Navigating the ERAS Application: The Ultimate Guide

What is ERAS and How Does the Match Work?

The Electronic Residency Application Service (ERAS) is used by graduates from medical schools in the US to apply to postgraduate residency training programs. Similar to the AMCAS, AACOMAS, or TMDSAS application you used to apply to medical school, ERAS is your ticket to becoming a resident doctor in the US.

Once your ERAS application is complete, you can register for and participate in the National Resident Matching Program’s (NRMP) Main Match, which pairs medical graduates with open positions in residency programs across the country. The Main Match is the method by which the NRMP facilitates and organizes the ERAS application process.

Keep in mind that some programs do not participate in the Main Match or use ERAS, so you will need to contact these separately to determine how to apply. For instance, the Urology Residency Match Program is a separate match from the NRMP and has different deadlines and application processes.

Applicants who use the ERAS database can apply to residency programs of interest. Programs will then respond to applicants by inviting them for interviews during the fall and winter of their 4^th or final year of medical school. Once interview season has come to an end, applicants will create and submit a residency Rank Order List of programs that they would accept a contract with. Programs will also submit a Rank Order List of applicants they would like to accept as residents.

The NRMP’s Main Match algorithm plays “matchmaker” in setting up applicants and programs. The Monday of Match week, residency hopefuls are notified whether they have matched, but not to which program they have matched to. For applicants who are not successful in matching, residency positions that remain unfilled are made available for applicants to attempt to secure them before the official Match Day results are released through the Supplemental Offer and Acceptance Program (SOAP). Students are notified on the third Friday of March about where they were matched.

Here’s a closer look at the ERAS timeline and important Main Match dates you need to know:

Want to know more about how the Residency Match works? Watch this video:

Supplemental ERAS Application and SOAP

ERAS offers a short, free supplemental application students can complete for participating specialties. While the supplemental ERAS application is optional, it allows students to answer additional questions and share more information about themselves with specific programs. Much like medical school secondary application essays, this is an opportunity to increase your chances of matching and set yourself apart from other competitors for the most competitive residencies. Right now, there are 16 specialties that offer students the supplemental ERAS application.

The Supplemental Offer and Acceptance Program, offered through the NRMP, is a way for applicants who went unmatched or partially matched to secure a residency position before the official results are released on Match Day. Since Match Day is on the third Friday of March every year, SOAP applications open on the Monday before Match Day and close on Thursday. During SOAP, you can apply to new programs or reapply to programs you applied during the Main Match, and try to improve your application after going unmatched. For instance, you can upload additional letters of recommendation or submit a new personal statement. If you’re participating in SOAP, also be ready for SOAP residency interview questions and answers, as these will be different from typical residency interview questions and you’ll have less time to prepare!

How to Navigate the ERAS Application

Now it’s time to break down how to tackle and navigate the information-dense world of ERAS! The AAMC resources and this guide will help make your application process go smoothly. Use this reference guide or the ERAS applicant checklist to double-check your work and monitor your progress.

Step #1: Check the requirements and deadlines for the programs you wish to apply to

Let’s start off by ensuring that the specialty programs you are interested in are included in the upcoming ERAS cycle. To verify their participation, you can visit the ERAS participating programs list.

You can check the requirements of a program through the ERAS portal or by going directly to the program's listed website. It is time-consuming, but it is better to research these programs to make sure they are right for you and that you meet all the requirements before applying.

Step #2: ERAS tokens

Contact your Designated Dean’s Office to receive your ERAS token. This is a one-time code you will use to register with MyERAS and begin your residency application. You will receive your code via email. You MUST have your ERAS token to register. If you don’t receive your code, contact your Designated Dean’s Office. For US medical school graduates, this means contacting the appropriate office at your medical school.

Note that Canadian medical graduates (CMGs) participating in ERAS use the Canadian Resident Matching System (CaRMS) as their Designated Dean’s Office. CaRMS has a separate process for CMGs who want to participate in the US match here.

International medical graduates can receive their ERAS token through the ECFMG once they have registered.

If you are a non-matched graduate reapplying to programs through ERAS and have had a previous token, you will have to purchase a new token for the upcoming year, as your token will expire on May 31.

