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The "Paperwork" of Applying to Residency

Colinson72x721Colin Son -- It is coming up on crunch time if you are a fourth year medical student. For most, the residency application service, ERAS, has been open for a month for students to fill out. Come September 1st, students will be able to submit their application.

You fill out your personal information online. Your personal statements, letter of recommendations, and photo are uploaded. That means that you fill out all of your information only once. Such wasn’t always the case. There was a time, not so long ago, when there was no centralized electronic application.

I remember filling out my fair share of paper applications when applying to college. That was for nine schools. If you want to do something fairly competitive for residency, it isn’t atypical to apply to thirty or forty or more residency programs. Imagining filling out thirty applications by hand is a little depressing, even from our current, easier, time.

With the benefits of the current system recognized, there are some things which are annoying me about ERAS and the current way we apply to residencies. Largely, I feel the full potential of a centralized electronic application isn’t being realized; that ERAS remains too much work.

The majority of my criticisms revolve around the difficulty in designating the programs you want to send your application to.

Imagine a student applying to twenty internal medicine programs and he wants to stay in a specific geographic area. Currently he has to search for each individual program, either by knowing its ACGME ID number or by searching by state and specialty and then scrolling through a list of programs. He has to repeat the process for all twenty of the programs.

On top of that he has to specifically designate which letters and which personal statement he wants sent to each individual program.

There is some sense behind this. Requiring students to meticulously enunciate which programs they’re applying to and what they want to include in their application to each individual program limits errors. As well, the powers that be are distinctly against students casting their nets too wide. For instance, despite the fact the electronic processing and transmission of a student's application is essentially a flat fee (i.e. it costs the same for one program to download your application as fifty programs), ERAS dramatically raises the application fee the more programs a student applies to. Consider that for the first thirty programs a student applies to the cost is $290 but to apply to another ten programs on top of that, for a total of forty, would cost $540. The costs serve merely as a deterrent so that students don’t simply ‘pan-apply’ and clog up the system. In the same sense, making students individually look up each program may act as a barrier to applying to a huge number of programs.

I’m not completely sold on this reasoning however.

The way ERAS should work is that you should be able to add programs in batches based on criteria. For instance, in the example above, the student should be able, with only a few clicks of the mouse, to add every internal residency program in his home state and the states bordering his.

In a similar way, you should be able to batch edit your application to programs. If you only have a single personal statement uploaded to ERAS, having to individually designate that personal statement to be sent to every program is just fruitless work required on the part of the student.

I’m also not comfortable with the onerous restrictions placed on the number of programs students can afford to apply to. I’ll throw in my personal story here. I’m applying to a pretty competitive specialty and so I want to apply far and wide. There are currently forty-six programs on my ERAS list.

That isn’t excessive and it isn’t going to clog up the system. At least I don’t think so. But the rapid rise in the cost of the application when applying to more than thirty programs makes my ERAS application financially difficult.

I’m in a significantly better place than if I was trying to apply to forty programs on forty paper applications, but that doesn’t mean ERAS is without room for improvement. With any hope the next generation of fourth year medical students will have the entire residency application process even easier.

August 21, 2008 in Colin Son | Permalink


It boggles my mind how people apply to so many programs for college/med school/residency. I applied to 1 college, 5 med schools, and (God willing) I will apply to <10 residency programs next year. Risky? Maybe, but time-saving and cost-effective. Yes and Yes!

Posted by: BP | Aug 26, 2008 3:18:48 PM

Actually, it depends on what you're applying for. I'm applying for internal medicine, and I have a pretty strong application. So, I'm applying to only 12. There are people with stronger applications than mine, but applying to Derm, and they're applying to over 20 programs.

Posted by: SA | Aug 27, 2008 4:38:02 AM

Thanks for such a fine information.
It has always been easier for the US Med graduates to get into residency and so they apply for a considerable less number of programs compared to IMGs who have to apply for more than 40 to 50 and sometimes over 70 programs considerably increasing the costs but still no guarantee of a position in PGY1 inspite of above 95 percentile....
So thats how our great American System works.
Cheers !!!
-Dr. PP

Posted by: Dr. PP | Aug 27, 2008 9:44:36 AM

Hi Colin,

while I agree that Eras is a pain in the neck, it does have its uses. If you (like me) want to apply to different types of programs, it is very nice to be able to designate which letters go to which programs. I personally would not want to have selected every program in my state, because there are many I would not want to go to. I would then have to deselect those. So, it goes both ways. BTW: as somebody who applied to 27 programs, got interviews at 22 and actually went to 17... I can tell you that that's way too many. You will be fed up with it by the time you hit 10. Also, ERAS may be expensive... traveling to all these places is even more expensive. And unfortunately, the more competitive programs are less likely to pay for say accomodations, so that adds cost. I would apply to a few less programs and ensure you had money left to actually go to your interviews! Anyway, good luck in the process. The end is in sight and then you will be able to enjoy the rest of your 4th year!

Posted by: | Aug 28, 2008 9:23:02 AM

..... God I'm applying to 60 pediatrics programs and I'm on the high side of double 99's ..... I wonder how many interviews I'll get. p.s. I'm an IMG so that'll take a toll on my application ='(
[is counting the money he is wasting on ERAS] I really doubt that applying to 60 programs is going to cost ERAS more than $20

Posted by: Sam | Aug 28, 2008 12:21:33 PM

I completely agree with you regarding the steep rise in the cost of application once u hit the 30 mark. I am an IMG and do realise where the AMGs and IMGs stand. On one hand, the AMGs have very high chances of getting into a residency program. According the data published by ERAS etc, more than 95% of AMG get matched into a residency program by the time they graduate. So they can opt to apply to fewer programs. Whether they get matched to a program of their choice is certainly a different issue. On the contrary, IMGs have to apply far more widely to increase their chances of getting matched which is 45-48%. This naturally would increase the cost of application dramatically. Considering the modern technical advancements, I don't think ERAS should have a problem with clogging up of the system due to an increase in the number of applications.

As far is the application part is concerned, I think having to individually select the letters and personal statements for each program is advantageous because it lets you pick what you want the program to know about you for instance in case of community-based Vs university-based programs. It is also useful if we are applying to more than one specialty which is not uncommon.

Posted by: winencherry | Sep 2, 2008 3:46:17 PM

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