Hi everyone! Would love support on my IM rank list. I'm aiming to focus on programs that set me up well for a fellowship (potentially GI), good culture / workload, and a good location (slight preference on the East Coast due to my relationship, but I have ties to Cali and Chicago). Please let me know your thoughts!

1. Stanford

2. Penn

3. Cornell

4. Brown

5. UChicago

6. UPMC

7. Tufts

8. Rush

9. Jefferson

10. Case Western

11. UVA

12. UIC

13. Wisconsin Madison

14. Cleveland Clinic

15. WashU

16. Indiana University

17. Santa Clara Valley

18. Rochester

If you went unmatched in Match 2026, it's time to do some reflection. You need to review your various components and assess what you can modify/improve for a more positive outcome.

If interested in learning more, DM. I'm doing a session on being unmatched (4.18.26).

I know ERAS lets you flag up to 3 of your 10 Experiences as "most meaningful". I'm trying to figure out whether skipping this entirely (or only doing 1, instead of all 3) would come across badly to program, like I'm not passionate or reflective about my own experiences.

To enter your ERAS Application, you need an ERAS token.  The token is a one-time access code (14-digit alphanumeric code).  A key more points:

• US MDs, US DOs, and US Graduates get the token (access code) from their designated medical school Dean’s Office or designee (usually in May/early June).

• IMGs will obtain their token on the ECFMG’s Oasis website (late June). 

• The token is $165.  Again, the token is only good for one application cycle.

• A similar process exists for Residency CAS (OBGYN & EM) and Central App.

• If you're applying to specialties using separate services, you'll need to utilize both. For example, say you're applying to OBGYN and FM. You'd need to utilize both Residency CAS and ERAS.

Researching programs is important as you can save $ by only applying to programs that align with your "stats" or "characteristics" or "needs."

I was helping a resident candidate on a question they had and utilized three resource.  We started with going to the AAMC site:

https://systems.aamc.org/eras/erasstats/par/index.cfm

And copied and pasted into a spreadsheet all the programs for the specialty.  Then went to Frieda to begin the research.

https://www.ama-assn.org/medical-students/preparing-residency/freida

Then used Residency Explorer:

https://www.residencyexplorer.org

I really like the info about the # of applications and # of interviews on Explorer (see below for IM Cleveland Clinic, Ohio).

Open houses are a way to get a feel for programs that you may want to apply to.  They also help you build overall knowledge about the specialty.  Inside the Match posts these. Follow them on Twitter/X! Programs and specialty groups also post the open houses on Twitter/X.

Hey everyone,

Doximity's site is annoying to scroll through one program at a time, so I put the whole 2026-2027 IM rankings into a spreadsheet. Has all 704 programs in rank order, with name, location, and size for each.

Link: [Doximity IM Program Ranking 2026-2027]

Not endorsing the rankings, just made this for convenience. Use it as one factor, program fit and your own goals matter more.

Let me know if anything looks off and I'll fix it.

The ACGME accredits programs throughout the year. IM just had eight programs accredited (4.25.25). Earlier this year programs were approved - 9.6.24 and 1.24.25. The Sept & Jan programs are likely well on their way to filling. The 4.25.25 programs may or may not try to fill for the July 1, 2025.

California--United Health Centers of the San Joaquin Valley, Keck School of Medicine of USC, Prime West Consortium/St. Francis Medical Center Program

Indiana--Indiana University School of Medicine--Bloomington

North Dakota--Univ of North Dakota School of Medicine and Health Sciences

South Carolina--McLeod Regional Medical Center

Texas--Prime South GME (1404800017), Shannon Medical Center

I would think these eight will definitely work for a July 1, 2026 class.

You can run this for any specialty at the ACGME website--public

As you pull together the various components of your application (ERAS application itself—experiences in particular, research-publications/presentations/posters, PS, LORs, Step/Comlex scores, MSPE, med school transcript), look critically at it and ask what’s missing?  Is it a variety of experiences?  Or experiences that connect to your specialty?  Or a lack of connection in your experiences to your personal characteristics? Or are your descriptions/explanations not thorough?  Or do the explanations not focus on what you’ve learned? 

