Five Considerations for Residency Applications

ERAS 2021 opens on June 8! On a good day, this is both equally exciting and nerve-wracking. However, I bet we’re feeling a little heavy on the nerve-wracking side given how the coronavirus pandemic has disrupted clerkship experiences, Step 2 testing, and Away Rotation plans, to mention a few. Many organizations involved in the residency application process are working hard to make the 2020-2021 cycle as hitch-free as possible. While you continue to monitor the situation closely, it is crucial to focus your energy on preparatory activities that are within your control despite the pandemic-related disruptions. To that end, we'll be covering five important things to keep in mind and strategically plan for as the cycle begins.

1. What specialty(ies) are you applying into? Third year is about figuring out what specialty you're both passionate about and good at. Given that the year is about wrapped up in most med schools, there's a whole new batch of M4s, most of whom are settled on the specialty they’ll be applying into. If you’re not yet decided, now is a good time to give great thought to the matter and maybe even decide to dual-apply. Ultimately, deciding what you're applying into will guide your research on the programs to apply to, and the letter-writers to approach, so it is vital to have an answer to this question ASAP.

2. What programs are you interested in? There is so much that goes into choosing what programs to apply to. Geographical location is a major factor for many folks, especially those trying to be close to family or significant others. Some also choose locations where they think they’ll likely settle post-residency. Program reputation is another factor i.e. what is the reputation of that program for the specialty you’re applying to? Are they known for graduating excellent clinicians? Do they have a strong research focus? And if you’re considering pursuing a fellowship after residency, do the program graduates often match into fellowship spots? Another factor worth considering is how your portfolio compares to that of current residents in the program. Similar to the strategy discussed in our medical school selection post, you want to apply to reach, match, and safety programs so that you have all your bases covered.

3. Personal Statement: I strongly believe that the personal statement (PS) is a crucial part of the application. 40,000 individuals submitted applications in the ERAS 2020 cycle so it is not some form of hyperbole when someone says you're in a sea of applicants. And when you're in a sea of people, your PS is your first shot at distinguishing yourself. The PS is supposed to be personal, something no one other than you could have written. Devote time to it and do not waste an opportunity to stand out. I had 20+, yes 20, iterations of my PS that I wrote over three months before I arrived at a version that satisfied me. My PS was brought up in >75% of my interviews so it was clear to me that it was not wasted effort. It is not too early to start writing so start now. If you're applying to a wide variety of programs, you may want to customize your PS for some of the programs so now is a time to give thought to how implement your customization.

4. Letters of Recommendation: The earlier you ask for them, the better! Ask for letters from individuals who can write about you with insight as opposed to generic fluff. Program Directors sniff out fluff easily so don't waste a chance to have someone make a solid case for why you'll make an excellent resident. Also, look into the upper limit of letters required for the programs you’re interested in and plan towards that. Most people you’ll be asking for letters are completely reliable and will provide them by the deadline. However, it can be frustrating to not have all your letters ready once submission opens so save yourself some stress by having one or two back-up letter writers. In my case, some programs required three while others required four so I had five letter-writers. If possible, give your letter-writers a deadline that is one to two weeks earlier than the ERAS submission date (September 1, 2020) so that you have your ducks in a row before submission date.

5. Visas: As an international student, you will need a visa to complete your residency. Your options are the H1B and J1 visas and more programs offer J1 visas than do H1B visas. You will need to decide which you want and figure out what the programs you’re interested in offer (a good resource for this is Frieda). The length of your training program (residency +/- fellowship) will affect which visa works best for you. Your long-term career goals will also affect your decision on which to pursue. The above are some basic considerations but there are many other aspects to this matter. Given the complex nature of this topic, we’ll be sure to do a more indepth post in the near future.

I hope this is helpful for you M3s/M4s in our community as you begin to prepare to application season. It wasn't too long ago that I was in your shoes so I understand just how stressful the process can be and I wish you the best! My biggest suggestion for you leading up to submission date is, "Do all (planning, preparation) you can to minimize your anxiety", your future self will thank you.

In Solidarity,

Tinu