research paper about medical school

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Med Sci Educ
• v.31(2); 2021 Apr

Teaching Medical Research to Medical Students: a Systematic Review

Gabriel sheng jie lee.

1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Yip Han Chin

Aimei amy jiang, cheng han mg, kameswara rishi yeshayahu nistala, shridhar ganpathi iyer.

2 Division of Hepatobiliary & Pancreatic Surgery, Department of Surgery, National University Hospital, Singapore, Singapore

3 Liver Transplantation, National University Centre for Organ Transplantation, National University Hospital, Singapore, Singapore

Shuh Shing Lee

4 Centre for Medical Education, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

Choon Seng Chong

5 Division of Colorectal Surgery, Department of Surgery, National University Hospital, 1E Kent Ridge Road, Singapore, 119228 Singapore

Dujeepa D. Samarasekera

Associated data.

Research literacy remains important for equipping clinicians with the analytical skills to tackle an ever-evolving medical landscape and maintain an evidence-based approach when treating patients. While the role of research in medical education has been justified and established, the nuances involving modes of instruction and relevant outcomes for students have yet to be analyzed. Institutions acknowledge an increasing need to dedicate time and resources towards educating medical undergraduates on research but have individually implemented different pedagogies over differing lengths of time.

While individual studies have evaluated the efficacy of these curricula, the evaluations of educational methods and curriculum design have not been reviewed systematically. This study thereby aims to perform a systematic review of studies incorporating research into the undergraduate medical curriculum, to provide insights on various pedagogies utilized to educate medical students on research.

Studies predominantly described two major components of research curricula—(1) imparting basic research skills and the (2) longitudinal application of research skills. Studies were assessed according to the 4-level Kirkpatrick model for evaluation. Programs that spanned minimally an academic year had the greatest proportion of level 3 outcomes (50%). One study observed a level 4 outcome by assessing the post-intervention effects on participants. Studies primarily highlighted a shortage of time (53%), resulting in inadequate coverage of content.

This study highlighted the value in long-term programs that support students in acquiring research skills, by providing appropriate mentors, resources, and guidance to facilitate their learning. The Dreyfus model of skill acquisition underscored the importance of tailoring educational interventions to allow students with varying experience to develop their skills. There is still room for further investigation of multiple factors such as duration of intervention, student voluntariness, and participants’ prior research experience. Nevertheless, it stands that mentoring is a crucial aspect of curricula that has allowed studies to achieve level 3 Kirkpatrick outcomes and engender enduring changes in students.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-020-01183-w.

Introduction

Medical research is of high value to clinicians and society. In modern-day practice, the continued growth of knowledge has added richness to the medical world and challenges medical professionals to stay afloat. As such, to navigate the ever-evolving advances in medical practice and technology, literacy in research remains crucial for the effective application of evidence-based medicine. In particular, medical research equips clinicians with skills to critically analyze the clinical relevance of papers to provide invaluable insights into novel treatments.

The integration of research into medical education has been documented to have translated into skills valuable to future clinical practice. Exposure to research experiences may improve analytical reasoning, communication skills, and application of emerging knowledge to patient care [ 1 ]. This may serve to benefit students as future medical practitioners. Early exposure to research experience as medical students may also enhance the relevance of research in routine practice as doctors and has shown to be associated with future postgraduate research involvement [ 2 ]. Lastly, integration of research into medical curricula may provide students with a suitable foundation on which they can further develop their skills as required in their careers [ 3 ].

Yet, despite the growing appreciation of research, the participation of medical students in research remains limited. Most students entering medical school are neither aware of how scientific research functions nor cognizant of its importance [ 4 ]. Research by Stone et al. showed that the motivations fueling students’ research interests include competing for residency and enhancing resumes, amongst others related to career advancement [ 5 ]. With the goal of research being the improvement of evidence-based practice and bench to bedside translational research, such motivations may seem almost perverse [ 5 ]. Furthermore, there are barriers within medical education systems that further hinder students’ exposure and participation in research. Medical students are deterred by the practical difficulties such as the lack of learning opportunities [ 6 ], and challenges in securing research-associated opportunities, particularly if they lack relevant skills [ 1 ]. Burgoyne et al. also found that over half of all medical students are interested in a career incorporating medical research [ 3 ]. Nevertheless, they remain largely unaware of such activities in their host institution due to gaps in the curricula [ 3 ], with even residents finding difficulties in completing research projects [ 7 ]. With the myriad of benefits that medical research can bring, it is therefore important to embrace research as an integral part of the undergraduate medical curriculum, and effectively integrate it into the curriculum.

Currently, studies discussing the effectiveness of imparting research skills to medical students in professional degree programs are available. However, a synthesis of these results has yet to be undertaken. The role of human medical research in medical education has been justified and established, but the nuances involving modes of instruction and relevant outcomes for undergraduate medical students have yet to be analyzed. This study thereby aims to perform a systematic review of studies incorporating research into the undergraduate medical curriculum, to provide insights on various pedagogies utilized to educate medical students on research.

Materials and Methods

Database sources.

In consultation with a medical librarian, three major electronic databases, MEDLINE, CINAHL, and Web of Science, were searched for articles related to educating students about research from inception until January 2020. With advice from a medical librarian, key search terms such as “medical students” and “research methodology” were applied in the search. The search strategy used can be found in the supplementary materials.

Article Selection and Eligibility Criteria

English articles that evaluated an intervention or existing programs educating medical students about research were included in this review. Medical students were defined in this study as students in a professional medical degree program (postgraduate or undergraduate studies), limited to the human medical field (veterinary field, dentistry, or nursing were excluded). Only primary research articles with the above criteria were considered—all opinions, reviews, commentary, or editorial papers were excluded. A two-stage process of selection was employed, where two authors independently screened through titles and abstracts to select articles according to the eligibility criteria. Thereafter, a full-text sieve was conducted, and articles were excluded based on the eligibility criteria.

Data Extraction and Synthesis

Two independent authors extracted the following data from the included articles: publication details, study sample demographics (year of study, sample size, research experience), and intervention details (curriculum design, frequency of sessions, mode of teaching). The data coded was then grouped into subcategories described by the included studies and captured the unique observations and perspectives of the pooled data.

While several methods are available for the synthesis of such knowledge [ 8 ], this study focused on emphasizing the relationship between time and resources invested in holistically increasing medical students’ research capabilities, and thus used directed content analysis and deductive theming [ 9 , 10 ]. For outcome measures, the Kirkpatrick model was used [ 11 ]. The Kirkpatrick model consists of four levels: reactions, learning, behaviors, and results of training participants. Specific to research education, level 1 measures participants’ self-reported changes in attitude and interest in research, while level 2 measures objective knowledge retention. Level 3 records changes in participant’s behaviors through increased research productivity and level 4 observes quantifiable outcomes and results beyond the education program such as an enduring active engagement in research [ 11 ]. Thereafter, the data was synthesized and grouped into major categories, according to pedagogy, assessment methods, and outcomes achieved. Any discrepancies were discussed and resolved in consensus or in consultation with a third author.

Quality Appraisal of Included Studies

Quality appraisal was conducted with the Medical Education Research Study Quality Instrument (MERSQI) designed to evaluate systematic reviews of education research. MERSQI is a 10-item instrument that grades studies on 6 domains: study design, sampling, type of data, validity of evidence, data analysis, and type of outcomes [ 12 ]. Two authors independently appraised the articles and resolved discrepancies via consensus or in consultation with a third author.

Through database searches, 3573 articles were identified. Thereafter, 157 full-text articles were assessed, and a total 35 articles were included in this paper (Fig. 1 ). Sample size ranged from 11 to 916 (mean = 148) and a total of 5182 students participated in the included studies. Twenty-one studies (60%) were conducted in North America while the remaining studies were conducted in Africa, Asia, Australia, and Europe. One study recruited participants from multiple European countries [ 13 ]. Participants were most often students in their pre-clinical years ( n  = 16, 46%), with six studies reporting prior research experience, and three studies reporting no prior research experience [ 14 – 16 ]. The remaining 26 studies did not report students’ prior research experience. Additionally, 19 studies involved voluntary elective educational interventions, while the other 16 studies observed enforced curricular interventions. Twenty-two articles were quantitative studies, 2 were qualitative, and 11 were mixed method studies. Table ​ Table1 1 summarizes the data of the included articles. Quality assessment was done, and most articles scored 10 and above according to MERSQI, details of the scoring can be seen in Table ​ Table1 1 .

PRISMA flowchart

Summary of included articles

The studies predominantly described two major components of research curricula—(1) imparting basic research skills to students and (2) longitudinal application of research skills. These components were used exclusively by 17 studies and combined into a multimodal approach by 18 studies. Most curricula incorporated a mentorship program ( n  = 28, 80%) to expose students to medical research. Didactic teachings were the next most common method ( n  = 22, 62%). Other methods include small group discussions, e-learning methods, and seminars. Interventions generally occurred over the academic year ( n  = 12, 34%), over the summer break ( n  = 12, 34%), over multiple years ( n  = 6, 17%), or as workshops lasting one to seven days ( n  = 5, 14%). A detailed breakdown of the education curriculum is provided in Table ​ Table2 2 .

Important characteristics of articles evaluating research education to medical students

a Individual studies employed multiple modalities of interventions, leading to percentages adding to greater than 100

b Study employed a mentored research program but did not specify occupation of mentor (peer, faculty member, or otherwise)

c Symposium style

d Self-conducted research

e The extent to which students reacted positively to the curricula, such as enjoyable content, comfortable learning experience, and effective teaching style

f The extent to which students have developed the expertise, knowledge, and skills needed to conduct research. These skills and knowledge were evaluated through increased tests used to measure the students content knowledge

g The extent to which students behavior has changed after completing the education curricula provided by the various schools/organizations. This is evaluated through increased research output through the curricula program

h The extent of success of the curricula in quantifiable factors such as increased rate of research articles published by the school due to students own initiative and not during the term of the curricula

Educational modalities were focused on two main goals. Firstly, studies described curricula designed to teach basic research skills such as formulating research questions and developing study designs [ 17 – 19 ]. The duration of curricula was generally one to seven days [ 20 ], after which participants could also express their interest in research projects [ 15 ]. Secondly, studies aimed to provide students an opportunity to apply their acquired research skills through the completion of a research project, primarily under the supervision of a mentor [ 13 , 15 , 17 – 19 , 21 – 42 ]. Broadly, studies utilized both methods in tandem, while some studies exclusively employed either method.

Basic Research Skills Curricula

Curricula utilized didactic teaching strategies to impart basic skills to students as an introductory course to research. These courses encompassed topics such as experimental design, research methodology, interpretation of experimental data [ 43 ], and statistical analysis [ 16 , 18 , 19 , 25 , 35 ]. Apart from formal didactic sessions, studies also included seminars ( n  = 4, 11%) [ 25 , 30 , 32 , 40 ], e-learning modules ( n  = 4, 11%) [ 37 , 40 , 44 , 45 ], and small group discussion sessions ( n  = 3, 9%) to equip students with research skills [ 23 , 32 , 36 ].

Longitudinal Application of Research Skills

Curricula also incorporated longitudinal mentored research experiences to expose students to research (Table ​ (Table2). 2 ). Students were assigned to mentors from a range of faculties and clinical settings, and were guided through basic biomedical, epidemiological, and community-health-related research projects [ 13 , 19 , 22 , 23 , 33 , 34 , 38 , 41 , 42 , 46 ]. These studies recruited faculty or community research mentors [ 13 , 19 , 22 , 23 , 30 , 31 , 33 , 34 , 38 , 39 , 42 ], with one study recruiting additional peer mentors ( n  = 1, 10%) with prior research experience to guide students [ 22 ].

A Multimodal Approach

Studies in this review predominantly adopted a multimodal approach ( n  = 18, 51.4%), involving both elements of didactic teaching as well as mentorship. Studies included initial classroom instruction on the theoretical aspects of research, followed by a period of practical application under the guidance of mentors [ 13 , 15 , 17 , 18 , 21 , 24 – 29 , 32 , 35 – 37 ]. Apart from incorporating the components mentioned above, such programs conventionally lasted the duration of a summer break [ 17 – 19 , 22 , 23 , 25 , 26 , 29 , 34 , 41 – 43 ], an academic year [ 14 , 21 , 24 , 27 , 28 , 31 , 32 , 36 – 38 , 40 , 45 ], or extended to multiple academic years [ 13 , 16 , 21 , 30 , 33 , 39 ].

Assessment Methods

To analyze the impact of didactic curricula and longitudinal research experiences on participants, a majority of the studies utilized pre- and post-surveys ( n  = 27, 77%) to gather both qualitative and quantitative participant feedback [ 14 – 18 , 20 , 22 – 24 , 26 – 32 , 35 – 37 , 39 – 41 , 43 – 45 , 47 , 48 ]. Students’ feedback was collated via qualitative questionnaires [ 39 ], feedback sessions [ 30 ], and Likert scale-type questions to measure their satisfaction with the curricula and interest levels in research [ 47 ].

Studies primarily used knowledge tests to determine the benefits of didactic curricula of students. Evaluation conducted by studies included pre- and post-quizzes (Table ​ (Table2), 2 ), in the form of multiple-choice questions to measure students’ retention of knowledge [ 28 , 47 ]. Quizzes comprised internally developed components and externally sourced questions adapted for institutions’ local contexts [ 44 ]. Studies also established student’s understanding of learning objectives through self-reported scores on closed-ended questionnaires [ 20 ].

Studies also evaluated the research output of students who undertook mentored research projects to assess the effectiveness of the curricula. The number of publications ( n  = 4, 40%) was used as a quantitative marker for effectiveness (Table ​ (Table2). 2 ). Additionally, studies also noted the number of student submissions for conference presentations. Participants were also assessed on their application of research skills via written and oral presentations of their research proposals to the faculty [ 24 ].

Studies that delivered research education through both modalities attempted to evaluate students on both theoretical and practical fronts. Studies developed questionnaires on research methodology and other practices surrounding information literacy to quantitatively assess students’ gain in knowledge [ 28 ]. Studies also monitored the number of students engaged in research beyond the program as well as the frequency of successful presentations and publications [ 25 ].

Level 1 outcomes centered around participants’ self-reported changes in behavior, knowledge, interest in research, and feedback towards the course. Students’ responses to the curricula were overwhelmingly positive [ 36 ]. Students found that research curricula were relevant, interesting, and improved their knowledge and research skills [ 48 ]. Next, studies evaluated level 2 outcomes by assessing the degree to which participants have gained knowledge and skills from curricula [ 16 , 28 , 37 , 44 , 47 , 48 ]. Studies reported significant increases in pre- and post-test results which encompassed both research skills and medical knowledge [ 16 , 42 ].

Curricula exclusively comprised of didactic teaching methods were often not able to produce level 3 outcomes. Two studies were able to observe completed research projects [ 48 ], out of which only one study gave rise to a 0.47% rate of publications produced per student [ 16 ].

Studies describing longitudinal research curricula also recorded level 1 outcomes, primarily in the form of students’ feedback. Participant feedback was uniformly enthusiastic [ 18 ], and participants reported significant increases in knowledge from their baseline to post-intervention [ 29 ]. Studies observed that students better understood the integral place of research in a physician’s role and were more motivated towards careers in specialties they were exposed to [ 13 , 23 ]. In terms of level 2 outcomes, studies revealed that the research curriculum facilitated the acquisition of research-related knowledge amongst students [ 28 , 48 ]. Students showed significant improvements between pre- and post-intervention knowledge quizzes and also reported significantly higher median scores for research items on tests [ 37 ].

Students were able to achieve level 3 outcomes when curricula required students to undertake a research project. Both interventions employing peer mentors ( n  = 2/2, 100%) and researcher mentors ( n  = 16//26, 62%) were shown to produce level 3 outcomes [ 15 , 17 , 21 , 22 , 25 , 27 – 29 , 32 – 37 , 40 , 42 ]. The duration of the educational interventions also had a substantial effect on the ability to achieve level 3 outcomes. Programs that spanned at least a single academic year had the greatest proportion of level 3 outcomes ( n  = 9, 50%) [ 16 , 21 , 27 , 28 , 32 , 33 , 36 , 37 , 40 ], where students reported research skill development and motivation to conduct research in the future [ 38 ]. They were also more likely to publish their completed research papers or present their abstracts at conferences ( n  = 7/12, 58%) [ 21 , 27 , 28 , 32 , 36 , 37 , 40 ].

Multimodal Approach

Studies undertaking a multimodal approach observed outcomes relevant to both didactic teaching and research mentorship. Integrating supervised research projects into curriculum significantly improved medical students’ self-perceived research experiences (level 1) [ 37 , 39 ], and was similarly associated with a large proportion of research publications and presentations ( n  = 12/18, 66%) (level 3). Four studies that incorporated both didactic teaching and a mentored research experience resulted in publication rates of over 50% [ 13 , 32 , 34 , 35 ]. In addition, one study highlighted a level 4 outcome by assessing the post-intervention effects on participants. The study revealed that the longitudinal application of research skills paved the way for future participation in research and attainment of research accolades [ 25 ].

Curricular Incorporation

Nineteen studies (54.3%) offered research programs to students on an elective basis, of which 10 produced level 3 outcomes, where students were successful in presenting their research and listed as co-authors [ 15 , 17 , 22 , 25 , 26 , 29 , 33 , 34 , 40 , 42 ]. Such elective programs were provided on a sign-up basis and took the form of summer programs or additional courses conducted outside of curriculum time. Notably, students have been noted to be engaged in research even after the course of the program [ 25 ].

Sixteen studies (45.7%) conducted research education as a compulsory portion of the medical undergraduate program. Studies devote a portion of the undergraduate curriculum to research education in the form of longitudinal or short-term modules. Similarly, more than half of these studies showcased students publishing articles during medical school. Unique to this group of studies was the reporting of level 2 outcomes, where students exhibited a gain in research knowledge [ 16 , 21 , 28 , 47 , 48 ]. Studies conducting mandatory courses have also been observed to offer research electives to students involving topics of interest. These students likewise proceeded to publish papers under international peer review [ 36 ].

Only 43% ( n  = 15) of all the studies discussed challenges in implementing their respective interventions [ 14 , 16 , 19 , 20 , 26 – 30 , 32 – 34 , 42 , 45 , 48 ]. The most frequently highlighted challenge amongst studies providing basic research theory was a shortage of time ( n  = 2/7, 29%) [ 20 , 48 ], which resulted in insufficient coverage of content.

Participant feedback highlighted a lack of time to complete research projects [ 48 ]. One study noted that multi-year curricula achieved learning objectives by providing sufficient time to facilitate participants’ longitudinal coverage of the community-oriented primary care cycle [ 16 ]. Other challenges surfaced include maintaining the commitment of mentors and finding an appropriate timeslot for the education program to avoid conflicts with other modules of the undergraduate medical program [ 16 , 19 , 20 , 34 ].

Naturally, the multimodal approach shares similar challenges to both pedagogies above. Studies noted a shortage of time to fulfil classroom learning outcomes, as well as to provide a significant window of time for students to undertake research projects under the wing of a mentor [ 26 – 28 , 30 ]. This was exhibited by student requests for more preparation in using statistical analysis software [ 26 ], and community partners’ low ranking of the program timeframe [ 27 ].

This systematic review summarizes the variety of methods that the institutions have utilized to impart research skills to medical students. The analysis highlights two main approaches of teaching these skills: through classroom-based teaching of basic theoretical research skills, and providing students a mentored research experience. Students first developed these skills through didactic teaching methods such as through workshops or seminars, which were then reinforced through the application of these skills under the supervision of a mentor. Our review found that curricula, which utilized both didactic and mentored research components, reliably achieved level 3 outcomes. Programs giving priority to mentoring students in the research process greatly reaped the benefits of mentors. The literature shows that such mentoring resulted in a greater proportion of published papers, compared to exclusively didactic teaching methods. Beyond supervising students, mentors also played an essential role in career counselling and motivating students, and prove to be of significant value in an academic setting [ 2 , 39 , 49 ].

Students’ levels of motivation to learn also bear weight on the outcomes of educational interventions and is of great interest to most educators [ 50 ]. This review found that there were no major differences in the research output of either elective or mandatory research programs. Mandatory research programs were often accompanied by standardized assessments, possibly arising from the institutions’ desires to evaluate the quality of their research education and students’ gain in knowledge [ 28 , 48 ]. It is thus unwise to attribute a recorded gain in knowledge solely to the motivation of students. However, it remains that motivation has a positive impact on the learning of students. Notably, Cluver et al. recorded a continued engagement in research following a research elective program, thereby underscoring the importance of an individual’s interest and motivation towards research [ 25 ].

This study also identified challenges to effectively develop and implement such curricula. Firstly, meaningfully incorporating a comprehensive and systematic research component into the content-heavy medical curricula, especially during the clinical phase of student learning, was difficult. This led institutions to limit the student exposure in research as well as the scope of content covered. Some institutions were able to circumvent this challenge by either integrating research as a longitudinal component of the undergraduate curriculum or dedicating time for students to work on research [ 16 , 21 ]. Studies that spanned at least one academic year achieved a higher number of students with level 3 outcomes. Secondly, mentored programs faced the additional challenge of sourcing for mentors, maintaining their commitment, and equipping them with sufficient knowledge and skills to both educate and provide a holistic learning experience in research. This second challenge was overcome with the inclusion of peer teaching, which eased the need to contend for trained medical professionals [ 22 , 40 ]. It is essential that institutions recognize and strive to overcome these challenges in designing an effective curriculum to equip medical students with research skills.

As part of continuous quality improvement and program reforms, most institutions have developed program evaluation processes. However, these processes heavily relied on participants’ self-reporting Kirkpatrick level 1 outcomes. Few studies focused on higher levels which required independent evaluators or standardized tests to obtain quantitative data. The focus was primarily on capturing short-term outcomes, which failed to highlight the long-term behavioral changes and did not necessarily equate to future application of learnt skills by students [ 11 ]. Program evaluations should strive towards attaining the fourth and final level of the Kirkpatrick model, where students are able to replicate, impart, and apply these competencies in future settings [ 11 ]. Endeavoring to achieve level 4 outcomes would push educational institutions to implement curricula that have an enduring impact on students beyond medical school, allowing them to develop both a capacity and an interest to continue research activities. However, studies face difficulty evaluating such outcomes because it necessitates tedious tracking of graduates’ research performance in their future careers.

An interesting observation was that most studies did not achieve level 2 outcomes as compared to levels 1 and 3. This can be attributed to two possible causes. Firstly, the model does not strictly limit a linear progression from levels 1 to 4. In the case of undergraduate medical research education, there is a prevalent usage of self-assessment tools which resulted in larger proportion of level 1 outcomes. Furthermore, undergoing a mentored research experience often results in a tangible, independently reviewed research product, which qualifies as a level 3 outcome. The second possible reason could be due to the additional required effort of preparing a quiz and conducting a pre- and post-tests, resulting in a lower number of published literatures on level 2 outcomes. This is as opposed to level 3 outcomes which are easily objectively measured by the number of journal publications or conference presentations, and level 1 outcomes through feedback surveys. Nevertheless, there are increasing doubts regarding the individual’s capacity to conduct self-assessments, which gives rise to self-inflated scores and inadequate learning of non-motivated students [ 51 ]. This calls for designing evaluations with more objective data points and long-term structured mentoring, which could bridge these gaps.

In order to achieve long-term and higher levels of outcomes, institutions need to design and cater curricula to students at different stages of research skill acquisition as they face different issues and disparate educational experiences depending on the level of competency they possess [ 52 ]. The Dreyfus model of skill acquisition presents five developmental stages— novice , advanced beginner , competent , proficient , and expert —that describes a shift from tedious analysis in line with abstract and rigid principles to a concrete foundation of experience that enables expeditious intuitive decision-making [ 53 ]. Adopting this model for research education introduces the need to teach these skills in a systematic and longitudinal fashion that is meaningfully integrated to the core medical curriculum. The curriculum can be structured in a way to teach the basic fundamentals of research to newer participants ( novices and advanced beginners ) and then move on to practical skills and real-life practice of paper-writing and statistical analysis for experienced students ( advanced beginners , competent , and proficient students) in later years of learning as well as to inculcate values and behaviors in students who have attained more proficient research abilities ( proficient and expert students) (Fig. ​ (Fig.2 2 ).

Dreyfus model of skill acquisition

The allocation of curriculum time to developing the research skills of students hinges upon the focus and goals of the individual institution. The formation of an intercalated program to nurture clinician-scientists will therefore preferentially expose students to a wide range of research opportunities and research seminars [ 54 ]. However, medical research is but one of the components of the undergraduate medical curriculum. The limitations and challenges discussed earlier hinder undergraduate medical students from potentially advancing to the higher tiers of the Dreyfus model [ 16 , 28 , 30 , 40 ]. It is thus impractical to expect institutions and students to achieve competency within the span of the course. Instead, institutions should opt to develop a curriculum streamlined according to students’ skill levels that will maximize the limited time students have under the institution’s care and jurisdiction and facilitate a more appropriate assignment of students to mentors who possess different resources and research projects at hand.

Most students enter the research fraternity with no prior research experience and start as novices, unfamiliar with research protocol and relevant analytical tools [ 55 ]. Such students require straightforward, rigid rules and guidelines to familiarize themselves with the various steps in conducting research. Offering novice students an opportunity to learn research in a safe environment is essential in lowering the barriers to entry and to demystify the processes for acquiring research skills and critical analytical skills [ 56 , 57 ]. As such, novices benefit greatly from didactic teaching modalities that elucidate theories and methodologies underlying research, focusing on the foundation knowledge needed for research [ 58 ]. After attaining a theoretical understanding of research, novices can progress to an advanced beginner through continuous testing of concepts and developing some functional skills. Advanced beginners better appreciate each step of the research process but require active recollection and effort to complete each task, and face difficulty with practical applications. For these students, curricula should provide students opportunities to join simple research projects under mentors, to allow them to accumulate experience, develop practical skills, and allow them to consolidate their knowledge to progress to the next stage, competency [ 59 ]. Institutions should expose students at this stage to a broader range of research projects in different fields, allowing them to accumulate experience from various medical fields. Competent individuals are able to complete most tasks involved in writing a paper but remain reliant on guidelines, especially in unfamiliar contexts, and thus require the scrutiny and supervision of mentors [ 60 ]. The accumulation of experience from various fields will allow them to develop pattern-recognition, thereby reducing their dependence on rigid rules, augmenting their quality of research. Most undergraduate medical students fall in the above categories, with the achieving of higher tiers of expertise restricted to an exceptional few, or to the domain of postgraduate courses and professional researchers.

