I read a lot of essays and, believe it or not, I’ve been known to write a few on occasion as well. The majority of them kind of linger in the back of my mind and are slowly forgotten. The ones that stick with me tend to be the application essays that I scrutinize every fall as part of the fellowship recruitment process. Some of them sparkle, giving a genuine sense of who the applicant is and why they are so passionate about entering our field. Others are more forgettable—well written and professional, but lacking that crucial spark that makes me sit up and take notice.
Writing an application essay is undoubtedly a skill that requires soulful reflection, yet there are also some general pieces of guidance for applicants. So what makes an effective application essay? Let’s rheuminate!
And, it should go without saying, please do not lie in your personal statements.
A common pitfall that I see is the tendency to write what the applicant thinks the reader wants to hear. Although it may be tempting to paint a picture of a perfect physician, the reality is that perfection is not what makes a great rheumatologist. Vulnerability—acknowledging challenges and reflecting on personal growth—reveals more about true character than a list of accomplishments ever could.
After reading dozens, if not hundreds, of essays over the stretch of a few weeks, I can say that program directors really enjoy the process of learning about who a person really is.
2. Cohesion: Tell a Story
In my opinion, the best essays tell a story, even if it is not classically a narrative that begins “Once upon a time.” Applicants may be tempted to treat the personal statement like an extended CV, rattling off a list of experiences, accolades and volunteer work without a thread to tie it all together. Although those details are unambiguously important, they need to be organized together in a meaningful way. A cohesive essay weaves disparate elements into a story that shows how the applicant’s experiences have shaped their path toward rheumatology.
As I mentioned, cohesion doesn’t necessarily mean a linear story, but it does mean the essay should feel connected, with each paragraph building on the one before. Whether it’s the story of how a personal experience with autoimmune disease inspired a career in rheumatology or how an applicant’s interest in immunology evolved during medical school, the essay should have a clear structure that leads the reader from one point to the next.
One approach is to focus on a central theme or idea that carries through the entire essay. For example, a hobby or passion may illustrate a personal philosophy or personality trait, which then translates to a central premise about how an applicant may be a promising rheumatologist. A story about a patient and how they influenced an applicant’s identity may help convey how an applicant considers relationships and makes meaning out of the world.
By framing the essay as a story, with internal logic and flow, the applicant gives the reader a sense of their journey, rather than just a series of disconnected experiences.
3. Originality: Add Something New
Program directors are bombarded with essays every season, and certain themes come up repeatedly, such as a fascination with autoimmune diseases or a desire to improve patients’ quality of life. That’s okay because the number of reasons that people get into rheumatology is limited. Indeed, originality doesn’t mean that essay writers need to reinvent the wheel or come up with something never before thought of. Rather, I would recommend offering a perspective or insight that isn’t readily available anywhere else in the application.
One way to achieve originality is by highlighting a unique aspect of the applicant’s background or personal life that hasn’t been adequately captured in other parts of the application. The addition of the impact statement has helped offload some of this, but the personal statement remains a vehicle to elaborate on elements of the application. For example, volunteering and civic engagement are always a plus, but I rarely get an understanding of how these experiences leave lasting impacts. The personal statement can help fill that gap.
By the same token, I want to caution that too much originality can veer into the experimental. Some of the more memorable essays that I’ve read were memorable for reasons that were likely not intended. After all, the reasons we use sentences and paragraphs are because they are tools and conventions to improve readability. Sometimes, disrupting these conventions may be distracting and too jarring for the message to be conveyed to the reader.
4. Aspiration: Tying Past to Future
Aspiration is the element that links the applicant’s past experiences with their future goals, the “So what?” of the entire application. A strong essay will not only describe what someone has done before, but tie those experiences to what they hope to achieve during their fellowship years and beyond. This forward-looking perspective gives the essay a sense of direction and purpose.
Why rheumatology? And why now? Even more important, where does the applicant see themself going? These are critical questions I often ask myself as I read the personal statements. As I’ve already mentioned, the essay should help the reader understand the applicant’s background, but without setting the stage for future contributions in the field, it ends up feeling a little empty. Aspiration is about bridging the gap between where the applicant has been and where they are headed. A good essay leads the reader to see a potential trajectory.
In fact, essays without a clear sense of where the applicant is going come across as wistful and nostalgic without a sense of excitement. By emphasizing what they hope to achieve—whether it’s advancing research, improving patient outcomes or advocating for better healthcare policies—applicants can leave a lasting impression of their long-term commitment to rheumatology.
Aspiration also gives readers confidence that the applicant is driven by a genuine sense of purpose, not just by career advancement or prestige. We want to know the future of our field is in good hands, and an essay that articulates a clear, ambitious vision helps us believe that it is.
5. Positivity: Focus on Strengths & Opportunities
Finally, an effective essay should radiate positivity. This doesn’t mean ignoring challenges or glossing over difficulties, but it does mean framing those challenges in a way that highlights resilience, growth, and the opportunities that lie ahead. An essay that is defensive or overly focused on weaknesses can come across as insecure, while one that is positive emphasizes the applicant’s readiness to take on the next step in their career.
Positivity in an essay is about focusing on strengths, both in terms of accomplishments and personal attributes. It’s about highlighting the skills and qualities that make someone a uniquely strong fit for rheumatology and, ideally, for the fellowship program they are applying to. Rather than focusing on what they don’t have or what they need to improve, applicants may redirect to how they seek to become the rheumatologists they aspire to be.
Moreover, a positive tone can set the stage for a collaborative, forward-thinking attitude. In successful fellowship programs, fellows work closely with patients and colleagues alike and this kind of energy that inspires others is invaluable. Essays that exude positivity leave the reader with a sense of optimism—not only about the applicant’s future, but about the future of rheumatology itself.
Conclusion: A Biopsy of the Emerging Rheumatology Community
Writing an effective application essay is not easy. It requires introspection, clarity and a balance between showcasing accomplishments and demonstrating humility. It requires practice and input from others but without the work-shopping that completely eradicates the soul of an essay. And to various degrees, it requires the five elements we’ve discussed—authenticity, cohesion, originality, aspiration and positivity.
When these elements unite in the right way, the result is an essay that not only informs but inspires. It gives the reader a glimpse into who the applicant is, what they stand for and where they are going. It leaps off the page as more than just a personal statement; it becomes a veritable biopsy of a future rheumatologist’s career, a snapshot of a future leader in our high-powered field.
And so, all the aspiring rheumatologists out there putting pen to paper or fingers to keyboard, I encourage you to approach your essay with these five elements in mind. Write from the heart, tell your story, offer something new, connect your past with your future, and always focus on the strengths you bring to the table. After all, the essay isn’t just text field to complete—it’s a vital opportunity to testify about why you belong in rheumatology and the field of rheumatology would be incomplete without you.
Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS, is the director of the rheumatology fellowship training program at the University of Iowa, Iowa City, and the physician editor of The Rheumatologist. Follow him on X (formerly Twitter) @BharatKumarMD.
