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Lewis Associates e-Newsletter

Volume 1 Issue 6
April, 2002

=> Welcome to Success Stories Newsletter!

=> Important News and Useful Links - 2002 Medical Student Match to Residency and Minority Population Medical Care

=> Dates and Reminders - Important AMCAS, AACOMAS and AADSAS News for Applicants

=> Important People, Schools and Programs - University of Miami School of Medicine begins national recruiting effort

=> Success Story of the Month - Off the Wait List to the Ivy Leagues

=> Question of the Month - When Should My Letters of Recommendation Be In My File?

=> Focus on a Health Profession - Surgical Calamities on Rise, Group Says

=> Our Services

=> Contact



Welcome to Lewis Associates!

Congratulations to the Class of 2001 advised by Dr. Lewis! We had 94% acceptance for our premedical applicants all over the U.S.!

April - A time for spring breaks and those studying for the dreaded MCAT!

If you want to change your career or reach your career goal, but do not know how to begin or how to jump all those hurdles, Lewis Associates can implement strategies that will change your life. Read about it in the newsletter and register from our website or phone or email us directly!

Developing YOU to your potential is our goal, and people are our "most important product". Dr. Cynthia Lewis has been advising Pre-health students with an overall acceptance rate of 85% since 1985. Lewis Associates was launched in 1998 to provide long-term personalized advising services to students across North America, specializing in Medicine, Osteopathic Medicine, Dentistry, Physician Assistant and Veterinary Medicine. Our success is real. You may be like our Advisees---highly motivated and intelligent, but needing focus, guidance and specific technical expertise. Dr. Lewis is a trained biologist, having taught and directed her own research programs for many years at two universities. She received two postdoctoral fellowships (one at NIH) and received the 1990 NACADA Outstanding Institutional Advising Program in the U.S. She teaches Professionalism, Leadership, and Quality and sets high standards for her Advisees.



n e w s a n d l i n k s

N E W S :

2002--U.S. Medical Seniors Enjoy Highest Match Rate Ever

Applicants in the National Residency Matching Program (NRMP) learned on March 21, 2002, where they will spend their residency training, as they were matched to open positions in residency programs across the country in March. There were 23,459 active applicants in the match, including 14,336 U.S. medical school seniors. Ninety-four percent of active senior applicants were matched to a first year residency program, the highest match rate ever for U.S. medical students.

Data from this year's match shows a decrease in applicants matched to primary care positions such as family practice, pediatrics, and internal medicine. There were 373 fewer U.S. seniors filling these generalist residency positions, with 205 less positions filled in primary care overall; international medical graduates made up the difference with 116 more matches to these positions than last year.

Interest in certain medical specialties, including anesthesiology, physical medicine and rehabilitation, and diagnostic radiology, appears to be on the rise; there were more matches this year in each specialty than in 2001.

More information: http://www.aamc.org/newsroom/pressrel/2002/020321.htm

L I N K S :

The Institute of Medicine issues report on racial and ethnic disparities in health care.

The Institute of Medicine has issued a report on ethnic and racial disparities in health care. The report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care," asserts that "minorities tend to receive lower-quality health care than whites do, even when insurance status, income, age and severity of conditions are comparable."

Information: Go to http://www.iom.edu



d a t e s

Important AMCAS, AACOMAS AND AADSAS News for Applicants

This is advice given to my Advisees (by Dr. Lewis): As of 3/25/02


What to do as an applicant now:

1. Get official copies of ALL college transcripts ASAP for yourself-NOW! We should discuss if you should include your spring grades or not - this is an individual decision.

2. Confirm to me that you have downloaded the 2003 AMCAS worksheet pdf; AMCAS 2003 will be available online on or about May 1, 2002. 3. Access or download the pdf Instruction booklet-available now online.

4. Save money-the first school costs $150; each additional school costs $30.

5. Use e-commerce to pay.

6. Use an email account that does NOT block spam since AMCAS bulk emails.

7. The transcript request forms will be available on or about about May 1st - download, print and submit to all schools to have transcripts mailed to AMCAS.

