Primary vs. Secondary Applications for Medical School

All that you need to know to prepare you for the application cycle.

Primary vs. Secondary Applications

Part 1: Introduction

Part 1: Introduction

The medical school application process can sometimes feel shrouded in mystery to premeds. The application cycle seems to have its own language: AMCAS, AACOMAS, TMDSAS, primary, secondary application…there are new words and acronyms to learn and seemingly little time to learn them. But it doesn’t have to be this way. Understanding exactly what lays in store for your application can be simple, once you’ve got a good grasp of the differences between two of the most important parts of the application cycle: the primary vs. secondary applications. 

We’ll help demystify these two components of the process so that you can feel confident and ready to tackle whatever the application cycle throws at you.

Part 2: Comparing the Primary and Secondary Applications

You’ll need to complete both the primary application and likely more than one secondary application if you hope to apply to medical school. While both primaries and secondaries are written elements of your application, opportunities for schools to assess your motivations, credentials and ability to express yourself on paper, they come at different times and serve different purposes.

Part 3: The Primary Application

The primary application is the first step of your medical school application (after your volunteer work, college courses, MCAT, and shadowing, of course!) Depending on the student, you may fill out between one and three primary applications. These are “generic” applications, if you will. You’ll fill out one primary application if you’re applying to M.D. (allopathic) programs and a separate one if you’re also applying to D.O. (osteopathic) programs. Students who apply to schools in Texas will fill out the Texas Medical and Dental School Application Service (TMDSAS). 

If you’re applying to MD, DO, AND schools in Texas, you’ll fill out all three…but that’s not usually the case for most applicants. 

Your primary application will ask you to:

  • Fill out important biographical information
  • List coursework and letter writers
  • You may consider submitting a letter of disadvantage with your primary application, if you experienced significant hardships on your way to a medical education. 

The two big components of a primary application, however, are the:

  1. Personal Statement 
  2. Activities Section.

This is a lot of writing, but it’s a lot of important writing. In primary applications, you’re demonstrating to your readers that you have thought a lot about medicine and you’re ready to commit to the hardwork and dedication that it takes to become a doctor. You’re showing your activities have prepared you, and through your personal statement, you’re telling stories that shine a light for the readers (the admissions committees) into your passion, motivation, and resilience for the road ahead. 

Think of the primary application as your chance to answer the following questions for medical schools:

  1. Why do you want to become a physician?
  2. Why will you be a great physician?

Check out the following resources for more info on the medical school primary application:

Part 4: The Secondary Application

After you hit submit on your primary application, you might fairly be asking: “what next?”

What happens next depends on several factors: where you applied (and what their secondary application policy is) and the strength of your primary application.

Some schools send secondary applications to everyone who submits a primary. That means that, no matter what your GPA, MCAT score, or the quality of your volunteer work, you get a secondary application. It could mean that your chances of getting an interview are really low, or really high: you still get a secondary.

Other schools filter candidates by GPA or MCAT. If your scores meet a certain threshold, then you’ll get a secondary application. This means a little bit more, because you’ve passed their first “test,” when it comes to considering your application for admissions.

Finally, there are some programs that do a holistic review when considering whom to send a secondary. In these cases, getting a secondary means the most…they’ve already decided that they like you.

Of course, schools don’t always advertise what their policy is…the reality of all this “difference” is that it ends up being hard to tell when/where secondaries mean a LOT to your application (schools that have already decided they like you) versus schools where secondaries don’t mean a whole lot (schools that might chuck your secondary without reading it, because it turns out…your test scores were too low for them). 

What exactly is a secondary?

It’s another collection of essay prompts that are specific to the school to which you applied. Primary applications go to everyone, but secondaries are special questions schools get to ask to learn more about you and how you might fit at their program.

If primaries are your chance to explain “Why YOU” and “Why MEDICINE,” then secondaries are your chance to explain “Why this SPECIFIC school”…and for purposes of secondaries, as cheesy as it sounds, write like that specific school is the only one you have ever imagined attending. (Medical schools, are kind of like prom dates, they want to feel loved and appreciated by you.)

