Medical

Residency Match Success: Lessons Learned

With medical students starting to think about the upcoming residency match season, it’s a good time to review what residency applicants can do to improve their chances of matching. Many students think that how they write their residency personal statement is all that matters, but this simply is not true. As September looms, I want to focus on factors that are still (for the most part) within the residency applicant’s control.  This article should also be useful for anyone who may be entering the match in the future.

  1. Do away electives
    These “audition electives” can really help your chances of matching at a program. Some applicants with whom I speak are often fearful of doing away electives because they believe a less than perfect performance may actually hurt their chances of matching at the program where they rotate. Indeed, this is often not the case. As the associate director of a program, I often found that applicants who demonstrated a solid (or even mediocre) performance when rotating with us were ranked higher than other applicants with slightly better stats. Most program directors would rather take a student whom they know will be a solid, “no-problem” resident than take a risk on someone with whom they have not worked.
  2. Get letters of reference from attendings in the specialty to which you are applying
    It is essential that you ask for letters from faculty within the specialty to which you are applying. I recommend getting at least two letters from faculty within that specialty. In general, the best letters are written by people with whom you worked and, ideally, they should be clerkship directors, program or associate program directors, chairs or other academic faculty. When I reviewed applications for an emergency medicine residency program, while I read all of the letters carefully, I paid special attention to those letters from emergency medicine faculty.
  3. Demonstrate interest in your desired specialty
    Your interest in your specialty goes beyond doing well on your rotations. For most residencies, doing research is not essential, but, in general, the more involved you are in your specialty, the more committed to it you appear. Consider joining your specialty’s national organization or becoming a student member on a national committee.
  4. Communicate your interest in your specialty through your residency personal statement
    It is most likely that the last personal statement you wrote was for medical school. The approach you should take for your residency personal statement is different; you must convince the reader of your commitment to the chosen specialty. Some creativity will help engage your reader, but, in general, this statement should be a less creative piece than was your medical school personal statement.  A well-written personal statement that piques the reader’s interest will increase the odds that you will be granted an interview. The Electronic Residency Application Service (ERAS) allows you to write more than one personal statement so consider writing different statements for different types of programs. For example, a community based program does not necessarily want an applicant who hopes to make research a major part of his or her residency training.  You can also write a statement targeted to a specific geographic area.
  5. Do not skimp when writing about your work/volunteer/research/ experience in your ERAS application
    The written descriptions of your activities in your application are also key.  Make these entries interesting. Be sure your application entries and personal statement complement each other.
  6. Practice for your residency interviews
    I find that many students are not comfortable talking about themselves so it is essential to practice interviewing. The interviewer is trying to assess your interest in, understanding of and commitment to the specialty. They want to discover if you have good interpersonal skills and if you will be a good fit for their program; they also want to make sure you do not have any major psychopathology. Most residency interviews are conversational and are conducted by a wide spectrum of people from senior residents to chairs. As a result, the experience and skill of your interviewers may vary tremendously.
  7. Plan a strong fourth year curriculum
    Your candidacy does not have to end when you send in your application. I was always impressed when applicants still had some “real” rotations scheduled for the remainder of the fourth year and weren’t wasting a valuable part of their medical education by taking rotations or electives that were obviously fluff.  This told me they were serious, really interested in becoming great doctors and took advantage of their time and opportunities. When I asked interviewees what they had planned for the rest of the fourth year, the least impressive answers went something like this: “Well, I have only one requirement left, so I am going to travel around Europe and take it easy before I start internship.”
  8. Be energetic, attentive, and personable and smile on your interview days
    All of your interactions on your interview day are important. Be kind and respectful to everyone you meet, including residents, nurses and staff. If, during an interview day, my residency coordinator had concerns about an applicant, I listened since I knew and trusted her judgment. Remember that everyone has influence in this process. One negative impression can cause your ranking to suffer– or worse, it may bump you off a list.
  9. Be courteous throughout this process
    A recent survey of program directors by the National Residency Matching Program indicated that following up with programs and “second looks” were not important factors when ranking applicants. That said, I believe that thanking those who took time out of their day to meet you demonstrates that you are gracious and courteous, which are important qualities for a medical professional.
  10. Do not be swayed by letters from programs
    I am amazed by some of the letters applicants receive from program directors to express the program’s interest in the applicant. While some of these letters may be sincere, I have found that many of them are not. While it surely isn’t a bad sign to receive these letters from programs, do not become too confident since often, it seems, these letters are sent to people who are not “sure to match.”
  11. Seek out an advocate
    Before you even start interviewing, identify a faculty member whom you think would be a good advocate. Once you decide how you will rank programs, ask this person to call your top choice programs to put in a good word. You should also consider asking for additional letters of reference that can be sent individually to all of the programs where you interview or will rank.
  12. Do not rank programs in which you are not interested
    It is Murphy’s Law. If you rank a program where you really don’t want to go, you will match there.  If you know, without a doubt, that you do not want to go to a program, then don’t rank it.

