Medical School Secondaries: Cautionary Tips on Trick Questions

medical school secondaries cautionary tips on trick questions

By Elizabeth LaScala, MD, PhD

Always read secondary prompts carefully. Whether they mean to or not, some medical schools provide secondaries that really can be answered incorrectly, no matter how well you write. Here are four types of questions to look out for and some tips for what to do when you encounter them.

The hidden “why us” question

Applicants who are prewriting their secondaries will know that schools often ask questions related to diversity, challenges faced, or research. Secondaries that arrive that fit those topics can be written easily by tailoring a prewritten essay to fit the prompt at hand.

But pay attention: sometimes the school is actually asking a “why us” question in the context of diversity, a challenge or research. Take this question as an example:

“Please share any lived experiences or challenges you have overcome that have influenced your pursuit of osteopathic medicine at Des Moines University. These experiences could be shaped through education, family, financial background, or your larger community setting. How will these experiences impact how you approach patient care in the future?”

This could be (mis)treated as a generic “challenge” or “diversity” essay. However, they very specifically ask how this challenge or experience has influenced your pursuit of osteopathic medicine at Des Moines University. So, this essay should really be treated as half challenge essay and half “why us” essay, with a substantial portion of the word or character count then dedicated to describing the applicant’s interest in the school.

Tip: Does the question name the school? If so, they are almost certainly asking about your interest in them specifically, using the challenge they ask for to support the match.

Inappropriate COVID responses

The height of the COVID pandemic was a tough time for everyone. What better way to understand a candidate’s ability to cope with trying times than to ask them about it? Before you answer though, make sure you understand the tone they are asking you to take. Do they ask about a silver lining, or do they ask about what hardships you overcame? Do they ask about how you served your community or how COVID impacted (positively or negatively) your path to medicine? Be sure to read their question carefully and answer exactly what they ask instead of providing a general synopsis of your experience (unless that’s what they ask for).

Tip: COVID questions tend to be optional. I usually advise students to answer all questions that are available – however, if your COVID experience doesn’t match what they are asking, you risk providing an inappropriate response. For example, if they specifically ask about the burden and hardship of COVID and you actually suffered little hardship, saying so in your essay will come across as disrespectful and lacking in empathy to those who fared far worse.

Only answer “if applicable” if applicable

Do not answer optional questions if they truly do not apply to you. For example, some schools ask for explanations of poor grades – if applicable. Now is not the time to dramatize how you overcame the difficulties of organic chemistry using teamwork and peer tutors if you got a B in the course instead of your otherwise unadulterated record of A’s.

Tip: Another “if applicable” question asks if there is an academic or experience gap that you would like to account for. Some applicants answer these, thinking it is a “challenge” or “adversity” essay. But if you have not been impacted academically or otherwise by your challenges or adversities, these more extremely worded optional questions are not for you.

Are they asking for “a” challenge or “THE” challenge?

A common topic for secondaries is overcoming challenges. Some of these prompts are worded in a way that shows they want to get to know your problem-solving skills. In this case, any type of recent challenge could be suitable, from climbing a mountain to troubleshooting an issue within your research. Other questions very clearly ask about the greatest challenge you’ve overcome. These require you to reveal something much more personal and ask you to reflect on how this experience has shaped your character. Do not mistake one kind of question for the other. If you state that your “greatest” challenge was that one time you had an uncomfortable but necessary conversation about time management with a lax colleague, I imagine you may land in the reject pile.

Tip: Some of life’s biggest challenges are too hard to write about. If this is the case for you, pick something else. Any deeper challenge would be more appropriate for this kind of question than something peripheral or fleeting.

Be sure your “failure” isn’t actually a triumph

Some questions ask about a time the applicant experienced a serious setback or failure. Applicants, knowing that they are supposed to show their best selves, occasionally treat this as a chance to show off a time where they triumphed, beating the odds and overcoming a setback that could have led to an adverse outcome or failure. This is not the right approach. Candidates should name a time they actually failed and explain how they dealt with the emotional and/or tangible ramifications of failure. There can be an emotional triumph of sorts, if overcoming failure led to personal growth and a determination to do better next time. But it would be incorrect to answer this question in a way that shows you avoiding failure.

Tip: I’ve seen applicants struggle to identify times when they have failed that are not academic in nature. Here are other types of failure to consider: failure to communicate clearly or be fully honest with yourself or others, failure to advocate for yourself or someone else when a situation was unfair, or failure to support a friend or colleague during a time of need. You can also reflect on your biggest regret. Regrets can sometimes stem from failure.


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