Non-traditional medical students are defined as those students who did not take the typical path to medical school. Non-traditional medical students can be some of the best candidates for American and Caribbean medical schools, yet they face unique challenges, particularly for older students when it comes to getting a residency. As we’ll discuss, age discrimination is not nearly as big a hurdle for getting into medical school as it is for residency placement. To create this guide, the UMHS Endeavour researched extensively and interviewed various experts including a medical school admissions representative, a medical school professor, and a medical school Associate Dean.
(Photo, inset right) NONTRADITIONAL MEDICAL STUDENTS: Whether you are 30, 35 or 40, it is not too late to attend medical school. Image: Sira Anamwong/FreeDigitalPhotos.net
Two Main Types of Non-traditional Medical Students
Non-traditional medical students can be divided into two main categories says Katherine M. Ruger in a US News and World Report article: 1) People right out of, or just a few years out of college with an undergraduate degree outside of the traditional “premed” disciplines; and 2) “career changers,” those who are already working in a field that may or may not be related to medicine.
(Photo, inset right) 30-SOMETHING & WORKING IN A HEALTH-RELATED JOB? Admissions departments at medical schools value older students who may have real-life job experience either in a related field like nursing or even something outside of medicine. Photo: FreeDigitalPhotos.net
For college graduates who did not take many science courses as an undergrad, fulfilling the requirements for medical school will include taking premed courses at a local community college. Some students may choose to enter a post-baccalaureate program. Depending on the type of the original undergraduate degree, admissions committees may want to see these candidates complete additional science coursework above and beyond the premed requirements of the medical school.
Career changers - people who are already working in various fields, from accountants to nurses, comprise the second group of nontraditional students pursuing an M.D. These students are generally older, and will need to invest substantial time in taking science courses, potentially retaking courses from the past, and preparing for a massive life-change.
Medical Schools Like Non-Traditional Students
“Nontraditional applicants bring a special set of qualities to medical schools,” says US News and World Report’s Katherine M. Ruger. “Admissions committees often find pleasure in reviewing applications from individuals who have not only succeeded academically, but who also have a unique set of life experiences to contribute to the medical profession.”
These sentiments are echoed by medical school admissions Vice President, Marie McGillycuddy of the University of Medicine and Health Sciences (UMHS). “There are a handful of nontraditional medical students who are graduates of UMHS and practicing in the United States and Canada. We also have nontraditional medical students who are currently attending UMHS. If you keep coming back to your original professional goal and desire of practicing as a physician, then medical school is a great fit for you.”
Ms. McGillycuddy has worked in medical school admissions for years and has seen many types of people decide to pursue an M.D., including those already working in healthcare-oriented careers.
“Over the years I have seen many medical students change career paths. Some were teachers, police officers, personal trainers, nurses and so on. I think it is quite admirable when someone can make a career change and fulfill their passion. In fact, students who have done this tend to be far more driven, mature and successful. If when you wake up in the morning you are not excited, and if at the end of your day you do not feel fulfilled then make that change, make it happen and go after what is meant to be yours,” Ms. McGillycuddy said.
Maturity and Experience are Assets
Medical schools value the mature student. We spoke to Prakash Mungli, M.D., M.B.B.S., Chair of the Department of Molecular Sciences and Professor of Biochemistry at UMHS, about how nontraditional medical students perform during and after medical school.
“With my personal experience of teaching for more than six years at UMHS, I have found most of the non-traditional medical students in my classroom have excelled, successfully completed Step 1 and are on their way to becoming physicians,” Dr. Mungli said. “The reason why nontraditional medical students are equally successful when compared to students who are fresh out of college is that these students are often more mature, and take responsibility for what they do. They carry experience with them, in one way or another; their experience will be their asset during their medical school years.”
Older students already working in health-related careers often make a smooth transition to medical school, Dr. Mungli said.
“I have seen many nontraditional medical students with paramedical experiences like nursing, laboratory technology, emergency medicine, medical research, and other allied health sciences. These students are already exposed to various medical concepts and terminologies. They have an experience of working with physicians and paramedics. These experiences will help them to understand medical concepts in a much better way because they can start to correlate things they learn in medical school with the experiences that they have had before.”
“With my personal experience of teaching to and interacting with nontraditional medical students while they were doing basic sciences at UMHS, and after they moved on to do clinical rotations and residency, what I’d like to say is, with both hard work and smart work combined, nontraditional medical students excel in medical school as equally as traditional medical students,” said Dr. Mungli of UMHS.
Ms. Ruger in her US News and World Report article noted that career changers should be forthcoming and honest about their real-life experience when applying to medical schools.
“Nontraditional medical school applicants should not be shy about referring to aspects of their lives that may be applicable in essays or interviews, and they should definitely not misrepresent aspects of their backgrounds,” she said.
Medical school requires an incredible degree of dedication and commitment no matter what age you are. More seasoned applicants should see their life experience as an asset for this unique journey.