Think of all your written materials, such as letters of reference, application and personal statement, as your “ticket” to your interview. If the person reviewing your application is intrigued, they will invite you for an interview. Then, your interview day becomes the key to your success. I know that all of this may be overwhelming as you embark on the path to your residency match, but as you start interviewing, you will become less anxious and more comfortable.  Good luck to everyone and match well.
Jessica Freedman, MD is a former medical admissions officer and president of MedEdits (www.MedEdits.com), a medical school, residency and fellowship admissions consulting firm. She is also the author of the MedEdits blog, a useful resource for applicants. (www.MedEdits.blogspot.com)

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    Vasu Gooty
  • August 17, 2009
Hello Dr. Freedman,
I am an International Medical graduate. I have gone through your article and I must commit that you have written it in an excellent manner regarding the process for the residency match and the most common mistakes that people commit during this process of matching.
Thank you very much for the information.
Regards,
Vasu Gooty
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    Vasu Gooty
  • August 17, 2009
Hello Dr.Freedman,
I would really love to hear any tips for the International Meidcal graduates while applying for the resideny application.
Thanks
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    Sammy
  • August 18, 2009
I too would me interested in US-IMG specific advice. We generally have much less guidance than US seniors. Thank you.
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    Rubina Afrin
  • August 20, 2009
Thanking you for such a nice laid out article. It will be a very helpful info for my future days preperation.
As an IMG I would like to rquest to write something as how we need to prepare ourselves compare to Canadian Medical graduates as I found a little opportunity left for the IMGs in the Canadian Residency stream.
I also heard about some initiative being taking in the form of pilot project to prepare teh IMGs to incorporate in the Canadian health care system by giveing them an opportunity for 6 months ( yet to deciode the time frame) internship and planning for June 2010 to be in effect. I came to know about this from CBC radio about three weeks ago but tunned at the very last minute of the news therefore not really sure about thew whole information. Do you have any information in this regards, please let us know.
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    Amitabh Joshi
  • August 26, 2009
The fact is that only about 23-30% if the IMG applicants eventually get a match. I have met an IMG who applied to 600 programs... Its a waste... it seems like for IMG's to apply in US if you cannot get scores above 90 in all steps in 1st attempt. Its really a waste for all the doctor spouses in the country who are permanent residents, of US but cannot further their career as medical residents...
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    Yuppers
  • September 22, 2009
How do DO's preform usually in their matching? Some advice on how DO's can stay competitive against the popular MDs would be great.
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    Uri
  • September 25, 2009
Amitabh Joshi, is it really only 23-30%??? If I recall correctly, it's slightly below or above 50%.
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    Broke
  • February 26, 2010
Please concider other options before starting your USMLE's and the entire expensive process to relocate to the USA. They are not very keen on giving residency post to foreign medical graduates. It cost a fortune to go through the process, all the additonal cost if you make use of some of them .... and still end up not having success. It is a rediculous process and a money making scheme. Good luck though to anyone that want to persue this :-(

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