Step-by-step ERAS residency guide for medical students. Learn how to apply for residency, ask for recommendations and boost your match chances confidently.
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The Basics of Applying to Residency--
Applying for residency is one of the biggest milestones in your medical journey. It can feel overwhelming at first, but with early planning, a clear strategy, and some encouragement, the process becomes not only manageable — but exciting.
In this guide, I’ll break down everything you need to know, step-by-step, to help you navigate residency applications with confidence. And, check out the end for a link to my website where I offer free residency application advising!
The residency application process begins long before you submit your materials, which you do through the Electronic Residency Application Service (ERAS). (Of note, there is now a main competitor to ERAS named ResidencyCAS.) Preparation involves building a strong academic and extracurricular profile throughout medical school. This includes excelling in coursework, gaining clinical experience, participating in research, and engaging in leadership and community service activities. These experiences not only enhance your application but also help clarify your interests and career goals.
When it comes time to apply, you must assemble a comprehensive application package. This includes letters of recommendation from faculty and mentors who can speak to your clinical skills, work ethic, and character.
A personal statement is also required, offering applicants the opportunity to articulate their passion for medicine and their chosen specialty. Crafting a compelling personal statement involves reflection and self-assessment, as it should convey both personal and professional aspirations.
Then, you identify up to ten “activities” and write a short statement about them. This is the meat & potatoes of the application, as these ten activities help demonstrate, along with your grades and personal statement, what you have been up to the last four (or more) years.
Choosing which specialties and programs to apply to is another critical aspect of the application process. Students often seek guidance from advisors, mentors, and peers to make informed decisions. Factors such as program reputation, location, and training opportunities play a significant role in this decision-making process. It’s essential for you to balance ambition with realism, and to apply to a range of programs that align with your qualifications and interests. To learn more about the Match, check out another blog post here.
The first step to a successful application season is understanding the timeline. Key dates to know include:
Your goal is to submit your ERAS application a few days before it goes out to programs. For the list of 2025-2026 dates, you can find them here. Note: ERAS cycles are named by the Match year; for instance, current third‑year students (in 2025) are applying in the “2026 ERAS Residency” cycle. You can also find important dates specific to the National Resident Matching Program (NRMP) here.
Start gathering your application materials — like your personal statement, letters of recommendation (LORs), and Curriculum Vitae (CV) — at least several months in advance. Waiting until the last minute leads to unnecessary stress and rushed materials, so give yourself room to polish everything carefully. I also recommend having a personal email, or an ERAS specific email, just for this process. It will help when the flood of interviews comes in or when you get the invite to your dream program in the middle of rounds.
Early preparation gives you flexibility, reduces anxiety, and allows you to enjoy your fourth-year electives, sub-internships, and away rotations without constantly feeling behind.
Your application is your first impression — make it count. For your application and personal statement, I wholeheartedly recommend having multiple eyes review them. I generally advise folks to have at least two people you trust in your specialty review them, and then have a third person who can go through them with a fine-toothed comb for spelling and grammar. This takes time, so start early!
Your ERAS Application needs to be clean, accurate, and free of grammatical errors. You will only be able to access ERAS with a token provided by your medical school. If you have the token, and before ERAS opens officially, you can go into the software and update the more mundane items such as your mailing address and demographics. Other categories include geographic and setting preferences, additional questions about prior criminal history, and education history.
Then, when ERAS opens for full editing in June, you may now begin inputting your experiences. When describing experiences, focus on what you did and what you learned. As of the time this blog was written, you have the ability to describe up to 10 experiences with 750 characters (with spaces) each, and you can further designate three of them as “most meaningful” with an additional 300 characters. There is no consensus on how to format your experiences, such as bullet points or paragraphs. Both are acceptable and it is more about what is in the writing versus the formatting. Of course, it’s terribly difficult to describe the impact of something you have done in just 750 characters so be sure to balance the description of the experience with what your main takeaways are. And remember, these are typically experiences you had during medical school, but that is not always the case. For example, I put research done during my gap years as well as prior work history. For each experience, you must also provide a title, list the organization, location, dates, and participation frequency. Optional items include setting, primary focus, experience type, and key characteristics. For ease of editing, you can use this document to help assemble your activities.
There is a separate section for Hobbies & Interests (300 characters) as well as all things publications/posters/presentations (unlimited).
The Personal Statement is your chance to show who you are beyond your CV. Share your story authentically — why you chose your specialty, what moments shaped you, and what you hope to contribute to the field. Avoid clichés and overused phrases like "I have always wanted to be a doctor." It’s important for you to connect with mentors and those in your chosen speciality as they will be able to provide targeted advice on your personal statement. For example, in Emergency Medicine, the personal statement is not meant to be flashy or to run the risk of standing out for the wrong reasons; it’s meant to convey a concise narrative. For most specialties, you want to aim to be at or under one page length (you can preview your ERAS application as a PDF and it will show you the length).
Letters of Recommendation are critical. Ideally, you should secure at least three strong LORs from physicians who know you well clinically. Ask early, provide your CV and personal statement (or a draft), and offer gentle reminders as deadlines approach. Once again, the number of letters you need and what types of letters (Chair Letter versus Standardized) differs based on the specialty you’re applying into. These LORs are uploaded directly to ERAS by the writer.
The Medical Student Performance Evaluation (MSPE, also known as the “Dean’s Letter”) summarizes your medical school performance. Although you won’t write it yourself, how you perform in clinical rotations and interact with faculty can strongly influence its tone. Your school likely has a timeline for when these get uploaded and released, so there’s not much you can do about it.
Finding the right residency program starts with asking: What’s most important to me?
Consider factors like geographic location, hospital size, academic vs. county vs. community focus, diversity, call schedules, and culture. Are you looking for a strong fellowship placement? Work-life balance? Urban or rural training environments?
