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Letters of Interest: No One Wants to be your Second Choice for the Prom

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Imagine you’re back in high school, planning to ask a fellow classmate to the prom. You approach your potential date, “Would you be interested in going with me to the dance? You’re one of my top three choices.”

Not very compelling…The same is true for letters of interest or, really, any outreach to medical schools or residency programs: Over the years, I’ve edited many letters in which applicants mention that an institution is “one of my top” picks.

Avoid that type of language. Instead you can say something like “I would be thrilled to be at your institution,” or “I am confident I can make a positive contribution.” In other words, you can stay honest while not shooting yourself in the foot.

p.s. I’m a huge Flight of the Conchords fan. See this song for reinforcement.

Let me know if you need assistance with a letter of interest.

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Is Making Medical School Tuition-Free Doing What it’s Supposed to?

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Six years ago, when Kenneth and Elaine Langone generously donated $100 million so that students could attend NYU Medical School tuition-free, the philanthropists’ main goal was to encourage more graduating doctors to enter primary care fields. 

Fast forward: In 2024, the number of NYU graduating medical students who went into primary care was about the same as it was in 2017. Furthermore, in the interim, the number of African-American students has declined – although the number of Latinos grew slightly. Additionally, at least in the first two years of the experiment, the percentage of incoming matriculants categorized as “financially disadvantaged” fell from 12% to 3%. 

One thing that has improved is NYU’s rankings and reputation.

All of this begs the question: Is making medical school tuition-free the most effective way to increase the number of primary care practitioners and improve equity?

See this clearly-written Atlantic article by Rose Horowitch for a deeper dive into the query. She was also recently interviewed by Kai Ryssdal on NPR’s Marketplace . 

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Some Medical Institutions are Offering their Trainees Coaching

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I was just reading an interesting piece by the AAMC’s Stacy Weiner on coaching for medical students and residents. The idea is that – beyond advising – students can benefit from the attention of skilled listeners to help them develop individualized plans to achieve short- and long-term goals. 

In the article, Dr. Dana Dunne, the director of coaching at Yale School of Medicine explains, “A coach mostly asks you questions. ‘How do you know when you’re doing well?’ ‘What does success look like for you?’ ‘What has helped you make decisions in the past?’” The AAMC article also highlights Colorado University’s Better Together program. The Better Together website addresses assistance with issues like imposter syndrome, time management, perfectionism, and burnout.

What a great opportunity! All things being equal, choosing an institution that has accessible coaching makes sense when you’re considering which medical school or residency to attend.

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Two Hundred New Residency Slots Open

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For a long time there has existed a bottleneck in the physician training system with more medical students graduating than residency spots available. This phenomenon has been one of the contributors to the physician shortage in the United States. 

In an effort to begin to relieve the problem, in 2021 Congress passed the Consolidated Appropriations Act Section 126 to expand the number of Medicare-supported residency slots. 

Last month the Centers for Medicare and Medicaid Services announced a list of hospitals that were awarded 200 new residency positions under the Act. About seven in 10 of the positions are going to primary care and psychiatry training programs. 

You can read an American Association of Medical Colleges (AAMC) news article about the new slots here. 

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Introducing NRMP’s Rank Order List Lock Pilot

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In October I wrote a blog entry about the benefits of virtual interviews. One issue that has come up is the concern that those who choose to do in-person interviews may have an advantage compared to candidates who interview virtually. The NRMP has noted this worry and is, consequently, instituting a voluntary Program Rank Order List Lock pilot for internal medicine, pediatrics, and vascular surgery for the 2026 Main Residency Match cycle.

The idea is that programs can choose to finalize their certified Rank Order Lists and then provide time for interviewed applicants to come in-person, thus reassuring candidates that visiting or not visiting will not affect their candidacies.

Here is a statement from NRMP regarding the voluntary pilot. It’s an interesting idea, and I’m curious to see how it will play out.

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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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Listen to Dr. Finkel’s interview on the White Coat Investor podcast:

Listen to Dr. Finkel’s interview on the FeminEm podcast: