internal medicine personal statement pdf

How to Write a Standout Internal Medicine Personal Statement

Learn how to write a standout internal medicine personal statement that will allow you to be a standout applicant to adcoms.

Posted January 10, 2024

Table of Contents

If you're applying for an internal medicine residency program, writing a standout personal statement is one of the most important things you can do to increase your chances of getting accepted. In this article, we'll guide you through the process of crafting a compelling personal statement that showcases your unique qualities as an applicant, highlights your academic and clinical achievements, and demonstrates your commitment to the field of internal medicine.

Why a Strong Personal Statement is Important for Internal Medicine Residency

The personal statement is your chance to introduce yourself to the residency program directors and show them why you're the best fit for their program. It's your opportunity to explain why you chose internal medicine as your field of study and what makes you stand out from other applicants. A well-written personal statement can help you overcome any shortcomings in your application and persuade the program directors to invite you for an interview.

Additionally, a strong personal statement can also demonstrate your passion for internal medicine and your commitment to the field. It can showcase your unique experiences and skills that make you a valuable asset to the residency program. Furthermore, a well-crafted personal statement can help you stand out from the thousands of other applicants and increase your chances of being accepted into your desired program. Therefore, taking the time to write a compelling personal statement is crucial for anyone pursuing a career in internal medicine.

Step 1: Start Early and Plan Strategically

Effective personal statement writing is a process that requires careful planning and ample time. Begin early to allow for brainstorming, drafting, revising, and proofreading. Here's a strategic plan to guide your timeline:

• Months 6-12 before application: Start brainstorming ideas, reflecting on your experiences, and researching programs.
• Months 4-6 before application: Develop an outline, write a first draft, and seek feedback from mentors, advisors, or peers.
• Months 2-4 before application: Revise and refine your draft, paying close attention to clarity, structure, and grammar.
• Month 1 before application: Finalize and proofread your personal statement, making sure it adheres to word limits and formatting guidelines.

Step 2: Find Your Unique Narrative

Your personal statement should tell a unique and engaging story about your journey into internal medicine. Avoid clichés and generic statements. Consider the following strategies to help you find your unique narrative:

• Reflect on pivotal moments: Think about experiences, patients, or encounters that influenced your decision to pursue internal medicine. Share these stories to showcase your genuine passion.
• Highlight your growth: Discuss how you evolved personally and professionally throughout your medical journey, demonstrating your commitment to continuous improvement.
• Incorporate your values: Explain the values and principles that drive your desire to become an internal medicine specialist. Showcase your dedication to patient care and evidence-based practice.

Step 3: Structure and Content

A well-structured personal statement is easier to read and conveys your message effectively. Consider the following structure and content guidelines:

• Introduction: Begin with a captivating hook that grabs the reader's attention. Briefly introduce yourself and your interest in internal medicine.
• Body paragraphs: Organize your experiences and narrative into coherent paragraphs. Each paragraph should focus on a specific aspect of your journey or qualities that make you an excellent candidate.
• Demonstrated qualities: Showcase qualities like empathy, teamwork, resilience, and adaptability through specific examples from your experiences.
• Program fit: Explain why you are interested in the specific internal medicine program and how it aligns with your career goals.
• Conclusion: Summarize your key points, reiterate your passion for internal medicine, and leave a memorable impression.

Step 4: Proofread and Edit

After drafting your personal statement, proofreading and editing are crucial. Errors in grammar, punctuation, or spelling can detract from your message. Here's a checklist for effective proofreading:

• Grammar and syntax: Ensure correct grammar, sentence structure, and punctuation.
• Clarity and conciseness: Eliminate unnecessary words and phrases to make your writing more concise and focused.
• Consistency: Check that your writing style, tone, and formatting are consistent throughout the statement.
• Avoid clichés: Remove clichés and overused phrases to make your statement more original.
• Seek feedback: Work with a Leland Coach to review your statement for feedback and suggestions. Here are some coaches we highly recommend:

Writing a standout personal statement for internal medicine residency requires careful planning, thoughtful reflection, and a lot of hard work. By following the tips and advice in this article, you can craft a compelling personal statement that showcases your unique qualities as an applicant and increases your chances of getting accepted to your dream residency program.

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• How to Craft the Perfect Medical School Interview "Thank You" Letter
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• Residency Application

Internal Medicine Residency Personal Statement Examples

As you get ready to apply for residency, it’s a good idea to look at internal medicine residency personal statement examples. One of the most crucial parts of your application will be your residency personal statement, whether you are navigating ERAS  in the US or CaRMS in Canada. Directors of residency programs are interested in learning about your personality, your potential as a resident physician, and the reasons behind your specialty decision. They’ll be looking to understand this from your personal statement.

With a fill-rate of less than 45%, internal medicine was the least competitive among the most competitive & least competitive residencies in a recent survey. The higher the fill-rate, the more competitive the residency program. However, this is not a reason to skimp on any aspect of your residency application. In this article, we provide three great examples of internal medicine residency personal statements to help you write your own and earn that coveted spot in the program of your choice.

>> Want us to help you get accepted? Schedule a free strategy call here . <<

Article Contents 11 min read

Residency personal statements.

Your CV is an impressive, legible, and flawless presentation of your achievements. Now it’s time for your personal statement. In one page, or about 500–800 words, you are setting out to explain to residency program directors why they should choose you, as well as all the events that led you to this particular decision and specialty. No pressure!

The purpose of a residency personal statement is to show the reader who you are. Unlike your medical school personal statement , this essay is not intended to convince someone to admit you. Instead, you are seeking the right Match. Consequently, your residency personal statement should highlight your accomplishments and potential contributions in a way that represents the truest reflection of you as a person and as a physician. The defining quality of a residency personal statement is authenticity. You want to find yourself in a residency program where you will thrive and be able to make a significant contribution.

Watch out for red flags in your residency application!

The following examples take different approaches to the personal statement, but they all include some essential components. They:

• Tell the applicant’s story
• Provide examples of significant moments and experiences
• Illustrate the applicant’s character
• Describe the applicant’s motivation for pursuing medicine
• Contextualize the applicant’s interest in a specialty
• List various skills and qualities the applicant will bring to the residency program

This personal statement presents the story of an international student applying to residency in the United States.

While studying medicine at the National University of Colombia, Bogotá, I experienced various life-changing events, many of which were associated with my role as a team leader for the response to aerial bombings of armed groups by the government. Along with other students, I travelled with paramedics and triaged the wounded in the ED at various hospitals. I came into contact with numerous communities. It was not uncommon to see some of these people again when they returned to our clinics for follow-up treatment or brought their family members in for the diagnosis of chronic illnesses.

Through this experience, I realized that medicine is a virtuous circle. Even in the most devastating circumstances, the connection with a doctor made by one person is often shared with others. Although I gained valuable expertise in emergency medicine, my interest in pathophysiological processes grew. I found it fascinating to be able to correlate clinical findings to reach an accurate differential diagnosis, a vital skill for an internist.

I also realized how important it is to communicate effectively with patients from different backgrounds. My exposure to various cultures and social strata has equipped me with the knowledge to appropriately treat individuals without causing offence. In Columbia, Catholicism is deeply culturally pervasive, for example, and knowing how to navigate patient expectations and limitations has a major influence on their medical decisions.

On our medical ward, there was a patient who had cutaneous leishmaniasis and was treated with parenteral and oral medications as well as local therapies before being discharged. She was a young, local girl of 19 who had been engaged to be married but felt stigmatized by the disease. With her permission, I reached out to both sides of her family and enrolled her in a directly observed treatment program. Seeing her recover successfully and renew her engagement in her subsequent marriage was both personally and professionally rewarding.

This encounter was one of many that confirmed my commitment to internal medicine. Although the ED gives a physician the sense of being immediately helpful in a crisis, I came to appreciate the value of building strong physician–patient connections. In time, I realized how wonderfully fulfilling it is to have such a significant impact on patients’ lives. I am certain my ability to effectively communicate with people from different cultural backgrounds is a strength that will help me become a capable and caring internist.

Recently, I completed a clinical elective at Kaiser Permanente in Pasadena, California, with the objective of acquiring useful US clinical experience. I am currently a clinical observer in the laboratory service. This practical training taught me so much about the American health care system. I’ve learned about patient management through case discussions, hospital rounds, and conferences. I’ve also become familiar with the duties of an intern. Given the courses I selected in medical school and hands-on experience with urgent care in Columbia, I see myself leaning toward infectious diseases as a specialty. This conviction was reinforced during the global health crisis when it became clear that we need more physicians with expertise and experience in this area. As an internist, I will have the exceptional opportunity to provide my patients with comprehensive analysis, appropriate treatment, and advocacy.

This personal statement presents the story of an American student applying to residency in the United States.

My achievements in life are a result of my enthusiastic embrace of challenges that pushed me to learn and grow while also cultivating deep connections. One such connection was with my volleyball coach, Dr. Sandy Mason, at Logan University. She selected me as captain during the last regular season of my senior year, even though I had ended the previous season with an injury. She told me it was because I had never lapsed in my commitment to the team, attending every game and cheering on my teammates, even when I was in pain. The year I was captain we emerged from the regular season undefeated.

