The Residency Application

Oh the joy of applying to Residency…a lovely process encapsulating your hard work during med school into a cookie-cutter application that will receive a quick glance from admissions committees. Outrageous fun. Let’s begin.

Similar to medical school applications during undergrad, applying to Residency mostly occurs during the summer between your 3rd and 4th year of med school. Although the application (run through a service called ERAS, the Electronic Residency Application Service) cannot be submitted till mid-September of your 4th year, everyone starts gathering the necessary documents around May, when ERAS opens.

Basic timeline for the application season:

• ERAS opens May

• ERAS submitted mid-September

• Interviews from October through February (varies by specialty)

• Rank Order Lists for the Match submitted end of February (elaboration below)

• The Match – 3rd week of March

ERAS allows you to complete one standardized application to submit to whichever Residency programs you choose, rather than completing separate applications for each program (if that was the case, I’d curl into fetal position and cry). It consists of standard demographic information, relevant Experiences (work, volunteer, research activities), honors and awards, memberships in professional societies, your transcript (uploaded directly by your medical school), letters of recommendation (uploaded directly by your LOR writers), your personal statement, and of course – a professional photograph.

As I alluded to above, it’s imperative to get a head start on the process. I personally think the best way to do this is to START WITH THE LORs. I’ll explain why: you want to give your writers adequate time to compose some serious praise on your behalf. For that to become reality, you must supply them with the right information early on (like I said above: your CV, Step score, and Personal Statement). By doing this, your CV will be complete early and you’ll have a solid draft of your Personal Statement. I asked my LOR writers towards the end of May, supplying them with that info. Naturally, I modified my CV and Personal Statement countless times between that and when I submitted my application in mid-September. But this way my writers had something to go off of, and I also had an early foundation to build upon.

Before diving in, I think it’s very important to keep this in mind when filling out the application: WRITE EVERY SINGLE WORD AS IF IT WILL BE SCRUTINIZED. Realistically, most admissions committees will only quickly rifle through your application (they simply don’t have time to thoroughly evaluate near a thousand apps). But you also never know what part will catch someone’s eye. This is the most important application of your life. Don’t cut corners and be lazy. Write descriptively but be concise. Double and triple check for spelling errors. Have other people review and critique your application. I asked my friends (both in and out of med school), family, and mentors to go over my application tons of times. Outside perspective lends great advice.

The ERAS application is fairly intuitive and the AAMC website has helpful tips and descriptions of each section. The three parts that I’ll expand on are:

1. EXPERIENCES SECTION 

2. PUBLICATIONS SECTION

3. PERSONAL STATEMENT.

The Experiences Section of ERAS is structured similar to the medical school applications you’ve already done. You give each experience a title, select the category (work, research, volunteer), state your role, the dates of involvement, hours per week, and then use a limited-character text box to describe it. You can also provide reasoning for leaving/terminating said experience if you think it’s applicable. There are three questions to ask in this section:

1. How many total experiences should I include?

2. What types of experiences are relevant to my Residency application?

3. How should I describe each experience?

Let’s tackle these in turn.

There’s no upper or lower limit to the number of experiences. You shouldn't feel the need to hit any magic number. Personally, I put 12 total experiences on my app: three work, five volunteer, and four research. What you don’t want to do is leave any category blank (for example, having nothing to list in the “research” section). The vast majority of applicants will have something for each section, so you should as well. But don’t add nonsense. Which leads us to the second question…

Each experience listed should convey something noteworthy about what you did during medical school, or depict something unique about you and your personality/interests. No fluff stuff serving as filler. As a personal anecdote, I played intramural Dodgeball at Baylor but didn’t include it on my app. Although fun, it simply added nothing to enhance my appeal as an applicant to Orthopaedic Surgery. However, if I was the student body Chair for Intramural Sports, helped organize multiple tournaments, arranged prizes, etc., then I would included it because it clearly demonstrates my interest in leisure sports and ability as an organizer.

The last item is how to describe the activities you’re including. This is very important. You want to give a succinct description of what the activity was (some things will simply not be intuitive from the title). Then you need to describe exactly WHAT YOUR ROLE WAS and WHAT YOU LEARNED FROM IT – why did it matter to you? If you did anatomy tutoring, don’t just say that you were a tutor. Everyone on the admissions committee of course knows what anatomy tutoring entails. So give them more. Why did you do it? Why did it matter? How much involvement did you actually have? I was an anatomy tutor, and here’s how I worded it (category – work experience):

Tutoring program organized by Baylor College of Medicine where select 2nd year medical students teach supplementary anatomy lessons to 1st year students throughout the duration of the anatomy curriculum. Responsibilities included: leading cadaveric dissections, displaying and labeling pro-sections, teaching anatomical relationships, and creating and distributing helpful worksheets and online learning tools. I found this to be a very rewarding experience because it allowed me to teach directly relevant material that many students find difficult, and it also forced me to study anatomy again and refine my own knowledge.