The proficient individual undertakes sustained active participation in research to accumulate experience. Students proficient in research have sharpened research skills, a significant understanding of the relevant analytical methods and resources in place. Moreover, they have an awareness of their interests, strengths, and weaknesses—critical for self-regulation—and are thereby able to consistently produce better quality research compared to their peers [ 59 ]. Institutions best serve by connecting students to organizations or experts with additional resources and research opportunities, which students may not be able to procure as individuals. It is also at this stage where students are sufficiently skilled to become peer mentors themselves. This process of peer mentoring further polishes research skills and makes individuals cognizant of knowledge gaps. In addition, students undergoing mentorship programs were more likely to take responsibility of both their own and their peers’ learning, ultimately facilitating tangible results [ 61 , 62 ]. Without mentoring, students in included studies often hit a glass ceiling at level 1 outcomes. This suggests that neither interest nor knowledge alone can propel a student towards desired behavioral changes. Rather, mentoring is the key to inducing a greater form of change amongst research students by allowing to them be engaged and inspire confidence in them [ 13 ]. This will also overcome the challenge highlighted earlier of recruiting faculty mentors and maintaining their commitment. Peer mentors have the relevant advantages of a lower cost, add to a larger pool of potential mentors, lend credibility and effectiveness in role modelling, and help develop a common perspective [ 63 ]. It is therefore of great value to institutions to involve proficient students as peer mentors in longitudinal mentorship programs, with additional guidance from faculty mentors or supervisors to develop intuitive research practices [ 60 ].

With cumulative experience as both mentee and mentor, proficient individuals eventually progress to become experts . Experts are distinguished by behavioral and attitude changes. This is key in a student’s journey towards becoming a clinician-scientist as this is marked by an endeavor to conduct research and contribute to existing literature. Experts possess experience in conducting research and writing research papers and are able to function more intuitively when tackling challenges and solving problems compared to their peers [ 58 ]. Curricula should focus on involving such students as mentors which will facilitate their own continuous education and prevent regression of skills [ 60 ]. This course of ramping up curricula in alignment with the Dreyfus model has been detailed in other studies and similarly underscore the progression from basic knowledge to functional skills and personal growth [ 60 , 64 ]. This ultimately equips students of different stages to meet challenges along their research journey in the limited time undergraduates have under an institution [ 58 ].

Theoretically, the Dreyfus model describes a progressive acquisition of research skills for a novice to become an expert. A student who achieves the level of an expert would undoubtedly possess a remarkable level of intuition and refined skillsets. However, most curricula from the included studies only facilitated students’ growth up to a certain point along the Dreyfus model. While the Dreyfus model serves as a guide to suggest how institutions may best nurture students from a broad spectrum of abilities, the role of undergraduate medical research education is not to simply achieve mastery. Rather, it is to develop the abilities of individuals. Presented with the challenges and limitations discussed earlier, institutions should endeavor to serve as a stepping stone in a student’s journey as a medical practitioner or researcher and to develop an enduring interest and improved capacity for research.

Recommendations

We present the following recommendations for consideration for institutions aiming to design curricula including research exposure.

• Adopt a longitudinal approach—Research modules spanning a longer period allow sufficient time to build a strong research foundation, multiple research opportunities, and greater rates of completion
• Mandate and incorporate research education into the core curriculum—Recognizing research as a core component of education and dedicating time minimizes future scheduling and resource conflicts with other modules of the program.
• Engage and consider student mentors—Mentors are indispensable in research training and should be engaged to ensure sustained, long-term commitment. Utilizing student mentors would further increase both the mentors’ and mentees’ commitment to learn, improve, and polish their acquired skills.

Limitations

This systematic review acknowledges a few limitations. Firstly, our review only considered studies observing undergraduate medical education incorporating research skills and did not consider postgraduate research degree studies such as Masters, MD, or PhD programs, which has greater rigor and a higher level of understanding for research. Next, we were also limited by the inherent quality and scope of the included studies, which lacked data on evaluative models. Currently, the available studies assess effectiveness of medical research educational programs using a myriad of internally designed questionnaires and tests and lack a consistent objective framework to evaluate the effectiveness of their intervention. Furthermore, many studies failed to determine the extent of participants’ prior experience in research and made minimal adjustments to curricula accordingly. As such, it was challenging to observe any enduring impact of the curricula on students.

Research literacy remains important for equipping clinicians with the analytical skills to tackle an ever-evolving medical landscape and maintain an evidence-based approach when treating patients. This systematic review has reiterated the value of incorporating a longitudinal mentorship program in the medical undergraduate curricula and has highlighted the importance of tailoring educational interventions, to allow students with varying experience to develop their skills and initiate the learning process for students without prior experience. There is still room for further investigation of multiple factors such as duration of intervention, student voluntariness, and participants’ prior research experience. Nevertheless, it stands that mentoring is a crucial aspect of curricula that has allowed studies to achieve level 3 Kirkpatrick outcomes and engender enduring changes in students.

(PDF 9 kb)

Acknowledgments

The authors would like to thank Ms. Annelissa Chin from Yong Loo Lin School of Medicine, medical library for assisting us with the search strategy.

Compliance with Ethical Standards

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Exploring the usage of learning resources by medical students in the basic science stage and their effect on academic performance

• Open access
• Published: 15 May 2024
• Volume 24 , article number  543 , ( 2024 )

Cite this article

You have full access to this open access article

• Sabin Kumar Ranabhat   ORCID: orcid.org/0000-0002-0658-5068 1 ,
• Mohan Lal Kunjukrishnan 2 ,
• Muskan Dubey 3 ,
• Vernon Curran 4 ,
• Arun Kumar Dubey 5 &
• Neelam Dwivedi 6  

The United States Medical Licensing Examination (USMLE) step 1 is one of the two examinations written after completion of the first two years (basic science stage) of medical school to be eligible to apply for residency training in the USA. A huge number and types of study materials are available to prepare for the exam which might confuse students choosing a resource.

We investigated learning resources being used by the third and fifth-semester medical students and their association with academic performance. We also compared learning resources and exam scores of high-performing and low-performing students.

Data collection was done using structured (quantitative study) and semi-structured (qualitative study) questionnaires during a face-to-face interview. This article is about the quantitative part which was designed as a correlational study. Single factor one-way analysis of variance (ANOVA), Pearson correlation coefficient test, T-test, and Fisher’s exact test were used to analyze the data.

About half of all students used three or more commercial resources dealing with the same content. A weak negative correlation was observed between the number of commercial resources and the exam scores, especially when the number of these resources was three or more ( r  = -0.26). The mean exam score of textbook users was statistically significantly higher than the mean score of textbook non-users ( p  = 0.01). The usage of textbooks was statistically significantly higher in the cohort of top performers in comparison to the rest of the students ( p  = 0.006). In addition to less usage of textbooks, the mean number of review books was higher in the group of weakest students (2.84 versus 3.7; p  = 0.75).

Conclusions

Most students did not use professional textbooks and about half used too many commercial review resources. While the former fact was significantly associated with poor academic performance, the later fact had weak negative correlation with exam score.

Pedagogical interventions are urgently needed to make the right type of learning resources available by making professional textbooks more USMLE-oriented and helping the students choose the best and right number of resources for optimum academic performance. By fulfilling the observed needs of the students in this way, they might feel empowered because of self-determination which will motivate studies.

Similar content being viewed by others

The effect of access to electronic resources during examination on medical and dental students scores in summative assessment: quasi experimental study

Frequency of Student Resource Use and Academic Performance in Preclerkship Education: A Survey Study

Learning Performance Indicators a Statistical Analysis on the Subject of Natural Sciences During the COVID-19 Pandemic at the Tulcán District

Introduction.

The United States Medical Licensing Examination (USMLE) is written by the United States as well as international medical graduates at the end of the two-year basic science stage of medical school to enroll in three to seven more years of medical training (residency) in different branches of medical science in the USA. In 2022, that number stood at 53,881, which is much higher than the residency slots available which is 39,205 [ 1 ]. The successful residency match rate in 2022 for US medical graduates, US International Medical Graduates (US IMG), and non-US IMGs was 92.9%, 61.4%, and 58.1% respectively [ 2 ]. However, there is a silver lining in the cloud: according to a report from the Association of American Medical Colleges in 2017, there will be a shortage of up to 104,900 physicians in the USA by 2030 [ 3 ].

To maintain the competitive edge, a student needs to score higher than the others in Step 2 Clinical Knowledge (CK) even though USMLE Step 1 score reporting has been changed to a simple pass-fail from the previous three-digit numeric scoring on January 26, 2022 [ 4 ]. Passing step 1 in the first attempt is also not an easy job which is necessary to make oneself competitive in the residency match.

Numerous commercial organizations and individuals have developed a multitude of resources that are supposed to help students with their studies and preparation for the USMLE examinations. These resources include review books, question banks, and audio–video resources based on the fact that more than 70% of students are multimodal learners as described by the VARK model: Visual, Auditory, Reading and Writing, and Kinesthetic. These resources give students the flexibility to choose one according to their needs [ 5 , 6 , 7 ]. However, an important caveat is these resources are written concisely mainly to help students revise the already learned USMLE content in a short period (e.g., a few weeks) before USMLE step 1 and as supplementary resources to traditional textbooks during the basic science years [ 8 ]. Nevertheless, many medical students are using these resources as the primary learning platforms from an early period of the first year itself or in the second year well before the dedicated USMLE study period. Such a phenomenon is called “Step 1 climate” [ 9 ].

Several factors contribute to this phenomenon as explained hence onward. The influence of the USMLE test preparation industry and social media often promote a humanistic approach to learning, emphasizing student choice and control over resources. This resonates with students who desire the freedom to select materials they find suitable. Many concise review resources prioritize testable, high-yield information, presented in formats like bullet points and buzzwords. While seemingly efficient, this approach can have drawbacks. By focusing solely on “high-yield” material, students might miss out on broader foundational knowledge and the context required to truly understand tested concepts. These resources may not cover all testable topics, and low-yield information, although not explicitly tested, can be crucial for comprehending the bigger picture. While these concise resources might seem convenient, they may not equip students with the comprehensive understanding needed to excel in their studies and future careers. The result is a potential gap in students’ knowledge base due to lack of in-depth study [ 9 , 10 , 11 ]. Unlike review resources designed for rapid revision and recall, textbooks support in-depth exploration of a topic by delving into the historical context and theoretical foundations of each topic. They provide multifaceted explanations and diverse perspectives. Through this comprehensive approach, textbooks empower students to transcend rote memorization and cultivate a deep, nuanced understanding of the subject matter [ 12 ].

Jeyaraju et al. analyzed 201 studies on USMLE exams and found that the most important factor for success was a good foundational base of knowledge supported by regular and continuous habits of learning over time from comprehensive resources. Practice tests were also found to be helpful as the number of practice test items and practice exam scores positively correlated with higher USMLE scores [ 12 ]. Other researchers have also found that the foundation of knowledge developed through an accredited curriculum during the basic science years is the most important factor for success in USMLE steps [ 8 , 13 , 14 ]. Nevertheless, it does not mean commercial review resources have no place in medical education. Some researchers have demonstrated that the usage of such resources along with traditional learning material helps students score higher marks in USMLE exams [ 15 , 16 ]. Using question banks, which is called retrieval practice, has been shown to improve long-term retention and recall of previously learned information which can be explained by Cognitivist learning theory [ 14 , 17 , 18 ].

The National Board of Medical Examiners (NBME) and the Federation of State Medical Boards (FSMB), the organizations that provide oversight of the USMLE examinations, have changed the scoring system of Step 1 to a pass-and-fail from a 3-digit-scoring system to encourage students to pay more attention to the accredited school curriculum and discourage too much focus on Step 1 score and unwise usage of commercial test resources [ 19 ]. However, due to the following reasons, this might not be enough to bring students to the classroom environment from step 1 climate. The fact that principles and facts of basic sciences are the core basis of clinical sciences learning and thus success with the USMLE step 2, knowledge acquired during the first two years at medical school is vital to score better in the step 2 exam. This reason and the increment in the passing score of Step 1 from 194 to 196 and a similar change in Step 2 CK score from 209 to 214 will ensure the ever-increasing proliferation of commercial test preparation resources tailor-made for USMLE step 1 [ 20 ]. Program directors from now on will shift their focus to Step 2 score for the screening of potential candidates for interviews to screen thousands of candidates for a handful of residency positions [ 21 , 22 ]. Before the change in scoring system, program directors used step 1 score as a first-line screening tool that could compare applicants objectively [ 23 , 24 ].

Therefore, it would be better to maintain the status quo on the numeric scoring system of USMLE and find other ways to strike a balance between traditional teaching–learning methods and the usage of commercial test resources by students.

Statement of problem/rationale of the study

As educators guiding students through the foundational basic sciences in our medical school, we have witnessed firsthand the pervasive influence of the “step 1 climate.”

Students have become increasingly drawn to the perceived efficiency of these concise review resources. They often express frustration with the time commitment required to grasp complex concepts from textbooks. This preference for quick solutions has manifested in several concerning ways: reduced class attendance, textbook neglect, and utilization of too many concise resources.

Our research aims to dissect this problem from multiple angles. We want to determine if there’s a tipping point where relying on too many concise resources becomes counterproductive for learning and by analyzing how high-performing and low-performing students utilize learning resources, we want to identify potential strategies that contribute to academic success. Armed with objective research findings, we will be able to engage in data-driven discussions with students, faculty, and the USMLE preparation industry to create a learning environment that fosters a strong foundation in basic sciences while adequately preparing students for the USMLE.

While the current literature acknowledges student confusion regarding resource selection, a comprehensive investigation into the potential downsides of relying heavily on commercial review resources and neglecting textbooks is lacking.

This research has the potential to significantly impact medical education by providing much-needed clarity on the role of commercial review resources, textbooks, and Question Banks, and their impact on student learning outcomes. Additionally, by comparing resource utilization patterns between student groups, we can glean valuable insights into effective learning strategies.

The purpose of the study was

Explore the types of learning resources medical students are using in the basic science stage of medical school and examine their effect on academic performance.

The specific objectives of the research were

Explore what learning resources students use.

Examine whether the types of resources utilized influence exam scores.

Compare learning resources and exam scores of high-performing students and low-performing students.

Methodology

Research design and variables.

Research design: It was a mixed quantitative and qualitative study. For the quantitative part, a correlational study design was used to find out the association between independent and dependent variables (Table  1 ). This research paper is about the quantitative part. The qualitative part of the study will be submitted to a journal for publication in the second stage.

Study site and ethical approval

The study was conducted at Xavier University School of Medicine, Aruba after ethical approval was received from the Institutional Review Board (IRB) of Xavier University School of Medicine (Study ID number: XUSOM/IRB/2023/03/001). The University offers a four-year undergraduate medical program, Doctor of Medicine (MD). Students complete the first two years, the basic science stage, in Aruba. At the time of this research, students were studying in the first semester, the third semester, and the fifth semester.

Study participants

Twenty-nine ( n  = 29) out of 30 Doctor of Medicine students in the 3rd semester and fifteen students ( n  = 15) out of 19 in the 5th semester were included in the study.

The sample size was calculated with the below-mentioned formula with following parameters: confidence level (1-alpha) 95%, margin of error 5%, and population size 49.

The participation was voluntary. Participants were selected randomly by a simple random sampling technique using a table of random numbers. Written consent was taken before data collection. Participants were anonymized by giving each of them a unique code as described below: the first participant of the third semester was given the code “M3.1” and the first participant of the fifth semester was given the code “M5.1”. Subsequent participants were coded serially.

Top-performing students were identified as those who scored 65% or more in the most recent NBME exam. Those students who scored less than 35% were identified as the weakest students. The score thresholds were selected for the purpose arbitrarily.

Study resources

In this research, three types of resources have been studied: professional USMLE-oriented textbooks, commercial review resources, and question banks. Learning resources have been categorized as mentioned below based on a pilot study, relevant literature, and personal experience (Table  2 ).

Exam scores

NBME nervous system exam scores were taken as the reference for MD 3 semester students and NBME cardiovascular system exam scores were taken as the reference for MD 5 semester students in order to compare with the usage of learning resources.

Data collection

Data collection was undertaken using a questionnaire survey completed during a face-to-face interview by the lead author adhering to the interview protocol. Questionnaire items included questions regarding demographic variables, types of learning resources students were using, study behavior, and perceptions about the different types of learning resources, lectures, and exams.

A pilot study was conducted among 6 students to validate the questionnaire to check the internal consistency and reliability of survey questions. The pilot study was also used to assess question clarity, answer options, and the overall flow of the survey. These students were not included in the main study. Some questions were deleted, some were modified, and some were added to the questionnaire after gaining new insights from the data of the pilot study. The questionnaire also underwent expert review to enhance its content validity and ensure it appropriately captures the target construct.

Responses to the qualitative part of the study were audio-recorded.

Survey questions

There are in total 23 items in the questionnaire. Two items are open-ended questions intended to gain insight into students’ perceptions about learning resources and study behavior (qualitative study). The rest 21 items are devised to collect quantitative data. Thirteen of these 21 items are related to learning resources which is the main subject matter of the current manuscript. The questionnaire has been uploaded as a supplementary file.

Data analysis

Quantitative data were analyzed by descriptive methods: frequencies, percentages, mean, and significance tests where applicable.

Single factor one-way analysis of variance (ANOVA) was used to determine whether there was a statistically significant difference between mean exam scores among different age groups. The Pearson correlation coefficient test was completed to analyze the correlation between the number of review books used and the exam score.

An independent samples T-test was used to compare the mean score between the two groups of students with the following variables viz., review books, Q Banks, textbooks, and gender. F test was used before the T-test to find out whether the variance of the two populations was equal or not.

Fisher’s exact test was used for two pairs of nominal data when the sample size was not large enough to use the Chi-square test. An alpha level of 0.05 was used for all statistical tests of significance. The qualitative part of the study will be presented in another article.

Demographic profile of participants

A total of 44 medical students of the basic science stage were enrolled in the study. The largest number of participants were in the age group of 25 to 34 years. Age-related mean, median, and mode values are 27.18, 26.5, and 26 respectively. Table 3 contains the summary of demographic information of participants.

Table 4 consists of information about age-groups and mean score for each age-group, mean exam score for males and female students and score categories. P value was calculated for different categories wherever applicable.

Figure 1  shows the major types of learning resources and percentage of students using them.

Clustered column chart- proportion of students using learning resources

In Table  5 , the Pearson correlation coefficient was calculated for categories under ‘commercial review resources’. The mean exam score was calculated for three groups of students who differed by the number of review books they were using. A similar statistical analysis was done with question banks. The findings are shown in the table.

Usage of commercial review resources (third-party resources): Table  5

All students used commercial review resources. Some students used a greater number of these resources than others. The use of many review resources was found to be associated with decreased exam scores as tested by the Pearson correlation coefficient ( r  = -0.26). The mean score of students who used one or two review books was higher than the mean score of students who used more than three review books although the difference was not statistically significant when tested by ANOVA-single factor test.

The most commonly used review book was First Aid (88.6%) followed by Boards and Beyond (56.8%) and Ninja Nerd (27.3%). Other less frequently used review resources were Med School Bootcamp, BRS books, Sketchy, Anky cards, Pathoma, Dirty Medicine, and Kaplan books.

Figure 2 shows that as the number of review books increase, exam score of students decreases.

Scatter plot- correlation between the number of review books (x-axis) and exam score (y-axis)

Usage of questions banks: Table  5

Approximately ninety percent of 90% of students used question banks. The number of different Q Banks ranged from one to four. The mean number of Q Banks among users was 1.7. The most used Q Bank was UWorld (45.4%), the second was USMLE Rx (31.8%) and the third was Amboss (25%). The mean score of students who used three or four Q Banks (60.4) was higher than the mean score of students who used two or fewer (52.1) although the difference was not statistically significant when tested by ANOVA-single factor test ( P value: 0.48). There was a weak negative correlation between the usage of two or fewer Q Banks and the exam score ( r  = -0.19). However, there was a weak positive correlation between the usage of three or more Q Banks and the exam score which was not statistically significant.

Usage of textbooks: Table  5

Only six students (13.6%) said they used three or more textbooks daily as the main learning resource, while the rest did not use textbooks as the main learning resource. Independent samples t-test assuming unequal variance was used to analyze the statistical significance between the mean scores of these two populations. The mean exam score of textbook users was found to be statistically significantly higher than the mean score of textbook non-users: 72.6 versus 51.1 ( P value = 0.01).

Usage of lecture notes

All students used lecture notes for internal examinations.

Top-performing students versus the rest of the students (Table  6 )

There were 13 students in the cohort of top performers and 31 in the rest of the cohort.

The usage of textbooks was statistically significantly higher in the cohort of top performers in comparison to the rest of the students ( P value: 0.006): Table  6 .

Usage of first aid review book: Table  6

Twelve out of thirteen top-performing students used first aid while twenty-six out of thirty-one in the other cohort used this review book. The difference was not statistically significant as calculated by Fisher’s exact test ( P value = 0.6).

Usage of Q Bank: Table  6

Twelve out of thirteen top-performing students and twenty-eight out of thirty-one in the other cohort used at least one Question Bank book. The difference was not statistically significant as calculated by Fisher’s exact test. The difference in mean number of Q Bank books between the two groups was also not statistically significant ( P value = 0.28).

There was no statistically significant difference between the means of the two groups regarding study hours and the number of review books (P values 0.71 and 0.75).

Varied learning resources: what do students choose?

With growing mobile device usage and greater internet connectivity, there has been a radical change in the type and nature of learning resources used by medical students. In the past, students had to rely solely on didactic lectures and print books for learning purposes, however, this is simply not the case anymore. Students have a wide array of choices ranging from professional textbooks in digital format and paperback to concise commercial resources in paperback, audio, and video format, and question bank books. The practice of blended learning where students use both traditional and new digital learning tools has been well-established universally [ 25 , 26 , 27 , 28 ]. How has this change affected academic performance concerning the type and number of resources utilized? This is the question that has prompted this research.

The impact of commercial review resources usage on academic performance

It has been found that most students choose concise commercial resources over comprehensive professional textbooks as the source to acquire knowledge. In the current study, only 13.6% of students used professional textbooks along with commercial resources which reflected similar findings from a study (15%) in a German medical school [ 29 ]. Makus D et al. from the University of Ottawa reported students spend 63% of their time on commercial resources [ 30 ]. Snow CE et al. and Scott K et al. found that students are less motivated to use textbooks when commercial review resources are available and are perceived as more effective [ 27 , 31 ]. These findings are very important from an academic viewpoint because the mean score of the group of students who used professional textbooks along with other commercial review resources was statistically significantly higher than the mean score of textbook nonusers in this research.

Students are more likely to choose too many commercial review resources of the same scope due to several reasons: availability of numerous brands of commercial resources, digital advertisements, and exchange of information on social media and peer effect [ 6 ]. In this study, 54.5% of students used three or more commercial resources dealing with the same content. This trend might be causing harm to the students because a negative correlation, although weak, was observed between the number of commercial resources and the exam scores, especially when the number of these resources was three or more. The mean exam score for this group of students who used three or more of these resources was found to be lower than the mean exam score for students who used only one or two of these resources. However, the difference in mean scores between the two groups was not statistically significant. This suggests that the usage of a greater number of commercial review resources may not offer any advantage in academic success. Ikonne U et al. found a statistically significant positive correlation between usage of review resources and academic performance in the case of both first- and second-year medical students. However, the correlation was not studied in relation to the number of resources [ 16 ]. Bauzon, J et al. found that higher exam scores were moderately associated with less utilization of commercial review resources [ 32 ].

The impact of question bank usage on academic performance

Medical schools and licensing board examinations including USMLE in developed nations and some developing countries utilize multiple choice questions in the form of clinical vignettes in all types of theoretical examinations. Students use many types of question bank resources to prepare for these types of exams. Using question banks has been shown to improve long-term retention and recall of previously learned information [ 15 ]. However, we found no statistically significant difference in the mean exam score among several cohorts concerning the use of question banks: non-users, students using one Q bank, two Q banks, and three or more Q banks. We cannot explain the reason for this dissimilar finding in our study.

Because 61.3% of students were using more than two or more Q banks, it was not possible to study the effect of a particular type on the exam score. Multiple regression analysis completed at the University of Alabama School of Medicine found that exposure of students to USMLE-type questions throughout the preclinical stage resulted in improved academic performance [ 32 ]. In a study that involved two groups of students writing the Emergency Medical Services fellowship exam, the group that completed the prescribed question bank obtained an overall 12% higher pass rate than the group of students who did not. However, it is not clear from the study whether the same subject experts who created the question bank were also involved in formulating questions for the fellowship exam. The most important fact is these students used question banks along with regular learning resources [ 33 ].

High-performing students versus rest of the students

Our study has a total of 44 participants who had exam scores from 26 to 86. We arbitrarily separated the top 13 students who had exam scores more than 65 and analyzed different variables head-to-head with the rest of the students who had scores less than 65. The difference in means of exam scores of these two groups is statistically significant and the only factor which has a significant effect on the exam scores is the usage of textbooks. Approximately 38% of students in the top-performing cohort used textbooks in comparison to just 3.2% in the cohort of the rest of the students. This same variable was also examined among students within the top-performing cohort. Textbook users had higher mean exam scores, although the difference is not statistically significant. We did not observe differences concerning other variables (usage of Q Banks, review books, and study hours) between the top-performing cohort and the rest of the students.

