Applying for medical residency is a multi-step process that runs roughly from June through March, using two main systems: ERAS (Electronic Residency Application Service) to submit your application and the NRMP (National Resident Matching Program) to rank programs and receive your placement. The process has a lot of moving parts, but each stage follows a predictable timeline, and knowing what’s ahead makes it far more manageable.
The Application Timeline
The 2026 ERAS season opens on June 4, 2025. From that point, you can begin building your application in MyERAS, uploading documents, and selecting programs. The first major deadline hits on September 3, 2025, when you can start submitting applications to programs. Programs then gain access to review your materials and your Medical Student Performance Evaluation (MSPE) starting September 24, 2025.
Interview invitations typically flow from October through January, with most interviews taking place during that window. After interview season wraps up, you’ll submit your Rank Order List to the NRMP, and Match results are released in March. The ERAS season officially closes on May 31, 2026.
What Your Application Includes
Your ERAS application is a package of several documents, each serving a different purpose. Here’s what programs will see:
- Personal statement. You can write multiple versions, tailored to different specialties or programs, but only one can be assigned to each program. Personal statements must be plain text with no formatting like bold, italics, or colored text.
- USMLE or COMLEX transcript. You authorize the release of your exam scores through MyERAS. The NBME or ECFMG charges a one-time $80 fee to transmit your transcript to the programs you designate.
- Medical Student Performance Evaluation (MSPE). Sometimes called the “Dean’s Letter,” this is uploaded by your medical school’s dean’s office, not by you. If you’re an international medical graduate (IMG), you’ll need to indicate in MyERAS whether you or your school will provide the MSPE to ECFMG.
- Letters of recommendation. You create entries for each letter in MyERAS, which generates a Letter ID. Your letter writer then uploads the letter through the Letter of Recommendation Portal using that ID. You can assign up to four letters per program.
- CV and program selections. MyERAS captures your education, research, work experience, and volunteer history in a structured format.
Start gathering letters of recommendation early. Writers need time, and the upload process requires coordination since your letter authors handle the submission themselves through a separate portal.
How Much It Costs
ERAS charges application fees per specialty. For the 2026 season, each of your first 30 programs within a specialty costs $11 per program. Programs 31 and above jump to $30 each. So applying to 30 emergency medicine programs would cost $330. If you apply in multiple specialties, the pricing resets for each one, meaning you pay the lower rate again for the first 30 programs in each specialty.
On top of ERAS fees, the NRMP charges separately for Match registration. If you register late (after January 31), there’s an additional $50 fee. Ranking more than 20 programs on your list costs $30 for each additional program code. Couples matching together pay an extra $45 per partner. For very long rank lists (100 or more), additional fees range from $50 to $200 depending on length. All Match fees are non-refundable.
Between ERAS fees, the USMLE transcript fee, NRMP registration, and interview-related expenses, the total cost of applying can run into the thousands of dollars depending on how many programs you target.
Requirements for International Medical Graduates
If you graduated from a medical school outside the United States or Canada, you need ECFMG certification to participate in the Match. This means passing both USMLE Step 1 and Step 2 Clinical Knowledge (CK). You must satisfy all exam requirements by the NRMP Rank Order List certification deadline.
Beyond exams, IMGs must complete one of six Pathways to meet clinical skills and communication skills requirements. These Pathways vary based on your background. Pathway 1 is for those already licensed to practice in another country. Pathway 3 applies if your medical school is accredited by an agency recognized by the World Federation for Medical Education. Pathway 6 involves evaluation of clinical patient encounters by licensed physicians and is required for anyone who previously failed Step 2 CS, regardless of eligibility for other Pathways.
All Pathways require a satisfactory score on the Occupational English Test (OET) Medicine to demonstrate communication skills.
The Interview Process
The AAMC recommends that residency programs use a virtual interview format. Their guidance encourages programs to offer virtual recruiting activities to all applicants and reserve in-person visit days for accepted applicants only. Some programs use a hybrid model where applicants can choose virtual or in-person, but the AAMC asks those programs to blind their selection committees to which format each applicant chose.
Virtual interviews have significantly reduced travel costs, which was one of the biggest expenses of applying in previous cycles. That said, you’ll still want to invest in a clean, well-lit setup with reliable internet. Programs evaluate professionalism during virtual interviews just as they would in person.
How the Match Algorithm Works
After interviews, both you and the programs create Rank Order Lists. You rank your preferred programs from top to bottom, and programs rank the applicants they interviewed. The NRMP then runs a computer algorithm to pair applicants with programs.
The system uses what’s called the Roth-Peranson algorithm, a version of the “deferred acceptance” model developed by mathematicians Gale and Shapley in 1962 (work that eventually contributed to a Nobel Prize in Economics). Here’s the key thing to understand: the algorithm is “applicant-proposing,” which means it works in your favor.
In the first round, the algorithm places you at your top-ranked program. If that program has space and ranks you high enough, you’re tentatively matched there. If not, you move to your second choice, and so on. Programs tentatively hold their highest-ranked applicants but can swap someone out in a later round if a more preferred applicant becomes available. This continues until every applicant is either matched or has exhausted their list.
The practical takeaway: rank programs in your true order of preference. Don’t try to game the system by ranking a “safer” program higher. The algorithm is designed so that ranking honestly gives you the best possible outcome. A program cannot see where you ranked them, and ranking a reach program first carries no penalty.
If You Don’t Match: SOAP
Not matching is stressful, but there’s an immediate next step. The Supplemental Offer and Acceptance Program (SOAP) runs Monday through Thursday of Match Week. It connects unmatched or partially matched applicants with programs that still have open positions.
When SOAP begins, you’ll see a list of unfilled programs in the NRMP’s R3 system, filtered to show only positions you’re eligible for. You can then apply to those programs through ERAS. Programs review applications and extend offers in a series of structured rounds. You’re responsible for confirming you’re eligible for any position you apply to.
SOAP moves fast. Offers go out and must be accepted quickly within each round. Having your application materials already polished and ready is critical, since there’s no time to write new personal statements or gather additional letters during Match Week.
Practical Tips for a Strong Application
Start building your MyERAS profile as soon as the season opens in June. Don’t wait until August to request letters of recommendation. Give your writers at least six to eight weeks, and send them your CV, personal statement draft, and any relevant details about the specialty you’re pursuing. Since you can assign up to four letters per program, think strategically about which combination of writers best supports each application.
Your personal statement should do more than summarize your CV. Programs already have your transcript and activity list. Use the statement to explain your motivation for the specialty, connect specific experiences to your career goals, and give program directors a sense of who you are beyond your scores. Writing a tailored version for different specialties is worth the effort if you’re applying broadly.
When selecting how many programs to apply to, weigh your competitiveness in the specialty against the cost. Applying to 30 programs in a single specialty runs $330 in ERAS fees alone, and the NRMP charges extra for ranking beyond 20. Many applicants in competitive specialties apply to 40 or more programs, but casting a wider net only helps if your application is strong enough to earn interviews at those additional programs.