Premedical and Health Professions Advisory Service
			CONTENTS MFHE Premedical and Health Professions Advisory Services Should You Go To Medical School? Dr. Brown's Internet Bibliography Related MFHE Publications

			Premedical and Health Professions Advisory Services
			The Mendocino Foundation offers to serve as a primary premed advisor for students without access to advising services or as a second opinion for students needing additional advice. Dr. Brown has written two books for premeds, Getting into Medical School, now in its eighth edition, and its sequel, You Can Get into Medical School: Letters from Premeds. He is a member of the National Association of Advisors for the Health Professions and is premedical advisor for the College of the Redwoods in Fort Bragg, California. Besides assisting with the mechanics of being a premed and applying to medical schools, Dr. Brown believes that, in the era of managed care, premeds need to know what's waiting for them once they become physicians. The focus is to produce contented graduates and not doctors who feel trapped in a profession that they don't have the temperament for but have too much time and energy invested in to give up. Back to the Top of the Page

			Reprinted from Postgraduate Medicine, June, 1996 Should You Go To Medical School? by Sanford J. Brown, M.D.
			For the past 20 years I have been in the unique position of being both a family physician and an adviser to premedical students. And for most of those 20 years, I was able to assure students that their arduous endeavors were worth the effort. For even in its halcyon days, medicine entailed more postgraduate education than any other profession and required more sacrifice. But the good news was that, after much time and expense, the student became a highly trained, well-paid professional with limitless possibilities for employment. I could and did say that it was worth it. Today I am not as optimistic. During the last 10 years and, particularly, during the last several, there have been cataclysmic changes in the practice of medicine. What I find of great interest and concern is that through all the ferment, the selection and training of physicians has not changed very much. Premeds still take the same required courses, and the medical school curriculum remains immutably intact. Furthermore, the factors that once motivated the best and brightest students to go into medicine, prestige, independence, high remuneration, security, mobility, intellectual challenge, and service, still do so. But the playing field has been leveled by managed care. The times call for different motivations for entering medicine if premeds are to be happy and successful. The fact that many have not given this credence is explained by what the great economist Thorstein Veblen described as "habits of thought," or the persistence of beliefs that are no longer useful after the institutions that fostered those beliefs die. Many believe that the old medical model of self-employed doctors practicing medicine the way they feel is best still exists. In the past, people who selected medical careers treasured their autonomy, were self-directed, and preferred having things their way. They liked to give orders, not get them. They liked to be in control. Current applicants to medical schools are a lot like this, but the medical world they want to enter will be changed. It will reward the team player, not the entrepreneur. It will favor people who can play by the rules and not question them. Medicine will no longer represent job security but will be a more and more uncertain livelihood as American medical schools and those abroad continue to crank out graduates to fill residency positions. Because of the high costs of medical education and the projected shrinking salaries of physicians, people of independent wealth will become prime candidates for the profession (Thus the reemergence of the "gentleman doctor" who doesn't have to work for money but just wants to be of service.) The need to serve, to be useful, to make a difference in other peoples' lives will still be a prime motivator. However, the many constraints on the way healthcare is delivered will prove frustrating to those who wonder why, after 7 to 10 years of postgraduate education to get an MD, they have to take orders from people who spent 2 postgraduate years to get an MBA. The crux of the problem is that there is no mechanism other than the market to regulate physician oversupply when there is a diminishing demand for their services. Managed care is extremely efficient and tolerates little waste. Many established physicians have already been given notice and have either moved to other locales to practice, retired early, dropped out, or retooled into a primary care specialty. It's no secret that physician dissatisfaction is high and many say they would not "do it all over again" if they could. This can be discouraging to premeds who are almost universally idealistic. But it may not be registering; more students are applying to medical schools today than ever before. What these premeds have probably not considered is that the institutions that control the demand for physicians (managed care organizations) are not the same as those controlling the supply (colleges and universities, medical schools and residency training programs). This presents the very real possibility that, because of a lack of central planning, doctors could become, at worst, a surplus commodity. At best, competition for available positions will be intense, the same way competition among PhDs is intense for university faculty positions, especially