The Changing Landscape of Residency Applications
Published on Thursday, January 23, 2025
By: Loretta Jackson-Williams, MD, PhD
In December 2020, there was an article for this newsletter written by me entitled, ‘From accreditation to pandemic, 2020 education events worthy of reflection’. In the article I stated that ‘At the beginning of the calendar year, those of us responsible for the SOM education program anticipated challenges for 2020 with the school’s accreditation site visit scheduled for February. We did not anticipate the avalanche of change that has occurred. It was announced [in February 2020] that the first part of the licensure exam, USMLE Step 1, would transition from a numeric score to pass/fail with implementation January 2022. It was understood at that time that this would cause ripple effects. In short, those ripple effects will occur over time in the selection processes for residencies, the promotion process within the UME educational programs that include passage of parts of the licensure exams, and the sequencing of the UME curriculum designed to deliver the content for these licensure exams. During this time period, the admissions and residency application processes were completely disrupted. ’
Well – those ripple effects have continued into 2024-25 and the residency application processes remain disrupted. Since ERAS (Electronic Residency Application Service) was created in 1995, it has served as the program for applicants to submit a single application to residency programs for the main match with the exceptions of the military and ophthalmology programs. This has enabled most applicants to use only one application service even if applying to more than one specialty. During the 2020-21 residency application cycle, plastic surgery piloted the use of the Plastic Surgery Central Application (PSCA) and has now transitioned to the use of PSCA only. During the 2024-25 residency application cycle, obgyn has used the Residency Centralized Application Service. During the 2024-25 residency cycle, some of the residency programs for anesthesiology have been piloting the Central Application. This change has created a new obstacle for applicants who now need to verify which application program each service and, in some cases, each program is using for applications. This process will continue to evolve.
In addition to the variability of the programs used for the application service, each specialty has significant variability in the use, type, and number of preference signals that applicants are expected to utilize when submitting applications for interviews. The intent of signaling is to allow applicants to specify which programs are of the most interest to the applicant. This process of signaling has essentially limited the number of programs offering interviews to applicants, especially for the programs that use double digit signals. Some of the specialties also use a two-tiered signaling process that allows applicants to indicate distinct levels of interest for programs prior to interviews. This process will continue to evolve.
Finally, each specialty and even specific programs within each specialty have individualized approaches to the interview process. Some specialties send invitations to interview on a specific date with specific response time frame expected of applicants. Some specialties have rolling invitations to interviews. Some specialties support virtual interviews even though some programs utilize in-person interviews for certain groups of applicants. Some programs offer and encourage structured second look visits, some programs offer informal second look visits, and some programs discourage second look visits. This will certainly continue to evolve.
Anyone providing guidance and advice to students for the residency application process will need to be aware of the ever-present flux in the process and encourage students to rely on credible information to engage in the process. The school will continue to provide individual student counseling with an assigned dean and group programming about the process through our ‘Road to Match’ series. We are all working towards a fair process for students while decreasing the administrative burden to residency programs. As always, we welcome suggestions for ways to improve how we manage this important process for our students, and we appreciate the collective work done by a lot of people to ensure the successful match of our students and programs.