Are you wondering exactly how many residency programs to apply to so you can ensure you get matched? Many students want guidance when they reach this point in their CaRMS or ERAS timeline. After making it through the rigors of medical school, you don’t want to halt your dream of becoming a resident doctor because of a poorly thought out application strategy.
In this blog, you’ll find out how many residency programs to apply to. You’ll also learn strategies to help you choose which residency programs to apply for, along with top tips to help you get into your top choice programs.
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How Many Residency Programs to Apply to?
With every year, the competition of matching residency programs for students graduating from medical schools in the US and Canada is on the rise, as shown by the growing number of “unmatched” applicants. After going through the academically rigorous and financially draining 4 years of medical school, no applicant wants to be left with no residency matches at all. One of the key factors to consider as you prepare for residency applications is the ideal number of residency programs you should apply to, in order to maximize your chances of getting matched.
“I do not think there is an ideal number, per say. You should apply to whichever program you imagine yourself working in for the next 2-6 years (or more). It is important to write down what is important to you and select the programs to apply to based on those criteria. I have friends (in various specialties) who applied to anywhere between 1-30 programs.” – Dr. Neel Mistry, MD, Diagnostic Radiology, University of Saskatchewan.
This kind of strategic application planning is an extremely important step that could determine your entire future.
The Average Number of Residency Applications Per Applicant
First, let’s consider the average number of applications for residency programs per student. As per the latest data released by the Association of American Medical Colleges (AAMC) and ERAS, the average number of applications varies widely depending on the specialty – it could be 23 (Thoracic Surgery) or 44 (Pediatrics) or 66 (Urology). When you consider the overall AAMC data, the average number of applications per applicant is 102.9.
The Canadian Resident Matching Service (CaRMS) also releases data about their application statistics. As per their latest reports, the average number of applications per applicant is 22.5, with this number continuing to rise every year. Though this number seems much smaller than the US figure, it’s only because the total number of residency programs and medical schools in Canada is also much lower.
How Many Residency Programs Should YOU Apply To?
So, does this mean that you should also be applying to at least 100 US residency programs to have a competitive chance of getting accepted? No! There are a number of reasons why this average number is so high and should not be considered a “typical” guideline for the average student. For one thing, International Medical Graduates (IMGs) tend to apply for double the amount of residency programs as their local counterparts, hoping to improve their odds of matching. Also, many local students indiscriminately apply to a huge number of residency programs, thinking this will somehow increase their chances of acceptance.
We recommend being more strategic and applying to no more than 30-35 programs, at most. The “ideal” range could be from 15 to 35, though it’s important to remember that there is no actual universally applicable “ideal” number of residency programs to apply to. You should decide the number of programs you apply to based on the larger context of your own application, including your strength as a candidate, the competitiveness of the specialties you’ve selected, and so on.
For example, if you’re a very strong candidate with an excellent USMLE step 1 score, a robust residency CV, stellar ERAS letters of recommendation and so on, and you’re applying to the least competitive specialties such as family medicine or internal medicine, you could get away with as few as 10 applications. On the other hand, if you want to become a plastic surgeon and you’re applying to the highly competitive plastic surgery specialty, you should apply to 20+ programs including several options from an alternate specialty as back up.
In fact, the composition of your rank order list is as important as the total number of applications. For example, if you’re a fairly competitive candidate, in addition to applying to your top-choice specialty programs, you should apply to at least 2-3 programs in another specialty. Your list should also include a few “buffer” programs since it’s possible some programs may reject your application after the interview, or you may change your mind about them after your interview. That’s why we don’t recommend applying to fewer than 10 programs. You definitely don’t want to apply to just 1 program, no matter how confident you are about getting in!
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How Many Residency Programs is Too Many?
In general, we also don’t recommend applying to too many residency programs, as that option comes with its own risks. Juggling 35+ applications could make your residency application season unduly hectic and prevent you from giving your applications your best shot. It could also lead to a stressful interview season, and you might find residency interview prep very difficult. Moreover, for most students, this process occurs during their last year of medical school, and you don’t want to have so many application tasks on your plate that you get distracted from your other important responsibilities.
“Balancing interviews with rotations [is tough]! At my medical school, it was well accepted that 4thyears would take time off for interviews, so most rotations are forgiving when you need time off. However, it was still difficult to map out an interview schedule as many times interviews would come with little notice or time to schedule.” – Dr. Monica Taneja, MD, Harvard South Shore, Psychiatry.
And finally, remember that every additional application comes with an extra application fee and adds to your financial burden. In fact, AAMC data points to the fact that there are diminishing returns on increasing the number of residency programs you apply to. This means that yes, up to a point, more applications result in a higher chance of getting matched; but beyond that point, further applications don’t correlate to higher acceptance rates. Any additional applications beyond that point result in a lower rate of return on your likelihood of entering a residency program.
