The Most Important Aspects of Your Residency Application

To be able to work and live in the United States of America (USA) as a doctor is most every international medical student’s dream.  Every year, thousands of students from all over the world apply for the residency match in the subject of their choice.  Some may have a high USMLE Step 2 scores, some may be carrying a research experience in a third world country, & some may have a exceptional LORs (Letter of Recommendations) from attending physicians that are leaders of their chosen field of work. This article aims to highlight which aspects of your residency application will help you most in winning the seeming lottery of earning interviews with program directors across the country.

Lets look at some important parameters, which could help you on your path to the residency of your choice:

1. The Basics – Believe it or not, many people ignore the basics and then get stuck in the wrong department and in the wrong place.  Everything starts with the basics.  The first basic step is to figure out where you’re open to moving in the US, both professionally and personally, as residency programs are very long (at least 3 years).  How do you do that?  Pick the top 3 universities, which run the top residency programs in the subject of your choice or who has the best program director under which you wish to work for where your qualifications meet their criteria.  Based on that, figure out the cities and their standards of living. Now think whether you will be able to sustain yourself for the next 3-8 years during your residency, on a resident’s salary.  Even if you are not able to get into the top universities, wait to be matched again.  We have seen many students experience, where they choose a field which is not of their choice and then struggle to complete the clinical residency program in time or worse are asked to leave due to non-eligibility to maintain the level of clinical acumen.

2. The Scores – There is no substitute for hard work, folks.  Each university has their own cut offs for subjects. Now that you have your list of universities/programs figured out, check out the cut-offs for these and see where you stand. Every university has their own cut-offs for specialties. Most of the program director will judge you depending upon your tests scores, both Step 1 and Step 2. Reviewing both steps scores has both pros and cons. A higher Step 2 score can or cannot mask your lower Step 1 score. But, a higher Step 2 is always better as it shows that the candidate has a good working knowledge with the patient, good bedside mannerisms and good self- improvement skills (fact that you were able to analyze your performance, changed the study plan and improved your scores.) According to the ECFMG website, a total of 27,293 first-year positions were offered in the 2015 Match. Of the 12,387 IMGs who participated in the 2015 Match, 6,302 (50.9%) matched. The competition is getting tougher every year. News just released by the National Resident Matching Program (NRMP), commonly referred to as the Match, shows that 3,060 graduating medical students choose a career in family medicine. This is the sixth straight year that the family medicine match rate ticked upward when compared to the previous year.

3. Great Letters of Recommendation (LORs) – After scores, the Letters of Recommendation (LORs) are your next opportunity to make your application stand out.  Good letters of recommendations are typically written by attending physicians or senior researchers in the specialty you wish to apply for residency in.  The ones written by residents or physicians from your home country have little or no significance.  You should have at least 3-4 LORs for your chosen specialty.  Try to find out from current residents in your residency of choice; what they wrote in their LORs and what would the program director like.  This could give you an insight on which LORs to use.  Need more convincing on the importance of a good LOR?  The places where you did your electives for USCE experience are the not just the best places to get best LOR from, but they are also your prospective places of clinical electives.  So, get hold of those seniors, impress them with your clinical acumen and skills and make a place for yourself. Get yourself matched!! 

4. The Personal Statement – A personal statement should give the program director a sense of what you’re all about and your medical education background.  Personal statements are important deal breakers for the program director when they have to choose between two similar candidates for an interview. They are the ultimate step you have to clear to get yourself matched. The important component of the statement are:

• Different PS for different programs – There can’t be one generic statement that you can use for all the programs. Every program is different and has different criteria’s for selection. Focus on the program and tailor your personal statement around that program. When the program director reads your statement, he will know that you have done your homework regarding the programs and are genuinely interested to join.
• Why the specialty of your choice – “I always wanted to become a pediatrician because I like kids”. These kinds of statement are good when you are trying to make a joke but otherwise I see 3 big red crosses written all over it. You have to use real experiences to illustrate your story and tell the program director how you reached that decision of choosing a particular specialty for yourself. You have to show the commitment and the skills that are required to excel in the specialty of choice.
• What are your strengths – Just writing skills such as “I have consistently shown excellent leadership during my rotation days and I am a good team player” does not cut it. You have to mention clinical instances (don’t go overboard and write volumes) where you exhibited good team player or leadership skills. Also, it is very important to mention any technical skill that you have gained during your clinical practice days related to the specialty you have applied for. This gives you an edge over the other candidates as this shows your experience and research in the specialty. 

5. The interview – All the above parameters will help you get an interview in your chosen university. Now what? How do we crack the interview? Lets become program directors for a while and see what you would like to see a candidate. I would to see interpersonal skills, interactions with the staff, and feedback from the residents, exhibiting skills of professionalism and of course commitment to the specialty. There are no crash courses or rulebooks that will help you crack this interview. But a commitment towards the specialty and a genuine desire to work can get through this.

The different aspects of residency program vary from year to year and program to program.  What will help you above all is your belief in yourself and the contributions you can make in the specialty of your choice.  Good Luck!!