A Year by Year Plan for Pre Med Extracurricular Activities | MedEdits

Students and parents often ask me how many hours of each "type" of extracurricular experience they should have. The reality is that there is no preset formula for what a premed student should engage in extracurricularly and how much time they should spend on each experience. When I sat on the admissions committee at the Icahn School of Medicine at Mount Sinai, I never saw an applicant admitted because a number of hours crossed a threshold. What we responded to was commitment, growth, and evidence that an applicant understood what a life in medicine involves.

Keep in mind that the AMCAS application has space for only 15 experiences and medical schools want to know which three of those are your most significant. According to the AAMC's 2027 AMCAS Application Workbook, each experience is described in 700 characters, and each of the up to three experiences you designate as most meaningful receives an additional 1,325 characters to explain why it mattered. We discourage students from taking a "check box" approach to their candidacy by engaging in experiences they think will look good to admissions committees. Instead we encourage students to be purposeful and focused when deciding what activities to pursue so when it is time for them to complete the application, they have three experiences that distinguish them.

Something you will hear me say repeatedly is that medical schools want authentic and genuine students, each of whom has their own interests and values. For example, the student who has spent every waking hour in the bioengineering lab helping to develop a new mitral valve will be just as valued as the student who has spent her time exploring an interest in narrative medicine, even enrolling in a masters level program to broaden her skills and knowledge.

Committees do pay attention to how applicants engage with the health of their communities, not only with hospitals and laboratories. In the 2027 AMCAS application, the experience type previously called Social Justice/Advocacy was renamed Community Health Advocacy, which reflects that emphasis.

DECIDE YOUR TIMELINE FIRST

Before you plan your activities, decide roughly when you intend to apply, because it changes everything that follows. A student applying at the end of junior year has about two and a half years to build a record. A student planning a gap year has more time, and can let experiences mature before the application captures them.

Taking time is now the norm. The AAMC's 2025 Matriculating Student Questionnaire found that 73.2 percent of matriculants took at least one gap year between college and medical school. If you are unsure whether you will be ready after junior year, planning early for the possibility of a gap year relieves a great deal of pressure. This is also one of the decisions where guidance from someone who has served on an admissions committee matters most, which I explain in my guide to what to look for in a premed advisor.

Here is a basic plan for students to think about as they decide what activities to pursue as premeds:

FRESHMAN YEAR

Freshman year is largely spent adjusting to college life, finding a support network, exploring interests, and learning how to manage your time! Join your college premed organization or club as well as any other clubs that interest you, and get a sense of what other successful premeds have done during college. Go to club fairs and start to think about how you might spend your time during college. Start thinking about what subjects and disciplines you might like to explore outside of the classroom.

This is also a good year to introduce yourself to your college's health professions advisor. And do not worry if your freshman activities never appear on your application. Their purpose is to help you discover what is worth committing to.

FRESHMAN YEAR

Freshman year is largely spent adjusting to college life, finding a support network, exploring interests, and learning how to manage your time! Consider getting involved in the following ways:

• Join your college premed organization or club as well as any other clubs that interest you.
• Get a sense of what other successful premeds have done during college.
• Go to club fairs and start to think about how you might spend your time during college.
• Start thinking about what subjects and disciplines you might like to explore outside of the classroom.
• Introduce yourself to your college's health professions or premed advisor.

Do not worry if your freshman activities never appear on your application. Their purpose is to help you discover what is worth committing to.

FRESHMAN YEAR SUMMER

Depending on when you are applying to medical school, what you do this summer may not "make it" to the medical school application on which you will have the opportunity to highlight 15 experiences. For the student who wants to apply to medical school at the end of junior year, however, what they do this summer is very important. Here are some ideas:

• Engage in research in an area of interest.
• Pursue clinical work as an EMT, scribe, nursing assistant or medical assistant.
• Shadow physicians.
• Contribute to a cause or societal issue through a community service organization.

If you can, choose something you could continue during the school year. An experience that begins this summer and continues for two or three years is far more valuable than a summer that stands alone.

SOPHOMORE YEAR

This is when things start to get a little more serious. Why? You have had time to settle into college, you have learned to manage your time, and hopefully you have given some thought to your interests. This is when you want to start thinking about the impact you can make through your activities and in which activities you might be able to demonstrate leadership even if not through a formal role. Keep in mind that you only want to take on as many activities as you can without compromising your academic performance. You also want to think about dropping any activities that are not important to you. Some activities to think about becoming involved in include:

• Is there any research you can pursue that is related to a curiosity either on campus or off campus?
• Are there any clinical programs nearby campus?
• Is there an on campus EMT service?
• What causes are you most curious about? Think about how you can get involved at your college or in the local community to advocate for those causes.
• What clubs and school-related activities can you become more involved with and make an impact?

SOPHOMORE YEAR SUMMER

At this point, you have hopefully identified some curiosities related to medicine, research, service, or advocacy. Do your best to immerse yourself in only a few very meaningful activities where you can make valuable and tangible contributions. Think about how you can explore these interests even more deeply this summer.

• Are there any new or existing research projects you can become more deeply involved in? Is it possible this can continue into the school year?
• Can you find some clinical work that you might be able to continue into your junior year on a part time basis?
• What about community service? Can you get more involved in an opportunity related to your interests?

If you plan to apply at the end of junior year, this is also a good time to map out your MCAT preparation so that studying does not collide with your most demanding semester.

JUNIOR YEAR

Junior year is a pivotal year as you will need to decide now if you plan to apply at the end of junior year. If you plan to apply to medical school at the end of this year, you will have to make time for MCAT preparation so make that a top priority. If you plan on taking a gap year, MCAT prep and test taking can wait until senior year. However, keep in mind that you want to build out your timeline so there is flexibility in case you want to take the MCAT a second time to reach a goal score.

