The Idaho College of Osteopathic Medicine provides support in career development for all medical students in all stages of medical school. Following this four-year checklist prepared by our team will help to successfully guide you through understanding yourself, exploring your options, choosing a specialty and preparing for your residency.
Additional resources can be found on AACOM’s Career Planning Guide for DO Students.
A CV will be a vital part of your 3rd and 4th year. It is important to plan ahead and have your CV prepared before your 3rd year. Use this medical student CV template to create and organize your CV.
For more information, contact our Coordinator for Academic Success.
The journey to become an osteopathic physician is exciting with many events along the way. From early volunteering experiences in medical care settings and the anticipation that comes with applying to medical school to the first day of osteopathic medical education and all of the days in between matriculation and graduation, so many things happen and so many decisions are made. One important decision is where to go for residency, and almost as important, how to successfully navigate the residency application and interview process. The following information can inform and help to guide this process. We wish you the best on your journey!
It’s good that you are aware of the continuum of medical education. You’ll spend the next four years gaining the medical knowledge and clinical skills necessary to be a caring and competent osteopathic physician. Once you’ve graduated, you’ll pursue residency training in your chosen specialty and work toward full medical licensure. Once you’re in practice, you’ll pursue board certification in your chosen specialty and perhaps will continue your training with further specialization in a fellowship program. A rich and rewarding career is ahead of you!
I’m a first year student. What do I need to know about the residency process?
At this point in the osteopathic medical education process, it is important to successfully transition to the rigors of medical school and settle into the habits that will make the most of your time and effort to do well in coursework. It’s important to keep an open mind to all of the medical specialties and to delay any decisions about residency at this time. Focus on building a broad and deep medical knowledge base, and honing your clinical and OMM skills. You will have the opportunity to explore different specialties via student clubs, residency fairs, and meeting with your advisor to begin conversations that explore your areas of interest.
I’m a second year student. What do I need to do to prepare for the residency process?
Second year coursework continues to build on the knowledge and skills gained in the first year. With third year core rotations a few months away, some time will be spent focusing on scheduling those rotations and becoming oriented to the expectations for clinical rotations. You will update your CV and prepare Letter of Recommendation (LoR) packets. In the spring of year two, you will receive a token to register individual information in the Electronic Residency and Application Service (ERAS) so that LoRs requested in the third year may be uploaded to your ERAS file.
In December of second year, you will be instructed in registering for the COMLEX-USA Level 1. Throughout the year you will be guided through the process to finalize preparation for the COMLEX-USA Level 1 to be taken in May/June after second year classes finish.
I’m a third year student. What are the tasks I must accomplish for the residency process?
In July of year three, you will take the Clinical Preparations course. Part of this course will be to perform a 12-station Objective Structured Clinical Encounter (OSCE) in preparation for the COMLEX-USA Level 2 PE. Upon successful completion of these OSCEs as well as receiving a passing score on the COMLEX-USA Level 1, you will be approved to register and schedule the COMLEX-USA Level 2 PE between December of third year and August of fourth year. You will participate in 4-week core (required) rotations in the following specialties; Family Medicine, Emergency Medicine, Internal Medicine, Pediatrics, Surgery, Psychiatry and Women’s Health. It will be important to do well in rotations regardless of whether or not you are interested in pursuing that specialty as your first choice specialty. Evaluation comments from the preceptors will be included in your Medical Student Performance Evaluation (MSPE). During these rotations, you’ll requester LoRs from your preceptors. These LoRs will become an important part of your application packet for residency programs to review.
In the fall semester of third year, you will complete assignments pertaining to specialty selection, write personal statements and prepare for audition rotations in year four. You’ll learn more about the various residency match programs and associated timelines.
In December of third year, you will be instructed in registering for the COMLEX-USA Level 2 CE. Throughout the year you will be guided through the process to finalize preparation for the COMLEX-USA Level 2 CE to be taken in June/July after third year rotations finish.
In the spring semester of third year, you will continue to finalize documents necessary for the residency application process, including submission of personal statement(s) for review and edit, and contribution to your MSPE. You’ll complete a residency preparation month and meet with your advisor to discuss the specialties to which you plan to apply. You’ll have the opportunity to speak with physicians practicing in your preferred specialty. Practice for interviews will begin and continue through July of fourth year.
I’m a fourth year student. What are the tasks I must accomplish for the residency process?
