How Many Residency Programs Should I apply to?

The numbers of applications to submit to the residency programs during the initial ERAS season per specialty will differ if you are an American medical graduate AMG or and International medical graduate IMG. Typically, the IMG will apply to far higher number of programs to get an acceptable number of interviews to help him or her get a successful residency match outcome.

The number of programs to apply to will vary from an applicant to another based on many factors which include in addition to the site of graduation and the type of specialty: financial ability, USMLE scores and attempts, number of USCE, year of graduation, need for visa and the amount of competition per that specialty. Except for the financial reasons which limit a lot and affect the number drastically in many cases, the remainder factors are played less often in the selection decision by the applicants. The reason for that is a lot of applicants started since 2009 with a new trend by applying to whatever they can afford to get the highest number of interviews possible. This creates a low pool of applicants getting interviews initially but eventually many will cancel and another bout of interviews are send again around November to fill the open interview spots.

In this post we are attaching here the median/range number of programs AMGs and IMGs usually apply to earn decent amount of interviews. Keep in mind that some financially able people has no limits on to how many residency programs or even specialties they are applying to, as long as they meet these Selection Criteria.

Specialty	Average Range of number of applications per AMG	Average Range of number of applications per IMG
Anesthesiology	20-40	50-80
Dermatology	50-90	70-100
Radiology	40-80	60-110
Emergency Medicine	20-40	50-90
Family Medicine	10-25	100-220
General Surgery	30-60	120-250
Internal Medicine	15-30	150-270
Med/Peds	10-20	30-50
Neurology	15-40	60-90
OB/Gyn	20-50	100-180
Orthopedics	40-70	100-130
Otolaryngology	45-80	60-100
Pathology	15-25	70-100
Pediatrics	20-30	100-140
PMR	15-40	40-60
Plastic Surgery	30-50	40-55
Psychiatry	10-30	70-140
Radiation Oncology	35-60	50-70
Transitional Year	15-30	40-70

Is internship a requirement before applying to residency in the US?

It is not a requirement to have completed a foreign internship to join a residency in the US if this what you mean by your question.

Medical residencies in the US are of 2 types in general depending on the specialty:

1- Either it includes internship integrated with the program so you match into PGY1 and continue residency in the same program

2- Or the program start with PGY2 but has a requirement of doing a US PGY1 hence you have to apply to both positions through the match in the same season where you will match to 2 different programs PGY1 and PGY2 simultaneously one staring same year and the PGY2 starting the next year.

If you match to a PGY1 only you can complete that year as hands on 1 year paid USCE and apply the next year to PGY2 positions. If you match to PGY2 only then you have either to find a PGY1 outside the match or forfeit your position and apply again from scratch the next season.

Surgery Residency for IMGs: Hard or just Competitive?

It is not hard an some extra steps are needed as any other competitive specialty. Let me first clarify the difference between competitive and hard. If you tell me 10% or less only of the positions in a certain specialty go to IMGs like Dermatology, Radiation oncology or plastic surgery YES this is hard. But if you tell me that in General surgery about 25% of spots go to IMGs, considering this is a competitive specialty even among AMGs themselves, then this is not hard or impossible but rather a competitive specialty that IMGs still get a good stake in it. With good credentials and preparation for the match, that many IMG surgery applicants unfortunately lack, you can hit your goal in the match. Let us go over the modifiable factors or steps you need to do for a successful match in surgery residency:

1. Bulk CV: Load your profile with Observerships or research or both if possible. But don’t waste your life in research as program directors usually prefer new graduates unless you were in a surgical residency back home then they would like and benefit from your experience.
2. If you are not done with your USMLEs, take it easy here and aim for a high score. You can monitor the progress of your studying using this awesome Table.
3. Try to get the advantage of having contacts in certain programs like your peers or seniors who matched before you. They can definitely throw a good word for you and get you some interviews here and there.
4. Match strategy is important and differ from other specialties in one thing: Prelim Surgery is a big player here. Most IMGs will apply to both Categorical and prelim positions. If you were not lucky in the first match and you get into prelim position which is relatively easy to get, this is considered one year hands-on surgery experience!  Many of those who start as prelim will end their year as Categorical residents because many AMGs will resign after they discover that surgery is not their favorite and hence you will be upgraded or you can move to another program that just had an open categorical spot. Anyway, if you continue as prelim, you will be able to apply the next year with one-year hands-on USCE. Make sure you apply widely to whatever programs you meet their Selection Criteria. You can find the average number of programs typically AMGs and IMGs apply to here in this Table.
5. When you get interviews, two things to remember, the Interviews questions are common and simple, try to read them before you go to any surgery interview. The other thing is don’t forget to send the Thank you cards. It is very important to make the directors and other people in the program involved in ranking the residents remember you.

A word of advice at the end, always consider back up programs like IM or FM when applying to competitive specialties. This way you at least get something out of your hard work on the USMLE track!

Good luck!

Old graduates in the residency match

Old graduates are like a Double-edged sword. Some are on demand by certain programs or specialties and others are less desired. On the either side old graduates can still manage to have successful match if they follow the appropriate strategy in their residency application.

Although each program and specialty may look differently to this issue however we will post here the  general guidelines that usually old graduates follow to hit the spot:


1- Choosing the specialty: definitely not radiology, those directors want only fresh grads with top scores. You need to fetch the specialty which will benefit from your experience like Internal medicine, family medicine or psychiatry. If you have good scores you might be able to get into anesthesia, neurology or pathology provided you have previous residency and current practice in this field.

  2- Top scoring is your key if you are an old graduate. Don't hesitate on taking a vacation for studying especially when it come to USMLE Step 1 "the application killer". If you score above 220 your mission is way easier. But don't give up if your scores are lower. Programs still need you and many old IMGs with low scores match every year.

  3- Enhancing your application with the appropriate USCE rotations. Try to do them in the States that have more IMGs so they get to know you better and invite you to interviews.


4- If you are an old graduate then definitely you have friends who are faculty members in residency programs in the US. Get these connections into work, they can definitely help you getting observerships and residency interviews.

How to calculate and go around the year of graduation cut off requirement?

What is meant by year of graduation YOG cut off? Why some programs set a YOG gap cut offs? How to calculate the YOG to residency application gap? How to go over this gap?

The YOG cut offs is the number of years gap between the date of graduation printed in your medical diploma (and confirmed in your Dean's letter or MSPE) and the time of opening of the ERAS application on September 15th. The YOG cut off is usually set by some of high tier programs in the purpose of attracting fresh graduates and minimizing the hassle of going over thousands of applications as happen in most community programs. However, these cut offs are not rigid and not worked by on most of the times. Here are the things that you can stress in your personal statement and ERAS application to go over this requirement:

1- If you are doing or recently done with residency can make the program directors go over the YOG requirement.

2- If you are old graduate but clinically active especially if you are applying to the same domain again also helps a lot. Some programs may consider extensive USCE as clinically active.

3- Although connections don't help you in matching but definitely helps you to get interviews and from there it's your duty to prove yourself competent for the position you are applying to. Try to contact your friends in various residency programs and see how they can help you.

How to make your CV stronger for residency?

There are really few things that you can do to make your profile sound perfect especially that program directors have already trained their eyes how to quickly scan applications during the extremely busy match season where each of them will receive thousands of applications via ERAS.

You need to focus and improve these points that usually graphic the attention of program directors which include:

1- USMLE scores: Usually USMLE step 1 is the strongest indicator of your level. This is true especially for AMGs who apply as medical students yet not done with their remainder steps. For IMGs both steps are important as it gives an overall idea of overseas graduates. In general, USMLE scores are important for competitive specialties like Radiology and Neurosurgery as well as most residencies hosted by university institutions. However for less competitive specialties especially in community programs other criteria usually overcome the need for superb scores which we will talk about it below.

2- USCE: Different types of  United States Clinical Experience is available for IMGs but unfortunately not all of the are really available compared yo the enormous number of IMGs applying to such spots. Although externships are the most desired but they are the least available. Most IMGs who are successful in getting to residencies dill end going 1-2 observerships and get US LORs which really help them earn the necessary interviews yo match. Large bug not least the research experience which can enrich your profile is also shrinking as institutions are cutting budgets and trying to save the invaluable pennies in this tough economic situation the nation is experiencing.

3- Residency back home for IMGs can replace the above two factors in the appropriate stetting. For example, if you you have average scores and no USCE your back home IM or whatever residency you did or are doing can definitely grab the eyes of the programs to your application as the directors usually like to see people with strong clinical background in their program rather than hiring those who by heart books without any clinical confidence or practice experience.

