How are Residency Programs Managing the $100,000 Fee for New H-1B Visa Applications?

The Association of American Medical Colleges (AAMC) recently published a piece on the effect H-1B visa fees will have on the Match, hospitals, and access to medical care going forward unless there is an exception made for the healthcare field. The article also explains the distinctions between the H-1B and J-1 visas for physicians.

Andrea Price-Carter, MPA, director of health equity advocacy and government relations for the AAMC points out that J-1 and H-1B visa holders do not displace U.S. medical graduates, and instead, fill gaps where there is a shortage of needed professionals.

Here's the AAMC piece.

AW(e)SOM(e)

This week a friend texted me a PBS NewsHour segment she saw about the Alice L. Walton School of Medicine (AWSOM) that opened for its inaugural class this cycle. The school is located in Bentonville, Arkansas, and its mission is to provide an innovative program that incorporates art and humanities. The school shares a campus with the Crystal Bridges Museum of American Art, and medical students are encouraged to learn the "art of healing." Importantly, for the first five cohorts, tuition is free, so the admission process is fierce. 

Take a look here at the PBS segment.

Some Faculty are Using AI to Craft Letters of Recommendation

The AAMC recently published a piece about faculty members who use artificial intelligence to craft first drafts – at least –  of recommendation letters for students. 

I understand the pull of AI for this purpose, but even if the flow and syntax are better, I'm concerned these letters will sound generic and unoriginal. Letters of recommendation can make a huge difference in a student's candidacy, and submitting something iterative or bland could be a real disservice to the applicant.

The article ends with a quote from a urologist advising that faculty members tell students and the institutions that receive their letters that they use AI to help compose the text, but I would go further and say that if a faculty member is planning to use AI, s/he should tell the student before writing the letter so the applicant can decline the recommendation if s/he wants to.

What is a DO Really Anyway?

Many laypeople and premeds are not clear on the difference between an MD and a DO. This piece from the New York Times was not written with medical readers specifically in mind, but it's helpful as a starting point for anyone. The American Osteopathic Association also has some good information on their website here.

How Some Colleges Make Their Acceptance Rates Look More Impressive

Those of you who read this blog regularly know that I'm a huge fan of Mark Stucker, the earnest, knowledgeable, and sweet college admissions expert who produces the Your College Bound Kid Podcast. There are many similarities and differences between college admissions and medical school admissions. Still, the economics and incentives of the college process are really fascinating and reflect on how strange and faulty both systems are.

Mark covered a really interesting topic in episode 604: Tactics some colleges use to make their acceptance rates look more impressive. While the techniques are technically ethical, they're certainly not student centered! Listen to the episode (at about seven minutes in) here.

Medical and Dental School Interviews: Preparing for your MMI

I just completed a Mock Interview Service with a lovely client who was about to face his first MMI-style interview. Although the majority of medical and dental school interviews are still traditional, some institutions utilize a multiple mini interview (MMI) platform. The MMI is a format that uses several timed stations to assess applicants' interpersonal skills and judgment.

A few things to note about MMI interview questions:

1) They are not always medically-related. You may be asked to manage an everyday problem (e.g. a disagreement at the supermarket).

2) They are not always situational. You need to be prepared for conventional questions (e.g. what are your three greatest strengths?).

3) Schools are trying to assess whether you can skillfully employ important techniques and demonstrate professionalism. Underlying topics might include your ability to offer effective counseling, your understanding of patient-doctor confidentiality, an ability to diffuse a heated situation, a capacity to admit wrongdoing, or reporting an impaired supervisor.

4) Make sure to read the school's description of their MMI format: How many minutes do you have to prepare with the prompt, how long are the stations, are there role-play scenarios? Knowing what the structure is will help decrease stress. 

It's important that you practice MMI questions before you go to your medical or dental school interview. Even if you have excellent social skills, there are techniques you should hone to expertly manage the challenging MMI format.

Time to Take a Reading Break

I hope each of you has a moment of downtime over this holiday season. One of the ways I relax is with a good book. Here's a piece I wrote for Student Doctor Network regarding great books for doctors in training.  

In addition to the list, I want to add another strong recommendation: Pulitzer Prize Finalist Paul Kalanithi's When Breath Becomes Air. Get ready to cry your eyes out, while appreciating beautiful prose and insightful content. Paul Kalanithi was diagnosed with metastatic lung cancer when he was a senior neurosurgery resident at Stanford. He chronicles his short life in a book that's hard to put down. 

Scholarships for Prehealth Students

Student Doctor Network (SDN) just announced their 2026 scholarship for prehealth students who are committed to under-resourced communities as future professionals. SDN is awarding up to four $2500 grants; eligibility requirements include having graduated from high school in a medically underserved area or having received fee assistance; applying to medical, dental, pharmacy, or other doctoral health programs; and being a US citizen or permanent resident.

Here's a link with more details regarding eligibility, timeline, and the application process.

Please note: Applicants demonstrating financial hardship through a current AAMC Fee Assistance Program grant may be considered for reduced rates for Insider services. Please contact me for more information. 

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.