Can you apply to too many residency programs?

The AAMC releases data on the optimal number of residency applications to submit for 19 specialties.
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New AAMC data shed light on the optimal number of residency applications fourth-year medical students should submit to maximize their chances of entering a residency program. The data calculate the point at which submitting one additional application results in a lower rate of return on the applicant’s likelihood of getting a residency position—known as the point of diminishing returns.

This is the second year the AAMC has released this data, meant to curtail the growing trend among students to apply to increasing numbers of residency programs, in the belief that applying to more programs also increases their chances of acceptance. That trend, which creates a financial burden on students and an administrative challenge for program directors, is due in part to increasing competition for residency positions. In 2018, 78.3% of medical students matched with a residency program; that includes graduates of allopathic medical schools (MDs), graduates of osteopathic medical schools (DOs), and international medical school graduates (IMGs). The match rate for graduates of allopathic medical schools was 94%.

But AAMC research shows that there is a point at which students can apply for too many residencies, when applying to one (or 100) more does not increase the chances of getting a position. In addition, the data show that the number of applications it takes to reach the point of diminishing returns varies by specialty and also depends on the applicant’s United States Medical Licensing Examination (USMLE) Step 1 score and applicant type. Students with lower USMLE Step 1 scores and U.S. DO, U.S. IMG, and foreign-born IMG students are less likely to obtain a position, the data show.

The AAMC data capture the point of diminishing returns for 19 specialties, from the very competitive orthopedic surgery residency positions to the less competitive neurology residency slots. For each specialty, the data detail how many residency applications you should ideally submit based on your USMLE scores to maximize your chances of entering a residency program in that specialty.

The AAMC recommends that residents put themselves in the best position to obtain a residency position by:

  1. Understanding the wide range of specialty and practice options available to physicians.
  2. Gauging their competitiveness and candidacy.
  3. Determining which specialty or specialties are right for them.
  4. Researching residency programs in their preferred specialty or specialties.
  5. Determining how many and which residency programs to apply to.
  6. Creating an effective residency application and preparing for interviews.

Atul Grover, MD, PhD, AAMC executive vice president, says the new data are meant to help students apply strategically to residency programs. “If a student says, ‘I’m going to apply to five more places,’ we’d like this data to help them apply to places where they are likely to be more successful and happy,” Grover says. Students also should consider grades, career goals, letters of recommendation, and other qualifications in determining which programs to apply to and how many applications to submit.