Write Your Secondary Essays First​

Last Updated on April 19, 2023 by Laura Turner

Most advice to applicants focuses on the personal statement and description of work or activities required to complete the initial centralized application service (CAS) application. In contrast, I urge you to write your school-specific “secondary” essays first. These secondary essays play a crucial role in admissions. Most applicants underestimate the stress of completing dozens of strong essays under intense time pressure.

Why Are School-Specific Essays Important?​

Secondary essays are the primary opportunity for applicants to show their strong interest and fit with a specific program within their application. The school-specific application is basically a written interview where the applicant can highlight specific experiences and audition for an interview spot.

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Programs use secondary essay prompts to signal their most important values and concerns. Schools know that strong applicants will have done all the basics: 

  • Taken the prerequisite and recommended courses
  • Satisfactorily completed shadowing, clinical, and patient-facing experiences
  • Worked with communities in need
  • Developed test-taking skills for high-stakes exams

The essay prompts are generally drafted and approved by admissions committee members or professionals to reflect their interest in specific attributes or professional approaches contributing to student success at their program. These prompts reveal a lot about the program’s values – which applicants should consider when making school lists.

School-Specific Essays Can Be Part of the Primary Submission​

In recent years, Liaison International has become the preferred host platform for most health professions central application services, or CASes. For example, AACOMAS, PostBacCAS, AADSAS, OptomCAS, PharmCAS, AACPMAS, PsyCAS, VMCAS, PTCAS, CSDCAS, and CASPA all run on the Liaison platform. Because they use the same base platform, all have begun to share the same features and similar resources. One of the recent enhancements allows individual programs to ask school-specific questions to applicants as part of their primary CAS submission. Once an applicant designates a school in the CAS, a set of prompts specific to that program can become available for the applicant and are only sent to that designated program. Those essays must be completed before you can submit the application.

The opportunity to ask these questions in the primary application prevents the redundancy of sending all applicants a lengthy secondary application. It can shorten the time admissions officers have to spend processing applications for initial review. Further integrations may allow you to add school-specific application fees on top of the required CAS application fees so that your credit card is charged once instead of multiple times. As a result, while many students think they have time to fill out their “secondary” essays after submitting their primary application, they may be surprised when they are asked school-specific questions after they designate the schools they want to apply for.

AMCAS, however, still runs on a different platform. So allopathic medical school applicants will be sent their school-specific applications following the submission of the initial application. Unless otherwise stated by the admissions office, Student Doctor Network experts highly recommend that these secondary essays be completed within two weeks of receipt.

Pre-Writing Secondary Responses​

The good news is that savvy applicants can prepare by pre-writing secondary essays before they receive them from schools. By pre-writing your secondary essays, you can spend more time reflecting on how you fit the values of your targeted school and get insight into potential interview questions. Pre-writing gives you more time to perfect your pitch. It also means that when you get 12 or more secondaries in your email inbox on the same day, you’ll be ready to complete the necessary high-quality responses promptly. 

Looking at past prompts also allows you to identify schools that craft very provocative topics year after year. The admissions committees at these schools want more profound insights and thoughts from applicants. If you apply to these programs, set aside additional time and energy to reflect on your drafts. Writing essays for dozens of applications requires dedicated time and sustained effort. It is too easy to burn out and lose the quality of your writing.

In the Student Doctor Network forums, verified admissions Experts can give you advice and feedback on your general ideas in the Confidential Expert Advice forum and the profession-specific forums.

Common Areas of Focus for Secondaries​

Most programs seek insights that confirm and complement their holistic review processes and reaffirm your mature preparation for the challenges ahead when reviewing your responses. While situational judgment assessments and interviews are meant to gain insight into the attributes and competencies that suggest your success as a student, the school-specific essays provide insight into your fit and value as a learning community member. Most reviewers want to know how you have handled adversity and maintained your resiliency despite challenges to your health, ethical values, service orientation, or intrinsic motivation. Because most clinical experiences involve teamwork and exposure to different cultural backgrounds, reviewers want to know how well you adjust to unfamiliar environments or to mistakes you have made in your cultural competency development.

