a) Marianne Smith M.D.,FACP b) Director of Medical Student Education c) Department of Medicine d) Staten Island University Hospital e) Clinical Assistant Professor f) SUNY Downstate Considering a Career in Medicine: Preparation and Considerations

Agenda 1. Questions to ask yourself about a career in medicine 2. Preparation High school, college, advisors/mentors, volunteer work, research, financial considerations, med school admissions, MCAT Types of paths to medical school Traditional vs. non-traditional 4. Medical school: what do you learn? 5. Residency and Beyond 6. Resources AAMC, Aspiringdocs.org, AMSNY 7. Panel discussion and audience questions

Questions to Consider - Do I enjoy helping people? - Am I compassionate and empathetic towards others and their problems? - Do I enjoy critical thinking and problem solving? - Do I have an interest in learning? - Do I have good communication skills? - Do I have an interest in new and ongoing developments in medicine and other sciences?

Commitment to a Lifetime of Learning - As in any other science medicine is ever changing, always conforming with the newest research on how to most effectively and ethically practice and treat patients - A career in medicine implies a commitment to continually keep oneself educated and informed - Medical education isn’t just 8 years – it’s a lifelong process

High School Preparation

Academics High school  Four years of science, mathematics and English  Balanced with humanities  AP courses (especially in math and sciences) helpful for lessening and/or preparing for college workload Not required, but also helpful for college admissions  If available, elective or AP courses in psychology or sociology

 Volunteering* and shadowing at local hospitals and healthcare centers/organizations Volunteering very important for college AND medical school admission  Participating in summer programs for high school students interested in medicine Check to see if the schools (colleges and med schools) you wish to apply to have any HS programs Look for research opportunities, it’s never too early ! Check major institutions in NYC. Many have hs student programs. (Sloan, Mt. Sinai, etc.) Extracurricular Activities

Extracurricular  Volunteering  Local hospitals, healthcare organizations/clinics, first aid/EMS centers etc.  Summer programs for high school students interested in medicine  Volunteer-based, research-based, college prep-based

College and Undergrad Preparation

Academics: Undergraduate  4 years, graduating with either Bachelor of Arts or Bachelor of Science Degree  Prerequisites intended to prepare students for demanding workload of med school  Should have balanced, well rounded transcript consisting of:  Med school prerequisite courses (sciences and math)  Humanities and Arts  Social sciences  Foreign language  Generally no set premedicine major; can choose any major and apply to med school  Most science prerequisites covered in major requirements for “typical” premed major (bio, chem etc.)

 General chemistry sequence  One full year lecture and lab  General biology sequence  One full year lecture and lab  Organic chemistry sequence  One full year lecture and lab  General physics sequence  One full year lecture and lab  Biochemistry  One semester  Mathematics : Calculus,statistics Academics: Science Prerequisites

Academics: Other Prerequisites  Varies by med school  Generally:  At least one( better more ) psychology and one other social science course (i.e. sociology)  A year or equivalent of foreign language (usually required by colleges for graduation)  A year or equivalent of an English/writing course (also usually required by colleges)  A presence of humanities courses, including a course focusing on a different culture (also required by most schools)  Can supplement transcript with practical med schools sciences such as Cell Biology, Anatomy and Physiology Immunology, Microbiology etc.

Extracurricular Passion is important  Volunteering  Local hospital, healthcare center/clinic, EMS, shelters  Food pantries, churches  EMT certification  Volunteer or private ambulance company  Research and shadowing  Research with college faculty or academic medical centers  Shadowing opportunities may be useful for exposure to medicine as well as establishing connections for research opportunities/collaborations  Summer programs for undergraduates  Typically research and/or shadowing based  Check to see if med schools you wish to attend have any that interest you

 Contact your advisor as soon as you know that you are interested in medicine  They will recommend the required courses  Give information on volunteering and research experience  College advisors will assist in developing a timeline for taking required prerequisites and applying for the MCAT  Make sure to establish ongoing contact with at least three science professors-you will need letters of recommendation  But Remember- there is more than one road to medical school and- if first you don’t succeed-try again! Advisors/Mentors

