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Residency Match Overview

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Some key players and acronyms to know first:

 

 

  • USMLE = United States Medical Licensing Exam 

    • A three-part exam series (Step 1, Step 2 Clinical Knowledge, and Step 3) needed to be licensed to practice medicine in the United States. A separate entry on the three exams will be uploaded in the next few weeks.

 

  • ECFMG = Educational Commission for Foreign Medical Graduates

    • Is an organization that grants foreign applicants with an ECFMG certification upon completion of Step 1, Step 2 Clinical Knowledge, and Step 2 Clinical Skills. With an ECFMG certification you are eligible to start medical residency in the USA.

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  • NRMP = National Resident Matching Program

    • Is the organization that will allocate applicants to residency spots. (The NRMP is also in charge of fellowship allocations following residency)​

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  • IMGs = International Medical Graduates

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  • AMGs = American Medical Graduates

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  • PDs = Program Directors

 

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What is the residency Match system?

 

The Residency Match is the yearly allocation of applicants to residency spots. Applicants can either be medical students in their last year of school or graduate doctors. This process is open to IMGs and AMGs.

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Overall the cycle looks something like this:

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  1. ERAS application (July - September*)

  2. Interview season (October - February)

  3. Ranking period (February)

  4. Match Day (March)

  5. SOAP (March)

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* Usually ERAS application submission date is September of each year. Due to the COVID-19 pandemic ERAS moved this to October 2020. They moved it back to Sept for the 2022 Match.

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As you can see, the application cycle takes at least 9 to 10 months. And every step of the way is a milestone for applicants: they celebrate taking their professional headshots, clicking Submit on their ERAS application, having their first interview, submitting their rank list, and of course, getting Matched into a program.

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Often times our loved ones might get confused when they see us celebrating these milestones in real life or on social media. They often misinterpret each milestone as "having landed a residency spot", so be prepared for non-medical people to ask for clarification from you or to mistakenly congratulate you for "getting into residency".

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ERAS vs. NRMP vs. ECFMG

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ERAS is the platform where you will create your application & upload your documents (personal statement, MSPE, USMLE transcripts, CV, etc). Through ERAS you will also select which programs to apply to and submit your application to them in September. The programs will then gain access to the ERAS applicants' database and release interviews to some of them.

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NRMP is the platform in charge of running the Match algorithm. You will use their R3 software to input your programs ranking and certify that list (in February of each cycle). The programs will do the same for applicants and the NRMP will run their algorithm software & announce the results the Monday of Match Week (March of every cycle), run the SOAP rounds that same week, and on Friday of that week announce to the applicants into which residency program they Matched.

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You must register for the NRMP before certifying your program list (ie before February of every cycle) otherwise you will not be a part of the Match.

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As you can see, ERAS and NRMP both play a vital but separate role in the Residency Match. They are separate entities and therefore have separate fees and deadlines, so keeping up with both is absolutely necessary.

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In addition, IMGs also need to keep track of ECFMG, a separate entity that is necessary for IMGs to be eligible to Match. ECFMG also has a separate set of requirements, deadlines, and fees.

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Now, let's take a more in-depth look into each period of a Match cycle.

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ERAS Application

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To begin this process you must first purchase a Token that will be made available by your school (so inform your school ahead of time if you wish to participate in the Residency Match). You will use this Token number to create an account on ERAS.com 

 

ERAS application includes a number of things such as submission of personal statement, letters of recommendation (LoRs), applying to programs, submission of a headshot picture, etc.

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In addition, IMGs will also need to apply for ECFMG certification. Read more here.

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Choosing Residency Programs

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Some of the resources that applicants use to select the residency programs they will be applying to are:

  • FREIDA

  • Match a Resident

  • Residency Explorer

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Considerations that applicants can have when choosing programs are:

  • Location of the program (e.g. proximity to loved ones)

  • Type of program: categorical, preliminary etc.

  • Opportunity for research.

  • Opportunity for community outreach & volunteering.

  • Is the program IMG friendly?

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An important thing to consider is that, on average, IMGs apply to more programs than AMGs, you can see the relevant data here.

