Eras Let The Computer Simplify Your Life

The NRMP is the corporation that supervises the Match process, ensures its integrity, and runs the computer algorithm that pairs applicants with residency programs. To do so, the NRMP receives rank-order preference lists from both parties. However, the NRMP is not a centralized application processing service. This is where ERAS — the Electronic Residency Application Service — comes in.

Remember how you applied to college? For a long time, the residency application process worked the same way. Medical students had to contact each individual program for a paper application, address envelopes for their letter writers, and drag out the old typewriter from the closet. The process was time consuming and tedious, especially for medical students applying to 20 or more programs in very competitive specialties. In 1995, ERAS changed the way medical students submitted applications. At first only obstetrics and gynecology participated in the service, using a system based on diskettes sent in the mail. Over the next few years, more specialties caught on, particularly as ERAS became an Internet-based application. Today, nearly all specialties participate in ERAS (exceptions include neurology, neurosurgery, otolaryngology, and ophthalmology).

ERAS has streamlined the entire application process. Every year, ERAS electronically transmits tens of thousands of digitized documents: transcripts, recommendation letters, personal statements, application forms, and Dean's Letters. The web-based format is extremely user friendly, making it very easy to apply to multiple specialties, add or delete programs, or customize which supporting documents to send to each program. By reducing the amount of paperwork for both applicants and hospitals, ERAS has lowered application fees ($6 per program for the first 20 programs). Another feature is that medical students can track the transmission status of every single document on line, 24 hours a day, through the Applicant Document Tracking System (ADTS). Most medical students rate the ERAS system very highly.

What about the disadvantages of ERAS? There is a significant one. This service is so easy to use that candidates can easily flood the application pool with far too many unnecessary applications. Students should think carefully about limiting the number of programs to which they eventually apply. With the click of a mouse, you can check a box and, on a whim, add more programs, particularly those you are not seriously considering. The excess applications cause the same students to receive most of the limited interview offers available for a given specialty, leaving others out in the cold. ERAS attempts to prevent this shot-gunning approach by increasing the fees for applying to more than 20 programs ($12 per program for 21-30 programs; $30 each for 31 or more programs). Realistically, very competitive specialties like orthopedic surgery and dermatology encourage students to apply to over 40 programs.

To set up a personalized MyERAS account, all medical students must obtain their preassigned ERAS token (a string of numbers and letters) from their Dean's Office. Enter this token to begin registration on the ERAS web site. Although the process is relatively straightforward, always refer to the detailed instruction booklet provided with your token. Apply as early as possible, so you will never have to worry about individual program deadlines (which can vary). A completed ERAS application consists of the following parts:

1. Profile:This 1-page form contains your name, identification numbers (social security, ERAS, NRMP, and USMLE), citizenship, medical school, and contact information. The entries can be changed at any time; an updated version is electronically sent to all programs.

2. Common Application Form (CAF): This 12-page form consists of all the basic background information typically found in a resume: degrees earned, research and work experience, extracurricular activities, hobbies, and publications. After completing the form and proofreading for typos, click on certify. The electronic certification process officially submits the CAF and locks out any further changes from being made. Until you cough up the money for your programs, ERAS will not allow supporting documents to be scanned and uploaded by your medical school.

3. Personal Statement:You should type, edit, and spell check the personal statement on a word processing program and then copy and paste it into ERAS. Simply create a blank new personal statement in the MyDocuments section. If you are applying to multiple specialties or preliminary programs, give it an easily recognizable title (e.g., Derm). Program directors will not see your titles. To create multiple personal statements, just click on the New Personal Statement button. Because the formatting of your document in ERAS will not look exactly like your original, print out a copy to view its appearance.

4. USMLE Transcript: The National Board of Medical Examiners (NBME) will send an unlimited number of USMLE transcripts to residency programs via ERAS (for a flat fee, of course). You must send all current USMLE scores and then choose whether or not to retransmit automatically updated transcripts when they become available. However, your decision is irrevocable and binding. If in doubt, do not choose the automatic retransmission option. Most medical students prefer reviewing their USMLE Step 2 scores prior to submission (in case they are poor). Manual retransmission of these transcripts incurs no additional cost.

5. Dean's Letter:This document is scanned and uploaded by your medical school. It does not count as one of the four possible letters of recommendation. ERAS transmits the Dean's Letter to all selected programs on November 1st.

6. Medical School Transcript:The applicant's medical school also uploads this document.

7. Photograph:Students must provide their Dean's Office with a wallet-sized photograph for scanning and submission. However, residency programs are prohibited from accessing the photo until an interview has been granted.

8. Letters of Recommendation (LORs):ERAS allows applicants to assign up to four LORs to each individual residency program. However, an unlimited number of LORs can be solicited, scanned, and uploaded into the ERAS system. In the MyDocuments section, simply create a new LOR for each expected writer, clearly indicating the faculty person's name on the file. Print out the LOR cover sheet, check the appropriate box whether or not you waive your right to review the letter, and give the form to the writer. The faculty member returns the recommendation to your Dean's Office for scanning and submission. If you complete a stellar rotation in late summer or early fall, a LOR can easily be submitted after the others have been transmitted.

Selecting residency programs and assigning the appropriate documents is the final step in the application process. Your program selection list remains strictly confidential. For every program on the applicant's list, ERAS will automatically transmit the Profile, CAF, medical school transcript, photograph, and Dean's Letter. At this point, some personalization comes into play. For every program, ERAS will prompt the applicant to assign one personal statement and up to four letters of recommendation from the total submitted files. This feature allows medical students to customize the supporting documents each program receives.

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