The pride I felt at that last game was more important to me than winning the playoffs. Not only was I satisfied with my own recovery and skills, but I was also proud of what our team was able to achieve through our combined efforts. Not all leadership requires teamwork, but in sports and medicine, it does. By making me captain while I was still undergoing therapy, my coach supported me both mentally and physically; I truly believe that this is what enabled me to turn around and direct that same good energy to my teammates.

Another interesting connection in my life is the one I made between my injury and my eventual career plans. Observing the doctors while they tried to assess the complex damage I had sustained to my ankle inspired appreciation but also intrigue. After my sessions, I often found myself limping into libraries or scrolling online to follow up on what they had said.

My current obsession is rheumatology, though my condition resulted from injury, not illness; the next connection I made was with fellow patients in the clinic and hospital. At some point, I was told that I would regain full mobility with proper therapy, but for certain patients, the prognosis was less positive. The idea that they were experiencing as much pain as I had, but over the long term, affected me deeply. As a result, in my last two years of medical school, I’ve sought opportunities to collaborate in research on comorbidity and multimorbidity of chronic diseases, such as arthritis and diabetes.

I am also employed as the lead grant writer for our faculty. I did not actively seek this position but was recommended to it by two of my professors. This show of support underscored how leaders can set a good example by recognizing, investing in, and lifting up juniors. Grant writing is also about teamwork – another connection – which I realized after reaching out to over twenty medical students and investigators just to prepare the first proposal. In this environment, I learned to create a strong application, carry out protocols, analyze data, conduct literature reviews, and draft studies. I would apply these skills in a residency program to support research and enhance outcomes for patients with complex pathology.

I am especially interested in research in therapeutic settings. For instance, during my rotations at St. Luke’s Hospital, I met many patients with arthritis, including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, fibromyalgia, and gout. Under the supervision of Dr. Xiu, our team surveyed these patients to compare the effects of current therapies on different types of arthritis and devise better treatments. Even at this early date, our research has led to improved results for a subset of patients who previously felt they didn’t have any other options. Applying what I learn is one of the most satisfying aspects of medicine for me, especially when it improves patients’ quality of life. I would be interested in continuing this work as a longitudinal study and potentially weaving it into my residency.

Going forward, I hope to learn existing approaches and techniques that represent best practices, but I am also keen to innovate and expand the scope of my specialty. I aim to have a lasting impact, first, by relieving pain and benefitting others as a caring, patient-centered physician, and then by devoting my energy to research, clinical excellence, and service.

Most importantly, I am seeking a residency that shares my vision of teamwork, as exemplified by my coach, Dr. Mason, my volleyball team, and my current faculty: first and foremost, everyone on the team is dedicated to achieving the same objective; everyone understands and values the contributions of each team member; everyone puts in a lot of effort; everyone encourages the personal growth of the other team members. If given the opportunity to join such a team, I will jump at the chance – and I will be able to do so, thanks to the doctors who helped me jump again.

This personal statement presents the story of a young immigrant to Canada applying to residency in Canada.

Not long ago, I returned to Syria, my birthplace, for the first time in eight years. I had left the country before the Arab Spring protests to participate in an international high school exchange program in science. Although I became more Canadian as time went on, I never stopped thinking about the rest of my family back home. I had expected to be gone for one year, but after my uncle was killed in the civil war, everyone urged me to stay in Canada. Ultimately, I was able to apply, with the help of my family, for Canadian Permanent Resident Status.

I pursued advanced science, biology, and physics options in high school, but during a career fair, I attended a presentation by Doctors Without Borders about their intervention in Syria. Two doctors who had recently returned from their tour spoke of their experiences, and the multimedia aspect, including photos and video, made me feel both homesick and terrified. The years of violence had severely damaged Syria’s infrastructure. The country’s once-relatively effective health care system was devastated. Numerous medical institutions had been destroyed, personnel had been killed or fled, and there were severe supply shortages. I understood then that what I had gained from my good fortune I would give back by returning to my country and meeting a part of the urgent need there, once I had the proper education and training.

After an undergrad and pre-med at Ontario Tech, I was accepted to the Michael G. DeGroote School of Medicine at McMaster. However, with a six-month gap between graduation and the start of medical school, I decided to return to Syria to visit family and investigate the health care situation for myself. I wanted to have a concrete plan for how and where I would ultimately work as a physician.

This journey changed me. Whole towns were scarred by the vestiges of war; some villages I had known were completely wiped off the map. More disturbing was the impact on the population. Many people living in massive refugee camps, such as Za’atari, had debilitating injuries from bombings or AR assaults. The number of people with acute or chronic diseases in the camps was significant. While I was there, I helped attend to three people injured in a fire and learned a lot from the resident physicians about identifying diseases that were common there but would have been unusual in Canada.

During my first two years of medical school, I was torn between a focus on emergency medicine and internal medicine. The recent global health crisis settled that question for me. As an intern at St. Joseph’s Hamilton Healthcare, I assisted in the ED, helped admit urgent cases, and provided care. To facilitate appropriate interventions, we collaborated closely with specialty teams. I felt genuinely at home on the ward, despite the lack of resources, trauma, exhaustion, and constant worry about getting sick or infecting someone else. In my mind, I drew a direct line to Syria and knew that if I returned, I would have what it takes to endure it, even if the war worsened again.

However, my perspective on emergency care evolved last year when the crisis eased, and we began to see more accident victims and critical cases, such as cardiac arrest or CVA. At the same time, certain cases were especially challenging: patients with a combination of pre-existing health conditions and long-term consequences of COVID-19 were winding up in the ED. This was when I noticed the convergence of my different educations. Attending physicians noticed it too. I identified symptoms in patients that sometimes went undocumented, and my instincts for which test to order were strong. I realized that my science background and ease with theory and analysis were contributing to my diagnostic ability, even though I was not yet allowed to take on such a responsibility. On the patient side, I picked up on visual signs and subtle cues and with knowledge of Arabic, English, French, and Russian, I was able to communicate with a wide range of people.

In the year since, I have increasingly gravitated toward internal medicine, as this is clearly where my skills and aptitudes lie. Although I have remained mainly at St. Joe’s, this has not limited my versatility but rather, enhanced it, as I have had the privilege of caring for a broad spectrum of patients and working with several departmental directors in various specialties. The extensive patient contact, along with the intellectual challenge and learning opportunities inherent in each new case, are what convinced me that internal medicine is exactly where I want and need to be. Should you accept me as a resident, you can be assured of a strong, serious, mature contribution by a sensitive team player with a wealth of experience.

It is hoped that these examples give you a good idea of how to approach your internal medicine residency personal statement and convince you that you can craft your own strong statement around what makes you unique as a person and as a physician.

Here are a few more ideas of what to include:

Your internal medicine residency personal statement should generally be between 500 and 800 words, or one page. Be sure to check the precise requirements of the residency program to which you are applying.

Simply put: Yes! Your residency personal statement provides you with the opportunity to interact with the program directors and explain why you want to pursue your chosen specialty. It also humanizes your application. Your chances of being accepted into your ideal school may be greatly increased with a powerful personal statement.

Get an early start, so that you won’t feel rushed. Conduct comprehensive research on the residency program. Write an outline. Include anecdotes and concrete examples in your essay. Once you have included all the relevant content, work on weaving a story together and revising your writing to make it more concise.

Leave yourself a good six weeks to write your internal medicine residency personal statement.

Red flags should only be discussed if they are pertinent to your personal statement, and you haven’t previously addressed them in another application component. If you do address any areas of concern, be sure to accept responsibility for the issue and detail how you improved as a result of your missteps or setbacks.

With a fill-rate of under 45%, internal medicine is one of the least competitive specialties.

Although unlikely, you may heed every piece of advice from your consultant and yet fail to find a match. Therefore, we advise choosing a professional service that is guaranteed. For instance, at BeMo, we offer a money-back guarantee that you can learn more about by scheduling a free first consultation.

Certainly! While they cannot actually create the essay for you, they can help you brainstorm, offer writing advice and strategies, and guide you through the editing process to ensure that you produce a great residency personal statement.

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Personal Statements

Your CV is a beautiful, readable, error-free summary of your accomplishments. You are moving on to your personal statement. You are ready, in one page, to tell residency program directors why they should select you, everything that has led you to this moment, to this decision, to this specialty choice. No pressure at all!

This blank page can be intimidating to many students. You are not alone. Take your time, so you can write several drafts.

Your CV tells people what you have done. Your personal statement tells people who you are.

• Do not use space in your statement re-stating what is already in your CV or other parts of your residency application.
• Don't redo your personal statement from your medical school application. You don't need to convince someone to admit you. You are in! You will have a job at the end of your fourth year.
• Do use your personal statement to help you find the job that is the most ideal match for you and your goals. You are going to be a doctor in a few short months. This personal statement should be much more focused on your specialty selection, your professional traits and your accomplishments that will impact your work as a physician.

