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 premed 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:
- What career am I seeking?
- What graduate degree do I need for that career?
- Does location matter?
- Which colleges/universities offer the program or degree I want?
- What are my financing needs and options?
- Is the school accredited?
- What is the reputation of the school or program I am considering?
- What is the school's placement rate for graduates?
- Do I have the needed undergraduate requirements to apply to the program?
- Are entrance exams required for admission?
- Is work experience required for admission?
- 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.
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.
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.
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 professional, they might misunderstand the differences between common medical professionals. 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.
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, the American Medical College Application Service (R) (AMCAS(R)). Tori - make these (r) the Registered circle.
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:
- Research schools with your program of study.
- Consider visiting the schools you are applying to and make contact with staff/professors.
- Take a practice GRE or other entrance exam if required or recommended for admission.
- Sign up for a GRE prep course.
- Register for the GRE general test if necessary.
- Begin drafting your statement of purpose for your application.
- Complete and submit applications by deadlines.
- 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.
“The MCAT score is a very important component of all those considered by the admissions committee at the University of Virginia for several reasons. It does reflect academic abilities; it is a standard across all undergraduate schools, which may have different curricula, grading policies, etc.; and the MCAT score generally predicts performance on licensing exams and board certification examinations. An applicant who cannot be successful on the MCAT is at high risk of never being licensed to practice medicine. It is considered, though, along with many other personal and professional characteristics.”
— Dr. R.J. Canterbury, senior associate dean for education, University of Virginia School of Medicine
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.”
“We place an emphasis on personal statements and goals, on ethical and professional traits as much as grades or MCAT. We look for students with a strong attitude of service as reflected in their activities up to application, for example, service activities, mission trips, previous medical care experience, etc. We are partial to those with healthcare experience and those with a history of service in the military.”
— Ronnie Martin, DO and professor of family medicine, Liberty University
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.
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.
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.”
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 that “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.
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
- Know your work.
- Read smarter, not harder.
- Focus less on grades and more on learning.
- Pick opportunities wisely.
- Consult others.
- 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.
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.
Lynchburg and Southside Graduate and Professional Schools Offering Healthcare Related Programs
Liberty University offers master’s degrees in biomedical sciences, clinical mental health counseling, divinity (healthcare chaplaincy), exercise science, psychology, and public health. Also offered are the doctor of nursing program (DNP) and the doctor of osteopathic medicine (DO).
Longwood University offers the master’s of science in communication sciences and disorders (speech-language pathology).
Lynchburg College offers master’s degrees in athletic training, physician assistant (PA), public health, and nursing. They also offer a doctor of nursing (DNP) program. They also offer a doctor of physical therapy (DPT) program.
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
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.
Ronnie Martin, DO with Liberty University College of Osteopathic Medicine.
Stephen M. Workman, PhD with Virginia Tech Carilion School of Medicine.