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Preparing for residency applications as an MS3 & MS4

Congratulations on making it this far! This is such an exciting time in medical school.

This post will focus on preparing for residency applications as an MS3/MS4. If you are participating in the couples match, check out our couples match post for more details! We will also have a more detailed post regarding residency interviews and timeline.

How can you start getting organized for residency applications?

Know your competitiveness (*) (* notation meaning adapted from our other posts)

This will take some introspection and help from a mentor, if you have one. We would highly recommend setting up a meeting with your mentor or program director at your school and have them evaluate your competitiveness. Bring them your CV, personal statement (or an outline of ideas), and STEP scores to give them an objective view of where you stand as an applicant. Try to meet with them as soon as you have all the materials you need (mid-third year if possible or whenever you solidify your specialty decision!). This will help you figure out how many programs you should be applying to and see if there’s anything you can be doing to enhance your application.

The AAMC has resources that provide a likelihood of matching based on the number of programs applied to with your given stats. This information can be used to estimate the number of programs needed before reaching a point of "diminishing returns."

Unfortunately, there’s not an easy way for us to tell you how many programs to apply to but many people have said 12-15 interviews is a safe number, so take that with a grain of salt. It's very difficult to estimate the number of interviews you will receive based on number of applications. Also, don’t forget to apply to prelim/intern programs if required by your advanced specialty! See our post on choosing an intern year for more information.

Start early

Good news--ERAS (the residency application system) is much simpler than the medical school application process! Luckily there is usually only one essay (your personal statement) and if you start working on your CV well in advance, it will be very easy to fill out the application itself. Some programs may also require a supplemental application so be sure to check the programs requirements. All that being said, starting early is always a good idea. In the winter/early spring of your MS3 year, start working on your personal statement and finalizing who will write your letters of recommendation. Preparation is key.

Personal statement

Tell your story! Some program directors and people on the application committee will read it, some won’t, but it’s always smart to give it your best shot. Talk about how you became interested in medicine, any life events that influenced your decision, what made you choose your specialty, your experiences in medical school (especially if it relates to the specialty you chose), extracurriculars that you participated in, etc. This is a great way for you to show the application committee who you are. Have multiple people read your personal statement and make suggestions. For instance, we had our mentors, families, and upperclassmen all look at ours and we were so glad we did!

Letters of recommendation (*)

First of all, decide who will write your recommendation letters. We’d recommend finding 4 or 5 attendings to write your letters. Even though ERAS only allows 4, it’s important to secure an extra just in case it falls through at the last minute. That way, you won’t be out a letter (this happened to one of us, so it does happen- attendings are busy and forget, especially if they are not academic physicians who know the application timeline well). Also read through your specialty's expectations. Some specialties require all the letters to be from physicians in that field, others don't. To make things even more complicated, some programs in orthopedics require a non-orthopedics letter. Be sure to know the requirements in advance so you don't run into any issues last minute.

Choose letter writers who know you well enough that the letters won’t be generic. Think about attendings that you’ve worked with on your third year rotations and you can even go ahead and ask them to write you a letter at the end of the rotation if you desire. Remember, even if you ask them early it doesn’t mean they have to end up writing it! The types of letters you need depend on the specialty and some require you to have a letter from the chairman of the department, so ask your advisor or mentors about this. In general, it’s important to have multiple letters from the specialty that you will be applying to. That being said, you can supplement with an internal medicine or another primary care letter since those specialties demonstrate your clinical skills well. When you ask attendings to write you a letter, it’s much more professional to ask in person rather than by email. When you set up your meeting, make sure to bring a CV, your personal statement (another reason to get it done early!), and your transcript/scores. The more you provide them with, the better.

ERAS typically allows no more than 4 letters to be assigned to a particular program but you can upload as many letters as you would like to the ERAS system. For instance, if I am applying to a preliminary medicine program for my intern year, I can assign 1 internal medicine letter, 1 family medicine letter, 1 OBGYN letter, and 1 radiology letter. For my radiology programs, I can assign 2 radiology letters, 1 internal medicine letter, and 1 family medicine letter. Furthermore, if I want to assign a letter that I got from an away rotation at an out-of-state location to my out-of-state schools, I can do that as well to show that I am willing to leave my home state. These are just examples, but as you can see, there are many possibilities.


Disclaimer: Once STEP 1 becomes pass/fail in 2022, this information might not be as relevant to you. However, we will go through our experience and discuss our recommendations and you can apply them to your situation as necessary. If possible (based on your clerkship schedule and away rotations) try to take STEP 2 CK as soon as you can. Once you start your interviews, it can be challenging to work it in and can be stressful to have to worry about studying in the midst of finalizing your application and traveling to and preparing for interviews. If you take it by July or August, that is ideal. Though it depends on the person, most people don’t need to study nearly as much for STEP 2 compared to STEP 1. For reference, many of us studied for about 4 weeks and that was adequate. Since the score typically takes about 4 weeks to come back, it’s ideal to have the score finalized by the time you go on interviews so the committee can see your score. Although, in general, STEP 2 tends to be slightly easier than STEP 1, do NOT take it lightly because it can make or break you. Take it seriously!


Again, the application itself is pretty straightforward! If you already have a CV filled out with your activities, publications, and leadership roles, this part will be simple. The application consists of demographic information, educational details, the personal statement, publications, and a large section consisting of work, volunteer, and research experiences. In the experiences section, make sure to provide detailed, concise statements that describe your role, hours spent, dates, and details about your experience. When listing your publications, make sure to format in the way ERAS requires. You can list your publications also as research experiences where you can describe the project and work you did in more detail.

As always, make sure to be detailed, honest, and thorough in your application. Have as many people read it as possible--this is one of the most important documents of your professional career! No pressure right?!

You're in the home stretch of medical school!


Disclaimer: Gmail is not sponsored in any way, we just found it to be helpful. Also, we have described our experience and what worked well for us, but take this advice and adapt to your situation based on your competitiveness. It's not a one size fits all.


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