High-performing students versus low-performing students

Similarly, the top-performing cohort was compared with the cohort of bottom-level students who scored less than 35 on the exam. The observation regarding textbook usage was the same as described above. In addition, the mean number of review books was higher in the bottom-level students than in the top-performing cohort although the difference was not statistically significant.

Usage of textbooks and their impact on academic performance

In a study done at the University of Michigan, Rafel JB et al. found that 77% of students who used commercial step 1 resources including concise review books and question banks early during the basic science stage along with preclinical curriculum, achieved higher step 1 scores [ 15 ]. In our study group, 13.7% of students used professional textbooks along with concise review books and question banks, and they had a significantly higher mean exam score. Parry S et al. have a slightly different finding than that of Rafel JB et al. In their study carried out in a Midwestern Medical School, the researchers found that preclinical grade was strongly associated with USMLE step 1 validating the usage of textbooks as the most important factor for success and interestingly, question bank usage but not the usage of review resources had a statistically significant positive impact on the scores [ 14 ].

According to the self-determination theory (SDT) proposed by Deci and Ryan, students feel motivated to learn when three psychological needs are fulfilled: autonomy to choose learning resources (feeling of self-governed), feeling competent to perform learning tasks, and the ability to engage with peers and teachers [ 34 ]. Professors at The University of Sydney School of Medicine opine that pedagogy should be aligned with self-determination theory and teachers should help students choose commercial resources of high quality to make learning more effective [ 25 ].

Embracing ‘step 1 climate change’ and ways to mitigate it

Step 1 climate is pervasive across all US and Canadian medical schools, and many parts of the world. Ikonne U et al. from Eastern Virginia Medical School found that students started using review resources from the first year. The authors recommend designing learning sessions and curricula to accommodate review resources to make students effective self-regulated learners [ 16 ]. Makus D et al. from the University of Ottawa suggest restructuring curriculum design and delivery in order to make room for nontraditional learning resources in the official curriculum [ 30 ]. Rather than denying and ignoring the “step 1 climate change”, it’s a good idea to embrace it and try to make it better.

In 2016, educators from the University of North Carolina School of Medicine undertook an audit of the basic science stage to evaluate content discrepancies between their curriculum and “high-yield” Step 1 topics. A highly popular review book among students “First Aid for USMLE Step 1 “and USMLE Step 1 score reports of students were used for this purpose. They also made customized exams administered by NBME, the same organization that oversees USMLE, mandatory to students. Many students-centered pedagogical interventions were also made: training students on test-taking skills, providing a subscription to USMLE-oriented resources namely USMLE-Rx for content and UWorld for multiple choice questions, and one-to-one counseling focused on the needs of a particular student. Because of the restructuring of the curriculum in line with USMLE step 1, the school achieved a resounding success with a first-time pass rate of 99.4% in 2018 which was 95% in 2016, and a numeric score of three points more than the national average [ 35 ].

The uniqueness of this study

The current study delves into the usage of learning resources by medical students in the basic science stage and its impact on their academic performance from multiple angles. While many studies have been done on this topic, the authors of this survey did not find any article in the literature regarding the comparison of high-performing students and low-performing students. Observations have been documented in the results section and described in the discussion section. These observations can help teachers and students make adjustments to enhance teaching–learning activities.

Apart from that, few studies have analyzed data regarding the number of commercial review resources and their effect on academic performance. We have divided students into four groups based on the number of review resources they are using, the data has been analyzed in detail.

Limitations of this study

We might get a clearer picture if research is done in many medical schools across all continents so that the findings can be generalized for all medical students in the basic science stage.

Mean exam score was found higher in the cohort of high-performing students than in the cohort of low-performing students because of the usage of textbooks in the former. However, to eliminate the confounding bias due to dissimilar levels of ‘intelligence’ among participants, this conclusion should be validated by a case–control study with a large sample size taking care to match the entry-time ‘Grade Point Average (GPA)’ of the participants in the two cohorts.

In this study, medical students in the basic science stage have provided themselves with the autonomy of choosing learning resources in line with Humanistic learning theory to fulfill unique needs demanded by the USMLE step 1 examination. However, it has been observed that the majority of students did not use professional medical textbooks and about half of the students used three or more commercial review resources. Both facts were significantly associated with poor academic performance.

It is therefore vitally necessary that medical schools, educators, and authors take the following pedagogical interventions to make the right type of learning resources available and help the students choose the best resources for optimum academic performance in the basic science stage of the MD program. In this way, students might feel empowered because of self-determination and stay on course because of the behaviorist paradigm from the subject experts.

Medical school curriculum should be restructured to incorporate balanced usage of commercial review books and NBME-styled multiple-choice questions apart from professional textbooks to fill the void of observed needs and felt needs of medical students.

Students should be discouraged from using too many parallel commercial review resources.

To draw students away from commercial review resources, authors should write textbooks in such a way that they are structured, aligned with the content of USMLE step 1, and concise without losing the depth and breadth of knowledge.

Availability of data and materials

All the data underlying the results are available which can be obtained through the corresponding author.

Early release of USMLE Step 1 2022 summary performance. Available from: https://www.usmle.org/early-release-usmle-step-1-2022-summary-performance . Cited 2024 Jan 8.

NRMP releases the 2022 main residency match results and data publication, the most comprehensive data resource for the Main Residency Match® 2022. Available from: https://www.nrmp.org/about/news/2022/06/nrmp-releases-the-2022-main-residency-match-results-and-data-publication-the-most-comprehensive-data-resource-for-the-main-residency-match/ . Cited 2024 Jan 8.

McKenzie L. Do medical schools still need books? Available from: https://www.insidehighered.com/news/2017/10/03/do-medical-schools-still-need-books . Cited 2024 Jan 8.

USMLE Step 1 transition to pass/fail only score reporting. Available from: https://www.usmle.org/usmle-step-1-transition-passfail-only-score-reporting . Cited 2024 Jan 8.

Samarakoon L, Fernando T, Rodrigo C, Rajapakse S. Learning styles and approaches to learning among medical undergraduates and postgraduates. BMC Med Educ. 2013;13(1). https://doi.org/10.1186/1472-6920-13-42 .

Finn E, Ayres F, Goldberg S, Hortsch M. Brave new e-world: medical students’ preferences for and usage of electronic learning resources during two different phases of their education. FASEB BioAdv. 2022;4(5):298–308. https://doi.org/10.1096/fba.2021-00124 .

Article   Google Scholar  

Hernandez JE, Vasan N, Huff S, Melovitz-Vasan C. Learning styles/preferences among medical students: Kinesthetic learner’s multimodal approach to learning anatomy. Med Sci Educ. 2020;30(4):1633–8. https://doi.org/10.1007/s40670-020-01049-1 .

Guilbault RWR, Lee SW, Lian B, Choi J. Predictors of USMLE step 1 outcomes: charting successful study habits. Med Sci Educ. 2020;30(1):103–6. https://doi.org/10.1007/s40670-019-00907-x .

Lee T, Bhushan V, Sochat M. First aid for the USMLE step 1 2021. 31st ed. New York: McGraw-Hill Education; 2021.

Google Scholar  

Gandhi MH, Mukherji P. Learning theories - statpearls - NCBI bookshelf. StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562189/ . Cited 2024 Jan 8.

Chen DR, Priest KC, Batten JN, Fragoso LE, Reinfeld BI, Laitman BM. Student perspectives on the “step 1 climate” in preclinical medical education. Acad Med. 2019;94(3):302–4. https://doi.org/10.1097/acm.0000000000002565 .

Jeyaraju M, Linford H, Bosco Mendes T, Caufield-Noll C, Tackett S. Factors leading to successful performance on U.S. National Licensure Exams for medical students: a scoping review. Acad Med. 2022;98(1):136–48. https://doi.org/10.1097/acm.0000000000004877 .

Wu W, Garcia K, Chandrahas S, Siddiqui A, Baronia R, Ibrahim Y. Predictors of performance on USMLE Step 1. Southwest Respir Crit Care Chron. 2021;9(39):63–72. https://doi.org/10.12746/swrccc.v9i39.813 .

Parry S, Pachunka J, Beck Dallaghan GL. Factors predictive of performance on USMLE Step 1: do commercial study AIDS improve scores? Med Sci Educ. 2019;29(3):667–72. https://doi.org/10.1007/s40670-019-00722-4 .

Burk-Rafel J, Santen SA, Purkiss J. Study behaviors and USMLE Step 1 performance: implications of a student self-directed parallel curriculum. Acad Med. 2017;92(11S). https://doi.org/10.1097/acm.0000000000001916 .

Ikonne U, Brodie A, Bay C, Campbell A. Frequency of student resource use and academic performance in preclerkship education: a survey study. Med Sci Educ. 2022;32(6):1465–79. https://doi.org/10.1007/s40670-022-01674-y .

Little JL, Bjork EL, Bjork RA, Angello G. Multiple-choice tests exonerated, at least of some charges: fostering test-induced learning and avoiding test-induced forgetting. Psychol Sci. 2012;23(11):1337–44. https://doi.org/10.1177/0956797612443370 .

Liu Q, Wald N, Daskon C, Harland T. Multiple-choice questions (mcqs) for higher-order cognition: perspectives of university teachers. Innov Educ Teach Int. 2023:1–13. https://doi.org/10.1080/14703297.2023.2222715 .

Moon K. USMLE Step 1 is now pass/fail - who benefits from this big change?. Forbes; 2020. Available from: https://www.forbes.com/sites/kristenmoon/2020/04/07/usmle-step-1-is-now-passfailwho-benefits-from-this-big-change/ . Cited 2024 Jan 8.

Change to step 2 CK passing standard begins July 1, 2022. 2022. Available from: https://www.ecfmg.org/news/2022/04/12/change-to-step-2-ck-passing-standard-begins-july-1-2022/ . Cited 2024 Jan 8.

Murphy B. USMLE Step 1 score switch: answers to medical students’ top questions. 2022. Available from: https://www.ama-assn.org/medical-students/usmle-step-1-2/usmle-step-1-score-switch-answers-medical-students-top-questions . Cited 2024 Jan 8.

Makhoul AT, Pontell ME, Ganesh Kumar N, Drolet BC. Objective measures needed — program directors’ perspectives on a pass/fail USMLE Step 1. N Engl J Med. 2020;382(25):2389–92. https://doi.org/10.1056/nejmp2006148 .

Palmerton A. Is step 2 CK the new step 1? Objective facts and surveys. 2021. Available from: https://www.yousmle.com/step-2-ck-new-step-1/ . Cited 2024 Jan 8.

Jayakumar KL. Numerical USMLE step 1 scores are still important in selection of residency applicants. Acad Med. 2016;91(11):1470–1. https://doi.org/10.1097/acm.0000000000001402 .

Wynter L, Burgess A, Kalman E, Heron JE, Bleasel J. Medical students: what educational resources are they using? BMC Med Educ. 2019;19(1). https://doi.org/10.1186/s12909-019-1462-9 .

Ruiz JG, Mintzer MJ, Leipzig RM. The impact of e-learning in medical education. Acad Med. 2006;81(3):207–12. https://doi.org/10.1097/00001888-200603000-00002 .

Scott K, Morris A, Marais B. Medical student use of digital learning resources. Clin Teac. 2017;15(1):29–33. https://doi.org/10.1111/tct.12630 .

Egarter S, Mutschler A, Tekian A, Norcini J, Brass K. Medical assessment in the age of digitalisation. BMC Med Educ. 2020;20(1). https://doi.org/10.1186/s12909-020-02014-7 .

Gutmann J, Kühbeck F, Berberat PO, Fischer MR, Engelhardt S, Sarikas A. Use of learning media by undergraduate medical students in pharmacology: a prospective cohort study. PLoS One. 2015;10(4). https://doi.org/10.1371/journal.pone.0122624 .

Makus D, Kashyap A, Labib M, Humphrey-Murto S. A curriculum ignored? the usage of unofficial commercial and peer learning resources in undergraduate medical education at a Canadian Medical School. Med Sci Educ. 2023;33(6):1379–88. https://doi.org/10.1007/s40670-023-01899-5 .

Snow CE, Torous J, Gordon-Elliott JS, Penzner JB, Meyer F, Boland R. Use of electronic resources for psychiatry clerkship learning: a medical student survey. Acad Psychiatry. 2016;41(5):656–60. https://doi.org/10.1007/s40596-016-0647-3 .

Bauzon J, Alver A, Ravikumar V, Devera A, Mikhael T, Nauman R, et al. The impact of educational resources and perceived preparedness on medical education performance. Med Sci Educ. 2021;31(4):1319–26. https://doi.org/10.1007/s40670-021-01306-x .

Clemency B, Martin-Gill C, Rall N, May P, Lubin J, Cooley C, et al. Association between EMS Question Bank completion and passing rates on the EMS certification examination. Prehosp Emerg Care. 2017;21(4):498–502. https://doi.org/10.1080/10903127.2017.1294225 .

Deci EL, Ryan RM. Conceptualizations of intrinsic motivation and self-determination. Intrinsic motivation and self-determination in human behavior. Psychol. 1985;11–40. https://doi.org/10.1007/978-1-4899-2271-7_2 .

Beck Dallaghan GL, Byerley JS, Howard N, Bennett WC, Gilliland KO. Medical school resourcing of USMLE Step 1 preparation: questioning the validity of step 1. Med Sci Educ. 2019;29(4):1141–5. https://doi.org/10.1007/s40670-019-00822-1 .

Download references

Acknowledgements

Xavier University School of Medicine management for funding the article processing charge.

Publication of this study was funded by Xavier University School of Medicine, Aruba as a part of the research grant to promote research.

Author information

Authors and affiliations.

Department of Pathology, Xavier University School of Medicine, Oranjestad, Aruba

Sabin Kumar Ranabhat

Department of Anatomy, Xavier University School of Medicine, Oranjestad, Aruba

Mohan Lal Kunjukrishnan

Xavier University School of Medicine, Oranjestad, Aruba

Muskan Dubey

Department of Medical Education, Memorial University of Newfoundland, Newfoundland, Canada

Vernon Curran

Department of Pharmacology, Xavier University School of Medicine, Oranjestad, Aruba

Arun Kumar Dubey

Department of Medicine, OSCE and SP Program, Xavier University School of Medicine, Oranjestad, Aruba

Neelam Dwivedi

You can also search for this author in PubMed   Google Scholar

Contributions

SKR collected data, designed study, analyzed data and prepared the manuscript. MLK and MD reviewed literature, contributed to manuscript drafting and revision. VC, AKD and ND contributed to study design, manuscript preparation and revision. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Sabin Kumar Ranabhat .

Ethics declarations

Ethics approval and consent to participate.

Ethical approval to conduct this research was obtained from the Institutional Review Board (IRB) of Xavier University School of Medicine on March 4, 2023 (Study ID number: XUSOM/IRB/2023/03/001), in compliance with the “World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects (WMA 2008) and the Council for International Organizations of Medical Sciences’ International Guidelines for Ethical Review of Epidemiological Studies (CIOMS 1991). Informed written consent was taken from each participant.

Consent for publication

Not applicable.

Competing of interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplementary material 1., rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Ranabhat, S.K., Kunjukrishnan, M.L., Dubey, M. et al. Exploring the usage of learning resources by medical students in the basic science stage and their effect on academic performance. BMC Med Educ 24 , 543 (2024). https://doi.org/10.1186/s12909-024-05511-1

Download citation

Received : 09 January 2024

Accepted : 02 May 2024

Published : 15 May 2024

DOI : https://doi.org/10.1186/s12909-024-05511-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• USMLE Step 1
• Learning resources
• Review books
• Medical students
• Find a journal
• Publish with us
• Track your research

Section 8 of the AMCAS® Application: Essays

New section.

Here you will upload your Personal Comments essay.

• AMCAS® Sign In

Every applicant is required to submit a Personal Comments essay. The available space for this essay is 5,300 characters (spaces are counted as characters), or approximately one page. You will receive an error message if you exceed the available space. Click the "What information should I consider including in my personal comments?" link in the application or see Section 8 of the  AMCAS Applicant Guide  for suggestions of things to think about when writing this essay.

• If you're applying to an MD-PhD program, you must complete two additional essays: the MD-PhD Essay and the Significant Research Experience Essay.
• To avoid formatting issues, we recommend that you type your essay directly into the AMCAS ® application rather than copying and pasting your essay from other software.
• Alternately, you can draft your essay(s) in text-only word processing software, such as Microsoft Notepad or Mac TextEdit, then copy and paste your essay(s) into the application. Copying formatted text into the application may result in formatting issues that you will not be able to edit after your application is submitted.
• Proofread carefully! There is no “spellchecker” in the AMCAS application, and no changes will be permitted to this section after you have submitted your application.

Send us a message .

Monday-Friday, 9 a.m.-7 p.m. ET Closed Wednesday, 3-5 p.m. ET

The 2025 AMCAS application is now open . If you wish to start medical school in Fall 2025, please complete and submit the 2025 AMCAS application.

As of May 17  AMCAS is:

Marking transcripts as "Received" that were delivered on or before:

Paper (mailed) – May 16

Parchment – May 16

National Student Clearinghouse –  May 17

Outline of the current AMCAS application process, policies, and procedures.

This resource is designed to help you prepare your materials for the AMCAS ® application but does not replace the online application.

The application processing fee is $175 and includes one medical school designation. Additional school designations are $46 each. Tax, where applicable, will be calculated at checkout. 

If approved for the Fee Assistance Program, you will receive a waiver for all AMCAS fees for one (1) application submission with up to 20 medical school designations ($1,030 value). Benefits are not retroactive.

• - Google Chrome

Intended for healthcare professionals

• Access provided by Google Indexer
• My email alerts
• BMA member login
• Username * Password * Forgot your log in details? Need to activate BMA Member Log In Log in via OpenAthens Log in via your institution

Search form

• Advanced search
• Search responses
• Search blogs
• How to get involved in...

How to get involved in research as a medical student

• Related content
• Peer review
• Anna Kathryn Taylor , final year medical student 1 ,
• Sarah Purdy , professor of primary care and associate dean 1
• 1 Faculty of Health Sciences, University of Bristol, UK

Participating in research gives students great skills and opportunities. Anna Taylor and Sarah Purdy explain how to get started

This article contains:

-How to get involved with research projects

-Questions to ask yourself before starting research

-What can you get published? Research output

-Advice for contacting researchers

-Different types of research explained

-Stages of research projects

Students often go into medicine because of a desire to help others and improve patients’ physical and mental wellbeing. In the early years of medical school, however, it can seem as if you are not making much difference to patient care. Involvement in research can provide exciting opportunities to work as part of a team, improve career prospects, and most importantly add to the evidence base, leading to better outcomes for patients.

Research is usually multidisciplinary, including clinical academics (medical doctors who spend part of their working life doing research), nurses, patients, scientists, and researchers without a medical background. Involvement in such a team can improve your communication skills and expand your understanding of how a multidisciplinary team works.

Participating in research can also help you to develop skills in writing and critical appraisal through the process of publishing your work. You may be able to present your work at conferences—either as a poster or an oral presentation—and this can provide valuable points for job applications at both foundation programme and core training level. This is particularly important if you are considering a career in academia. You will also develop skills in time management, problem solving, and record keeping. You might discover an area of medicine in which you are keen to carry out further work. For some people, getting involved in research as a medical student can be the first step in an academic career.

Kyla Thomas, National Institute for Health Research clinical lecturer in public health at the University of Bristol, says, “my first baby steps into a clinical academic career started with a research project I completed as a medical student. That early involvement in research opened my eyes to a whole new world of opportunities that I never would have considered.

“Importantly, participating in undergraduate research sets students apart from their colleagues. Applying for foundation posts is a competitive process and it is a definite advantage if you have managed to obtain a peer reviewed publication.”

Getting involved with research projects

Although it is possible to do research at medical school, it is important to be realistic about how much free time you have. It might be possible to set up your own research project, but this will require substantial planning in terms of writing research protocols, gaining ethical approval, and learning about new research methodologies. Other opportunities for research that make less demands on your time include:

Intercalated degrees—these often have time set aside for research in a specific area, so it is important to choose your degree according to what you might like to do for your dissertation (for example, laboratory-based work in biochemistry, or qualitative research in global health. Some subjects may have options in both qualitative and quantitative research).

Student selected components or modules can provide a good opportunity to be involved in an ongoing study or research project. If you have a long project period, you might be able to develop your own small project.

Electives and summer holidays can also provide dedicated time for research, either within the United Kingdom or in another country. They can allow you to become established in a research group if you’re there for a few weeks, and can lead to a longstanding relationship with the research group if you continue to work with them over your medical school career.

If you don’t know what to do, contacting the Student Audit and Research in Surgery (STARSurg), 1 the National Student Association of Medical Research (NSAMR), 2 or your medical school’s research society may be a good place to start.

The INSPIRE initative, 3 coordinated by the Academy of Medical Sciences, gives support and grants to help students take part in research. Some UK medical schools have small grants for elective and summer projects, and organise taster days for students to get an idea of different research areas.

You may also be able to access other grants or awards to support your research. Some of the royal colleges, such as the Royal College of General Practitioners and the Royal College of Psychiatrists, offer bursaries to students doing research in their holidays or presenting at conferences. Other national organisations, such as the Medical Women’s Federation, offer bursaries for elective projects.

Box 1: Questions to ask yourself before starting research

What are you interested in? There is no point getting involved in a project area that you find boring.

How much time do you have available? It is crucial to think about this before committing to a project, so that your supervisor can give you an appropriate role.

What do you want to get out of your research experience? Do you want a brief insight into research? Or are you hoping for a publication or presentation?

Do you know any peers or senior medical students who are involved in research? Ask them about their experiences and whether they know of anyone who might be willing to include you in a project.

Box 2: Research output

Publication —This is the “gold standard” of output and usually consists of an article published in a PubMed ID journal. This can lead to your work being cited by another researcher for their paper, and you can get up to two extra points on foundation programme applications if you have published papers with a PubMed ID.

Not all research will get published, but there are other ways to show your work, such as presenting at conferences:

Oral presentation —This involves giving a short talk about your research, describing the background, methods, and results, then talking about the implications of your findings.

Poster presentation —This involves creating a poster, usually A1 or A2 in size, summarising the background, methods, and results of your research. At a conference, presenters stand by their poster and answer questions from other delegates.

Contacting researchers

Most universities have information about their research groups on their websites, so spend some time exploring what studies are being carried out and whether you are interested in one of the research topics.

When contacting a member of the research group, ask if they or someone else within their team would be willing to offer you some research experience. Be honest if you don’t have any prior experience and about the level of involvement you are looking for, but emphasise what it is about their research that interests you and why you want to work with them. It’s important to have a flexible approach to what they offer you—it may not initially sound very exciting, but it will be a necessary part of the research process, and may lead to more interesting research activity later.

Another way to make contact with researchers is at university talks or lectures. It might be intimidating to approach senior academics, but if you talk to them about your interest they will be more likely to remember you if you contact them later on.

Box 3: What can students offer research teams?—Views from researchers

“Medical students come to research with a ‘fresh eyes’ perspective and a questioning mindset regarding the realities of clinical practice which, as a non-medic myself, serves to remind me of the contextual challenges of implementing recommendations from our work.”

Alison Gregory, senior research associate, Centre for Academic Primary Care, University of Bristol, UK.

“Enthusiasm, intelligence, and a willingness to learn new skills to solve challenges—bring those attributes and you’ll be valuable to most research teams.”

Tony Pickering, consultant anaesthetist and Wellcome Trust senior research fellow, University of Bristol, UK.

Box 4: Different types of research

Research aims to achieve new insights into disease, investigations, and treatment, using methodologies such as the ones listed below:

Qualitative research —This can be used to develop a theory and to explain how and why people behave as they do. 4 It usually involves exploring the experience of illness, therapeutic interventions, or relationships, and can be compiled using focus groups, structured interviews, consultation analysis, 5 or ethnography. 6

Quantitative research —This aims to quantify a problem by generating numerical data, and may test a hypothesis. 7 Research projects can use chemicals, drugs, biological matter, or even computer generated models. Quantitative research might also involve using statistics to evaluate or compare interventions, such as in a randomised controlled trial.

Epidemiological research —This is the study of the occurrence and distribution of disease, the determinants influencing health and disease states, and the opportunities for prevention. It often involves the analysis of large datasets. 4

Mixed methods research —This form of research incorporates both quantitative and qualitative methodologies.

Systematic reviews —These provide a summary of the known evidence base around a particular research question. They often create new data by combining other quantitative (meta-analysis) or qualitative (meta-ethnography) studies. They are often used to inform clinical guidelines.

Box 5: Stages of research projects

Project conception—Come up with a hypothesis or an objective for the project and form the main research team.

Write the research protocol—Produce a detailed description of the methodology and gain ethical approval, if needed.

Carry out the methodology by collecting the data.

Analyse the data.

Decide on the best way to disseminate your findings—for example, a conference presentation or a publication—and where you will do this.

Write up your work, including an abstract, in the format required by your chosen journal or conference.

Submit . For conference abstracts, you may hear back swiftly whether you have been offered the chance to present. Publication submissions, however, must be peer reviewed before being accepted and it can take over a year for a paper to appear in print.

Originally published as: Student BMJ 2017;25:i6593

Competing interests: AKT received grant money from INSPIRE in 2013.

Provenance and peer review: Not commissioned; externally peer reviewed.

• ↵ STARSurg. Student Audit and Research in Surgery. 2016. www.starsurg.org .
• ↵ NSAMR. National Student Association of Medical Research. 2016. www.nsamr.org .
• ↵ The Academy of Medical Sciences. About the INSPIRE initiative. 2016. www.acmedsci.ac.uk/careers/mentoring-and-careers/INSPIRE/about-INSPIRE/ .
• ↵ Ben-Shlomo Y, Brookes ST, Hickman M. Lecture Notes: Epidemiology, Evidence-based Medicine and Public Health. 6th ed . Wiley-Blackwell, 2013 .
• ↵ gp-training.net. Consultation Theory. 2016. www.gp-training.net/training/communication_skills/consultation/consultation_theory.htm .
• ↵ Reeves S, Kuper A, Hodges BD. Qualitative research methodologies: ethnography. BMJ 2008 ; 337 : a1020 . doi:10.1136/bmj.a1020   pmid:18687725 . OpenUrl FREE Full Text
• ↵ Porta M. A Dictionary of Epidemiology. 5th ed . Oxford University Press, 2008 .

