FAQs
Do I need services of an agency to make it to a program?
No, absolutely not. If you have good credentials and plan well in advance, you can make it on your own.
How important is Step I score?
Step I should be considered the most important component of the requirements because this is what gets your foot into the door of the interview process.
How important is Step II score?
A good Step I score helps you to cross the initial barrier but a good Step II score is needed if you want to get interviewed in the specialty and the program you are interested in. Surgical specialties may need higher scores. Most programs do mention the average score they look at. In some programs in high demand the cut off score may be high. A good step II score is very desirable.
How important is Step III score?
Step III is not needed at the application stage. You can take Step III even during residency. You should pass Step III before you complete your residency program. So the choice of when to take Step III is yours.
Does a US Observership guarantee LOR?
No, the Observership only provides a certificate of participation. LOR depends on the faculty with whom you rotate.
Many programs are asking for US clinical experience in the requirements.
In the current pandemic situation there may be some virtual training/ clinical experiences available.
What is ERAS?
ERAS (Electronic Residency Application Services, supported by American Association of Medical Colleges) is a single point application from where your application is forwarded to all the residency programs you wish to apply. Thus, you don’t need to apply to all programs individually. The charges will depend on the number of programs to which you want your application to be forwarded.
Though most residency programs participate in ERAS, some programs ask for application to be sent to them directly. You need to check these also.
What is NRMP?
NRMP (National Residency Matching Program) is an electronic matching system which matches the candidate’s preference of program with the program’s merit list of candidates and makes a match.
There are a few residency programs in the US that do not participate in the NRMP match. You need to search for these and apply separately.
What is ACGME?
ACGME is a nonprofit private body that evaluates and certifies the quality of a program. Almost all of the residency programs are accredited by ACGME. There will however be some good programs which may not go for ACGME accreditation.
How does the MATCH work?
How does the match work? Let us say there are 5 programs A, B, C, D, and E all having 3 residency spots, that makes a total of 15 spots. Based on an arbitrary 1:10 ratio, 150 students should have been interviewed but the actual number may be 110 because some were interviewed at more than one place. The candidates have expressed their preferences of programs (they can choose all programs or limit their interest) and the programs have listed their choice of candidates, say 20 each for the 3 spots. NRMP considers FIRST the candidate’s preference. Candidate 1 expressed interest in program C (their choice for soot 2), so both appear on both lists so they are matched and candidate 1 and spot2 of program C are removed from the match leaving 109 candidates and 14 spots to match. Candidate 2 has opted for program A,B, C and E but did not opt for program D. However, the programs he opted for did not shortlist him. Program D however shortlisted him but he did not opt for program D. So in spite of very high USMLE scores candidates 2 will not match anywhere. Program D, unlike other programs interviewed only 15(1:5) and out of them only 8 expressed interest and of those 8, 6 matched at other programs.
Is it recommended to do electives, fellowships or observerships for getting residency in US?
Let us take it in the sequence
Electives are done during the med school and mostly by US students apart from their parent institute also in other med schools as visiting student to widen the exposure or to do elective in a choice subject. International students are also offered 4 to 12 week electives based on their dean’s recommendation[performance based] and good grades. These could be hands-on . From the cost perspective these may be pretty expensive for an non-us med student/outsider. Between the 3 options you asked we would rate electives very high.
Observerships are for international graduates who should have already taken USMLE steps as well as English language proficiency. As the nomenclature goes these are not hands-on training. Again there could be some cost involved and your chances of LOR are unpredictable. However these are considered as American experience are therefore desirable though not mandatory. As of now because of the pandemic scenario they are not being offered. Some programs however are offering virtual observerships again could be free or paid. Since in -person observerships are not being offered this might be the only option. The scene might change if the pandemic scenario improves.
We can look at the Fellowship scenario in two perspectives. First is the post residency sub-specialty fellowship. I presume you are not referring to this fellowship. The second scenario is if someone has not matched into a residency. While waiting for the next match cycle one could do a fellowship to improve the clinical experience, contacts and hopefully generate a good LOR. Also the program where you do the fellowship will get to know you better. These fellowships could be either research or 12 month training offered by some programs. You can consider this option to strengthen your application.