This is an exciting time for the residency application and interviewing process with much to do! In July, you’ll complete your MyERAS application, pay and submit COMLEX-USA scores, and upload your photo and personal statement(s). You’ll continue to practice your interviewing skills. In September, you’ll apply to residency programs and as interview offers come in, you’ll confirm and attend these interviews. You’ll likely be traveling across the country for interviews from September through January with the months of October to December being particularly busy. Toward the end of interview season you’ll finalize your thought process for completing your rank order list. This rank order list is your designation of which program(s) you’d like to match with and in the order of your preference for matching.
In March, your anticipation will increase as you await the third Monday of the month. On that day you’ll find out if you matched to a residency program from your rank order list. Later in the week, you’ll find out where you matched. If the news on that Monday is not as anticipated, ICOM will assist any student needing to pursue residency placement through the Supplemental Offers and Acceptance Program (SOAP).
Following the match, all ICOM students will participate in Senior Month with the final assessment of the Core EPAs along with ACLS and BLS recertification. Graduation in May will soon follow!
Osteopathic medical students take the Comprehensive Osteopathic Medical Licensing Exam (COMLEX-USA) for licensure to practice medicine. Level 1 is a computer-based exam taken at the end of the second year of medical school. Level 2-Cognitive Evaluation (CE) is a computer-based exam taken at the end of the third year of medical school, and the Level 2-Physical Evaluation (PE) is a clinical skills exam taken during the third or fourth year at one of two national testing sites. Upon graduation, the graduate is a doctor in training and enters residency with a temporary medical license that requires the doctor in training to be supervised. During the first year of residency training, the Level 3 computer-based exam is taken. With successful completion of all phases of the COMLEX-USA, the graduate is awarded full medical licensure. Medical licensure is applied for and granted on a state-by-state basis.
Choosing a medical specialty
This may be something you’ve thought about since you first thought about attending medical school. Rest assured that you will not need to commit to a specific medical specialty until fourth year approaches. To help you in this process, ICOM will provide a Careers in Medicine (CiM) subscription. This online resource includes information about each of the many specialties and has assessments you can take to gauge your fit for any given specialty. Additionally, you’ll have the opportunity to talk with physicians practicing in the various specialties and their insight can be very helpful to you.
Timeline for residency application and interviewing
Some of the tasks for the residency application will need to occur as early as second year with most tasks accomplished during the fourth year. July through January of fourth year will be busy with the residency application process, audition rotations and interviews. ICOM will guide you through each step in the process.
Student responsibilities for the residency process
Your first responsibility is to give your best effort to coursework and rotations. Your patients will appreciate your knowledge and skills, and residency program directors will want to see a successful academic record. Tasks for you to complete will be to update your CV, prepare personal statements for each specialty of interest, contribute to the MSPE, complete your MyERAS application online, pay for and submit board scores, pay for and apply to residency programs, confirm and attend offered interviews, and submit your rank order list. Many of these tasks will have a deadline associated with them, so it will be important to follow the timelines provided. Your advisor will be available to assist and guide you as requested.
School responsibilities for the residency process
ICOM will guide you through the residency process and provide information as you need it. In addition to presentations and coursework related to residency, ICOM will work within the ERAS system to upload transcripts and MSPEs for each student. ICOM will monitor your progress throughout the residency cycle and assist where needed.
ICOM will assist with any paperwork required from the school for your residency program. You will receive a contract from the residency program and will need to sign it within a certain timeframe. By virtue of your participation in the match, the contract from the program to which you matched is a legally binding agreement.
Graduation and preparation for residency
In April, after the residency match process has been completed you will return to campus for the Senior Month course. You’ll have the final assessment of the Core EPAs as well as ACLS and BLS recertification.
ICOM, via the Registrar’s office, will help to prepare and submit your information for the temporary medical license.
What is ERAS?
The Electronic Residency Application Service (ERAS) is an online platform used by most residency and fellowship programs. Components of ERAS for applicants includes a MyERAS page for the information typically found on your CV. It also provides the space to upload your photo, personal statement(s), MSPE, medical school transcript, letters of recommendation, and the ability to release your COMLEX-USA transcripts. You will use the ERAS program to apply for programs and in many cases, to communicate with programs, including scheduling interviews.
When does ERAS open?
You will receive a “token” in the spring of 2nd year to access a portion of the ERAS system. You will enter some basic identifying information about yourself and then have the ability to set-up letter slots for the LoRs you collect during third year rotations. In June of third year, you will be allowed to fully access the ERAS website.
How is information uploaded into ERAS?
You will upload the information that goes into your MyERAS page, your professional photo and personal statement(s). Links in ERAS will take you to the pages to pay for and release your board scores. Your MSPE and ICOM transcripts will be uploaded by ICOM. Your requested LoRs will be uploaded by the letter writer with the confidentiality of the letter maintained, e.g. you will not see what a letter writer has written.