4- No visa need is also an important factor in an applicant where program directors can save money for their institutions. I am not encouraging anybody here to get married for the purpose of getting green card but am just trying to encourage those who have it or are IMG US citizen to look at these programs who don't sponsor visas where they have good chances but also they have to consider visa sponsoring institutions where also their chances are bit better for the same reason as well.

5- Although the fresh graduates are more lucky but this is usually true for AMGs. Don't worry much about year of graduation cut offs set by programs if you have continued clinical experience or previous residency. If you are still in medical school, try to get of the USMLEs as the information is still fresh in your mind and hence you will save much time and apply early to the residency match.

6- Connections don't work much especially that program directors want to be on the safe side when picking their residents. However connections can help you getting into interviews and then the remainder is your duty to impress the faculty on the interviews.

Are foreign medical graduates still accepted in US residencies?

There have been rumors going around the net about no more IMGs in the match in the near future. Even some morons wasted there time writing articles about the subject. There is a non-ending severe shortage of physicians in the US. Some may say that medical schools are enrolling and graduating more AMGs. This is right, but AMGs will never be able to take spots that traditionally go to IMGs especially in community hospitals with internal medicine, family medicine and even psychiatry residencies. Moreover, residency programs are also expanding and ECFMG NRMP statistics show yearly increase in the number of FMGs matching every year. Nationwide statistics show steady increase in the number of population and this will definitely necessitate increase in the number of hospitals and hence residency programs. The bottom line message is there will always be shortage for physicians in the US and if anything happen it will be only more and more increase in the number of international medical graduates matching in residency programs in the US.

Number of applying attempts allowed in the residency match

Many people ask this question especially those with low scores and old year of graduation who have been trying to match for couple of years: how many times I can apply to the match?

The answer is you can apply as many times as you can. Although the ECFMG ERAS system will identify you as a repeat applicant and will give you the option to reuse your uploaded documents from the previous match season, however, the program directors will not know that you are a repeat applicant.

Hint: If you are unsuccessful in the match for 2 consecutive times then you need to take a look on your CV to see what is missing, usually the culprit is lack of appropriate application strategy in the sense of what specialties to apply to and what number of programs you are applying to. Sometimes lack of USCE can be the culprit. In general IMGs  need to get 1-2 months of observerships. Old graduates need good scores and need to document evidence of continued clinical activity like residency or private practice back home. You can get US LORs from this list: USCE programs.

Individual versus couple match

Which gives us better chances in the residency match, applying as a couple or individuals?

Couples match gives you way much better chances to match. Statistics show that more than 90% of those who apply as couples do match which is a very good percentage in this competitive process. In general, program directors prefer giving their spots to couples rather than individuals for some reasons:

1- Couple in the same program always means these two people will stay in their spots till the end of their residency because usually it is tough to find two open spots in same place if they want to move to another place for any reason like if they don't like their current program.

2- Couples can support each other and their performance in residency is usually better than their peers. If one have some family or private issues outside then the other part can cover and hence less headache for the chiefs.

3- Couples usually have good scores and profiles compared to their peers, so when both are high on the programs rank list this means the director will guarantee 2 people with high scores rather than getting those on the bottom of his list.

Moreover, on the applicants side, if one have relatively low scores then the partner's profile can help covering lot of things and increase his/ her chances. Once a couple get their first interview they are then more than half of their way to a successful match.

Applying to different specialty in the SOAP

Many people come across this query when SOAP season approach, can we apply to specialty different than that we apply initially during the regular ERAS NRMP match?

Let us shed some light on the background of this question before giving the answer. SOAP as you know is the mini match which occur the week after the main match results come out to match a resident to unfilled position. So people who didn't match from one side and the programs with unfilled spots from the other side will be in this organized game.

The answer is yes you can apply to as much specialties you want in the SOAP even if you didn't apply to them during the regular match season. But you need to pay attention to the fact that you are limited yo total of 45 programs during the SOAP so make use of them and Apply wisely.

Types of residency programs

What are the types of residency programs you can apply to through ERAS?

There are 5 types of programs available via the ERAS NRMP match:

• Categorical Residency Programs
• Advanced Residency Programs 
• Preliminary Residency Programs
• Transitional year Residency
• Integrated Residency Programs

1- Categorical Residency Program means you do the whole training in one tract or block which will include the PGY-1 or internship as the first year. You will have to apply only to one spot via the match to get into this program. e.g. Categorical Internal Medicine and Categorical Neurology.

