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Graduating … To Graduate School

Written by  Tina Joyce

OurHealth’s four-part series: How to in Healthcare, is a step-by-step guide for those interested in pursuing a career in healthcare.

Imagine a career that has the potential to save lives each and every day. From emergency medical technicians and anesthesiologists to physical therapists and trauma surgeons, those who work in the healthcare field come together to save lives or improve the quality of life for their patients.  

OurHealth is exploring numerous healthcare employment opportunities and sharing expert advice on ways to reach career goals in healthcare.

In Part I, the March/April issue, we shared tips for families of students interested in exploring collegiate opportunities with a medical focus in mind.

In Part II, the May/June issue, OurHealth asked college and university representatives to share insights on certificate and degree programs that transition students directly into the healthcare workforce as well as tips to help students successfully pursue a four-year degree.

In this issue, we explore healthcare careers requiring postgraduate studies, including graduate school, professional school, residency programs and fellowships. We also offer planning considerations to assist students who are currently pursuing a bachelor’s degree but looking to further their education.

Previous OurHealth issues have revealed that career opportunities in healthcare are numerous, and each program of study has different requirements. Understanding the complex world of graduate school includes comprehending undergraduate requirements, entrance exams and waiting lists — a potentially overwhelming process if it is conducted without guidance.

The best plan of action is to conduct thorough research — as early as possible — about programs and colleges with specific career interests in mind.

Undergraduate students who are considering an advanced degree in healthcare must begin preparing well in advance of receiving their bachelor's degree. This includes maintaining a high GPA and taking required and advanced courses. For example, a student who wants to attend medical school is likely to be enrolled in a pre-med undergraduate program, taking a course load with a heavy concentration in math and science.

When it comes to graduate programs in the healthcare field, students can either attend a graduate school or a professional school. Graduate schools offer master's and doctoral degrees. Medical schools fall into a category called professional schools, which also includes dental schools, pharmacy schools, chiropractic schools, etc.

There are multiple questions students should consider when making decisions about advanced education:

  1. What career am I seeking?
  2. What graduate degree do I need for that career?
  3. Does location matter?
  4. Which colleges/universities offer the program or degree I want?
  5. What are my financing needs and options?
  6. Is the school accredited?
  7. What is the reputation of the school or program I am considering?
  8. What is the school's placement rate for graduates?
  9. Do I have the needed undergraduate requirements to apply to the program?
  10. Are entrance exams required for admission?
  11. Is work experience required for admission?
  12. When is the application deadline?

The best resource for a student beginning to look into graduate schools would typically be the institution’s website. Most, if not all, programs have extensive descriptions of the application process, entrance requirements and deadlines on their websites.

Once an online search has narrowed down which colleges and universities offer the chosen graduate program of study, students can begin to dissect the steps needed to apply to their school(s) of choice. Graduate programs are usually quite competitive; therefore, it is recommended that students apply to more than one. Each school has its own requirements, and every program within the school has yet another set of criteria for admission.

“My advice [to students looking to apply for graduate school], is to start the process as soon as possible. Do your research, do your homework. You have to find an area you are passionate about. If you can work in the field in some capacity, it helps. You don’t have to go directly into graduate school. Experience in the field can be very helpful. Look for internships and assist faculty when possible…and of course, keep your grades up,” advises Dr. F. Douglas Boudinot, Dean of Graduate School at Virginia Commonwealth University.

Additionally, undergraduate schools generally have pre-graduate and pre-professional advising programs that students can access, either online or in person. If there are specific questions an applicant has about a program, an email or phone call will likely prompt a helpful response from someone in the department.

“I would not suggest calling professional programs with general career advising questions — they have neither the expertise nor time to answer those types of questions. But if there is a specific question to which an answer cannot be found on the website, then contact is appropriate,” explains R.J. Canterbury, MD, senior associate dean for education at the University of Virginia School of Medicine.

Exploring possibilities

It is important to realize there are numerous, highly sought after and lucrative healthcare opportunities besides becoming a physician. Students can explore many different facets of healthcare — both clinical and administrative — that require graduate work. For example, Virginia Tech offers a professional Master of Public Health degree. “We also offer graduate programs in biochemistry; biomedical engineering; consumer health; human nutrition, foods, and exercise; psychology; genetics; bioinformatics; and computational biology — all health sciences fields,” says Cathy Grimes, communications manager for Virginia Tech Graduate School.

