Clone of University of Rochester Health Professions Questionnaire

Health Professions Questionnaire (HPQ)

SUBMISSION DEADLINE: Saturday, February 28, 2026, at 11:59 pm. Read the Health Committee Letter (HCL) Instructions carefully before completing and submitting this questionnaire. Please complete all sections of the form by the deadline date. Interviews will take place from March 2 to May 1, 2026. Applicants may begin scheduling their interviews on February 23, 2026 after submitting the HPQ. Interviews must be scheduled and completed by Friday, May 1, 2026 to be considered "on time" for a Health Committee Letter. You may schedule your interview online through Handshake by selecting "Graduate School Advising," and then the "HPQ Interview" appointment type. If you have any trouble accessing Handshake, please contact the Greene Center at (585) 275-2366 to schedule your HPQ Interview. You will receive instructions on how to request a letter through your application portals in early to mid-May, as you cannot request letters until you submit your application.
Directions for completing your Health Professions Questionnaire

The Health Professions Questionnaire serves two purposes. First, because it is modeled after healthcare profession applications, it provides you with an opportunity to think, reflect, and collect information that will be helpful in the application process, which will help you be better prepared for this cycle. Secondly, it provides the Healthcare Committee with valuable information to assist us in writing a Health Committee Letter that supports you in your future educational and career goals. Before completing the HPQ we encourage you to visit the websites relevant to your field/area to read through and think about the different competencies expected in these different areas of healthcare. AACOMAS, ADEA, AAMC, AAVMC and others all have websites that reflect the competencies required to be successful in these various fields. Learn to tell your story through the lens of the competencies of your chosen field as you answer the questions both here and in your applications.

Links for Healthcare Competencies
- AAMC Competencies: https://students-residents.aamc.org/applying-medical-school/article/core-competencies/
- AACOM Requirements and Personal Qualities: https://choosedo.org/admission-requirements/
- ADEA: https://www.adea.org/docs/default-source/uploadedfiles/uploadedfiles/adea/site-pages/adeacompetenciesnewdentist.pdf?sfvrsn=97ac4101_1&id=45172
- AAVMC Competencies: https://www.aavmc.org/wp-content/uploads/2025/08/AAVMC-CBVE-2.0-2025-02.CompetencyFramework-1.pdf

Student Information
Date*

MonthDayYear
Date
Last Name*
First Name*
Student ID*
College email address*
example@example.com
Personal email address (most used)*
example@example.com
Date of Birth*

MonthDayYear
Date
What pronouns do you use?
Are you a U.S. Citizen or Permanent Resident?*

YesNo
If you are NOT a U.S. Citizen or Permanent Resident, please state your citizenship status
(i.e. Student F1 Visa, Refugee, etc.)
Were you born in the United States?

YesNo
Please list your country of origin
What age did you come to the United States.
In 2-3 sentences, please describe your background before college as it relates to your interest in healthcare professions.*
Have you overcome challenges or obstacles in your life that you would like to describe in more detail?This could include lived experiences related to your family background, financial background,community setting, educational experiences, and/or other life circumstances..*

YesNo
Please use the space below to describe why you selected “yes.”
Did/do you have to maintain employment as an undergraduate to fund your tuition expenses?*

YesNo
If you answered "Yes" to the above question, how did the need to work impact your undergraduate experience?

Application Information
What professional program(s) are you applying to? (List multiple programs with a comma to separate them - MD, DO, MD/PhD, MD/MPH, MD/MBA, DDS, DVM, Other - please identify)
Briefly explain your interests and motivations to pursue the healthcare program(s) you listed above?*
Have you previously applied to any of the above programs?*

YesNo
Have you ever submitted a HPQ previously?*

YesNo
Have you had a Health Committee Letter written on your behalf previously?*

YesNo
Standardized Test Score (MCAT, DAT, GRE). Please list both the cumulative score and individual section scores. (There will be an opportunity to update with scores in April/May)
If you have not yet taken the MCAT, DAT or GRE, what date are you planning to take it?

