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    AAMC Research and Innovations Supporting the Residency Application Process

    The AAMC is regularly exploring ways to improve the residency application process through initiating its own research, supporting research led by other stakeholders in the academic medicine community, and making improvements to the ERAS® program. Not all research yields changes to the application process, but each project has the potential to inform the AAMC — and its partners — in creating future innovations.  

    Active AAMC research and innovations

    • New Foundational Competencies Available in December 2024: In alignment with the UGRC report recommendations, the AAMC, American Association of Colleges of Osteopathic Medicine (AACOM), and Accreditation Council for Graduate Medical Education (ACGME) co-sponsored an initiative to create a common set of shared, foundational competencies for U.S. medical schools that recognize the unique identities and contributions of both DO- and MD-granting schools to the health care system. A report will be released December 2024 that detail the new competencies and their intended use in advancing competency-based medical education (CBME).

    • New AAMC Collaborative to Accelerate Improvements in the Transition to Residency: The AAMC is bringing together dozens of representatives to form a National Collaborative to Improve the Transition to Residency (NCITTR). The new virtual collaborative will accelerate improvements in the transition from undergraduate to graduate medical education. Updates on this invitation-only collaborative will be shared on this page going forward.

    • Residency Explorer™ Tool Adds New Source-Verified Data: The Residency Explorer tool is designed to help applicants explore and identify programs where they may be competitive and that meet their professional and personal needs and interests, offering an unparalleled depth of information, providing insights into over 5,000 individual residency programs across 25 specialties. This year’s updates, including program-level interview invitation data and the ability to assess alignment with a personalized profile comparison, continue to set a high bar for transparency and relevance in the residency selection process. The Residency Explorer tool also provides significant value to first-, second-, and third-year medical students as they evaluate residency options and plan for away rotations with greater clarity and ease. This holistic approach supports both applicants and advisors by providing critical data for informed decision-making throughout the entire residency application cycle.
    • Updated Residency Preference Exercise from AAMC Careers in Medicine® (CiM): A new Residency Preference Exercise (RPE) — a tool that helps medical students consider and evaluate their requirements, priorities, and preferences for their residency or fellowship training, then assess training programs based on those criteria — is now live on the CiM website. The tool’s content remains the same while the user experience has been enhanced with a new look and feel, a more streamlined workflow, clearer instructions, improved accessibility, and a device-responsive (mobile-friendly) design. For more about how the RPE can help students create their smart residency application strategy, visit the CiM website (sign-in required).
    • CiM Specialty Profiles Now Feature New Program and Signal Data: Specialty signaling and geographic preference data from previous residency application cycles and their impact on interview invitations are now available on the CiM website for select specialties (sign-in required). Additionally, for specialties participating in signaling for the upcoming 2025 ERAS season, the CiM specialty profiles now display the number and percentage of programs participating from that specialty, as well as the number of signals available to applicants. These and other data provided within the specialty profiles offer important insights to help students explore and compare specialties, consider their competitiveness, and create their application strategy and/or parallel plan. 
    • AAMC and Thalamus Introduce New Application Programming Interface: Programs in the 2025 ERAS July fellowship program cycle were the first to use the new AAMC-Thalamus application programming interface (API) when they began reviewing applications on July 17. The API streamlines data and document transfer between the ERAS Program Director’s WorkStation (PDWS) and Thalamus products and provides a single sign-on (applicants and program users will be able to use their AAMC username and password, and Thalamus credentials, to log in to Thalamus products).
    • GSA-OPDA Working Group Creates New Residency Guide Template: Leaders of the AAMC Group on Student Affairs (GSA), Careers in Medicine® (CiM), and Organization of Program Director Associations (OPDA) are collaborating to increase transparency in the residency application process through use of a Residency Guide template for each specialty. Seventeen specialties are already participating this year in this pilot project. All Residency Guides for participating specialties can be found on the ERAS 2025 Participating Specialties and Programs webpage. 
    • Principles for Responsible AI in Medical School and Residency Selection: Medical schools and residency programs can advance toward more efficient, effective, fair, and informed admissions and selection processes by thoughtfully applying artificial intelligence (AI). To help schools and programs leverage AI tools to streamline their operations and promote equity, the AAMC — in collaboration with a multidisciplinary technical advisory committee — developed six key principles to guide the design and use of AI-based selection systems.  