Step #3: Register for the Match!

Visit the NRMP website to register for the Main Residency Match. Registration will open in mid-September.

Step #4: Register on MyERAS

You will want to register early and as soon as you’ve received your ERAS token to ensure that all of your uploaded documents and information are in order. Certain documents take a few days to upload. The photo can take 2 days to upload so register that token early and begin uploading your info.

Visit MyERAS to proceed with registration. Read through and answer the ERAS registration questions carefully and thoroughly to prevent mistakes. You can only register once!

Once you’ve successfully registered on MyERAS, you can access your account and begin creating your application.

Step #5: Fill out your Personal Information

Now that you’ve successfully registered on MyERAS, it is time to fill out your personal information. You can always come back and update the information on your Personal Information page, even after you submit your ERAS application. Ensure that your permanent address is correct, as this is one section of the Personal Information page that cannot be changed after submission.

Aside from personal information required (full name, contact information, marital status, address, etc.) the following information may have you stumped as to whether they may apply to you. Check only the ones that are applicable to your situation:

•   AOA ID (Required of all DO applicants)
•   NBOME ID (Required of all DO applicants)
•   ECFMG Certification (Only applies to foreign medical graduates)
•   A checkbox to indicate participation in NMS/Couples Match (Optional)
•   A checkbox to indicate participation in NRMP/Couples Match (Optional)
•   ACLS, BLS, and PALS Certification information and dates. Be aware of the dates you will be attending your training sessions and which certifications you have already completed successful training for.

Step #6: Start your MyERAS application

Click on "My Application" in the MyERAS portal to begin. You only complete one application, and once certified and submitted, it is sent to the programs you choose. Your additional documents like ERAS letters of recommendation and your personal statement can be customized per program and are attached later. Take your time completing your application. You are able to save your work and continue as you want. As long as you have not clicked “Certify and Submit,” you can change any information you have filled out at any time.

There will be a section on your application with the heading, “Biographical Information.” This is an optional section that asks for information regarding your race and ethnicity. You may choose whether or not to leave these sections blank.

Step #7: Certify and Submit your application

Now it is time to Certify and Submit your application. Review it one last time before submission! Check spelling and grammar and that all fields are filled out.

Prior to submission, there is a section titled “Designated Dean’s Office” authorization to view your application once it has been submitted and certified. Make sure to select yes.

Step #8: Upload your documents

This section is for uploading your personal statement, letters of recommendation and transcripts. This is a work area where you will tailor your application to market yourself to programs and bring you one step closer to securing your residency spot.

Step #9: Select your residency programs

Find the “Programs” tab, click on it, and Search your programs of interest. Programs can be searched by ACGME #, specialty, or location. Pay attention to whether they are osteopathic or allopathic programs. You can save a program to apply to it later. This gives you the chance to organize which documents you want to send to each program. Just because you have saved a program does not mean you have to apply to it. This section allows you to edit your selected programs (add/remove) before your official program submission to your “MyERAS Application.” The programs saved in this section are still in their “editing” phase, as your programs of interest have not received your tailored application.

Receiving an “Incomplete Registration” prompt means that a program is not participating in the ERAS cycle and cannot be applied to through ERAS. Contact the programs beforehand to ensure they are participating in ERAS.

Once you’ve officially submitted your application to your selected programs (see “applied to programs” section below) you will not be able to remove a program that you’ve already applied to, but you will be able to request the withdrawal of your application.

You are only able to remove programs you originally planned on applying to when in your “Selected Programs” list. If you’ve officially submitted an application to a program of interest, you are no longer able to remove this program from your list. In the event that you are no longer interested in applying to a program that has already received your application, you can request an “application withdrawal.” Although the ERAS server does not electronically remove your application from the server of the program you’ve already applied to, ERAS will officially mark your application as “withdrawn.” After ERAS has officially marked your application as withdrawn from the program you have selected, you should personally contact the program and let them know of your decision to withdraw.

It cannot be stressed enough that you should review each step multiple times before moving forward for official submission, at ANY stage of the process, as this will not only save you precious time but will also allow you to budget when it comes to your ERAS associated fees (there are no refunds!).

