Apply smart: New data to consider
Your likelihood of securing residency training depends on many factors. One of many considerations is the number of residency programs you apply to. As you consider the number of residency programs to apply to, you should do so in light of your complete application and personal circumstances. But you may not know where to start the process.
So researchers at the AAMC conducted a study with the goal of helping anchor your initial thinking about the optimal number of applications. They wondered if there was a point at which the relationship between the number of applications submitted and the likelihood of entry into residency changes. The researchers investigated whether there is a point of diminishing returns—a point at which the value added by submitting one additional application is reduced relative to the value added by each application before reaching the point of diminishing returns.
The researchers used data from applicants who applied through the AAMC Electronic Residency Application Service® (ERAS®) to residency programs in select specialties from 2010 to 2015. The exceptions are anesthesiology, dermatology, diagnostic radiology, neurology, radiation oncology, and urology, in which researchers used data from applicants who applied from 2010 to 2014.
The researchers used the number of programs an applicant applied to, the applicant’s most recent USMLE Step 1 score, and the applicant’s type (e.g., U.S. MD) to predict whether an applicant entered a residency program in the application year. (For anesthesiology, dermatology, diagnostic radiology, neurology, radiation oncology, and urology, the researchers predicted whether an applicant entered a residency program in either the first or second year after application because some programs in these specialties required a preliminary year.) The study did not differentiate how applicants entered a program (e.g., National Resident Matching Program Main Residency Match, Supplemental Offer and Acceptance Program).
The researchers used a specialized type of regression analysis known as “spline regression” to understand the relationship between the number of programs to which an applicant applied and entry into a residency program.
What the findings tell us
The likelihood of entering a residency program varies by specialty, Step 1 scores, and applicant type. On average, applicants applying to primary care specialties, those with higher Step 1 scores, and those who are U.S. MD applicants (i.e., U.S. MD seniors and graduates) have a higher likelihood of entering a residency program compared with applicants applying to competitive specialties, those with lower Step 1 scores, and those who are U.S. DO, U.S. IMG, and foreign IMG applicants.
There is a point at which submitting one additional application results in a lower rate of return on the applicant’s likelihood of entering a residency program. This means that the value added by submitting one additional application is reduced relative to the value added by each application before reaching the point of diminishing returns. Note: This point of diminishing returns is an estimate and is not perfectly precise.
The point of diminishing returns varies based on USMLE Step 1 scores. On average, applicants with higher USMLE Step 1 scores require fewer applications to reach the point of diminishing returns compared with applicants with lower USMLE Step 1 scores.
The point of diminishing returns also varies by specialty and applicant type. On average, applicants to competitive specialties had to submit more applications to reach the point of diminishing returns compared with applicants to primary care specialties. The point of diminishing returns was, on average, lowest for U.S. MD applicants compared with U.S. DO, U.S. IMG, and foreign IMG applicants.
Data on the point of diminishing returns are presented separately for the following specialties:
The AAMC is continuing to analyze data on additional specialties and will make reports on the results available over time.
How to interpret and apply the findings
Use these findings as a starting point for considering the number of programs you will ultimately apply to. There is no magic number that applies to all applicants, so consider the point of diminishing returns in the context of your overall residency candidacy and application. Evaluate a wide variety of information—such as your unique experiences, qualifications, and residency application strategy—as you work with your advisor to determine how many programs and which ones to apply to.
How to develop a smart application strategy
Remember, in addition to considering the point of diminishing returns in light of your complete application, to best position yourself, you should:
- Understand the wide range of specialty and practice options available to physicians.
- Gauge your competitiveness and candidacy.
- Determine which specialty or specialties are right for you.
- Research residency programs in your preferred specialty or specialties.
- Determine how many and which residency programs to apply to.
- Create an effective residency application and prepare for interviews.
Well before you approach the time to consider your residency application strategy, focus on becoming the best medical student, future physician, and colleague you can be. These efforts can only help pave the way toward securing residency training.