    • New research study on a curricular resource to prepare students for surgery residency: 

      AAMC staff, along with staff at the American College of Surgeons and other surgical educators, co-authored a study, Piloting a National Curricular Resource for the Transition to Surgical Residency: Characteristics of Participating Schools and Their Students, that was published in the Journal of Surgical Education in March 2024. The study showed that a high proportion of U.S. MD-granting schools chose to pilot this curricular resource. Although school participation in the pilot varied among schools, there were no gender or racial/ethnic disparities at a national level in access to the curriculum, based on medical school attended, among students planning to enter surgery residency.

    • Data to help medical schools improve their curricula: The 2023 Resident Readiness Survey recently launched on January 2, 2024. The Resident Readiness Survey is a national, standardized survey for program directors to share the preparedness of PGY-1 residents with their respective graduating medical schools. All residency programs with 2022-2023 graduates from the 174 participating medical schools (149 MD schools and 25 DO schools) have until February 23 to complete the surveys in GME Track. For more information, please visit the Resident Readiness Survey website or email [email protected]. 

    • USMLE Step 1 Exam and COMLEX-USA LEVEL 1 Pass-Fail Transition Collaborative Research: In February 2020, the National Board of Medical Examiners (NBME) announced that it would only report pass/fail outcomes for USMLE Step 1 exams taken on or after January 26, 2022, with the National Board of Osteopathic Medical Examiners (NBOME) following with a similar announcement for COMLEX-USA LEVEL 1 exam scores. This, in part, led the AAMC, NBME, National Resident Matching Program® (NRMP®), American Association of Colleges of Osteopathic Medicine (AACOM), and NBOME to collaborate on a research program that evaluates the impact of this change both during and after the transition to residency. The multi-year research agenda will establish a baseline before pass/fail outcomes are reported for all applicants and explore changes over time. Research results will provide the community with information about current and planned future practices for students and advisors and identify any need for training and guidance regarding best practices for appropriate use, fairness, and validity in selection. 

    • ERAS Application: 

      For the 2025 ERAS cycle we continue to collaborate with the community to update and standardize other areas of the MyERAS® application.

    • Program Signaling: In 2020, the AAMC started a partnership with otolaryngology to evaluate their preference signaling program. The association’s team of researchers with expertise in selection served in a consulting role to help design the research program, analyze data, and report out results. After reporting and sharing initial findings, detailed follow-up analyses from the 2020 administration linking signals to interview and Match outcomes were published in JAMA Network Open, with the results of this work helping to inform future adoption of preference signaling in the residency application process. The AAMC, NRMP®, and NBME have also partnered to examine multiple years of signaling data across specialties as it relates to match outcomes, with longitudinal analysis planning set to begin in Fall 2023. In addition, the results of analyses examining the relationship between signaling and interview invitations in the pilot year of signaling for dermatology, internal medicine, and general surgery have been accepted for publication at the Journal of Graduate Medical Education, and the results were published in December 2023. 

    • Program characteristics and Match® data: Since 2018, the AAMC and eight other organizations involved in the transition to residency have offered a free tool called Residency Explorer™. The Residency Explorer tool was created to empower applicants as they consider where to apply for residency. It allows applicants to compare themselves with previously matched applicants and residents entering a program and to explore many program characteristics.  

    • Virtual interviews and anti-bias training: The AAMC’s team of selection experts developed training materials and best practices to help applicants and program directors navigate virtual interviews. These free resources included strategies to help applicants prepare for virtual interviews and guidance for program directors about setting up and implementing a fair virtual interview process. These resources continue to help students and program directors. 

    • Interview Resources: The AAMC developed interview resource hubs that will help both applicants and programs prepare for residency interviews.

      • The Interview Resources for Residency Applicants page shows applicants what they can expect throughout the interview process, including tips for preparing for interviews, a guide to virtual interviews, and advice from current residents.

