In 2025, Cali Pastor wrote for SDN Review about her journey to medical school in Spain — the false starts, the visa complications, the steep academic learning curve, and ultimately her decision to build her career in the European Union. That article covered the broad strokes. In March 2026, SDN editor Emil Chuck sat down with Pastor for a recorded Q&A that went deeper on life as a medical student in Spain: the practical logistics most students never think to ask about, how to navigate language prep the right way, what nobody tells you about banking and financing, and why the political moment in the U.S. is sending a new wave of students her way.

“It’s Never Too Early, and It’s Never Too Late”

SDN readers might assume studying medicine abroad is a choice made in high school because Pastor herself made that leap directly after graduation. But her message to students at any stage is more expansive.

“I think medical school is one of those things that if it’s truly your vocation and it’s truly what you want to do, that vocation will never go away,” she said. “I see people all the time that are either in college or have finished college or have a primary degree and they want to go back to medical school.”

She also hears from students as young as freshman year of high school. The through line isn’t age, but rather awareness. Pastor’s advice is to understand what the path looks like as early as possible, because the earlier you know your options, the more strategically you can prepare.

One underrated advantage: having relatives in the country you’re considering. “Moving abroad is very daunting because you’re going into a new country, a new culture, sometimes even a new language. And so anything that can help ground you — whether it’s friends or family or somebody you met in high school — any sort of ties or connection will help you get started.” The practical value of local family goes beyond emotional support: they can sign legal letters, help you navigate appointments, and vouch for you in ways that friends often can’t.

And it’s not just medicine. Through BigSisterMD, Pastor has fielded questions about dentistry (a four-year program in Spain, generally easier to gain admission than medicine) and veterinary medicine (five years, with university hospitals and subspecialty tracks like oncology and dermatology). Both fields offer public and private sector programs. “The public sector is almost like the Ivy Leagues in America,” she explained. “Very difficult to get into and a lot cheaper, with a lot of incentives versus the private sector.”

The Language Shortcut That Doesn’t Exist

For students drawn to Spanish-language programs, language preparation is the variable they most consistently underestimate. Pastor’s path through this should be considered a cautionary tale, not a blueprint.

“I started medical school, realized I could not keep up with the language, and I had to drop out and do full private academy learning for a year — biology in Spanish, chemistry in Spanish, math in Spanish, physics in Spanish, and also just basic Spanish language and grammar.” She had completed AP Spanish in high school, which she describes as nowhere close to sufficient.

Her recommendation for students earlier in the process: seek out an academy specifically approved by the Institut Cervantes (Spain’s official language certification authority) and gear instruction toward the DELE exam (Diploma de Español como Lengua Extranjera), the EU’s standard Spanish language certification. “If you find a course that is specifically approved by them and geared toward that exam, then you’re really on the right path.”

The target level is B2 to C1 on the European language scale, but that’s only half the preparation. The other half is medical vocabulary: “Watch Grey’s Anatomy in Spanish. Watch The Pitt in Spanish. Something where you’re getting that language constantly fed into your brain.” The gap between conversational and technical Spanish is wide, and medical school will expose it immediately.

The same challenge applies, in varying degrees, across EU medical programs. Spain, Italy, and Portugal share a similar six-year post-high school structure. France is far more competitive. All health professions share a common first year, then subdivide based on grades, which is why Pastor has French classmates who chose Spain because French medical school proved too difficult to access. Northern European countries like Germany and the Netherlands host many English-language programs specifically designed for Western students who want a financially accessible alternative.

What Nobody Tells You About Paying for It

Pastor’s original article made clear that Spanish tuition is dramatically cheaper than U.S. medical education. What it didn’t cover is the financial infrastructure — and the gaps in it.

“American student loans don’t loan you money for international schools,” she said. “And Spanish banks — the loans are typically three years and medical school is six years. So their loans are not set up for students. They don’t have a student loan. That’s not a thing that exists.”

Pastor is supported by her family, and she’s candid about the currency dimension that entails. “There are certain times when the dollar is doing better and it’s easier to pay tuition, and other times when the dollar is not doing so great compared to the euro and it is much more expensive.” Wire transfer fees compound the issue — each transaction from a U.S. account to a Spanish account carries a flat fee on top of the exchange rate, a recurring expense that adds up across six years.

The banking setup itself has a sequencing problem that trips up new arrivals: Spanish banks often require a local visa or EU passport to open an account. But you need a bank account to sign a lease, set up a phone bill, or pay for anything else. “There’s this whole timing nightmare of figuring out — okay, I have to apply for my visa, and then once I got the visa, then I can open the bank account, and then I can get a phone bill, and then I can apply for an apartment and do all these things.”

