How to keep a premed journal

What a premed journal is

A premed journal is a running record of the experiences that prepare you for medical school: clinical work, volunteering, shadowing, research, leadership, teaching, and employment. It combines two kinds of writing.

• A log of verifiable facts: where you were, when, for how long, in what role, and who supervised you.
• A reflection on what you saw, did, thought, and learned, written while the details are still clear.

Advising offices at several universities, including Indiana University and Missouri State University, recommend keeping one. It is not part of the application, and no admissions committee will ask to see it. Its value is in what it lets you write and say later.

Why keep one

• Memory fades faster than you expect. Many students begin clinical and volunteer work years before they apply. By then, specific conversations, cases, and turning points are hard to recall accurately.
• The application asks for exact details. Every Work and Activities entry requires dates, hours, an organization, a location, and a contact person. Reconstructing these from old emails and calendars is slow and error-prone.
• Reflection tests your motivation. Writing about what you saw on a shift shows you, over time, whether medicine is the right fit and why. That reasoning is the core of a convincing personal statement.
• Specific stories are more persuasive than general claims. "I learned the importance of empathy" says little. A brief account of what you did for one frightened patient says much more, and you can only write it if you recorded it.
• It shows patterns. Reading entries side by side reveals which competencies your experiences demonstrate and which you have not yet developed, while there is still time to fill the gap.

When to start and how often to write

Start with your first activity. If you are a first-year student who has just begun volunteering, that is the right time. An entry written today is more useful than a polished summary written during application season.

Write after each shift or event, ideally the same day. Ten minutes is usually enough. If a shift was uneventful, record the facts and one sentence; not every entry needs a reflection.

Review regularly. A short weekly check keeps hours accurate. At the end of each term, read back through your entries, total your hours by activity, update contact details for supervisors who have changed roles, and note which experiences stood out.

Keep going until you matriculate. Experiences during the application year still matter for secondary essays, update letters, and interviews.

What to record: the facts

These fields mirror what the AMCAS Work and Activities section asks for in each entry, so recording them as you go saves you from reconstructing them later.

What to record: the reflection

A useful reflection focuses on one moment rather than summarizing the whole shift. Four questions are enough to structure it:

1. What happened? Describe the situation briefly and concretely.
2. What did you do? Your own actions, even small ones, matter more than what the physician or team did.
3. What did you notice or feel? Include uncertainty, discomfort, or mistakes. These often lead to the most honest writing.
4. What did you learn, and what would you do differently? Connect the moment to how you understand patients, teams, or medicine.

Prompts for different experiences

• Shadowing: How did the physician explain a diagnosis or plan to a patient? What did they do when the patient disagreed or was upset? What part of the physician's day surprised you?
• Clinical work: When did you help a patient feel more comfortable or understood? What did you learn from a nurse, technician, or other team member?
• Nonclinical volunteering: What needs did you see in the community you served? What changed in how you understand those needs?
• Research: What question were you trying to answer? What went wrong, and how did you respond?
• Leadership and teaching: When did you have to resolve a disagreement or support someone who was struggling?
• Setbacks: What did you do after a poor exam result, a rejection, or a difficult conversation? What would you tell someone in the same position?

Medical schools also look for maturity, judgment, and self-awareness, so record moments that challenged your assumptions, not only ones that went well.

An example entry

The entry below is a constructed example, not a real student's journal. Note how the facts are complete and the patient cannot be identified.

This entry records hours and a verifiable contact, describes one specific moment, shows an action the student took, and ends with something learned. It could later support a Work and Activities description, a paragraph about empathy and service orientation, or an interview answer about a time you advocated for a patient.

Protecting patient privacy

Clinical reflection is valuable, but patient information is not yours to record. Write about your own observations and actions, and describe patients only in general terms.

• Leave out direct identifiers: names or initials, dates of birth, medical record numbers, room or bed numbers, addresses, phone numbers, and photos.
• Avoid combinations that identify someone indirectly. A rare diagnosis, an exact age, and a specific date together can point to one person, especially in a small community.
• Use general descriptions such as "an older man" or "a teenager with a sports injury."
• Follow your site's rules. Hospitals and clinics expect volunteers and shadowing students to follow their privacy policies, and they often require HIPAA training. Those rules apply to your notes.
• Keep the journal private. Do not post entries on social media or keep them in a document shared with others.

The same rules apply when you later turn entries into essays: admissions readers expect patient stories to be de-identified.

