In the 2022 match, the average number of residency applications grew to 68 for US MD students, 92 for DO students and 139 for international medical graduates
COVID-19 threw a monkey wrench in residency applications, and it doesn’t appear to be going away. Traditionally, medical students applied to residency programs through the ERAS (electronic residency application service) to the speciality or two of their choice. This has not changed. What has changed is the shear number of applications each medical student is submitting to residency programs. For the 2022 match, according to the AAMC, MD applicants submitted an average of 68 applications while DO applicants submitted 92, and international medical graduates submitted 139.
“The number of applications is crazy!” says an international MD applicant in this year’s match. “I expected the match to be competitive, but I didn’t realize it was going to be so difficult.” The consensus is similar across the board with many students saying that the cost of applications (even without travel), and the stress related to applying to a large number of programs, is unsustainable.
Residency program directors are also having a difficult time sorting through so many applicants. One program director, who wished to remain anonymous, says that “I have to screen 90% of applicants before I even open their application. If I don’t, I would do nothing expect review applications for 4 months of the year. It’s impossible.” An average program may receive 1,000+ applications for around 10 spots. With over 100 applicants per spot, it’s very difficult for residency program directors to not filter and screen applications.
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Why the increase in applications to residency?
There has been a rising number of applications to residency for nearly a decade, but the recent spike is unprecedented. Like many application processes, the match process has traditionally been expensive and laborious. However, the COVID-19 pandemic introduced a large fundamental change – the substantial decrease in need to travel to each residency program. During the 2021 match cycle, virtually all residency programs conducted interviews virtually. This continues in 2021, with a large portion of programs still interviewing candidates virtually. With the introduction of Zoom interview days, applicants are able to schedule more interviews, closer together, without the need for travel in between many different cities. This is a blessing for many applicants, who save thousands of dollars in travel cost. But it is also a curse, with increased competition for each program and little ability to accurately refine a residency list.
Which program has the most applicants?
According to the AAMC, candidates for orthopedic surgery in the 2022 cycle submitted an average of 88 applications. Other highly competitive fields such as interventional radiology, plastic surgery, urology, otolaryngology, and dermatology saw an average of 80+ applicants per student. That is a 10-15% increase from previous years. Even in less competitive fields, such as internal medicine, which typically doesn’t match all available residency spots, graduates applied to an average of 70+ programs.
What about USMLE Step going pass/fail? How will that change things?
The introduction of a Pass/Fail grading system for USMLE Step 1 will likely make the overall picture worse in the short run. That is because program directors will have relatively little to screen applicants by, meaning more applicants may try for programs around the country where they previously may have shied away from due to higher average board scores.
How many students are in the match for 2022?
Over 46,000 medical graduates have applied for the 2022 residency match so far: approximately 23,000 MDs, 8,000 DOs, and 15,000 international graduates.
What changes may come in future residency matches?
One proposed changed in front of the AAMC, who administers ERAS, is to limit the amount of programs each medical graduate can apply to. That may force students to selectively pick programs that are more in their target range, or acceptable to them overall. Many programs introduced supplemental ERAS applications this year in order to try to further select candidates. This trend may continue with more programs requiring supplemental applications and those applications being used as selection criteria.
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