by Sanford J. Brown M.D.



You can get into medical scool COVER


The Premed College Student's Guide to the Perplexed-Majors and Grades

Not surprisingly, I receive more letters from college premedical students than from any other group of premeds. Yet I am continually surprised that the most frequently asked question among this group continues to be which science major to choose for becoming premed. Consider these three letters:

February 24, 1980

Dear Dr. Brown:

I am currently a freshman at a university in New York City. I am interested in entering the field of dentistry, although my only reasons are for financial security and less pressures than a medical career.

My reason for writing to you concerns my major. I know that you wrote in your book that a student should major in whatever he enjoys (not necessarily science), but I guess I need some reassurance. I imagine I should discuss this with my premed advisor, but a fellow freshman told me about a talk he had with the advisor which totally turned me off. The student went to the premed advisor for curriculum guidance. The advisor told him, "You'll take this course this year and you'll take that course next year and you'll major in biology or chemistry." The advisor treated the situation like an assembly line.

Getting to the point, I'd like to concentrate my undergraduate studies in French (I took it from 5th grade through 11th grade and enjoyed it) and perhaps also study economics (the field fascinates me). But I'd also like to study something that will enable me to enter a financially secure career if I don't get accepted to dental school. In short, I'd like to play it safe.

Please write to me when you have time and give me your feelings on my problem with a major as well as being safe career-wise.

Richard Heiss

November 17, 1981

Dear Dr. Brown:

In your book you suggested that a non-science major would be better than a science major because too many science courses would create boredom when taken again in medical school. This raised a question in my mind. I enjoy Spanish and I speak it well. Next year, when I'm a junior in high school, I will be in a college level class. My question is, should I major in Spanish instead of a science in college? Will that look good on my medical school application?

Stan Smith (future M.D.)

September 27, 1982

Dear Dr. Brown:

I was half-way through your book when I thought I'd drop you a line. I am a premed in my second year of college and taking a great number of science courses. I have been employed as an operating room technician and I have also worked as an assistant to an embalmer, so I have been able to learn from viewing human anatomy, making my interest in medicine even greater. My medical interest is forensics. I'd like to work as a medical examiner or coroner. What type of route would you recommend I'd take? I am a bit confused about what to major in: biology, chemistry, or zoology. I really am in a spot. What would you say, Dr. Brown?

Steve Mendez

As far as medical schools are concerned it really does not matter what you major in so long as you do well in your premedical science courses. Usually this means two years of chemistry, one year each of biology and physics, all with lab, and perhaps a year of mathematics. That's it. The entire premedical requirement can be taken in one year (two semesters and summer session) unless there are more specific courses required by individual medical schools. You do not have to major in a science. In fact, I argue in my book that since science is generally a harder major than the humanities majoring in a science will tend to lower your overall GPA. A premed who would like a career as a research scientist would do well to major in biology or chemistry. A premed interested in family medicine would do better with an English or psychology major.

Messieurs Heiss and Smith would do well with a foreign language major. Being bilingual is an asset when applying to medical school, particularly fluency in Spanish. In fact, I can hardly think of a more useful major considering the many Hispanic-Americans who do not speak English. My advice to Mr. Mendez is the same I would give to any aspiring premed; major in whatever you would like and do well in the premedical science courses. Use your college years for personal growth and don't burden yourself with a major that's not intellectually satisfying. Not only will college become a more pleasurable experience but you're bound to do well in courses you enjoy, and boost your grade point besides. But don't just take my word for it. Here's a letter from a premed English major at Harvard University:

February 1, 1984

Dear Dr. Brown,

Since I last wrote to you I've had a diverse and interesting under-graduate experience. Due to various requirements, being an English major and a premed at Harvard has been very challenging because, unlike biology majors whose premed courses count toward their major, I've had few electives. However, I do not at all regret pursuing a liberal arts education before going to medical school. I had the chance to go straight into a six-year medical program but felt my life would be poorer for passing up a four-year undergraduate education and I now know the decision to be an English major was a very good one.

I thank you for not being pragmatic and advising premeds to major in the sciences but instead to try to have the best and most fulfilling undergraduate experience possible. Many of my friends have regretted majoring in the sciences. I don't see how undergraduates can be happy with constantly sacrificing the present for some vague future situation. Medical school should be a priority but not the only one. Undergraduates should keep the "big picture" in clear view and study what they find truly interesting. They'll probably end up with a more successful college career gradewise to boot!

