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Addressing Red Flags in Your ERAS Residency Application (Jan 2024)

Updated: Jan 15


Sad man waving red flag

Even though I’ve seen, throughout my career, a crucial piece of this advice work countless times, I have yet to hear of it shared anywhere else. This article covers when to discuss red flags in your residency application, how to talk about them, and the two BEST methods for doing so.

 

You’ll be utilizing either your ERAS personal statement or ERAS Experiences section.

 

Table of Contents:

 

 

Types of red flags to talk about elsewhere or not at all


Confused doctor

Not all red flags are created equal. Instances like short gaps in your education and even failed semesters are either not worth talking about or should only be touched on very briefly in the allotted space in ERAS. Let’s examine a few:

 

Short gaps -- Students take short gaps for all sorts of reasons. This used to be a bigger deal, but interruptions are very common especially now in the post-Covid world. ERAS has a field with a small character limit you should utilize to explain your short gap.

 

Failed semesters -- Again, the above-mentioned field in ERAS is a good place to talk about this. Better yet, study super-hard and get great STEP scores in order to make your previous difficulties a moot point. Soon we’ll talk about leveraging the ERAS Experiences section to your advantage in instances like this, but I’d recommend leaving failed semesters OUT of your personal statement. No need to generate undue attention.

 

Poor grades -- Many medical schools grade on the pass-fail scale, so don’t be concerned if your institution assigns scores and yours aren’t great. Did you pass? Awesome.

 

Non-US medical degrees -- Depending on the programs you’re applying to, this either puts you at a disadvantage or it doesn’t. Your education experience in a country other than the United States will come across in multiple facets of your application, so there’s no need to address it as a red flag. When you do talk about it in your personal statement or otherwise, refer to it as the positive, unique, diverse building block of your background that it ABSOLUTELY is.

 

Types of red flags to address in your ERAS Experiences or personal statement


Thinking doctor

Your ERAS Experiences section can be invaluable in setting you apart from other applicants. Similarly, every sentence in your personal statement is a precious opportunity to stand out.


Cool! So then which red flags are worth discussing in them?

 

Transfers between medical schools -- This is debatable. If you only transferred once for a not-so-serious reason, you should consider just mentioning it briefly in the appropriate ERAS field. Some students had to transfer multiple times for an array of reasons; if that’s you, programs will want a clear picture of what went on. Thus, I recommend a detailed explanation in either your personal statement or ERAS Experience section.

 

Multiple attempts at the STEPs -- If you failed a STEP attempt or two, know you aren’t alone. I’ve helped dozens upon dozens of students in your situation successfully match. You’ll want to address your poor STEP performance directly in either your personal statement or ERAS Experience section.

 

Legal trouble (DUIs, arrests, etc.) -- I’ve helped many students with these kinds of red flags successfully match as well. Again, being direct and up front is the only solution here.

 

Why you shouldn’t sneak red flags into the body of your ERAS personal statement


Sign pointing in directions of "Good Choice" and "Bad Choice"

Some advisors might recommend that you to try to incorporate red flags into the body of your personal statement. It can work if done correctly, but I recommend NOT doing this for two reasons:

 

1.       It’s very difficult to get right. Though I’ve seen this method work effectively in certain cases, why complicate things? To wedge in red flags seamlessly is no easy task because you don’t want to dwell on the topic, but you still have to write transitions around it. This makes for a choppy read. Not to mention it actually calls more attention to your red flag, which is the second reason...

 

2.       Granting your red flag a portion of the priceless space within your ERAS personal statement’s body takes the focus OFF the great things you offer to prospective residency programs. By doing this, you’re adding a negative (red flag) and subtracting a positive (whatever great thing you decide to leave out) simply by making room for that negative. The math just doesn’t add up.

 

What is the alternative? Read on.

 

How to discuss red flags in the ERAS Experiences section


Blocks saying "Lessons Learned"

ERAS changes every year, and the Experiences section is a newer addition. Within that section, the area marked “Impactful Experiences” is where you can address your red flag.

