Applying to residency is one of the most stressful junctures in an aspiring doctor’s journey to a career in medicine — and overapplication has been a pain point for everyone involved. But the AAMC’s bold commitment to continuous innovation, data transparency, and collaboration across the academic medicine community is dramatically improving the process for applicants, schools, and residency and fellowship program directors.
The result: Students are submitting far fewer residency applications (thus lowering their costs), and specialty program directors have reported much greater ability to identify, interview, and select interested applicants.
For the second year in a row, application numbers have dropped across multiple medical specialties thanks to candidates applying in more focused ways. In fact, preliminary data from the 2024-2025 residency application cycle show that the average number of applications per candidate declined 7.3% this cycle compared to last year — with some specialties seeing a decline of nearly 30%.
“At the AAMC, we are committed to taking meaningful action to make the transition to residency better for students, advisors, and programs — and it’s working,” says AAMC Chief Services Officer Gabrielle V. Campbell, MBA, LLM. “We’ve accelerated innovation, reduced the cost of applying, and made a vast array of data resources accessible and easier to use through collaborations with specialty, technology, and academic medicine leaders.”
Preliminary data from the 2024-2025 application cycle shows a 7.3% decline in applications per applicant, with some specialties experiencing a drop of 30-45%.
Among key advances is the custom program signaling available to all residency and fellowship specialties using the Electronic Residency Application Service® (ERAS®). ERAS signaling has been transformative as it helps programs identify candidates who are genuinely interested in their programs, do a deeper dive into applications, and find applicants who are a good fit for their missions. It helps applicants find residencies where they can thrive personally and professionally.
Residency programs benefiting from reduced numbers of applications can better implement holistic review and invest precious interview time in candidates who are seriously considering training there. Applicants want a way to indicate such interest given the pivotal role of interviews in the application process. Signaling aids both groups.
Applicants receive a certain number of signals in their ERAS application — three to 30, depending on the specialty — to indicate particular interest in select programs.
The effort — which has expanded to 21 specialties from three since its launch in 2022 — is paying off. Signaling increases the likelihood of an interview invitation in most participating specialties, regardless of race, gender, or applicant type (such as graduates of international medical schools). In family medicine, for example, the median interview rate for applicants who sent signals was 42% during the 2023-2024 residency application cycle, compared to 15% who did not signal.
Starting in December 2024, signaling expanded beyond residency applicants to ERAS users applying to fellowships in participating specialties. Meanwhile, the AAMC is working hard to help programs use signals wisely. For example, webinars train programs on how to position signals as part of a broader, holistic review of candidates.
Of course, signals aren’t very useful without the data necessary to help applicants select appropriate programs. That’s where the Residency Explorer™ tool comes in. The only residency tool offering verified program data from multiple sponsoring organizations, Residency Explorer eliminates the need for applicants to sift through multiple websites or rely on hearsay about programs.
In August 2024, the tool, which is free to residency applicants, launched some crucial new features.
For one, users now can generate individualized reports about programs based on their personal needs and professional interests. A user can select from a list of desired factors — everything from salary ranges to special training tracks to child care and research offerings — and learn how many of their criteria each program matches.
In another advance, the site generates data to help applicants work out whether they are competitive candidates for a particular program. For example, thanks to the integration of consolidated interview data through the success of the AAMC-Thalamus collaboration representing over 90% of interview data across residency specialties, students can see the percentage of prior applicants who received an invitation to interview. And they can do so based on such characteristics as whether they signaled the program or had attended medical school in the same state as the program.
“Crafting such changes through constant collaboration with multiple organizations is vital,” says Dana Dunleavy, PhD, AAMC senior director of admissions and selection research and development. “Although the volume of applications decreased in the previous year, it was only after including signaling with interview data in the Residency Explorer tool that the drop became dramatic."
Not surprisingly, the number of applicants who used the Residency Explorer tool rose 43% from 2023 to 2024.
In addition to enhancing the Residency Explorer tool for applicants, the AAMC has expanded its specialty selection resources, added data insights from earlier in the learner journey into the ERAS suite of tools, and cut application costs for applicants.
The ERAS and Careers in Medicine® (CiM) teams are collaborating with multiple specialty societies (family medicine, pediatrics, internal medicine, general surgery, and emergency medicine) to add a series of new and very popular Specialty Spotlight webinars to their residency season event roster.
In December 2024, the ERAS Dean’s Office WorkStation for advisors also began incorporating additional information into its dashboard. For example, it now includes data from the Visiting Student Learning Opportunities TM program, which facilitates the “away rotations” that often serve as auditions at residency programs. Among the benefits: Advisors can see which students haven’t pursued those experiences and can suggest doing so as part of their application strategy. The AAMC will also add data from its CiM program in early 2025.
In another advance this season, the AAMC offers a new, simplified ERAS fee model that saves most applicants up to 36%. Applicants pay $11 for the first 30 applications and an additional $30 for each one after that. (The model restarts with each new specialty in which a person applies.)
The AAMC has also expanded its Fee Assistance Program to include residency applicants who had been approved for benefits during their medical school application process. In this application cycle, 4,300 qualifying applicants automatically were eligible to receive a 60% fee discount on up to 50 ERAS applications, which amounted to approximately $2.4 million in students’ savings in 2024. The AAMC is now assessing how the program might evolve to support additional applicants who might qualify but hadn't applied before medical school.
And starting in July 2025, residency and fellowship programs using the ERAS platform will have complimentary access to Thalamus’ Cortex, following the success of a pilot across three specialties for the 2024-2025 residency application cycle. This technology-assisted application screening software facilitates holistic review and decreases faculty review time by an average of 50%.
“We continuously listen to our community and have taken decisive action to improve our technology, data analytics, and specialty collaborations,” says Patrick Fritz, AAMC senior director for residency and fellowship services. “We’ve also had a good deal of positive feedback regarding these efforts, including broadening collaboration with Thalamus, and are eager to expand efforts to further support learners and programs. This is just the beginning. Our goal is to help nurture a physician workforce well-equipped to improve the health of all.”
To learn more, visit the ERAS program website, browse the AAMC transition to residency webpages for resources, and sign up for the quarterly UGRC/transition to residency newsletter.