Use trusted tools like FREIDA, residency program websites, and advice from mentors or recent graduates. Don't underestimate the value of reaching out to current residents for their honest insights. And, look them up on Instagram!
Create a personal "target list" that includes a mix of safety programs (where you're very likely to match), target programs (good fit), and reach programs (more competitive). This strategy maximizes your chances without spreading yourself too thin. For emergency medicine specifically, categories I listed included program type, length, trauma level, salary, hours per shift, sign out culture, family friendly, volume, parking, stipends, didactics, and what electronic medical record software they use. These became more important during interview season, but also helped guide me on where to even apply to.
For more information about the cost of residency applications, check out this page by the AAMC. In summary, it is $11 for each application 1-30 and then $30 for every additional application after 30. You must also pay to order official board examination transcripts.
Applying smartly is just as important as applying widely.
How many programs should you apply to? It depends. Competitive specialties may require a broader net, while less competitive fields allow for a more targeted approach. Discuss your situation with an advisor or mentor. This becomes even more important if you are considering dual applying.
Whenever possible, tailor your application. Mention your genuine interest in specific programs or geographic areas. This is best done through the various “preference” options provided by ERAS. Programs appreciate candidates who demonstrate thoughtful connections to their mission and community. You are also able to send a customized personal statement to each individual program if you so choose.
Whenever you feel ready, it’s time to hit submit. Aim to hit “submit” before the universal release date (for 2025–2026, that’s September 24, 2025). There are absolutely programs who download all the applications day one and never download any more. Fortunately for you, the “verification” process is nearly instantaneous and adding additional programs is quite easy. You can submit your ERAS application without your LORs uploaded or your MSPE. Sure, programs will see it as missing, but it will update once they are submitted. So, while your letter writers should have them in on time, if you have enough other LORs, go ahead and submit your app, and then update programs when that final LOR goes live. It’s more important to be in the first batch of applicants this time around as compared to when applying to medical school.
And then… you wait.
Once you get interviews, the real work begins. Some specialties send out interview invites the day after applications are sent out, some have a universal release date, and some will periodically send out from September through February.
Residency interviews may be in-person, virtual, or a mix of both, depending on the year and specialty trends. Prepare by practicing common interview questions — why this specialty, tell me about a challenge, and your greatest strengths/weaknesses are frequent topics. There is a fine line behind robotic/rehearsed and winging it. Have a few key parts you want to hit and practice, but do not memorize and regurgitate.
Research each program beforehand. Knowing their unique features helps you tailor your answers and ask thoughtful questions. (Nothing screams "I'm not interested" like asking a basic question easily found on their website.)
Professionalism matters throughout — from your first email to your final thank-you note. Respond promptly, show genuine enthusiasm, and dress appropriately for both in-person and virtual settings.
Keep track of your thoughts during the interview. Some of you will do more than 30 interviews, and at a certain point, they all start to blend together. I created a document that I tracked what interview this was, the program, left a blank space to write notes during the day, wrote down who my interviewers were and something specific we talked about, and then had a list of pre-thought out questions to choose from based on who I was asking (resident vs. faculty vs. program director). I also urge you to write down candid thoughts immediately once the interview day ends. You can look back on these notes when forming your rank list which helps a ton, I promise!
Finally, be on the lookout for red flags during interviews. Trust your instincts if something feels off about the culture, workload, or support structure.
The Match, officially known as the National Resident Matching Program (NRMP), is the system that pairs medical students with residency programs across the U.S. Established in 1952 to bring order to a chaotic process, the NRMP now uses a computerized algorithm to match applicants and programs based on mutual preferences. Most specialties participate, but a few — like the military match, ophthalmology, and urology — have separate systems.
The Match algorithm, based on the Nobel Prize–winning Gale-Shapley model, prioritizes applicants’ preferences and ensures a fair, optimized outcome for everyone. If you're curious, check out this NRMP video that explains the process better than I ever could.
After interviews wrap up, you create a rank order list of the programs you’d most like to attend. This process is highly personal, shaped by insights from interviews and individual goals. Crafting a thoughtful list means weighing factors like program culture, location, work-life balance, and training opportunities. Importantly, you should rank programs in your true order of preference — the Match algorithm prioritizes what you want, not what you think programs want. (Speaking from experience, this was harder to trust than I expected!)
Conversations with mentors, advisors, and family can be incredibly helpful in sorting through your priorities. In the end, your list should reflect where you’ll thrive both personally and professionally — setting the foundation for the next chapter of your medical journey. The window to create your rank list in the NRMP system opens in February, with submissions closing in early March. And then the long wait until Match Week begins.
Every year, some applicants fall into the same traps. Here’s how to avoid them:
Stay mindful, stay organized, and don’t lose sight of the big picture.
Residency applications can feel like a marathon — and like any long race — pacing and perseverance matter. Anyone who personally knows me knows I am a “do this thing 3 months in advance” type of guy. And, that holds true here. Stay diligent and on top of your application and its materials.
Expect unexpected challenges — maybe a delayed LOR, a bad interview day, or needing to adjust your rank list. Flexibility and resilience will carry you far.
Lean on your mentors, advisors, and classmates. Don’t isolate yourself during the process — you are not alone.
Most importantly, prioritize your well-being. Sleep, exercise, hobbies, and staying connected to family and friends are just as important during this process as your interview prep.
Every year, thousands of medical students match successfully — and you will too. If you put in the work, trust the process, and stay true to yourself, your future is bright. Celebrate each milestone, from submitting your application to completing interviews, and finally submitting your rank list. These are incredible accomplishments in their own right.
I am happy to announce that I offer free CV and ERAS application editing which can be found on my website at KJDMD.com.
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