Virginia Commonwealth University offers a Master of Health Administration degree and a graduate concentration in healthcare management as part of a Master of Business Administration degree. Liberty University also offers a Master of Public Health and a Master of Science in biomedical sciences.

Exploring the success rates of students in particular programs should be a consideration in the program selection process. "We regularly have over 60% of our students who complete that program [pre-med] are accepted into medical school. Those students who meet the benchmarks after the first semester are guaranteed a seat in the DO program at one of three campuses for the following August. Other similar programs only guarantee an interview for a medical program,” shares Dr. Brain Hill, Vice Dean for Graduate Biomedical Sciences with Edward Via College of Osteopathic Medicine (VCOM).

Understanding the difference

The healthcare field is immense. Exploring careers can be overwhelming to even the most astute students. Unless students have personal experiences with a particular health profession, they might misunderstand the differences between common medical careers. For example, the differences between psychologists and psychiatrists; optometrists and ophthalmologists; and dentists, orthodontists and periodontists.

Confusion often exists between Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees. Both degrees mean the doctor is a licensed physician, but their training and approach to healthcare differs slightly. Medical doctors generally focus on one condition or area of the body, whereas osteopathic physicians are dedicated to treating and healing the patient as a whole.

Another point of clarification has to do with a specialization. An orthodontist has completed dental school and gone on to receive further training to specialize in the prevention and correction of misaligned teeth and jaw. A psychiatrist is a medical doctor who specializes in mental health. In contrast, a psychologist has earned a master’s or doctorate degree but focuses on studying and evaluating mental processes.

Some career paths are similar, but do have distinctions. “One of the biggest differences between a PT and an OT is that a physical therapist treats the patient’s actual impairment, while an occupational therapist treats that impairment in action,” explains Sarah Boswell, Assistant Director of Admissions at Jefferson College of Health Sciences.

It is important for students to research and learn as much as possible about the careers they are considering prior to investing time, money, and energy in academic pursuit. During undergraduate studies, summer internships or part-time jobs allow students to explore careers and interview people working in the field of interest. Refer to the March/April issue of OurHealth for other recommendations.

As a reminder and to help alleviate confusion, acronyms related to advanced degrees and some licensure programs are listed below:

MSN – Master of Science in Nursing
MNA – Master of Nurse Anesthesia
CRNA – Certified Registered Nurse Anesthetist
NP – Nurse Practitioner
DNP – Doctor of Nursing Practice
PhD – in nursing, psychology and other healthcare areas
PharmD – Doctor of Pharmacy
PA – Physician’s Assistant
MD – Doctor of Medicine
DO – Doctor of Osteopathic Medicine
DPM – Doctor of Podiatric Medicine
DPT – Doctor of Physical Therapy
LCMHC – Licensed Clinical Mental Health Counselor
LCP – Licensed Clinical Psychologist
LCPC – Licensed Clinical Professional Counselor
LCSW – Licensed Clinical Social Worker
PsyD – Doctor of Psychology
DC – Doctor of Chiropractic
DPM – Doctor of Podiatric Medicine
DrPH – Doctor of Public Health
DDS – Doctor of Dental Surgery
DMD – Doctor of Dental Medicine
AuD – Doctor of Audiology
OD – Doctor of Optometry
DVM – Doctor of Veterinary Medicine

Application and entrance exams

The application process varies from school to school and program to program. Sometimes there is a common application form. For example, students applying to medical school complete a national application through the American Medical College Application Service (AMCAS).

Information about the application and medical careers can be found on the website of the Association of American Medical Colleges. The organization provides valuable information for all students seeking admission to medical schools across the country.

Most clinical postgraduate programs require some type of entrance exam. For example, most graduate programs in clinical psychology require the Graduate Record Exam for application. The GRE is widely regarded as an entrance exam for many postgraduate programs, not just for medical fields. Some healthcare graduate programs require both an entrance exam and work experience.

