Beginners Guide To Getting Into A Residency Program

Each year, thousands of medical students anxiously await their MATCH results in the third week of March, a culmination of nearly a decade or more in education and training. While the process may seem daunting, remember you have applied to college and medical school in the past, and this process mirrors those in many ways. Once you familiarize yourself with the key features of the application and timeline, you will be prepared to set yourself up for a successful match.  

Learn the Components of a Residency Program Application

The residency application process is a key milestone in your training, where you set the foundation for your medical career. Typically, you prepare for this process during your third year of medical school, as you will submit your application in the fall of your fourth year. In order to do so, you must familiarize yourself with the components of the application. At a minimum, this will include a professional headshot, your Step 1 and Step 2 scores, your clerkship grades and comments, 3-4 letters of recommendation, and an ERAS (Electronic Residency Application Service) application. This will include your extracurricular activities such as prior jobs, research projects, publications, and community work.

Certain subspecialties, such as plastic surgery or emergency medicine, will also require away rotations or other standardized evaluations. Even before you choose your specialty,  performing as best you can on your clinical rotations and Step exams will ensure you begin to build a solid foundation for your application. Additionally, fostering your extracurricular interests will also be a key component of your application, regardless of your field of choice. Finally, be sure to familiarize yourself with the residency timeline published by the AAMC. Make sure you are aware of key deadlines as you prepare your application.

Determine What Residency Specialties Interest You

When starting your residency application process, you should have an understanding of what fields you gravitate towards and why.  Such an understanding will allow you to determine what area you should ultimately pursue, what faculty members you should reach out to, and what programs will ultimately suit you best. While it is often difficult to take time to reflect during your clinical rotations, consider the following questions:

• Do you enjoy procedures or do you prefer medical management?
• Would you like your practice to be more clinic-based, inpatient based, or surgical?
• Do you prefer a wide variety of cases, or would you rather be an expert in a narrower field of practice?

Even if you are deciding between a few different specialties, knowing these key preferences will ensure you narrow your fields of interest down. This way you can explore more deliberately. This will allow you to both make a more confident decision about your specialty and allow you to build meaningful connections with faculty members along the way. Additionally, application processes vary widely across specialties, and understanding the nuances within each field will allow you to prepare accordingly. 

Meet With Your Program Directors or Faculty Advisors

So now you have an idea of what field you want to go into. That’s great! The next key step is to reach out to individuals in your field of interest. They can help you review the timeline and connect you to additional experiences. In some cases, this may mean meeting with the program director at your medical school for the residency you want to go into. If your medical school does not have your residency of interest, you will need to meet with your school’s available residency advisors, or with an Elite Medical Prep residency advisor to learn more about the application process and help connect to program directors at other institutions.

There are a few key points you want to make sure you understand:

• How many programs do students typically have to apply to in order to match their area of interest?
• Where have prior students matched?
• What additional supplemental components does your specialty of choice require? For example, away rotations or video interviews.

If away rotations are required, which is often the case in surgical subspecialties, you will need to apply for those during your third year and complete them in the summer before you submit your application. Additionally, it is helpful to know what scores on your USMLE Step 2 are typically required to determine if you are a competitive applicant in your field of choice.

A helpful resource is Texas STAR (Seeking Transparent in Application to Residency). This is a nationwide survey that medical students complete regarding their applications and where they matched. For each specialty, it lists details about each residency program including the average USMLE Step 2 scores, number of honors on clinical rotations, percent in Alpha Omega Alpha Honor Society (AOA) or Gold Humanism Honor Society (GHHS), and research experiences matched applicants had. This allows you to accurately gauge how competitive a field is. The login for these is typically made available through your medical school. 

Seek Out Additional Experiences and Information

Once you have a timeline and specialty before you, it’s time to consider additional experiences and information. Pursuing additional electives and research projects is extremely helpful in strengthening your application. Specifically, you should pursue available electives at your school in your field of interest and become familiar with the individuals in your department who you may work with going forward.

This often means pursuing away rotations at other institutions to gain additional clinical experience and understanding of your chosen field. We also recommend getting involved in either medical education or research projects related to the field you choose to enter. Ultimately, programs are looking for evidence of dedication to a field. Pursuing related projects outside of your clinical day-to-day can further demonstrate this. In addition, it may allow you to gain helpful connections in the specialty which are advantageous as you begin interviewing and preparing your rank list.

Determine Who Will Write Your Letters of Recommendation

One of the most important components of your residency application is your letters of recommendation. As you go through your clinical rotations in medical school, take note of the rotations where you received the best feedback and spent the most time with an attending. Outstanding letters of recommendation require the writer to know you well and be able to attest to your clinical, educational, or research talents.

