For many medical students, preparing the Electronic Residency Application Service (ERAS) personal statement is a dreaded and lonely component of the application process. They realize that residencies use the statements in selecting candidates for interview but not for final ranking1; in fact, emergency medicine program directors reported that personal statements were the least important factor in the resident selection process, just below extracurricular activities and basic science course grades.2 Students understand that residency programs expect personal statements to reflect common themes, such as an applicant’s motivation for the specialty and personal attributes, but also know that eloquence is less important than basic, grammatically correct, error-free writing.3
In addition, students discover contradictory advice online. “Don’t be afraid to be creative.”4 “Avoid showing too much creativity.”5 “Avoid using quotations.”6 “Capture their attention from the beginning by using … a quote.”5 “[Get] help [from] experienced editors available through residency personal statement services.”7 “Definitely, don’t use a service that will write your personal statement for a fee.”6
The time, energy, and—for some—money spent preparing essays is not insignificant. Each year, 34,000 active applicants prepare a personal statement for ERAS and submit rank order lists through the National Resident Matching Program (NRMP).8 Many, if not most, share drafts of their statements with mentors who, in turn, invest time and energy in edits and suggestions.
The personal statement is a hurdle to be cleared by every senior medical student despite stress, the uncertainty of the essay’s significance, and conflicting advice. At the Medical College of Wisconsin (MCW), we used this ambiguity as an opportunity to employ medical humanities techniques to engage senior medical students with reflection, speedwriting, and peer editing. We hoped to launch them toward crafting a satisfying and insightful personal statement.
Prompts, speedwriting, and peer-edit critique are common tools in many levels of education. Prompts and speedwriting9 stimulate creativity and overcome “writer’s block.” MFA (masters in fine arts) programs use peer editing among creative writers and poets to build teamwork, enhance writing, promote self-reflection, and provide feedback for works-in-progress.
With logistical support from the associate dean for student affairs, in 2013 and 2014 each fourth-year student in the Classes of 2014 (n = 188) and 2015 (n = 189) was invited to attend a Residency Application Personal Statement Writers Workshop. Students were told to expect a two-hour session tailored to the preparation of their residency application essay. All participants were asked to complete a research questionnaire during the workshop, and an online survey around the time they submitted their ERAS application. The anonymous research questionnaires and online survey were approved by the MCW institutional review board. Participation in the research was not a prerequisite to participating in the workshop.
Components of the workshop
Workshops were offered in June and July, two to three months prior to the mid-September ERAS submission deadline. All sessions were held at the end of the workday in a classroom with tables set for small-group work. No advance preparation was necessary. Optional follow-up workshops were offered in August.
Enrollment was limited to 30 participants per session, although sufficient numbers of opportunities were offered so that every interested student could participate. Students self-selected into groups of four to six. A preworkshop questionnaire was administered. The workshop outline is shown in Chart 1.
Prompts. The facilitator guided the students through a process of selecting their own personalized writing prompts by reading a list of specific incidents or examples of personal experiences (Chart 1) and asking the participants to jot down a word to two about each. The students then picked the one or two experiences that were most immediately compelling to them. These would be the prompts for speedwriting.
Speedwriting. After an introduction, the participants were timed for 20 minutes of speedwriting—writing continuously and without editing, focusing on narrative, story, and action. They were encouraged to work without stopping (“If you can’t think of anything, write ‘I can’t think of anything’ until something comes to you. Just keep going!”).
After speedwriting, the students spent five minutes reworking what they had written; cross-outs, arrows to indicate reordering, and basic editing were now permitted. When ready, they stacked their essays with those of the other group members. Each table handed the stack to a facilitator for photocopying. Enough copies were made so that every group member would have a complete set of essays for the peer-edit critique.
Peer-edit critique. While the photocopies were being made, the facilitators demonstrated the peer-edit critique. The “writer” read his or her essay aloud while the “listeners” followed along, marking their copies where their interest was piqued or where they found wording unclear. After the reading was completed, the listeners spent a few minutes adding written comments, including completing the phrase, “This essay seems to be about….” Once all of the listeners had completed their written comments, the listeners went around the table, taking turns and discussing the essay while offering observations and encouragement. The writer sat quietly and without comment, taking notes and paying attention, but refraining from answering, defending, or explaining. Then the group returned all copies to the writer and shifted to the next essay. The process was repeated with each student taking a turn as “writer.” Thirty minutes were allotted for the peer-edit critique portion of the workshop.
After 30 minutes, the peer-edit critique was paused. Students discussed what they had discovered, and the postworkshop research questionnaire was administered. Any groups that had not completed peer editing then continued for as long as needed.
Optional follow-up workshop
In mid-August, an optional follow-up session was offered to interested participants. The students brought five double-spaced copies of their draft ERAS personal statement and self-selected into student-only or facilitator-led groups. The groups participated in a peer-edit critique which lasted 45 minutes. Session-specific pre- and postworkshop questionnaires were administered.
Students who provided permission received a link to an online questionnaire shortly after September 15 to coincide with their ERAS submission. The questionnaire asked whether the workshop was effective in kick-starting their personal statement, whether it was a good use of their time, and how much of their final statement grew out of the workshop essay. Free-text comments were encouraged.
Six workshops were offered (three each to the MCW Classes of 2014 and 2015). Three optional follow-up workshops were offered (one to the Class of 2014 and two to the Class of 2015). A total of 109 students elected to participate in one of the initial workshops: 42 (22%) from the Class of 2014 and 67 (35%) from the Class of 2015. Thirteen students left after the introduction and prior to any writing, usually without explanation. Three left after completing the preworkshop questionnaire but before the session; these students’ responses are included in the preworkshop questionnaire results. The remaining 93 students stayed for the entire workshop. Two students who completed the workshop did not provide an e-mail address to be contacted for the online questionnaire. Eight students in the Class of 2014 and 7 students in the Class of 2015 participated in the optional follow-up workshop.
Therefore, 96 students completed pre- and 93 completed postworkshop questionnaires. All 15 participating students completed the pre- and postworkshop questionnaires at the optional follow-up workshop. Fifty-four students completed the post-ERAS submission online survey.
Slight modifications in logistics were made between the sessions, although the instructions, format, and questionnaires were unchanged. One author (B.H.C.) and at least one coauthor facilitated every session.
Preworkshop questionnaire results are shown in Table 1. Only 28 (29%) of the participants strongly agreed or agreed that they were comfortable with creative and reflective writing, and only 20 (21%) strongly agreed or agreed that they had taken more English or writing courses than their peers. Eighteen (19%) participants agreed that reflective and narrative exercises are “a waste of time,” whereas 47 (49%) believed that their medical school peers felt that way. Eighty-three (86%) strongly agreed or agreed that they were anxious about preparing their personal statement.
Postworkshop questionnaire results reveal that 65 participants (70%) had been surprised by their own productivity, and 71 (76%) felt less anxious about their statement.
Fifteen students returned for the optional follow-up workshop. When asked about the requirement to read their essay draft aloud during the initial workshop, seven (47%) said that this had caused them discomfort (data not shown).
Fifty-four (59%) of the students who provided e-mail addresses completed the online questionnaire after submitting their ERAS application (Table 2). Fifty-one (94%) indicated that the workshop had been effective in getting their essay launched and that it had been a “good use of my time.” Forty-two (78%) agreed that the workshop had made them less anxious. The technique of working in groups with other students was helpful to 46 (85%), although 33 (61%) found it intimidating. Forty-nine (91%) would recommend the workshop to future students, and 47 (87%) agreed that the workshop was “fun.” Fifty-one (94%)—all but 3—reported that some of the writing generated at the workshop was included in their final essay (Table 3).
Free-text comments were positive:
- “The workshop actually helped me decide on which specialty I was going to choose.”
- “I liked the free writing. It is not something I would have ever done on my own but surprised me in how much it helped just getting thoughts on paper.”
- “Really enjoyed being able to listen about others’ thoughts without needing to defend/explain my writing. Easier to see ways to improve.”
- “I think this was really helpful, especially the peer analysis part.”
- “Great insights from fellow students.”
- “Working with our peers actually turned out to be really helpful despite most of us being very nervous to read our speedwriting paragraphs out loud!”
Students found the “most difficult task” to be reading aloud and getting started. The “most helpful task” was sharing and receiving feedback.
The full workshop (prompts, speed writing, and peer-edit critique) will be repeated yearly at MCW. We were encouraged by the jump in participation between the two years and hope that this is attributable to word of mouth.
We learned that reading aloud was the most intimidating aspect of the workshop and were concerned that some of the students who left prematurely did so because they were unwilling to share with their peers. For some groups of students, therefore, a shorter, “nonthreatening” version (prompts and speedwriting only) is appropriate. We used this shorter approach successfully with a large-group gathering of the entire Class of 2016 to help them reflect on their clinical rotations in December and June of their third year.
We hope to offer workshops to residents preparing fellowship applications and will seek further opportunities to expand this approach to groups of students, residents, and faculty.
Acknowledgments: This project was developed as part of the 2013 Docere2 Education Course sponsored by the Medical College of Wisconsin (MCW) Society of Teaching Scholars and the MCW Office of Educational Services. The authors are grateful to Emily Transue, MD, who adapted the speedwriting format from Goldberg9; to Kim Suhr, MFA (director, Red Oak Writing Studios, Milwaukee, Wisconsin), who adapted and shared the peer-edit critique format; and to Elizabeth Evans, MFA (Jean V. Naggar Literary Agency, New York, New York), for help with the workshops.
1. National Resident Matching Program. Data Release and Research Committee: Results of the 2012 NRMP Program Director Survey. 2012 Washington, DC National Resident Matching Program
2. Crane JT, Ferraro CM. Selection criteria for emergency medicine residency applicants. Acad Emerg Med. 2000;7:54–60
3. Smith EA, Weyhing B, Mody Y, Smith WL. A critical analysis of personal statements submitted by radiology residency applicants. Acad Radiol. 2005;12:1024–1028
4. USMLEWeb. . Tips to write an effective personal statement. http://www.usmleweb.com/showarticle44.html
. Accessed June 19, 2015
5. University of North Carolina School of Medicine Office of Student Affairs. . CV & personal statements. http://www.med.unc.edu/ome/studentaffairs/residency-and-the-match/residency-application-process/cv-personal-statements
. Accessed June 19, 2015
6. Association of American Medical Colleges. Careers in medicine: Writing your personal statement. https://www.aamc.org/cim/residency/application/applying/337864/writingyourpersonalstatement.html#
[subscription and login required]. Accessed June 19, 2015
7. Essay Edge. . Writing a great residency personal statement. http://www.essayedge.com/medical/residency-personal-statement
. Accessed June 19, 2015
8. National Resident Matching Program. . . Results and Data: 2013 Main Residency Match. 2013 Washington, DC National Resident Matching Program
9. Goldberg N Wild Mind: Living the Writer’s Life. 1990 New York, NY Bantam Books