The Fundamentals of Health Professions Advising

2. The Fundamentals of Health Professions Advising Texas Association of Advisors for the Health Professions 44rdAnnual Meeting University of Texas Southwestern Medical Center Dallas, TX February 7, 2013 New Advisors Workshop Leila E. Diaz Assistant Dean of Admissions (credit: Filo Maldonado)

3. TAAHP New Advisors Workshop—2013 Overview • Giving Advice • Exploring 3 Cases • Starting the Process • The Application to Medical School • The Personal Statement • The MCAT • Grades • The Interview • Applicants of Special Backgrounds • Letters of Evaluation • Post-Application Follow-up • Addendum

4. Know the facts Medical schools TMDSAS/AMCAS/AACOMAS Criteria for selection Research/Volunteer Opportunities Esprit De Corps Be prepared Know your advisees’ profiles and circumstances As an advisor you can be a mentor, guide, teacher and role model. Plan for the visit Study the options Lay out viable alternatives Win–Lose Decisions Stave off fear of making decisions Help adjust view of possible outcomes Matching Choices to Needs What does one need to reach the highest level? Additional course work? Another degree ? Retesting? Experiences? Maturity? Reality Check? TAAHP New Advisors Workshop—2013 Giving Advice

5. TAAHP New Advisors Workshop—2013 Giving Advice – Case #1 The Non-traditional, doctors’ kid Al is the 32 year old son of two Mexican-American physicians and he has two older siblings, both of whom are in medicine. His father is in academic medicine and his mother is in private practice. He grew up in a wealthy suburb and attended an elite private high school in Houston where he accumulated an undistinguished academic record. He scored extremely well on the SAT, however, and attended an Ivy League college where he majored in Fine Arts, with a concentration in photography. He took Introduction to Biology as a freshman, received a B- both semesters and took no additional science courses. His overall GPA as an undergraduate was 3.12. After college he worked as a photojournalist for several years, traveled widely, improved his Spanish, and published two books of photographs contrasting the lives of the wealthy and the poor in Mexico and Latin America.

6. TAAHP New Advisors Workshop—2013 Giving Advice – Case #1 The Advisor’s Encounter At the request of a colleague, you agreed to advise Al who is now contemplating returning to school with his sights set on applying to medical school. In your initial visit, you learned that while he had spent most of his adolescence and young adult life rebelling against the family expectation that he would become a doctor, he now saw differently. He further noted that while he has enjoyed his work as a photojournalist, it has left him unfulfilled. He had volunteered for the last 18 months at a clinic for homeless people, shadowed his mother on her rounds and decided that he should go to medical school.

7. TAAHP New Advisors Workshop—2013 Giving Advice – Case #1 Questions for Discussion • How would you assess Al’s strengths as an applicant? • What additional preparation, if any, do you think Al should consider before applying to medical school? • What advice would you offer? • Would you recommend Al for a medical school interview? Would you recommend him for acceptance? • Do you see any other options for Al on the basis of the currently available information?

8. TAAHP New Advisors Workshop—2013 Giving Advice – Case #2 The 22-year Old, Tunnel Vision Applicant DJ is a 22-year old 2012 graduate of a major Texas university, having received a BS with honors in Biochemistry and Molecular Biology. As an undergraduate he tutored students in chemistry, was a member of the premedical society and played intramural sports for 2 years. His profile indicates that he participated briefly in the Big Brother/Big Sister program and in Habitat for Humanity. His profile did not indicate any medically related exposure or clinical encounters. His science GPA was 3.92 and overall GPA was a 3.77. He used AP and summer courses to fulfill most of his humanities requirements and took very few non-science courses at the university. He took the MCAT once and his score was 35-P; 13’s in the sciences and 9 in Verbal Reasoning. During his senior year he focused on his academic work and his honors thesis which centered on research he did over an 18-month period beginning in the fall of his junior year. He decided to continue his research after graduation by working in the same laboratory he did his undergraduate research. He is second author on a paper published in a respected basic science journal and first author on both an abstract and a manuscript submitted for publication. A very recent letter from his research mentor describes him as, “one of the most accomplished student scientists I have seen in 28 years as a faculty member at three major universities.”

9. TAAHP New Advisors Workshop—2013 Giving Advice – Case #2 The Advisor’s Encounter DJ decides to visit the health professions office at the university to inquire about applying to medical school. You’ve been assigned to advise DJ. In your interview with DJ you detect a somewhat distant and reserved young man who made poor eye contact and who was difficult to warm up to. Based on the profile he provided before your visit, you are troubled by the fact that he did not have any medically related experience and did not continue with any of his service work after his initial activities in his sophomore year. You sensed that he was just checking off the boxes on his list of required activities for medical school. DJ had few questions and when he spoke he rambled about his research and his potential contributions to the world.