Once established, though, the cost structure is genuinely simpler than U.S. programs. Pastor said she’s bought exactly two books in six years of medical school — Gray’s Anatomy and the Netter Atlas. “They’ll either put blurbs of the book into their PowerPoint presentations or they’ll offer the book in the library. It’s not a requirement.” No textbook bills, no exam fees (the MIR, Spain’s residency placement exam, is free), no USMLE-equivalent preparation costs. Private universities typically include test prep resources for the MIR as part of their higher tuition — along with perks like VR anatomy tools and immersive simulation hospitals — to justify the premium over public tuition of under 1,000 euros a year. As for white coats and scrubs: “We get given scrubs and white coats because they have the logo on it and everything — so that is included.” Hospital floors provide their own scrubs by department; students can’t bring outside ones.

The Immigration Reality

The visa process warrants its own honest conversation. Pastor’s original article noted that immigration was complex and time-consuming. In conversation, she was more direct.

“When they publish this list of documents that you need — what I found after many years of trial and error is that the list they publish on the website is not the actual list that they want you to have.” She described waiting months for appointments, arriving prepared, and being turned away for documents that weren’t on any official list. “After many years of many mental breakdowns and crying leaving the embassy and all these things, I decided to get a lawyer.”

Finding the right lawyer was its own process. Many Spanish immigration attorneys specialize in Latin American or African immigration cases and aren’t familiar with the specific documentation requirements for U.S. nationals. “I ended up going through multiple immigration lawyers after multiple failed visas and a lot of money being spent until I finally found a lawyer that worked for me.” Her advice: budget for legal help from the beginning, not as a fallback after things go wrong.

The payoff, once residency or citizenship is secured, is substantial. EU residents carry a European Health Card, which provides free emergency medical care in any EU member state. “If you were to go on vacation to Germany and you’re a Spanish citizen and you break your leg, you’re taken care of completely for free.” For students considering dual citizenship, whether through Latin American ancestry (Spain has expedited citizenship agreements with many Latin American countries) or European lineage, Pastor’s advice is to consult a lawyer well before applying, as some citizenship options must be secured before residency applications begin.

Why 2026 Is a Different Conversation

By the time this interview was recorded, something had shifted in the questions Pastor was fielding. Two forces are driving new interest in studying abroad.

The first is financial policy. July 1, 2026, brings changes to federal student loan caps and repayment structures. Pastor has already started hearing from students caught in an uncomfortable gap: “They already have student loans in America and want to figure out how to pay for school in Spain, but if they’re not able to have student loans there, they’re not really well off enough to do one or the other.”

The second is political. For students interested in reproductive medicine, immunology, and women’s health (areas Pastor plans to pursue) the U.S. environment feels increasingly constraining. “After living here and working in the socialized public healthcare system, I wouldn’t want to go back to the American healthcare system because it just feels almost non-ethical that we’re not taking care of everybody. Not everyone can afford healthcare.”

She’s careful to note that going abroad doesn’t mean permanently closing the door on the United States. “There are really four stages of any medical career: your premed, medical school, your residency, and then your actual working as a fully functional doctor. All four of those can be done in different places in the world.” Students who want to keep the U.S. option open can apply as an international medical graduate (IMG) for U.S. residency after graduation, though Spanish medical schools neither discuss nor facilitate that pathway. The EU degree also travels freely within the European Union: a medical diploma from Spain requires no additional testing for residency applications in Italy, Ireland, or anywhere else in the bloc.

Within the Spanish residency system itself, geography is broader than many students realize. Residency applications can be filed anywhere on the Iberian Peninsula, in the Balearic Islands (Mallorca and Ibiza), the Canary Islands, and Ceuta, offering everything from urban centers to island practices off the coast of Africa.

Finding Your People

Pastor created BigSisterMD specifically because she couldn’t find the mentor she needed. “I really felt alone. I felt like nobody really understood what I was going through.”

Her most effective tool since then has been proactive LinkedIn outreach. “I reached out to a whole bunch of immunologists in Madrid, specifically women, trying to connect. One of them turned out to be the head of a hospital in Spain and she was like, ‘Hey, come for the week. I’ll show you around, you can see some patients with me.'” The lesson she draws from it: “Being proactive and being your own best advocate is the best tool that anyone can really have for themselves.”

Students can reach Pastor through BigSisterMD on TikTok, Instagram, YouTube, and Facebook, or via her website at bigsistermd.com. She checks messages daily.

