Navigating the Pre-med Track to Medical School

Are you dreaming of being a physician? You’re not alone. From 2017–2019, over 200,000 people took the Medical College Admission Test (MCAT), the exam required for admission to nearly every medical school in the United States and many schools outside the U.S. 

If you’re planning to pursue the pre-med track in college in the hopes of attending med school — and ultimately becoming a medical doctor — you should know that it’s an extremely rigorous path. Up to the challenge? Here’s how to navigate it.

Overview of the Pre-med Track

“Pre-med” doesn’t describe a specific major but a set of courses that most medical schools require for admission. Often, your undergraduate college will assign you a pre-med advisor in addition to a major advisor to help you ensure you fulfill these requirements, even if you don’t necessarily need to take them to graduate. 

Rather than immediately matriculating at a med school after receiving their bachelor’s degree, more than half of students take one or more gap years, pursuing opportunities like working in research or being a medical scribe. There are also post-baccalaureate programs for students who decide to enter the pre-med track later on as undergraduates.

If you’re thinking of being a pre-med, it’s important to consider how challenging the road is — even before med school. Up to half of students originally interested in medicine in a given freshman class don’t ultimately end up fulfilling the requirements and applying to med school, and only 30% of that original pool gain admission to med school. Even among those who apply, less than 50% receive admission in a given year.

Pre-med Track Challenges

Anyone who chooses to take on the pre-med track will face stiff competition from peers, in terms of opportunities for research and extracurricular activities and tough curves. It can be difficult to earn high grades in curved classes that are required for med school, especially at large schools, because so many other students are pre-med, too.

You’re also contending with a strict schedule that leaves little time for socializing and extracurricular activities that aren’t related to medicine. You’ll need to have discipline and be willing to make sacrifices.

Relative Importance of Application Components

Generally speaking, medical school applications are weighed accordingly:

• GPA: 30%
• MCAT: 30%
• Activities: 20%
• Personal Statement: 10%
• Recommendation Letters: 10%

Of course, this varies from school to school.

How to Build a Pre-med Profile in High School

You don’t have to wait until college to start building a pre-med profile. In fact, demonstrating your passion for medicine and career aspirations now will make you a more appealing candidate for undergraduate admissions.

Scientific Passions

Participating in team competitions like Science Olympiad and Chemistry Olympiad can be useful. However, selective colleges will want to see you placing in regional competitions to be competitive for admissions. Meanwhile, individual competitions like Intel ISEF are highly impressive, but offer fewer awards and no opportunities for leadership.

Undertaking scientific scientific research is another prestigious activity for pre-med hopefuls. Consider conducting your own research or working under the guidance of a professional. There are also research programs like Summer Science Program, Research Science Institute, and Governor’s School.

While not quite as valuable for admissions as the above activities, science interest clubs at your high school will also demonstrate your passion for the subject. The best way to differentiate yourself from other candidates is to secure a leadership position.

Service Work

Service work can also play a role in setting you apart from other applicants. You could, for example, gain patient experience by shadowing a doctor or working as a receptionist in a medical facility. Most students volunteer in a medicine-related capacity instead, so a more involved role could allow you to differentiate yourself. Keep in mind that there may be age or other restrictions.

If you do volunteer in a hospital, nursing home, or other medical facility, look for opportunities that allow you to demonstrate long-term commitment.

There are plenty of other opportunities for community engagement, too. Global health work is one popular option, and many students are pursuing social justice advocacy, which shares many of its core tenets with medicine.

Academics

Anyone planning on majoring in a STEM or related discipline should, of course, have strong grades in the STEM coursework. Colleges will also want to see plenty of advanced coursework in science and math, including honors or AP-level classes in biology, chemistry, physics, and calculus. You should also be competent in the humanities, although solid performance in honors or AP-level English, foreign language, and social science classes is a bonus.

You’ll also need a strong score in Math on the SAT or ACT. If you take the ACT, your Science score will need to be high as well. Scores are generally slightly higher for pre-meds on these exams than they are for people pursuing other disciplines.

SAT Subject Tests are generally optional for the high school class of 2021 due to the pandemic (as are the SAT/ACT). In future years, you’ll want to take Subject Tests in Biology, Chemistry, and/or Math II.

College and Major Selection

College Selection Factors

Grade Inflation & Deflation

A school that has grade deflation (for instance, a B at a grade-deflation school would be equivalent to another school’s A) can be detrimental to your medical school prospects since your transcript and GPA will appear weaker compared with those of other applicants. 

