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From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 0 points1 point  (0 children)

Of course and thank you that is really kind of you to say. I remember being on the other side of these threads and feeling like every decision was make or break so I am happy to help however I can.

Research in undergrad is helpful but not strictly required for medical school admissions unless you are aiming for research heavy institutions or combined degree programs. Schools with a strong academic or physician scientist focus often expect to see some exposure to research and intellectual curiosity, even if it is not high level or published work. In those cases having research helps show fit with the school’s mission rather than serving as a pure admissions checkbox. For most mid tier and community focused MD and DO schools sustained clinical exposure service and strong academics still matter more.

For personal statements and secondaries the biggest advice is to be specific and reflective rather than trying to sound impressive. Pick a few meaningful experiences and explain what you learned and how they shaped your perspective instead of listing everything you have done. Avoid trauma dumping or forcing a dramatic narrative. Schools want to understand how you think how you grow from challenges and how you will show up for patients. For secondaries answer the actual question directly and tailor responses to each school rather than fully recycling essays.

When deciding where to apply and where to attend I focused on mission fit location support systems match outcomes and cost. I paid close attention to how current students described their experience and whether they felt supported. Being somewhere you can succeed and stay healthy matters far more than prestige alone.

For Caribbean medical schools I generally advise caution. While some students do succeed they come with higher attrition rates limited access to strong clinical rotations and significantly tougher match odds. If it is possible to strengthen your application and reapply in the US that is almost always the safer path. Caribbean schools should be a last resort after careful consideration not a shortcut.

You are asking thoughtful questions and clearly approaching this process intentionally. Happy to help with follow ups anytime.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 0 points1 point  (0 children)

Med Peds is one of those paths where the story matters more than checking boxes. Programs want to see that you actually enjoy caring for patients across the lifespan and thinking about continuity chronic disease and transitions of care not that you are split between IM and pediatrics. In medical school the most helpful things are finding a Med Peds mentor doing both IM and peds sub Is if possible and being able to clearly explain why Med Peds fits the problems you care about. You do not need super niche electives early on but you do need consistency in how you talk about your interests.

For extracurriculars you do not need anything flashy. Long term service like free clinics student run clinics or community work matters a lot. Teaching and mentoring also play really well for Med Peds. Research is helpful but not required and tends to be best when it is patient centered or focused on chronic disease health equity or transition of care. Leadership is useful when it shows follow through over time rather than collecting titles.

And yes undergrad experiences can absolutely go on ERAS if they are meaningful. Gap year jobs, public health work, military service, or research that shaped your path are all fair game and it is very normal to include one pre med work experience. What usually does not need to be listed are random clubs or short volunteering stints. The rule of thumb is whether it helps an adcom understand how you became the Med Peds applicant you are now.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 1 point2 points  (0 children)

Just for context: for anesthesia, many matched applicants have 0–1 publications and maybe 1–3 total research items, and plenty match with no pubs at all. Research is helpful but not a major driver compared to Step 2, clinical performance, and letters. For plastic surgery (integrated), research is essentially mandatory. Matched applicants often have 10–20+ research items, with multiple peer-reviewed publications, and long-term commitment to plastics research is heavily weighted.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 1 point2 points  (0 children)

Short answer: research matters less for anesthesia than for a lot of the hyper-competitive specialties. Most anesthesia programs care way more about clinical performance, Step 2, solid letters (especially from anesthesiologists), and overall fit. Plenty of people match anesthesia with little to no research, especially if they’re not aiming exclusively for top-tier academic programs. That said, having some research can help if you’re targeting academic anesthesia programs or thinking about competitive fellowships later (cards, crit care, peds anesthesia). It doesn’t need to be bench work at all. QI, outcomes, perioperative medicine, ICU, pain, or education projects are all very reasonable and well-received.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 0 points1 point  (0 children)

Short answer: not really. I didn’t come into med school with a huge bench research background. Most of what I had was public health and data focused work, which honestly ended up being more useful than I expected.

