Whether you are just starting medical school or already writing your , as a medical student, you inevitably wonder how to prepare for residency applications. What can you do to gain a competitive edge? What can you do to stand out? How can you make sure that your application represents the best you?
In our blog, we will discuss methods you can implement early on in your medical school journey to make sure that when the residency application season arrives, you will be ready to impress program directors. Similarly, if you are in the process of preparing your or application right now, this blog will help you strategize what last-minute things you can do to stand out in your application and how to put your best foot forward.
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Despite modest in the United States and Canada, you made it into medical school! Congratulations!!! While it will take at least a year to get used to the rhythm and demands of medical school, it is never too early to start thinking of your residency application. It is completely expected for you to require some time to adjust to life in medical school and transition into the new stage of your career, but you should keep in mind that working on a stellar residency application takes time, effort, and dedication. Whether it’s your and scores, your , or your extracurriculars, these important application components take time to complete and perfect.
This is why starting to plan your application in the 2nd and 3rd years of medical school is ideal. Working on your test scores and building up your should be incorporated into your medical school schedule. By the time you enter your 4th year, you will be busy cataloging what to include and how to highlight the most important experiences. Your 2nd and 3rd years are the time for getting involved in impressive extracurriculars and rotations, gaining additional clinical experiences, as well as building strong bonds with your mentors.
However, this does not mean that your application is set and solidified in those years. You can greatly influence your residency application in your final year of medical school by deliberately presenting yourself as the best and most fitting candidate for your chosen programs. There are certain strategies you must implement to make your residency application stand out, so it's essential to use your last year of medical school wisely to secure your future.
As you start preparing for your applications, make sure to use our to see how competitive you are for your chosen programs and specialty. This will help you plan and strategize how to best compile your app components!
And now, let’s go over some tips and strategies you can use to make your residency application stand out.
Getting ready for residency?
This is the most critical period of your residency preparation. And even though your focus should certainly be your medical school studies, it is time to start thinking of and how to bolster your chances of matching your dream program. But how to do this before you even finalize your decision of which specialty to pursue? And what can you do to make sure that any program you apply to within 1 or 2 years sees you as a desirable candidate?
Shadow several specialists
You already have experience with gaining . But this time, your shadowing experience will be more selective. When you participate in shadowing in preparation for medical school applications, you are not very choosy about who you shadow and which specialty you learn about. The only important decision is whether you shadow a MD or an DO, depending on which degree you are applying to.
When it comes to choosing a medical specialty, you must "try on" different fields and disciplines during medical school. You will certainly have your chance to test drive different specialties during clinical rotations in the 2nd and 3rd years, but you can also actively look for shadowing opportunities to broaden your knowledge and experience. Reach out to teaching physicians at your medical school and ask them whether you can shadow them. This experience will allow you to see in more detail what kind of work different physicians perform, what their patient interactions are like, and allow you to ask questions regarding the path to becoming a physician in that specialty. Ask them about , what being a is like, , what kind of experiences you need to gain to match, and so on. This is a prime opportunity to test drive a potential specialty and learn what to do to increase your chances of matching from those who are already successful in this career path.
Get stellar test scores
Your USMLE and scores are strong indicators of your clinical theoretic knowledge. While exams are typically used to test this knowledge later in your medical career, the first parts of licensing exams are usually used to see whether you have the proper amount of knowledge to carry out your clinical duties. This is why residency programs consider these scores quite important.
Your first and second years of medical school should be considered as your preparation for USMLE Step 1 or MCCQE Part 1. Do not slack off in class, take thorough notes, and start taking practice tests closer to the date of your exam. Remember, these are comprehensive exams that test you on everything you learned in the first 2 years of medical school. Do not take these exams lightly.
Preparing for your USMLE Step 1?
Be active during your rotations
After acing your USMLE or MCCQE, it will be time to start your clinical rotations. This is your chance to learn and participate in different aspects of the medical profession. Be proactive! Ask questions, arrive at rotations on time, stay after the rotations to talk to the attendings, and make sure to develop a friendly rapport with them. Clinical rotations are perhaps one of the most important indications of your suitability for the medical profession. Why? Here’re some of the reasons.
