2026 AACOMAS Secondary Application Guide

Applying to osteopathic medical schools comes with its own set of considerations, and the secondary application is where many DO applicants lose ground they worked hard to build. The primary got you in the door. The AACOMAS secondary is where admissions committees decide if you actually belong there.

DO programs want applicants who understand osteopathic medicine, believe in its philosophy, and can articulate why this path is specifically for them. A generic secondary that could have been written for any MD program won’t cut it. Within 2 to 4 weeks of submitting your primary, your secondaries start arriving. How you handle them will determine whether you get an interview.

AACOMAS vs. AMCAS Applications

There are a few different medical school application services in the United States, and the one you choose will depend on where in the country you want to study, as well as the type of doctor you want to become; namely, an osteopathic (DO) doctor or an allopathic (MD) doctor.

The vast majority of students applying to osteopathic (DO) schools will use the American Association of Colleges of Osteopathic Medicine Application Service (AACOMAS) to apply to medical school, whereas the vast majority of medical school applicants studying to become an allopathic (MD) doctor will use the American Medical Colleges Application Service (AMCAS) to apply to medical school.

Both are centralized online application services, meaning that you only need to prepare one set of application materials to submit to the service, which will then verify, process, and send out the materials to the schools of your choosing. If you are considering applying to both DO and MD schools, you will need to use both services.

While the application requirements of both services are very similar, there are a few key differences to be aware of.

These are the AMCAS vs. AACOMAS vs. TMDSAS Med School Application Differences.

The practical differences go beyond which portal you use. AACOMAS asks why you want to become a doctor of osteopathic medicine specifically, which means you can’t recycle your AMCAS personal statement without significant revision. AACOMAS also strongly recommends at least one letter of recommendation from a DO physician. For a full breakdown of how the three services differ, see our guide on AMCAS vs. AACOMAS vs. TMDSAS application differences.

MDs and DOs are both fully licensed physicians who can prescribe medications, perform surgery, and practice across all 50 states. The average DO matriculant enters with a 3.60 GPA and a 502.97 MCAT, compared to a 3.81 GPA and 512.1 MCAT for the average MD matriculant. That gap reflects a real difference in applicant pool competitiveness. DO graduates also have a harder time matching into competitive specialties and face more limited recognition outside the US. If you’re weighing the two paths, our full MD vs. DO breakdown covers the residency match data and what it means for your long-term options.

Applying to DO programs makes sense if your stats fall below the MD threshold, if you’re committed to primary care or a specialty where DO graduates match well, or if osteopathic medicine aligns with how you want to practice. If you receive both MD and DO acceptances, take the MD.

What to Expect from AACOMAS Secondary Applications

Submitting your primary through AACOMAS is only the first step. Secondary applications arrive as early as two weeks after schools receive your primary, right when most applicants are burning out on the process.

Unlike the primary, secondaries are sent directly by each school you applied to. Most programs send them to nearly every applicant, partly to collect secondary fees and partly to gauge genuine interest. If you don’t submit within a reasonable timeframe, admissions committees take notice.

Secondaries are your chance to demonstrate why you’re a strong fit for each program specifically, not just medicine in general. If you applied to 25 to 30 schools, as we recommend, you could receive that many secondaries. Preparing in advance is the only way to handle that volume without sacrificing quality.

AACOMAS Secondary Deadlines and Timeline

The AACOMAS application will typically open in early May for the following year’s medical school class. By mid-June, colleges begin receiving and processing applications. This means that if you plan to start medical school in the fall of 2028, you need to begin the application process in the spring of 2027.

Once you submit your primary application, you can expect to receive secondaries within two to four weeks.

Your chances of being accepted to medical school decrease the later you submit your application due to rolling admissions, so it is imperative that you stay on top of all deadlines and prepare to submit your primary and secondary applications long before the actual deadline.

Secondary applications should be completed as soon as possible without sacrificing quality.

Despite the number of secondaries you may receive, it’s vital that you submit quality responses within 7-14 days. It’s a great deal of work to complete in such a short time frame, which is why you must prepare for your secondaries well in advance.

