The premed stereotype

Is being competitive and grade-obsessed the right way to approach medical school?

“Why medicine? Why do you want to be a doctor?”

These are two of the most important (and frightening) questions that premeds have to ask themselves. Let me elucidate a premed’s future: four years of medical school, followed by fellowship application, then four years of residency (on average) working in select hospitals. This is a lot of work just to get a job. It calls for absolute dedication.

So what drives students to go into medicine? For some, the reason is socioeconomic status: the belief that working as a doctor will make you lots of money and propel you to the top of the social totem pole. For others, it’s pride: to be shown off by your parents, and to have friends refer to you superficially as “the doctor.” But I’d like to think that the right reasons are selfless ones: to commit yourself to helping others, to grow comfortable dealing with daunting dilemmas, and to serve those too sick to help themselves.

But I believe that these motives are lost to some premeds at MIT. I want to correct that.

Premeds are stereotyped as being overly competitive and grade-obsessed (and this is the part where I will get myself into trouble), and I have seen these behaviors at MIT. Many premeds I know put pressure on themselves from the need to have the “perfect GPA” or the “perfect MCAT score” to get into medical school. Because of this belief, the current average GPA for a premed at MIT is a 4.7, as compared to the overall MIT average of 4.1. This discrepancy clearly shows the emphasis that premeds at MIT place on their GPAs.

This also suggests why premeds at MIT are considered competitive; they are constantly trying to score more A’s than B’s, effectively trying to one-up each other. But this strive for academic perfection can be damaging to the mental health of individual premeds and peers. I can’t count the times I have seen premeds cry after exams because they believe that they have scored below an A, thereby distancing themselves from a 5.0.

I’ve seen so many premeds retake classes because they believe that the second time around they will get an A. This practice is effectively stunting their learning, as the second-time-around will teach nothing new (which begs the question, why did you pay so much for a college education?). There have been a number of times when I’ve studied with premeds reluctant to share notes, believing that they are safeguarding their higher grade — contradicting the collaborative spirit of MIT. MIT is a place where students huddle together to weather tough problem sets and harsh exams. Together we help each other to get the most out of our educations. Somehow, it seems, being a premed is the exception.

But I generalize. There are many premeds who do not fit the stereotypes. They do not chase after perfect grades. Rather, they try their best. They take a hard class, they get a B, they accept it, because they know they are imperfect. But most importantly, they also know that they challenged themselves. I say this not only because I think it, but because medical schools think so as well.

Many medical schools, along with almost all the top-tier schools, have adopted the pass-fail system. Incoming medical students will no longer be graded by letter-ranking but by a comfortable “P” or “F.” The reason for this is eloquently articulated by Bonnie M. Miller, an Associate Dean of the Vanderbilt School of Medicine. “We just feel it’s in [incoming medical students’] best interest to get away from the external reward system of working for grades,” Miller said. “We want them to work for learning and learn for the love of learning, the love of medicine, and for the sake of the patients they’ll be serving.”

The study of medicine should not be a rat race for the highest grade, but an opportunity to learn. Medical schools will appreciate this, and they know that the best students are those who are truly passionate about medicine. I recently sat down with Marcia Goldberg, Professor of Microbiology at the Harvard Medical School, and a chair on the MD/PhD admissions committee, to do a mock MD/PhD application. We reviewed different hypothetical profiles of strong medical school candidates. Interestingly enough, she chose the candidate with the lowest GPA of 4.3, because despite the grade, the candidate frequently “shadowed” other doctors, and had a great deal of research experience under his/her belt. She explained that the grade is only one factor, and that her decision also depends on whether the student is truly committed to a career in the field of medicine or research.

While Goldberg’s review process may be unique to Harvard’s committee, the conclusion is clear. To be overly competitive and grade-obsessed is uncharacteristic of an exemplary future medical student. If a premed really wants to matriculate into medical school, then it will take personality, cooperation, and devotion.

Hopefully by next time, when people see a student studying for the joy of it, they will say, “Oh, such a premed.”

1 Comment
Chris Su \'11 over 10 years ago

I wrote an opinion to the Tech in 2011 titled something along the lines of "MIT is a great place for doctors, not med students." The intellectual challenges at MIT makes it a great place to train potential doctors who would really be able to THINK about the diagnosis, not just blindly classify patients into different treatment groups. However, the current grading system is too tough for premeds and as such there's a lot of stress on the premed students and all of this silly course retaking that goes on, which - as you correctly pointed out - stunts learning.

However, I don't expect much will change at all at MIT. You make the point that a student with a 4.3 can potentially get into HMS MD/PhD, but how often do students with 4.3 even make it into a med school at MIT? If you look at the MIT premed admission stats, it follows pretty much the same trend as many elite universities that do not have as challenging of a courseload as MIT. This means that admission committees don't necessarily give more "credit" to MIT just because it's hard (a notable exception may be HMS and the overrepresentation of MIT premeds there may be an indication of this bias).

So what should ambitious one-track premeds do?

Simple. Don't come to MIT.

I didn't decide to be premed until sophomore year at MIT, but since then I realized that it is a steep path. It's really hard to not "play the premed" game simply because the realities of life require you to do so. Despite your best efforts to "learn for the sake of learning," there's always going to be premed students at MIT who have 4.9s and 5.0s, some because they work ridiculous hard, some because they are naturally smart, others because they retake classes over and over again. And guess who gets into the top medical schools at MIT? The upper half of MIT premeds. It's really not as simple as counseling at premed to suddenly embrace learning for the sake of learning, as nice as it sounds.

Therefore, I argued that if you are committed to being a premed before college, it might actually be a better idea to go to a school that's less competitive, so you have an easier playing field so you don't have to work so hard for the A and thus have more time to pursue other academic interests (which I believe, like you, should be the essence of college).

Chris '11, course 7 and 21H, Mount Sinai MS-2

ps. You might want to double check your first paragraph - med school - residency - then fellowship.