Episode 53: Boston University School of Medicine

Okay. Hi, my name is Dr. Christian Gidell and I am the Associate Dean for Admissions at Boston University School of Medicine. From Case Question Reserve University School of Medicine in beautiful Cleveland, Ohio, this is the All Access Med School Admissions podcast. Hello again everybody, I'm your host Christian Esman and I'm the Senior Director of Admissions in Financial Aid here at Case. This episode goes out to all those listeners who have been requesting Boston University in patiently waiting. I'm finally able to bring this conversation, so thanks for hanging in there and I had a great conversation with Dr. Gidell, so I hope that you find it to be well worth the wait. So hey, let's get right into it. Located in Massachusetts, the Boston University School of Medicine is one of the graduate schools of Boston University. Founded in 1848, the Medical School was the first institution in the world to formally educate female physicians. It was originally known as the New England Female Medical College, but was renamed Boston University School of Medicine in 1873 when the Medical School was required, acquired by the growing university. In 1864, they became the first medical school in the United States to award an MD degree to an African American woman. Interestingly, their other claim to fame is that they were the first medical school to connect the study of medicine with the care of patients integrating clinical practice, education, and research. BUSM, as they're called, is located in the heart of Boston, where its primary teaching hospital, Boston Medical Center, takes care of predominantly underserved and extraordinarily diverse population. The hospital's motto is "Exceptional Care Without Exception." Now only does the Boston Medical Center operate the largest level one trauma center in New England, but they have the largest network of regional community health centers in the area. To be sure, BUSM is a social justice medical school. This emphasis on social justice is evident in their curriculum and the extracurricular activities for students in the faculty's areas of research and expertise and in the patients they serve. Interestingly, all of the social justice does not make BUSM a community program or a primary care school, but rather is a major research institution with international expertise in emerging infectious diseases, chronic traumatic encephalopathy, substance use disorder treatment, and the impact of social determinants of health. BUSM is a private institution and accepts applications from all U.S. citizens, international applicants, including Canadians, and those with the DACA status, but on a case-by-case basis. For the entering class of 2021, the Boston University School of Medicine received 12,090 applications and interviewed 993 applicants for a class size of 150, which included six NB-PhD students. 60% were women and 16% self-identified from groups underrepresented in medicine. You've already heard a little bit about Dr. Gidell, but let me share some additional information about her background with you. In addition to being the Associate Dean for Admissions, she is also an assistant professor of Family Medicine at Boston University School of Medicine, and she is an Academy Medical Educator at BUSM, coaching, advising, and teaching clinical skills to all four years of medical students. Dr. Gidell received her bachelor's degree from the Colby College and her MD from Columbia University College of Physicians and Surgeons. She completed a residency in Family Medicine from the Tufts University Family Medicine Residency Program and the Tufts Master Teacher Fellowship from Tufts University School of Medicine. Dr. Gidell is interested in leadership development and in growing a diverse and effective physician workforce and has served in multiple national leadership positions, including co-chair of the Leadership Development Task Force of the Council on Academic Family Medicine, Treasurer of the Society of Teachers of Family Medicine, and Chair of the National Council on Graduate Medical Education. She is currently a member of the Double EMC's MCAT Validation Committee as well. Okay, there you go. Now let's just jump right into my conversation with Dr. Gidell. Enjoy. Awesome. Well, I've been looking forward to meeting with you and I know there's a lot of people listening to this that are looking forward to hearing from you because I've received their emails saying, "Can you get Boston University to come on?" So thank you for joining me and coming on my show today. I am delighted to hear. I have so many things I want to ask you. I have a ton of questions on my sheets in front of me, but this is my selfish one. I'm always fascinated as to how did you land in admissions? Like, what drew you to this realm of medical school and this part of the process? Yeah. So that's what I'm happy that you asked. I think it's actually kind of interesting. So I started off my career really as a medical educator and actually I should go back a little further because this is interesting to some people too. I went to medical school and actually matched into general surgery and I did three-year general surgery residency and then I switched a family medical school. Oh my gosh. That's a whole other story. But it's kind of interesting. And when I did my family medicine residency, one of the things I had the chance to do during residency was to begin teaching. I did this longitudinal teaching elective. I knew that I liked to teach. I had done it in various forms like even as a high schooler and then in medical school, I helped run our student coaching program and things like that. And so I got involved in teaching medical students and then really after I finished my family medicine residency went right into what we called the master teacher fellowship. And so that was like I was seeing patients part of the time, but I was also teaching medical students and learning about teaching and learning and developing curricula. And then from there, basically ever since I finished that, I've always had what used to be a 50/50 split between patient care and academic work. You know, the jobs went through a couple of iterations. I had started at Tufts and then I moved over to Harvard Medical School. And while I was at Harvard, again, my primary focus there was education. I was working at the Center for Primary Care and Harvard Medical School, kind of leading their efforts to focus education a little bit more on primary care. And I happened to participate in the admissions committee because somebody, my boss, I guess, suggested that maybe I would like to. And I thought, oh, that sounds fascinating. I would love food admissions. And so I was on the admissions committee there. And I found out that I just absolutely loved it. And it was the most kind of fun thing that I did. And it didn't feel like worked to me. And a lot of times I would have colleagues that would say the person you should really ditch the admissions committee is just taking too much of your time. I was like, oh, too big. I love it. So yeah, that was great. And then after I was at Harvard for about five years, I started to realize that it was time for me to take the next career step. And I thought what I wanted that next step to be was an associate dean role. And so I figured, I actually kind of figured that I was probably going to be an associate dean of education somewhere. And I was actually thinking about all right, I've got to look at all the medical schools across the country. Like there are only 150 of those jobs in the country. So I have to look everywhere. And I also thought, well, I would also consider doing student affairs because that gets you working a lot with students or possibly admissions. And so I was sort of planning to make this big leap and maybe have to relocate. And then a friend who was working at BU said, hey, you know, BU's dean of admissions is retiring and they're going to hire somebody. And so I thought, okay, well, sure, I'll throw my hat in the ring. There's no way they would hire me to do admissions at BU. I didn't go to BU and I didn't find there. Like why would they do that? But but it it worked out. And you know, one of the really kind of amazing and fortuitous things that happened is it turns out that BU is really a leader in holistic review. My predecessor, Dr. Robert Wittsburg, really sort of pioneered that term, published about it in New England Journal, about this way of looking at applications to medical school, it took into effect lots of different things. And there's not having strict cuddle or filters. Although I had not read that article and didn't know about Dr. Wittsburg's kind of eminence in the field and didn't do any intel beforehand. When I came from a series of interviews, it just so happened that that's the way I already was thinking. And one of the stages of my interview was they actually made gave me a test kind of they had me do a task. They gave me a bunch of applications with the information redacted and said, all right, we're putting in a conference room, you have 30 minutes to review these applications, summarize them briefly and then decide who you want to accept, who you want to wait, listen, who you want to reject, ready to go. Oh my gosh. They were like and then you're going to come talk to us about it. So I get that. And you know, and then I walk into this conference room where the interviewers were. And again, it's me and 10, I guess eight or 10 people that were always this big interview, but is the only. candidate and they had read my responses that I typed out. Or you know, my summaries and it was really interesting. It just it just turned out that the way I was reviewing and summarizing those applications was totally consistent with the way Boston University wanted to do it, which is to say that I was, you know, looking at the whole application and trying to figure out who is this person and what are the special things that they bring to the table and how is that going to contribute to the particular mission of this school that we have here. So so it just worked out really beautifully that that was that I was kind of in line with