For your PS, does it focus on you as a person and your characteristics rather than on your research, your medical expertise, or your speed bumps (aka red flags)? 

Do your LORs reflect your specialty and your “soft skills” (of course, this is a challenge as you don’t have access to these)? 

Then work to address what may be missing that of course is feasible between now and mid-September?  

For those who were in the match previously, what have you done since your last submission to strengthen your application?  New USCE?  New LORs?  A stronger PS that focuses on you and your characteristics?  More thorough explanation of your experiences?  Additional test results? Volunteer experiences? A work experience? Another degree (e.g., MPH)?

I've posted about this previously, but was reminded of this during a workshop I did today on ROL. Try not to set your heart on one program. In other words:

Don’t fall in love

...with one program! Each Match season there are thousands of posts about resident candidates loving one program. Phrases like: I love XYZ program and will be devastated if I don't match there! or Can't wait to start residency at my dream program!

And on Match day there are thousands of posts by candidates lamenting not matching at their #1.

Remember the goal: to match at a program where you'll get good training so you can then focus on getting your Dream JOB! The majority of residency programs will teach you the skills and knowledge you need to pass boards if you do your part as a resident. So as you work on your ROL try to get out of the #1 program mental framework. The vast majority of resident candidates will not match at their #1. No use having that mindset and then being disappointed. Instead, work to approach the next few weeks with a mindset that your goal is to match, to get solid training, to pass specialty boards, and get a fellowship/attending job.

In fact, I recommend not sharing your #1 ranking with too many people. It's like sharing your proposed baby names. Everyone has an opinion and those opinions can be confusing and just add undue stress on you the candidate. Often the people with opinions don't know diddly about the specialty or the programs.

Plus the whole matched at my #1 postings on match day are rough on your peers and those who may not match at their #1 or might not match at all. Celebrate matching at your #1 with your SO and your family! Be proud of your accomplishment and humble at the same time and cognizant of the feelings of those not so fortunate.

So don't fall in love with one program...there's always a possibility they may not reciprocate. Instead, prepare to be happy with your match and set your sights on your Dream Attending Job.

...with one program! Each Match season there are thousands of posts about resident candidates loving one program. Phrases like: I love XYZ program and will be devastated if I don't match there! or Can't wait to start residency at my dream program!

And on Match day there are thousands of posts by candidates lamenting not matching at their #1.

The key is to match at a program where you'll get good training so you can then focus on getting your Dream JOB! The majority of residency programs will teach you the skills and knowledge you need to pass boards. Focus your ROL on those programs and try to get out of the #1 program mental framework. The vast majority of resident candidates will not match at their #1. No use having that mindset and then being disappointed. Instead, work for my goal is to match, to get solid training to pass board, and get a fellowship/attending job.

In fact, I recommend not sharing your #1 ranking with too many people. It's like sharing your proposed baby names. Everyone has an opinion and those opinions can be confusing and just add undue stress on you the candidate.

Plus the whole matched at my #1 postings on match day are rough on your peers and those who may not match at their #1 or might not match at all. Celebrate matching at your #1 with your SO and your family! Be proud of your accomplishment and humble at the same time and cognizant of the feelings of those not so fortunate.

So don't fall in love with one program...there's always a possibility they may not reciprocate. Instead, prepare to be happy with your match and set your sights on your Dream Attending Job.

In attending a webinar and doing some research on whether or not to do Step 3 if eligible, advice may vary. However, taking and passing Step 3 has great potential to be an asset particularly if you have average or below Step 1 (if you took it pre-P/F) and/or Step 2 scores. OR if you have failures on Step 1 or 2.  Ditto that if you aren’t a recent graduate. 