Applying to graduate school? When planning, it’s helpful to work backward from the application deadline and follow these steps:

  1. Research schools with your program of study.
  2. Consider visiting the schools you are applying to and make contact with staff/professors.
  3. Take a practice GRE or other entrance exam if required or recommended for admission.
  4. Sign up for a GRE prep course.
  5. Register for the GRE general test if necessary.
  6. Begin drafting your statement of purpose for your application.
  7. Complete and submit applications by deadlines.
  8. Request that undergraduate transcripts be sent.

For example, if a student receives a Bachelor of Science in nursing and wants to pursue a Master of Science in nursing, the tests required to get into a school that offers an MSN vary.

Christine Kueter, communications coordinator at the University of Virginia School of Nursing explains, “A year's worth of clinical experience is required for the Clinical Nurse Specialists (CNS) master's and Nurse Practitioner (NP) master's tracks, but the Clinical Nurse Leader (CNL) master's program — that's the one degree for non-nurses pivoting into the profession who have at least a bachelor's degree in another field — has no such requirement. Students who already have a bachelor of science in nursing (BSN) and are applying to an Master of Science in Nursing (MSN) program must have passed the National Council Licensure Examination (NCLEX) and have at least a year of clinical experience, but GREs are not required for entry. All students applying to a master's program must have completed a statistics course within the last five years.”

Similarly, students seeking admission to a medical school might be required to take the Medical College Admissions Test (MCAT). However, not all programs require the MCAT for admission, and some require the test but do not have a minimum score to be considered for admission, according to College Admissions Partners, a college admissions counseling service provider.

“Obtaining the benchmark MCAT is essential to admission to the VCOM medical program. However, our benchmark MCAT is lower than most other similar programs as we have found that the GPA within the Post-Baccalaureate program is more indicative than MCAT for student future performance within the D.O. program.”
--Dr. Brian Hill, Vice Dean for Graduate Biomedical Sciences at Edward Via College of Osteopathic Medicine (VCOM)

For admission to Liberty University College of Osteopathic Medicine, the MCAT is a factor, as are grades, but it is not an overriding factor in the selection process. “We establish a high enough level for test scores and grades that it demonstrates with 95 percent probability they can do the work of medical school, but it is not a determining factor,” says Ronnie Martin, DO and professor of family medicine. “The MCAT predicts how the students will do on national boards like the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) or United States Medical Licensing Examination (USMLE) but not the type of doctor they will be or how they will perform in medical school.”

Similar to deciding on an undergraduate college or university, choosing the “best fit” graduate school is extremely important for success. Expending energy to apply to schools that a student has no interest in attending or has a low probability of being admitted can be unwise. Conduct the research first and then apply to schools that are a good fit academically, socially and professionally.

According to Stephen M. Workman, PhD, associate dean for admissions at Virginia Tech Carilion School of Medicine, “Generally, students should pick their home state to apply to public graduate and professional schools because a larger number of in-state students are accepted each year. Student have a better chance of being accepted outside of their state of residence if they apply to a private school.”

Students shouldn’t overlook schools close to home. Virginians are fortunate to have outstanding colleges and universities within a few hours drive. Graduate schools are plentiful and diverse, while medical schools are competitive and well-respected in the state.

Residency programs

Once students have completed four years of medical school, they enter the next stage of training called "residency." During residency, students practice medicine under the direct or indirect supervision of an attending physician in a hospital or clinic setting.

Third-year medical students complete electronic applications to apply for a residency match. The residency placements are typically coordinated by the medical school's student affairs office.

According to the American Academy of Family Physicians, all students seeking a residency position should enroll in “The Match.” Once enrolled, students are bound to abide by the terms of the National Resident Matching Program.

During the fourth year of medical school, students participate in residency interviews. Based on the interviews and applications, the National Resident Matching Program places applicants for postgraduate medical training positions into residency programs at teaching hospitals throughout the U.S. Match results are made public in March.

A day in March is known as National Match Day — the day medical students find out where they will complete their residency.

“The state where you practice residency very often becomes where you are likely to end up residing,” Dr. Workman says. “National Match Day is a very anticipated day for medical students.”