Another question that comes up is whether or not to include political/religious activities, as these can be polarizing topics. While at Baylor College of Medicine, I founded the Muslim Medical Association for the purposes of creating networking opportunities among Muslim healthcare professionals, increasing general awareness of Islam, and participating in volunteer and community activities. I was initially unsure whether or not to include it on my application, precisely because it may be polarizing for people who are ignorant or flat out racist/bigoted. However, I realized that it was something I was proud of and truly believed to be important. And if someone doesn’t offer me an interview because I am a Muslim…then I’m better off not going to that program. If you are contemplating potentially including something similar, talk to your Deans and mentors about it for advice (that’s what I did). But ultimately, don’t compromise on your integrity and ethics. This is how I worded it (category – volunteer experience):

Started this campus organization at Baylor College of Medicine with the goal of participating in community service and increasing awareness and understanding of Islam. Since our formation we have participated in vaccine drives, run information booths at health fairs, arranged interfaith dialogues, organized banquet dinners with over 100 guests ranging from medical students, residents, faculty and professors, and local community members of all different faiths. We live in a diverse community, and I believe spreading knowledge and information is vital to establishing mutual understanding and respect for all people, something that can help us in our professions and in our daily lives.

The last category is research experiences. Keep in mind that this is TOTALLY SEPARATE from the “Publications Section” (which includes works that are already published, submitted, in process, abstracts, posters, oral presentations, etc.). You can mention your publications or presentations in the description for the research category, but the purpose of this is different. You want to show why you chose certain areas for your research, how you got involved, what precise roles and responsibilities you assumed. If you wrote and were awarded a grant, mention it because that’s something not many students have successfully done. Same thing if you received a research scholarship, summer research fellowship, wrote an IRB, etc. These are uncommon and impressive, and definitely merit mention. One research experience I included was a joint project that I led between the Center for Space Medicine and Department of Orthopaedic Surgery at Baylor. We used a novel device to create non-thermal plasma from argon gas and assess whether it could direct mesenchymal stem cell differentiation towards the osteoblastic lineage. Here’s how I described it (category – research experience):

Research project assessing ability of cold atmospheric argon plasma to convert human mesenchymal stem cells into osteoblasts. I approached professors in departments of Space Medicine (Dr XXXX) and Orthopaedic Surgery (Dr XXXX) with the project idea, drafted a grant proposal, and was awarded a research grant through the Center for Space Medicine. I recruited 3 other medical students and 2 post-doctoral fellows to assist with laboratory work and experimental design, which entailed exposing stem cells to argon plasma and several controls over 4 weeks and running serial assays to assess for osteoblastic conversion. Currently, we are in the process of analyzing our results in order to submit the manuscript.

Now let’s talk about the Publications Section.

Like I mentioned previously, this section includes anything that has been published, presented, accepted, or even submitted. The section has drop-down menus for filling in all the categories such as Manuscript Title, Journal or Conference Name, Location, Date, Authors, and Status (published, accepted, submitted, etc). Include absolutely everything you’ve done (it’s a numbers game…number, numbers, numbers!). Papers in peer-reviewed journals, abstracts, posters, oral presentations at conferences, book chapters, and even non-peer reviewed publications (such as an article you wrote for Huffington Post’s Blog). You can also include things from college. I did one research project in college. I traveled to Costa Rica and studied leaf-cutter ants, and presented a poster at TCU’s annual symposium. And you better believe that I included it.

I had a far above-average number of items in the Publications section (close to 20). As I’ve stated above, this in no way implies 20 different projects. Yeah right. You simply have to maximize every project you do by not only vying for publications but also getting as many presentations and abstracts as possible. Submit abstracts to all the conferences in your area. Some Residency programs place a far greater emphasis on research than others, so give yourself the best chance by getting involved in things that interest you (and don’t forget to set expectations, like I described in the Big Four section).

Lastly, the Personal Statement (PS).

There is no definitive prompt or style for this. You simply write a narrative detailing why you want to do XYZ specialty. The most common style that students opt for is opening with a vivid patient experience showing why they want to do XYZ. Then they further describe what they like about the field, why they’d be a good fit, the type of program they’re looking for, and where they see their future in the field. This is the most common format because it addresses all the main points you need to convey. Here are the five main areas to hit in your PS:

1. DO NOT exceed 1 page (no one wants to read a novel)

2. Why did you choose this specialty?

3. What characteristics make you a good candidate for this specialty?

4. What type of Residency program (aka what training style) do you want?

5. What is your future in the field (aka what will you contribute to the field)?

Rather than verbosely explicating each point, here’s the direct transcript of my PS:

Beaming smile. Colorful clothing. Constant giggling. The young girl standing before me barely resembled the solemn patient with scoliosis I evaluated before surgery. I was shocked. The mechanical corrections we made to her anatomy and posture had actually transformed her into a more confident, vibrant version of herself. I couldn’t believe how remarkable a change our direct hands-on work had on this little girl. As an Orthopedic Surgeon I will bring this same satisfaction and joy into my patients’ lives by combining surgical skill, love of patient care, and a desire to learn and improve constantly.