in desirable locations. Although the number of applicants will diminish as people realize that medicine no longer represents a guaranteed livelihood, there will always be more applicants than there are places and there will always be so many students in the pipeline that doctors will never have the collective bargaining power they once possessed. Market demands will dictate specialty choice, but because of a declining need for physicians services, it will be hard to predict, for more than 1 or 2 years at a time, which specialties will experience shortages. And, because of the long training programs that residents are locked into, new graduates may begin a residency optimistic of future employment only to find a surfeit of their kind 3 to 5 years later. Yet there is no incentive for managed care conglomerates to control the selection and educational process. Such action gives the appearance of impropriety and is unnecessary from management's point of view. Without any outside interfererence, the existing system will continue to produce a cheap labor pool, which will only benefit the corporate providers of healthcare. Turf wars between special interest groups will make mutual cooperation difficult. All of this will work to the detriment of the newly minted MDs, who will wonder how on earth they are going to pay back their debts while living on the salaries offered them. Should you be a premed? Should you to medical school? Yes, if you're truly fascinated by medicine, if you really want to make sick people well or prevent disease and disability, if your true mission is service, if you want a job with a fair amount of prestige, decent income, and regular hours. Yes, if you want a challenging career, crave opportunities for intellectual growth and diversity, and prefer working with a group of peers. And of course yes, if nothing else will do. But no, if you treasure your independence, want to be your own boss, need to do it your way, or prefer working alone. No, if you have zero tolerance for bureaucracies and red tape. No, if income or the ability to choose what you will do and where you will do it is of primary importance. No, if you can't live with having an education loan as large as your house mortgage. And especially no, if you are counting on medicine to be a "secure" profession. There will always be sick people, and we will always need physicians to care for them, but let's have physicians who are content in their work and know what they are facing and not physicians who feel trapped in a job in which they have invested too much time, energy, and money to leave, although it may not suit their temperament. Back to the Top of the Page

			DR. BROWN'S INTERNET BIBLIOGRAPHY
			In my second book, You Can Get into Medical School: Letters from Premeds, I ended with a bibliography of books, periodicals and articles that I found indispensable. They covered such major topics as statistics on applicants, medical school admission policies, undergraduate preparation for medicine, the MCAT, minority admissions, older applicants, and financial aid, as well as some less common areas, such as the premed syndrome, the handicap student, and the approaching physician glut. I implored students to keep a file of relevant premedical literature, having collected over seventy magazine, journal and newspaper articles myself. I remember how I obtained my information; through frequenting bookstores and libraries. Since I live in the country, articles had to be ordered through the library's interloan service and took one to two months to arrive. Books only took a week or two. If I had specific questions I had either to write letters or try and track people down by telephone. The process was extremely laborious. It's now ten years later and how things have changed! I did all my research for this revision at home on my PC through the Internet and E-mail. What follows is a listing of websites that are useful jumping off places for you in amassing information. If you know of other home pages with health professions links, clue me in! ChronoNet http://www.he.net/~chronow1 Simply the best premed website that I have found to date. In fact, I liked it so much that when its' constructor, Greg Chronowski, a third year medical student at Jefferson Medical College in Philadelphia, found that his costs for maintaining the site were mounting and asked if anyone was interested in a sponsorship I immediately took him up on it. As a result, the Mendocino Foundation now helps to keep ChronNet out there in cyberspace. The site is a treasure trove of information, and includes a search engine, biographies of famous doctors, useful premedical links and some personal information about Greg. Most useful, however, are the forums for premeds and Greg's own advice about getting into medical school. Stephen Georges Health Professions Page http://www.amherst.edu/~sageorge/health.html This is Amherst College's page, with links to information sources for premedical students, personal accounts of students' experiences, questions and advice, summer opportunities, MCAT preparation services, health professions career information other than medicine, med school application info, postbac programs and listings of premedical student organizations. This is an excellent place to start your search.   Brads Premed Resource Center http://rio.atlantic.net/~xyz/premed.html Here you will find links to general information, advice, MCAT prep, schools, interviews and other homepages. I don't know who Brad is, but he has links I haven't seen anywhere else, such as a medical school interview feedback page and places where you can have questions answered.   