Ultimate Guide to the MD/PhD Secondary Application

I have reviewed the secondary applications for over 50 MD/PhD programs to write this blog post. There’s a wealth of information on common essay questions for medical school admissions, yet comparatively few address what you need to know for the MD/PhD supplemental essays. The goal of this post is to demystify the process and create an essential resource for MD/PhD secondary application prep.

I will:

1. Explain the purpose and relative value of secondary applications
2. Provide you with high-yield essay questions for MD/PhD programs
3. Share best practices for writing a secondary application that earns MD/PhD interviews

For MD/PhD applicants, the secondary application can be a tour de force. Some programs have 2 essays, others have 10; the character count varies in a manner that limits essay recycling. You will need to do research on each program you apply for and write specifically about why you’re an excellent fit. You need to establish a systematic, organized way of doing this early to manage your time and write salient essays. Even if you’re not clear on what exactly you want to do in graduate school, you should paint a picture that conveys clarity. You can always change your mind later.

The secondary application is critical for determining who gets an interview invitation. You will find that many secondary essay prompts are completely redundant with the primary application. This is likely because referring to the secondary application is easier for deciding on interview invites than using AMCAS. It’s fine if you repeat answers from the primary application in the secondary essays. To create a coherent and consistent narrative, I think that you should use the same answers, though you should not rely solely on copy-paste to deliver it.

The format of MD/PhD secondary applications is variable. Some programs will provide you with an MD/PhD-specific secondary, others will add supplemental questions in addition to the prompts for MD admissions. The most common questions that you should be prepared to answer for MD/PhD secondary applications are:

1. What graduate program(s) are you interested in pursuing?
2. Which faculty members are you interested in meeting? (5–12 faculty)
3. Why do you want to come to program [xyz]?
4. Explain your most significant research experience
5. What are your research interests / PhD goals?
6. Describe your motivation to pursue MD/PhD
7. Character trait essay
8. Failure and problem-solving essay
9. Diversity, Equity, and Inclusion essay
10. List of publications, posters, and presentations
11. Honors and awards
12. If you have graduated from college, summarize what you have done since

1) What graduate program(s) are you interested in pursuing?

You will select or rank 2–4 graduate programs that best match your research interests. You usually do not need to provide rationale for these choices, but it should make sense in the context of your application. For example, even if you have never done computational work, if you want to do a PhD in computational biology, it should be clear from your application that you have made an effort to explore it. An example of the selection process is shown below:

In addition, you may be asked to provide keyword(s) or a ~20-word description of your interests in graduate study, and your response can look something like this:

Cancer, metastasis, organotropism, precision medicine, cancer stem cell, CRISPR/Cas9 technology, biomedical engineering

2) Which faculty members are you interested in meeting? (5–12 faculty)

For the selection of faculty members, you usually only need to list the names of the potential mentors you’d like to meet if given the chance to interview. If you are asked to elaborate, you can explain why you chose a particular faculty member in a sentence or two. Is there a project that fascinates you or a technique you want to apply in your research? Alternatively, some programs will ask you to provide this faculty list only after you have been offered an interview. It’s good practice to do this research early; the prevalence of faculty who are a good fit for your interests should be a reason you want to attend a program.

3) Why do you want to come to program [xyz]?

Take time to research your answers for this question. The students who put in effort to evaluate the program distinguish themselves from those who copy-paste and change the program name. It’s no secret that different programs have different strengths. If your goal is to pursue computational or medical anthropology research, you should investigate the departments that will support your research training. What institutional programs do they have and how will they support your career goals? Explore the collaborations between departments and search for new initiatives on campus. For example, my university recently built a Precision Medicine Institute and added an A-Eye wing to their renowned ophthalmic imaging center. Since my interests align with these initiatives, I would explain how the unique opportunities and innovative culture at the University of Wisconsin-Madison would provide me a first-rate education in my areas of interest.

4) Explain your most significant research experience

You have already explained your significant research in the primary application. Now it is time to go deeper and demonstrate that you can indeed talk the talk. You will be asked to either 1) talk about one project in depth or 2) discuss each of the projects you have been involved with. Provide a clear set up with a logical flow: introduction, rationale, results, publications or presentations. Explain how you were involved in each stage and what you learned along the way. You will likely have limited space, so use it wisely.

5) What are your research interests / PhD goals?

I think this is one of the most important questions, and it will be asked in various ways on each MD/PhD secondary. It’s important because it’s the first time you’ve been asked to explain in detail why you want a PhD. What do you aim to achieve in your career and why will having a PhD support you in reaching that goal? Inspire the reviewer and illustrate your drive to become a capable, productive scientist. Talk about a desire to dive deep into a project and embrace the challenging art of experimental design. Profess a passion for mentorship and aims to teach the next generation. How will you pave the way for underrepresented students in science and medicine?

6) Motivation to pursue MD/PhD

Chiefly, you should convince the admissions committee that your motivation will sustain you for the 8 year training period. You can draw from your Why MD/PhD essay to explain the reasons you find the combined MD/PhD training compelling. You might explain your goal of becoming an academic physician-scientist and how this path will provide you with personal and professional fulfillment throughout your career.

7) Character trait essays

What are the qualities of the best physicians and scientists you have worked with? Which aspects do you aim to emulate? In this essay, I want to see your individual character and value system through real examples. Reveal your kindness and empathy.

Here are 5 character trait essays for you to consider.