The 2003 AMCAS Application - Changes

Biographic Information:

- Applicants are required to include either a Social Security Number or Canadian Social Insurance Number. Applicants who have neither are requested to contact AMCAS.
- Applicants can now include alphabetic characters in their Alternate IDs.

Post-Secondary Experiences:

- Applicants can enter a maximum of fifteen (15) experiences.
- Contact Daytime Telephone Number and E-Mail Address fields have been removed.


- The Practice Vision essay has been eliminated.

Course Work:

- Applicants can no longer override automatic AMCAS grade and Semester/Supplemental Hour conversions.
- Applicants who believe that these fields have been converted incorrectly can request that AMCAS make a change. Payment:
- Applicants can now pay their application fees using Telecheck, an electronic check service.

Post-Submission Changes:

After the initial submission of an application, the applicant may only make changes to the following questions:

- Required and Alternate IDs
- Name, including Full Legal Name, Preferred Name and Alternate Names.
- Contact Information, including Permanent and Preferred Mailing Addresses, and Alternate Contact Information.


- April 22, 2002 is date the web application should go online for inputting data and submission of your application. Paper will be available, but web is faster and more efficient.
- In 2000 (latest data) average of matriculants:
- Science GPA 3.36, overall GPA 3.43, non-science GPA 3.5, VR 8.1, PS 8.2, BS 8.7
- You need a copy of all official college transcripts NOW to fill in your AACOMAS.
- AACOMAS estimates it will take 2-2.5 hours to complete filling in the application (if you cut and paste pre-written essay and other information).
- This year, it will be easily printed and an email confirmation will be sent to you. - LECOM, NYCOM and CCOM will require an on-site personal statement.


- May 15, 2002 is date the web application should go online for inputting data and submission of your application.
- There is NO transcript matching form; transcripts are mailed directly to AADSAS.
- In 2000 (latest data) average of matriculants: Science GPA 3.25, overall 3.35, DAT academic average 18.5, PAT 17.7, total science 18.3



p e o p l e & s c h o o l s

University of Miami School of Medicine begins national recruiting effort

In a striking departure from previous admissions policies, The University of Miami School of Medicine will begin enrolling up to 35 non-Florida residents in each entering class. This change is effective with the 2002 entering class.

Non-Florida applicants are expected to have a cumulative GPA of at least 3.6 and an MCAT composite score of 30+. All applicants should have a diversity of life experiences and a history of significant patient contact experiences, which have had a meaningful impact on their decision to study medicine. Class size is 150.

The University of Miami School of Medicine-Jackson Memorial Medical Center is the second-busiest medical center in the US and has one of the most diverse patient populations found anywhere. Located on the medical campus are several world-renowned clinical specialty centers, including the Bascom-Palmer Eye Institute, The Miami Project to Cure Spinal Cord Paralysis-Lois Pope LIFE Center, the Batchelor Children's Research Institute, the Diabetes Research Institute, the Sylvester Comprehensive Cancer Center, and the Ryder Trauma Center.

The School of Medicine has an MD-PhD program, an MD-MPH program, and is currently developing an MD-MBA program to start in the fall of 2003.

For further information about the University of Miami School of Medicine, visit the web site at: http://www.miami.edu/medical-admissions



s u c c e s s s t o r y

D A V I D   S C H A T Z - Off the Wait List to the Ivy Leagues:

David is the son of my personal physician, Dr. Michael Schatz. I was honored to advise him during a long and arduous year for the Class of 2001 premedical application process. David had high numbers and excellent clinical, community service and research experience, including publications coming into his application process. He also had very high expectations of where he wanted to matriculate to medical school. In David's own words, here is part of his application story:

March 3, 2002:

"Hello there fellow medical school applicants and students. I'm sure that life is a bit crazy for all of you, whether you are waiting to hear from schools or slaving through your anatomy course in first year as I am. If you are the former and are checking your mail boxes more often then you are sitting down for meals, then you are exactly where I was last year: on a string being jerked around by the medical school establishment. I truly feel your pain, because the whole application process is overwhelming and unbelievable. Although the entire experience was strange, there were moments, which bordered on the absurd. Let me preface my story, though, by saying that the whole thing couldn't really have worked out better. But what a journey it was...

