GoKawiilIt was mid-October, peak leaf-peeping season in Hanover, New Hampshire, and Chad Markey was on a rare break between clinical rotations during his last year of medical school. He should have been inhaling Green Mountain air and gossiping with his Dartmouth classmates about life after graduation. In a few months, they’d all be going their separate ways to start residency training at hospitals around the country.
Instead, Markey was alone in his apartment, deep down a rabbit hole, preparing to go to war.
He’d wake each morning, eat breakfast, open his laptop at the kitchen table or settle into the tan armchair with the good back support, and start coding. Some days, he wouldn’t notice the sun had gone down until one of his roommates came home and asked why the lights weren’t on.
For days, Markey had been scrolling through a Discord group about medical residency, a font of crowdsourced knowledge where students report back to their peers on every stage of the application and selection process. He’d watched as other students, lots of them, posted about the interview invitations they’d received.
Markey didn’t have any interview offers, only outright rejections. That seemed not just odd but wrong to the quiet-mannered 33-year-old from Houston, Texas, who speaks confidently about his accomplishments without bragging. He had good grades from an Ivy League medical school, author credits on articles in the Journal of the American Medical Association and The Lancet, a heart-wrenching personal statement, and glowing letters of recommendation. One professor wrote that they had “never met a medical student who is more skillful, talented, and appropriately situated in his pursuit of the field of medicine than Chad.”
Markey combed through his application looking for a fatal flaw. He didn’t find anything he thought would prompt a residency program director to toss an otherwise competitive application, so his suspicion turned to another culprit. He’d heard rumblings that some hospitals were using a free AI screening tool to help process applications—and that it had been displaying incorrect grades for some students. He began to wonder whether AI was responsible for his lack of interview offers.
On the first page of his Medical Student Performance Evaluation, a comprehensive summary of his early career prepared by his school, Markey spotted language that he suspected might trigger an automated screening tool to downgrade his application. The MSPE stated that Markey had “voluntarily” taken three separate leaves of absence, totaling about 22 months, and had chosen to extend his third year of coursework over two years for “personal reasons.”
That wasn’t quite true. In 2021, Markey was diagnosed with ankylosing spondylitis, an autoimmune disease that affects the spine and could flare up to the point where he couldn’t stand, much less do the intensive physical work expected of medical students during clinical rotations. He was on track to graduate from medical school in seven years, rather than the typical four, but his absences had been unavoidable and medically necessary. This was explained in a narrative paragraph on the first page. Calling the absences “voluntary,” Markey felt, might be interpreted as evidence that he had succumbed to the pressure of medical school and not been able to keep up with his studies.
As the days went on, Markey said, he felt increasingly afraid that his years of training would end in failure. “I crawled out of a fucking black hole,” he told WIRED, referring to his diagnosis. “I could not walk for six months. I’ve come this far, and this is happening?” He was asking himself the same question that pops into the minds of millions of other job seekers every day: Did an AI trash my application?