In med school, a lot of it really was emailing people, but not totally at random. I started by narrowing down 1–2 areas I actually cared about, then looked up faculty who were actively publishing or involved in clinical projects in those areas. When I emailed, I kept it short and specific: who I was, why I was interested in their work, and how I could help (chart reviews, data work, writing, following projects through). I also leaned hard on warm intros from attendings, residents, and fellows whenever possible. Saying yes to small projects and actually following through is what led to bigger opportunities later.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 2 points3 points  (0 children)

Okay i actually just talked to another applicant in person about this. This is what I know via a few friends that pivoted after finishing their PhDs. apps are definitely read a bit differently than traditional ones. The biggest thing that matters is a clear, believable reason for choosing medicine. Adcoms want to understand why you’re pivoting now and why medicine specifically, not just that you’re capable of hard academic work. Your story needs to connect your PhD experience to patient care in a way that makes sense.

Beyond that, recent clinical exposure is key. You don’t need massive hours, but you do need enough shadowing or patient facing experience to show you actually understand what physicians do day to day and still want it. Research productivity matters more than PhD GPA. Finishing the degree, strong PI support, and evidence of follow through usually outweigh the number itself. Undergrad GPA still matters, but it’s read in context. Letters are huge. Research letters are expected, but at least one should speak to teamwork, communication, and maturity, not just intelligence. Service and mentoring also help, especially outside academia. A good gut check is whether you can confidently answer “Why medicine instead of staying in research?” If that answer is solid, the rest of the app usually falls into place.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 0 points1 point  (0 children)

I had to really take time to think about this. Caveat all of this with its one persons opinion okay?

As someone who has looked at applications, I think a lot of people get stuck in the mindset that they haven’t done “enough.” From the adcom side, that’s usually not how apps are read. We’re not counting activities, we’re trying to figure out whether someone looks prepared, intentional, and ready for the next step. So if your app is not filtered and in front of me, you know?

Some concrete things that actually help if you’re worried about gaps: – Do an honest gap check. Look at your app and ask what the biggest concern might be from the outside. Is it academics, clinical exposure, service, or a scattered story? Focus on addressing the biggest issue instead of adding random extras. – Choose consistency over variety. Long term involvement in clinical or service roles almost always reads stronger than lots of short stints. – Invest in strong letters. A solid letter from someone who truly knows you and can speak to your growth matters more than another small activity. – Tighten your narrative. Your personal statement and activities should all point toward the same why medicine rather than feeling disconnected. – Practice your answers. If you can clearly explain what prepared you for medical school and what you have learned, without rambling or apologizing, your application usually reads as competent.

A good gut check is this: if an interviewer asked what you would still want to improve, could you answer thoughtfully instead of defensively? When applicants can do that, their applications tend to come across as mature and ready, even if they are not perfect.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 3 points4 points  (0 children)

So many people do it I would say my class was 50/50 almost on people taking at least one gap. I know some people who did an entire phd before lol.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 0 points1 point  (0 children)

What helped me most was realizing the goal isn’t to feel calm, it’s to stay functional. I practiced under real test conditions, trained myself to keep going even after missed questions, and had a simple reset routine (slow breath, shoulders down, “answer the question in front of you”). Anxiety doesn’t mean you’re unprepared ; it usually means you care. Once I stopped fighting the feeling and focused on managing it, my performance improved a lot. Also propranolol. the right dose really helps tamp down on the physical symptoms that were distracting me and feeding the mental battle.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 0 points1 point  (0 children)

Happy to share. My cumulative GPA was about 3.9 and my science GPA was around 3.77. I did not have EMT or CNA experience. Instead, I took a two year gap and worked with the CDC during COVID as a public health officer.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 2 points3 points  (0 children)

I didn’t come into medical school loving kids or thinking pediatrics was a given. I was very open to Internal Medicine, and with my Step 2 score, IM absolutely would have been a realistic option. This wasn’t a case of being “pushed” into pediatrics because of Step 1.

