The Differences in Applying to Medical School vs. Residency

The Differences in Applying to Medical School vs. Residency

A guest post by InvestingDoc


Medical School vs. Residency


Applying to medical school vs. residency are two vastly different experiences. Medical school by far has a larger applicant pool all trying for the same spots. When applying to residency, the number of applicants is much smaller seeking work at various programs all over the nation. According to the AAMC, about 21,000 applicants will be fortunate to receive an acceptance letter to medical school out of the 50,000 to 60,000 people that applied. Having a 50% chance of being accepted is a much different experience from wondering if you will match to your top residency choice  (~80% US grads will match into one of their top 3). 


You need them more than they need you.

Applying to medical school is a matter of supply and demand. The medical schools each receive thousands of applications for often less than 200 spots. For example, let’s look at one school in particular on the list from the link above, Austin’s new medical school. Last year there were almost 5,000 applications for an entering class of 50.

If you were one of the 5,000 that applied, you had a 1% chance of joining this medical school. In order to increase your odds of being accepted, it’s necessary to apply to often more than 20 schools to increase your chance of matriculation.

Applying to residency can be a very selective process for certain specialties. Dermatology, radiation oncology, plastic surgery, and CT surgery to name a few all have a limited number of spots. As a result, these programs tend to be very competitive to apply to. However, if not accepted into one of these programs there is always the option of doing a transitional year or preliminary year while you reapply. And of course, you can always choose a similar, but less competitive residency (Think Fam-Med/Sports medicine in place of Orthopedic surgery, Neurology in place of Neurosurgery). 


Differentiating yourself from the crowd.

GPA and MCAT are still the most important factors on the application to obtain an acceptance letter to medical school. In order to stand out from the thousands of applicants, individuals will often do research, volunteer, shadow physicians, or have some outside interest that makes their application unique. The pressure to stand out among the crowd can be intense. This leads to college students joining an organization or having some sort of activity that they think will make them stand out.

When applying to residency, there is not as much time for extracurricular activities beyond studying. Some students still find time to do some research or join an student interest group but many others will solely focus on doing well in medical school. For many residencies, STEP 1 is the most important determining factor and students choose to focus on this test over doing research.

Each specialty has its own culture for what is desired on their application. For example, if interested in neurosurgery it is often highly recommended to do some sort of research in the field and to personally get to know the program director. The more competitive the residency, the more items an applicant usually has on their resume.


Pressure of Testing.

The two largest tests that any doctor will take are the MCAT then USMLE STEP 1. Both are used as a metric for stratifying applicants into who may be more competitive. The MCAT is taken before medical school and has the possibility of being taken more than once while the USMLE STEP 1 is usually only taken once.

The pressure to perform well on the USMLE is very high for those individuals who want to enter a competitive residency. Underperforming on the USMLE unfortunately can mean that some residencies may not be an option in the future. Once STEP 2 is over, the need to score well on standardized test drastically decreases.


Applying to residency was more fun!

Due to fewer people applying to residency compared to medical school, it’s not uncommon to make some friends while on the interview trail. I ended up seeing some of the same people at many of the interviews that I went to. We started to swap contact information and to this day I remain good friends with some of the people I met on the interview trail.

Before residency interview days there will often be a dinner the night before. This is a time for you to go have some drinks, unwind, and get unfiltered advice from people in the program about what life is like. I even had a few interviews where the dinner was at the program directors house. It was a strange change of pace to go from the sea of black suits for medical school interviews vs drinking wine at the program directors house the night before the interview.

Keep in mind during this fun time that you still need to act professional. Doing shots or getting drunk is usually a very bad idea. Keep sober, but know that it’s okay to loosen up a little bit during the diner the night before the interview.


The interview itself is more laid back.

I felt like my interviews for medical schools were very uptight filled with high levels of anxiety. For residency, everyone seemed to have a genuine smile and good time while interviewing with an overall less stressful feeling.

I recall my medical school interview felt very much like they were asking me why they should even consider me. For residency the interviews were often much more laid back with lighter conversation. I spent almost the entirety of one interview talking about my love for cooking and brewing beer. Several months after the interview I ended up raking it first and matching at the program.


Overall, applying to residency was a lot of fun but also one of the most important decisions that I could make. Deciding where to do your training will have an impact on how you practice medicine and the connections built in your field of study. Don’t be confused as less stress when applying does not mean that this is not as important of a decision. In the end, always remember to be yourself, stay honest, and have some fun along the way.


Investing Doc Blog

InvestingDoc is a blog dedicated to personal finance and investing for medical students, residents, and doctors. You can read more from InvestingDoc via the website or via twitter (@InvestingDoc). 


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