```text Listen and Watch the "Life as a Patient-Doctor" Podcast
Episode on this Blog Post:
With the advent of COVID-19 and Step 1 becoming Pass/Fail, the ERAS system underwent several important changes to the online residency application.
One of the most notable changes was the inclusion of a section titled "Impactful Experiences," with a 750-character limit (including spaces!).
What Counts as an Impactful Experience?
Some examples include:
Family background (e.g., being the first generation in your family to graduate from college)
Financial background (e.g., growing up in a low-income household, working to support your family, or participating in a work-study program to pay for college)
Community setting (e.g., food insecurity, poverty, high crime rates, or limited access to medical care)
Educational experiences (e.g., limited educational opportunities or limited access to advisors and mentors)
Other significant life circumstances (e.g., the loss of a family member or serving as a caregiver while working or attending school)
I was also advised by residency advisors and program leadership that this may be an appropriate place to provide context for certain "red flags" in your application, such as failed exams, retakes, health problems, leaves of absence, or other significant circumstances that affected your medical education.
However, the goal should not simply be to explain what happened. You want to show what you learned, how you grew, and how the experience shaped the physician you are becoming.
How Do You Talk About Failures in a Residency Application?
Failure is difficult to discuss in a residency application, especially when medical training often makes us feel like we need to present ourselves as perfect.
But your application does not necessarily need to show perfection.
It needs to show growth.
Instead of focusing solely on the failure itself, consider discussing:
What happened
What you learned from the experience
What you changed afterward
How you demonstrated resilience
How the experience will make you a better resident and physician
Lessons Learned From Failure
One of the most important concepts is developing a growth mindset.
A growth mindset means learning from failure, using difficult emotions as fuel for compassion and motivation, and continuing to persevere in the face of challenges.
One way I have described my own experience is:
"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 and 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 adversity while learning from those experiences and continuing to grow.
Six important components of resilience include:
Confidence
Adaptability
Positivity
Perspective
Mastery
Stamina
Here is my journey breaking down my own "impactful life experiences."
Download my full 2023 ERAS application here.
My First Draft: 707 Words (4,173 Characters With 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 health insurance provided by my medical school, I had the opportunity to consult physicians and specialists who had previously been out of reach. During my second year, I received diagnoses and treatment for several health conditions I had unknowingly lived with and had previously accepted as a normal part of my life. While these concerns affected my academic progress, the most significant setback occurred during my struggle to pass Step 1, which ultimately led me to take a leave of absence.
Failing Step 1 opened my eyes to the possibility of receiving disability assistance, which allowed me to obtain the accommodations necessary to successfully pass the exam. This experience taught me a crucial lesson about seeking help and effectively communicating my needs to support my future success.
During my leave of absence, while studying diligently for Step 1, I faced financial insecurity that resulted in significant housing and food concerns. These adversities profoundly affected both my living situation and my academic environment. However, I refused to succumb to despair. I demonstrated resilience in the face of financial uncertainty by working three jobs and utilizing government assistance to support my family and myself.
Unfortunately, living in a lower-income area also meant that we lost internet access for several days, which coincided with an important summative exam. Determined to find a solution, I arranged to take the exam at a proctor's home.
Seeking a more stable living arrangement, we returned to Colorado and temporarily lived with my husband's parents and two siblings, one of whom has special needs. Because of the limited space, I did not have a dedicated room for virtual classes or studying. Depending on where family members were, I often studied either in the backyard or in the living room.
Eventually, we secured a new rental home back in Chicago. However, this residence presented its own challenges. The basement contained black mold, asbestos was discovered in the attic, the air conditioning and heating systems frequently malfunctioned, and we dealt with insects and rodents inside the home.
One unforgettable incident involved discovering two mice on top of a homemade pizza that had been left to cool. When we reported the issue to our landlord, we were met with dismissal. He insisted that occurrences like this were normal in Chicago and advised us simply not to leave food unattended.
During the coldest month of winter, our furnace broke. When the landlord refused to address the issue promptly, we endured freezing temperatures for nearly an entire week. Ultimately, we were forced to break the lease and relocate once again.
This marked my fourth move during medical school, further compounding the challenges I faced while trying to maintain my academic progress. Because of our financial difficulties, we were also forced to sell our car and many personal belongings, fundamentally changing my understanding of what possessions are truly necessary for a fulfilling life.
These struggles, compounded by the COVID-19 pandemic and the demands of my second year of medical school, created significant stress and disruption in both my daily life and academic pursuits.