 

The Impactful Experience portion of that section is an opportunity to share something positive and memorable; it’s a chance to discuss circumstances that don’t fit anywhere else in your application. You can talk about your family or financial background, obstacles you’ve overcome, or go into depth about a job you’ve had or an accomplishment of which you are particularly proud.

 

Accordingly, utilizing the section to instead address your red flag is a decision not to be made lightly.

 

If the ERAS Experiences section makes the most sense to house your red flag discussion, follow these guidelines:

 

1.       Be succinct. There is a strict character limit, so every word counts.

 

2.       Do not come across as complaining or making excuses. The way to do this is to focus on what you’ve learned and your next steps and not get lost in listing all the reasons that led to your red flag.

 

3.       This is the structure I like to use: 1) State exactly what your red flag is, no frills or emotion attached. 2) Briefly reflect on what happened and how it felt at the time. 3) Talk about how you’ve grown from the experience, and what you’re doing differently today because of it.

 

EXAMPLE: I failed Step 1 on my first attempt. My father fell ill and required hospitalization in the weeks before my exam. Thankfully he recovered, but advocating for him drew my focus away from my studies, and I still chose to sit for the test despite knowing I was not quite ready. I was certain my dreams of becoming a physician were shattered. However, a few days later, I resolved to use the situation to better myself as a student, prospective doctor, and person. I took full responsibility, hired a tutor, and easily passed my next attempt. No, I would not change what happened even if I could go back in time. The lessons and study habits I learned will be invaluable to me throughout my career.

 

The supplemental paragraph, aka the priceless secret I SHARE with anyone who will listen


One woman whispering a secret in another's ear

The idea of throwing optimal word count out the window and utilizing a supplemental paragraph AFTER the ERAS personal statement’s conclusion began as an experiment:

 

It was toward the beginning of my career as personalstatementman when a student, desperate to finally match in his THIRD year of trying, asked if I could help him brainstorm ways to effectively explain his red flags. He was an IMG who had multiple STEP failures and education gaps. He had landed only two interviews in his first two years of attempting to match.

 

“I don’t have anything to lose,” he told me.

 

I came up with the supplemental paragraph. We would keep his personal statement relatively short (600 words or so), and then, independent from the document’s body, we would share a concise, honest, and positive account of his difficult history with medical school and the match process.

 

It looked something like this:


 

“A note about my academic challenges, gaps, and multiple match attempts:

 

I know I have significant red flags. Adjusting to medical school was hard for me, and later I had to find resourceful ways to make ends meet financially. Rather than analyze the factors that contributed to my struggles, I want to assure your team that I’ve embraced each tough moment as an opportunity to grow. I have not made the same mistake twice. I take nothing at all for granted. I continue to maintain a positive and grateful attitude. The fact that I have stayed the course on my journey is proof of my earnest passion for medicine. Thus, you can be confident in my commitment to integrity, collaboration, work ethic, and devoted patient care.

 

It would be my humble honor to openly discuss all of this and more in person in an interview.”

 

That student, rewarded for his courage and perseverance, got four interview requests and later matched into his top choice.

 

I still use that same formula to this day. It still works incredibly well.

 

Sure, some readers won't like if your personal statement goes well onto a second page. Most won’t care though, and a few might really respect a stand-up approach. They might even remember you and your supplemental paragraph when it comes time to choose interviewees.

 

In my medical residency personal statement writing guide, I state that there are no set-in-stone rules you are required to follow. The supplemental paragraph is evidence of this. As long as your writing is intelligent and thoughtful, most readers won’t care that there’s an extra paragraph.

 

Just as you would explain your red flag in the ERAS Experiences section:

 

1.       Be concise.

 

2.       Do not complain or make excuses.

 

3.       Use the following structure: 1) State your red flag. 2) Reflect on what happened. 3) Discuss how you’ve grown and what you’re doing differently as a result.

 

3 Takeaways


1.       Not all red flags are worth addressing in either your ERAS personal statement or ERAS Experiences section.

 

2.       Don’t try to jam your red flags into the body of your personal statement.

 

3.       When you do explain your red flags, be direct, succinct, and honest.


 

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