Connecting entries to the AAMC premed competencies

The AAMC describes 17 Premed Competencies for Entering Medical Students, grouped into 11 professional, 2 science, and 4 thinking and reasoning competencies. Admissions committees use them as a shared vocabulary for the qualities they look for. In 2026 the AAMC renamed two of them: Cultural Humility is now Self-Awareness, and Cultural Awareness is now Understanding Others.

After writing an entry, note the one to three competencies it shows most clearly. Do this honestly rather than generously: an entry about restocking supplies shows reliability, not leadership. Over a term, the tags show where your experiences are strong and which competencies you have little evidence for. The AAMC also publishes worksheets for reflecting on experiences against each competency.

Using the journal in your application

AMCAS Work and Activities

• You can list up to 15 experiences, and each description can be up to 700 characters.
• You can mark up to three experiences as most meaningful, and each of those gets up to 1,325 additional characters to explain why it mattered. If you list two or more experiences, at least one must be marked most meaningful.
• Each entry asks for the experience type, dates, hours, organization, city and country, and a contact who can verify your participation.
• The section cannot be edited after you submit the application, and formatting such as bullet points and bold text does not carry over.

With a journal, you choose your 15 experiences by reading what each one actually involved, copy dates and hours from your log, and build each 700-character description from specific moments rather than a list of duties. For most meaningful experiences, the reflections you wrote at the time are the raw material for explaining how the experience changed you.

The personal comments essay

The AMCAS personal comments essay allows 5,300 characters, including spaces. The AAMC suggests addressing why you chose medicine and what motivates you. Read through your journal before drafting and mark the two or three moments you return to most often; they are usually the center of a strong essay. The essay goes to every school you apply to and cannot be changed after submission.

Secondary essays

Many schools send secondary applications with prompts about challenges, teamwork, diversity of experience, or why you chose that school. These ask for specific examples, often several at once. A journal gives you a pool of documented examples to choose from instead of reusing the same story for every prompt.

Interviews

Interviewers often ask behavioral questions such as "Tell me about a time you worked on a team that disagreed" or "Describe a difficult interaction with a patient." Before interview season, pick eight to ten entries that cover different competencies and practice telling each in about two minutes: the situation, what you did, and what you learned. Rereading your own words from the time also helps you answer follow-up questions with accurate detail.

Notebook, document, or app

The format matters less than writing consistently and keeping everything in one place. Each option has tradeoffs.

If you choose a notebook or document, the field table and reflection questions above are all the structure you need. If you would rather have the structure built in, PremedJournal is a free web app designed around this method. Entries are linked to activities, hours are totaled by category (clinical, volunteering, research, leadership, and shadowing), and entries can be analyzed against the 17 AAMC premed competencies (3 entries on the free plan, every entry with Premium). It also automatically redacts common identifier patterns, such as dates of birth, medical record numbers, and names written after words like "patient", as a safety net. It does not replace your own care. Premium adds drafts of AMCAS activity descriptions with a 700-character count, CV bullet points, and a personal statement builder that works from entries you select. Any draft is a starting point to revise in your own words.

Common mistakes

• Waiting until application season. A journal started late cannot recover details that are already gone.
• Recording only hours. A log of hours without reflection gives you nothing to write about.
• Writing only summaries. "Great shift, learned a lot" will not help you in two years. Record one specific moment instead.
• Losing track of contacts. Supervisors change jobs. Record names, titles, and contact details while you are still in touch.
• Including patient identifiers. Treat every entry as if someone else might read it.
• Only recording successes. Mistakes, doubts, and how you responded to them are often the most useful material for essays and interviews.
• Inflating entries. Write what actually happened. Your application must accurately reflect your own experiences, and interviewers ask follow-up questions.

Frequently asked questions

Sources

AAMC and AMCAS details were checked against the AAMC's published guidance on October 13, 2026. Requirements can change each application cycle, so confirm them in the current AMCAS Applicant Guide before you apply.

• AAMC, Premed Competencies for Entering Medical Students
• AAMC, AMCAS Applicant Guide: Work/Activities
• AAMC, AMCAS Applicant Guide: Adding Work Experience and Activities
• AAMC, Section 5 of the AMCAS Application: Work and Activities
• AAMC, AMCAS Applicant Guide: Personal Comments Essay
• AAMC, Premed Competency Experience Worksheets
• Indiana University Health Professions and Prelaw Advising, Keeping a premed journal
• Missouri State University, Maintaining a pre-medical journal or diary