Being Valued is Undervalued

Back in 2022, an interesting JAMA study called "Trends in Clinician Burnout With Associated Mitigating and Aggravating Factors During the COVID-19 Pandemic" came out. The survey reflected responses from over 20,000 US clinicians and demonstrated that chaotic workplaces and lack of control of workload were associated with higher burnout (think emergency departments or a poorly run, overscheduled clinic), while efficient teamwork and feeling valued were associated with lower burnout. 

People sometimes pay lip service to the importance of being appreciated, but this study supports its significance.

Consider this study's results when making decisions about what field to choose, where to train, and what position to take after residency. Here's the article.

AAMC Report on Residents 2025

Yearly, the Association of American Medical Colleges publishes a report with residency statistics. The 2025 edition has some interesting data:

1. In 2024, women accounted for 50.2% of residents and fellows, representing a persistent increase that has been noted over the past years.
2. Only approximately 29.4% of medical students list the same specialty preference on their graduation questionnaire as they did on their matriculating student questionnaire.
3. US osteopathic (DO) seniors saw a 92.6% PGY-1 Match rate, the highest ever.

You can find more information here.

Two of my Very Talented Friends - Together

I want to recommend a great podcast episode: On her Visible Voices Podcast, my pal and former resident Dr. Resa Lewiss recently conducted a fantastic interview with another friend and former resident Dr. Shan Liu.  

Resa co-authored the book "MicroSkills: Small Actions, Big Impact" and launched Visible Voices in 2020. Shan, who is on faculty at Harvard, wrote the children's book Masked Hero about her great-grandfather Wu Lien-teh who designed a facemask that helped successfully contain the 1910 Manchurian plague and who was the first Chinese person ever nominated for a Nobel Prize in Medicine. It's a fascinating story about public health, systemic racism, legacy, and important passion projects.

Medical School and Residency Admissions: It's Not Personal

When I was in my second year of medical school, a third-year student (who later also went into emergency medicine, as I did) came to speak to our class about being on the wards. He gave an animated talk about how important it was to recognize that when residents, attendings, or nurses hollered at us on our clinical rotations, 99% of the time, it wasn't personal. He likened the situation to Boston traffic - how drivers lean on their horns simply because they are frustrated about their days.

It's not personal, he said.

I say the same to those I mentor. Applicants get an interview at one highly ranked institution but rejected at what is considered a lesser one with no clear cause. Faculty interviewers mix candidates up with one another; some turn up wholly unprepared - reading applicants' AMCASes or ERASes for the first time during the interview itself. 

Remember: It's not personal. This process is arduous and cruel, and most candidates, faculty, and program coordinators are tired and doing their best in a dysfunctional system.

Going to Medical School at Age 30+

According to the American Association of Medical Colleges (AAMC), approximately 3.5% of this year's matriculants to medical school are entering at 30+ years old. I was in my early twenties when I started, and there was a definitive difference in maturity and composure between the "older" students in the class and the rest of us.

Traditionally, some medical schools have been reluctant to train older students, as they see their career longevity truncated compared to younger pupils', however, with increasing demand for physicians and burnout that may shorten younger doctors' careers anyway, some schools are now more open-minded.

Here is a piece from the AAMC about folks who start medical school later.

Three-Year Medical School?

Ezekiel Emmanuel recently wrote a piece in the New York Times with two collaborators arguing the benefits of changing medical school to three years from four. The primary point was financial: Starting next year, under the "One Big Beautiful Bill Act," federal student loans for those in professional graduate programs will be capped at $50,000 per year. Grad PLUS loans will be eliminated completely, leaving half of medical students in the lurch.

Dr. Emmanuel and his collaborators point out that most medical students now arrive with upper-level academic background in sciences and that fourth-year medical school is almost like a "gap year." While I hesitate to agree with those two points, I do think he and his colleagues make other reasonable assertions: For example, making medical school harder to pay for will lead to fewer students from rural backgrounds and therefore fewer future physicians who will work in those needy areas.

Take a look at the piece here.

Reciprocal Liking

When I was at Harvard, we interviewed a residency applicant about whom I was enthusiastic, but when we sat down to talk about the candidate’s credentials, one of my colleagues put the kibosh on the applicant’s prospects. As it turned out, the candidate had made it clear (at least in my colleague's eyes) that he did not want to leave California. “If he’s not interested in us, why should we be interested in him?” my colleague asked.

Although you hope institutions will like you, keep in mind that institutions want to see that you are serious about them as well. 

There is a psychological principle called Reciprocal Liking: People tend to have positive feelings for those whom they perceive have positive feelings for them. Apply Reciprocal Liking to institutions when you interview. Be so familiar with the school/program that you implicitly convey you are excited and sincere about spending the next several years there. Know details about the institutional priorities, extra clinical opportunities, location, and associated hospitals. Make sure to have specific questions for your interviewer, ones that demonstrate your intimate knowledge of the institution and your belief that you could be a contributor and leader.

A Great Opportunity for College Premeds

Applications for the Summer Healthcare Professionals Education Program (SHPEP), a Robert Wood Johnson funded opportunity for college students interested in healthcare professions, open on November 1. SHPEP specifically targets students from economically or educationally disadvantaged backgrounds and those with demonstrated interest in issues affecting underserved populations. The goal is to help college freshmen, sophomores, and juniors apply and matriculate successfully to health professions schools. SHPEP is housed at 10 universities across the country with different start dates – all over the summer. Housing, meals, stipend, and travel expenses are all paid.

Take a look at the program's FAQ page here. The application deadline is February 5.

Check Out the AAMC Virtual Medical School Fair

The AAMC (Association of American Medical Colleges) will be holding a live informational fair Wednesday, October 29 and Thursday, October 30. There will be sessions with staff from medical schools, postbac programs, and the AAMC. Registering also affords you 15% off a one- or two-year subscription to the Medical School Admissions Requirements (MSAR®) website.

You can register here. I offer individually-tailored, one-on-one assistance for pre-meds and candidates applying to postbaccalaureate programs, but there's no downside to hearing more general tips from the AAMC itself.

Making Medical School Tuition-Free is Not Encouraging More Doctors to Enter Primary Care Fields

In 2018, when Kenneth and Elaine Langone generously donated $100 million so students could attend NYU Medical School tuition-free, the philanthropists' main goal was to encourage more graduating physicians to enter primary care fields.

However, by 2024, the number of NYU graduating medical students who went into primary care was about the same as it was in 2017. Furthermore, in the interim, the number of African-American students had declined – although the number of Latinos had grown slightly. Additionally, at least in the first two years of the experiment, the percentage of incoming matriculants categorized as "financially disadvantaged" had fallen from 12% to 3%. One thing that had improved was NYU's rankings and reputation. (See this well-written Atlantic article by Rose Horowitch for a deeper dive into the query.)

Last year Hackensack Meridian School of Medicine in New Jersey launched a Primary Care Scholars Program to tweak the calculus. After being admitted, medical students may apply to the program if they commit to pediatrics, family medicine, general internal medicine, or geriatrics. The program covers a 50% tuition scholarship during the three-year MD track, $7500 as a relocation grant, and $2500 monthly for living expenses. The medical school plans to offer 15 spots next year. Here's a piece on the program and its potential future expansion.