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Students cite insufficiencies with U. Health Careers Advising

Though health careers see soaring applicant numbers, students face institutional problems in advising around country

The matriculation rate for Brown students attending medical and other health professional schools has been consistently at or near double that of the national average since 2012, according to the Health Careers Advising website. Yet despite feeling generally supported by HCA, current students and alumni cited low appointment availability, depersonalized advising and gaps in information throughout the application process.

“The people in (HCA) have been supportive to me in my process overall,” said Olivia ’22, who asked to remain anonymous as she recently applied to medical schools during the most recent admissions cycle. “But when it comes to the actual application process, there's a lot that you have to figure out on your own.” 

In the last two years, the number of medical school applicants has risen nationally by nearly 18%. For the past two application cycles, Brown has seen a similarly “significant increase” from around 130-150 yearly applicants to 170-180 applicants, according to George Vassilev, associate dean of the college for Health Career Advising. 

Despite this increase in applicants, HCA continues to only employ two advisors: Vassilev, who works with upperclassmen and alumni, and Kathy Toro-Ibanez, who advises underclassmen.

Required application documents: The committee letter 

One of the pieces of the application process for students applying to schools for health professions is the committee letter — a document submitted along with the school application written by members of Brown’s HCA Committee.

The committee letter is a “highly personalized way” to support applicants in institutions with large numbers of students interested in health professions and is constructed from a student’s interview with a member from the HCA committee as well as the HCA Dossier completed in February, Vassilev said.

“The committee letter … highlights achievements, contextualizes challenges and focuses on the essential aspects of each individual applicant's journey,” Vassilev said. Medical schools, especially those on the East Coast, “expect or appreciate” committee letters from institutions that provide them, he added. 

The HCA Dossier is a “consolidated form” modeled after the primary medical school application, according to Vassilev. It enables students and alumni to “reflect on (their) journey up to that point,” about a half year before applications are submitted. 

To schedule this required interview, an email is sent out by the HCA committee with a Google Calendar for students to reserve a time slot. 

But there are not enough initial spots for all prospective applicants, and many get placed on a waiting list, said Quinn ’21, who chose to remain anonymous because she has recently applied to medical schools. 

“It literally felt like you’re buying tickets for a concert,” Quinn said. “They dropped the email and (then) they’re booked up for like, two months … It just feels really frustrating because you know how many students have submitted their HCA Dossier.” 

“Brown is notorious for sending (committee letters) out extremely late,” Quinn added. Quinn’s committee letter was sent to medical schools last year in mid-August. 

The HCA committee meets regularly throughout the application cycle and offers interviews to students with completed applications, according to the HCA website. “Leading into the summer… we work on these additional letters,” Vassilev said. 

“Completing applications early … increases (students’) chances of being interviewed early in the cycle if (the) application is well-liked,” according to the website.

Olivia’s application was verified by the American Medical College Application Service in mid- to late-June, days before medical schools began to send out secondary school-specific applications. But her committee letter was submitted at the end of August.

“I think to some extent, (people) have to kind of come to terms with understanding that their committee letter might not come at the earliest date possible, and it's kind of out of their control,” said Lang Liang ’22, who applied to dental school this past cycle. 

Liang added that while he thought his overall experience was “pretty well-organized,” HCA “could expand their team a little bit so that they have more slots available for HCAD interviews.” This would allow for letters to be written quicker, he said. 

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A medical school cannot consider an applicant for an interview until they receive their complete application, which includes the applicant’s committee letter, according to Shekinah Elmore ’04, assistant professor in the department of radiation oncology at the University of North Carolina Chapel Hill. 

As a fourth-year medical student at Harvard, Elmore served on the main admissions committee for their medical school. The timing of the committee letter “certainly matters because there are only so many interviews that can be done in a season,” Elmore said. 

Individual advising

Elmore, who advises “premedical and medical students across the country,” said she often sees a “gatekeeping mechanism” among advisors. 

“I’ve seen it happen to applicants where an advisor is really playing kind of a preemptively evaluative role, like they’re trying to act a little bit like the committee,” Elmore said. “I think it’s good to give students a heads up as to what the challenges to their application might be, but I think often times … especially when things are busy, advisors really may take liberties with who they select to provide more advising to or more support for their success.”

Both Olivia and Benjamin, a junior who also chose to remain anonymous because he is currently applying to medical schools, said it was hard to make an appointment with Vassilev, as individual appointments filled up quickly once made available to students. 

“I think a lot of universities feel sort of under-resourced when it comes to things like Health Careers Advising,” said Sarah Taylor, instructor and senior academic advisor in the biology department. Brown’s HCA is no exception — “that’s been a persistent issue for years… their office is just absolutely swamped,” she added.