Cali Pastor is a third-year medical student studying in Spain and founder of BigSisterMD. Her 2025 SDN Review article, “Medical School Abroad: My Journey Studying Medicine in Spain,” covers the structure of the Spanish medical education system, the application process, and her personal path to enrollment.

Chelsea Wesnofske, Ph.D., is the Director of Admissions at the University of Georgia School of Medicine, where she leads the design and implementation of a mission-aligned admissions process for the newly accredited institution. With a professional background spanning pre-health advising and career services, she has supported thousands of students pursuing careers in medicine and the health professions.

Briefly describe the timeline/origin story of UGA School of Medicine receiving preliminary LCME accreditation. What essential admissions policies and tasks must be approved for LCME review?

Chelsea Wesnofske, Ph.D.: For LCME review, we really had to have our policies and procedures fleshed out. That includes our selection criteria, how we screen and interview applicants, how committees are structured to make decisions, and the policies that guide mitigating conflicts of interest. It also includes how we document decisions and communicate with applicants. At the core, if it impacts fairness, consistency, and alignment with our mission in the admissions process, it’s something that needs formal approval and oversight.

How did your admissions team develop a timeline and strategy to rapidly screen and interview applicants? What systems needed to be in place?

This was a highly condensed cycle for us, so we had to move quickly. With that we had to stay flexible while maintaining consistency. We leaned heavily on our CRM to keep things moving and routed key decisions through our admissions committee to maintain transparency and effectiveness. It wasn’t always linear, in fact, I would say it was a very iterative process. There were some long days, real-time pivots, and complicated issues that arose, but we stayed grounded in our shared goal and kept the process moving forward in a thoughtful, mission-aligned way. We built resources such as our interviewer handbook and our website to provide guidance to both our interviewers and our applicants. We knew applicants would have a very quick turnaround and we wanted to help them be as prepared as possible which is why we posted our secondary questions to our website and provided resources for interview prep. Communication is always key in any cycle, but in this case, it was even more important because there were so many moving parts happening simultaneously.

Whose advice have you sought to navigate this “sprint admissions” timeline?

We have not been shy about asking for advice and insights! We reached out to peer institutions, especially newer medical schools, to learn from their experiences and what they wished they had done differently. We also connected with in-state programs to share insights and think about opportunities for alignment and collaboration. And honestly, we had incredible support from the UGA community—faculty, staff, and partners who stepped in, offered perspective, and helped us move quickly. UGA already has several professional schools like veterinary medicine, pharmacy, and law school and connecting with them has been incredibly helpful as we build out our processes.

Student success: Any plans for orientation?

I’m really excited about our orientation because we’re doing something a bit different. We’re taking our students on a three-day road trip across Georgia to learn firsthand about the health needs of our communities. Our mission is central to everything we do, so it’s important to us that students engage with Georgia’s diverse communities and health systems early. It’s not just about exposure-it’s about starting to think together about how we can show up, partner, and problem-solve in meaningful ways across the state. So, we are very excited for this new approach to orientation for our students. I think it will really set the tone for their experience here at UGA.

How quickly can you apply lessons learned from this experience to a full-cycle recruitment process?

Immediately. While there were many challenges to this first condensed cycle, one major advantage is being able to apply our lessons learned in real time. We have already begun refining our processes for next cycle that will help us implement a more streamlined, engaging, and consistent experience for applicants.

Financial aid and scholarships: Who will be involved in managing financial aid and scholarships, including any “negotiations”?

Our director for Financial Aid, Emily Baldwin, has been leading the charge with scholarships and funding opportunities. She has been working closely with our development team, administrative leadership, and admissions team to establish selection criteria, secure funding amounts, and design resources to help students navigate the financial landscape of paying for medical education. Our financial aid team prioritizes accessibility and is happy to meet with our applicants and students to make sure they are equipped with everything they need to make the right financial decisions for their needs.

Over the next four years, prospective students will want to know why they should attend a program that hasn’t graduated a class (and has no history of “match data”). What insights do you have to persuade them?

I think it starts with being transparent while also helping students see the opportunity in being part of something we’re building with intention. While we don’t yet have match data, we’re designing the program with that outcome in mind-strong clinical partnerships, individualized advising, and a curriculum that prepares students to be competitive and mission-aligned. Students also have the unique opportunity to help shape the culture and identity of the school from the very beginning. For the right student, especially one who is drawn to our mission and to serving Georgia’s communities, that’s a really compelling reason to choose us.

Is there anything memorable (in a good or humorous way) about how this process has been going?