A well-written personal statement should accomplish the following goals:

• Help pull you out of the crowd of applicants – be sure to include unique experiences, background, and information.
• Give the reviewer a glimpse at the type of resident you will be – don't say you are hard working (all residency applicants are). Instead, include examples of how you have acquired the attributes you want to feature in your statement. (See more ideas below.)
• Make the case that this specialty is really the right match for you. No program director wants to select a student who, six months into the residency, realizes they are not a good fit. What have you done to be sure this is the right career path for you?
• Be specific about what you like about the specialty. Do you enjoy the procedures? Why? Do you like the environment of the OR? Why? What type of patients do you enjoy working with? What experiences led you to consider this specialty? And, ultimately, why did you select this specialty?
• What about you will contribute to the specialty and the program? Residency programs, and residents, want to select their future peers and colleagues. What do you bring to them? What can you offer? How will you enhance that area of medicine?

Students should select six to 10 characteristics to weave into their statements. Some possibilities you could consider including are:

• leadership skills
• future practice location
• team building skills
• organization
• ability to work under stress
• problem solving
• patient communication skills

Sample Personal Statements

Sample statements are from University of Nevada, Reno School of Medicine graduates who matched into various specialties. Ideas can be used for any specialty choice. The Associate Dean and the Director of Student Services are available to give you feedback on your personal statement draft. You can email a draft to Cherie Singer .

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A Personal Statement Checklist

Hi everyone,

With fellowship application season approaching, many of you are starting to write personal statements. Even if you plan to apply next year, or the year after that, or even if fellowship’s not for you, you’re still going to write a personal statement someday, so read on.

Before you begin, check out my PD Note on Personal statement “Do’s and Don’ts . The talent pool is deep and you want to rise to the top. A powerful essay will boost you.

Each year, I review more than 30 personal statements and without fail, common errors emerge. You don’t want to spend hours drafting an essay just to be told it needs an overhaul, so hopefully this checklist will help:

• Check your spelling: Make it perfect. Run a spell check.
• Check your grammar: Make this perfect too. Nix the bad syntax, misplaced commas, and run-on sentences. Read your essay out loud and hear how it sounds.
• Be compelling: Make it enticing. If you were a fellowship director, would you choose you?
• One page max: You may think your tome is riveting, but think again. Fellowship directors read hundreds of essays and you don’t want to make them yawn. Take pity. Be brief.
• Explain why you chose your field: Cut the hyperbole and be specific. Fellowship directors can see through dubious odes to their specialty, like how you swoon over pee or dream about diarrhea. You can’t out-love the competition’s affection for hormones or sputum. Instead, explain how a field aligns with your interests and skills. And don’t trash other specialties. Cardiology isn’t the only field that deals with life and death, and oncology isn’t the only specialty with novel treatments. Finally, don’t waste space on this topic: you’re obviously interested, because you’re applying. Move on.
• Show how you will contribute: Fellowship directors don’t really care about your happiness and fulfillment, at least when it comes to choosing fellows, but they’re laser focused on your academic potential. Tell them how you will advance the field.
• Show your sophistication: Demonstrate that you know where the field is going. For example, describe the significance of your research or consider how the specialty is likely to change during your career.
• Describe the skills you seek: These can include procedural, research, and teaching skills, like advanced endoscopy, trial design, and medical education training.
• Outline what you’re looking for in a fellowship: Examples could include basic science opportunities, exposure to specific patient populations, or access to graduate degrees. Make sure the fellowship’s mission aligns with your career plans.
• Map your trajectory: Academic fellowship directors aim to train funded investigators, master educators, and cutting-edge clinicians. They love to brag about their alumni. As much as you can, without being overly specific, look into your future. Be true to yourself- don’t pursue a research-intensive fellowship if you plan to become a master clinician. You’re looking for a match.
• Strive for coherence: Your narrative should make sense. It’s easier to convey an interest in investigation when you have extensive research experience, or an interest in teaching when you’re pursuing a Clinician Education Distinction. You’re permitted to change paths- for example, many MD PhDs become clinician educators, but explain the transition.
• Highlight your accomplishments: What makes you proud? Don’t rehash your CV. Provide context and color, and show your growth.
• If necessary, address questions and concerns: If you failed a test, took an extended leave, or got derailed temporarily, seize the narrative and address the issues here. If you get stuck, talk to a trusted advisor.
• Seek input: It’s easy to lose perspective, particularly after hours of writing and editing. When your eyes start glazing over, ask for help.

In the end, your personal statement should highlight your potential. Use the checklist. Make yourself shine.

Enjoy your Sunday, everyone, and when your drafts are ready, send them to me for review.

Featured in this article

• Mark David Siegel, MD Professor of Medicine (Pulmonary); Program Director, Internal Medicine Traditional Residency Program

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Creating a high‐quality personal statement for residency application: A guide for medical students and mentors

Adaira landry.

1 Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts, USA

Wendy C. Coates

2 Department of Emergency Medicine, Harbor‐UCLA Medical Center, University of California, Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles California, USA

Michael Gottlieb

3 Department of Emergency Medicine, Rush University Medical Center, Chicago Illinois, USA

INTRODUCTION

In 2022, a total of 50,830 applicants applied to residency programs in the United States. 1 The majority of the application are data driven, including Step 1 and 2 scores, preclinical and clinical grades, and the Medical Student Performance Evaluation (MSPE or “Dean's Letter”). While there is some flexibility in choosing who writes one's letters of recommendation, there are caps on the number allowed and the contents are usually unknown to the applicant. Therefore, a high‐quality personal statement adds subjectivity and provides flexibility to frame an applicant in the strongest light. Prior research reveals that the personal statement has not always been valued universally. 2 , 3 However, the personal statement may be gaining importance with the recently increased focus on holistic review as well as the transition of USMLE Step 1 to pass/fail and the increasing prevalence of pass/fail grading in U.S. medical schools. 4 , 5 , 6 , 7 This is relevant as objective metrics inconsistently predict a student's ability to practice medicine and succeed in residency 8 , 9 and may present a potential for racial and other forms of bias in applicant selection. 10

While the objective aspects of the application emphasize comparison based on standard measures, the subjective narrative is curated and individualized by the applicant. Moreover, the National Residency Matching Program 2021 Program Director survey data suggest that personal statements influenced some applicants' likelihood of receiving an interview offer, especially when the application was near a program's self‐directed objective cutoff metric; however, its impact on rank list position was less influential. 11 Therefore, it is in the candidate's interest to craft a statement that engages the reviewer. The primary goal of the personal statement must be honest and reflective and be able to tell the story of the applicant (e.g., the influence of their background, key current personal interests, and future goals). Linear and crisp writing makes a personal story easier to read. Despite the stakes, there are few published resources guiding applicants on how to write an effective personal statement. 12

In this paper, we provide recommendations for creating a high‐quality personal statement. The authors have served as advisors to medical students, residents, fellows, and faculty for over 35 years across four separate major academic institutions. They have held core faculty roles, medical school, residency program, or fellowship leadership positions and have served on resident selection and interview committees and in the dean's office. The information compiled here was based on consensus of opinion as well as relevant literature where available. While the primary audience of this article is medical students, the principles may also be valuable for their mentors.

GENERAL GUIDELINES

The personal statement provides context to your personal and professional experiences and ambitions. It should not be a line‐by‐line recap of your entire application. Rather, it should highlight aspects which deserve greater attention and detail than are provided in your curriculum vitae. 13 Resist the urge to exaggerate truth, but do not undersell your accomplishments. Stating what you learned from experiences can strike a balance. The personal statement offers a prime opportunity to discuss gaps in training, motivation to pursue a particular field, notable extracurricular activities, general career plans, and concerns with your application. Controversial topics, such as social or political issues, may occasionally be included after careful consideration on how to frame your message and language. A trusted specialty‐specific advisor or mentor can help determine which key points are strategic to address.

Most importantly, your personal statement should be unique and reflect your personal journey and not be at risk of being mistaken for a different applicant or plagiarized from a published work. We recommend that you craft your personal statement directly from your voice and through your lens. While it is prudent to consult a proofreader to check spelling and grammar, it is unacceptable to hire a writer to construct your statement.

Before writing your personal statement, we recommend engaging in self‐reflection. Focus on the crossroads of your path and application that you want to highlight. These form the central points of your essay and may stimulate conversation during your interview. Your trusted network (mentors, significant others, siblings, parents, and close friends) can help early to identify significant traits and experiences. Anything written in a personal statement is available for discussion during the interview, including some topics that are frequently disallowed. Be prepared to discuss what you disclose. Table  1 summarizes general pearls and pitfalls for the personal statement.

Pearls and pitfalls for the personal statement

WRITING STRATEGICALLY

Writing can be a challenge but following a few basic writing strategies can simplify the task. Creating an outline helps adhere to purposeful clarity and flow. The flow should be linear so that the application reviewer can easily follow the discussion without having to decipher the relevance of content or the meaning of vague analogies. The ability to compose clear, easily readable prose will reflect favorably on your communication skills.

Writing with brevity and paying attention to the word count yields readable, short, and sharp sentences. For many specialties, a one‐page personal statement is the norm; however, ERAS (Electronic Residency Application Service) does have a cap of 28,000 characters (approximately 5 pages). 12 Your mentor can advise on the preferred length for your intended specialty. Use simple words that convey your meaning to enhance comprehension, and avoid overly colorful language and unnecessary adverbs and adjectives. Minimize the temptation to provide extraneous details, especially when trying to set the scene of a clinical environment, patient encounter, or historic event (e.g., a family member with a medical encounter). You should be the focus of your personal statement.