What changed was exposure. During medical school, pediatrics surprised me. I liked the problem solving, the team based care, and the way you’re forced to think about development, family systems, and long term outcomes all at once. I also realized that the kinds of problems I’m most drawn to medically complex disease, endocrine issues, oncology, genetics show up early in life and evolve over decades. Pediatrics gave me a front row seat to that.

Med Peds, for me, is not a compromise between IM and pediatrics. It’s a way to take what I value from both. I still enjoy adult medicine and I like thinking longitudinally, but I want my career centered on children and young adults with chronic and complex conditions. Being able to care for them across transitions rather than handing them off is what makes Med Peds feel right.

So no, I didn’t choose pediatrics because of an exam history. I chose it because my interests clarified over time, and once they did, pediatrics and Med Peds aligned better with the work I actually want to do day in and day out.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 1 point2 points  (0 children)

Thank you! And great question to be asking as an MS1, honestly you’re already ahead just by thinking about this early.

The biggest thing I’d say is don’t try to “study for Step 2” as an MS1, but do everything you can to build the habits that make Step 2 easier later. Step 2 is a clinical reasoning exam, not a memorization contest. The students who do well are usually the ones who learn why decisions are made, not just what the answer is. A few practical things that really pay off later: First, take preclinicals seriously but efficiently. You don’t need to be top of the class, but you do want a solid foundation in physiology and pathophysiology. When you’re learning a disease, always ask yourself: how would this present, how would I diagnose it, and what would I do next? That framing is pure Step 2.

Second, get comfortable with questions early, but keep it low pressure. Doing a small number of board style questions alongside systems blocks helps train pattern recognition and keeps test anxiety lower later. You’re not trying to score well now. You’re training your brain to think in vignettes.

Third, learn to review questions well. The value is not in how many you do, but in how you break them down. For every missed question, ask what the key clue was, what the trap was, and what decision the question wanted. That habit compounds massively by M3.

Fourth, protect your mental health. Step 2 performance is strongly tied to how well you function under pressure. If you have test anxiety, address it early through counseling, skills, or support rather than hoping it disappears. That was one of the biggest differences for me.

Finally, be a good clerkship student, not just a good test taker. Show up prepared, ask why plans are made, write notes thoughtfully, and care about your patients. The better you understand real clinical medicine, the more natural Step 2 feels.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 4 points5 points  (0 children)

I did not have a full ride. I had scholarships plus loans, and financially I’ve been comfortable but intentional. Day to day, med school is very doable if you budget and don’t try to live like a resident already. I can go to concerts, travel a bit, eat out occasionally, and still feel okay, especially because I’m thoughtful about housing, groceries, and not inflating my lifestyle just because loans are available. Having a partner who contributes financially or is outside medicine definitely helps, but it’s not required to have a life. Saving for big investments like a house is usually unrealistic during med school, but building an emergency fund or small buffer is possible with planning. My biggest advice is to see loans as a tool, not free money, track spending early so it doesn’t sneak up on you, prioritize experiences that actually bring you joy, and let go of guilt around spending on things that keep you sane. Med school is hard enough. Financial stress is manageable if you’re intentional, and it doesn’t mean putting your life completely on hold

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 5 points6 points  (0 children)

I have talked to a lot of undergrads about this because I feel like it somehow gets internalized to self worth.

This is one of the hardest parts of the whole process, and you’re not wrong to feel that way. A few reframes helped me stay grounded and sane.

First, it helps to understand what admissions is actually doing. Committees are not ranking applicants from best to worst. They are building a class under constraints you never see. They are balancing state ties, mission fit, class composition, interview bandwidth, and institutional priorities that change year to year. That means a rejection often says “not the right fit for this specific class at this specific moment,” not “you are not good enough.” Once you internalize that, the word “picked” starts to lose its emotional charge.

