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.

I Highly Recommend this Paid, Summer Opportunity

I was an American Association for the Advancement of Science (AAAS) Mass Media Science Fellow in 1995 (during medical school). The program was truly fantastic and life-altering.

Applications for this year's fellowship are already open and will remain so through January 1, 2026. The scholarship is a 10-week summer program that places science, engineering, and math undergraduate and graduate students at media organizations across the nation - outlets like NPR, the Los Angeles Times, and WIRED. I worked at the Oregonian in Portland and had a tremendous time, learning how to write effectively and edit. I also gained an appreciation for the immense public health influence journalists can have. 

Here are the anticipated dates for this cycle:
Application window: October 1, 2025 - January 1, 2026
Fellowship: June 3, 2026 - August 18, 2026
Orientation in DC: June 3 - 5, 2026
Dates onsite: June 8 - August 14, 2026
Wrap-up in DC: August 17 - 18, 2026

Steep Fees for H-1B Visas Would be Devastating for International Medical Graduates, the Healthcare Profession, and Patients as a Whole

The US administration recently implemented a $100,000 fee for initial applications for H-1B visas – to be paid by prospective employers. The American Medical Association is lobbying for an exemption for doctors. Currently, new physicians from international locations represent one in six medical residents and fellows at US teaching hospitals, approximately 15,500 doctors in 2024. See this piece by Roni Caryn Rabin from the New York Times that covers the panic about and resistance to the policy's application to physicians and nurses. 

The Number One Strategy for Crushing Medical School and Residency Interviews

 Google had a problem. As a 2012 New York Times article described it, Google executives were growing increasingly aware that they were not hiring enough women. Worse still, they were attracting negative attention about it. So, Google did what Google does best: They amassed data and mined it.

In their analysis, among other findings, Google concluded that the company was overlooking women who tended to be more modest than comparable male applicants during interviews. The interviewers inappropriately perceived the women applicants to be less accomplished, and the candidates were not offered jobs. (Once they understood the problem, Google reported that they altered their internal hiring policies, accordingly.) 

No matter what your gender, the story is instructive in understanding how to strategically approach your medical school or residency interview: I call it, Let Your Story Show Your Glory.

Let’s start with this overarching strategy, one that can be gleaned from the Google story: The interview process is a persuasive one. Your role is to convince medical schools or program directors you deserve a slot at their institutions. The best way to persuade is with facts, just like a lawyer does when s/he is trying a case in front of a judge. Saying you are compassionate or hardworking is not convincing, and it doesn’t distinguish you from the scores of other candidates the interviewer is meeting. You need to prove your worth by highlighting your academic, clinical, research, community service, leadership, international, and teaching achievements.

When mentoring applicants, I hear them ask: Michelle, if I showcase my accomplishments in my interview, doesn’t that mean I’m being redundant? My answer: Absolutely! Think of the medical admissions process like building a house. Your AMCAS/ERAS/ResidencyCAS and letters serve as one layer of that house – like scaffolding. In other words, your accomplishments are conveyed simply and succinctly there. The personal statement is your opportunity to apply a thicker layer, one in which you flesh out your achievements, thus persuading the reader of your distinctiveness (plumbing, pipes, electrical). Finally, the interview is your chance to add on the thickest peel (exterior, roof).

Discussing your accomplishments in detail can seal the interviewer’s positive impression of you. 
If you still feel shy about drawing attention to your achievements, I can assure you that, occasionally, interviewers do not leave adequate time to review materials for the candidates they will ultimately judge, or they are asked to interview such a large number of applicants that they might understandably get candidates confused. If you treat every interview as though it were a “blind” one, you address these obstacles. Determine in advance how you want your interviewers to remember you when they represent you to the committee, and tailor your interview to leave that impression. At the end of the week, when your interviewer asks what others thought of the "young woman who volunteered with Mother Teresa while doing malaria research and competitive hammer-throwing," all the other admissions officers will know immediately she is referring to you.

Remember: You can say you are smart or caring or that you want to heal the world, but to admissions committees and program directors, who you are is what you’ve done...and what traits and skills you’ve honed accordingly.

[A version of this blog was previously published on the Varsity Tutors website, where I was part of their Admissions Expert Series.]

What is ResidencyCAS?

ResidencyCAS is a centralized application platform that replaces ERAS for OB/GYN, Emergency Medicine (EM) and EM's dual programs. It's less expensive than ERAS for applicants, includes an optional "experience essay" for special circumstances, and has a more limited personal statement character count of 4000. 

There are advantages to ResidencyCAS, but if you're applying in two specialties, you'll likely need to manage two platforms (unless you happen to be applying in OB/GYN and Emergency Medicine). Here's more information about ResidencyCAS.

