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With the advent of COVID-19 and Step1 being P/F, the ERAS system has some important changes to the 2023 & 2024 Online Residency Application.
Most notable is the inclusion of a box titled "Impactful Experiences" with a 750 character limit (with spaces!)
Some suggestions they include:
Family background (e.g., first generation to graduate college).
Financial background (e.g., low-income family, worked to support family growing up, work-study program to pay for college).
Community setting (e.g., food scarcity, poverty or crime rate, lack of access to medical care).
Educational experiences (e.g., limited educational opportunities, limited access to advisors or mentors).
Other general life circumstances (e.g., loss of a family member, serving as a caregiver while working or in school).
I was recommended by Residency Advisors and Directors that this is a great place to address any "red flags" in your applications such as failed exams, retakes, health problems, etc.
How to talk about Failures in Residency Application:
Lessons Learned from Failure:
Growth mindset- learn from failures, take emotions of anger fuel into compassion and motivation, persevere in the face of challenges
"This journey to becoming a doctor has taught me so much more than how to properly read an X-Ray… it has taught me the value of failure & being imperfect. I am learning from my socially prescribed “failures” to NOT be a perfectionist but a 'healthy achiever'”
Development of Resilience:
Resilience is the ability to persevere through stress and trauma and learn from experiences to be stronger
Six pillars of Resilience:ConfidenceAdaptabilityPositivityPerspectiveMasteryStamina
Here is my journey breaking down my own "impactful life experiences:"
Download my full 2023 ERAS application here
First draft: 707 words (4,173 characters w/ spaces):
My medical school years provided me with a transformative experience, granting me access to a wealth of medical, academic, and financial resources that proved invaluable in overcoming the challenges I faced. With the aid of the health insurance allocated by my medical school, I had the privilege of consulting physicians and specialists who were previously out of reach. It was during my second year that I received diagnoses and treatment for several health conditions I had unknowingly lived with, accepting them as a normal part of my life. While these concerns did impact my academic progress, the most notable setback occurred during my struggle to pass Step 1, which ultimately led me to take a year of absence.
The realization of failing Step 1 opened my eyes to the possibility of receiving disability assistance, which allowed me to obtain the accommodations necessary for successfully passing the exam. This experience taught me a crucial lesson in seeking help and effectively communicating my needs to ensure my future success.
During my leave of absence, when I was studying diligently for the Step 1 exam, I found myself facing financial insecurity that resulted in significant housing and food concerns. These adversities had a profound impact on my living situation and academic environment. However, I refused to succumb to despair, demonstrating resilience in the face of financial uncertainty by working three jobs and utilizing government assistance to support both my family and myself. Unfortunately, living in a lower-income area meant we experienced a loss of internet access for several days, coinciding with an important summative exam. Determined to find a solution, I arranged to take the exam at a proctor's house. Seeking a more stable living arrangement, we returned to Colorado and temporarily resided with my husband's parents, alongside two siblings, one of whom has special needs. Due to limited space, I lacked a dedicated room for attending virtual classes, finding myself studying either in the backyard or the living room, depending on the whereabouts of family members.
Eventually, we managed to secure a new rental home back in Chicago. However, this new residence presented its own set of challenges. The basement contained black mold, and asbestos was discovered in the attic. The air conditioning and heating systems frequently malfunctioned, and we were forced to confront the presence of insects, as well as rodents inside the home such as rats and mice. One unforgettable incident involved discovering two mice atop a homemade pizza that had been left to cool. When we reported this issue to our landlord, we were met with callous dismissal, as he insisted such occurrences were normal in Chicago, advising us to avoid leaving food unattended. During the coldest month of winter, our furnace broke down, and the landlord, refusing to address the issue, left us to endure freezing temperatures for almost an entire week. Ultimately, we were compelled to break the lease and relocate once again. This marked the fourth move during my medical school journey, further compounding the challenges I faced while striving to maintain my academic progress. To cope with our financial difficulties, we were even forced to sell our car and many personal belongings, fundamentally challenging our perception of what possessions are truly necessary for a fulfilling life.
