University of Virginia Health System

The idea of being a physician appeals to many young people even if they are not clear as to what physicians do other than saving lives. Others think of becoming pharmacists or physical therapists, for instance, because the education time is shorter, they can earn a living, and they can help people, but they, too, rarely have real knowledge as to what will be demanded of them educationally or in practice. How do you discover what the life of a physician or other health care worker is like? It is possible to read job descriptions for information, but that is akin to trying to know what a person is like by looking at a photograph. There is no substitute for being in the presence of working professionals-observing them at work, talking to them about what they do, and for most health professions, being where there are patients.

Where do you find these experiences? One place to start is with a hospital: in the hospital there are physicians, nurses, many kinds of technicians, physician assistants, physical therapists, hospital social workers, pharmacists, and health administrators. Find the volunteer office at any convenient hospital; become a volunteer. If you can't afford to give time without getting paid, try to get a job there, even if the task is menial. The pay may not be any better than at a fast food restaurant, but the fringe benefit is significant. Observe everyone and everything. Remember, the purpose is to learn as much as you can about health occupations and the people engaged in them. It is not about passive exposure but active experience. It is not about-at least for pre-medical students-creating a laundry list of how many operations were watched or techniques learned, but about gaining insight into yourself and patients and the demands on skill, knowledge, and emotions the profession entails. Some colleges have arrangements with local hospitals and clinics where you can do volunteer work; check with your pre-health professions advisor to see if your college has such an arrangement.

Another possibility for learning about a health career is to talk to your own physician, dentist, or optometrist, or someone else you know who is a health care professional. It is better, however, to speak with several different persons to sample a variety of opinions and experiences. It is important to seek out, though not necessarily exclusively, professional people who are like yourself in gender, ethnicity, culture, and religion. Their experiences as professionals are more likely to be shared by you when you become a professional than the experiences of those from other backgrounds. Think for a moment of what you might hear from a woman surgeon instead of a male surgeon; some things will be similar but really not the same.

Summer programs at medical schools often include hospital experience as part of the schedule. These programs provide opportunities to have discussions with health care professionals, see clinical procedures, learn about current issues in health care delivery, and visit clinics, wards, and research facilities. For summer program availability, check with your pre-health professions advisor. You can also check the website of the Association of American Medical Colleges <http:\\www.aamc.org> and the websites of medical schools which offer such programs for specific information about the program and requirements.

The purpose of a self-assessment is to help you choose an appropriate career for yourself. While gaining the experience discussed in the preceding paragraph, by observing and studying others, look at yourself as well. Ask yourself questions and seek honest answers to determine if a career in the health professions is right for you.

The first question to ask is: Why do you want to be a physician? Look at your academic record to see which courses you loved. Reflect on what you consider to be an ideal day. Don't choose medicine if you don't like the coursework. Don't choose medicine because you want to help others-that reason is insufficiently compelling. Don't choose medicine because of family expectations and pressures. While it's hard to disappoint others, it would be worse to seek a career in which you get neither pleasure nor satisfaction. Are you comfortable dealing with sick people? Are you comfortable working with people who are different from you in culture, ethnicity, religion, and lifestyle? Are you comfortable with elderly people? Are you comfortable with children? Are you comfortable touching and handling people, especially those who are seriously ill, in pain, or disfigured from disease? How much risk do you think you can accept working in an environment where you might be exposed to disease yourself? Are you skilled in talking with people? How well do you accept responsibility, especially for other people's well-being? You may think of other questions to ask yourself as well.

It may also be useful to consult the career planning office at your institution. Trained professionals can provide you with additional information about specific fields or refer you to professionals willing to talk with you about various career options. Many of these offices also have SIGI PLUS (System of Interactive Guidance and Information-PLUS more), a computerized software program developed by the Educational Testing Service. SIGI PLUS includes a self-assessment which allows you to consider your values and interests in making an informed career selection. Based on the self-assessment, the program then guides you through a series of questions related to what occupations you might like, skills that may be required, strategies for preparing for the chosen field, considerations in preparing (i.e., time management, financial planning, coping with difficulties, and staying motivated), and determining the appropriate career choice for you. If your institution does not have access to SIGI PLUS, call toll free 1-800-257-7444 for further information.

