Test day tips for the USMLE Step 1

Writing Technique Suggestions for the Residency Personal Statement

In our series on writing the personal statement for residency application, we thought it would be a good addition to have a section on writing technique. Below are some suggestions that have not yet showed up in the blog series, along with examples to help you with some of the recommendations.

1.  Open with something interesting that clearly connects to your interest in your specialty. Close with something similarly strong.

Example:   I fainted my first day on the pediatric burn unit and then again on the second and third day. The stifling heat on the unit was overwhelming, but needed to help the children whose temperature regulation was compromised. However, by the time I had finished my rotation and assisted several times on revision surgeries, I knew that my future lie in pediatric plastic surgery and a return to work with burn injuries.

Example:   I began medical school with Belonephobia, a fear of venipuncture. How embarrassing it was to bring up my breakfast in front of two hundred peers on my first day of medical school. My classmates and tenured professor carried me from the floor, drenched in sweat, where my parasympathetic system humiliated me beyond return. But I did return. Again… and again.  After overcoming that first mortification, I grew to love anatomy and physiology, my surgery clerkships, and now cannot wait to get to the operating room in the early morning hours. Surgery is my reverie and the OR my second home.

2.  Use formal language throughout. This is a formal writing assignment.

  • Do not use a poem or other unusual format. It will not be seen as unique and inspirational – it will be viewed as “odd”
  • Avoid using contractions, such as don’t, can’t, they’re, etc., or abbreviations unless in a quote
  • Use “children” instead of “kids” when writing about pediatrics
  • Avoid using slang
  • Avoid using abbreviations for institutions or procedures (even though you are trying to save space)
  • Avoid using casual language

This could be rewritten to use more formal language and still express his message and not lose his enthusiasm:

     In college and medical school I got to coach 11-14 year old kids’ soccer in my local community. It was neat to see how the kids got better over time. I led them to victory several times and they blew the top off of the GCSL championship two times in a row. I’d never been able to know I would enjoy hanging out and working with teens without this early experience.

3.  Do not forget to tie the end of the essay to the beginning if you begin with a theme or an example. Also, if you use an allegory to describe an interest in a specialty, then you need to be sure to use it throughout the essay or formally bring it to a conclusion so the reader is not left hanging.

This student did an excellent job of opening with a patient example and tied the same patient story into his ending.

Opening paragraph:

     Mr. D, the owner of several local clubs and a sardonic sense of humor, told me he was unable to remember the last time he went to the doctor; a kind of pride hiding in his voice as he said it. In between questions for his admission H&P on my first month of internal medicine, we bonded over being exiled by Hurricane Ike to San Antonio and the disruption to our lives it caused. He blamed the mold growing in his water-logged house for his new fatigue, pallor, and bleeding gums. However, his CBC and bone marrow biopsy filled with blastic cells suggested otherwise. Knowing his outlook was grim, I was nervous about taking on Mr. D as a patient. The patients I had encountered so far were fairly straightforward and were discharged within a few days, but I felt ready for the challenge.

 Closing paragraph:

          A little over a month later, I missed a noon conference on a call day to help admit a new patient. One of the interns from my first service later told me that the hematologists had presented Mr. D’s case. “It’s a shame you weren’t there,” he said, “He was your patient.” At that moment, the role and responsibilities of the internist became very clear to me. The next level of my professional growth was to take full responsibility for my patients and tend to all aspects of their care, answer questions, and to always respect the privilege of having their care entrusted to me. The pivotal role the internist plays in a patient’s life is one I will honor with my deepest dedication.

4.  Make sure your personal statement has 4-5 paragraphs. Shorter paragraphs make for easier reading and hold reader interest better. An essay consisting of only 2-3 paragraphs results in longer paragraphs where the reader has to wait for a break. Long paragraphs are more difficult to read and keep your reader’s interest. Don’t risk losing your reader’s interest when you can break your thoughts into two separate paragraphs that make for easier reading.

5.  Avoid overuse of the “I” and “my” as much as possible. It is the “team” effort that is important. Remember that saving the patient is a team effort. In different narratives, the focus should also be on the patient and less on you. You want to sound as compassionate as possible while still getting your message across. Focusing on the patient and how you tell your story about the patient, expresses your work ethic, your empathy, your skill level, etc.

 In this short section, there are 13 uses of “I and my” and two additional uses of “me.”

     Throughout my second year of medical school I  found organ system physiology to be very interesting.  I also enjoyed learning about the mechanisms of disease and the pharmacology used to treat those diseases. I began to think seriously about a career in Internal Medicine. In my third year of medical school I was lucky enough to have three very interesting months on my Internal Medicine rotation that solidified my interest in that field. I found that the patients I encountered during this period taught me a lot about the clinical, social, human and ethical aspects of medicine. On one month I worked along-side a Geriatrician who worked in 4-5 different nursing homes and assisted living centers as well as made home visits. This month taught me a great deal about chronic care as well as about the dying process in nursing homes. I found the work that I did that month to be very gratifying.

 This section can easily be rewritten minimizing the use of “I” and “my.” Now we have 1 “I” and 5 references to “me.”

       During the basic sciences, organ system physiology was fascinating. Learning about the mechanisms of disease and the pharmacology used to treat those diseases were equally enthralling. From this pattern of interests, it occurred to me that themes paralleling a career internal medicine were evolving and Ibegan to consider this field seriously. Three months of internal medicine clerkships, learning from and working beside faculty and residents, completely convinced methat this specialty was the perfect match for me. The patients during this rotation taught me unforgettable lessons about the social, human, clinical, and ethical aspects of medicine and how they inexorably operate together in wellness and illness. One month of the rotation was spent alongside a tireless Geriatrician working in five different settings, as well as making home visits. That very gratifying experience was invaluable in teaching me about chronic care and the dying process in a long term treatment facility.

 6.  A literate document will always be chosen over the interesting but poorly written essay:

  • Check spelling again and again and again
  • Avoid long sentences with complicated wording and punctuation
  • Write short, well-developed paragraphs. Avoid overly long, hard to follow paragraphs
  • Remove repetitive thoughts, words, and sentences
  • Use active vs. passive statements, i.e. “I feel” vs. “It is felt that”
    • Commas and periods always go inside quotation marks, as in, “At least that is what my grammar reference book says.”
    • Question marks go inside the quotation marks only when it applies to the quote (The patient asked, “Is that my appendix?”). The question mark goes outside the quotation mark when it applies to the entire sentence (Weren’t you the patient that asked, “Is that my appendix”?).
    • Avoid overuse of flat adjectives that are not adequate descriptors such as great, good, and very

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