 How much does medical school cost?  What is the average debt a medical student incurs?  Are physician salaries keeping up with the debt incurred? With the downturn in the economy and tightening of state and local budgets funding for medical education has been compromised.  How do I pay for medical school? Federal student loans, nonfederal loans, grants, scholarships, financial aid. Financial Considerations

The median amount of debt for the class of 2014: $180,000* The median 4-year cost of attendance for the class of 2015: $226,447* (public school) and $298,538* (private school) The 2013 median starting salary for Internal Medicine (first year post residency): $180,000**Although debt and cost are high, so is the starting salary for the average primary care physician.

MCAT 2015 The exam has changed to keep pace with the changes in medicine The competencies required for medical school are shifting A major change is the new section on Psychological, Social,& Biological Foundations of Behavior

MCAT 2015 Format  Standardized, computer-based multiple choice test designed to assess problem solving, critical thinking, and knowledge of natural, behavioral, and social science concepts and principles prerequisite to the study of medicine  Four multiple choice sections: 1. Chemical and Physical Foundations of Biological Systems 2. Critical Analysis and Reasoning Skills 3. Biological and Biochemical Foundations of Living Systems 4. Psychological, Social and Biological Foundations of Behavior  Individual section scores range from 118 – 132  Total scores range from 472 – 528  7.5 hours, including two 10 minute breaks and one 29 minute lunch break

MCAT Typically taken in the calendar year prior to the year in which you plan to enter medical school Usually during junior or senior year of college, or post graduation once all prerequisites are completed Highly reccommended that you complete biochemistry and molecular biology/genetics courses prior to taking the exam In a single testing year, you can take the MCAT up to 3 times

In 2013 there were 48,000 total applicants, 21,070 were accepted Path to Medical School

A few medical schools are experimenting with accelerated programs especially for students who wish to enter Primary Care where students graduate in three years. Shorter Training, Less Tuition

Nontraditional Routes: 7 Year Programs Undergraduate courses typically completed in 3 years, and direct start of graduate medical education courses in the last 4 years Typically no MCAT, with direct admission into the associated medical school Combined BS/MD

Nontraditional Routes: Post-Baccalaureate Programs Complete major and receive BA/BS first, then complete med school prerequisites, usually along with some 1 st year med school courses Generally 2 types, both of which can be either master’s programs ( MS in Biomedical Sciences) or simply supplementary to your college curriculum: 1. GPA booster programs 2. Nonscience major/career change programs Some have MCAT/undergrad GPA requirements, others do not. Acceptance to med school not guaranteed.  Postgraduate programs to complete med school prerequisites or as GPA boosters offered at undergraduate institutions and Medical Schools

Mt Sinai Flexmed Program  This is a program for college sophomores in any major to apply to early acceptance to the Icahn School of Medicine at Mt Sinai  It is extremely competive and admissions will take your high school records and SAT into consideration.(icahn.mssn.edu/flexmed)  Applicants must have completed at least one year of Chem, Bio or Physics. There is no MCAT required if accepted.  There are accelerated summer programs at Mt Sinai for Cell Biology, Biochemistry and Genetics.

What do you learn? Medical School

 Biochemistry, Cell Biology, Medical Genetics, Gross Anatomy  Structure and Function of Human Organ Systems, Neuroscience, Immunology Year 1

 Abnormal Structure and Function  Infectious Diseases, Pharmacology, Pathology  Clinical Diagnosis and Therapeutics  Health Law Year 2

 Generalist Core  Internal Medicine, Pediatrics, Surgery, Obstetrics/Gynecology, Psychiatry, Family and Community medicine Year 3

Subinternship Subspecialty Segment Dermatology, Orthopedics, Urology, Cardiology, Pulmonary, Neurology, Ophthalmology, Sub Internship, ER, ICU Applying and interviewing for residency programs Year 4

Residency and Beyond

GOOD LUCK AND STAY STRONG!