Admissions Decisions

At last you have reached that glorious mountain summit that once seemed so far and out of reach. With hard work and dedication, however, you have managed to surmount the obstacles in your way. You have done all that can be done as far as the application process goes. Finally, you can breathe a huge sign of relief…

Now you must sit and wait. Believe us, as tough as the whole process was, it is more difficult in some ways to be at the mercy of the faceless, yet powerful, admissions committee gods who hold your fate in their hands. These almighty deities will weigh your strengths and weaknesses, pass judgment, and ultimately dictate the course of your life. The worst part is that the adcoms are not known for their quick decisions or expeditious notification. They will almost certainly test your resolve as you hound the mail carrier each day for that golden letter. Their power may even tempt you to go to such lengths as making animal sacrifices and other offerings. We suggest that you refrain from such behavior and instead focus on other things during the months you must wait. Remember, you have done all you can. Eventually, you will reap what you sow.

Selection Factors

It does help to have some knowledge of the admissions committees’ criteria for decision making. The admissions process has a fairly stochastic nature, which you’ll no doubt experience when you ask friends and other applicants to which programs they were admitted. Rest assured though that the choice of applicants is not entirely arbitrary.

Admissions committees look for certain characteristics in M.D./Ph.D. applicants. The regular medical school admissions process tends to emphasize the whole package, including extracurricular activities, unusual talents, unique experiences, and personality traits. Strong academic potential and an ability to develop rapport with others are sought qualities. Interpersonal skills are highly emphasized at the interview stage, above MCAT scores and GPA. Simply put, interviewers look for applicants who have the potential to become successful physicians.

To a certain extent, the same qualities are sought in M.D./Ph.D. applicants. However, the most highly emphasized aspect of M.D./Ph.D. admissions is one’s research experience. Most successful applicants have worked multiple years in one or more laboratories. Some have taken a year off after college to pursue a full-time year of research, and consequently have publications. Others have presented at conferences and interacted with researchers in the field. The letters of recommendation represent a critical component to the application, as they provide a subjective assessment of the applicant’s demonstrated abilities and potential to do well in a medical and graduate school class. The ability to communicate scientifically either verbally during the interview or in publications or presentations is essential. In addition, you must show your commitment to science, as some applicants who are undecided about whether to pursue the combined degree attempt to use these funded programs as a route to a “free M.D.” You must demonstrate your motivation for pursuing both degrees. By applying for an M.D./Ph.D. program, you are attempting to take a difficult path traveled by few.

Acceptance, Waitlist, or Rejection

Given the multitude of highly qualified applicants competing for a limited number of spots, programs often have a difficult time making decisions. At a certain point, the admissions process becomes somewhat subjective, as there are few characteristics that can differentiate the top applicants. There are several hundred applications for these programs each year and the top schools interview a select group of around 60-80 applicants. Thus, if you are able to secure several interviews (we suggest 6 is the magic number), know your research well, and can hold a decent conversation, chances are you will be admitted to at least one program. It is very difficult to say exactly to which schools you will gain acceptance, however. You may have heard that there is a certain degree of randomness to regular medical school admissions. For M.D./Ph.D, multiply this by 100. You’ll find that there is no rhyme or reason to where you or some of the people you meet on interviews will be admitted. Some of us, for example, were admitted to certain programs, while others didn’t even get interviews at these schools. We each had multiple acceptances, but few of us got accepted to all of the same places. The best we can tell you is that arbitrary factors such as how well your interviewers liked you probably made the differences.

After waiting so long, there are usually four possible results in the M.D./Ph.D. admissions process: 1) Nirvana (a.k.a. acceptance), 2) Limbo (waitlist), 3) Chaos (M.D.-only acceptance), and 4) Hell (rejection). To make things more confusing, numbers 2 and 3 are not mutually exclusive, as you may be admitted by the medical school, but waitlisted by the M.D./Ph.D. program. You’ll probably experience each of these resultsduring the process.
The best to hope for is outright acceptance (Nirvana) at all of your top choice schools, but this rarely happens, even for those rare applicants with stratospheric MCATs and GPA, years of research experience in a Nobel Prize winner’s lab, and first-author Nature and Science papers. Some applicants are admitted to more than one program. Multiple acceptances can feel great, but we recommend that you move to quickly narrow your choices so that you free up spots for other applicants. A good idea is to make a list or chart comparing your top programs. Often, it may take a revisit weekend to help you make your decision.

About Limbo: some programs refuse to call the waitlist a waitlist, as they feel this may in some way stigmatize applicants. However, all of the individuals put on the waitlists are absolutely qualified to be admitted, but programs can only offer a limited number of spots initially. Based on our experiences, if you are high on a waitlist at a particular school, chances are that you may be eventually admitted. There is quite a bit of shuffling that takes place as applicants make decisions and withdraw multiple acceptances to narrow their choice to one program.

Commonly, applicants end up in a situation in which they have been admitted M.D.-only at a particular school. They may be waitlisted for M.D./Ph.D. Alternatively, most programs will consider you for regular medical school admissions even if you are rejected from the M.D./Ph.D. program. Thus, a problem arises in which an applicant may be admitted to a higher ranked school M.D.-only and a lower ranked one for M.D./Ph.D. What do you do in this situation? Hence, we call this Chaos. One option is to go to the higher ranked school M.D. and reapply for the M.D./Ph.D. program the following year. In the next chapter, we discuss factors for choosing a school.

When all Hell breaks loose, we recommend that after punishing a punching bag or your pillows, you take a breather and think rationally about the situation. We all have to deal with rejection from time to time. All of us went through it during the M.D./Ph.D. admissions process. Although you may feel the sting of not being accepted at a particular school, it is important to consider that other programs may look at your application differently. Perhaps you had a bad interview. Or maybe your interviewer just didn’t speak up enough at the admissions committee meetings. It is always difficult to nail down exactly WHY something like rejection happens. However, we suggest that you look at the positives and turn your focus toward other programs.

Despite our somewhat facetious appraisal of the randomness associated with M.D./Ph.D. admissions, we realize the serious nature of the process. After all, this is a life-altering experience that will determine the course of your career and even your non-academic life. Many of us were lucky to have several good choices in the end. However, we also know people who were not so fortunate. It can be extremely frustrating when, despite your time, money, and effort spent, the results come up negative.

If you end up in the situation of having to reapply, the first step is to ensure that all aspects of your application are the best they can be. For example, low grades, GPA, or test scores need to be explained or improved. Your personal statement, M.D./Ph.D. essay, and letters of recommendation need to be glowing. During the extra year while reapplying, you should try and be as productive as possible. For example, you may choose to do research, volunteer work, or something else that will help bolster your application. Any publications should be mentioned. Furthermore, practice interviewing and be able to explain your research project and goals. You need to go into the process humble, yet confident. Additionally, apply earlier and to a larger number of schools the next time around to increase your chances. We personally know people who have applied multiple times and ultimately have been successful. An investment of additional hard work and dedication can often pay dividends