How important are LORs?
Letters of Recommendation (LoRs) are used by program directors to make decisions about which applicants they will offer an interview. After board scores, LoRs from the specialty are the 2nd most important influencer in the interview selection process. And, in the program director’s decision for where to place an applicant on the program’s rank order list, LoRs are sixth in importance. It is advisable to obtain LoRs not only from your preferred specialty but from other specialties as well since this could reaffirm your knowledge and skill set to the program directors reading your LoRs. While most programs require three LoRs, most will accept four. You may collect as many LoRs as you wish because you will designate which LoRs should be shared with which program. This practice allows you to focus the LoRs to the program or specialty to which you are applying.
What is the MSPE?
The Medical Student Performance Evaluation (MSPE) is an objective assessment prepared by the school to indicate your overall performance during medical school. It includes an assessment of preclinical performance, grades and comments from third year core rotations, and an overall summary of your preparedness for residency. You will contribute to the introductory portion of the MSPE, providing a brief list of unique characteristics. Your advisor will assist you in that task.
What is a personal statement, how is it used, and how do I prepare it?
The personal statement is a one-page narrative that you will write to show your interest and ability in your preferred specialty to program directors. If you apply to more than one specialty for residency, you will prepare a personal statement for each specialty. Our best advice will be for you to write a personal statement when you have a core rotation in a specialty that resonates with you. ICOM will guide you through the writing process and provide helpful edits as you prepare your personal statement(s).
When do I register and take the COMLEX-USA Level 1? Level 2-CE? Level 3-PE?
In December of second year, you will be instructed in registering for the COMLEX-USA Level 1 to be taken in May/June after second year classes finish. Upon successful completion of the OSCEs in the Clinical Preparations course as well as receiving a passing score on the COMLEX-USA Level 1, you will be approved to register and schedule the COMLEX-USA Level 2 PE between December of third year and August of fourth year. In December of third year, you will be instructed in registering for the COMLEX-USA Level 2 CE to be taken in June/July after third year rotations finish.
How do I research residency programs?
Two online sites provide information about accredited residency programs; AMA Freida (ama-assn.org) and Opportunities (osteopathic.org). Many residency programs will also sponsor websites describing their program and providing information for interested applicants. Current residents are a resource for their residency program and some programs will share important information at ICOM’s annual residency fair.
What are the signs of a good residency program?
Each person researching residency programs may have different priorities for what constitutes a good residency program. In general, you are advised to seek out residency programs which have a regularly-scheduled didactics program with plenty of time for patient care. You’ll want to ask about the variety of patient cases you’ll see and what the typical resident schedule looks like. As an osteopathic physician, you are advised to look at how many DOs are listed amongst their residents and attendings. Having other DOs as role models during the residency years is helpful in advancing your own sense of osteopathic philosophy. When talking to the residents, how do they report being treated? Are they happy in the program? Do you sense any burnout? You’ll want to know how often a resident is terminated or does not have a contract renewed. Of course, you’ll likely consider geographic location when selecting programs to which you’ll apply. And, as best as you can determine, you’ll seek the answer to whether or not the program will give you the skills you need to be the kind of caring and compassionate physician that you want to become.
How will program directors evaluate me and my application?
Program directors review your ERAS application twice during the residency application process. First, they look at board scores, LoRs, the MSPE and your personal statement to determine if they’ll offer you an interview. Board scores and the GPA information on the MSPE give them an idea of your academic performance. The LoRs, preceptor comments on the MSPE and your personal statement lend insight into your interest and abilities for medicine overall and that specialty specifically. If you are offered and attend an interview, they’ll be very interested in your interaction with program staff, residents and any one else you encounter during the interview process, both in person and via email or phone. They are looking for people who can function well in a team. When it comes to where a program director places your name on their rank order list, they’ll consider your interpersonal skills as well as your aptitude for that specialty.
How competitive are the different specialties?
Competitiveness of a specialty is largely based on the number of available training spots as compared to the potential number of medical students or graduates who might choose to apply in that specialty. Specialties with fewer numbers of available training spots and a high number of applicants may use board scores and LoRs to stratify applicants prior to selecting those who will be invited for an interview. Some specialties with a high number of applicants may also stratify potential applicants during the audition rotations, giving preference to those who meet or exceed a target board score. Some specialties, primary care specialties in particular, have many residency programs with many available training spots. With so many more options, these may be seen by some as less competitive. A good perspective on this is to think of these specialties as being necessary for most patients in the general population to visit this type of provider as compared to patients having fewer encounters with some of the specialists. For example, we all need to regularly see our primary care provider and may not ever need to see an orthopedic surgeon. Every two years, the NRMP publishes several resources called Charting Outcomes in the Match with one focused on match outcomes for osteopathic medical students; www.nrmp.org. These documents can help you see how your academic performance and approach to the match compares to others who’ve previously matched into that specialty.