Ed Spillane, '85

Next in frequency to questions concerning college majors I receive letters from students who have done poorly in one or more of the premedical science courses or had a poor overall GPA. The following letter from a Colgate University undergraduate highlights this common problem of many premeds:

January 25, 1979

Dear Dr. Brown:

I am a sophomore premed at Colgate University in Hamilton, New York I know that I want medicine as a career because service to others is most important to me. During January 1978, I worked in a hospital at home and last summer I worked as an orderly in an infirmary for geriatric patients. Next week, I will observe surgery in the local hospital in Hamilton. I thrive on the atmosphere of a medical institution.

My freshmen year at Colgate was not good academically. Not having read your book before I came here, I took a terribly competitive year-long course in inorganic chemistry and received a year average of a C. Also, I jumped into a y ear-long course in calculus with other students who had already had advanced math courses in high school. My year average was a C. My semester averages for freshmen year were 2.5 (fall) and 2.93 (spring).

Last fall, I did quite well in introductory biology (animal) and physics, receiving an overall cumulative term average of 3.5. Next semester, I will take introductory biology (plant) and the remainder of physics. Next year, I was planning to retake the year of inorganic chemistry with organic chemistry so that I will have good science grades before I apply to medical school. Do you think that this is a wise decision? I don't know what to do about the calculus grades. I don't have time to take that many courses over again. What do you suggest?

Another problem I have is that of deciding a major. I do fairly well in biology, but I don't know if I like it well enough to major in it. Music is what I do best, but would I be considered as seriously as a science major when applying to medical school? Are there any advanced biology courses (comparative anatomy, histology, etc.) that are necessary preparation for the MCAT?

Where would I write for a listing of specific undergraduate courses that medical schools require for admission?

Thomas Palm

Dear Thomas:

If a better grade in inorganic chemistry will expunge the C, then take it over. If not, don't waste your time. Take other sciences courses, do well in them and boost your overall science GPA. Medical schools recognize that some students have trouble during their freshman year, and they look to see if their grades improved over time. Better to do poorly your freshman year than your junior one.

Major in whatever turns you on, and take your premedical courses on the side. Necessary preparation for the MCAT is basic physics, chemistry and biology. Medical schools vary somewhat in the undergraduate courses they require. I would suggest you begin writing now to those schools you would like to apply to later, and ask them for the specifics. Procure Medical School Admission Requirements, easily the most useful source of information for the uninitiated.

Good luck in your quest.

Sandy Brown, M.D.

At many schools, unfortunately, old grades are not expunged for new ones, they are averaged in with them. This is the case at the university my next correspondent attends:

March 5, 1983

Dear Doctor Brown:

I am a premed sophomore at the University of Washington in Seattle. My major is psychology.

First off, I'm terrified of chemistry classes after having been conditioned to hate it from 9th grade physical science class. I made the mistake of entering college and taking inorganic chemistry along with everyone else. Needless to say, I did badly. Now, I know a lot of my friends' standard of bad is a 3.0, but what I mean by bad is a D. I worked myself hard that year of inorganic (constantly carrying that chemistry book) and thinking everything was fine until the test. I had to compete with people the class for the second or third time. I pride myself on not failing. At our school, if you take a class again you have to average your old grade with your new one. I've heard medical schools don't like you retaking classes and I feel I know that material anyway. Enough ranting! So, here I am at the 2nd quarter of my sophomore year with a blown GPA of 2.4 because of those chemistry classes. Organic will be taken at a community college!

I volunteer at a hospital weekly and know I have always wanted to be a doctor. I was an honor student in high school but find myself unable to compete with some of these grade hungry pre-meds. I recently saw some guy cry over two points to a professor.

My premed advisor is absolutely no help.

Dr. Brown, I know I could be a competent doctor if given the chance, but how do I keep my marbles and raise my GPA at the same time?

Tina Lears

I truly sympathize with Ms. Lears. I can imagine her predicament when, as an entering freshman just out of high school, she was shuttled into inorganic chemistry on the advice of her premedical advisor. There she found herself competing not only with students who had taken the course before but probably with biology, chemistry and engineering majors as well. She did poorly and now must consider re-entering the same milieu to re-take the course. What a bummer! How much easier it would have been for her, admittedly "terrified of chemistry classes, "to have taken inorganic at a local community college, where she would have earned an A or B, not blown her GPA and still been a contender for medical school.

