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.

Funky Away Rotations

The AAMC's Stacy Weiner recently wrote a piece on creative away clerkships, highlighting interesting medical school rotations, including those in wilderness medicine, Emergency Medical Services, and autopsy medicine. See her piece here. Of note, international rotations are also a fantastic opportunity to explore something new for a manageable amount of time. In medical school and residency, my husband traveled to Kenya, China, Bali, and Argentina for rotations and other medical opportunities. He also spent six weeks in Santa Rosa, California for a family medicine rotation, living in a double-wide trailer with other medical students. (He describes it as "paradise.")

Whether you're interested in doing an "audition" rotation or something more unusual, it's worth starting with the Visiting Student Learning Opportunities (VSLOs) website/database here.

Your Residency Application: Five Factors to Prioritize When Creating your Rank List

Creating your Match rank list can be absolutely agonizing because it feels like so much is at stake. Sometimes it helps to step back and look at the big picture. Below, I briefly note a few important considerations when making your list:

1. Make sure you understand how the NRMP algorithm works. See my previous blog post regarding errors to avoid at all costs. The key is to rank in the order you want - first goes first, second goes second, etc.
2. Consider your happiness and life balance. Blasphemy perhaps, but I would argue that they are more important than the strength of the training program.
3. Reflect on the culture, geography, size, and even maturity/age of the program. Think about whether you will fit in.
4. Consider whether you could spend your whole life at the institution or in that program's location. It's a lot to grapple with, but many residents graduate and stay for the rest of their careers. (Of course, you don't have to stay post-residency, so if this consideration is too stressful, don't worry about it.)
5. Decide whether you liked the program director, chairperson, and faculty generally. They could make or break your happiness and success.

¡Ay Caramba!

More from the AAMC: I read a troubling piece recently regarding a bizarre problem Puerto Rican medical students are having. Apparently, some folks don't understand that Puerto Rico is part of the United States. Some Puerto Rican students report they are being misidentified as international medical graduates (IMGs).

The crux of the matter is that Puerto Rican medical schools are - like other U.S. allopathic medical schools – accredited by the Liaison Committee on Medical Education (LCME), recognized by the U.S. Department of Education. On the other hand, many medical schools in other parts of the Caribbean are not LCME-accredited and graduate IMGs. 

IMGs have a tougher time matching. In the last cycle, U.S.- citizen IMGs matched at a rate of 67% and non-U.S.-citizen IMGs matched at a rate of 58.5%. On the other hand, U.S. MD graduates matched at a rate of 93.5%. Thus, being misidentified as an IMG is to the detriment of Puerto Rican medical students in the Match.

See Bridget Balch's interesting article with more details here.

The AAMC 2025 Fee Assistance Program Application is Open

Now that the next medical school application cycle is on the horizon, I want to remind candidates about the Association of American Medical Colleges' (AAMC) Fee Assistance Program (FAP) and Insider Medical Admissions' available discount for those with a current FAP. The FAP is designed to offer help to individuals with financial limitations who cannot pay the MCAT registration and/or AMCAS application fees without financial support. (Of note, there also exists an FAP for dental school candidates through the American Dental Education Association.)

If you think you are eligible, it's worth applying for an FAP grant early: When applicants submit their AMCASes prior to receiving decisions on their FAP applications, those candidates are ineligible to receive the FAP benefits for the AMCAS even if their FAP grants are approved. In other words, the FAP is not retroactive. You snooze, you lose.

There are other benefits including a free two-year subscription to the Medical School Admissions Requirements database, discounted AAMC PREview exam registration fees, and a 60% fee discount on up to 50 applications for residency through the ERAS. 

For more information on the FAP, please click here. I offer a significant discount on one non-package service for any pre-med applicant who can demonstrate financial hardship through a current AAMC FAP grant. After researching the issue, I believe Insider Medical Admissions is the only medical admissions consulting company that currently supports a discount for FAP grant recipients. (I apologize if I'm missing a company.) Once you have been granted the FAP and thus, can prove receipt, please feel free to contact me for more information.

