How to Get Into Medical School: The Ultimate Guide (2024)

Shemmassian Academic Consulting

Everything you need to know to get into medical school, whether you’re a student, recent grad, or non-traditional applicant, including a step-by-step guide to get into your dream program

Two medical students wearing blue scrubs and holding clipboards while doctors talk to each other behind them

Part 1: Introduction

Part 2: What medical schools look for

Part 3: Medical school applications

Part 4: A four-year guide to getting into medical school

Part 1: Introduction

Getting into medical school and becoming a physician is a dream for many—and with good reason.

Beyond being a highly respected and lucrative profession, medicine uniquely allows you to combine your love for science with your desire to help people directly. While the latter—wanting to help people—is clichéd, it’s true and necessary if you want to be fulfilled as a doctor. You wouldn’t be interested in so many years of training if you were simply motivated by earning potential or prestige. For instance, you could achieve the former faster as a software engineer.

As a reader of this article, you probably fall into one of four categories:

Regardless of which category you fall into, you’re in the right place. After helping thousands of students get accepted to med school for nearly 20 years—and answering every imaginable question about how to get into medical school—I decided to write a guide that covers all medical school requirements, from various degree programs and extracurricular activities to MCAT prep, admissions essays, and interviews.

Reading this guide thoroughly will help you approach medical school admissions the right way, whether you’re a high schooler, college junior, nontraditional applicant, or anything in between. It will also help you avoid applying bad advice on premed forums or the opinions of misinformed people so you can maximize your odds of getting into med school in the shortest amount of time possible.

This guide focuses on getting into U.S. medical schools—allopathic (MD) and osteopathic (DO). That said, the majority of advice also applies to Canadian medical schools and Caribbean medical schools, the latter being a consideration for students with low grades or test scores. On the other hand, international medical schools fall outside the scope of this article.

Paths to medical school

Historically, the most traditional path involves completing a four-year college degree and applying to medical school during the summer between your junior and senior year of college. If successful, you would enroll in medical school a few months after graduation. This path is also known as “going straight through.”

However, the average age of matriculation into medical school is 24, which means that most students take at least one gap year before enrolling. Gap years are typically used to supplement or bolster your application, whether you need to complete outstanding prerequisite courses, boost a low or so-so GPA, or deepen your involvement in various extracurricular activities, like research. While taking a gap year is not required, it is helpful for students who are not ready to go straight through.

In addition, some people take over two years—sometimes way more than two years—to enroll in medical school. While there is no agreed-upon definition, nontraditional applicants are typically those who are over 24 years old. They may be career changers or individuals who focused on personal responsibilities (e.g., raising children) before returning to school.

On the other end of the spectrum, high-achieving high schoolers who are certain about wanting to become a physician have the option to apply to direct medical programs, otherwise known as BA/MD or BS/MD programs. (More recently, BS/DO programs have begun to attract students interested in osteopathic medicine. We’ll cover osteopathic medical schools in a moment.) Direct medical programs allow students to complete their undergraduate and medical degree in 6 to 8 years—7 years is most common—depending on the program. Moreover, these combined programs offer “conditional acceptance” to medical school, meaning you have to maintain a minimum GPA and achieve a minimum MCAT score to secure your position.

Finally, a small number of medical schools offer early assurance programs to college students who have exhibited an extraordinary level of achievement and promise during their first year or two of undergrad. Accepted students are not required to take the dreaded Medical College Admission Test (MCAT)—the standardized test for medical school—and can focus on their studies, research, clinical experiences, and so on.

While most medical students receive a single degree—MD or DO—a subset of students complete dual degrees, such as an MD/PhD, MD/MPH, or MD/MBA. Typically, these admissions processes require that you separately get admitted to the two programs. However, if you get rejected from the “other” program, you will still be considered for the medical program.

Types of medical schools

U.S. medical schools are mainly divided into allopathic and osteopathic programs. The former confers the widely-recognized MD degree, whereas the latter offers the less-recognized DO degree.

Historically, the osteopathic model has focused on holistic medicine, which is sometimes thought of as “treating the whole person.” Criticism of osteopathy has largely focused on the use of therapeutic techniques that are not necessarily evidence-based (i.e., research-supported).

