The Logistics: applying for residency & scheduling interviews
In this post for my residency interview series, I’ll go over some logistics on the application process itself. As with all of my posts, keep in mind this is just one person’s perspective; be sure to seek advice from your mentors in addition to reading posts like mine.
General overview
ERAS (electronic residency application service) is the online program through AAMC where you will actually apply for residency. You will fill out your personal information, education history, experiences, publications, hobbies & interests, and other awards/accomplishments all in their system directly. ERAS separates “experiences” into work, volunteer, and research categories. You will use ERAS to select programs you want to apply to, manage your letters of recommendation, and after you submit you may also be offered interviews through ERAS directly. Once you submit your ERAS application, you can only edit your personal information, so be sure you’ve proofread thoroughly before pushing submit! Don’t worry, you shouldn’t accidentally submit the app; ERAS requires you to enter your password as a hard stop to be sure you’re ready to submit your application. There are fees associated with applying for residency programs, starting at $99 for the first 10 apps, $16 each for the next 10, and it goes up slightly from there.
The NRMP (national resident matching program) is a separate website you’ll register for. You will use NRMP to create your rank list after your interview season is complete, and it is the NRMP who does “the match”. You can register for the NRMP program as you’re filling out your ERAS application so that they can generate an NRMP ID for yourself, and you’ll enter this into the ERAS application. You can “rank” all of the programs that you interview with, but you don’t have to. However, if you interview at a program and then choose not to list them on your rank list, you are basically implying that you’d rather go unmatched than attend that program. Unlike ERAS where you can’t edit once you submit, you can re-certify or edit your rank list up until the date when it closes. Fees start at $85 to rank up to 20 programs, and if you rank more programs than that there are additional costs.
Preparing your application
As you’re starting your fourth year of medical school and just beginning to think about your application, definitely consider drafting your CV and personal statement. It’s definitely never too early to have a draft of these things done.
Your CV (curriculum vitae) is basically a long version of your resume where you’ll list all of your work, extracurricular, volunteer, and research experience as well as any awards or achievements, and maybe also your hobbies. It’s a good idea to have this drafted sooner rather than later because you should give this to anyone you ask for a letter of recommendation. It’s generally a good idea to keep your CV clean, easy to read, and keep your descriptions pretty brief. Before I opened ERAS, I was incorrectly assuming that I’d be sending my personal version of my CV directly to programs. In reality, you’ll use the CV you make for yourself as a reference as you enter all the same information into the ERAS system.
Everyone’s personal statement will be unique, and it is a tough topic to offer advice on. In general, the purpose is to tell residency programs why or how you selected your specialty. Some students may also choose to explain a unique circumstance if they had any come up in medical school or if they have any “red flags” in their application they can choose to address that here. Definitely draft this early and be ready to completely rewrite it a few times before you get a result you’re happy with. Also be sure to have some advisors read it in addition to more close friends or family if you’re comfortable. At a later time, I’ll share my own personal statement with you.
Filling out ERAS
Like the VSAS system we used for away rotations, I think the scariest part about ERAS is opening it for the first time. I definitely recommend opening it as soon as you can just to start clicking through all of the menus and getting used to the system.
The bulk of the work of filling out your application is in entering all of your “experiences”. You should already have your CV for reference for your dates and the details about your positions. But, the part that takes the most time is writing a “description” for each of your experiences. I chose to create a separate google or word document where I typed out my descriptions so that I could have someone easily proofread them, and so I could keep coming back to that document as I edited my responses. I suggest talking to an advisor in your respective specialty and asking them how detailed they think your descriptions should be. For emergency medicine, I was given the advice to keep descriptions as concise as possible while being sure to include my general responsibilities or accomplishments in each role.
A couple of small details for when you’re in the process of entering your experiences:
- List all of your work experiences
Yes, even include the little summer job you had during college. Your residency program director is your first boss after medical school, so in general it is helpful for them to see that you’ve successfully worked in the past. - You don’t have to fill out every single item for every experience
ERAS gives you a lot of options to include things like “reason for leaving” and “average hours/week”. However, I personally chose to only include hours for my work experiences, and I only included a reason for leaving on some of my experiences.
Choosing where to apply
Deciding which programs to apply for and how many applications to submit are two of the most difficult decisions you’ll make in this process. They are difficult because they will vary widely depending on your specialty, your personal goals, your strength as an applicant, where you want to live, and a seemingly endless list of other factors…
To start, you may hear a term called a “magic number” or something like that. My understanding of this term honestly did help guide me in deciding how many interviews to keep, but it didn’t help me decide how many applications to submit initially. Each year the NRMP releases match outcome data that is organized by specialty and shows some statistics for applicants who matched. From this data, you can see on average how many ranks students who match into your specialty of interest tended to have. For emergency medicine from 2020, the “mean number of contiguous ranks” for those who matched was 12.8. Based on this “magic number” of ranks, in combination with the fact that I’m coming from a new medical school and that I was applying during the pandemic and all interviews were virtual and “nobody knows what’s going to happen”, I set out with a goal of attending 14-15 interviews.
With this all being said, once you have a goal number of interviews in mind, you’ll still have to decide how many programs to apply for. I found EMRA’s resources extremely helpful, and I also sought the advice of my school advisor and an emergency medicine program director in making my decision on how many applications to initially submit. Depending on the timeline of your application year (for us it was shortened due to the pandemic), you can also choose to apply in two waves. In other words, you can start by applying for X number of programs, give it a few weeks and see how many interview invitations you receive, and then decide if you’d like to submit additional applications. I chose to apply for my number all up front, especially given our shortened timeline. I honestly over applied and was extremely fortunate to be in a position of declining interviews as the season went on, but I’d rather have been in that position than not having applied to enough programs to reach my goal number of interviews.