For many applicants, it is crucial to plan your answers carefully to these questions so they will complement your personal essay without repeating information. Pre-writing should be considered your opportunity to “show your cards.” Consider a few possible experiences and stories that could be shared in essays and interviews with admissions reviewers. Further refinement will be necessary to answer the specific questions the committees ask.

By writing on these topics, you should be able to identify convincing themes or experiences that point to your motivation to pursue a health professional career and elaborate further in a personal statement essay. While repeating a story from a personal statement to a school-specific essay is not explicitly verboten, many admissions committees appreciate the variety of experiences and depth of insight gained from additional experiences and self-reflection.

Here are examples of commonly seen topics in secondary essays:

Diversity Essay​

How will your unique background and perspective contribute to the diversity of our learning community?

How do your meaningful personal or professional activities affirm your own identity and the diversity of your peers and colleagues you are with?

The “diversity essay” asks applicants to reflect on the identities they associate with that govern their social status or behavior, especially with those who don’t share their background or status. Students often think of “diversity” only in terms of sexual orientation, race/ethnicity, or socioeconomic status. However, you should also consider the many possible dimensions of diversity described in the AAMC Experience-Attributes-Metrics model. Everyone should be able to connect these facets of diversity with their own personality and opportunities to excel or collaborate as an applicant.

Articulating effectively how you can contribute to a diverse, inclusive culture helps show how you can effectively relate to or connect with others with different experiences as a healthcare provider. More importantly, you can demonstrate your accountability to diversity and inclusiveness in your interactions with other students or community members in your service experiences. 

If you have any difficulties expressing your thoughts about working in diverse environments, the AAMC recently published Diversity, Equity, and Inclusion Competencies Across the Learning Continuum, which should help you assess your own competencies and expectations for your future training.

Challenge Essay​

Recount a time when you faced a challenge, setback, or failure. How did it affect you, and what did you learn from the experience? (Indiana University School of Dentistry)

The “challenge essay” focuses on applicants’ problem-solving approaches, including post hoc analysis and reflection. Approaching a challenge can require intense planning and goal-setting, feedback to measure progress, management of team expectations, and flexibility to consider other solutions. Applicants generally describe challenges they have successfully faced and met, so many admissions committees ask applicants to reflect on “failures,” “disappointments,” or “regrets” they have had to accept and why. Variations may ask about one’s reaction to being underappreciated or situations where you are not acknowledged for your efforts.

Adversity Essay​

Describe any situations in your life that you have had to overcome and that you feel may have affected your ability to achieve your academic/career goals. Disadvantaged circumstances are evaluated as one or a combination of economic, educational, and/or cultural-environmental factors. (Colorado State University College of Veterinary Medicine, adapted)

In contrast to the “challenge essay,” “adversity essays” focus on the specific barriers that applicants have faced when approaching a challenge that increased the odds of failure. Applicants should be able to identify those oppositional forces they have had to work against, including chronic, structural barriers due to societal inequities. Can you name the headwinds that prevented you from reaching your dreams or maximizing your potential? Can you help others persist despite these headwinds? Be aware that these essays are not meant to be an opportunity to confess or excuse one’s mistakes in judgment, such as being caught for academic infractions. Make sure multiple trusted advisors give you feedback.

Advocacy Essay​

Describe how you have demonstrated a commitment to diversity and inclusion in the past, and how you hope to grow that commitment in medical school. (University of Pittsburgh School of Medicine)

With the lessons learned from the pandemic about structural inequities, social justice, and social determinants of health, more programs want candidates to describe examples where they have taken a stance on behalf of someone else. This topic is becoming more frequent and signals a significant sea change. Historically, the usual expectation was that prehealth and professional students should avoid controversial positions or “rocking the boat” as those actions might risk one’s future unnecessarily. These essays gauge the applicant’s understanding, empathy, and actions taken to address circumstances that adversely affect others from different backgrounds. The Diversity, Equity, and Inclusion Competencies can help applicants with self-assessment language to characterize their competency level, but a deeper dive may require more exposure and self-reflection.

