The “Good Advice” That Keeps Premeds Stuck

Most advice that premeds receive isn’t malicious. In fact, it’s usually very well-intentioned.

The problem is that much of it is designed to make you feel calmer in the moment. It reduces anxiety today, but it doesn’t necessarily increase your odds of getting into medical school or reduce risk over the long term.

And in a process where more than half of all applicants don’t matriculate in any given cycle, feeling calm and being strategic are two very different things.

What follows is the kind of “good advice” that’s socially accepted, comforting, and widely repeated, yet quietly increases the chances that you get stuck.

1. “Apply Like Everyone Else” (15–20 Schools)

Why It Feels Good

Applying to 15–20 medical schools feels manageable. It’s cheaper, less overwhelming, and reassuring because everyone seems to recommend it. When advice is repeated often enough, it starts to feel safe.

Why It Keeps People Stuck

“Standard” strategy reflects average behavior, not optimal odds.

According to the AAMC, the acceptance rate for applicants to allopathic medical schools was just under 45% for the 2025 application cycle, with approximately 54,699 applicants competing for around 23,440 spots. AAMC data from the 2023 cycle showed applicants submitted an average of 18 applications each through AMCAS alone.

This means that the average applicant follows an average strategy, and more than half of all applicants don’t get in. That outcome is exactly what you’d expect. When the acceptance rate hovers around 40–45% year after year, doing what everyone else does predictably produces a large number of rejections.

If your goal is to reduce the risk of not getting in, following the crowd is rarely the best approach.

The Better Approach

To reduce risk, most applicants benefit from applying more broadly, but doing so intelligently.

For many students, odds improve meaningfully when applying to roughly 25–30 schools before flattening out. This isn’t about being neurotic. It’s about optionality. In practical terms, it’s buying insurance in a high-stakes process with limited control. This is one of the most common risk miscalculations we see. We walk through the numbers and strategy in detail in You Are Not Applying to Enough Medical Schools.

2. “Don’t Apply Wider. Secondaries Will Destroy You.”

Why It Feels Good

This advice validates overwhelm. It gives permission to stop early and acknowledges how exhausting secondaries can feel.

Why It Keeps People Stuck

Secondary guides are far more repetitive than most applicants expect.

The first 8–12 secondaries are the hardest because you’re building your core stories and templates. After that, prompts start repeating. Later secondaries often become much faster because you’re reusing and tailoring existing material rather than starting from scratch.

Later secondaries often become much faster because you’re reusing and tailoring existing material rather than starting from scratch. If you stop at 15 schools, you absorb the most painful part of the process while missing much of the payoff.

The Better Approach

Effort is front-loaded. Knowing this changes your strategy entirely.

A more effective approach is to build 6–10 reusable “story modules” ahead of time, experiences related to challenge, failure, growth, teamwork, service, leadership, and ethics, and map prompts to those modules. This turns secondaries into refinement rather than reinvention.

This approach also has a hidden benefit: it forces you to deeply reflect on your experiences early, which makes your writing sharper across every application.

3. “If You Don’t Get In, Just Take a Gap Year.”

Why It Feels Good

This advice sounds compassionate. It lowers anxiety and makes rejection feel less threatening. It frames a setback as “just part of the process.”

Why It Keeps People Stuck

Reapplication cycles are emotionally, financially, and strategically costly. They introduce delays, opportunity cost, and additional scrutiny.

Medical schools expect reapplicants to demonstrate meaningful improvement. Reapplying without clear changes, or simply hoping for a different outcome, is rarely persuasive. Admissions committees can see your previous application history and will look for concrete evidence that you’ve addressed whatever held you back the first time.

There’s also an important distinction that often gets overlooked: intentional versus accidental gap years.

The Better Approach

Gap years aren’t bad. But accidental gap years often are.

An intentional gap year is planned in advance with specific goals: completing a master’s program, accumulating meaningful research, gaining clinical experience, or addressing a clear weakness in your application.

An accidental gap year happens when an application cycle fails unexpectedly, and suddenly you’re scrambling to figure out how to spend the next 12–18 months in a way that justifies reapplying.

The default strategy should be reducing the probability of needing an accidental gap year, not assuming one will be harmless.