The Applied to Programs section consists of programs you have officially sent your ERAS application to. The programs in this area cannot be edited (add/remove) since you have already applied. The Assigning Documents section can still be changed and is the only area that can be edited at that time.

Want to know the easiest and most competitive residencies to get matched to? Watch this video:

Step #10: Assign your documents to specific programs and apply

After you have finalized the list of programs you want to apply to, you will then assign documents to each program. Every program you select to apply to will receive the same skeleton application of documents, which include your ERAS application, Dean's Letter/MSPE, transcript, and photo. The documents you must personally assign to each program are your USMLE/COMLEX transcripts, letters of recommendation, and personal statements. Double-check your documents to make sure they are going to the correct program. An LOR is ready for assignment after you have "Confirmed" the letter once it has been uploaded by either you or the author.

In the event that an LOR has been officially submitted to the program you have chosen, and needs to be revoked and re-submitted (due to an error correction by your LOR author, for example), the original LOR author is authorized to replace the original document with the corrected document, allowing the program to only view the corrected version.

Step #11: Payment and fees

Now it is time to officially apply and pay. Before the official transmission of your ERAS application to your respective programs, you must submit payment via MyERAS (view fees here). Look over all associated ERAS fees to understand the fee breakdown and calculations, and to better manage your residency budget.

Once you are ready to submit payment and are taken to the invoice, make sure you review and understand your fee breakdown. Complete payment, and make sure to keep the final processed invoice in your records.

Step #12: Check the status of your applications

There are two vital MyERAS electronic sections that you should routinely check to keep an eye on the progress and status of your ERAS applications, once you have submitted them: programs applied to and message center. The message center displays any correspondence from the programs. Check on it to make sure you are receiving all your messages.

The “My Profile” section has important information for how the programs can get in touch with you. If you move or change phone numbers, update this immediately. Keep your NRMP match participation up to date. Are you an International Medical Graduate? Make sure your visa status and ECFMG status are current.

Applying to additional programs can be done at any time during the ERAS application season. As you initially did when searching for potential programs you wanted to explore applying to, select your programs of interest, assign your documents, review all of your uploads, and officially transmit your applications to their respective programs. Make sure your application is not being submitted past the deadline for a particular program!

How to Create a Stellar ERAS Application

The bulk of your ERAS application is comprised of the supporting documents you will submit to show residency programs why you are a great fit and ideal candidate. Some of these documents you will be able to upload yourself, and others will be submitted for you, such as your MSPE, which is compiled by your medical school, or letters of recommendation, which can be uploaded by your referees through the ERAS LOR portal.

Keep in mind that each residency program may have different requirements for supplemental documents, such as how many letters of recommendation you can include or personal statement length.

Your ERAS application supporting documents can include:

1. Personal Statement
2. Letter(s) of Recommendation (LoRs)
3. Residency CV
4. USMLE Transcript (optional)
5. COMLEX-USA Transcript (optional)
6. Medical Student Performance Evaluation (MSPE or “Dean’s Letter”)
7. Medical School Transcript
8. Photo (optional)
9. ECFMG Status Report (International Medical Graduates only)

You are responsible for uploading the first three documents on this list to your application and submitting them to residency programs. The rest of the required documents, except the photo, will be submitted by your medical school at your request. While uploading a photo of yourself is optional, it’s recommended to give residency program directors a way to recognize you and put a face to your application.

Next, we’ll cover our tips on how to use these supporting documents to create a great ERAS application!

1. ERAS Personal Statement

Your ERAS personal statement is an opportunity for residency programs to get to know you and to convince program directors to give you an interview. Talk about your interest in the specialty and why you are pursuing this career. Include research experiences, outside interests, or medical experiences that influenced your decision to enter this specialty and why you are passionate about it. 

Also, tell them what you are looking for in a program. Let them know if you are passionate about research or would love to work in underserved communities. State your career goals and how you plan to apply your residency training to future pursuits. 

Your residency personal statement should reflect a significant increase in professionalism, maturity, and personal growth from the time you started medical school. You are progressing to the next level of training to become a doctor, so use your personal statement to reflect the changes and growth you’ve experienced so far in your medical school journey.