Nevertheless, I found the strength to persevere, demonstrating resilience and adaptability in the face of adversity.
These experiences deepened my compassion for individuals enduring similar societal challenges. The fear of not knowing whether your landlord may evict you because you have fallen behind on rent is terrifying.
I also came to understand the temporary nature of many stressors. Even during moments that felt hopeless, I discovered the power of taking action — whether that meant seeking additional employment, asking my communities for assistance, or finding another way forward.
The perseverance I developed through a lifetime of overcoming obstacles prepared me to confront the financial, academic, and health challenges I faced during medical school.
Next Draft: 250 Words (1,622 Characters With Spaces)
My medical school years granted me access to invaluable medical, academic, and financial resources that I had never previously had access to. 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 Step 1 led me to seek disability assistance, teaching me the importance of asking for help and effectively communicating my needs. Financial insecurity during my leave of absence resulted in housing and food insecurity, but I worked multiple jobs and utilized government assistance to support my family while studying for Step 1. Despite losing internet access and living in an area with increasing crime, I found a way to complete an important exam at a proctor's home.
A temporary move back to Colorado with my husband's family presented additional challenges due to limited space for studying and living with an adult sibling with special needs.
When we later returned to Chicago, our new rental had black mold, asbestos, a malfunctioning air conditioner and furnace, and a rodent infestation. When these concerns were reported, the landlord offered no meaningful resolution. After enduring freezing temperatures without a functioning furnace, we were forced to break our lease and relocate again, making it my fourth move during medical school.
Financial difficulties also forced us to sell our car and personal belongings.
These struggles, combined with the pandemic and demands of medical school, created significant stress. Nevertheless, I persevered, developing greater compassion for those facing societal challenges and learning the importance of action, adaptability, and resilience in the face of adversity.
Updated Version: 117 Words (750 Characters With Spaces)
In 2020, after losing internet access and experiencing increasing crime, we moved across the country to live with my in-laws, which presented challenges due to limited space and living with a sibling with disabilities. My medical school's health insurance enabled me to receive previously inaccessible healthcare, diagnoses, and treatments for conditions I had unknowingly lived with. Financial insecurity during my leave of absence resulted in housing and food insecurity, but I managed multiple jobs and utilized government support. Struggling to pass Step 1 led me to receive academic accommodations I was previously unaware existed. Our rental later had black mold, asbestos, a malfunctioning furnace, and a rodent infestation. When the landlord offered no resolution, we were forced to break the lease.
Another Example of an Impactful Experience (739/750 Characters)
As the first in our families to enter the medical field, my husband and I were committed to becoming physicians beginning in our undergraduate years. Together, we relied on student loans and Pell Grants, maintained jobs throughout college and our gap years, and supported each other's journeys. These experiences gave me tremendous empathy for others who pursue education while relying on government-sponsored programs. During our M1 year, COVID led to a temporary return to our family's home, which presented additional challenges, including limited space for studying and taking exams while helping care for an adult sibling with special needs. By overcoming these challenges, I learned the value of perseverance and the importance of embracing resilience in the face of adversity.
Q: Was Your Medical Education or Training Extended or Interrupted?
During my M2 year, I was diagnosed with and began treatment for medical conditions I had unknowingly struggled with for most of my life. While these conditions are now well managed, at the time they resulted in my needing to retake course exams and ultimately necessitated a leave of absence (LOA) to address my health.
This LOA brought unforeseen challenges, including financial instability, housing insecurity, and food scarcity. Because of these circumstances, I needed to prepare to retake Step 1 while simultaneously working multiple part-time jobs to support my family.
Q: Is the Impactful Experiences Section the Best Place to Address Application "Red Flags"?
I think this depends on the specific circumstance and whether the experience genuinely meets the criteria for an impactful experience.
The goal should not be to force every application weakness into this section.
Instead, use the space when the experience provides important context about your journey, particularly when it demonstrates how socioeconomic circumstances, health challenges, caregiving responsibilities, educational barriers, or other significant life experiences affected your path through medical training.
When discussing a "red flag," focus less on defending yourself and more on helping the reader understand:
What happened
How you responded
What you learned
What changed afterward
How the experience contributed to your growth
Your goal is not to convince residency programs that the challenge never mattered.
Your goal is to demonstrate that you have insight into what happened, that you grew from the experience, and that you are prepared to move forward successfully in residency.
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 application "red flags" or residency application, sign up for my personalized coaching here.