The Interactive Medical Student Lounge http://falcon.cc.ukans.edu/~nsween/ A top 5% website, this homepage includes links on how to apply to medical schools, general medical sites and medically related homepages, medical school lists, residencies and the USMAL. Of particular interest are bulletin board messages with forums for premeds and medical students and a volunteer list of medical students at home and abroad who you can e-mail to with questions about their schools.   Erick's Guide to Medical School Admissions http://homepage.seas.upenn.edu/~santos/MedGuide.html Essentially, the author's own story and opinions about the facets of medical school admissions and education, but many worthwhile links to other premedical sites and other personal accounts of getting into medical school.   MedWeb Educational Resources http://www.emory.edu/WHSCL/medweb.html A comprehensive listing of all things medical, including detailed information on most medical specialties, electronic publications, guides and sites. There are valuable links to the National Library of Medicine and the American Association of Medical Colleges.   Other Important Sites:   The American Association of Medical Colleges (AAMC) http://www.aamc.org The first place to start surfing the net, the AAMC controls medical education in this country. Their homepage has a student and applicant section. This is dogma, and the AAMC Guidebook is the bible from which it comes. One can peruse and download for hours at this website. This information is the official line and the place to learn the rules. There are sections for admissions (including the American Medical College Application Service, or AMCAS), Applicant Information, data on Financial Aid and Minority Programs, and on the MCAT. All U.S. and Canadian medical schools are listed and hyperlinked to their home pages.   Premed http://premed.edu/imsl.html An extremely worthwhile site sponsored by Hunter College, which, among other things, has a section on application essays and a listing of national premed associations. In addition, there are links to over thirty national premed organizations and an interactive premed lounge is under construction. National Association of Advisors for the Health Professions (NAAHP) http://ns.netplace.net/naahp/ This site has listings of publications the association has for sale to premeds which may be ordered online, and a hyperlink to the National Prehealth Student Association. Their mission is to provide all prehealth students with timely, accurate information and to create a participatory forum for their members on issues affecting their future. They produce a quarterly journal, which is mailed to you, offer several guidebooks that come with membership and have a travel program with discounted airfares when you go for your health professions interviews.  Stanley Kaplan MCAT page http://www.Kaplan.com Although Kaplan is a commercial operation and is trying to sell you their course and study materials, there is some useful information here about the structure and scoring of the MCAT with test dates and registration information. There is also a message board and student links, which are quite good.   Princeton Review http://www.review.com Another proprietary service, Princeton Review's website offers useful information about medical schools that do not accept out-of-state residents, the few medical schools that do not participate in AMCAS and those that do not require the MCAT. The MCAT information is rudimentary but there is a free MCAT available for downloading. The following is a useful listing of other Health Professions' Web Sites:   American Association of Colleges of Osteopathic Medicine (AACOM) http://www.aacom.org   American Association of Dental Schools (AADS) http://www.aads.jhu.edu   American Association of Naturopathic Physicians (AANP) http://infinity.dorsai.org/Naturopathic.Physician/   American Medical Association (AMA) http://www.ama-assn.org   General Nursing Resources http://www.yahoo.com/Health/Nursing/   General Pharmacology Resources http://www.yahoo.com/Health/Pharmacology/   Podiatry FAQ http://www.slip.net/~soredawg/podfaq.txt   Any of the search engines on the Internet (Infoseek, Alta Vista, Excite, etc.) are great places to start looking for premedical links. In fact, that's where I found all of mine. Many individual college premed programs and services will come up there as well as more general sources. Spend the time surfin' the net and you'll be surprised how much data you will find.   I do not mean to imply that there is no useful knowledge other than that gleaned from cyberspace. To the contrary, your premedical library should include the current AAMC Medical School Admissions Requirements, The MCAT Student Manual and MCAT Practice Tests, also put out by the AAMC. James L. Flower's book, A Complete Preparation for the New MCAT, published by Betz, is helpful as are the quarterly issues of The Advisor and Between the Issues, put out by the NAAHP and, of course, my two books, Getting Into Medical School and You Can Get Into Medical School: Letters from Premeds.  Write to the AAMC at 2450 N St, N.W., Washington, D.C., 20037, the NAAHP at POB 5017, Station A, Champaign, IL 61820. Getting Into Medical School is available for $11.95 and You Can Get Into Medical School: Letters from Premeds. is available for $7.95. Add $2.00 per order for postage and handling. Send a check or money order c/o the Mendocino Foundation to POB 1377, Mendocino, CA 95460. Good luck in your quests to become physicians!
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