TAKING FLIGHT--PREPARING FOR

RESIDENCY APPLICATION
Isaac K. Ike Wood, M.D.
Senior Associate Dean for Medical Education and Student
Affairs
Virginia Commonealt! "ni#ersit$ Sc!ool of Medicine
%ic!mond, Virginia
OBJECTIVES: &olloing t!is lesson, t!e student ill 'e a'le to(
). E*+lain t!e 'asic algorit!m used '$ t!e ,ational %esidenc$ Matc!ing -rogram.
.. Delineate t!e c!aracteristics of t!e t!ree t$+es of interns!i+ +rograms.
/. Descri'e t!e +rocess for s+ecial situation matc!es suc! as t!e cou+les matc!,
militar$ matc! and earl$ matc!.
0. -lot t!e deadlines for t!e ,%M- a++lication +rocess.
1. Construct an effecti#e curriculum #itae t!at accuratel$ +ortra$s !is2!er academic
and +rofessional accom+lis!ments.
3. Descri'e t!e as+ects of a +ersonal statement and 'e familiar it! !o to com+ose
a successful +ersonal statement.
4. Identif$ t!e com+onents of t!e Medical Student -erformance E#aluation.
5. Iterate !o 'est to ask for a letter of recommendation and !at t!e student s!ould
su++l$ to eac! letter riter.
6. 7utline t!e do8s and don8t of successful inter#ieing for a residenc$
+rogram.
)9. Identif$ resources a#aila'le to t!em for com+leting t!e residenc$ a++lication and
+re+aring for inter#ies.
THE NATIONAL RESIDENCY MATCHING PROGRAM
(NRMP) AND OTHER MATCHES:
:!e Matc! is a s$stem '$ !ic! students are +aired it! residenc$ training +rograms.
-rior to )61., a++alling a'uses of t!e s$stem occurred suc! as eak +rograms +ressuring
students to sign contracts; +rograms not a'iding '$ a uniform announcement date; and
misre+resentation of +rograms. :o +rotect t!e students and t!e training +rograms t!e
,ational %esidenc$ Matc!ing -rogram as created.
:!e ,%M- is o#erseen '$ multi+le agencies(
Association of American Medical Colleges
American <os+ital Association
American Medical Association
American =oard of Medical S+ecialties
American Medical Student Association
AAMC 7rgani>ation of Student %e+resentati#es
AMA Medical Student Section
Consortium of Medical Student 7rgani>ations
:!e ,%M- uses an algorit!m designed to fa#or students. All a++licants ?".S. M.D.
Students, D.7. Students, +!$sicians, and International Medical @raduatesA are treated
eBuall$. "sing t!e algorit!m, t!e com+uter matc!es students to a training +rogram in si*
minutes.
:!e Matc! !andles eac! a++licant in seBuence. An attem+t is made to +lace an a++licant
into !is or !er most +referred +rogram. If t!is is unsuccessful, an attem+t is made to
+lace t!e a++licant into t!e second, t!ird, etc. ranked +rogram. :!is +rocess continues
until t!ere is a ?tentati#eA matc! or until t!e a++licant8s listed +rograms !a#e 'een
e*!austed.
W!en su'seBuent a++licants go t!roug! t!e +rocess, an attem+t is first made to +lace
t!em into t!eir most +referred +rogram. If t!e +rogram t!e$ ranked !ig!l$ !as ranked
t!em !ig!er t!an a++licants alread$ tentati#el$ matc!ed, t!e ne a++licant gets t!e s+ot
and t!e +re#iousl$ matc!ed a++licants go 'ack t!roug! t!e algorit!m. W!en a++licants
are 'um+ed from a s+ot and go 'ack t!roug! t!e Matc!, t!e +rocess 'egins again it!
t!eir firstCc!oice +rogram. :!e Matc! is com+lete !en all a++licants !a#e eit!er 'een
matc!ed it! one of t!eir c!oices or all t!e +rograms listed '$ t!e a++licants !a#e filled
t!eir +ositions.