How do you figure this out? One way is to speak with older students who have attended or are currently attending the school. You can even ask this question on college tours. You can also scan internet forums like Reddit and Student Doctor Network to learn more.

If you are a strong student at a prestigious school, though, you will do well even if the school does have grade deflation.

Advising Services

The quality of the pre-med advising you receive in college can certainly impact your candidacy for med school. Judging this will also require speaking with current students and alumni. It’s a good idea to speak with the admissions office about the resources available, such as one-on-one meetings and help with your personal statement, too.

If you can, try to ask the admissions office to connect you with pre-med advising. Ask questions about when they typically start meeting with pre-med students and if they have materials to review about the med school process and timeline.

Affiliated Hospitals and Research Institutions

If there are affiliated hospitals on or near campus, you’ll have a much easier time integrating clinical activities like shadowing doctors and volunteering into your schedule because your commute time will be short. You’ll also have greater access to research facilities, promoting more productive work.

Moreover, the name recognition of schools and medical facilities that are part of one institution makes it possible to take advantage of available positions — there’s a sense of familiarity and trust.

You can still take advantage of unaffiliated hospitals and research facilities near the campus, but it will be more difficult to secure coveted volunteer or work positions.

Finances

It’s no secret that college is expensive — and whether you like it or not, it may play a role in the school you ultimately attend. Private institutions can cost as much as $260,000 over four years and public institutions cost around $140,000 for undergraduate education. Many students take out loans of up to $50,000/year (private) or $20,000/year (private). There’s another roughly $5,000 for book costs and $10,000 for room and board.

Meanwhile, medical school tuition costs $200,000 on average, and students take out roughly $50,000 in loans per year over four years.

In total, between your undergraduate education and medical school, you could be looking at a $450,000 price tag. If cost could be an issue, consider your state medical school, when financial aid becomes especially important.

College Reputation

Students may notice the feeder school effect — the fact that colleges with attached medical schools tend to accept more applicants who were undergraduates at the university than from any other school. This is not a guarantee, though; in a medical school class of 200, perhaps 20 or so will come from the associated undergraduate school. And if there are 250 undergraduate pre-meds at a given school, the cast majority can’t follow the path to med school. (Bear in mind that even if there is no established affiliation — like UC Berkeley, and UC San Francisco — many students may be admitted to medical school from a given undergraduate college.)

Prestige matters, too. Top-tier schools often have better advising and a stronger track record of top med school admissions. Because many of these schools may have grade deflation, it’s more difficult to have a competitive GPA, and medical schools will take note if you have a high GPA from one of these schools, especially compared with equally high GPAs from a lower-ranked school. If you have excelled at a lower-ranked school, then leaving additional time for extracurriculars will strengthen your application.

Ultimately, a high GPA and MCAT score will play the biggest role in your likelihood of admission to medical school.

College Selection: Large State Universities

There are several benefits to attending a large state university for your undergraduate education. For example, there’s generally strong research funding, along with connections to in-state medical schools. Because medical schools have received so many applications from these schools, they are well known.

On the downside, there’s less personal pre-med advising and more competition for opportunities. At the most prestigious, large universities like UC Berkeley and the University of Michigan, you may also encounter grade deflation.

College Selection: Small Liberal Arts Colleges

Small liberal arts colleges often have strong pre-med advising and solid majors and courses even outside of the sciences. There are usually fewer pre-meds competing for opportunities, too. However, there are also fewer opportunities overall, along with less research funding and a lack of affiliated hospitals to provide clinical experience. To learn more, see our post: Should I Attend a Liberal Arts College as a Pre-med?

College Selection: Small Private Universities

Private universities share several of the qualities of both public universities and liberal arts schools: strong pre-med advising and great research funding. Additionally, you’ll receive a potential prestige boost during med school admissions — these schools tend to be well-known to med schools.

That said, you could also be contending with possible grade deflation and tough curves, as well as a higher price tag and more competition for pre-med opportunities.

Choosing a Major

Ultimately, your goal is to maximize your GPA. Ideally, you will start out with strong grades and maintain them. Still, it will also be to your benefit to show an upward trend over time. A downward trend, on the other hand, will reflect poorly on you.

For admissions, your science GPA will be considered separately from your cumulative GPA. Most med school matriculants were science majors as undergraduates because this makes it easier to cover pre-med requirements. The most common majors are:

• Biological / Physical Sciences (~60%)
• Social Sciences (~10%)
• Mathematics / Statistics (~10%)*
• Humanities (~10%)

*Mean MCAT is highest for students in mathematics and statistics fields at 510.5.

