Preparing for Residency Applications

The fourth year of medical school is both extremely stressful and refreshingly relaxing at the same time. Stressful because you need to secure employment to pay back your massive student loans and prepare to be an actual doctor. Relaxing because you don’t really have any exams and you get more say in the rotations you do.

The process of navigating this year was quite difficult for me for a number of reasons. Our school only has so much insight into the process and the majority of useful tips I got came from my kind seniors and The Successful Match book by Dr. Katta and Dr. Desai.

I have gotten a few emails from my classmates about tips regarding the residency application process and I wanted to share a few posts with my perspective on this topic. I will be spreading it out into three posts: Prepping to apply, Navigating interviews and Post-interview Interactions/Rank List Organization. Now, let’s delve into preparing to apply!

  1. Letters of Recommendation (LORs):

I feel that this was one of the most stressful aspects of the application for me. I wasn’t sure about what I wanted to go into for much of third year and I was a complete noob so I don’t think I actually did well enough to stand out and ask someone for a letter. Also, many of my rotations had limited interactions with the attending and more interactions with the residents and unfortunately, they can’t write your letters. About three months before third year was over, I started to freak about getting letters in time.

If I could do it again, I would make it a point to get letters of recommendation from physicians where you have the opportunity to spend a lot of time with them, one on one. You need to show them how you interact with patients, how you formulate treatments and how you take social factors into consideration when you make a plan. If you have the opportunity to work with attendings who let you see patients on your own instead of shadowing, I would definitely consider asking them for a letter. Also, your letters don’t have to be exclusive to your field. Most programs will want 1-2 letters from doctors in the field you are applying for, but apart from that you can use this as an opportunity to show diversity. If you ever have the chance to get a LOR from a program director, take it! It goes quite far because they know exactly what to say to appeal to other program directors. Also, if you have a great experience with an attending early in third year, don’t hesitate to ask them for a letter at the end of your rotation! It’s a lot easier to have them write it when they remember you well as opposed to 8 months later when they’ve worked with so many more students after you. I think it’s not always on everyone’s mind early in third year because shelf exams take over your life, but you will be much less stressed later!

I was told often that I could get letters during 4th year as well and even get interview offers without having all my letters in. I’m an extremely anxious person so I got all my letters in before sending out applications but I know it’s not an option for everyone. I feel that it’s just easier for programs to decide about interview invites if they have all your information in front of them so it’s to your advantage to have your materials in early.

When requesting a LOR, make sure you provide them with a resume of your activities and your personal statement, if you have it available. I would make sure to emphasize to them which field you are applying for just to make sure there are no accidental discrepancies in the letter. Some will keep the letter more focused on you as an applicant rather than mentioning the field you are applying for. This can be beneficial if you end up having a change of heart part way through the application season and need to switch gears.

2. Personal Statement: 

The personal statement is quite important for your application. It needs to be succinct but also reveal a lot about you to programs. The Program Director at the program I matched into had actually highlighted and made notes all over my statement and we discussed those things during my interview. If you made any major mistakes, this is the place to address it. If you can provide tangible examples about how you are working on not repeating any mistakes in your record, it is received more favorably than providing excuses. You need to show why you love the field you are choosing to dedicate your life to and show examples of what lead you there. I kept a short list (no patient identifiers of course) where I noted particularly meaningful patient experiences I had during my rotations. It helped to have this when I was brainstorming on how to formulate my personal statement because I had real experiences I could draw on and I didn’t have to guess about things/fabricate them. I had a lot of people read my personal statement (different age groups and professions) and took all of their critiques seriously. In the end I was pretty happy about the final product. One thing I would advise strongly is to start working on this early. I was so burnt out from COMLEX 2 studying that I procrastinated and I ended up submitted ERAS late because it took me such a long time to hash out a statement that I liked.


Prior to starting ERAS, I was worried about the fact that I had almost completely neglected extracurriculars during medical school. However, the nice thing is that you can include activities from your undergraduate years and any time you took off before starting medical school. I was often asked about activities from years ago and interviewers will use this information to find out more about you as a person. I would give importance to the boxes that allow you to summarize each activity on ERAS. What lessons did you learn/traits did you develop from these experiences that would help you to be a good medical resident? Make sure you showcase this information in the written part of your application in addition to during the interview because these will all be important when the program is making their rank lists 5-6 months after having interviewed you. Also, don’t skimp on listing hobbies on ERAS because they serve as useful conversation starters on interview day! Anything listed on your ERAS application is fair game for questioning on interview day (one interviewer started by asking me to list the finger lakes in NY because of where I had done the majority of my rotations) so make sure you familiarize yourself with it well before the interview.

4. COMLEX Level 2/USMLE Step 2:

Everyone learns differently so I won’t go into specifics about how to study. I personally spent more time on practice questions this time around and it helped me to see an improvement in my score. It’s a good idea to take this as early as you can before interview invites go out because it is often used as a filter for sending out invites. My COMLEX 1 score was not spectacular so having improvement on COMLEX 2 that I could show to programs really helped in getting those interview invites.

5. Audition rotations:

I unfortunately did not have too much experience with this as I only really did one audition rotation during the application season. It seems like it could be good and bad in some ways. There are definitely some specialties that prefer them so it is important to show up and do well. However, in my field of Internal Medicine they were not crucial so I didn’t invest much time in pursuing that. Apart from having so many difficulties with my school’s rotation schedule and the programs I wanted to rotate with, I feel that it can be difficult to try to coordinate interviews around the same time you have auditions taking place. If you have a few programs you are sure you want, I think auditions can be a good investment of time but it’s important to keep in mind that you have to be giving 100% when you’re on that rotation.

Thanks for reading and feel free to message if you have any questions or comments!

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