Be careful to avoid reiterating your CV. Use this space for information that is not anywhere else on your ERAS application. You do not need to waste space telling them why you wanted to become a doctor. This should be about you and your relationship to the specialty you choose and how you would thrive in their program. Finally, be sure to check your work and keep your personal statement to one page in length.

2. Letters of Recommendation (LOR)

LORs can be influential in securing interviews. They give residency programs an in-depth look at who you are as a candidate. Your letter writer should be someone who has seen your performance in clinical rotations and has knowledge of your skills. You want your letters of recommendation to be as strong as possible, so ask referees who will be able to confidently and positively extol your strengths and abilities.

Give your writer enough time to get to know you before you ask for a letter. Asking the first day is too soon but waiting until the last day is too late. Let them know during your rotation that you would appreciate a letter from them so that they have time to compose the LOR. Remember, they are physicians with crazy schedules, so giving them a copy of your CV or personal statement will assist them in writing it. If a faculty member offers to write you a LOR before you have the chance to request one and appears to be excited to take the time to write one, seize the opportunity!

Don't know who to ask? LORs should be written by faculty members who know you best, those who have observed you and worked with you throughout countless clinical situations and have watched you shine, especially under pressure. The better a faculty member knows you, the stronger and more impactful a letter will be in supplementing your application.

Ensure that at least two of your letters are written by faculty members who work within your specialty of interest, as they will be able to best describe why you would be a perfect fit for the specialty. ERAS only allows you to submit a total of 4 letters of recommendation to any one program, but you can choose which letters to submit to which residency programs.

3. Residency CV

Some residency programs may ask for a residency CV. Use this as a chance to highlight your professional experience and accomplishments, including any research experience, clinical experience, volunteering, and noteworthy awards. If you have any publications or presentations, include these in your CV. Notable hobbies, leadership experiences, or personal accomplishments, such as being fluent in multiple languages, can also be an asset on your residency application. Showcase and highlight accomplishments that are not presented in your personal statement or MSPE that you want residency programs to know about.

4. USMLE or COMLEX Transcripts

Your USMLE and COMLEX scores can be submitted to residency programs as another way to stand out from a crowd of qualified applicants. Of course, an exceptional score on your USMLE will be favored by competitive residency programs and may give you an edge over other candidates. If your USMLE or COMLEX scores are not above average, and the residency program you’re applying to does not require you to submit them, you can consider leaving your exam scores out of your application. You can use a USMLE Step 1 prep course or COMLEX prep course to help you get ready for these exams and obtain the best score possible, giving your ERAS application another boost.

Note that you will need to arrange for your scores to be released ahead of any residency program deadlines if you plan to submit them. Contact your Designated Dean’s Office to arrange for the release of your exam transcripts.

5. Medical Student Performance Evaluation (MSPE)

Your MSPE is an evaluation submitted by your medical school program and outlines your performance during clinical rotations or clerkships. It gives residency programs a look at where you excelled in medical school and what your instructors thought of you. As part of your ERAS application, you’ll also be filling out the MSPE Noteworthy Characteristics section, which provides a more detailed, qualitative evaluation of your medical school performance.

Since you won’t have control over writing your MSPE, which is compiled by your medical school, the best way to ensure you have a standout performance evaluation is to make an impression by knowing how to prepare for clinical rotations and acing these. Build relationships early on with your instructors and peers, participate in research opportunities, and create a positive reputation for yourself as a medical school student.

Watch this to learn about residency application red flags to avoid:

How to Prepare for ERAS Interviews

Your residency interviews typically begin in the fall and winter of your final year of medical school. This is a critical step in the process, as it not only allows residency programs to evaluate you in person, but also allows you to determine which residency programs are the best fit for you.

This is where researching residency programs is helpful, to learn about what residency program directors look for in their applicants, as well as find out what pros and cons a particular program has for you. It’s important to evaluate whether a program aligns with your career goals and values because you won’t be able to change your mind once the match results are in.

If you’re hoping to match to a particular specialty or program, prepare yourself with some practice interview questions. For example, some common family medicine residency interview questions will focus on your communication, empathy, and patient experience, while surgery residency interview questions may ask about your technical skills or dexterity.

