Everything you need to know about selecting residency programs
When medical students and graduates prepare to apply to residency programs during the residency application process, they often do not realize the level of awareness and effort required. While applying to residency programs may seem like a simple task of picking residency programs and applying to them, there is so much more involved to make sure you are applying to the right programs. By following a careful procedure for choosing the right medical specialty, correctly researching residency programs, selecting the most compatible residency programs and applying through ERAS, residency candidates can increase their chances of obtaining interviews and matching.
Choosing a Medical Specialty
The very first step residency candidates should take before starting the process for researching and applying to residency programs is choosing which medical specialty they will be focusing on.
When it comes to choosing a medical specialty to apply to, you may end up considering more than one. NRMP data and statistics suggest that residency candidates, especially International Medical Graduates (IMGs), who apply to, interview in, and rank two to three specialties are the most successful in obtaining a residency Match.
Residency candidates often pick a primary specialty of interest, a backup specialty, and sometimes, a third specialty to apply to. Keep in mind, applying to any more than three specialties can become risky as residency candidates often spread themselves out too thin. When you are thinking about how many specialties to apply to, you must also remember you will need more supporting documents for each specialty and to divide your budget appropriately to cover each specialty without compromising your chances in your primary specialty.
Choosing a medical specialty or medical specialties to apply to is not an easy task, and should not be taken lightly. Proper decision making requires a thorough and methodical approach where a residency candidate examines the many different factors.
Your Personal Preferences
Arguably, the most important factor in picking a medical specialty are your own personal preferences in what you can see yourself doing for the rest of your life. Some residency candidates dream of pursuing surgical specialties and cannot fathom the idea of practicing in primary care. Others enjoy the day to day relationships they form with patients in specialties like Internal Medicine, Family Medicine or Pediatrics. Whatever your case may be, it is crucial to examine your own preferences to choose the medical specialty that will represent your future path in life.
Your Professional Credentials
Other very important factors to consider when thinking about medical specialties are which specialties are best suited to your professional credentials. The biggest professional credentials that will play a role in your decision-making process are: USMLE exam score and attempts, and your Time Since Graduation or educational gap.
Some medical specialties are incredibly competitive such as Orthopedic Surgery or Dermatology and demand absolute excellence in USMLE exams, medical school performance and more. Other medical specialties are less competitive with regards to USMLE scores and prefer other attributes such as experience in the specialty or research.
Your Medical Background and Experience
After your professional medical credentials, the next most important factor is your background of medical experience. There are residency programs within certain medical specialties that value a genuine interest in their medical specialty above other criteria like your USMLE scores.
For example, many Family Medicine residency programs would rather choose a residency candidate with extensive dedicated Family Medicine experience over a residency candidate with high USMLE scores that has a clear background in another specialty. Additionally, a research-heavy specialty like Pathology would value a candidate with research experience over a candidate with lots of primary care experience.
Your Supporting Documents
Tied in with your professional background and experiences are the ERAS application supporting documents you will be able to obtain. For EACH medical specialty you choose to pursue you will need at least one specialty specific Personal Statement and ideally three specialty specific Letters of Recommendation. If you cannot get ahold of even one specialty specific Letter of Recommendation, it may not be wise to apply to the specialty.
IMG Friendliness (For International Medical Graduates)
There is an additional factor that only relates to International Medical Graduates (IMGs), or those who received their medical education outside of the US. One of the realities of the medical residency process is that some medical specialties are considered IMG friendly, while others are not.
The most IMG friendly specialties are historically:
The least IMG friendly specialties are usually:
- Orthopedic Surgery
- Emergency Medicine
- Radiation Oncology
- Physical Medicine and Rehabilitation
While it is certainly not impossible for an IMG to get a position in these specialties, there is a level of difficulty which should be taken into account while deciding which medical specialty to apply to.
Researching Residency Programs
Once you have decided which medical specialty or specialties you will be applying to, the next step is to begin finding the right residency programs to apply to. There is a unique science to picking the right residency programs to apply to as residency candidates want to focus on only applying to residency programs they are compatible with along with a number of other considerations.
Residency candidates often wonder what is the correct amount of residency programs to apply to that will give them the best chances. Keeping in mind that applying to residency programs can be quite expensive (see the Applying to Residency Programs section below), residency candidates should be careful how many programs they choose to apply to. They do not want to limit their chances by applying to too few programs, while they also do not want to spread themselves out too thin financially by applying to too many programs. Some simple guidelines to follow are:
International Medical Graduate: A minimum of 100 programs per specialty (if the specialty is large enough)
US Medical Senior: Anywhere from 15 to 30 programs
US Medical Graduate: Anywhere from 50 to 100 programs
However, these are just suggested guidelines and may not be applicable to you and your own circumstances. Please consult with a residency mentor to figure out what is best for you.
The next part of the residency program research process is learning which program minimum requirements are important to know in order to gauge your compatibility with each program. Each program has its own unique set of minimum requirements they take into account when reviewing residency applications.
