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After You Get In

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The AAMC recently published a piece called “Congratulations, you got into medical school! Now what?” in which staff writer Bridget Balch lists seven tips for rising first-year medical students. You can see the article here.

The author makes several suggestions, including leveraging the orientation and embracing the academic challenge, but I would highlight her recommendations to find mentors and prioritize your health.

Identifying strong mentors not only affords you the potential for good letters of recommendation and little-known opportunities, but also doing so can support you when medical school is a terrible grind. Mentors can be especially important role models for women and those in traditionally underrepresented groups. The key is to assert yourself and overcome feelings of insignificance. Many faculty are eager to meet and guide students.

With regard to physical and emotional health, I’ve written recently and many times in the past about clinician burnout and depression. Medical school can be a time of significant contraction in your life. Make sure to care for yourself physically and seek mental help when needed.

In the meantime, before school starts, take a well-deserved break!

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A Novel Approach: Reading throughout your Rotations

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I had a thoughtful advisee years back who told me about an interesting plan she had made for herself: As she rotated through different specialties during medical school, she read a book appropriate to each field. For internal medicine, she read “Being Mortal,” by Atul Gawande. For neurology, she read the classic “The Man who Mistook his Wife for a Hat,” by Oliver Sacks. For surgery, she read “When Breath Becomes Air,” a beautiful book by Paul Kalanithi. The list goes on.

I was impressed by this contemplative approach to third and fourth year. So many of us are understandably focused on Shelf Exams and letters of recommendation that we don’t give ourselves a chance to comprehensively reflect on our subject matter and patients’ experiences.

If you have a moment, please check out a few book recommendations I have for those in the medical field. Perhaps my advisee’s stellar plan can be one that other medical students adopt. (You’ll see that I strongly recommend Cutting for Stone. Dr. Abraham Verghese has a new book out that I’m reading right now called The Covenant of Water.)

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Letters of Recommendation: Lead the Witness

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When pre-meds, medical students, residents, nurses, and physician colleagues asked me to write them letters of recommendation (LORs) when I was Assistant Residency Director, the first thing I requested was that they send me background information to make my letter robust…and my job easier. Accordingly, whether you are applying to medical school, dental school, residency, or fellowship, I strongly recommend you create a “LOR packet,” which can include the following:

1. A brief, well-written cover letter defining all of your important accomplishments
2. Your curriculum vitae (CV)
3. Your personal statement in its final form and/or
4. Your transcripts.

With regard to the cover letter, keep it streamlined: Thank the writer and highlight your pre-professional achievements on one page. The point of the cover letter is to supplement a writer’s knowledge of your candidacy and offer flattering content for inclusion. A college professor may know  you made the only A in an organic chemistry class, but her LOR for medical school will be more complete, and she will demonstrate a more intimate familiarity with you if she knows enough to write that you volunteer regularly at a homeless shelter.

With regard to the CV and personal statement, these make useful supplements to the LOR packet only if they are in professional and final form. Don’t include rough drafts. Poorly organized background information leaves your writer with the impression that you are a disorganized person. Also, only include the transcript if it bolsters your candidacy, demonstrating academic achievement. Don’t shoot yourself in the foot if you have some bad grades you’d rather not showcase.

Bottom line: An applicant who offered me a list of her accomplishments in a tidy, accessible package was more likely to get a strong, comprehensive letter that was submitted promptly. She also distinguished herself from the majority of candidates who requested letters without demonstrating a comparably sophisticated understanding of the demands this process made on my time. If you can make a letter writer’s job easier, your forethought is likely to pay dividends in the letter you receive. The savvy applicant can take subtle advantage of her ability to “lead the witness.”

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What to Do in the Summer after Your First Year of Medical School

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A super nice client of mine who is currently a first-year medical student recently emailed me to ask my suggestions for what he should do this upcoming summer. The summer after the first year of medical school is – unless you take a gap year – the last free one you will have for a while, so it’s important to use it wisely. Of course, it’s hard to plan with COVID, but generally, the advice I give is that if someone plans to go into a highly competitive specialty like dermatology or neurosurgery, research is probably the best bet. Those specialties require a significant early commitment to the field and a lot of investigative experience/ publications. 

For less competitive fields, research is still an option, but other opportunities should be considered. If you know you’re not going into a highly competitive field, you have a bit more flexibility. After my first year of medical school, I participated in Harvard’s Urban Health Project and spent my time shadowing a physician in an underserved clinic.

Of course, I would not recommend spending the summer at Club Med :), but I would try to make sure you are happy over the summer – near family or friends – no matter what specialty you are seeking.

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Love Letters and Janet Jackson

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Letters of interest (LOI) – or what some applicants jokingly call “love letters” – can be used in several types of situations:

1) Residency and medical school applicants who want to make an impression post-interview before decisions are made about their candidacies.
2) Medical school and residency applicants who have not yet been invited to interview.
3) Medical school applicants who have been waitlisted.

When writing your letters of interest, you should have the following goals:

1) Restating your strong interest in the institution
2) Positioning yourself as a distinctive candidate who can contribute fully to the institution

The biggest errors I see in LOIs are:

1) Too much content about a specific institution’s advantages. There is no reason to spend a paragraph or more telling a PD or medical school admissions member what makes their institutions special. Using your precious space this way is an opportunity cost, keeping you from fully showcasing what makes you a compelling applicant.

2) Writing about how the program or school will help you. The focus should be on how you will be a contributor to their 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 “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 different institutions with different goals (i.e. requesting an interview or demonstrating your interest post-interview). You can also modify the letter and send it to your top choices because, if you are not making commitments, then you can honestly use it for multiple institutions. 

For those of you interested in LOI assistance for medical school or residency applicants, 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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