2015-2016
Residency Application FAQs
Preface
Getting into residency is one of the most
complex job interviews in the world. This is
especially true for osteopathic medical students.
These FAQs will help guide the CUSOM student
through this process. These FAQs should be read
early in the third year and frequently reviewed as
the student is advancing their plans. Good luck.
Robert Hasty, DO, FACOI, FACP
Associate Dean for Postgraduate Affairs
Campbell University Jerry M. Wallace School of
Osteopathic Medicine
Section 1
What is ERAS?
ERAS is the Electronic Residency Application Service. It is the application service
used by most residency and fellowship programs in the US. ERAS includes the
following components: application, personal statement, photo, COMLEX-USA/
USMLE transcripts, MSPE (medical student performance evaluation or "dean's
letter"), and letters of recommendation. The Office of the Registrar provides
student support for the ERAS for CUSOM medical students.
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Section 2
When does ERAS "open"?
In late May of the applicant's third year, the Dean's Workstation opens and
CUSOM will be able to generate and distribute "tokens" to third-year medical
students. Students will be to complete and submit their application, personal
statement, COMLEX-USA/USMLE transcripts, print letter request forms to
distribute to authors of letters of recommendation, and pay fees.
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Section 3
How important are LoRs?
Letters of recommendation (LoRs) are very important. In fact, they are the second
most important determinant in being selected for residency placement (after board
scores). ERAS requires that all letters now be submitted directly by the letter
author. Most programs require a minimum of 3 LoRs (4 is the maximum)
designated to their individual program. However, an applicant can have an
unlimited number of letters submitted for them to the service. The student
coordinators at all CUSOM sites might be a resource for faculty members who
have technical questions when uploading. The best way to get great LoRs is to be
an excellent medical student. Many program directors report that LoRs from
colleagues in their specialty, people that they know, and remarkably good letters
are most helpful when using LoRs as decision tool. Also, it is common for the
specialty chair at the medical school to write LoRs for applicants into that
specialty. It is important to ask attendings who they have worked with whether
they would write a LoR and it is important for the student to let the author know
that it will need to be uploaded in the late spring or early summer at the end of
third year.
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Section 4
What is MSPE (medical student performance evaluation)?
The MSPE, formerly known as the "Dean's Letter" is a letter prepared by the
medical school to give a global assessment of the medical student's performance
and covers both curricular as well as service achievements. The CUSOM MSPE
process will be addressed elsewhere with medical students. The Office of the
Registrar provides student support for the MSPE for CUSOM medical students.
5
Section 5
Is the personal statement important? What resources is CUSOM going to make
available for preparing my personal statement?
Yes. It is the 5th most important item considered for inviting candidates to
interview. CUSOM will have a self-directed learning activity to help you write your
personal statement. Also, you will be required to submit your draft personal
statement to your advisor by April 1st. Your advisor will give you honest feedback.
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Section 6
When should I register to take the COMLEX-USA 2-CE and PE?
COMLEX-USA Level
Deadline to Register
Information
COMLEX-USA Level 1
December 15th of M2 Year
Deadline for Registering for
COMLEX-USA Level 1 is
December 15th of M2 ear.
Student must register to sit for
exam before July 1st preceding
M3 year.
COMLEX-USA Level 2-PE
July - First Monday in October
of M3 Year
Deadline for Registering for
COMLEX-USA Level 2 PE is
between July - First Monday of
October of M3 year. Students
must register to sit for the exam
between July - October of M4
year.
COMLEX-USA Level 2-CE
March 15th of M3 Year
Deadline for Registering for
COMLEX-USA Level 2 CE.
Students must register to sit for
exam before November 1st of
M4 year.
*Dates
Subject to
Change
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Section 7
How do I research residency programs?
AMA Freida (ACGME-accredited programs) and AOA Opportunities (AOAaccredited programs) are great places to start with researching programs. Many
residency programs now have promotional websites and videos discussing
programs. Personally interviewing current residents is also an excellent way to
research programs. The best way to really learn about a program is to spend time
at the program
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Section 8
What should I look for in a program?
Your goal is to get into the best program for you that you can reasonably
matriculate into. Here are some questions you should ask about programs that you
are considering:
Can I get into that program?
Is the program in a geographical area where I would be happy?
Will the program give me the skills that I need to be the kind of quality and caring
physician who I want to be come?
How are the residents treated?
Are the current residents in the program happy?
Do the residents seem burned out?
Do residents in the program frequently get terminated or not have their contract
renewed?
Will the program push me to get the service and academic skills that I need?