Graduation from medical school happens in May, and students begin their residencies in the summer. A residency is a minimum of three years. Not all students will receive a match for placement. Student who graduate at the bottom of their class or are not competitive might not receive a residency match.

Fellowship training

A fellowship is post-residency education that provides training in an area of specialization, ultimately allowing students to also teach or work in a large hospital. Students gain additional knowledge and expertise in a particular area, which might or might not include a certificate of added qualification.

According to the website of the American Academy of Orthopaedic Manual Physical Therapists, “A fellowship is designed for the graduate of a residency or a board-certified therapist to focus on a subspecialty area of clinical practice, education or research.”

Changing direction

A question looming in the minds of some graduate students may be, “I feel like I might be heading in the wrong direction. What do I do now?”

Some students question their program path often throughout undergraduate studies, causing a change of majors, while others have known their career choice from high school or earlier.

Several factors can contribute to a change in academic direction heading into graduate school or after a couple of semesters. Test scores, work and personal experiences, finances and advisor recommendations continue to shape a student’s career direction. For example, a student might not get accepted into the graduate or professional school of choice. “They may apply a second time or choose to go into a more research-based program,” Dr. Workman says.

Dr. Canterbury recommends, “a medical student who is unhappy with his or her choice generally should not continue. Medicine is a great career and many would say a 'calling,' but it’s very hard work with many challenges. If a student does not find it gratifying, it will be difficult to be a good physician. There are many other wonderful careers that might make the person happier.”

To continue down a path of rigorous academic challenge, students must be completely committed to the profession they are pursuing. Doubts and fatigue may seep into their minds, but relying on strong relationships with advisors, professors and supportive family members will provide the support necessary to finish strong. Because there are so many options in healthcare, it is possible for a student to change directions but still remain in pursuit of health-related profession. However, changes cost time and money.

Seeking balance

In addition to supportive relationships, diet and exercise play an important role in the mental, physical and social health of students. Inadequate sleep is common and often leads to chronic fatigue for students completing residencies and other intense work experiences.

Fatigue in turn leads to illness and can have an adverse affect on course work and personal relationships. Competitive programs have very little room for error, and grades falling below a B can result in dismissal from the program. Therefore, it is vitally important for students to stay physically active, eat a healthy diet with limited use of stimulants such as energy drinks and excess caffeine and get as much rest as possible.

U.S. News & World Report has reported that many medical schools are initiating wellness and social programs to help students achieve work-life balance.

Last year, Psych Central (www.psychcentral.com) recommended 12 tips for surviving graduate school, commenting that unlike college, grad school is a full-time job. The top six tips were

  1. Know your work.
  2. Read smarter, not harder.
  3. Focus less on grades and more on learning.
  4. Pick opportunities wisely.
  5. Consult others.
  6. Manage your time well.

Also, taking study breaks every few hours optimizes the retention of information. This is a good time to take a walk, have dinner with a friend or take a nap. If these breaks are not built into their schedule, students soon find themselves working or studying 24/7 and ultimately experiencing burnout.

Also, looking for blended programs or alternative course offerings maybe the best fit for some students. “Jefferson College of Health Sciences facilitates student success in the Doctor of Health Science and Doctor of Nursing Practice programs by providing an online learning environment, allowing students to study and complete coursework whenever and wherever it is most convenient. Students have access to library resources such as journals, databases, and eBooks using an online portal,” Sarah Boswell, Assistant Director of Admissions offers students.

Professional healthcare careers require planning and discipline to complete. Those with a heart to serve and a desire to continually learn will likely have the mindset for this type of career. Researching, planning, studying and finding balance will help make the student’s transition to graduate school a success.

Entrance Exam Requirements for Post-Graduate Schools

Applying to a graduate or professional school often requires taking a standard entrance exam. Standardized exams are designed to measure an applicant's potential to succeed in graduate or professional school. While a high grade point average (GPA) indicates success at an undergraduate college or university, standardized tests permit fair comparisons of students from a variety of universities and colleges with potentially differing grading standards. Below is an overview of the different types of graduate and professional schools entrance exams.

