The "Paperwork" of Applying to Residency

Colin 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.