Recently matched DOs share tips on applying to residency via ERAS

‘Tis the season of applications and the ERAS (Electronic Residency Application Service) buzz is in the air. For many (or most, if not all) fourth-year medical students, this is a time of great anticipation. It is also likely a time of some anxiety. And rightfully so. The ERAS is the gateway to residency.

My hope is to try alleviating some anxiety (for those seeking residency). In May 2022, I wrote an article for The DO in which I interviewed 38 individuals who successfully matched into their #1 program choice. One of the questions I asked these now-residents was what advice they had about ERAS applications. Thus, this article is specifically focused on the responses from these residents with some input based on my experience with ERAS in the 2021-2022 application year. (Think of this article as an addendum to the earlier one referenced.)

In my experience, I found the advising and oversight offered by different medical schools on ERAS is extremely variable. Having insight from individuals who used it recently and used it well would have been invaluable to me when I was filling out ERAS. Completing the ERAS process is complex and involved, and thus one short article may not be sufficient to guide an applicant’s entire ERAS experience; however, it should be a good place to start.

I have codified and quantified the answers given by these #1 matchers. You’ll find their answers displayed below. My methodology was simple: if a concept was mentioned by an interviewee, I gave that concept a tally. There were many more items in the codified and tallied list, I have included only the top eight results.

First, a note from the interviewer

Throughout the interview process, it was apparent that the interviewees were well-oriented to how competitive all the moving parts are in the ERAS process. This included knowing which programs were highly competitive, which ones were less so (aka “safety programs”), and, most importantly, how competitive they were as applicants. Obtaining that level of orientation may be daunting for new applicants. However, becoming familiar with the notion of relative competitiveness is straightforward.

Though it comes in seventh place on the list above, using FREIDA (Fellowship and Residency Electronic Interactive Database) and Residency Explorer was implied by virtually every interviewee. FREIDA and Residency Explorer are databases of residency programs available in the United States.

During my application process, I spent a significant amount of time clicking through programs and comparing my application to their statistics. Doing this provided the awareness I needed to decrease my anxiety and help temper my expectations. Th awareness provided by FREIDA and Residency Explorer was crucial as I decided what programs to apply to.

FREIDA is a database created and maintained by the American Medical Association and Residency Explorer was created and is maintained by the Association of American Medical Colleges. Both are invaluable, must-have resources during the ERAS application process. Applicants should access and refer to one (or both) often throughout applying to residency.

Casting a wide net

The age-old question: “How many programs should I apply to?” It is a question most future applicants are already wrestling with–and those who are not currently wrestling with it probably should be to some degree. The 38 interviewees thought it was extremely important to apply to a large number of programs. But what does that mean?

In 2021, a study was done analyzing the number of programs that residency applicants applied to. A telling graph of its data is shown below:

In 2020, the average U.S. medical graduate applied to 70 programs. Based on the trajectory of the data, it is reasonable to assume that number has only increased in recent years.

Many factors should be considered when selecting the number of programs to apply to, including the specialty of choice, competitiveness of the applicant, the cost of the applications, and the advice given from trusted advisors and contacts. All of these components are of vital importance and each needs to be considered with great of care. It is also important that applicants understand the fact that the average applicant in 2020 applied to 70 programs.

It is paramount that applicants remember the most commonly given piece of advice for ERAS applications is to cast a wide net. I could not agree more with this advice. In my experience, I found that it was more common for applicants to apply to more than 70 programs. The sentiment of “rather be safe than sorry” is one that I adopted and one many applicants have adopted as well.

Be realistic

The second most common admonition was for applicants to be realistic. Knowing what is and is not realistic can be accomplished first through proper utilization of FREIDA and Residency Explorer. Also, seeking the advice from trusted mentors is a fantastic barometer for ERAS realism. These mentors can include medical school advisors, graduates from an applicant’s medical school, and residents or physicians in the specialty of interest. All this information needs to be synthesized to determine what programs are the best fit for an applicant.

It is worth noting that most of the 38 interviewees matched into a program that, to their estimation, they were average or above average competitors for. Especially at this juncture, delusions of grandeur will only hurt applicants in the end.

Start early

The ERAS application is a long and arduous process. For greater success, applicants should start as early as possible. There are various facets to the application process, each of which takes a considerable amount of time, organization, thought and preparation. Facets to remember include:

• Writing a personal statement
• Inputting experiences into ERAS
• Researching programs
• Procuring letters of recommendation
• Inputting standardized information including test scores, transcripts, Dean’s letter, and other information

Applicants need to make sure they have set aside significant time to accomplish all of these tasks. In my experience, it was not uncommon for applicants to require upwards of 10-12 hours to complete ERAS, separate from the time spent on a personal statement. Starting early on the application process can certainly be a key to success.

Researching programs

Too often, applicants resign themselves to the notion that they’ll, “Go wherever they take me.” This mindset is one that applicants need to fight against. Applicants need to remember that they are in the driver’s seat when it comes to which programs are eligible to “take them.”

There are over 5,000 residency programs in the United States. Each is unique in culture, location, size, and type. Applicants who do not do their due diligence in researching which programs fit their personal wants and needs are doing themselves a disservice. Even before residency program research begins, applicants should consider their priorities and what they value most in their future residency program.

These priorities and values should guide what programs they apply to — keeping in mind that some compromise may occur when making sure to cast a wide enough net.

The ERAS application process can be intimidating, but the key to warding off that intimidation is preparation and gathering information. Knowing the playing field and not procrastinating are a significant part of the ERAS battle. I found that when I had accomplished those two things, the process became much more manageable. It is apparent that the 38 interviewees agreed with that notion as well.

Hopefully this article can provide a starting place for applicants diving into the frothy waters of residency application season. And if you ever feel like you are drowning, please ask for help.

Related reading:

Audition rotations: Successful residents share 6+ tips

How to Match into your No. 1 program: Insights from 38 applicants who did it