HCA advises about 600-800 students and alumni in any given year, according to Vassilev. “Sometimes it takes a couple of weeks for us to meet individually,” he said. “It's also our duty to provide really informative guidance to students.” 

But Benjamin felt his individual advising meetings were “very impersonal.” 

“I felt no personal connection at all,” Benjamin said. “It's more of a, ‘you have to come to us and prove to us that you're ready.’”

Olivia, Quinn and Liang all said they felt supported in their individual advising meetings.

Vassilev has “been supportive, and I think that speaks volumes,” Quinn said. “But I really think that the office is short-staffed with how many pre-meds are applying. … I just think there's not enough resources for this personalized approach.”

“We always approach students with empathy and care, with honesty and with their interests at heart,” Vassilev said. “In each of our individual advising conversations, I make it a point to talk to students holistically about their own interests (and) about where they are in their own process.” 

Lack of communication, gaps in information

HCA hosts five application seminars throughout the year, which cover approaching the application process, writing a personal statement, selecting schools and preparing for interviews. While the first and fifth sessions are mandatory for all prospective applicants, the other seminars are “highly recommended,” according to the HCA website. This is one of the ways HCA supports students, along with their “really detailed website,” Vassilev said.

“The overall advising program is really based on the premise that we need to be able to proactively reach out to students and be available as much as possible, in as many modalities as possible,” he added.

Yet students still reported feeling a lack of guidance in navigating particular areas of the application process, such as knowing which deadlines to stay on top of and how to construct a balanced list of medical schools to apply to.

“There were a lot of questions that I had throughout the process,” Olivia said. “I found that most of the help I was getting was from my friends, who were also applying during the cycle. Some of it (was) from mentors, some from networking.” 

Olivia also said she did not “really get a good idea of how to figure out the balance” between which schools to apply to from the HCA seminars. She mentioned using Reddit and other websites where fellow students share insights on the application process to get more information. 

Benjamin had questions about what specific medical schools to apply to, and said it was “unclear” how helpful the applicant seminars would be in constructing an application strategy.

As part of Brown’s HCA team, there are six Health Careers Peer Advisors, who are undergraduate students and “could be especially helpful in providing a peer perspective to (first-year) and sophomore students,” Vassilev said.

Quinn said she thinks the peer mentorship program is an “underutilized tool,” but it would be more helpful to expand the program and include alumni and people already accepted to medical school. 

Looking for improvements

In 2016, The Herald published an article describing structural flaws in HCA following interviews with dozens of students and alumni. Olivia said she felt her experiences were similar to those in the article, adding that “nothing has changed.”

“Brown is obviously known to be a school where supposedly if students protest about something, that change is enacted,” Olivia said. “But I feel like that's not the case with health advising.” 

Quinn said that while she thinks HCA does listen to feedback, they’re just “slow to the feedback.”

“Any concern, questions or suggestions are really welcome,” Vassilev said. “We approach everyone with open hearts and open minds. Both my colleagues and I speak with students and alumni all the time and write emails all the time, and our focus is always on providing the best possible guidance and conveying care.” 

Taylor emphasized how the remote format due to the pandemic may have diminished advising’s “visibility” among students. 

“I’m sort of interested (in) how much of the shift back (to in-person meetings) might help mitigate some of the continued frustrations that students have about” resource accessibility, Taylor said.

Elmore stressed a “strengths-based approach” to advising instead of advising from an “evaluative standpoint.” 

“Oftentimes people just don’t have the imagination to see the excellence in people who don’t fit what has been a historical frame for excellence,” Elmore said. 

When Elmore received a C on an exam in her first semester at Brown, she was told by the health careers advisor at the time that she “probably wouldn’t go to medical school.” 

“I know that all the steps are different now than when I was there, but I think the circumstances sound really similar,” Elmore said. “It really felt like it wasn't meant to be a process that looked at you holistically, … but more of ‘we see these mistakes on your transcript.’”

While previously working as an advisor for undergraduates applying to medical school at Harvard and as a current mentor for premed and medical students across the country, Elmore said she has enjoyed helping students tell stories of their improvements and circumstances.  

“I really love when I can be an advisor to someone and say, ‘okay, you have a C on your transcript, we'll deal with that, we can talk about that in your statement,’ because it's a story about how you improved or what the context of that was.”

Brown is “such a unique and enriching environment that really cares about individual intellectual trajectories,” she added. “I am tremendously hopeful that if anyone can get pre-health advising right, it's Brown.”



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