By Sunny Nakae

The Stritch School of Medicine received 11,355 applications for 160 seats for the 2016-2017 season.  Thousands of applicants have the required coursework, strong grades and test scores.  The word is out that students need volunteer work, clinical exposure, leadership, and research in order to be competitive.  Every applicant submits a primary personal statement as well as responses to school-specific supplemental questions. As an admissions dean who reads hundreds of applications per year, I would like to offer some advice to all the premeds out there who are looking for a competitive edge: reflection is key to achieving and demonstrating personal growth…

How do you stand out in a field of thousands of qualified applications? An average application essay summarizes accomplishments as a means to explaining motivation.  The average candidate extols the virtue of service, humanity, teamwork, or scientific discovery writ large.  In contrast, excellent candidates are able to connect their experiences to their values and their personal identities while grappling with incongruence, tensions, and open questions.  Excellent candidates stand out because the written components of their applications are unique to self.  Another way to state this is that their personal statements are not interchangeable with those of other candidates.  Demonstrating authentic personal growth through reflection is far more achievable if you have intentionally left the comfort zone for “the growth zone.”  To interrogate your personal beliefs and motivations you must place yourself in environments where those beliefs can be tested.

Being a physician is essentially dedicating yourself and your life to a demanding career that focuses on others.  Your writing must be consistent with this ethos. Focusing exclusively on you or choosing topics that are trivial stirs doubt about whether a candidate, in a just a few years, will be ready to handle the rigors of medicine.  If you write about winning a hockey championship at age 13 or playing doctor at age 4, I wonder why you don’t have something more substantive and relevant to say.  If you discuss your greatest interpersonal challenge as learning to play piano, I wonder if you are prepared to handle delivering bad news to a patient or coping with the grief that often comes through medicine.  I contemplate the judgment and (lack of) maturity that prompted you to share this with an admissions committee as evidence that they should choose you.  I ask: does the writing indicate a level of self awareness and maturity that inspires confidence in the candidate’s ability to be coached, to learn from mistakes, to persist through inevitable challenges?

Reflection means you have considered your own identity and journey – the good, the bad, and the imperfect.  A reflective essay shows you have engaged in genuine curiosity of self and others, and also taken time to acknowledge differences, privileges, inequalities, and systems at work beneath the surface.  Beware the mundane commentary about “feeling good when being of service to others” or “being grateful for the opportunity to use talents to make the world a better place.”  This is equivalent to “duh” in an application essay!  Deep reflection means you have thought about reasons not to go into medicine, or moments when you considered changing your mind. Authenticity may include doubts, faults, shortcomings, and mistakes alongside accomplishments, triumphs, and accolades. The central questions are: What does it mean to you?   Why is the experience meaningful?  How will your future patients benefit from your growth?

Originally I started this blog with a long list of things to avoid writing about in a medical school essay, but soon I realized that I could never cover everything.  Instead I offer an exercise that may help you assess whether or not you have a strong essay.  Read your essay through the lens of a future patient.  Would you choose you to be your doctor in 10 years based on what you wrote? Would you choose you as a provider for a loved one in the future?

Lastly, when all else fails: Google it.  Search reflection questions; there is no shortage of fabulous prompts to contemplate your experiences.  If upon reflection you find yourself coming up short on substance, it is time to get real with yourself and head for “the growth zone.”

Thanks for letting me share my thoughts with you.  To all the medical school hopefuls out there: May you have ample resilience and fortitude for the challenges ahead and presence and wisdom to reflect along the way.

Sunny Nakae, MSW, PhD, is a clinical associate professor of social medicine, population, and public health and Associate Dean for Student Affairs at the University of California-Riverside School of Medicine. She has previously held administrative positions at the University of Utah School of Medicine, Feinberg School of Medicine at Northwestern University, and Loyola University Chicago Stritch School of Medicine. She is the author of Premed Prep: Advice from a Medical School Admissions Dean (Rutgers University Press, 2020)