The Future Is Now: Using AI to Evaluate Medical School Applicants

The AAMC recently published a piece regarding the use of artificial intelligence (AI) to assess medical school applications: Multiple institutions, including the Zucker School of Medicine and NYU, use AI for initial screening of medical school applications. Others, like the University of Cincinnati College of Medicine and GW, are developing AI capabilities to pilot within the next couple of years.

Admissions officers say the amount of time necessary to review the thousands of applications they receive is overwhelming and that they can teach AI – using years of successful applications to the school – how to effectively assess candidates. Of course, one big downside is that if an AI platform is based on past human decisions, it will inherently propagate and reflect previous biases that produced admissions results.

See the AAMC article here.

Check Yourself Before You Wreck Yourself: How to Create a Match Rank Order List

As you look toward the NRMP Match rank order list open date on February 3, you'll want to avoid simple missteps. Improving written materials and interview skills are critical, but all of that work can go to waste if applicants do not understand basic strategies for the Match. Way back in November 2015, the NRMP published an article called, "Understanding the interview and ranking behaviors of unmatched international medical students and graduates in the 2013 Main Residency Match" in the Journal of Graduate Medical Education. The data is still relevant today.

Sadly, the authors found that some applicants made strategic errors including the below:

1. Declining to rank all programs at which they interviewed or not ranking all programs they would be willing to attend.
2. Not attending all interviews, thus failing to capitalize on every opportunity to market themselves. (I suspect this error is less common now with the advent of virtual interviews.)
3. Misunderstanding the Match and, thus, ranking programs at which applicants did not interview.
4. Failing to rank programs based on true preferences or ranking programs based on the perceived likelihood of matching.

It kills me to read about these mistakes :(. Here is a video explanation of the Match algorithm. If you do not understand how the Match works, it is absolutely critical that you learn about it to avoid destructive errors.

More Medical Students, Fewer Applicants, and a 3.86 (!) GPA Mean

The AAMC published information recently demonstrating several trends about last year's cycle:

1) The number of medical students has expanded because of new medical schools. First-year matriculants increased 0.8% from the previous academic year to 23,048.

2) On the other hand, the number of applicants decreased for the third year in a row. There was a 1.2% decline versus 4.7% the previous year and 11.6% two years ago. Remember, though, that there had been a huge increase in numbers during the height of the COVID pandemic.

3) Underrepresented minority group matriculant numbers generally declined.

4) What impressed me was that the current incoming class had a mean GPA of 3.86. Wow!

You can see all of the numbers and the AAMC's conclusions here.

Great Podcast Episode for the New Year

I've blogged before about Four Thousand Weeks: Time Management for Mortals by Oliver Burkeman. This wonderful nonfiction book is targeted at those of you who – like me – are productivity geeks. However, unlike other time management authors, Burkeman recommends you surrender to the fact that you cannot get everything done and that traditional time management strategies, which are supposed to help you multitask, will fail and cause anxiety. He recommends recognizing that our lives are finite and that we make choices about our time accordingly.

Burkeman was recently interviewed by Ezra Klein, and I strongly recommend listening to their conversation, especially now, at the beginning of the new year. I found it extremely affecting.

With regard to the book's title, four thousand weeks is how much time the average human has on this earth.

Letters of Interest: No One Wants to be your Second Choice for the Prom

Imagine you're back in high school, planning to ask a fellow classmate to the prom. You approach your potential date, "Would you be interested in going with me to the dance? You're one of my top three choices."

Not very compelling...The same is true for letters of interest or, really, any outreach to medical schools or residency programs: Over the years, I've edited many letters in which applicants mention that an institution is "one of my top" picks.

Avoid that type of language. Instead you can say something like "I would be thrilled to be at your institution," or "I am confident I can make a positive contribution." In other words, you can stay honest while not shooting yourself in the foot.

p.s. I'm a huge Flight of the Conchords fan. See this song for reinforcement.

Let me know if you need assistance with a letter of interest.