I read an essay advocating the disclosure of personal trauma on medical school applications as a means of overcoming stigma and taboo often associated with rape and other forms of trauma. The authors lamented that a culture of silence persists in medicine despite movements such as #MeToo. They concluded: “We, as physicians, have a duty to reduce shame to promote recovery in both our patients and in ourselves.”
Not all readers were in agreement. One individual commented: “Let me just say some topics are meant to be on an essay for a medical school application and some are not. Just because someone doesn’t write about a painful or traumatic experience doesn’t mean that it’s a ‘culture of silence.’ Having healthy boundaries and sharing information with essentially strangers about a topic so personal may not be appropriate for everyone.”
A physician cynically remarked: “All I read was that we should no longer have a culture of silence regarding physical or emotional traumatic events. So, the applicant writes that they were sexually assaulted at some time in their lives. What will the admissions board do with that information? Have the applicant undergo psychologic testing and evaluation? Not accept the applicant? Come in for a personal interview to see whether they think the applicant is too psychologically traumatized to become a physician?”
I’ve advised many medical students about the content of their personal statements. I tell them there is a middle ground between disclosing sensitive personal information and withholding it, and it’s largely up to them to decide, depending on several factors.
1. Relevance. Personal experiences shared should have relevance to your journey towards medicine. This could include insights gained through volunteering, research, clinical experiences, or personal experiences with health care.
2. Professionalism. While sharing personal experiences, maintain a level of professionalism. Avoid sharing any information that could potentially be viewed negatively or controversially.
3. Balance. Strive to maintain a balance between personal anecdotes and your professional goals. The personal statement should not read like a diary entry, nor should it be a mere listing of accomplishments.
4. Boundaries. Certain personal topics such as political beliefs, religious beliefs, or highly personal experiences (unless they directly relate to your motivation for pursuing medicine) should be approached with caution.
5. Strengths, challenges, and growth. It’s important to discuss your strengths, how you’ve overcome challenges, and how you’ve grown from your experiences. These are personal aspects, but they’re also professional in nature.
Whether to specifically disclose traumatic events in personal statements is a delicate and personal decision. It depends largely on the individual’s comfort, the nature of the trauma, and how it relates to their journey to become a doctor. Here are a few points I ask students to consider:
1. Influence. If the trauma has directly influenced your decision to pursue medicine or has shaped your perspective on health care, it could be appropriate to discuss.
2. Resilience and growth. If you choose to disclose, focus on how you’ve overcome or are managing the trauma, what you’ve learned from the experience, and how it contributes to your resilience, empathy, or understanding of patients’ experiences.
3. Content. Personal information should not contain gratuitous violence or deliberately make the reader feel uncomfortable. Avoid graphic or overly emotional descriptions that knowingly would be upsetting to the reader.
4. Confidentiality. Be mindful of maintaining the confidentiality and respect of others who may be involved in your trauma story.
Personal statements on medical school applications should be personal enough to provide insight into the applicant’s character, motivations, experiences, and commitment to medicine. They are not a tool to elicit sympathy, and they should not delve too deeply into overly personal or sensitive topics that are not relevant to medical school or future medical practice. The primary goal of the personal statement is to illustrate a passion for medicine, highlight attributes, and convince admissions committees that being selected will be a valuable addition to their program.
Disclosing trauma should not be the central theme of the essay, but rather a part of the larger narrative describing a student’s journey to the doorstep of medicine. And of course, the disclosure of sensitive information does not need to be about trauma at all.
I mentored a college student. One of the greatest challenges he faced was whether he should disclose a past history of a drug-related felony, even though it was in the process of being legally expunged. To help him decide, I sought the opinion of several medical school deans. All agreed that past criminal offenses should be disclosed if applications specifically inquire about them, reasoning that it was the ethically responsible course of action and that the offense could still be discovered on the Internet regardless of its legal disposition.
The student incorporated his experiences related to his substance use disorder in his “secondary essays.” He described how recovery deepened his passion for helping others and how he planned to use his empathy to treat all patients with dignity and respect. The student was granted interviews at several medical schools, and he was accepted into the school of his first choice. He is planning on a career in psychiatry.
Students with trauma histories, like those who are forthcoming about prior criminal activities, may actually enhance their application to medical school if they can demonstrate in their essays that they have undergone a personal transformation that reflects positively on their personality, professionalism, and dedication to the field of medicine.
Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine and Medicine on Fire: A Narrative Travelogue.