After creating this first draft, several strategies can be used to improve it. Waiting a few days to edit the statement allows you to reread it from a fresh perspective. Trusted allies may offer valuable insights and assess for flow, context, and comprehension. Mentors can evaluate your statement from the lens of a reviewer. Listening to the statement being read aloud can help identify errors. It is common to need several revisions before settling on your ideal personal statement. As a last step, be sure to check the document for spelling and grammar. Table  2 provides resources that will help with the technical craft of writing.

Writing resources

COMPONENTS OF A PERSONAL STATEMENT

There is no rigid template for a personal statement. Its design and development should be sculpted to describe your unique experiences and ambitions, while being mindful of the storytelling and writing principles outlined above. To that end, no singular format or framework will work for every student. The goal is not to capture the reviewer's or programs's exact preferences, because there is too much variability to predict what is desired. 2 The primary goal of the personal statement is to write clearly about your journey so that reviewers understand who you are. In this section, we provide examples of components to consider including in your personal statement. We do not expect that each of these components will be included in everyone's personal statement. Instead, each author should decide which components best represent their desired message. We understand the temptation to be creative with your writing; however, we recommend caution. A lively statement, specifically in the opening, runs the risk of being cliché or distracting. Table  3 offers suggestions of how to structure the description of your experiences.

Approach to describing experiences in personal statement

Motivation for pursuing medicine overall (consider including, if desired)

The decision to pursue the field of medicine is significant and worthy of discussion. Often students open with a brief description of an educational or clinical encounter, a relative's journey as a patient, or even a personal illness. You may briefly state your reasons for becoming a physician (e.g., enjoyment of clinical medicine, desire to improve health care delivery). No matter the influence that inspired you to pursue medicine, reviewers will appreciate your authenticity.

Motivation for selected residency field (included by many applicants 14 , 15 )

Describe why you are applying to your specialty and highlight personal traits and experiences that make you an ideal fit. Mentors in your desired specialty can discuss the strengths, weaknesses, and future of the field and can assess your compatibility. Avoid superficial phrasing such as “I am applying to emergency medicine because I am interested in helping people.” While this answer is honorable, it lacks a detailed understanding of the nuanced aspects of the field and could apply to any student and specialty. There is no need to describe the specialty to the readers—they are living it daily and want to learn why you will succeed within the specialty's framework.

Tentative plans for residency and career (included by strongest applicants)

If you have tentative plans for residency, possible fellowship, and your subsequent career path, you can include them and any supporting evidence. For instance, “Based on my research thesis studying cardiac biomarkers, I plan to focus on early signs of cardiac disease. I will pursue a fellowship in population health, obtain a Master of Public Health degree, and later work in an academic setting.” You may also link these ambitions, whether clinical or nonclinical, back to why you pursued medicine or the specific discipline. Selection committees value your ability to create a global plan, but they also understand that it may change during residency and will not be disappointed if you revise your path as you discover new opportunities during your training.

Brief context of academic experiences (consider including, if applicable)

The variety of applicants' experiences is as varied as the applicants themselves. It is important to clarify your motivation for engaging in an activity, the depth of your role, and how you improved as a result of your participation. For example, the experiences of a student who is listed as an author on a publication may vary from data entry to principal investigator. An honest reflection of your role and lessons learned is far better than hyperbole. Describe your decision making behind a project and how your skills improved or how it influenced your personal mission as a result. Detailed descriptions are not necessary. Instead, focus on the key components of one or two influential experiences. You may be expected to elucidate the details during your interview.

Relevance of extracurricular activities and prior employment (consider including, if applicable)

Most applicants have a long list of activities to report, and many may not be well understood by the selections committee. The personal statement gives you an opportunity to frame selected experiences. Highlight your important role in an activity or why the activity endorses your potential success in your specialty. There is a significant distinction between a student who created a student‐run clinic (e.g., generated the idea, sought approval, built a team, gathered supplies, scheduled students and faculty) and a student who staffed the clinic twice during medical school. Similarly, your role in a previous job, whether it was career focused or casual, can shed light on your skills (e.g., to highlight management skills, you could recount your experience as a residence hall assistant in college or your role as a team leader in industry).

Special considerations (consider including, if applicable)

The following are selected special considerations for writing your personal statement. They can carry a higher level of sensitivity, so be mindful of word choice. We want to emphasize the importance of discussing your approach with a trusted advisor or mentor. Be prepared to discuss any topics mentioned in the statement during your interview. While this may seem daunting at first, it is an opportunity to directly answer a question that the selection committee may have while reviewing your application. Reading your thoughtful explanation may allay their fears about the event in question and spur their decision to take a chance on extending an interview invitation. No matter the issue, be sure to demonstrate personal and professional growth and how, if at all, the concern enhanced your ability to become a physician.

Leave of absence

If you took a formal leave from medical school, we suggest you acknowledge it in your application. While ERAS has a designated section for leave of absences, consider also mentioning the absence in the broader context of the personal statement. You are not obligated to provide details. You are free to state, “I took 3 months off for a familial obligation.” However, further details can help the reviewer contextualize the absence: “This allowed me to spend the necessary time addressing the issue without compromising my training. Upon my return from leave, I fulfilled the expectations of my medical school.” It is important that your reason for the leave of absence is viewed by the school in the same fashion. If there is any conflict in the purpose of the leave, speak with your medical school leadership to discuss and resolve any disconnect.

Medical history

You are not mandated to disclose medical conditions. However, if the condition precludes you from performing your duties completely or partially, it is in your best interest to assess whether the program is supportive of providing the least restrictive accommodations for you to participate fully in the training program. While the Americans with Disabilities Act and Rehabilitation Act requires employers to provide reasonable accommodations, it does not require that you disclose your disability until they are needed. Early disclosure gives employers ample lead time to put accommodations into place but may also lead to bias. 16 , 17 We recommend you discuss with your support system when and whether to disclose a disability and whether this decision will cause relief or worry for you and your potential employer.

Shelf exam/board scores/grades

Standardized test scores may influence students' interview opportunities and ability to match in residency. 11 It is prudent to discuss low scores or failures. A brief but clear description of the likely cause, remediation process, and subsequent successful outcome is needed. Any additional positive data points can be mentioned. For example, “I have since passed all of my shelf exams and my Step 2 score was in the Xth percentile.”

Concerning evaluation

Clerkship evaluations on the MSPE may contain negative comments that might be detrimental to the application. You are generally allowed to review your MSPE prior to finalization. If a detrimental comment is found, you should discuss evaluation concerns with your mentor as soon as possible to plan how to mitigate any negativity. Some negative comments are truthful and constructive and will remain in the MSPE. If the comment remains in the MSPE, the personal statement is available to explain the circumstances clearly and concisely and without casting blame on others. It is important to share the most important stage of processing feedback: self‐reflection and identifying areas of growth. 18 , 19 It is reasonable to direct the reader to subsequent instances of how the initial concern later was cited as a strength.

Limited access to extracurricular activities

Statements often highlight select activities so the reviewer can focus on what you perceive to be the most influential activities. However, not all students have access to the same experiences. There is no clear quantitative marker for how many extracurricular activities such as research, volunteering, or leadership roles one should obtain. Resources can vary from one institution to another, and individuals may not have time to engage in copious activities if they have other financial or family obligations during medical school. The personal statement is an opportunity to briefly explain any limitations with obtaining extracurricular activities.

Social and political factors

Often our personal identity is closely entwined with our societal and political experiences. It is an individual choice how to tell your perspective through your personal lens and whether to disclose your preferences. Incorporating personal identifiers, such as your gender, race, age, ability, sexual orientation, parenting status, religion, or political affiliation, informs the reader on aspects of your life that you feel have influenced your journey. 6 , 7 Revealing these can run the risk of unfair or discriminatory judgment but can also demonstrate your comfort with yourself and positively support the reasons you will shine as a resident physician. 12 Depending on your passion and involvement in a particular topic, this can be an opportune segue to explain your interest and future ambitions. Be prepared to discuss any of these disclosures during your interview. Consulting with your mentor is a good way to gauge the impact this decision may have on your application.

Writing a personal statement can be a challenging task. A thoughtful, organized approach will help you create a meaningful personal statement that enhances your application. Streamline the writing to convey your message concisely. The best personal statements are clear and brief and contain specificity to reflect and explain your unique perspective. This is your opportunity to highlight why you are the ideal candidate for a residency in your chosen field. While this guide cannot guarantee an interview invitation or a match into a desired program, we hope this resource will help ensure that your personal statements can showcase your best possible self.

CONFLICT OF INTEREST

AL has received funding personally from EchoNous for consulting. The other authors declare no potential conflicts of interest.

ACKNOWLEDGMENT

The authors acknowledge Drs. Michelle Lin at UCSF and Sara Krzyzaniak at Stanford for their advice on leave of absences.