This data also corresponds to specific factors such as your USMLE step 1 score, the competitiveness of your specialty, and the type of student you are. As we explained above, in general, the higher your USMLE score and the less competitive your choice of specialty, the fewer the number of residency programs you need to apply to in order to maximize your chances of success. On other hand, students graduating from a DO school and international medical graduates have relatively lower match rates and a higher “diminishing returns” cut-off figure.
You should check the Apply Smart tool on the AAMC website for the detailed breakdown of how the “ideal” number of applications per student intersects with entrance rates per specialty, for different types of students, with varying USMLE scores. You can enter your own data and review the results to identify how many residency programs you should be applying to, based on your circumstances.
Interested in a summary of our key points on how many residency programs to apply to? See the infographic below:
How To Choose Which Residency Programs to Apply to
As you can see from the analysis above, there are specific factors that you need to keep in mind as you decide your list of residency programs. We recommend conducting a thorough research to identify the residency programs best suited for you.
“My strategy was simple – I ranked all programs based on proximity to home (location) first and foremost. The next was quality of resident training (i.e., weekly rounds, resident teaching, exposure to a breadth of cases, fellowship potential) and wellness culture (time off for residents, planned activities, measures to prevent burnout, etc.).” – Dr. Neel Mistry, MD.
While the starting point of your research should always be your interest and skills, you should also think strategically about which programs are most likely to accept you. Your list of residency programs should include a balanced mix of “safe” programs where you exceed their average acceptance statistics, “competitive” programs where you match the average acceptance statistics, and “high-reach” programs where you are slightly below the average accepted statistics but could get in based on other application elements like your extracurriculars or ERAS letters of recommendation.
If you are ready to enter your letters of recommendation into ERAS, check out this infographic:
This means that to understand your realistic chances of getting matched to a residency program, you need to find out the average requirements and acceptance data of that program and consider how you compare. For example, you should check the average USMLE step 1 and MCCQE part 1 scores of accepted applicants, as well as the typical medical school grades they expect. You should also consider your educational background and how that could impact your possibility of getting a match.
For example, students from medical schools with best match rates, such as Ivy League medical schools, can afford to be a little more picky as they compile their list of residency programs. Remember, only programs where you exceed the average acceptance figures would be considered a safe choice for you and you should definitely have at least a few of these in your list of residency programs.
Another factor to consider is how well the qualitative aspects of your application align with the requirements and vision of the residency programs you’re applying to. For example, residency program directors look for candidates who can prove that they are committed to their specific specialty and have the capability for it. Your extracurricular activities, medical school electives, and clinical experiences are all crucial indicators of your interest in a specific specialty.
To get into a psychiatry residency program at Harvard South Shore, our MD expert Dr. Monica Taneja focused on engaging in activities psychiatry programs valued:
“Psychiatry specifically focuses on a holistic view of applicants and creating cohesive residency classes. I showed preparedness and interest in psychiatry by engaging in research and taking advantage of unique psychiatry rotations offered at my medical school. These both gave me plenty of stories to talk about how I validated the field and showcase how I see my career progressing in psychiatry.” – Dr. Monica Taneja, MD, Harvard South Shore, Psychiatry.
Additionally, residency programs look at your residency personal statement and letters of recommendation to judge how suitable you are for specific specialties. You should be able to back up your interest in a specific specialty with references to clinical experience, skills, and previous exposure to that specialty. If you apply to a dermatology residency program, but you haven’t completed any clinical rotations in dermatology, you’re unlikely to get an acceptance, even if you have excellent grades and test scores. That’s why it’s very important to know how to choose a medical specialty that aligns with your interests as well as experiences.
Another aspect to creating a “balanced” list of residency programs is making sure you include a mix of highly competitive residencies and less competitive programs. If your list only includes highly competitive programs, you’re taking a huge risk. You might end up with no matches. For example, if your top choice specialty is a highly competitive one, consider deciding on 1 or 2 back-up specialties including at least 1 that is relatively easier to get into. We don’t recommend having more than 3 specialties represented on your list. Additionally, remember that a residency match is legally binding. So, you should not be including any programs that you’re not fully committed to attending.
For many students, logistical issues could also be a critical factor in their choice of residency programs. For instance, knowing how long residency is, if you have family obligations or some other personal circumstances due to which you need to stay in a specific geographic location, you may choose to apply only to residency programs in that area.
“For me, having a good support system was paramount to remain in the right mental space for the next 5 years … [Other factors included] the learning experience and quality of training. The program’s emphasis on resident wellness and call structure. Ability to undertake a variety of electives in senior years as well as preparation/resident support.” – Dr. Neel Mistry, MD.
