not sure if I have my academic goals are clear in this essay
The solution for this problem is always to do some web research and get more specific in your mind about what you want to do.
My parents have never been to college. ---- why begin by saying this?
Oh.. as I continue to read, I understand why. Well, I think you can express the idea of the first paragraph in ONE sentence. I think you should have one great sentence about their sacrifice and combine it with this:
I intend to accomplish their dream of seeing their daughter
going attending college.
Express it all in one or maybe two sentences. Do not let it take up the whole introduction, and do not end the first para with a sentence about actualizing their dream.
End the first paragraph with YOUR specific plan. You might have to make one right now. Establish 5 goals for yourself for the next 4 years, and make sure they are goals that will benefit you in your chosen career. Is there a common theme for all your goals? Whatever it is, express it at the end of your first paragraph. :-)
Paragraph 2 is just all vague description of yourself. I think you should get rid of it and make more room to focus on your specific intentions.
In your first and last paragraphs, discuss the areas of specialization that interest you, and maybe even your philosophy of medicine. Google around, and get specific. Give definition to this by adding detail about your plans. A person with detailed plans is a person who is really going to do it.