These formidable struggles, compounded by the backdrop of the COVID-19 pandemic and the demands of my second year of medical school, imposed significant stress and disruptions on both my daily life and academic pursuits. Nevertheless, I found the strength to persevere, showcasing resilience and adaptability in the face of adversity. This profound experience fostered within me a deepened sense of compassion for individuals enduring various societal challenges. The fear of not knowing if, on any given day, your landlord might evict you for falling behind on rent is a terrifying reality. Moreover, I came to understand the inherent transience of certain stressors. Even in the most hopeless moments, I discovered the power of action, whether it be seeking additional employment or opening up to the communities I am a part of and requesting assistance. The perseverance I developed through a lifetime of overcoming obstacles, dating back to my youngest years, prepared me to confront the financial and health challenges I confronted during my medical school journey.
Next Draft: 250 words, 1622 ch w/ spaces
My medical school years granted me access to invaluable medical, academic, and financial resources which I had never had access to before. With school-provided health insurance, I consulted previously inaccessible physicians and received diagnoses and treatment for health conditions I had unknowingly lived with. Struggling to pass Step1 led me to receive disability assistance, teaching me the importance of seeking help and communicating my needs effectively. Financial insecurity during the year of absence led to housing and food insecurities, but I worked multiple jobs and utilized government assistance to support my family all while studying for Step1. Despite a loss of internet access and a tightened crime rate, I was able to take an exam at a proctors home.
A temporary move back to Colorado with my husband’s family presented challenges with limited space for studying and living with an adult sibling with special needs. However, the new rental had issues like black mold, asbestos, malfunctioning AC and furnace, and rodents. Reporting these problems to the callous landlord led to no resolution, leaving us to endure freezing temperatures for a week. We were forced to break the lease and relocate once again, making it the fourth move during my medical school journey. Financial difficulties forced us to sell our car and personal belongings. These struggles, combined with the pandemic and demands of medical school, caused additional stress. Nevertheless, I persevered, developing compassion for those facing societal challenges and learning the power of action and resilience in the face of adversity.
Updated: 117 words (750 ch w/ spaces):
In 2020, with internet loss and increased crime we moved across the country to live with my in-laws which posed challenges due to limited space and living with a sibling with disabilities. The medical school's health insurance enabled me to receive previously inaccessible health care, diagnoses, and treatments for conditions I had unknowingly lived with. Financial insecurity during my year of absence resulted in housing and food insecurities, but I managed multiple jobs and government support. Struggling to pass Step1 led me to receive academic accommodations I was unaware existed. Our rental had black mold, asbestos, a malfunctioning furnace, and a rodent infestation, which the landlord offered no resolution, so we had to brake the lease.
Other impactful experiences (739/750 ch)
As the first of our family entering the medical field, my husband and I were committed to becoming physicians since our undergraduate years. Together we received student loans and Pell Grants, maintained jobs during college and gap years, and supported each other’s journey. I have developed tremendous empathy for those who have similarly pursued education while reliant on government sponsored programs. During our M1 year, COVID led to a temporary return to our family’s home which presented additional challenges such as limited space for studying and taking exams while caring for an adult sibling with special needs. By overcoming challenges, I have learned the value of perseverance and embracing resilience in the face of adversity.
Was your medical education/training extended or interrupted?* (500/510-ch)
During my M2 year, I was diagnosed and began treatment for medical conditions I had unknowingly struggled with for most of my life. While now well managed, at the time it led to me needing to retake course exams and necessitated a leave of absence (LOA) to address my health. This LOA brought about unforeseen challenges, including financial instability, housing insecurity, and food scarcity. Due to these circumstances, I needed to retake Step1 while working multiple part-time jobs to support my family.
What do you think? Is this the best place to address red flags if they meet the criteria of impactful experiences?
My Podcast: "Life as a Patient-Doctor"
Blog Post: Disability Disclosure in Residency Applications
Blog Post: Applying to Residency A Strategic Guide for Medical Students
If you would like to meet to discuss your own red flags or residency application, sign up for my personalized coaching here.