The Public Absence of Pre-Meds

January 7, 2013

Screenshot_1_7_13_11_30_AMI was struck by this tweet from Roheet Kakaday, a premed student. It followed a brief thread about the rehearsed presence of the med school applicant and the potential role of a digital life stream/portfolio.

Roheet is someone worth looking at.  He writes on his blog, The Biopsy, where he sticks his neck out to connect his ideas with the world (beautiful site design, I might add).  Most premeds I’ve met work desperately to avoid being seen.  A scorched earth policy regarding public presence rules the day.  They’ve learned to never stray away from the group.  Most prefer to cook with a timeless recipe:  maintain a high GPA at any cost, invest time, money, passion and bandwidth into a prep course for the MCAT and, most importantly, ‘volunteer in a hospital’ so you’ll have something intelligent to say in an interview.

This recipe fuels a distinct population goose stepping into the future assuring that the mindset of the next generation of physicians won’t be much different than generations past.

We need more doctors willing to define themselves and their passions.  And that starts with students willing to say, ‘Here I am. What I bring to medicine will be really different. You can see what I’ve done.  You may not like it but it’s who I am.’

I first met Roheet at Stanford’s Medicine X where he spent the entire meeting in the front row.  His coverage of the meeting was profiled live during Medicine X by director and Stanford Professor, Dr. Larry Chu.  Most med school applicants have never heard of Medicine X, which is fine.  But the reality is that even if they knew and the meeting happened in their back yard, I suspect many wouldn’t be interested.  It’s too risky, too unknown.  And besides, it would be precious time away from MCAT test preparation.

If I were looking to create leaders to bring the medical profession onto the 21st century, I’d look for someone like Roheet. I don’t know anything about his numbers.  But so long as he has the capacity to make it through, he has the ability to change the way our profession sees the world.


Amol January 7, 2013 at 1:41 pm

As a current pre-med, I’d unfortunately have to agree that your characterization of pre-meds is spot-on. But what if this is a scenario of “don’t hate the player; hate the game?”

Most aspiring physicians probably fit the model that you describe because that’s what they’ve been coached towards by their academic advisors, and that’s what a numbers-driven culture in medical school admissions has incentivized them to do. I’m not saying that I agree with it or that it’s a good way to select into medicine; rather, I think I’ve been one to spite myself over the years by pursuing opportunities off the beaten path, obtaining experiences at the expense of numbers. What I am saying is that perhaps the critique of pre-meds should lead to a discussion of how ‘the system’ should be redesigned to select for game-changers and innovators like Roheet.

Certainly, I’m willing to be an applicant who says, “Here I am. What I bring to medicine will be different.” But I’m skeptical about that really having any major effects on the system until medical schools decide that they want that applicant instead of the biology major with the cookie-cutter profile and a 39 MCAT.

Lois Wingerson January 8, 2013 at 11:59 am

Bravo for sharing this. As a long-ago pre-med student who took the major intending to go into publishing, not medicine, it’s disheartening to see that the scene has not changed in the least over many decades.

I remember deciding that I would never want to be treated by any of my classmates, which is discouraging given my Baby Boom demographic. I had hoped that younger doctors might be different.

As publishing moves doggedly forward toward open-source content and some degree of crowd-sourcing, these ants may eventually be forced to march in a different direction anyway.

Wendy Sue Swanson, MD January 8, 2013 at 12:03 pm

Fantastic to be reminded of The Biopsy. You do have guts, Roheet. And prescience, too. Keep it up.

I still think the main reason I got into an ivy league medical school was because of a letter I wrote to admissions with my application. I had good scores, but not at the 99% mark like most of my peers on the first day of classes. I think when I showed up and told them I wanted to make change in health care they believed me.

Those incredible instructors, visionaries, and stodgy professors from medical school taught me so much. And those mentors who believed I would do what I said I would try to do, they helped, too.

Vision and passion, coupled with honesty and hard work are necessary for health care reform and delivery. Thanks, Roheet and Bryan.

Katharine January 8, 2013 at 7:19 pm

I agree that the typical pre-med does tend to follow a cookie-cutter format, but I would also like to add that this is definitely a 2-way street. The reason why students force themselves to get a high GPA, high MCAT, and the usual volunteering activities is because it tends to be what medical schools look for in applicants. And when students who are driven to do medicine for the right reasons see what they need to do in order to get there, they are going to follow that format because that’s what the track-record has shown.

For things to really change, students would probably feel more comfortable branching away from the usual path if medical school admissions made statements such as the one you did.

Leo January 8, 2013 at 10:13 pm

This isn’t limited to medicine. Many people take this approach, concerned that HR departments will be trolling social media channels and may not like what they find.

The problem is processes that are focused on reducing risk (finding some information that may not be seen as positive), while discounting benefits of someone who knows how to communicate effectively with new technologies. Perhaps it’s related to loss aversion biases?

Our institutions also show loss aversion in their selection processes. So, how do we fix the processes? Can we?

DrV January 9, 2013 at 5:19 am

Leo. Thanks for the heads up on the loss aversion bias. You’re right on, I think. This is a cultural issue related to new technology. In the words of Esther Dyson, change will come one retirement at a time.

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