Moral Injury

It’s troubling, but make sure to read this recent piece in the New York Times called “The Moral Crisis of America’s Doctors” about physicians’ “moral injury.” The phrase refers to emotional damage caused to workers – when in the course of fulfilling their duties – they commit an act or acts that conflict with their core values. The piece argues that, in part, our profit-driven system causes doctors moral injury and, in turn, they become depressed and/or burned out.

I remember many times when I had only bad alternatives in directing my emergency patients for follow-up: If they had no insurance, our knowledgeable social workers advised us that our sole option was to send those patients to the public hospital nearby for follow-up care. This meant I would splint someone with a non-operative, non-emergency fracture and advise him/her to then be seen at another hospital’s emergency department with a multiple-hour wait because that was the only way to get into the system for the affordable orthopedic clinic. I found this very upsetting and contrary to what seemed right to me: It was so hard on the patients, and it also burdened the already overwhelmed medical system.

If you’re interested in recent physician burnout statistics, please see this February 2023 blog on the topic.

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Toxic Work Environments Adversely Affect Those in Training

I recently came across a Medscape-sponsored discussion called “How can we make medical training less toxic?” The video is visible here, and you can log into Medscape to read the transcript. The participants – two emergency physicians and one surgeon – discuss sexism in the workplace, corrosive and inaccurate narratives about women residents, the importance of strong mentorship, and diversity training. This topic is additionally important because toxic work environments can lead to depression, burnout, and suboptimal patient care. My experience in residency was marred by sexism and sexual harassment. It saddens me that these problems are still present, but I’m pleased the issues are starting to be addressed.

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Brevity is the Soul of Wit

As Shakespeare so wisely pointed out, being concise is critical for good writing. I’ve edited a lot of personal statements over the last few months, and I deliberately recommend a word count of 800 or fewer for a couple of reasons:

First, I’ve found that 750 to 800 words is just the right balance of content and streamlining: Over that number lends itself to a meandering admissions essay. Second, your reader is likely reviewing scores of applications. S/he is looking to limit time, while still getting a good flavor for your candidacy. Don’t burden your reader with verbiage.

Having trouble being brief? Here is some guidance:

1) Avoid flowery language. You can omit many non contributing phrases or sentences if you follow this guideline.

2) Read through your writing aloud. Oftentimes doing so will make clear what can be cut.

3) Imagine AMCAS, AACOMAS, or ERAS are charging you $10 per word. How would you keep costs down?

4) Avoid constructions like “I was able to…” and “I chose to…” Instead of “I was able to publish…,” try “I published…”

5) Cut out unnecessary prepositions: “As a volunteer at the university…” can change to “As a university volunteer….”

6) Use abbreviations to your advantage, but only after you define them the first time they are introduced: “At the University of Southern California (USC), I wrote…” Then, you can use “USC” to your heart’s desire, avoiding unnecessary characters.

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What to do Once Your AMCAS is Submitted

Tomorrow – May 30 – is the first day applicants can submit their AMCASes. Please see my recent blog about the advantages of submitting an optimal application on the earlier side

Once your AMCAS is submitted, take a deep breath, relax for a few days, and then start thinking about your secondary essays. Here are a couple of blogs on secondaries, including how to get started on the “Why Our School” prompt and how to approach a diversity prompt

Also, once the AMCAS is in, take a moment to do some soul searching about what you’re seeking geographically, philosophically, and educationally. You want to make considered decisions when the time comes.

Finally, you can start practicing for your interviews. Here is information on my mock interview services.

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Get “Full Credit”

This past week I attended a high school program that included mock admissions case studies for college. Sample, fabricated applications were presented and then discussed in small groups led by a college admissions officer.

Of note, one of the individuals who led the program mentioned something that translates to medical school and residency applications: If the reader doesn’t understand, the candidate will not get full credit. It’s important to explain awards, for example, and not just name them. The illustration the admissions officer gave was “The Titan Award,” a hypothetical prize, but one that the admissions officer noted is not interpretable unless an explanation is given.

I echo the sentiment that if candidates don’t clearly define their accomplishments, those applicants may be overlooked. Make sure you detail anything that would not be readily recognizable to a reader who is not familiar with your geography, institution, or focus of study. You deserve full credit for your very hard work. 

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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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