10. TAAHP New Advisors Workshop—2013 Giving Advice – Case #2 Questions for Discussion • How would you assess DJ’s strengths as an applicant? • What additional preparation, if any, do you think DJ should consider before applying to medical school? • What advice would you offer? • Would you recommend DJ for a medical school interview? Would you recommend him for acceptance? • Do you see any other options for DJ on the basis of the currently available information?

11. TAAHP New Advisors Workshop—2013 Giving Advice – Case #3 The Disadvantaged Applicant EW is a 24 year old African American woman who grew up in a series of foster homes in a large metropolitan city in Texas. She never knew her father and her mother died from a drug overdose before EW was 3 years old. She attended inner city schools with very high minority enrollment, low graduation rates, and limited educational opportunities. She worked part-time through most of her high school years and then full-time for 2 years after graduating. She gained admissions to a well respected college as part of a special program designed to “provide educational opportunities to minority graduates of underperforming urban schools.”

12. TAAHP New Advisors Workshop—2013 Giving Advice – Case #3 The Advisor’s Encounter EW will complete her junior year in the spring of 2013, majoring in Women’s Studies with a minor in Biology. She is visiting your office for the first time and you learn just how much EW has overcome and how resilient she is. EW has plans to apply to medical school immediately after graduating from college. She has carried light course schedules until this spring term. She has come to realize that in order to complete her prerequisites and prepare for the MCAT she would have to step it up. Currently she has a science GPA of 3.19, brought down by a C+ in Organic Chemistry I and a B- in Physics II. Her overall GPA is a 3.24 and on a recent simulated Kaplan full length MCAT test she scored a 24N; 7-VR, 8-PS, 9-BS. She has been active in a variety of campus organizations and she has been a leader in Alternative Spring Break, despite working 25 hours per week. EW has also tutored students in a local elementary school located in a very economically depressed area of the city during her freshman year and more recently she led a successful grant application for support of a program to enable her college to participate in a summer program providing HIV/AIDS education to urban teenagers.

13. TAAHP New Advisors Workshop—2013 Giving Advice – Case #3 Questions for Discussion • How would you assess EW’s strengths as an applicant? • What additional preparation, if any, do you think EW should consider before applying to medical school? • What advice would you offer? • Would you recommend EW for a medical school interview? Would you recommend her for acceptance? • Do you see any other options on the basis of the currently available information?

14. Put your effort where it counts Organize Set goals and deadlines Maintain good files Communicate Be timely & efficient Know your students Participate in student organization activities Know something about the profession of medicine The latest issues Specialties or post-grad training Familiarize yourself with each medical school Philosophy, mission, goals Know your resources Texas Medical & Dental Schools Application Service (TMDSAS) American Medical College Application Service (AMCAS) American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS) Medical School Admissions Requirements (MSAR™) AAMC Recommendations for Medical School Admission Officers and Medical School Applicants TAAHP New Advisors Workshop—2013 Starting the Process http://www.aamc.org/students/amcas/start.htm

15. Stress early application Help avoid application snarls Timing is of essence Know requirements for completed applications TMDSAS Application Secondary Application Fee and Certification Page Letters of Evaluation Latest/Repeat MCAT Discourage the medical school blinder Encourage your students to apply to multiple or all the Texas Schools Encourage thoroughness Have them respond to all items as directed (and with care), particularly the following: Record of college work Prescribed Course Record Record of community service, medically related and/or research activities Dates and hours of service Role or duties Optional Essays (particularly optional essay #2) Secondary Application Essays TAAHP New Advisors Workshop—2013 Application to Medical School

16. Monitor and stress accuracy and authenticity Academic record Extracurricular activities Life circumstances Encourage a well written, thoughtful, andoriginal personal statements Explain motivation for medicine Discuss philosophy of medicine Indicate goals relevant to profession Discuss value of experiences Encourage optional questions Any unique circumstances or life experiences Characteristics/experiences contributing to diversity of class Encourage original secondary application essays Stress professionalism when interacting with admissions office personnel Politeness Good manners Urge students to follow up Give them the responsibility TAAHP New Advisors Workshop—2013 Application to Medical School