Once secondaries are submitted, invitations for interviews could arrive as early as late August or as late as spring of the following year. Since you may receive invitations at any point during this time, it is critical that you start preparing for interviews well before you begin to receive invitations.

AACOMAS Secondary Application Cost

In addition to the innumerable other costs of applying to medical school, many medical schools charge a fee for secondaries. Osteopathic schools are no exception. Secondary fees vary depending on the school’s prestige and ranking. More prestigious or recognized programs will come with higher fees, but generally, DO schools charge around $100 for secondary applications. Unlike primary application fees, secondary application fees are paid directly to the schools.

AACOMAS Secondary Questions

Each osteopathic school has its own unique secondary application that asks a few targeted essay questions. The number of essay prompts and the required length of your responses will vary from school to school, but you can expect to respond to 2-8 essay questions for each secondary.

Example Medical School Secondary Prompts:

• The mission statement of our medical school is “X.” Please state why you are a great fit for our community.
• Please describe a moral or ethical dilemma that was particularly memorable and what you learned from this experience.
• Describe a challenge you’ve faced and the steps you took to overcome it.
• After residency, describe the community in which you see yourself practicing medicine.
• Indicate any special experiences, unusual factors, or other information you feel would be helpful in evaluating you, i.e., education, employment, extracurricular activities, or prevailing over adversity.
• Describe an experience you had in interacting/relating with people whose backgrounds are different from your own. What did you learn from it? How did it change your perspective?
• Why have you chosen to apply to our program, and how will we help make you the physician you aspire to be?
• Do you have any immediate family members who have graduated from our program?

Use our free, continuously updated Secondary Essay Prompts Database.

Medical School Secondary Strategies

1 | How to Prioritize Your AACOMAS Secondary Applications

Secondary applications will begin to arrive within two to four weeks of a medical school receiving your primary application. If you applied to 25 or more programs, most of them will verify your application and send out secondaries around the same time, with additional secondaries arriving in the following weeks. And since medical school interview invitations are sent out on a rolling basis, it’s critical that you submit secondaries as soon as possible.

It’s a great deal of work, which is why you must prioritize certain secondaries over others. Although you may have applied to 25-30 programs, there’s likely a choice few that you are more passionate about. Prioritize responding to these secondaries first.

In addition, if you notice a secondary is much more intensive than others, start with that one first. This way, you can get a sense of the kinds of questions you can expect to answer and how long the process will take. Plus, you will have more material to recycle for your other secondaries. (More on that below!)

This is the ideal order to complete secondaries. 

2 | When to Submit Your AACOMAS Secondary Applications

The sooner you submit your secondaries, the more likely it is you’ll receive an interview for that particular school, which is why we recommend submitting secondaries within 7-14 days of receiving them.

It’s not a lot of time to draft a convincing, thoughtful response to each of the medical schools you applied to. The best way to prepare is to draft your responses early.

3 | Pre-Write Your Secondary Essays Before They Arrive

Don’t wait until you receive a secondary to begin drafting a response. Medical schools repeat many of the same general questions, and since a school rarely changes its secondary essay questions from the previous year, you can get started in advance. Once you start receiving secondaries, you can edit your responses to suit each school’s specific questions.

While it’s not always the case that a school will repeat the same questions from the preceding year, it’s still smart to draft answers to the questions you expect to receive—especially when it comes to the schools you’re most interested in attending.

Prewriting your secondaries is an essential preparation tactic that will better enable you to submit high-quality responses to your secondaries within the 14-day window.

4 | How to Answer the “Why Us” Secondary Essay Question

It’s safe to assume you’ll receive one or more variations of the “Why Us” question on each secondary application. Although it appears generic on the surface, this question asks much more than the school’s mission statement.

Simply regurgitating the school’s mission statement or saying you’ve always wanted to live where the school is located does not adequately convey your interest in the specific program. These kinds of ineffectual responses are automatic red flags for admissions committees.

Why are you a specifically great fit for the school’s specific program?