Non-Traditional Medical Students Increase Diversity
Diversity is another reason many medical schools like to admit nontraditional students, but for a different reason than most think, according to an article by Premed Life. Just like how medical schools admit students of differing racial and ethnic backgrounds to enrich the learning environment, enrolling people from various age groups and career backgrounds helps to elevate the learning environment as well.
“This is so important because if you have students from all different backgrounds then their base level of knowledge will be different from other students,” the article said. “Also, the way that people think is based on their environment, educational background, and so much more. The more ‘types’ of students there are, the more varied the discussion. Discussion is a vital part of the medical school experience because there are sessions in which you sit with your fellow peers in small groups and discuss ways to take care of a made-up patient.”
Having the diversity of non-traditional medical students enriches the clinical experience for medical schools and generally makes for a more diverse array of residency placements. As Premed Life noted, “[I]f medical schools want to fill in different specialties, they want to attract different types of medical students. A diverse medical student group provides a rich array of different personalities who will all pursue different specialties in the future.”
The Challenges for Older Non-Traditional Medical Students
At the end of the day, medical school is only a stepping stone to a career in medicine, and without a residency, there is still no certainty that becoming a doctor will happen. For older medical students, particularly those over 40, getting a residency after medical school can be very challenging. The Endeavour spoke to Patrick McCormick, Associate Dean of Academic & Student Affairs at UMHS, about what students over age 40 can expect. Patrick and his team in the Academic Affairs Office have a collective 50 years of experience in coaching and guiding medical students through the medical residency match process in both the US and Canada. He is a true expert when it comes understanding the nuances and realities for non-traditional medical students in getting residency.
Can you get a residency if you are in your 40s or 50s?
“Although we have examples of some successful older students who have matched in residencies, it can be challenging,” Mr. McCormick said. “Residency programs are not officially permitted to discriminate in their hiring considerations against age, but that doesn’t mean they don’t do it quietly. Given this and other factors, a similarly accomplished older student garners comparably fewer opportunities to interview with residency programs compared with a younger applicant. With this in mind, any older applicant must understand the elevated importance of achieving a quality academic performance in medical school, high scores on objective national examinations, and that their accomplishments beyond their medical education and perceived commitment to medicine will be scrutinized even more.”
“Although every residency is different, students are encouraged to apply to many residency programs in order to increase their chances. Each year older there could be one, or two, or three more programs that will perceive the applicant’s age as an issue,” Mr. McCormick said. “Knowing the scrutiny will inevitably be greater on performance for older students, such students must take their own temperature on performance and interest in medical school early on and often, knowing to “cut the cord” if their performance isn’t meeting a high standard or their interest in becoming an M.D. isn’t where they thought it would be. So to an even greater degree than normal, passion, dedication and love of medicine must be unwavering for an older student to see similar results compared to their younger counterparts.”
For students over 40 who have no prior healthcare experience, matching into a residency can be even more challenging.
“Although programs cannot officially discriminate against age, yes, the data suggests an older graduate without prior experience can be a victim of quiet discrimination,” Mr. McCormick said. “The caveat here though is that programs can simply cite lack of experience, even if age was a quiet consideration as well. Also, age plus a lack of experience in health care prior to attending medical school affects the perceived thought that an older student would not be able to contribute to medicine for the expanse of a longer career than a younger student with similarly limited experience.”
What will older students face?
“With programs seeking potential long-term retention, they therefore seek to work with skilled physicians in their growth and expansion. Older students without a medical background are seen to have a limited scope by which their learning can be expansive and long-term,” Mr. McCormick said. “To mitigate this, such a student would have to make up for this lack of experience in and out of the medical school curriculum, perform highly on objective examinations, and be persistent in finding programs willing to take them on and be open to hearing their pitch for what a program would be getting from them that makes up for any perceived lack of both experience and potential longevity in the field.”
Medical students over 40 may have the best luck in getting a residency in primary care fields.
“It would be easier for a student over 40 to obtain a residency in a primary care field, not just because it is less competitive, but also because the emphasis is larger on physician comportment as opposed to refined and tenured technical skill sought in the specialty fields, the latter of which can only be achieved at its highest level after years of practice,” Mr. McCormick said. “In primary care, there is more emphasis on teaching prevention, diagnosis, listening, follow up, interpersonal rapport, community involvement, and how the physician is perceived by the patient. With older physicians being perceived as more trustworthy, this can be an asset. But the emphasis on a more accomplished medical school record, exam scores, and overall background is still paramount.”
There are even nontraditional students over 60 in medical school. What can someone over 60 accomplish in medical school?
“At the very least, personal pride, an M.D. behind their name and having completed a life-long dream,” Mr. McCormick said. “As for the reality of residency training, I’ll use our one example. UMHS boasts one student who matched over age 60 and he was uncommonly accomplished and amazing in every way before applying. But he only received two interviews in his second year trying (he didn’t get any interviews in his first year) and many people worked hard to make good on those two opportunities. Given this, the concrete benefit of an M.D. at that age can be argued but it would come down to the persistence of the individual and x-factors that are difficult to articulate without knowing the student or his/her personality, intent, worldly experience, connections, etc. It can be done, but it will be a big challenge on many levels.”