Over the years, MD and DO programs have come to be more similar. Allopathic physicians consider disease prevention, mental health, and systemic factors more than ever, and osteopathic physicians focus on delivering evidence-based care. Moreover, many are involved in cutting-edge research.

While MD and DO physicians can practice the same specialties, their residencies have long been separated. This changed in 2020, when residency programs for the two merged. However, some applicants, parents, and DO students are concerned about having to compete against highly regarded MD students for the same positions, especially when it comes to entering highly competitive specialties.

There are two main reasons for MD programs being more coveted:

  1. The MD degree is generally more widely recognized.
  2. MD programs tend to admit higher-achieving students. In other words, it is typically easier to get into a DO program than an MD program. Therefore, most students prefer to attend an MD program and see DO programs as Plan B.

In truth, DO students who do well in medical school and ace their board exams can go on to have careers that are just as successful and impactful as their MD counterparts. However, the prestige issue is hard for many med school hopefuls to shake off, so the DO vs. MD debate rages on.

Part 2: What medical schools look for

I often tell students, “Medical school admissions is hard, but it’s not complicated.”

My point is that while there is little mystery regarding what it takes to get into medical school, pulling it off can be difficult. As an analogy, it’s one thing to understand how to dunk a basketball on a 10-foot rim—grab the ball, jump and extend your arm high enough to get the ball over the hoop, and dunk—but an entirely different thing to do it.

Getting into medical school is so hard, in fact, that over 60% of applicants fail to matriculate into all MD programs they apply to. In other words, most applicants don’t get in anywhere. Therefore, there is little room for error with the admissions process and it’s important that you achieve at the highest levels you’re able, with regard to academics and extracurriculars.

While it’s important to know medical school requirements (e.g., which specific classes to take), it’s also critical to understand why medical school admissions committees (adcoms) expect you to complete certain coursework, achieve at a certain level, and participate in various extracurricular activities: to demonstrate your commitment to medicine, including the lifelong pursuit of academic knowledge, passion for promoting health, and desire to serve people.

"Medical school admissions is hard,
but it's not complicated."

Without this understanding, you may adopt a “checklist mentality” and, rather than develop a clear “it factor” (more on this later), fail to stand out due to completing academic and extracurricular requirements at a surface level.

The Association of American Medical Colleges (AAMC) provides an official list of core competencies, as follows:

Thinking and reasoning competencies:

This is an overwhelming list, but you need not worry. Core competencies are not separate medical school requirements, but can rather be demonstrated through the academics and extracurricular activities you will have to pursue anyway.

To make things more digestible, medical school admissions factors fall into the following categories:

Academics

Your stats—GPA and MCAT score—collectively represent your level of academic achievement and fitness for medical school. While GPA is perhaps the single most important variable for med school admissions, different grading practices and prestige across schools affect its interpretation. Because there is no GPA conversion table, we don’t know that a 3.7 GPA at Vanderbilt is the same as a 3.8 GPA at, say, Penn State.

That said, your undergrad does matter for med school—that is, medical schools indeed consider the strength and prestige of your institution—so a 3.6 GPA from UC Berkeley is valued more than a 3.6 GPA from UC Riverside.

To further complicate things, adcoms consider your overall GPA and science GPA, the latter comprising your biology, chemistry, physics, and math (BCPM) courses. Most students will have a slightly higher overall GPA than a science GPA, reinforcing the widely held belief that humanities courses are easier to do well in than science courses.

Medical schools use the MCAT, a difficult standardized exam, to address these GPA-related variabilities. The MCAT is composed of four sections—roughly Biology, Chemistry/Physics, Psychology/Sociology, and CARS (reading comprehension)—that make up an eight-hour testing day. It is graded on a 472–528 scale, with 500 corresponding to the 50th percentile score. To do well, you’ll want to study hard anywhere between two and four months and focus just as much on test strategy as you do test content.

I often get asked, “What MCAT score do I need to get into medical school?” or “What MCAT score should I aim for?” The answer depends on where you’re trying to get into, your GPA, and your other extracurricular achievements. The more prestigious the med schools you want to get into, the higher your MCAT score will need to be. The higher your GPA, the more it will buffer your MCAT score. Similarly, stronger extracurricular achievements, like multiple research publications, will assuage adcom concerns about your MCAT score.