The next letter raises a similar point:

July 7, 1982

Doctor Brown:

I have a question which I would like you to address. How would medical school admission boards view a student who retook premed courses in order to raise their grades in those courses? And what if the course was taken at a school other than the one from which the student had graduated? I guess I am in this situation right now. I feel I have to strengthen my GPA to have a good chance of getting into a medical school. Right now my overall GPA and science GPA are both below a 3.0.

Doug Lauter

Medical schools do not look disfavorably on students who retake science courses if they improve the grades significantly the second time around and have a good reason for doing poorly in the first place. Since grades may be averaged at many colleges raising a C to a B would be insignificant and not worth your time. Raising a D to an A, however, would be worth the effort. And, if your original poor grade was earned while you were working 30 hours a week to put yourself through school or during a period when you were caring for a sick parent, by all means, try it again.

Concerning taking courses at other schools all I can say is that an A in organic chemistry from Podunk State does you more good than a D from Yale. Furthermore, it will help you "keep your marbles and raise your GPA at the same time. "

One letter I received was exciting because the student, although doing poorly the first semester of her freshman year, improved her performance second semester and this feat gave her morale a badly needed boost. Here's that student's letter:

June 14, 1980

Dear Dr. Brown:

I am a sophomore, about to enter the College of Notre Dame in the fall. I spent my freshman year at Waynesburg College as a biology major. I had a rough first semester all around, and my GPA ended up being a depressing 1.5. But, last semester, having "gotten my act together," my GPA improved to a 3.0. This tremendous improvement in my grades gave me the confidence to face a goal that has always been in the back of my mind-medical school. I feel it is within my reach, and I have the confidence to improve even more, to measure up to medical school standards. And now, I can even share my goal with others for the first time! I am very excited about this new direction my life is going to take. I have even signed up for volunteer hospital work, which I am finding extremely rewarding.

Ann Kelly

I honestly don't know if Ms. Kelly has blown it with a first semester 1.5 GPA, but consider her attitude: it's positive. She's feeling good enough about herself to share her secret ambition with her friends (you'd be amazed how many "closet" pre-meds there are out there-students who feel that they're just not good enough to make it into medical school). I'd be willing to wager that she ultimately gains admission to a medical school because she has already experienced success and believes in herself.

Contrast her positive attitude with my next writer who seems somewhat frazzled in comparison:

August 7, 1979

Dear Dr. Brown:

Please excuse the horrible stationery. I am sitting in a lab right now and have nothing else to use. I have debated with myself at length over writing you for advice and have come to the conclusion that I must, and quickly. Where to begin...

I was browsing through a bookstore two months ago and picked up Getting into Medical School and I read, much to my shock, that one need not be a science major to get into medical school. I am an ornamental horticulture major at a small, private college on the east coast. However, I have many problems and that is why I am writing.

First, I should tell you that, to the best of my knowledge, there is no premed advisor at my college although several graduates who majored in biology have gone on to med school.

I am currently 24 years old. I began undergraduate college in 1973. After spending three miserable semesters and achieving a fabulous cumulative average of 1.858 I withdrew and entered the U.S. Marine Corps. I did extraordinarily well, advancing from private to sergeant in well under two years. After being honorably discharged, I returned to my former college. Since returning this past fall, I received a 3.67 and 3.52 for two semesters, but that still leaves my c cum at a paltry 2.676, and even if I get a 4.0 for my senior year semesters I will only graduate with a 3.0. Needless to say, this will not get me into medical school.

Mistakes are made. Big mistakes. But can't they be at least partially corrected? What should I do? Am I out of the game altogether?

I have always wanted to be a physician but was continually discouraged throughout high school, being told that my grades were too low and that premed was terribly difficult. Still, I persisted, belonging to the health careers club in high school and traveling on Saturdays to Jefferson Medical College in Philadelphia to listen to health career seminars. I spent an entire summer

at Hahnemann Medical College in a bio-science program. However, the guidance counselor's lectures about my poor grades won out and I entered a college for ornamental horticulture.

So, where am I now? I do not want to be all osteopath dentist, physician's assistant, nurse, or chiropractor, nor will I consider a foreign medical school. I suppose it boils down to four questions:

1. Realistically, do I have a fighting chance to get into medical school in the future or has my past performance blackened me permanently?