Important Considerations When Applying to Medical School as an Older Student
Make sure your science coursework is up-to-date
Because the world of science and medicine is constantly changing, an older student who completed his or her undergraduate studies more than 10 years ago will likely need to retake their premed courses. In an excellent blog post, by former UC Davis post bac student advisor, Alician McNease Nimonkar, she recommends that coursework should be no more than seven years old.
“If you completed most of your prerequisites or science coursework more than seven years ago, enroll and take classes to demonstrate that you are ready to reenter the school environment,” she said. “Make sure you earn all A’s in your current coursework.”
Students can follow this link for the typical premed prerequisite courses. Students have the option to take these courses in-person or online at any accredited U.S. community college (labs too). Canadian students can take these courses online at an accredited Canadian online university like Athabasca University.
Don’t use “expired” MCAT scores
Some medical schools only accept MCAT scores that are two years old or less, Ms. Nimokar said in her blog post. “If your scores are too old, choose a test prep program and register for a date.” Others medical schools such as UMHS will accept MCAT scores that are less than 10 years old.
Be sure to have all of your important premed coursework already in place before you take the MCAT though. One of the most common mistakes students (non-traditional or not) make is to take the MCAT before they’ve completed all of the coursework that is tested on the exam. Taking the MCAT too soon is a surefire way to hurt your chances for getting a high score.
Update your résumé
Many older applicants to medical school forget to update their résumé. You might be surprised just how relevant your life’s work experience could be. How to get started? “One way to start is to list everything, and then edit out the less important experiences as you create your CV,” Ms. Nikomar said in her post. “Remember, this is where you can demonstrate how your extra years of life experience have provided you with a rich backdrop on which to build a career in medicine. Use this space wisely.
Only use current letters of recommendation
No medical school wants to see a letter of recommendation more than a year old. “Selection committee members actually get angry when they see old letters of recommendation,” Ms. Nikomar wrote.” All of your letters of recommendation should be dated within the year that you are applying.
Use a letter from a current supervisor who is really familiar with your work and can explain why you would make a good doctor.
Make sure your personal statement is current
Always submit new essays: Keep in mind that the personal statement/essay most U.S. and Caribbean medical schools require for applicants should give you a chance to explain your situation. Why are you applying to medical school at your age? What unique situations or life experiences might help you as an applicant?
Ms. Nikomar wrote in her post that many older medical school applicants mistakenly submit old essays to schools, forgetting some school they may have applied to in the past. “If you applied to medical school or other programs before, be sure to rewrite all of your essays,” she said. “If you applied years ago, chances are that you have changed dramatically. It can also be refreshing to take a step back and look at your life in the context of reflective writing. What have you learned over the years? How have your life goals changed? Who do you aspire to be? Don’t submit an essay about the person you were in the past; create a new essay that illustrates who you are today.”
Make sure your family is informed and on the same page
If you are married or have a long-term partner, it is best to make a joint decision about attending med school. “A partner who more accurately anticipates the necessary sacrifices, shares the dream with their spouse and perceives medical school as a joint decision will have a better shot at a lasting marriage than one who is uninformed or misinformed,” says Dr. Kathleen Franco in her article for US News and World Report. These sacrifices and commitments include time, money, and the possibility of having to relocate often.
“Medical students have a shortage of free time, and they often may have to pass on attending family and social events,” Dr. Franco wrote. “Money can be a contentious issue. Arguments over expenses when only one – or perhaps neither – is working is not unusual. Funding childcare needs and college tuition for older children present insurmountable hurdles for some couples.”
“Geography is yet another issue,” wrote Dr. Franco. “Relationships have fallen apart because a partner couldn't find a job where the student was accepted for medical school or residency. Sometimes couples are able to navigate these issues early only to have emotional wounds erupt again during residency training.”
We don’t discourage non-traditional medical students from pursuing their dream of becoming a doctor, and as we’ve discussed, non-traditional students can be a great asset to their medical school and their future patients. Even for nontraditional medical students well over 40, it's still possible to match into a residency after graduation. However, students should be particularly aware of the unique challenges they may face. Although hospital residency programs are not legally allowed to discriminate based on age, data shows that many do. The older you are, the harder it will be to get a residency. Prior healthcare and clinical experience can help to mitigate age discrimination. Older students have the best chance of matching into a residency in a primary care field such as family medicine, pediatrics or internal medicine. In addition to excelling academically and on all licensing exams, older non-traditional medical students must be exceptionally flexible and persistent if they are to become a licensed and practicing physician.
Built in the tradition of the best US universities, the University of Medicine and Health Sciences focuses on individual student attention, maintaining small class sizes and recruiting high-quality faculty. We call this unique approach, “personalized medical education,” and it’s what has led to our unprecedented 96% student retention rate, and outstanding residency placements across the US and Canada. UMHS is challenging everything you thought you knew about Caribbean medical schools.
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Scott is Director of Digital Content at UMHS and editor of the UMHS Endeavour blog. When he's not writing about UMHS students, faculty, events, public health, alumni and UMHS research, he writes and edits Broadway theater reviews for a website he publishes in New York City, StageZine.com.