My experience really began during my undergrad years, where I sold my soul to the pre-medical gods in return for good grades. After I did decently on the MCATS, I felt I was in a good position to get into some of the medical schools I really wanted to go to. To make absolutely certain that I had the best chance possible of getting into a good medical school, I enlisted the advice and services of Dr. Lewis. So, with Dr. Lewis' help, off my application went to 16 different schools, which was far below the 37 that one guy I met on interviews applied to, but probably still average. I returned secondaries to 13 schools and was granted interviews at 12 of these schools. Of course, the one that didn't grant me an interview was one of my state schools, but we won't get into that. Let's just say that their basketball team doesn't get my fan support anymore. So, after getting excellent advice on how to approach the interview process, and then successfully interviewing at these 12 schools, I was on top of the world. Although I considered two or three "safety schools" (if there is such a thing in medical school), fully 9 of them would have been absolutely incredible to attend. So, the first school I heard from was one of the safety schools, and they essentially accepted me two weeks after I interviewed (about mid December). Although I should have been happier, I was only slightly overjoyed because, hey, I still had 9 other great schools to hear from, and they all couldn't reject me, could they?

I finally heard from one of the big nine, and they said that I had been waitlisted. "No biggy", I figured. I really didn't want to attend that school anyway. I still had the other big eight left. And there was really one that I really wanted to attend, the Medical School of America (of course that's not it's real name, but I've changed the name to protect the guilty. We all know which one thinks of themselves as the only medical school in America). So, about mid February, I got the letter from my top choice telling me I had been flat out rejected. And that letter, started a downward spiral of two other rejections and SIX other waitlists in the next two months. To me, it seemed that the unthinkable had happened: all nine of the schools had rejected or waitlisted me. I was devastated. I remember when the last school told me I was in the hopeless limbo of the lower waitlist, I called my mother and cried for the first time in ten years (but that's just between you, the thousands of other readers of this newsletter, and me). I'd say these dark times were also one of Dr. Lewis' shining moments for me. She was always there to explain the ridiculousness of the medical admissions process, to assure me that she would talk to her connections at the various schools, and to simply listen to me bitch and moan. As rough as things were for me then, they would have been far rougher without Dr. Lewis' constant support.

Well, after spending the summer doing exactly what one does on the waitlist (write letters discussing how you are still interested in the school, what new things you have accomplished and, ...well, ...waiting), I was invited back to two schools. One school in the Ivy Leagues seemed very ready to accept me, and I was overjoyed. I was in to one of my top choice schools! Of course, their enthusiasm for me also had something to do with Dr. Lewis. I believe that the biggest role her connections played in the whole process was getting me toward the top of the waitlist there. I don't know if I would have been accepted anyway, but Dr. Lewis' help all but assured that I would get in there. The whole deal of where I would be next year still wasn't under wraps yet, however. The Medical School of New York (name again changed to protect the guilty), also invited me back for a second interview, and told me that, in about a month, they would be making a decision about my application. "NEW YORK!" I was thinking. That's where I want to be. So, I sat for another month waiting to hear from them. But the call never came, and when I called New York, they told me that they were as shocked as I was, but that they had no place for me. So, my decision was made, and I was attending one of my top choice Ivy League schools.

The epilogue is that the Ivy League school where I now attend is an amazing school with the entire undergraduate and medical school campuses located in one area, so there's a lot going on. It's also a great curriculum with a lot of exciting opportunities. In other words, I'm very happy here. So the moral of the story is to remember a) not to get too cocky, b) that medical schools love to waitlist, so don't get too discouraged, and most importantly c) medical school admissions is like the opposite sex (whichever one that is for you(: you want their attention very badly, and no matter how hard you try, their actions will never make any sense. So good luck to all of you out there, and remember it only gets better!"



q u e s t i o n o f t h e m o n t h

When Should My Letters of Recommendation Be In My File?

This is the season for getting all of your application materials "in order". These materials consist of your drafted application (AMCAS, AACOMAS, AADSAS, CASPA, VMCAS) with your essay(s), preparing for and taking your application test (MCAT, DAT, GRE), going through any review cycle required at your institution for evaluation, AND getting appropriate Letters of "Recommendation". Actually, about 20 years ago, the term Letters of "Recommendation" was changed to Letters of "Evaluation." If these letters are to be valuable to those assessing the applicant's qualifications, they must provide a balanced story of strengths and weaknesses, thus the term "Evaluation."