Most -@DC) +ositions are offered t!roug! t!e ,%M- Matc! using t!e Electronic
%esidenc$ A++lication Ser#ice ?E%ASA. 7+!t!almolog$ uses t!e San &rancisco
Matc!ing -rogram and "rolog$ !as its on Matc!ing -rogram.
:!ere are t!ree t$+es of -@DC) +ositions offered(
). Categorical
.. -reliminar$
/. :ransitional
CATEGORICAL POSITIONS: Categorical +ositions are interns!i+s !ic! are +art of
t!e general training +rogram. :!e$ are designed for 'road s+ecialties. :!e$ do not
reBuire an$ +reliminar$ training. After com+letion of t!e interns!i+, t!e trainee remains
in t!e same +rogram for residenc$ training. :!ese are usuall$ found in areas suc! as
&amil$ Medicine, Internal Medicine, -ediatrics, Emergenc$ Medicine, 7'stetrics and
@$necolog$, @eneral Surger$ and -at!olog$. <oe#er, +rograms differ. Dou ill need
to researc! eac! indi#idual +rogram to determine if it offers a categorical interns!i+ or if
$ou s!ould +ursue alternati#e training.
PRELIMINARY POSITIONS: :!ese interns!i+s are offered for students !o matc! to
an ad#anced +rogram ?as a -@DC.A or !o are seeking one to to $ears of clinical
e*+erience +rior to anot!er s+ecialt$. :!e$ are a#aila'le in eit!er Internal Medicine or
.
@eneral Surger$. If $ou are a++l$ing to an ad#anced +rogram, $ou must a++l$ se+aratel$
for a +reliminar$ +rogram.
TRANSITIONAL POSITIONS: :!ese interns!i+s are designed for students !o
cannot decide on a medical s+ecialt$. Students +artici+ate in a num'er of clinical
e*+eriences, muc! like t!e M/ $ear, 'ut it! more res+onsi'ilit$. Some ad#anced
+rograms ill allo $ou to su'stitute a transitional $ear for a +reliminar$ $ear.
E*am+les of +rograms t!at ma$ reBuire a +reliminar$ or transitional $ear are(
Anest!esiolog$
Dermatolog$
,eurolog$
7+!t!almolog$
-!$sical Medicine and %e!a'ilitation
Diagnostic %adiolog$
%adiation 7ncolog$
Emergenc$ Medicine
,eurosurger$
7tolar$ngolog$
:<E S:"DE,: M"S: C<ECK WI:< EAC< -%7@%AM :7 DE:E%MI,E I:S
%EE"I%EME,:SF
RANK-ORDER LISTS: :!e order in !ic! a student lists +rograms is t!e %ankC7rder
Gist ?%7GA. :!e +rograms create a similar list of candidates. :!e %7G is su'mitted to
t!e ,%M- electronicall$. :!e %7G ma$ 'e modified as often as desired until midC
&e'ruar$ at !ic! +oint t!e student MUST CERTIFY a final %7G. :o o+timi>e t!e %7G,
t!ere are to ke$ elements( list $our firstCc!oice +rograms first and consider !o man$
+rograms $ou s!ould list.
A++licants consistentl$ do 'etter if t!e$ list t!eir to+ c!oice first. :!ereafter, rank
+rograms in t!e order of t!eir desira'ilit$ to $ouHnot in t!e order in !ic! $ou t!ink $ou
are acce+ta'le to t!e +rograms. &or !ig!l$ com+etiti#e s+ecialties, a long %7G increases
t!e odds a student ill matc!. &or +rograms t!at are easier to matc! it!, t!e student
ma$ ant a relati#el$ s!ort list. :!e ke$ to success is to consider, for eac! +rogram $ou
list, !et!er $ou ould rat!er go to t!at +rogram or !et!er $ou ould +refer to 'e
unmatc!ed and take $our c!ances in t!e scram'le. :!e most common reason t!at
a++licants don8t matc! is t!at t!e$ do not list enoug! +rograms.
