Your Guide to the ERAS Application

MSPE or “Dean’s Letter”

The Medical Student Performance Evaluation (MSPE), or the Dean’s Letter, is not a letter of recommendation. It’s a summary of your time in medical school. Your Dean’s Office is responsible for preparing your MSPE and uploading it into ERAS.

However, you will likely have to submit a CV and info form to your Dean’s Office to help them prepare your MSPE. Be on the lookout for MSPE-related instructions from your school in the spring of your fourth year.

To provide a broader view of your medical school performance, the MSPE includes the following information about you:

• Three noteworthy characteristics (these are chosen by you).
• Academic history, including info about your matriculation and graduation dates, any leaves of absence, any dual degree programs, any course remediations, and any adverse actions taken against you.
• Academic progress, which includes grades and performance summaries from courses and clerkships.
• A general summary of your med school performance and readiness for residency.

Transcript

Your Dean’s Office is responsible for uploading your med school transcript when it is available. It should be done without you having to manually upload anything.

By the time you’re filling out your residency application, there’s not much you can do about your transcripts. However, if you’re reading this early, remember that your grades and clerkship scores are a major part of how residency programs evaluate your eligibility.

Program Signals

Program signals (AKA preference signals) allow you to show interest in specific residency programs as you’re filling out the ERAS. By signaling a program, you can increase your chances of landing an interview or gaining admission.

Signals are received at the institutional level by specialty. This means you cannot signal a specific program track while excluding other program tracks in the same specialty at the same institution.

It’s important to keep in mind that programs only see that you signaled them; they don’t see where else you sent signals or where you didn’t. 

For some specialties, a tiered-signaling system is used. Rather than the standard program signal (just “yes”), tiered program signals give you the option to choose between “Gold” (“most preferred”) and “Silver” (“preferred”). 

The number of signals you can send to programs depends on the specialty or number of specialties you are applying to. Here’s a list of how many signals you can send to programs in the 2025 ERAS application cycle. (It includes the number of Gold and Silver signals you can send, too.) 

Should You Use Program Signals?

Recent data shows program signals not only matter but also help increase the chances of getting an interview and being selected. In recent cycles:

• Over 90% of program directors (PDs) considered program signals during application reviews, with two-thirds stating signals were “important” or “very important” in residency selection. 
• More than two-thirds of residency directors said they interpreted Gold signals as more valuable than Silver in the 2023-2024 cycle. (In other words, Gold signals often lead to higher interview rates than Silver.)
• PDs have recently ranked program signals among the top five most important application components. 
• More than one in four PDs said they use signaling between two candidates with equal competitiveness in tiebreaker situations.
• Not signaling a program often means you have much lower odds of landing an interview.

“Interview invitation rates are higher for applicants who signaled… Interview invitation rates are higher for applicants who sent a Gold than a Silver signal… Interview invitation rates for applicants who did not signal are near zero.” – AAMC, 2025 ERAS Analysis

Ultimately, program signals are now among the most powerful tools for applicants during ERAS. It’s in your best interest to use each signal available to you strategically and to prioritize the programs you’re serious about. 

ECFMG Status Report (For IMGs Only)

The Educational Commission for Foreign Medical Graduates (ECFMG) needs to include a Status Report for international medical graduates (IMGs) to apply for residency in the U.S. The ECFMG should automatically upload the report to ERAS.

This report confirms an applicant’s ECFMG certification status and includes details about their exams and international medical school education. In addition to establishing that your medical education qualifies you for a U.S. residency, the status report is also used to confirm your English proficiency (tailored specifically for physician communication).

The ECFMG report does not include USMLE scores from NBME/FSMB, though it does include confirmation that you have passed Step 1 and Step 2 CK.

A Photograph (Optional)

An optional headshot can be uploaded to ERAS. It is recommended that you include a professional photo of yourself smiling to help make your application more memorable and humanize it with a real person’s face.

The photo file must meet the following requirements:

• File type: JPEG/JPG or PNG
• Maximum dimensions: 2.5 in x 3.5 in
• Maximum resolution: 150 dpi
• Maximum file size: 150 KB

Pro tip: Use CloudConvert to compress your image file if it’s too large. 150 KB doesn’t give you much room to work with. It’s fast and free; you don’t have to sign up.

International medical graduates (IMGs) cannot upload their own photos. The Educational Commission for Foreign Medical Graduates (ECFMG) is responsible for uploading the IMG’s photo into the ERAS system.

USMLE or COMLEX-USA Transcripts

Once you take a licensure test (USMLE for MD, COMLEX for DO) and scores are released, Step/Level scores are automatically available through the ERAS system.

However, you do have to authorize the release of your USMLE and/or COMLEX transcript and assign it to your designated programs on the “Additional Documents” page. This ensures that the programs you apply to receive your scores.

Your COMLEX Level 2 or USMLE Step 2 scores tell residency directors your likelihood of passing Level 3 or Step 3 exams and any specialty-specific board exams.

Step 1 is now pass/fail, which means that Step 2 CK is the only numerical score that residencies can use to evaluate your application (for MD grads).

Note that the Step 2 CS (Clinical Skills) test was permanently discontinued in 2021.

Curriculum Vitae (CV)

Your residency application auto-populates into a readable format on the CV section. This format is likely how residency programs will read your application, so review it to ensure everything that auto-populates comes across how you wanted it to.

Timeline and Important Dates

Here are the most important dates for the residency ERAS timeline:

• June 4, 2025 — 2026 ERAS season begins at 9 a.m. ET.
• September 3, 2025 — Residency applicants may begin submitting ERAS applications to programs.
• September 24, 2025 — Residency programs may begin reviewing ERAS applications and Medical Student Performance Evaluation (MSPE).
• October 2025-January 2026 — Interview season is in full swing.
• May 31, 2026 — 2026 ERAS season ends at 5 p.m. ET.

Read for More In-Depth Information: ERAS Residency Application Timeline

After Submitting Your Application

It is your responsibility to ensure residency programs are correctly listed on your ERAS application. You need to authorize each program to receive your application, test scores, and more.

Stay up to date with your MyERAS Message Center. Program directors may contact you via the ERAS program, email, phone, or snail mail. Keep track of interview invites with a detailed spreadsheet.

Read Next: What’s the Average Number of Residency Applications I Should Send?

ERAS vs. NRMP

ERAS is the AAMC-run service you use to apply to residencies. The National Resident Matching Program (NRMP) runs the algorithm to match applicants (who have interviewed) with their preferred residency programs.

You typically apply to residencies through ERAS at the end of your third year of med school. 

You rank programs through NRMP. You list residencies (where you interviewed) in order of how much you want to accept a residency position there. Residencies also send their ranking of interviewed students to NRMP. The NRMP uses an algorithm to match applicants to programs during NRMP Match Week. 

Read More In-Depth: The Residency Match Process & NRMP

FAQs