• Open access
• Published: 13 May 2022

Academic and non-academic predictors of academic performance in medical school: an exploratory cohort study

• Marija Franka Žuljević   ORCID: orcid.org/0000-0001-9805-7491 1 &
• Ivan Buljan   ORCID: orcid.org/0000-0002-8719-7277 2  

BMC Medical Education volume  22 , Article number:  366 ( 2022 ) Cite this article

2509 Accesses

4 Citations

1 Altmetric

Metrics details

Medical schools should also evaluate applicants’ non-academic characteristics in the search for successful students and future physicians, but ideal non-academic criteria have not yet been found. We followed two successive generations of medical students at the University of Split School of Medicine (USSM) to assess both academic and non-academic constructs as predictors of academic performance, defined as medical school grade point average (GPA). We also interviewed some of the participants to gain additional insight for future studies.

We measured study GPA in first and last year, as well as attitudes towards science, motivation, emotional intelligence, self-esteem, and perceived personal incompetence in first year. We also obtained their scores on existing medical school enrollment criteria, the State Graduation Exam (SGE) and high-school GPA. Regression models were constructed for predictors of GPA in the last year of medical school. Four structured pilot interviews were conducted to explore participants’ perceptions of necessary traits for medical school and later practice.

Regression analysis showed that only SGE predicted final academic performance in medical school (β=0.35, 95% confidence interval (CI)=0.06-0.64), while none of the non-academic constructs we assessed predicted this outcome of education. The two generations did not significantly differ in any variable except that intrinsic motivation was higher in the generation that enrolled in 2011 (OR=1.47, 95%CI=1.12-1.93, P =0.005).

None of the non-academic constructs predicted academic performance in medical school. Their use as selection criteria may not be warranted as they could impact the academic quality of enrolling medical students.

Peer Review reports

The value of an admission criterion for medical school is its ability to predict the applicant’s performance during undergraduate medical training, as well as after graduation [ 1 , 2 ]. However, it is very difficult to reach a consensus on the most desirable personal qualities of medical school applicants, and it is equally difficult to reliably measure them [ 3 ]. Most current established methods of selecting suitable students are cognitive and knowledge-based assessments [ 4 ]. Most of these, such as the high-school grade point average (GPA) and medical school aptitude tests, have been established to be good predictors of students’ academic performance [ 5 , 6 ]. However, a systematic review showed that academic scores account for only 23% of the variance of progress measures at medical school [ 6 ]. The discriminatory power of academic tests may be decreasing, as more students now get top grades [ 7 ]. Some argue that academic performance may be necessary for creating a competent clinician later on, but that it alone is not sufficient [ 7 ]. The current opinion is that medical schools should also evaluate applicants’ non-academic characteristics [ 8 , 9 , 10 , 11 ]. Additionally, in light of the COVID-19 pandemic, many Ivy League institutions in the US have pledged “test-optional” policies for standardized admission testing, while some of them have also argued that these tests discriminate against certain applicants and should be eliminated [ 12 , 13 , 14 ].

There are mixed results on whether non-academic constructs are useful as admission tools for medical school [ 4 ]. Only a few non-academic assessment methods, like the multiple mini interview [ 15 ], have successfully been implemented into practice. Self-reported personality factors show a significant relationship with medical school academic performance [ 16 ], but their relationship is complex and nonlinear, and the evidence on their use is inconclusive [ 7 ]. Their use could potentially reduce the diversity of applicants and their long-term predictive validity is insufficiently explored [ 7 ]. Emotional intelligence (EI) assessments could be a valuable tool in future selection [ 7 ], although EI has only been explored in mostly preliminary studies [ 17 , 18 , 19 ]. A meta-analysis found that psychological factors such as motivation and self-esteem, among others, show some potential in predicting the academic GPA of university students in general [ 20 ]. Motivation may also positively affect academic performance in medical school [ 21 , 22 ]. “Non-cognitive” traits assessed in the UK Clinical Aptitude Test were evaluated and a weak correlation of self-esteem and academic performance in medical school was found [ 23 ], but self-esteem was linked with a higher clinical competence [ 24 ].

Ideal non-academic criteria for entry into medical school have not yet been found [ 25 ]. Well-structured cohort studies exploring non-academic constructs are still lacking [ 7 ]. The questions raised on the validity of non-academic tests and the fairness of their use in a high-stakes evaluation have also not been answered [ 26 ]. Harris et al have emphasized the fact that non-academic tests have not shown good validity in predicting academic performance in comparison with traditional academic tests, and that their implementation is not fully warranted by evidence [ 27 ]. Students could be coached to give desirable answers to non-academic admission tests, making this a potential barrier to implementing such assessment methods [ 1 ]. Suggested use of a social desirability scale to detect false responses did not fully address the issue [ 28 ]. With the lack of the evidence about the predictive validity of non-academic measures, which would bring the incremental value to existing measures, more research is warranted.

To address the existing gaps in knowledge, we aimed to explore the ability of existing academic assessment methods and non-academic constructs to predict final-year academic performance, defined as study grade point average GPA, in two successive generations of medical students at the University of Split School of Medicine (USSM). As this was an exploratory study, we decided to focus on non-academic constructs that were previously inconclusive as academic predictors: EI, motivation, and self-esteem; as well as two constructs previously unexplored in medical students: attitudes towards science and perceived personal incompetence. To measure them, we used questionnaires that were previously validated in our setting. To gain additional insight about the student perceptions about medical studies program and their motivations, we also conducted interviews with a smaller number of study participants.

Study design and setting

This study was an exploratory prospective cohort study and was performed at the USSM, a medical school in Split, Croatia. Medical schools in Croatia, as in most European countries, are integrated undergraduate and graduate studies resulting in a degree of medical doctor (MD).

USSM enrolment scheme

Students need to pass the State Graduation Exam (SGE) at the end of their high school education to graduate and qualify for enrolment in the USSM medical school program. Information on the SGE structure and scoring, as well as some changes in enrolment requirements from 2010/2011 to 2011/2012 are described in Additional file 1 .

Structure of the USSM program

The USSM program consists of six academic years of study: the first three include pre-clinical subjects, and the last three are clinical and involve contact with patients [ 29 ]. Academic performance is measured by grades on a scale ranging from 2 – pass to 5 – outstanding. The study grade point average (GPA) on a scale 2.0-5.0 is therefore used and can be calculated for each study year separately, as well at the total study years together. We chose this GPA as the main outcome measure of participants’ academic performance, especially since study GPA is important criterion for receiving scholarships and accommodation within student dorms in the Croatian education system. Likewise, Croatian medical students’ GPA is important when applying to clinical residencies and is one of the main parts of their admission scoring system.

Participants

Participants were medical students at the USSM from two generations that enrolled in the program during the academic years 2010/2011 and 2011/2012. These two generations made up two different cohorts that were followed during this study. We excluded students repeating the first year, as well as those partially repeating first year.

Cohort 2010/2011

A total of 86 students were enrolled into the 2010/2011 generation. They were required to complete the SGE before enrolment, but to qualify for enrolment, they were also required to pass obligatory exams in Biology, Chemistry, and Physics as a part of the SGE.

Cohort 2011/2012

A total of 82 students enrolled into the 2011/2012 generation. They also had to complete the SGE before enrolment, but had no obligatory exams required apart from the basic exams in the SGE.

Questionnaire

At both data collection points, participants were asked to provide their current GPA (on a scale 2.0-5.0), and this was considered the main outcome measure of their academic performance. They were also asked if they were partially enrolled in or repeating the academic year during which they were surveyed. At baseline (first study year), we asked them to provide basic demographic information (age at enrolment, gender), their score on the SGE, and their GPA at the end of high-school education (scale 2.0-5.0). They were then asked to fill out the following questionnaires: Attitudes Towards Science Scale [ 30 ], Work Preference Inventory [ 31 ], Emotional Skills and Competence Questionnaire (ESCQ-45) [ 32 ], Rosenberg Self-esteem Scale [ 33 ], Perceived Personal Incompetence Scale [ 34 ]. Detailed descriptions of the questionnaires are given in Additional file 2 .

Data collection

Data were collected (by IB) at two points during the participants’ medical education using a paper-based survey. Additional information on the survey setting, data collection time points, and pairing of participant responses is provided in Additional file 1 .

Missing data

A participant’s answers were included in the data analysis if we collected their data for both measurements. If participants were repeating the first year, we concluded they would be excluded from the final analysis, as we only wanted to follow the original cohorts, i.e. students who enrolled for the first time. Participants were also excluded from the final analysis if they had any questionnaires missing, i.e. began completing the survey, and then gave up midway or at the beginning. We calculated the average score for each item and replaced each missing response with the average item score. This way, the overall result was not affected, and we did not need to exclude participants due to missing items.

The sample size calculation was performed using an online sample size calculator [ 35 ]. Based on previous research results on academic performance [ 20 ], where the percentage of variance explained was R 2 =0.28 (f 2 =0.50), we calculated (β=0.8, α=0.05) that we will need, at minimum, 45 participants to perform a regression analysis with eleven predictors.

Data analysis

All statistical analyses were performed using JASP software v. 0.13.1.0 (JASP Team, 2018, Amsterdam, Netherlands) and MedCalc software v. 19.5.3 (MedCalc Software Ltd, 2020).

Demographic data and response rate

Gender and response rate was expressed for both generations as frequencies and percentages. Response rate was calculated for each generation and compared by a chi-square test (χ 2 ).

Descriptive statistics and comparison of cohorts

Results for all collected variables were calculated separately for the 2010/2011and 2011/2012 generations and expressed using a median with 95% confidence interval (CI) after determining data distribution for each variable by using the Shapiro-Wilk test. The Mann-Whitney independent samples test was then used to compare the two generations for each variable. A Bonferroni correction for multiple measurements was performed (0.05/12) and determined the significance cut-off for the comparisons to be P =0.004. Significant variables were entered into a stepwise logistic regression to confirm any differences, with results expressed as odds ratio (OR), a corresponding 95%CI, and P-value.

GPA prediction

As first-year and final-year GPA are linked variables, their correlation was estimated using Pearson’s r. We used stepwise linear regression to assess predictors of final-year GPA. Results were expressed as standardized regression coefficients (β) with 95%CI, along with the coefficient of determination (R 2 ) for significant predictors. We calculated the 95%CI for β using the following equation [ 36 ]: 95%CI=β±1.96∙(β/t value ).

Baseline participant characteristics and dropout

We used the Mann-Whitney independent samples test to compare all variable scores between participants at baseline that were included in the study, and those that were not included in the study (i.e. filled out the survey only in first year). Results were expressed as P-values with a significance cut-off of 0.05. For additional confirmation, we entered significant results into a logistic regression model with the results expressed with an odds ratio (OR) and 95%CI.

Ancillary pilot interviews

One of the authors (IB), a teacher at the USSM, conducted four structured interviews in June 2017 with sixth-year USSM medical students, who were also participants in the quantitative part of the study and volunteered to additionally do the interviews. The interviews’ main purpose was to provide a brief insight into participants’ personal reflections and observations to help inform and refine which constructs should be explored in future studies. Students were asked about their experience, attitudes and perceptions on their medical studies, as well as what a good physician is, in their personal opinion (questions shown in Additional file 3) . The participants had no previous relationship with the interviewer. A more detailed description of the interview methodology is available in Additional file 1 . The COnsolidated criteria for REporting Qualitative research (COREQ) checklist [ 37 ] was used to guide our reporting (available in Additional file 4 ).

Overall, 65 students were included in the final analysis. We constructed a flowchart to show the numbers of individuals involved at each stage of study (Fig.  1 ).

Flowchart showing the number of participants at each stage in the study

Generation 2010/2011 had 24 participants, with a female majority ( n =18, 75%) and a response rate of 27.9% (24/86). The 2011/2012 generation had 41 participants, with a female majority as well ( n =31, 75.6%). The response rate was 50% (41/82) and was higher than for generation 2010/2011 (χ 2 =8.63, P =0.003).

The two generations did not significantly differ in any variable except their motivation, where generation 2011/2012 had higher intrinsic motivation ( P <0.0001) and extrinsic motivation ( P =0.0002) scores (Table 1 ). A stepwise logistic regression model only confirmed intrinsic motivation to be significantly different (OR=1.47, 95%CI=1.12-1.93, P =0.005), while extrinsic motivation and other variables were not.

We estimated a very high correlation between first-year and sixth-year GPA ( r =0.745, P >0.001), confirming the linked nature of the two variables. Based on this, we chose not to include first-year GPA in our stepwise linear regression model [ 38 ]. However, we included all other academic variables (high-school GPA, SGE score) and all surveyed non-academic variables (attitudes on science, motivation, EI, self-esteem, perceived incompetence). Only the SGE score was a significant predictor of final academic performance in medical school (β=0.35, 95%CI=0.06-0.64), explaining 12.3% of variance of sixth-year GPA scores.

Participants that completed the study had a higher intrinsic motivation ( P =0.009) than students who only filled out the survey in first year and were then lost to follow-up. There was no significant difference in any other variable (data not shown). Results of a logistic regression model also showed that intrinsic motivation significantly predicted whether a student completed the study, although the effect size was small (OR=1.05, 95%CI=1.01-1.09).

Four participants were approached for the interviews, and all of them agreed to participate. The final sample of interviewed students consisted of four medical students (female sixth year students, age range 23-24 years, GPA range 3.70-4.96).

We present the most relevant findings below. Participant quotes, along with the full division into themes and sub-themes, are available in an additional file (Table 1.3 in Additional file 3 ).

Perception of a “good physician”

When participants were asked on how they perceive a good physician, both technical knowledge and personal characteristics and traits related to professionalism were perceived as necessary. Three participants placed a special emphasis on empathy.

Medical studies’ role in education

Three participants elaborated that medical studies cannot teach non-academic skills such as empathy and that these values are already pre-existing in a person. Some participants stated that their ability to empathize actually decreased over the course of their medical education.

Selection of students for medical school

Perception of academic-based selection methods such as the SGE or entrance exams was that they are good methods of selecting students with a willingness to learn and good technical knowledge, but not for favorable personal characteristics. Some participants observed that there are other medical students who are poorly fit to be future physicians, and that some experience mental disorders during the course of their studies in a way that also makes them less fit for this role.

Predictors of academic success in medical school

Perseverance was perceived by all four participants to be the main predictor of academic success for medical students, with some participants placing exclusive emphasis on perseverance in terms of studying and fulfilling obligations.

Our results show that only the pre-admission knowledge test (SGE), predicted the overall academic performance of medical students. EI, motivation, and self-esteem, attitudes towards science, and perceived personal incompetence showed no ability to predict GPA in medical school, in the sample of participants who completed six years of medical school. However, participants that completed the study, i.e. those who completed their medical education within 6 years, had a higher intrinsic motivation than those lost to follow-up, indicating that intrinsic motivation was predictive for medical study program attrition, however, with only a small, non-practical, effect.

Even though previous research has emphasized the need to use students’ non-academic characteristics when selecting medical students [ 8 , 9 , 10 , 11 ], our study did not find them to be significant predictors of academic performance. Our results support the preliminary findings on EI [ 17 ] and self-esteem [ 23 ] which previously showed no significant association with academic performance. However, our findings on motivation are different from past studies which found merit in its predictive ability for academic performance [ 21 , 22 ]. There are no studies on the association of attitudes towards science and perceived personal incompetence thus far, and our findings can be considered preliminary in this context. Our study is also one of the first to assess the predictive ability of the SGE, along with Ravlić-Gulan et al. who initially described its association with academic performance [ 39 ]. However, they found that a change in SGE enrolment criteria between study generations impacted academic success, which was not observed in our study. Our findings on the SGE are similar to what is known about the SAT tests in the US, which are also taken at the end of high-school education and seem to have some predictive ability for early academic performance in medical school [ 40 , 41 ]. However, we found that the SGE also predicts academic performance in later clinical years.

Newly implemented admissions systems with non-academic criteria could select students with low academic credentials and result in them causing problems for the faculty [ 3 ]. Such situations could thus cause additional resistance to implementing any new admissions system [ 3 ]. We reaffirm that a non-academic construct still needs to be able to predict academic performance. As other researchers reported, the implementation for the non-academic constructs that we assessed may also not be warranted by evidence [ 9 ]. Their potential importance cannot be excluded, but there is a risk of a decrease of academic quality of students if they are included as admission criteria, especially in settings such as in our study. Academic outcomes are deeply embedded within the curriculum in the Croatian setting and are important to the advancement in a student’s medical career. It also has a long-standing tradition of using academic admission criteria. A 30-year retrospective study at the USSM found that high-school GPA and entrance exam scores (used before the SGE was introduced) predicted medical school GPA [ 42 ]. For our setting, these findings imply that a classical entrance exam is not necessary for medical school with a standardized national test like the SGE in place. Overall, even though we agree that including non-academic admission criteria would be more fair, we highlight that the problem of coaching for socially desirable answers remains a significant barrier to their implementation as admission tests in practice, even if their predictive ability is observed [ 1 , 28 ].

A strength of our study is its prospective cohort study design, as other studies on this subject are mostly cross-sectional [ 6 ]. Even though we had a smaller sample size, any existing predictive effects should be evident in a smaller sample. Our observed predictive ability of academic constructs is therefore more likely to represent a true effect. The two surveyed generations differed only in motivation scores, something we considered as adequate rationale for analyzing them as a single sample. Still, our study has certain methodological limitations. Even though our overall response rate was satisfactory, we still experienced significant participant dropout [ 43 ]. This is the reason we conducted an additional analysis of attrition bias. Due to the anonymous nature of our surveys, we cannot be sure about the reason the students did not make it to the final year of study. Likewise, the length of our survey may have caused fatigue for participants, so we provided candy bars as participation incentives [ 44 ]. Our choice GPA is also not fully ideal, as it is a rough outcome measure. However, it was the best and most objective measure that we could select within our setting and one that is also very relevant to our participants’ future education and training. Alternative assessment methods would depend on teacher assessment, could be prone to bias, and would disrupt the anonymous nature of the study. Self-reported GPA is also a measure that may be subject to recall bias. However, due to the high emphasis on GPA in our setting, we believe that the potential for recall bias is low, as the students are very well aware of their GPA, especially in the first (high-school students come prepared for GPA importance as it is equally important in high school and for the enrolment at a university) and last years of medical school (they are monitoring their GPA as it impacts the application for all career options immediately after obtaining their medical doctor degree). Therefore, we assert that the potential for recall bias is no more than is usual for survey studies in general.

Overall, as the constructs assessed in this study may not be adequate candidates as admission criteria, our findings may serve as a guide to better focus future research efforts on constructs that can hold up to more rigorous assessment in their predictive ability for a variety of outcomes. Future studies could consider also looking at outcomes such as the OSCE, which are often formally assessed as part of a medical school curriculum [ 45 , 46 ]. We encourage the search for other non-academic constructs that can predict academic success, especially using a multi-site longitudinal study design. Based on the pilot interviews we conducted, we found that participants highlighted empathy as an important trait for a future physician and perseverance for fulfilling academic obligations in medical school. Interviewees also reaffirmed the necessity of finding adequate non-academic constructs to screen students. Although the preliminary findings on the predictive ability of empathy for academic performance are not particularly encouraging [ 17 ], future studies on its association with important outcomes of education could be insightful. Perseverance i.e. grit could also be explored further [ 47 , 48 ], especially its association with study success is already known in a non-medical setting [ 49 ].

Our exploratory analysis of two successive cohorts of medical students at the University of Split School of Medicine showed that the State Graduation Exam score, a standardized knowledge test, predicted students’ academic performance in medical school, i.e. the final GPA at the end of the medical studies. We assessed several constructs that have either been unexplored or previously had preliminary findings only: EI, motivation, self-esteem, attitudes towards science, and perceived personal incompetence, and found that none of them predicted overall academic performance in medical school. Based on their inability to predict an important outcome of education, their use as selection criteria for medical school may not be warranted at present, as it could impact the academic quality of enrolling students. Further research efforts should be focused on assessing different non-academic constructs in longitudinal studies, such as perseverance and empathy.

Availability of data and materials

The dataset supporting the conclusions of this article is available in the Open Science Framework repository, http://doi.org/10.17605/OSF.IO/7RQY3 .

Abbreviations

Standardized regression coefficient

95% confidence interval

Emotional intelligence

Emotional Skills and Competence Questionnaire

Grade point average

Objective Structured Clinical Examination

State Graduation Exam

University of Split School of Medicine

Kreiter CD, Axelson RD. A perspective on medical school admission research and practice over the last 25 years. Teach Learn Med. 2013;25(Suppl 1):S50-56. https://doi.org/10.1080/10401334.2013.842910 .

Article   Google Scholar  

Benbassat J, Baumal R. Uncertainties in the selection of applicants for medical school. Adv Health Sci Educ Theory Pract. 2007;12(4):509–21. https://doi.org/10.1007/s10459-007-9076-0 .

Albanese MA, Snow MH, Skochelak SE, Huggett KN, Farrell PM. Assessing personal qualities in medical school admissions. Acad Med. 2003;78(3):313–21. https://doi.org/10.1097/00001888-200303000-00016 .

Siu E, Reiter HI. Overview: what’s worked and what hasn’t as a guide towards predictive admissions tool development. Adv Health Sci Educ Theory Pract. 2009;14(5):759–75. https://doi.org/10.1007/s10459-009-9160-8 .

Sawyer R. Beyond Correlations: Usefulness of High School GPA and Test Scores in Making College Admissions Decisions. Applied Measurement in Education. 2013;26(2):89–112. https://doi.org/10.1080/08957347.2013.765433 .

Ferguson E, James D, Madeley L. Factors associated with success in medical school: systematic review of the literature. BMJ. 2002;324(7343):952–7. https://doi.org/10.1136/bmj.324.7343.952 .

Patterson F, Knight A, Dowell J, Nicholson S, Cousans F, Cleland J. How effective are selection methods in medical education? A systematic review. Med Educ. 2016;50(1):36–60. https://doi.org/10.1111/medu.12817 .

Abbiati M, Baroffio A, Gerbase MW. Personal profile of medical students selected through a knowledge-based exam only: are we missing suitable students? Med Educ Online. 2016;21:29705. https://doi.org/10.3402/meo.v21.29705 .

Mahon KE, Henderson MK, Kirch DG. Selecting tomorrow’s physicians: the key to the future health care workforce. Acad Med. 2013;88(12):1806–11. https://doi.org/10.1097/ACM.0000000000000023 .

Adam J, Bore M, McKendree J, Munro D, Powis D. Can personal qualities of medical students predict in-course examination success and professional behaviour? An exploratory prospective cohort study. BMC Med Educ. 2012;12:69. https://doi.org/10.1186/1472-6920-12-69 .

Morrison J. How to choose tomorrow’s doctors. Med Educ. 2005;39(3):240–2. https://doi.org/10.1111/j.1365-2929.2004.02080.x .

New York Times. More Colleges Are Waiving SAT and ACT Requirements. https://www.nytimes.com/article/sat-act-test-optional-colleges-coronavirus.html . Accessed 2 Mar 2021.

Charmatz M. UC System may not use SAT/ACT tests for admissions and scholarship decisions. Disabil Compliance Higher Educ. 2020;26(4):1–3. https://doi.org/10.1002/dhe.30932 .

NPR. Lawsuit Claims SAT And ACT Are Illegal In California Admissions. https://www.npr.org/2019/12/10/786257347/lawsuit-claims-sat-and-act-are-illegal-in-california-admissions . Accessed 2 Mar 2021.

Eva KW, Reiter HI, Rosenfeld J, Norman GR. The ability of the multiple mini-interview to predict preclerkship performance in medical school. Acad Med. 2004;79(10 Suppl):S40-42. https://doi.org/10.1097/00001888-200410001-00012 .

Lievens F, Coetsier P, De Fruyt F, De Maeseneer J. Medical students’ personality characteristics and academic performance: a five-factor model perspective. Med Educ. 2002;36(11):1050–6. https://doi.org/10.1046/j.1365-2923.2002.01328.x .

Todres M, Tsimtsiou Z, Stephenson A, Jones R. The emotional intelligence of medical students: an exploratory cross-sectional study. Med Teach. 2010;32(1):e42-48. https://doi.org/10.3109/01421590903199668 .

Austin EJ, Evans P, Magnus B, O’Hanlon K. A preliminary study of empathy, emotional intelligence and examination performance in MBChB students. Med Educ. 2007;41(7):684–9. https://doi.org/10.1111/j.1365-2923.2007.02795.x .

Wijekoon CN, Amaratunge H, de Silva Y, Senanayake S, Jayawardane P, Senarath U. Emotional intelligence and academic performance of medical undergraduates: a cross-sectional study in a selected university in Sri Lanka. BMC Med Educ. 2017;17(1):176. https://doi.org/10.1186/s12909-017-1018-9 .

Richardson M, Abraham C, Bond R. Psychological correlates of university students’ academic performance: a systematic review and meta-analysis. Psychol Bull. 2012;138(2):353–87. https://doi.org/10.1037/a0026838 .

Kusurkar RA, Ten Cate TJ, van Asperen M, Croiset G. Motivation as an independent and a dependent variable in medical education: a review of the literature. Med Teach. 2011;33(5):e242-262. https://doi.org/10.3109/0142159X.2011.558539 .

Kusurkar RA, Croiset G, Galindo-Garre F, Ten Cate O. Motivational profiles of medical students: association with study effort, academic performance and exhaustion. BMC Med Educ. 2013;13:87. https://doi.org/10.1186/1472-6920-13-87 .

Finn GM, Mwandigha L, Paton LW, Tiffin PA. The ability of “non-cognitive” traits to predict undergraduate performance in medical schools: a national linkage study. BMC Med Educ. 2018;18(1):93. https://doi.org/10.1186/s12909-018-1201-7 .

Hojat M, Callahan CA, Gonnella JS. Students’ personality and ratings of clinical competence in medical school clerkships: a longitudinal study. Psychol Health Med. 2004;9(2):247–52. https://doi.org/10.1080/13548500410001670771 .

Powis D. Selecting medical students: An unresolved challenge. Med Teach. 2015;37(3):252–60. https://doi.org/10.3109/0142159X.2014.993600 .

Kreiter CD. A research agenda for establishing the validity of non-academic assessments of medical school applicants. Adv Health Sci Educ Theory Pract. 2016;21(5):1081–5. https://doi.org/10.1007/s10459-016-9672-y .

Harris BH, Walsh JL, Lammy S. UK medical selection: lottery or meritocracy? Clin Med (Lond). 2015;15(1):40–6. https://doi.org/10.7861/clinmedicine.15-1-40 .

Hojat M, Erdmann JB, Gonnella JS. Personality assessments and outcomes in medical education and the practice of medicine: AMEE Guide No. 79. Med Teach. 2013;35(7):e1267-1301. https://doi.org/10.3109/0142159X.2013.785654 .

University of Split School of Medicine. http://mefst.unist.hr/en . Accessed 8 February 2021.

Hren D, Lukic IK, Marusic A, Vodopivec I, Vujaklija A, Hrabak M, et al. Teaching research methodology in medical schools: students’ attitudes towards and knowledge about science. Med Educ. 2004;38(1):81–6. https://doi.org/10.1111/j.1365-2923.2004.01735.x .

Amabile TM, Hill KG, Hennessey BA, Tighe EM. The Work Preference Inventory: assessing intrinsic and extrinsic motivational orientations. J Pers Soc Psychol. 1994;66(5):950–67. https://doi.org/10.1037//0022-3514.66.5.950 .

Takšić V, Mohorić T, Duran M. Emotional skills and competence questionnaire (ESCQ) as a self-report measure of emotional intelligence. Horizons of Psychol. 2009;18(3):7–21.

Google Scholar  

Rosenberg M. Society and the adolescent self-image. Princeton: Princeton University Press; 1965.

Book   Google Scholar  

Bezinović P. Percepcija osobne kompetentnosti kao dimenzija samopoimanja. [doctoral dissertation]. Zagreb: Filozofski fakultet Sveučilišta u Zagrebu; 1988.

Free Statistics Calculators. A-priori Sample Size Calculator for Multiple Regression. http://www.danielsoper.com/statcalc/calculator.aspx?id=1 . Accessed 10 February 2021.

Centre for Evidence-Based Medicine, University of Oxford. How do you calculate a standard error of a beta coefficient? http://www.cebm.ox.ac.uk/resources/data-extraction-tips-meta-analysis/calculate-standard-error-beta-coefficient . Accessed 18 February 2021.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57. https://doi.org/10.1093/intqhc/mzm042 .

Bazdaric K, Sverko D, Salaric I, Martinovic A, Lucijanic M. The ABC of linear regression analysis: What every author and editor should know. Eur Sci Editing. 2021;47. https://doi.org/10.3897/ese.2021.e63780

Ravlic-Gulan J, Zauhar G. The Correlation between Enrolment Criteria and Students’ Success in the Study of Medicine: a Five-Year Retrospective Study. Acta Medica Acad. 2020;49(1):21–35. https://doi.org/10.5644/ama2006-124.280 .

Bridgeman B, McCamley-Jenkins L, Ervin N. Predictions of Freshman Grade-Point Average from the Revised and Recentered Sat ® I: Reasoning Test. ETS Res Rep Ser. 2000;2000(1):i–16. https://doi.org/10.1002/j.2333-8504.2000.tb01824.x .

Hannon B. Predicting College Success: The Relative Contributions of Five Social/Personality Factors, Five Cognitive/Learning Factors, and SAT Scores. J Educ Train Stud. 2014;2(4):46–58. https://doi.org/10.11114/jets.v2i4.451 .

Maslov Kruzicevic S, Barisic KJ, Banozic A, Esteban CD, Sapunar D, Puljak L. Predictors of attrition and academic success of medical students: a 30-year retrospective study. PLoS One. 2012;7(6):e39144. https://doi.org/10.1371/journal.pone.0039144 .

Gustavson K, von Soest T, Karevold E, Roysamb E. Attrition and generalizability in longitudinal studies: findings from a 15-year population-based study and a Monte Carlo simulation study. BMC Public Health. 2012;12:918. https://doi.org/10.1186/1471-2458-12-918 .

Edwards PJ, Roberts I, Clarke MJ, Diguiseppi C, Wentz R, Kwan I, et al. Methods to increase response to postal and electronic questionnaires. Cochrane Database of Syst rev. 2009;3:MR000008. https://doi.org/10.1002/14651858.MR000008.pub4 .

Harden RM, Stevenson M, Downie WW, Wilson GM. Assessment of clinical competence using objective structured examination. Br Med J. 1975;1(5955):447–51. https://doi.org/10.1136/bmj.1.5955.447 .

Zakarija-Grkovic I, Simunovic V. Introduction and preparation of an objective structured clinical examination in family medicine for undergraduate students at the University of Split. Acta Med Acad. 2012;41(1):68–74. https://doi.org/10.5644/ama2006-124.39 .

Duckworth AL, Quinn PD. Development and validation of the short grit scale (GRIT-S). J Pers Assess. 2009;91(2):166–74. https://doi.org/10.1080/00223890802634290 .

Duckworth AL, Peterson C, Matthews MD, Kelly DR. Grit: perseverance and passion for long-term goals. J Pers Soc Psychol. 2007;92(6):1087–101. https://doi.org/10.1037/0022-3514.92.6.1087 .

Shechtman N, DeBarger AH, Dornsife C, Rosier S, Yarnall L. Promoting Grit, Tenacity, and Perseverance: Critical Factors for Success in the 21st Century. Washington: US Department of Education; 2013.

Download references

Acknowledgements

We sincerely thank Matko Marušić, MD, PhD, for developing the idea and methodology for this study, obtaining ethical approval, and participating in the data collection. We thank Mario Malički, MD, PhD, for participating in the in vivo data collection and planning the study methodology, as well as assisting us with important information on the dataset. We also thank Mislav Sudić, who participated in an earlier statistical analysis of the dataset, for his cooperation and communication. We thank Dubravka Komić and Piero Marin Živković, MD, for participating in the data collection.

This study was funded by the grants from the Croatian Science Foundation: Professionalism in Health (ProHealth, grant No. IP-2014-09-7672) and Professionalism in Health - Decision Making in Practice and Research (ProDeM, grant No. IP-2019-04-4882). The funder had no role in the design of this study, data collection, analyses, interpretation of the data, or the writing of the manuscript.

Author information

Authors and affiliations.

Department of Medical Humanities, School of Medicine, University of Split, Šoltanska 2, 21000, Split, Croatia

Marija Franka Žuljević

Department of Research in Biomedicine and Health, School of Medicine, University of Split, Split, Croatia

Ivan Buljan

You can also search for this author in PubMed   Google Scholar

Contributions

IB and MFŽ participated in planning the study concept and methodology. IB performed the in vivo data collection. MFŽ and IB analyzed and interpreted the data. MFŽ wrote the first draft of the manuscript and IB revised it for intellectual content, with major contributions. Both authors read and approved the final manuscript.

Corresponding author

Correspondence to Marija Franka Žuljević .

Ethics declarations

Ethics approval and consent to participate.

All parts of the study, both quantitative and qualitative, were conducted in accordance with the principles outlined in the Declaration of Helsinki. The study was approved by the Ethics Committee of the University of Split School of Medicine (Class: 003-08/11-0310005, Reg. No: 2181-198-03-04/10-11 -0038) as a part of the project funded by the Croatian Science Foundation: Professionalism in Health (ProHealth) (grant No. IP-2014-09-7672). All participants, both in quantitative and qualitative parts of the study, were informed about the purpose of the study, were assured their identities would remain protected, and that they were not obliged to participate. In the paper-based survey, they were told that continuing to fill out the survey was considered to be their consent to participation. After the survey, which was filled in after regular classes, we asked for volunteers for interviews on this topic and considered their verbal consent sufficient to continue with an interview, as the application to the Ethics Committee did not specify the way informed consent should be obtained. Voice recordings from the interviews were used only for obtaining the transcripts, and the transcripts were anonymized, saved as encrypted and password-protected files at a secure server.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’ s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Additional file 1., additional file 2., additional file 3., additional file 4., rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Žuljević, M., Buljan, I. Academic and non-academic predictors of academic performance in medical school: an exploratory cohort study. BMC Med Educ 22 , 366 (2022). https://doi.org/10.1186/s12909-022-03436-1

Download citation

Received : 20 July 2021

Accepted : 03 May 2022

Published : 13 May 2022

DOI : https://doi.org/10.1186/s12909-022-03436-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Medical students
• Academic performance
• Medical education

BMC Medical Education

ISSN: 1472-6920

• Submission enquiries: [email protected]
• General enquiries: [email protected]

AMBOSS Blog

• Student Life

How to Write and Publish Clinical Research in Medical School

From working hard on the USMLE® exams to holding leadership positions in a specialty’s academic society, there are many ways medical students can work towards matching into the residency of their choice. One such activity that looks great on residency applications is finding clinical research opportunities in medical school to write and publish papers. No one knows this better than Dr. Eve Bowers. 

An Otolaryngology resident at the University of Miami/Jackson Memorial Hospital, Eve became an expert in writing, submitting, and publishing manuscripts during her final years in medical school. Check out Eve’s blog post below to get valuable insights on how to get published in medical school. 

As medical students, we’re told that research is important and that publications are “good”, and even “necessary to match ” into residency, but we often aren’t given the tools we need to turn ideas into manuscripts. This is especially true given our rigorous schedules. 

When I looked through my CV, I saw I had a few abstracts and presentations, but no manuscripts. I wanted to write, but publishing seemed like just checking another resume box. On top of that, I didn’t know where to begin. 

My writing journey started with a case report I nervously picked up during my surgery clerkship . Then, over ten months of typing, editing, and sending unanswered emails, I went from writing 0 to ten manuscripts. The process was sometimes painful but mostly gratifying (yes, research can be gratifying), and you can do it, too.

To make finding, starting, and publishing high-quality research articles a little bit easier and a lot more enjoyable, check out my five tips for publishing clinical research in medical school.

1. Build your network to find publication opportunities in medical school

When looking for projects, finding great mentors is often more useful than finding the perfect project. This is especially true when starting out. Use your time on clerkships to identify attending and resident mentors who you trust to support your budding author ambitions.

At this stage, residents especially are your friends . When you demonstrate follow-through and receptiveness to feedback, you will be given more research opportunities. Don’t be shy about asking mentors for tasks if you can juggle multiple projects, but don’t bite off more than you can chew. It’s important to communicate honestly and be transparent about the amount of time you have.

2. Kickstarting your research during medical school: start small 

If you have no research experience, start with a case report. Volunteer to write an article about an interesting case you saw in the operating room or clinic. It’s much easier and more rewarding to write about patients you have experience with, and case reports are a great way to demonstrate your writing ability to more senior authors.

Pro tip : Try to figure out as much as you can independently by using published reports as blueprints before asking for help. Nevertheless, don’t be afraid to seek guidance when you need it! If you approach a mentor with a problem, come prepared with 2-3 realistic solutions or examples of how you tried to figure it out on your own.

3. Know the criteria for writing a clinical research paper 

Before you begin, ask your mentor where they would like to submit the completed work. Each journal has specific standards, styles, and submission criteria. For guidance, look to papers previously published in that journal. 

As far as annotations and citations are concerned, download and learn how to use Endnote or Zotero right now! You’ll save days of work formatting your references.

Additionally, consider creating folders and spreadsheets to keep track of projects. Set goals and timelines for yourself from the beginning, and block off dedicated time to conduct a literature review, analyze data, and write.

Pro tip : If you are the first author and overseeing a large team, improve communication and efficiency by making everyone’s roles and expectations very clear to the group via email.

4. Follow up with your mentor

Sometimes you’ll send your mentor a draft, but she won’t get back to you with edits and feedback in a reasonable timeframe. Surprisingly, many projects do not get past this point because of insufficient persistence. Here’s what to do if this happens:

• Politely nudge your mentor with follow-up emails and schedule a meeting to discuss in person or via Zoom.
• Set deadlines and give specific reasons why the paper needs to be submitted. Some reasons could include, “I need this submission for my residency application ” or “this is a requirement for my school.”
• Ask your co-author resident and/or fellow to advocate for edits and submission.

Whatever happens, don’t give up at this point. You’ve put in the work, and persistence makes or breaks a successful student-author.

5. Write about the medical topics that you love

Writing is fun when you focus on subjects you’re really passionate about. You also don’t have to stay within your institution: feel free to branch out if you come across an interesting research opportunity at a different program. A little cold email can go a long way!

If your goal is quantity, you can increase output by asking around about “productive” research mentors and sticking to topics related to clinical practice or medical education. However, my advice is to never let relatively quick publication opportunities compromise the quality of your work. Remember — every paper you write gets easier and more enjoyable, and your work will be truly important to advancing the field you care about. Good luck!

About the Author : Eve is an Otolaryngology Resident at the University of Miami/Jackson Memorial Hospital. She attended medical school at the University of Pittsburgh School of Medicine and undergrad at the University of Pennsylvania. She is passionate about medical education, mentorship, and increasing minority and female leadership in surgical fields. For more tips and tricks, follow her on Twitter and Instagram !

For more information on residency applications, check out the AMBOSS Residency Applications Clerkship Survival Guide. 

Related posts you might like

Amboss apps: for medical students during clinical rotations.

No matter the specialty, the clinical clerkship period is full of challenging moments critical to ...

On the Wards: The Unwritten Rules of Clerkship Etiquette

You’re kicking off your clerkships this year, and there’s plenty to sink your teeth into as you ...

How to Order Your Clerkships

M3 is the year you’ve been waiting for. It’s finally your chance to be in the clinic, put your ...

Join Our Mailing List

And get updates on new posts and news about AMBOSS sent directly to your inbox.

All-in-one resource for residents and medical students.

10 Successful Medical School Essays

Sponsored by.

-- Accepted to: Harvard Medical School GPA: 4.0 MCAT: 522

Sponsored by A ccepted.com : Great stats don’t assure acceptance to elite medical schools. The personal statement, most meaningful activities, activity descriptions, secondaries and interviews can determine acceptance or rejection. Since 1994, Accepted.com has guided medical applicants just like you to present compelling medical school applications. Get Accepted !

I started writing in 8th grade when a friend showed me her poetry about self-discovery and finding a voice. I was captivated by the way she used language to bring her experiences to life. We began writing together in our free time, trying to better understand ourselves by putting a pen to paper and attempting to paint a picture with words. I felt my style shift over time as I grappled with challenges that seemed to defy language. My poems became unstructured narratives, where I would use stories of events happening around me to convey my thoughts and emotions. In one of my earliest pieces, I wrote about a local boy’s suicide to try to better understand my visceral response. I discussed my frustration with the teenage social hierarchy, reflecting upon my social interactions while exploring the harms of peer pressure.

In college, as I continued to experiment with this narrative form, I discovered medical narratives. I have read everything from Manheimer’s Bellevue to Gawande’s Checklist and from Nuland’s observations about the way we die, to Kalanithi’s struggle with his own decline. I even experimented with this approach recently, writing a piece about my grandfather’s emphysema. Writing allowed me to move beyond the content of our relationship and attempt to investigate the ways time and youth distort our memories of the ones we love. I have augmented these narrative excursions with a clinical bioethics internship. In working with an interdisciplinary team of ethics consultants, I have learned by doing by participating in care team meetings, synthesizing discussions and paths forward in patient charts, and contributing to an ongoing legislative debate addressing the challenges of end of life care. I have also seen the ways ineffective intra-team communication and inter-personal conflicts of beliefs can compromise patient care.

Writing allowed me to move beyond the content of our relationship and attempt to investigate the ways time and youth distort our memories of the ones we love.

By assessing these difficult situations from all relevant perspectives and working to integrate the knowledge I’ve gained from exploring narratives, I have begun to reflect upon the impact the humanities can have on medical care. In a world that has become increasingly data driven, where patients can so easily devolve into lists of numbers and be forced into algorithmic boxes in search of an exact diagnosis, my synergistic narrative and bioethical backgrounds have taught me the importance of considering the many dimensions of the human condition. I am driven to become a physician who deeply considers a patient’s goal of care and goals of life. I want to learn to build and lead patient care teams that are oriented toward fulfilling these goals, creating an environment where family and clinician conflict can be addressed efficiently and respectfully. Above all, I look forward to using these approaches to keep the person beneath my patients in focus at each stage of my medical training, as I begin the task of translating complex basic science into excellent clinical care.

In her essay for medical school, Morgan pitches herself as a future physician with an interdisciplinary approach, given her appreciation of how the humanities can enable her to better understand her patients. Her narrative takes the form of an origin story, showing how a childhood interest in poetry grew into a larger mindset to keep a patient’s humanity at the center of her approach to clinical care.

This narrative distinguishes Morgan as a candidate for medical school effectively, as she provides specific examples of how her passions intersect with medicine. She first discusses how she used poetry to process her emotional response to a local boy’s suicide and ties in concern about teenage mental health. Then, she discusses more philosophical questions she encountered through reading medical narratives, which demonstrates her direct interest in applying writing and the humanities to medicine. By making the connection from this larger theme to her own reflections on her grandfather, Morgan provides a personal insight that will give an admissions officer a window into her character. This demonstrates her empathy for her future patients and commitment to their care.

Her narrative takes the form of an origin story, showing how a childhood interest in poetry grew into a larger mindset to keep a patient's humanity at the center of her approach to clinical care.

Furthermore, it is important to note that Morgan’s essay does not repeat anything in-depth that would otherwise be on her resume. She makes a reference to her work in care team meetings through a clinical bioethics internship, but does not focus on this because there are other places on her application where this internship can be discussed. Instead, she offers a more reflection-based perspective on the internship that goes more in-depth than a resume or CV could. This enables her to explain the reasons for interdisciplinary approach to medicine with tangible examples that range from personal to professional experiences — an approach that presents her as a well-rounded candidate for medical school.

Disclaimer: With exception of the removal of identifying details, essays are reproduced as originally submitted in applications; any errors in submissions are maintained to preserve the integrity of the piece. The Crimson's news and opinion teams—including writers, editors, photographers, and designers—were not involved in the production of this article.

-- Accepted To: A medical school in New Jersey with a 3% acceptance rate. GPA: 3.80 MCAT: 502 and 504

Sponsored by E fiie Consulting Group : “ EFIIE ” boasts 100% match rate for all premedical and predental registered students. Not all students are accepted unto their pre-health student roster. Considered the most elite in the industry and assists from start to end – premed to residency. EFIIE is a one-stop-full-service education firm.

"To know even one life has breathed easier because you have lived. This is to have succeeded." – Ralph Waldo Emerson.

The tribulations I've overcome in my life have manifested in the compassion, curiosity, and courage that is embedded in my personality. Even a horrific mishap in my life has not changed my core beliefs and has only added fuel to my intense desire to become a doctor. My extensive service at an animal hospital, a harrowing personal experience, and volunteering as an EMT have increased my appreciation and admiration for the medical field.

At thirteen, I accompanied my father to the Park Home Animal Hospital with our eleven-year-old dog, Brendan. He was experiencing severe pain due to an osteosarcoma, which ultimately led to the difficult decision to put him to sleep. That experience brought to light many questions regarding the idea of what constitutes a "quality of life" for an animal and what importance "dignity" plays to an animal and how that differs from owner to owner and pet to pet. Noting my curiosity and my relative maturity in the matter, the owner of the animal hospital invited me to shadow the professional staff. Ten years later, I am still part of the team, having made the transition from volunteer to veterinarian technician. Saving a life, relieving pain, sharing in the euphoria of animal and owner reuniting after a procedure, to understanding the emotions of losing a loved one – my life was forever altered from the moment I stepped into that animal hospital.

As my appreciation for medical professionals continued to grow, a horrible accident created an indelible moment in my life. It was a warm summer day as I jumped onto a small boat captained by my grandfather. He was on his way to refill the boat's gas tank at the local marina, and as he pulled into the dock, I proceeded to make a dire mistake. As the line was thrown from the dock, I attempted to cleat the bowline prematurely, and some of the most intense pain I've ever felt in my life ensued.

Saving a life, relieving pain, sharing in the euphoria of animal and owner reuniting after a procedure, to understanding the emotions of losing a loved one – my life was forever altered from the moment I stepped into that animal hospital.

"Call 911!" I screamed, half-dazed as I witnessed blood gushing out of my open wounds, splashing onto the white fiberglass deck of the boat, forming a small puddle beneath my feet. I was instructed to raise my hand to reduce the bleeding, while someone wrapped an icy towel around the wound. The EMTs arrived shortly after and quickly drove me to an open field a short distance away, where a helicopter seemed to instantaneously appear.

The medevac landed on the roof of Stony Brook Hospital before I was expeditiously wheeled into the operating room for a seven-hour surgery to reattach my severed fingers. The distal phalanges of my 3rd and 4th fingers on my left hand had been torn off by the rope tightening on the cleat. I distinctly remember the chill from the cold metal table, the bright lights of the OR, and multiple doctors and nurses scurrying around. The skill and knowledge required to execute multiple skin graft surgeries were impressive and eye-opening. My shortened fingers often raise questions by others; however, they do not impair my self-confidence or physical abilities. The positive outcome of this trial was the realization of my intense desire to become a medical professional.

Despite being the patient, I was extremely impressed with the dedication, competence, and cohesiveness of the medical team. I felt proud to be a critical member of such a skilled group. To this day, I still cannot explain the dichotomy of experiencing being the patient, and concurrently one on the professional team, committed to saving the patient. Certainly, this experience was a defining part of my life and one of the key contributors to why I became an EMT and a volunteer member of the Sample Volunteer Ambulance Corps. The startling ring of the pager, whether it is to respond to an inebriated alcoholic who is emotionally distraught or to help bring breath to a pulseless person who has been pulled from the family swimming pool, I am committed to EMS. All of these events engender the same call to action and must be reacted to with the same seriousness, intensity, and magnanimity. It may be some routine matter or a dire emergency; this is a role filled with uncertainty and ambiguity, but that is how I choose to spend my days. My motives to become a physician are deeply seeded. They permeate my personality and emanate from my desire to respond to the needs of others. Through a traumatic personal event and my experiences as both a professional and volunteer, I have witnessed firsthand the power to heal the wounded and offer hope. Each person defines success in different ways. To know even one life has been improved by my actions affords me immense gratification and meaning. That is success to me and why I want to be a doctor.

This review is provided by EFIIE Consulting Group’s Pre-Health Senior Consultant Jude Chan

This student was a joy to work with — she was also the lowest MCAT profile I ever accepted onto my roster. At 504 on the second attempt (502 on her first) it would seem impossible and unlikely to most that she would be accepted into an allopathic medical school. Even for an osteopathic medical school this score could be too low. Additionally, the student’s GPA was considered competitive at 3.80, but it was from a lower ranked, less known college, so naturally most advisors would tell this student to go on and complete a master’s or postbaccalaureate program to show that she could manage upper level science classes. Further, she needed to retake the MCAT a third time.

However, I saw many other facets to this student’s history and life that spoke volumes about the type of student she was, and this was the positioning strategy I used for her file. Students who read her personal statement should know that acceptance is contingent on so much more than just an essay and MCAT score or GPA. Although many students have greater MCAT scores than 504 and higher GPAs than 3.80, I have helped students with lower scores and still maintained our 100% match rate. You are competing with thousands of candidates. Not every student out there requires our services and we are actually grateful that we can focus on a limited amount out of the tens of thousands that do. We are also here for the students who wish to focus on learning well the organic chemistry courses and physics courses and who want to focus on their research and shadowing opportunities rather than waste time deciphering the next step in this complex process. We tailor a pathway for each student dependent on their health care career goals, and our partnerships with non-profit organizations, hospitals, physicians and research labs allow our students to focus on what matters most — the building up of their basic science knowledge and their exposure to patients and patient care.

Students who read her personal statement should know that acceptance is contingent on so much more than just an essay and MCAT score or GPA.

Even students who believe that their struggle somehow disqualifies them from their dream career in health care can be redeemed if they are willing to work for it, just like this student with 502 and 504 MCAT scores. After our first consult, I saw a way to position her to still be accepted into an MD school in the US — I would not have recommended she register to our roster if I did not believe we could make a difference. Our rosters have a waitlist each semester, and it is in our best interest to be transparent with our students and protect our 100% record — something I consider a win-win. It is unethical to ever guarantee acceptance in admissions as we simply do not control these decisions. However, we respect it, play by the rules, and help our students stay one step ahead by creating an applicant profile that would be hard for the schools to ignore.

This may be the doctor I go to one day. Or the nurse or dentist my children or my grandchildren goes to one day. That is why it is much more than gaining acceptance — it is about properly matching the student to the best options for their education. Gaining an acceptance and being incapable of getting through the next 4 or 8 years (for my MD/PhD-MSTP students) is nonsensical.

-- Accepted To: Imperial College London UCAT Score: 2740 BMAT Score: 3.9, 5.4, 3.5A

My motivation to study Medicine stems from wishing to be a cog in the remarkable machine that is universal healthcare: a system which I saw first-hand when observing surgery in both the UK and Sri Lanka. Despite the differences in sanitation and technology, the universality of compassion became evident. When volunteering at OSCE training days, I spoke to many medical students, who emphasised the importance of a genuine interest in the sciences when studying Medicine. As such, I have kept myself informed of promising developments, such as the use of monoclonal antibodies in cancer therapy. After learning about the role of HeLa cells in the development of the polio vaccine in Biology, I read 'The Immortal Life of Henrietta Lacks' to find out more. Furthermore, I read that surface protein CD4 can be added to HeLa cells, allowing them to be infected with HIV, opening the possibility of these cells being used in HIV research to produce more life-changing drugs, such as pre-exposure prophylaxis (PreP). Following my BioGrad laboratory experience in HIV testing, and time collating data for research into inflammatory markers in lung cancer, I am also interested in pursuing a career in medical research. However, during a consultation between an ENT surgeon and a thyroid cancer patient, I learnt that practising medicine needs more than a scientific aptitude. As the surgeon explained that the cancer had metastasised to her liver, I watched him empathetically tailor his language for the patient - he avoided medical jargon and instead gave her time to come to terms with this. I have been developing my communication skills by volunteering weekly at care homes for 3 years, which has improved my ability to read body language and structure conversations to engage with the residents, most of whom have dementia.

However, during a consultation between an ENT surgeon and a thyroid cancer patient, I learnt that practising medicine needs more than a scientific aptitude.

Jude’s essay provides a very matter-of-fact account of their experience as a pre-medical student. However, they deepen this narrative by merging two distinct cultures through some common ground: a universality of compassion. Using clear, concise language and a logical succession of events — much like a doctor must follow when speaking to patients — Jude shows their motivation to go into the medical field.

From their OSCE training days to their school’s Science society, Jude connects their analytical perspective — learning about HeLa cells — to something that is relatable and human, such as a poor farmer’s notable contribution to science. This approach provides a gateway into their moral compass without having to explicitly state it, highlighting their fervent desire to learn how to interact and communicate with others when in a position of authority.

Using clear, concise language and a logical succession of events — much like a doctor must follow when speaking to patients — Jude shows their motivation to go into the medical field.

Jude’s closing paragraph reminds the reader of the similarities between two countries like the UK and Sri Lanka, and the importance of having a universal healthcare system that centers around the just and “world-class” treatment of patients. Overall, this essay showcases Jude’s personal initiative to continue to learn more and do better for the people they serve.

While the essay could have benefited from better transitions to weave Jude’s experiences into a personal story, its strong grounding in Jude’s motivation makes for a compelling application essay.

-- Accepted to: Weill Cornell Medical College GPA: 3.98 MCAT: 521

Sponsored by E fie Consulting Group : “ EFIIE ” boasts 100% match rate for all premedical and predental registered students. Not all students are accepted unto their pre-health student roster. Considered the most elite in the industry and assists from start to end – premed to residency. EFIIE is a one-stop-full-service education firm.

Following the physician’s unexpected request, we waited outside, anxiously waiting to hear the latest update on my father’s condition. It was early on in my father’s cancer progression – a change that had shaken our entire way of life overnight. During those 18 months, while my mother spent countless nights at the hospital, I took on the responsibility of caring for my brother. My social life became of minimal concern, and the majority of my studying for upcoming 12th- grade exams was done at the hospital. We were allowed back into the room as the physician walked out, and my parents updated us on the situation. Though we were a tight-knit family and my father wanted us to be present throughout his treatment, what this physician did was give my father a choice. Without making assumptions about who my father wanted in the room, he empowered him to make that choice independently in private. It was this respect directed towards my father, the subsequent efforts at caring for him, and the personal relationship of understanding they formed, that made the largest impact on him. Though my decision to pursue medicine came more than a year later, I deeply valued what these physicians were doing for my father, and I aspired to make a similar impact on people in the future.

It was during this period that I became curious about the human body, as we began to learn physiology in more depth at school. In previous years, the problem-based approach I could take while learning math and chemistry were primarily what sparked my interest. However, I became intrigued by how molecular interactions translated into large-scale organ function, and how these organ systems integrated together to generate the extraordinary physiological functions we tend to under-appreciate. I began my undergraduate studies with the goal of pursuing these interests, whilst leaning towards a career in medicine. While I was surprised to find that there were upwards of 40 programs within the life sciences that I could pursue, it broadened my perspective and challenged me to explore my options within science and healthcare. I chose to study pathobiology and explore my interests through hospital volunteering and research at the end of my first year.

Though my decision to pursue medicine came more than a year later, I deeply valued what these physicians were doing for my father, and I aspired to make a similar impact on people in the future.

While conducting research at St. Michael’s Hospital, I began to understand methods of data collection and analysis, and the thought process of scientific inquiry. I became acquainted with the scientific literature, and the experience transformed how I thought about the concepts I was learning in lecture. However, what stood out to me that summer was the time spent shadowing my supervisor in the neurosurgery clinic. It was where I began to fully understand what life would be like as a physician, and where the career began to truly appeal to me. What appealed to me most was the patient-oriented collaboration and discussions between my supervisor and his fellow; the physician-patient relationship that went far beyond diagnoses and treatments; and the problem solving that I experienced first-hand while being questioned on disease cases.

The day spent shadowing in the clinic was also the first time I developed a relationship with a patient. We were instructed to administer the Montreal cognitive assessment (MoCA) test to patients as they awaited the neurosurgeon. My task was to convey the instructions as clearly as possible and score each section. I did this as best I could, adapting my explanation to each patient, and paying close attention to their responses to ensure I was understood. The last patient was a challenging case, given a language barrier combined with his severe hydrocephalus. It was an emotional time for his family, seeing their father/husband struggle to complete simple tasks and subsequently give up. I encouraged him to continue trying. But I also knew my words would not remedy the condition underlying his struggles. All I could do was make attempts at lightening the atmosphere as I got to know him and his family better. Hours later, as I saw his remarkable improvement following a lumbar puncture, and the joy on his and his family’s faces at his renewed ability to walk independently, I got a glimpse of how rewarding it would be to have the ability and privilege to care for such patients. By this point, I knew I wanted to commit to a life in medicine. Two years of weekly hospital volunteering have allowed me to make a small difference in patients’ lives by keeping them company through difficult times, and listening to their concerns while striving to help in the limited way that I could. I want to have the ability to provide care and treatment on a daily basis as a physician. Moreover, my hope is that the breadth of medicine will provide me with the opportunity to make an impact on a larger scale. Whilst attending conferences on neuroscience and surgical technology, I became aware of the potential to make a difference through healthcare, and I look forward to developing the skills necessary to do so through a Master’s in Global Health. Whether through research, health innovation, or public health, I hope not only to care for patients with the same compassion with which physicians cared for my father, but to add to the daily impact I can have by tackling large-scale issues in health.

Taylor’s essay offers both a straightforward, in-depth narrative and a deep analysis of his experiences, which effectively reveals his passion and willingness to learn in the medical field. The anecdote of Taylor’s father gives the reader insight into an original instance of learning through experience and clearly articulates Taylor’s motivations for becoming a compassionate and respectful physician.

Taylor strikes an impeccable balance between discussing his accomplishments and his character. All of his life experiences — and the difficult challenges he overcame — introduce the reader to an important aspect of Taylor’s personality: his compassion, care for his family, and power of observation in reflecting on the decisions his father’s doctor makes. His description of his time volunteering at St. Michael’s Hospital is indicative of Taylor’s curiosity about medical research, but also of his recognition of the importance of the patient-physician relationship. Moreover, he shows how his volunteer work enabled him to see how medicine goes “beyond diagnoses and treatments” — an observation that also speaks to his compassion.

His description of his time volunteering at St. Michael's Hospital is indicative of Taylor's curiosity about medical research, but also of his recognition of the importance of the patient-physician relationship.

Finally, Taylor also tells the reader about his ambition and purpose, which is important when thinking about applying to medical school. He discusses his hope of tackling larger scale problems through any means possible in medicine. This notion of using self interest to better the world is imperative to a successful college essay, and it is nicely done here.

-- Accepted to: Washington University

Sponsored by A dmitRx : We are a group of Chicago-based medical students who realize how challenging medical school admissions can be, so we want to provide our future classmates with resources we wish we had. Our mission at AdmitRx is to provide pre-medical students with affordable, personalized, high-quality guidance towards becoming an admitted medical student.

Running has always been one of my greatest passions whether it be with friends or alone with my thoughts. My dad has always been my biggest role model and was the first to introduce me to the world of running. We entered races around the country, and one day he invited me on a run that changed my life forever. The St. Jude Run is an annual event that raises millions of dollars for St. Jude Children’s Research Hospital. My dad has led or our local team for as long as I can remember, and I had the privilege to join when I was 16. From the first step I knew this was the environment for me – people from all walks of life united with one goal of ending childhood cancer. I had an interest in medicine before the run, and with these experiences I began to consider oncology as a career. When this came up in conversations, I would invariably be faced with the question “Do you really think you could get used to working with dying kids?” My 16-year-old self responded with something noble but naïve like “It’s important work, so I’ll have to handle it”. I was 16 years young with my plan to become an oncologist at St. Jude.

As I transitioned into college my plans for oncology were alive and well. I began working in a biochemistry lab researching new anti-cancer drugs. It was a small start, but I was overjoyed to be a part of the process. I applied to work at a number of places for the summer, but the Pediatric Oncology Education program (POE) at St. Jude was my goal. One afternoon, I had just returned from class and there it was: an email listed as ‘POE Offer’. I was ecstatic and accepted the offer immediately. Finally, I could get a glimpse at what my future holds. My future PI, Dr. Q, specialized in solid tumor translational research and I couldn’t wait to get started.

I was 16 years young with my plan to become an oncologist at St. Jude.

Summer finally came, I moved to Memphis, and I was welcomed by the X lab. I loved translational research because the results are just around the corner from helping patients. We began a pre-clinical trial of a new chemotherapy regimen and the results were looking terrific. I was also able to accompany Dr. Q whenever she saw patients in the solid tumor division. Things started simple with rounds each morning before focusing on the higher risk cases. I was fortunate enough to get to know some of the patients quite well, and I could sometimes help them pass the time with a game or two on a slow afternoon between treatments. These experiences shined a very human light on a field I had previously seen only through a microscope in a lab.

I arrived one morning as usual, but Dr. Q pulled me aside before rounds. She said one of the patients we had been seeing passed away in the night. I held my composure in the moment, but I felt as though an anvil was crushing down on me. It was tragic but I knew loss was part of the job, so I told myself to push forward. A few days later, I had mostly come to terms with what happened, but then the anvil came crashing back down with the passing of another patient. I could scarcely hold back the tears this time. That moment, it didn’t matter how many miraculous successes were happening a few doors down. Nothing overshadowed the loss, and there was no way I could ‘get used to it’ as my younger self had hoped.

I was still carrying the weight of what had happened and it was showing, so I asked Dr. Q for help. How do you keep smiling each day? How do you get used to it? The questions in my head went on. What I heard next changed my perspective forever. She said you keep smiling because no matter what happened, you’re still hope for the next patient. It’s not about getting used to it. You never get used to it and you shouldn’t. Beating cancer takes lifetimes, and you can’t look passed a life’s worth of hardships. I realized that moving passed the loss of patients would never suffice, but I need to move forward with them. Through the successes and shortcomings, we constantly make progress. I like to imagine that in all our future endeavors, it is the hands of those who have gone before us that guide the way. That is why I want to attend medical school and become a physician. We may never end the sting of loss, but physicians are the bridge between the past and the future. No where else is there the chance to learn from tragedy and use that to shape a better future. If I can learn something from one loss, keep moving forward, and use that knowledge to help even a single person – save one life, bring a moment of joy, avoid a moment of pain—then that is how I want to spend my life.

The change wasn’t overnight. The next loss still brought pain, but I took solace in moving forward so that we might learn something to give hope to a future patient. I returned to campus in a new lab doing cancer research, and my passion for medicine continues to flourish. I still think about all the people I encountered at St. Jude, especially those we lost. It might be a stretch, but during the long hours at the lab bench I still picture their hands moving through mine each step of the way. I could never have foreseen where the first steps of the St. Jude Run would bring me. I’m not sure where the road to becoming a physician may lead, but with helping hands guiding the way, I won’t be running it alone.

This essay, a description of the applicant’s intellectual challenges, displays the hardships of tending to cancer patients as a milestone of experience and realization of what it takes to be a physician. The writer explores deeper ideas beyond medicine, such as dealing with patient deaths in a way to progress and improve as a professional. In this way, the applicant gives the reader some insight into the applicant’s mindset, and their ability to think beyond the surface for ways to become better at what they do.

However, the essay fails to zero in on the applicant’s character, instead elaborating on life events that weakly illustrate the applicant’s growth as a physician. The writer’s mantra (“keep moving forward”) is feebly projected, and seems unoriginal due to the lack of a personalized connection between the experience at St. Jude and how that led to the applicant’s growth and mindset changes.

The writer explores deeper ideas beyond medicine, such as dealing with patient deaths in a way to progress and improve as a professional.

The writer, by only focusing on grief brought from patient deaths at St. Jude, misses out on the opportunity to further describe his or her experience at the hospital and portray an original, well-rounded image of his or her strengths, weaknesses, and work ethic.

The applicant ends the essay by attempting to highlight the things they learned at St. Jude, but fails to organize the ideas into a cohesive, comprehensible section. These ideas are also too abstract, and are vague indicators of the applicant’s character that are difficult to grasp.

-- Accepted to: New York University School of Medicine

Sponsored by MedEdits : MedEdits Medical Admissions has been helping applicants get into medical schools like Harvard for more than ten years. Structured like an academic medical department, MedEdits has experts in admissions, writing, editing, medicine, and interview prep working with you collaboratively so you can earn the best admissions results possible.

“Is this the movie you were talking about Alice?” I said as I showed her the movie poster on my iPhone. “Oh my God, I haven’t seen that poster in over 70 years,” she said with her arms trembling in front of her. Immediately, I sat up straight and started to question further. We were talking for about 40 minutes, and the most exciting thing she brought up in that time was the new flavor of pudding she had for lunch. All of sudden, she’s back in 1940 talking about what it was like to see this movie after school for only 5¢ a ticket! After an engaging discussion about life in the 40’s, I knew I had to indulge her. Armed with a plethora of movie streaming sights, I went to work scouring the web. No luck. The movie, “My Son My Son,” was apparently not in high demand amongst torrenting teens. I had to entreat my older brother for his Amazon Prime account to get a working stream. However, breaking up the monotony and isolation felt at the nursing home with a simple movie was worth the pandering.

While I was glad to help a resident have some fun, I was partly motivated by how much Alice reminded me of my own grandfather. In accordance with custom, my grandfather was to stay in our house once my grandmother passed away. More specifically, he stayed in my room and my bed. Just like grandma’s passing, my sudden roommate was a rough transition. In 8th grade at the time, I considered myself to be a generally good guy. Maybe even good enough to be a doctor one day. I volunteered at the hospital, shadowed regularly, and had a genuine interest for science. However, my interest in medicine was mostly restricted to academia. To be honest, I never had a sustained exposure to the palliative side of medicine until the arrival of my new roommate.

The two years I slept on that creaky wooden bed with him was the first time my metal was tested. Sharing that room, I was the one to take care of him. I was the one to rub ointment on his back, to feed him when I came back from school, and to empty out his spittoon when it got full. It was far from glamorous, and frustrating most of the time. With 75 years separating us, and senile dementia setting in, he would often forget who I was or where he was. Having to remind him that I was his grandson threatened to erode at my resolve. Assured by my Syrian Orthodox faith, I even prayed about it; asking God for comfort and firmness on my end. Over time, I grew slow to speak and eager to listen as he started to ramble more and more about bits and pieces of the past. If I was lucky, I would be able to stich together a narrative that may or may have not been true. In any case, my patience started to bud beyond my age group.

Having to remind him that I was his grandson threatened to erode at my resolve.

Although I grew more patient with his disease, my curiosity never really quelled. Conversely, it developed further alongside my rapidly growing interest in the clinical side of medicine. Naturally, I became drawn to a neurology lab in college where I got to study pathologies ranging from atrophy associated with schizophrenia, and necrotic lesions post stroke. However, unlike my intro biology courses, my work at the neurology lab was rooted beyond the academics. Instead, I found myself driven by real people who could potentially benefit from our research. In particular, my shadowing experience with Dr. Dominger in the Veteran’s home made the patient more relevant in our research as I got to encounter geriatric patients with age related diseases, such as Alzhimer’s and Parkinson’s. Furthermore, I had the privilege of of talking to the families of a few of these patients to get an idea of the impact that these diseases had on the family structure. For me, the scut work in the lab meant a lot more with these families in mind than the tritium tracer we were using in the lab.

Despite my achievements in the lab and the classroom, my time with my grandfather still holds a special place in my life story. The more I think about him, the more confident I am in my decision to pursue a career where caring for people is just as important, if not more important, than excelling at academics. Although it was a lot of work, the years spent with him was critical in expanding my horizons both in my personal life and in the context of medicine. While I grew to be more patient around others, I also grew to appreciate medicine beyond the science. This more holistic understanding of medicine had a synergistic effect in my work as I gained a purpose behind the extra hours in the lab, sleepless nights in the library, and longer hours volunteering. I had a reason for what I was doing that may one day help me have long conversations with my own grandchildren about the price of popcorn in the 2000’s.

The most important thing to highlight in Avery’s essay is how he is able to create a duality between his interest in not only the clinical, more academic-based side of medicine, but also the field’s personal side.

He draws personal connections between working with Alice — a patient in a hospital or nursing home — and caring intensely for his grandfather. These two experiences build up the “synergistic” relationship between caring for people and studying the science behind medicine. In this way, he is able to clearly state his passions for medicine and explain his exact motives for entering the field. Furthermore, in his discussion of her grandfather, he effectively employs imagery (“rub ointment on his back,” “feed him when I came back from school,” etc.) to describe the actual work that he does, calling it initially as “far from glamorous, and frustrating most of the time.” By first mentioning his initial impression, then transitioning into how he grew to appreciate the experience, Avery is able to demonstrate a strength of character, sense of enormous responsibility and capability, and open-minded attitude.

He draws personal connections between working with Alice — a patient in a hospital or nursing home — and caring intensely for his grandfather.

Later in the essay, Avery is also able to relate his time caring for his grandfather to his work with Alzheimer’s and Parkinson’s patients, showcasing the social impact of his work, as the reader is likely already familiar with the biological impact of the work. This takes Avery’s essay full circle, bringing it back to how a discussion with an elderly patient about the movies reminds him of why he chose to pursue medicine.

That said, the essay does feel rushed near the end, as the writer was likely trying to remain within the word count. There could be a more developed transition before Avery introduces the last sentence about “conversations with my own grandchildren,” especially as a strong essay ending is always recommended.

-- Accepted To: Saint Louis University Medical School Direct Admission Medical Program

Sponsored by Atlas Admissions : Atlas Admissions provides expert medical school admissions consulting and test preparation services. Their experienced, physician-driven team consistently delivers top results by designing comprehensive, personalized strategies to optimize applications. Atlas Admissions is based in Boston, MA and is trusted by clients worldwide.

The tension in the office was tangible. The entire team sat silently sifting through papers as Dr. L introduced Adam, a 60-year-old morbidly obese man recently admitted for a large open wound along his chest. As Dr. L reviewed the details of the case, his prognosis became even bleaker: hypertension, diabetes, chronic kidney disease, cardiomyopathy, hyperlipidemia; the list went on and on. As the humdrum of the side-conversations came to a halt, and the shuffle of papers softened, the reality of Adam’s situation became apparent. Adam had a few months to live at best, a few days at worst. To make matters worse, Adam’s insurance would not cover his treatment costs. With no job, family, or friends, he was dying poor and alone.

I followed Dr. L out of the conference room, unsure what would happen next. “Well,” she muttered hesitantly, “We need to make sure that Adam is on the same page as us.” It’s one thing to hear bad news, and another to hear it utterly alone. Dr. L frantically reviewed all of Adam’s paperwork desperately looking for someone to console him, someone to be at his side. As she began to make calls, I saw that being a physician calls for more than good grades and an aptitude for science: it requires maturity, sacrifice, and most of all, empathy. That empathy is exactly what I saw in Dr. L as she went out of her way to comfort a patient she met hardly 20 minutes prior.

Since high school, I’ve been fascinated by technology’s potential to improve healthcare. As a volunteer in [the] Student Ambassador program, I was fortunate enough to watch an open-heart surgery. Intrigued by the confluence of technology and medicine, I chose to study biomedical engineering. At [school], I wanted to help expand this interface, so I became involved with research through Dr. P’s lab by studying the applications of electrospun scaffolds for dermal wound healing. While still in the preliminary stages of research, I learned about the Disability Service Club (DSC) and decided to try something new by volunteering at a bowling outing.

As she began to make calls, I saw that being a physician calls for more than good grades and an aptitude for science: it requires maturity, sacrifice, and most of all, empathy.

The DSC promotes awareness of cognitive disabilities in the community and seeks to alleviate difficulties for the disabled. During one outing, I collaborated with Arc, a local organization with a similar mission. Walking in, I was told that my role was to support the participants by providing encouragement. I decided to help a relatively quiet group of individuals assisted by only one volunteer, Mary. Mary informed me that many individuals with whom I was working were diagnosed with ASD. Suddenly, she started cheering, as one of the members of the group bowled a strike. The group went wild. Everyone was dancing, singing, and rejoicing. Then I noticed one gentleman sitting at our table, solemn-faced. I tried to start a conversation with him, but he remained unresponsive. I sat with him for the rest of the game, trying my hardest to think of questions that would elicit more than a monosyllabic response, but to no avail. As the game ended, I stood up to say bye when he mumbled, “Thanks for talking.” Then he quickly turned his head away. I walked away beaming. Although I was unable to draw out a smile or even sustain a conversation, at the end of the day, the fact that this gentleman appreciated my mere effort completely overshadowed the awkwardness of our time together. Later that day, I realized that as much as I enjoyed the thrill of research and its applications, helping other people was what I was most passionate about.

When it finally came time to tell Adam about his deteriorating condition, I was not sure how he would react. Dr. L gently greeted him and slowly let reality take its toll. He stoically turned towards Dr. L and groaned, “I don’t really care. Just leave me alone.” Dr. L gave him a concerned nod and gradually left the room. We walked to the next room where we met with a pastor from Adam’s church.

“Adam’s always been like that,” remarked the pastor, “he’s never been one to express emotion.” We sat with his pastor for over an hour discussing how we could console Adam. It turned out that Adam was part of a motorcycle club, but recently quit because of his health. So, Dr. L arranged for motorcycle pictures and other small bike trinkets to be brought to his room as a reminder of better times.

Dr. L’s simple gesture reminded me of why I want to pursue medicine. There is something sacred, empowering, about providing support when people need it the most; whether it be simple as starting a conversation, or providing support during the most trying of times. My time spent conducting research kindled my interest in the science of medicine, and my service as a volunteer allowed me to realize how much I valued human interaction. Science and technology form the foundation of medicine, but to me, empathy is the essence. It is my combined interest in science and service that inspires me to pursue medicine. It is that combined interest that makes me aspire to be a physician.

Parker’s essay focuses on one central narrative with a governing theme of compassionate and attentive care for patients, which is the key motivator for her application to medical school. Parker’s story focuses on her volunteer experience shadowing of Dr. L who went the extra mile for Adam, which sets Dr. L up as a role model for Parker as she enters the medical field. This effectively demonstrates to the reader what kind of doctor Parker wants to be in the future.

Parker’s narrative has a clear beginning, middle, and end, making it easy for the reader to follow. She intersperses the main narrative about Adam with experiences she has with other patients and reflects upon her values as she contemplates pursuing medicine as a career. Her anecdote about bowling with the patients diagnosed with ASD is another instance where she uses a story to tell the reader why she values helping people through medicine and attentive patient care, especially as she focuses on the impact her work made on one man at the event.

Parker's story focuses on her volunteer experience shadowing of Dr. L who went the extra mile for Adam, which sets Dr. L up as a role model for Parker as she enters the medical field.

All throughout the essay, the writing is engaging and Parker incorporates excellent imagery, which goes well with her varied sentence structure. The essay is also strong because it comes back full circle at its conclusion, tying the overall narrative back to the story of Dr. L and Adam, which speaks to Parker’s motives for going to medical school.

-- Accepted To: Emory School of Medicine

Growing up, I enjoyed visiting my grandparents. My grandfather was an established doctor, helping the sick and elderly in rural Taiwan until two weeks before he died at 91 years old. His clinic was located on the first floor of the residency with an exam room, treatment room, X-ray room, and small pharmacy. Curious about his work, I would follow him to see his patients. Grandpa often asked me if I want to be a doctor just like him. I always smiled, but was more interested in how to beat the latest Pokémon game. I was in 8th grade when my grandfather passed away. I flew back to Taiwan to attend his funeral. It was a gloomy day and the only street in the small village became a mourning place for the villagers. Flowers filled the streets and people came to pay their respects. An old man told me a story: 60 years ago, a village woman was in a difficult labor. My grandfather rushed into the house and delivered a baby boy. That boy was the old man and he was forever grateful. Stories of grandpa saving lives and bringing happiness to families were told during the ceremony. At that moment, I realized why my grandfather worked so tirelessly up until his death as a physician. He did it for the reward of knowing that he kept a family together and saved a life. The ability for a doctor to heal and bring happiness is the reason why I want to study medicine. Medical school is the first step on a lifelong journey of learning, but I feel that my journey leading up to now has taught me some things of what it means to be an effective physician.

With a newfound purpose, I began volunteering and shadowing at my local hospital. One situation stood out when I was a volunteer in the cardiac stress lab. As I attached EKG leads onto a patient, suddenly the patient collapsed and started gasping for air. His face turned pale, then slightly blue. The charge nurse triggered “Code Blue” and started CPR. A team of doctors and nurses came, rushing in with a defibrillator to treat and stabilize the patient. What I noticed was that medicine was not only about one individual acting as a superhero to save a life, but that it takes a team of individuals with an effective leader, working together to deliver the best care. I want to be a leader as well as part of a team that can make a difference in a person’s life. I have refined these lessons about teamwork and leadership to my activities. In high school I was an 8 time varsity letter winner for swimming and tennis and captain of both of those teams. In college I have participated in many activities, but notably serving as assistant principle cellist in my school symphony as well as being a co-founding member of a quartet. From both my athletic experiences and my music experiences I learned what it was like to not only assert my position as a leader and to effectively communicate my views, but equally as important I learned how to compromise and listen to the opinions of others. Many physicians that I have observed show a unique blend of confidence and humility.

