Leaders in medical education are continually striving towards optimizing the residency application & match processes. As we are in the midst of preparing for the 2024 residency application and match processes, there are changes that have been put in place for this cycle that are worth noting.
*Please note, the following may seem like quite a bit of information, and it is. If you have any questions or would like to discuss your individual planning step-by-step as an MSI-MS3 medical student or MS4 residency applicant, please don't hesitate to reach out.
**Also, a gentle reminder to do something joyful or relaxing every day: remember that every moment is a part of your life and that you are not your career, you are so much more.
On January 26, 2022, the USMLE Step 1 changed from a 3-digit numerical score to Pass-Fail scoring. The COMLEX Level 1 soon followed step by also making the change to P-F. These pivotal transitions occurred during a time and residency match environment with rising numbers of medical student applications for individual residency positions and uncertainty regarding the best way to reconcile medical student accomplishments, strengths, and interests with those of residency programs to ensure the best fit for both. Ideally, achieving the goal of establishing a "win-win" for both applicants and programs.
Fast forward to July 26, 2023 (today). All stakeholders within the medical education continuum ranging from medical education leaders, individual specialty and subspecialty organizations, residency program directors, and medical trainees have been in continuing conversations regarding the best steps in moving forward. With an emphasis on trainee and stakeholder wellness, diversity, equity, fairness, and ease of process(es), it seems to be no easy task but one worth working toward. Having the opportunity to collaborate within one of AAMC's Next Step 1 workgroups, and more specifically focusing on medical student wellness, it has been inspiring to see the care and thought that propels those involved to make residency matching the best it can be for everyone involved.
As Class of 2024 medical students actively continue pursuing steps towards matching this upcoming year, there are several changes from 2023 that are important to note. They are as follows:
First, ERAS has modified its application by eliminating the pilot Supplemental Application (2022 & 2023) and instead incorporating aspects of the previous Supplemental Application into the ERAS application itself. Hence, students are tasked with indicating any impactful experiences (if applicable), their geographic & demographic residency program preferences (or lack thereof), their individual program preferences through program signaling, and a maximum of ten experiences with three that are most meaningful to them. The AAMC has also recently joined in a collaboration with Thalamus wherein a transition will occur beginning this year involving the interview platform and addressing AAMC's data and technology needs.
Next, different specialties have continued to evolve in their requests for specifics from applicants. For example, similar to emergency medicine, other specialties now request that students submit standardized or summary letters of evaluation rather than only letters of recommendation. Additionally, individual specialties have individual requirements regarding expectations from residency applicants (e.g. number of signals, research expectations, examinations for osteopathic medical students, interviews [e.g. release dates}, second looks). Of note, post-COVID, virtual interviews now continue to be the norm, providing some ease to both applicants and programs in scheduling, cost, and planning,
Finally, the change of USMLE Step 1 and COMLEX Level 1 to Pass-Fail scoring has led to new considerations for both applicants and residency programs. With a greater emphasis on Level 2CE/Step 2CK, students benefit from garnering strong scores that are available prior to the ERAS release date of applications to programs on September 27, 2023. Additionally, not having scores early on may lead to uncertainty for applicants who are determining their competitiveness for specialties and/or programs that weigh exam scores highly and as screening criteria. Applicants are also determining how best to "stand out" and show their fit for residency programs. As such, there is a continuing, if not greater stress placed upon students as they strategize how to optimize their application with experiences that fit their specialty, determine whether they need to apply to a "parallel" specialty, identify their geographic/demographic preferences, and finally specifically signal programs of interest.
Of note, while aspects of the residency application process have changed, the NRMP residency match process seems to have stayed essentially the same with the 2024 cycle. The NRMP match calendar parallels that of the prior year and the SOAP schedule still notifies applicants of their match status on Monday followed by the SOAP beginning on the same day. Also, as with the 2023 cycle, there are 4 SOAP rounds, allowing the opportunity for more students to successfully SOAP compared to the 3 rounds in prior years. Of note, it is important for applicants to remember that the match works in the favor of applicants but the SOAP works in favor of programs; hence avoiding any reliance upon SOAP is preferred.
In summary, there are many areas of the process that Class of 2024 residency applicants should be cognizant of as they are preparing to submit their applications and interview for residency. The culmination of years of schooling (e.g. undergraduate studies, gap years, alternate careers, four years of medical school) is tied into the upcoming months. The challenge for students is knowing how to best present themselves as the remarkable individuals that they are and the excellent physicians they will be. Through the years, I have found that medical students are better equipped and more accomplished than they realize.
To the Medical School Classes of 2024, you are almost at the finish line! The next steps include:
1. creating an ERAS application & personal statement that best reflects who you are and what you desire
2. selecting the specialty(ies) and programs that you feel will serve you the best in achieving your future goals
3. preparing to share the essence of who you are professionally in your interviews
4. ranking programs in the order of your true preference
5. completing the remainder of your medical school rotations with a focus on learning all that you can :)
To all those who are dedicated to optimizing medical education including those within Change MedEd {AMA}, AAMC, AACOM, and other involved organizations, thank you for all you do. Future generations of medical trainees will benefit from the innovations that are being considered.
Change is inevitable. Change is exciting. Enjoy this time...it is fleeting but so memorable. I can't wait to see what lies ahead in medical education and am optimistic about the future.
Wishing the Class of 2024 wellness, hope, peace, and success, always,
Take good care,
Sincerely,
Dr. Vora
Rupal S. Vora, M.D., MPH, FACP
MedStudentCoach LLC Founder
Associate Clinical Professor, Internal Medicine, Creighton University School of Medicine
(Assistant Dean Student Achievement ATSU-SOMA 2013-2022)
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