Landry A, Coates WC, Gottlieb M. Creating a high‐quality personal statement for residency application: A guide for medical students and mentors . AEM Educ Train . 2022; 6 :e10797. doi: 10.1002/aet2.10797 [ CrossRef ] [ Google Scholar ]

Supervising Editor: Dr. Jason Wagner

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Best Internal Medicine Personal Statement Examples For Residency

In this article, we discuss the best internal medicine personal statement examples for residency.

Do you want to pursue a career in internal medicine, but are unsure how to write your personal statement for residency?

Keep reading for great examples – and find out how a car accident, a COVID-19 vaccine health campaign and solving a tricky chronic pain puzzle led three candidates to become internist physicians.

This guide will provide you with examples of the best personal statements for residency programs.

Table of Contents

What is an internal medicine personal statement.

• Tips for Writing an effective internal medicine personal statement

Internal Medicine Personal Statement Example 1 – Saving a Life in South America

Internal medicine personal statement example 2 – patient advocacy in three languages, internal medicine personal statement example 3 – a more focused approach to pain management, faq (frequently asked questions), more personal statement tutorials.

It’s an important part of the application package when applying for an internal medicine residency program. It outlines your background, experience, and career plans, to show the selection panel why they are the ideal candidate for the program.

The statement should emphasize the applicant’s interest in internal medicine, providing a narrative of their relevant experiences, skills, and characteristics that are applicable to being an internist.

Tips for Writing an Effective Internal Medicine Personal Statement

1. identify a target specialty and include it in the statement.

Writing an internal medicine personal statement requires you to identify and reflect on what attracts you to the specialty.

My ultimate goal is to become an oncologist and work in a hospital setting, where I can make a meaningful difference in the lives of my patients and advocate on their behalf for the most effective and appropriate treatment. I am committed to lifelong learning and staying up-to-date with the latest advances in the field. I am confident that I have the dedication, compassion, and skills to excel in this field, and I look forward to the opportunity to continue my education in internal medicine.

Start by reflecting on why you are interested in the specialty and how your background and skills will help you succeed. Consider your long-term goals, what you hope to accomplish, and your desired setting.

Finally, be sure to include why you are passionate about the specialty and how it aligns with your interests and goals, as well as any particular qualities or strengths you possess.

2. Research the residency programs and include relevant details

Researching residency programs can be an invaluable tool in crafting an effective internal medicine personal statement.

Knowing the values and goals of the program can help applicants demonstrate how their skills, experience, and personal attributes are well-suited to the specialty and training.

You need to write a narrative that shows how your own goals are aligned with the programs.

3. Include personal details that will help the reviewers connect with you

Including personal details in your internal medicine personal statement can help reviewers connect with you on a more personal level, allowing them to see you as a unique individual with a unique perspective.

• Share a personal story: Begin your statement with a personal story that relates to your interest in internal medicine. This can be a brief anecdote that highlights your passion for the field or a personal experience that led you to pursue a career in medicine.

As a young child, I watched my grandfather suffer pancreatic cancer, which had a profound impact on my life. Witnessing his struggles and the care he received from dedicated medical professionals sparked a respect within me for medicine and, in particular, internal medicine and I started a lifelong journey of fundraising for local hospices to try to support other families in similar situations.

• Explain your motivation: Discuss why you are motivated to pursue a career in internal medicine. Share personal experiences that have inspired you, such as a family member’s illness or a volunteer experience that had a profound impact on you.
• Discuss your values: Share your personal values and how they align with the values of the medical profession. This can include a commitment to serving others, a dedication to lifelong learning, or a desire to make a difference in the world.
• Share your hobbies and interests: Discuss your hobbies and interests outside of medicine, such as sports, music, or travel. This can help reviewers see you as a well-rounded individual with diverse interests and experiences.
• Discuss your future goals: Share your long-term career goals and how you see yourself making a contribution to the field of internal medicine. This can help reviewers see that you have a clear vision for your future and are committed to achieving your goals.

Just be sure to strike a balance between personal and professional details, focusing on those that are most relevant to your career goals and experiences in medicine.

4. Focus on your accomplishments and skills

It is important to illustrate the specific ways in which you have gained qualifications and skills that make you suited to the internal medicine field.

Make sure you talk about patient advocacy if possible – making it clear you will be supporting the person and not just treating the disease.

Through my experiences, I have come to appreciate the importance of a patient-centred approach to medicine, where the focus is on understanding the patient as a whole person and working collaboratively to achieve the best possible outcomes.

By doing this, you can show the admissions committee that you are capable of the rigorous learning and clinical practice that the field of internal medicine demands.

5. Use a compelling narrative to tell your story

By choosing a compelling opening story that is both unique and specific, you have a better chance of creating a persuasive statement that effectively conveys your interest and aptitude in the field.

A great example is telling the story of your first surgery rotation and how it impacted your interest in the medical field. This can also be done by sharing a personal experience such as working on a project with the local community.

No matter what narrative you choose for your personal statement, make sure it ties into your skills and dedication to the field of internal medicine.

As a fluent speaker of Arabic as well as English, I can recognise the importance for patients of being able to access information in the language they are most comfortable speaking, and being able to ask as many questions as they need to where there is any ambiguity. I am currently learning Spanish in order to better be able to serve my future patients in the southern states.

6. Make sure your statement is well-written and organized

• Step 1: Carefully read the sample. This will provide you with a better understanding of how to write your own personal statement.
• Step 2: Understand the structure of the statement. It is important to have a well-structured personal statement that logically progresses from one point to the next.
• Step 3: Identify the kinds of information you need to include. Make sure to include information that is relevant to internal medicine, such as your analytical skills, collaboration skills, and experiences.
• Step 4: Pay attention to the tone. It is important to ensure that your personal statement is easily readable and interesting.
• Step 5: Abide by university regulations. Make sure you read and understand the requirements of the university or program you are applying to, and make sure your personal statement meets those requirements and is the correct word count and format.

7. Include any relevant research, volunteer, or work experience

Including research, volunteer, or work experience in an internal medicine personal statement can be done by providing specific anecdotes that demonstrate your skills and abilities.

First, you should make a list of your experiences and then decide which ones would be most relevant and interesting to the selection committee. Once you have decided what to include, you can explain each experience in a few sentences, emphasizing the impact it had on your growth as a healthcare professional.

As a medical assistant, I have gained valuable clinical experience in a variety of settings, including hospitals, primary care clinics, and urgent care centers. These experiences have further solidified my passion for internal medicine and reinforced the importance of a patient-centered approach to healthcare. One experience that particularly stands out to me is when I was working with a patient from my own community who had been struggling with chronic pain for years. She had felt dismissed by doctors when trying to communicate in English, as she was unable to express all the nuances of her experiences. Through careful observation, thorough medical history-taking, and a collaborative approach to care, I was able to identify the root cause of the patient’s pain and develop a treatment plan that ultimately provided much-needed relief.

8. Make sure to proofread carefully

Proofreading a written internal medicine personal statement is incredibly important if you want your application to be successful.

Read your essay aloud and ask for feedback.

Check for overused words, absence of flow, an ineffective writing style, exaggeration of the facts and overly complex tales.

Examples of best internal medicine personal statements

Below, we have provided three internal medicine personal statements to help guide you to write the best personal statement.

My path to medicine was not a straight one, however. I initially pursued a degree in business, but after a life-changing experience overseas, I realized that my true calling was in medicine. I was travelling in a rural area of South America when I witnessed a community health worker save the life of a child who had been struck by a car. We were miles away from the nearest hospital and that little boy would almost certainly have died without immediate medical help. At that moment, I realized the power of medicine to make a real difference in people’s lives, even in the most challenging circumstances.

Since that experience, I have dedicated myself to pursuing a career in internal medicine. I have completed extensive coursework in anatomy, physiology, and pharmacology, as well as clinical experience in a variety of settings. Through my experiences, I have come to appreciate the importance of a patient-centred approach to medicine, where the focus is on understanding the patient as a whole person and working collaboratively to achieve the best possible outcomes.

In addition to my academic and clinical experience, I have also been involved in various community service activities. I have volunteered with local health clinics, providing health education and screening services to underserved populations in rural North Carolina. My fundraising activities for various health-related charities in the USA and overseas have, to date, raised more than a quarter of a million dollars.

Throughout my academic and professional career, I have been drawn to the field of medicine, specifically internal medicine. My passion for medicine stems from my desire to work collaboratively with healthcare professionals and advocate for patients’ well-being.

As a healthcare professional, I understand the importance of teamwork and collaboration in achieving the best outcomes for all patients. During my clinical experience in Bethesda Hospital, I have worked with multidisciplinary teams, including physicians, nurses, social workers, and other healthcare professionals, to provide comprehensive and compassionate care to patients. I believe that effective communication, mutual respect, and shared decision-making are critical components of successful teamwork in healthcare.

In addition to teamwork, patient advocacy is a core value that guides my practice. I am committed to empowering patients to make informed decisions about their care and advocating for their needs and rights. I believe that every patient deserves to be treated with dignity, respect, and compassion, regardless of their background or circumstances. As a fluent speaker of Arabic as well as English, I can recognise the importance for patients of being able to access information in the language they are most comfortable speaking and being able to ask as many questions as they need to where there is any ambiguity. I am currently learning Spanish in order to better be able to serve my future patients in the southern states.

