“Optional” Secondary Essays: Are They Really?

Optional secondary essays are a conundrum because it’s hard to know if they are truly non-mandatory: Will an institution see a non-response as lazy or truly discretionary?

How to approach these essays depends on two things – the prompt itself and your candidacy.

The beauty of a generic “additional comments” section is that it is intentionally vague. It’s your chance to provide details, context, or qualifications that the structure of the application didn’t allow you to present. For that reason, if you have a candidacy without any red flags, I lean toward using a nonspecific “additional comments” space to both highlight who you are and any exceptional aspects of your candidacy that you’d want a reader to know before making an interview decision. One good option in this circumstance is to pick something completely nonmedical that distinguishes you and is nowhere else to be found in your application. Since an interview isn’t guaranteed, don’t save your best material for an in-person meeting. (On the other hand, if you have a large weakness in your candidacy, you usually want to use an optional, generic prompt or a more focused one to gingerly address the issue. See the next paragraph for guidance.)

Sometimes an optional essay is more pointed. Two cycles ago, an applicant forwarded me this prompt: “Please describe any extenuating circumstances that may have affected your medical or non-medical service experiences, including any circumstances that impacted your engagement in activities, academics, and MCAT that would have helped to prepare you for medical school.” If you have no major deficiencies in your candidacy, there’s no need to write this essay. On the other hand, you should draft a response to this prompt if there’s a big elephant in the room. While, in general, I tell applicants to avoid highlighting standard weaknesses, sometimes someone has a big problem that’s important to address head on. It’s better that you write your own story than let someone else do it.

Bottom line: Optional essays are frequently worth completing because this process is so competitive. And, if you have a big weakness, you should leverage an optional prompt to explain extenuating circumstances.

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How Fast Do You Need to Submit Your Secondaries?

I’ve received several questions recently asking in what time frame secondary essays need to be submitted.

Frankly, this is a hard question to answer because the sooner you can get secondaries in, the better, but if you don’t do quality work, you could bomb your candidacy. 

The question reminds me of one I get frequently: What MCAT scores should I target? Well, the higher the better, but there are downsides to fixating on a number. 

So, while you might have heard the popular belief that you must get your secondary applications submitted within two weeks, that’s completely arbitrary. What you want is to do outstanding work as efficiently as possible.

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Secondary Essays: Simply Not Fun

I’ve been getting a ton of questions about secondary essays. As many of you know, I’m not a fan of the entire secondary application requirement. (See my piece, “The Medical School Admissions Process is Falling Short.”) Having said that, most pre-med candidates will have to complete several – if not many – secondary essays and do so on an expedited timeline. 

Secondary essay prompts vary, but there are a few that are standard fare, and one of the most important is “Why do you want to attend our school?” 

Medical school admissions officers want to be assured you know their institution, are seriously considering it, and will fit in well. In approaching the “why-our-school” question, do your research on the institution and link something specific about you with the school’s philosophy, curriculum, patient population, and/or extracurricular programs.For example, if you were a physics teaching assistant in college, you might link your use of the Socratic method with a school’s tutorial-based learning. In that way, you demonstrate knowledge of the school, show you connect well with it, and showcase your distinctive accomplishment.  

The paradox here is that – although you’re focusing your essay on one school – because so many institutions have overlapping philosophies, curricula, programs, and objectives – you can oftentimes use the same framework for many different institutions. That’s one strategic way to cut down the overwhelming workload that secondary applications present.  As you craft your essay, it’s key, however, to know and leverage the names of institution-specific programs like student-run clinics, summer travel scholarships, and/or primary care tracks, for example.

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Two Important Updates for Medical Students

1) Future residency applicants, the USMLE recently announced a significant change to the Step exam calendar – moving from near continuous availability to limited testing dates starting in 2028. There will only be a 45-day window to test. USMLE posits that this change will improve the integrity of the exams. They say they will expand the number of testing centers to mitigate fewer exam dates.

Of note, this will make strategic timing around clerkships, the application season, and the Match more difficult for students.

2) For IMGs applying to residency this year, please note that ERAS tokens are now available through the Intealth portal. If you are applying through ResidencyCAS instead of ERAS (obstetrics and gynecology, emergency medicine), you do not need an ERAS token.

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Pregnancy During Residency: An Impossible Feat?

The AAMC recently published a piece by Beth Howard on residency programs looking to support female residents during and immediately after pregnancy. The article highlights research that demonstrates that trainees who become pregnant during residency or fellowship have an elevated risk of miscarriage, preterm birth, and other pregnancy-related complications compared to the general population.

Starting in 2022, the ACGME mandated at least six weeks of paid parental leave for residents (without causing adverse effects on board eligibility), and last year an ACGME task force published recommendations, including the elimination of overnight calls and 24+- hour shifts in the third trimester, among other supportive policies.

Interestingly, according to a Massachusetts General Hospital randomized trial, instituting a specific pregnancy supportive intervention for trainees kept the burnout curve flat versus a significant burnout increase in the control group. The study points out that the cost of the intervention ($2300) was less than the estimated price of burnout per employee ($7600).

Here’s the AAMC news article for more details. 

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital. She was appointed to the Assistant Residency Director position for the Harvard Affiliated Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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