Blog Archives

Beware: Smart People Can Offer Dumb Advice

Thanksgiving is a time for gratitude and reflection. It’s also a time to consider what will make you happy in the future.

When I was a medical student applying for emergency medicine residency programs, a well-meaning, smart dean gave me foolish advice: I was determining the order of my rank list and was particularly concerned about one program that had an excellent reputation but was in a city I didn’t like. The dean told me, “You’ll be so busy during residency, it won’t matter where you live.” Luckily, the advice rubbed me the wrong way, and I wholeheartedly disregarded it. I would argue that where you live for medical school, residency, or fellowship is as important as the quality of the institution. The reasons are several-fold:

1. Medical education/training is time-consuming, and you want to be in a city you can enjoy fully when you have a few moments to blow off steam.
2. Medical education/training is extremely stressful, and you want to be in a city where you have social support.
3. Medical education/training is not completed in a vacuum. Your personal life continues. If you’re single you may meet someone and end up staying in the city where you’ve trained for the rest of your life. If you’re in a long-term relationship you may decide to have children or may already have them. Down the road you might not want to relocate your family.

Not everyone gets the opportunity to go to medical school or train in a residency and fellowship program in a city she likes. But you can make choices that will increase your chances. Consider these options – and your happiness – as you practice gratitude this week and make professional decisions this coming year.

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

No application to medical school (or residency) is perfect, which is why it’s important you have a well-considered strategy for managing interview questions about gaps in your candidacy. Addressing a bumpy freshman year or a suboptimal first MCAT attempt with aplomb can make a big difference in how an interviewer and admissions committee perceives you.

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

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AAMC MCAT Prep Workshop – November 8

The AAMC is offering a free webinar “Preparing for the MCAT® Exam” on November 8 at noon PST/3 PM EST. They’re publicizing that the session will include tips for creating a study plan, low-cost prep resources, a demo of their free MCAT Contact Outline Course, and time to ask questions. You can register here. (You will need to create a free AAMC account if you don’t have one.)

As an aside, if you believe you qualify for the AAMC Fee Assistance Program (FAP), make sure to apply for it early. This year’s deadline is December 8. The FAP covers the MCAT, but the grant is not retroactive.

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Pay Inequities Based on Gender and Race Persist in Emergency Medicine

This piece by Dr. Starr Knight on discrepancies in pay for women and black emergency physicians is important but disturbing. The problem has been long-standing and continues, according to recent studies cited in the piece. One 2023 survey found that the average annual income of women emergency physicians was more than $43,000 less than that of their male counterparts. 

Of note, some have argued that differences in hours and part-time versus full-time status account for the pay discrepancies, but a 2017 paper using multivariate linear regression models demonstrated that those reasons are not a valid explanation for the discrepancies. 

See more sobering data in Dr. Knight’s article.



Congratulations and Congratulations

I’ve heard from several clients who have already been accepted to medical school this cycle. Congratulations! I’ve also heard from several clients who have been waitlisted. Congratulations! The waitlist can feel like a disappointment, but it’s important to see it for what it is – a potential acceptance.

One of the hard parts of being on a waitlist is the uncertainty. We humans like to be in control! One way to alleviate this discomfort is to do something. Assuming the school you’re waitlisted at allows communication through their portal, email, or snail mail, I recommend sending a letter of interest (LOI).

When writing your LOI, you should have the following goals:

  1. Restating your strong enthusiasm for the institution
  2. Positioning yourself as a distinctive candidate who can contribute fully to the school
  3. Showcasing any updates to your candidacy. (If you don’t have updates, you should still write the LOI.)

LOI errors to avoid:

  1. Don’t include generic content about the institution’s advantages, meaning don’t waste valuable “geography” telling a medical school admissions officer what makes his/her institution special. Using precious space this way is an opportunity cost, keeping you from fully showcasing what makes you a compelling applicant. Instead, a good technique is to link one of your particular accomplishments with a distinctive opportunity at the institution. For example if you’ve done cancer research, make sure to showcase it and point out that you’ll contribute to the renowned oncology center the institution is associated with.
  2. Don’t focus on how the school will help you. (“Your medical school will assist me in reaching my career goals.”) Your angle instead, should be on how you will be a contributor to their institution. For example, you can detail how one of your leadership experiences has given you the tools to make you a future leader at this institution. (It’s the “What have you done for me lately?” Janet Jackson principle.)

Finally, let me say that I find the term “letter of interest” to be better than the old jargon “letter of intent” because, generally, I don’t recommend you let institutions know what your intent is (since it might change). Note that with a letter of interest you can create one general letter that you modify and send to multiple institutions with different goals (i.e. if you are placed on another waitlist, to request an interview, or to demonstrate your interest post-interview at another medical school). You can also modify the letter and send it to your top choices because, if you are not making a commitment to one school, then you can honestly use it for multiple institutions. 

For those of you interested in LOI assistance for medical school, please contact me.

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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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