Extracurricular activities

Adcoms review applications from many students with a high GPA and MCAT score, and it’s incredibly difficult to discern from stats alone who the top applicants really are.

In addition, medicine transcends scientific knowledge and achievement. In other words, it’s not just about your ability to do well in science classes or on exams. Therefore, medical school adcoms rely on your extracurricular activities to understand how you spend your time outside the classroom, your efforts to get involved in the medical field, what you’re passionate about, your commitment to service, and your leadership potential.

Obtaining shadowing experience is typically the first clinical step for premed students. Shadowing a doctor is a mostly hands-off experience where you will observe a physician’s daily activities. Your goal will be to shadow 2–4 physicians—for 50–100 hours total—across multiple specialties and medical contexts (e.g., inpatient vs. community clinic) to show adcoms that you know what a doctor does.

Clinical experience is a broad term that encompasses the following:

While it’s important to get involved with service opportunities, there is no substitute for true, hands-on patient exposure.

(Note: Working as a clinical scribe falls somewhere between shadowing and patient exposure. Scribing is more active than shadowing, but does not provide the same direct patient experience as other activities.)

Community service/volunteering is another foundational extracurricular category. Your service could be medically relevant, but it does not have to be. For instance, leading after-school math programs for students from low-income backgrounds, developing community gardens in urban food deserts, or organizing large beach clean ups or other environmental initiatives are all meaningful activities. Since medicine is viewed as a career of service, adcoms want to see evidence that you share their mentality.

Finally, conducting scientific research is more or less required by noteworthy medical schools as a demonstration of your scientific literacy and ability to contribute knowledge to the field. You can work in a basic science lab or get involved in clinical research. Moreover, you can work in a wet lab or dry lab, as well as conduct biological experiments or focus on data science in a cognitive psychology lab. More important than the specific lab chosen is your longstanding commitment and, ideally, your publication record.

(Note: Competitive MD/PhD applicants participate in research for years, and often work in multiple labs. If you’re interested in MD/PhD programs, you will be expected to submit letters of recommendation from all PIs you worked with.)

While it’s important to shadow, work with patients, volunteer, and conduct research, the best applicants are those who develop a specialty or “it factor” in one, perhaps two extracurricular activities.

Top medical schools especially want to admit students who are “world class” (i.e., the best of the best) at something. For instance, some of the students I worked with who got into top-10 schools demonstrated a research specialty by publishing three first-authored papers in peer-reviewed journals. Yet, others founded science teaching initiatives for elementary students in low-income schools.

The point is that one extracurricular category is not inherently better than the other. This should be liberating. Instead of looking around to see what your peers are doing and attempting to mimic their achievements, consider how you want to spend your time, where your passions lie, and what type of impact you want to make in your community or the medical field.

To stand out, you must be memorable, and you’re much more likely to be remembered for being great at one thing vs. pretty good at a bunch of things. And even if you are pretty good at a bunch of things, you’ll still want to be great at one thing.

To use another basketball analogy: Stephen “Steph” Curry of the Golden State Warriors is a perennial NBA All Star, widely recognized as one of the best players who ever lived. And while he’s incredible in a number of ways on a basketball court, he is credited for revolutionizing basketball mostly for his unprecedented three-point shooting ability. Countless articles have been written about how no one in NBA history has shot three pointers as well as Steph Curry, and from such incredible distances.

Your goal is to be the Steph Curry—relative to your peers—of your chosen area, no matter how niche. For instance, you can be the Steph Curry of publishing autism fMRI research or the Steph Curry of opening soup kitchens. Fortunately, even if you get 80-90% of the way to Steph Curry status, you’ll be ahead of 99% of the applicant pool.

Sound difficult? It’s supposed to be. At the same time, it’s doable. If your aim is to get into a top med school like Stanford or Johns Hopkins, you have to be a top applicant. And there’s no better way to separate yourself from the other academic high achievers than through an extracurricular specialty.

Qualities

Medical schools aren’t looking to admit applicants who have simply checked all the right boxes with regard to academics and activities. Rather, they want to admit students who have demonstrated certain qualities during their premed years, such as compassion (e.g., patient exposure, community services) and desire for knowledge (e.g., research, honors thesis).

