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The Residency and Medical School Application Process: Moving Past Impostor Syndrome

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First described by psychologists Drs. Suzanne Imes and Pauline Rose Clance in the 1970s, impostor syndrome (IS) occurs among high achievers who can’t easily internalize their successes. They often externally attribute their accomplishments to luck and worry others will eventually realize they’re frauds.

Recognize this phenomenon of self-doubt? You’re not alone.

Although many people suffer in silence (because they don’t want their perceived deficiencies revealed), IS is quite common, especially in medical school. According to one often-cited 2016 study by Villwock et al, almost a quarter of male medical students and nearly half of female students surveyed suffered with IS. A 2026 metaanalysis by Abouelmagd et al reported the overall pooled prevalence of IS was 49%. The phenomenon can be associated with depression, burnout, and anxiety. The American Psychological Association offers a few tips for overcoming IS including speaking to mentors, recognizing where you excel, and talking to a professional.

Here’s a fun article on IS by Joelle Borhart MD, the Program Director of the MedStar Georgetown University/Washington Hospital Center Emergency Medicine Residency Program. I also recommend Amy Cuddy’s TED talk with over 77 million views.

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“Optional” Secondary Essays: Are They Really?

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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?

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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

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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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Get Reliable Post Baccalaureate Program Information

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For those applicants seeking post baccalaureate guidance, I highly recommend the AAMC database. On the left panel you can filter by public or private, undergraduate or graduate, and special focus. For the latter, distinguishing whether you need a career changer or academic record enhancer program is critical.

For each individual program, you can search whether the curriculum awards a certificate of completion or a master’s degree, affiliations like linkage programs, and, importantly, length of time to complete the program (from one year to 24 months).

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

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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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