How do I decide which specialty to choose?
Choosing a specialty is a personal decision that takes into account factors most important to you. While at ICOM you’ll be provided with access to the Careers in Medicine website which has information about the specialties as well as some assessments you can take to guide you in which specialties mesh well with your personality and career expectations. Throughout your time at ICOM you’ll have the opportunity to interact with physicians from various specialties, and during your third year rotations you will be able to experience many of the specialties firsthand. Keep an open mind during the early years of your osteopathic medical education. You might be surprised what specialty resonates with you!
When do I decide on a specialty?
While we’ll ask you each semester to tell us what you’re thinking about area of practice, you won’t have to narrow it down until partway through third year rotations. By then, you’ll have to start thinking about audition rotations in your chosen specialty during the first half of the fourth year. When you apply to residency programs, you’ll apply to programs in your preferred specialty as well as some programs in an alternate specialty. It’s always a good idea to have an alternate specialty in mind. While we hope each student matches into their preferred specialty, some students may not. And, the outcomes for matching into any specialty are better for fourth year medical students than those who sit out for a year. So, having an alternate specialty in case your preferred specialty doesn’t work out is a good idea.
Why do I need to consider an alternate specialty?
Obtaining a residency position is a competitive process that requires a well-thought out strategy and attention to timelines. Your best chances for matching into a residency program are during the fourth year of medical school. The possibility of matching into a program after you’ve been out a year is drastically reduced as compared to matching in fourth year. An alternate specialty is advised to optimize your residency options. As difficult as it is to think about not having a residency program to attend post-graduation, you have to ask yourself this question, “What is my comfort level with not having a residency program to enter right after I graduate?” Presuming that you want to see your effort to do well in medical school and have a rewarding career happen, having an alternate specialty may help you have a residency to attend post-graduation. So, the focus shifts to the idea of, “If I couldn’t do specialty ___, I could still have a happy and fulfilling career in specialty ___.” At ICOM we’ll advise you to consider what alternate specialty you could pursue. We’ll guide you through the thought process on how competitive you may or may not be for your preferred specialty. Charting Outcomes in the Match is an online resource that can help you determine your competitiveness and strategy for pursuing specialties that interest you; www.nrmp.org.
What is the timeline for the residency application and interview process?
During the third and fourth year, you’ll request LoRs from preceptors while on rotations. Those may be uploaded into ERAS at anytime during the third or fourth year. In July of fourth year, you’ll complete your MyERAS application, pay and submit COMLEX-USA scores, and upload your photo and personal statement(s). You’ll continue to practice your interviewing skills. In September, you’ll apply to residency programs and as interview offers come in, you’ll confirm and attend these interviews. You’ll likely be traveling across the country for interviews from September through January with the months of October to December being particularly busy. Toward the end of interview season you’ll finalize your thought process for completing your rank order list. This rank order list is your designation of which program(s) you’d like to match with and in the order of your preference for matching.
What are audition rotations?
Audition rotations are elective rotations that happen early in the fourth year and occur at institutions which have a residency program onsite. It is an opportunity for you to see the program firsthand as well as showcase your skills for the residents and program director to see how well you might fit in at their program. Some residency programs prioritize interviews for those who’ve done an audition rotation at their program.
Should I use a transitional year as a backup if I don’t match into a specific specialty?
Your best chances for matching into a specific specialty occur as a fourth year medical student. The rate at which applicants match post-graduation decreases significantly, so it’s advisable to seek a full residency position in your fourth year match cycle. Because residency programs are funded for the exact number of years that the residency lasts, someone entering a residency with one year of time taken with a transitional year risks not having funding for the last year of their residency. So, it’s best to try to be placed to a full program and use the transitional year option as a remote back-up plan. ICOM will advise you during the residency application, interview and matching process.
What is the couples match?
When two individuals, for personal reasons, decide that they wish to pursue residency in close proximity to each other, they will identify themselves as a couple for the match. The residency specialty that each member of the couple pursues may be the same or different. When the matching algorithm occurs, their rank order lists will be considered together. This adds complexity to the process with special considerations for the couple to think about. Couples matching works best in larger cities which have many residency programs, and couples are advised to apply to more programs than they might have applied to if applying as a single. ICOM will assist those students who indicate their interest in pursuing a couples match.