The first step is researching the school. Do some digging. What sets them apart from the other programs you’ve researched? What are the school’s values? What type of medicine do they specialize in? Relate your discoveries to your own experiences. Is there an extracurricular they offer that you were actively involved in in the past? Is there a physician at the school you’re particularly excited to work with? How do your past experiences embody the school’s values?

Leave no stone unturned in your research, and be specific and authentic with your responses.

5 | Carefully Review School Names

If you are recycling responses from one secondary to the next, take special care to review the school names. Yes, it may seem like obvious advice, but don’t misname the school you’re responding to in your secondary. Admissions committees do not appreciate it, and it demonstrates severe carelessness on your part. The words ‘severe carelessness’ and ‘doctor’ do not go hand in hand.

6 | Proofread Every Secondary Before You Hit Submit

Proofread your work for typos and grammar, and review all school names. We recommend using online editing apps like Grammarly and Hemingway Editor to screen for more obvious errors, but do not rely on these apps alone. They catch a lot, but being that they’re only bots, they can miss extremely obvious errors your ten-year-old cousin could catch in an instant.

Never submit secondaries without triple-checking them first. Consider asking a trusted friend, family member, or mentor to read them over as well. Spelling and grammar mistakes are immediate red flags to admissions committees. They once again exhibit carelessness, which is never a good look for an aspiring DO.

Why Generic AACOMAS Secondaries Don’t Work

Every DO applicant now has access to the same AI tools, which means admissions committees are reading secondary essays that are increasingly polished and increasingly indistinguishable from one another. Confident tone, specific-sounding details, mission-aligned language. They may not be able to prove it was AI-generated, but they can feel it.

This matters most for DO programs because the “Why Us” and “Why osteopathic medicine” questions are where AI does the most damage. A tool that pulls publicly available information about a program’s community focus or philosophical approach can produce a convincing-sounding essay in minutes. So can every other applicant using the same prompt.

What AI can’t generate is your actual reason for choosing osteopathic medicine, like a mentor who practiced OMM and changed how you think about patient care, a clinical experience that connected directly to a DO program’s mission, or a specific faculty member whose work aligns with yours. That level of specificity is what DO admissions committees are looking for, and it’s the one thing that can’t be manufactured.

Use AI to edit and tighten your writing. Don’t use it to write your secondaries for you.

Don’t Leave Your AACOMAS Secondaries to Chance

AACOMAS secondaries are where a lot of otherwise strong DO applicants lose ground. The volume is relentless, the turnaround is tight, and every essay needs to speak directly to why you belong at that specific program.

Our Medical School Secondary Application Editing services pair you with physician advisors who have served on admissions committees and read hundreds of secondary essays. They know what stands out and what gets passed over. If you want your secondaries to work as hard as your primary did, that’s where we can help.

AACOMAS Secondary Application FAQ

Do I need to submit both AACOMAS and AMCAS secondary applications?

Only if you’re applying to both DO and MD programs. They are separate application services and not interchangeable. If you’re applying to both, you’ll manage two distinct sets of secondaries with different timelines and essay prompts.

Can I reuse my AMCAS secondary essays for AACOMAS secondaries?

In some cases, you can recycle responses with modifications, but DO programs are specifically looking for applicants who understand osteopathic medicine and can speak to it directly. A generic secondary that reads like it was written for an MD program will work against you.

If I get into both an MD and DO program, which should I choose?

Take the MD. The residency match data is consistent on this. MD programs offer stronger access to competitive specialties, broader international recognition, and more flexibility as your interests evolve during medical school. Our full MD vs. DO guide breaks down the data in detail.

Do DO students need to take the USMLE in addition to COMLEX?

Technically, no, but practically yes if you have competitive specialty ambitions. Many residency programs prefer or require USMLE scores, and taking only COMLEX limits your options. If you’re applying to dermatology, plastic surgery, neurosurgery, or other competitive specialties, plan on sitting for both.

What makes a strong AACOMAS secondary application?

Specificity. DO programs want applicants who understand osteopathic medicine and can articulate why this path is specifically for them. A secondary that could have been written for any MD program won’t cut it. Research each school, connect their mission to your own experiences, and submit within 7 to 14 days of receiving each secondary.