Graduate Record Examination (GRE)

The GRE is the general test that is used for admission into most graduate school programs. Administered by the Educational Testing Service (ETS), the GRE tests verbal reasoning, quantitative reasoning (math), and analytical writing (essay section). This computer-based test is available year-round at locations across the United States. Scores are available at the test center and you have the option of sending the scores to whichever schools you choose. There is a fee to take the GRE, and registration can be completed online.

Graduate Management Admissions Test (GMAT)

The GMAT exam is primarily used for admissions decisions by business school graduate programs. If you’re considering a Master’s in Healthcare Administration degree, you may also be required to take the GMAT. It consists of a 30 minute analytical writing assignment, 12 integrated reasoning questions (30 minutes), 37 quantitative questions (75 minutes) and 41 verbal questions (75 minutes). These questions are designed to measure the skills needed to succeed in business school. The GMAT is given year-round and there is an average of fee of $250 to take the exam. While unofficial scores are available at the test center, your official scores will be sent to you within 20 days of completing the exam. Registration can be completed online.

Doctor of Philosophy (PhD)

A PhD is an advanced, post-graduate academic degree awarded by universities to a candidate who has submitted a thesis or dissertation that is based on extensive and original research in his/her chosen field. In general, the PhD is the highest level of degree a student can achieve, and usually follows a master’s degree. In most cases, a PhD involves three to four years of full-time study.

Requirements for PhD programs:

In order to be accepted into a PhD program, a student must have a master’s degree from an accredited college or university. In addition, most universities will require several letters of recommendation, a research proposal for the thesis or dissertation, letter of motivation from the application specifying his or her objections and determination to work hard on a project, and a face-to-face interview. Some universities also require a PhD entrance exam.

Doctor of Health Science (DHS or DHSc)

A Doctor of Health Science (DHS or DHSc) is a post-professional academic degree for those with a master’s degree who intend to pursue or advance a professional practice career in health arts and sciences and healthcare delivery systems, to include clinical practice, education, administration and research. Individuals who complete the DHS/DHSc. face the particular challenge of understanding and adapting scientific knowledge in order to achieve health gain and results. This degree leads to a career in high-level administration, teaching, applied research, or practice, where advanced analytical and conceptual capabilities are required. The Doctor of Health Science is a degree that prepares scholarly professionals in healthcare.

Entrance Exam Requirements for Doctor of Health Science:

DHS and DHSc programs require a master’s degree from an accredited college or university, as well as related work experience in a clinical or healthcare-related educational setting. An interview may also be required as part of the admission process. There are no specific entrance exams required for this program.

Professional Degree Programs

A professional degree is a graduate level degree that is offered upon completion of necessary undergraduate components, followed by additional study in a specialized field. In this model, the undergraduate portion generally lasts five or more years, followed by four years at the graduate level.

Entrance Exam Requirements for Professional School Programs:

Medical School: The Medical College of Admission Test (MCAT) is a computer-based standardized exam required for prospective medical students. It is designed to assess problem solving, critical thinking, written analysis and knowledge of scientific concepts and principles.

Dental School: The Dental Admissions Test (DAT) is a timed multiple-choice exam conducted by the American Dental Association (ADA) that is used as part of the admissions process for dental school. The DAT measures the general academic ability, comprehension of scientific information, and perceptual ability of the prospective dental student.

Chiropractic School: The educational requirements for chiropractors specify a minimum of two years of pre-chiropractic study and four years of chiropractic school, after which the Doctor of Chiropractic degree is awarded. However, the majority of successful applicants have completed three or four years of college work before entering chiropractic school. There is no entrance exam required for admission into chiropractic school.

Nursing School: For graduate students entering nursing school, the required exams include the Graduate Record Exam (GRE), The Test of Essential Academic Skills (TEAS) and the National Council Licensure Examination (NCLEX). Exams can vary by institution, and some may require only one test.

Optometry School: All schools of optometry require the Optometry Admission Test. The OAT is a standardized examination, sponsored by the Association of Schools and Colleges of Optometry (ASCO), designed to measure general academic ability comprehension of scientific information.

Pharmacy School: The Pharmacy College Admission Test (PCAT) is a specialized test that helps identify qualified applicants to pharmacy colleges. It measures general academic ability and scientific knowledge necessary for the commencement of pharmaceutical education. The PCAT is constructed specifically for colleges of pharmacy.

