How To Craft Stand-out Most Meaningful Paragraphs

Back in 2012, seemingly out of the blue, a new component appeared on AMCAS®. Applicants were being asked to identify up to three of their most significant extracurricular experiences and support their selections with more writing. The instructions stated:

This is your opportunity to summarize why you have selected this experience as one of your most meaningful. In your remarks, you might consider the transformative nature of the experience, the impact you made while engaging in the experience and the personal growth you experienced as a result of your participation. 1325 max characters.

Now the Most Meaningful Paragraphs are par for the course, but applicants routinely make a few avoidable errors in crafting them. Here are tips to do your best work:

1) Don’t merge the descriptors with the Most Meaningful Paragraphs; they are separate sections: You can complete descriptors for up to 15 activities with a maximum of 700 characters each, plus up to three Most Meaningful Paragraphs with a maximum of 1325 characters each. The fact that these are two different tasks might seem clear to some, but every year, I receive AMCAS drafts to edit with merged descriptors and Most Meaningful Paragraphs.

2) Don't use patient anecdotes in your Most Meaningful Paragraphs: Most medical school applicants have patient vignettes to share, which means that a patient story does not distinguish an applicant from the masses of other candidates. Also, these patient stories can sound trite or even inadvertently condescending. Talk about yourself instead. (See below.)

3) Don’t repeat what you've written in your descriptor. The Most Meaningful Paragraphs are an opportunity to delve deeper into your achievements. Let’s say you're showcasing your experience as a teaching assistant (TA) who was promoted to head TA or simply asked to return the next semester. Highlight teaching achievements that propelled you to get the lead position or the return invite. Did you offer an unconventional way of learning the difficult material? If so, what was it? Did you provide service that was above and beyond what was required? If so, what exactly did you do and how did it help your students? Did you get excellent teaching reviews? By delving deeper, you can truly demonstrate the “transformative nature of the experience, the impact you made while engaging in the experience and the personal growth you experienced as a result of your participation.” Make sure you address at least one of the three topics mentioned in the prompt - transformative nature, impact, and/or personal growth - in your Most Meaningful Paragraph.

Bottom line: The Most Meaningful Paragraphs are an opportunity for you to demonstrate your distinctiveness and worthiness for medical school. Write substantively to make sure you don’t waste the opportunity to further your candidacy.

Residency Applicant Characteristics: Key Differences Between Those who are Ranked Highly and Those who Aren't

The NRMP posted a webinar on applicant characteristics associated with success and failure in the recent Match, specifically focusing on Family Medicine, OB/GYN, Otolaryngology, Pathology, and Diagnostic Radiology.

The webinar presents data tracking trends in whom programs (from those five specialties) ranked. NRMP says they hope to help applicants and residency directors gain a clearer understanding of the factors influencing candidate selection. Some of the data is to be expected (average Step 2 scores are higher for Otolaryngology than for Family Medicine), but there there are more specifics offered: Over three quarters of Otolaryngology programs don't take applicants with Step 2 scores under 225 whereas half of Family Medicine programs take applicants with Step 2 scores as low as 215. There are some other interesting factoids that might guide candidates' approach to the Match.

Here's the YouTube link. 

Will Scientific Research Cuts Lead to Increased Medical School Applications?

The AAMC recently posted a piece by Bridget Balch about how rescinded offers and smaller PhD cohorts might have long-term consequences for biomedical science. In addition to withdrawn offers, for some PhD applicants, the research funding chaos has led to increased rejection rates and delayed decisions regarding admissions. Programming for science graduate students from underrepresented minorities has also been hit.

I just heard about an acquaintance's son who will be changing his plans from getting a PhD to applying to medical school, as he sees being a doctor as a more secure career path. I wonder if an unintended consequence of the cuts in scientific research will mean an increased number of students applying to medical school in the next few cycles. Only time will tell.

Which Specialties are Using ResidencyCAS Instead of ERAS this Cycle?

In place of ERAS, a few specialties will be using ResidencyCAS, another centralized application platform for residency programs. In the past, OB/GYN used the newer service, and this year, emergency medicine will as well. ResidencyCAS promises enhanced features like data analytics, specialty-specific design; a mobile platform; and a single system for applying, scheduling, and completing interviews. 

You can click toward the bottom of the page here for an applicant worksheet PDF both for OB/GYN and for emergency medicine.

Of course, candidates applying to OB/GYN or emergency medicine and a second specialty will still need to complete ERAS.

The Medical School Waitlist: Can Anything Be Done?

Recently, I've heard from several medical school applicants who are waitlisted. It's extremely frustrating, especially as the current cycle advances and the next one is on the verge of starting. 

What can you do?

