CHOOSING A MEDICAL

SCHOOL AND
MD-PhD Program
A Black Student’s Guide
Volume 1
Hi Accepted Black Student,

Congratulations on getting accepted! Now you may be wondering: How

can I make the best decision for me regarding where I attend medical
school or pursue an MD-PhD. The purpose of this guide is to do just that:
to give tips on what questions to ask, red flag signs and what to do before
you make a decision. However, before starting we wanted to put a
disclaimer:

All of these institutions historically and presently continue to do harm to

Black medical students, therefore this guide is meant to serve as a
guiding tool to best select an institution most aligned with your goals.
We encourage you to choose a place where you have more protective
factors (a support system, a location you enjoy, an opportunity to engage
in your hobbies, etc). This document is broken into three sections:1)
Ideas to Think About, 2) Additional Questions to Ask Current Students or
Alumni and 3) What to do once you’ve made a decision.

We are not necessarily promoting pursuing medicine since it’s so

ingrained with racism, sexism and all the isms you can think of,
however, we are here to support and help guide Black medical and
MD-PhD students through this journey. We hope to provide insight on
the realistic challenges of being in medical school and MD-PhD
programs, so you are provided with hidden insight on what to look out
for before you say Yes to an institution.

Overall, this short document is out of place of love (and our own pain), so
that you feel less frazzled as you try to make the choice best for you. Even
when these institutions may not support us, we got us y’all.

Made In Love by,

Black Doc & Double Doc Resources Initiative
 Ideas to Think About

1) Speak to Mainly Black Students BUT understand their

Background
Honestly take non-Black students’ perspectives like a grain of salt BUT
at the same time understand where Black students are coming from
when speaking with them. For example, if you are an out of state Black
student, speak to other out of state Black students. If you are a
first-generation Black student, speak with other first-generation Black
students. All Skinfolk ain’t kinfolk is especially true in predominantly
White institutions, so also beware of that when making a decision.
Oftentimes the medical student panelists you see during interview days
have had more pleasant experiences. Therefore, it is important to
solicit a wide range of opinions to ensure you are receiving the most
up-to-date and accurate depiction of institutional culture.

2) Examine the financial package

Think about how this financial package will affect your life years from
now. Will you be in loads of debt after graduating and have to worry
about paying the cost off later on? Is there a way to negotiate this
financial package with other schools? Are there scholarships offered
that you would qualify for? Consider the length of training for different
residency specialties considering the low-wages residents are paid. Be
sure to reflect on what items are covered in your financial aid package.
Costs to consider that may or may not be factored into your package
such as: USLME step exams and practice materials, transportation for
rotations, financial aid coverage during vacation (specifically summer
after MS1 and moving costs after MS4).

3) Location is mad underrated.

● Think about how far you may be from friends and family.
Having your support system nearby can make such a huge
difference on your experience. Research shows how protective
factors like social support can make such a big impact on one’s
mental health and wellbeing. Will you have to rebuild your
 support system? How long is the plane ticket home and on
average how much does it cost for a round trip?
● Consider life events, such as having children, medical
emergencies, and other events that require strong social support.
● Also think about: how does the weather affect my mood?
● What is the broader community like? Like what is the
availability of hair braiding places, cultural foods, etc?
● If you are going somewhere new, begin looking and asking
students who would be a good mentor and ally for you during
your training.
● MD-PhD students should take into account cost of living in a city
along with stipend cost.
● Understand the impact of being out of state vs an in-state public
academic institution vs. private institution. If you are also an out
of state student and the school consists of people mainly from
the state, then it can make your experience even more difficult
and isolating.

4) Diversity is NOT everything. Support, justice and equity is more

important.
Many institutions have yet to understand this core concept, so justice
and equity is not prioritized. Many schools use language of
appeasement within their programs instead of actively learning how to
make the institution better as they accept more Black students.
Therefore, it’s important to understand that just because there is a
certain number of Black people, don't completely discount a program
because of its diversity metrics. Having 5 or less Black students in a
class isn’t ideal but you’d be surprised by the fact that there might be
better support there than institutions with higher diversity metrics. The
best way to gauge this is to speak mainly with Black students while
understanding how their current or past experiences/context relates to
your own experiences/context, as stated in point one. Also ask them if
their Black community is collaborative and well connected with each
other.

