How Many Residency Programs & Where to Apply

Deciding how many and which residency programs to apply to plays a critical role in your matching success!

In order to address the question of how many residency programs you should apply to and where, it is critical to ask yourself: What residency am I applying to? What is my USMLE Step 1 score? What is my medical school background (ie MD, DO, IMG)? What are my other distinguishing features/honors (eg. research, teaching, etc)? The answers you come up with to these questions will be weighed against each other in order make sure your expectations match reality. For example, if you are wanting to apply to a highly competitive residency but have a lower USMLE score or not many distinguishing features, you may need to reevaluate your residency application choice. Often, it is very helpful to get another person’s take on your answers to these guiding “reality check” questions, especially a professional. Talking with advisers, faculty at your home institution, recent graduates from your program, or even Elite Medical Prep tutors can help clarify some of these questions and provide you with additional perspective you may need.

Before getting bogged down in the details, the most important step in this process is an honest evaluation of what specialty you are applying to. Like we mentioned before, this can determine whether you match or not. Perhaps what many students don’t realize is that within each residency, there are often ways to sub-specialize to a particular field of interest (eg. if you really want to do dermatology, but you are worried you may not match, did you know that you could apply to pathology (which is much easier to match in), and then do a fellowship in dermatopathology? (It actually might be nicer in the end because you won’t have to actually touch people’s feet!). Critically evaluating what truly motivates you to pursue medicine as a career and being honest with yourself about your motivations are key.

When you’ve firmly decided your specialty of choice, now is the time to get real about the numbers. Based on a recent study by the Association of American Medical Colleges (AAMC), applicants applying to primary care specialties, those with higher Step 1 scores, and those who are U.S. MD applicants (i.e., U.S. MD seniors and graduates) have a higher likelihood of matching compared with applicants applying to competitive specialties, those with lower Step 1 scores, and those who are U.S. DO, U.S. IMG, and foreign IMG applicants. The AAMC also compiled information for several specialties regarding the point at which submitting one additional application results in a lower rate of return on the applicant’s likelihood of entering a residency program.

This information can be found here: https://students-residents.aamc.org/applying-residency/article/apply-smart-data-consider/

Additionally, the importance of networking with various programs cannot be stressed enough. If you want to stay at your home institution, get to know as many people as possible in the program you’re interested in. If you want to go somewhere else, go to conferences or ask if faculty at your home institution can put you in touch with somebody there, and do away rotations if necessary. All of these personal interactions will make your application stand out and have residency program directors expecting your application. From a program directors mouth, “for many of these applicants, the margins are razor thin. Many applicants have great letters and similar STEP scores.”

In conclusion, spend your time on two things: critically evaluating your application and reflecting on what is most important to you; and talking with people.