what they were doing already and so it made it a very natural fit. And so yeah, I got that. Yeah, I guess the moral story is don't count yourself out because you had you not thrown your name out there. Yeah. Gosh, that's amazing. Yeah. And you haven't worked a day since. So yeah, I love this stuff. Yeah, it's great. I love that. We have great jobs. What Dr. Goodell, what do you do for fun? What's something that people surprised to know about you that you do for fun? I got to tell people everything. I don't know if they're that big surprise. I think the thing that comes to mind is that I like to cook. I cooked dinner for my family basically every night and I actually realized this past year, 18 months or so, how important that activity is for me in terms of my transition from work to relaxing. And it's good transition, but in what it really is is it's just exactly the right amount of relaxing distraction for me. So I am I have more energy than most grownups. And I don't I don't like unstructured free time. Like going on to make. So I'd like if as soon as I free time I structure it, I put a bunch of things. So anyway, but this the process of like making a dinner and kind of being creative with cooking is perfect because it's not hard or stressful at all. But in it gives my brain like just enough distraction so that I'm not like fretting about work or fretting about my children or something I'm not fretting at all. I'm just like focusing on like, what else should I put? Yeah. Oh, yeah. That's great. Yeah. And then everybody benefits around the table. Yeah. Oh, that's cool. So though I thought we'd start with let's start with the curriculum, the school details and then we'll transition and talk about the admissions process. And so let's bring people in to start to understand what are some of those important things that you like. Perspective applicants or current applicants to know about Boston University and we can go in a lot of different directions, but maybe the maybe the highlights of the first two years of the curriculum. What does that look like for students when you're talking to people and you they say, tell us about the first two years of curriculum, what do you want them to take away from from from that? Okay. So I would say is, first of all, the thing that the way that you understand Boston University School of Medicine compared to our peer schools is that we are a social justice school. Right. Now, all medical schools take care of a diverse group of patients, 100% of them are going to say that. And they're all going to tell you that they care about social justice. And I mean, they do all care about social justice. I don't mean to be dismissive of that. But for us, that's like our core mission. And I do think I think for applicants, it's a little bit hard to understand, but I think is is important to understand is that like where the range of colleges, the spectrum of colleges that you could go to is immense, right? There's five thousand colleges in the universities. Exactly. There are some tiny, there are some huge, there are some really structured, there are some very flexible there are like, you know, like part time for like it's just an enormous range of where you can go and get a college degree. The spectrum of medical schools is not like that. There are, you know, a hundred, six of us or something like that. And we have to all teach the same stuff. And we have to partly because that's what you need to know to be a doctor, but also partly because it's required or else we lose our day. That's right. Yeah. But it's not a huge spectrum. So when you are looking at schools and you're like, I don't know how to tell them different schools, they basically all sound the same. It's because like, yeah. And I mean this to sort of be reassuring to people is when if you were inclined to stress about which school is going to be the best, I would like try to worry about that less if possible because any of these accredited medical schools is going to get you to your goal, which is the absolutely. And to and to a pretty significant degree, it really doesn't matter which one you go to. You're all going to get to be a doctor and that is the point. That being said, do it too. Okay, which out of those 150, whatever you're going to apply to. So all right. So so how we stand out is that we are a social justice medical school. You asked about the curriculum in the first two years. And this is one of the ways that where you see this kind of social justice idea kind of to play. So for starters, we have a standalone course called patient to population health, which is basically epidemiology, bio stats, ethics and essentials of public health. And that is a course that happens in the first year. It is very, it involves project work and small groups. It's very much team based learning. There are almost no lifters in that class. And it's it's very sort of community focused it that when I say project work, it's we have everybody doing a project with a community organization. And that's that's really cool. So that's one thing and that not all medical schools have that. Again, those are topics that have to be that they credit. And body tells us, but some schools like do it mixed in with other things. And we hear think like, no, this is like really, so many people on this, this is we want to highlight it. So we pulled it out. But then in addition to that, when you look at the rest of our curriculum, you also have social determinants of health and race and gender and sexuality and all of those issues are really woven into the fabric of everything else you're learning. So, you know, there are sort of besides the patient population health course, there are two other primary courses that happen during the first two years, which is actually a little shorter than two years. So during the pre courtship curriculum, one is a longitudinal basic science class that's divided into organ systems as is many other medical schools. And then the other and that one is sort of that sort of like the hard science class, right? And then the other course is doctrine. And that one is all it's, well, it's not all. It is where you learn interviewing physical diagnosis and clinical reasoning. And basically for medical students in the first year and second year, you have two afternoons a week dedicated to doctrine. Usually one of those afternoons is a small group session and one of those afternoons is with a patient or with patient. And so just to give you an example of how we kind of again, weave the social justice aspects in when we have the case discussions, it's never just a case of a patient with asthma. It'll be, you know, so the topic of the day, and this is taught along when students are learning pulmonary and respiratory medicine, right? So it's taught during that time. And they're also also doing the chest dissection. Okay, right. So it all is lined up. Exactly. It's all lined up. And so you'll have this small group discussion eight students, one faculty member, and you will be, there'll be a case. And so one of the learning objectives will be to sort of get a better understanding of asthma in the context of a patient. Another learning objective will be how do you do an interview with a child? Because in that case, the patient is child under five years old. And so you have to interview the parent. But then, you know, the patient has a whole story. And so the students objective is to get the whole history, not just to ask about asthma symptoms and these are the five questions you asked to understand how the asthma is going, but also like, so tell me where your family is living right now. And how does Roberto spend his time during the days, he home with you or just he go to school? Okay. Who else cares for him? You know, what are some of the, like just learning all you've got to learn all about past stuff? Yeah. If animals in the house and yeah, yeah, yeah. And then, you know, another part of the case is management planning. And so the management planning involves stuff like, okay. So the gold standard for asthma cares and asthma action plans. So who needs to have the asthma action plan? Well, certainly the parents, but then also his uncle takes care of him sometimes. And he only speaks Spanish. So we got to make perfect version asthma action plan. And then he's going to go to pre-K. So we got to figure out what the school needs and communicate with them. And then we need to talk about, all right. And so how can we address our, so you live in this neighborhood near us called via Victoria. And we need to figure out with via Victoria, how do we need to, how can we do to ensure that the whole environment is as optimized as it can be with regard to pests with regard to mold, all these things that people who are renting don't necessarily have control over and off and are kind of worried about bringing up. So how can we help with that? So we bring, we weave in all these different factors into our case discussions. at the same time as we're saying, okay, so you said you did a physical exam and you heard a wheeze, so what is that exactly? Like what is that? Like what's okay, yeah, what this is sound, but like what's making the sound? Oh, okay, so fine. All right, so it's air through a constricted airway. So um, all right, but what is making the airway constricted, you know, and how do you get from like pollen in the air to a constricted airway? Like what what's happening at the cellular level? Like what is the chain of events at the at the cellular level that produces that? So we really bring in all these things. You can probably see on the screen. Yeah, no, I'm excited because I think people listen to that sound so cool. It sounds fun and engaging and all those different aspects kind of weaving it all, pulling it all together. Yeah, that's I mean, that's actually by the way like why being a doctor is fun, because that's actually the job. Yeah, yeah. So and it's to think about like at the same time to think about the human and also the complicated science. That's like the job of being a doctor. So this is like what we medical schools in general, but in particular we are really trying to focus on. So that's another way that we