How many residency programs should I apply to?

This was one of the most pressing questions that I had when I was applying, and the lack of clarity in the answers I received helped to inspire me to start Med Student Edge and contribute to the conversation with a letter to the editor addressing this topic.  The medical school I attended did not have an integrated plastic surgery program, and thus the attendings were unfamiliar with the particulars of the application process.  Furthermore, we only had one applicant to plastic surgery in each of the three years prior to my application cycle.  Thus, there was a paucity of people able to provide insightful advice to how many programs I should apply to. 

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This question is an anxiety provoking question for a number of reasons.  You want to apply to enough programs to get enough interviews and match.  You never know exactly how you stack up against the other applicants in your cycle.  There are financial pressures as for each program you apply to and each interview you take, you accrue an additional cost.  Specialty governing bodies are struggling to deal with this problem as they seek new ways to reduce the number of applications and cost of applying to residency.  I ended up getting one abstract and one tangible piece of advice from mentors, neither of which I really followed.

One attending told me, “Apply to where you want to go.” I think that is good advice in a perfect world. I ended up applying to a lot of programs that I really didn’t want to go to.  But…the problem is that I would have rather gone to one of those programs than to not match into the field of my choice.  That is largely where a lot of my difficulties were.  How do I determine how competitive I am compared to my peers so that I can inform my application decisions?  One resource that helped aid my confidence (though didn’t affect my ultimate decision) is the AAMC’s specialty-specific statistics on the diminishing returns of additional applications.  

Another attending told me, “Apply to all plastic surgery programs, plus 10-12 general surgery programs.”  I thought long and hard about this.  There were 81 integrated plastic surgery programs when I applied.  I ended up applying to all of them.  Given my confidence in my CV, I couldn’t justify dual applying to general surgery.  This belief was compounded by the fact that I had gone straight through undergrad and medical school, and if I didn’t match I would be okay with taking a year off to do research.  These were all considerations that I thought through before applying, so that I would be comfortable and confident in my approach.  While confident, I was not willing to sacrifice the possibility of not matching into a plastic surgery program.  One of the issues with applying is that some times it just doesn’t make sense.  When I applied, I classified LSU New Orleans as a safe program for me meaning I was very confident I would receive an interview invite there: I am from Louisiana, went to medical school in the south, had scores that were higher than the students that had matched there in previous years, and met a faculty member from there at a research conference.  Despite those qualifications and connections, I did not receive an interview there.  Examples like this make the process very anxiety provoking.

Summarizing, it is hard to generally answer how many residency programs applicants should apply to, but I will instead list a summary of points that you should consider when deciding.  Feel free to reach out with specific questions based on your own situation.

  • Consult your mentors
  • Ask previous applicants from your school
  • Compare your CV to the AAMC’s Match Data
  • How risk tolerant are you? Would your rather dual apply or are you comfortable taking a year off and reapplying if you don’t match?
  • Is it worth applying to a program that you would not want to train at?  Would you rather not match than attend that program?
  • Are you comfortable matching anywhere in the country or are you confined to a certain geographical location?
  • Some programs require a research year.  Would you want to add an additional year to your time in training?

Do you have specific questions about how many programs you should apply to for residency?  Use all the resources above and reach out with any questions to Med Student Edge or comment below. 

Carter J. Boyd, MD, MBA
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