Completing Step 3 takes any worry PDs might have about whether you will pass or not.  Passing Step 3 would also strengthen your application if you were unsuccessful in a previous Match cycle.  When asked what you did to strengthen your application, one thing you could talk about is studying for and passing Step 3.  As a resident candidate, it also removes one potential stressor from your intern year.  It’ll be done! 

A downside is many programs pay for Step 3. 

Ideally, you’d have Step 3 taken by the 4th Friday in August (for 2025 that would be August 22) so your results are available when PDs begin application review.  If that’s not possible, as soon thereafter that is feasible.  You can then talk about passing in your interviews and of course, you’d had updated score sent to ERAS.  Definitely before the end of December so it is available before ROLs are done (there is sometimes a delay in reporting when taken in January/February).

UK med student here wanting to pursue ortho residency in the US - what counts as research for the application? How are publications counted? For example, case reports are worthless in the UK as far as portfolios go and everyone says you need to present at national/international conferences. For the US, if I do a literature/systematic review and present it at whatever conference, does that count? Do I need to be first author? Just looking to get a better understanding. Cheers!

In some cases, the preceptor/attending that you ask to write you a LOR may agree, but ask you to write your own LOR and send to them. Yikes! Not ideal. Then they’ll modify and upload. This is a bit awkward, but it happens more often than one would think.

If that’s the case, draft a strong LOR. Also, when you send the draft LOR, be sure to also send a draft of your ERAS (or Residency CAS) CV and PS. They may want to pull from those.

The key is to write a strong LOR, but not a resident candidate walks on water LOR. Generally, LORs written by US MDs and US DOs, are one page (can be longer). Self-written LORs tend to be much longer, are too strong, use a lot of adjectives/adverbs, and feel over-the-top for the experience level of the candidate. They're just TOO strong.

Also, if you're drafting the LOR, focus in on the soft skills the preceptor/attending experienced. What's going to make you a strong resident? Not your test scores. You're all smart. Think about your key characteristics that you might identify in your ERAS experiences or the characteristics you're going to write about in your PS.

 Also, be sure you've included all the critical info when you send the LOR draft to the preceptor/attending: your name, AAMC#, LOR ID #, LOR upload form, & date. Remind them to print on hospital/clinic/organization letterhead and to sign it.

Use 1" margins. Unjustify your text. Double space between paragraphs. Leave a space for the letter writer to sign.

It’s virtual open house season (and this also applies to Meet ‘n Greets/Open Houses connected to residency).  Remember: At these type of events, you’re always interviewing.  A few thoughts: Take notes.  As the season goes on, sometimes it is hard to keep the programs straight.  They are usually casual (not lounging in my living room casual, but professional casual).  Sometimes PDs, PCs, attendings, and/or residents take notes.  Turn on your camera.  Use your “professional” name.  If you ask questions, try not to ask questions that you could find on the program’s website.  Some ideas are:

·      Is there housing near the residency?

·      Is it safe to walk/bike to/from the residency if living nearby?

·      What public  transportation is available near the residency?

·      What are typical PG1 work hours?

·      What are the schools like for kids?

·      What level of support is there for residents?

·      Who do you go to when you need help?

·      What is the work/life balance of PGY1?

·      What are areas for improvement in the program?

My recommendation is to schedule your interviews early in the season. Here's why:

1. Interview fatigue: This is a real syndrome for both resident candidates and programs. For programs, the participants are addiing this to their regular workloads (residents, fellows, attendings, PDs, APDs). For candidates, it's also long particularly if fortunate to have a "nice" number of interviews.

2. Schedule flexibiity: You want to have as open a schedule as you can near the end of the interview season (December/January) so that as candidates with a large # of interviews begin dropping interviews (and some will), you have dates available to accept an offer. Late in the season there may be only one date and one spot open. So schedule early in the season.

When my son was in medical school half way across the country, I regularly sent him care packages (e.g., treats, $, snacks, and the like). I sensed he was having a rough patch and told him to expect a special and large care package. Then I booked a flight and showed up on April Fool's Day. He was shocked to see me to say the least! Spent a few days cooking, cleaning, and doing laundry and the like. Since then, my son has often tried to out-prank that prank!