Many students mistakenly think that leadership is its own extracurricular category. They then pursue activities that require a significant time investment but that are not impressive. You can demonstrate leadership through any experience, whether leading an organization you started or taking on increasing responsibilities in your research lab.

Personal factors

Doctors serve diverse people—individuals from high-income and low-income backgrounds, ethnic majority and ethnic minority groups, patients from urban and rural areas, religious and non-religious individuals, and so on.

To be treated well, the diverse human race requires a diverse physician workforce. Therefore, medical schools look to recruit individuals from various backgrounds to their programs. While personal factors like your ethnicity, sexual orientation, and familial income are outside your control, you can demonstrate an appreciation for and commitment to serving diverse people through your coursework and extracurricular activities.

Part 3: Medical school applications

Your academic and extracurricular paths will eventually converge on your medical school applications, which are divided into three phases:

  1. Primary applications
  2. Secondary applications
  3. Interviews

Some people will say that your primary application, which includes your personal statement, is more important than your secondary applications. Others will say the exact opposite. While some medical schools indeed weigh one more than the other, you should apply your maximum effort towards all of your application materials. You’re putting in a lot of work into your premed journey; don’t slack off as you near the finish line.

In addition, it’s imperative that you begin working on your applications early. Not only is there a significant amount of work to complete, but applying late can hurt your chances, as medical schools practice rolling admissions, meaning that they invite students for interviews—and accept them—on a rolling basis. Therefore, the earlier you submit, the fewer people you’ll be competing against for more spots. Conversely, the later you submit your applications, the greater the competition for fewer spots.

You should begin working on your medical school applications months before the submission dates open in May. There is a significant amount of work to complete, and starting later will compromise your ability to submit applications early.

Primary applications

Your primary applications, otherwise known as “primaries”, are the centralized application systems that will send your demographic information, transcript(s), MCAT score(s), letters of recommendation, expanded resume, and personal statement to individual medical schools.

There are three main primary applications:

Fortunately, each application will require you to more or less submit the same materials, with a few exceptions.

Entering demographic information is relatively straightforward. Medical schools want to know your age, gender, state of residence, family income, etc. Next, you’ll be asked to enter all of your academic information: your college courses and grades, as well as your MCAT attempts and scores. (Note: Your official transcripts and MCAT scores will have to separately be sent to each application system’s physical address.) You will also be asked to indicate who will submit your medical school letters of recommendation.

Next, you’ll be asked to complete the AMCAS Work and Activities section, which is essentially a long-form resume. You’ll list your extracurricular activities and awards, hours devoted to each, along with a short description. Moreover, you will be asked to further discuss a few of your most meaningful activities.

If you’re applying through AACOMAS or TMDSAS, these application systems also have Work and Activities sections called ‘Experiences’ and ‘Personal Biography and Activities,’ respectively. Both are quite similar to the AMCAS Work and Activities section but neither limits the number of examples you can add. However, AACOMAS limits your descriptions to 600 characters while TMDSAS limits them to 500.

Next comes your medical school personal statement, a 1.5-page narrative essay that describes your personal path to and reflections on medicine. Your personal statement is your single most important application essay and will likely take up more time—and stress you out—than any other piece of your primary applications.

You can write your personal statement on any topic. Many students mistakenly believe that some topics are better than others, but that’s not the case. I’ve seen great essays written about pretty much every topic, and I’ve seen poor essays written about those same topics. Therefore, how you write your personal statement and every other essay is at least as important as what you write about. Just make sure that your essay highlights why you want to be a doctor and the qualities that will make you an asset to the medical community.

The final step before submitting your primaries is to choose the list of schools that you’d like your applications to be sent to. Ideally, your school list will include a number of schools whose average stats are lower than yours (undershoots), about the same as yours (targets), and slightly higher than yours (reaches). Target schools should comprise the single largest category.

(Note: TMDSAS will ask you to submit two additional essays—Personal Characteristics Essay and Optional Essay. The Optional Essay should be treated as a required essay. You can find examples of each in our TMDSAS: The Ultimate Guide)

Secondary applications

Shortly after your primary application(s) is verified, it will be sent to every school you indicated. Save for a few medical schools that automatically filter applications that don’t meet certain GPA and MCAT cutoffs, you will receive a secondary application, otherwise known as a supplemental application, from every school you applied to.