      • The Interview Resources for Residency Programs page helps program directors and faculty participating in interviews to prepare for, conduct, and review interviews to ensure an experience that is beneficial, equitable, and consistent for both programs and applicants.

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    Past AAMC research and innovations

    The following projects have been discontinued or are no longer active.

    • Supplemental ERAS Application: For the 2024 ERAS cycle, content from the Supplemental ERAS Application was moved into the main ERAS application. This updated application content is designed to help students share more about themselves and assist program directors in finding applicants that fit their programs’ setting and mission.  

    • Supplemental ERAS Application Data: The current analysis of the supplemental ERAS application for Year 2 is available on the Data and Reports page including resources to assist in understanding interview yield.

    • July 2022 Transition to Residency Workshop: In July 2022, the AAMC convened a two-day workshop to create evidence-based action plans for four complex and urgent challenges during the transition to residency: away rotations, the GME interactive informational database, holistic review in residency selection, and interview protocols. This report summarizes the proceedings, discussions, priority activities, and next steps from the workshop.

    • Data to help students reduce number of applications: From 2017-2021, the AAMC provided annual data to help students anchor their initial thinking about the number of residency programs they should apply to. There is a point of diminishing returns (which varied by specialty, USMLE Step 1 score, and applicant type) where submitting one more application did not necessarily increase the student’s likelihood of entering a residency program. The association also provided data showing overall entrance rates for each specialty, the portion of applicants who enter training in another specialty, and entrance rates for applicants who fail their first attempt of the USMLE Step 1 exam. 

    • Video or virtual interviewing: The AAMC completed a multiyear Standardized Video Interview pilot project to explore how to create a uniform video interview process for residency applicants and programs. The project informed future work supporting unbiased virtual interview experiences. 

    • Application caps: Using archival data, the AAMC has been modeling the implications of different levels of application caps on the probability of entering training in general, and by applicant type, gender, and race/ethnicity. The goal of this work is to identify any unintended consequences of application caps and to use empirical evidence to inform changes to the residency application process. In 2022, this research has been extended to a broader sample of specialties, and work will continue to refine preliminary models. Despite certain limitations regarding model fit and available data, preliminary findings show that it is possible to reduce the number of applications submitted without impacting estimated entry rates, although implementing caps may disadvantage DO and IMG applicants. Further details on these preliminary findings and potential impact for differing gender and race/ethnicity groups were shared at the Learn Serve Lead meeting in 2022. 

    Recent AAMC studies on the Core EPAs

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    Resources from Academic Medicine 

    U.S. Medical School Graduates’ Placement in Graduate Medical Education: A National Study
    This study describes graduate medical education (GME) placement outcomes for recent U.S. medical school graduates and examines racial and ethnic differences in GME placement among these graduates.

    Application in Parallel to U.S. Residency Training Programs in Multiple Specialties: Trends and Differences by Applicant Educational Background, 2009–2021
    This article discusses research on the prevalence or contributions of parallel applications (application to residency in multiple specialties) toward the growth in the number of residency applications per applicant and application costs.

    The Undergraduate to Graduate Medical Education Transition as a Systems Problem: A Root Cause Analysis
    This article describes the work of the Undergraduate Medical Education to Graduate Medical Education Review Committee to apply a quality improvement approach and systems thinking to explore the underlying causes of dysfunction in the UME-GME transition.  

    Reimagining the Transition to Residency: A Trainee Call to Accelerated Action  
    The authors reflect on their experience as the trainee representatives on the Undergraduate Medical Education to Graduate Medical Education Review Committee. They call for the medical education community — and the Coalition member organizations in particular — to accelerate fully implementing the UGRC recommendations that were released in August 2021.   

    Blue Skies with Clouds: Envisioning the Future Ideal State and Identifying Ongoing Tensions in the UME-GME Transition  
    The authors describe how the Undergraduate Medical Education to Graduate Medical Education Review Committee envisioned an ideal state for the transition to residency, analyzed 3 persistent key tensions in the transition, and devised strategies to balance the upsides and downsides inherent to these tensions.   