• Please describe your most meaningful leadership positions (300 words)
• Discuss a time you tried to right a perceived wrong, felt moved to speak up for someone, or took a stand against a situation you felt was unjust.
• What is the toughest feedback you ever received? How did you handle it and what did you learn from it? (200 words)
• Describe a time when you needed to ask for help. (200 words)
• Outside of medicine, and beyond what we can read in your application, please tell us what you’re curious about, or what you’re passionate about, or what brings you joy — and why. (250 words).
• The components of EI include self-awareness, self-regulation, motivation, empathy, and social skills. Briefly describe one example of a time you harnessed your EI to resolve a difficult situation, AND one example of a time your failure to use your EI compounded a difficult situation. What did you learn about yourself in each of these situations? (2050 char)

8) Failure and problem-solving essay

If you have read my other blog posts, you will know that having experience with confronting failure and solving problems is essential for successful MD/PhD admissions. The admissions committee wants to know that when the going gets tough, you have the coping skills, resiliency, and life experiences to persevere. Reveal your critical thinking and decision-making skills in moments when there was no clear solution.

Here are 5 examples of how the question might be framed:

• Describe a time or situation where you have been unsuccessful or failed. (3000 chars)
• Share with us a difficult or challenging situation you have encountered and how you dealt with it. In your response, identify both the coping skills you called upon to resolve the dilemma, and the support person(s) from whom you sought advice. (550 words)
• Tell us about a challenging problem you faced and how you resolved it. Include how the experience contributed to the person you are today. (250 words)
• Discuss a time in your life that demonstrated your resilience. (1550 chars)
• Please describe a significant personal challenge you have faced, one which you feel has helped to shape you as a person. Examples may include a moral or ethical dilemma, a situation of personal adversity, or a hurdle in your life that you worked hard to overcome. Please include how you got through the experience, how you handled the uncertainty or stress, and what you learned about yourself as a result. (3,500 char)

9) Diversity, Equity, and Inclusion essay

DEI is of critical importance for success in medical school and MD/PhD admissions. We don’t need doctors and scientists who only know a monoculture — this reflects neither your future patients nor the increasingly globalized world. At the heart of academia is a spirit of camaraderie and collaboration across departments, cultures, and perspectives. While you certainly can be a diverse white male, you better work damn hard to demonstrate how. This is a major key to the game you signed up to play.

No, speaking Spanish as a second language does not make you diverse. I’ve seen it tried; it’s a flop. Instead, you should talk about how you used your Spanish-speaking ability to gain diverse patient care experiences, to challenge your cultural perspectives, and to empathize with others outside your bubble. It’s one thing to have taken Spanish classes in high school or college, it’s an entirely other thing to have communicated with a Spanish-speaking patient in a stressful clinical situation. Show me that you’ve put yourself into a vulnerable position to serve another person.

Diversity, of course, comes in many forms, including intellectual diversity. What does intellectual diversity mean? For example, maybe your academic background is at the intersection of economics and biochemistry, you play an instrument, and you’ve lived abroad in a place where you didn’t speak the language. The key to demonstrate intellectual diversity is synthesis. What perspective(s) have you gained from your experiences that have provided you valuable insight? How will you contribute that insight to promote a polyculture in academic medicine and increase the value of your future MD/PhD cohort?

As a Moroccan American, I approached this question through the lens of my life experiences “living in the gray area”. Neither black nor white, I had a hard time figuring out where I fit in growing up. I was the kid who celebrated Ramadan and Christmas. I accepted the identity of biculturality, which I leveraged to connect with people across groups, especially with those who also didn’t fit in. This allowed me to understand the experience of being a minority, and this understanding is what allows me to promote inclusion and diversity throughout my life’s work. The admissions committee desires students who bring diverse experiences, and who are motivated to pay it forward to secure a more DEI future for the next generation of academic physician-scientists.

Here’s 5 example prompts for you to consider:

• Describe your identity and how it has impacted the development of your values and attitudes toward individuals different from yourself and how this will impact your interactions with future colleagues and patients.
• If you recognize and/or represent a voice that is missing, underrepresented, or undervalued in medicine, please describe the missing voice(s) and how increased representation in medicine could impact the medical community. (400 words).
• How does your background (past work, leadership, identity, etc) inform your understanding of systemic oppression and support our existing initiatives in justice, equity, diversity, and inclusion or inform new ones? (700 chars)
• The Committee on Admissions regards the diversity (broadly defined) of an entering class as an important factor in serving the educational mission of the school. You are strongly encouraged to share unique attributes of your personal identity, and/ or personally important or challenging factors in your background. Such discussions may include the quality of your early education, gender identity, sexual orientation, any physical challenges, or any other life or work experiences. (2000 chars)
• Describe an example where you contributed to the diversity of a group, team or class. Connect this to how you will contribute to the diversity of the XXX School community.

10) List of publications, posters, and presentations

11) Honors and Awards

These two questions are straightforward. You should develop an updated CV before the application process to make answering these easier. Have a clear format. Make tables if it helps with organization. Be succinct and write compelling descriptions. You might not have publications, which is fine, but you should ensure that you have posters and presentations. Even a 30 minute talk you gave once counts.

12) If you graduated from college, summarize what you have done since

This question is usually the first on the secondary application. I saved it for last because it will be the topic of my next blog post. The choice of taking gap year(s) is especially important for MD/PhD applicants. As MD/PhD admissions become more competitive, those students with life and research experiences beyond college often have a depth of maturity that is more attractive to admissions committees. From my personal experience, taking a gap year was one of the best decisions I’ve made.

Until next week.

If you find this information helpful and are applying for MD/PhD programs in the next year or two: I’m offering a free, 5-week MD/PhD prep course starting in January 2023 with limited availability. If you’re interested, reach out to info@jakekhoussine.com or visit https://madrasaadvising.com/ for details. Do it soon, I’m advertising everywhere.