The Health Professional Student Association launched the Becoming a Student Doctor course to provide HPSA members and donors with a curated resource to develop a voice and competency insight as future advocates and champions for marginalized communities. Competitive applicants and students can also build their advocacy toolkit by reviewing the resources in the freely available interprofessional mini-course on Treating Transgender Patients featuring over nine hours of audiovisual insights from transgender patients and health professionals.

Institutional Action Disclosure Essay​

Please explain any academic discrepancies or extenuating circumstances that you feel the Admissions Committee should know. (University of Texas Southwestern)

Address in your secondary essay any of the following items when applicable:

  • I have received a warning notice for a non-academic issue that did NOT result in disciplinary action.
  • I have been subject to disciplinary action and/or administrative action, expunged or not, while an undergraduate or graduate student.
  • I currently have disciplinary charges pending.
  • I have been prohibited or suspended from practicing in a professional capacity because of alleged misconduct.

(Albert Einstein School of Medicine, adapted)

Is there anything in your social media presence (past, or present) that would bring discredit or dishonor on you, the institution, the program, or profession (if applicable) or that could be considered derogatory, hateful, or threatening? (New York Medical College)

One of the most important essays for many applicants is the disclosure statement on any academic or legal infractions. Following state laws and regulations, each program may have different requirements to disclose reportable offenses, deferred decisions, or expunged convictions. While you must disclose all details when necessary and prompted, you must be proactive in designing a response that conforms to their legal requirements. To adequately express contrition and humility, applicants should work closely with their student affairs administrators from their undergraduate or postbaccalaureate programs to review how their academic infractions will be reported if requested.

Understanding Competency Essay​

Do you think all physicians should be leaders? What characteristics are necessary for successful leadership? (Wayne State University School of Medicine)

What creative/innovative ways have you found to continue to build upon the competencies for entering medical students [during the pandemic]? (Rosalind Franklin University Chicago Medical School)

Describe a competency you feel you best developed on your path to a healthcare career. See examples at Real Stories Demonstrating Core Competencies .

While all health professional programs emphasize the importance of competency-based education, this question tests your understanding in seeing and explaining your abilities to self-assess your growth in these areas. While arguably, programs prefer you have reached mastery of all competencies, you should be able to show mastery of introspection in these essays. Use the self-assessment guide to draft your responses. 

Why Us Essay​

Why did you decide to apply to this program? (Various)

What are your specific interests and experiences related to our program? What opportunities would you take advantage of as a student here? Why? (George Washington University, adapted)

Applicants should be able to craft answers to their unique fit and interest in each program where they apply. The “why our program” essay probes your understanding of a particular school’s unique mission, clinical experiences, and curriculum. It also allows you to highlight specific experiences and values that align with the program. If specific institutes, clinics, or volunteering opportunities strongly appeal to you, present the experiences you had that would be of value to your participation in the program.

Vision and Lifelong Learning​

Where do you see yourself in 10 years? Where do you want to serve and practice? (Marshall University School of Medicine)

Re-applicants: Since your last application, what steps have you taken to strengthen your candidacy? Please note any relevant academic, employment, clinical and personal experience. (University of South Dakota Sanford School of Medicine)

Admissions committees also want to see how realistically applicants self-assess their chances. Applicants are asked about any ongoing plans during the application cycle to prepare for starting professional school the following summer. Many schools also ask those applicants who took gap years to discuss what they did that helped them. Some schools may ask reapplicants to highlight specific improvements to their profile since their previous unsuccessful application. In contrast, others may ask applicants about their self-perception of their chances for acceptance. In most of these situations, admissions committees want to see how students have critically evaluated their own progress toward a successful application as a proxy for the rigorous culture of self-assessment they will have to handle once they become professional students.