For help, please contact me ASAP.

Residency Applicants Have a Looming Date Ahead

Here's a quick reminder for residency candidates: Programs can start reviewing ERAS applications and MSPEs at 9 am EST on September 24.

There is an advantage to submitting your ERAS so that it's in the first batch program directors (PD) see. As one of my PD friends wrote to me, since the residency application is arguably one of the biggest steps in one's medical career, getting the application in as early as possible should be a given.

On the other hand, if your application is not in its optimal form, waiting a few days is preferable to submitting an inferior ERAS that will be tossed into the "do not invite" pile. 

Contact me ASAP for help with your residency application.

How to Turn that Elephant in the Room into a Cuddly Kitten

No medical school or residency application is perfect: That's why it's important you have a well-considered strategy for managing interview questions about gaps in your candidacy. Addressing a bumpy freshman year (pretty common) or a suboptimal Step 2 score with aplomb can make a big difference in how an interviewer, admissions committee, or program director perceives you.

Check out this KevinMD article I wrote a few years back about how to be upfront regarding a major deficiency in your candidacy and how to demonstrate strategically — with evidence from the remainder of your application — that the weakness is not representative of your abilities.

Avoid the Trite

The goal of your written materials (and your interview) is to distinguish yourself from everyone else to demonstrate that you are worthy of a competitive medical school, residency, fellowship, or postbaccalaureate slot.

Therefore, it's critical that you avoid flowery or trite language: Using it does the opposite of making you distinctive. When I'm editing, I often reference a piece by Lisa Miller called, "When Did Everything Become a 'Journey'?" about the overuse of the word. Miller cites linguistics professor Jesse Egbert who notes that "journey," as a noun, has almost doubled in American English since 1990. 

In her piece, Miller also includes a wry quote from a Los Angeles clinical psychologist who describes the word "journey" as "eye-rollingly cheapened." In editing personal statements, I see the word used frequently – maybe once in every four essays I revise.

Good writing takes a lot of time - brainstorming, outlining, and many drafts. Make sure your written materials are the best they can be by being diligent about your process (and by getting help).

Medical School Interview Tips: What Do AdComs Really Want?

For those of you who've submitted your secondary essays, it's time to start thinking about medical school interviews. Here are tips on what medical school admissions officers/committees are seeking:

1. They want someone distinctive. Your goal is to distinguish yourself from all of the other applicants by showcasing your accomplishments. Anyone can say s/he wants to help people or is hard working. Fewer candidates can prove it with their pre-professional achievements.

2. They want to ensure you're committed to medicine and you have an idea of what you're getting yourself into. Medical school is tough; the institutions are not seeking someone who is ambivalent and might quit. Giving examples of your clinical experience can help.

3. The schools want to ensure you're reasonable. They want to see that you don’t have a problem personality, aren’t going to harass your colleagues, and aren’t going to cause the institution embarrassment or extra work. Being professional during the interview day and having strong letters are important.

4. They want to hear you're particularly interested in their program. You can convince them of your enthusiasm by knowing specifics about the school and city.

You would never take the MCAT without practicing first, and yet, countless applicants go to medical school interviews without preparing. If you're interested in working with me, please hire me soon, as I'm booking up for September.

Doctors' Longevity Benefits Don't Apply to Everyone

It's well known that there are longevity advantages to higher education and income, however a recent study by Brigham and Women's Hospital researchers Christopher M. Worsham, MD, MPH, and Anupam “Bapu” Jena, MD, PhD demonstrated that female physicians don't reap those benefits. Neither do Black doctors. 

Black women physicians were shown to have the highest mortality rate in the profession.

A recent AAMC article reporting on the study also touches on other gender inequities, including female physicians' excessive burnout and home responsibilities, experience of sexual harassment, likelihood to quit medicine, as well as their lower pay. 

Check out the AAMC piece with more details here.

Going to Medical School in the Shadow of the New Tax Bill

Many of you know that I'm a fan of the sweet and informative podcast Your College Bound Kid. In recent episode 556, a student called in asking if she should change her career path away from medicine in light of the newest tax bill. Host Mark Stucker offered a deep-dive answer that I'd recommend. You can start listening at 9:55.

For Pre-Meds Applying in the Next Cycle, What IS Solid Clinical Experience Anyway?