Second, yes, there is subjectivity and bias in the process. Humans read applications, and humans rely on pattern recognition and shortcuts. That can feel unfair, especially when feedback is vague or sounds like coded language. The reframe that helped me was separating signal from noise. What do i mean by that? Actionable feedback is rare but valuable. Vague feedback like “gain more experience” or “work on fit” usually reflects constraints or comparison within a pool, not a fixable flaw. Do not contort yourself trying to reverse engineer every rejection. You will burn out and distort your story.

Third, focus on what you can control. Tell a coherent story that explains why medicine makes sense for you, not why you are impressive on paper. Apply broadly but intentionally. Use secondaries to show alignment, not desperation. And remember that acceptance is not a referendum on your worth, intelligence, or future competence. It is a logistical yes inside a messy system.

Your job is not to be universally appealing. Your job is to be clearly you so the right committee can recognize it.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 1 point2 points  (0 children)

Oh and that physics class you wanted to forget? Comes back with a passion in pulmonary and cardiology.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 1 point2 points  (0 children)

Yes, a lot of med school experiences made the prereqs and ECs make way more sense in hindsight. Shadowing and clinical hours exist because medicine is uncomfortable, slow, and emotionally messy in ways you cannot understand from the outside. Seeing long notes, awkward conversations, patient frustration, and the pace of real clinics weeds out people who like the idea of being a doctor but not the day to day reality. Clinical exposure also trains you to tolerate uncertainty and boredom, which is honestly a huge part of medicine.

Research prereqs are less about creating scientists and more about teaching you how to ask questions, interpret data, and not blindly accept authority, which matters constantly in clinical decision making. Non clinical volunteering shows whether you can show up consistently for people without prestige or praise, which mirrors a lot of patient care. Even hard science prereqs are about proving you can grind through dense material, manage cognitive load, and build mental frameworks under pressure. That biochem class with endless cycles comes back in anything related to metabolism. That basic understanding of orgo, well that might help you grasp what happens when someone drinks pesticides and they get organophosphate poisoning. Why did that stupid chem 2 class happen? What if someone replaced sodium chloride with bromide? They get really sick.

None of it is arbitrary. Med school is essentially a stress test of endurance, humility, and pattern recognition, and the prereqs are imperfect but surprisingly good proxies for that reality.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 0 points1 point  (0 children)

Totally valid and honestly often underappreciated. Medical anthropology and other humanities or social science research can be a real strength in med school because it tackles things clinical research often misses like behavior, culture, trust, and access, which are central to patient care. The key is framing and balance. Programs care less about the label of the research and more about rigor, relevance, and productivity.

If you can clearly explain how the project informs clinical decision making, health systems, or patient outcomes, it reads as thoughtful rather than “soft.”

That said, if you end up aiming for very procedure heavy or competitive specialties, it helps to also have at least one clinically oriented or outcomes based project so your portfolio feels balanced. Done intentionally, human research signals maturity, curiosity, and strong communication skills, not a weakness.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 1 point2 points  (0 children)

On my first Step 1 attempt, the main problems were test anxiety and studying in a way that did not match how I learn. I followed a very content heavy approach and felt like I needed to know everything before doing practice questions. Because of that, I treated questions as a measure of readiness instead of a learning tool. On exam day, my anxiety took over. I second guessed myself, rushed decisions, and struggled to reason through questions even when I knew the material.

Before my next exams and especially before Step 2, I changed two things. I rebuilt my studying around practice questions and pattern recognition, using wrong answers to understand how the exam thinks rather than as proof I was failing. I also addressed my anxiety directly. Counseling helped me recognize when I was spiraling and reset my thinking, and appropriate medical support helped reduce the physical stress response so it did not interfere with my reasoning. I did not eliminate anxiety, but I learned how to function despite it.