1. Realize that getting into medical school has become increasingly competitive. Being waitlisted is infinitely better than being rejected, and thus a positive, despite the anxiety it causes.
2. Send a letter of interest. Let the school know of your continued enthusiasm and your new accomplishments. Ensure the letter is well written, streamlined, and brief. If the school is absolutely, positively your first choice, let the admissions committee know that. Feel free to send more than one letter if you are on a medical school waitlist for months.
3. Ask the school if you can set up a second look. A supplementary visit indicates to the institution that you are serious, and it offers you more data in making your decision if you're later offered a spot.
4. Ask a well-positioned faculty member who knows your work to make a call or send an email on your behalf. This tactic is especially helpful if the supervisor has a connection to the institution. (I do not recommend that a family friend who hasn't worked with you contacts the school.)
5. Plan for last minute notice. At some institutions, applicants are offered slots off the medical school waitlist throughout the summer. I’ve even heard of acceptances being offered the day before school was to begin. Would you be able to change your living situation, move your personal belongings, and uproot if this were to happen? Be prepared. 

Match 2025 Results Are Out

The NRMP® has already published data from last month's Match. Of note, under 80% of the applicants who submitted a certified rank order lists matched to either a categorical or preliminary year. Match rates specifically for US-citizen and foreign national IMGs were 67.8% and 58.0%, respectively.

My field of emergency medicine did quite well this year, a big contrast from two years ago. (The field is notorious for waxing and waning in popularity over the years.) Primary care specialties also eked out a win.

See more Match statistics here.

Numbers of Black and Hispanic Medical School Matriculants Have Declined, a Problem that May Intensify

A recent piece by the Kaiser Family Foundation (KFF) predicts that numbers of underrepresented minorities in medical school may dwindle further amid recent executive orders regarding diversity, equity, and inclusion in federally funded programs. 

After the 2024 Supreme Court ruling that race-conscious college admissions policies violated the 14th Amendment, numbers of Black and Hispanic matriculants to medical school fell by double-digit percentages compared with the previous year. 

This downswing was particularly troubling, considering that higher proportions of Black primary care doctors are correlated with longer life expectancy and lower mortality rates for Black individuals, according to a 2023 JAMA Network research article. Furthermore, a variety of studies have shown insidious biases against Black patients.

According to the Association of American Medical Colleges, in 2024-5, Black medical school enrollees declined 11.6% and students of Hispanic origin fell 10.8%. The decline in enrollment of American Indian or Alaska Native students was 22.1%. New Native Hawaiian or other Pacific Islander enrollment declined 4.3%.

Here is the KFF piece.

Avoid These Ten Common AMCAS Mistakes

Here's a brief list of AMCAS Work and Activities section errors to avoid at all costs:

1. Don't write to write. While you want to include many strong achievements, you do not want your AMCAS to be so wordy that your reader is tempted to skim.

2. While you need to be brief, don't write in phrases; use full sentences. It’s a formal application, and you want to make your written materials as readable as possible.

3. Don't assume your reader will carefully study the "header" section (including the title of the activity, hours, etc.). Make sure your descriptor could stand alone: Instead of "As an assistant, I conducted experiments..." use "As a research assistant at a Stanford Medical School neuroscience lab, I conducted experiments..."

4. Don't be vague, dramatic, or trite. Make sure you spell out your accomplishments clearly and substantively. If your reader doesn’t understand an activity, you will not get “full credit” for what you’ve done. Make no assumptions.

5. Avoid abbreviations. Again, you want to be formal; plus, abbreviations you think are common might not be familiar to the reader.

6. Write about yourself and your role – not an organization. For example, don’t use the space to discuss Doctors without Borders. Use it to discuss the specifics of your role at Doctors without Borders.

7. Avoid generalities and consider using numbers to be persuasive. Saying that the conference you organized had 300 participants says it all.

8. Don't merge the descriptors with the most meaningful paragraphs because they are separate sections: You can complete descriptors for up to 15 activities with up to 700 characters each plus up to three most meaningful paragraphs of up to 1325 characters each.

9. Unless your PI won the Nobel, avoid using supervisors' and/or doctors' names in your descriptors as they will be meaningless to the majority of your readers.

10. Choose the right category for each activity, so you get "full credit." (Please note AMCAS added a category last year called "Social Justice/Advocacy.")

Bonus: Get help. Do not submit your medical school application without having it reviewed by someone with a lot of experience. You do not want to showcase suboptimal materials for a process that is this important and competitive.

Welcome to Match Week

This is Match Week:

Monday: Programs find out if they filled; applicants find out if they matched; SOAP begins. Here's a 2025 primer on SOAP.
Tuesday through Thursday: SOAP process in play.
Friday: Match Day.

If you were one of my residency clients this year, I'd appreciate hearing from you when you have a moment to update me. I'm sending everyone the best of wishes.

Medscape Physician Mental Health Report 2025: Burnout is Still Very High

The annual Medscape burnout survey is out, and, while the numbers are being touted as an improvement, a whopping 47% of physician respondents reported being burned out and 24% reported depression. (The burnout statistic is lower than it was over the last few years' surveys.) When asked, "Can doctors in your specialty be happy and well-balanced?" only 63% of emergency physicians (my field) said yes, the lowest of all specialties surveyed. (Of note, 94% of allergy and immunology physicians gave an affirmative response, the highest of all specialties surveyed.) Additionally, 63% of physicians responded that they would accept a pay cut for better balance.

According to Medscape, "These results portray a profession that has work to do in finding happiness, balancing work and family demands, and developing friendships that sustain one in a demanding career."

Here is a graphic representation of the survey results.