Check the background record of your Dean of Students. This person is

often the point of contact for issues concerning learning environments,
 academic difficulty, professionalism, etc. It is important that your Dean
of Students is visible and has a developed record that they support
students and their voice holds weight when discussing student issues.
It may also be worth inquiring about the roles the DEI office holds
within the campus climate and observe how they interact with students
in person. If the schools run community programs, inquire about the
funding sources, the level of support students are provided, and the
relationship campus resources are utilized in the community.

5) Look into agenda minutes on Student Government Websites

This is a little secret that it doesn’t seem like a lot of people know about
but some schools have student government websites that show
meeting minutes. Looking through these minutes and notes can really
give you an inside look of what’s really going on within institutions
that you may not see in public.

6) Don’t underestimate the impact of attending a HBCU

HBCUs do have their own issues BUT do not underestimate the
fact that seeing Black physicians within your school and being among
mainly Black students can make a huge impact on your experience.
The mental toll of being in a predominately White institutions can be a
lot, so being at a HBCU where you have more space to be just a student
may also help your mental well-being.

7) It’s a red flag sign if students don’t have anything bad to say
When you ask students, what they like or don’t like about a school, and
they cannot provide you with constructive examples on how to improve
medical education, it is best to find another source to help inform your
decision. This is important to note because every school has it’s issues
and no school is perfect, so if someone has nothing bad to say, that’s
probably more concerning than hopeful. Each medical school has
areas of improvement that are constantly being addressed, especially
in terms of increasing the matriculation, retention, and graduation
rates of Black medical students. It is important to ask students that are
informed on campus environments. A place to start soliciting opinions
are students that hold leadership positions for student government.
However, these students may also be required to participate in revisit
 days and recruitment, so make sure you ask a broad group of people.

10) Reach out to current students or alumni via social media.

Look into contacting current and graduating students through social
media sites like Linkedln, Twitter, or even Instagram. For example,
privately message medical school students who are documenting their
journey at a particular institution via Instagram, Youtube or other
social media site because you may be able to set up a one on one call
with them. For MD-PhD applicants, look at their current students list
on their website, google search “[Insert School Name]
Directory” and then you are able to search for the student’s name and
find their email so that you can contact them.

11) Look into grading policies for pre-clinical vs. clinical year and
failing/re-taking exams.
You’d preferably want to go to a school where at least pre-clinical year
is P/F and where there is no internal ranking. Questions to think about
regarding grading:
● You also want to know what their policies are regarding if
students fail and re-take coursework like do they need to be
remediated, how are remediations provided (e.g. essay vs. repeat
final exam)?
● Do they need to just re-take and nothing shows on their
transcript about re-taking?
● How many times are you offered a re-take for a given course?
● In the event a student fails a re-take, what are the policies
dictating an individual’s promotion to the next block?
● How long do students receive to prepare for the re-take and
when are re-takes offered? Knowing about this takes asking
administrators about this and even students about their
experiences.
Additionally, look into if your school has longitudinal integrated clerkships, i
students apply for this and if it’s competitive because this can also
improve one’s clinical experience.

12) Speak to Older Students

Speak to older students within the medical school and MD-PhD
 Program. The older students have a much more longitudinal viewpoint
and can give a much more general overview of their 4 or 8 years. They
can also give you advice of people who can mentor you within the PhD.

13) Dedicated Policies

Do you struggle with standardized exams? It is important to know
when you will be required to take USMLE STEP 1. Even though the
exam has transitioned to a pass/fail grading scale, the exam requires
understanding and recalling information covering your first 1-2 years
in medical school. The average time for dedicated is 4-8 weeks. It is
important to know if your school allows extensions to your dedicated
period and if you are able to delay your exams due to
medical/academic reasons.