For all health professions careers, science courses are the core of both the pre-professional curriculum and the professional curriculum. Therefore, strong science skills, as well as ability in mathematics (essential for chemistry and physics), are important for pre-health preparation. How well were you prepared in high school in mathematics, chemistry, biology and physics? How well did you do in these subjects in high school? Do you like science or is it distasteful to you? Do you struggle with mathematics?

Keep in mind that science skills are not the only abilities a promising pre-health student must possess. In general, evidence of a strong performance in college English classes is considered advantageous when applying to health professions schools. You may also want to ask yourself the following questions: Do you have good study habits? Are you disciplined? Do you procrastinate? How are your skills in reading and writing? What is your ability to read and understand large amounts of material, especially when time is short? How adept are you in critical thinking and problem solving?

You should also consider your ability at taking standardized tests. One major obstacle on the road to a health professions career is national entrance examinations, which are required for admission to graduate health professions schools. These examinations are very much like the SAT in that they test an enormous volume of knowledge and give you little time to answer the questions. Achieving high scores is at least as much (if not more) a function of English proficiency, being numerate, and having talent at taking tests, as it is mastery of the subject matter. Your experience with the SAT (or ACT) should be a guide in determining whether you should seek assistance from a learning skills or career center on your campus. These centers usually administer tests to help evaluate your strengths and weaknesses (some centers charge a fee for these services). Do not wait until a few months before you have to take a test, such as the Medical College Admission Test (MCAT), to register for a review course! Consult your pre-health professions advisor to find out what help may be available at your college.

To assist you in conducting you self-assessment, the checklist on the following page may be helpful to you.

Check (ü ) all true statements on the left and rate the frequency on the right using the following key:

After the self-assessment, you need to develop a thorough and specific action plan, including long-term SMART goals, short-term objectives, action steps for each objective, a support system, progress checks along the way, and completion dates. The plan must include actions to help you work on your weaknesses and enhance your strengths using the results of the self-assessment.

• A SMART goal is Specific, Measurable, Attainable, Realistic, and Timed. As you complete all the elements on the action plan, all of the above attributes must surface. Since your long- term goal is to become a health professional and that will take at least eight years to be accomplished, short-term objectives will give you the milestones that will show your progress step-by-step in shorter periods of time. Some examples of short-term objectives are: (1) to complete undergraduate studies in four years, (2) to follow the right academic sequence, (3) to pass the MCAT with an 8 or higher score, or, (4) to be admitted into graduate school.
• Action steps are the specific things that you will do to accomplish every short-term objective, which at the end will have contributed to reaching your long-term goal.
• For every short-term objective, you need to identify the individuals, services, and mechanisms within your campus that can provide you with the assistance needed to maintain excellent academic progress. Some are: your academic advisor, your career/personal counselor, peers, and tutoring services.
• Through the implementation phase of the plan, it is important to monitor your performance and make changes, if necessary. Plan the sequence of your courses so that you are not taking all the difficult courses in the same semester and ensure that you will be meeting all the admissions requirements of the professional schools to which you plan to apply. Look ahead and make sure that the courses that you need will be offered in the semesters in which you have them scheduled. Progress checks will help you make adjustments to your action plan. For example, if you planned to take 15 credits in one semester and a special circumstance prevented you from achieving that objective, you may need to take summer courses instead of participating in a summer internship program. On the other hand, if you took a sufficient number of credit hours, you may not have to take summer courses. It is recommended that you make progress checks before registration, before and after mid-terms, before and after finals, and at the beginning and the end of each semester. Your advisor can help you in this planning.
• Completion dates will help complete your steps on time. Deadlines will help complete short-term objectives and action steps on time.

In the course of eight years-four undergraduate and four graduate school years-many events will take place that could impede your progress towards the goal of attending a health professions school. Such obstacles can be frustrating, disappointing, and discouraging. In anticipation of the unexpected, flexibility is key to the implementation of your action plan. You must be willing to make adjustments to the plan as you take the action steps toward the accomplishment of your goals and objectives. The following pages provide two grids to guide you through the development of your action plan and weekly activities. Make as many copies as you need.

