Pre-medical (often referred to as pre-med) is an educational track that undergraduate students in the United States and Canada pursue prior to becoming medical students. It involves activities that prepare a student for medical school, such as pre-med coursework, volunteer activities, clinical experience, research, and the application process. Some pre-med programs providing broad preparation are referred to as “pre-professional” and may simultaneously prepare students for entry into a variety of first professional degree or graduate school programs that require similar prerequisites (such as medical, veterinary, or pharmacy schools).
At most colleges and universities, students do not have the option of pre-medical academic major or minor. A student on a pre-med track may choose any undergraduate major in any field, so long as certain required courses are completed. Such courses are generally focused in the scientific fields of biology, chemistry, organic chemistry, neuroscience, and physics, which are necessary to prepare for the Medical College Admission Test (MCAT) and satisfy most medical school prerequisites. It is for this reason students on a pre-med track generally undertake a major associated with one of those fields; however, an increasing number of students with a background in humanities have been applying in recent years, a situation applauded by medical schools. For example, Mount Sinai School of Medicine has created a program specifically for non-science majors. The Humanities and Medicine Program admits undergraduates majoring in the humanities or social sciences without requiring the MCAT, or science coursework.
Typical pre-med students will structure their coursework in their first year in university to accommodate the required courses. After a semester, many pursue extracurricular activities that demonstrate a commitment to medicine. Once junior year arrives, students register for and take the MCAT, the required standardized exam that medical schools use to identify qualified candidates. Once the test is taken, students apply to various schools using the automated American Medical College Application Service (AMCAS) system, American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS) system, or in some cases, the school's own application system. AMCAS primary applications are verified by AMCAS staff, a process that often takes four to six weeks. The application process consists of a review of academic records, MCAT scores, activities, work experience, and a personal statement. Applicants can expect to hear from schools within a few months, at which point they may receive "secondary applications". Different schools have different policies on sending secondary applications to students; many send secondary applications to all students, others screen applications prior to inviting an applicant to submit a secondary application. These applications are generated by each individual school. They generally contain essay questions that the applicant must answer to demonstrate that the applicant possesses qualities that the schools deem necessary to be a good medical student and physician. Qualified applicants can next expect to receive invitations to interview at schools. Upon completion of an interview and receipt of any additional application materials, the application is considered to be complete, and the student then waits for the school's decision to either accept or reject the student.
Some applicants receive admittance to medical school through a "post-baccalaureate" pre-medical program. These programs may be formal, such as the programs offered through Columbia, Johns Hopkins, Mayo Clinic with Barrett, The Honors College, Bryn Mawr, Goucher and Scripps, or semi-formal, such as the program offered at Harvard, but often consist of a student informally enrolling in a college to complete science coursework required for admission to medical school prior to sitting for the MCAT. The Association of American Medical Colleges (AAMC) maintains a list of all formal and semi-formal post-baccalaureate pre-medical programs in the United States.
The pre-medical coursework is offered at many American colleges and universities; however, it is considered to be a "track" that follows a certain curriculum. Most pre-medical students major in the natural and applied sciences, such as agricultural science, biology, chemistry, or physics, though this is not a requirement. Some pre-professional degree programs in agriculture prepare students for direct entry into the workforce in fields in high demand, while also meeting requirements for medical or veterinary schools. The latter curriculum model is meant to enhance employability of graduates awaiting admission or choosing not to attend professional or graduate school.
The courses that must be taken to meet the pre-medical requirements from the AAMC are two years of chemistry, with one being in chemistry, one year of biology, and one year of physics. These course requirements are expected to change since the MR5 Committee, charged with revising the MCAT has created a new set of core competencies for success in medical education and practice. Those core competencies will include a greater emphasis on molecular genetics within the biology curriculum and will include biochemistry. In addition, the 2015 MCAT will test in areas related to multicultural sensitivity and in critical analysis of ethics and philosophy. Many colleges of medicine and undergraduate pre-medical advising offices have yet to formalize pre-medical curricular recommendations. Though it did not address changes in the mathematics, physics, psychosocial or humanities portion of pre-medical education, the American Society for Biochemistry and Molecular Biology (ASBMB) developed a set of pre-medical curricular recommendations. ASBMB advocated that the year of biology includes genetics; that general and organic chemistry be taught with an orientation toward the chemistry of molecules encountered in living things; that one semester of biochemistry be required and two semesters of biochemistry be recommended; and that the laboratory course requirement can be taught in biology, chemistry or biochemistry, so long as research methods and data analysis are emphasized.
Pre-medical students may be advised or required to take upper level biology and chemistry electives, such as cellular biology, physical chemistry, biochemistry, molecular biology and genetics. Specific requirements for these courses vary by institution. Schools may also have requirements for non-science classes. Some require a certain number of general humanities credits, while others have specific requirements for courses in English, psychology, or other disciplines.
Volunteering and clinical experiences
Many pre-medical students volunteer in a health care setting to explore the option of a career in medicine. Past volunteer experience can increase an applicant's chances of acceptance to a medical school. Often volunteer experiences are topics of discussion during medical school interviews. Some students "shadow" a physician, where the student follows a physician, directly observing the doctor as they care for patients.
In Australia and the United Kingdom, a number of universities offer a three or four year Bachelor of Medical Science, Bachelor of Health Sciences or Biomedical Science degree, which is similar in content and aim to pre-med courses in the US. However, it is also possible to gain entry to a professional degree program in medicine (usually the Bachelor of Medicine and Bachelor of Surgery degree) directly from High School if the applicant achieves high grades upon graduation and is successful in the Undergraduate Medicine and Health Sciences Admission Test (UMAT), for Australian and New Zealand medicine courses, and the UK Clinical Aptitude Test (UKCAT) and BioMedical Admissions Test (BMAT) for UK medicine courses.
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