who know what they want to do going into medicine since they tend to afford you more flexibility to only learn what you need to learn so you waste less time learning things that are less relevant to your interests. Another big factor is if you want to do residency in the United States or potentially do a fellowship or work there then you will need to do your USMLE step 1 examination. This test is ideally done in the gap between pre-clerkship and clerkship but with a 3-year program you not only lack an entire year of building foundational information, but you also tend to lack summers off to be able to study for this so it may be difficult, but it can still be done.

After making that decision, you should look at any remaining schools and compare their curriculum. How do they teach you, what do they offer you? Do they provide you access to cadavers? How do they assess your learning? Is it through frequent tests or midterms and finals? Do they have a mix of group-based learning or is it all lecture-style? A great way to learn a bit more about a school is to reach out to current students and ask them specific questions about their experiences. Along with the curriculum it is important to look at the hospitals associated with the school. Do they offer a broad range of specialties, do they have a good reputation and are there leaders in both clinical and research work in these centers? By having access to not only tangible resources, but also the social resources such as mentors with a variety of experiences, you set yourself up for a successful career.

Another huge factor to cover is finances. I will actually make a completely separate post on financing yourself in medical school, but the first thing I should cover is getting a line of credit (LOC). Unless you or your parents are very well off, and they are willing to pay for your expenses, you are going to need to have access to liquid capital because medicine is an expensive field to study. Tuition, at the time of me writing this, is over $27,000/year for most schools, and it continues to rise, not to mention the living expenses of a city. If you do plan on taking electives and interviewing for residency positions, your final year can be VERY expensive because of consistent trips to various locations for electives and interviews. Once you get your offer you should start shopping around for a line of credit. Make appointments with various banks and speak with them about what they offer. Come in with questions prepared based on what you think is important. I will not share the details of the specific plan I chose because I am not being sponsored by any of the banks, plans are consistently changing, and because I would like to offer you unbiased advice that you can interpret from your own lens based on what you think is most important to you.

So, to start off compare the actual line of credit itself. At the time of me writing this, it should be a $300,000 line of credit with an interest rate of prime minus 0.25%. What this means is that you have access to $300,000 and the interest that they charge you monthly for whatever amount you borrow is prime rate, which is the interest rate that the central bank sets and is subject to change, minus 0.25%. If a bank offers you any rate that is higher than this such as prime or prime PLUS any percentage, then walk out the door. Do not waste your time, every major bank will offer this base. Ensure that the line of credit also DOES NOT need a cosigner. The purpose of this line of credit is that they are tying it to future earnings since the average physician in Canada will make good money, so it is a low risk investment for the banks. By having a cosigner if something were to happen to you, you are leaving behind a stockpile of debt for your cosigner to have to deal with. You do not need a cosigner and once again if a bank requires this, then walk out the door. The only exception I can think of is if you have a bad credit score in which case the bank may require a cosigner due to the elevated risk you carry. If you know that is the case for you, try to go to other banks and see if it is a consistent theme, and if it is then you may unfortunately need to have one. After you have confirmed the amount and rate of the line, check the period in which you have access to it. Once the period of access is over it becomes a repayable loan which should still be at prime minus 0.25% and then whatever money you have borrowed you need to start paying back and you no longer have access to the capital. Typically, this occurs after the end of your training, so ensure all of medical school, residency AND fellowship is accounted for in this period. While you will make money in residency and fellowships, the amount you make will not offset any significant burden of debt you have accumulated, and you want access to fluid capital in case something significant occurs. Next, check to see how they charge interest. Do they debit your bank account, or do they withdraw the amount from your line of credit directly? While there is no actual difference, since you will just withdraw the money from your line of credit and put it in your bank account to pay off the monthly interest, it can be an extra step and you never want to have a deficit since then you get into overdraft which carries extra fees, so it can be nice to have the auto removal from the line. Outside of the line itself they will offer you credit cards and their premium banking packages. Do a lot of research on the credit cards they offer since that is where the variation per bank comes in. Some will offer you cards with travel rewards and others offer cash back cards. There is no right answer to which one is best, it just depends on what you need and what your expenses are. Just know that there will be a significant amount of travel in your medical career and having travel benefits is something that can be extremely helpful.

That should cover enough about line of credit for now, as mentioned I will have a separate post completely devoted to finances in medicine to delve into greater detail. Now we should talk about the summer before med school starts. This is honestly one of the best summers you will have. During this time there are no expectations, no responsibilities, just your time. Please take a solid break. You have worked hard to get where you are, enjoy a nice break. A lot of people take the time to travel in the summer, and I would highly recommend this. The best tips I can give for you during the summer before is do not do anything that is taxing. If you are working to save up some money, do not overwork yourself. If you think grand scheme, any amount of work you do in a couple months most likely will not contribute significantly to the financial burden you are about to take on, but I can understand how people are in different financial situations and some might have a need to work. If you do work, then take on something you are genuinely interested in and make sure it is not too taxing. I personally did AI based research the summer before medicine. I set my experience up so if I had not gotten into medical school I would continue my project as my Honour’s thesis, however, the project was interesting enough, and flexible enough with time, that I was able to take it on the summer before and still enjoy my time without feeling burnt out. I spent the summer seeing lots of friends, relaxing, exercising, and watching tons of TV – all things that I knew I would not have as much time to do after. In retrospect I wish I had traveled more, but I do not regret my summer since I still had a great time overall. I hear about some people studying concepts before med school starts, something I would advise against. Not only will it make no significant difference in your knowledgebase for medical school, you are depriving yourself of one of your last summer’s off with no responsibilities to do something you will be doing for the rest of your life. Trust me when I say you will have plenty of time to study medicine, please do not study before starting school. So enjoy your summer before your life completely shifts, you have earned this time.

