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Applying to residency in the U.S. is an involved and overwhelming process. Here is a FAQ that we hope will clarify the process and help develop your action plan.
1. WHAT ARE THE TASKS INVOLVED WHEN APPLYING FOR RESIDENCY?
- Apply for ECFMG certification.
- Schedule exam appointments for the USMLE® Steps 1, Step 2 CK, and Step 2 CS.
- Decide which specialty(ies) to apply to.
- Research where you will apply.
- Search for U.S. clinical experience opportunities to strengthen your residency application.
- Solicit Letters Of Recommendation (LORs).
- Prepare ERAS application components and submit documents to ERAS.
- Apply to programs in September.
- Complete your U.S. clinical experience.
- Check on your visa status.
- Prepare for interviews.
- Write Thank You letters to programs where you interviewed.
- Finalize and submit your Rank Order List to ERAS.
- For important dates/deadlines, visit the NRMP website.
2. HOW DO I RESEARCH PROGRAMS?
- Visit FREIDA Online (Fellowship & Residency Electronic Interactive Database) for information on participating residency programs.
- Visit specialty-specific sites such as www.aafp.org or www.abim.org.
- Network with other IMGs to determine where they received interviews or matched.
- Search for lists of unfilled positions from previous match years. This provides an index of possible IMG-friendly programs.
- Look into program websites for specific application requirements.
- Call programs to learn score or other selection criteria.
- Look also at community programs, not just university programs which are usually more competitive.
- Note that programs are free to set their own policies, rules, and requirements.
3. HOW MANY PROGRAMS SHOULD I APPLY TO?
- The typical US applicant applies to 20-25 programs.
- The typical IMG applies to 30-40, or more.
- Applying to 40+ programs that have not been researched beforehand is a waste, as not all consider IMG applicants. Do your research beforehand!
4. HOW MUCH DOES IT COST TO APPLY TO PROGRAMS?
- The ERAS processing fee depends on the number of applications per specialty. Click here for fees.
5. WHAT DO PROGRAMS LOOK FOR WHEN CONSIDERING APPLICANTS?
- USMLE®Step 1 and Step 2 CK scores and number of attempts.
- USMLE® Step 3 score, if available.
- Sometimes Step 2 CS results.
- Year of medical school graduation.
- Evidence of U.S. clinical experience.
- Strength of LORs and their sources.
- Personal Statement – unique, engaging, meaningful.
- Conduct during interview.
6. WHAT ORGANIZATION(S) CONDUCTS THE MATCH?
- NRMP handles matching for accredited programs in most specialties.
- Some specialties, such as Ophthalmology, are handled by a separate match called the San Francisco Matching Program.
- Urology has its own, separate match: The Urology Match.
- Note that both the San Francisco and Urology matches occur earlier than the NRMP match.
7. WHAT STRATEGIES CAN I EMPLOY FOR BETTER CHANCES?
- Just passing will not give you the competitive edge, so aim for the highest score you can. Remember: Exams may never be retaken to improve scores.
- Competitive programs want both Step 1 and Step 2 CK passed on 1st attempt.
- Residency programs use USMLE® scores to filter at the very start of the process. It is crucial to have both Step 1 and Step 2 CK scores when you apply.
- Availability + Step 1 score + Step 2 CK score are crucial to getting interviews.
- Apply for Step 2 CS as soon as you are eligible and schedule your exam and your preparation for the earliest feasible date. To ensure your CS score is available when you apply, take the Step 2 CS no later than July.
- Apply to programs as soon as NRMP registration opens.
- NRMP and ERAS allow entry before ECFMG certification is complete.
- Timing is key to the number of interviews you can expect to get.
- Monitor www.ecfmg.org and www.usmle.org for updates, news, and announcements.
8. WHAT ABOUT LETTERS OF RECOMMENDATION (LORs)?
- You will need 3-4 LORs.
- Try to have at least one of your letters authored by a U.S. physician.
- Recently dated LORs count more.
- Effective LORs comment on how you function in the clinical setting and are not merely character references.
- Use specialty-specific LORs to apply only for positions in that specialty.
- Submit as many as you like, ERAS allows you to designate which LORs for which programs, up to 4 per program.
ERAS Support Services at ECFMG recommends strongly that you retain copies of all of your documents for your personal records!
For more information and a timeline, please refer to our article “GET READY FOR MATCH 2014”:
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