Most secondary applications comprise a number of school-specific essay prompts with varying character or word limits. The three most common prompts are those generally pertaining to diversity, a challenge you’ve experienced, and why you want to attend the specific school.

Given rolling admissions, you should submit your secondary applications within two weeks of receiving them. If you begin working on your applications early, you can pre-write many of your secondaries by viewing previous years’ secondary prompts, since they change little from year to year.

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Medical school interviews

Anywhere from a few days to a few months after you submit your secondary applications, you may receive invitations for in-person medical school interviews. The earlier you receive interview invitations, the better the omen.

There are two main types of interviews: traditional and multiple mini interview (MMI). The former, as the name suggests, will involve you answering typical interview questions, such as, “Tell me about yourself,” “What is your biggest weakness?,” or “Why do you want to be a physician?” MMI interviews, on the other hand, will require you to visit various interview stations, where you will be asked how you would behave if presented with a certain ethical dilemma, communicate with an actor playing the role of patient, work with a teammate to solve a problem, and so on.

Years ago, medical school interviews tended to be much more stressful than they are today. You are unlikely to encounter uncomfortable personal questions or “put on the spot.” Rather, medical school adcoms are hoping to get to know you interpersonally and to confirm their positive reaction to your application.

It’s important to practice your interview skills with experienced interviewers. Instead of focusing on rare questions like, “How do you feel about Obamacare?,” you should practice more common questions, such as, “Why do you want to attend our program?” and focus just as much on how you come across in your answers as you do on the content of your answers. Remember: if they simply want to know the content of your answers, adcoms could’ve just asked you to write more essays.

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Waiting

Waiting—for interview invitations or for admissions decisions—is the most stressful part of the application process for most students.

During this time, you should do what you can to take your mind off the admissions process. You should also consider sending update letters—letters of interest or letters of intent—to schools when you have meaningful updates to share, and also to express your continued interest in their program. If a school explicitly requests that you not communicate with them after submitting secondaries or interviewing, honor their request.

Admissions decisions

Some time after submitting your secondary applications or interviews, you will receive one of the following admissions decisions from medical schools:

While acceptances and rejections are fairly straightforward, navigating wait lists is more tricky. Some schools will invite you to send letters of continued interest, whether others will let you know that you will not need to send in anything. In the latter case, consider sending an update letter, unless expressly told not to.

If you are accepted to multiple medical schools, you will have to accept one of your offers by May 15 and turn down the others. If you receive additional acceptance past May 15, you’ll have two weeks to decide whether you want to keep your accepted offer or turn it down in favor of the new one.

Financial aid

Unlike with undergrad, few medical schools offer financial aid in the form of grants or scholarships. And the schools that do offer scholarships tend to give them to one of the highest achieving students they admitted and that they want to recruit

Unless you can afford to pay for medical school out-of-pocket, you will have to finance your school through loans or external scholarships, fellowships, or employment.

Part 4: A four-year guide to getting into medical school

How this guide is organized

This section is separated into four parts that correspond to the traditional four-year college path, assuming that you will apply straight through. However, it is meant to be applied flexibly.

For instance, if you’re a college sophomore and realize that you didn’t complete one of my freshman-year recommendations, it doesn’t mean you should skip over those. Rather, you should work hard to “catch up” by completing tasks you may have missed. Conversely, if you’ve completed a recommended task ahead of time, you don’t have to repeat it. In addition, if you intend to take one or more gap years, you can space out various tasks.

In addition, each year has a theme to guide your approach to academics and extracurricular activities. Therefore, you should never be over-focused on one or the other. Remember that maintaining strong stats is critical, so never take on too much coursework or too many extracurricular commitments that they compromise your grades. At the same time, you don’t want to be seen simply as an academic high achiever.

At first, you’ll want to cast a relatively wide net. Over time, your interest will become more clear. As you decide which area(s) to pursue deeply, your “it factor(s)” will naturally develop. Think of your medical school admissions journey as a funnel, where your focus gets narrower over time.

Freshman year: Healthy foundations and breadth

The first year of your undergraduate career will speed by much more quickly than you think. In addition, you will receive seemingly endless opinions on your many questions about how to navigate your premed years. Here are the most common ones: