Match Day 2026: The countdown ends, the journey begins
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Picture yourself in the emergency department in desperate need of acute care.
If you are lucky, you quickly check in with a triage nurse who takes your vitals and registers your complaint—before sending you back to the lobby. Hours pass and it's likely you still have not been treated. You are surrounded by other sick people, some with contagious diseases. As the clock ticks, many people leave, taking a risk to manage their illness on their own. Finally, someone takes you to the treatment area, but it's only to wait again surrounded by what seems to be utter chaos before eventually, sometimes hours later, a harried doctor comes to see you.
Now picture yourself on the other side. You are an emergency physician, nurse or one of the countless other providers who contribute to this critical care. You want desperately to see the patient who has been waiting for hours, but the department is short staffed because of widespread nursing shortages, projected to create 450,000 open positions by 2025. Your ED is full of people "boarding", or who need to be admitted to the hospital but are stuck - there are not enough beds available to transfer that person out of the emergency department. This leaves less space to see or treat the now growing line of people in the waiting room.
People lash out at you out of frustration over their long waits. Your department is gridlocked because you can't move people out or to get things done because there are not enough people. You feel powerless, exhausted and even grief-stricken.
By now, thanks to COVID, many people are aware of the challenges of working in an emergency department. But many of these problems existed before the pandemic, and it looks like things are getting worse. A few days ago, on the largest Match Day in history, when about 40,000 medical students all over the country learned where they would do their next years of training after an often ultra-competitive process for a limited number of spots, hundreds of emergency medicine residency positions went unfilled. In two years, the number of applications for usually-competitive emergency medicine residencies has dropped by 26 percent, leaving 555 spots open this year.
Emergency medicine physicians and the nurses who work with us are suffering from burnout, depression, and deep moral injury more than ever before. When people come to us, some on the worst day of their lives, we cannot take care of them in the way that we have been trained to do. Match Day tells us that medical students are realizing this. We have long known emergency departments are broken. We need our administrators to acknowledge this, to listen to us and to rebuild our environments so that we can treat people quickly, fix what's wrong, and when called to, save their lives.
When, I chose this specialty 30 years ago, I knew that the emergency department would be a high volume, high stress environment. I knew that I would face uncertainty at times. But I loved that the emergency care was supposed to be a great equalizer—a safety net where we treat you regardless of your race, creed, gender or ability to pay. I have loved that it's an exciting field of medicine—at any moment anyone and anything can walk in, whether a 23-year-old gunshot victim or a 60-year-old patient in cardiac arrest, and I'd have to use everything I'd ever learned in medical school, plus some, to try and help them. I have loved that over the years, I have helped some of our most vulnerable people get the care that they could not get elsewhere.
But lately, my love has dampened. In some parts of the U.S., particularly in rural areas and states without Medicaid expansion to cover uninsured people, my colleagues have to send some out after their emergency visits without viable options for follow-up. This affects their health outcomes. The uncertainty of having to think on our feet that initially fueled our adrenaline has morphed into an uncertainty of staffing and resources that now fuels our anxieties.
When we deal with these extraneous things, instead of providing optimal and sound clinical care, it transforms that idealistic vision we had as young doctors into a dark and unpleasant one. It creates moral distress, then moral injury. It burns us out, which makes us prone to medical errors, racial bias, depression and career changes. When health care providers have poor relationships with leadership, do not feel supported by their organization, believe that they are being treated unfairly or are unable to communicate grievances, this makes moral injury, and burnout worse.
To that end, hospital administrators must make our work environments better. The people who run our hospitals have to involve us in figuring out solutions, because we know how our department works better than anyone. Beyond the emergency department, clinicians often reserve inpatient hospital beds people who are having non-emergency procedures, planned surgeries for people who are ill but don't need the emergency department. Our administrators can spread out these planned admissions and their subsequent discharges over the whole week, including evening hours and weekends, to decrease the bottlenecks that lead to high hospital occupancy rates and boarding.
A fully functioning emergency department requires more than just doctors. Hospitals have to reinvest profits and devote a critical part of their budget to hire more nurses and ancillary staff. We need nurse to patient ratios that promote quality care rather than the bare minimums we often have. They have to make emergency care better paying and safer for nurses, otherwise they leave, and then doctors cannot do our jobs as effectively.
Our hospital leaderships need to explore temporary ways to manage staffing shortages and to ease physician workloads, including scribes and simplified electronic medical record systems. They can work with paramedics to bridge some of our growing nursing shortage, as paramedic and nursing skills have some overlaps. We can more widely adopt telemedicine in triage to conduct medical screening exams to reduce patient wait times and free up providers. However, no one solution will work alone. It has to be a dedicated effort on multiple fronts.
The day after match day marked another milestone—the one-year anniversary of the Lorna Breen Health Care Provider Protection Act, named after our emergency medicine colleague who committed suicide in the pandemic, which aims to eliminate the stigma of mental health care among medical professionals.
While the Match Day shortfall may not be apparent in emergency departments right away, and some people predict a potential oversupply of emergency physicians by 2030, if this year's match number plunge continues, we will eventually face a shortage. Then, many more of us will leave, burned out. This leaves us as a society with an important and difficult question—how we will we survive if you go into an emergency department, and there are no doctors or nurses left to care for you?
This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.
If a husky gets heartworms or a cat gets a cold, pet owners turn to veterinarians for help in nursing their beloved creatures back to health. So do farmers and biomedical researchers for whom animals are an essential part of their work.
But according to Oliver Garden, dean of LSU's School of Veterinary Medicine, there is a serious shortage of veterinarians worldwide.
"We estimate that, right now in the U.S. Alone, there are at least 5,000 too few vets and probably many more," he said. "If we don't increase the number of graduates we put out in the world and all of the other vet schools do likewise, by 2030, that number will be at least 15,000 plus and some estimate up to double that."
To address the shortage, the veterinary school is planning to increase the number of students admitted from 120 to 200 — with "a bit of leeway" to go up to a maximum of 220 students, almost double the size.
It's a big push for a school that is famously among the most difficult programs at LSU to get into. Out of 1,500 applicants to the vet school last year, only 120 were accepted.
To help meet the new admissions goal, the state of Louisiana has given the school $2.2 million. Garden said the money will be used to expand teaching staff in the surgical training center and veterinary clinical sciences, among other departments.
Oliver Garden, Dean and Kenneth F. Burns Endowed Chair in Veterinary Medicine at LSU's School of Veterinary Medicine, talks in his office on Friday, March 24, 2023 about the state's decision to invest $2.2 million in the school.
STAFF PHOTO BY TRAVIS SPRADLING"Virtually all of them are getting at least one more faculty member and some are getting more, like oncology, where we're quadrupling the number of medical oncologists from one to four, we hope," he said. "It's challenging in academia to recruit into some of these specialties but we are well-positioned to do that."
Increased state funding will also help the school offer more scholarships so attract students for whom the school might otherwise be out of reach, Garden said.
"You just really buckle down"Madison Hopper, a second-year student at the vet school, said the challenge of vying with hundreds of other students for relatively few seats can be very stressful.
As a premed gearing up to apply to medical school, you're likely hoping for admission into top-tier medical schools like Johns Hopkins, University of California–San Francisco, Stanford, and Harvard.
If you're hard at work earning excellent grades and studying for the MCAT, the good news is that you've already taken the first step toward getting into a top medical school. You might feel, as a Harvard undergrad, that you're a shoo-in for most medical schools. But you're still unsure about whether you can get into a top program.
Not to mention the bad news: if you're aiming for the most prestigious schools, it's a safe bet that the majority of your fellow applicants will also be well-qualified. While a terrific GPA and MCAT score are the foundation of any medical school application, it's important, even as an excellent student from Harvard, to distinguish yourself in other ways so that you won't be disappointed at the conclusion of the admissions cycle.
In this article, we'll discuss strategies that you can employ to boost your chances of acceptance into a top medical school. We'll go over the right way to approach extracurriculars, application materials, and interviews in order to help you stand out to admissions committees.
How hard is it to get into a top medical school?Getting into medical school is difficult, period. In the 2019–2020 application cycle, only 41 percent of applicants to American medical schools matriculated, meaning that nearly 60 percent of applicants most likely didn't get in anywhere. Even medical schools that aren't especially well-known often have acceptance rates under ten percent.
At the most prestigious medical schools, the odds are even more daunting. The vast majority of top-tier medical schools have acceptance rates under five percent, and the average GPA and MCAT score of accepted students tends to be high (around 3.8 and 518, respectively).
If you're in this ballpark, your odds of acceptance into medical school are favorable, especially given Harvard's rigorous reputation. In fact, GPA and MCAT scores are what we consider "tier one" admissions factors, meaning that they're among the most heavily weighed qualifications that admissions committees consider.
Nevertheless, if you're aiming for acceptance into the most selective medical schools, you should think of your academic accomplishments as a baseline rather than sufficient qualification. Because the best medical schools receive thousands of applications from academically gifted students, it's critical to find other ways to differentiate yourself.
What are medical schools looking for?One way that we can understand what medical school admissions committees look for is by reviewing the Association of American Medical Colleges' list of "core competencies." According to the AAMC, successful applicants should be able to demonstrate a number of qualities, which they group into the following competencies:
The former two competencies include criteria such as critical thinking, written communication, and knowledge of living systems. Rest assured that if you're taking care to excel in your premed classes and other coursework, exhibiting these competencies should more or less take care of itself.
The list of pre-professional competencies describes the personal characteristics that are desirable in medical students and, by extension, doctors. These include good social skills, reliability, cultural competency, an orientation towards service, and more.
How might you go about showcasing these traits? Your extracurricular activities, application materials, and interviews are all excellent ways to prove that you are not only academically qualified for a top medical school, but that you also have the necessary personal characteristics to become a first-rate doctor.
Developing an outstanding extracurricular profileDemonstrating a robust roster of extracurricular activities is crucial for a couple of reasons. As we mentioned, it provides admissions committees with insight into your character, which is key in a service-oriented profession like medicine. For example, volunteering at the same soup kitchen for four years displays commitment. Working as part of a research team reveals your capacity for teamwork.
Active participation in extracurriculars shows that you're engaged and proactive in the medical field. It also demonstrates your desire to gain as much experience and knowledge as you can.
Here are the five areas of extracurricular experience—and the minimum number of hours—that we recommend having in order to be a competitive medical school applicant:
Earlier, we used the word "robust" to describe the best approach to extracurricular activities—what does "robust" really imply, though? Medical school applicants often think that they need to check every metaphorical box and participate in all available extracurriculars. By adopting this mindset, you run the risk of not playing a significant role in any of your activities.
A far more effective strategy is to focus deeply and intently on one or two things. In other words, though it is important to demonstrate familiarity and experience within all five above categories, you should also undertake your extracurriculars with the intention to develop one to two areas of specialization.
As you might imagine, a specialist will always be more memorable than a generalist. So rather than dabble in a wide variety of activities, aim to be remembered for your meaningful efforts in something unique.
To use a sports analogy: Shaquille O'Neal was one of the most memorable players in the history of basketball, remembered for his ability to use his physical size to get past defenders and score. Most basketball analysts would agree that he was one of a kind, and that few players have been able to replicate his dominant style since his retirement.
Aim to be the Shaquille O'Neal of your chosen specialty. Be "the campus nutrition advocate," "the caffeine addiction researcher," "the medical interpretation service founder," and so forth.
Becoming a specialist takes hard work and commitment, but it's not an especially mysterious process. The trick is to slowly but surely push further than what other students in the same activity typically do.
For example, if you're part of a volunteer organization, consider a currently unaddressed issue and brainstorm how you can take initiative in tackling it, whether that's coordinating a fundraiser, organizing an outreach effort, or starting your own offshoot organization. Or, if you're working in a lab, you might eventually ask your PI if you can pursue your own project with the goal of publishing original research.
You may look at someone who's conducted independent research or started their own volunteer organization and think their successes seem out of reach. However, by taking gradual steps over time, the very same results are possible for you.
Preparing compelling application materialsEarning top grades and standing out in your activities is one thing; packaging them for your medical school applications is another.
It's essential to put the time and effort into your application materials for a couple of reasons. Not only are they a space in which you can highlight your achievements and character, they're also your biggest opportunity to frame these accomplishments yourself and demonstrate that they qualify you for acceptance.
Three important components of your medical school applications include your personal statement, the Work and Activities section of your AMCAS application, and your secondary essays.
Writing your medical school personal statementAlong with your GPA and MCAT score, we consider your personal statement to be a tier one admissions factor. It's the part of your application in which your personal characteristics—the AAMC pre-professional competencies we discussed earlier—have the best chance to shine through.
Of tier one admissions factors, the personal statement is the one over which you have the most control. While your grades and test scores will speak for themselves, think of your personal statement as a chance to make the case directly to admissions committees that your personal narrative sets you apart from other qualified candidates.
Conversely, academically competent students who fail to gain acceptance to medical school might have underdeveloped or clichéd personal statement essays.
So how do you write a standout personal statement? The key is to frame your specific experiences and personal qualities within a compelling narrative that clearly explains who you are and why you want to become a doctor.
When brainstorming what to write their personal statements about, applicants often have a hard time settling on a topic that feels worthwhile. Great and lousy personal statements can be written on any topic, and how you write about it is what actually makes the difference.
In other words, any subject can work so long as it's well executed, conveying your unique perspective and explaining why you'll make an excellent doctor. We've seen fantastic personal statements on topics ranging from multilingualism to family cuisine to mental illness stigma.
Here's the step-by-step approach that we recommend in order to write a great medical school personal statement:
Create a list of personal qualities that you'd like to convey through your personal statement. For example, you might choose compassion, resilience, communicativeness, and optimism.
Brainstorm experiences, events, or contexts in which you've expressed those qualities.
Begin writing by describing your chosen experiences in narrative form.
Discuss how your experiences have led you to pursue a career in medicine.
Conclude your essay and tie everything together by reemphasizing your personal qualities, your interest in medicine, and what perspectives your experiences have given you.
Create a list of personal qualities that you'd like to convey through your personal statement. For example, you might choose compassion, resilience, communicativeness, and optimism.
Brainstorm experiences, events, or contexts in which you've expressed those qualities.
Begin writing by describing your chosen experiences in narrative form.
Discuss how your experiences have led you to pursue a career in medicine.
Conclude your essay and tie everything together by reemphasizing your personal qualities, your interest in medicine, and what perspectives your experiences have given you.
While writing, make sure to demonstrate the qualities that you're focusing on rather than list them outright—in other words, "show, don't tell." Consider these two versions of the same idea: "through volunteering at the homeless shelter, I became a more reliable person" vs. "over my four years of volunteering at the homeless shelter, I learned that if I did not do my assigned tasks, they might not get done—this motivated me to show up every week." The latter is undoubtedly more memorable and convincing.
Ultimately, what's important in your personal statement is not the experience you describe but what the experience says about you. Though it's common to choose an experience to write about and then figure out its significance, our strategy is more effective because it allows you to work in reverse. By first deciding what you want to convey about yourself and then determining which experiences support those traits, you can more easily argue that you're a worthy candidate for medical school.
AMCAS Work and ActivitiesThough less frequently discussed, the Work and Activities section is an important component of your AMCAS application. A key reason for this is that the Work and Activities section appears before your personal statement in your admissions file, which makes it responsible for delivering a positive first impression.
In the Work and Activities section you'll have the opportunity to create up to 15 entries that succinctly detail your various non-academic experiences. AMCAS allows you to categorize your experiences into 18 different pre-set designations such as extracurriculars, employment, research, service, athletics, and more. However, you may only create one entry per category, so it's important to assign them carefully.
The meat of each entry will consist of a 700-character description of the activity. As you write each description you'll want to hit these main points: how much time you spent on the activity, what your responsibilities and accomplishments were, what impact you made, and what skills and qualities you demonstrated through the activity.
Three of your entries can also be designated as "most meaningful," which allows you to write an additional 1,325 characters per experience. The important points to cover in this extra space are what you learned from the activities and how they helped you grow.
Similar to your personal statement, your Work and Activities entries are a valuable opportunity to carefully choose the experiences that you want to highlight for admissions committees. Given the limited space available, you should include only your most significant experiences, making sure to avoid listing trivial activities simply for the sake of filling up the section, even if that means you end up with fewer than fifteen.
Here's how we advise applicants to choose which experiences to include:
Make a list of every non-academic experience you've had during your college career (and post-baccalaureate program, if you've taken time off after graduation).
For each experience, write out brief descriptions or keywords in response to each of the following: time spent, responsibilities and accomplishments, impact, competencies demonstrated, and lessons and growth.
For each experience, figure out all the categories that it could conceivably fall under, as experiences that can be labeled multiple ways leave you with greater flexibility. For example, a campus organization in which you hold an officership could be designated as "Leadership," leaving the "Extracurricular" slot free for something else.
Using these descriptions and categories, choose the activities that you'll include in your AMCAS application.
Take your descriptions and flesh them out into full sentences to create mini-narratives of your experiences, taking care to remain within the length limits.
Make a list of every non-academic experience you've had during your college career (and post-baccalaureate program, if you've taken time off after graduation).
For each experience, write out brief descriptions or keywords in response to each of the following: time spent, responsibilities and accomplishments, impact, competencies demonstrated, and lessons and growth.
For each experience, figure out all the categories that it could conceivably fall under, as experiences that can be labeled multiple ways leave you with greater flexibility. For example, a campus organization in which you hold an officership could be designated as "Leadership," leaving the "Extracurricular" slot free for something else.
Using these descriptions and categories, choose the activities that you'll include in your AMCAS application.
Take your descriptions and flesh them out into full sentences to create mini-narratives of your experiences, taking care to remain within the length limits.
In light of the space constraints, it's essential to write with brevity. As such, the writing style you employ will likely differ from that of your personal statement. In this section, it's fine to both "show" and "tell" if necessary — your primary concern should be conveying the requisite information and highlighting your accomplishments and excellent character.
By writing clearly and concisely about your experiences, you'll be able create a positive first impression for admissions committees and set the stage for the rest of your application materials.
Writing your secondary essaysThe final pieces of the medical school application puzzle are your secondary application, which you'll turn to after submitting your AMCAS application. The bulk of your secondary applications consists of essays that you'll need to write in addition to your personal statement.
Though secondary essays are often much shorter than the personal statement, their inclusion in the application process increases your workload significantly since most secondary applications ask for three or more extra essays. With the average applicant applying to sixteen medical schools — we recommend that most students apply to 20-30 schools — this can add up to a great deal of work.
Luckily, there are steps you can take to considerably streamline the secondary essay writing process. If you examine the prompts used for secondary essays, you'll notice that a large number of them fall into the following three categories:
We advise applicants to use this to their advantage by pre-writing one of each of these essays, which they can later tailor per school.
To write compelling secondary essays, you can use the same process that we outlined in our discussion of the personal statement: choose experiences that demonstrate the attributes you'd like to emphasize. Below are additional tips to help you write each of the three essays.
The diversity essay: in our experience, the biggest misconception surrounding diversity essays has to do with the concept of diversity itself. Many applicants erroneously believe that a diversity essay must take on their racial or ethnic background, socioeconomic status, sexual orientation, gender identity, or religion. These are excellent topics to write about, but the list doesn't stop there.
Rather, any element of your background, experiences, identity, or aspirations that gives you a unique perspective can be used to write a diversity essay. We've worked with applicants on fantastic diversity essays about military service, competitive rock climbing, growing up on a farm, being a parent, using stand-up comedy therapeutically, and the list goes on.
No matter what you write about, the key to a successful diversity essay is to connect what makes you unique with your potential and goals. Don't assume that your contribution to a medical school's diversity statistics is meaningful in and of itself. Rather, take care to use anecdotes that explain why you have something unique to add and which demonstrate that you'll bring cultural sensitivity to your medical school community.
The adversity essay: adversity essays are not meant to measure suffering, but instead to get a glimpse into how you handle challenges, stress, and problem-solving. That's why the best topic for this type of essay isn't always the one that shows the greatest setback; instead, it's the one that displays the most growth.
To brainstorm, we suggest creating a list of challenges you've faced, no matter how big or small, and listing the following for each:
Once you've developed a list, choose the situation that exhibits the greatest development of maturity, improvement, and resilience.
The "why us?" essay: these prompts might ask questions like, "why are you specifically interested in pursuing your medical education at Mayo?" or "please explain your reasons for applying to Penn."
Applicants are often surprised to learn that the best approach to answering these questions is not to simply discuss the school's laudable mission, desirable location, or prestigious name. Instead, a compelling response will be equally focused on yourself.
The most effective "why us?" essays explain how your specific interests, background, and career goals fit closely with a school's specific curriculum, resources, and ethos. Top-tier medical schools know they're great — your task is to convince them that you'd fit into, benefit from, and contribute to their greatness.
How to ace your medical school interviewsMany applicants consider interviews the most nerve-racking part of the admissions cycle. Rest assured that if you receive an invitation to interview at a medical school, your academic and extracurricular credentials have already proved you to be a worthy candidate.
The primary purposes of medical school interviews are to confirm that who you are in real life matches the fantastic candidate you've submitted on paper. They also want to make sure that your social and interpersonal skills are sufficiently developed. We've made a point to underscore the importance of demonstrating desirable personal characteristics in your application materials; your interviewers will be looking to see that you display these characteristics in real life, too. Not only is it critical for physicians to possess well-honed social faculties, medical schools also want to ensure that you'll fit into their community.
That's why the manner in which you conduct yourself in your interviews (including on-campus social interactions and correspondence with faculty and admissions staff) is as important as what you actually say. Your task in your interviews is to infuse your candidacy with a human dimension that is personable, likable, and polished.
In order to prepare for interviews, we recommend that you prepare thoughtful responses to common questions and practice your delivery through mock interviews.
Begin by mastering your own materials—you should be ready to discuss any detail of your AMCAS application, secondary essays, and academic record. Then spend time with the school's website in order to fluently understand their programs, culture, and focus.
To understand which questions you might be asked, look up interview questions that past applicants have received at the schools at which you'll interview and prepare your responses. We also recommend having answers ready for the following common questions:
"Tell me about yourself": a good answer to this question will touch on both the personal and the medical. We suggest beginning by briefly describing your background, such as your upbringing and interests. Then transition into a discussion of experiences that have been relevant in your journey towards medical school.
"Why do you want to become a physician?": while many applicants fear sounding clichéd when answering this question, the truth is that an interest in science or a desire to help others are valid reasons to enter medicine. Our advice is to answer honestly and to ground your response in specifics and anecdotes, making sure that your reasoning is consistent with what you've written in your personal statement and secondary essays.
"Why do you want to attend our school?": you can think about this question the exact same way you think about your "why us?" essay: use specific details to explain how you and the school are an ideal fit.
"What do you see as the biggest problem with healthcare in the United States?": this sort of policy-oriented question can be intimidating, but take comfort in knowing that your interviewer isn't expecting you to take on a specific political stance. Rather, they're looking to see that you can defend your beliefs. Going into your interview, do make sure that you're reasonably well informed on current healthcare issues. When faced with this type of question demonstrate that you are aware of current debates by acknowledging both sides of the issue. Finally, state your position and thoughtfully back it up.
Having rehearsed responses at your fingertips will help you greatly as you interview; at the least, it'll aid you in feeling reassured and relaxed. That said, it's also crucial not to seem robotic or canned. Don't insist on sticking to your script if that's not where the conversation naturally flows or if your interviewer brings in a complex question. Demonstrating that you can adapt and think on your feet is just as important.
We recommend arranging practice interviews with trusted premed advisors, professors, admissions consultants, or friends who have already been through the medical school application process. Ask your mock interviewers to evaluate both your answers and your delivery so that you can perfect both, all the way down to eye contact and handshakes.
You've already proven that you're intellectually fit to become a doctor. Demonstrating in your interviews that you're also socially capable and put-together will help you stand out from the rest of the applicant pool.
Final thoughtsApplying to medical school is a competitive, grueling process, especially for those hoping to enter the top tier. Earning excellent MCAT scores and superb grades, particularly from a first-rate institution like Harvard, will do the work of placing you in the realm of qualified applicants. Becoming a specialist in your extracurriculars, preparing top-notch application materials, and acing your interview will help you demonstrate that your disposition and character are as admirable as your intellectual achievements. Work hard to distinguish yourself from your competition and you'll be on your way to acceptances at the most selective and prestigious medical schools in the country.
For over 15 years, our team of admissions experts has helped thousands of high-achieving students get into top medical schools like Hopkins, Harvard, and UCSF.
The Crimson's news and opinion teams—including writers, editors, photographers, and designers—were not involved in the production of this article.
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