My dedication to patient advocacy is reflected in my involvement in community service activities, such as volunteering at a local free clinic and participating in health education campaigns. Most recently, I worked with community faith leaders to encourage the uptake of the covid-19 vaccine. As a Muslim, I was able to demonstrate an understanding of respectful and appropriate strategies to answer concerns and questions, while emphasising the health benefits for the whole community. Through these experiences, I have developed a deep understanding of the healthcare needs of underserved communities and the importance of patient-centred care.

As I continue my education in internal medicine, I am committed to building on my teamwork and patient advocacy skills. I am eager to learn from experienced healthcare professionals and contribute to the care of patients in a clinical setting. Ultimately, my goal is to become a cardiologist and work in both a large research hospital and smaller rural clinics.

In conclusion, I am confident that my passion for medicine, dedication to teamwork, and commitment to patient advocacy makes me a strong candidate for an internal medicine course. I look forward to the opportunity to learn, grow, and contribute to the field of internal medicine, wherever that may lead.

From a young age, I have been fascinated by the complexities of the human body and the ways in which it can be healed. My early interest in medicine has since blossomed into a passion for internal medicine, which I believe offers unique opportunities for problem-solving and holistic preventative patient care.

My journey to becoming a doctor has not been a straightforward one. As the fifth child of Bangladeshi immigrant parents, I faced numerous challenges and obstacles on my path to pursuing higher education. However, through hard work, determination, and perseverance, I was able to overcome these challenges and earn a degree in biology from Brown University on a full scholarship.

During my undergraduate studies, I was particularly drawn to courses in physiology, anatomy, and pharmacology, where I gained a deep understanding of the mechanisms behind various medical conditions and treatments. I was also drawn to the problem-solving and critical thinking skills required in the field of medicine. As a medical assistant, I have gained valuable clinical experience in a variety of settings, including hospitals, primary care clinics, and urgent care centres. These experiences have further solidified my passion for internal medicine and reinforced the importance of a patient-centred approach to healthcare.

One experience that particularly stands out to me is when I was working with a patient from my own community who had been struggling with chronic pain for years. She had felt dismissed by doctors when trying to communicate in English, as she was unable to express all the nuances of her experiences. Through careful observation, thorough medical history-taking, and a collaborative approach to care, I was able to identify the root cause of the patient’s pain and develop a treatment plan that ultimately provided much-needed relief. This solidified my passion for internal medicine, where I believe that careful observation, critical thinking, and a patient-centred approach are key to successful problem-solving and positive patient outcomes.

As I move forward in my career, I am eager to continue to hone my problem-solving skills and to provide compassionate and comprehensive care to patients to make a meaningful difference in their lives. I am excited about the opportunity to further develop my skills and knowledge in internal medicine to become a specialist in osteopathy and specifically, work in pain management.

In conclusion, I believe that my life story, passion for internal medicine, and demonstrated problem-solving skills make me a strong candidate for an internal medicine course. I am eager to take on the challenges of this field and to contribute to the advancement of patient care, for the people of my own community and all my patients.

Some of these questions were already covered in this blog post but I will still list them here (because not everyone carefully reads every paragraph) so here’s the TL;DR version.

What specialties are available in an internal medicine residency program?

The specialties available in an internal medicine residency program include general internal medicine, geriatrics, endocrinology, cardiology, haematology and oncology, rheumatology, gastroenterology, infectious disease, pulmonary medicine, and many more.

Other specialties may be available depending on the program. IM residents may choose to pursue subspecialty training after completing their residency, such as nephrology, critical care, and hospital medicine.

Additionally, IM residents have the opportunity to pursue research, teaching, global health, and quality improvement opportunities.

What type of data should be included in an internal medicine residency application?

It is important to include data that highlights your unique attributes and demonstrates a fit with the program values. You should explain your interest in internal medicine and the skills that you will use during your residency.

This can include relevant anecdotes and an explanation of your research or clinical experience. Also, your interests, skills and any awards and scholarships you have received.

What types of fellowships are available for internal medicine residency programs?

Fellowships for internal medicine residency programs are generally classified into two categories: Clinical Fellowships and Research Fellowships.

Clinical Fellowships are designed to provide additional training and experience in a subspecialty area of internal medicine such as Cardiology, Endocrinology, Gastroenterology, Hematology, Oncology, Pulmonary Medicine, or Infectious Diseases. Fellows are expected to develop advanced skills in clinical practice, laboratory medicine, and teaching.

Research Fellowships, on the other hand, allow Fellows to develop and implement an independent research project. This could include clinical or basic science research or a combination of both. Fellows are expected to develop advanced skills in research design, data management, and analysis. In addition, fellows typically attend educational seminars and conferences and present their research findings at national meetings.

How can patient advocacy help during the internal medicine residency application process?

Showcasing how the applicant has served as a patient advocate, either through research or through direct action, can be a great way to further differentiate themselves as a candidate.

Patient advocacy is a crucial skill for internal medicine residents, as they will be responsible for representing their patient’s needs, making sure they receive the best care available. Experience being a primary advocate for a patient’s overall health and well-being shows you have the skills and experience to be a successful patient advocate and can be a powerful way to get noticed by the residency selection committee.

What types of medical research are available in an internal medicine residency program?

An internal medicine residency program offers a variety of medical research opportunities.

These include clinical research, which focuses on the assessment, treatment planning, and care of adult patients; and translational research, which involves the development and testing of new treatments.

Additionally, research into the prevention of diseases in adults is conducted, as well as research into new diagnostic tests and treatments.

Finally, research into the literature and evidence-based medicine is also conducted to find the best course of treatment for internal medicine patients, particularly those with multiple diagnoses.

What types of rewards are associated with an internal medicine residency program?

An internal medicine residency program can be very rewarding. You could have the opportunity to work with and care for adult patients and the opportunity to specialize in the treatment and prevention of diseases, as well as the chance to develop and hone skills in assessment and treatment planning.

Additionally, successful completion of a residency program can open up opportunities for further subspecialty training, and the personal satisfaction of advancing one’s medical career.

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• Craig Higgins
• London School of Hygiene & Tropical Medicine , London , UK
• Correspondence to Dr Phil J Edwards, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK; phil.edwards{at}LSHTM.ac.uk

Background Plans to phase out fossil fuel-powered internal combustion engine (ICE) vehicles and to replace these with electric and hybrid-electric (E-HE) vehicles represent a historic step to reduce air pollution and address the climate emergency. However, there are concerns that E-HE cars are more hazardous to pedestrians, due to being quieter. We investigated and compared injury risks to pedestrians from E-HE and ICE cars in urban and rural environments.

Methods We conducted a cross-sectional study of pedestrians injured by cars or taxis in Great Britain. We estimated casualty rates per 100 million miles of travel by E-HE and ICE vehicles. Numerators (pedestrians) were extracted from STATS19 datasets. Denominators (car travel) were estimated by multiplying average annual mileage (using National Travel Survey datasets) by numbers of vehicles. We used Poisson regression to investigate modifying effects of environments where collisions occurred.

Results During 2013–2017, casualty rates per 100 million miles were 5.16 (95% CI 4.92 to 5.42) for E-HE vehicles and 2.40 (95%CI 2.38 to 2.41) for ICE vehicles, indicating that collisions were twice as likely (RR 2.15; 95% CI 2.05 to 2.26) with E-HE vehicles. Poisson regression found no evidence that E-HE vehicles were more dangerous in rural environments (RR 0.91; 95% CI 0.74 to 1.11); but strong evidence that E-HE vehicles were three times more dangerous than ICE vehicles in urban environments (RR 2.97; 95% CI 2.41 to 3.7). Sensitivity analyses of missing data support main findings.

Conclusion E-HE cars pose greater risk to pedestrians than ICE cars in urban environments. This risk must be mitigated as governments phase out petrol and diesel cars.

• WOUNDS AND INJURIES
• CLIMATE CHANGE

Data availability statement

Data are available in a public, open-access repository. Numerator data (numbers of pedestrians injured in collisions) are publicly available from the Road Safety Data (STATS19) datasets ( https://www.data.gov.uk/dataset/cb7ae6f0-4be6-4935-9277-47e5ce24a11f/road-safety-data ). Denominator data (100 million miles of car travel per year) may be estimated by multiplying average annual mileage by numbers of vehicle registrations (publicly available from Department for Transport, https://www.gov.uk/government/statistical-data-sets/veh02-licensed-cars ). Average annual mileage for E-HE and ICE vehicles may be estimated separately for urban and rural environments using data that may obtained under special licence from the National Travel Survey datasets ( http://doi.org/10.5255/UKDA-Series-2000037 ).

https://doi.org/10.1136/jech-2024-221902

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WHAT IS ALREADY KNOWN ON THIS TOPIC

Electric cars are quieter than cars with petrol or diesel engines and may pose a greater risk to pedestrians.

The US National Highway Transportation Safety Agency found that during 2000–2007 the odds of an electric or hybrid-electric car causing a pedestrian injury were 35% greater than a car with a petrol or diesel engine.

