A medical school application is a multi-layered process that unfolds across several months and involves three distinct stages: a primary application, secondary applications from individual schools, and interviews. The primary application alone contains nine separate sections covering your academic record, personal experiences, and a personal statement. Here’s what each piece looks like and what you’ll need to prepare.
The Three Application Services
Most applicants don’t apply directly to medical schools. Instead, you submit through a centralized application service that distributes your materials to every school on your list. Which service you use depends on the type of school:
- AMCAS handles applications for most MD-granting (allopathic) medical schools in the U.S.
- AACOMAS handles applications for DO-granting (osteopathic) medical schools.
- TMDSAS handles applications for medical and dental schools in Texas, covering both MD and DO programs in that state.
If you’re applying to both MD and DO programs outside of Texas, you’ll fill out two separate applications through AMCAS and AACOMAS. The sections overlap significantly, but the formatting and rules differ in ways that matter.
Nine Sections of the Primary Application
The AMCAS application, which is the most widely used, is organized into nine sections: Identifying Information, Schools Attended, Degrees, Biographic Information, Coursework, Work/Activities, Letters of Evaluation, Medical Schools (your school list), and Standardized Tests. AACOMAS and TMDSAS follow a similar structure with some variation. TMDSAS, for example, includes a separate Chronology of Activities section and its own residency determination process for Texas applicants.
The coursework section is one of the most time-consuming parts. You’ll enter every college course you’ve ever taken, including community college and summer courses, along with credit hours and grades. AMCAS then verifies this against your official transcripts and calculates its own GPA, which can differ from the one on your transcript because it uses its own grading scale and includes courses your school may have replaced through grade forgiveness policies.
Work and Activities
This section is where you present your extracurricular profile: clinical experience, research, volunteering, leadership, employment, hobbies, and anything else meaningful. On AMCAS, you can list up to 15 experiences, each with a description of up to 700 characters (roughly 100 words). You then select three as “most meaningful” and get an additional 1,325 characters for each of those to explain their impact on you.
AACOMAS handles this differently. There’s no cap on the number of experiences you can list, but descriptions max out at 600 characters each, and there’s no “most meaningful” designation. This means the two applications require different writing strategies. On AMCAS, you’re curating and prioritizing. On AACOMAS, you can be more comprehensive but need to be concise in each entry.
For each experience on AMCAS, you can log up to four separate time periods, so a long-running commitment like a research position you held across multiple years can be captured under one entry. Schools pay close attention to the total hours and timeframe, not just what you did but how sustained your involvement was.
The Personal Statement
Every application service includes a personal statement, and on both AMCAS and AACOMAS the limit is 5,300 characters including spaces. That works out to roughly one full page, single-spaced. The AAMC frames this as your “personal comments essay” and gives you broad latitude: why medicine, what experiences shaped that decision, and what you want admissions committees to understand about you that the rest of the application doesn’t capture.
AACOMAS adds two additional essays beyond the personal statement, with limits of 5,000 and 2,500 characters. These typically ask about your understanding of osteopathic medicine and why you’re pursuing the DO path specifically. TMDSAS has its own essay set as well. So if you’re applying across all three services, you could be writing five or more primary essays before secondaries even arrive.
Letters of Evaluation
Medical schools typically want three to four letters of recommendation, though the exact format varies. AMCAS accepts up to 10 letters (with committee packets counting as one), while AACOMAS accepts up to six. Most schools expect some combination of the following: letters from science faculty who taught you, a letter from a non-science or non-academic source like a clinical supervisor or community mentor, and possibly a committee letter from your undergraduate pre-health advising office.
The University of Wisconsin’s requirements are a good example of how schools structure this. They accept one of three formats: a committee letter plus one non-academic letter, a packet of three faculty letters plus a non-academic letter, or four individual letters (three academic or professional, one from a mentor). If you’ve been out of school for several years, most schools are flexible about substituting professional supervisors for faculty recommenders.
MCAT Scores and Academic Benchmarks
Your MCAT score is reported through AMCAS automatically for MD schools, but you’ll need to separately authorize score release for AACOMAS and TMDSAS. For the 2023-2024 entering class, the mean MCAT for students who matriculated into MD programs was 511.7 out of a possible 528, and the mean undergraduate GPA was 3.71. Those are averages across all matriculants nationally, so individual schools range widely. A state school might have a mean around 509, while a top-20 program might sit above 520.
Schools see your total MCAT score and each of the four section scores. They also see every attempt if you’ve taken the test more than once.
Situational Judgment Tests
Beyond the MCAT, a growing number of schools now require one or both of two online situational judgment tests: Casper and PREview. Casper presents you with difficult interpersonal scenarios and asks what you would do. PREview focuses on ethical dilemmas you might encounter in medical school. Not every school requires these, and some require one but not the other, so you’ll need to check each school’s requirements individually. Both are taken online and scored separately from your MCAT.
What Secondary Applications Look Like
After a school receives your primary application, most will send you a secondary application, which is a school-specific set of essays and sometimes a supplemental fee. This is the stage where the volume becomes intense. If you applied to 20 schools, you could receive 15 to 20 secondaries within a few weeks of each other, each with its own essay prompts and deadlines.
The most common secondary essay themes fall into a few categories: a personal challenge or moment of resilience, how you’ll contribute to diversity at the school, and why you’re specifically interested in that program. Some schools give you two weeks from the date of invitation to submit. Others allow up to a month. Speed matters here because admissions committees review on a rolling basis, and earlier submissions generally get earlier interview invitations.
Secondary essays typically range from 100 to 500 words each, and a school might ask anywhere from one to six of them. Writing all your secondaries can easily take several weeks of focused work.
Costs and Timeline
Applying to medical school is expensive. The AMCAS application costs $175 for your first school and $46 for each additional school. AACOMAS starts at $198 for the first school and $57 per additional school. Most secondary applications carry their own fees, typically $50 to $125 per school. An applicant sending 20 MD applications and receiving 15 secondaries could spend well over $2,000 before travel costs for interviews.
The cycle begins in late spring. The AMCAS application typically opens in May, with the earliest submission date in late May or early June. Verification, the process where AMCAS checks your transcript data, can take four to six weeks during peak periods. Schools then send secondaries over the summer, conduct interviews from September through February, and issue final decisions in the spring. From the moment you start your application to the day you receive an acceptance, the process spans roughly 10 to 14 months.
How the Pieces Fit Together
The full picture, then, looks like this: a detailed primary application covering your academic history, activities, personal statement, and test scores, followed by a wave of school-specific secondary essays, followed by interviews at schools that are seriously considering you. Each stage narrows the pool. Of the roughly 52,000 people who applied to MD programs in 2023, about 22,800 ultimately enrolled.
The application rewards preparation that starts early. Requesting transcripts, lining up letter writers, drafting your personal statement, and pre-writing common secondary prompts are all things you can do months before the application opens. The students who submit in the first two weeks of the cycle and turn around secondaries within days of receiving them give themselves a measurable advantage in a process that is, at every stage, rolling.