weave kind of social justice and the social terms of health into our curriculum. It's really part of everything going on. Yeah, that's really cool. One more thing can I say? Yeah, this is all about you. Okay, so another this is a new innovation. So this course has been hugely revised. It's only and it's just we're just starting up the third year. For this course, there was a it's something there were things proceeding it, but this is a new version. And one of the cool things that we're doing now is that you have your doctorate students and one faculty member stays together for the whole four years. So in the first year, you're you've got a group of students and a faculty person and that faculty person is also your advisor. So they teach you in the classroom leading you through these case discussions. Okay. And they're also advisor. So we're the core advisor making sure that you're like settling in. Okay, like I have oh shoot, I actually just am realizing I meant to bring in treats for my first years because they are their first exam today and I totally dropped it off. Are you guys? Treats were on their way, but just not today. We'll follow. We'll follow. Anyway, so we are advising our students and trying to trying to just make sure they're settling in and that they're doing that what the things they need to do in medical school, we make sure that they have resources they need for academic support or social support or mental health support or whatever. Then in the second year, the people who teach doctrine begin to assess their students. And so what that means is you can't have your advisor assessing you because that's no right students need to have an opportunity. They can trust and they don't have to be able to worry like oh no, she thinks that I'm having a bad time. She's going to give me a bad grade or whatever. Oh, what happens in the second year is then I will keep my advisees, but I'll get a different group to teach in the classroom because I also assess them. So now I've got two groups of students starting in the second year going forward. And one group I continue to advise and the other group I continue to to coach and teach and assess. So in the second year, it's the same kind of thing in the classroom leading the case discussion, teaching physical exam. And then in the third year, we're doing these things where we observe all of our kind of our observations students. We do three observations kind of in vivo while they're on their clerkships. And so we just pop in, and we have a time, we go, we meet our students, we watch them do something with a patient, and then we give them feedback about it. And then we do that again in the fourth year. And the idea is that we really want to make sure that students are not, that their clinical skills are not diminishing over time. A thing that people don't like to talk about that has been not great about medical education is we teach this stuff in the first couple of years. And then we send people to third year and we're like, I'm sure they're doing it in the clerkship, but far too often nobody watches them. I don't, I mean, I went to medical school a long time ago, but I don't remember anyone in the third year of medical school ever watching me do a physical exam. Like maybe somebody caught me doing part of it, but nobody ever said, Hey, you do a blah, blah, blah. I'm going to watch. And that's that's really been the case. Like people maybe they catch a little bit, but maybe not. And so we think that that's not good. And we think that you we need to be like careful to make sure that everybody is getting observed and getting feedback. And it should be from a trusted person that's been watching you all along and have has a sense of who you are. And I guess we hope that this creates a really supportive, supportive and rigorous learning environment. You know, it's so interesting. Like one of those thing about following up with people and watching people through their third and fourth years, but I think is so important. I've heard a lot of people who are concerned about grading in the third and fourth years and the subjectivity of it and the possibility of bias. And and I think what I hope is that having somebody who's again, you've got this relationship with and who's known you over a long time will help to offset those concerns and offset loans if they're happening. Even if you look at the good side of medical school, I can promise you that there are students who I've had a really favorable impression of because of their work in the classroom. And then when I see them actually doing something kind of on demand like, Hey, it's Tuesday here. I am. Let's go find a patient and they do it. And I'm kind of like, huh, all right, actually, they missed a bunch of things. We need to go over this. And that's you otherwise. I was like, Oh, they're going to be fine. They crushed the first two years. Yeah, which is by the way, like, I think that's what happened to me in medical school. I think that I graduated and a whole lot of people, but she's fine. She's going to be fine. She's fine. And I mean, I suppose that's true. But like wouldn't it be better? Yeah. You had watched and said like, pretty good, but you could do this better. Right. Right. It sounds like there's a lot of touch points. There's a lot of hands on time. Students feel supported. And for you as the preceptor or faculty member, you get to know each student where kind of where like you mentioned that we're coaching like some people, maybe she, you know, he's a little more reserved. I think sometimes we need to come out a little bit more and be, you know, can't be walked on and rounds or something and somebody else maybe needs to turn it down a little bit. And you kind of figure out where the strengths are and where areas they need to work. I don't want to say weaknesses because I, there's areas of improvement. We can all we're all working on something like that. And that's yeah, that's really cool that you have that very, well, specific mentorship program going on. I think it's really I mean, I, I think it is I think it's going to work out well. I don't know how I'm a person who believes in assessment and I don't know how to really measure the impact of this program. But as far as I know, it's fairly novel in the country. I don't know of other places that have it set up this way where you follow people all the way through with a specific focus on clinical skills. And, you know, now that they're not, we're not having this step to clinical skills exam anymore. It's actually exactly this kind of thing that I think is going to be essential. So I feel as though when residency programs look at our students, they're going to read the evaluations that our school produces and be like, oh, this sounds actually pretty limited. You know, like somebody who's really paying attention as opposed to the like, they seem to be fine. Yeah, yeah, I know I've read a lot of medical school websites, particularly for this podcast thing. And I've not seen something as, as unique as that. And as that small group longitudinal kind of mentorship tracking and along the way, I have not seen it anywhere. So right on. That sounds really cool. I got from my research that a lot of the students clinical work is done there at Boston Medical Center. You work there. Tell people what's Boston Medical Center like? What's the patient population like? But what is the vibe in that place? Yeah, it's really interesting. You know, and it's it's maybe different than what I would have thought before I came here. So we take care of a predominantly poor and underserved. And by that, I mean 75% of our patients have Medicare or Medicaid are both for their insurance. In Massachusetts, 98% of the population has insurance because we passed a law about that five years before the affordable care. I will just point out still working. We are not bankrupt yet. There you go. Anyway, rest of the country. I'm just saying. Two percent of our population in Massachusetts doesn't have insurance at any given time. Sometimes that's because somebody just fell through the cracks like they lost their job and they didn't get around to signing up for something yet. Sometimes that's people who've said, no way, man, I'm not buying that stuff. And sometimes it's people who are afraid like they're undocumented, no way are able to get their afraid to call attention to themselves. Anyway, all those people have to get care somewhere so they get care of our health care. There's one other place and it's out in Springfield just a couple hours away. So so so so right. So poor and underserved. The other another way to sort of think about that is that about 25% of our patients are unstable housed. And so sometimes that means homeless in the way that people typically imagine homelessness, which is to say living on the street or in a shelter. But a lot of times it's something that's not quite that but not quite stable either. So there, you know, maybe it's a family who has got like a couple of kids are staying with my sister. And then I'm going to stay with my friend and my husband's going to stay with his mother for a little while. - Yeah, it's peeped off. - Different places. Sometimes it means a family that's kind of giving some money to another family who has an apartment that they're renting, but you know, like can stay as long as it's working out, there are no problems as long as nobody finds out. So 25% of our patients are unstable at house. So when we talk about underserved, that's what we're talking about. And I think I knew that before I came here, that's really, that's a Boston Medical Center's role in the city. We also have an enormous emergency department that is very well known. It's a level one, it's the biggest level one trauma center in New England. We get 35% of all the ambulance traffic in Eastern Massachusetts. So it's sort of known as the place this where you come if somebody, if you get shot or stabbed or whatever. So I think many of those things. So I was kind of mentally preparing myself for someplace that was kind of tough and grieved. - So that you'd see on Thursday night, prime time on NBC. - Exactly, yeah, something like that. That's what I had