Firstly, rotations demonstrate to you what kind of specialties you can pursue. Actively participating in your rotations can help you learn more about the specialty, its subspecialties, common cases, and more. You can test, more than during shadowing, whether this specialty is the right fit for you and whether you enjoy patient interactions in this field.
Secondly, attendings can often be very influential over your Medical Student Performance Evaluation (). This assessment is prepared by the dean or the faculty of your medical school. The MSPE includes your academic history and performance during medical school, including electives and core rotations. Most importantly, the MSPE can include comments from each rotation attending. These are the same comments that the attending makes on your in-training evaluation report (ITER) rotation evaluations. Because of their busy schedules, many attendings will not leave specific comments on individual evaluations reports; they will simply fill out the standardized form. But if you are an active and conscientious student, who seeks feedback and advice, the attending can leave comments regarding your performance that can eventually be used for your .
To get comprehensive comments from the attending, approach them on the last day of the rotation. Ask them to fill out the ITER form with comments addressing your performance in the rotation. If you have a good relationship with them, they may sit down and go through each section of the form with you and provide feedback on your strengths and things you can work on. So, take initiative during your rotations! Be an active participant, arrive on time, ask questions, and take comprehensive notes during your rotation. This will not go unnoticed!
Make connections with your attendings
This is closely connected to the previous point. Your attending can be a great influence on your residency application, not only as a source of your MSPE noteworthy characteristics but also as the source of advice and experience. If you have a good relationship with your attending, they can help you find extracurriculars to boost your candidacy and link you up with research opportunities on campus or in the medical facilities associated with your school. They can also help with advice and inner knowledge of the specialty you are trying to pursue.
They can also become a mentor and a guide through the thickets of residency applications processes. These professionals know what makes a great specialist and can advise on what you can do to stand out among the crowd. While they may not always have the time to provide comprehensive guidance, their support can mean a great deal, especially if they write you a glowing reference.
Continue with extracurriculars
We are sure you participated in stellar that helped you develop amazing skills. It is possible that after getting into medical school you paused your participation. If you did, we strongly advise that you reconnect with your colleagues and try to continue your involvement with this activity. If you moved to another city to attend medical school, try to find opportunities that would help you develop new skills and hone already-existing qualities highly valued by program directors, such as responsibility, conscientiousness, patient interaction, communication skills, and more.
Remember, your supervisors can become great referees for your ERAS or CaRMS applications. Program directors value letters of recommendation from mentors who witnessed your growth and development in the medical field and beyond. While attendings and instructors from medical school are invaluable sources of evaluation, supervisors from extracurricular activities will be able to comment on your long-term development, your core qualities, your achievements outside of medicine, and more.
Interested in seeing some of our top advice in point form? This infographic is for you:
When you are already preparing your residency application, you have very limited time to gain more extracurriculars or make strong connections with your mentors. While this is all possible in the 4th year, you do not want to rely on the 4th year alone to build strong relationships for recommendations, participate in shadowing and your preferred rotations, and so on. In your fourth year, you must solidify the choices you made regarding your specialty, so take electives that will further support your candidacy for the specialty you chose and continue to gain relevant academic and clinical experiences - but do not wait for the fourth year to be the year when you finally gain relevant experience for your medical specialty and find a mentor who would support your application for your chosen field.
What you can do in your fourth year--or during your , if you choose to take one--is to shape and mold your application into the perfect representation of who you are, what you can do, and what your chosen programs could gain from choosing you. This is a job no less difficult than participating in clinical rotations or passing your USMLE or MCCQE exams. It takes a lot of effort to create an application that speaks for you and that inspires a program director to invite you to a residency interview.
So, what can you do in 4th year to prepare for residency applications?
Plan ahead for your residency personal statement
We often give this advice to our students: make sure to give yourself ample time to write and perfect your personal statement. Many of the aspects of your residency application are outside of your control, but your personal statement is the number one tool you have to demonstrate your suitability for your specialty, your communication skills, your expertise and skills, and your goals. No other application component can do all of these things at once. This is why your personal statement must be outstanding.
Give yourself at least 8 weeks to develop, write, and edit your statement. You will go through multiple versions of this essay. Remember, it must speak for you during application review when you are not there. While your answers the questions of , your residency statement will answer why you are pursuing your chosen specialty. Demonstrating why and how you have decided to become a physician in your chosen discipline is a tall order!