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Section 9
What are program directors looking for?
Top 5 Factors for Ranking Applicants
Top 5 Factors for Selecting Applicants for Interview
1 COMLEX-USA Level 1/USMLE Step 1
1 Interview
2 Letters of Recommendation
2 Interpersonal Skills
3 MSPE
3 Interactions with Housestaff
4 COMLEX-USA Level 2-CE/USMLE Step 2
4 Feedback from Residents
5 Personal Statement
5 COMLEX-USA Level 1/USMLE Step 1
* NRMP 2014 Program Director Survey
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Section 10
How competitive are specific specialties?
The National Resident Matching Program, Charting Outcomes in the Match, 2014
is one of the best resources for looking at the various competitiveness of residency
programs and for predictive data. (http://www.nrmp.org/wp-content/uploads/
2014/09/Charting-Outcomes-2014-Final.pdf).) It is important to be realistic when
applying for residency programs.
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Section 11
How do I decide on which specialty to choose?
Deciding on your specialty is an incredibly personal and important decision. Data
suggest those who pursue their passions and strengths tend to be the happiest
and most successful. Experiences during your third year can give you insight into
what life might be like in that specialty. It is nearly impossible to spend time in
every conceivable specialty while in medical school. Some medical students have
found it helpful to observe various specialties on their days off. Talking with
residents and attendings in various specialties can also be helpful. Medical
students should be careful not to be overly influenced by money, lifestyle,
perceived importance of specific specialty, friendly mentors, or choosing
specialties that others want you to do.
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Section 12
When should I decide on my specialty?
January 1st of your third year. CUSOM requires you to submit a non-binding
choice of your top specialty by the time. The link will be sent to you in advance. If
you are still undecided by January 1st, you may indicate it and the Associate Dean
for Postgraduate Affairs will work with you to help you advance to a decision. The
reason why it is important for you to decide midway through your third year is that
you will need to take a series of steps at the end of your third year to help you get
into your desired residency program. These include researching programs in your
desired geographical area, writing a personal statement that reflects your desires,
schedule audition rotations, work with the CUSOM chair of the specialty to
develop plans and get a recommendation letter, assemble letters of
recommendation pertinent to your specialty, and begin networking in your desired
specialty.
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Section 13
What are realistic board scores for my specialty?
MWU/CCOM Average COMLEX-USA Scores by Specialty (2008-2014)
Specialty
Level 1 (Average)
COMLEX-USA Level 1 (and/or USMLE Step 1) scores are the
Level 2-CE (Average)
Anesthesiology
548
564
single most important determinant on whether applicants are
Dermatology
595
550
selected for interviews into their specialty. It is important for
Diagnostic Radiology
602
610
applicants to be realistic with the programs and specialties that
EM
529
549
they apply to with their scores in mind. The attached table shows
FM
489
513
historical data from MWU-CCOM that was shared with CUSOM
General Surgery
521
547
IM
514
524
that lists average COMLEX-USA scores with acceptance into
Neurology
543
564
OB/GYN
511
534
Ophthalmology
583
553
getting more competitive. Also, there may be a geographical bias
Orthopedic Surgery
565
565
to their results which includes a cohort of medical students and
Pathology
512
531
programs that are different from CUSOM.
Pediatrics
512
542
PMR
508
510
Psychiatry
486
508
Urology
596
613
selected specialties. It is important to consider that these are
historical numbers and the residency application process is
*Courtesy of Rita Getz, PhD
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Section 14
What is the timeline for the residency application process (AOA and ACGME
Programs)?
January 1
(MS3)
Late Winter/ Late May
Spring
(MS4)
(MS4)
July 15
(MS4)
September
15 (MS4)
January
(MS4)
February
(MS4)
Choose
Desired
Specialty
Research
Programs
and Plan
"Audition
Rotations"
AOAaccredited
residency
programs
may start to
review
applications
ACGMEaccredited
residency
programs
may start to
review
applications
Applicants to
AOAAccredited
programs
must submit
their rank
order list to
NMS
Applicants to
ACGMEAccredited
programs
must submit
their rank
order list to
NRMP
ERAS opens
up to
applicants
(applicants
can start
sending out
links to
authors of
letters of
recommend
ation to
upload)
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Section 15
What are “golden months”? Are they important? How should I plan my
audition rotations?
Audition rotations (aka "golden months") are rotations where fourth-year medical
students spend elective time at residency programs to which they are applying
during the last half of the calendar year. Experts differ in what the ideal months are,
but they are typically considered August - December. With the number of
applicants to programs and the number of programs being applied to, they are
less important than they used to be, but still important. There are a few small
programs that will only rank applicants that have rotated through the program.
