Residency application tips include the obvious: Excel in your clinical rotations, get stellar scores on your Boards and juggle all of that seamlessly while heaping on robust and distinctive extracurricular activities.
However, as we approach the start of the residency application cycle, it’s worth considering mundane mistakes that even sophisticated students make in applying for residency and addressing what can be done to mitigate these missteps.
Ensure Your Written Materials Are Outstanding
As a former emergency medicine assistant residency director and current admissions consultant, I have read thousands of personal statements and Electronic Residency Application Service® (ERAS) Experiences sections. I can tell you that quality varies widely.
An applicant with many clinical honors will get attention for academic excellence but can wipe out those gains with a poorly crafted personal statement or ERAS Experiences section. Remember that the most recent National Resident Matching Program® (NRMP) Program Director Survey reported that 78% of residency directors in all specialties combined said the personal statement was a factor in selecting applicants for interview, and the average importance they scored the personal statement on a scale from 1 to 5 was 3.7.
Furthermore, the survey reported that “leadership qualities,” “other life experience,” “volunteer/extracurricular experiences” and “demonstrated involvement and interest in research” — all of which should be conveyed in a well-written ERAS Experiences section — are factors program directors consider in deciding whom to interview. Don’t make the mistake of assuming good grades or Board scores will be enough to demonstrate your worthiness for a residency spot.
Get Strong Letters of Recommendation
Asking faculty to take time to write nice things about you can feel awkward and be one of the most uncomfortable parts of the residency application process. Perhaps because of this discomfort or simply a misunderstanding of the importance of letters of recommendation (LORs), some applicants simply see the LOR requirement as a box to check.
If we review the evidence, however, we can appreciate the necessity of securing enthusiastic LORs. In the Program Director Survey for all specialties combined, 86% of program directors reported that “letters of recommendation in the specialty” was a factor they used in deciding whom to interview, and the average importance was 4.2. On the same survey, the USMLE Step 2 CK/COMLEX Level 2 CE score was 80% and 4.0, and just think of how long you studied for that test. It’s worth putting at least as much care into cultivating relationships to procure strong LORs in your chosen field because on average, they will have an even greater impact on your residency application than your Step 2 score.
Practice for Those Interviews
You would not walk into a USMLE or COMLEX exam without studying, but medical students routinely appear at their interviews without any practice. It’s critical to rehearse in advance with someone experienced who can help you hone your answers so you can demonstrate that you are a distinctive candidate worthy of a residency spot.
You also want to be prepared for difficult interview questions about the weaknesses in your application or situational questions in which you need to showcase your ability to react deftly and make tough decisions. Save the surprises for your birthday. You want to walk into your interview with a clear strategy for how you will showcase your accomplishments regardless of the specific questions you are asked.
Understand How the Match Works
Doing well in your rotations and your Boards while focusing on your written materials, LORs and interview skills are critically important competencies to master. Your aptitude in these areas will be wasted if you do not understand basic strategies for the Match.
Back in 2015, the NRMP published “Understanding the Interview and Ranking Behaviors of Unmatched International Medical Students and Graduates in the 2013 Main Residency Match” in the Journal of Graduate Medical Education. The NRMP reported that several simple errors in the residency application process had undermined applicants’ opportunities for a successful match. Those errors included:
- Not attending all interviews, thus failing to capitalize on every opportunity offered.
- Not ranking all programs at which applicants interviewed or all programs they would be willing to attend.
- Misunderstanding the basic rules of the Match and therefore mistakenly ranking programs at which they did not interview.
- Failing to rank programs based on true preferences and instead ranking programs based on the perceived likelihood of matching. (Remember that, although mathematically complicated, the Match algorithm is weighted toward the applicant’s preference; candidates should simply rank in order of their desired programs.)
It’s no surprise that those who take the time to learn the residency application rules have a greater chance of winning the game. By combining a deep knowledge of how the Match works with stellar written materials, LORs and interview performances, you can leverage your candidacy to create the impression that you are precisely that superstar applicant that programs will be fortunate to land.