If You're an IMG, Make Sure to Review this Page

If you're an international medical graduate (IMG) applying for residency this year, I'd recommend you take a look at the Educational Commission for Foreign Medical Graduates® (ECFMG) ERAS Support for Residency main page. There, you can find eligibility requirements, an overview of the IMG application process, a timeline, and details regarding which documents ECFMG ERAS Support Services will upload for candidates and what your obligation is regarding those documents.

There's also technical guidance for your letter of recommendation writers, so you can direct them to online instructions through the Support for Residency main page.

Check out the NRMP Program Directory for Main Residency Match Applicants

The NRMP® recently launched a directory of residency programs that showcases over 6000 Match-participating PGY-1 and PGY-2 programs. It's a searchable database that includes locations, program type, and NRMP program codes.

I fiddled with the directory a bit, and I found it most helpful in 1) narrowing down programs by specialty and geography and 2) providing residency director names and program website links.

The NRMP says it will continue to update the database so it remains current.

"Optional" Secondary Essays: Are They Really?

I've recently received several questions about optional secondary essays. How to approach these depends on two things – the prompt itself and your candidacy.

The beauty of a generic "additional comments" section is that it is intentionally vague. It's your chance to provide details, context, or qualifications that the structure of the application didn't allow you to present. 

For that reason, if you have a candidacy without any red flags, I lean toward using the "additional comments" space to both highlight who you are and any exceptional aspects of your candidacy that you'd want a reader to know before making an interview decision. One good option in this circumstance is to pick something completely nonmedical that distinguishes you and is nowhere else to be found in your application. Since an interview isn't guaranteed, don't save your best material for an in-person meeting. (On the other hand, if you have a large weakness in your candidacy, you usually want to use an optional, generic prompt or a more focused one to gingerly address the issue. See the next paragraph for guidance.)

Sometimes an optional essay is more pointed. An applicant recently forwarded me this prompt: Please describe any extenuating circumstances that may have affected your medical or non-medical service experiences, including any circumstances that impacted your engagement in activities, academics, and MCAT that would have helped to prepare you for medical school. If you have no major deficiencies in your candidacy, there's no need to write this essay. On the other hand, you should draft a response to this prompt if there's a big elephant in the room. While, in general, I tell applicants to avoid highlighting standard weaknesses, sometimes someone has a big problem that's important to address head on. It's better that you write your own story than let someone else do it.

Bottom line: Optional essays are frequently worth completing because this process is so competitive. And, if you have a big weakness, you should leverage an optional prompt to explain extenuating circumstances. 

Secondary Essays: The Diversity Prompt

In considering your strategy and content for the medical school secondary diversity prompt, I’d recommend you ask yourself the following question:

What ethnic, religious, racial, gender, language, socioeconomic, or sexual orientation aspects of me, my family, or my experience make me distinctive?

Please note that experience is part of the question I have posed. An applicant I mentored a few years back wrote to me concerned that she did not fit into a minority category and thus, could not answer the prompt effectively. I suggested she consider an experience that targeted the prompt’s theme, and she wrote a strong essay about her successful efforts to increase diversity during sorority rush, which she spearheaded. When I applied to medical school, I crafted one of my secondary essays on my experience hearing Spike Lee speak on my college campus. Don’t be afraid to think outside the box.

If you haven't already, check out my Doximity piece on shortcomings of the medical school admissions process, especially the secondary applications (a moneymaker for institutions).

15 ERAS Tips to Boost your Residency Candidacy

Over the years, I've cultivated many tips for crafting the best ERAS Experience Section. I've included 15 important ones below:

1. Include relevant pre-professional accomplishments from college. If you conducted research, for example, list and describe it. Do not include high school achievements unless they were truly unique (worked at the White House, sang on Broadway, published in Nature ;)).

2. As of last year, you have only 10 slots, so avoid minor activities (like an afternoon health fair). 

3. Write in a streamlined fashion. Avoid verbiage. Of note, as of last year, you can choose three most meaningful activities, but you only have 300 characters for each. So while you want to explain why the activity was impactful, you'll need to keep your writing here especially tight.

4. Use full sentences. It’s a formal application, and you want to make your written materials as readable as possible.

5. Avoid most abbreviations. Ones you think are common might not be familiar to the reader.

6. Avoid contractions; they are too informal for an ERAS. 

7. Make sure you spell out your accomplishments clearly. If your reader doesn’t understand an activity, you won't get “full credit” for what you’ve done. Make no assumptions - not even that the reader has reviewed the experience's introductory information (position title, location). 

8. Write about yourself and your role – not an organization. For example, don’t use the space to discuss Physicians without Borders. Use it to discuss the specifics of your role at Physicians without Borders.

9. Use numbers to be persuasive. Saying that the conference you organized had 500 participants says a lot.

10. Unless your PI won the Nobel, avoid using supervisors' and/or doctors' names in your descriptors as they will be meaningless to the majority of your readers.

11. Do your best not to leave the "Medical School Awards" section blank. Even if you have to simply include clerkships in which you obtained honors (or high honors), fill that section out.

12. If you have not already, consider joining your specialty's national organization and listing it under the "Membership in Honorary/Professional Societies" section. If you are applying in two fields, take this advice, though. 

13. Try to end your entries with a sentence about how the experience you just described will help you as a future specialist. Making that connection for the reader furthers your candidacy. 

14. As with all good writing, avoid redundant language. Having the word "research" three times in two lines is distracting and demonstrates a lack of originality. 

15. Get help. Don't submit your residency application without having it reviewed by someone with a lot of experience. (I started Insider Medical Admissions in 2007.) You do not want to put forward suboptimal materials for a process that is this important and competitive.

(Please note that there are a few changes to this year's ERAS. For more information, see this AAMC page.)