2. If I do have a chance, what, specifically, must I do?

3. Would any of the medical schools in Philadelphia (my hometown) be likely to agree to counsel an undergraduate, or are they too busy to bother?

4. When, in my case, would it be wise to take the MCAT and apply?

I must register for school in three weeks and am totally confused about what to do. Sometimes I get so disgusted I could scream. Would you be kind enough to advise me and be totally objective and honest? As I stated, I truly want to become a physician. However, if I am swimming upstream with little or no chance of survival I'd better find out now so I might (disappointedly) direct my energies elsewhere.

William Niman

August 30,1979

Dear William,

You have a chance but it is, literally, a fighting chance. You cannot expect to get into medical school by traditional means, i.e. grade point average. You have to make medical schools aware about how you are different than other applicants in ways that would work to your advantage as a physician. For example, with a major in horticulture I suspect that you might be interested in medical toxicology or pharmacology. If you are, mention it. Your background is out of the ordinary and should be stressed.

You should visit all the Philadelphia medical schools and insist on counsel (since your school has no premed advisor and you are a resident of PA). If you're lucky you

might find someone who's sympathetic and will be your advocate on the admissions committee

Several of your questions (MCAT more undergraduate courses) are are adequately covered in my book.

In short, you should not hesitate to be aggressive and creative in your quest for medical school admittance. High MCAT scores are essential in your case to offset a mediocre college performance. Do not leave yourself without alternatives in the event you are unsuccessful.

Sandy Brown, M.D.

On rare occasions I have the unpleasant task of advising a premed to cease and desist from their premedical endeavors. These are students who have usually done poorly in more than one premedical science, like my next correspondent:

May 17, 1985

Dear Dr. Brown,

I am a sophomore biology major at the University of California-Irvine. Before I started college I really did not know where my interests and strengths lay. I majored in biology because I believed it would give me an advantage over others who were applying to medical school. Well, I was wrong. My grades in biology were poor. From there I became despondent and unwilling to try. This resulted in my failing first-quarter inorganic and third-quarter organic chemistry.

I have found my highest grades to be in economics. If what you say about majors and grades is true wouldn't I be better off changing my major to economics? My only problem is that the classes I've failed are on my record. I'm willing to take them over again at another college and work towards getting As. Do you believe I still have a good chance of acceptance into medical school if I take this action?

Desperately seeking guidance,

Mary Assante

Dear Mary,

I usually try to be encouraging to my premedical readers but I don't feel I can be optimistic in your case. A bad grade in one premedical course may be remedied by retaking it and getting an A (still, it must be explained).

However, failing grades in two chemistry classes and poor grades in biology are, I think, irremediable, especially in California where competition for medical school places is so fierce.

You must remember that grades in the required premedical science courses are the ones most closely scrutinized by admissions committees. If you had failed in economics the effects would have been only on your overall G.P.A. and not nearly as disastrous.

Don't set yourself up for future disappointment; start planning for an alternative career now.


Sandy Brown, M.D.

A more winning strategy to medical school is highlighted by this undergraduate's letter:

July 7, 1984

Dear Dr. Brown,

I am currently entering my sophomore year at a fine liberal arts college with a double major in Spanish and psychology. My reason for attending a liberal arts school is to enable me to pursue my interest in foreign languages (I am proficient in six of them). I do not have time to take the necessary premedical science courses without sacrificing those areas of the humanities which, I feel, add dimension to life as a doctor. Therefore, I attended two summer sessions at another college and plan to attend the evening session at a nearby community college during the school year. Are science courses taken this way acceptable to medical schools?

Jill Brooks

Summer and evening sessions offer golden opportunities for premeds to take those biology, chemistry and physics courses required by medical schools. Usually these sessions are attended by people seeking self-enrichment or filling requirements for other allied health professions. They are not predominantly premed and science majors, as is the case in day-session. I expect Ms. Brooks to someday receive an acceptance letter to medical school and support my contention that grades are, in themselves, more important than where they are earned.

There isn't much more that I can say on the subject of grades except to stress that they are extremely important and that premeds must maximize them by choosing a major in which they can do well, and by taking ridiculously hard premed science courses at less competitive schools. The only thing that may offset poor grades is a set of outstanding MCAT scores, my next topic for discussion.




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