How many programs should I apply to?
For the 2018 Match, osteopathic applicants applied to an average of 69 programs. The actual number you might apply to will depend in part on your competitiveness for the preferred and alternate specialties you choose, geographic location and personal considerations.
At how many programs should I interview?
This number will vary for each applicant. Generally, being more competitive for a specialty lessens the number of interviews. Plan to interview at a minimum of 10 programs. Most students will interview at 15 with some interviewing at 20 or more. If programs consider you competitive for that specialty, the interview offers should happen readily. Once interviewing season begins, you are advised to accept every interview offered until you reach a personal limit. Then you can become choosier about which interview offers you accept. If you receive more interview offers for your alternate specialty than your preferred specialty, it is likely that program directors see you as less competitive than average for that preferred specialty. ICOM will work with you during this process and will likely advise you to accept every interview in your preferred specialty while you also redirect your focus on the alternate specialty.
What is the approximate cost to apply and interview for residencies?
Every student will pay a one-time fee of approximately $80 to release COMLEX-USA scores. You’ll also pay to apply to programs. The cost for each program application increases as the number of programs applied to increases. Estimating the cost of the average number of applications for the 2018 graduate, 69 applications, totals to approximately $1,400. Applicants are also responsible for interview expenses; travel, lodging and meals. This may add $5-10K to the budget for the fourth year. Sometimes applicants will group interviews geographically or coordinate housing with friends or stay with relatives in the area.
How are residency interviews scheduled?
Every residency program has a program coordinator who will contact you for interviews. This individual may contact you via your email or via the ERAS website. It will be important for you to respond promptly and should your plans change, to inform the program as soon as you know that you will not be able to attend the interview.
How should I prepare for a residency interview?
Once selected for an interview, the impression you make on the program director and other residency staff is the most important factor for being ranked by that program. Your interpersonal skills need to shine before, during and after the interview process. ICOM will help you prepare for the actual interview by offering mock interviews. A seasoned interviewer will provide feedback to you as you answer some common interview questions. It is advised to be prepared to answer questions like these: Why are you interested in this program and specialty? What do you know about this program? Where do you see yourself in 5 years or 10 years? What has been most rewarding about being in osteopathic medical school? What are you most proud of having accomplished? If you could improve yourself, what area(s) would you focus on? What has been your biggest challenge in your life thus far? Describe any perceived weaknesses as they pertain to board scores, GPA, rotation evaluations. Tell me how you function in a group.
What matches are available to me?
Students on a military scholarship, HPSP, may elect to participate in the military match; www.militarygme.org. Students pursuing urology residency and fellowships will participate in the urology match; www.urologymatch.com. Students pursuing ophthalmology, plastic surgery, neurotology and certain fellowship programs will participate in the San Francisco match; www.sfmatch.org. Most students will participate in the National Residency Matching Program; www.nrmp.org. Each match has different timelines and may have different requirements for application. ICOM will assist students as they determine which match service is appropriate for them.
Where do I find information about how previous DO students have fared in the NRMP match?
Every two years, the NRMP publishes outcomes from the Match. Their most recent publication focused on osteopathic medical student outcomes may be found by clicking here.
What is a rank order list?
After you have completed your residency interviews, you’ll take some time to consider which program is your number one choice, which is your number two choice, etc. This will become your rank order list (ROL). You are advised to only list programs on your ROL at which you would be comfortable attending for your residency training because once “matched,” it is a legally binding commitment. You will electronically rank the programs at which you interviewed, verify the ROL and submit the ROL within the timeframe required by the National Residency Matching Program (NRMP). While you are preparing your ROL, program directors are also preparing a ROL for the spots available in their program. After the ROL deadline, a computer algorithm will compare ROLs and “match” you at the program highest on your ROL that also ranked you high enough for a spot.
What is the SOAP?
On the third Monday in March of fourth year, you will receive email notification of whether or not you matched to a residency program from your NRMP rank order list. If the news on that Monday is not as anticipated, ICOM will assist any student needing to pursue residency placement through the Supplemental Offers and Acceptance Program (SOAP). This is a process through which unmatched seniors may apply for remaining open positions at the residency programs. The SOAP is a schedule-driven process with specific rules and timelines that must be followed.
Once I’m notified of a match, am I able to change my mind?
By virtue of your participation in a residency match, you are legally committing to be bound by the outcome of the match. It is important to seek guidance during the residency application and rank order process to be sure that you are making choices suitable to your personal goals for your career.
How are residency programs funded?
Established in 1965, the Centers for Medicare and Medicaid Services (CMS) provide funding for most residency programs.