Getting into medical school has gotten so competitive that it's essential to have a strong candidacy with excellent grades and robust extracurricular activities. However, one mistake I see pre-meds make is that they are so focused on leadership and research, they forget a critical component - clinical experience. To prove you want to be a doctor, it's crucial you obtain clinical experience for a significant period of time - not just a health fair or two. Good grades will not make up for a lack of clinical experience. Here are some ideas for obtaining strong clinical experience:

EMT (Some universities have EMT classes and/or jobs on campus; takes time to certify.)
Participate in a good hospital clinical care extender program (Regular hospital volunteer programs are usually not clinically focused enough.)
Work at a low-income clinic (Many require a one-year commitment.)
Certified Medical Assistant (Takes time to certify.)
Certified Phlebotomist (Same)
Certified Nursing Assistant (Same)
Work at a hospice (Because of the nature of the work, may need to be paired with another, more hands-on clinical experience.)
Scribe (Usually a full-time job)
Veterinarian's Assistant (A great way to get hands-on procedural experience; need to explain this choice in your application.)

Pharmacy Assistant (Make sure the role is patient facing.)
Volunteer for a crisis text/phone line (May need to be paired with an in-person clinical experience.)

Shadowing is a mixed bag: Medical schools don't know whether you're second-assisting in the operating room or just standing in a corner being ignored. If you choose to shadow, make sure you strategically delineate your clinical experience in your written materials.

If you're not excited about getting clinical experience, it's time to question your interest in a career in medicine... which is exactly what admissions committees will do if they don't see that experience.

Do your research before accepting a "clinical" job so you ensure you'll really get a satisfying experience and show admissions committees you can handle the heat.

For Those Seeking Postbaccalaureate Program Info

Over the years, I have strongly recommended the AAMC database for those applicants seeking postbaccalaureate programs. On the left you can filter by public or private, undergraduate or graduate, and special focus. Importantly, for the latter, distinguishing whether you need a career changer or academic record enhancer program is critical.

Here's some additional information from the AAMC regarding postbaccalaureate programs – what to look for, how the curriculum prepares students for medical school, etc. 

Writing Your Own Letter of Recommendation: An Offer you Can't Refuse

Every year applicants ask me if it's okay to write their own letters of recommendation when the offer is made by a faculty member. It's not unethical to write your own letter if you're asked to do so. If you'd like to explore the scruples of this issue, take a look at this classic New York Times Ethicist column about the topic.

The mistake I see candidates make in this situation is that applicants don't write very strong letters for themselves, likely because they feel awkward about showcasing their accomplishments fully. If you have the opportunity to write your own letter, craft a glowing one. Be effusive and full-throated in your remarks about yourself! Remember that the letter-writer can choose to tone down the recommendation if s/he doesn't agree. But if s/he does, you've utilized an opportunity fully and bolstered your candidacy tremendously.

Excel During Your (Emergency Medicine) Rotation

Medical students starting their third and fourth years are navigating required clerkships, specialty-specific electives, and sub-internship rotations. What are the tricks to making a good impression during these long weeks and months? Here's a piece I wrote on how to succeed in your emergency medicine rotation; many of the tips translate to other rotations as well.

15 ERAS Tips to Boost your Residency Candidacy

Over the years, I've cultivated several tips for crafting the best ERAS Experience Section. I've included 15 important ones below:

1. Include relevant pre-professional accomplishments from college. If you conducted research, for example, list and describe it. Do not include high school achievements unless they were truly unique (worked at the White House, sang on Broadway, published in Nature ;)).

2. As of 2023, you have only 10 slots, so avoid minor activities (like an afternoon health fair). 

3. Write in a streamlined fashion. Avoid verbiage. Of note, you can choose three most meaningful activities, but you only have 300 characters for each. So while you want to explain why the activity was impactful, you'll need to keep your writing here especially tight.

4. Use full sentences. It’s a formal application, and you want to make your written materials as readable as possible.

5. Avoid most abbreviations. Ones you think are common might not be familiar to the reader.

6. Avoid contractions; they are too informal for an ERAS (but okay for this blog entry ;)). 

7. Make sure you spell out your accomplishments clearly. If your reader doesn't understand an activity, you won't get “full credit” for what you’ve done. Make no assumptions - not even that the reader has reviewed the experience's introductory information (position title, location). 

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

9. Use numbers to be persuasive. Saying that the conference you organized had 500 participants says a lot.

10. 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.

11. Do your best not to leave the "Medical School Awards" section blank. Even if you have to simply include clerkships in which you obtained honors (or high honors), fill that section out.

12. If you have not already, consider joining your specialty's national organization and listing it under the "Membership in Honorary/Professional Societies" section. If you are applying in two fields, take this advice, though. 

13. Try to end your entries with a sentence about how the experience you just described will help you as a future specialist. Making that connection for the reader furthers your candidacy. 

14. As with all good writing, avoid redundant language. Having the word "research" three times in two lines is distracting and demonstrates a lack of originality. 

15. Get help. Don't submit your residency application without having it reviewed by someone with a lot of experience. (I started Insider Medical Admissions in 2007.) You do not want to put forward suboptimal materials for a process that is this important and competitive.

