*What is “The Track”?

“The Track” is the road to being a physician. Every step of the way you are on “the track”.

*What do you mean?

Well, when one decides to become a physician, they have given themselves a direction and placed them firmly on “the track”.

This decision can come as young as the classic “I’ve always wanted to be a physician” or as old as “I hate my current job and missed my calling as a physician, so I want to do it now.”

Let’s go over the “traditional track”.

Graduate high school and do well. Be valedictorian maybe.

Go to college and be on the “pre-med” track, or not, whatever. Just do your medical school pre-requisites and take the MCAT.

Do well on said courses. In fact, do well on all your courses. Do well on the MCAT.

Throw in some shadowing of physicians, research, and community service to pad your resumé.

Apply to medical school. Go on interviews and get in to 1 or more.

[MAJOR CHECKPOINT]

Go to medical school. Study hard. Pass your classes and more so than that, learn the material.

Pass Step 1, and try to do as well as possible.

Start clinical rotations. Try hard. Honor as many as possible. Do well on the Shelves.

Pass Step 2, and try to do as well as possible.

Do some electives 4th year, hopefully in things you are interested in.

Apply for the Residency Match. Get interviews. Go on interviews.

[MAJOR CHECKPOINT]

Match on Match Day.

Cruise through the rest of 4th year.

Attend graduation ceremony.

<GAME OVER> [BEST ENDING] — right?

WRONG. JUST ANOTHER [MAJOR CHECKPOINT]

Survive intern year and pass Step 3.

Become a capable senior resident.

Pass boards and get first job.

Negotiate a good contract.

Become a capable attending.

Cry when you realize your student loans are enormous.

Accept that you will need to live like a resident for as long as possible.

It continues on from here… but this is where I am now.

Ok, so many how steps was that “traditional track”? Like 20 maybe? Sounds about right.

However, each step probably has at least 20 of its own steps. So 20 x 20 = 400. So 400 steps then? Sounds about right.

So then… let me ask you this… What happens if you *trip*? What happens if you… fall off the track? How do you get back on?

Well for me it wasn’t easy.

I think this is something that happens to a lot of pre-med hopefuls. Some, like me are lucky and are able persevere and try to move forward.

However, others may get lost in the trees:

I spoke with a guy who was 26 years old and doing a job somewhat related to medicine, in pharmaceuticals, but really disliked his job. He was a pretty solemn guy, and didn’t like talking about himself much. However, he eventually opened up to me and told me that he had already graduated college and had been pre-med. He even had a 3.6 GPA overall, and I think it was a similar GPA for his science courses. However, his MCAT score was low, I think it was like 28 or so.

He confided in me that over the course of the last few years he had retaken the MCAT multiple times, with a high score of 33, and received a grand total of 7 medical school interviews over the last few years, but was never accepted. After a little prodding, he explained that even went completed a Master’s degree to try to buff his application a bit. Now, I don’t know this guy that well, but he seemed like a good guy… and I think he’d make a good doctor.

What went wrong? Why isn’t this guy in medical school?

Introspection is hard. It’s easy to focus on your strong points, like getting a 3.6 GPA or getting a 33 on the MCAT. However, only when you delve deeper do you find out he had taken the MCAT multiple times and had received a 28 on his initial take, and likely a few lower scores on retakes before or after getting the 33. Additionally, his GPA during his Master’s degree was actually lower than his undergraduate (~3.4). Now, that’s not bad, but it is uncommon. Usually people go get a Master’s degree to help boost their application.

Unfortunately, this guy is what I like to call “at the cusp”. His application is decent, as was demonstrated by receiving -some- interviews, but he is lacking something to push him over into the admit pile. He needs either to really knock them dead at the interview or have done something really interesting in order to bump him up. So is he not interviewing well? More introspection is necessary.

I advised him that his GPA is what it is and I don’t think he can change it much now. However, a killer MCAT score would really help his cause. By killer I mean 38+, or whatever that is on the new scale. This can make adcoms forgiven a lot of things. Then he admitted that his highest MCAT score (the 33) is on the verge of expiring and won’t be eligible for the next application cycle. He felt defeated and distraught. He wasn’t sure whether to retake the MCAT or go to a foreign school.

I tried to explain that I thought he had the ability to do better on the MCAT, but would need to devote himself to studying in order to achieve the number he needed. I do not think that going to a foreign school was a good option for someone like him “on the cusp.” However, he told me “I don’t think I can do it.”

Another potentially great doctor probably lost. Will he go to a foreign school? Maybe. But I think he really deserved a chance at a US school.

How can we help these potentially great doctors who “fall off the track?”

I think they need people who have experienced the same difficulty to talk to. I think he talked to me because, like him, I had fallen off the track, but I somehow managed to get back on. Those who “fall off the track” become silent, ashamed or embarrassed to have fallen off. You feel excluded from your friends who have continued on without you. It is difficult to find someone who is struggling with the same difficulties you are. Moving forward is hard when you don’t know where to go and hold yourself back.

Sometimes all you need to someone to point you in the right direction.

TL;DR

Medicine is a long road which I call “The Track” with multiple checkpoints a long the way.

There are an infinite number of ways to fall off “the track”.

How can we help these potentially great doctors who fall off “the track” get back on?

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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