17. When giving advice on writing a personal statement, you should be aware of certain criteria. These same criteria are also important considerations when evaluating a statement. As an evaluator, you must determine the personality of the writer. Criteria Consistency of response Depth of understanding Conviction Social desirability Conceptualization of questions Examine the topics evident in the statement and the communication skills reflected in the writing. TAAHP New Advisors Workshop—2013 Application to Medical SchoolPersonal Statement

18. Consistency of Response–try to determine if the response of the applicant holds throughout the entire statement. Compare different points in the statement and matching comments with activities. For example, an inconsistency is evident: If an applicant writes that she or he is interested in rural medicine or practicing in an underserved area, but does not discuss rural or underserved background, involvement or issues. If an applicant claims in the statement that she or he cares about people but has no activities that are other-centered. TAAHP New Advisors Workshop—2013 Personal Statement – General Criteria

19. Depth of Understanding –the response leaves you absorbed with an aspect of the applicant’s personality. A statement with depth is one that reflects the applicant’s understanding of self and the medical field. The adjacent statement reveals a humble, mature understanding of self. “One decision I have made about the career I choose is that it will in no way exploit or neglect the needs of others with whom I am involved. I realize the interdependence that all of us have toward one another and am committed to the principle of cooperative action as a strategy for human survival. I came to understand this principle primarily through experience with food cooperatives and camp counseling. Working with other people, especially those of different background and circumstances than me, has taught me the synergistic value of mutual support and cooperation. Through the practice of medicine I feel that I would have a skill to offer my community, and could work with people in a positive manner to better understand health and health care.” TAAHP New Advisors Workshop—2013 Personal Statement – General Criteria

20. Conviction – an essay with conviction exhibits a force, a passion that reflects a writer with a very stable personality. The adjacent statement reveals a strong, vibrant sense of self. “I am indebted to those experiences of intimacy with people whereby we have shared our victories and vulnerabilities. To have done so allowed for my self-discovery and clearer understanding of the dynamics of relating to people. As a result of such growth, I believe I have acquired the confidence, sensitivity and the ability to interact – tools necessary for establishing effective communication.” TAAHP New Advisors Workshop—2013 Personal Statement – General Criteria

21. Social Desirability – all writers, especially those in an application, are very aware of their audience. Sometimes the writer will try to please the reader, to express certain ideas for the sake of stroking the reader and keeping the reader in a very favorable frame of mind. Emphasize caution because this can be a weakness. The first response fails to look at the implications of the weakness. The second response is honest in its coverage of the weakness. “I have a tendency to overextend my time commitments such that I complete tasks relying on boundless energy rather than consistent discipline. I do not always discriminate the appropriate time to adopt a matriarchal role. I do not always give myself enough personal nurturing, ‘recharge’ time.” “At times I tend to overextend myself. I have had difficulties in the past saying ‘no’ to others. This has tended to dilute my areas of concentration and I am not yet as self-disciplined as I would like to be. This, however, I feel is improving since I have recognized it.” TAAHP New Advisors Workshop—2013 Personal Statement– General Criteria

22. Conceptualization of Questions – A good response looks at all the ramifications of the question within the physical boundaries of the answer. The applicant thoughtfully and structurally puts his/her ideas together. The applicant builds on the answer without straying from the question. For example, a question in our secondary application requires to “briefly discuss what activities or personal attributes demonstrate best that you would be a good custodian of our honor code1.” The sample statement builds on the answer and expresses the value of the experience. 1A Texas A&M medical student is a professional who exhibits leadership, honesty, integrity, compassion, respect and self-discipline. “I believe that my work and volunteer experiences best demonstrate this in my life. I have volunteered with Save Our Streets Ministries in Bryan, Texas (SOS) for the past three years. Two years ago, I was asked to be the Assistant Director for the children’s ministry at SOS. Now, I am in charge of coordinating about 25 volunteers and up to 50 kindergarten to second grade children every week. I believe that I show leadership by leading the other volunteers. My volunteering at Save Our Streets also demonstrates compassion and respect. The kids I work with at SOS are from the inner city and have difficult backgrounds. It is difficult to work with them sometimes because they are so different from me, but it is wonderful to see them change when they are shown kindness, discipline and respect as a person...” TAAHP New Advisors Workshop—2013 Personal Statement– General Criteria

23. What personal characteristics have positive or negative implications? Positive Characteristics(+) Commitment to serving people Realistic notion of strengths and weaknesses Involvement in areas not necessarily socially-reinforced Evolution of a desire to enter the health profession Positive Characteristics (+) Ability to introduce structure Participation in rigorous activities A mature perception of one’s life Negative Characteristics (–) Compulsiveness Fanaticism Providing information without discussing importance Insensitivity to the needs of others Patronizing Hostile Arrogant TAAHP New Advisors Workshop—2013 Application to Medical SchoolPersonal Statement

