We read the article by Moulton et al and would like to commend them on their excellent study investigating the role of the personal statement in residency applications.1 We agree that the personal statement is an invaluable part of a holistic residency application that is able to convey a unique presentation of the candidate. We also agree with Moulton et al regarding their conclusions that personal statements should be well written, help the applicant stand out, and should demonstrate fit for the program. Similarly, we acknowledge the ubiquitous nature of isomorphism as it relates to the selection process as mentioned by the authors.
We would like to comment on an aspect of the personal statement not broached by Moulton et al. We believe that the personal statement could also be used as a place to explain any deficiencies or obstacles the candidate faced that are not otherwise described in the application. Examples of deficiencies that we recommend candidates discuss, if applicable, are below-average USMLE Step 1, 2 scores, gaps in training, remediation of a course, or legal issues. If an applicant had a family emergency or complicating event around the timing of their testing, it could help explain a poor score, and their personal statement could be used to help shed light onto it. Similarly, if a candidate had to take a year off training, the personal statement should be used to explain this gap. Lastly, if an applicant had prior legal action taken against them, the personal statement could be used as a way to explain the situation as well as their growth from the event. We recognize that these are only a few types of the deficiencies that could be presented to a program director in an application and encourage applicants to describe any significant deficiency in their personal statement to help convey their uniqueness. It is our belief that deficiencies should be discussed with a mentor prior to incorporation into the personal statement so that the applicant's desired message is conveyed in an authentic fashion.
Program directors may be turning to the personal statement to understand unusual journeys through training or how an applicant overcame challenges. While isomorphism aims to create a diverse group of residents in each class, we feel that the process can be bolstered by elaborating on application deficiencies using the personal statement. We believe this would add a more accurate representation of overcoming adversity.