    A Simulation of the Effect of Interview Caps on the National Resident Matching Program® Match in Otolaryngology  
    The authors created a simulation otolaryngology Match® to analyze the effects of interview caps. The simulation included 120 residency programs, 360 positions, and 570 applicants (each assigned a competitiveness weighted value).  

    Interview Without Harm: Reimagining Medical Training’s Financially and Environmentally Costly Interview Practices   
    Travel for medical school, residency, and fellowship interview generates carbon emissions that damage the environment and population health. The authors call for creative, structural reforms that reduce the need for such travel while increasing equity.  

    Program Directors’ Assessment of Postgraduate Year 1 Residents’ Readiness for Graduate Medical Education: Lessons and Insights From the Association of American Medical Colleges Inaugural 2020–2021 Resident Readiness Survey 
    A newly published abstract describes the AAMC Resident Readiness Survey (RRS) and includes evidence about the feasibility of this standardized process for program directors to provide feedback to medical schools about their graduates. 

    Responding to Recommended Changes to the 2020–2021 Residency Recruitment Process From a Diversity, Equity, and Inclusion Perspective 
    This article examines recommended changes to the 2020–2021 residency recruitment process from a diversity, equity, and inclusion perspective, highlighting new opportunities created by these recommendations and detailing challenges that programs must carefully navigate to ensure equity for all candidates. 

    The Otolaryngology Residency Program Preference Signaling Experience 
    As part of the 2021 Match®, otolaryngology applicants could participate in a preference signaling process — signaling up to five programs of particular interest at the time of application submission. In this report, the authors describe that preference signaling process, and they report that signaling markedly increased applicants’ ability to obtain interview offers from programs of particular interest, and that this effect was present across the spectrum of applicant competitiveness. 

    A Question of Scale? Generalizability of the Ottawa and Chen Scales to Render Entrustment Decisions for the Core EPAs in the Workplace 
    In this single-school study, conducted at a school participating in the Core EPAs pilot, the authors report on the results of their study comparing modified versions of the Ottawa and Chen scales on workplace-based assessment forms. 

    Entrustment Decision Making in the Core Entrustable Professional Activities: Results of a Multi-Institutional Study 
    In this article, the authors report on the results of the first round of theoretical entrustment decision-making at four of the participating pilot schools. 

    Workplace-Based Entrustment Scales for the Core EPAs: A Multisite Comparison of Validity Evidence for Two Proposed Instruments Using Structured Vignettes and Trained Raters 
    In undergraduate medical education (UME), competency-based medical education has been operationalized through the 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs). Direct observation in the workplace using rigorous, valid, reliable measures is required to inform summative decisions about graduates’ readiness for residency. The purpose of this study is to investigate the validity evidence of two proposed workplace-based entrustment scales. 

    Development and Validation of a Machine Learning-Based Decision Support Tool for Residency Applicant Screening and Review 
    In this article, a multidisciplinary team discusses the development and validation of a machine-learning based decision support tool for residency applicant screening and review as a way to address the growing number of applications that residency programs receive. 

    Using Machine Learning in Residency Applicant Screening 
    Complementing the article above, this episode of the “Academic Medicine Podcast” describes the development of a decision support tool that incorporates machine learning and the use of that tool in residency applicant screening. It also looks at the residency application process and potential ways that artificial or augmented intelligence might mitigate current challenges. 

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    Collaborations with specialties 

    Some examples of how the AAMC has supported or developed connections with other researchers and leadership organizations within the academic medicine community include:  

    • Exploring working with the Association of Professors of Gynecology and Obstetrics on modeling and evaluating the early result acceptance program as part of the AAMC’s efforts to improve the overall residency application process and contribute to evidence-informed innovations.  

    • Continuing the Careers in Medicine program’s annual Virtual Specialty Forum providing medical students exposure with specialty representatives at 21 participating specialties.  

    • Regularly maintaining connections with specialty organizations (such as OB-GYN and otolaryngology) to maintain awareness of the innovations they are researching.

    • Facilitating discussions between the undergraduate medical education and graduate medical education (GME) communities (student affairs and program directors).  

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    ERAS data supporting transition to residency research initiatives

    In addition, ERAS data are used to support a variety of internal and external research initiatives, including studies promoting diversity and equity in graduate medical education.  

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