For many fourth-year medical students, the process of applying to residency is marked by anxiety, fierce competition for a select number of spots and, often, difficulty gauging which residency programs are most likely to meet their needs.
It’s a scenario that has led many students to send out dozens of applications in the hopes of increasing their odds of matching into a program, consequently adding to their own stress and forcing programs to wade through an inordinate pool of candidates.
To help MD and DO students and international medical graduates make better-informed decisions about where to apply, the AAMC has partnered with eight national boards and associations that play critical roles in medical education and licensure to develop Residency Explorer. The tool, which launched on June 26, is intended to give medical students a clear picture of how they compare — in experiences and exam scores — to applicants who matched previously to programs, as well as provide dozens of characteristics of specific residency programs.
“Students told us that the information they previously had access to was fractured, incomplete, and unreliable,” says William Mallon, EdD, AAMC senior director of strategy and innovation development and one of the leaders of Residency Explorer. “Students had difficulty finding any one source that had everything they needed.”
A personalized approach
Residency Explorer is designed to personalize medical students’ search for residency programs by allowing each student to create a profile that represents what they will be putting on their applications, including exam scores, peer-reviewed publications, volunteer work, and research experiences.
Once a student has created a profile and selected a specialty, they can refine the results to be limited to a certain state, region, or distance from ZIP code.
The tool will then show the student how they compare to applicants who matched with specific programs from 2016 to 2020 in each of the various criteria.
“Students told us that the information they previously had access to was fractured, incomplete, and unreliable.”
William Mallon, EdD
AAMC senior director of strategy and innovation development
Beyond matching criteria data, the tool provides a page for each residency program that gives a snapshot of its characteristics, including how many people applied and what percentage were offered an interview, the program’s self-reported USMLE or COMLEX-USA exam score ranges or minimum requirements, salary and benefits information, average hours per week a first-year resident works, the demographic makeup of the residents, and other information.
Students can select multiple programs and the tool will generate a spreadsheet to show side-by-side comparisons on the various metrics.
Turning to a reliable source
David Bernstein, MD, MBA, first learned about Residency Explorer when it was in its initial phases and he was serving as the chair of the AAMC Organization of Student Representatives. At the time, he was a fourth-year medical student at the University of Rochester School of Medicine and Dentistry, and he was beginning to think about his own residency applications.
He was happy to hear that there would be a reliable source of information that could help him as he began the process of narrowing down which programs he would pursue.
“There’s a lot of … unverified data and information out there,” Bernstein says. “Understanding that this was coming from the keepers of the true data was of interest to me and of value to me.”
He notes that he and his peers could turn to mentors and advisors for guidance about various programs, which was helpful, but he believes that the verified data provided by Residency Explorer helped give him a more complete picture.
“You didn’t have that before,” he says. “It was just a guesstimation.”
Bernstein is now starting his first year of residency in orthopedic surgery at Harvard Medical School, a program he chose because he believed it would not only prepare him to be a great surgeon but also foster his interests in patient advocacy, public policy, and the business of health care.
“Right now, the students apply to a lot of programs and see what programs offer them an interview. It’s like throwing spaghetti at the wall and seeing what sticks.”
Donna Elliott, MD, EdD
Vice dean for medical education at the Keck School of Medicine of the University of Southern California
It’s factors like these that should play a major role in matching decisions for both students and residency programs, says Donna Elliott, MD, EdD, vice dean for medical education at the Keck School of Medicine of the University of Southern California.
“The students have trouble figuring out at the 30,000-foot level what’s a good fit,” she says. “The values, the opportunities, the patient populations — does it match what I’m interested in?”
She’s seen students become overwhelmed by options, with those pursuing particularly competitive subspecialties applying to as many as 120 residency programs.
“Right now, the students apply to a lot of programs and see what programs offer them an interview,” she explains. “It’s like throwing spaghetti at the wall and seeing what sticks.”
Research conducted by the AAMC shows that there is a point at which a student’s chances of matching does not increase with the number of additional applications. That number can vary by specialty and depends on the student’s testing scores, but it suggests that students can save time, money, and administrative hassle by limiting the number of programs to which they apply.
Elliott believes Residency Explorer will take some of the guesswork out of the process and may help applicants make better informed decisions about where to apply. In turn, that could potentially help residency programs by giving them fewer applications to consider.
And with fewer submissions to sift through, Elliott hopes that, in the future, residency programs might be able to loosen up on policies that disadvantage learners with lower testing scores in favor of looking at each student as a whole.
“The program will put a filter at [a USMLE score of] 240,” she says. “Programs are probably missing some excellent residents when they do that.”
Easing the student-to-resident transition
The path to Residency Explorer began several years ago when nine national associations and boards came together to help students with the struggles they faced in transitioning from medical school to residency. In addition to the AAMC, the groups were the Accreditation Council for Graduate Medical Education, the American Association of Colleges of Osteopathic Medicine, the American Medical Association, the Educational Commission for Foreign Medical Graduates, the Federation of State Medical Boards, the National Board of Medical Examiners, the National Board of Osteopathic Medical Examiners, and the National Resident Matching Program®.
“Our organizations realized that none of us had all the data and information that students wanted to help them make more confident decisions about where to apply,” Mallon explains. “But if we pooled our resources, we could provide a tool with the source-verified information that students desired and could trust.”
After building and testing multiple prototypes with input from scores of medical students and their advisors, the organizations launched Residency Explorer on June 26, designed for rising fourth-year medical students and applicants for the 2021 ERAS® and Match® season.
“This is one piece of a very complex, high-stakes, high-stress period in the life of medical students and others applying to residency, and this tool addresses one of those factors that contribute to that.”
AAMC senior director of integrated learner services
In feedback provided on the 2019 working prototype, 9 out of 10 users said that, after using the tool, they felt more confident about which programs to apply to and more informed about the characteristics of their programs of interest.
“This is one piece of a very complex, high-stakes, high-stress period in the life of medical students and others applying to residency, and this tool addresses one of those factors that contribute to that,” says Angelique Johnson, AAMC senior director of integrated learner services and one of the leaders in developing Residency Explorer. “That’s one thing we can move out of the way.”
More useful than ever
This year is proving even more stressful than usual for fourth-year medical students.
On top of the anxiety that comes with applying to residency, students are now having to deal with the disruptions that have come with the COVID-19 pandemic. These include all-virtual interviews, not being able to visit a program or do audition rotations, and changes to the application timeline.
“It was already stressful, and I think this year is even more so,” says Samuel Bunting, a rising fourth-year medical student at Chicago Medical School at Rosalind Franklin University of Medicine and Science and an AAMC student representative.
He began using Residency Explorer when it was in a testing phase to get a sense for the psychiatry residency programs he might want to pursue.
Now, he’s looking forward to the relaunch of the tool with more complete and up-to-date data as he works toward identifying the roughly 50 residency programs he plans to apply to this October.
“What’s been nice is looking at specific programs beyond their STEP score — being able to look at what they place importance on,” Bunting says. “Now, more than ever with this modified cycle, having that data is going to be really important.”