Typical areas of self-improvement include changing residency status due to a move (and having to apply to a new set of schools), health concerns, additional immersion in community service or clinical experience, participating in cutting-edge research, or enrolling in a more rigorous academic program. One can mention changes in one’s study environment, resources, or circumstances when paired with a significantly improved result on high-stakes exams.

Finding Secondary Prompts on the SDN School-Specific Forums​

Previous secondary essay prompts are often shared on the school-specific forums and can be used, like practice interview questions, to prepare for the application cycle fully. Schools know that many applicants can lose their enthusiasm for a school if the secondary essay prompts are confusing or deflating, so admissions committees spend a lot of time developing prompts. Take the time to review their prompts from past cycles to get an idea of what their ideal candidate should be able to address confidently. Consider dropping that program from your list if you feel uncomfortable with a question prompt.

You can find the secondary prompts for each school in either the school-specific threads forums or the appropriate pre-health forum, detailed below:

Re-Writing Tips for Reapplicants​

Going through this exercise also can help reapplicants create alternate responses to personal statements and school-specific questions. While one cannot always have the option of re-writing some essays (such as the Institutional Action Disclosure Essay), being able to consider new experiences that address the general concerns of the other school-specific prompts is an opportunity to show improvement and growth from an initial application. Most schools are unlikely to compare responses from previous cycles. However, it is still recommended that new essays are written for reapplications whenever possible.

Common Mistakes​

Many applicants and reapplicants make a big mistake by talking about their own troubles or issues with their application preparation as answers to the general essay prompts. It is considered bad form to discuss how one’s final exam score was much lower than the practice exams as a “disappointment” or how being sick or grieving from a family death resulted in accidental plagiarism. These types of answers highlight the applicant’s incompetence in being fully prepared or their inability to properly navigate academic culture. 

Characteristics of Strong Essays​

It is imperative that any secondary essay directly answers the stated prompt within the stated character or word count. While stories help applicants set themselves apart, it is impractical to include them if the required length is rather short. Smaller essays require more direct answers, while longer essays provide more room for stories and reflective insights. This may mean writing a new essay to address the prompt or the constraints. Your pre-writing serves as a brainstorming activity, but you must provide a polished response to each nuanced prompt.

You should also consider your entire set of school-specific essays as a portfolio of your thoughts, attributes, and potential for your program of interest. Aim for as little overlap as possible with your initial application essays or each other. All essays should be reviewed by trusted readers who know you and your strengths as a future healthcare provider. You should search for your mistakes in spelling and grammar by reading your final drafts out loud before submitting them. You should also take advantage of the volunteers who have themselves gotten into the schools on your list. Many of them can be found on the Student Doctor Network forums.

Additional benefits for interview preparation​

While pre-writing takes a lot of effort, strategically planning your answers regarding these attributes and other valued competencies will also help you with any additional assessments you may encounter. Many programs are employing asynchronous online assessments (such as the Kira Talent platform) to identify other “diamonds in the rough” that can contribute to the diversity of the program’s learning environment. Getting comfortable with self-reflection can also help you prepare for the Acuity Insights assessments (Casper, Duet, Snapshot) or the AAMC PREview assessment. Finally, knowing what you feel comfortable writing or speaking for a recorded assessment will prepare you for any surprise questions you may encounter during your application and interview process. 


Ultimately, your success relies on the holistic impression your application essays, experiences, metrics, and interviews convey to assessors and admissions committee members. Hence, it is essential to look at all of the work the programs ask you to do before you begin your application journey. Ensure you are using every resource to your advantage, including your valuable time. Get your secondary essays pre-written to reduce stress and prepare for the application process.