A Guide to a Successful Gap Year

It wasn’t so very long ago that the typical medical student went straight from high school to a premedical program and then onto medical schools itself. This traditional pathway, however, is not so traditional anymore. The question of a gap year is one which comes up more and more frequently nowadays–and it is also one which can cause aspiring medical students a lot of anxiety as they make the decision about whether to take time off from academia when the undergraduate work is finished.

This article covers different aspects of the gap year, including the reasons why students take it, the fact that is it actually becoming more popular among pre-med students and different opportunities that students can take advantage of during this year off.

What is a Gap Year?

The term “gap year” usually refers to time taken off between the end of undergraduate work and the beginning of medical school. This does not usually refer to students who get accepted into medical school and then defer attending by a year. When students take a gap year, they generally decide not to apply to medical school the summer before their senior year and wait until the summer after instead. This leaves at least a year free to be able to pursue other interests. In the past, the gap year used to be stigmatized and students were strongly encouraged to go right to medical school after completing their undergraduate degree.

However, it should be noted that, if properly planned, this time off can be an attraction for medical schools and is seen as a way for students to increase academic background, prepare for the MCAT and gain the life and clinical experience and maturity that will help them get through the rigors of medical school.

Common Reasons for a Gap Year

There are a number of reasons why students decide to take a year–and sometimes more–off between the end of their undergraduate careers and the beginning of medical school. These can include:

● Taking a break from the rigors of academia to be better prepared for the long haul of medical school itself. Preparing emotionally for life as a medical student can reduce the chances of burnout.
● Engaging in hobbies or activities of interest or achieving desired goals before medical school begins, when there will be little time for extracurricular activities.
● Strengthening academic skills with post-bacc programs or other classes that can provide students with a stronger base of medical/scientific knowledge which they can build on as medical students. This is especially important if a student feels that their undergraduate grades are not strong enough to be competitive for school.
● Gaining more experience in the medical sector; popular choices for this include working in pharmaceuticals, clinical research or even doing volunteer work at a clinic or hospital. This can help to give students the opportunity to develop hands-on, real-life skills.
● Using the gap year to strengthen or get control of finances to help prepare for the monetary strains of medical school. Many students will use a gap year to work and be in better financial shape when they start life as pre-med students.
● Getting life skills. For those who are just leaving home, the gap year is also a time when it is possible to get used to living in an apartment, paying rent and other bills, balancing a budget, etc. Many students who do this during their gap year do not feel so overwhelmed when they begin to use these skills during medical school.

It should be pointed out that one of the most important reasons for taking a gap year is to think about whether or not a career in medicine is really what you want.

This is no light question. The amount of commitment required to complete medical education is incredibly high, and it is better to know ahead of time that it is really what you want. According to the AAMC, 6% of medical students do not wind up completing their medical education. Only rarely is this a matter of not being able to handle the stress or academic pressure of becoming a doctor: more often than not, it is a realization that medicine is not the right path for them to take.

A gap year can help avoid this problem by not only exposing potential pre-med students to the “real world” of clinical practice but also to give time for self-reflection before making the commitment to medical school.

A Growing Trend

The concept of a “gap year” is a growing trend among medical students. The Crimson, the newsletter for Harvard, notes that the majority of applicants to the Harvard Medical School are alumni rather than seniors coming out of an undergraduate program. This trend began in 1999 and in the decade since, it has become more marked. As of 2013, 204 of the 309 admitted students had taken at least a year off, while only 82 were entering directly from undergraduate programs.

The Crimson also notes that these students are coming in from a variety of backgrounds, having taken a year off for travel fellowships, a different graduate degree, research projects, community service or other paid employment. He notes that, “That data marks a shift in the perception of gap years before medical school as an opportunity to gain life experience before coming to the profession, to develop integral and scientific skills and to bolster an applicant’s chance of success.”

This trend has not just been observed at Harvard. The University of Pennsylvania School of Medicine now has a majority of applicants who are alumni students rather than graduating seniors. The Duke School of Medicine also has noted higher acceptance rates of alumni and the Duke University Office of Health Professions Advising note, “Students who engage in a year or more of experiential activity after graduation and before entering a health professions school are more mature, resilient, confident and accomplished–and competitive.”

Examples of Gap Year Opportunities

For those who are wanting to take a gap year to enhance their backgrounds and make themselves more competitive when it comes to admission to medical school, there are many institutions across the country which offer opportunities to gain significant clinical experience. These are examples of some of the gap year programs that medical students can sign up for.

Internships for Clinical Experience

No amount of reading or studying can give you the feel for what is will be like to actually interact and treat patients during the course of clinical practice. Internships like the ones below can give you the kind of authentic experience that will help you later as a medical student.