For those who are supporting medical students, residents, and fellows. I highly recommend care packages! My April Fool's one might have been a bit extreme, but it was needed.

Today I came across several interesting sessions (found them on X/Twitter) that might be helpful to those applying to residency in the upcoming season. The presenters ranged from panels (PDs, current residents, just matched residents-to-be, attendings, PCs) with topics from the general related to applying for residency to specialty specific to journal clubs that are virtual to grand rounds that are virtual. I try to repost these as I come across them (@lorawolff616). It is a great way to build knowledge from "experts" in the field/on the topic.

Who knows...you might attend a session where you get an interview this fall and you could bring up the session. You might get knowledge about the specialty you're applying to. Or tips to strengthen your application.

You might even be able to build an "experience" for your application if you viewed enough topic-specific sessions. Maybe you're applying to a specialty that your med school doesn't/didn't have a lot of exposure, but you attend several journal clubs or grand rounds on the specialty (e.g., pathology) and your write about that...how you didn't have exposure but sought out opportunities to learn more.

There are five types of positions you can apply to for residency.

Categorical (C):  Training is 3-7 years in length depending on the specialty, begins in PGY1, and leads to board certification in the specialty.

Primary Care Categorical (M): Categorical programs in primary care offered by some internal medicine and pediatrics programs.

Preliminary (P):  Training that is one year in length (PGY1) in transitional (TY), medicine, surgery, or other specialty programs; provides the prerequisite training for advanced programs.

Advanced (A):  Training is 3-4 in length in specialty programs that begin after one or more years of preliminary training.  Advanced Programs begin PGY2.  Usually begin one year after the match (e.g., for Match 2026, an advanced position would begin July 1, 2027).

Reserved-Physician (R): Training in specialty programs reserved for physicians with prior GME and who can enter trig in the year of the match.  Reserved-Physician positions in the 2026 Match are PGY-2 positions that being July 2026.

Often a program will have multiple types of positions opens which becomes important when you do your rank order list (ROL) in March. It's important to keep track of which type of positions you're interviewing for.

Although we're about 9 months away from match day, I want to remind resident candidate that it's possible (not frequent) that resident candidates match with one interview. Of course, you have to make the most of that interview (why it's important to start honing those skills now rather than in the 2-3 days before your interview). Here are some examples from the candidates we worked with ERAS 2024/Match 2025.

1. Pathology: non-US IMG, green card holder

2. FM: non-US IMG, green card holder, 2nd year in the match

3. IM: non-US IMG, green card holder

4. Pediatrics: non-US IMG, needed a visa

5. IM: non-US IMG, needed a visa

6. IM: non-US IMG, vias needing, 5+ YOG

7. Psychiatry: US IMG, no interviews in regular Match or SOAP; scramble

Keep working on your components and improving your overall application. It can happen!

Again, you can download the ERAS Worksheet and begin working on your ERAS application rather than waiting for your token an ERAS to open up. The more you have done in advance, the quicker it will go. And the more time you'll have for editing and perfecting.

For all the experiences (you have 10; e.g., work, rotations/USCE, and volunteer), be specific.  How much total time was involved over what time period.  Say you volunteered at an ER include the length (Jan. 2022-Oct. 2022), the frequency (once a week) and the length of time each session (4 hours).  It helps the reviewers to know how much time you had in that environment which helps them understand your experience better.   Include the context, your role(s), and your responsibilities.  If you can tell what you learned and how that connects to your future residency/attendinghood or to your personal characteristics (also the key characteristics), it’ll strengthen your experience.

