American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

An Application Chronology

Winter and Spring of Your Third Year in Medical School

Conduct informal or formal conversations or interviews with surgery residents, faculty, and/or community surgeons. Firm up your personal career resolve. Make a list of programs you are interested in after reviewing the information in this site and those that may be interested in you. It is important to select a surgery faculty member to act as your advisor, preferably someone who knows you, can write a letter for you, and understands the application and match process well. Review your list with your advisor or another knowledgeable faculty member.

Late Spring, Early Summer of Your Third Year

Plan your fourth year elective schedule. Apply for away rotations through the Visiting Student Application Service of the Association of American Medical Colleges (AAMC). Familiarize yourself with the Electronic Residency Application Service (ERAS) and National Resident Matching Program (NRMP) sites. Develop your personal statement. Provide your application list to your dean's office so the dean's letter can be mailed on November 1 to those programs.

Summer of Your Fourth Year

Approach the faculty you have selected for strong letters of recommendation (LOR). Provide the faculty members who are writing your letters a copy of your curriculum vitae, LOR cover sheet (available in your Student Affairs office) and personal statement. Refine your list and complete your ERAS applications by early September. Applications are made to all accredited programs using the ERAS forms. Please consult the ERAS for detailed instructions.

Register for ERAS.

Acquire your ERAS tokens from your designated dean’s office. For U.S. applicants, tokens can be obtained from your medical school of graduation. International applicants receive their tokens from the Educational Commission for Foreign Medical Graduates (ECFMG), and Canadian applicants receive their tokens from the Canadian Resident Matching Service (CaRMS).

Take required examinations, such as Step II of the United States Medical Licensing Examination (USMLE) and/or Comprehensive Osteopathic Medical Licensing Examination (COMLEX), and authorize sponsoring institutions to release your results to ERAS.

September Through October of Your Fourth Year

Register for the NRMP.

Schedule and complete interviews. Take “audition” electives, if planned. Make sure your letters of support have been sent. (Showing your appreciation to the faculty member's assistant who types the letter is a very good idea).

November Through January of Your Fourth Year

Complete interviews. Notify the programs if you have been elected to Alpha Omega Alpha (AOA) or the Gold Humanism Honor Society if you received honors, grades, or other awards. Work with your dean's office and/or advisor to develop your rank order list (ROL). List at least eight residency programs.

February of Your Fourth Year

The applicants and programs must submit their final rankings by mid-February.

Match Day

On Match Day, a Friday in mid-March, you and your classmates will open your envelopes and learn the good news! Most students get one of their top choices, but if by some chance you did not match, you will be notified by your dean's office on the Monday of Match week.

A supplemental match process, the Supplemental Offer and Acceptance Program (SOAP), has been developed to assist unmatched students. Your dean’s office will work with you to submit applications to unfilled programs through ERAS. The SOAP match then begins at noon EST on Wednesday. If you are matched, you have two hours to electronically accept the position. There are multiple rounds of this process scheduled on Wednesday, Thursday, and Friday. The SOAP process is binding once an applicant agrees to the position. Match day is on Friday of Match week for all matched applicants, and results are posted online at 1 PM EST.

Program Grading Guidelines

Not all programs are looking for similar characteristics and therefore gauging your competiveness for a program varies markedly depending on what you are looking for and what the program is looking for. Many of the more competitive, strongly academic university programs stress election to AOA, class rank in the top 10%, with research publications or graduate degrees to train the next generation of research-oriented academic surgeons. USMLE scores above 220 are felt by many program directors to be a predictor of success in passing boards, while others use class rank in the upper 25% as a better predictor of success. Recently, election to the Gold Humanism Honor Society is playing a role in some program directors decision making. The middle tier of institutions, either university or independent medical center programs may prefer election to AOA and ranking in the top 25% as well as higher USMLE scores. There are a significant number of institutions who do not place as much value on election to AOA, research, or class rank as other parameters. These may be programs where USMLE scores below 220 are accepted.

If you have all the credentials: election to AOA, USMLE scores in the upper 10%, ranked in the upper 10% of your class, research publications, and excellent letters of recommendation from attending surgeons, you should be able to qualify for any program in the country. Since USMLE is an objective screening device, you need to make sure your USMLE part II score is in your file when you apply. A high USMLE score gives you a better chance of getting an interview at a program of your choice.

If you know roughly where you rank in your own medical school class and have excellent USMLE scores, you can quickly determine whether you might be competitive for a given program. Although “reaching” is encouraged, using these guidelines for institutions can help you determine whether you should go to the not-inconsiderable expense in time, effort, and money required for an application and interview. A knowledgeable dean or surgical mentor should be able to help guide you in your application process and have some feel for what many programs desire and require from its applicants.

Important Note

In the Residency Program Profile of the searchable database, the category "Operations performed by residents" represents cases in which the resident and attending surgeons work closely together, as a team, under the direction of the attending surgeon. It is not ethically or educationally acceptable to have residents caring for surgical patients without attending staff supervision, and there is no implication that the resident has independent or unsupervised responsibility for any surgical procedure at any institution.

The Division of Education at the American College of Surgeons would like to sincerely thank the following surgeons for their invaluable help revising Sections I and II of this website:

  • Mark Friedell, MD
  • Nancy Gantt, MD
  • Ashley Lentz, MD
  • H. David Reines, MD
  • Susan Steinemann, MD
  • Maureen Tedesco, MD