The irony is that the advice “just take a gap year” is often given to premeds who could have avoided needing one if they’d applied more strategically in the first place.

If you’re considering a gap year, read this first: Should You Take a Gap Year?

4. “Any Med School Is Fine. Just Get In.”

Why It Feels Good

This removes decision pressure and feels mature and non-prestigious. It reframes success as simply crossing the first hurdle.

Why It Keeps People Stuck

Medical school isn’t the final gate. Residency is.

Different schools provide different levels of access to mentorship, research, clinical exposure, and specialty-specific resources. Environment matters, especially if your interests change.

According to the AAMC’s Careers in Medicine program, only about one-quarter of medical students who begin school with a specialty preference stick with that choice throughout medical school.

Most medical students do change their minds about their specialty. If you discover an interest in a competitive field later on, attending a school without the relevant infrastructure can make an already difficult path much harder.

If you discover an interest in a competitive field later on, say, orthopedic surgery, dermatology, or plastic surgery, attending a school without the relevant infrastructure, mentorship networks, or research opportunities can make an already difficult path dramatically harder. You’re not just competing against your own merits; you’re competing against peers who had access to resources you didn’t

The Better Approach

This isn’t about prestige. It’s about infrastructure and probability.

The school you attend can raise or lower your ceiling. When you’re evaluating schools, think less about rankings and more about whether the school offers robust research opportunities across multiple specialties, strong residency match track records in competitive fields, mentorship from faculty who are active in the specialties you might pursue, and clinical rotation sites that expose you to a wide range of practice settings.

Choose the option that preserves flexibility and opportunity for future-you.

5. “MD vs DO vs International Doesn’t Matter”

Why It Feels Good

This advice is inclusive and supportive. It reduces the sting of a less ideal outcome, and anecdotes of success are easy to find online.

Why It Keeps People Stuck

Outcomes differ by pathway, and those differences matter more as competitiveness increases.

Survivorship bias dominates online discussions. While some DOs and international graduates match into highly competitive specialties, those cases are the exception, not the norm. Data consistently shows meaningful differences in match rates by degree type.

Some pathways add friction at every step: access to rotations, research opportunities, letters of recommendation, and the Match itself.

The Better Approach

This isn’t about judging anyone or questioning the quality of doctors. It’s about risk and optionality.

If your goal is to keep doors open, the general hierarchy reflects ease of progression: U.S. MD offers the least resistance, DO can be very viable but often adds friction, and many international pathways represent the steepest climb.

You can succeed from any path. The question is why choose hard mode if you don’t have to, unless you have a truly specific reason.

6. “Plan Your Future Around the Specialty You Want Right Now.”

Why It Feels Good

Certainty feels motivating. Telling yourself “I’m going to be a surgeon” gives you an identity, a direction, and a sense of purpose. It makes the whole exhausting premed grind feel more meaningful.

Why It Keeps People Stuck

The majority of medical students change their minds once exposed to real clinical work. Even the specialties with the highest “loyalty rates” still see massive turnover. Psychiatry had the highest continuity rate, and that was still only 59%. In most specialties, the majority of students who end up in that field didn’t start medical school planning to go there.

Early, narrow optimization can close doors you didn’t even know you’d want. If you spend all of your premed years tailoring every experience, every research project, and every clinical hour toward one specialty, and then you change your mind during third-year rotations (as most people do), you may find yourself without the breadth of experiences needed to pivot effectively.

Having preferences is fine. Locking yourself into a rigid strategy too early is not.

The Better Approach

Early strategy should maximize flexibility.

Build a diverse portfolio of experiences, research that demonstrates your ability to engage in scholarly work regardless of specialty, clinical exposure across multiple settings, and leadership experiences that reflect who you are as a person rather than who you think you’ll be in ten years.

Optionality is invisible until you need it. You’ll never regret having kept more doors open. You might deeply regret having closed them.

What It Comes Down To

Much of the “good advice” premeds hear is optimized to reduce anxiety today. Your job is to reduce regret later.

You don’t need to suffer. You just need to be honest about tradeoffs.

The applicants who get stuck aren’t the ones who lack talent or drive. They’re the ones who follow comfortable advice instead of strategic advice, who optimize for how they feel in the moment rather than where they want to be in five years.

Choose optionality, align your probabilities, and then work hard.