Remember that the strength of your statement is not in the number of experiences that you list, but in their quality. You will have your CV to demonstrate the myriad of activities and skills that you have gained throughout college and medical school, so forget about including all your triumphs in the statement. Your statement should be around 750-900 words in length, so be very selective when choosing which experiences and skills to highlight.
Your personal statement should be a narrative, not a list. To create a narrative, your statement should be structured as an academic essay, with an introduction, body, and conclusion. Keep in mind that all three parts of the essay should be connected via transitional sentences and create a holistic story of who you are and why you are a great candidate. This should be done by incorporating experiences and skills that best demonstrate your suitability for your chosen specialty. Whether it’s a rotation, a case, an elective, a patient experience, or an extracurricular activity, the elements of your biography that you choose to emphasize must leave no doubt in the mind of program directors that you would be a great addition to their program and to that field of medicine in general.
This is not easily accomplished. An outstanding personal statement is a feat of self-awareness, reflection, and great communication skills. This is why it’s important to give yourself at least a couple of months to work on your statement.
Working on your personal statement? Check out our tips:
Ace your USMLE Step 2 CK
This is another examination that will affect your chances of matching your dream residency program. USMLE Step CK tests your readiness for clinical practice. The questions you face in Step 2 will examine whether you know how to deal with common patient cases, what to do during patient interactions, and more. The score you receive will demonstrate your theoretical knowledge of what it means to be a practicing physician. This is an important indicator of how well you are prepared to transition to residency.
How do you ensure a high score? Your clinical rotations and electives will be the primary source of your knowledge. During rotations, keep detailed notes on common cases and diagnoses. Jot down any useful information about patient interaction you need to succeed in your field. When you are ready to start the heavy phase of exam prep, take practice tests that would allow you to recreate the exam setting and environment.
Take an elective in your chosen institutions
You should try to take an elective at the institution where you hope to do your residency training. This can be advantageous for three main reasons:
Secure strong recommendations for your chosen specialty
You already did the leg work of building strong professional relationships with your professors, attendings, and other supervisors. Now, you must reach out to them to ask for their support in your chosen medical field. Letters of recommendation are some of the most important components of your residency applications. According to the latest NRMP data, 70% of residency programs rank references 5th after interpersonal skills and interactions with staff and residents when ranking applicants. These skills are typically evaluated during the interview, but the reference letter can be a great aid in getting that coveted invitation and impressing the interview committee!
Ideally, you will have a reference letter for each of the specialties you are pursuing. This means that if you are applying to and general surgical residencies, you should have at least one recommendation that supports your qualifications for family medicine, and one reference that validates your candidacy for surgery. The program directors need to see that your aspirations to pursue your chosen specialty are supported by professionals in the field. This is a great indication of your suitability. Having the support of the medical community on your side can affect the impression you make on the program directors.
Even more impressive is having a recommendation letter from a faculty member of the program where you are applying. If you followed our previous advice and managed to secure a rotation at your desired residency site, your supervisor from that rotation can be an invaluable reference. If the program director sees that you have the support of internal staff, this can help your chances for interview and matching.
Important reminder: you want only strong letters. That’s right, lukewarm and mediocre letters from attendings or volunteer supervisors will not help you get that interview invitation. When you approach your potential reference writers, make sure to ask for a strong letter of support. Ask your referees to specify your strengths, suitability, and skills that make you the perfect candidate for that specialty. Politely remind them to use specific examples that demonstrate your critical thinking, problem-solving, communication skills, and knowledge. Remember, your letters are not program-specific, but specialty-specific. So, make sure that your referee knows you well and can speak in detail of your candidacy to the specific specialty you are pursuing.
Learn more about residency letters of recommendation in our video:
Choose a second-choice specialty that you can demonstrate experience in
will also depend on how many specialties you choose to pursue. You can have a top-choice specialty and a top-choice program, but you should also have a back-up specialty and back-up programs that would also satisfy you professionally in case you do not match your top-choice residency program. Your applications to both specialties, your top-choice, and back-up, should be supported by solid experiences and skills. Remember that you should also have references that support your candidacy for each specialty.