Letters for Veterinary and Physician Assistant school application require a different timetable and another set of "rules", so will not be discussed here.

We will not deal with "who" should write them or "how to get them" in this newsletter today. Dr. Lewis assists her Advisees to determine the answer to those questions for each Advisee individually, although there are some broad generalizations we can make. The most important are that your letters should be: - requested from "people who know you well" - reflect all of your important academic, clinical, leadership and service activities (and any skills or special recognitions or achievements).

We will address the issue of "when" should my letters be in my file? If you are submitting an application to medical or dental school, the application itself should be ready to submit in mid June to early July at the latest. Your letters of Evaluation need to be in your letter file BEFORE your writers depart for the summer (and before finals week if they are university faculty). This file can be held by your Advisor or a Career Services office that will submit them to schools which request them

Why? Because these people are doing you a favor---one which most of them appreciate as an important task, yet it is NOT their highest priority. Most faculty are deeply involved in research, teaching and committee/administrative work which takes much of their time. What happens if your writer gets ill and is away from the office for a month? What happens if no one can reach them? Even the secretary?

Writing letters is something professionals do with "discretionary" time. If you are going through a university evaluation process, then there may be a late spring-early summer timetable in the university that the involved faculty will honor. However, all letters that you need outside of this process should be in your file at the latest by spring finals week for faculty or others who will be away over the summer and by early July for all others who will be in communication through June and July. Lewis Associates sends Confidential Letters as a packet; we prefer not to send any individually because they may be lost in the mountain of paperwork each school deals with.

What happens when your letters are not "all" in? Your secondary package is not complete without all letters. If your secondary package is not complete, then your medical/dental school application file is "not complete", and generally, you will not be screened in or out for interview. What happens to a Class of 2002 candidate who is competitive except that he did not have his letters completed until ...March 2002? This single issue affects the applicant's competitiveness in the application process! Possibly few or no interviews---which may mean not being accepted this year.

Don't wait to ask or follow up to get your letters! And, don't allow your letters to keep you from being as competitive as you should be!

You can't change past grades in college, but you CAN control when you get your letters into your file!

We will feature an important question each month. Please submit one that interests you for Dr. Lewis to answer. Send your questions to drlewis@lewisassoc.com



h e a l t h p r o f e s s i o n

Surgical Calamities on Rise, Group Says

Reports of Doctors Operating on Wrong Body Part -- or Patient
by David Brown, Washington Post Staff Writer, Thursday, December 6, 2001; Page A14

The number of surgical calamities in which a doctor operates on the wrong part of a patient's body, and occasionally on the wrong patient, appears to be increasing, according to the organization that accredits U.S. hospitals.

Reports of "wrong-site surgery" have risen from 16 in 1998 to 58 this year, including 11 in the last month, according to the president of the Joint Commission on Accreditation of Healthcare Organizations.

It is unknown whether this reflects a true increase in this most notorious type of surgical accident or simply more complete reporting of cases. About 80 percent of events catalogued by JCAHO were reported voluntarily, with the balance coming from patient complaints and news reports.

"I think it's real," said Dennis S. O'Leary, a physician who heads JCAHO, which accredits about 95 percent of the hospital beds in the United States. "If you look at the trend line, you see an increase in every single year" since 1995.

The organization requests that hospitals thoroughly investigate each case of wrong-site surgery to determine the sequence of events leading to it. Although the reasons are many, the trend toward high-volume, same-day surgery appears partly to blame.

"The preponderance of cases are in ambulatory surgery centers. I think patients are churning through these places," O'Leary said. "People are busy and patients are being put to sleep before there is an opportunity to verify who the patient is, what procedure is going to be performed and on what site."

The mistakes include operations on the wrong finger, replacement of the wrong hip joint, fusion of the wrong spinal disk, cataract removal from the wrong eye and biopsy of the wrong side of the brain.

A small number resulted in death. Some had serious consequences, such as the removal of a healthy kidney instead of a cancerous one. The subsequent need to remove the cancerous one forced the patient to use renal dialysis. But many of the mistakes produced no permanent disability.

