First Steps



First Steps

Because most residency applicants now apply to programs which participate in the NRMP via an electronic residency application service (ERAS), many prospective applicants are unaware that they must still do their own research on specific programs. If you are currently attending a US medical school, make an appointment to meet with your clinical or residency advisor first to get help in identifying programs that match your career goals and strengths. If you are applying as an Independent Applicant, obtain access to the Graduate Medical Education Directory (also known as the Green Book) or the online FRIEDA database. Both of these are available through the American Medical Association and contain specific information about individual programs, listed by specialty and by location.

Many specialties organizations also maintain web based residency program listings and contact information. However, individual residency programs are free to set their own deadlines for accepting applications and for what they must receive before considering an application. Therefore, after you compile a list of programs you are interested in, contact the programs directly by either email or phone to obtain this program-specific information so you will know what they expect you to submit and when. Following is a list of web resources to use in researching programs:

Once you gather the necessary application materials and information from specific programs, it is wise to arrange program information by the application deadlines so that you won't miss out on applying because a particular program had an earlier than usual deadline or required a unique piece to complete your application packet. Before making choices about where to apply, you will need to spend time doing some serious research. This process may seem laborious (and it is), but it will be your competitive advantage. In our experience, the amount of work and effort you do early in this process will have a lot to do with your success in getting interviews and, ultimately, to being ranked highly and getting matched to a position. This research can be time consuming and even frustrating. But remember that if information about what programs to apply to were easily obtained, then everyone would have it, and you could not gain any special advantage through your own efforts. The research you do becomes your edge, putting you in the right place at the right time to get the job.

Start your research with the NRMP Match results books (www.aamc.org/nrmp). These books list programs that did not fill and which are therefore prime candidates for you to target. First, assemble a list of programs in the specialty of your choice that did not fill in one or more of the 3 previous years. List each program�s name, phone number, email address, and location, along with the program's Match results. Keep in mind that the better a program, the more likely it will fill its positions through the Match. Programs that offer competitive training, high fellowship acceptance rates, high specialty board exam passing rates, a strong and receptive leadership, and a balance between education and service tend to fill their positions year after year.

Some states have more graduate medical education positions than there are graduates from the medical schools in that state to fill them. This means that residencies in that state are used to recruiting residents from outside the state. Reviewing the same references listed above would identify the states and communities with large numbers of GME positions. These locations should be reviewed closely for the patterns of past Match fill rates. There are often opportunities there.

Another good way to identify likely programs is to ask friends, colleagues, and relatives to tell you of programs that they know of that will accept IMGs. Some of these programs may even offer contracts to IMGs before the Match. Don't be afraid to ask. You might be amazed at the information you can uncover just by asking. Be methodical. Make a list of all the people you know in medicine, both inside and outside the United States. Then, beside each name, indicate not only what they can do to help you, but also your sense of how likely they are to provide that help. With this list in front of you, start making contacts. By phone is best; by e-mail or letter if you must. Explain that you are in the process of seeking a residency position in the United States. Ask if they have any advice and whether they know anyone who might help you. If they seem uninterested, be gracious and move on to the next person on your list. Don't be pushy, but this is not a time to be shy, either.

Explore programs affiliated with community hospitals as well as those affiliated with universities. While it is true that obtaining fellowship training after residency may be more of a challenge if you train in a community program, it is better to secure training someplace and then work to strengthen your fellowship competitiveness later than to apply only to university programs and end up without a match at all. Many community based programs offer excellent training, particularly if you aren�t interested in sub-specializing, although they don't usually offer research opportunities. Depending on what you career goals are, a community based program may be just what the doctor ordered!

Smaller less well-known programs may also be more welcoming than large programs with national reputations. The latter receive huge volumes of applications and to cope with the volume, they impose high score standards or even refuse to consider IMG applicants at all. Smaller programs in a sense are hungrier and, with fewer applicants to consider, they are often willing to look at applications as a whole and view more experienced and mature IMG applicants as a real bargain.

If you speak certain languages, this might also be an asset that certain programs are looking for. Search for programs that are likely serve patient populations that speak the language you speak. Not having to find translators every time a patient shows up streamlines the clinical work flow, so finding residents who can speak Spanish, for example, is a priority for many programs.

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