The UK Transport Research Laboratory found the pedestrian casualty rate per 10 000 registered electric or hybrid-electric vehicles during 2005–2007 in Great Britain was lower than the rate for petrol or diesel vehicles.

WHAT THIS STUDY ADDS

In Great Britain during 2013–2017, pedestrians were twice as likely to be hit by an electric or hybrid-electric car than by a petrol or diesel car; the risks were higher in urban areas.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

The greater risk to pedestrian safety posed by electric or hybrid-electric cars needs to be mitigated as governments proceed to phase out petrol and diesel cars.

Drivers of electric or hybrid-electric cars must be cautious of pedestrians who may not hear them approaching and may step into the road thinking it is safe to do so, particularly in towns and cities.

Introduction

Many governments have set targets to reach net-zero emissions to help mitigate the harms of climate change. Short-term health benefits of reduced emissions are expected from better air quality with longer-term benefits from reduced global temperatures. 1

Transition to electric and hybrid-electric (E-HE) cars

One such target is to phase out sales of new fossil fuel-powered internal combustion engine (ICE) vehicles and replace these with E-HE vehicles. 2 3

Pedestrian safety

Road traffic injuries are the leading cause of death for children and young adults. 4 A quarter of all road traffic deaths are of pedestrians. 5 Concerns have been raised that E-HE cars may be more hazardous to pedestrians than ICE cars, due to being quieter. 6 7 It has been hypothesised that E-HE cars pose a greater risk of injury to pedestrians in urban areas where background ambient noise levels are higher. 8 However, there has been relatively little empirical research on possible impacts of E-HE cars on pedestrian road safety. A study commissioned for the US National Highway Transportation Safety Agency based on data from 16 States found that the odds of an E-HE vehicle causing a pedestrian injury were 35% greater than an ICE vehicle. 9 In contrast, a study commissioned by the UK Department for Transport found pedestrian casualty rates from collisions with E-HE vehicles during 2005–2007 were lower than for ICE vehicles. 10 Possible reasons for these conflicting results are that the two studies used different designs and estimated different measures of relative risk—the first used a case–control design and estimated an OR, whereas the second used a cross-sectional study and estimated a rate ratio. ORs will often differ from rate ratios. 11 Other reasons include differences between the USA and the UK in the amount and quality of walking infrastructure. 12

Aim and objectives

We aimed to add to the evidence base on whether E-HE cars pose a greater injury risk to pedestrians than ICE cars by analysing road traffic injury data and travel survey data in Great Britain.

We sought to improve on the previous UK study by using distance travelled instead of number of registered vehicles as the measure of exposure in estimation of collision rates.

The objectives of this study were:

To estimate pedestrian casualty rates for E-HE and ICE vehicles and to compare these by calculating a rate ratio;

To assess whether or not the evidence supports the hypothesis that casualty rate ratios vary according to urban or rural environments. 8

Study design

This study was an analysis of differences in casualty rates of pedestrians per 100 million miles of E-HE car travel and rates per 100 million miles of ICE car travel.

This study was set in Great Britain between 2013 and 2017.

Participants

The study participants were all pedestrians reported to have been injured in a collision with a car or a taxi.

The exposure was the type of propulsion of the colliding vehicle, E-HE or ICE. E-HE vehicles were treated as a single powertrain type, regardless of the mode of operation that a hybrid vehicle was in at the time of collision (hybrid vehicles typically start in electric mode and change from battery to combustion engine at higher speeds). 13

The outcome of interest was a pedestrian casualty.

Effect modification by road environment

We used the urban–rural classification 14 of the roads on which the collisions occurred to investigate whether casualty rate ratios comparing E-HE with ICE vehicles differed between rural and urban environments.

Data sources/measurement

Numerator data (numbers of pedestrians injured in collisions) were extracted from the Road Safety Data (STATS19) datasets. 15

Denominator data (100 million miles of car travel per year) were estimated by multiplying average annual mileage by numbers of vehicle registrations. 16 Average annual mileage for E-HE and ICE vehicles was estimated separately for urban and rural environments using data obtained under special licence from the National Travel Survey (NTS) datasets. 17 We estimated average annual mileage for the years 2013–2017 because the NTS variable for the vehicle fuel type did not include ‘hybrid’ prior to 2013 and data from 2018 had not been uploaded to the UK data service due to problems with the archiving process (Andrew Kelly, Database Manager, NTS, Department for Transport, 23 March 2020, personal communication). Denominators were thus available for the years 2013–2017.

Data preparation

The datasets for collisions, casualties and vehicles from the STATS19 database were merged using a unique identification number for each collision.

Statistical methods

We calculated annual casualty rates for E-HE and ICE vehicles separately and we compared these by calculating a rate ratio. We used Poisson regression models to estimate rate ratios with 95% CIs and to investigate any modifying effects of the road environment in which the collisions occurred. For this analysis, our regression model included explanatory terms for the main effects of the road environment, plus terms for the interaction between type of propulsion and the road environment. The assumptions for Poisson regression were met in our study: we modelled count data (counts of pedestrians injured), traffic collisions were independent of each other, occurring in different places over time, and never occurring simultaneously. Data preparation, management and analyses were carried out using Microsoft Access 2019 and Stata V.16. 18

Sensitivity analysis

We conducted an extreme case analysis where all missing propulsion codes were assumed to be ICE vehicles (there were over a 100 times more ICE vehicles than E-HE vehicles on the roads in Great Britain during our study period, 16 so missing propulsion is more likely to have been ICE).

The sample size for this study included all available recorded road traffic collisions in Great Britain during the study period. We estimated that for our study to have 80% power at the 5% significance level to show a difference in casualty rates of 2 per 100 miles versus 5.5 per 100 miles, we would require 481 million miles of vehicle travel in each group (E-HE and ICE); whereas to have 90% power at the 1% significance level to show this difference, 911 million miles of vehicle travel would be required in each group. Our study includes 32 000 million miles of E-HE vehicle travel and 3 000 000 million miles of ICE vehicle travel and therefore our study was sufficiently powered to detect differences in casualty rates of these magnitudes.

Between 2013 and 2017, there were 916 713 casualties from reported road traffic collisions in Great Britain. 120 197 casualties were pedestrians. Of these pedestrians, 96 285 had been hit by a car or taxi. Most pedestrians—71 666 (74%) were hit by an ICE car or taxi. 1652 (2%) casualties were hit by an E-HE car or taxi. For 22 829 (24%) casualties, the vehicle propulsion code was missing. Most collisions occurred in urban environments and a greater proportion of the collisions with E-HE vehicles occurred in an urban environment (94%) than did collisions with ICE vehicles (88%) ( figure 1 ).

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Flow chart of pedestrian casualties in collisions with E-HE or ICE cars or taxis from reported road traffic collisions in Great Britain 2013–2017. E-HE, electric and hybrid-electric; ICE, internal combustion engine.

Main results

During the period 2013 to 2017, the average annual casualty rates of pedestrians per 100 million miles were 5.16 (95% CI 4.92 to 5.42) for E-HE vehicles and 2.40 (95% CI 2.38 to 2.41) for ICE vehicles, which indicates that collisions with pedestrians were on average twice as likely (RR 2.15 (95% CI 2.05 to 2.26), p<0.001) with E-HE vehicles as with ICE vehicles ( table 1 ).

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Pedestrian casualties due to collisions with cars or taxis from reported road traffic collisions in Great Britain 2013–2017—by vehicle propulsion type

In our extreme case analysis, the 22 829 pedestrian casualties where vehicle propulsion was missing were all assumed to have been struck by ICE vehicles. In this case, average casualty rates of pedestrians per 100 million miles were 3.16 (95% CI 3.14 to 3.18) for ICE vehicles, which would indicate that collisions with pedestrians were on average 63% more likely (RR 1.63 (95% CI 1.56 to 1.71), p<0.001) with E-HE vehicles than with ICE vehicles ( table 2 ).

Extreme case sensitivity analysis—pedestrian casualties due to collisions with cars or taxis from reported road traffic collisions in Great Britain 2013–2017 by vehicle propulsion type where 22 829 missing vehicle propulsion codes are assumed to be ICE vehicles

Relative risks according to road environment

Casualty rates were higher in urban than rural environments ( tables 3 and 4 ).

Pedestrian casualties due to collisions with cars or taxis from reported road traffic collisions in Great Britain 2013–2017—by vehicle propulsion type in urban road environments

Pedestrian casualties due to collisions with cars or taxis from reported road traffic collisions in Great Britain 2013–2017—by vehicle propulsion type in rural road environments

Urban environments

Collisions with pedestrians in urban environments were on average over two and a half times as likely (RR 2.69 (95% CI 2.56 to 2.83, p<0.001) with E-HE vehicles as with ICE vehicles ( table 3 ).

The extreme case sensitivity analysis showed collisions with pedestrians in urban environments were more likely with E-HE vehicles (RR 2.05; 95% CI 1.95 to 2.15).

Rural environments

Collisions with pedestrians in rural environments were equally likely (RR 0.91; 95% CI 0.74 to 1.11) with E-HE vehicles as with ICE vehicles ( table 4 ).