24. Be familiar with the MCAT Length Format (Computer Based) Timing Scoring Statistical Significance (Addendum) Changes in 2015 Know how important the scores are to the process of evaluation Encourage and promote preparation Counsel and support students, especially after a weak performance on the MCAT Know when to say, “let’s consider other options” especially after repeated unsuccessful attempts Encourage taking the early administrations of the MCAT January, April, and May June and July Important Resources 2011 MCAT Essentials (Required Reading) MCAT Exam Schedule FAQ Examinee Data Research Practice Tests TAAHP New Advisors Workshop—2013 Application to Medical School MCAT http://www.aamc.org/students/mcat/start.htm

25. Stress to students to make a clean sweep by making A’s and B’s in all courses (a 3.50 GPA minimum) Stress particularly the prerequisite courses Upper level science Encourage students to balance their curriculum Science and non-science Counsel students wisely about taking above average loads Counsel students who struggle early to recover quickly and maintain a solid performance within the range of a 3.50-4.00 GPA in remaining 45-90 credit hours Counsel students to consider a graduate degree or Post-Baccalaureate Programs of Study TAAHP New Advisors Workshop—2013 Application to Medical School Grades http://services.aamc.org/postbac/

26. Prepare students for the interview. Interview questions center around these qualities: Interpersonal skills and communicating effectively Social Consciousness Maturity, Stability, Tolerance Motivation Attitude about learning and education Stress looking the part Professional (business) attire Well groomed Stress communication with medical schools Stress timeliness Stress knowledge Stress a good attitude and facilitate appropriate personal presentation Polite, well-mannered demeanor Sound grasp of issues Articulation of ideas Familiarize students with their responsibilities TAAHP New Advisors Workshop—2013 Application to Medical School Interview AAMC Recommendations for Medical School Applicants

27. What are some strategies for applicants to be effective in the interview? What attributes or circumstances should be stressed in the interview? Strategies Be yourself, for interviews can bring out betrayals of character. Communicate clearly and succinctly. Avoid rambling. Be ready to respond to all kinds of questions, many unrelated to medicine. “If you had a morning unscheduled, how would you spend it? Attributes or Circumstances Be prepared to discuss your motivation for the study of medicine and any activity or experience which is relevant to your goal of medicine as a career. “Tell me about the development of your interest in the study of medicine. What have you done to test your interest?” Be prepared to discuss social issues across several domains. “If you were asked to give a keynote speech to your graduating class about societal problems, which problems would you focus on?” What major points would you make?” Be prepared to discuss in what capacity your have served others. “I am interested in learning more about your work in the community. Elaborate on one of your most profound experiences. How have you changed from that experience? TAAHP New Advisors Workshop—2013 The Interview

28. What are additional strategies? Strategies: Avoid second guessing the interviewer. Answer questions honestly. Avoid attempting to “butter up” the interviewer. If you don’t know the answer to a question, say so. There are almost as many approaches to interviewing as there are interviewers. Strategies: Explain deficiencies honestly and don’t offer mere excuses and rationalizations. Don’t hesitate to ask questions for the interview serves equally the purpose of the applicant. Don’t be on the defensive or the offensive. Avoid rudeness or impoliteness. Don’t judge the success of the interview by its length. TAAHP New Advisors Workshop—2013 The Interview

29. Underrepresented Minorities Grutter v. Bollinger, et al., 123 S.Ct. 2325, 2341 (2003) Disadvantaged Students HB 1641, 2001 SES Codes: A – D Married couples applying Non-traditional Older than traditional applicants (25 or older) Other careers Disabled Applicants Section 504 of the Rehabilitation Act of 1973, 29 US.C.A.§ 794 (1975) Non-residents Enrollment of non-residents may not exceed 10% of entering class International students HB 1403, Summer 2001 Replaced by SB 1528 Some eligible; some not U.S. Permanent Residents Texas residency issues Foreign course work Foreign degrees F-1 Visas Academic Fresh Start SB 1321, April 1993 TAAHP New Advisors Workshop—2013 Applicants of Special Backgrounds

