You just spent four years as an undergrad, plus four years in medical school and possibly two years working on your master's degree in between. You've been awarded the degree of M.D. or D.O. Congratulations! Unfortunately for you, however, the worst is yet to come.
Although you have your degree, you aren't allowed to practice medicine independently until you complete a residency at a teaching hospital. The process of getting "matched" with a hospital is incredibly stressful, and that's before you even get to the joys of an 80-plus hour work week, 24-hour shifts and all the glamour and glory that comes with being lowest on the totem pole when you arrive. On top of all that, the labyrinthine match process leaves you remarkably little say in the matter – a decision made by a computer could send you to a hospital all the way across the country -- and it might be the hospital you ranked last on your want list.
From navigating the residency application process to all the excitement (and terror) of Match Day, we'll take you through the process of applying for a medical residency.
Medical Residency Requirements
In order to receive a medical residency, you must have completed medical school. That is, you need an M.D. or D.O. degree, from an accredited medical school. You also need to have taken the United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examination (COMLEX); depending on the requirements of the individual schools you choose, you may have to take both. The application process usually encompasses the fourth year of medical school, with interviews taking place between October and February.
While each hospital has its own requirements, they're relatively uniform between hospitals. Typically, applicants are required to hold a degree from a U.S. or Canadian school accredited through the Liaison Committee on Graduate Medical Education (LCME) or the American Osteopathic Association (AOA). Applicants who attended medical school outside the U.S. or Canada need a certificate from the Educational Council on Foreign Medical Graduates (ECFMG) [source: University of Wisconsin].
Graduates of medical schools outside the U.S. and Canada must be eligible to work in the U.S., either through citizenship, a visa or a resident alien permit. Hospitals outside the U.S. have their own criteria for applying for medical residency, which varies from country to country. Check with the individual hospital to determine if you're eligible.
Of course, there's a lot more to applying for a residency than just your degree and your USMLE score. We'll explain the rest in the next section.
Medical Residency Applications
Applications for medical residency in the U.S. are all handled through the Electronic Residency Application Service (ERAS), a program run by the Association of American Medical Colleges (AAMC). The AAMC is a non-profit organization that represents most of the medical schools and teaching hospitals in the U.S. Canada [source: AAMC].
The ERAS system makes things quite a bit easier for medical residency applicants. You only have to submit required documents and scores once (to ERAS), then ERAS sends the relevant info to the hospitals you apply to. All of this is handled through the MyERAS application page.
Through ERAS, you'll submit your medical school transcript, your USMLE or COMLEX score, a personal statement, curriculum vitae, letters of recommendation, performance evaluations and other materials, as requested by the hospitals you apply to.
Once you've submitted all of your documents and selected the hospitals you wish to apply to, ERAS handles the rest. It sends copies of documents to the residency programs you've applied to. Residency staffs even use it to look at applicants and evaluate their applications [source: ERAS].
Once you've submitted your application, you'll move on to the interviews. Find out what to expect in the next section.
Medical Residency Interviews
Arranging and attending interviews at teaching hospitals is a huge part of the process. You'll want to interview at some hospitals before you apply, so you can decide if they're somewhere you really want to spend the next three to five years (or more) of your life. However, some schools won't interview you unless they've invited you, so you'll have to apply first. If you want a really good look at a hospital before you apply for a residency there, you can spend some time working there during the clinical portion of med school. This is known as a visiting elective.
Experts in the interview process recommend setting up your interviews fairly early, and scheduling them so that the programs you really want to join are fourth or fifth on your list. That way you get some practice in before you have any high-stakes interviews [source: Kopriva].
Don't forget that you need to be able to get to the interview. Some hospitals will pay travel costs for applicants, but not all of them do. If you're applying to a hospital in Hawaii that doesn't cover costs, make sure you can afford the plane ticket. You might have to take out additional student loans to cover your interview travel costs.
Aside from practice, the key to a successful interview is planning. Make sure all the logistics are squared away (your flight in and out, housing, transportation and itinerary). Do a thorough job of researching the program. Make sure you know who you'll be meeting with, their titles and what part they play in the program. That will let you address the correct person when you have questions during the interview and also show the program directors that you're serious about joining them. You should be knowledgeable in the specialty you want as well – if you say you're interested in the dermatology specialty, but don't seem to know much about it, it won't speak well of your dedication and passion for medicine (two things residency programs look for).
Preparing for the interview itself is similar to prepping for any big interview you'll experience in your life. Be on time, dress appropriately, don't lead off with questions about salary, and make sure to smile at everyone you meet.
Once the interviews are done, who determines what hospital you'll be a resident at? Find out about Match Day in the next section.
After interviewing and applying to hospitals, applicants rank the hospitals where they want to be residents. The programs you desperately want to work at go at the top. Those you like but aren't quite as interested in go farther down the list. Don't put a program you're not sure you'll be comfortable at on your list, because if you're matched to that program, you're obligated to attend it. No takebacks.
What does it mean to be matched to a program? After all the interviewing and applying, and after all the applicants rank their programs, the programs then rank their applicants. A computer algorithm compares all the lists, and then matches applicants with residency programs. In mid-March, all applicants are notified if they were matched or not. Match Day, the day when all medical students nervously open envelopes to see where they were matched, follows on the third Friday in March. Are they headed to prestigious programs in their own hometowns? Or to programs they ranked lowest five states away?
What if you don't get a match at all? Then you get to participate in "the scramble," which basically means making a lot of phone calls to residency programs that still have openings. Starting in 2012, the National Residency Matching Program (NRMP) will conduct an organized scramble. Unfilled positions will be offered through ERAS, with applicants having a time limit of two to three hours to accept or decline the offer. This is called the Supplemental Offer and Acceptance Program (SOAP). If that doesn't work, you'll have to start the entire process again the next year.
There are other matching programs in the U.S., including one for military hospitals and one for osteopathic medicine. They generally hold Match Day earlier than the NRMP's Match Day so that unmatched applicants can try for an NRMP match.
- Association of American Medical Colleges. "About the AAMC." (Feb. 13, 2012.) https://www.aamc.org/about/
- Association of American Medical Colleges. "About ERAS." (Feb. 13, 2012.) https://www.aamc.org/students/medstudents/eras/about/
- Harrison, Valerie M. "Medical Residency, ERAS, NRMP, the Residency Match and the Scramble." MomMD.com. (Feb. 13, 2012.) http://www.mommd.com/dreadedresidency.shtml
- Kopriva, Phyllis. "The Residency Interview: Making the Most of It." American Medical Association. (Feb. 13, 2012.) http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/minority-affairs-section/transitioning-residency/the-residency-interview-making-most-it.page
- University of Wisconsin School of Medicine and Public Health. "How to Apply to our Residency Program." (Feb. 13, 2012.) http://www.fammed.wisc.edu/residency/apply