2- Advanced Residency Program means a program which starts as PGY-2. In this case you will need to match to a PGY-1 residency year at the same time. PGY-1 residency include Preliminary internal medicine, preliminary surgery and transitional year residency. Examples of advanced residency programs include advanced neurology and advanced radiology.

3- Preliminary Residency program means a program which is only 1 year, it means like an internship. It is done usually as a prerequisite for advanced programs. Also some people who have low scores and need hands on experience may apply to preliminary years positions extensively during the match so they can do this 1 year internship then apply again in the next match with stronger profile. There are two types of preliminary year residency: internal medicine and surgery.

4- Transitional year residency is also a PGY-1 only residency but the rotations are not concentrated to one specialty as in IM or surgery but include more electives and specialties. This type of residency is more competitive than the other prelims.

5- Integrated  Residency Programs (and Combined residency programs) as in case of plastic surgery where instead of doing first general surgery the applicant will go ahead directly into plastic surgery, you start from the beginning in an integrated plastic/general surgery. Our understanding is that ACGME will be eliminating the combined programs from existence by 2018. Combined program means the applicant finish general surgery residency first then move into plastic surgery residency. Other examples of integrated residencies include cardiothoracic surgery residency.

Are the criteria posted on programs sites doomed?

Many applicants refrain from applying to certain programs after reading the criteria posted on their web page. To be clear, many applicant actually match to programs they don't meet even a minimum criterion. There are many factors that have to do with this issue, we will talk about the more important ones that matter to applicants especially the IMGs.

1- Most of these websites are not updated and these criteria were set in the past mainly for AMGs in the days where residency programs were fewer than these days and applicants were fewer as well.

2- These days, IMGs with certain positive points in their CVs can bypass the filters. Worth to mention are Green card holders (or no visa needed status) and extensive observerships.

3- People who also do observerships in these programs and prove that their USMLE scores don't really reflect their clinical knowledge also will have priority on other people that meet the criteria especially that they are already familiar with the system. Program directors and other interviewing staff do appreciate LORs from their colleagues in the same program.

So the take home point is don't stick to these criteria posted on the programs sites but apply widely to as much as programs you can afford otherwise you will end getting no interviews.

Match Statistics and Scores for Anesthesia Residency

What are the match statistics for anesthesia?

About 70% of positions offered in the match go to AMGs and about 30% of positions go to IMGs. About 95% of AMGs who apply do match and about 45% of IMGs who apply to either categorical or advanced do successfully match , which is considered a very good percentage in this competitive specialty.


What are the average scores for AMGs and IMGs who matched in Anesthesia?

The average scores for AMGs who matched in Anesthesia in USMLE step 1 and 2 CK are 226 and 235 respectively.

For IMGs who matched in Anesthesia the average scores in USMLE step 1 and 2 CK are 229 and 231 respectively.


In which programs were IMGs interviewing and matching?

The full list of programs which invites IMGs to interviews are mentioned in this high-yield matching list including programs selection criteria and requirements:

 ANESTHESIOLOGY IMG Friendly Residency Programs List




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Match Statistics and Scores for Combined Med-Peds Residency

What are the match statistics for combined medicine-pediatrics residency?

About 83% of combined med/peds positions offered in the match go to AMGs and about 27% of positions go to IMGs. About 90% of AMGs who apply do match and about 50% of IMGs who apply do successfully match , which is considered a very good percentage in this competitive specialty.


What are the average scores for AMGs and IMGs who matched in Combined Med-Peds?

The average scores for AMGs in USMLE step 1 and 2 CK who matched to Combined Internal medicine/Pediatrics are 230 and 242 respectively.

For IMGs who matched in Combined Med-Peds the average scores in USMLE step 1 and 2 CK are 217 and 221 respectively.


In which programs were IMGs interviewing and matching?

The full list of programs which invites IMGs to interviews are mentioned in this high-yield matching list:

COMBINED MED-PEDS IMG Friendly Residency Programs List


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Match Statistics and Scores for Emergency Medicine Residency

What are the average score for AMGs and IMGs who match in Emergency Medicine?

The average scores for AMGs who matched in Emergency Medicine in USMLE step 1 and 2 CK are 223 and 234 respectively.

For IMGs who matched in Emergency Medicine the average scores in USMLE step 1 and 2 CK are 218 and 223 respectively.

 

What are the match statistics for Emergency Medicine?