in mind. And I was ready. I was like, yeah, cool. I've always wanted to help people that need to most help. Like awesome, I'm gonna do that. And then it turns out actually, the hospital doesn't really feel like that. It is extraordinarily well run. I mean, really well run. Like our, it's kind of unusual for me to praise a bunch of administrators, but I think they're doing a phenomenal job. This hospital feels to me like every other academic medical center I've worked in, which is now a bunch of them. It feels like that this real deaconist it feels like Columbia Presbyterian. It feels like, toughs, you know what I mean? Like these are the other times, it doesn't feel chaotic, it doesn't feel tough and gritty. A little example is like how unbelievably smoothly we manage things for COVID. And our hospital was really one of those places that was inundated. We were in what we called surge capacity. We stopped all of our elected procedures. We stopped, you know, ambulatory, everything, except for the emergency room. We changed the pediatric floors into adult COVID boards. Like that was what we were doing at the beginning. And yet it felt five. Yeah, quote, quote, fine, but it just like the organization that felt okay, you know, like there was a really good communication from the administration. This is what's happening. There's so many patients we've seen today. This is how many in the year. This is how many in the ICU. This is how many cases pending. This is how many staff have been infected. They, the vaccine roll out was like so smooth. I got my first vaccine on December 22nd of this year. Sheesh. No, yeah, yeah, yeah, 2020 was a blur. So yeah, but I know what you mean. And it was like the way they did it was just was it was just it was really smooth. They were like, here's an email. They were like, we're saying, you know, they, I don't know, they divided up the staff. Everybody was assigned to a day. You got an email. Once you got your email, you can call and make an appointment. You know, no lines, no chaos. All you need it was your ID. You get your shot. You know, it's just been, it's been handled so smoothly and effectively. And I guess the other little thing I would say about how nice the hospital is is that like I switched my primary care doctor to be a doctor here. And I got a primary care doctor for my husband to be a doctor here because and you know, so and we've had, you know, diagnostic testing and different things done and it was supposed to do and like, it's fine. It's totally pleasant. I also just really forgot to get blood run. That's. I have a lot of life. So yeah, we things, I think I really think very, very highly of this place and MFN. The other thing people should know in terms of what it's like to be here is that it's just the diversity of our patient population. And again, this is another thing where every medical school says, I don't know, we take care of a very diverse group of patients. Here's what I mean by that. 32% of our patients don't speak English as their primary language. And so lots of times applicants are like, oh, so could I use my medical Spanish? And I'm like, yes, also if you happen to speak Haitian Creole Vietnamese Portuguese Cape Verde, like all of the things here's every day. So the average number of languages access through our interpreter services services every day is 72. Holy moly. Can you even name 72 languages? Gosh, it's a. So we just have people from everywhere. We have special clinics for refugees in our doctoring course. This coming week, one of the sessions that we're doing for doctoring is a session about trauma-informed physical exam. That's being led by doctors who work in our refugee clinic because they operate under the assumption that all refugees have to talk. And so they talk about, OK, specifically what are some things to keep in mind? Would they talk very clearly about like, these are the kinds of words to use and to not use? And these are the things that you should, these are the ways to approach the physical exam that are less likely to be perceived as threatening or whatever. It's really. So I mean, that's what, so that's what we mean by diverse. And you know, you were saying, oh, you see patients and probably the story I should have said just succinctly would have captured it was. I can think of there's a recent morning that I was seeing patients in clinic. And this is like, this is so like classic family medicine right? So I saw among, I see 12 patients in a morning. So among those 12 patients were the 13 year old son of one of our staff members who was there with what turned out to basically be growing pains. 13 years old, he's like six feet tall. I didn't notice him. I conducted a visit with an interpreter with a man who is 65 this year's old, a Polish interpreter. He was brought in by his daughter who was worried that maybe he was depressed and he was. So we conducted a visit to address his diagnosed and treat his depression with a Polish interpreter. And then there was another patient that I saw that was Kate Verdean and was sort of came in with her family and was being seen and follow up from COVID recovery. Another person who had spoke Spanish and had a paramecia, which is an infection of the fingernail bed. So you know, just all these, that's the kind of thing. It sounds like you will see as a student, you will see a little bit of everything under one big room at a Boston medical center. Oh, that's exciting. Our patients are being complicated, which is this is different from my previous practice. Which before I came here, my practice was in the suburbs. I still have family doctors. There's still lots of variety of infectious in the suburbs. And the patients here are much more complicated than in a typical kind of out suburban primary care. And a lot of it is because people come from other places. A lot of times they have not had. They've had some kind of spotty medical care. So people are sicker. They have more problems. They have more unusual problems. So you can do your clinical rotations at Boston Medical Center. But another unique thing I found is that maybe you could go do six or 12 months at Boston University Kaiser Medical in California. So how does a student go coast to coast? And maybe serendipitously scheduled their third year clinical rotation during January, February, March, April. California, California, San Jose, or Santa Clara. Yeah. So right, the Kaiser-- so we basically have a-- it's not a track. It's really just sort of like a branch campus out there. And it's only for the third year. And we have an affiliation with two of Kaiser's campuses. And our students can choose to go out there. They can choose to either go for all or half of their third year. There's a limited number of spots. So there's a three for it. But if you're interested, you say, OK, I want to go. And then you go. And the way it works is that you pick your rotation-- your preferred rotation order, and then your sites. But if you're wanting to go to Kaiser, the first thing is I want to go to Kaiser. And then you pick your order. And they try and set it up for you. It's really cool. We, like most private medical schools, have a lot of students from California. I was just going to say it's nice for them. Yeah. Yeah, California turns out a lot of things. So a lot of the students that go there are students that live there, or that are from California, decide, oh, I might want to go back there for residency, or I think it'd be nice to be close to home. My advise is going. And she is, in fact, managed to schedule the winter part of her third year. So she's going to be in San Jose, which is awesome. It's a convenience. That's great. Very cool. Very cool. Very exciting stuff. And I should say to about third year-- so the pre-third year clinical work is basically entirely done, either at Boston Medical Center or one of our community health centers. So we also are affiliated with the largest network of community health centers in Boston. And so some students rotate there like to do their doctorate work. But once you get to third year, you can choose rotations at BMC, but you also will likely have some rotations elsewhere like this. Yeah, like at the VA. We've several different A-sides. We have a couple of-- there's Roger Williams Hospital and Providence. If the couple things just are in an area, around Boston and community hospitals. And that's, I actually think that's a really good idea. It's, it is a good idea to be in different hospitals and realize that like, oh, the way my school does it is not to be all in and all. In fact, there are different ways of bridging the same problem and they're all-- One more thing I want to ask you before we switch gears and talk about the admissions piece is that you mentioned social justice as a big piece. And I get the feeling your students are very social justice-minded. Yet you don't have a community service requirement, which I think is kind of cool. Like, you are looking to attract students who want to be involved in the community somehow. And you just know-- I have to believe you just know like when they get here, they're going to bring that track record with them. We're not going to make you do it. We bet you're probably going to do it anyway. Yeah. Right, that's exactly right. We have the most popular thing for our students to do besides going to class and studying is that they participate in some sort of a service organization. And right now, I think 17 of them and they're all student led. So they change a little bit over time based on student interest and need. And yeah, everybody does that. And it's exactly right. I would say in general, we're not that big on requirements. We also don't have a research requirement, but 85% of our students do research while they're in medical school, more than 50% graduate with their names on paper. So that's really good. And again, there's no requirement for it. It's just we just make it really easy for people to do and we collect a bunch of people who are jazzed about it. And so they come in and they go, wow, you're doing that? That's what I wonder if I can do that or something like that. Maybe twist on it. And so that's who we get. And that's the way