High school activities and medical school admissions

I thought about this, but I wasn't able to find compelling data supporting the view that less prestigious schools have laxer grading standards.

Wikipedia's page on grade inflation says that the average GPA at Harvard during 2004 was 3.48, contrasting with 3.05 at UC San Diego. This is consistent with grading standards being roughly the same at the two schools.

Anecdotally, I haven't noticed much variance in grading standards for the same course across the ~4 colleges that I've had personal exposure to. I would guess that grading standards vary far more acros... (read more)

High school activities and medical school admissions

by JonahS 4 min read9th Sep 201312 comments


Many people consider medicine to be a desirable profession because of the high status of the job of being a doctor, the opportunity to help people, and the high income. Whether conventional views about what it’s like to be in medicine are well grounded is unclear, but it’s undeniable that many young people aspire to become doctors.

In order to become a doctor, you need to secure admission to medical school. This post offers one perspective on one aspect of what to do if your goal is to get into medical school.

What Matters for Medical School Admissions?

Medical school admission is competitive, with the overall rate of acceptance to US medical schools at 45.2%. So in order to get into medical school, the average applicant faces the challenge of differentiating him or herself from other applicants.

Many high school students who aspire to be doctors place high emphasis on getting into a good college, because they think that it will better position them to get into medical school.

Medical school acceptance rate varies significantly according to college attended. The statistics that colleges release about the acceptance rates for their undergraduates can be misleading, because some colleges discourage underqualified students from applying to medical school. But there’s a strong case that among those undergraduates who aspire to be doctors, Harvard undergraduates get into medical school with much higher probability than do undergraduates at lower tier state universities.

Some high school students take this to be evidence that going to a more prestigious college increases their chances of getting into medical school. This could be true, but a major confounding factor is ability bias: students who are able to get into a prestigious college are unusually strong academically, and so would have been more likely into medical school independently of where they went to college. Though different people have different views, it appears that the consensus view of medical advice forums and websites is that undergraduate institution attended plays a relatively minor role in medical admissions (see, e.g. here).

What are the major inputs into medical school admissions? The Association of American Medical Colleges publishes statistics on percentage of applicants accepted to US medical schools, according to GPA range and MCAT range. The associations between GPA and MCAT scores and probability of acceptance are very strong. Though correlation is not causation, elite conventional wisdom is that the association is mostly causal: increasing your GPA and MCAT scores increases the probability that you’ll get into medical school.

Focusing on GPA: of med school applicants who scored between 30 and 32 on the MCAT, acceptance rates associated with different GPA ranges (>= 3.0) were as follows:

3.80-4.00 GPA — 82.3%

3.60-3.79 GPA — 72.1%

3.40-3.59 GPA — 55.5%

3.20-3.39 GPA — 38.7%

3.00-3.19 GPA — 29.7%

This suggests that for medical school admissions, the grades that you get in college matter far more than where you go to college, except to the extent that where you go to college impacts your grades and MCAT scores.

How does where you go to college impact your grades and MCAT scores? 

  • Some people have said that going to a more prestigious college exposes students to a peer group that facilitates academic success. For example, Ben Kuhn wrote:

    Most of the more difficult courses I've taken have given me at least some value by granting better access to more smart, competent people. […] By watching how more competent people work and think, you can often pick up useful study habits and better techniques for the subject you're studying. […] Both more advanced students and instructors can be very useful for the academic advice they provide later. Knowing talented students has given me info about several excellent courses, as well as summer opportunities, I wouldn't otherwise have known about.

    This could be a highly significant factor.
  • Some people believe that the quality of education at more prestigious colleges is higher. If this is true, prestigious colleges could do a better job of preparing students for the MCAT. I believe that this probably isn’t true in a systematic way: it’s been observed that community colleges often provide higher quality introductory level courses than four year colleges do ([1], [2], [3], [4]).

Implications for how to spend time as a high school student

Two functions that a high school student’s activities serve are building human capital and signaling quality to colleges.

As above, signaling quality to colleges might matter for medical school admissions, because of more prestigious colleges offering a better peer group. The other benefits of going to a more prestigious college are less clear. 

For some high school students, the opportunity to increase their chances of getting into medical school by building human capital may be much more significant than the opportunity to increase their chances of getting into medical school by signaling quality to colleges. 

Building human capital in preparation for future coursework

The main inputs into medical school admissions are probably GPA and MCAT scores.

Students take the MCAT near the end of college, and it’s unclear that it’s possible for high school students significantly influence their test scores 4+ years in the future (although it may be possible for them to do so).

It’s more clear that high school students do have the opportunity to engage in activities that will increase their college GPA. Medical schools require that college students take two years of chemistry, one year of biology and one year of physics (in addition to English and sometimes calculus). High school students are in a good position to get started learning the material that will be covered in these college courses, improving their chances of getting good grades in these courses.

High school students can take Advanced Placement courses in biology, chemistry and physics. The material in these courses overlaps with the material in the courses that medical schools require, and in some cases is prerequisite to it. 

It’s often possible to get an ‘A’ an AP course without mastering the material. High schoolers can benefit substantially more from AP courses, by learning the material more thoroughly than they need to get A’s in the courses (and 5’s on the AP exam), and practice well beyond the point of initial mastery. This will prepare them noticeably better for the corresponding college courses than merely taking the AP courses and getting A’s in them. 

High school students can enhance their ability to master material in AP courses by learning the material in prerequisite courses well.

Students who learn chemistry and physics often find math to be a stumbling block.  So high school students can prepare themselves to do better in college chemistry and physics by learning high school math well.

Balancing building human capital and signaling quality to colleges

Taking and learning biology, chemistry, physics and math in high school, and learning them unusually well, signals quality to colleges. Colleges look favorably upon good grades in AP courses. Learning sciences well prepares students to do well on the SAT subject tests in the respective sciences, and scores on SAT subject tests are an input into college admissions decisions.

At the same time, doing these things may not be optimal for signaling quality to colleges. Learning math and science really well during high school can come at the cost of grades in other subjects, and extracurricular activities. College admissions committees don’t reward learning beyond what’s needed for high grades and SAT subject test scores.

So spending high school time building skills for succeeding in future premed college courses (and thereby having better prospects for getting into medical school) can be in conflict with signaling quality to colleges. 

One is then faced with the question of how to balance the two things. For a given student, some relevant questions are:

  1. How much does having a stronger, more motivated peer group matter? Some students have no trouble learning on their own, and staying goal directed, while others find it much easier to stay motivated and learn when they’re interacting with peers who have similar goals.
  2. To what degree is signaling quality to colleges compromised by a given opportunity to learn premed science?

What’s best for a given individual depends on contextual particulars. But it’s worth noting that “doing well in high school” in a conventional sense may not be the best approach for getting into medical school.