The introduction is the most important part of your essay, and it has one purpose to fulfill above all others: to draw the reader in. Ideally this should all begin right from the attention-grabbing opening sentence. If the introduction can then go on to orient the reader to the focus of the essay, then that can be very helpful. But orientation is not an essential purpose because that can be achieved gradually in the essay. Many people make the mistake of writing a paragraph that explains what they're going to talk about in the rest of the essay. Such a paragraph might include something like the following: "My journey toward medicine has been shaped by a variety of experiences, including academic studies, volunteer work, and extracurricular activities." The reader knows that you're going to talk about these things and is most likely muttering to herself, "Get to the point."
If you have a paragraph like this in your essay, the best move would be to delete it. Often your second paragraph, which begins to discuss a specific experience, will work much better as an introduction. But you may also find that a later paragraph works even better. In general, you should bring your most compelling experience to the forefront and then structure your essay around that.
The following is a list of possible approaches to the introduction, with an emphasis on the opening sentence itself:
Some people will start with a compelling experience but will insist on prefacing that experience with a very generic statement such as the following: "My interest in medicine can be traced back to the time I had knee surgery as a child." Often the reason people will write such a statement is that they feel compelled to restate the question in some way. If your essay is answering the question "Why are you interested in medicine?" you should be able to demonstrate your reasons without relying on such a bland summary sentence.
If, on the other hand, you're tempted to use the first sentence to explain context, you should respect the reader's intelligence enough to save that context for later. For example, consider the following passage, which constitutes about half of this applicant's introduction:
"I originally became interested in the health care field at a very early age because my mother was a nurse and I spent considerable time in my childhood observing her at work. I was attracted to the idea of helping people with physical problems, although I had no thought about any specific specialty. However, in time physical therapy became the logical focus of my attention for a number of reasons. For one, I have memories from a very young age of my grandfather in Czechoslovakia, disabled by a stroke, his problems unmitigated by any attempts at physical therapy. I will never forget the devastating consequences of this."
This applicant probably felt that he had to start from the beginning and show the context for his interest in physical therapy. But this leads to a very unoriginal first statement that includes several hackneyed points: 1) starting with his original interest; 2) tracing it to his childhood; 3) tracing it to a parent.
Now look at the following restructuring, which grabs the reader's attention more immediately and conveys the necessary context in time:
"Disabled by a stroke, my grandfather in Czechoslovakia never fully recovered, his problems unmitigated by any attempts at physical therapy. Despite my young age at the time, I will never forget the devastating consequences of this. My interest in the health care field began at a very early age because my mother was a nurse and I spent considerable time observing her at work. I was attracted to the idea of helping people with physical problems, although I had no thought about any specific specialty. Gradually, however, memories of my grandfather and subsequent encounters with physical therapy directed my attention toward this path."
As you can see, it's possible to establish context later on, after you have the reader's attention. This revision also has the advantage of making a specific point about physical therapy, as opposed to an ambiguous, general statement about the writer's interest in the health care field.
The advice to jump right in also applies to anecdotes. One effective way to grab the reader's attention is to describe the action of your story. The above introduction might have begun by relating an episode as follows: "Grandpa struggled to reach his cane on the floor. He refused my parents' help but smiled when I picked it up for him."
If you can make yourself stand out right from the first sentence, then you will have contributed a great deal to your case for admission. You should not of course just throw out a random fact about yourself, but if your essay is going to emphasize a unique aspect of your life, then by all means that should come up right away.
This applicant starts as follows: "Not every dental school applicant has supported himself for five-and-a-half years jousting and sword fighting in a Las Vegas show."
This applicant takes very much the same approach: "I am a 26-year-old woman who has spent much of the past nine years engaged in such unusual activities as jumping out of airplanes, briefing Chuck Yeager (on more effective flying, of all things!), running through trenches, being a test parachutist, taking apart and then reassembling (blindfolded) a vintage M-1 rifle, earning a pilot's license, and learning how to survive behind enemy lines (including resisting interrogations and escaping captivity)."
Both writers have succeeded in grabbing our attention and revealing something unique about their personalities, which they will go on to explain in further detail.
Starting with a concrete image helps the reader to grasp your point more immediately. The hypothetical anecdote we wrote under the Jump Right In heading is one example, but even non-narrative openings can start with a specific image. For example, this applicant explains her attempts to comfort her grandfather: "From massaging his arm to simply keeping him company, I tried to assist my grandfather in any possible way after a stroke had left his left arm partially paralyzed." This is not a particular episode, but she offers a specific action detail, and so we can picture her sitting by her grandfather's side, massaging his arm.
Generally we would not advise starting with an abstract point over a concrete image, but if you have an interesting idea to convey, it can be very effective. This applicant sets up a dichotomy that provokes the reader's mind: "I grew up in circumstances that provide a classic example of the frequent disparity between appearance and reality." He then goes on immediately to fill in the details so we are not left hanging on an abstract theme.
The danger with this approach is that your idea might have been used too many times already. For example: "I learned early on that helping others is not just a fulfilling purpose, but a moral responsibility." This is an abstract point, but there's no mystery here because the idea is too predictable.
By stating a problem, you create instant curiosity because the reader wants to see how you will address this problem. This applicant states a personal difficulty, and the rest of the essay goes on to detail his response. You don't need to limit yourself to personal issues, however. You could state a general problem you've observed in the health care system and then go on to describe how you hope to address it in your career. You might also cite a discouraging statistic and then reflect on its significance. There are many possibilities here, but what unites them is the element of drama, and you should use that to your advantage in creating a strong lead.
This is the type of approach that we can't ignore because it has the potential to be so effective, but it also could have disastrous results. The same warnings apply here that we enumerated for humor in the Tone section. Try to be subtly and creatively clever rather than outrageous.
This applicant makes a humorous observation about his upbringing: "Sometimes I like to tell people that my father knew I wanted to be a doctor long before I did, but the truth is that the idea of becoming a physician has probably been gestating within me in some form or other since an early age." It's an interesting twist on the idea of wanting to become a doctor for all of one's life. Even here there's a slight risk: will the reader be critical of the writer's admission that his father was such a strong influence? Recognizing this possible interpretation, the applicant immediately asserts his independent development and later makes further reference to his independent decision.
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