You can use the AAMC residency explorer tool to explore the best residency programs in the US, their requirements and statistics.
Finally, make sure to check out our Residency Match Calculator to see your match chances!
Top Tips for Getting Into Your Top Choice Residency Program
Here are some top tips to make your residency application stand out and get you accepted into your top choice residency program:
#1: Impressive Application Components
This essentially refers to the “academic” requirements such as your history of coursework, GPA, and standardized exam scores, and your written components such as the personal statement. These requirements vary depending on the location and type of program you’re applying to. Residency programs in the US ask for your USMLE scores, while in Canada, you need to complete the first part of the MCCQE exam. DO school graduates also have to complete the COMLEX exam, as well as the USMLE if they want to match to a program dominated by MD candidates. You will also have to arrange for your MSPE (Medical School Performance Evaluation) or MSPR (Medical Student Performance Report). This is a report that is prepared by your school and shared with the residency program directly. It provides a summary and evaluation of your experiences, attributes, and academic performance.
It’s crucial that you work hard throughout medical school to maintain an excellent academic performance, and work towards acing your standardized exams to achieve a competitive score. As we discussed previously in this blog, your standardized test scores are a crucial determinant of your likelihood of getting an acceptance. Residency programs also look at your grades and MSPE/MSPR to determine if you have the academic proficiency, discipline, and dedication to be a good fit in their program.
#2: Meaningful Clinical Rotations and Electives
Your chances of getting matched to a specific specialty are extremely low if you don’t have prior exposure to that specialty. That’s why you need to start planning your medical school electives early, so you can devote enough time to research, find the best choices that align with your long-term career goals, and apply early to secure your spot in prestigious rotations. The timing of your electives is also crucial. They are typically completed in the last year of medical school and you’ll need to plan carefully to ensure you complete the ones you want to reference in your application before the ERAS or CaRMS application deadlines.
Additionally, try and include a variety of electives so you can strategically plan your application when the time comes. You should have clinical experience in at least 2 different specialties, and in two different locations. That way, you can target applying to at least 2 specialties, and you’ll have a more diverse, rich body of experiences to reference in your application.
“Demonstrating preparedness for your specialty is key to convincing the application committee and ultimately securing your top residency program. To do so, you want to highlight specific personal experiences where you have demonstrated key skills required for your specialty. For instance, collaboration, communication, and independent problem solving are essential to the job of a radiologist. I made sure to give specific examples to demonstrate how I have developed each of these skills throughout medical school.” – Dr. Neel Mistry, MD.
#3: Robust Residency CV
Your residency application CV is different from any of your previous resumes. Make sure that you don’t just recycle your old resumes, but create a new, detailed CV that matches the requirements for ERAS or CaRMS, whichever system you’re applying through.
This CV is essentially a detailed summary of all your significant experiences and accomplishments all the way from high school to the present date. This is a whole lot of information! Many students struggle with selecting the right experiences to include. The critical thing is to highlight the most impressive accomplishments and meaningful experiences relevant for the medical profession, while also building a consistent narrative with the other elements of your application. As you’re filling out your CV, ask yourself if the activity shows your best side, how it fits in your overall medical journey, and how comfortable you would be talking about it in further detail during your interview. Consider which experiences support the “theme” of your application and prioritize including those.
“I really enjoy working with students, so I did a lot of volunteer medical school mock interviewing for my graduate and undergraduate schools. I also continued to participate in my hobbies including photography, which came up a lot during interviews!” – Dr. Monica Taneja, MD.
An impressive CV for residency programs includes a variety of extracurriculars including clinical experience, volunteer hours, research work, published papers and presentations, academic awards, leadership experiences, and so on. Try to tailor your list to align with the priorities of the residency programs you’re applying to. This will show the residency program directors that you have a long-term commitment to the same goals and vision, and will therefore be an ideal candidate to join them.
#4: Relevant Reference Letters
Your letters of recommendation are a crucial aspect of your residency application. They provide supportive proof from an external source about your suitability for the program, and they should ideally align with the overall narrative you are building in your application.
You should aim to have at least 2 letters of recommendations from attending physicians or professors in your top-choice specialty. Ideally, you should work towards cultivating a meaningful relationship with these referees long before you actually need references from them. Don’t restrict yourself only to faculty members – use your clinical rotations and electives to form useful connections, explore your university’s alumni network to find mentors, and take up extracurriculars that will give you a chance to work with potential referees.
Make sure you reach out to your referees at least a month or two in advance, so they have plenty of time to work on your letters. When you reach out, approach them with prepared notes about your memorable achievements, academic record, strengths, key skills, and any other relevant information. That way, this data will be fresh in their minds as they write your letter.
