Maria Lofftus, manager of the admissions office at the UCSD School of Medicine, had just finished explaining to an irate father why his son's application had been rejected. She has a repertoire of responses to all kinds of complaints — for the angry fathers whose dreams have been dashed, the sobbing mothers who think their child's life has been destroyed, the bigots who say UCSD admits too many colored folk, the people who deliver their "I'm a taxpayer, so you gotta let my kid in" spiel, and so on. Lofftus is usually pretty good at calming them down. But this fellow persisted.
"Come on, how much does it cost?" he said.
"You don't understand, sir, it doesn't work that way," replied Lofftus.
"Just tell me who I have to payoff. There's got to be somebody I can pay off." Lofftus assured the man it couldn't be done.
"Okay, listen, I'll tell you what. You let my kid in and I'll donate my body to UCSD. I'll pledge my body to science. What do you say?"
Everybody, it seems, is trying to get into medical school. Charles Spooner, Associate Dean of Admissions at the UCSD School of Medicine, is in charge of the committee that selects new medical students. He has a big job. This year 3777 young people from across the nation pushed an application across his desk, each having invested untold hours encapsulating his or her entire life in a small file of documents, building a case for acceptance. The competition these applicants face is intense, and their jury is smugly discriminating. It can afford to be, confronted as it is with a brigade of eager and ambitious young minds, thousands strong — all charging after the coveted knowledge and power of medical science. Why? Many reasons. Medicine is a challenging and dynamic field. In the hierarchy of American professions, it is the king of the hill. Medicine is one of the few professions in which realism and idealism can exist in harmony, in which you can earn a great deal of money making people feel better.
"I'm looking for young people who have integrity; you can usually spot it," says Spooner, a professor of neurosciences at the medical school. "I look for those who know how to and aren't afraid to take risks. I'm looking for the reasonable adventurer." An apt term. Apt because for so many, medical school is the goal at the end of an arduous quest. The applicant who wonders "Will 1 be chosen?" is asking the same question legendary knights must have asked when they dreamed of Excalibur, the enchanted sword embedded in a stone, awaiting the chosen knight who could wrench it free. The scalpel is the modern-day Excalibur, the blade that symbolizes knowledge, status, and power in this more reasonable age. Small wonder that each year as many as one-third of UCSD's approximately 3000 incoming undergraduate freshmen hope that someday they will wield the magic knife.
But the UCSD School of Medicine has only 130 scalpels for its 3777 applicants, and they are secured not in stone but bureaucracy. They are defended, really, from the onslaught of applicants by a staff of four administrative assistants, by committee head Spooner, by the admission committee's faculty chairman Dr. Arnold Gass, by Special (minority) Admissions Committee chairman Percy Russell, by some forty other faculty who conduct interviews, and — perhaps most ominous of all — by a computer.
The admissions committee has devised a very elaborate selection process — it spends more than $100,000 per year — to bring a human element into what could be a strictly mathematical decision. The committee members spend hundreds of man-hours interviewing applicants a poring over letters of recommendation, personal statements, lists of extracurricular activities, and other elements of the application. Nonetheless, two factors rise above others in importance: grade point averages (GPA), and scores on the Medical College Admissions Test (MCAT), the national examination required of all applicants. For far too many undergraduates who wish to become physicians, college is less a matter of learning than it is a matter of building impressive acronyms, high GPAs and MCATs. The result this academic tunnel vision is "pre-med syndrome," an unpleasant, often painful, always debilitating condition.
In their efforts to gain one of 17,200 spots in 128 medical schools in the U.S., pre-meds have taken on a cruel task. They have to measure themselves against the "ideal medical student," whom no one can define but everyone understands to be a cross between Picasso, Mother Teresa, and Louis Pasteur. Here is how this hybrid might look on paper: Sharp as a blade, he (or she) has a 3.8 grade point average (out of a possible 4.0) and scored 13 (out of a possible 15) on the MCAT: he's volunteered in a hospital for two years emptying bedpans for dying geriatrics: he's worked in a lab, washing test tubes and dissecting rats for a Nobel laureate: he strums guitar for fun but his true love is playing cello in the community chamber orchestra: he spent his junior year abroad in France, where he worked on a vendange for a month, harvesting grapes alongside Spanish and Greek laborers; he toured Togo and Upper Volta last summer to study health conditions there; and he was a history major with a minor in biochemistry.
What's incredible is that this standard is all too standard. There really are a lot of students applying to medical schools who have irresistible credentials, who look ... well, like young King Arthur might look in a white smock.
Nicole Moran, in charge of the Pre-Medical Advisory Committee, sees irony in the medical school selection process. "Medical schools say they want the guy who plays trumpet in the band, the champion surfer, the marathon runner, the symphony lover, and so on," she says. "But the reality is that the training they get in medical school robs them of these interests."
In one of Charles Spooner's medical school lectures, a second-year medical student stood up and made the same point, criticizing the UCSD medical school for being so "dehumanizing." Spooner says that he told her, "We choose people with high social commitment and altruism because we know their training is going to knock a lot of it out of them, and by the time they get through we want to be sure there's still some left."