Medical Residency, ERAS, NRMP, the Residency Match and the SOAP

Before you can be licensed as a physician, you must transition from medical school, through the Match, into an internship and a medical residency program – a sort of on-the-job training for doctors.

Depending on your specialty, medical residency can last from a minimum of two years to six or more. After accumulating debt over the previous eight years, you will finally be drawing a small paycheck. The pay starts at about $32,000 for the first year and tops out around $48,000 for sixth-year residents. The first year of training after medical school is called internship, or PGY-1 (post graduate year No. 1), the second year is PGY-2, and so on.

During your clinical rotations you will have gotten a pretty good idea in which area you might want to specialize. Competition for medical residency through the National Residency Matching Program (NRMP) can be fierce, regardless of specialty, and it's worth looking at the numbers:

Of the 38,377 graduates applying for residency spots in 2012, 26,772 were matched, leaving 11,605 applicants out in the cold. That's a chilling figure that might leave you wondering how you'll ever reach your end goal of becoming a licensed MD. But as with your application to medical school, there are people who can help and a centralized service to compile your information and place you into a medical residency program.

ERAS, NRMP, the Residency Match, and SOAP

The Electronic Residency Application System (ERAS) is designed to compile your information and submit it to your selected medical residency programs in a standardized format. Completion and submission of the application is similar to using AMCAS to apply for medical school.

What takes place next is the "Match." Using the ERAS applications, the National Residency Matching Program (NRMP) helps recent graduates find residency positions and helps hospitals find residents to fill their slots. As with the AMCAS process, students must start applying early to the programs that interest them, travel to interviews if invited, and await a decision from the admissions committee. Then on Match Day, held every year on the third Friday of March, their fates are revealed and the residency matches announced.

Starting in 2012, the Association of American Medical Colleges (AAMC) and (NRMP) did away with what was called the "Scramble" for what they believe is a more civilized, sane, and compassionate route to a residency spot for everyone involved. With the Scramble, unmatched graduates had to telephone unmatched residency programs in a desperate attempt to find jobs. What is in place now is the Supplemental Offer and Acceptance Program, or SOAP, which take away the frenzied uncertainty. Visit the Association of American Medical Colleges (AAMC) and learn about the NRMP for more information.

The Role of Medical Residency Programs and the Medical Resident in the Healthcare System

The residency program is a fundamental part of our healthcare system and the use of low-paid interns and residents help control costs. Residents work long hours and can be "on call" every 2 to 4 days. Historically they often spent 30 to 36 hours at a time in the hospital, often with little or no sleep. In recent years, though, there has been an outcry about the harsh working conditions to which new doctors are submitted. Organizations like the American Medical Student Association (AMSA) made substantial progress toward limiting the hours worked by student doctors, including limiting residents to a maximum of an 80-hour work week, with a maximum of 36 hours on-site, and required naps for long shifts. For some residency programs that means that residents are effectively limited to 60-hour work weeks. While these are still long hours, the situation is much improved compared to that of previous years.

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