you see that play out there. Before we talk about admissions, is there anything that you wanted to highlight that I didn't ask about? I guess the only other thing that I would mention is the fact that we do a lot of research. So I think sometimes when people hear social justice, they tend to think about like, oh, is it like a community medical school or primary care school? And that's actually not the case. The interesting thing about the way we do social justice is actually that we're a giant research university. And so the 85% of our students do research. And what you often see is that those things come together really effectively. So for example, one of our biggest research projects right now is that we are the lead site for a major national multi-central trial that is validating a specific tool to ask all patients about their social determinants of health that's called the thrive screening. And it's in our EHR, it's done with every single patient. This is like the idea is to see, if we ask people about these social determinants of health and then address them, because that's ethically speaking, you don't ask things if you're not going to do anything about it. So if we can ask them and address these issues, is it going to improve people's health? Which sounds like a very foundational question and the kind of thing that people might be like, thanks for spending my tax dollars on that. But we don't actually know, though, right? We don't know if the medical system can effectively intervene in improving people's health by way of social determinants of health. But it seems awfully important to figure that out. So that's a huge NIH funded trial. So it's an example of how research and social determinants of health come together. Another example is we have just a, I've got an enormous grant to basically address addiction in the state of Massachusetts. And we're specifically working with certain communities. We have a ton of expertise in that area. Again, lots of students involved. That's sort of, that's got its tendrils and a whole bunch of different places in and around the hospital. And then, but then again, we do stuff that has nothing, doesn't have anything. We all have some social determinants of health, but that's not as directly related. Like we've got this big center for chronic traumatic and cephalopathy. We've got the needle, the national, emerging infectious diseases laboratory. That we don't really famous for the last. - I would think so, yeah. (laughs) - So there, I think those are, it's just good for people to be aware that that's, that's the context. This isn't like a sort of scrappy little situation where we're out there, like just working to try and make things better. You know, it's not a startup, I guess, is what I would say. - Very well established. And it goes back to your point that that's like, one of the core of the mission statement or the mission of your school, great stuff. All right, so now I think people are fired up and I would think, I'm kind of fired up. So one question I usually transition to is, all right, so what are you looking for in people? But you've already answered it because I looked on your website, you have a great website by the way. And so people are saying, go to the website 'cause they have these videos and you're gonna see Dr. Gidell, so you're hearing her now, but now you can see what she looks. And she answers the question, "Here's what we're looking for in people." So I guess that's a big question and it's probably the most difficult one to answer 'cause we get it all the time. What are you looking for? When you, so last year, I think you guys got like, just shy of like 10,000 applications or something. - Last year we had 12,000, yeah. - Here before it was just shy, 10. So yeah, 12,000 last year. I guess a question that pre-meds want to know is, what gets me to, from 12,000 into your interview cohort? How do I, what stands out? How do I get to that point? And how so how do you answer that? 'Cause it's a tough one. - It is a tough one. And you know, I guess I think that there is no formula because we don't use a formula. So which I, okay, so what I hope that people, I hope that applicants can see is the pluses and minuses of this approach. So we, I know that people would like it if we were, or many people would feel sort of more comforted if we were able to say like, okay, you need this GPA and this M-CAP, or in this many hours of this activity and this many whatever. The problem is that none of us really think that that's, we think that that's gonna leave people out. You know, if we do that. You're lots of people that would be terrific doctors who had some different thing that didn't have them, you know, didn't give them the chance to do whatever those things are. And it doesn't seem right to just, I mean, we could. We have a lot of applicants, so we could. We could just be like, now we're just making a rule. - Yeah, but we'll put it some AI into your, or it's some triggers in, we could just push out these students that met that criteria. - Yeah, but I guess I just, so far, it's two people are too complicated and too interesting. And the thing is like, we like complicated and interesting people, so. So we don't wanna kind of set those things. So in other words, so the bad news is it makes it kind of stressful, 'cause there is no way that I can say, you look, if you just do these XY things, you're definitely gonna get an interview. There is, I can't. On the other hand, the good news is that it creates opportunities for people to demonstrate their excellence in many different ways. Okay, so that being said, in terms of what we're looking for, I think that, you know, we, the first thing that you have to be able to do is that you have to be able to manage the curriculum. So we don't have cutoffs in terms of scores and grades, but we do need to be very sure that you're going to be able to manage this curriculum. And I guess I, from my own experience, both as a medical student myself, but then also, you know, teaching in medical schools for the whole time I've been doing this. It's hard, like medical school just is hard. It just is almost everybody shows up at medical school and goes, whoa. Okay, it's a lot. You know, my students who've been studying for their first exam that's happening right now, I've been like chatting with them as I pass them, as I pass them in the school this week, and they're all, like, they're all going to library again, and again, and again, it's hard. So they're appropriately kind of freaked out. Yeah, and so I, and the thing is, like, I also want to know, like, to tell people, medical schools are not making it hard to be mean. It's because like, it's a lot of new information. And in my opinion, as somebody who practices medicine, you have to know it. Yeah, it was a big responsibility. It's an enormous responsibility to all that, to all that knowledge you have to be responsible for. - Right, exactly. - I completely agree with you. That's one thing that I think we need to see, we can't look into a crystal ball and say, this person's going to be successful, but we have to do our best. And I think I agree with you. We get that from an academic track record of what it looks like, and try to predict if they're going to, if we think they're going to be a viable student in our curricula. - Right, so for example, you know, when you, it's interesting, like I was reviewing applications yesterday and I'll do more today, but you know, I think yesterday, I said, there was somebody that I designated for interviews, whose undergraduate GPA was like a 3.15 or something, but he graduated in 2015. And since then, he's done a post-back program and another master's degree. And in both of those, you know, his GPA in those programs something north. of 3.8 and he did really well in the MCAT. So I was like, well, I don't care what he was doing in 2014. It was years ago, you know what I mean? He's a different person now. So that's why we don't do that. But when I say like we're looking for a track record, I need to be quite convinced of like, okay, you're going to be able to manage this. So that's the most that I would, when people ask if those factors are the most important, like what factors the most important, I would say, we have to be convinced of that or else it's a no go. So no amount of passion and excellent work in other fields is going to convince me that you can manage the curriculum if the academic work doesn't convince me you can manage the curriculum. Excellent point. Excellent point. You can do all the research and helping people in Central America and all those things. But that's great. It's a wonderful, you know, impact you're making, but really that I agree that we have to have that reassurance that academically you're going to be okay. Right. So that's one thing. And then for us, when we look at all the other stuff, we really are looking at people that are going to kind of feel at home here and that are going to kind of, you know, just sort of like how I felt when I took my job here that I showed up and was like, oh excellent, turns out these people think just the way I think. That's kind of what we are. Well, okay, think the way I think that sounds like very restrictive. That's not what I mean. Please don't be too good at broad enough. Talk about politics. I'm talking about people who are also invested in our mission of serving and underserved and diverse population. People who also want to approach their work with an academic event and and an inclination to contribute to the general knowledge by doing research. You know, people who are really caring of others and have demonstrated in that lots of ways. So that's what we're looking for and, you know, the ways to demonstrate that I think are too numerous to count. So that is why we don't have like, oh, you have to do a minimum number of hours of such a piece because people would just like find ways to get out of it. I got my 40 hours. So I check that off. But that's not really the question we're answering. The question we're answering is like, do we think you're the kind of, you know, does it seem like you are going to come here and be all excited about what we're