For a medical school applicant with a criminal record, calling the issue complex is an understatement.
The Association of American Medical Colleges does a national criminal background check on medical school applicants and recommends their use by med school admissions committees. Most do that, but school policies and state laws vary.
A small minority of schools on the AAMC website do not use the AAMC-facilitated Criminal Background Check Service. Nine AMCAS-participating medical schools are in Texas and use a state check, and the City University of New York School of Medicine does not require a check.
The majority of schools that use the AAMC criminal background check use no other, but may do additional searches and fingerprinting. At CUNY’s med school, for example, there is no criminal background check requirement. However, when students seek clinical training via a clerkship, traditionally during the third year, hospitals typically request a criminal background check and a drug screening before allowing students to see patients. Those who refuse testing aren’t allowed to participate and therefore won’t be able to meet graduation requirements. If they can’t graduate, they obviously won’t be able to get a license or residency.
Why do medical schools care? Because they are expected to keep patients safe and they want their students to ultimately be able to obtain a license to practice medicine. They also want to avoid liability for any subsequent issues.
In terms of patient safety, any history of criminal convictions — for harm to another person, violence, driving under the influence or driving when intoxicated, fraud of any kind, rape, drug-related crimes, embezzlement, very dangerous or reckless driving, perjury or murder — will definitely raise serious concerns. Either the event was not healthy for a person or could be considered unsafe.
Though there are doctors holding licenses with such infractions, it is not common for med school applicants with a criminal record to be successful without long-term demonstrated behavioral change and restitution.
What do med school admissions committees do? They make their best guess on whether an applicant would allow the event to happen again. If it did occur again, what would be the ripple of consequences? It’s easy to understand why a murder conviction would be too concerning for most admissions committees.
The American Medical Association recommends that all states use criminal background checks for their medical boards, but some do not. Generally, a wide variety of disqualifying arrests can halt licensing in health care, although most states indicate that no offense automatically disqualifies someone.
A state’s medical board may deny an application for a license to practice medicine, or restrict how it can be used. Misdemeanors, especially multiple ones, can fall into that category. In some states, several misdemeanors within a certain time period — such as three drunk driving-related convictions within 10 years — equal a felony.
The bottom line is that a med school admissions committee may not be able to predict for certain that some convictions could or couldn’t prevent licensure. They have to give it their best guess and perhaps consider what their state board has done recently.
As admissions committees consider patient safety and seek to help their graduates get licensed, they will consider how serious an applicant’s criminal conviction was and how long ago it happened. One DUI four years ago may be more concerning than a speeding ticket, but that applicant may still have a chance to get accepted. Murder six months ago will be too high of a risk.
If you have a criminal record and are applying to med school, make sure you have seen the exact police record, because that is what the school will see. Explain the issue clearly and describe any extenuating factors, but do not give excuses. Express sadness or shame if you feel that, and describe what you have done since the incident to assure that it will not happen again.
Dishonesty doesn’t work. The committee will see through it and will not trust you with patient care. In medicine, truth must be the bottom line — assuring you can count on team members to do surgery on the correct leg, indicate the correct diagnosis or order the correct tests on the chart.
Lying about having a drug problem when medication is so accessible would never work well for the doctor, the patient or colleagues. If perjury or fraud occurred in the past, what will keep misrepresentations from happening again on a chart, in verbal orders or with a patient?
Honesty is a habit of excellence. It is a must on medical school applications. Spinning the truth or giving only half-truths pops out on the institutional action description or discussion of a criminal conviction. These usually cause an applicant to get screened out immediately before there is an invitation to interview.
There are blog posts about expunged convictions. I remember a young woman who believed her conviction had been expunged, but it had not. I have also read that in some instances, original convictions can still be found online, even if expunged.
Always take to heart any drug or alcohol problem, convictions or not. Patients who trust their doctor don’t deserve someone with an impaired brain who is not thinking clearly, even if the doctor thinks he or she is. Drugs and alcohol are temptations throughout life when you live under fairly constant stress. It is easy to sweep such a problem under the carpet, but being honest with yourself while still an undergraduate will help prepare you as a medical student to find other ways to cope with stress.
In some states, if a doctor turns to a rehab program before being forced to see the medical board, he or she is more likely to get a pass and continue with practicing. It usually doesn’t go as well for those who don’t do that on their own and then land in front of the medical board.
I have seen doctors lose their licenses due to drug or alcohol abuse. It is sad that they went through so much preparation in their training. Fortunately, many states are putting more effort on the use of probation, rehabilitation and further supervision than in the past.
I once advised a young premed student who had a DUI and was struggling about how to prove he had grown through the incident. I suggested that he volunteer at an alcohol rehab unit. He did and found it to be one of his three most meaningful activities. With his straightforward disclosure and explanation of the impact of his mother’s death and how he had grown through the experience — including the volunteering — he was accepted to medical school and succeeded there.
Whatever your mistakes in life, you can grow through them and become a better person. Ignoring a serious lapse in judgment won’t make it go away, but showing how you have grown and responsibly dealt with past mistakes will help your application.
Most criminal convictions do not prohibit you from becoming a physician, but they do require you to make a knowledgeable disclosure and explain what happened and why without excuses. A sincere expression of regret and awareness of how others could have been or were harmed are helpful. Demonstrate through action, if possible, how you have grown and developed.
Apply to a larger number of medical schools, since you can’t predict the minds of admissions deans. Perhaps call prospective schools in the spring to discuss a criminal issue before including the schools on your application list. Getting sound, objective advice ahead of the application is always wise.
If you don’t have to consider the problem of a criminal record before applying to med school, count your blessings and stay alert. Mistakes can happen to anyone.
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Tips for Medical School Applicants With Criminal Records originally appeared on usnews.com