Prepare for the typical interview questions as well, with the help of a residency mock interview. Some common residency interview questions are:

1. Why should we choose you?
2. What are you looking for in a residency program?
3. How will you contribute to our program?
4. What are your strengths and weaknesses?
5. Why did you apply to this program?
6. Tell me about yourself.

After you complete an interview, it might be wise to send a residency letter of intent to help improve your standing with your preferred residency program. Remember to only send a letter of intent to your top choice program!

When you have completed your interviews, you will have to rank the programs. Factors to consider are programs you are willing to attend, the location of the program, the overall work environment, personalities of the affiliated residents, and financial commitments, etc.  Rank ALL programs that you are willing to attend in the order you want to attend them. There is no benefit to having a short ranking list.

Need practice with residency interview questions? Watch this!

How to Prepare for ERAS Applications in Medical School

You have come so far from your first day of medical school; now you are getting ready to pick a career and begin your residency training. The totality of your experiences, knowledge, hardships, and joys have shaped the physician you are about to become.

As a medical student, you will begin preparing for your residency applications in the third year of medical school and will be working on your ERAS application by your fourth year. It’s important to get started as soon as possible by not just thinking about what medical specialty you want to pursue or whether you’re interested in a medical fellowship, but by forging relationships with supervisors, participating in research, and gaining valuable clinical experience.

Third Year Medical School

Start developing your Curriculum Vitae (Residency CV). It is more detailed than a standard resume and takes time to get it right. You will be listing your work and volunteer experiences and other highlights of your medical career. Did you get a paper published? Make sure to add it to your CV. Keeping an up-to-date CV is essential and makes getting recommendation letters from doctors easier.

At this time, it may be a good idea to start looking at the Match outcomes for specialties. You can compare their qualifications and match rates for each specialty. It is good to get an idea of what specialties might require. Knowing what scores you will need on licensing exams and how many letters you will need in that specialty will improve your chance of success. It might be wise to review the most competitive and least competitive residencies to see how you measure up.

It is never too early to get started on your residency personal statement. Make notes of interesting cases you see or memorable patients. Getting ideas early on will keep you from stressing as more deadlines approach. You can review residency personal statement examples to help you get started. Still nervous about your personal statement? You may feel more confident with residency personal statement editing with the help of your advisor. Don't be afraid of getting help. Have as many people as you can edit and review your statement.

Choosing a medical specialty

Wondering how to choose a medical specialty for your residency training? Med school is YOUR time to explore various fields and specialties in the world of medicine. Take the time to be honest with yourself regarding your likes and dislikes when figuring out how to choose medical school electives. Each specialty has pros and cons. Make notes of these as you are exposed to them during electives, rotations, clinicals, and research. Create a pros and cons list for the specialties you are interested in.

Also, consider where you want to live in the future and the type of practice you want to have. Certain areas are in need of different specialists or have different positions available. This may factor into your decision. If you are undecided between a few specialties, spend more time on rotations with those doctors. Immerse yourself in the field to get a feel of what your life would be like. Do not be afraid of consulting doctors and your medical school advisor. They are valuable resources. 

Apply for Clerkships

There are advantages to setting up clerkships, and they may give you an edge. Students are given the option of pursuing a sub-internship and additional elective clerkships toward the end of their 3rd year and the beginning of their 4th year. You should take advantage of this opportunity to work more closely with patients, residents, and attendings. These electives and internships are your chance to really stand out and demonstrate your interest in the field. Showing dedication to a field like family medicine is very important come interview season. Elective clerkships are an ideal time to request those letters of recommendation from attendings.

Want our help with residency applications? Here's what students say about our services!

Conclusion

Applying through ERAS is a time-consuming process. Altogether, your residency application, interviews, and match will take a year to complete, and your preparation for residency begins even earlier during medical school. The best way to make sure you ace your ERAS application is to follow instructions carefully and start as early as possible. Make sure you start researching residency programs, putting together your supporting documents, and gathering the information you need to succeed.

FAQs

To your success,

Your friends at BeMo

BeMo Academic Consulting

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