There are some programs that give "courtesy" interviews to anyone who rotates
through the program. These are important things to know when researching
programs. These rotations are also probably the best way to find out what a
program is really like. In general, it is advisable to schedule audition rotations at
the programs that you are most interested in. Popular rotations and competitive
specialties typically fill up several months in advance, and it is wise to start
planning these rotations in the winter/spring of the third year. It is important to go
through VSAS for the programs that participate. It is also important to know that
nearly everyone that you encounter during your time in a program may give
feedback about your performance, and any negative interactions may prevent you
from ever ranking into that program.
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Section 16
Should I use an internship (traditional rotating/transitional year/
preliminary) as a backup?
Overall, your best chance of getting into a residency program is when you are a
fourth-year medical student. Successful matriculation into the specialty of your
choice decreases after you graduate from medical school. In most cases, it is wise
to save this option as one of last resort.
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Section 17
What is the "couples match"?
A couples match is where two residents who wish to matriculate into a residency
or residencies in close proximity of each other for personal reasons. This is an
extremely helpful tool to help keep families together. This can add additional
complexity to the decision making process for the residents. It works really well
when both applicants are very competitive and applying to programs in a
geographic are where they are both likely to be ranked. It can be more challenging
if one or both of the residents are noncompetitive for programs they are applying
to in varied geographic areas. Being in the couples match can limit your chances
of matching into your desired programs, but this must be weighed with the desire
to be close to your loved one for the next three to five years. Overall match rate for
couples in 2015 was 94.8%. The general advice is that participants in a couples
match should apply to more programs than they would have normally.
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Section 18
How many programs should I apply for?
The number of programs an individual applicant needs to apply for depends on a
number of variables: competitiveness of specialty, competitiveness of applicant,
interviewing and interpersonal skills of applicant. The overall goal is to get enough
interviews at programs that you are interested in matriculating into to secure your
chances of a matching into a desirable residency program. CUSOM is mandating
that each student applies to at least 20 programs. Our expert opinion suggests
that this is the minimum number for most applicants to help get at least 8
interviews (a number that has been associated with a successful match). This may
not necessarily be enough for some students, especially if the competitiveness of
the programs applied for exceeds the competitiveness of the applicant.
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Section 19
How expensive is the application and interview process for residency?
Applying and interviewing for residency programs can be costly. The ERAS fees for
applying to residency programs varies depends on the number of programs
applied to and typically ranges from $300 - $400 for many students (with
additional fees for COMLEX-USA and USMLE transcripts (if applicable)).
Applicants are typically responsible for interview expenses such as travel, lodging,
and meals (a few programs might pay for lodging and/or food). Many fourth-year
medical students report spending between $5,000 - $10,000 in the process.
Applicants can reduce expenses by trying to schedule interviews together
geographically and coordinating lodging with other students or friends/relatives in
the area. AAMC has a good resource to additional information at https://
www.aamc.org/download/94416/data/applyingformedicalresidency.pdf.
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Section 20
How do I schedule interviews?
Most invitations for interviews will come from the coordinator or other staff
member from the residency program. Invitations are typically sent by email and
many programs use scheduling tools, such as Doodle, to coordinate interview
dates/times. It is important to have professional and timely response with the
person coordinating the invitation as they may offer feedback to the program. It is
also important only to select interview dates that you have a commitment to
attend. If your plans change, it is important to notify the program immediately and
professionally about your intentions. Unprofessional behaviors, such as "no
shows" frequently get reported to the medical school and may result in disciplinary
action.
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Section 21
Are residency interviews important and how should I prepare?
Yes. The interview is the most important determinant for getting into a residency
after getting selected for the interview. CUSOM will require you to go through
mock interviews as part of the residency preparation block at the end of the third
year. A seasoned interviewer will give you feedback on your interview as you
answer common interview questions. Every applicant going into interviews should
be prepared to answer common residency interview questions:
1.
Why are you interested in this program and specialty?
2.
What are your strengths/weakness?
3.
Where do you see yourself in the future (10 years)?
4.
What do you like to do for fun?
5.
Describe your weaknesses (e.g. board scores, GPA, rotation
evaluations, etc.)
6.
What do you know about this program?
7.
What has been your biggest challenge?
8.
Why did you choose to go to osteopathic medical school?
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Section 22
What are the "matches"?