You know, we really didn’t know what to expect with this first cycle. We spent countless hours planning and then quickly implementing but we still just weren’t sure what this cycle would yield. I have to admit that I have been incredibly impressed not only with the quantity of applications (over 2000 in two weeks) but also with the strength of the applicant pool. It’s made me even more excited about what we are building here and more importantly the impact our future students will have for Georgia.

One of the privileges of being a newly admitted professional student is the opportunity to use your application insights to help others. Looking back on a successful application may clarify the lessons you learned from your struggles. Now that prehealth students ask for your feedback, how can you give the best advice to help others with the writing process? Here are some tips for making effective suggestions on personal statement drafts.

Learn to Read Like a Screener

Personal Statements Are Not a College Writing Assignment

Everyone experiences the writing process differently. Most high school and undergraduate students are well-versed in a five-paragraph essay, and prehealth students likely got A’s or B’s in their writing classes. However, science majors generally avoid writing-intensive classes, so they have had few opportunities to have their writing critiqued by expert writers unless they visit their campus Writing Center while they are crafting their personal statements.

Few prehealth applicants journal regularly, so most arrive at the application without having proccessed their experiences or reflected on why they feel called to a health profession. Additionally, they may not have thought about how community structures or current events might affect their families or communities. This can make it harder for them to discuss controversial topics.

Find out how the writer has approached their process (sample questions). How have they defined their professional purpose, and how comfortable are they talking about their challenges? Ask for outlines or drafts of pre-written secondary essays.

How Much Do You Read?

A person’s reading habits are a tell-tale sign of their ability to understand others. When I ask an applicant about their favorite fictional characters or books, I discover how invested they are in empathizing with others’ lives, especially when the characters do not share their heritage or worldview. I also ask follow-up questions to see whether the applicant anticipated my question in their answer with a canned response or if they are responding authentically.

Reviewers who do not share the writer’s life challenges or experiences may find it difficult to read the applicant’s reflections. Because most screeners are a decade or more older than the applicant, having an intergenerational group of reviewers sharpens the applicant’s professional voice. What resources has the applicant read to better understand how older health professionals perceive health care and social challenges? Conversely, what stories do older non-traditional students read to connect with younger students?

Exposure to multiple stories can expand your horizons when making suggestions. While generative AI programs can analyze writing based on an aggregate of examples, their suggestions often make an essay sound generic. The genAI tools may be great for writing quick email communications, but models can reinforce the user’s communication style rather than challenge them to engage the application reader more effectively.

Reading Fast and Slow

If you watch personal statement feedback videos from influencers and admissions consultants online, you can appreciate their systematic critiques. For anyone who asks you to read their drafts, assume they have already watched a few of these breakdown videos. Many applicants begin watching these videos to get a personal statement framework: address my passions, my background, and my professional aspirations. For medical school applicants, additional essays ask for more detail about these same topics.

Keep in mind that some videos are most effective for applicants considering a specialized education track, such as a focus on community health, or a graduate degree in medical education or research, rather than a professional school essay. The graduate faculty who review applications to their certificate track, master’s, or doctoral program usually schedule time to review applications, statements of purpose, and resumes. Viewing you as a future student-collaborator, research faculty examine how you communicate research hypotheses and concepts to a lay audience and to a scholarly audience of your peers, with the understanding that your skills may require more guidance.

In contrast, because of the number of submitted applications, professional school application essays are graded very quickly. Medical or dental school application readers get swamped with hundreds of applications to read every day in the early part of the cycle. Screeners prioritize application reviews based on metrics, geography, and mission alignment, but they must make quick recommendations on whether to advance a file for interview consideration. A rubric usually disciplines the reader to review all parts of an application, but an applicant’s impression is formed quickly as each file is triaged. For many screeners, the personal statement gives an early impression of the applicant’s fit with the learning community. Others begin with program-specific essays, the activities inventory, or a quick scan of letters of evaluation. All submitted materials are fair game.

As someone giving feedback, read each application as if you were a screener. A personal statement and Other Impactful Experiences read-through should take no more than five minutes. AMCAS work and activities with the three Most Meaningful Essays should take no more than ten minutes overall. What impressions do you have after reviewing the primary application materials?

Often, two independent screeners will disagree. At many schools, the application is then marked for en banc review by all screeners or by the admissions committee leadership (directors, chairs, deans, and other designees). In these meetings (for AMCAS), the personal essay and the Other Impactful Experience are often read aloud. As a volunteer reader, give yourself the opportunity to read the essay aloud to identify the writer’s voice and your response.

Some Reviewer Shortcuts

When I read research papers, I first look at the abstract’s conclusions and results. Similarly, when I read personal statements, I look for the takeaway “roadmap” in the final paragraph. Often, writers spend so much time perfecting their final thesis statement that the preceding thousands of characters become irrelevant.