doing and ready to jump right in and help? And so there again, there are so many different ways to demonstrate that. Some of them are, okay, you went to you went to you super late and you volunteered at the suitcase clinic and then you became like the leader of the suitcase clinic and then you did some innovation while you were there. And then also you decided, wow, this was really cool and I'm pretty interested in social determinants of health. And so then you decided to go get an MPH or take some classes in public health or maybe add a minor in public health. And then you did your senior thesis project on something related. And then you know, like, so things sort of line up to make us thinking, ah, we get it. All right, you are, you are kind of person. That's one way. But then another way is the person who comes to medicine from a totally different route, you know, like I, my family were immigrants to this country. I grew up in a community where most of the adults didn't speak English. I did a whole heck of a lot of translating for people. I saw many friends and family members not get adequate care. And I think that a gift that I have is being able to understand the science and communicate with my community. And so that's why I'm going to medical school. So what you're describing here is holistic review. And that's what that is a topic that I get a fair amount of e-mails about saying, all these people that you interview say they do holistic review. And everybody does it differently. What does it really mean? And so I think people that are listening just heard Dr. Cadill describe how you, what that means. Is that accurate? That's, yes, I think that that is what the original originators of the term intended. But I agree with people that everybody says that they do holistic review. And people mean different things by that. So some people, for example, they're all in there are all different ways that I don't know that one is any better than the other, but that's the way we do it. You know, the other ways to do it are some people, I know some schools, for example, who do set a floor. Okay, we've just got it that this has been been among academic standards for entry. And once you meet that floor, you're getting an interview and then we they'll make cross out those numbers. We don't let anybody else see them. And after that, we just decide based on the other things in your application. That's another way to get this to review. So there are lots of different ways to do it, but that's the way we do it is by trying to figure out understand who you are and what you bring to the table. And I just I just in case it's not abundantly clear, context is an enormous factor. So for all of you who are out there worrying that you weren't able to get this opportunity or that opportunity, please know that we understand that, right? It's way way way, it is a million times like if my either one of my kids wanted to do hospital volunteering, like they could because I work here. No, and like I could call up the volunteer office who owes me a couple of favors anyway. And they can make it come and they'd be like, oh yeah, sure Dr. Bill, like that's easy, right? Not everybody has that. And we get it. Like please know that we get it. And that's true for I have yet to determine a metric for medical school entrance that is not influenced by privilege. I can't think they're all inspired, but so we're trying to do the best we can to mitigate that. I think the best way is to try and understand people's context. So to those of you listening, please tell us your context. Another thing that we do at BU is that we send every single person to secondary. It's because our secondary application asks about context. It gives you opportunities to tell us more about who you are and what your background is, how different things have impacted you. And so the reason we do that is because we don't want to do any interpretation without really understanding where and then who goes for COVID as well. I was just going to say speaking of impact, and I listeners that they've been listening, they've heard this me bring this up multiple times, but I just think they need to hear and keep hearing that how are you going to evaluate all the things that have been disrupted and canceled for pre medical students that are applying to you this year. What is your approach to what's your admissions committee or screening committee kind of been charged with in assessing that this year? So we just know that the applications don't look the same as they did in previous years. I think in previous years, I probably would have sort of scoffed at virtual shadowing. And now what I think is this student was doing the best they could. That was the opportunity they had. They did it, you know. So I think I guess just know that we know that all the applications look different and you're swimming in the same pool as everybody else, right? It wasn't just like Massachusetts or just the students in Maine are impacted. Everybody's stuff was shut down. And the course, so I talked about the core academic question being like, are you going to be able to manage the curriculum? And then I talked about how the people that stand out to us are the people that are really very clear mission fits for us. But in terms of like what else it takes and what the other, so when we're looking at the rest of the application, there are questions that we're trying to answer that are sort of the minimum standard questions. And so those are, it's not how many hours did you do of this or that? It is, does this person have enough clinical experience to know what they're getting into? And so that can come in about a million different ways. Like there was another application that I read yesterday where the person had, I don't know, maybe done a tiny bit of shadowing or something. I don't remember not much. But on the other hand, had themselves had a significant illness and then had spent, had cared for their grandparents at the end of life, which, you know, and so that's actually, and it looked lots of interactions with the medical system that they wrote about. So this was like, let's person those what they're getting into. So that's one of the questions. We just want to make sure that you know what it's all about. And it's crazy, as it sounds, people who are listening to this podcast are probably not in this group, but we do get applications from people who I think are like, what the heck? I think I'll just apply to med school. You know, and like they're really smart, so they get kind of far in the process. And, you know, so we want to make sure you know what you're getting into. The other big question that we're looking, thing that we're looking for is, do you, have you demonstrated evidence that you are inclined to serve people to help people? And while like pre 2020, such a kind of easy way to do that was like, oh, I'll volunteer in the hospital and then I'll get clinical experience. Plus, I'll also show that I'm helping people to burn to one stone. So fine. But this past year, I was amazed. And like really thought it was beautiful. The ways that our applicants found to take care of other people that were not as part of a program, not anything from a pre health advisor. This includes, you know, a woman who got sent home from college was at home on Cape Cod, didn't kind of know what to do with herself, really wanted to do something to help out in the pandemic. And so she started reaching out to neighbors. There were a lot of elderly people and she started reaching out and saying, hey, do you want me to go do your errands for you? I can just do that. Yeah. Yeah. You know, like, or I mean, many people who supervised online school, either for younger siblings or like, again, neighbors, people in their neighborhood. Many people who might have done some sort of like, like, oh, I'm going to establish this science mentoring and tutoring program in this one particular neighborhood. Well, instead they reached out to their old elementary school principal and said, how can I help? To be helpful. So like, I mean, these things like they, they, like, I don't know, they make me tear up. I just think like that's, that's the kind of person. So you know, it doesn't have to be, we're just looking to see that you cared and you were trying to do the best you could. Yeah, thank you for that. Because I, I just, as I said, I'd like to have people reiterate it and hear it again and again to note, because there's always this very high level of anxiety for students that initiate this process, which we talked about before we hit record for something else. But it just to continue to hear that we get it, we get it. And we're trying to put it in the context of your story and what you've had to go through in the last year. So we get it that the applications are not going to look like they have for the past several decades, the same kind of things that we've been used to seeing. One other thing I wanted to ask you about, well, before I ask you about your research and with the, some of that research did with MCAT, Casper, you're requiring Casper this year. And I asked you, I asked you about that and you said, oh, I'd love to. So how are you using the Casper score, which is for those that don't know, it's like a situational judgment test, kind of online assessment, if you will. Right. So the reason that we, so what I liked about Casper when I learned about it is that it seemed like a way to try to get a handle on some personal characteristics or skills that are essential for physicians that are otherwise very difficult to assess in the context of an application. And these are things like empathy, judgment, your inclination to teamwork, communication skills. I don't mean to, you know, there are other things that we can look for. We can look at your activities and see if they demonstrate empathy, but frankly, like, people write about things in the best, most positive way on their application, which is the right thing to do. But it's hard to tell sometimes if that was like really coming from your heart, or if you were just like, you could probably well groomed essays. But, yeah, people have gone over them and other people have