A pandemic-disrupted—and decidedly different—residency application cycle will begin Sept. 1, when future physicians can begin submitting applications through the Electronic Residency Application Service (ERAS) where a modified process has been put in place.

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With students in this application cycle losing months of potential clinical experience during the pandemic, applications are different from recent years. What will the key changes be and how will program directors view them?

Patrick Cocks, MD, director of the internal medicine program at NYU Langone Health offered insight on how decision-makers within residency programs may view applicants differently in the upcoming cycle.

The Medical Student Performance Evaluation (commonly referred to as the dean’s letter), grades from clerkship and subinternships and United States Medical Licensing Examination\Step 1 scores are among the key pieces of information that programs rely on during residency selection. The pandemic’s disruption to training, Dr. Cocks believes, means that program directors need to weigh more information.

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“Many clinical experiences were interrupted or suspended because of COVID,” Dr. Cocks said. “We need to recognize that it wasn’t just one moment in time. Here in New York, it was [most impactful on training] February to March. In the Southeast it was in July and August. COVID has been a continuous challenge and interruption to our medical education programs. We need to look deep to not rely on one piece of data. To correlate the narrative comments with a students’ experiences, whether they be work experience, research experience or leadership experience.”

One’s journey to, and through, medicine—often referred to as “distance traveled” in medical school admissions—is a factor in viewing an applicant. For residency selection, that is often detailed in the personal statement. This is an aspect of the application that Dr. Cocks believes could take on increased meaning in this application cycle.

“The personal statement is an opportunity for the student to highlight experiences that they mav have missed out on due to COVID or describe experiences that have been interrupted or even augmented,” Dr. Cocks said. “Typically, the personal statement is used during the interview day to add depth to who the person is and perhaps some questions. When you look at data, previously it played little role in decisions to invite someone” for an interview. Historically, the personal statement played a minimal role in the decision to invite an applicant.

“But I would anticipate—as programs try to piece together the information presented so they can see the whole applicant—many will review the essay in a meaningful way as they decide whether or not to invite someone for an interview.”

Check out these four great tips for writing a standout personal statement.

Students who did miss clinical experiences that may have been relevant to their chosen specialty should look to supplement those with fourth-year electives relevant to their career path. That may not be part of the application portfolio in the fall, but it will certainly be an aspect of training that could come up during interviews, Dr. Cocks said.

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“Be extremely thoughtful and strategic in the timing of electives during fourth year,” Dr. Cocks said. “Should their clerkship of their specialty of choice be interrupted or suspended in any way, they should take the opportunities to do electives within that subspecialty field and do it early in their last year of training. It provides them the skills and knowledge if they hope to move in a subspecialty down the road, and it’s the opportunity for evaluation and narrative that can be additive to their application.”

As highlighted in a recent AMA webinar, specialties such as emergency medicine have said they are going to require fewer letters of recommendation.

Dr. Cocks anticipates that will also be the case for internal medicine. As far as his advice for what should be in a letter in this cycle, it’s the same as in other years: More specific information is better. “A letter of recommendation that has more nouns than adjectives, to me, is a more valuable one because it is describing behaviors,” he said. “Similar to pre-COVID, we will look to see what the experiences are that the letter writer has used to describe the applicant and how they mesh with our educational environment.”

The AMA has curated a selection of resources to assist residents, medical students and faculty during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events at this time.

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