At this point, hopefully you have some clearly defined disciplines, topics, causes and on campus activities that interest you. Whether you plan on a gap year or not, junior year grades are paramount so don't let your academic focus slip. Most applicants do well junior year as they get more invested in their major coursework.

• If you are involved in research, continue this even if on a part time basis. If you haven't yet done any research, try to find an opportunity that relates to your interests.
• Make a quantifiable impact in your other involvements related to service, community health, advocacy, and outreach.
• Take on either formal leadership roles or lead by taking initiative in whatever you are committed to.
• Build relationships with the faculty, physicians, and supervisors who will write your letters of recommendation.

The impact you build this year is what you will describe in your AMCAS entries, so aim for contributions concrete enough to explain in 700 characters. The strongest letters come from people who have watched you grow over time which is why you want to ensure you are building those relationships..

SENIOR YEAR

What senior year looks like depends on your timeline, but for every premed it matters more than students expect.

If you are applying to medical school during senior year

If you are applying to medical school during senior year, keep your grades up and stay focused on your coursework. This year you want to continue making the greatest impact possible in whatever you have committed yourself to thus far. Try to take on any leadership roles available to you.

Many students assume their application is finished once it is submitted. It is not. What you accomplish during senior year can still move the needle, because you will have opportunities to share it with schools:

• Keep your grades strong. Schools will see your senior year transcript, and a strong final year reinforces everything in your application.
• Continue your activities and look for new responsibility or accomplishments within them.
• Send update letters to the schools where you are under consideration when you have meaningful news to share, such as a new role, a publication or presentation, an award, or a significant development in an ongoing experience.
• If you are waitlisted, send a letter of intent to your top choice school, and continue to update the other schools where you remain on the waitlist.
• Prepare thoroughly for medical school interviews, which often happen during this year.

An update letter is only as strong as the update itself. The students who have the most to say during the waitlist season are the ones who kept building during senior year instead of coasting.

If you are taking a gap year

For students planning a gap year, senior year is often the most important year of the entire premed timeline. It is usually the last full year of experiences, grades, and relationships that your application will capture before you submit, and for many students it is also the year they prepare for and take the MCAT.

• Plan your MCAT preparation around your course load, and schedule your test date so your score is released before you intend to submit your application.
• Keep your grades strong. Your senior year grades will be on your transcript when you apply.
• Deepen the activities most likely to become your three most meaningful experiences.
• Secure your letters of recommendation while faculty and supervisors know your work well.
• Line up your gap year plans, ideally clinical work, research, or service that continues something you have already begun.

If you plan on taking a gap year, it is fine to pursue new activities or involvements this year as long as you can continue them during your gap year!

GAP YEAR

A gap year is valuable only when it strengthens your record. Common ways students use it well include:

• Full time clinical work as a medical assistant, scribe, clinical research coordinator, or EMT.
• More serious research in an area of interest, ideally with increasing responsibility.
• Service through a structured program or job.
• Additional coursework to address an academic weakness.

Whatever you choose, the same principle applies: a gap year spent deepening one or two experiences tells a committee far more than a year spent sampling many things briefly.

FREQUENTLY ASKED QUESTIONS

How many clinical hours do I need for medical school?

There is no required number of clinical hours, and hours alone do not get anyone admitted. In our experience, competitive applicants typically have 200 or more hours working directly with patients, but what committees respond to is sustained, hands-on patient contact that shows you understand what caring for patients involves. Two years in one clinical role whether paid or volunteer, with growing responsibility, says far more than a large number of hours spread across brief experiences.

When should premeds start extracurricular activities?

Start exploring freshman year, but do not expect those early activities to appear on your application. Sophomore year is when most students begin committing to the few experiences they will sustain. The earlier you find activities you genuinely care about, the more time they have to grow into something meaningful.

Do I need research experience to get into medical school?

Research is not required at most medical schools, though it is expected at almost all allopathic medical schools, research-intensive schools and for MD-PhD applicants. Research strengthens an application when it grows from real curiosity and shows sustained involvement. It does not replace clinical experience, which nearly every committee expects to see.

Is shadowing enough clinical experience?

No. Shadowing shows that you observed physicians, which is valuable, but it does not show that you participated in caring for patients. Committees want to see hands-on clinical work or service, such as roles as an EMT, scribe, nursing assistant, or medical assistant, alongside shadowing.

How many activities should I list on the AMCAS application?

The AMCAS application allows up to 15 experiences, each described in 700 characters, and up to three can be designated as most meaningful, with an additional 1,325 characters each. You do not need to fill all 15 entries. A shorter list of substantial experiences reads better than a long list padded with minor ones.

Can I include high school activities on my medical school application?

Committees focus on what you have done since high school. A high school activity is generally worth including only if you continued it into college or it was truly exceptional. Your college years and beyond should carry your application.

What should premeds do during senior year?

If you are applying during senior year, keep your grades strong, continue your activities, and share meaningful accomplishments through update letters and, if you are waitlisted, a letter of intent. If you are taking a gap year, senior year is often your most important year, because it is usually when you take the MCAT and build the record you will submit.

Should I take a gap year before medical school?

Not by default, but many successful applicants do. The AAMC's 2025 Matriculating Student Questionnaire found that 73.2 percent of matriculants took at least one gap year. A gap year helps only when it strengthens your record, typically through full time clinical work, research, or service that continues something you have already begun.

What if I am starting my extracurriculars late?

Start now, and choose depth, and genuine interest, over quantity. One sustained clinical experience and one meaningful service commitment, pursued seriously, will serve you better than several rushed additions. For many late starters, a gap year is the most effective way to give those experiences time to mature before you apply.