14) Academic Progress

On revisit day, it is important to inquire and ask your school to provide
examples about how they support students with academic difficulties.
There is a common practice for students that struggle to encourage a
leave of absence or other forms of delayed promotion, however the
Infrastructure at each school is different. Medical school is a place
where students are diagnosed with health issues and disabilities,
therefore understanding how your school addresses these unexpected
developments to your trajectory is important. In summary, understand
the governing body that decides if students can change their curricular
pace (e.g. Dean of Students or Committee), if there is additional help
with the recurring paperwork (e.g. Learning specialist or Student
Academic support), and how leniency and flexibility is granted. Overall,
for this, it's best to ask for concrete examples and try to locate students
who have failed courses, shelf exams, STEP exams, etc. and find out
how the school directly responded to these events and if necessary
support was given or not.

15) Bylaws
It is important to review your school’s bylaws regardless of where you
choose to attend medical school. When it comes to advocating for
yourself and seeking adjustments to your curricular pace, these policies
will define the routes of action you are able to pursue. There is variable
 interpretation of the school’s bylaws, depending on who is able to
enforce said policy, but it is critical that you are well-informed
on the expectations your school sets for you. Oftentimes, you will not
hear about students who had to decelerate, therefore it is up to each
individual student to understand when they are able to slow down and
regroup if that is what is needed and best for you as a medical student.

16) Check Out The Free Guide to Medical School Admissions

This gives a really good breakdown into the timelines and some more
tips of what to consider when choosing a program

Additional Ideas for MD-PhD Applicants

17) People say not to consider the medical school program much, but
you really should understand the support and curriculum structure of
the medical school.
The PhD portion is important but you are also in the medical
school for four out of the eight years of the program, so don’t
neglect the other 16 points made in this document section.

18) Speak to your PhD Director and other Black PhD faculty members
who could maybe be possible mentors
Speak with possible Black research mentors and gauge if you get
along when speaking with them but also beware that just because
someone is Black, doesn’t mean that they may be a good mentor to you
at an academic institution. However, speaking with them can give you
a better idea if they would be supportive as a Black faculty member.

19) It may be a red flag sign if MD-PhD students avoid speaking about
or advertising the medical school program
For MD-PhD Programs, there tends to be a really big emphasis on the
PhD portion, but definitely look into whether or not students talk much
at all about the medical school. If not, this may be a red flag sign that
students may not want to tell the truth or say something about the
medical school (this may or may not always be the case, but it’s
possible). However, if this does happen, definitely ask specific questions
about the Medical school program.
20) Look into whether there are multiple possible PhD mentors with
your research interest and that your PhD department has many options
in case you change your research interests.
Make sure there are multiple PhD researchers that you are interested in
in your department. Understand the reality that PhD mentors can leave
in a couple of years, so ask them if they are on sabbatical soon. In
addition, know that just because you like someone’s research,
doesn’t mean that they will be a good mentor, so if you’re able to ask
current students within the lab about their experience.

When speaking to possible PhD advisors, ask them if they have ever
mentored a PhD student or MD-PhD Student in the past because you
may or may want to work with a PI who has prior mentoring
experiences.

21) Check to see if there are multiple students in the MD-PhD Program
pursuing your PhD degree.
For example, if you are pursuing an MD-PhD in a non-traditional PhD
Degree, it is important to have more than one person within the
MD-PhD program who is pursuing PhD with non-traditional degrees
because they can also provide support and advice to you during your
Journey. This advice can definitely apply to other PhD departments.

22) Examine what people say about the MD-PhD Director and also Meet
with privately with both the MD-PhD and PhD Director
Ask multiple students about both the MD-PhD Director and PhD
Director. Do they say good things about the director? Also when you
speak with the MD-PhD Directors, do you feel comfortable around
them? Do you laugh and/or feel relaxed?

23) Speak to Black students within the PhD Department who are part of
the MD-PhD program and those not in the PhD Department
Ask them the hard questions about whether they feel supported in their
department by asking them to provide specific examples. Inquire about
how their department handles sexual assault/harassment,
microaggressions and mistretament.
 Encouraging Note

At the end of the day, be completely HONEST with yourself about your
priorities and what is important to you. That may look different for everyone.
Others might be okay not having friends around and may want to move away
and explore something new. Some may really need to be in a city where they
have their people close by.

