The Dilemma of Disclosure: Applicants' Perspectives on Sharing Their Distance Traveled

The concept of "distance traveled" (DT), which contextualizes applicants' achievements within their lived experiences, has emerged as a key component of holistic medical school admissions. However, little is known about how applicants interpret and navigate disclosing DT within application materials. This study explores medical students' experiences with sharing DT and offers actionable recommendations for incorporating DT into equitable and holistic medical school selection processes.

The authors conducted semistructured interviews with medical students from US medical schools. Participants were recruited through purposive sampling to ensure demographic and geographic diversity. The Social Ecological Model guided interviews to explore students' understanding of DT, disclosure decisions, and admissions process reflections. Interviews were conducted between October and December 2021. Transcribed interviews were qualitatively analyzed using interpretive description.

In total, 31 medical students from 7 US medical schools were included in the study. Three major themes emerged: (1) navigating unclear expectations-students experienced confusion about what aspects of their DT to share, how much detail to include, and how their narratives would be received; (2) balancing vulnerability and perception-students feared being judged negatively or perceived as seeking pity, leading some to omit significant experiences; and (3) the burden of personal disclosure-students described discomfort with recounting personal hardships in a professional context, especially when unsure who would read or interpret their stories.

Although DT disclosures can enrich holistic review, applicants face emotional, strategic, and informational barriers to sharing their lived experiences. Medical school admissions processes are encouraged to provide more precise guidance on DT, promote culturally responsive review practices, and support applicants through thoughtful design and implementation of narrative components. These changes can help ensure DT is equitably and meaningfully incorporated into applicant evaluations.