• The Personal Statement

    In the past, I always told residency applicants that there is a general rule about personal statements. About 5% are so bad that they can sink an application. About 5% are so good they can make one. The other 90% are so forgettable that they do nothing. My advice to most residents is to shoot for that mid-90%. It looks like many do that:

    As the director of an internal medicine residency program, I read hundreds of personal statements every year. I know many program directors who find them irrelevant at best, and I confess I can’t blame them. These statements usually follow 1 of 3 scripts: The candidates relay a medical catastrophe that afflicted them or their family. Curiosity is piqued. They indulge their curiosity by poring over endless tomes of biologic sciences and end up in medical school. Or, they know that they’ve wanted to be a doctor since conception. They were always exceptionally skilled in the sciences but really wanted to help people. Medical school was the natural conclusion. Or, lastly, the curious case of Mr. X, who tells me a great deal about the unfortunate patient but surprisingly little about the candidate. All candidates then have some sort of revelation during their internal medicine clerkship, and that is how their applications arrived on my computer screen.

    It’s stunning to me how true this is.* It even holds true in fellowship applications.

    They whole piece is worth a read. Especially if you have anything to do with admissions. The advice given at the end is superior to mine:

    Our medical students need to be encouraged to bring themselves to life in their personal statements. They need to find something—anything—that describes them as an individual. Encourage them to share their love of dogs, their fear of clowns, their culinary successes, and their camping nightmares. Tell them to present themselves as someone swimming in this ocean of life and not the buoy bobbing on top of it. For the sake of program directors everywhere, I beg this of you.

    Now that I spend so much time writing, I think this is a much better idea.

    *For the record, my personal statement was about Curious George and my love of reading. I feel pretty good about that.


    • I wrote a traditional 5 paragraph essay for my medical school application. I used the same one for residency and fellowship with only slight modifications. Classic.

    • It’s also a big issue to get into med school. I’ve just helped my son with his personal statement to get into med school here in the UK – we are waiting to see if any of the four schools he has applied to will offer him an interview. I think he did a good job – here you really have to have some experience to stand out and he’s been to Thailand and been in an operating theatre for a week; he volunteers at a local hospice; and has also spent a week at a GP in a rough area of London. The statement though emphasised what these experiences meant to him. Plus he’s great on his Stratocaster electric guitar…

    • Your original advice still makes sense to me. I’ve never been to medical school or applied for a residency, but it’s hard to see why a person should be selected for either based on whether s/he loves or hates clowns, prefers cats or dogs or neither, or is a good or a bad cook. Another blog (by Harold Pollak, perhaps) suggested that most graduate school candidates would do a fine job if admitted. I expect that the same is true of medical school and residency applicants, too.

      • I hear you. But after a while, I’ve started to think that being a better human being is more important to being a good doctor than many realize. The personal statement is one of the opportunities to show that.

    • The same could be said for virtually every candidate selection process from the start of med-school onwards. I’ve heard the chatter – and once the hoops have been jumped through and the right boxes checked, it basically comes down to whether they liked the person or not. The same hearsay suggests this is even more important in residency, which of course makes sense since you’ll be spending a great deal of time with them in close quarters.

      Beyond using a combination of MCAT scores and grades to establishes that a candidate has sufficient intelligence and conscientiousness to complete the coursework in med-school, the entire application process is essentially random and I’d be astonished if selection by lottery or a pool of random citizens produced a pool of clinicians that were significantly better or worse than we get with the current methods.

      There’s a large medical school nearby that prides itself on its excellence in primary care and its dedication to advancing that mission – yet somewhere between being selected by the admissions committee and graduation an astonishingly high percentage of the graduates wind up quite a long ways from practicing primary care in underserved communities.

      I understand that the rational incentives all push quite strongly in this direction, but I can’t help but wonder if it has ever led the admissions committee to wonder how well their selection process is serving their nominal mission.