Overall, being supported and examining which factors can make a negative or
positive impact on your wellness is more important than prestige.

As Nali Julia Gillepsie (@NaliJulia) said on Twitter:

“ Prestige will not hug you back”
Additional Questions to Ask Current Students or Alumni

1) Who is the Dean of Students/Student Affairs/Diversity?What is

this person’s track record for supporting students?
○ What is the overall student involvement from other deans and
prominent faculty?
○ Are these individuals student-facing and involved in student
affairs?
○ Do they understand their own campus climate?

2) What are specific examples of ways that you have not been
supported as a Black student? But also ask: What are specific
examples of ways that you have been supported as a Black
student?
Remember, to understand if someone is a good resource, they would
give you at minimum a balanced review of their school. There is no
perfect medical school so someone who is withholding critique is
probably not the best resource to use when determining how to rank
your acceptances and ultimately choosing your final school.

3) How is the school actively being anti-racist?

Like have they made any changes in the last couple of years regarding
curriculum change regarding racism in medicine? Once again, most
schools are doing a poor job of this, but it can give you an idea of
whether or not the school is listening to people’s feedback. Many
schools will tout their curriculum, which is often done “after-the-fact”
and is hosted by actual experts in the field, therefore do not let this be a
selling point for the school. It’s important to focus on POLICIES because
that demonstrates the history of progression of a medical school more
than anything else.

4) How was the medical school and graduate program responded to

the murder of George Floyd and other police killings within their
own city? Do they show support to students after these events?
For example, there is a policy at an institution that allows students to
 have a designated flexible testing period during events that involve
racial violence. Policies matter because it reduces the burden of
advocating that the student is required to do.

5) What are specific ways that the school has listened to student’s
feedback?

6) What are specific ways that the school hasn’t listened to student’s
feedback?

7) Are students compensated for their DEI Work?

The answer to this question is probably no for most schools, but it's
worth shooting your shot and asking to gauge if they value DEI and
students’ time. Also what K-college programs exist to mitigate the
decades of exclusion to academic medicine? Who funds these programs
and how effective are they?

8) Does the school offer mentorship programs or engages in ways to

give back?

9) How are the student run clinics run? Is it mainly students

operating or is there better attending supervision?
Be wary of student fun free clinics. Oftentimes, they are used as CV
fluffing elements, but ignore the possible harm of allowing medical
students without much medical knowledge to work with patients that
are already marginalized in society.

10) Ask alumni and students: Would you choose the school or
program again?
You’d be surprised at how many people will be honest. Some won’t be
honest, but others will be honest and the answer to this question can be
extremely eye opening.

11) Does the institution allow there to be a space just for Black
students or do they think it’s segregation to promote these
spaces?
12) What does student activism look like? Are only Black students
involved in the work?

13) Do you have an active White Coats for Black Lives and/or SNMA
Chapter? How much freedom do these student organizations have
to engage with communities?
Sometimes Diversity offices will in a way ‘take control of SNMA’ and
sort of use those in SNMA Eboard positions to do a lot of their
departments’ tasks. It’s better to go to a place where SNMA and White
Coats for Black Lives have their own freedom to do more independent
initiatives and community oriented work.

14) Yes, pass/fail, whether for pre-clerkships or clerkships will

have its overwhelming benefits, but how does each block
pre-clinically and rotation during your clinical year breaks down
your grade?
Although people will say medical school is just “pass/fail,” it can
actually be a harmful narrative to invalidate those struggling
academically. Sometimes passing is HARD. It is important
to see if it's common practice to have grading schemes that are
composed of various factors. For example, pre-clinically, is your grade
dependent on just exams or are things like clinical skills and other
longitudinal courses also incorporated into that grade? Do they award
things like attendance or quizzes at home?

15) What do the vacation times throughout the four year

curriculum look between your school offers?

16) During the clinical year, what is the absence policy?