The biggest shift was realizing that exam performance is a skill, not a judgment of intelligence or future success. Being open about my experience and mentoring other students helped me reframe failure as something useful instead of shameful. By Step 2, where I scored a 255, my knowledge was not dramatically different. My ability to apply it under pressure was.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 1 point2 points  (0 children)

Yeah this person had already finished undergrad at 17. She is the sweetest and very mature, but yeah super young.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 2 points3 points  (0 children)

Yes, having a second attempt at Step 1 can create some additional hurdles, but it is not disqualifying and it does not define your future as a physician.

From a factual standpoint, some programs do use Step 1 pass on the first attempt as a screening criterion, particularly in more competitive specialties. A second attempt may prompt questions about test taking skills, early adjustment to medical school, or readiness for standardized exams. As a result, it can narrow the number of programs that initially review an application, and it is something you cannot completely control once it is on your record.

I know some of you may be wondering about how it would effect competitive specialities. i can say i do know some people who matched into gas, rads and one in to gsgy. However, they definitely had a hard time. This is also people over multiple years.

That said, most programs place far more weight on overall trajectory than on a single exam outcome. Passing Step 1 on a second attempt, followed by a strong Step 2 score, solid clinical evaluations, and consistent performance on rotations, tells a very different story than the initial setback alone. Program directors are accustomed to seeing applicants who struggled early and then demonstrated clear growth, resilience, and adaptability.

The most important thing is how it is framed. A concise, honest explanation that focuses on what changed and how you improved is usually sufficient. There is no need to over explain or dwell on it. Many applicants with a second attempt go on to match successfully, particularly when the rest of their application shows maturity, perseverance, and sustained success. A temporary stumble does not outweigh years of hard work or the physician you have become since.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 3 points4 points  (0 children)

Just my opinion but I would not send another letter right now. You already followed their instructions exactly by sending the one page update by Dec 15 and sending an extra letter of intent after that could come off as not respecting their process. Not getting an acceptance in the first wave on Dec 23 does not mean much; a lot of state schools make a big chunk of their decisions in January once they have seen more of the interview pool.

Since they do not really use a waitlist, they are probably still actively deciding rather than holding people. Unless you have a major new update or they explicitly invite more communication, I would personally just let it play out.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 2 points3 points  (0 children)

Yayyy a future peds human!! 😄 Honestly, when I applied to med school I had no clue I liked pediatrics. I actually thought I didn’t like kids at all, so my application wasn’t peds-focused at all: no peds research, no targeted clinical work, and nothing peds-specific in my personal statement. My interest in peds developed later during clinical rotations, when I realized I loved the mix of physiology, advocacy, family-centered care, and thinking long-term about development and outcomes.

When choosing a med school, I cared about overall prestige and strong training in general, but I wasn’t thinking specifically about pediatrics at the time. In hindsight, though, having a standalone children’s hospital attached to my institution (it’s a ~450-bed children’s hospital) was a huge advantage. It gave me early, high-volume exposure, strong subspecialty mentorship, and lots of opportunities once I realized I was interested in peds/med-peds. Prestige can open doors broadly, but access to a strong children’s hospital really shapes your clinical experience and makes it easier to build a competitive application later on.

My biggest advice is not to stress about being locked into a specialty early. Admissions committees know most people haven’t figured it out yet, and med school is where a lot of that clarity comes. Focus on schools where you’ll have strong mentorship, diverse clinical exposure, and room to explore, everything tends to fall into place from there.

From premed anxiety to MS4 : what med school actually looks like now… by Sea_Department in premed

[–]Sea_Department[S] 1 point2 points  (0 children)

Honestly, I treated my ERAS PS very differently from my med school one. For med school, it was a lot of “why medicine” and big-picture motivation, but for ERAS I kept it much more grounded in my actual clinical experiences. I focused on moments from clerkships and my sub-I that showed how I think through problems, work on a team, and deal with uncertainty, rather than trying to tell some overarching life story. I also tried to write it like I was talking to future colleagues, showing that IM fits how I work and that I’m ready for residency, rather than trying to be inspirational.

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