Typically, a program will have you submit 3-4 letters of recommendation. A common approach is to obtain at least one letter from an attending with whom you worked clinically for an extended period of time, commonly on a sub-internship or away rotation. Another letter is then typically obtained from someone you worked with in extracurricular activities, such as your research mentor or a volunteer supervisor with whom you have worked longitudinally. If you do not yet have someone you feel would be appropriate to write your letter, begin to seek clinical or academic opportunities where you can obtain one.

Select a Preliminary List of Residency Programs

While there are many lists of residency programs out there, determining the best place for you should be a tailored and reflective process. Your faculty or subspecialty advisors will typically assist you in determining how many programs to apply to. They may also have some insight into which programs would suit you best. There are also several online tools to research programs in your specialty including the AAMC Residency Explorer and Doximity Residency Navigator.

While students frequently gravitate to the highest-rated programs, be disciplined in your approach to selecting your list of programs. This is not just a training program. It is your first job as a physician. During your residency, you will live and work in a collaborative environment for many years. It is helpful to make a list and write down the key components you want to get out of your training. A few example points to keep in mind are:

• Are you more interested in a research career, or do you want to work in a community hospital?
• Do you have only a certain region where you can live, or are you able to apply broadly?
• What areas are reasonable from a cost-of-living perspective?
• Is it important you have parental leave or other specific benefits available?

Approaching this process with an open mind will ensure you select the optimal places to apply and interview. Keep in mind if you are going into a competitive specialty, you may need to apply to most or all of the residency programs available.

Start Your Personal Statement

While the ERAS personal statement carries relatively less weight than your grades on your clinical rotations and letters of recommendation, it is still an important part of your application! It is a unique opportunity to provide the program with information on what makes you a standout applicant. We recommend that you start your personal statement no later than the spring of your third year of medical school. When writing, it is best to focus on information and experiences not otherwise covered in the remainder of your application. If you have specific geographic preferences, this is an opportunity to point out why. It is recommended that you send this to your subspecialty or other trusted advisor for review and recommendations to ensure it is as strong as possible.

Fill Out Eras Early and Submit Your Application as Soon as Possible

The ERAS application is essentially a digitized form of your curriculum vitae. This is where you can upload your clinical rotation grades and comments, Step 1 and 2 scores, professional headshot, and letters of recommendation. There is also an area in ERAS to designate AOA or GHHS status. ERAS generally opens in early August. You can submit your application around the first week of September (see the AAMC official timeline).

If possible, it is extremely important to submit your application as soon as you are able. Many programs offer interviews on a rolling basis. For these, the earlier your application is seen the more likely you are to get an interview offer. Before you submit, make sure to review your application several times for errors. An easy way to do this is by printing the application out and reading it). It’s a good idea to get a second pair of eyes on this part of the process as well. Don’t be afraid to ask for help from a residency advisor on this!

Schedule and Complete Your Residency Interviews

Once you submit your application, you will likely begin to receive residency interviews. In some cases, these are released on scheduled dates, and in other cases, they are released on a rolling basis. As soon as you get an interview, it is recommended that you schedule it immediately. Often preferred time slots will close rapidly, precluding you from interviewing in a certain location. We recommend setting up text or email alerts to ensure that you are immediately notified of an interview offer. If you know you will be unavailable for an extended period of time (traveling or taking an exam), consider giving someone you trust your email information and calendar so they can schedule the interviews for you.

Pay close attention to the location of the interview, specifically if it is in person or virtual. Do your best to bundle in-person interviews in similar locations together. For each program, take some time to review their curriculum and come up with one to two questions to ask the program director to show you have done your research. If you know trainees at these programs, reach out early and learn what to expect from interview day. Make sure to take notes on the programs as you interview. This way, you are able to compare them come time to make your rank list. Interviews typically run over several months, commonly from November to January though this varies by specialty.

To prepare for your interviews, we recommend that you consider some of the commonly asked questions ahead of time. It’s also a great idea to get some practice in! You can practice answering common questions in front of a mirror, and schedule at least two mock interviews with a residency advisor.

Submit Your Residency Program Rank List

Once you have completed your interviews, it is time to submit your rank list. Remember that the algorithm runs in your favor, so be sure to rank the programs in the order in which you would like to match. Listing all the programs you have interviewed can increase your chances of matching. When making this list, it is important to talk to trainees at the programs and the program director to get a thorough understanding of the area you are committing to for the next few years. Pay attention to the deadline, which is typically in later February or early March. Be sure to submit it on time, and then relax! At this point, it is truly out of your hands. The results will come in the third week of March on match day.

For more help reviewing your ERAS application, CV and personal statement editing, mock interviews, and more, consider enlisting the help of an Elite Medical Prep residency advisor! Schedule a complimentary consultation today to hear more about what we can do to help you succeed!