helped you write them. So yeah, and even the experience descriptions and stuff. So we look for something like that. And then, and then, you know, like, okay, you can look at the letters of recommendation to see if they, sometimes the letters talk about these key things and sometimes they don't. And it kind of depends on the letter writer. And, honestly, a lot of time, that's not the applicant's fault. And then, in, you know, like, and it's not to mention also that like, nearly everybody can find someone to write a nice letter for them, or, you know, three people or whatever. So, so I think those are qualities that are really difficult to assess, but, but I don't know any doctors that don't think that they're a critical part of the job. So I was mentioning like medicine is hard. Part of it is that it's very academically challenging. But like, in addition to being way smarter than average, you also need to be like a way better communicator than average. And also, you know, more empathetic and compassionate, although I don't know how, maybe the average person is really empathetic and compassionate. So maybe that's okay. I don't know. I don't have a good scale for that one. But, but I think you have to be, you have to be able to do all these things. So Casper kind of promised a way to assess that. And I thought, all right, that seems pretty good. The Casper people have really excellent research to back up their product, which is one of the things that won us over. But the way, and so, so I thought that seemed promising. The way we are using it. And by the way, this is also how I've heard my colleagues, they're using Casper or a similar test. This is how I've also heard them using it. We do not use it as a weed in or weed out tool. It is one of a number of factors that we consider when we are reviewing the applications. And we actually keep it as part of the application all the way through. This is not, in my opinion, this test is too new and lacks sufficient evidence for us to make it too big of a factor. Yeah. That makes sense. It's more than we incorporate it with other things. So if somebody looks great, but they've got a really low Casper score, I'm like, well, I don't know what to make it. Yeah. Yeah. Yeah. Who knew for me to say, oh, on the other hand, if somebody is writing as a little awkward and their interview doesn't go that well, their letters are tepid and they have a low Casper score, then we're like, yeah. Maybe it correlates a little bit with something that you saw. Even if they did amazing research and have terrific academic metrics, then we might be like, hmm, not sure the position thing is going to be the right thing. You know what I mean? So that's kind of how that's kind of how we use it. And and conversely, we've also had a couple of people who were just, you know, maybe they, I think, I think Casper might actually sort of maybe overcome a little bit of initial anxiety or shyness, if you will. So there are always people who worry about interviews because they're nervous about the interview. So people are nervous interviewers who are quiet when they're nervous. And then they've got a bunch of letters who say, like, oh, this is like a quiet, diligent student did all their work seem to do fine, you know. But then they they're they have a super high Casper score. Then I think like, okay, it's not that they're not engaged. It's there's no problem with their judgment. They're simply introverts. Yeah. I know. Like we like that. We need introverts in our classes. We can't have classes full of bombastic extraverted people. So we need we need a whole mix of different types of personalities. Oh, that's cool. The other thing I want to ask you about is not only are you doing admissions work every day, but you're also doing some research in it. And you look, I when I was looking at your biography, you did the recent did some recent work in analyzing the the middle third of MCAT scores. And what what did you find from that? Just like in a kind of a snapshot. Yeah. So basically what we found is that the we looked at and this is I should say this is I'm part of the MCAT validity committee. This is a committee that is convened by the double MC that is the people that own and produce the MCAT. So just I just want to make that potential conflict of interest clear. But they don't pay me. But you know, so anyway, we looked at the MCAT score and we essentially broke the MCAT score range into thirds. And then we looked at okay, how many people first of all are accepted to medical school from the with that have scores in the bottom third compared to the middle third compared to the top third. And then we looked at and how do those people perform? And what we found is that the people who are accepted to medical school with scores in the middle third of the MCAT scale. So this is something between like I would say like a change is a little bit year to year, but like a 497 to a 504 or something like that. I don't remember the top number. I know. Well, anyways, sorry MCAT, but it's the crazy is grading scale. It is. It's a totally hard to remember. And I don't remember like what the 70th percent of changes are here. But like the top scores 528 and the lowest degree yet is 474 to being anyway. So we looked at the students at the school of that scores in the middle of the vast majority of them progress through the curriculum, you know, graduate in four or five years. The vast majority of them progress through the curriculum on time. They start third year on time. The vast majority of them passed at one on the first try. So those are and then we also we so that's the important thing to know about the middle school and the other thing when we also looked at the middle third of the scale. What we found is that those students are dramatically more diverse than the students with scores in the top. And we looked at a number of different diversity factors. We looked at socioeconomic status. We looked at race and ethnicity. We looked at being a first generation college student living in a rural area. There were six factors that we looked at. And students in that middle group were much more likely to have one of those factors that they were much, much more likely to have two of those factors compared to the students in the top with scores in the top third. So our message to, you know, people out there in the world is, hey, remember how we've all been to survey medical school of needs and 99% of the executive deans of medical schools said, yes, we want to make our classes more diverse. So our answer to that is like, okay, so you can calm down about the MCAT scores a little bit and accept more people with scores in the middle third. You don't need to worry like, oh gosh, are they going to do okay? The answer is like, yeah, most the vast majority of them. And when I say vast, I mean, like, it depends on the specific number, but I want to say that it's something like 88% of that goal. >> So pretty high, very high. Yeah, oh, very interesting. >> So people out there wondering, although almost everybody they go to medical school, graduates from medical school, this idea, like there are hiccups along the way. And I think people, you know, so it's not- >> That's a question of getting a lot of is like, how many people drop out? Like, gosh, you know, we kind of joke internally here. It's like, it's really hard to get in, but it's also really hard to get out. There's multiple safety nets that come under students. So if things hiccups come along the way, it's not just like, "Whoa, okay, you're gone." You're- there's- we want to- to keep you in. We want to keep you in. Okay, let's just to kind of wind things down. I want to talk about your interview day briefly and then and then we have applications staring at us. What what's your plan this year for for your interview day process online hybrid in person? That can look like. So we are keeping our interviews online this year. We, um, we freed ourselves from the structure of an interview day. And that was because I don't like being on zoom for many hours and. It doesn't have to be like I don't have to be on zoom for many hours in a row, but I was thinking about myself as an applicant and I just didn't want to. So yeah, so we have three things that applicants have to do. They have to do an overview session with me where I talk about the school. They have to do a session with students that student run where again, they're talking about the school, but it's the chance to sort of meet our people and find out like, okay, who are these people? Do I like them? You know, and then they do their interview. So there are three components. And those can be scheduled all on the same day or in the same half day. But also they could be done. They don't need to be done on the same day. And so we really just tried to make that as flexible as possible. We can ask that people do the overview with me before their interview. This is it's actually really to their benefit. If they don't, then they go to their interview and the interviewer, we had a couple times this year where interviewers wrote in their reports. I don't think this person's that interested in the school. They didn't seem to know that much about us. And I was like, let's because they didn't go to my thing. Yeah, yeah. So tip like where I tell you, there's your tip. So yeah, so there's your tip. And we tell people to do it before, but not everybody listens, but you know, as a medical student, like you should follow directions. It's important. Details count. Details count. Yeah. So those are the three components, you can do them all the same day or not. And then what we are going to do is starting in the winter time, we're planning a boring unforeseen circumstances, ever, but currently the plan is starting in January, we will have a series of optional in-person visit days for accepted students. That's because we really do want to give people the chance to come and kind of see what we're all about. And I, and you know, I think this is a big decision. And, you know, but on the other hand, it was pretty clear to us after last year that we could do a perfectly reasonable job of the evaluative part of the interview, like it was