This is not just cold pragmatism. Applying to two specialties eliminates risk and broadens your possibilities. While you may have a dream specialty, it is always possible to find a second specialty that speaks to your interests, skills, and expertise. Having back-ups will not hurt your chances of matching your top-choice program, but not having back-ups can increase anxiety during the waiting period and limit your chances of matching in the first round.
Bonus: Get professional help
Balancing medical school studies and residency applications is not easy. Preparing your residency applications is a nuanced and laborious task. Creating an application that will represent your candidacy to 10-15 programs is a huge task, and you must put all your efforts to ensure that you know exactly how to represent yourself. Writing and submitting is easy, but knowing which strengths to emphasize, how to demonstrate your best self, and how to discuss setbacks in your application is a tremendous challenge.
It is often difficult to objectively evaluate yourself and perform at your top game. This is where a professional advisor can truly help shape your application. A great consultant will not write your statement for you or prepare your CV, but they will extract the most impressive and relevant information and guide you to create an application that will be a reflection of your strengths and achievements. Proper advice can mean the difference between matching and rejection. Reflect on your own timeline and abilities in creating the application you know you deserve and consider whether professional help is worth it. Matching your top-choice residency is not easy, but with the right help, it can be achieved.
Still deciding what specialty to pursue?
Once your application is ready and submitted, we recommend you start your ERAS or right away. It may seem unnecessarily early but trust us that interview prep is a difficult and time-consuming process. You do not have to start practicing with mock interviews and sample right away, but interview prep is so much more than practice! It's the gathering of relevant information, skill-building, learning the proper etiquette, and more. Make sure to read our blogs regarding residency interview prep to learn what it takes to properly get ready for your interview.
1. When should I start preparing for my residency application?
Your preparation for residency applications begins in 2nd year of medical school. This does not mean that you have to start writing your personal statement, but you should continue participating in extracurriculars, focus on building strong relationships with your instructors, and preparing to ace your USMLE and MCCQE tests. All of this will eventually help you compose a stellar residency application.
2. Is 4th year of residency too late to start preparing for your residency application?
In some ways, yes. The 4th year is critical in solidifying your choices in a specialty, choosing your references, and writing and perfecting every application component. The majority of your preparations will take place throughout the first 3 years of medical school; this includes good USMLE scores, gaining quality experiences, performing well in your rotations, and more. While the 4th year activities and experiences can add to an already amazing student profile, you should not leave your application prep to the last year of medical school.
3. How can I explore different medical specialties during medical school?
Clinical rotations will provide you with the opportunity to test out different specialties in the 2nd and 3rd years. During your electives in your 4th year, you can further explore your chosen specialties and assess which specialties you should apply to.
If you want to explore different specialties even earlier in your medical school career, you can look for shadowing opportunities with different specialists in your 1st and 2nd year of med school.
4. How many residency programs should I apply to?
There is no ideal number. It all depends on how competitive of an applicant you are. You should aim to apply to a minimum of 15 programs and a maximum of 35 programs per cycle. The number of programs you apply to should be calculated based on factors such as the strengths of your application, how competitive your specialty is, how competitive the programs you are applying to are, how good of a fit you are, and so on.
5. How many specialties should I apply to?
You should have at least 1 back-up specialty, or second-choice specialty. It is normal to have a dream specialty that you work hard towards. But you should always prepare a plan B in case you do not match your desired programs of that specialty.
6. When should I start writing my personal statement?
You should give yourself at least 2 months to brainstorm, write, and edit your personal statement.
7. How can I prepare an impressive residency CV?
Our number one tip is to keep track of all the activities you participate in during college and medical school. Have a spreadsheet that outlines the name of the activity, the organization, your supervisor, duties, timeline, and so on. When it comes time to create your CV, all of the information will be available to you in one convenient place.
8. What kind of letters of recommendation should I get for residency applications?
You should have at least one reference letter supporting each of the specialties you chose to pursue. So, if you are applying to internal medicine and surgery, you should have at least one strong reference supporting your candidacy for internal medicine and one strong letter supporting your candidacy in surgery. Having more than one letter is advisable, but you should aim to have a variety of letter writers, such as attendings, professors, work supervisors, volunteer mentors, and so on.
9. What should I do once I submit my applications?
You should start residency interview prep. You do not have to start running through practice questions right away, but you should at least research what kind of interview formats your programs of choice use and familiarize yourself with the format and the kind of questions you may be asked.