#5: Memorable Interview Performance
Interviews provide the opportunity not only for the residency program to get to know the candidates better, but also for the candidates to evaluate the programs. Make sure you schedule the interviews at the right time of the day, so you can be fresh and engaged during the entire process, and make the most of your given time.
This interview is your chance to show the residency program why you, personally, would be a great addition to your team. They’ve already seen your application with all its impressive facts and figures; now, they want to see who you are as a person, your communication skills, and how well your qualities translate from the page to in person.
“I made sure to know my 2-3 key talking points but focused on just having a good conversation with my interviewer. This is really important when you are talking to a resident, as the most important thing to them is making sure you would mesh well into the program.” – Dr. Monica Taneja, MD.
To make the best impression, you should spend some time practicing the most commonly expected residency interview questions, such as “tell me about yourself”. You should also prepare for the specific format you’re facing, via realistic mock interviews, to help you gain confidence in your communication skills.
Make sure you go into your interview as prepared as possible. Spend some time researching the residency program, including clinical and medical details related to attending physicians, facilities, and career opportunities, as well as general information such as the location, local communities, culture, demographics, and so on. You should be able to demonstrate that you’ve thought seriously about joining their residency program, and can answer any questions about local patient demographics.
Check out our blog about CaRMS interview prep for more useful residency interview prep tips.
Want to watch a video instead? Check out some useful tips to make your ERAS application stand out.
FAQs
1. How many residency programs should I apply to?
There is no universally applicable ideal number of residency programs you should apply to, but we recommend you stay within the broad range of 10 to 35 applications. We recommend that you use the AAMC Apply Smart tool to check the exact number of applications that corresponds with the maximum percentage of match rates for your specific circumstances.
2. How many specialties should I apply to?
We recommend that you apply to a maximum of 3 different specialties, ideally just 2. This is because you won’t be able to create a robust application for each specialty if you have too many listed. If you split up your clinical experiences, extracurriculars, electives, and letters of recommendation across too many different specialties, you’ll end up with not enough material for each individual specialty. For example, you should ideally have at least 2 letters of reference from referees belonging to a specific specialty and ERAS does not allow more than 4 letters per program.
3. How can I decide which residency programs to apply to?
When you’re deciding which residency programs to apply to, take some time to analyze your application and compare the key data with the average acceptance rates of the programs you’re applying to. Your list of programs should include a few “safe” options where you know you can get in based on your experiences and academic record. Consider if you have the right extracurriculars and clinical experiences for the programs; remember that if you have zero previous exposure in a specific specialty, then the chances of getting an acceptance to a program in that specialty are almost nil.
4. Should I apply to residency programs I don’t want to attend?
No! Residency match is a legally binding contract, which means once you’re matched, you have to attend that program. Do not apply to even a single program that you aren’t 100% sure of attending. After the interview, you’ll have the option to drop specific programs if you no longer wish to attend them.
5. How to ensure I get into my top-choice residency program?
To get into your top-choice residency program, first of all, ensure you maintain an excellent academic record throughout your medical school education. Make sure you also achieve great scores for standardized tests such as USMLE, MCCQE, or COMLEX. Back up your academic proficiency with a diverse range of extracurriculars that help you develop key skills for the medical profession and help you demonstrate qualities such as leadership, empathy, creativity, innovation, and so on. Make sure your written application components, such as the personal statement and CV are well-written and effectively communicate your best qualities to the residency program. Your letters of recommendation should be glowing testimonials of your skills and capabilities, from relevant referees such a professors or physicians. Finally, make sure you spend some time doing mock interviews and practicing with sample questions so you can ace your residency interview.
6. What are the key factors that influence residency match rates?
These key factors influence residency match rates: your standardized test scores, academic performance, your extracurriculars and letters of recommendation, the competitiveness of the programs you’ve applied to, and the number of programs you’ve applied to. You need to analyze your own strengths and weaknesses and strategically balance all these factors to ensure you get matched.
7. I’m a DO school graduate. How many medical programs should I apply to?
DO graduates have slightly lower residency match-rates as compared to MD graduates. As per AAMC data, they should apply to a higher number of medical programs than their MD counterparts to maximize their chances of acceptance. You can check the Apply Smart tool on the AAMC website to confirm the exact recommended number of applications for DO graduates based on your preferred specialty and test scores.
8. What is the maximum number of residency programs I can apply to?
You can include up to 300 residency programs in ERAS. CaRMS does not have a “maximum” number of residency programs so you can apply to as many as you wish. However, we do not recommend that you use these numbers as a guideline for how many residency programs you should apply to. Be realistic about your abilities to create strong residency applications for each specialty and curate your list based on your own goals and programs that appeal to you.
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