For this reason, you MUST be clear, focused and articulate about the school to which you’re applying in your secondary application. Don’t write that you love the “unique curriculum,” at your dream school. Every school thinks they have a unique curriculum and every premed applicant writes that they are excited to learn that “unique curriculum.” Get in the weeds.

  • Do you love that the program tests every week because you’ll stay on top of the curriculum that way?
  • Are you enamored with the digital anatomy lab because you think it’s the future of medicine?
  • What about their condensed preclinical curriculum? 

Do. Not. Be. General. Cite the mission. Cite the vision. Be specific:

  • Write about future mentors you hope to work with
  • research projects the school is highlighting on their website
  • Find the student activities list and choose the clubs that speak to you
  • Ask admissions if you can talk to a current student and write about that in your secondary.
  • Draw parallels between YOUR goals, dreams, and accomplishments to opportunities that are available at the school to which you’re applying 

This is not the time to play hard to get. A well done secondary application shows schools that you’ve done your research, you know why they’re special, and if they invested in you, you would pick them as your medical school. 


Check out the following resources for more info on medical school secondary applications:

Part 5: Prewriting and Preparation

Is there any way to get a head-start on all this writing? It’s never too early to think about your primary application; it can be helpful to keep a journal or a log during your shadowing and volunteer experiences so that you can remember what was impactful to you. This will make it much easier to find inspiration once it comes time to sit down and write your personal statement.

When it comes to secondaries, some premed students also like to get a head-start. Google searches can often turn up student accounts of last year’s questions and sometimes, schools don’t change them. While you can prepare and write essays for schools to which you send a primary, this is a bit of a gamble. If they don’t send you a secondary, that’s an awful waste of time; similarly if they end up changing the prompts. 

What can often be a better idea, is reviewing the TYPES of prompts that medical schools frequently ask in secondary applications;

Make a list of scenarios that demonstrate how you’ve overcome a challenge. Reflect on what makes you different, or unique, that would be appropriate to a diversity prompt. Prepare to hit the ground running, but don’t make extra work for yourself. When your secondaries start to roll in, you want to be prepared, NOT exhausted.

Part 6: Getting Ready for What's Next

Writing both primary and secondary applications should take up a lot of time and energy. That might not be what a tired premed wants to hear, but it’s true. You can make the process easier for yourself by thinking a couple steps ahead while you’re slogging through the application cycle. Make a folder for each school to which you apply. Go old-school and write it out or print it. Take notes on what you love about each school. 

While you’re researching for your secondary application, make note of what you talk about in each part of your application, and also make sure that you’re brainstorming new ideas to talk about during your interview.

Keep a copy of your secondary application in the folder along with a running list of questions, reasons why that school is a good choice for you, and things you’re curious about. This will help ensure that you’re being thorough in your approach to writing your secondary, but it will also give you a head-start if you’re offered an interview.

And with prep like that? Of course you’re going to be offered an interview!

Importantly, for both applications, remember that you need to think not just about listing your motivations and achievements, but also how you’re structuring your argument, telling your story, and the quality of your writing. Medical schools want to see that you can make an argument (i.e. an argument for why you should go to medical school–their medical school!) because making an argument is the foundation of diagnostic medical practice.

When you are developing a differential diagnosis, you’re making a case. You’re thinking critically and your application materials, both primary and secondary, are your first chance to demonstrate that you’re capable of doing so. 

To a worn-out premed, it might seem as though the application questions are frivolous and tediously long for no reason. That’s not true. The application is the first time schools can see if you’re committed.

  • Do you finish the whole application, and return your secondaries within a week?
  • Is the last question you answer as strong as the first?
  • Are you making a coherent argument?

These skills: timeliness, thoroughness, critical thinking are all ones you will use as a physician. Primary and secondary applications are not just hoops to jump through. They are important milestones in demonstrating your readiness to care for patients. 

So invest in this process. MotivateMD is here to help you do just that; our advising and editing services make every part of the application cycle, primaries and secondaries, a breeze. It is a long road, but you can do this! We’re here to help every step of the way.

If you’re ever interested in working with us, feel free to text, call, or email Becca. She’s great about getting back to everyone within a day. Her email is: support@motivatemd.com and her number is: 917-994-0765

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