I will end the post with a few words on things I wish I knew going into medical school that I know now. I was lucky in that I went into medical school without much of an idea in terms of what specialty I was interested in, and that left me with a pretty open mind in terms of specialties to explore. I will reiterate the importance of entering medical school with a very open mind. What you think you know about a career and the truths behind it can be very different, and once you are in medical school your perspectives on medicine shift drastically. You will soon recognize that there are many aspects of a career that are important outside of the work itself. While there is the career and the work performed, you also need to think about the patient population you would like to work with, what types of centers you would like to work in whether it be academic centers or community centers, and if you would not mind being on-call. Certain specialties only have jobs in large hubs such as Toronto and if you would like to work in a community hospital or would prefer not to live in a big city then you might have to reconsider your career choice. Each specialty also targets various demographics of people. OBGYN physicians for instance mainly work with a younger population of women who tend to be healthy, while a pediatrician will be working with children and their families, and an internist will generally work with more complex and sick older population. You might not think the patient population matters, but you will soon recognize it can have a big impact on work satisfaction.

How much of a life outside of medicine is important to you? This is a very difficult question, and your answer to this most likely will change as you progress in your career. Most individuals at the start of medical school want it all and do not think about aspects in their life outside of their career. As you go through your education, as you shadow more and more, and as you speak with various physicians, you start to recognize what specialties will suit you based on that aspect. You start to realize you might like to be a parent that raises their own kid. You may not want to be on-call every weekend. Perhaps you would like to have the ability to reduce your clinical work without your skills significantly waning. There are many aspects of your life that you want your career to adhere with, but you also want a career that fulfills you, so determining the specialty that is perfect for you can be extremely difficult. Go in with an open mind and shadow early! Get as much exposure to different specialties, especially ones that you were not considering or do not think you would be interested in. Make sure your gut feeling is correct through objective means before ruling a specialty out. First find a specialty in which the work satisfies you. For most people this involves first distinguishing between surgery, and medicine. Making the initial choice of whether or not you enjoy surgery and you see yourself as a surgeon is an important first step. Surgery and medicine are very different in terms of work, lifestyle and employment prospects. If you cannot be happy outside the operating room, then surgery is most likely the specialty for you. If you find happiness in multiple realms, then you need to really immerse yourself in surgery, and see if you could live the life of a surgeon. If the work provides you a level of satisfaction that medicine could not provide, and you can live the lifestyle, then surgery is probably for you. If you are not as excited about surgery, then do some research on what the life of a surgeon is like and think if it is something that you could see yourself pursuing. Following that choose a specialty from the list that fits your lifestyle criteria.

It is not an easy decision in terms of deciding what specialty is right for you, and truthfully no one really knows until clerkship if it is the right choice, and even then, people switch specialties after matching a residency. You are not locked into any decision for some time. I am still exploring and am not completely sure what specialty is right for me. As mentioned, throughout your training keep an open mind. Do not worry if you finish your first or even second year and are still unsure, many medical students are in the same boat. The best advice I could give is just rule out specialties first and figure out which ones you cannot see yourself doing. You will eventually narrow down the list to a small number that you can then have more experience between and make a better decision.

There is a stress about matching a residency position, and if you are just starting medical school please do yourself a huge favor and do not worry. You will have plenty of time to worry about residency matching and worrying about it at the moment will not help you out in any way really. I wish I could sit here and provide you advice on how to set yourself up for the match, but I have yet to go through the match, and I myself am still seeking out advice. Do some research online and read about it so you have an understanding of what it entails. Speaking with upper years and getting mentorship from residents and those who just went through the match or are currently going through it can be very beneficial. For now, do yourself a huge favor and do not worry about it.

Conclusion

If you did not get in, keep your chin up. Do some reflection, reach out for advice from others, figure out your weak spots, try to work on them and keep at it. If being a doctor means everything to you then as long as you keep working on yourself and keep trying, I do not see why you will not eventually get in. At the same time, I understand the process is extremely draining, and a lot of your life is left on hold, so it is hard to just keep trying especially given how much the process costs, so maybe this attempt was your last. Remember that medicine is just another career option at the end of the day. Everyone is different but no matter who you are, do not let whether or not you get into medical school define you. If you are not applying again you gave it a good go and I wish you the best of luck in whatever you decide to pursue. If you are applying again keep your spirits high and best of luck with the upcoming cycle.

If you got an offer of admission, congratulations. I am very much looking forward to having you as a future colleague, and if you see me around feel free to stop me for a quick chat. I hope whatever advice I have provided to you up until this point has helped you in your journey, and I hope you continue to read my posts going forward to provide you more perspective on what is to come.

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