About 75% of EM residency positions offered in the match go to AMGs and about 25% of positions go to IMGs. About 90% of AMGs who apply do match and about 55% of IMGs who apply do successfully match , which is considered a very good percentage in this competitive specialty.



In which programs were IMGs interviewing and matching?

The full list of programs which invites IMGs to interviews are mentioned in this high-yield matching list:

EMERGENCY MEDICINE IMG Friendly Residency Programs List


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Match Statistics and Scores for Family Medicine Residency

What are the match statistics for Family Medicine?

About 40% of positions offered in the match go to AMGs and about 60% of positions go to IMGs. About 97% of AMGs who apply do match and about 45% of IMGs who apply do successfully match , as well as 40% who apply to the post match SOAP in FM also get positions.


What are the average scores for AMGs and IMGs who matched in Family Medicine?

The average scores for AMGs who matched in Family Medicine in USMLE step 1 and 2 CK are 213 and 225 respectively.

For IMGs who matched in Family Medicine the average scores in USMLE step 1 and 2 CK are 204 and 208 respectively.


In which programs were IMGs interviewing and matching?

The full list of programs which invites IMGs to interviews are mentioned in this high-yield matching list:

Family Medicine IMG Friendly Residency Programs List


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Match Statistics and Scores for Internal Medicine Residency

What are the match statistics for Internal Medicine?

About 55% of positions offered in the match go to AMGs and about 45% of positions go to IMGs. About 96% of AMGs who apply do match and about 45% of IMGs who apply do successfully match , as well as 20% who apply to the post match SOAP in IM also get positions.

What are the average scores for AMGs and IMGs who matched in Internal Medicine?

The average scores for AMGs who matched in Internal Medicine in USMLE step 1 and 2 CK are 226 and 237 respectively.

For IMGs who matched in Internal Medicine the average scores in USMLE step 1 and 2 CK are 225 and 228 respectively.


In which programs were IMGs interviewing and matching?

The full list of programs which invites IMGs to interviews are mentioned in this high-yield matching list:

 Internal Medicine IMG Friendly Residency Programs List

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Match Statistics and Scores for Neurology Residency

What are the match statistics for Neurology?

About 58% of positions offered in the match go to AMGs and about 42% of positions go to IMGs. About 98% of AMGs who apply do match and about 60% of IMGs who apply do successfully match.


What are the average scores for AMGs and IMGs who matched in Neurology?

The average scores for AMGs who matched in Neurology in USMLE step 1 and 2 CK are 225 and 233 repectively.

For IMGs who matched in Neurology the average scores in USMLE step 1 and 2 CK are 224 and 227 respectively.


In which programs were IMGs interviewing and matching?

The full list of programs which invites IMGs to interviews are mentioned in this high-yield matching list:

Neurology IMG Friendly Residency Programs List


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Match Statistics and Scores for Neurosurgery Residency

What are the match statistics for Neurosurgery?

About 90% of positions offered in the match go to AMGs and about 10% of positions go to IMGs. About 85% of AMGs who apply do match and about 30% of IMGs who apply do successfully match.


What are the average scores for AMGs and IMGs who matched in Neurosurgery?

The average scores for AMGs who matched in Neurosurgery in USMLE step 1 and 2 CK are 245 and 250 respectively.

For IMGs who matched in Neurosurgery the average scores in USMLE step 1 and 2 CK are 245 and 250 respectively.

In which programs were IMGs interviewing and matching?

The full list of programs which invites IMGs to interviews are mentioned in this high-yield matching list:

Neurosurgery IMG Friendly Residency Programs List


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Match Statistics and Scores for Obstetrics and Gynecology Residency

What are the match statistics for OB/GYN?

About 70% of positions offered in the match go to AMGs and about 30% of positions go to IMGs. About 94% of AMGs who apply do match and about 52% of IMGs who apply do successfully match.


What are the average scores for AMGs and IMGs who matched in Obstetrics and Gynecology?

The average scores for AMGs who matched in OB/GYN in USMLE step 1 and 2 CK are 220 and 233 respectively.

For IMGs who matched in OB-GYN the average scores in USMLE step 1 and 2 CK are 218 and 223 respectively.


In which programs were IMGs interviewing and matching?

The full list of programs which invites IMGs to interviews are mentioned in this high-yield matching list:

Book Obstetrics and Gynecology IMG Friendly Residency Programs List

eBook Obstetrics and Gynecology IMG Friendly Residency Programs List

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