Academic Information
Class Year?*
Major(s)?*
Minor(s)?
If you do not have any minors please right "none" or N/A
Cumulative GPA to date (as of the end of your last completed semester)?*
How do you see you major(s)/minor(s) related to your interest and preparation for the program you seek to enter?*

0/750
Briefly describe your experience and growth through special opportunities (For example: Take 5, E5 Undergraduate Research, or Study Abroad).

0/750
Please list any honors or awards you have received during your time at the University of Rochester (i.e. number of semesters on Dean's List, Research and Innovation Grant, Leadership Awards, Phi Beta Kappa, Latin honors, etc.)

0/750
Have you ever been the recipient of any institutional action for unacceptable academic performance or conduction violation? You must answer Yes, even if such action did not interrupt your enrollment or require you to withdraw, and even if the action does not appear on, or has been deleted or expunged from, your official transcripts as a consequence of institutional policy or personal petition.*

YesNo
If you answered "Yes" to the previous question, please describe the situation and what you learned from the experience.

0/750
You do not have to authorize the release of your conduct history information; however, choosing not to do so may prevent you from moving forward with the Health Professions Questionnaire (HPQ) and Health Committee Letter process. If you have any questions about the information that will be shared, you are encouraged to contact the Center for Student Conflict Management at conflict.management@rochester.edu.
Do you authorize the Center for Student Conflict Management to release your information related to your conduct history to the Health Professions Advisory Committee?*

YesNo
Do you authorize the Board on Academic Honesty to release any record of violations of the College Academic Honesty Policy for which you have been found responsible?*

YesNo

Work & Experiences

Please list up to 15 on- and off-campus activities (i.e. shadowing, internships, research, volunteering, on-campus jobs, clubs and co-curricular activities, etc.). For each activity, please include details such as experience type (i.e. research, volunteering, etc.), name, organization, dates, total hours, location, names/titles of supervisors, and a short description that reflects your development of health professions competencies (limit 750 characters). Additional boxes will appear as you fill in each activity. (On most applications, you will be limited to 750 characters - we are allowing for 850 in the HPQ, as in the application, they will have a separate field for the type of activity, organization, etc.)
Activity #1

0/850
Activity #2

0/850
Activity #3

0/850
Activity #4

0/850
Activity #5

0/850
Activity #6

0/850
Activity #7

0/850
Activity #8

0/850
Activity #9

0/850
Activity #10

0/850
Activity #11

0/850
Activity #12

0/850
Activity #13

0/850
Activity #14

0/850
Activity #15

0/850
Please identify up to three of the activities/experiences you included above that you consider to be the most meaningful and explain why they are particularly meaningful to you. When writing your summary, you may want to consider the transformative nature of the experience, the impact you made while engaging in the activity, and the personal growth you experienced as a result of your participation, again considering the competencies valued in your intended field within the healthcare professions (1325 characters).
Meaningful Experience #1*

0/1325
Meaningful Experience #2*

0/1325
Meaningful Experience #3*

0/1325
Describe the greatest challenge you have faced (1325 characters).*

0/1325
Please describe anything else you would like to share with the Health Professions Advisory Committee.

0/1000

Submission Agreement

By submitting this form, you agree to the following:
- You have read and understood the policies and procedures for requesting a Health Committee Letter as outlined on the Health Professions Advising web-page.
- You understand that if you do not meet the requirements or deadlines, do not respond to communications from the Greene Center after two attempts, or inform the Greene Center that you are no longer applying within the current application cycle, a Health Committee Letter cannot be written on your behalf.
- You understand that the Health Committee Letter is confidential and can only be sent to your relevant application services or professional programs. The letter may not be sent to any individuals or those outside of these organizations, or otherwise be used in ways not intended.
- You understand that all information you provide within the HPQ, as well as learned from the academic honesty and conduct waivers may be included in your HCL.
- You agree to abide by these policies.
Should be Empty:

Health Professions Questionnaire (HPQ)

Directions for completing your Health Professions Questionnaire

Student Information

Application Information

Academic Information

Work & Experiences

Submission Agreement