In terms of where to apply, this is a very personal decision you’ll have to make for yourself while considering a multitude of factors. I offered some advice on things to consider in my previous residency series post. For some, geography will play a significant role, and it is helpful to truly picture yourself living in each city you apply for. It is also helpful to consider what types of programs you are more drawn to: community, county, or academic. I also honestly think it’s okay to be working on developing your list of things you want in a program even as the interview season is going on. It’s okay to sort a lot of things out in real-time as you’re deciding what interviews to keep, and as you’re researching programs.
Actually scheduling interviews
Okay, after all this talk and all these headaches and decisions in getting the app in, next is one of the more exciting parts as you get your interview (IV) offers!
In general, once programs have access to your application, you will have to keep your email notifications and access to your schedule on your person at all times. This sounds extreme, but it truly isn’t. Once you receive an email that you’ve been offered an interview, you need to schedule it as soon as possible to be sure you get a date you like. Interview scheduling will take place on many different systems/websites, and navigating those at first is confusing. It can be anxiety provoking to keep your phone or computer on you during a clinical rotation, but just communicate with your residents your reasoning and they’ll understand; they’ve all been in your shoes before.
I chose to keep track of things in a few different ways:
- Separate folder in my email inbox for all interview related emails
- Spreadsheet with: program name, state, city, IV date, IV scheduling system, website (and I later added gut feeling/misc notes, pros, cons, and current ranking to this spreadsheet)
- I also had a spreadsheet (that EMRA’s match feature actually made for me) with all of the programs I applied for listed. On this sheet I kept track of what date the IV was offered, and listed additional program details like program director name, what type of setting it was, patient volume, number of positions, etc.
As you’re scheduling interviews (and hopefully travel arrangements), keep a few things in mind. To save on cost if you can group some regions closer together that might be a good strategy. Most interview dates will have a “resident dinner” the evening before the actual interview day where you and other applicants can hang out and get to know the residents with no faculty present. Though this may be listed as “optional”, you should make every effort to attend. Even my year where all our gatherings were virtual, the resident dinners were extremely helpful in getting a “feel” for the program, how happy the residents were, and whether or not I thought I’d fit in with their resident family. Lastly, interviews are equally exciting and exhausting; I wouldn’t recommend scheduling more than 2-3 interviews in the same week. I had one week with 3 interviews, and I was really struggling on the third one, and that was without travel.
Researching programs
You’ll be reading a program’s website at multiple points during this process. As you’re deciding where to submit your applications initially, it’s a good idea to at least skim through program websites, especially if you’re still deciding if you’d like to apply there. Once you’re offered an interview, you’ll do your most thorough research on the program in preparation for that interview. And lastly, as you’re creating and finalizing your rank list in the months that follow you’ll likely find yourself looking again at program websites and any notes you took.
I chose to take notes on the programs on one big word document in bullet points, others choose to take handwritten notes; whatever system works best for you, it will probably be easiest if you use the same system throughout the interview season. Major categories I took notes on included:
- People
Take note of the program director and program coordinator. Also keep track of the names and email addresses for everyone you interview with. I would write a couple of facts about the person if I felt it may be helpful in my interview with them. - Site information
What type of program it is (county, community, academic, a mix), training sites, shift information - On shift / learning
For me this meant things like what the program’s graduated responsibility was like, what teaching and learning is like for the residents, unique rotations, patient population etc. - Wellness/relationships/mentorship (things that are important to me)
- Community outreach (another thing that’s important to me)
- Living in [city]
I kept track of what residents do for fun, what type of setting they tend to live in (apartments vs houses), cost of living, etc.
This is just one example, again find a system that works best for you, and it very well may adjust as you go through a couple of interviews. The most important thing is that you are thorough in your research of the program before your interview. Click through every page on the program website, find their social media accounts, watch every video if they have any, etc. Also be sure to thoroughly read the emails and attachments you were sent when you were offered the interview.
Honestly, a lot of the information on the websites looked similar and would run together at times. It took looking through at least 3-4 websites before I started to feel I was able to tease out what made each program unique. For emergency medicine, pretty much every program is going to highlight their volume, acuity, procedure exposure, and other similar characteristics. I personally felt that some of the most helpful pages were when programs had messages written directly from their residents about why they chose that program. This is particularly helpful as you’re still learning what makes this program stand out, and of course what drew residents there.
Once you’ve completed your research, I also recommend practicing your answer to “why is this program for you?” Review the notes you took on the program; what notes or quotes from the website did you bold out of interest? What are the unique things that that program offers its residents? Write down a few bullets and practice saying out loud what draws you to that program in particular. You will almost certainly be asked this on interview day in some capacity. When I was first considering my answer to this question, I asked a resident mentor for some advice because I wanted to be sure that I was being genuine and honest in my responses. I think it is okay to mention similar characteristics in different programs. I always tried to be thoughtful with my language, saying things like “I’m drawn to your program because xxx” or “I initially applied to your program because I saw that you offer xxx”, rather than making any commitments this early in the process. I’ll give more advice in a later post for the interview itself, and expand on how important it is to just be honest and be yourself throughout this entire process.