● American Cancer Society Internships. For students wanting to gain more experience with cancer treatment, diagnosis and research, the ACS offers 8-week internships throughout the year.
● American Public Health Association Internships. These internships last between 3 months and a year and help give students the opportunity to learn more about public health and about improving the health status of underserved populations.
● AYUDA Summer Internships. These internships are sponsored by American Youth Understanding Diabetics Abroad and take place in Latin America and give the opportunity to learn more about the toll that diabetes can take on Hispanic populations.
● Church Health Center Internships. This is the largest faith-based clinic of its kind and every year hires pre-med students to work with uninsured patients.
● Gap Medics. This offers students the chance to shadow physicians in the variety of specialities (like ob-gyn, operating room, internal medicine or urology). It takes place abroad and offers opportunities in Thailand, Tanzania, Croatia and the Dominican Republic among others.

Federal Fellowships for Health and Public Policy

For potential pre-med students who are interested in shifting their careers towards public health policy and to finding ways improve healthcare in America and to close disparities that still exist in the system.

● Energizing Leaders Program. This is a two-year paid program with the Department of Health and Human Services which is meant to help students develop leadership and management skills in the healthcare sector.
● Presidential Management Fellows Program. This is also through the federal government and was set up to bring young people from a variety of backgrounds to learn more about public policies and programs.
● United States Schweitzer Fellows Program. This program is intended for graduates in health-related fields to learn more about ways to improve healthcare and improve unmet healthcare needs.

Research Opportunities
For those who are attracted to the idea of medical research as a career or simply want more experience in this area prior to medical school, there are also great opportunities for research across the country.
● Summer Research at University of Michigan. This site offers a list of the research opportunities at the university.
● There are research programs also available from the National Institutes of Health, American Heart Association, Cincinnati Children’s Hospital, Fred Hutchens Cancer Research Center and Northwestern University.

Humanitarian Opportunities
Choosing humanitarian work, whether at home or overseas, not only gives you the chance to really help those who need it most, it can also give important clinical experience and help you decide if a career in medicine is right. It also has the added benefit of looking great on an application for medical school and helping you to stand out from the crowd of competitors.
● For students who want to take their gap year to give back to their communities, there are opportunities through the Peace Corps or Americorps. These offer special programs to work either within the United States or abroad and gain important clinical experience in underserved areas.

Tips for Planning a Great Gap Year
In short, there are a lot of good reasons to take a gap year–and many great opportunities to fill with with, from research to humanitarian work to clinical research. However, it is important to remember that in order to have a great gap year, you will have to put some thought into it and plan wisely.

The University of Medical and Health Sciences, St. Kitts., Director of Admissions Sean Powers advises that, “However you choose to spend the gap period between completion of your undergraduate degree and beginning the medical school process, make sure that your efforts are strengthening your eventual application package. Take a close look at your background and determine when you might be able to improve your qualifications.”

To make this gap year count, it is necessary to:
● Know your weaknesses and remedy them. Make sure that some of your gap year is dedicated to making up for some deficiency in your medical school application: for instance, if you have no experience in clinical research, then a research program or internship is a good choice.
● Prepare for testing. If you have not already taken the MCAT or wish to retake it, take preparation courses to make sure your score is as high as possible.
● Stabilize your finances. If you have undergraduate debts, it is also a good idea to help pay them down so that later on, your debt will be less overwhelming.
● Take time for self-reflection. During the course of your undergraduate career, taking time out to for thought and reflection might not have been high on your list or priorities. Now that the pressure of academia is removed, you can take a look at what you really want.

To sum up, the gap year has been increasingly destigmatized in recent years and even in some of the most competitive medical schools like Harvard, it is now the norm to have taken at least one year off between undergraduate work and the beginning of medical school. While a good gap year can take some planning–and a lot of honesty with yourself–it can not only be a great way to enrich your application to medical school, but can also give you time to get to know yourself and give you the extra experiences and emotional maturity you will need to successfully become a physician.

References
A Sampling of Summer and Gap Year Opportunities for Pre-Health and Other Students. The Career Center, University of Michigan. 2009. http://career.ucsd.edu/_files/Gap_year.pdf
Franco, K. Understand Common Reasons Students Leave Medical School. U.S. News and World Report. 2013. www.usnews.com/education/blogs/medical-schools-admissions-doctor/2013/10/22/understand-common-reasons-students-leave-medical-school
Fu, M. and Joung, J. More Students Take Time off Before Applying to Medical School.
The Harvard Crimson. 2015. www.thecrimson.com/article/2015/2/25/medical-applicants-time-off/
Harrah, S. Why Some Take a “Gap Year” Before Starting Medical School. The UMHS Endeavor. University of Medical and Health Sciences, St. Kitts. 2014. www.umhs-sk.org/blog/why-some-take-a-gap-year-before-starting-med-school/
Morris, S. Plan for a Successful Gap Year. U.S. News and World Report. 2013.
www.usnews.com/education/blogs/medical-school-admissions-doctor/2013/11/12/
Pre-Med Internship Programs Abroad. Gap Medics. 2014.
www.gapmedics.com/programs/premedicine-internships/
Sheth, S. The Medical School Gap Year: Is it Right for Me?. Kaplan Test Prep.
www.kaptest.com/blog/med-school-pulse/2012/03/05/the-medical-school-
Why a Gap Year or Years. Office of Health Professions Advising, Duke University. 2015.
http://prehealth.duke.edu/prepare/checklists-and-applying/why-a-gap-year-or-years