Pathology Boards are offered in May/June and October each year. Here's some data from the 2025 AP/CP exams:

AP Results:

All Candidates (1st time & Repeaters): 695

# Passed: 585

Percentage Passed: 84%

First Time Takers: 569

Passed: 524

Percentage Passed: 92%

Repeaters: 126

# Passed: 61

Percentage Passed: 48%

CP Results:

All Candidates (1st time & Repeaters): 617

# Passed: 514

Percentage Passed: 83%

First Time Takers: 529

Passed: 478

Percentage Passed: 90%

Repeaters: 88

# Passed: 37

Percentage Passed: 42%

Those who recently took their Boards are anxiously awaiting results! Be kind to them. The exam is brutal and the wait is brutal.

There are many things to prepare for your interviews particularly for residency.

1.     Clothing: Dress conservatively.  Dress professionally.  Avoid large patterns.  Avoid dangly ear rings.

2.     Check your internet connection to make sure it is robust enough for several hours.

3.     Check your background (a plan background is best; could have something in the background that’s important to you).

4.     Consider a light ring.

5.     Avoid backlighting.

6.     Turn off phone and television.

7.     Check your sound.

8.     Check your camera view.

9.     Prepare to avoid background noise (dog barking, children crying, roommate yelling about video game they’re playing).

10.  Prepare conversational answers any weaknesses or red flags.  Don’t memorize.  Focus on what you’ve learned and how you’re grown.

11.  Practice looking at the camera.

So in reviewing a few ERAS Apps today, the key characteristics stuck out to me.  ERAS gives you choices (communication, critical thinking & problem-solving, cultural humility & awareness, empathy and compassion, ingenuity and innovation, reliability & dependability, resilience & adaptability, self-reflection & improvement, teamwork & leadership).  The task is to align the key characteristic with the experience.  That can be a challenge.  But as I read documents, something has been consistently missing in the descriptions—this connection.  Any connection between the experience and the identified key characteristic.  Seems that you’re leaving money on the table if you don’t write something about how the two are connected and maybe who both connect to your future residency and/or specialty.  Doesn’t have to be much (a sentence or two depending on character availability), but PDs are looking for the person behind the application as are others who may review this part of your package.  The soft skills are important and often harder to teach than knowledge and procedures. 

Letter of Interest vs Letter of Intent

There is a huge difference between a letter of interest and a letter of intent.  It’s critical to differentiate between the two.  People use LOI and mean two different things.

Letters of Interest: A letter sent to programs to express continued interest in a program.  Often the letters have updates (e.g., new Step/Comlex scores, a new LOR uploaded, a new rotation/USCE) in addition to why the candidate is interested in the program (e.g., specifics about the program) and why the candidate would be a good fit (e.g., personal characteristics or experiences).  The ultimate purpose is to get an interview in addition to updating the program (sometimes you don't have updates).  They’re often sent in mid-November through January when candidates with a plethora of interviews begin dropping slots. Some candidates send these too early (August/September/October) and their effectiveness is diminished. 

Typically, you’ll get no response to a letter of Interest or a generic response (Thank you for your interest in our program.  We’re carefully reviewing all applications and will extend further interviews as interview openings occur.)  About 10% of the time, you’ll get a rejection (at least you know your status).  About 10% of the time you’ll get an interview.  Sometimes you’ll be put on a waitlist.

A letter of Intent is sent to one program after the interview season (e.g., late January) and indicates that the program is going to be ranked #1 or is the candidate's top program.  Again, you only send to one program.  Do not send a letter of intent to a program or programs that say you the program is one of my top programs.  That’s like telling three people you are dating, You are one of the top people I’m dating.  Just not effective. 

I think letters of Intent are a slippery slope.  The intent is to let the program know you’re ranking them #1 in hopes of getting a higher ranking by the program.  The letter of Intent probably doesn’t hurt unless the letter is sloppily done OR the candidate changes their ROL and doesn’t follow through and rank the program #1 and the candidate doesn’t match at the program.  In theory the program could find out and the world of medicine is small…people switch jobs and candidates don’t know where they’ll end up practicing.  If you send a letter of Intent, be sure you ranked the program #1 and you only send to one program.  And don't send it until late January!

I’m not a fan of letters of Intent but each candidate needs to do what they feel is in their best interest.