30. Submit a Health Professions Advisory Committee (HPAC) packet with a summary letter. Be honest, and evaluate Include at least two professor letters with evaluation forms Use a definable scale of recommendations (based on 1-2 years of application cycle percentages) Recommended with Enthusiasm Recommended with Confidence Recommended Recommended with Reservation Not Recommended Write a health professions advisor letter (in the range of 1-2 pages) discussing the following: Academic background Communication skills and ability to interact Breadth and depth of interests & activities Extent of medical experiences Community service and/or altruistic activities Personality Promise for medicine One extra letter can be sent to TMDSAS Additional letters must be mailed directly to the schools (if accepted) TAAHP New Advisors Workshop—2013 Application to Medical School Letters of Evaluation

31. Post-Application Follow-up Use the TMDSAS Health Professions Advisors Report to determine your students’ statuses Be a liaison and conduct phone follow-ups with Deans of Admissions Be prepared to provide additional information Falsification issues Criminal charges Institutional reprimands Analyze your students’ interview visits Critique the personal statement(s) Counsel students to reduce anxiety, especially after the interview season Have students exercise responsibility and planning TAAHP New Advisors Workshop—2013

32. TAAHP New Advisors Workshop—2013 THANK YOU!

34. ADDENDUM TAAHP New Advisors Workshop—2013

35. Reliability, Standard Error of Measurement, Confidence Intervals Total Score (SE is 2 pts) SE used to derive confidence intervals 68% Confidence interval (+/- one standard error) SE’s represent the range of test scores within which true achievement level probably lies. Example: Student 1 – Total Score of 23 Student 2 – Total Score of 26 Student 1 [ 21 22 23 24 25 ] Student 2 [ 24 25 26 27 28 ] The example shows The gray bold, underscored scores (in the center of the CI’s) indicate students’ reported scores Total Score confidence intervals for the 2 students overlap (both include scores 24 and 25) TAAHP New Advisors Workshop—2013 Application to Medical School MCAT What one can assess from this data is that if the applicant were to take the MCAT multiple times, it would be expected that his or her score would fall in this range about 2/3rds (68%) of the time. When score bands overlap, performance is essentially equivalent.

36. TAAHP New Advisors Workshop—2013 Disadvantaged Factors • Socioeconomic Status • Parents’ level of education (high school/GED or less) • Type of community (rural, urban, suburban, military, etc.) • First generation to attend or graduate from college • Parent or guardian of dependent children while attending school • Bilingual or multilingual proficiency • Size of household • Household income • Estimated value of residential property (owned or rented) • Subsidized housing • Participant of the Federal Free and Reduced Meal Programs • Responsibility of raising other children in the household while attending school elementary and/or high school • Employed steadily through high school to contribute to overall family income

37. TAAHP New Advisors Workshop—2013 Disadvantaged Factors (cont.) • Region of residence • Rural, underserved, and/or health professions shortage area of state (http://www.dshs.state.tx.us/chs/hprc/MUAlist.shtm) (http://www.dshs.state.tx.us/chs/hprc/hpsa.shtm) • Location of high school district • Performance on the MCAT in comparison with that of other students from similar socioeconomic backgrounds • Admission to a comparable accredited out-of-state institution

38. TAAHP New Advisors Workshop—2013 Academic Fresh Start The "Right to an Academic Fresh Start" legislation, passed by the 73rd Texas Legislature: • Entitles Texas residents to seek admission to public institutions of higher education as undergraduate students without consideration of courses undertaken ten or more years prior to enrollment. • Gives students the option of electing to have coursework taken ten or more years prior to enrolling either counted as usual or ignored for admission purposes. • Applicants who are admitted as students under this law may not receive any course credit for courses undertaken ten or more years prior to enrollment. The intent of the "Fresh Start" legislation is to provide students with an opportunity to clear their academic records, if they choose to do so, of all college-level work accumulated ten or more years ago. Students may not pick and choose what is to be ignored and what is not. Either all college hours ten or more years old are ignored or they are counted.

39. TAAHP New Advisors Workshop—2013 Academic Fresh Start • Professional schools cannot consider course credits/grades earned 10 or more years before the starting date of the semester at a state public college or university. • A student admitted under this provision cannot receive any credit for courses taken 10 or more years before enrolling.

40. TAAHP New Advisors Workshop—2013 Academic Fresh Start • A student who completes either a minimum of 90 credit hours or a baccalaureate degree under the AFS law, then applies to a professional program at a public institution, the professional school considers: • Only the GPA established by the course completed after enrollment under the AFS law • Standard admissions criteria applicable to persons seeking admissions to a professional program

41. % 2008-10 Applicants Accepted into at Least One Medical School by MCAT and UGPA