How Many Residency Programs Should You Apply To? Expert Tips

How Many Residency Programs to Apply to?

This is a common question among students as they prepare for residency applications; while the answer isn’t black and white, we recommend being strategic and applying to no more than 30-35 residency programs.

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.

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 strongly advise against applying to fewer than 10 programs (even though it does happen)…

“I do not think there is an ideal number [of residency programs to apply to], per se. 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

 Let’s say that 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. 

Interested in a summary of our key points on how many residency programs to apply to? See the infographic below:

The Average Number of Residency Applications: Can You Apply to Too Many Programs?

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 59-78, depending on the program—for IMGs, this average is typically over 100.

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. 

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. 

Are you an IMG looking to match to your dream residency program in the US or Canada?

So, how many residency programs are too many? Can you overdo it?  

In general, we also don’t recommend applying to too many residency programs, as that option comes with its 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. Here’s what one of our MD consultants had to say:

“Balancing interviews with rotations is tough! At my medical school, it was well accepted that 4th years 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. It’s also worth noting that those 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 Residency Explorer 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!

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Check out our Residency Match Calculator to see your match chances!

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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. First, we recommend conducting thorough research to identify the residency programs best suited for you. Below, you'll find a few more tips...

“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.

Think Strategically

 While the starting point of your research should always be your interests 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.

Another aspect of 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. It’s also crucial to remember that a match is legally binding, so you should only apply to programs you are committed to attending!

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. 

Consider your Values and Goals

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.

Assess your Suitability

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.

Consider Any Personal or Logistical Barriers

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.

Top Tips for Getting Into Your Top Choice Residency Program

Want to watch a video instead? Check out some useful tips to make your ERAS application stand out.

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