Matching Services
Programs
Link
NMS (National Matching
Service)
All AOA-accredited programs
https://www.natmatch.com/
NRMP (National Residency
Matching Program)
Most ACGME Programs
http://www.nrmp.org/
SF Match
ACGME Ophthalmology, Plastic
Surgery, Neurotology, and
various fellowship programs
https://www.sfmatch.org/
Urology Match
ACGME Urology Residencies
and Fellowships
http://www.urologymatch.com/
"Military Match" (Joint Service
Graduate Medical Education
Selection Board)
All military programs
http://www.militarygme.org/
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Section 23
What is a rank order list (ROL)?
The matches require applicants to submit a ROL by a specific deadline. It is
important for applicants to never rank a program or specialty on their submitted
rank order list to a matching program that they wouldn't be comfortable with as a
"match" is a legally binding contract with a program. Also, it is important to rank
your preferences in descending order as the match processes will match you with
the highest program on your ROL where a program has a position for you.
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Section 24
What is the "SOAP"?
Supplemental Offer and Acceptance Program. In general, it is an "organized
scramble" for applicants who participated, but did not "match" into a participating
NRMP residency program. It is a sophisticated process and participants of the
NRMP match should be familiar with the process at NRMP.org prior to submitting
a rank order list with the NRMP.
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Section 25
What happens if I don't match? What resources is CUSOM going to make
available during the scramble?
CUSOM will have open a "GME Command Center" after the NMS and NRMP
matches which will be staffed by the GME team to give students who didn't match
access to open/available programs, GME experts on scrambling into programs,
and access to communication and faculty resources. The AOA Post Match (http://
cf.osteopathic.org/aoapostmatch/ ) and the AAMC's FindAResident program
(https://services.aamc.org/findaresident/) are good sites to look at to find available
positions after the matches.
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Section 26
What is CUSOM doing to increase residency opportunities?
CUSOM is focused on creating GME positions which increase opportunities for
our graduates and advance our mission. As of November 2015, CUSOM has
collaborated to help create 363 approved residency positions in 19 programs at 7
different organizations which led to CUSOM winning the 2015 AOA STAR award.
Also, CUSOM is developing an excellent reputation nationally that will help create
opportunities for graduates.
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Section 27
How is the single accreditation system going to affect the class of 2017 and
subsequent classes?
The AOA will cease to accredit residency programs on June 30, 2020 and most
existing AOA-accredited programs will apply for ACGME accreditation with the
intent to transition over prior to this deadline. Considering that about half of all
osteopathic graduates used to apply to AOA-accredited programs through the
NMS match and that nearly a quarter of osteopathic medical students were
unsuccessful with the NRMP match (the main ACGME match) before the single
accreditation system, it is expected that competition for residency positions will be
more competitive for the class of 2017 and beyond.
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Section 28
Should I have a safety specialty/program?
Maybe. Competitive applicants following a good strategic plan will likely match.
However, uncompetitive applicants applying to competitive specialties and
programs are unlikely to successfully match. It would be wise for the latter group
to have backup or safety plans.
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Section 29
Can I transfer out of a program or specialty once I match into it?
Being "matched" into a program is a legally binding commitment to a program
(typically a one-year contract that must be signed within a particular time frame
after the match). To be released from a match obligation, the program director
must be willing to release the applicant. This only happens in rare occasions and
typically in unusual circumstances. Most residents graduate from the residency
(and specialty) that they match into. There are services, such as residentswap.org
that do help to facilitate program transfers. One reason that transfers between
specialties are uncommon is that funding of a resident is potentially reduced if a
resident transfers from a shorter duration specialty to a longer duration of a
specialty. This is because the funding for an individual resident is defined by CMS
(who funds most GME) as the "initial residency period (IRP)" and is determined as
the minimal number of years required to achieve completion in that specialty. For
example, a resident who enters into family medicine is funded for only three years
and programs would only receive full funding for that resident for these three
years. If a resident first completes only one year in family medicine and then
transfers into a program such as general surgery that requires five years, the
accepting program would only get full funding for two years of the resident training
and programs might not be able to afford taking in residents who are not eligible
for full funding. This reinforces the standard advice given to applicants that their,
"first attempt at applying to residency programs is their best shot".
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Section 30
How are residency programs funded?
Most residency programs are funded through CMS. AAMC has an excellent
resource on what every medical student and resident should know about GME
funding, called, "Medicare Payments for Graduate Medical Education: What Every
Medical Student, Resident, and Advisor Needs to Know" (https://
members.aamc.org/eweb/upload/Medicare%20Payments%20for%20Graduate
%20Medical%20Education%202013.pdf).
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