O'Leary would not provide scenarios of individual errors, saying the reports are collected with the promise that details will be kept confidential.

In 1999, 41.3 million surgical procedures were performed, said a spokeswoman for the federal government's National Center for Health Statistics. The number of operations has fallen slightly in recent years, from 158 procedures per 100,000 in 1994 to 152 per 100,000 in 1999.

JCAHO's "sentinel event alert" report included three categories of mistake: operations on the wrong body part (76 percent of cases), operations on the wrong patient (13 percent) and the wrong operation on the right patient (11 percent). Orthopedic surgery -- which involves operations on limbs and consequently has the greatest opportunity for right-left confusion -- was the specialty involved most often, in 40 percent of cases.

About 20 percent of the events were in general surgery (which usually involves the abdominal organs); 14 percent in neurosurgery; 11 percent in urology; and the rest in chest, heart, throat, eye or dental surgery. The calamities occurred in outpatient or ambulatory surgical centers in 58 percent of cases; in regular hospital operating rooms in 29 percent; and in emergency rooms or intensive care units in 13 percent. (About 70 percent of orthopedic cases now take place in outpatient surgical centers.) Analysts of medical errors have found that most calamities result from the accumulation of several oversights involving more than one person.

There is general agreement that altering systems is more important than changing the behavior of single individuals. O'Leary, who is an internal medicine physician, not a surgeon, said he was not surprised by the increase in wrong-site operations. "The need to systematically build in safety has not achieved a level of urgency in our health care systems. You need a CEO who says, 'We have a problem here, and I am going to hire some industrial engineers, and we are going to take our system apart and put it back together until it's safe.'"

The main purpose of JCAHO's data collection, O'Leary said, is to provide advice to hospitals on how to prevent such calamities. JCAHO is requiring that hospitals analyze vulnerable systems -- such as the procedure for delivering medications to patients -- to figure out where they are weak, and to fix them.

JCAHO accredits general hospitals, psychiatric hospitals, ambulatory surgical centers and long-term-care centers. Review by the organization is voluntary; hospitals do not need it to operate.

The American Academy of Orthopedic Surgeons in 1997 began a program called "Sign Your Site," in which surgeons were urged to talk to the patient immediately before surgery, confirm in conversation what was to be done and sign the operative site -- usually a limb -- with an indelible marker. About 60 percent of orthopedic surgeons routinely sign their operative sites, said Terry Canale, a Memphis surgeon who is the immediate past president of the organization. "We were hoping it would be higher than that, and I'm disappointed that the amount of wrong-site surgery hasn't decreased," he said.

Last year, about 915 hand surgeons (out of about 1,600 in the country) responded to a survey from their professional society. Twenty percent reported performing wrong-site surgery sometime in their careers, and 16 percent said they had prepared the wrong site for surgery but caught the mistake before making an incision. The study estimated that wrong-site hand surgery occurred once in every 29,000 procedures.

According to JCAHO, there were 16 wrong-site cases in 1998, 28 in 1999, 51 in 2000, and 58 to date in 2001.


lewis associates advising services

Lewis Associates specializes in personal, effective and professional premedical advising and placement for traditional and non-traditional applicants. Often, non-traditional students are older than 21 years of age, career changers, international applicants or second-round applicants for admission to health professions school.

Lewis Associates' services meet the needs of all types of students from pre-applicants to applicants, including hourly advising support for specific needs. Click here.


"It's never too late to be who you might have been."

If this is how YOU feel, then, maybe Lewis Associates is the place for you. Lewis Associates provides Mentoring and Coaching through the rigorous and often circuitous pre-health preparation and application process. Other consultants may support programs like Law and Business or graduate school -- not Lewis Associates. We are the experts in Health Professions based on 23 years of a successful track record.

Call or email today to set your first appointment!

805.226.9669 imaclewis@lewisassoc.com

Copyright 2009, Lewis Associates. All rights reserved. Please do not repost on any website without direct permission from Lewis Associates.

Please feel free to forward this newsletter to any friends, classmates, or colleagues you feel would find its contents beneficial.

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