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Writing Secondary Application Essays – Choosing Practice Setting

There are many secondary application questions that ask you in what setting do you plan to practice medicine in the future. They ask to choose between the following kinds of settings:

Academic Medicine
Non-Academic Clinical Practice (Group Practice, Solo Practice)
Health Policy/Administration
Primary Care
Public Health (Community Health, Global Health)

Some applicants know exactly what they want to do in the future (cardiothoracic surgery at an academic institution). But most of you are probably wondering, “I don’t know, I just want to get into medical school.” So how do you approach this question? Is there something the admissions committee is looking for?

You have to keep in mind that pretty much everyone who is reading your application is involved in academic medicine in some way. Most physicians who works for a university hospital are in academic medicine. Physicians on the admissions committees are almost guaranteed to be involved in academic medicine. Being interested in academic medicine suggests that you are interested in teaching and/or research, two crucial pieces of being an academic physician. So does this mean you should always say that you are interested in academic medicine? Not necessarily.

Academic medicine is not necessarily mutually exclusive with health policy, administration, primary care or even public health. All of these other practice settings can all be done in or out of the academic setting. For example, you can be a physician who works at the Center for Disease Control and Prevention meaning that you are in public health but not necessarily in academic medicine. All this to say, don’t be afraid to choose settings that are not academic medicine. Members of admissions committees understand that academic jobs are limited and we need physicians in various roles, even private practice. Therefore, the most important thing in these essays are not what you choose, it’s how you explain your decision.

As you going through your medical training, you’ll encounter this stigma that going into private practice is all about the money. You may have heard this stereotype even before going to medical school. This may deter you from choosing “Non-Academic Clinical Practice” in these essays. But like I mentioned, it’s not what you choose, it’s why you choose it. For example, if you’re from a small town or you’re interested in practicing medicine away from a major metropolitan area, you’re most likely going to be in private practice. There is a huge shortage of physicians in rural areas. If you mention that you are interested in private practice because you want to serve a underserved population, that is definitely acceptable and even commended in the eyes of admissions committees.

The worst thing you can do in these essays is choose a practice setting without having a reason why or the evidence to back it up. For example, you should not say that you plan to be in public health when you have done nothing public health related in college. You should not say you are very passionate about being academic medicine because you love mentoring if you have not mentored anyone or been mentored. It’s common sense that our previous experiences guide our future desires.

In conclusion, there is no true right or wrong answer to this question. However, there are certain rules you must follow. You must have reasons and evidence to back up why you want to practice a particular setting. Keep in mind that private practice can be looked upon negatively by academic physicians so if you do choose private practice, make sure you have legitimate reasons why. Don’t feel pressured to choose academic medicine because that’s what you think admissions committees want to see. Try to be as genuine as possible but just keep in mind that you can change your mind at any point during your training. Just because you choose academic medicine in this essay does not mean you can’t go into private practice in the future.

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Edward Chang

Edward Chang is the Co-founder and Director of Operations of ProspectiveDoctor.com. He graduated from the David Geffen School of Medicine at UCLA and is currently a urology resident at the University of Washington. He also attended UCLA as an undergraduate, graduating with a major in Molecular, Cell, and Developmental Biology. If you are interested in contributing to ProspectiveDoctor.com, please contact him at edwardchang@prospectivedoctor.com. Follow ProspectiveDoctor on Twitter, @ProspectiveDr.

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