The purpose of the self-assessment is to help you do well in classes. If you are weak in mathematical skill or preparation, do not jump right into calculus, chemistry, or physics. Do take first whatever algebra or pre-calculus is advisable. If you are not proficient in English, whether reading or writing, do take whatever preparatory courses are suggested. If English is a weakness, be cautious about taking biology first because that subject, more than chemistry or physics, depends upon English proficiency. Use good common sense and judgment.

Because of the cost of education, particularly at private colleges and/or residential colleges, students are naturally anxious to complete college in no more than the standard four years. Because of that, many students each semester try to undertake unmanageably large course loads or unsuitable course combinations. Such students at the very least jeopardize their ability to secure their professional education or more commonly actually shatter their opportunity. Poor grades also have a nasty habit of destroying a young person's self-esteem, a needless thing to happen, while only adding to the misery of watching the future slip away. Such students may well ponder the trade-off between saving time and money and losing out on their future. It might be better to take more time and spend more money. In the long run, by becoming a professional, the money can be recouped, but otherwise the money saved in the short run may be forever lost. It seems better to arrive at the goal-the professional education-than to worry about how long it takes to get there. Remember the fable of the tortoise and the hare: it was the slow tortoise who got to the finish before the speedy hare. Be a tortoise rather than a rabbit!

It is a widespread misconception that it is necessary to major in a science, especially biology, to be a pre-medical or other pre-health professions student. It is also a widespread misconception that health professions schools prefer science majors. The truth is that any academic major is suitable and acceptable; in fact, data relating to medical school admission have always shown that students with different majors are accepted in roughly the same proportions as science majors in the applicant pool.

Selecting a major only because it is believed that major will improve the probability of professional school acceptance is not a wise decision. Professional schools are looking at the overall quality of performance and the range of undergraduate coursework. For example, other things being equal, a student majoring in chemistry or biology who has weak grades will not be accepted to medical school, whereas a music major with high grades will. The major you choose is irrelevant to the probability of your being accepted to a professional school.

How, then, choose a major? Be guided by your love of, or interest in, a particular subject matter. If you love biology, major in biology. Or, consider what you might choose for an alternate career should you change your mind about a health career or should you not be accepted to a health professions school. If you choose a non-science major, keep in mind how you will mesh the major courses with your pre-professional course requirements. Have a strategy for a sensible, balanced course load each semester so you can do well in both the sciences and your other courses.

The optimal college preparation for medical school or any profession is a balanced liberal arts education consisting of a good cross-section of courses taken in the social sciences, the humanities, and the natural sciences. In the sciences, be sure to include those courses that are necessary to meet admissions requirements at the professional schools to which you plan to apply. Do the right thing for yourself when choosing a major and other courses. College is an education. It lays the groundwork for becoming an educated person which you will then be for the rest of your life. College should not be regarded as an obstacle course on the way to trade school. Learn. Enjoy your college years. Have a social life. Participate in other activities, both on and off campus.

For additional information, see the chapter on Premedical Planning in the AAMC publication, Medical School Admission Requirements.

• Keep focused on your goal. It is up to you to accomplish your goal. Do not allow distractions to get in your way.
• Practice good study habits. Excellent undergraduate performance is key to admittance into professional or graduate school. Assess your study habits and keep those that work for you. Change them as needed. Develop your own study strategies.
• Keep the appropriate course sequence. It will help you stay on track and complete your undergraduate studies on time.
• Don't overload yourself. Know your strengths and limitations.
• Do not procrastinate. If you have an assignment due on a certain date or a test coming soon, do not wait until the last minute to complete the assignment or study for the test. Take your general education requirements as seriously as your major courses. When in academic or personal difficulties, get help immediately!
• Begin developing your support system now. Establish positive and productive relationships with your academic advisor, professors, and peers. Use the services available on campus (e.g., tutoring, counseling, career center, or learning center).
• Participate in out-of-the-classroom experiences (e.g., internships, research, summer jobs, volunteer work, conferences, workshops). They are very important for your professional development, and they look impressive in your health professions application portfolio.
• Develop a network. Maintain contact with people you will meet at conferences, workshops, internships, summer jobs, and other out-of-the-classroom experiences. In the future these contacts will be instrumental in the practice of your profession.
• Begin preparing for "THE EXAM" from your first year in college. Be aware of what undergraduate coursework will be included in the exam to enter the health profession school of your choice. Pay particular attention to these courses.

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