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ECFMG Certification (only for IMGs)

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This step is done only by IMG applicants and is either done simultaneously with your ERAS application or ideally before it (in a way that the certification comes out before you have to rank your programs).

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ECFMG certification is basically giving the ECFMG your USMLE scores and Occupational English Test and having them verify its veracity and recognize you as an eligible applicant for the Residency Match.

 

Given the COVID-19 pandemic, this process underwent some new changes that started with Step 2 Clinical Skills getting cancelled. These new implementations have been carried and expanded to include the Match 2022 process as well.

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Interview Season

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For Match 2021, due to its unprecedented interview format, they encountered a new problem: applicants were hoarding interviews. The same pool of applicants was monopolizing the vast majority of interviews while many other applicants did not receive even a single interview.

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Many comments were done about this on social media: applicants were rightfully expressing their frustration, others were appealing to the empathetic side of applicants hoarding interview and asking them to let go of the ones they truly did not want or need. Some experts were also voicing possible solutions for this (you can read Dr. Carmody's thought on this here).

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Ranking Period

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Applicants are given a few weeks to rank in order of preference the programs that they interviewed at. To do this, applicants will need to register in the NRMP and pay the associated fees. Similarly, residency programs will rank the applicants in the order in which they want them. The general advice here is to rank in your personal order of preference, not the way you think the program will rank you because the algorithm used by the NRMP is said to work in favor of the applicants.

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Match Day

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Finally, the day is here. You get to find out if you Matched or not. Because initially, that is all you will find out. After a couple of days, the NRMP will tell you exactly into which program you Matched.

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Ideally, this should be the culmination of all your hard work. Unfortunately, this is not the case for many applicants who will not receive that highly-priced email. Instead, they will move on to the SOAP.

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SOAP

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SOAP stands for Supplemental Offer and Acceptance Program and it takes place during Match Day, immediately after you find out if you Matched or not. This system offers unfilled residency spots to un-matched applicants.

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You must prepare for SOAP ahead of the Match Day, read what it entails, how the process goes, the DOs and the DON'Ts; because things start happening the second you receive the email that you did not Match.

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Take the time before Match Day/SOAP to not only plan for SOAP but to also weigh in the pros and cons of doing it. For example, are you willing to SOAP into a specialty that is not your initial preference? Or would you rather reapply for the Match the following year? This sort of planning requires some time and introspect into what your career & life goals are.

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Check out the Match 2021 Tweets section for some advice regarding SOAP.

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For Match 2021, due to the problems of interview hoarding, most applicants are predicting that more than 1 or 2 rounds of SOAP will take place.

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Useful Resources

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Dr. Carmody is one of my favorite accounts on Twitter. He speaks objectively and unapologetically about the medical education system in the United States. He also has a website where he provides valuable information regarding the Match: The Sheriff of Sodium.

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Dr. Gómez-Cintrón is a residency program director who often posts important tips for applicants (as you can see on my Match 2021 Tweets compilation) through his Twitter and YouTube accounts.

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Inside The Match is a Twitter account that was constantly sharing tips, tweets, and resources relevant to Match 2021, I'm hoping they will continue their work for Match 2022 and beyond!

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Similarly, you have The Internal Med Applicant's Twitter account also sharing Match 2021 tips that are useful even if you are not an Internal Medicine applicant.

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Another Twitter account targeted more towards IMGs is Advocates for IMGs, they share important information, updates, and tweets regarding the US Residency Match process.

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Dr. Mahad Minhas has been a strong advocate for Match applicants. Check out his Twitter account to know more on some unspoken aspects of the Match process.

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Check out this presentation by Dr. Kevin Carroll, he provides a very thorough explanation on what Matching into the US entails.

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For financial advice targeted to medical students/fresh graduates/and professionals, you can check out Mr. Olson's Twitter account and website.

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Search for the relevant hashtags on social media eg #Match2022, #ERAS, #USMLE, #MedStudentTwitter, #MS4, #IMG etc. There are also specialty oriented hashtags: #EMBound #PedsMatch, #UrologyMatch, #FutureRadRes.

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Search for hospitals' or residency programs' social media accounts to learn more about them.

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