Confidentialit$ is e*tremel$ im+ortant in t!e Matc!. Matc! rules do not allo +rograms
or a++licants to ask eac! ot!er !o t!e$ ill 'e ranked. %7Gs from 'ot! +arties are
confidential. A++licants must re+ort an$ +rogram to t!e ,%M- t!at offers a contract
outside of t!e Matc! for +uniti#e actions.
/
MATCH RESULTS TIMELINE:
The !he"#$e %&' (he S#))$e*e+(,$ O%%e' ,+" A!!e)(,+!e P'&-',* (SOAP) ./$$ 0e ,
%&$$&.
M&+",1 ))(/9 am Sc!ool ill recei#e "nmatc!ed Seniors %e+ort
).(99 +m "nmatc!ed students and unfilled +rograms notified
)(99 +m A++licants 'egin E%AS a++lications
.(99 +m E%AS transmits a++lications to +rograms
?,7:E( A++licant2-rogram communication occurs
o#er t!e ne*t to da$s; +rograms must initiate
tele+!one inter#ies it! a++licantsA
PLEASE NOTE: N& %,!#$(1 !,+ ,"2&!,(e &+
0eh,$% &% (he (#"e+( #+(/$ (he )'&-',* *,3e
%/'( !&+(,!( ./(h (he (#"e+(4
T#e",1 ))(/9 am -rograms 'egin entering +reference lists
5e"+e",1 ))(11 am -rograms finali>e +reference lists
).(99 +m -rogram offers 'egin( #alid for . !ours
?,7:E( Students ma$ a++l$ or rea++l$ to an
additional )9 +rograms until :!ursda$ at ))(16amA
.(99 +m &irst offer e*+ires
.(11 +m Deadline for +rograms to u+date lists
.(11 +m E%AS u+date of a++licant and +rogram information
/(99 +m Second offer sent to a++licants
1(99 +m Second offer e*+ires
A total of eig!t offer c$cles during t!e eek.
F'/",1 ).(99 +m Matc! Da$ Ceremon$
1(99 +m Eig!t! offer e*+ires, S7A- ends
SPECIAL SITUATIONS:
COUPLES MATCH: :!e Cou+les Matc! ma$ 'e used '$ married students,
engaged students, close friends or an$ set of students t!at ant to 'e matc!ed in
t!e same localit$. :!e cou+le enrolls in t!e Matc!, 'ut indicates t!e$ ant to 'e
in t!e Matc! as +art of a cou+le. Cou+les a++l$ to and inter#ie at +rograms
se+aratel$, 'ut it!in t!e same geogra+!ic region. Eac! cou+le com+letes a
%7G, tr$ing to rank +rograms eBuall$. :!e cou+les are treated as a single entit$
'$ t!e Matc! com+uter.
MILITARY MATCH: Students in t!e Sc!ool of Medicine of t!e "niform
Ser#ices "ni#ersit$ of t!e <ealt! Sciences ?t!e militar$ medical sc!ool in
=et!esda, Mar$landA and students enrolled in t!e <ealt! -rofessions Sc!olars!i+
-rogram are o'ligated to use t!e Militar$ Matc!. :!e latter oe t!e militar$ one
$ear for eac! $ear of funding it! a toC$ear minimum o'ligation. A student
ma$ do t!is as +art of t!e residenc$, or after com+leting a ci#ilian residenc$, if
alloed to defer. <oe#er, an$one ma$ a++l$ for a militar$ residenc$. :!e ".S.
0
Arm$ residenc$ +rograms ?all s+ecialtiesA go t!roug! E%AS. :!e +rocess is
similar to t!e ,%M- in terms of %7Gs. <oe#er, re+resentati#es of t!e teac!ing
!os+itals make t!e selection rat!er t!an a com+uter. Also, matc! results are
distri'uted in Decem'er of t!e senior $ear. Students ma$ still oe t!e militar$
time s+onsored as a resident ?recei#es officer8s +a$, some 'enefits, and a salar$
'onusA u+on com+letion of t!e residenc$.