The PCAT consists of 232 multiple-choice items and one writing topic. Candidates are given approximately four hours to complete the test (including administrative time for instructions and time for a short rest break about halfway through the test).

Physician Assistant School: Physician assistant schools may vary when it comes to which exam they require. For example, some schools require the Graduate Record Examination (GRE), which is also often required for various types of master's degree programs. Other schools will accept the Medical School Admissions Exam (MCAT) instead of the GRE.

Physical Therapy School: Most physical therapy (PT) programs require applicants to complete the Graduate Record Examination (GRE). Programs may have minimum acceptable scores and last acceptable test dates. Policies regarding the consideration of multiple sets of GRE scores vary by institution.

Podiatric Medical School: Almost all podiatric medical schools require applicants to take the Medical College Admissions Test (MCAT).

Speech-Language Pathology School: Applicants are required to submit scores earned within the last five years from the general test portion of the Graduate Record Examination (GRE). The general test of the GRE measures verbal reasoning, quantitative reasoning, and writing skills. The test is available year round in a computer-based format.

Veterinary School: The Graduate Record Examination (GRE) is required by most veterinary schools, and some also require the Biology GRE. The Medical College Admission Test (MCAT) is also accepted by some schools in place of the GRE.

Southwest Virginia Graduate and Professional Schools Offering Healthcare Related Programs

Edward Via College of Osteopathic Medicine
www.vcom.edu
The Edward Via College of Osteopathic Medicine offers the doctor of osteopathic medicine (DO) degree.

Jefferson College of Health Sciences
www.jchs.edu
Jefferson College of Health Sciences offers the master of healthcare administration degree as well as the master of science (MS) degree in family nurse practitioner (FNP), nursing administration, occupational therapy (OT), and physician assistant (PA). They also offer the doctor of health sciences and doctor of nursing practice (DNP) degrees.

Radford University
www.radford.edu
Radford University offers master’s of science (MS) degrees in communication sciences and disorders (speech and language pathology), counseling and human development, and psychology. They also offer the master of social work (MSW) and master of occupational therapy (MOT) degree programs. Doctorate degree programs include doctor of psychology (PsyD), doctor of nursing practice (DNP), and doctor of physical therapy (DPT).

Virginia Tech Carilion School of Medicine and Research Institute
medicine.vtc.vt.edu
The Virginia Tech Carilion School of Medicine and Research Institute is a unique partnership between a public research university (Virginia Tech) and a private healthcare organization (Carilion Clinic). It is a fully accredited, private four-year medical school. The VTC School of Medicine and Research Institute offers the doctor of medicine (MD) degree program after which, graduates are matched with a residency program.

Virginia Tech
www.vt.edu
Virginia Tech offers the master’s of science (MS) degree in biological sciences, biomedical engineering, human development, human nutrition, foods and exercise, psychology, and sociology. They also offer the master of public health (MPH) degree, and the doctor of philosophy degree (PhD) in biological sciences, genetics, bioinformatics and computational biology, human development, human nutrition, foods and exercise, psychology, sociology, and translational biology, medicine and health.

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Sources:
Association of American Medical Colleges - www.aamc.org
College Admissions Partners - www.collegeadmissionspartners.com
The National Resident Matching Program - www.nrmp.org
American Academy of Family Physicians, AAFP - www.aafp.org
American Academy of Orthopaedic Manual Physical Therapists - www.aaompt.org

Expert Contributors:
R.J. Canterbury, MD with University of Virginia School of Medicine.
Cathy Grimes with Virginia Tech Graduate School.
Christine Kueter with University of Virginia School of Nursing.
F. Douglas Boudinot, PhD with Virginia Commonwealth University Graduate School.
Dr. Michelle Whitehurst-Cook with VCU School of Medicine.
Ronnie Martin, DO with Liberty University College of Osteopathic Medicine.
Stephen M. Workman, PhD with Virginia Tech Carilion School of Medicine.
Brian W. Hill, PhD Vice Dean for Graduate Biomedical Sciences with Edward Via College of Osteopathic Medicine.
Sarah Boswell, Assistant Director of Admissions with Jefferson College of Health Sciences.


 

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