○ What is the grading scheme that is implemented?
○ How many days are given after the rotation is complete to study
for shelf exams?
○ Do their shelf exams have passing cut offs?
○ What is required to pass a rotation and what goes into the
grading scheme?
○ How much of the clinical grade for each rotation is dependent on
shelf exam score?
 The less your grade is weighted on exams, often times the more
freedom you have within your personal life since you have the freedom
to not always feel the need to study, but also as a learner since you can
focus on patient experience over testable content that you are required
to know only for shelf exams and not actual meaningful clinical
practice at a medical student level.

17) Are there flexible exam periods?

t is really important to be at a school that will not force you to take an
exam before you are ready or before giving you additional time to
prepare. Life always happens. This is really important!

Additional Questions for MD-PhD Students:

18) How has the MD-PhD Director directly supported students

when they may have had to switch PhD advisors or if there are
relationship issues/drama with PhD advisors?

19) What does funding look like during the graduate phase? Is it
guaranteed funding?

20) How does the MD-PhD Program help with the transition from
preclinical to medical program and graduate phase to clinical
program?
It’s best to ask older students in the program or students during the
graduate phase about these transitions. Like, are there programs in
place to make these transitions easier within the PhD Portion?

21) Are clinical experiences integrated within the PhD years of

the program?
There are MD-PhD Programs that have clinical experiences integrated
within the PhD Portion so that you don’t neglect all clinical experiences
and have the opportunity to explore other clinical experiences. Look
into whether this option is available and if it’s required for all students
to participate in.
22) Is there flexibility to switch PhD Programs?
For example, you may want to switch from PhD in Immunology to PhD
in Cancer Biology, especially if there are problems within the PhD
Department or if your research interests change.

23) If you are interested in interdisciplinary work with your

research, ask:
○ Who are you allowed to have on your dissertation committee
team?
○ How many people have to be in your department?
○ How many are supposed to be out of your department?

24) How much coursework do you have to take for your PhD
Program?
If you do have a lot of coursework, would you be able to start your
dissertation work before you finish your coursework so that you are
able to finish on time?

25) Is it common for students to graduate on time or do many

students take an extra year or multiple to complete the
MD-PhD Program?

26) What initiatives are integrated within the MD-PhD program

to make it a supportive environment?
● Is there a JEDI/DEI Committee? If so, is it mainly student run or
are MD-PhD leadership members involved with the work also?
● Are students involved in admissions?

27) What does support look like for first year MD-PhD Students?
● Is there a peer mentorship program within the MD-PhD
program where first year students are paired with second year
students?

28) How has the MD-PhD Leadership responded to police killings

of Black individuals within their own city?
 What To Do Once You’ve Made A Decision

1) Do not neglect the power of having non-Black mentors. Not all skinfolk
are kinfolk especially when it comes to higher positions and peers within
these predominantly White institutions.

2) Contact people via social media (Ex: Twitter, Linkedln, Instagram, etc)
to ask current students, faculty members they can connect you with and
be a mentor with. It may be best to contact M4s or people near the end of
the MD-PhD program for advice on who is best to contact.

3) Start finding a Black therapist now BUT also explore other coping
mechanisms whether that is accupunture, meditation, exercise etc

4) Trust your suspicions and gut instinct about others. Don’t be too quick to
judge, but you’d be surprised at how accurate your instinct is about
people you first meet in predominantly White institutions.

5) For MD-PhD students, ask older students within your PhD program who
you should speak with based on your research interests and who you
should maybe avoid due to past mentorship problems.

6) If you want to get more involved with your local community, get
involved earlier rather than later by attending local events and meeting
with people. For MD-PhD students starting summer research rotations,
you also have the freedom to start doing this in the summer time before
school begins.

7) Determine what your values and boundaries are and understand that it is
okay if your values and boundaries change over time.

8) Actively decide now that you will remain true to yourself and still
prioritize keeping in contact with your non-medical school friends. It is
easy to get swamped into letting medicine and/or research become your
whole life but try to resist. It’s hard to do this but it’s important to
remain yourself.