:!ere are +itfalls to t!e Militar$ Matc!. :!ere are generall$ man$ more
a++licants for militar$ residenc$ +ositions t!an a#aila'le slots. So, militar$
students ill ant to a++l$ for 'ot! militar$ and ci#ilian Matc!es. Also, ci#ilian
residences ma$ 'e unilling to take a student from t!e militar$ unless t!ere is
ritten commitment t!at t!e student ill not 'e +ulled for acti#e dut$.
EARLY MATCH: :!e Earl$ Matc! +rograms use t!e San &rancisco Matc!ing
ser#ice ?e'site( .sfmatc!.comA. :!e "rolog$ +rograms conduct t!eir on
matc! ?e'site( !tt+(22.auanet.orgA. :!e San &rancisco Matc! does not set
t!e deadline dates, t!e +rograms do. &or e*am+le(
EARLY MATCHOPHTHALMOLOGY (See .e0/(e %&' e6,!( ",(e)
J#+e: Acce+t reBuests for registration.
M,1-J#+e: -rogram director$ a#aila'le on line and students contact
+rograms for deadline dates.
S#**e': @at!er all a++lication materials and mail to t!e S&M. :arget date
is earl$ Se+tem'er.
E,'$1 N&2e*0e': Medical Student -erformance E#aluation is released.
De!e*0e': -rograms and a++licants su'mit %7Gs
E,'$1 J,+#,'1: All %7Gs must 'e in '$ ). noon -S:.
M/" J,+#,'1: -rograms and Dean of Student Acti#ities fa*ed Matc! results.
M/" J,+#,'1: A++licants !o do not kno t!e results ma$ call.
M/" J,+#,'1: %elease of #acancies.
EARLY MATCHUROLOGY (See .e0/(e %&' e6,!( ",(e)
S)'/+- -J,+#,'1: Information a#aila'le on line and registration is acce+ted
t!roug! mid Decem'er. A++lication #ia E%AS.
F,$$-J,+#,'1: Inter#ie it! +rograms.
De!e*0e'-e,'$1 J,+#,'1: A++licants and +rograms su'mit +reference lists.
E,'$1 J,+#,'1( Deadline for +reference lists.
E,'$1 (& */" J,+#,'1: Matc!ing +rocess +erformed.
M/" J,+#,'1: %esults fa*ed to Dean of Student Acti#ities.
IMPORTANT DATES IN THE NRMP APPLICATION PROCESS:
M,'!h-N&2e*0e': Students o'tain information from residenc$ +rograms.
1
M/"-J#$1( A++licants ill recei#e a token so t!e$ can register it! E%AS
and 'egin orking on a++lication materials. :!e ,%M- Director$ of
-rograms is +osted on t!e ,%M- e'site.
M/"-A#-#(( A++licants can 'egin registering for t!e ,%M-s Main Matc!CC
I19 fee.
Se)(e*0e' 78: Students ma$ 'egin sending a++lications to training
+rograms.
O!(&0e' 7( :!e Medical Student -erformance E#aluation ?Dean8s letterA is
released to +rograms.
De!e*0e' 7: :!is is t!e initial ,%M- deadline. After t!is date t!ere is an
additional I19 c!arge to register it! t!e ,%M-.
E,'$1 J,+#,'1 (& M/"-Fe0'#,'1: A++licants and +rograms enter t!eir
%ankC7rder Gists using t!e %/ S$stem on t!e ,%M- e'site.
J,+#,'1 97( -rograms must su'mit t!eir final +rogram information on t!e
num'er of +ositions a#aila'le.
M/"-Fe0'#,'1: :!e %/ S$stem closes.
M,'!h: Scram'le and Matc! results.
REFERENCES
A @uide to t!e -re+aration of t!e Medical Student -erformance E#aluation, Association
of American Medical Colleges, .99..
IsersonJs @etting Into A %esidenc$( A @uide for Medical Students, Kennet! V. Iserson,
M.D., @alen -ress, G:D, .99/.
:!e %esidenc$ Matc!( )9) =iggest Mistakes and <o to A#oid :!em, Samir -. Desai,
M.D., MD.= -ress, .99/.
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