When I first entered medical school, residency was the last thing I was thinking about. I was completely consumed by the firehose of information contained in basic science lectures and anatomy labs. I think that’s completely appropriate. You have plenty of time to think about specialties and residency as you meet different mentors, stumble upon different research opportunities, and feel out your third-year rotations.
However, I think there are some broad strokes about applying to residency that I wish I had known earlier. You will be surprised by how quickly residency applications sneak up on you!
The “Nuts and Bolts” of a Residency Application
ERAS application (list of work experiences, volunteer experiences, research experiences, publications, hobbies & interests, medical school awards)
Letters of recommendation
USMLE board scores
Medical school transcript
MSPE (medical student performance evaluation, or a comprehensive assessment of your performance by the medical school)
Board Scores and Clinical Grades are Extremely Important
“Numbers” like board scores and clinical grades should NOT be only the focus of medical school, but they play a key role in the application process. I always thought that I wanted to become a pediatrician, and older medical students told me that pediatrics wasn’t one of the most competitive specialties and that I didn’t have to worry about my Step 1 or Step 2 CK scores or my grades on my clinical rotations. However, I would argue that it’s better to have the mindset to try your hardest at every step of the way, regardless of your specialty choice. Board scores and clinical grades (unfortunately) are easy markers that residency programs can use to screen their applicants. This probably especially holds true for the most competitive specialties where applicants traditionally have very high board scores.
Residency Applications Aren't All About Numbers If you end up getting lower Step 1 scores or clinical grades than you hoped for, that’s okay! The residency ERAS application has plenty of space for things that aren’t related to scores, including: A. Past volunteer and work experiences are often the ones that inspired us to go into medicine in the first place, and you should make sure to keep making time for those important experiences throughout medical school. They will not only keep you more grounded throughout medical school but also are important ways that residency programs can get a sense of who you are, what you value, etc. and differentiate you from the other applicants. B. Research is another obvious way to strengthen your application. “Research experiences,” where you write a paragraph or so expanding upon the research topic and/or experience working in a lab or with a particular researcher, and “publications,” where you list all publications in your ERAS application can really strengthen your residency application. Research is time-consuming and can take forever to publish! I remember thinking that nothing would be accepted by the time that I applied for residency. However, don’t forget that poster presentations, oral presentations, online articles, and/or case reports also count as research publications in ERAS that you can complete by the time you apply for residency.
Mentors Play A Crucial, Even Life-Changing, Role
I wouldn’t have stumbled upon my specialty or had any idea how to navigate the residency application process without my mentor’s incredible guidance. Once you know what specialty you want to pursue, find a mentor! Shadow different people in the field to see if there is one you click with. Talk to older medical students who know which attendings like to work with medical students. Reach out to attendings who do research in the area you’re interested in.
In terms of the residency application, a close mentor will vouch for you and be able to write a strong, personalized letter of recommendation. Residency programs take these letters of recommendations seriously. Residency applications aside, it is life-changing to meet someone who wants to mentor you, and someone who you want to become when you grow up!
To summarize, good scores and grades will only help you because residency programs can easily use these markers to screen their applicants, especially in competitive specialties. However, residency applications are not all about numbers, and other components, including volunteer experiences, work experiences, and research are equally important ways to strengthen your application. Finally, I can’t emphasize the importance of trying to connect with a mentor who can guide you through the residency application process and your career beyond!
Hannah Song is a fourth-year medical student at Harvard, future dermatologist, and tutor for USMLE Pro.