What I noticed was that medicine was not only about one individual acting as a superhero to save a life, but that it takes a team of individuals with an effective leader, working together to deliver the best care.

College opened me up to new perspectives on what makes a complete physician. A concept that was preached in the Guaranteed Professional Program Admissions in Medicine (GPPA) was that medicine is both an art and a science. The art of medicine deals with a variety of aspects including patient relationships as well as ethics. Besides my strong affinity for the sciences and mathematics, I always have had interest in history. I took courses in both German literature and history, which influenced me to take a class focusing on Nazi neuroscientists. It was the ideology of seeing the disabled and different races as test subjects rather than people that led to devastating lapses in medical ethics. The most surprising fact for me was that doctors who were respected and leaders in their field disregarded the humanity of patient and rather focused on getting results from their research. Speaking with Dr. Zeidman, the professor for this course, influenced me to start my research which deals with the ethical qualms of using data derived from unethical Nazi experimentation such as the brains derived from the adult and child euthanasia programs. Today, science is so result driven, it is important to keep in mind the ethics behind research and clinical practice. Also the development of personalized genomic medicine brings into question about potential privacy violations and on the extreme end discrimination. The study of ethics no matter the time period is paramount in the medical field. The end goal should always be to put the patient first.

Teaching experiences in college inspired me to become a physician educator if I become a doctor. Post-MCAT, I was offered a job by Next Step Test Prep as a tutor to help students one on one for the MCAT. I had a student who stated he was doing well during practice, but couldn’t get the correct answer during practice tests. Working with the student, I pointed out his lack of understanding concepts and this realization helped him and improves his MCAT score. Having the ability to educate the next generation of doctors is not only necessary, but also a rewarding experience.

My experiences volunteering and shadowing doctors in the hospital as well as my understanding of what it means to be a complete physician will make me a good candidate as a medical school student. It is my goal to provide the best care to patients and to put a smile on a family’s face just as my grandfather once had. Achieving this goal does not take a special miracle, but rather hard work, dedication, and an understanding of what it means to be an effective physician.

Through reflecting on various stages of life, Quinn expresses how they found purpose in pursuing medicine. Starting as a child more interested in Pokemon than their grandfather’s patients, Quinn exhibits personal growth through recognizing the importance of their grandfather’s work saving lives and eventually gaining the maturity to work towards this goal as part of a team.

This essay opens with abundant imagery — of the grandfather’s clinic, flowers filling the streets, and the village woman’s difficult labor — which grounds Quinn’s story in their family roots. Yet, the transition from shadowing in hospitals to pursuing leadership positions in high schools is jarring, and the list of athletic and musical accomplishments reads like a laundry list of accomplishments until Quinn neatly wraps them up as evidence of leadership and teamwork skills. Similarly, the section about tutoring, while intended to demonstrate Quinn’s desire to educate future physicians, lacks the emotional resonance necessary to elevate it from another line lifted from their resume.

This essay opens with abundant imagery — of the grandfather's clinic, flowers filling the streets, and the village woman's difficult labor — which grounds Quinn's story in their family roots.

The strongest point of Quinn’s essay is the focus on their unique arts and humanities background. This equips them with a unique perspective necessary to consider issues in medicine in a new light. Through detailing how history and literature coursework informed their unique research, Quinn sets their application apart from the multitude of STEM-focused narratives. Closing the essay with the desire to help others just as their grandfather had, Quinn ties the narrative back to their personal roots.

-- Accepted To: Edinburgh University UCAT Score: 2810 BMAT Score: 4.6, 4.2, 3.5A

Exposure to the medical career from an early age by my father, who would explain diseases of the human body, sparked my interest for Medicine and drove me to seek out work experience. I witnessed the contrast between use of bone saws and drills to gain access to the brain, with subsequent use of delicate instruments and microscopes in neurosurgery. The surgeon's care to remove the tumour, ensuring minimal damage to surrounding healthy brain and his commitment to achieve the best outcome for the patient was inspiring. The chance to have such a positive impact on a patient has motivated me to seek out a career in Medicine.

Whilst shadowing a surgical team in Texas, carrying out laparoscopic bariatric procedures, I appreciated the surgeon's dedication to continual professional development and research. I was inspired to carry out an Extended Project Qualification on whether bariatric surgery should be funded by the NHS. By researching current literature beyond my school curriculum, I learnt to assess papers for bias and use reliable sources to make a conclusion on a difficult ethical situation. I know that doctors are required to carry out research and make ethical decisions and so, I want to continue developing these skills during my time at medical school.

The chance to have such a positive impact on a patient has motivated me to seek out a career in Medicine.

Attending an Oncology multi-disciplinary team meeting showed me the importance of teamwork in medicine. I saw each team member, with specific areas of expertise, contributing to the discussion and actively listening, and together they formed a holistic plan of action for patients. During my Young Enterprise Award, I facilitated a brainstorm where everyone pitched a product idea. Each member offered a different perspective on the idea and then voted on a product to carry forward in the competition. As a result, we came runners up in the Regional Finals. Furthermore, I started developing my leadership skills, which I improved by doing Duke of Edinburgh Silver and attending a St. John Ambulance Leadership course. In one workshop, similar to the bariatric surgeon I shadowed, I communicated instructions and delegated roles to my team to successfully solve a puzzle. These experiences highlighted the crucial need for teamwork and leadership as a doctor.

Observing a GP, I identified the importance of compassion and empathy. During a consultation with a severely depressed patient, the GP came to the patient's eye level and used a calm, non-judgmental tone of voice, easing her anxieties and allowing her to disclose more information. While volunteering at a care home weekly for two years, I adapted my communication for a resident suffering with dementia who was disconnected from others. I would take her to a quiet environment, speak slowly and in a non-threatening manner, as such, she became talkative, engaged and happier. I recognised that communication and compassion allows doctors to build rapport, gain patients' trust and improve compliance. For two weeks, I shadowed a surgeon performing multiple craniotomies a day. I appreciated the challenges facing doctors including time and stress management needed to deliver high quality care. Organisation, by prioritising patients based on urgency and creating a timetable on the ward round, was key to running the theatre effectively. Similarly, I create to-do-lists and prioritise my academics and extra-curricular activities to maintain a good work-life balance: I am currently preparing for my Grade 8 in Singing, alongside my A-level exams. I also play tennis for the 1st team to relax and enable me to refocus. I wish to continue my hobbies at university, as ways to manage stress.

Through my work experiences and voluntary work, I have gained a realistic understanding of Medicine and its challenges. I have begun to display the necessary skills that I witnessed, such as empathy, leadership and teamwork. The combination of these skills with my fascination for the human body drives me to pursue a place at medical school and a career as a doctor.

This essay traces Alex's personal exploration of medicine through different stages of life, taking a fairly traditional path to the medical school application essay. From witnessing medical procedures to eventually pursuing leadership positions, this tale of personal progress argues that Alex's life has prepared him to become a doctor.

Alex details how experiences conducting research and working with medical teams have confirmed his interest in medicine. Although the breadth of experiences speaks to the applicant’s interest in medicine, the essay verges on being a regurgitation of the Alex's resume, which does not provide the admissions officer with any new insights or information and ultimately takes away from the essay as a whole. As such, the writing’s lack of voice or unique perspective puts the applicant at risk of sounding middle-of-the-road.

From witnessing medical procedures to eventually pursuing leadership positions, this tale of personal progress argues that Alex's life has prepared him to become a doctor.

The essay’s organization, however, is one of its strengths — each paragraph provides an example of personal growth through a new experience in medicine. Further, Alex demonstrates his compassion and diligence through detailed stories, which give a reader a glimpse into his values. Through recognizing important skills necessary to be a doctor, Alex demonstrates that he has the mature perspective necessary to embark upon this journey.

What this essay lacks in a unique voice, it makes up for in professionalism and organization. Alex's earnest desire to attend medical school is what makes this essay shine.

-- Accepted To: University of Toronto MCAT Scores: Chemical and Physical Foundations of Biological Systems - 128, Critical Analysis and Reading Skills - 127, Biological and Biochemical Foundations of Living Systems - 127, Psychological, Social, and Biological Foundations of Behavior - 130, Total - 512

Moment of brilliance.

Revelation.

These are all words one would use to describe their motivation by a higher calling to achieve something great. Such an experience is often cited as the reason for students to become physicians; I was not one of these students. Instead of waiting for an event like this, I chose to get involved in the activities that I found most invigorating. Slowly but surely, my interests, hobbies, and experiences inspired me to pursue medicine.

As a medical student, one must possess a solid academic foundation to facilitate an understanding of physical health and illness. Since high school, I found science courses the most appealing and tended to devote most of my time to their exploration. I also enjoyed learning about the music, food, literature, and language of other cultures through Latin and French class. I chose the Medical Sciences program because it allowed for flexibility in course selection. I have studied several scientific disciplines in depth like physiology and pathology while taking classes in sociology, psychology, and classical studies. Such a diverse academic portfolio has strengthened my ability to consider multiple viewpoints and attack problems from several angles. I hope to relate to patients from all walks of life as a physician and offer them personalized treatment.

I was motivated to travel as much as possible by learning about other cultures in school. Exposing myself to different environments offered me perspective on universal traits that render us human. I want to pursue medicine because I believe that this principle of commonality relates to medical practice in providing objective and compassionate care for all. Combined with my love for travel, this realization took me to Nepal with Volunteer Abroad (VA) to build a school for a local orphanage (4). The project’s demands required a group of us to work closely as a team to accomplish the task. Rooted in different backgrounds, we often had conflicting perspectives; even a simple task such as bricklaying could stir up an argument because each person had their own approach. However, we discussed why we came to Nepal and reached the conclusion that all we wanted was to build a place of education for the children. Our unifying goal allowed us to reach compromises and truly appreciate the value of teamwork. These skills are vital in a clinical setting, where physicians and other health care professionals need to collaborate as a multidisciplinary team to tackle patients’ physical, emotional, social, and psychological problems.

I hope to relate to patients from all walks of life as a physician and offer them personalized treatment.

The insight I gained from my Nepal excursion encouraged me to undertake and develop the role of VA campus representative (4). Unfortunately, many students are not equipped with the resources to volunteer abroad; I raised awareness about local initiatives so everyone had a chance to do their part. I tried to avoid pushing solely for international volunteerism for this reason and also because it can undermine the work of local skilled workers and foster dependency. Nevertheless, I took on this position with VA because I felt that the potential benefits were more significant than the disadvantages. Likewise, doctors must constantly weigh out the pros and cons of a situation to help a patient make the best choice. I tried to dispel fears of traveling abroad by sharing first-hand experiences so that students could make an informed decision. When people approached me regarding unfamiliar placements, I researched their questions and provided them with both answers and a sense of security. I found great fulfillment in addressing the concerns of individuals, and I believe that similar processes could prove invaluable in the practice of medicine.

As part of the Sickkids Summer Research Program, I began to appreciate the value of experimental investigation and evidence-based medicine (23). Responsible for initiating an infant nutrition study at a downtown clinic, I was required to explain the project’s implications and daily protocol to physicians, nurses and phlebotomists. I took anthropometric measurements and blood pressure of children aged 1-10 and asked parents about their and their child’s diet, television habits, physical exercise regimen, and sunlight exposure. On a few occasions, I analyzed and presented a small set of data to my superiors through oral presentations and written documents.

With continuous medical developments, physicians must participate in lifelong learning. More importantly, they can engage in research to further improve the lives of their patients. I encountered a young mother one day at the clinic struggling to complete the study’s questionnaires. After I asked her some questions, she began to open up to me as her anxiety subsided; she then told me that her child suffered from low iron. By talking with the physician and reading a few articles, I recommended a few supplements and iron-rich foods to help her child. This experience in particular helped me realize that I enjoy clinical research and strive to address the concerns of people with whom I interact.

Research is often impeded by a lack of government and private funding. My clinical placement motivated me to become more adept in budgeting, culminating in my role as founding Co-President of the UWO Commerce Club (ICCC) (9). Together, fellow club executives and I worked diligently to get the club ratified, a process that made me aware of the bureaucratic challenges facing new organizations. Although we had a small budget, we found ways of minimizing expenditure on advertising so that we were able to host more speakers who lectured about entrepreneurship and overcoming challenges. Considering the limited space available in hospitals and the rising cost of health care, physicians, too, are often forced to prioritize and manage the needs of their patients.

No one needs a grand revelation to pursue medicine. Although passion is vital, it is irrelevant whether this comes suddenly from a life-altering event or builds up progressively through experience. I enjoyed working in Nepal, managing resources, and being a part of clinical and research teams; medicine will allow me to combine all of these aspects into one wholesome career.

I know with certainty that this is the profession for me.

Jimmy opens this essay hinting that his essay will follow a well-worn path, describing the “big moment” that made him realize why he needed to become a physician. But Jimmy quickly turns the reader’s expectation on its head by stating that he did not have one of those moments. By doing this, Jimmy commands attention and has the reader waiting for an explanation. He soon provides the explanation that doubles as the “thesis” of his essay: Jimmy thinks passion can be built progressively, and Jimmy’s life progression has led him to the medical field.

Jimmy did not make the decision to pursue a career in medicine lightly. Instead he displays through anecdotes that his separate passions — helping others, exploring different walks of life, personal responsibility, and learning constantly, among others — helped Jimmy realize that being a physician was the career for him. By talking readers through his thought process, it is made clear that Jimmy is a critical thinker who can balance multiple different perspectives simultaneously. The ability to evaluate multiple options and make an informed, well-reasoned decision is one that bodes well for Jimmy’s medical career.

While in some cases this essay does a lot of “telling,” the comprehensive and decisive walkthrough indicates what Jimmy’s idea of a doctor is. To him, a doctor is someone who is genuinely interested in his work, someone who can empathize and related to his patients, someone who can make important decisions with a clear head, and someone who is always trying to learn more. Just like his decision to work at the VA, Jimmy has broken down the “problem” (what his career should be) and reached a sound conclusion.

By talking readers through his thought process, it is made clear that Jimmy is a critical thinker who can balance multiple different perspectives simultaneously.

Additionally, this essay communicates Jimmy’s care for others. While it is not always advisable to list one’s volunteer efforts, each activity Jimmy lists has a direct application to his essay. Further, the sheer amount of philanthropic work that Jimmy does speaks for itself: Jimmy would not have worked at VA, spent a summer with Sickkids, or founded the UWO finance club if he were not passionate about helping others through medicine. Like the VA story, the details of Jimmy’s participation in Sickkids and the UWO continue to show how he has thought about and embodied the principles that a physician needs to be successful.

Jimmy’s essay both breaks common tropes and lives up to them. By framing his “list” of activities with his passion-happens-slowly mindset, Jimmy injects purpose and interest into what could have been a boring and braggadocious essay if it were written differently. Overall, this essay lets the reader know that Jimmy is seriously dedicated to becoming a physician, and both his thoughts and his actions inspire confidence that he will give medical school his all.

The Crimson's news and opinion teams—including writers, editors, photographers, and designers—were not involved in the production of this content.

How to Get Publications from Undergraduate Research

• By Amit Pandey, M.D.
• October 13, 2022

It’s no secret that undergraduate research is a key component of medical school applications. These days, very few students apply to medical school without some sort of research experience. Those who don’t include research experience are taking a significant risk, as they will be lacking a huge component of their application that nearly all of their peers will have.

How much does it matter to get published? Will publications really strengthen your application? How do you achieve publications? In this post, we’ll break down the importance of research publications as well as how to secure your own publications.

1 | How Much Do Research Publications Matter for Medical School Applications?

There is no exact answer to this question, but there are a few guiding principles. At the end of the day, research in itself, whether or not it yields a publication, is extremely important for medical school applications. All undergraduate students should complete research to make themselves competitive applicants.

Solid research experience is essential to discuss on your primary and secondary applications , and it will lead to questions during the interview process . It is almost inevitable that interviewers will ask you to discuss your research. If you can talk intelligently about your project and demonstrate that you had substantial and meaningful involvement with it, you will be a more strong and competitive applicant.

The next key outcome of research experience is securing a letter of recommendation . While you don’t need to have a letter written by your research PI (or Principal Investigator—the head of the lab and your boss during your research time), research PI’s make great letter writers because they can discuss your skills and attributes outside of pure academics. These tend to make very strong letters ; thus, one of the goals of research should be to obtain a strong letter of recommendation.

A publication is the cherry on top of the sundae that is your overall research experience. The first thing to understand is that a publication is not truly necessary. Many students get into medical school without publications.

With that said, a publication does make you a stronger applicant. It is a tangible output of your prior achievement—a quantifiable metric of your success as an undergraduate. This certainly helps, so it’s a worthy cause to pursue a publication from your hard work in the lab.

2 | Basic Science vs. Clinical Research

Now that you have some context, the first step is to decide what type of research you are targeting. The two broad categories are the following:

Basic science —research performed in a laboratory to evaluate scientific questions from a cellular, molecular, and physiological level. This usually consists of experiments collecting data from cellular or animal models.

Clinical Research —research conducted by collecting patient data to answer a clinical question pertinent to the current practice of medicine. This generally involves collecting data through patient interviews or chart review.

The reason the distinction is relevant is that the two categories can differ in the ease of publication.

Basic science research is often more difficult to publish because cellular and animal experiments can be very time-consuming and labor-intensive, making these projects harder to complete. It does, however, offer you the opportunity to collect substantial experience, which can be more engaging to discuss on applications and during interviews.

Clinical research can sometimes be easier to publish because the data is generally simpler to collect, especially if it comes from chart review. The downside is that chart review can often be less exciting and interesting than basic science work. Additionally, the experience may not be perceived by admissions committees as equally substantial to basic science.

Most undergraduate students perform basic science research, as these positions are more readily available, but it is worthwhile to understand the options when considering your path.

3 | Find a Research Lab That Publishes Frequently

Finding a lab that publishes frequently is an important point to consider if publishing is a priority for you. Find a PI who is productive in terms of research publications. More importantly, find a PI who has a track record of working effectively with undergraduates and helping them get publications.

This is not always possible to find, as not all PI’s and research mentors will make undergrad publications a priority, but it is something to consider.

It may be difficult to determine which labs to seek out. Your strongest resource will be students currently in the lab or those who have worked there previously. Consider consulting your major’s premedical advisors, as they often have knowledge of this sort of thing. Finally, a basic PubMed search for prior publications may tell you what you need to know.

4 | Communicate Effectively With Your Mentor

Communication is crucial from the beginning. When meeting with a PI or research mentor, clearly express your overall goals. State that you want to be a strong contributor to the lab in whatever way possible. Make it clear that you hope to take on significant responsibility, and if it’s appropriate, you would like to be published in some capacity.

If you phrase this in the correct way, as a hopeful and humble request rather than a demand, it should go over well. It’s reasonable to ask the PI if this is possible. Hopefully, they will provide you with an honest reply, and you can make a plan regarding this going forward.

Do not make the publication a huge priority early on; instead, revisit the topic later, once you have gained your mentor’s trust and feel it is appropriate to open the discussion again.

5 | Be Proactive in Your Research Work

Understand that you must earn your publications with hard work and dedication. The first step is doing your job well, with a consistently strong work ethic and continued attention to detail.

Beyond this, see if you can take on more responsibility. Seek opportunities to expand your role and do more. Mentors will take notice of this, and if your contribution is significant, you will be more likely to be rewarded with publications. Furthermore, this will increase your likelihood of receiving a strong letter of recommendation.

If possible, you may even seek out the chance to meet with your PI one-on-one and discuss your ongoing work and possible future projects. If there is a question you identify while working, and it’s something you think may be worth exploring, discuss it with your PI. Your initiative will generally be regarded highly, even if it does not amount to the exact desired outcome.

Enjoying the Experience

If you choose something you are genuinely interested in as opposed to simply seeking a publication, you will be more likely to work hard and succeed. Be mindful of choosing a lab with a PI and mentors who will guide and lead you effectively.

Getting a publication from undergraduate research is a worthwhile goal, but it is certainly not imperative. Focus first on finding a good research position and gaining solid experience, which will benefit you in many ways. Once you have secured this, follow the advice here to see if you can make a publication happen!

Don’t stress if you are unable to achieve a publication prior to applying, as you can still be very successful without one. There’s also a chance that you can secure a publication during the application process, which you can update the admissions committee about later on.

For advice on how to best spend your time as a premed and how to secure research publications, reach out to the Med School Insiders team to be paired with a one-on-one advisor .

Our doctor-led team can advise you on any aspect of your research to maximize your opportunity for publication, but more importantly, they will help you make the decisions that will lead to medical school acceptance.

Amit Pandey, M.D.

First Day of Medical School – 4 Things to Know

Medical school is a completely different beast from your pre-med years in college. Here are four things you should know and prepare for in order to have the most productive, effective, and happy experience of medical school!

Premed and Medical Student Summer Research Guide

We break down the value of summer research, how to find research positions, and tips to make the most of summer research opportunities.

How to Find an Undergraduate Research Position

Research is a crucial component of any medical school application. Utilize the following tips to streamline the process of finding an ideal research position.

This Post Has One Comment

Outstanding! Thank you Dr. Pandey for all the valuable information!

Leave a Reply Cancel reply

Join the Insider Newsletter

Receive regular exclusive MSI content, news, and updates! No spam. One-click unsubscribe.

Customer Note Premed Preclinical Med Student Clinical Med Student

You have Successfully Subscribed!

share this!

May 16, 2024

This article has been reviewed according to Science X's editorial process and policies . Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

peer-reviewed publication

trusted source

First-generation medical students face unique challenges and need more targeted support, say researchers

by University of Chicago Medical Center

Medical research is increasingly informed by recognition of diversity's key role in addressing health equity. But when it comes to medical education, there's a group that has remained not just underrepresented but also under-researched: first-generation (first-gen) medical students—those whose parents have not earned bachelor's degrees.

These students are more likely to be older, identify as racial or ethnic minorities, be immigrants or children of immigrants, or come from low-income families . Along with anecdotal evidence, the minimal previous research indicates that these students face some unique struggles on top of the common challenges most medical students encounter.

"It became clear to me that schools—even the great ones that are intentional and diligent about building diverse classes—are not truly ready to receive first-gen students," said Catherine Havemann, MD, an emergency medicine chief resident at UChicago Medicine. "Admission isn't the same as full access to the institution. Sometimes support doesn't exist, and other times it's off-target."

To increase understanding of the first-gen experience and identify opportunities for educators and administrators to provide the most meaningful support, Havemann helped lead a team of researchers to perform an in-depth qualitative study . They analyzed data collected in interviews with a diverse group of medical students recruited from 27 medical schools across the U.S.

The results, published in JAMA , have the potential to inform efforts at increasing educational equity at both the institutional and individual level.

Struggles shared among a diverse first-generation population

Overall, the study confirmed that first-gen medical students feel that they face disproportionate adversity throughout their education and do not receive the support they need to compensate for that. Participants identified four main themes: feelings of isolation and exclusion; difficulties accessing basic resources such as food, rent, transportation and textbooks; a general lack of institutional support; and pressure to rely on personal "grit" and resilience for survival.

Some issues highlighted in the data were relatively unsurprising, such as financial difficulties.

"No matter which subset of first-gen students we talk to, money is a foundational part of the challenges they face—even if they're not technically low-income," said Havemann, the paper's first author. "Within the medical community, we need to talk more about the discomfort of disadvantaged students entering incredibly wealthy institutions with mostly wealthy peers. What does it mean to create some basic degree of equity?"

Other issues emerged as more persistent than the researchers had anticipated. For example, interviewees frequently mentioned transportation problems, such as situations where student loans don't cover the cost of having a car but medical school necessitates one. An especially striking theme was that many students reported being overtly discouraged by mentors or teachers during their education.

"People who meet the criteria for medical school admission are being told 'This is not for you,'" Havemann said. "It's disheartening to see, and it makes me think differently about my career as an aspiring educator. Saying 'yes'—even in a small way—to someone who has heard a lifetime of 'no' can make all the difference. To think there are people out there discouraging others is frankly appalling."

Responding to the findings

Havemann said the paper resonated strongly with student communities online following its publication.

"Responses ranged from 'This is obvious' and 'Water is wet' to 'Why doesn't my school understand this?' or 'We knew this already—where are the solutions?'" she said.

As a former first-gen student herself, she was struck by the consistency of experience revealed by the study's results. "It was validating as a researcher but also profoundly validating as a person."

But while the student response online served as important confirmation that the study's findings are representative, the real target audience is the educators who have the power to make a difference.

"I would love for them to read this paper and feel what a powerful position they're in to make a more equitable world," Havemann said. "Even the little things matter a lot."

Even as she and others conduct more research on this topic, Havemann said institutions can and should already be taking steps to provide better support for first-generation medical students .

"People like to talk about using holistic review in admissions to look at the whole student—we also have to look at holistic support once they enroll," she said.

Future studies will dive deeper into themes like professional identity formation, financial challenges, burnout and sense of belonging. Now that the qualitative groundwork has been laid, researchers can design more nuanced quantitative and mixed-method studies.

"For example, I'd like to quantify the percentage of first-gen students who are not only trying to support themselves but also keeping the lights on for their parents," Havemann said. "I think the answers would be gutting."