While working with Dr. [redacted] and Dr. [redacted], I was immediately captivated by Orthopedics. I lost track of time and work became fun when I used my hands to gauge range of motion, apply casts, and reduce fractures. Even after a long night of ER trauma consults, coming in the next morning to operate on anatomy that can be seen, felt, and manipulated in three-dimensional space was fantastic. From seeing kids with cerebral palsy in clinic to operating on older patients with degenerative disease, I loved the patient diversity in Orthopedics. The evolving technology of improved arthroplasty implants and 3D printed models for periacetabular osteotomies will benefit my patients and ensure constant growth throughout my career.

On a personal level, Orthopedics allows me to do something I cherish: empower others through teaching. Leading after-school science classes for 5th graders, mentoring undergrads eager for med school acceptance, tutoring anatomy to first year med students, educating patients on proper care for a sprained ankle – teaching not only inspires others but also solidifies my own knowledge. I am excited to continue this as an Orthopedic Surgeon, educating medical students, residents, and my patients.

In addition to edifying others, I have always endeavored to improve myself. I savor the pursuit of mastery of a physical skill, and I trained in martial arts since I was eleven. From hurling kicks in Tae Kwon Do to manipulating joints in wrestling and Brazilian Jiu Jitsu, I learned from every situation and opponent, making adjustments to hone my skills and better myself. Additionally, my childhood fascination with outer space drew me to enroll in Baylor’s Space Medicine Track, exposing me to the many physiologic changes in microgravity impacting spaceflight and astronaut health. Being a proficient Orthopedic Surgeon will always be my primary goal; but I hope to continue my research on multi-function devices such as the cold argon plasma torch that have medical applications for wound and fracture healing on earth and in resource-limited realms such as space. I will employ this tenacity for learning to master musculoskeletal anatomy and body mechanics throughout my career as an Orthopedic Surgeon.

I want to see the smile of my young patient with scoliosis mirrored brilliantly on the faces of all my patients. To do this I seek a residency program that emphasizes hands-on operative experience, pushing me to my limits as a surgeon. I have never shied away from hard work or long hours to get the job done; I hope to do this in a collegial environment where I take pleasure in the work itself and genuinely enjoy the camaraderie of my colleagues. I plan to subspecialize, and I seek a program that will guide me as a surgeon and educator who delivers the best possible care to my patients.

My PS is far from being inducted into any literary Hall of Fame. But it’s very direct. I hit on all the main points while including unique activities and personality traits about myself, as they relate to becoming an Orthopaedic Surgeon. I open with a patient experience that drew me to Orthopaedics, and then further elaborate on what I enjoy about the field. A good test I used for this was to switch every mention of “Orthopaedic Surgery” in my PS with another field, such as “Urology”. If the PS still made sense and applied to Urology as well…then it was too general and I needed to be more specific to Ortho. One of my good friends gave me this piece of advice and it helped immensely to focus my writing.

Moving to the next point, I use concrete examples to illustrate my love of teaching, self-betterment and perseverance, and commitment to research and advancing science in my career. Finally, I make clear that I’m seeking a program where I get a lot of operative time and work hard while having fun. This is especially important for Orthopaedics, as there are two broad and different categories of programs across the country. Generally, there is a distinction in most specialties between workhorse, high volume programs (“blue collar”) and lower volume, academic research powerhouses (“white collar”). There are merits and negatives to both. You just have to decide what’s right for you (more on this below).

A common question that arises is whether you should write several versions of your PS, each geared towards particular types of programs and/or regions (in ERAS you can upload multiple PSs and select which ones go to which programs). For example, you may write one version talking about how you love hard work and high volume environments because you learn best by “actively doing” rather than “didactics and reading”. Simultaneously, you write another version stating that you value academic support from the program to pursue your vast research interests because you want to practice in a large academic center. These two versions are in relative contention with one another. Is that somewhat disingenuous? Debatable.

Your goal at this point is to Match into Residency. Period. Thus, you need as many interview offers as possible. If you believe that writing multiple tailored PS versions will help you do that, by all means go for it. You have to do what’s best for you. And since many other students will do this anyways, don’t hesitate if you think it’ll help. Personally, I did not do this. I wrote only one version of my PS, which you’ve read above. Although my PS directly conveyed my desire for a more “blue collar” program, I also discussed my interest in research (and had a lot of it in my application). I believed that my application demonstrated that I’d be a strong candidate in both program types.

Last note on your PS: PROOFREAD the hell out of it. I wrote close to ten drafts before finalizing. I asked many people to proofread it (med school friends, faculty mentors, family and friends outside of medicine). I requested all my proofreaders to be brutally honest and tear my PS apart. No punches pulled (I wanted my self-esteem to hit a new low after their critiques haha). I ultimately asked them to answer three questions upon reading it:

1. Does the PS clearly convey why I want to be an Orthopaedic Surgeon?

2. Does the PS show rather than tell my unique characteristics?

3. Would you want to interview this person?

I received great advice from everyone who proofread my PS. I highly recommend that you ask people from diverse backgrounds. If you solely rely on yourself or med school people, you’re doing yourself a disservice. When you’re so honed in on something you can lose perspective about the “big picture”. Trust the people that know and love you.

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