Many writers spend the opening sentences of their first vignette describing their roles and responsibilities in an experience before introducing a key character. On the other hand, some writers begin their first vignette with a dialogue between mysterious characters without providing context. Some writers’ drafts may contain paragraphs where multiple “closing sentences” are stacked to make the transition to the next paragraph more jarring and increase the likelihood of readers stopping. Help writers choose effective transition sentences that begin and end their paragraphs.

Thank U Next: Sometimes I Stop Reading

The biggest temptation that most screeners have is the urge to stop reading the application. The admissions office pays screeners by the application (specifically, the number of reviews completed), and there is significant incentive for us to hit our target number of applications read every day over six months. Because we know our role is to help bring promising new professionals into healthcare; we try to stay focused… but we get tired of reading generic, unprofessional stories that give us no insight into why we should read the rest of your application. Few personal statements are memorable to a reader who grades a dozen applications per hour.

For smaller screening groups, this dynamic is different. A graduate program admissions committee full of professors may enjoy reading something that doesn’t sound like a grant, a peer-reviewed paper, a patient record, or a university memo. Their motives focus on your contribution as a future member of their group, department, or program. As I mentioned before, they enjoy reading your applications as they discern how you would add to their lab or learning community.

Because admissions professionals expect the final copy to have been vetted, the personal statement is more a reflection of the applicant’s “village” than of the person. It is foolish to submit an application that has not been vetted by one’s circle of trusted advisors or references, of which you are one. Keep the writer accountable to the professional expectations of the admissions process.

Coach the Writer

Listen Before You Comment

Applicants often ask our volunteer readers to “tear their essays into shreds.” Before I grant their request, I intentionally ask the writer about their background, professional discernment, and key messages they want conveyed in their overall application; often, a personal statement feedback session is enhanced when the rest of the primary application or idea brainstorming is included. I ask how the writer arrived at the structure of their vignettes and how that structure connects to their essays’ takeaways. I also want to know how confident and how vulnerable the applicant is in their communication and their application strategy.

Listening to the writer should help you determine if their voice is authentic in the drafts. Notice what stories give the writer pride or concern. Determine how the writer processes conflict and failure. Establish safety and trust by delivering critiques professionally and with purpose.

Look for Details

Many essays resemble comic strips rather than movies. Early drafts focus on “showing” dialogue or emotion without giving more color to the characters in the scene. Initial recollections of being a patient can leave out the basics: where it happened, how old the writer was, and what the healthcare team actually did. Too often these passages read like a medical history instead of a portrait of a person. Help the writer identify the details needed to make their stories more vivid.

Good reviewers understand the impression they get from the writer’s word choices for adjectives and adverbs. One effective adjective or adverb can replace “stacking” multiple words to carry a vignette or a reflection. A strong essay balances showing and telling and reads naturally.

Make Corrections Together

Most writers benefit from live guidance. If you have the time to work with the writer, ask them to review their drafts and discuss their vignettes, word choices, tone, and organization. Their answers reveal their approach and the impressions they want to convey.

When giving feedback, do not write their essay in your words. While you can clarify what you would do, let the writer use their preferred voice. Understand the appropriateness of “showing” versus “telling” in a vignette; showing often focuses on one-on-one interactions while telling summarizes an overall impact.

The best advice for writers encourages experimentation that stretches their communication skills in their next revision. Reviewers should explain why the writing elicited specific impressions. For example, expressing humility acknowledges opportunities for further growth rather than a litany of deficiencies. I suggest using comparison signals (“not only, but also”) sparingly. I challenge writers to refrain from using “not” when revealing insights (“I was not an observer, I was a caregiver”).

Writers can gain meaningful feedback by focusing on concrete concerns. Encourage writers to ask for feedback on specific parts of a draft rather than a top-to-bottom overhaul. A targeted question gets targeted help.

Trust the Process

My ideal personal statement feedback session leaves the writer enthusiastic about making some changes and trying new approaches in their writing process. Ultimately, the personal statements I enjoy reading reflect the writer’s enthusiasm for their future.  The most effective application essays invite admissions committee members into a conversation with a prospective student and future professional colleague, without resorting to marketing pitches or clichés. So encourage the writer to trust their writing process and become a more confident, self-aware professional.

Acknowledgments

This essay was inspired by prepared notes for the Personal Statement Workshops that were organized byHealthcareStories.org, the RELATE LAB, the Social Mission Alliance, and the Student Doctor Network (February to April 2026). Student photo generated using ChatGPT.