USMLE Exam Scores and Attempts
Many residency programs have a minimum USMLE exam score cut off for the USMLE Step 1 and USMLE Step 2 CK. They may also limit the amount of attempts a residency candidate needed to take in order to pass the exams.
Time Since Graduation Cut Offs
Another big residency requirement is Time Since Graduation or your Year of Graduation. Programs can have cut offs starting at recent graduates, 3 years or less, 5 years or less, or no cut off at all.
This is not necessarily a requirement, but some programs may have a cut off date for when they will stop accepting new applications. If you are applying late or looking to apply to more programs, these are dates you should be aware of.
This only relates to Non-US IMGs who will require a visa. They will need to look for residency programs that either accept the J1 visa (provided by ECFMG) or sponsor the H1-B visa.
US Clinical Experience
Another IMG-only requirement is US Clinical Experience (USCE) which is hands on work with patients in a US medical environment. Some programs may prefer or require some amount of USCE.
Just like with choosing a medical specialty, IMGs will need to find residency programs that are IMG friendly. This means the program is willing to consider IMG applications and has IMGs in their current active roster.
While it may appear to be a simple task, researching thousands of residency programs will take up a lot of time, effort and patience that residency candidates may not realize. It can be difficult to fathom the scope of the task, especially when credible sources of information can be hard to find.
To research each and every program, residency candidates end up spending hours and hours to:
- Start with Google to look up each program
- Try the program’s website which may or may not be updated, have all of the information you are looking for and may not reflect a program’s true requirements
- For example, a program website may SAY they have not USMLE score cut offs, but they are really looking for more competitive USMLE scores
- Look through enormous public databases which also typically provide an inconsistent level of information per program or remain outdated when they are not updated by program faculty who have to log in and adjust the information themselves
- Try emailing or calling the program directly which comes with many risks such as giving yourself a bad name with the program if the conversation goes wrong
- Cycling through each information resource over and over again
All this time and effort to maybe get the right information to make your residency program application decisions.
Overwhelmed with the residency research process and don’t know where to turn? Match A Resident can help! Match A Resident provides Customized Residency Program Lists that are expertly filtered according to important program minimum requirements such as your Applicant Type, USMLE exam scores, Time Since Graduation, visa needs, US clinical experience and more. Much more than just a Customized Residency Program List, every Match A Resident member is able to:
- Get an insider’s look at the residency programs on your Customized List with program information gathered through a sophisticated and exhaustive information gathering procedure
- Diver deeper into each residency program with the additional program information, criteria comments and available interview feedback from past residency candidates
- Customize your list even further with the Additional Filters for USMLE Exam attempts, Bookmarked programs, program deadline, missing USMLE Step 2 CS and more
- Learn which programs have interviewed a candidate like yourself in the past with the I-Link feature
- Find your most compatible programs within your Customized List with the Match A Resident Exclusive Compatibility Score
- Receive support throughout the entire residency application cycle with the Interview Manager and Rank Assist features
- Explore the numerous education resource pages and extensive residency blog
- Have the most knowledgeable residency application Support Team to contact with any questions
With Match A Resident, you will instantly have access to the most trustworthy source of residency program information to base those all-important residency decisions along with many additional features and dedicated residency support.
➔ Learn more about researching residency programs with Match A Resident
Applying to Residency Programs
Once you have prepared your personal list of residency programs to apply to, the final step is to apply to residency programs. Most residency programs accept applications through AAMC’s ERAS platform.
In order to apply to residency programs using ERAS, you will need to:
1. Register for an ERAS account using a current ERAS Token from either your medical schools (USMGs) or ECFMG (IMGs)
2. Complete the full ERAS application
a. MyERAS Application
b. Personal Statement(s)
c. Letters of Recommendation
d. Medical School and USMLE Transcripts
f. PTAL (Only for applying to California programs)
3. Begin searching for and saving residency programs
4. Assign supporting documents
5. Apply to the programs you have already picked out
The ERAS system is fairly straightforward, however, if you run into any trouble there is a User Guide and other tools available on the ERAS website or through ECFMG for IMGs.
Applying to residency programs with ERAS can be expensive. ERAS uses a tiered cost structure that begins with $99 for the first 10 applications, $13 per application for the next 10 applications, $17 for the following 10 and $26 per application for every application you submit after 31. This can add up quickly leading residency candidates to spend thousands of dollars on residency applications alone.
For example, if a residency candidate submits 100 programs, just within one medical specialty, the cost is over $2,000. This is not including applications to other medical specialties or other residency related fees!
The cost of applying to residency programs is a large part of why it is so vital to research residency programs carefully, especially when most residency candidates are applying on a tight budget.
Applying to residency programs can be a long and difficult journey. First, you have to choose the medical specialty or specialties you are going to apply to. Then, you have to research hundreds or thousands of residency programs to find the most compatible programs for you, which can be challenging, especially when you are relying on unfounded speculations and with a lack of credible resources in the field. Finally, you have to see if your research will yield the best results when you invest in your applications to residency programs within ERAS.