However, you could help differentiate yourself if you’re able to perform well in both a humanities major and your pre-med courses. In fact, we recommend double-majoring in the humanities and STEM to stand out, if possible. For more about choosing a pre-med major, see our post: Best Pre-Med Majors.

Academics and Maximizing Your GPA

As we’ve discussed, maximizing your GPA should be your ultimate goal. Without a strong GPA, your other efforts to improve your application may not prove useful. 

Class Scheduling

When considering whether to use AP credits, you can generally disregard credit for courses in which you’re comfortable with the material and pretty much guaranteed to get a strong grade. This will help your GPA. You should leverage AP credit for changing courses that might hurt your GPA.

Meanwhile, if you’re not planning on doing a gap year, try to finish your pre-med requirements as early as possible so you can show strong grades by the time you apply. Still, you should spend one semester exploring your extracurricular interests and generally adapting to college.

Remember, too, that other students have done this before you. Look to older students and at forums online like Rate My Professors to learn how to find manageable classes and professors. These students can advise you on subjects like which classes have friendlier curves, along with general tips on studying, utilizing the pre-med advising office, forging faculty relationships, finding the best resources, and more. Don’t forget to pay it forward when the time comes!

It’s also a good idea to balance hard and soft science classes in any given semester. Because hard science courses generally have labs, they are both difficult and time-consuming. Taking more than one at a time can be overwhelming. The dreaded organic chemistry is considered the ultimate “weed-out” class, so if you’re worried about passing it, think about taking it over the summer or at another institution where you can still apply the credit.

Basic Course Requirements per the AAMC

According to the Association of American Medical Colleges (AAMC), you should take the following courses as a pre-med: 

• Biology (2 semesters with lab)
• General Chemistry (2 semesters with lab)
• Organic Chemistry (2 semesters with lab)
• Physics (2  semesters with lab)
• English (1 semester)

The AAMC also recommends the following courses (many med schools require these courses):

• Biochemistry
• Calculus
• Psychology
• Sociology
• Statistics/Biostatistics
• Genetics
• Humanities
• Behavioral Sciences
• Social sciences

GPA Targets

Depending on the tier of medical school you’re striving for, you should target the below GPAs by the time of your application:

3.9: Top 10-20 medical schools

3.7: Typical state med schools

3.5: DO (osteopathic) and Caribbean schools

Achieving a Strong MCAT Score

Your MCAT score plays a substantial role in the admissions process. So, how do you make sure you do well?

MCAT Score Targets

The average MCAT score overall is 510 out of 528. This is on par with the average score for a typical state medical school. However, if you’re hoping to attend a top-tier school like Harvard, you’ll need to do a bit better — the average score is 520. Meanwhile, DO schools and Caribbean programs have a slightly lower score at 505.

You should aim to be above the 50th percentile mark for students admitted to your medical school of choice.

MCAT Preparation

Pre-med coursework gives you a solid base of knowledge, but you’ll need to build on it with independent study. The MCAT is by no means easy; it tests both your skills and endurance, lasting for more than six hours.

Taking practice tests will be your best preparation. Ensure that you’re simulating true testing conditions so you’re not caught off guard during the actual test.

Preparing to Take the MCAT

Types of Prep Materials

The AAMC provides practice tests and information booklets. You can also access free or low-cost materials from websites like Coursera, Khan Academy, and similar organizations. Or, if you’re willing to spend more money, you can take in-person courses through organizations like Kaplan and the Princeton Review (keep in mind that in-person courses are generally more than $2,000, while online, self-directed materials cost around $1,500).

Timelines

It’s best to take the MCAT after you’ve completed your pre-med prerequisites when the knowledge is still fresh. Ideally, you should schedule your test date after a period of less strenuous activity (meaning during a break from school) to give yourself dedicated study time. You also want to give yourself time to retake the exam — up to 20% of students end up retaking it. However, you should avoid retaking it, especially multiple times, at all costs. Unlike many undergraduate colleges, medical schools will see every score, and multiple low scores will hurt your application.

Med school admissions open in May, and the last test is typically in April (COVID may affect this timeline). According to our survey, most students take three months of study time at 20 hours per week.

Low Test Scores

If you receive a disappointing test score, try to adjust your expectations with respect to the rest of your application. Work on emphasizing your strengths in your essays and activity write-ups. 

