Jefferson Medical College Alpha Omega Alpha Guide to Residency

Applying to Residency

The Regular Match (NRMP)

All American Allopathic medical students must participate in one of the official residency matching programs in order to start residency immediately after medical school. The vast majority of specialties participate in the National Residency Matching Program (NRMP) or “regular match.” Basically the match is a huge computer program that matches up residency programs with perspective residents. Each applicant registers with the match and lists the programs where they would like to train in order of preference. The programs list applicants in the order they would like to train them and then both lists go into a huge computer. What comes out is one program for each applicant. Once the match is made, it is a binding legal contract for one year of employment at that program. Match lists are submitted in late February and Match Day is in late March. For more information about the match (you can even look at the algorithm!) go here: http://www.nrmp.org/ . NRMP registration is around $60 with a $50 fee for registering late (after Dec 1).

The Early Match

The specialties of ophthalmology, neurosurgery, and urology are not included in the NRMP. These specialties have their own matches, usually in January and often referred to as the “early match”. More information will be available on the specific specialty pages. If you are interested in these specialties, it is important to be aware of the deadlines for application materials and letters of recommendation because they are much earlier than for the NRMP. Early match programs may use ERAS. Always check with the individual programs you are interested in.

Check these links for more specific information about these early match programs:

SF Match (ophthalmology, neurosurgery): http://www.sfmatch.org/general/welcome.html

Urology Match: http://www.auanet.org/residents/resmatch.cfm

How to Apply (ERAS)

http://www.aamc.org/students/eras/start.htm

The Electronic Residency Application Service (ERAS) is a handy service in which applicants input their data once and it is sent to all programs they are applying to. Most (if not all) residency programs use ERAS exclusively. The page is open for information input around July 1 of the application year and can be transmitted to programs on September 1. Although most program deadlines are not until much later, it is best to get your application in as soon as possible after September 1. Many programs start sending interview invitations before the Dean’s Letter is available on November 1.

There are several sections of ERAS. The first is the Profile. This section includes some basic information about you (like your current mailing address) and can be updated throughout the application period. The Common Application Form (CAF) contains the information from your profile plus a lot of other information, including past work/volunteer experience, schools you’ve attended, research experience, honors and awards etc. It’s a lot like AMCAS. Once you put all of this information in, ERAS will format it into a CV for you (helpful). Unlike the Profile section, the CAF (and the CV) cannot be changed once you certify it. However, this is the only section that is unchangeable. This is very important because once you finalize the CAF, you can apply to programs (after September 1) even if nothing else is turned in. Remember this!

The Documents section is where you will input/release your personal statement, letters of recommendation (LORs) and USMLE scores. Everything in this section can be changed at a later date. Do not wait on one more recommendation letter or even on a completed personal statement to apply. Especially if you are already late. Just get your name in the hat and get everything in as soon as you can. Some programs wait until the application is complete to offer interviews, but other don’t. ERAS will continue to send your application out as things are added, which means that it can be completed in piecemeal. Included in the Documents section:

• Personal Statement - you can write more than one of these. Reasons to do this include applying to more than one specialty or applying to both a preliminary/transitional year and an advanced match position. You will assign one personal statement to each program. Name them each something different so you can keep track of them.
  
• USMLE scores - you will have to pay the AAMC to release these scores (~$50). Once you do this, they will release scores for all the exams you have taken so far. If you have already taken Step II by the time you get to this part of the application, these scores will also be submitted to programs along with your Step I score. However, if you have not yet taken Step II, you can choose not to automatically release your score once you take it. This is usually a good idea since you don’t know what your Step II score will be yet. If you choose to automatically release your score, the schools will see the score before you do. If you choose to not automatically release the score, once you get your score report in the mail, you can immediately release the score manually (very easy and doesn’t cost any more money) and the schools will get the score in a day or two. Unless you are taking the exam very late and worried they will not get the score in time, there is probably no reason to automatically release your score. Just remember to release it before the match.
  
• LORs - Most programs require at least three letters of recommendation from physicians you have worked with. Programs vary in who they want these letters from, and some have very specific requirements. You should check individual program websites to make sure you are giving them what they want. Do this early in 4 th year, because you may need to track someone down from one of your 3 rd year rotations. You probably don’t need to get letters from attendings as you go through 3 rd year, since you likely don’t know what you’re applying for yet and there’s plenty of time to get the letters as a 4 th year. Give attendings as much time as you can, but realize that they know we are making these decisions (and changing our minds a lot) quickly during the first few months of 4 th year. Most can produce a letter in a couple of days as long as you’re very nice to them and you have a good reason for being so late about it. Most letters come from people you work with during your electives because you will work closely with attendings—something you may not do much of during the 3 rd year. You should not get letters from residents. There is debate about who is better to get a letter from: the junior attending who you worked extremely closely with for hundreds of hours or the world famous attending who you spent six hours silently retracting for on one occasion. This is a question for your specialty specific advisor because it varies between specialties. Some programs or whole specialties (like internal medicine) want a letter from the chairman of your department. Don’t worry if you’ve never met him or her. This is part of his or her job description and some sort of system will be in place to get this letter written. The chairman’s letter is usually just another version of the dean’s letter (discussed later). You must have at least one letter from someone in the specialty you are applying to.

The last part of the ERAS application, the Programs section, requires the applicant to designate which programs to send the application to. This is also the part that costs money. Basically the more programs you apply to, the more you have to pay (sort of). There is a flat fee for up to 10 programs and then after that you pay for each one separately. It’s too complicated to explain here, but you can go to the link to get the most recent fees (it seems to change every year). This can cost you from around $60 to hundreds of dollars depending on the number of programs and the number of types of programs you are applying to.

Where to Apply

Deciding which programs and how many programs to apply to is one of the most complicated parts of this whole process.

The first step is to research some programs:

• FRIEDA (http://www.ama-assn.org/ama/pub/category/2997.html) is run by the AAMC and is a database of the programs participating in the NRMP. You can find all sorts of useful information here including how many residents the program takes each year, hospital affiliations, health benefits and compensation information, etc. There is usually a link to the program’s website. This information does not seem to be always completely accurate, but it gives you somewhere to begin.
  
• Scutwork (www.scutwork.com) contains reviews of specific residency programs written by residents and medical students (who either interviewed at the program or rotated there). Not all programs are listed and the reviews may not be up to date (although they are dated, which at least gives you a clue). Worth checking out, but be aware that the site is anonymous and may not be accurate.

After browsing on the web a little, this might be a good time to go talk to you specialty specific advisor. There are countless ways that students select programs to apply to including geography, future career goals, competitiveness, etc. Bringing along a copy of your CV and transcript may be helpful when meeting with your advisor. They should be able to help you by recommending programs where you would be competitive and that fit your specific criteria. Ask them how many programs you should apply to.

If you are applying to an advanced position, which is a residency that starts after you’ve completed one year of postgraduate training (like radiology), you will also need to apply for Post-graduate Year 1 positions (PGY-1 or “internships”). You can do a “transitional year” which is a mix of elective and floor rotations and differs by program, or you can do a preliminary year (an intern year in medicine, ob/gyn, pediatrics or surgery). The requirements for the intern year vary depending on what advanced position to which you are applying. Spend some time on FRIEDA or talk to your advisor. Transitional years tend to be a little more competitive to match into because they are often thought of as “easier” than preliminary year programs.

You have the option of participating in the couples match. Please see this (http://www.nrmp.org/res_match/special_part/us_seniors/couples.html), to learn more about the couples match process.

Last updated: March 2010