Journal information: Journal of the American Medical Association , JAMA Network Open

Provided by University of Chicago Medical Center

Explore further

Feedback to editors

Composition of gut microbiota could influence decision-making

10 hours ago

Researchers realize multiphoton electron emission with non-classical light

11 hours ago

Saturday Citations: Mediterranean diet racks up more points; persistent quantum coherence; vegan dogs

Physicists propose path to faster, more flexible robots

18 hours ago

Scientists develop new geochemical 'fingerprint' to trace contaminants in fertilizer

May 17, 2024

Study reveals how a sugar-sensing protein acts as a 'machine' to switch plant growth—and oil production—on and off

Researchers develop world's smallest quantum light detector on a silicon chip

How heat waves are affecting Arctic phytoplankton

Horse remains show Pagan-Christian trade networks supplied horses from overseas for the last horse sacrifices in Europe

Ion irradiation offers promise for 2D material probing

Relevant physicsforums posts, physics education is 60 years out of date, is "college algebra" really just high school "algebra ii".

May 14, 2024

Plagiarism & ChatGPT: Is Cheating with AI the New Normal?

May 13, 2024

Physics Instructor Minimum Education to Teach Community College

May 11, 2024

Studying "Useful" vs. "Useless" Stuff in School

Apr 30, 2024

Why are Physicists so informal with mathematics?

Apr 29, 2024

More from STEM Educators and Teaching

Related Stories

Exploring challenges in learning for nursing students in Morocco

May 6, 2024

Taking a leave of absence can harm medical students' match prospects, finds study

Apr 16, 2024

First study on teacher effectiveness for students with and without disabilities

Mar 25, 2024

Minority students more likely to leave medical school: study

Jul 19, 2022

Study finds clear instruction, parental support predict students' sense of school belonging

Mar 27, 2024

Medical students with disabilities are at higher risk of burnout than peers

Jan 10, 2024

Recommended for you

Investigation reveals varied impact of preschool programs on long-term school success

May 2, 2024

Training of brain processes makes reading more efficient

Apr 18, 2024

Researchers find lower grades given to students with surnames that come later in alphabetical order

Apr 17, 2024

Earth, the sun and a bike wheel: Why your high-school textbook was wrong about the shape of Earth's orbit

Apr 8, 2024

Touchibo, a robot that fosters inclusion in education through touch

Apr 5, 2024

More than money, family and community bonds prep teens for college success: Study

Let us know if there is a problem with our content.

Use this form if you have come across a typo, inaccuracy or would like to send an edit request for the content on this page. For general inquiries, please use our contact form . For general feedback, use the public comments section below (please adhere to guidelines ).

Please select the most appropriate category to facilitate processing of your request

Thank you for taking time to provide your feedback to the editors.

Your feedback is important to us. However, we do not guarantee individual replies due to the high volume of messages.

E-mail the story

Your email address is used only to let the recipient know who sent the email. Neither your address nor the recipient's address will be used for any other purpose. The information you enter will appear in your e-mail message and is not retained by Phys.org in any form.

Newsletter sign up

Get weekly and/or daily updates delivered to your inbox. You can unsubscribe at any time and we'll never share your details to third parties.

More information Privacy policy

Donate and enjoy an ad-free experience

We keep our content available to everyone. Consider supporting Science X's mission by getting a premium account.

E-mail newsletter

Do You Have To Write Essays In Medical School? (Explained Plus Tips!)

Because writing isn’t a huge part of being a doctor, you might be thinking it’s pretty low on the list of activities med students do.

We know you have to write essays for applications, but do you have to write essays in medical school?

Some med schools, specifically the top tier ones, expect students to write formal research essays in med school. Others might ask for essays as part of a final assessment for a specific course. Although essay writing isn’t as heavy as it can be in other majors, it is often required of med students.

In this article I’ll go into the question further. Here’s what we’ll cover:

• When you might need to write essays in med school
• What types of subjects/topics you could be asked to write about
• If you have to write a medical dissertation or research paper
• What tips you can use to improve your med school writing

Having written my fair share of med school essays myself (especially in subjects like biophysics, social medicine and even anatomy and physiology), I know how annoying a task it can sometimes be. And that’s as a former English major!

The truth is, for many of us, writing is a serious drag. Especially when we thought we’d escaped it by studying medicine…

So are you ready for the good and bad news? Let’s go!

When do I have to write essays in med school?

Depending on where you study medicine, the amount of writing you’ll need to do in med school can vary.

Some schools, like Yale, Harvard and NYU, require you to do a research thesis as part of your degree. In this case it’s not optional (opportunities to publish in these respective schools’ journals also exist).

But most other med schools almost always require some form of essay writing too.

Here are some circumstances that call for it:

• As a “final” exam component of a particular course/subject
• Detailed patient history or physical reports
• Group papers/presentations in classes/seminars

Of course the quantity and level of writing vary. Depending on where you go to school and what’s assigned, you might only ever need to do 1-2 pages of writing for a single course each semester. Others might only ever grade you based on oral examinations or question-based tests.

The different medical school curriculums also factor in. Practice based learning (PBL) schools have a reputation for a fair bit of writing.

Check out the specific curriculums (and grading criteria) for the med schools you’re interested in to get a sense of how much (or if) you’ll need to write. Or talk to existing students.

That’s the only way to know for sure.

What med school subjects involve the most writing?

Common med school subjects that can involve essay writing include:

• Medical ethics
• Clinical practice
• Psychology/psychiatry
• Biostatistics
• Public health and sociology

These are subjects that are a little more “esoteric” than the harder sciences. And ones where a thesis or case study goes well.

Other subjects might ask for essays too. As I mentioned before, I’ve had to write mini-essays for many subject finals (including anatomy, biochemistry, biology, physiology and more). Here’s how it usually works:

• The course syllabus lists all possible topics making up a subject (anatomy, in my case, had something like 350+)
• You draw a topic at random to write about for a set time (usually 30-60 minutes)
• You then present this essay to the professor and are asked questions about it
• Finally you’re awarded a grade based on your performance

Of course this is just my own experience as a student at MU Varna . Your med school might not operate this way, while the pandemic has also encouraged a shift away from the “essay-oral” format.

Related : A Rough Guide To European Medical School Exams

The bottom line is; you could be asked to write an essay on any syllabus topic for any subject in med school.

It depends on the subject’s department and how they like to format final and mid-term exams.

Do you have to write essays in medical school in the UK?

The UK is similar to both US and most European international med schools. Many of their schools expect med students to write essays. Oxbridge is a case in point. Here are a couple of students explaining exactly how this works…

Many other students at UK-based schools suggest the same.

Follow the same advice to know for sure; double check with existing students and the course curriculum (if publically available).

Are med students good at writing essays?

Obviously I write a blog about medical education (and healthcare work) so am no stranger to writing.

For most med students however the story can be quite different.

Not all students are confident writers. Or have a lot of experience.

Oftentimes the closest they’ve got to writing essays are in earlier studies (as pre-meds) or in their carefully put together med school applications. It’s not something you typically get a lot of practice with.

There’s obviously a lot of international students in medicine whose native language isn’t English either. For some, writing essays can seem even more anxiety-provoking.

How well are med students expected to write?

The good news is, at least in my experience, that the standard of writing (especially when it comes to the types of essays you do in final exams, midterms or class presentations), by no means has to be perfect.

The most that’s expected are factors like:

• Handwriting that’s not too difficult to read
• Good grasp of grammar and punctuation
• Solid understanding of the topic you’re asked to write about

Med school professors aren’t looking for well polished, proofread, near perfect essays for the most part.

Not unless they’re submitted as a research thesis (which you’re expected to have put serious time and effort into).

In that case they’re expected to be as professional as possible. For which you’ll usually have a thesis supervisor or research lead to help guide you.

Do medical doctors have to write a dissertation?

There’s no rule that says doctors have to write a dissertation (or even do published research). It’s possible to get into med school, graduate and find a job without ever having done any serious writing.

But it is rare.

To be competitive, especially when it comes to residency applications (and even admissions in some cases), medical dissertations or research papers can help. A lot.

General writing tips for med school essays

As for tips on how to approach your writing in med school, here are a few pointers that’ve helped me:

• Don’t aim for perfection : keep the language simple and the arguments easy to understand
• Define everything : your professor will be looking to see you understand what you’ve written about
• Break it up : use subheadings to divide the essay up and improve the flow (don’t throw it all out there in one chunk)
• Practice : sketch out essay outlines for the high yield topics (those likely to show up on exams) and attempt a couple

Getting comfortable with the process will help improve your confidence.

Med school essays aren’t anything to fear for the most part. For the more serious research or thesis-based essays, make sure you follow the guidance of the research lead or project coordinator.

Summary: Writing essays in med school

You might get lucky and never have to write an essay in med school but it’s unlikely. Writing is more central to a successful doctors career than you might think.

Being more confident with it (and learning how to do it better) can definitely help when it comes to reports, research, patient communication and everything else.

Writing is still a major skill you’ll want to focus on if you plan on a career in healthcare.

• https://medicine.yale.edu/education/research/mdthesis/

Born and raised in the UK, Will went into medicine late (31) after a career in journalism. He’s into football (soccer), learned Spanish after 5 years in Spain, and has had his work published all over the web. Read more .

What Premed Students Should Know About Emerging Fields of Medical Research

Aspiring physician-scientists should bone up on areas such as gene editing, nanotechnology and regenerative medicine.

Premeds and Emerging Medical Research

Getty Images | Image Source

If you find a field that interests you, don't hesitate to join a like-minded laboratory while training.

Premedical students aspiring to become physician-scientists will be tasked with navigating emerging fields in research and translating exciting discoveries into the clinical realm. Understanding the latest trends and breakthroughs in biomedical science is paramount for those hoping to bridge the gap between such cutting-edge research and clinical practice – a career goal for many aspiring physician-scientists.

What are these emerging fields, what should aspiring physician-scientists – including those applying to combined M.D.-Ph.D. programs – know about getting involved in these fields, and are there any pitfalls? 

This is an extraordinarily exciting time in scientific research, with recent breakthroughs in diverse fields such as gene editing, immunotherapies, nanotechnology, precision medicine, machine learning and regenerative medicine. Highlights run the gamut of the biomedical spectrum, including evolutionary genomics, novel neurotechnology, advances in cardiovascular imaging, cell-based therapies and therapeutic manipulation of the microbiome, to name a few.

Aspiring physician-scientists will undoubtedly be tempted to ride this wave of exciting discoveries and join laboratories moving the needle in these fields, many of which are still in their infancy. 

Premed students should be aware of these emerging fields, as these advances are expected to contribute increasingly to health care throughout the coming decades and will undoubtedly remain important for the duration of a lengthy career in medicine .

These fields are likely to hold long-term career opportunities for students interested in biomedical research. They also represent opportunities to contribute to innovation, be involved in groundbreaking discoveries and help shape the future of science and medicine.

Many emerging fields are exciting in part due to new or newly appreciated applications to clinical practice, with direct implications for patient care . By understanding these emerging fields, premed students will remain informed and up to date regarding novel treatment paradigms, new diagnostic tools and different preventive strategies that could benefit their future patients. 

Students’ research interests often evolve during undergraduate, graduate and postgraduate education. Many fascinating fields of biomedical science are neither new nor well known, and they deserve serious consideration. You will have multiple opportunities to change fields should your interests diverge at any point, so you should not feel locked in to the discipline of your first research experience.

However, if you do have a genuine intellectual interest in a popular scientific field at an early phase of training, don’t hesitate to join such a like-minded laboratory. 

Finding a Laboratory in Emerging Research Fields

If you are a premed student interested in an exciting field like cancer immunotherapy, genomics, AI-enabled precision medicine , etc., you may struggle to understand which laboratories would be appropriate and rewarding to join and a good fit for your career goals.

To start, assess the research landscape at your home institution through departmental web pages and note which faculty in your field of interest are involved in active research projects. Get in touch with a few faculty members and discuss the possibility of joining their laboratory.

As you learn about their research projects, you can also ask if they know of other labs in the same field that may also be of interest. Often, research faculty themselves are the best resource for understanding the current research landscape of the university, as departmental web pages and related resources can be out of date. 

Departmental administrators or undergraduate research coordinators may also be quite helpful in finding a lab in a specific area that would be a good fit for an undergraduate student. If you read a lay press article – especially from a local publication – about an area of exciting, “hot” science, pay attention to which studies and researchers they reference or quote. These investigators are often leading voices in the field. 

Use PubMed to find the latest work in a field or by a specific investigator. Explore the "trending articles" section to see which articles have had recent activity – a sign of a field gaining broad interest. If you find investigators doing work that is particularly interesting to you, use the "saved searches" function to get updates about their work directly in your email inbox. 

Appreciate that emerging fields are often a result of novel collaboration across disparate disciplines such as distinct subfields in biology and medicine, biomedical engineering or computer science .

Application of a known technology to a new field can also yield exciting advancements. A recent example is cryo-EM-mediated determination of complex structures, such as ligand-bound receptors, which could not previously be accurately determined.

Look for labs that are working in an interdisciplinary manner to tackle an important question in medicine or biology, and you are likely to find stimulating research in an important emerging field. 

Pitfalls to Avoid

Avoid presuming that only well-known fields with significant popularity and press attention are the only interesting domains of scientific research. The biggest discoveries often come from unpredictable places, and their genesis can be traced to less well-known fields.

Recent high-profile examples include prokaryotic genomics that spawned CRISPR/Cas9-based gene editing, and nucleoside modifications that advanced mRNA vaccines. This is characteristic of biomedical research and should lead you to explore various fields and meet with a variety of investigators to find the field, research and lab that most interest you. 

A few exceedingly popular fields – such as microbiome research, cancer immunotherapy , etc. – run the risk of becoming oversaturated, with many excellent investigators trying to solve similar problems. These fields can thus become quite competitive, with several associated challenges.

If you do join a competitive field, look for opportunities to do novel work that can separate your project from the rest of the crowd. A good strategy when selecting a laboratory is to assess which researchers are pushing the boundaries in these fields and are looking to incorporate interdisciplinary approaches, as they are more likely to be working in their own lane, away from other investigators. Use the same approach when selecting a project within your lab.

Medical School Application Mistakes

Tags: medical school , research , graduate schools , education , students

About Medical School Admissions Doctor

Need a guide through the murky medical school admissions process? Medical School Admissions Doctor offers a roundup of expert and student voices in the field to guide prospective students in their pursuit of a medical education. The blog is currently authored by Dr. Ali Loftizadeh, Dr. Azadeh Salek and Zach Grimmett at Admissions Helpers , a provider of medical school application services; Dr. Renee Marinelli at MedSchoolCoach , a premed and med school admissions consultancy; Dr. Rachel Rizal, co-founder and CEO of the Cracking Med School Admissions consultancy; Dr. Cassie Kosarec at Varsity Tutors , an advertiser with U.S. News & World Report; Dr. Kathleen Franco, a med school emeritus professor and psychiatrist; and Liana Meffert, a fourth-year medical student at the University of Iowa's Carver College of Medicine and a writer for Admissions Helpers. Got a question? Email [email protected] .

Popular Stories

Best Colleges

Applying to Graduate School

Paying for College

Medical School Admissions Doctor

Applying to College

You May Also Like

Get accepted to multiple top b-schools.

Anayat Durrani May 16, 2024

How to Get a Perfect Score on the LSAT

Gabriel Kuris May 13, 2024

Premeds Take 5 Public Health Courses

Rachel Rizal May 7, 2024

Fortune 500 CEOs With a Law Degree

Cole Claybourn May 7, 2024

Why It's Hard to Get Into Med School

A.R. Cabral May 6, 2024

Pros, Cons of Unaccredited Law Schools

Gabriel Kuris May 6, 2024

An MBA and Management Consulting

Sammy Allen May 2, 2024

Med School Access for Minority Students

Cole Claybourn May 2, 2024

Different jobs with med degree

Jarek Rutz April 30, 2024

Completing Medical School in Five Years

Kate Rix April 30, 2024

• Share full article

Advertisement

Supported by

Ethical Lapses in the Medical Profession

More from our inbox:, don’t cave, columbia, a florida book oasis, balloon release ban.

To the Editor:

Re “ Moral Dilemmas in Medical Care ” (Opinion guest essay, May 8):

It is unsettling, and dismaying, to read Dr. Carl Elliott’s account of moral lapses continuing to exist, if not thrive, in medical education. As a neurology resident in the early 1970s, I was assigned a patient who was scheduled to have psychosurgery.

He was a prisoner who had murdered a nurse in a hospital basement, and the surgery to remove part of his brain was considered by the department to be a therapeutic and even forward-looking procedure. This was despite its being widely discredited, and involving a prisoner who could not provide truly informed consent.

A fellow resident and I knew that refusing would almost certainly result in suspension or dismissal from the residency, so we anonymously contacted our local newspapers, whose reporting resulted in an overflow protest meeting, cancellation of the psychosurgery and legislative action placing conditions on the acceptance of informed consent by prisoners.

It is lamentable that even though bioethics programs are widely incorporated into medical education, moral and ethical transgressions remain a stubborn problem as part of medical structures’ groupthink.

As Richard Feynman has emphasized , doubt, uncertainty and continued questioning are the hallmarks of scientific endeavor. They need to be an integral element of medical education to better prepare young doctors for the inevitable moral challenges that lie ahead.

Robert Hausner Mill Valley, Calif.

I would like to thank Carl Elliott for exposing the “Moral Dilemmas in Medical Care.” There is a medical school culture that favors doctors as privileged persons over patients.

I can remember multiple patient interactions in medical school in which I thanked a patient for allowing me to examine them and apologized for hurting them during my exam of their painful conditions.

I was then criticized by attending physicians for apologizing to the patients. I was told, on multiple occasions, that the patient should be thanking me for the privilege of assisting in my education.

Medical training, in a medical school culture that favors the privilege of the medical staff over the rights and feelings of patients, needs to be exposed and changed.

Doug Pasto-Crosby Nashville The writer is a retired emergency room physician.

As a psychiatrist and medical ethicist, I commend Dr. Carl Elliott for calling attention to several egregious violations of medical ethics, including failure to obtain the patient’s informed consent. Dr. Elliott could have included a discussion of physician-assisted suicide and the slippery slope of eligibility for this procedure, as my colleagues and I recently discussed in Psychiatric Times .

For example, as reported in The Journal of Eating Disorders , three patients with the eating disorder anorexia nervosa were prescribed lethal medication under Colorado’s End-of-Life Options Act. Because of the near-delusional cognitive distortions present in severe anorexia nervosa, it is extremely doubtful that afflicted patients can give truly informed consent to physician-assisted suicide. Worse still, under Colorado law, such patients are not required to avail themselves of accepted treatments for anorexia nervosa before prescription of the lethal drugs.

Tragically, what Dr. Elliott calls “the culture of medicine” has become increasingly desensitized to physician-assisted suicide, nowadays touted as just another form of medical care. In the anorexia cases cited, informed consent may have been one casualty of this cultural shift.

Ronald W. Pies Lexington, Mass. The writer is on the faculty of SUNY Upstate Medical University and Tufts University School of Medicine, but the views expressed are his own.

Carl Elliot’s article on medical ethics was excellent. But it is not just in the medical profession that there exists the “subtle danger” that assimilation into an organization will teach you to no longer recognize what is horrible.

Businesses too have a culture that can “transform your sensibility.” In many industries executives check their consciences at the office door each morning. For example, they promote cigarettes; they forget they too breathe the air as they lobby against clean-air policies; they forget they too have children or grandchildren as they fight climate-friendly policies or resist gun-control measures. The list could go on.

In every organization, we need individuals to say no to policies and actions that may benefit the organization but are harmful, even destructive, to broader society.

Colin Day Ann Arbor, Mich.

Re “ Columbia’s Protests Also Bring Pressure From a Private Donor ” (front page, May 11):

Universities are meant to be institutions of higher learning, research and service to the community. They are not items on an auction block to be sold to the highest bidder.

Universities that sell off their policy platform to spoiled one-issue donors who threaten to throw a tantrum no longer deserve our respect. Grant-making foundations should not be grandstanding online. Give money, or don’t, but don’t call a news conference about it.

If Columbia caves, why should prospective students trust it as a place where they can go to become freethinkers and explore their own political conscience as they begin to contemplate the wider world and issues of social justice?

This is a real test of Columbia and its leadership. I do not envy its president, Nemat Shafik, who has few good choices and no way to make everyone happy. What she should not sell is her integrity, or the university’s. She should stand up to these selfish donors. Learn to say, “Thanks, but no thanks.”

Carl Henn Marathon, Texas

Re “ Book Bans? So Open a Bookstore ” (Arts, May 13):

Deep respect for the American novelist Lauren Groff and her husband, Clay Kallman, for opening the Lynx, their new bookstore in Gainesville, Fla. The store focuses on offering titles among the more than 5,100 books that were banned in Florida schools from July 2021 through December 2023.

To all the book clubbers and haters of bans: Order straight from the Lynx.

Fight evil. Read books.

Ted Gallagher New York

Re “ Keep a Firm Grip on Those Mickey Mouse Balloons. It’s the Law ” (front page, May 9):

Balloons are some of the deadliest ocean trash for wildlife, as mentioned in your article about Florida’s expected balloon release ban.

Plastic balloon debris poses a significant threat to marine life, often mistaken for food or becoming entangled in marine habitats, leading to devastating consequences for our fragile ocean ecosystems.

As the founder of Clean Miami Beach, an environmental conservation organization, I’m concerned about the impact of plastic pollution on Florida’s wildlife and coastal areas. Florida’s stunning beaches and diverse marine life are not only treasures to us locals but also draw millions of tourists each year.

Because of the dangers, intentional balloon releases have been banned in many cities and counties across the state. A poll released by Oceana showed that 87 percent of Florida voters support local, state and national policies that reduce single-use plastic. Gov. Ron DeSantis must waste no time in signing this important piece of legislation into law.

Our elected officials should continue to work together to address environmental issues so Floridians and tourists can enjoy our beautiful state without its being marred by plastic pollution.

Sophie Ringel Miami Beach

Cookies on GOV.UK

We use some essential cookies to make this website work.

We’d like to set additional cookies to understand how you use GOV.UK, remember your settings and improve government services.

We also use cookies set by other sites to help us deliver content from their services.

You have accepted additional cookies. You can change your cookie settings at any time.

You have rejected additional cookies. You can change your cookie settings at any time.

• Education, training and skills
• Further and higher education, skills and vocational training
• Further and higher education courses and qualifications

350 extra medical school places allocated in NHS training boost

The government has funded 350 additional medical school places in England for the academic year 2025 to 2026 in latest step to deliver NHS Long Term Workforce Plan.

• The government has funded 350 additional medical school places in England for the academic year 2025 to 2026 
• This is the next stage in delivering the NHS Long Term Workforce Plan commitment to double medical school places by 2031
• The places have been allocated to medical schools across the country but targeted to address disparities in the distribution of places and support under-doctored areas

The government has allocated an additional 350 medical school places, to deliver the future workforce the NHS requires.  

Last year, the NHS set out its Long Term Workforce Plan, backed by more than £2.4 billion in government funding. It outlines how the NHS will recruit and retain hundreds of thousands more staff over the next 15 years - delivering the biggest training expansion in the health service’s history.  

One of the key commitments is doubling the number of medical school places in England to 15,000 by 2031 and levelling up the geographic training of places to help tackle unequal access to services.  

In the next step to deliver this commitment, the Office for Students ( OfS ) has now allocated 350 places in the academic year 2025 to 2026 to medical schools across the country.  

Health and Social Care Secretary Victoria Atkins said:  

Thanks to the government’s plan for a faster, simpler and fairer healthcare system, the NHS now has record funding and a record number of doctors. I want to make sure that we will have the medical professionals we will need in the years ahead. That’s why we are delivering the NHS Long Term Workforce Plan and doubling the number of medical school places, so we can train the next generation of world-class doctors to offer patients the highest-quality care.

Education Secretary Gillian Keegan said:

Our frontline health workers do tremendous work in serving the nation every single day and ensuring all of us receive the care we need. I know what a popular career medicine is among young people and it’s so important they have the chance to pursue their ambitions. With this expansion of places - alongside our new doctor degree apprenticeship - the opportunities for a career in medicine are greater than ever

Amanda Pritchard, Chief Executive of NHS England, said:

This is a hugely important moment for the NHS Long Term Workforce Plan and marks one of the first steps towards our ambition to train more doctors in England than ever before - the record expansion will help us boost care for patients right across the country.   The ambitious blueprint for our workforce, is a once-in-a-generation opportunity to put NHS staffing on a sustainable footing, particularly as we continue to adapt to new and rising demand for health services.

Dr Katie Petty-Saphon, CEO, Medical Schools Council, said: 

The Medical Schools Council welcomes the announcement of 350 additional student places from 2025.  Medical schools are committed to widening participation to the profession and particularly important is the need for local recruitment in under-doctored areas. We will continue to work with stakeholders to ensure that the NHS has the staff it needs to deliver high-quality patient care.

Places have been provided across the country, but the OfS has used analysis of geographical distribution provided by NHS England to target under-doctored areas in its allocation of the places.  

This includes substantial increases to medical schools at universities in Sunderland, Leeds, East Anglia, Anglia Ruskin, Plymouth and Surrey. The University of Surrey is also receiving government-funded places for the first time.  

This is the second year of expansions to deliver the NHS Long Term Workforce Plan. Delivery started a year early, allocating 205 additional medical school places for the 2024 to 2025 academic year, including providing government-funded places to 3 schools for the first time. 

This builds on the 25% expansion of medical school places in England that the government completed in 2020, taking the total number of places to 7,500 per year and delivering 5 new medical schools. 

A combination of the additional medical places this year and next, along with medical apprenticeship places, puts us on track to exceed current plans. 

Through the allocation of places for 2026 to 2027 and beyond, the government and NHS England will work closely with partners including medical schools, NHS trusts and the General Medical Council to deliver ambitious reforms to medical education set out in the NHS Long Term Workforce Plan.

Full list of medical school allocations

East of england, north east and yorkshire, share this page.

The following links open in a new tab

• Share on Facebook (opens in new tab)
• Share on Twitter (opens in new tab)

Is this page useful?

• Yes this page is useful
• No this page is not useful

Help us improve GOV.UK

Don’t include personal or financial information like your National Insurance number or credit card details.

To help us improve GOV.UK, we’d like to know more about your visit today. Please fill in this survey (opens in a new tab) .