fine. Even though I would rather talk to people in the same way. I know. I'm with you. It was fine. So yeah, so it was just like just doesn't seem quite right to ask people to shell out all that money and travel. And like you, we've got an our applicant pool is national. So people have to get on a plane and you know, take it out for work or school. So yeah, so we are, we are the in person days will be only for except the students first of all. And they'll also be optional. But we'll have that option for people that are. Yeah, want to come and see. Have you gone down the road yet of looking into the future that this might be the way you keep doing it or just kind of year to year. Like we'll see how this year goes and then re-evaluate or because I know some schools are like, you know what, this is it. This is what we're going to do. We're going to keep doing it online because of the equity issues that were exposed last year. And like you mentioned, the financial issues that that strains it puts on applicants. Exactly. Exactly. So I think that we are more likely than not to keep doing it this way with online interviews, but an option for people that want it. I, and it really is because of equity and fairness, it just doesn't seem fair to put more of a burden on people, especially like if you haven't even gotten in yet. And it, you know, the idea of having an optional what that's I really worry that that's kind of like that's going to be really unfair because then people are going to held to come and. Yep. I don't know. The other thing is, you know, reading ourselves up from the structure of an interview day also made it easier, much easier for our interviewers. So we had had quite a fixed schedule like you have to do interviews Monday, Wednesday, Friday, 8am or 9am, which was like easy for my office. But on the other hand, it was terrible for interviewers. And so, well, like it's easier to get interviewers because they can do it, they, you know, whatever, whatever time they have free during. I agree. We saw the same thing a lot of our, we were able to retain more of our clinical interviewers. Yes, longer period of time over the course of the interview season, because you'd see them pop into their office, whether, you know, they're seeing patients that day, but they could pop in for 45 minutes, interview a candidate and then walk right out and get back to, you know, patient care. Right. Yeah, it also made it possible for us that so like we can have Kaiser people. Right. They're just on the admissions committee now because like, it doesn't matter if they're on California or Boston. So they got. Which is great. Really quickly about your interview day, they get one interview or two. They want to interview one fact. And it does affect the interview, have access to everything in the application, or are they, are they planning to do anything? The faculty is, the faculty interviewers are our most important evaluators of the application. So we have whoever does the initial review, there's a group of like 15 of us that do those. They kind of decide who gets an interview. And there's a standardized process for that. And then the interviewers really read like just every word of that whole application and they evaluate the application. We use this online evaluation system and the interview is part of their evaluation of the application. And so then they fill out this online, it's like they read a report basically. And then that just added right to the application file. And so then at the very end, there's not the very end, but there are selection meetings. We have one selection meeting in November and one in February. And the select the whole admissions committee against same people so it's all the interviewers are on the committee. They come together, they break up into groups are four or five, each group of four or five gets a virtual stack of applications. And they go through, they discuss each one and make a recommendation about what to do. And so they are discussing the interviewers report, but they also have all the stuff. And sometimes they agree with what the interview says and sometimes well, so you're then your admissions process or the like notifications are not rolling. You do them at two touch points or all at the end. Yeah, we do them at two touch points. And really, it's interesting. There is no difference between that first group and the second group. It's not a prioritization or anything. We just can't we interview a thousand people. It's a lot. Yeah, so we just can't do it all on one day. And so it's half of that. Okay, so for people to hear that, if you're in group two, it's not, you're not, it doesn't matter. It doesn't matter. You're hearing it here from the Dean thing that so okay. Yeah, it's like it might have to do with when you submitted your application. So if you don't submit your application until September, then yeah, you're probably going to be in second group. But whatever, there are a bunch of people that end up there that submitted in July. And it's not anything bad. It means like, Oh, because like this person said they were going to do the review. And then they went out on maternity leave. And so then we had to disperse and we gave it to somebody else or, oh, this person wanted me to look at it. Yeah. So don't overanalyze it. Don't overanalyze it. Hey, after them. So if I'm an applicant and I find out the news that I didn't get in, I wasn't accepted in there that from the selection committee, but I've been placed on your your wait list or alternate list. Do you want to hear from me? Or do you have enough information and just don't call us, we'll call you. That's a great question. It's perfectly fine for me to hear from people. Anything that you send us, we just upload and attach your application. And then really when we look at it is the next time we look at your application. I think the later in the process, we are the more important it is. So you know, if you have an interview and then you send me a note saying, Oh my gosh, Dr. Gidell, this was my favorite thing I've done so far. And I love your school. And it's October. I'm going to be like, you don't even hold a case question yet. Yeah. So yeah. So I then I mean, I treat that like a like a thank you notes like light, but doesn't really mean that. But on the other hand, if we are in April or may we are at this time and you're on our wait list and you're like, OK, I have a plan A for medical school, but you guys are my people. Yep. Coming. Then like that's actually quite meaningful because we want people who want to be here. So I think later on it makes more. Yeah, strategic about a piece of strategic. Yeah. Yeah. And you know, you don't have to do thing. I know I know it seems like we put these hoops out there for people to jump through just to make life difficult. But like this is not one of them. We have others. Yeah. Oh, that's great. Is there anything that we didn't what we covered a lot of different topics? And this has been a thrill for me. You're a great person to I can tell you love this. And you love what you do both as a physician and as a dean of admissions and as a mom and as you know, as a preceptor, a mentor. Do we leave anything out? Did I not ask you a question you wanted to talk about or you were expecting? I don't think so. I don't think so. I um. Yeah, I can't think of anything in the highlights that you looked at. I always ask people when we used to have people come in groups and I'll do this now and people come back again for visits or I do this when I talk to people online too. I always ask people if they have any questions that the sea underbelly of admissions. I give us the low down. Like when you and every now and then an applicant will be like, do you guys really read the letters? Yeah, yeah. Yeah. So I love questions like that to me, that's the only thing that's missing, but you know, your audience doesn't get that's questions. Well, I mean, we do. Now, do you guys wear black robes for your selection meetings and have candles and stuff in the room like we do? There's a chance. Yes. Actually, have you seen Animal House? No, I'm just kidding. Oh my gosh. Oh, that's. Yeah, we get a little irreverent. But it's all. we do take it very seriously, but. I was very curious. I tried to like, I tried to like, fly the selection of the admissions committee members. We like give them food, we give them coffee and try and keep them in good mood while they're doing work. Yeah, but the snacks are important. Food is important. Well, Dr. Goodell, this has been fun. This has been such a treat and I'm so grateful for spending as much time as you have for me today. I'm sure people are listening. We're going to get a real kick out of this too. So thanks for doing this. Oh, well, it was my pleasure. Yeah. Well, I can't wait to meet in person too, or next WAMC meeting or something. I have a lot of people I have to meet in person. So I'm going to take my list of people. I got to track down and you'll be on that list. So thanks a lot. Yeah, you should have a reception. That's a good idea. Like an alumni. You can have like floor sessions, Emily, I'm seeing that. You should invite me. I'm really fun person. Well, you sound like a really fun person. And the reason why I started, one of the reasons why I started this was we were sitting in a lobby. Whereas at the PDC in Orlando a few years ago, there's all these admissions people in this huge hotel lobby. And all we're doing is talking about admission stuff. And I thought if you were a pre-med kid walking through this lobby, it would be like you wouldn't you just try to sit down and listen to everything people are talking about. Because it was all talking about shop. And I thought, how can we bring them into those conversations? And that was one of the places that brought me to doing this. So I also took a bring a voice and some personality to schools. So you have definitely checked off those boxes in a very meaningful way. So thanks so much. Well, thank you for having me. It's been, it's been really fun to talk to you. I hope this is helpful for the people who take us. You better this. All right, I'll see you around. Thanks. All right, take care. [BLANK_AUDIO]