You should also work on expanding your school list to add less selective schools. Consider DO schools, too.

You can also retake the exam up to three times (total) per year. However, remember that the more times you retake the exam, the more you’ll be penalized by medical school adcoms. Retaking it once is completely reasonable — many students do it — but taking the test more than twice will raise questions about whether you’re able to handle the rigorous coursework at a med school level.

Preparing to Apply

Create a School List

You will be a competitive candidate at schools where your profile is on par with that of accepted students, so mainly target scores where you’re above the 50th percentile for both your MCAT and GPA.

Understand Your Competitiveness

Look at your application in context. Medical schools consider your MCAT, GPA, activities, essays, and recommendation letters.

Speak to your mentors and advisors, too. They can give you insight into your prospects based on how previous students with similar profiles have done.

Building Your Resume for Applications

Most Important Activities

While your academic profile (MCAT score and GPA) matters the most in med school admissions, adcoms will also consider your extracurricular profile. These activities will (in descending order of importance) impact your application:

• Clinical experience
• Research experience
• Service roles
• Leadership roles
• Volunteer experience
• Teaching experience
• Fraternity/sorority involvement
• Sports involvement

Meanwhile, the top 10-20 medical schools will consider the following

• Clinical experience
• Research experience
• Service roles
• Leadership roles
• Volunteer experience
• Teaching experience

This is slightly different for your typical state medical school:

• Clinical experience
• Service roles
• Leadership roles
• Volunteer experience

While DO or Caribbean school will put the most weight on these activities:

• Clinical experience
• Service roles

Patient Care Experience

Med schools look favorably upon students who have patient care experience, especially if it’s hands-on, like working as a scribe or EMT. These roles also tend to be more time-consuming than hospital volunteering and shadowing, which mainly involve observation.

Choosing Research Experiences

Most research experiences span several years. That means you’ll need to carefully consider which opportunities to pursue.

Clinical research often results in more frequent publications. However, non-clinical research in a strong lab can lead to publication in high-impact journals.

How do you choose a mentor? Look for someone who is well-established but not close to retirement. Ask previous mentees for feedback on the mentor, including their experiences and what the mentors are looking for. This can help you know what to hone in on when sending out your resume and information.

Of course, potential compensation matters, too. Look into when you’ll be paid for summer research or receive any stipends for research during the year. (Remember, though, that payment will mean expectations regarding your work will be higher.)

Networking and Recommendations

Recommendation Letters 

Med schools usually ask for three or more recommendations from faculty. These should include two from biology, chemistry, or physics professors and one from a non-science professor.

You’ll also need a letter from your college’s pre-med committee, similar to your guidance counselor letter for undergraduate admissions. This letter will synthesize information about the applicant. Make sure you meet with your advisor or committee early to ensure that the letter is submitted on time.

You can also submit additional letters, provided they add true value to your application. They may be related to leadership, work, or volunteering experience. Some medical schools require physician letters, which you can obtain by working as a medical assistant, scribe, or EMT or by shadowing a physician.

Network Development

It takes time to build relationships with physicians, professors, and others, so start working on it early on. For example, attend office hours in addition to earning a good grade, remembering that you should really only ask for a recommendation if you earn an A in the course. Don’t be overly aggressive, though — this will be off-putting.

Anyone you ask for a recommendation should receive your resume and personal statement so they know more about you. Highlight salient points that your professors can reference when writing your letter — this makes their job easier.

Time Management

The pre-med track is extremely rigorous. That doesn’t mean you can’t have any social life, though — it will just largely be concentrated to weekends. Pursue outside interests, too, but in moderation, focusing on the activities you really care about.

Overall, your workload will peak at the end of the second year through the early part of your third year of school as your classes become more difficult and you begin preparing for the MCAT and working on your applications.

Generally speaking, your weekly schedule will look something like this:

Class: 25 hours

Studying: 30 hours

Extracurriculars: 25 hours (10 clinical/10 research/5 other)

Total: 80 hours

Don’t be too intimidated: many students have successfully conquered the pre-med track and made it to med school. 

You may also like these posts:

Ranked List of the Best Pre-Med Schools

10 Most Underrated Pre-Med Schools

If you’re thinking of ultimately pursuing a career in medicine, it’s never too early to start. CollegeVine can help you improve your profile in high school to help you gain admission into a top pre-med school. Sign up for a free CollegeVine account to see your chances of acceptance to over 500 colleges and learn how to improve your profile.