The extreme case sensitivity analysis found evidence that collisions with pedestrians in rural environments were less likely with E-HE vehicles (RR 0.68; 95% CI 0.55 to 0.83).

Results of Poisson regression analysis

Our Poisson regression model results ( table 5 ) showed that pedestrian injury rates were on average 9.28 (95% CI 9.07 to 9.49) times greater in urban than in rural environments. There was no evidence that E-HE vehicles were more dangerous than ICE vehicles in rural environments (RR 0.91; 95% CI 0.74 to 1.11), consistent with our finding in table 4 . There was strong evidence that E-HE vehicles were on average three times more dangerous than ICE vehicles in urban environments (RR 2.97; 95% CI 2.41 to 3.67).

Results of Poisson regression analysis of annual casualty rates of pedestrians per 100 million miles by road environment and the interaction between vehicle propulsion type and environment

Statement of principal findings

This study found that in Great Britain between 2013 and 2017, casualty rates of pedestrians due to collisions with E-HE cars and taxis were higher than those due to collisions with ICE cars and taxis. Our best estimate is that such collisions are on average twice as likely, and in urban areas E-HE vehicles are on average three times more dangerous than ICE vehicles, consistent with the theory that E-HE vehicles are less audible to pedestrians in urban areas where background ambient noise levels are higher.

Strengths and weaknesses of the study

There are several limitations to this study which are discussed below.

The data used were not very recent. However, ours is the most current analysis of E-HE vehicle collisions using the STATS19 dataset.

Before we can infer that E-HE vehicles pose a greater risk to pedestrians than ICE vehicles, we must consider whether our study is free from confounding and selection bias. Confounding occurs when the exposure and outcome share a common cause. 19 Confounders in this study would be factors that may both cause a traffic collision and also cause the exposure (use of an E-HE car). Younger, less experienced drivers (ie, ages 16–24) are more likely to be involved in a road traffic collision 20 and are also more likely to own an electric car. 21 Some of the observed increased risk of electric cars may therefore be due to younger drivers preferring electric cars. This would cause positive confounding, meaning that the true relative risk of electric cars is less than we have estimated in our study. Regarding selection bias, it is known that the STATS19 dataset does not include every road traffic casualty in Great Britain, as some non-fatal casualties are not reported to the police. 22 If casualties from collisions are reported to the police differentially according to the type of vehicle propulsion, this may have biased our results; however, there is no reason to suspect that a pedestrian struck by a petrol or diesel car is any more or less likely to report the collision to the police than one struck by an electric car.

We must also address two additional concerns as ours is a cross-sectional study: The accuracy of exposure assignment (including the potential for recall bias) and the adequacy of prevalence as a proxy for incidence. 23 First, the accuracy of exposure assignment and the potential for recall bias are not issues for this study, as the exposure (type of propulsion of the colliding vehicle, E-HE or ICE), is assigned independently of the casualties by the UK Department for Transport who link the vehicle registration number (VRN) of each colliding vehicle to vehicle data held by the UK Driver Vehicle and Licensing Agency (DVLA). 10 Second, we have not used prevalence as a proxy for incidence but have estimated incidence using total distance travelled by cars as the measure of exposure.

We may therefore reasonably infer from our study results that E-HE vehicles pose a greater risk to pedestrians than ICE vehicles in urban environments, and that part of the risk may be due to younger people’s preference for E-HE cars.

A major limitation of the STATS19 road safety dataset used in this study was that it did not contain a vehicle propulsion code for all vehicles in collisions with pedestrians. We excluded these vehicles from our primary analysis (a complete case analysis) and we also conducted an extreme case sensitivity analysis. We will now argue why imputation of missing vehicle propulsion codes would not have added value to this study. Vehicle propulsion data are obtained for the STATS19 dataset by the UK Department for Transport who link the VRN of each colliding vehicle recorded in STATS19 to vehicles data held by the UK DVLA. The STATS19 data on reported collisions and casualties are collected by a Police Officer when an injury road accident is reported to them; Most police officers write details of the casualties and the vehicles involved in their notebooks for transcription onto the STATS19 form later at the Police station. 24 The VRN is one of 18 items recorded on each vehicle involved in a collision. Items may occasionally be missed due to human error during this process. Where a VRN is missing, vehicle propulsion will be missing in the STATS19 dataset. The chance that any vehicle-related item is missing will be independent of any characteristics of the casualties involved and so the vehicle propulsion codes are missing completely at random (MCAR). As the missing propulsion data are very likely MCAR, the set of pedestrians with no missing data is a random sample from the source population and hence our complete case analysis for handling the missing data gives unbiased results. The extreme case sensitivity analysis we performed shows a possible result that could occur, and it demonstrates our conclusions in urban environments are robust to the missing data. Lastly, to impute the missing data would require additional variables which are related to the likelihood of a VRN being missing. Such variables were not available and therefore we do not believe a useful multiple imputation analysis could have been performed.

Strengths and weaknesses in relation to other studies

Our study uses hundreds of millions of miles of car travel as the denominators in our estimates of annual pedestrian casualty rates which is a more accurate measure of exposure to road hazards than the number of registered vehicles, which was used as the denominator in a previous study in the UK. 10 Our results differ to this previous study which found that pedestrian casualty rates from collisions with E-HE vehicles during 2005–2007 were lower than those from ICE vehicles. Our study has updated this previous analysis and shows that casualty rates due to E-HE vehicle collisions exceed those due to ICE vehicle collisions. Similarly, our study uses a more robust measure of risk (casualty rates per miles of car travel) than that used in a US study. 9 Our study results are consistent with this US study that found that the odds of an E-HE vehicle causing a pedestrian injury were 35% greater than an ICE vehicle. Brand et al 8 hypothesised, without any supporting data, that “hybrid and electric low-noise cars cause an increase in traffic collisions involving vulnerable road users in urban areas” and recommended that “further investigations have to be done with the increase of low-noise cars to prove our hypothesis right.” 8 We believe that our study is the first to provide empirical evidence in support of this hypothesis.

Meaning of the study: possible explanations and implications for clinicians and policymakers

More pedestrians are injured in Great Britain by petrol and diesel cars than by electric cars, but compared with petrol and diesel cars, electric cars pose a greater risk to pedestrians and the risk is greater in urban environments. One plausible explanation for our results is that background ambient noise levels differ between urban and rural areas, causing electric vehicles to be less audible to pedestrians in urban areas. Such differences may impact on safety because pedestrians usually hear traffic approaching and take care to avoid any collision, which is more difficult if they do not hear electric vehicles. This is consistent with audio-testing evidence in a small study of vision-impaired participants. 10 From a Public Health perspective, our results should not discourage active forms of transport beneficial to health, such as walking and cycling, rather they can be used to ensure that any potential increased traffic injury risks are understood and safeguarded against. A better transport policy response to the climate emergency might be the provision of safe, affordable, accessible and integrated public transport systems for all. 25

Unanswered questions and future research

It will be of interest to investigate the extent to which younger drivers are involved in collisions of E-HE cars with pedestrians.

If the braking distance of electric cars is longer, 26 and electric cars are heavier than their petrol and diesel counterparts, 27 these factors may increase the risks and the severity of injuries sustained by pedestrians and require investigation.

As car manufacturers continue to develop and equip new electric cars with Collision Avoidance Systems and Autonomous Emergency Braking to ensure automatic braking in cases where pedestrians or cyclists move into the path of an oncoming car, future research can repeat the analyses presented in this study to evaluate whether the risks of E-HE cars to pedestrians in urban areas have been sufficiently mitigated.

Conclusions

E-HE vehicles pose a greater risk to pedestrians than petrol and diesel powered vehicles in urban environments. This risk needs to be mitigated as governments proceed to phase out petrol and diesel cars.

Ethics statements

Patient consent for publication.

Not applicable.

Ethics approval

This study involves human participants and was approved by the LSHTM MSc Research Ethics Committee (reference #16400). The study uses the anonymised records of people injured in road traffic collisions, data which are routinely collected by UK police forces. The participants are unknown to the investigators and could not be contacted.

Acknowledgments

We thank Rebecca Steinbach for her advice on analysis of National Travel Survey data, Jonathan Bartlett for his advice on missing data, and Ben Armstrong for his advice on Poisson regression. We are grateful to the reviewers and to Dr C Mary Schooling, Associate Editor, whose comments helped us improve the manuscript. We are grateful to Jim Edwards and Graham Try for their comments on earlier versions of this manuscript.

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Contributors CH and PJE developed the idea for this study and supervised SM in performing the literature search, downloading, managing and analysing the data. SM wrote the first draft of the manuscript, which was the dissertation for her MSc in Public Health. PJE prepared the first draft of the manuscript for the journal. All authors assisted in editing and refining the manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. PJE (guarantor) accepts full responsibility for the work and the conduct of the study, had access to the data and controlled the decision to publish.

Funding This study was conducted in part fulfilment of the Masters degree in Public Health at the London School of Hygiene & Tropical Medicine. The second author was self-funded for her studies for this degree.

Competing interests None declared.

Provenance and peer review Not commissioned; externally peer reviewed.

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