(Please note that there are a few changes to this year's ERAS, including the use of Thalamus for interview scheduling. For more information, see this AAMC page.)

Not Quite What I Was Planning

Years ago, I read a beautiful book called Not Quite What I Was Planning: Six-Word Memoirs by Writers Famous and Obscure edited by Larry Smith and Rachel Fershleiser. The premise is that individuals were asked to sum up their lives in six words. Famous contributors include Margaret Atwood and Stephen Colbert, among others.

I thought about the book recently when I was at my medical school reunion: A dozen of us sat around a round table and talked about what we had been up to for the last 30 years. After we finished, we concluded that the overriding theme was that all of us were doing something different than what we thought we would be doing. I found that concept refreshing, and I suspect it might be reassuring to current students who feel burdened with big decisions.

I just checked out the e-book from the library so I can read it again. 

Federal Cuts are Forcing Academic Medicine into an Existential Mess

I was in Boston last week for my 30th Harvard Medical School reunion. I thought it would be fun, but it was even better than I expected.

Unfortunately, the festivities were marred by a black cloud of current and threatened federal cuts to academic medicine. Harvard, in particular, is getting hit hard, but my classmates were recounting the difficulties they are facing at their current, respective institutions - Harvard and others. 

The AAMC has done a good job offering specific examples of the damage in their recent piece "The Impact of Federal Actions on Academic Medicine and the US Health Care System." Read it and weep. 

The Disadvantages of a BS/MD Program

I've always had major qualms about BS/MD programs, especially the six and seven-year ones, perhaps because I appreciated my college experience so much. There are many other disadvantages (and a few advantages) of these programs, which are extremely well covered in podcast episode 542 of Your College Bound Kid. 

There, college counselor extraordinaire Mark Stucker does a very deep dive into the BS/MD option. Start at 10 minutes into the podcast for his extensive discussion of the (few) pros and (multiple) cons.

White Coat Investor Scholarship 2025 Applications are Now Open

Each year the White Coat Investor (WCI) offers a scholarship opportunity to students enrolled in full-time US professional schools. This year's application opened June 1, and the deadline is August 31. Students must be in good academic standing in eligible professional schools, including medical, dental, law, podiatry, pharmacy, physician assistant, nurse practitioner, and veterinarian, among others. The stated goal of the scholarship is to reduce winning students' indebtedness and to promote financial literacy in professional schools.

The lion's share of the application is an 800 to 1200 word essay. There are 10 grand prize winners.

For more information please check out this web page.

Great Podcast Episodes for College Applicants on Pre-med Paths

For those high school students already considering a career in medicine, I recommend a recent, two-part Your College Bound Kid (YCBK) podcast series. YCBK is run by Mark Stucker, a genial college counselor who covers a panoply of topics on the college admissions process. 

He and his colleague Susan Tree recently spoke about what pre-med students should be looking for and avoiding when considering colleges. They get down to the nitty-gritty, including inflated medical school acceptance statistics, specific institutions that offer mentored research programs, and the corporatization of modern medicine. The episodes are number 537 and 539. 

The Middle School Drama Class you Took Could Help your Medical Career

Taking Spanish and typing classes were two of the best decisions I made in middle school. But after reading Dr. Christina Brown's Doximity article "How We Can Help Women in Medicine Become Better Presenters," I realize that going to performing arts camp was also a boon. Brown points out that women are less likely to be speakers at medical conferences, which limits their career trajectories. She contends that public speaking, writing, and networking skills should be taught during medical school and residency to propel professional success. Her piece is worth a read.

Leverage the MSAR for Your Benefit

The Medical School Admission Requirements (MSAR) database is an online resource that allows users to search, sort and compare information about U.S. and Canadian medical schools. (When I was applying in the 90s, the MSAR was a hard copy book.) The 2025 MSAR was just recently published; if you're applying to medical school, I'd recommend purchasing the current version because it provides so much information about institutions and their admissions statistics. The MSAR allows you to compare schools by median MCAT scores, AMCAS GPAs, and other criteria. (Of course, how institutions utilize the MCAT score is variable, which contributes to the shameful opaqueness of the medical school admissions process.)

You should use the MSAR to help determine which schools are in your range and which are "reach" schools. While it's okay to have a lot of "reach" schools (if you can afford it), it's critical to ensure you are applying wisely to schools that match your numbers. The advantage of the MSAR is that you can make evidence-based decisions. I've found some applicants have eye-opening experiences when they thoroughly review schools' statistics and either realize their numbers are on the lower side and that they should apply to schools accordingly or, happily, that they have numbers that match with top schools. Either way, reviewing the data is critical to good decision making.

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.